Spectral exponent assessment and neurofilament light chain: a comprehensive approach to describe recovery patterns in stroke

Jacopo Lanzone; Aida Zulueta; Marilisa Boscarino; Matteo Gallotta; Maria Rosaria Argentieri; Alessandro Viganò; Simone Sarasso; Michele A Colombo; Sasha D'Ambrosio; Christian Lunetta; Eugenio Parati

doi:10.3389/fneur.2024.1329044

Spectral exponent assessment and neurofilament light chain: a comprehensive approach to describe recovery patterns in stroke

Front Neurol. 2024 Mar 18:15:1329044. doi: 10.3389/fneur.2024.1329044. eCollection 2024.

Affiliations

¹ Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation Department of the Milano Institute, Milan, Italy.
² IRCCS Fondazione Don Carlo Gnocchi, ONLUS, Milan, Italy.
³ Department of Biomedical and Clinical Sciences, Università Degli Studi di Milano, Milan, Italy.
⁴ Department of Health Sciences, Università Degli Studi di Milano, Milan, Italy.
⁵ Department of Clinical and Experimental Epilepsy, University College London, London, United Kingdom.

Abstract

Introduction: Understanding the residual recovery potential in stroke patients is crucial for tailoring effective neurorehabilitation programs. We propose using EEG and plasmatic Neurofilament light chain (NfL) levels as a model to depict longitudinal patterns of stroke recovery.

Methods: We enrolled 13 patients (4 female, mean age 74.7 ± 8.8) who underwent stroke in the previous month and were hospitalized for 2-months rehabilitation. Patients underwent blood withdrawal, clinical evaluation and high-definition EEG at T1 (first week of rehabilitation) and at T2 (53 ± 10 days after). We assessed the levels of NfL and we analyzed the EEG signal extracting Spectral Exponent (SE) values. We compared our variables between the two timepoint and between cortical and non-cortical strokes.

Results: We found a significant difference in the symmetry of SE values between cortical and non-cortical stroke at both T1 (p = 0.005) and T2 (p = 0.01). SE in the affected hemisphere showed significantly steeper values at T1 when compared with T2 (p = 0.001). EEG measures were consistently related to clinical scores, while NfL at T1 was related to the volume of ischemic lesions (r = 0.75; p = 0.003). Additionally, the combined use of NfL and SE indicated varying trends in longitudinal clinical recovery.

Conclusion: We present proof of concept of a promising approach for the characterization of different recovery patterns in stroke patients.

Keywords: EEG; biomarkers; neurofilament; rehabilitation; stroke.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Ministero dell’Università e della Ricerca (PRIN2022) and by the “Ricerca Corrente” funding scheme of the Ministry of Health, Italy.