{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:01:37Z","timestamp":1791820897000,"version":"4.3.4"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T00:00:00Z","timestamp":1765584000000},"content-version":"vor","delay-in-days":468,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T00:00:00Z","timestamp":1725148800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Christoph Vollmuth","award":["Project No. 413657723"],"award-info":[{"award-number":["Project No. 413657723"]}]},{"name":"Markus Otto","award":["MOODMARKER, SFB1279, D.3830 and D.5009"],"award-info":[{"award-number":["MOODMARKER, SFB1279, D.3830 and D.5009"]}]},{"name":"Alexander M. 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Montellano","award":["Project No. 413657723"],"award-info":[{"award-number":["Project No. 413657723"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Blood-based biomarkers may improve prediction of functional outcome in patients with acute ischemic stroke. The role of neurofilament light chain (NfL) and glial fibrillary acidic (GFAP) as potential biomarkers especially in severe stroke patients is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods:<\/jats:title>\n                    <jats:p>Prospective, monocenter, cohort study including consecutive patients with severe ischemic stroke in the anterior circulation on admission (NIHSS score\u2009\u2a7e\u20096 points or indication for mechanical thrombectomy). Outcome was assessed 3\u2009months after the index stroke by the modified Rankin Scale (mRS). Serum biomarkers levels of NfL and GFAP were determined by ultrasensitive ELISA. Univariate and multivariate logistic regression models were performed to determine the association of biomarker levels and functional disability. Discrimination, calibration, and overall performance were analyzed in different models via AUROC, calibration plots (with Emax and Eavg), Brier-score and R2 using variables, identified as important covariates for functional outcome in previous studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Between 06\/2020 and 08\/2021, 213 patients were included [47% female, mean age 76 (SD\u2009\u00b1\u200912) years, median NIHSS score 13 (interquartile range, IQR 9; 17)]. Biomarker serum levels were measured at a median of 1 [IQR, 1; 2] day after admission. Compared to patients with mRS 0\u20132 at 3\u2009months, patients with mRS 3\u20136 had higher serum levels of NfL (median: 136\u2009pg\/ml vs 41\u2009pg\/ml; p\u2009&amp;lt;\u20090.0001) and GFAP (700\u2009ng\/ml vs 9.6\u2009ng\/ml; p\u2009&amp;lt;\u20090.0001). Both biomarkers were significantly associated with functional outcome [adjusted logistic regression, odds ratio (95% CI) for NfL: 2.63 (1.62; 4.56), GFAP: 2.16 (1.58; 3.09)]. In all models the addition of serum NfL led to a significant improvement in the AUROC, as did the addition of serum GFAP. Calibration plots showed high agreement between the predicted and observed outcomes and after addition of the two blood-based biomarkers there was an improvement of the overall performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Prediction of functional outcome after severe acute ischemic stroke was improved by the blood-based biomarkers serum NfL and GFAP, measured in the acute phase of stroke. These findings have to be replicated in independent external cohorts.<\/jats:p>\n                    <jats:p>Study registration: DRKS00022064<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23969873241234436","type":"journal-article","created":{"date-parts":[[2024,2,24]],"date-time":"2024-02-24T06:12:28Z","timestamp":1708755148000},"page":"751-762","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":39,"title":["Incremental value of serum neurofilament light chain and glial fibrillary acidic protein as blood-based biomarkers for predicting functional outcome in severe acute ischemic stroke"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5893-1196","authenticated-orcid":false,"given":"Christoph","family":"Vollmuth","sequence":"first","affiliation":[{"name":"University Hospital W\u00fcrzburg, Department of Neurology, W\u00fcrzburg, Germany 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelia","family":"Fiessler","sequence":"additional","affiliation":[{"name":"University of W\u00fcrzburg, Institute for Clinical Epidemiology and Biometry, W\u00fcrzburg, Germany 2"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9438-0854","authenticated-orcid":false,"given":"Felipe A","family":"Montellano","sequence":"additional","affiliation":[{"name":"University Hospital W\u00fcrzburg, Department of Neurology, W\u00fcrzburg, Germany 1"},{"name":"University of W\u00fcrzburg, Institute for Clinical Epidemiology and Biometry, W\u00fcrzburg, Germany 2"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander M","family":"Kollikowski","sequence":"additional","affiliation":[{"name":"University Hospital W\u00fcrzburg, Department of Neuroradiology, W\u00fcrzburg, Germany 3"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Essig","sequence":"additional","affiliation":[{"name":"University Hospital W\u00fcrzburg, Department of Neurology, W\u00fcrzburg, Germany 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Oeckl","sequence":"additional","affiliation":[{"name":"University Hospital Ulm, Department of Neurology, Ulm, Germany 4"},{"name":"German Center for Neurodegenerative Diseases e.V. 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