scholarly journals ASSESSMENT OF THE NEURONAL DAMAGE AND OXIDATIVE STRESS MARKERS LEVEL IN POST STROKE PATIENTS

2019 ◽  
Vol 15 (3-4) ◽  
pp. 48-53
Author(s):  
V.R. Gerasymchuk
Keyword(s):  
Oxidative Stress ◽  
Functional Status ◽  
Neuronal Damage ◽  
Recovery Period ◽  
Estimation Methods ◽  
Enzyme Linked Immunosorbent Assay ◽  
Antioxidant Systems ◽  
Stroke Patients ◽  
Nihss Score ◽  
Post Stroke

Relevance. 100-110 000 acute disorders of cerebral circulation are registered in Ukraine annually, about 57% of which are ischemic stroke (IS). Study of dynamics of the neuronal damage markers level and their correlation with oxidative stress indicators may be informative for estimating the prognosis of the IS recovery period. Objective: to study the features of of neuronal damage markers level, the pro- and antioxidant systems status and their effect on the of neurological deficiency manifestations and the functional status of post stroke patients. Materials and methods. 120 patients in the early recovery period of first-ever hemispheric atherothrombotic IS were examined. The control group (CG) included 20 healthy individuals, representative by age and gender. Assessment of neurological deficiency and functional status of patients was performed with the help of the NIHSS scale, the Scandinavian Stroke Scale (SSS), the modified Rankin Scale (mRS) and the Bartel Index (BI). The level of neuron-specific enolase (NSE) in serum was determined by enzyme-linked immunosorbent assay. The determination of the level of oxidative protein modification (OPM) products in serum, glutathione reductase (GR) and glutathione peroxidase (GP) activity was performed spectrophotometrically. Statistical processing of the results was carried out using Statistica 6.0 statistical analysis package (StatSoft, Inc.) with the help of nonparametric results estimation methods. Results. In patients after 1 month after IS an increase of AFGn (356 nm) content by 33.9% (p<0.05) compared to CG was observed. KFGn (370 nm) level was increased by 26.0% (p<0.05), AFGo (430 nm)  - by 76.2% (p<0.01), CFG (530 nm) - 125.0% (p<0.01). The general OPM products was 37.0% higher than in CG (p<0.05), while the activity of GP and GR decreased by 31.6% and 28.6%, respectively (p<0, 05), and the NSE level was increased by 150.6% (p<0.05). The NIHSS score correlated with the level of AFGn (356 nm) (r=0.24; p=0.032), KFGo (530 nm) (r=0.41; p=0.047) and the general OPM products level (r=0.25 ; p=0.039), whereas the GR activity significantly influenced the NIHSS score (r=-0.27; p=0.048), SSS score (r=0.23; p=0.034) and BI (r=0.31; p=0.038). Also significant correlations were found between the NSE level and the concentration of all OPM products, GP ans GR activity. Conclusions. The NSE level increase is characteristic for the post stroke patients, which correlates with the degree of neurological deficiency manifestations and the patients’ functional status. The NSE level increases due to the increase of OPM products concentration and the decrease of GP and GR activity, which may indicate a worsening of the neuronal damage degree, linked to the pro- and antioxidant systems imbalance. These processes adversely affect the functional status of patients, with the greatest influence of the KFGo (530 nm) concentration, the general OPM products level and the GR activity.

Abstract TP274: Orosomucoid-1 Protein Increases Following Ischemic Stroke in the Brain and Periphery

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Hetal Mistry ◽  
Madeline Levy ◽  
Meaghan Roy-O'Reilly ◽  
Louise McCullough
Keyword(s):  
Sex Differences ◽  
Ischemic Stroke ◽  
Rna Sequencing ◽  
Multiple Testing ◽  
Enzyme Linked Immunosorbent Assay ◽  
Mrna Levels ◽  
Stroke Patients ◽  
Post Stroke ◽  
Protein Levels ◽  
The Brain

Background and Purpose: Orosomucoid-1 (ORM-1) is an abundant protein with important roles in inflammation and immunosuppression. We utilized RNA sequencing to measure mRNA levels in human ischemic stroke patients, with confirmation by serum ORM-1 protein measurements. A mouse model of ischemic stroke was then used to examine post-stroke changes in ORM-1 within the brain itself. Hypothesis: We tested the hypothesis that ORM-1 levels increase following ischemic stroke, with sex differences in protein dynamics over time. Methods: RNA sequencing was performed on whole blood from ischemic stroke patients (n=23) and controls (n=12), with Benjamini-Hochberg correction for multiple testing. Enzyme-linked immunosorbent assay was performed on serum from ischemic stroke patients (n=28) and controls (n=8), with analysis by T-test. For brain analysis, mice (n=14) were subjected to a 90-minute middle cerebral artery occlusion (MCAO) surgery and sacrificed 6 or 24 hours after stroke. Control mice underwent parallel “sham” surgery without occlusion. Western blotting was used to detect ORM-1 protein levels in whole brain, with analysis by two-way ANOVA. Results: RNA sequencing showed a 2.8-fold increase in human ORM-1 at 24 hours post-stroke (q=.0029), an increase also seen in serum ORM-1 protein levels (p=.011). Western blot analysis of mouse brain revealed that glycosylated (p=0.0003) and naive (p=0.0333) forms of ORM-1 were higher in female mice compared to males 6 hours post-stroke. Interestingly, ORM-1 levels were higher in the brains of stroke mice at 6 hours (p=.0483), while at 24 hours ORM-1 levels in stroke mice were lower than their sham counterparts (p=.0212). In both human and mouse data, no sex differences were seen in ORM-1 levels in the brain or periphery at 24 hours post-stroke. Conclusion: In conclusion, ORM-1 is a sexually dimorphic protein involved in the early (<24 hour) response to ischemic stroke. This research serves as an initial step in determining the mechanism of ORM-1 in the ischemic stroke response and its potential as a future therapeutic target for both sexes.

Abstract TP224: Interleukin-37 Level is Elevated in Acute Ischemic Stroke

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Saif Bushnaq ◽  
Atif Zafar ◽  
Kempuraj Duraisamy ◽  
Nudrat Tasneem ◽  
Mohammad M Khan ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Inflammatory Responses ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Delayed Presentation ◽  
Stroke Patients ◽  
Post Stroke ◽  
Urine And Serum ◽  
Serum And Urine

Background: Interleukin-37 (IL-37) is a new member of IL-1 cytokine family with a defined role as a negative feedback inhibitor of pro-inflammatory responses. IL-37 has yet to be evaluated in non-immune neurological diseases like ischemic or hemorrhagic stroke. This study aimed to measure the urine and serum IL-37 levels in patients with acute ischemic stroke. Method: Twelve patients consented for the study. Two sets of serum and urine samples were obtained and analyzed; one upon admission to the hospital, and the second the next morning after overnight fasting. The trends in serum level of IL-37 in 5 stroke patients, while trends in urine level of 6 patients were available, measured by real-time polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA). Prior studies with healthy volunteers as control group have consistently showed IL-37 plasma level around or less than 65 pg/ml with maximum normal levels on ELISA approximated at 130 pg/ml. Results: IL-37 level in urine in stroke patients ranged from 297 - 4467. IL-37 levels were in the range of 300s to 1000s in patients with ischemic stroke compared with reported healthy controls in literature where the level was always less than 90. Three of these 10 patients presented within 3 hours of stroke onset with IL-37 serum levels being 2655 pg/ml, 3517 pg/ml and 5235 pg/ml. In all others, it ranged much less than that, with the trend of delayed presentation giving less IL-37 levels, both in urine and serum. There were no clear differences found in patients with or without tPA, diabetes, hyperlipidemia and high blood pressure in our small study. Conclusion: The study shows a rather stable elevation of IL-37 levels post-ischemic stroke, which if compared to available data from other studies, is 3-10 times elevated after acute ischemic stroke with an uptrend in the first few days. IL-37 plays some role in mediating post-stroke inflammation with significant rise in serum and urine IL-37 levels suggesting a key role of this novel cytokine in post-stroke pathology. This is the first ever reported study measuring and trending IL-37 levels in human plasma after an acute ischemic stroke.

scholarly journals Changes in PHQ-9 depression scores in acute stroke patients shortly after returning home

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259806
Author(s):  
Brent Strong ◽  
Michele C. Fritz ◽  
Liming Dong ◽  
Lynda D. Lisabeth ◽  
Mathew J. Reeves
Keyword(s):  
Depressive Symptoms ◽  
Acute Stroke ◽  
Recovery Period ◽  
Stroke Severity ◽  
Stroke Survivors ◽  
Stroke Patients ◽  
Early Recovery ◽  
Post Stroke ◽  
Early Recovery Period ◽  
Over Time

Introduction Post-stroke depression is a disabling condition that occurs in approximately one-third of stroke survivors. There is limited information on changes in depressive symptoms shortly after stroke survivors return home. To identify factors associated with changes in post-stroke depressive symptoms during the early recovery period, we conducted a secondary analysis of patients enrolled in a clinical trial conducted during the transition period shortly after patients returned home (MISTT). Methods The Michigan Stroke Transitions Trial (MISTT) tested the efficacy of social worker case management and access to online information to improve patient-reported outcomes following an acute stroke. Patient Health Questionnaire-9 (PHQ-9) scores were collected via telephone interviews conducted at 7 and 90 days post-discharge; higher scores indicate more depressive symptoms. Generalized estimating equations were used to identify independent predictors of baseline PHQ-9 score at 7 days and of changes over time to 90 days. Results Of 265 patients, 193 and 185 completed the PHQ-9 survey at 7 and 90 days, respectively. The mean PHQ-9 score was 5.9 at 7 days and 5.1 at 90 days. Older age, being unmarried, and having moderate stroke severity (versus mild) were significantly associated with lower 7-day PHQ-9 scores (indicating fewer depressive symptoms). However, at 90 days, both unmarried patients and those with moderate or high stroke severity had significant increases in depressive symptoms over time. Conclusions In stroke patients who recently returned home, both marital status and stroke severity were associated with depressive symptom scores; however, the relationships were complex. Being unmarried and having higher stroke severity was associated with fewer depressive symptoms at baseline, but both factors were associated with worsening depressive symptoms over time. Identifying risk factors for changes in depressive symptoms may help guide effective management strategies during the early recovery period.

scholarly journals Post-stroke Hyperglycemia in Non-diabetic Ischemic Stroke is Related With Worse Functional Outcome: A Cohort Study

2021 ◽  
Vol 45 (5) ◽  
pp. 359-367
Author(s):  
Jin A Yoon ◽  
Yong-Il Shin ◽  
Deog Young Kim ◽  
Min Kyun Sohn ◽  
Jongmin Lee ◽  
...  
Keyword(s):  
Cohort Study ◽  
Ischemic Stroke ◽  
Glucose Level ◽  
Functional Outcomes ◽  
Stroke Patients ◽  
Nihss Score ◽  
Post Stroke ◽  
Significant Difference ◽  
Functional Assessments

Objective To investigate long-term and serial functional outcomes in ischemic stroke patients without diabetes with post-stroke hyperglycemia.Methods The Korean Stroke Cohort for Functioning and Rehabilitation (KOSCO) is a large, multi-center, prospective cohort study of stroke patients admitted to participating hospitals in nine areas of Korea. From KOSCO, ischemic stroke patients without diabetes were recruited and divided into two groups: patients without diabetes without (n=779) and with post-stroke hyperglycemia (n=223). Post-stroke hyperglycemia was defined as a glucose level >8 mmol/L. Functional assessments were performed 7 days and 3, 6, and 12 months after stroke onset.Results There were no significant differences in baseline characteristics between the groups, except in the age of onset and smoking. Analysis of the linear correlation between the initial National Institutes of Health Stroke Scale (NIHSS) score and glucose level showed no significant difference. Among our functional assessments, NIHSS, Fugl-Meyer Assessment (affected side), Functional Ambulatory Category, modified Rankin Scale, and Korean Mini-Mental State Examination (K-MMSE) showed statistically significant improvements in each group. All functional improvements except K-MMSE were significantly higher in patients without post-stroke hyperglycemia at 7 days and 3, 6, and 12 months.Conclusion The glucose level of ischemic stroke patients without diabetes had no significant correlation with the initial NIHSS score. The long-term effects of stress hyperglycemia showed worse functional outcomes in ischemic stroke patients without diabetes with post-stroke hyperglycemia.

scholarly journals Stroke and the Orthopaedic Surgeon

2013 ◽  
Vol 2 (1) ◽  
pp. 43-46
Author(s):  
AK Banskota
Keyword(s):  
Functional Status ◽  
Multidisciplinary Team ◽  
Orthopaedic Surgeon ◽  
Stroke Patients ◽  
Stroke Event ◽  
Post Stroke ◽  
Orthopaedic Treatment ◽  
Stroke Victim ◽  
Term Management

The role that can be effectively played by the orthopaedic surgeon in the long-term management of the stroke victim is often overlooked. Post-stroke patients rely heavily on the orthopaedist, amongst other members of the multidisciplinary team, to regain the maximum possible functional status following the stroke event. A great need to understand and implement the principles of post-stroke orthopaedic treatment and rehabilitation exists in our own community and practice.DOI: http://dx.doi.org/10.3126/noaj.v2i1.8139 Nepal Orthopaedic Association Journal Vol.2(1) 2011: 43-46

Abstract P50: IV Alteplase Use Predicts Favorable Discharge Disposition in Patients With Acute Ischemic Stroke: Insights From the UTHSC Houston Stroke Registry

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Nneka Ifejika-Jones ◽  
Nusrat Harun ◽  
Elizabeth Noser ◽  
James Grotta
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Functional Status ◽  
Inpatient Rehabilitation ◽  
Level Of Care ◽  
Stroke Patients ◽  
Short Term ◽  
Post Stroke ◽  
Discharge Disposition

Introduction: Acute ischemic stroke patients receiving IV alteplase (t-PA) within 4.5 hours of symptom onset are 30% more likely to have minimal or no disability at 3 months. During hospitalization, short-term disability is subjectively measured by discharge disposition, whether to home or Inpatient Rehabilitation (IR), Skilled Nursing Facility (SNF) or Sub-acute Care (Sub). There are no studies assessing the role of IV t-PA as a predictor of short-term disability, evidenced by post-stroke disposition. Hypothesis: Low NIHSS is a predictor of high functional status. We assessed the hypothesis that similar to low NIHSS, t-PA predicts post-stroke disposition to a level of care suggestive of high functional status. Methods: All patients with acute ischemic stroke admitted to the UT Service between January 2004 and October 2009 were included. Stratification occurred for age>65, NIHSS and stroke risk factors. Using multivariate logistic regression, the data was analyzed to determine whether there were differences in post-stroke disposition among patients who received t-PA. Results: Patients with mild (NIHSS<8) and moderate (NIHSS 8 to 16) stroke were discharged to the highest level of care in each analysis. Home vs. Other Level of Care Of 2261 patients, 1032 were discharged home, 1229 to another level of care. Patients who received t-PA were 1.7 times more likely to be discharged home (P = <.0001, OR 1.663, 95% CI 1.326 to 2.085). IR vs. SNF Of 1111 patients, 731 patients were discharged to acute IR, 380 to SNF. There were no statistically significant differences in disposition between patients who received t-PA. (P = .0638, OR 1.338, 95% CI 0.983 to 1.822). SNF vs. Sub Of 498 patients, 380 were discharged to SNF, 118 to Sub. There were no significant differences in disposition between patients who received t-PA. Conclusion: Acute stroke patients who receive IV t-PA are more 1.7 times more likely to be discharged home. If post-stroke care is necessary, there is a trend toward rehabilitation at a level reflective of improved functional status (IR vs. SNF). This study is limited by its retrospective nature and the undetermined role of psychosocial factors related to discharge. Prospective studies of time to t-PA therapy in relation to post-stroke disposition are warranted.

VP54 Costs And Benefits Of Intensive Inpatient Rehabilitation After Stroke

2017 ◽  
Vol 33 (S1) ◽  
pp. 172-173
Author(s):  
Youshin Suh ◽  
Jeonghoon Ahn
Keyword(s):  
Functional Status ◽  
Societal Perspective ◽  
Cost Savings ◽  
Inpatient Rehabilitation ◽  
Government Subsidy ◽  
Costs And Benefits ◽  
Stroke Patients ◽  
Post Stroke ◽  
Study Results ◽  
The Cost

INTRODUCTION:This study estimated, from the societal perspective, the costs and benefits of the intensive inpatient rehabilitation treatments (IIRT) on patients after stroke using the interim results of a large ongoing registry in Korea, the Korean Stroke Cohort for Functioning and Rehabilitation (KOSCO) (1).METHODS:Among others, the benefits were measured by two major cost savings: (i) decrease in government disability subsidy and (ii) caregiver savings. One of the KOSCO study results showed the functional status of the post-stroke patients, measured by the Korean Modified Barthel Index (K-MBI), improved significantly and the disability grades, which the government is using to classify the subsidy amount, reduced as well. Caregiver cost savings were calculated by K-MBI improvements, the average daily compensation of caregivers (USD58.33) and the average period of caregiving. To measure the cost of IIRT on post-stroke patients, the average costs reported by a National Evidence-based Healthcare Collaboration Agency (NECA) Health Technology Assessment report was used (2).RESULTS:The disability grade improvements showed savings of government subsidy by USD58.65 to USD478.39 depending on the patient income from the registry. The average caregiving cost decrease was USD6,042 annually. The average cost of IIRT on post-stroke patients was USD926.34 for the first year.CONCLUSIONS:This study estimated the cost-benefit of IIRT on post-stroke patients using the KOSCO study interim data. The intensive rehabilitation treatment improves patients functional status significantly enough to save two major cost items, the disability grades which also resulted in a decrease in government subsidy amounts and the caregiver costs which the patient family has to pay in Korea. The results warrant the use of IIRT for the post-stroke patients in Korea from the societal perspective.

Abstract P70: SPAK/OSR1 Signaling as a Novel Target for Post-Stroke Oxidative Stress Brain Injury

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Jun Wang ◽  
Victoria M Fiesler ◽  
Gulnaz Begum ◽  
Mohammad Iqbal H Bhuiyan ◽  
Shuying Dong ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Ischemic Stroke ◽  
Brain Injury ◽  
Neuronal Damage ◽  
Recombinant Tissue Plasminogen Activator ◽  
Primary Therapy ◽  
Post Stroke ◽  
Stroke Models ◽  
Novel Target

Stroke is the second leading cause of death worldwide, and ischemic stroke accounts for the vast majority of stroke cases. Currently, recombinant tissue plasminogen activator and endovascular thrombectomy are the two primary therapy strategies for acute ischemic stroke patients. Reactive oxygen species (ROS)-mediated oxidative stress can cause brain injury during reperfusion. We have shown that the Ste20/SPS1-related proline-alanine-rich protein kinase/oxidative stress-responsive kinase-1 (SPAK/OSR1) are activated in ischemic stroke brains, resulting in worsened outcomes in murine stroke models. SPAK activation induces the production of pro-inflammatory cytokines. Post-stroke administration of a novel SPAK inhibitor ZT-1a attenuates cerebral edema and protects against brain damage in in vivo model of ischemic stroke. However, whether ROS mediated oxidative stress directly activate SPAK/OSR1 pathway and induces SPAK pro-inflammatory cytokine production in ischemic brains remains unknown. In our extended study, we examined activation of SPAK/OSR1 and its substrate Na-K-Cl cotransporter (NKCC1) in cultured mouse primary neurons in response to hydrogen peroxide (H 2 O 2 )-mediated oxidative stress. We found that exposure of neurons to H 2 O 2 for 24 hrs triggered upregulation of protein expression and phosphorylation activation of SPAK/OSR1 and NKCC1 ( p < 0.05), which are accompanied with an increase in intracellular Na + concentration and neuronal death ( p < 0.01). These changes were blocked by an ROS scavenger ebselen. Interestingly, both novel SPAK inhibitor ZT-1a and NKCC1 inhibitor bumetanide are able to block H 2 O 2 -induced neuronal damage. We are in the process to assess effects of SPAK inhibitor ZT-1a in reducing ROS-mediated inflammation and brain injury in in vivo model of ischemic stroke. Together, our study suggests that ROS can activate SPAK/OSR1 complex during reperfusion injury and the therapeutic potentials of SPAK inhibitor ZT-1a for ischemic stroke.

scholarly journals The effectiveness of using modern technologies in early recovery period treatment of post-stroke patients

2018 ◽  
Vol 9 (1) ◽  
pp. 10-17
Author(s):  
Z. M. Mizieva ◽  
E. V. Shirshova
Keyword(s):  
Treatment Effectiveness ◽  
Recovery Period ◽  
Motor Dysfunction ◽  
Upper Limbs ◽  
Stroke Patients ◽  
Early Recovery ◽  
Post Stroke ◽  
Early Recovery Period ◽  
Positive Effect ◽  
Modern Technologies

This study presents the results of investigation «Amadeo», «Armeo» effectiveness in treatment of 61 post-stroke patients during early recovery period with upper limbs motor dysfunction. Comparative characteristics of treatment effectiveness in patients with ischemic and hemorrhage stroke are given. The results of investigation represent positive effect of using robotic technologies in post stroke patients rehabilitation therapy.

scholarly journals Natural History of Swallow Function during the Three-Month Period after Stroke

Geriatrics ◽  
2019 ◽  
Vol 4 (3) ◽  
pp. 42 ◽  
Author(s):  
Viridiana Arreola ◽  
Natàlia Vilardell ◽  
Omar Ortega ◽  
Laia Rofes ◽  
Desiree Muriana ◽  
...  
Keyword(s):  
Natural History ◽  
Functional Status ◽  
Spontaneous Recovery ◽  
Dynamic Condition ◽  
Oropharyngeal Dysphagia ◽  
Stroke Patients ◽  
Post Stroke ◽  
Volume Viscosity ◽  
History Of

Oropharyngeal dysphagia is a prevalent complication following stroke (PS-OD), and one that is sometimes spontaneously recovered. This study describes the natural history of PS-OD between admission and three months post-stroke, and the factors associated with its prevalence and development. PS-OD was assessed with the volume-viscosity swallow test (V-VST) in all stroke patients on admission and at the three-month follow-up. We analyzed clinical, demographic, and neuroanatomical factors of 247 older post-stroke patients (National Institute of Health Stroke Scale (NIHSS) = 3.5 ± 3.8), comparing among those with PS-OD the ones with and without spontaneous recovery. PS-OD prevalence on admission was 39.7% (34.0% impaired safety; 30.8%, efficacy) and 41.7% (19.4% impaired safety; 39.3%, efficacy) at three months. Spontaneous swallow recovery occurred in 42.4% of patients with unsafe and in 29.9% with ineffective swallow, associated with younger age and optimal functional status. However, 26% of post-stroke patients developed new signs/symptoms of ineffective swallow related to poor functional, nutritional and health status, and institutionalization. PS-OD prevalence on admission and at the three-month follow-up was very high in the study population. PS-OD is a dynamic condition with some spontaneous recovery in patients with optimal functional status, but also new signs/symptoms can appear due to poor functionality. Regular PS-OD monitoring is needed to identify patients at risk of nutritional and respiratory complications.

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