Clinical, Neuroimaging and Serum Heat Shock 70 kDa Protein-8 as Predictors of Post Stroke Epilepsy: A Prospective Cross-Sectional Study

Background:Heat Shock 70 kDa protein-8 (Hsc70) is a chaperone protein that is related to heat shock protein 70 family. It stabilizes or breaks down mutant proteins and helps misfolded and newly translated proteins fold correctly. It facilitates signal transmission, apoptosis, autophagy, protein homeostasis, cell proliferation, and differentiation.
Objective:This study aimed to compare blood biomarker Hsc70 with clinical and neuroimaging data to predict poststroke epilepsy (PSE).
Patients and methods: There were 15 control subjects and 80 patients. To assess onset of epilepsy in cases, ischemic stroke was identified in 65 individuals and hemorrhagic stroke in 15 patients. They were admitted to the Neurology Department, Mansoura University Hospital and Mansoura International Hospital during the period from May 2023 to May 2024. They were diagnosed clinically and confirmed radiologically. Serum Hsc70 protein was done to patients and control.
Results: Serum Hsc70 protein showed statistically significant downregulation between cases who developed epilepsy in comparison to cases who didn’t develop epilepsy (p = 0.046). It had mean values of 2.06, 1.54, and 0.3 ng/ml in cases who did not develop epilepsy, cases who developed epilepsy and control groups, respectively. When a cut-off value < 2.32 ng/ml is applied, serum Hsc70 had sensitivity and specificity of 77.8% and 62.4%, respectively, for prediction of epilepsy after stroke. National Institutes of Health Stroke Scale (NIHSS) and Modified Ranking Scale (mRS) demonstrated a significant increase in patients who developed epilepsy (p < 0.005).  
Conclusion:The statistically significant risk factors for developing PSE include stroke severity, degree of disability, temporal lobe stroke and downregulation of Hsc70.