Bad research, we don't need associations that 'may play' a role. We need defined protocols that deliver 100% recovery.
Xin Wang1,2†,
Tao Liu
1,3†,
Haixin Song
1,
Shaoyang Cui
1,
Gang Liu
1,
Andrea Christoforou
1,
Patrick Flaherty
4,
Xun Luo
5,
Lisa Wood
6 and
Qing Mei Wang
1*
- 1Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, Boston, MA, United States
- 2Department of Rehabilitation, Clinical Medical College, Yangzhou University, Yangzhou, China
- 3Clinical School of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
- 4Department of Mathematics, College of Science and Mathematics, University of Massachusetts Boston, Boston, MA, United States
- 5Kerry Rehabilitation Medicine Research Institute, Shenzhen, China
- 6William F. Connell School of Nursing, Boston College, Chestnut Hill, MA, United States
Amino acids have been shown to be among the most important
metabolites to be altered following stroke; however, they are a
double-edged sword with regard to regulating hemostasis. In this study,
we conducted a targeted metabolomic study to examine the association
between serum levels of amino acids and functional recovery after
stroke. Three hundred and fifty-one patients with stroke admitted to an
acute rehabilitation hospital were screened, and 106 patients were
selected based on inclusion and exclusion criteria. Recruited patients
were stratified using Montebello Rehabilitation Factor Score (MRFS)
efficiency. We selected the top (
n = 20, 19%) and bottom (
n
= 20, 19%) of MRFS efficiency for metabolomic analysis. A total of 21
serum amino acids levels were measured using ultra high performance
liquid chromatography and mass spectrometry. The normalized data were
analyzed by multivariate approaches, and the selected potential
biomarkers were combined in different combinations for prediction of
stroke functional recovery. The results demonstrated that there were
significant differences in leucine-isoleucine, proline, threonine,
glutamic acid, and arginine levels between good and poor recovery
groups. In the training (0.952) and test (0.835) sets, metabolite
biomarker panels composed of proline, glutamic acid, and arginine had
the highest sensitivity and specificity in distinguishing good recovery
from poor. In particular, arginine was present in the top 10
combinations of the average area under the receiver operating
characteristic curve (AUC) test set. Our findings suggest that amino
acids related to energy metabolism and excitotoxicity
may play an
important role in functional recovery after stroke. Therefore, the level
of serum arginine has predictive value for the recovery rate after
stroke.
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