Stroke biomarkers: the promise of point-of-care testing

Stroke remains a leading cause of disability and mortality requiring rapid and accurate diagnostic tools to improve patient outcomes. Biomarkers such as N-terminal pro B-type natriuretic peptide (NT-proBNP), glial fibrillary acidic protein (GFAP), C-reactive protein (CRP), S100B, neurofilament light chain (NfL), and microRNAs have been introduced as promising indicators for early stroke detection, subtype differentiation, and prognosis. However, typical laboratory-based assays are time-consuming and lack the portability required for emergency settings. Recent advances in biosensor technologies, including electrochemical, optical, and nanomaterial-based platforms, offer transformative potential for point-of-care (POC) stroke diagnosis. These biosensors enable ultrasensitive, rapid, and cost-effective detection of stroke biomarkers, facilitating timely clinical decision-making. This review first focuses on blood biomarkers related to ischemic stroke, including protein and RNA based biomarkers and other relevant molecules. Then, it summarizes the latest optical, and electrochemical bio-sensing techniques for the detection of critical biomarkers in stroke. Finally, we discuss analytical performance and advances in biosensor technology for use in POC devices. By providing a wide-ranging discussion on the stroke biomarkers and current state of biosensor approaches for stroke detection, this review aims to highlight the importance of these devices in improving patient outcomes and progressing stroke-based studies.