Abstract
Cerebrovascular disease is the leading cause of long-term disability in the world and the third-leading cause of death in the United States. The early diagnosis of transient ischemic attack (TIA) is of great importance for reducing the mortality and morbidity of cerebrovascular diseases. Patients with TIA have a high risk of early subsequent ischemic stroke and the development of permanent nervous system lesions. The diagnosis of TIA remains a clinical diagnosis that highly relies on the patient’s medical history assessment. There is a growing list of biomarkers associated with different components of the ischemic cascade in the brain. In this review, we take a closer look at the biomarkers of TIA and their validity with a focus on the more clinically important ones using recent evidence of their reliability for practical usage.
Highlights
Cerebrovascular disease is the leading cause of long-term disability and the secondleading cause of death worldwide [1]
Since many studies had evaluated the role of biomarkers in diagnosing patients with either ischemic stroke or transient ischemic attack (TIA), we searched for all studies of brain ischemia
Considering the fact that cerebral spinal fluid (CSF) changes could be a close reflection of cerebral tissue changes and the specific presence of DJ-1 protein in brain tissues, the idea of detection of DJ-1 protein serum changes in patients with cerebral ischemia could be of early diagnostic value for stroke, especially in advanced infarct age [19,22]
Summary
Cerebrovascular disease is the leading cause of long-term disability and the secondleading cause of death worldwide [1]. A possible solution to the diagnostic difficulties in TIA could be an addition of serum or imaging biomarkers, or a combination of biomarkers that can reliably assist in the diagnosis of transient brain ischemia. Due to the similarities in the pathological mechanisms and the ischemic cascade of TIA and ischemic stroke development, most of the available biomarkers can potentially be applied for the diagnosis of both diseases. Most of these biomarkers have a low predictive value for stroke in the hyperacute or reflect the severity of an established subacute or completed stroke. We consider that a diagnostic panel for TIA should have a high positive and negative predictive value and should be able to detect the event up to several days after the transient symptoms
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