Department of Internal Medicine, Public Health, Environmental and Life Sciences, University of L'Aquila, Piazzale Salvatore Tommasi, 67100, L'Aquila Italy.
Curr Neurovasc Res. 2012 Nov;9(4):266-73. doi: 10.2174/156720212803530717.
We investigated in post-acute ischemic stroke patients the influence of intensive neurorehabilitation on oxidative stress balance during recovery of neurological deficits. For this purpose, fourteen patients were included in the study within 30 days of stroke onset. Outcome measures were the National Institutes of Health Stroke Scale (NIHSS), the modified Rankin Scale (mRS), the Barthel Index, and the Katz Index. Redox balance was assessed by measuring plasma peroxidative by-products, nitrite/nitrate metabolites (NOx), as an index of nitric oxide (NO), Cu/Zn Superoxide Dismutase (Cu/Zn SOD) activity, serum urate concentration, autoantibodies against ox-LDL (OLAB) serum level and plasma antioxidant capacity. Assessments were made before and after neurorehabilitation. Fifteen apparently healthy controls were investigated to compare redox markers. Intensive neurorehabilitation was associated with an improvement of all the outcome measures (P < 0.05). Decreased values of peroxidative by-products and of NOx (P < 0.05) were observed after neurorehabilitation in stroke patients even though their values were higher than in controls (P < 0.05). Changes observed before and after neurorehabilitation in NIHSS scores (Δ NIHSS scores) and in plasma NOx amount (Δ NOx) correlated positively (r=0.79; P < 0.005). No differences in EC-SOD activity, OLAB and serum urate concentrations were found between stroke patients and controls, before and after neurorehabilitation. Total plasma antioxidant capacity, lower in stroke patients than in controls before neurorehabilitation, was unchanged thereafter. Our data provide evidence of the effectiveness of neurorehabilitation on reducing redox unbalance in stroke patients and hints the role of NO as a messenger involved in post-ischemic neuronal plasticity influencing recovery of neurological deficits.
我们在急性缺血性脑卒中患者中研究了强化神经康复对神经功能缺损恢复过程中氧化应激平衡的影响。为此，在脑卒中发病后 30 天内，我们纳入了 14 名患者进行研究。研究的结果评估指标包括国立卫生研究院卒中量表（NIHSS）、改良Rankin 量表（mRS）、Barthel 指数和 Katz 指数。通过测量血浆过氧化物产物、亚硝酸盐/硝酸盐代谢物（NOx），作为一氧化氮（NO）的指标、Cu/Zn 超氧化物歧化酶（Cu/Zn SOD）活性、血清尿酸浓度、抗 ox-LDL（OLAB）的自身抗体血清水平和血浆抗氧化能力来评估氧化还原平衡。在神经康复前后进行评估。为了比较氧化还原标志物，我们还对 15 名健康对照者进行了调查。强化神经康复与所有结果评估指标的改善相关（P＜0.05）。尽管脑卒中患者的过氧化物产物和 NOx 值高于对照组（P＜0.05），但神经康复后这些值仍有所下降（P＜0.05）。神经康复前后 NIHSS 评分变化（Δ NIHSS 评分）和血浆 NOx 量变化（Δ NOx）呈正相关（r=0.79；P＜0.005）。神经康复前后，脑卒中患者和对照组之间的 EC-SOD 活性、OLAB 和血清尿酸浓度均无差异。神经康复前，脑卒中患者的总血浆抗氧化能力低于对照组，此后保持不变。我们的数据提供了神经康复可降低脑卒中患者氧化还原失衡的证据，并提示 NO 作为一种信使参与缺血后神经元可塑性，影响神经功能缺损的恢复。
