Irene Ciancarelli, Caterina Pistarini, Antonio Carolei and Maria Giuliana Tozzi Ciancarelli
Oxidative stress was investigated in 10 post-acute stroke patients (median age 76.40 ± 2.09 years) assigned to in-hospital neurorehabilitation within 7 days of onset of a first-ever ischemic stroke. Assessments were made before and after neurorehabilitation. Outcome measures were the National Institutes of Health Stroke Scale (NIHSS), the Barthel Index (BI), the Katz Index (KI), the modified Rankin Scale (mRS) and the modified PULSES profile. Differences between scores evaluated before and after neurorehabilitation were expressed as Δ scores. Oxidative stress was assessed by measuring plasma amount of total peroxides by-products, nitrite/nitrate metabolites (NOx), total plasma antioxidant capacity (TEAC), Cu/Zn Superoxide Dismutase (Cu/ZnSOD), and serum urate concentration. Ten healthy volunteers (median age 74.30 ± 3.03 years) were recruited as controls for comparison of oxidative
markers. Neurorehabilitation was associated with an improvement (P<0.05) of all the outcome measures except the mRS score. ΔPULSES correlated negatively with ΔBI scores (r=-0.656; P=0.040). Higher plasma levels of total peroxidative by-products and NOx metabolites were found in stroke patients than in controls before neurorehabilitation (P<0.05). Their values decreased in stroke patients after neurorehabilitation and were higher than those measured in controls (P<0.05). TEAC, Cu/Zn SOD and serum urate levels were lower in stroke patients than in controls before neurorehabilitation (P<0.05). Their values increased after neurorehabilitation so that no differences were observed
comparing these values with those found in controls. Changes observed before and after neurorehabilitation in plasma NOx amount (ΔNOx) correlated positively with ΔNIHSS scores (r=0.675; P=0.032) and negatively with ΔPULSES (r=- 0.845; P=0.002). Cu/ZnSOD changes found before and after neurorehabilitation (ΔCu/Zn SOD) and ΔKI correlated positively (r=0.713; P=0.021). Our results showed that intensive neurorehabilitation may modulate oxidative stress and suggest its effectiveness in redox-mediated plasticity processes involved in the recovery of stroke-induced neurological deficits.