Stroke biomarkers: Issues of diagnosis and medical rehabilitation

Abstract

Stroke is the main death and invalidization factor throughout the world. Stroke prevention, early diagnostics and treatment, as well as proper rehabilitation, are the key research directions to reduce death and invalidization numbers. Current clinical practice widely uses many biochemical markers (biomarkers) found in blood, urine or cerebrospinal fluid to make therapeutic decisions. Used along with standard examination methods, the potential benefit of stroke biomarkers could be seen in stroke type differential diagnostics, complication development forecasting and rehabilitation events personification. Many potential stroke biomarkers and combined panels, including those used for rehabilitation intensity estimation, are described in science literature. Among them prevail peptide molecules connected with the damage of neurons and their axons, neuroglia, brain vessels endothelium. Less attention is given to blood proteins, lipids and other metabolites. There appears more and more reliable data on circulating nucleic acids as stroke manifestation and progress markers. Despite obvious clinical and economical biomarkers prospects, no studied stroke markers are used in everyday clinical practice. That could be caused by obtained suboptimal sensitivity and specificity indicators and difficulties with translational studies organization and conducting. Relevance of stroke biomarkers as a way to control rehabilitation intensity also highlights the necessity to additional researches.