Neuron-Specific Enolase as a predictor for outcomes in ischemic stroke: a prognostic biomarker review

Abstract

Abstract Recent studies have investigated the role of neuron-specific enolase (NSE) as a potential predictor for outcomes in acute ischemic stroke patients. However, up to date, the current body of research has yielded inconclusive results, as its role in cerebrovascular diseases remains poorly understood. Moreover, the limited sample sizes in these studies have restricted the applicability of any potential findings. This study aims to determine whether NSE serum concentrations at Emergency Department (ED) admission correlate with stroke severity, infarcted brain volume, functional outcome, and/or death rates. Literature was searched using Pubmed, Embase and Scopus databases, and all published reports identified as potentially relevant were independently assessed by each reviewer. All relevant original observational studies (cohort, case-control and cross-sectional studies) were included. Eleven studies (1,398 patients) satisfied the entry criteria. Among these, six studies reported a significant correlation between NSE serum levels and stroke severity, while only one study found no association. Regarding infarcted brain volume assessed by imaging, four studies indicated a positive relationship with NSE levels, contrasting with the findings of only one study. In terms of functional outcome and death rates, four studies identified an association, while three others did not reach statistical significance in their findings. These data highlight that NSE levels at the admission to the ED proved to be a promising tool in predicting ischemic stroke patients' outcome in the majority of the studies, although with some discrepancies. Therefore, further research is necessary to establish and define the role of NSE in clinical practice.