• Peng Wang, Jiankang Huang, Hongbo Wen, Xiuling Liang, Jie Wang, Pengyu Ding, and Jie Ding.
• Department of Neurology, Nanjing Lishui People's Hospital, Nanjing, Jiangsu 211200, China.
• Neuroscience. 2025 Jan 29.

AbstractThis study investigated the clinical predictive value of cerebrospinal fluid (CSF) γ-aminobutyric acid (GABA) and serum neuron-specific enolase (NSE) and microRNA-155 (miR-155) for post-stroke epilepsy (PSE) in patients with cerebral infarction (CI). A total of 69 CI patients with PSE and 84 with non-post-stroke epilepsy (N-PSE) were retrospectively enrolled, with their clinical baseline data (CI type) and the National Institute of Health Stroke Scale (NIHSS) score collected. CSF GABA and serum NSE and miR-155 expression levels were determined, with their clinical value further assessed. The results showed that the proportions of patients with cardiogenic CI, multiple infarcts, and cortical involvement and NIHSS score in PSE patients were higher than those in N-PSE patients. CSF GABA was lowly expressed and serum NSE and miR-155 were highly expressed in PSE patients. The NIHSS score negatively correlated with GABA and positively correlated with NSE and miR-155. GABA [area under the curve (AUC) = 0.906], NSE (AUC = 0.908), miR-155 (AUC = 0.862) and their combined detection (AUC = 0.963) all had certain value in the occurrence of PSE in CI patients, with their combined detection showing higher AUC than that of single detection. Briefly, CSF GABA was reduced while serum NSE and miR-155 were elevated in PSE patients. GABA and NSE combined with miR-155 had high diagnostic value for PSE occurrence in CI patients. Lowly-expressed GABA or highly-expressed NSE and miR-155 were independent risk factors for PSE in CI patients, which could provide effective guidance for the clinical diagnosis and management of PSE.Copyright © 2025. Published by Elsevier Inc.

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