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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Neurological Biomarkers
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1490023

Serum neuritin as a predictive biomarker of early neurological deterioration and poor prognosis after spontaneous intracerebral hemorrhage: a prospective cohort study

Provisionally accepted
Yongming Xu Yongming Xu *Yanwen Xu Yanwen Xu Hanyu Zhu Hanyu Zhu Yuqi Su Yuqi Su Zhizhi Chen Zhizhi Chen Chuanliu Wang Chuanliu Wang Ming Yang Ming Yang Feifei Jiang Feifei Jiang Yunping Li Yunping Li
  • Quzhou City People's Hospital, Quzhou, China

The final, formatted version of the article will be published soon.

    Objective: Neuritin is significantly expressed in injured brain tissues and is implicated in molecular mechanisms underlying acute brain injury. We aimed to explore the prognostic predictive value of serum neuritin in ICH.In this prospective cohort study, serum neuritin levels were quantified at admission in 202 patients, at post-ICH days 1, 3, 5, 7, and 10 in 54 of them and at entrance into study in 100 controls. Glasgow coma scale (GCS) and hematoma volume were used as severity indexes. Poor prognosis was defined as a modified Rankin scale (mRS) scores of 3-6 at 90 days after ICH. END was defined as a decrease of ≥2 points in the GCS score within 24 hours of admission. Multivariate logistic regression model was configured to determine the independent relations of serum neuritin levels to END and poor prognosis.Results: Serum neuritin levels were significantly increased at admission of patients, continued to rise at day 1, peaked at day 3 and then diminished gradually from day 5 until day 10, and were substantially higher during 10 days in patients than in healthy controls. The levels were independently related to GCS scores and hematoma volume.In subgroup analysis context, the levels were linearly relevant to likelihoods of experiencing END and poor prognosis at 90-day mark after ICH. Also, the levels were independently associated with END, ordinal mRS scores and poor prognosis. Under the receiver operating characteristic (ROC) curve analysis framework, END and poor prognosis were effectively predicted by serum neuritin levels. The two models with 4 incorporation of GCS, hematoma volume and serum neuritin were described by applying two nomograms separately for distinguishing risks of END and poor prognosis. The models were clinically efficient, stable and valid under ROC curve, calibration curve and decision curve. An internal validation of the two models was finished in randomly-extracted 101 patients. The two specific weighted scoring systems were built for optimizing clinical prediction of poor prognosis and END after ICH.Conclusions: Elevated serum neuritin levels are tightly associated with severity, END and 90-day poor neurological outcomes following ICH, substantializing serum neuritin as a potential prognostic biomarker of ICH.

    Keywords: intracerebral hemorrhage, Neuritin, Early neurological deterioration, prognosis, severity, Outcome

    Received: 02 Sep 2024; Accepted: 10 Dec 2024.

    Copyright: © 2024 Xu, Xu, Zhu, Su, Chen, Wang, Yang, Jiang and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Yongming Xu, Quzhou City People's Hospital, Quzhou, China

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