Biomarkers for Cerebral Ischemia as a Novel Method for Validating the Efficacy of Neurocytoprotectors

Objectives. To assess the diagnostic value of NR2 peptide as a biomarker for cerebral ischemia by studying its plasma concentration in patients with ischemic stroke (IS) and to determine changes in levels due to treatment with the low molecular weight neuroprotector Cortexin. Materials and Methods. A total of 120 patients aged 18–70 years were studied, of which 36 were diagnosed with transient ischemic attacks (TIA) and 84 with IS – 70 in the carotid basin and 14 in the vertebrobasilar basin with Wallenberg–Zakharchenko syndrome. Determination of neurological status included assessment on the NIHSS stroke scale. Plasma NR2 concentrations were estimated in all patients on admission and after courses of treatment and results were compared with CT and MRI neuroimaging studies. Results and Conclusions. NR2 peptide fragment concentrations in all patients were above the normal value (>1.5 ng/ml, p < 0.0001). A direct correlation was found between the concentration of NR2 peptide (from 3.38 ng/ml to 15.6 ng/ml) and the size of the ischemia zone from a few mm to 80 mm (rs = 0.73). After 10-day courses of treatment with Cortexin, NR2 peptide fragment concentrations decreased (from 8.5 to 5.9 ng/ml, p < 0.0001). These data lead to the conclusion that this blood test for cerebral ischemia is valid and that Cortexin has significant therapeutic efficacy.

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