Rapid and Sensitive Differentiating Ischemic and Hemorrhagic Strokes by Dried Blood Spot Based Direct Injection Mass...

Area of Science:

• Biochemistry
• Neurology
• Medical Diagnostics

Background:

• Cerebral infarction (CI) and intracerebral hemorrhage (ICH) are critical cerebrovascular diseases with overlapping symptoms but different treatments.
• Prompt diagnosis is crucial for effective management and improved patient outcomes in emergency settings.

Purpose of the Study:

• To investigate the utility of targeted metabolomics for differentiating CI from ICH using dried blood spot samples.
• To identify specific metabolic biomarkers for distinguishing between CI and ICH.

Main Methods:

• A targeted metabolomics approach was employed, analyzing 23 amino acids, 26 carnitine/carnitine esters, and 22 calculated ratios in 129 CI patients, 73 ICH patients, and 98 controls.
• Direct injection mass spectrometry was used for absolute quantitation on dried blood spot samples.

Main Results:

• Distinctive metabolite alterations were observed between CI and ICH groups compared to controls.
• Specific metabolites like Tyr, Cit, Asn, Pro, Val, Arg/Orn, Leu, and Val/Phe were elevated in the CI group, while C5:1, Phe/Tyr, (C0 + C2 + C3 + C16 + C18:1)/Cit, and Met/Leu were decreased.
• A regression model utilizing these biomarkers achieved 79.07% accuracy in confirming stroke patients in a validation set.

Conclusions:

• Targeted metabolomics analysis of dried blood spots provides a promising method for rapid and timely differentiation of stroke types.
• Metabolite profiling can serve as a valuable tool for distinguishing cerebral infarction from intracerebral hemorrhage, aiding clinical decision-making.