Abstract WP466: Optimism Reduces Stroke Severity and Inflammation

Abstract

Introduction: Post-stroke inflammation is detrimental to the brain and leads to impaired recovery. Optimism has been associated with lower inflammation and better health outcomes among people with medical conditions, but no studies have assessed this association in stroke population. The overall goals were to examine the relationship between optimism, stroke severity, physical disability, and inflammation during hospitalization and to evaluate this relationship over the three-month post-stroke period. Hypothesis: Patients with higher levels of optimism have lower stroke severity on presentation, less physical disability, decreased inflammation, and better recovery during the first three months after stroke compared to those with lower levels of optimism. Methods: This pilot study is a secondary analysis of data prospectively collected from the BioRepository of Neurological Diseases biobank. Outcomes included optimism level measured by the revised Life Orientation Test (LOT-R), stroke severity evaluated via the NIHSS, physical recovery defined by the mRS, and levels of inflammatory markers (IL-6, TNFα, and CRP) assessed by ELISA. Spearman’s correlation, Wilcoxon signed-rank test, multiple linear regression, and mixed-effect regression model were used to determine the relationship among the variables. Results: The sample consisted of 49 subjects at baseline and 13 subjects at 3-month follow-up. LOT-R scores were negatively correlated with NIHSS (ρ= -.41, p=.003), mRS (ρ= -.30, p=.05), and inflammatory markers IL-6 (ρ= -.44, p=.008) and CRP (ρ= -.40, p=.02), but not with TNFα. After adjusting for potential confounders, NIHSS and CRP remained negatively correlated with the optimism level. For every unit increase of LOT-R, subject’s NIHSS scores decreased by .27 point (p=.001), mRS decreased by .11 point (p=.03), and level of CRP decreased 148.6 ng/ml (p=.02). However, LOT-R was not correlated with mRS the three-month follow-up. Conclusion: Optimistic stroke survivors showed lower inflammation, less stroke severity, and less physical disability. Although the number of patients was low in this initial cohort, understanding this relationship may provide a scientific framework whereby new strategies for stroke recovery can be developed.