TY - JOUR N2 - Background: Cerebrospinal fluid (CSF) biomarkers reflect ongoing processes in the brain. Growth-associated protein 43 (GAP-43) is highly upregulated in brain tissue shortly after experimental ischemia suggesting the CSF GAP-43 concentration may be altered in ischemic brain disorders. CSF GAP-43 concentration is elevated in Alzheimer?s disease patients; however, patients suffering from stroke have not been studied previously. Methods: The concentration of GAP-43 was measured in longitudinal CSF samples from 28 stroke patients prospectively collected on days 0?1, 2?4, 7?9, 3 weeks, and 3?5 months after ischemia and cross-sectionally in 19 controls. The stroke patients were clinically evaluated using a stroke severity score system. The extent of the brain lesion, including injury size and degrees of white matter lesions and atrophy were evaluated by CT and magnetic resonance imaging. Results: Increased GAP-43 concentration was detected from day 7?9 to 3 weeks after stroke, compared to day 1?4 and to levels in the control group (P = 0.02 and P = 0.007). At 3?5 months after stroke GAP-43 returned to admission levels. The initial increase in GAP-43 during the nine first days was associated to stroke severity, the degree of white matter lesions and atrophy and correlated positively with infarct size (rs = 0.65, P = 0.001). Conclusions: The transient increase of CSF GAP-43 is important to take into account when used as a biomarker for other neurodegenerative diseases such as Alzheimer?s disease. Furthermore, GAP-43 may be a marker of neuronal responses after stroke and additional studies confirming the potential of CSF GAP-43 to reflect severity and outcome of stroke in larger cohorts are warranted. ID - discovery10065062 PB - BMC UR - http://doi.org/10.1186/s12883-018-1210-5 SN - 1471-2377 JF - BMC Neurology A1 - Sandelius, A A1 - Cullen, NC A1 - Kallen, A A1 - Rosengren, L A1 - Jensen, C A1 - Kostanjevecki, V A1 - Vandijck, M A1 - Zetterberg, H A1 - Blennow, K KW - GAP-43 KW - Stroke KW - Neurodegeneration KW - Cerebrospinal fluid KW - Biomarkers TI - Transient increase in CSF GAP-43 concentration after ischemic stroke VL - 18 AV - public Y1 - 2018/12/07/ EP - 8 N1 - Copyright © The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. ER -