Title:Oxidative Stress in Post-Acute Ischemic Stroke Patients after Intensive Neurorehabilitation
Volume: 9
Issue: 4
Author(s): Irene Ciancarelli, Daniela De Amicis, Caterina Di Massimo, Antonio Carolei and Maria Giuliana Tozzi Ciancarelli
Affiliation:
Keywords:
Intensive neurorehabilitation, ischemic stroke, neurovascular unit, neuronal plasticity, nitric oxide, peroxidative byproducts, antioxidant defences, neuroimaging, reactive oxygen species (ROS), reactive nitrogen species (RNS)
Abstract: 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.