Chaturvedi Poonam, Singh Ajai Kumar, Tiwari Vandana, Thacker Anup Kumar
Department of Neurology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, UP, India.
Department of Biochemistry, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, UP, India.
J Family Med Prim Care. 2020 Jul 30;9(7):3361-3369. doi: 10.4103/jfmpc.jfmpc_1051_19. eCollection 2020 Jul.
Brain-derived neurotrophic factor (BDNF) plays an important role in repairing normal as well as in the injured brain. Physical exercise may have a positive impact on the release of BDNF.
PNF is a neurophysiological approach that facilitates the stimulation of central and peripheral nervous systems. In this study, our aim was to assess the levels of BDNF as well as functional recovery before and after the intervention of PNF in patients with acute stroke.
A total of 208 patients with first time confirmed stroke were recruited and assessed for stroke severity, type, mini-mental state exam (MMSE), functional independence measure scale, and BDNF levels before and after PNF intervention. BDNF levels were also assessed in healthy individuals for control values.
A significant decline in levels of BDNF was observed after in stroke. BDNF levels in patients (with different risk factors) with diabetes, hypertension and DM+ HTN, alcohol, and smoking history were 8.8 ± 4.04 ng/mL, 8.86 ± 4.68 ng/mL, 8.65 ± 3.26 ng/mL, 8.51 ± 4.26 ng/mL, and 8.9 ± 3.4 ng/mL, respectively. A decline in BDNF levels was observed in accordance with the severity of stroke in both ischemic and hemorrhagic stroke with the least level being in severe stroke (NIHSS >15 and ICH >3). Despite the type of stroke and the presence of risk factors, a significant improvement in BDNF levels and FIM scale scores was seen in all subjects who received PNF exercises.
Thus, PNF is efficient in improving functional level in acute stroke irrespective of the type of stroke and risk factors.
脑源性神经营养因子（BDNF）在正常脑以及损伤脑的修复中发挥重要作用。体育锻炼可能对BDNF的释放产生积极影响。
本体神经肌肉促进法（PNF）是一种促进中枢和周围神经系统刺激的神经生理学方法。在本研究中，我们的目的是评估急性卒中患者在PNF干预前后的BDNF水平以及功能恢复情况。
共招募208例首次确诊卒中的患者，在PNF干预前后评估其卒中严重程度、类型、简易精神状态检查（MMSE）、功能独立性测量量表以及BDNF水平。还评估了健康个体的BDNF水平作为对照值。
卒中后观察到BDNF水平显著下降。患有糖尿病、高血压、糖尿病+高血压、有饮酒和吸烟史（具有不同风险因素）的患者的BDNF水平分别为8.8±4.04 ng/mL、8.86±4.68 ng/mL、8.65±3.26 ng/mL、8.51±4.26 ng/mL和8.9±3.4 ng/mL。在缺血性和出血性卒中中，均观察到BDNF水平根据卒中严重程度下降，严重卒中（美国国立卫生研究院卒中量表>15分和脑出血>3分）时水平最低。尽管存在卒中类型和风险因素，但所有接受PNF训练的受试者的BDNF水平和功能独立性测量量表评分均有显著改善。
因此，无论卒中类型和风险因素如何，PNF在改善急性卒中患者的功能水平方面均有效。
