Plasma nerve growth factor level is associated with functional outcome after ischemic stroke

Nerve growth factor (NGF) is implicated in the modulation of neurogenesis, neuroplasticity, and neuroinflammation, but its impact on the prognosis of ischemic stroke remains unclear. This study aimed to investigate the associations between plasma NGF levels and functional outcome after ischemic stroke.

Plasma NGF levels were measured within 48 h after symptom onset among 3527 patients with ischemic stroke enrolled in the China Antihypertensive Trial in Acute Ischemic Stroke. We followed up patients within 1 year after stroke, and the poor functional outcome was defined as the composite outcome of death and major disability (modified Rankin Scale [mRS] score, 3-6). Multivariate logistic regression analysis was performed to estimate the association between plasma NGF levels and poor functional outcome after ischemic stroke. Additionally, restricted cubic splines were used to explore the dose-response relationship between NGF levels and poor functional outcome after ischemic stroke.

During 1 year of follow-up, 761 patients (22.3%) experienced poor functional outcome. After multivariate adjustment, elevated NGF was significantly associated with an increased risk of poor functional outcome (odds ratio, 1.39; 95% CI, 1.09-1.77; P_trend = 0.009) when 2 extreme tertiles were compared. Each SD increase of log-transformed NGF was associated with a 11% (95% CI, 1%-23%) increased risk of poor functional outcome. Multivariable-adjusted spline regression model showed a positive linear relationship between plasma NGF and the risk of poor functional outcome (P_linearity = 0.006).

High plasma NGF levels measured within 48 h after stroke onset were associated with poor functional outcome at 1 year after ischemic stroke, suggesting that plasma NGF might be a prognostic biomarker for ischemic stroke. Further studies from other samples of ischemic stroke patients are needed to confirm our findings.