Matrix metalloproteinase-9 blood level as a predictor of post-stroke cognitive impairment

Abstract

Ischemic stroke is one of the leading causes of disability of the population. Among the consequences of stroke besides motor, speech disorders, the most important cause of cognitive impairments, it’s frequency is variable between 25-40%. Post-stroke cognitive disorders are pathogenetically heterogeneous conditions. The nature, modality and severity are determined by the clinical subtype of it’s development. So, cognitive impairment most often can be a consequence of a strategic infarcts, multi-infarct damage, decompensation of chronic cerebrovascular pathology against the background of an acute condition or neurodegenerative process that existed earlier and diagnosed before the appearance of any signs of stroke. In addition, the subtype of ischemic stroke also matters. In stroke, a family of zinc-binding proteolytic enzymes, in particular matrix metalloproteinase-9, plays a significant role in the development of damage of the brain tissue, which is of great importance in the reconstruction of the extracellular matrix. A high serum concentration of metalloproteinase-9 increases the severity of ischemic damage, the severity of the stroke and worsens the functional outcome of the disease. In addition, metalloproteinase-9 is also considered as a biomarker for Alzheimer’s disease, since it acts as a proteolytic enzyme, which, along with neprilizine, cleaves the amyloid protein. The results of a survey of 135 patients in the acute and early recovery period of ischemic stroke are presented. The level of metalloproteinase-9 and cognitive impairment have been studied on 1-2 and 21-22 days of the disease. It was found that a higher level of metalloproteinase-9 in blood plasma reflects a high probability of post-stroke cognitive impairment at the end of an acute period of ischemic stroke. The increase in metalloproteinase-9 did not depend on the localization of the focus of the stroke and its volume. Thus, metalloproteinase-9 investigation in the acute period of the ischemic stroke can predict the development of post-stroke cognitive decline.