Don Carlo Gnocchi ONLUS Foundation, P.le Morandi 6, 20121, Milan, Italy.
AFaR Division, Service of Medical Statistics and Information Technology, Fatebenefratelli Foundation for Health Research and Education, Lungotevere de' Cenci, 5, Rome, Italy.
J Neural Transm (Vienna). 2017 Dec;124(12):1557-1566. doi: 10.1007/s00702-017-1805-9. Epub 2017 Oct 30.
Patients affected by stroke, particularly subacute stroke patients, often complain of neuropathic pain (NP), which may severely impair their quality of life. The aim of this exploratory study was to characterize NP and to investigate whether there is a correlation between NP and serum brain-derived neurotrophic factor (BDNF) and serum markers of oxidative stress. We enrolled 50 patients divided in subacute (< 90 days from stroke onset) and chronic (> 90 and 180 < days from stroke onset). The Barthel Index, Deambulation Index, and Short Form 36 were used to assess the patients' degree of disability and quality of life. Pain-specific tools, namely the Numeric Rating Scale (NRS), Neuropathic Pain Diagnostic questionnaire (DN4), and Neuropathic Pain Symptom Inventory (NPSI), were also used. Serum levels of BDNF and markers of oxidative stress and of metal status were evaluated: copper, iron, transferrin, ferritin, ceruloplasmin concentration (iCp) and activity (eCp), Total Antioxidant status (TAS), Cp/Tf ratio, eCp/iCp ratio, and non-ceruloplasmin bound copper (Non-Cp Cu). We found the highest value of BDNF in subacute with NP (DN4 score ≥ 4). The TAS, Cp/Tf ratio, and eCp/iCp not only fell outside the normal reference range in a high percentage of subacute and chronic patients, but were also found to be related to specific NP symptoms. These preliminary results reveal altered BDNF and oxidative stress indices in subacute stroke patients who complain of NP. These investigative findings may shed more light on the mechanisms underlying NP and consequently lead to a more tailored therapeutic and/or rehabilitation procedure of subacute stroke patients.
患有中风的患者，尤其是亚急性中风患者，常抱怨患有神经性疼痛（NP），这可能严重影响他们的生活质量。本探索性研究旨在描述 NP 并探讨 NP 是否与血清脑源性神经营养因子（BDNF）和血清氧化应激标志物之间存在相关性。我们招募了 50 名患者，分为亚急性（中风发作后<90 天）和慢性（中风发作后>90 天和 180 天<）期。使用巴氏指数、行走指数和简短表格 36 来评估患者的残疾程度和生活质量。还使用了疼痛特异性工具，即数字评分量表（NRS）、神经性疼痛诊断问卷（DN4）和神经性疼痛症状量表（NPSI）。评估了血清 BDNF 和氧化应激及金属状态标志物水平：铜、铁、转铁蛋白、铁蛋白、铜蓝蛋白浓度（iCp）和活性（eCp）、总抗氧化状态（TAS）、Cp/Tf 比值、eCp/iCp 比值和非铜蓝蛋白结合铜（Non-Cp Cu）。我们发现伴有 NP（DN4 评分≥4）的亚急性患者的 BDNF 值最高。TAS、Cp/Tf 比值和 eCp/iCp 不仅在高比例的亚急性和慢性患者中超出了正常参考范围，而且还与特定的 NP 症状有关。这些初步结果揭示了亚急性中风患者中 BDNF 和氧化应激指标的改变，这些患者抱怨患有 NP。这些研究结果可能更深入地了解 NP 的发病机制，并因此导致对亚急性中风患者进行更具针对性的治疗和/或康复程序。
