A study with 600 patients confirms the value of the neuron-specific enolase (NSE) protein as a predictor of poor neurological prognosis.
It can help guide more accurate medical decisions during the crucial first hours of hospital admission.
Predicting whether a person will recover after a cardiac arrest can be key to guiding medical treatment and informing the family. A study led by the Clinical Laboratory of the Southern Metropolitan Territorial Area at Bellvitge Hospital has identified a biological marker—the neuron-specific enolase (NSE) protein—as a potential indicator of the prognosis of brain damage caused by this type of emergency.
A retrospective analysis of 600 patients showed that high levels of this protein, measured 48 and 72 hours after the arrest, are associated with a poorer neurological prognosis. In other words, it can indicate which patients are more likely to suffer severe outcomes such as a vegetative state, cognitive disabilities, or, in the most extreme cases, death.
“This biomarker can give us very valuable guidance in the first hours, when we still don’t know whether the patient’s brain has suffered irreversible damage,” explains Dr. Maria José Castro, specialist in clinical biochemistry and lead researcher of the study.
A Support Tool for Critical Decisions
Cardiac arrests are one of the most serious causes of admission to intensive care units (ICUs) and especially affect the brain due to the sudden lack of oxygen. In many cases, it’s not easy to determine whether the patient will recover, or what lasting effects they may face.
“NSE, along with other clinical and neurophysiological tests, can help us make a more complete and rapid assessment of brain damage,” adds Dr. Misericòrdia Veciana, from the Neurophysiology section at Bellvitge.
Despite medical advances, studies show that less than half of the people who arrive at the hospital alive after a cardiac arrest survive—and only one-third do so with a good neurological outcome.
Collaborative Research: Biochemistry and Neurology Working Together
This work highlights the value of collaboration between clinical laboratories and care services such as ICUs and neurology, aligning with the personalized medicine model: using objective, case-specific data to better tailor treatments.
The results also open the door to future research lines involving other biomarkers that could detect brain damage even earlier than NSE—such as S100beta proteins, TAU, or neurofilaments.
“Having tools like this will help us make difficult decisions with more information and greater precision,” the researchers conclude.
Caption (left to right): Maria José Castro, pharmacist and specialist in Clinical Biochemistry, lead researcher of the study, Core Biochemistry Area of the Southern Metropolitan Territorial Clinical Laboratory; Misericòrdia Veciana, physician and specialist in Clinical Neurophysiology, Neurophysiology section of the Neurology Department; and Isabel Cachón, pharmacist and specialist in Clinical Biochemistry, Core Biochemistry Area of the Southern Metropolitan Territorial Clinical Laboratory.