Abstract TP378: Malondialdehyde as a Clinical Indicator for Oxidative Stress: Associations with Age, BMI, and Cognitive Impairment

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Introduction: The molecular and metabolic changes that occur after acute ischemic stroke (AIS) are not fully understood. One mechanism known to trigger systemic inflammatory responses and neuronal death during ischemic stroke cascades the rapid increase in Reactive Oxygen Species (ROS). Accumulation of oxidative stress has been shown to trigger the initiation and progression of cognitive deficits, including mild cognitive impairment (MCI) and Alzheimer’s Dementia (AD). One emerging biomarker able to reliably measure oxidative stress is Malondialdehyde (MDA), a reactive carbonyl compound originating from polyunsaturated fatty acid oxidation and lipid peroxidation. Due to its composition, MDA readily reacts with lipid membranes, making it a sensitive oxidative stress biomarker. This study assessed MDA levels in the plasma of AIS patients to evaluate its ability to predict cognitive impairment and long-term functional outcomes. Hypothesis: We hypothesized that oxidative stress correlates with long-term functional outcomes in AIS patients and varies based on non-modifiable risk factors such as sex and race. Methods: In this study, we used peripheral blood plasma from healthy volunteers (HV, N=24), and from ischemic stroke patients (N=27) at 3d and 7d post-stroke to capture the temporal profile of MDA after injury. Cognitive impairment was assessed during hospitalization with the Brief Neurocognitive Screening Test (BNST), with a score of 8 or below denoting cognitive impairment. Results: AIS patients had an increase in MDA levels compared to the control group, as seen in prior literature. There was a significant correlation with increase age of stroke patients and higher levels of MDA (p<0.05). Higher levels of oxidative stress was also associated with increased levels of cognitive impairment among the stroke population (p<0.05). There was no relationship between levels of MDA during hospitalization and functional outcome at 3 months post discharge. Conclusion: MDA appears to be a promising biomarker for oxidative stress in AIS patients, with notable associations with age and cognitive impairment. These findings underscore the possible mechanisms behind the rapid development of cognitive impairment seen in patients post stroke.