ASSESSMENT OF THE NEURONAL DAMAGE AND OXIDATIVE STRESS MARKERS LEVEL IN POST STROKE PATIENTS

Abstract

Relevance. 100-110 000 acute disorders of cerebral circulation are registered in Ukraine annually, about 57% of which are ischemic stroke (IS). Study of dynamics of the neuronal damage markers level and their correlation with oxidative stress indicators may be informative for estimating the prognosis of the IS recovery period.
 Objective: to study the features of of neuronal damage markers level, the pro- and antioxidant systems status and their effect on the of neurological deficiency manifestations and the functional status of post stroke patients.
 Materials and methods. 120 patients in the early recovery period of first-ever hemispheric atherothrombotic IS were examined. The control group (CG) included 20 healthy individuals, representative by age and gender. Assessment of neurological deficiency and functional status of patients was performed with the help of the NIHSS scale, the Scandinavian Stroke Scale (SSS), the modified Rankin Scale (mRS) and the Bartel Index (BI). The level of neuron-specific enolase (NSE) in serum was determined by enzyme-linked immunosorbent assay. The determination of the level of oxidative protein modification (OPM) products in serum, glutathione reductase (GR) and glutathione peroxidase (GP) activity was performed spectrophotometrically. Statistical processing of the results was carried out using Statistica 6.0 statistical analysis package (StatSoft, Inc.) with the help of nonparametric results estimation methods.
 Results. In patients after 1 month after IS an increase of AFGn (356 nm) content by 33.9% (p<0.05) compared to CG was observed. KFGn (370 nm) level was increased by 26.0% (p<0.05), AFGo (430 nm) - by 76.2% (p<0.01), CFG (530 nm) - 125.0% (p<0.01). The general OPM products was 37.0% higher than in CG (p<0.05), while the activity of GP and GR decreased by 31.6% and 28.6%, respectively (p<0, 05), and the NSE level was increased by 150.6% (p<0.05).
 The NIHSS score correlated with the level of AFGn (356 nm) (r=0.24; p=0.032), KFGo (530 nm) (r=0.41; p=0.047) and the general OPM products level (r=0.25 ; p=0.039), whereas the GR activity significantly influenced the NIHSS score (r=-0.27; p=0.048), SSS score (r=0.23; p=0.034) and BI (r=0.31; p=0.038). Also significant correlations were found between the NSE level and the concentration of all OPM products, GP ans GR activity.
 Conclusions. The NSE level increase is characteristic for the post stroke patients, which correlates with the degree of neurological deficiency manifestations and the patients’ functional status. The NSE level increases due to the increase of OPM products concentration and the decrease of GP and GR activity, which may indicate a worsening of the neuronal damage degree, linked to the pro- and antioxidant systems imbalance. These processes adversely affect the functional status of patients, with the greatest influence of the KFGo (530 nm) concentration, the general OPM products level and the GR activity.