Table 1 Biomarkers for post-stroke epilepsy
From: Blood and CSF biomarkers for post-stroke epilepsy: a systematic review
Study | Duration of study | Biomarker | Study design | Case- control sample size | Sex and age | Duration of stroke | Assay used | Conclusion | Results | Limitation | Sensitivity | Specificity |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
Zhang et al. 2014 (China) [7] | September 2010 to April 2013 | CD40 | Case-control study | 410 IS patients, 389 PSE patients, and 160 healthy controls | Males and females | 48 h | Immunoassay, Real-time PCR analysis | The frequency of T allele and sCD40L level were significantly higher in PSE patients than in IS patients. | The T allele of the CD40 − 1C/T polymorphism may be associated with PSE susceptibility. The CD40/CD40L system is involved in the process of PSE. | Sample size is relatively small. Cell experiments were not conducted to reveal the pathogenic mechanism | – | – |
Abraira et al. 2020 (Spain) [8] | 2012–2017 | d-dimer, Endostatin, FasL, S100B, Hsc70, APO CIII, GroA, IL-6, NT-proBNP, VAP-1, vWF, IGFBP-3, TNF-R1, NCAM | Nested case-control | 45/752 (of 752 IS patients, 45 had PSE, and 707 were non-PSE or taken as control) | Males and females | 6 h | Immunoassay | The high level of endostatin > 1.203 and low levels of Hsc70 and S100B < 1.364 had strong positive associations with PSE. | Increased level of endostatin and decreased levels of Hsc70 and S100B may be associated with PSE. | There can be a negative impact on the number of late seizures because of increased number of loss-of-follow up due to death. | – | – |
Zhang et al. 2020 (China) [9] | June 2013 to June 2018 | IL-1β | Nested case- control | 107 IS patients with seizure recurrence, 131 IS patients without seizure recurrence | Males and females 54–73 years | – | Quantitative real-time PCR (qRT-PCR) | IL-1β expression level was higher in patients with seizure recurrence than in patients without recurrence. | IL-1β might be a useful biomarker for early discovery of recurrence after the first epileptic seizure in IS patients. | – | 70.09% | 87.02% |
Fu et al. 2109 (China) [10] | 2014 to 2018 | TRPM6 rs2274924, Mg2 + . | Case- control | 378 PSE patients/420 stroke patients | Males and females | – | PCR analysis, ion selective electrode method | Among 3 genotypes (TT, CT, and CC) of TRPM6, the frequency of the CC genotype was significantly higher in the PSE patients than in the controls | The increased frequency of CC genotype was significantly associated with PSE. | Further studies are needed for the exact understanding of molecular mechanisms. | – | – |
Eriksson et al. 2020 (UK) [11] | 2013 to 2016 | tau, NFL, GFAP, S100b, NSE | Case control | 4 PSE patients with thrombectomy /86 IS patients with thrombectomy | Males and females | 2 h, 24 h, 48 h, 72 h, and at three months. | Tau or GFAP kit Single molecule array (Simoa) 2.0 assays | Tau protein showed 100% sensitivity and 73% specificity. Other bio-markers (NFL, GFAP, S100B, and NSE) showed 100% sensitivity and 77%–93% specificity | All blood biomarkers displayed interesting sensitivity and specificity. | Small sample size | 100% | Tau protien: 73%, NFL, GFAP, S100B, or NSE: 77–93% |
Jia et al. 2020 (China) [12] | March 2013 to March 2018 | IL-6 mRNA | Nested case control | 105 PIS patients with recurrent seizures /104 PIS patients without recurrent seizures | Males and females 37–82 years. | – | qRT-PCR | The expression of IL-6 mRNA was higher in the case group than in the control group. | IL-6 was independently correlated with seizure recurrence in patients with the first post-ischemic stroke seizure | The study had a retrospective design. An unequivocal distribution of the follow-up period, | 68.57% | 75.00%. |
Yang et al. 2014 (China) [13] | – | ALDH2 rs671 | Case- control | 225 PSE patients, 240 IS patients and 267 healthy controls | Males and females | – | Polymerase chain reaction-restriction fragment length polymorphism | The frequency of rs671 A allele was higher in the PSE patients compared to the IS patients. | There is a positive association between ALDH2 polymorphism and PSE. | The study did not provide exact role of ALDH2 in PSE | – | – |
Wang et al. 2021 (China) [14] | January 2015 to December 2018 | Neuropeptide Y | Case- control | 78 PISE patients /86 IS patients | Males and females | 24 h | ELISA detection | Neuropeptide Y was inversely associated with PSE. | There was a 62% risk reduction in PISE patients with every 5 ng/ml increment of serum NPY. | Short duration of study, and sample size of the study was small | 84.62% | 86.05% |