The association between serum orexin A and short-term neurological improvement in patients with mild to moderate acute ischemic stroke.

Abstract

The serum orexin A level was significantly lower among patients with acute ischemic stroke (AIS) and negatively related to the volume of the infarction, but the relationship between serum orexin A and prognosis of AIS was still unclear. We aimed to clarify the association between serum orexin A and the short-term neurological improvement in patients with mild to moderate AIS. We consecutively enrolled patients with first ever mild to moderate AIS admitted to hospital within 48h from symptom onset in this prospective observational study. The serum orexin A concentrations were determined on the second morning since the admission. The short-term neurological improvement was defined as more than 1 point decrease in the National Institute of Health Stroke Scale score within 7 days after admission. We detected increased serum orexin A level in mild to moderate AIS patients with early onset of stroke-related insomnia (33.44vs 18.66 pg/ml, p=.004) as well as in patients with short-term neurological improvement compared to those without improvement (31.78vs 16.24 pg/ml, p=.038). The serum orexin A level was positively associated with the short-term neurological improvement after adjusting for sleep condition and other related variables. Serum orexin A might be a useful biomarker for the assessment of early prognosis in patients with mild to moderate AIS.