Lower baseline serum neuronal-specific enolase levels predict better rate of recovery of functional walking ability in post-acute stroke patients

Journal article

Introduction: Evaluate the association between functional recovery and a panel of specific neuronal biomarkers, in a cohort of stroke patients. Material and methods : Serum levels of neuronal specific enolase (NSE), neurofilament light chain (NfL), brain derived neurotrophic factor (BDNF), amyloid-β42 and β40 peptides (Aβ42/Aβ40 ratio) and total tau (t-tau), were measured in 20 patients within one month after stroke event (baseline, T0). After six weeks of extensive multimodal cognitive and motor rehabilitation (T1), levels of each biomarker were correlated with changes in clinical scales for disability and mobility (Barthel Index (BI), Rivermead Mobility Index (RMI), Functional Ambulation Categories (FAC), Fugl Mayer Assessment Upper Extremity (FMA). Results : Linear regression was performed to predict changes in clinical scales during follow up, according to baseline biomarkers levels. NSE at T0 was a significant predictor of improvement in FAC and RMI, where the higher the NSE concentration, the smaller the improvement. Therefore, baseline NSE explained 39% of the variation in FAC and 31% in RMI over time. No significant differences were observed with respect to other scales or other biomarkers. Conclusions: This exploratory study suggested that serum NSE may be a predictor of functional mobility recovery in post-acute stroke patients and represents a useful tool for patients’ stratification.

Authors: Brunelli, S; Nourbakhsh, S; Grimaldi, L; Calvani, A; Gentileschi, N

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Springer
• Journal: Neurological Sciences
• Volume: 47
• Issue: 1
• Article number: 39
• Publication date: 2025-12-25
• Acceptance date: 2025-10-06
• DOI: 10.1007/s10072-025-08723-5
• EISSN: 1590-3478
• ISSN: 1590-1874
• Language: English
• Keywords: Stroke; Rehabilitation; Neurodegeneration; Brain-derived neurotrophic factor; Neuronal specific enolase; Blood biomarkers