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Updated: Jun 28, 2026
A Cell Culture Model for Studying the Role of Neuron-Glia Interactions in Ischemia
Published on: November 14, 2020
High plasma glutamate concentrations are associated with infarct growth in acute ischemic stroke
M Castellanos1, T Sobrino, S Pedraza
1Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Ctra de Canyet s/n, E-08916 Badalona, Barcelona, Spain.
Background:
Excitotoxic and inflammatory mechanisms have been demonstrated as mediating early neurologic deterioration (END) in patients with cerebral infarction. Here we investigate whether molecular markers associated with END are related to the volume and outcome of the diffusion weighted image (DWI) lesion in acute ischemic stroke.
Methods:
MRI was performed on admission and at 72 hours in 197 patients with acute hemispheric infarction of <12 hours' duration. DWI lesion enlargement was calculated as the absolute difference between volumes on admission and day 3 of evolution. NIH Stroke Scale was scored at the same intervals. END was defined as an increase >/=4 points within the 3 days. Glutamate, l-arginine, interleukin-6 (IL-6), and tumor necrosis factor-alpha levels were analyzed in blood samples obtained on admission.
Results:
DWI lesion growth was found in 144 (73%) patients (median increase 38 [6.5, 83.4] cm(3)) and END occurred in 58 (29.4%) patients. Baseline glutamate (r = 0.71), l-arginine (r = -0.35), and IL-6 levels (r = 0.50) showed a high and significant correlation with the DWI lesion enlargement (all p < 0.001). After adjustment for potential confounders, glutamate levels were the only molecular marker associated with DWI lesion enlargement at 72 hours (beta = 0.21; SD = 0.07; p = 0.004).
Conclusions:
Molecular markers of early neurologic deterioration may play a role as mediators of lesion growth in cerebral ischemia. Plasma glutamate concentration is the most powerful and independent predictor biomarker of lesion enlargement in the acute phase of ischemic stroke, and so may well be useful as a signature of tissue at risk of infarction.
Insights
Plasma glutamate levels predict lesion growth in acute ischemic stroke patients. High glutamate indicates a higher risk of early neurological deterioration and larger lesion volume.
Area of Science:
- Neuroscience
- Biomarkers
- Ischemic Stroke Research
Background:
- Early neurological deterioration (END) in cerebral infarction is linked to excitotoxic and inflammatory processes.
- Investigating molecular markers associated with END in relation to diffusion-weighted imaging (DWI) lesion volume and outcomes is crucial.
Purpose of the Study:
- To determine if molecular markers correlate with DWI lesion volume and patient outcomes in acute ischemic stroke.
- To identify specific biomarkers predictive of lesion enlargement and neurological deterioration.
Main Methods:
- 197 acute hemispheric infarction patients (<12 hours) underwent MRI at baseline and 72 hours.
- DWI lesion enlargement was quantified; END was defined as a ≥4-point NIH Stroke Scale increase.
- Blood levels of glutamate, l-arginine, IL-6, and TNF-alpha were measured on admission.
Main Results:
- DWI lesion growth occurred in 73% of patients; END in 29.4%.
- Baseline glutamate, l-arginine, and IL-6 levels significantly correlated with DWI lesion enlargement (p < 0.001).
- Adjusted analysis revealed plasma glutamate as the sole independent molecular predictor of DWI lesion enlargement at 72 hours (p = 0.004).
Conclusions:
- Molecular markers may mediate lesion growth in cerebral ischemia.
- Plasma glutamate concentration is a powerful, independent biomarker predicting lesion enlargement in acute ischemic stroke.
- Glutamate may serve as a signature indicating tissue at risk of infarction.
