Serum neuron specific enolase could predict subclinical brain damage and the subsequent occurrence of brain related vascular events during follow up in essential hypertension

• Published in: Journal of the neurological sciences Vol. 363; pp. 158 - 163
• Main Authors: González-Quevedo, Alina, González-García, Sergio, Hernández-Díaz, Zenaida, Concepción, Otman Fernández, Sotolongo, Luis Quevedo, Peña-Sánchez, Marisol, Rosales, Benjamín Márquez, Freixas, Rosaralis Santiesteban, Fernández-Almirall, Isabel, Menéndez-Sainz, María Caridad, Fernández-Carriera, Rebeca
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 15.04.2016
• Subjects: Adult; Aged; Aged, 80 and over; Arterial hypertension; Biomarkers - blood; Blood biomarkers; Brain damage; Brain Injuries - blood; Brain Injuries - diagnosis; Brain Injuries - epidemiology; Cross-Sectional Studies; Essential Hypertension; Female; Follow-Up Studies; Humans; Hypertension - blood; Hypertension - diagnosis; Hypertension - epidemiology; Longitudinal Studies; Male; Middle Aged; Neurology; Neuron specific enolase; Phosphopyruvate Hydratase - blood; Predictive Value of Tests; S100B; White matter hyperintensity; Young Adult; SBP; NSE; RW; white matter hyperintensities; body mass index; IVS; rear wall; transient ischemic attack; HT; S100B; systolic blood pressure; TIA; interventricular septum; Blood biomarkers; Arterial hypertension; White matter hyperintensity; DBP; WMH; diastolic blood pressure; neuron specific enolase; Brain damage; hypertension; BMI; Neuron specific enolase
• ISSN: 0022-510X; 1878-5883
• DOI: 10.1016/j.jns.2016.02.052

Abstract The object of this work was to explore if blood based biomarkers of brain damage could predict subclinical brain lesions and clinical outcome during follow-up in asymptomatic hypertensive patients. This was a cross-sectional study including 101 patients with essential hypertension and no clinical evidence of neurological disease and 53 healthy controls, followed by a longitudinal study of 62 hypertensive patients for an average of 33 months. Serum concentrations of two brain specific proteins (S100B and neuron specific enolase - NSE) were determined at inclusion. Fundoscopic exploration, brain MRI and echocardiographic studies were also performed. Clinical outcome at follow-up was registered: transient ischemic attack (TIA), stroke, vascular headache or migraine, cardiovascular events and death. Higher serum NSE and S100B concentrations were observed in hypertensive patients; and multiple regression analysis revealed independent associations of clinical variables and more severe white matter lesions only with NSE concentration. A panel combining two clinical variables (blood pressure > 140/90 and years of hypertension > 10) and serum NSE > 13 μg/L predicted more severe white matter lesions with 80% sensitivity and 94.4% specificity. Higher NSE levels at inclusion were associated not only with the occurrence of vascular events related with the CNS (stroke, TIA and vascular headache), but also with an earlier presentation of these events during the follow-up period. Serum NSE concentration could be a useful biomarker to predict subclinical brain damage and future vascular events related with the CNS in hypertension. Blood based biomarkers could aid in filtering hypertensive patients with a higher risk of cerebrovascular disease for brain MRI scanning.