Abstract
Several key issues impact the clinical practice of stroke rehabilitation including a patient’s medical history, stroke experience, the potential for recovery, and the selection of the most effective type of therapy. Until clinicians have answers to these concerns, the treatment and rehabilitation are rather intuitive, with standard procedures carried out based on subjective estimations using clinical scales. Therefore, there is a need to find biomarkers that could predict brain recovery potential in stroke patients. This review aims to present the current state-of-the-art stroke recovery biomarkers that could be used in clinical practice. The revision of biochemical biomarkers has been developed based on stroke recovery processes: angiogenesis and neuroplasticity. This paper provides an overview of the biomarkers that are considered to be ready-to-use in clinical practice and others, considered as future tools. Furthermore, this review shows the utility of biomarkers in the development of the concept of personalized medicine. Enhancing brain neuroplasticity and rehabilitation facilitation are crucial concerns not only after stroke, but in all central nervous system diseases.
Highlights
According to the updated definition, stroke is an acute episode of neurological dysfunction caused by the cerebral, spinal cord, retinal infarction, or hemorrhage
The main goal of this review is to introduce a new approach for stroke recovery biomarkers, which are based on angiogenesis and neuroplasticity processes
Coculture provided symmetric and proliferative division of neural stem cells to produce undifferentiated stem cell sheets, generate neurons, oligodendrocytes, and astrocytes [22]. These results show that examination of vascularization in post-stroke patients may be a good biomarker for specific patients to monitor the effect of pharmacotherapy and rehabilitation
Summary
According to the updated definition, stroke is an acute episode of neurological dysfunction caused by the cerebral, spinal cord, retinal infarction, or hemorrhage (including subarachnoid hemorrhage). There are two main causes of stroke associated with its etiology: ischemia and hemorrhage. There are quite effective early treatment strategies for ischemic strokes, like intravenous tissue plasminogen activator (tPA) or endovascular thrombectomy (EVT) [4]. The time window for EVT treatment is available for all patients who arrived at the hospital within 6 h and, in particular cases, within 6–24 h (including stroke upon awakening with unknown onset time). Post-stroke rehabilitation uses selected therapies for motor function improvement like aerobic training (AE), repetitive task training (RTT), constraint-induced movement therapy (CIMT), mirror therapy, muscle strengthening, electromechanical, robot-assisted training, noninvasive brain stimulation (NIBS), and neuromuscular electrical stimulation (NMES) [7]. To maximize the post-stroke care effectiveness, coordinated effort from the medical team is required including physical and occupational therapists, speech-language pathologists, psychologists, nutritionists, recreation therapists, and others [8]. The proteins present in the manuscript could be used to determine the innovative algorithm of the procedure to evaluate an outcome of post-stroke patients and applied therapy
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