Havlovska Yaroslava Yu, Lytvynenko Nataliya V, Shkodina Anastasiia D
Department of Neurological Diseases, Poltava State Medical University, Poltava 36007, Ukraine.
Neurological Department, Municipal Enterprise "1 City Clinical Hospital of Poltava City Council", Poltava, Ukraine.
Neurol Res Int. 2023 Mar 15;2023:5578850. doi: 10.1155/2023/5578850. eCollection 2023.
40-70% of patients after a stroke, including a mild one, may experience cognitive impairment. Brain-derived neurotrophic factor (BDNF) plays a significant role in the pathogenesis and rehabilitation of ischemic stroke and also affects the patients' recovery prognosis. An association between cognitive impairment in the poststroke period and lower peripheral BDNF levels is known, but the prognostic significance of serum BDNF levels and clinical characteristics for the risk of developing cognitive impairment in the acute period remains uncertain. We conducted a prospective cohort study of patients in the acute phase of ischemic stroke. Clinical examination, assessment of neurological status, neuropsychological testing, and laboratory analyzes were performed on patients at 1 and 14 days after ischemic stroke. The state of cognitive functions was assessed by the Mini-Mental State Examination scale. Quantification of BDNF in blood serum was performed by solid-phaseenzyme-linked immunosorbent assay (ELISA). We found that within 14 days after an acute ischemic stroke, we found a decrease in the clinical severity of patients compared to 1 day of the onset of the disease before the start of treatment and a significant decrease in the level of BDNF in the blood serum of patients with ischemic stroke both on the first and on the 14th day. However, during the 2 weeks of the acute period, no significant changes were detected, despite the general improvement of the clinical condition. In our study, cognitive impairment was found in almost half of the patients on the first day of ischemic stroke, and there was no significant reduction in this prevalence over 2 weeks. We found that a low level of BDNF and a thrombotic subtype of ischemic stroke can be risk factors for cognitive impairment in the acute period, which can be useful in planning treatment and rehabilitation measures.
40%至70%的中风患者，包括轻度中风患者，可能会出现认知障碍。脑源性神经营养因子（BDNF）在缺血性中风的发病机制和康复过程中发挥着重要作用，也会影响患者的恢复预后。中风后认知障碍与外周BDNF水平降低之间的关联是已知的，但血清BDNF水平和临床特征对急性期发生认知障碍风险的预后意义仍不明确。我们对缺血性中风急性期患者进行了一项前瞻性队列研究。在缺血性中风后1天和14天对患者进行了临床检查、神经状态评估、神经心理学测试和实验室分析。通过简易精神状态检查表评估认知功能状态。采用固相酶联免疫吸附测定（ELISA）法对血清中的BDNF进行定量分析。我们发现，在急性缺血性中风后的14天内，与治疗开始前疾病发作1天时相比，患者的临床严重程度有所降低，且缺血性中风患者血清中BDNF水平在第1天和第14天均显著下降。然而，在急性期的2周内，尽管临床状况总体有所改善，但未检测到显著变化。在我们的研究中，几乎一半的缺血性中风患者在发病第一天就出现了认知障碍，且在2周内这一患病率没有显著降低。我们发现，BDNF水平低和缺血性中风的血栓形成亚型可能是急性期认知障碍的危险因素，这对于规划治疗和康复措施可能有用。
