USELESS! Biomarkers don't do one damn thing for stroke recovery. Tell us EXACTLY how to increase BDNF levels to get better recovery. Don't you blithering idiots have any functioning neurons?
Send me hate mail on this: oc1dean@gmail.com. I'll print your complete statement with your name and my response in my blog. Or are you afraid to engage with my stroke-addled mind? I need an explanation of your thought processes on stroke research and why you're not solving stroke.
Article Commentary: “High-Serum Brain-Derived Neurotrophic Factor Levels Are Associated With Decreased Risk of Poststroke Cognitive Impairment”
Poststroke cognitive impairment (PSCI) is one of the most common neurological repercussions following stroke, negatively affecting patients’ life quality. The chance to identify putative PSCI markers appears to be mandatory for better refining risk prediction and deciphering the pathogenesis. Brain-derived neurotrophic factor (BDNF) is a highly relevant molecule belonging to the neurotrophin family in the central nervous system, implied in neuronal cell differentiation and survival. Although some epidemiological studies have investigated the association of serum BDNF with cognitive decline and stroke, none has been able to clearly evidence the significance of such factor on PSCI. Thus, the authors of the present study carried out a secondary retrospective analysis based on the CATIS study (China Antihypertensive Trial in Acute Ischemic Stroke) to possibly assess a relation between serum BDNF levels and the risk of PSCI.
A cohort of 593 patients with ischemic stroke with hypertension was included in this analysis. ELISA assays were performed on serum samples, determining BDNF levels. Patients with higher BDNF levels tended to be younger and drinker subjects, characterized by higher diastolic blood pressure, body mass index, and platelet counts, as well as higher prevalence of family history of stroke, high-sensitivity C–reactive protein, and lower NIHSS score, if compared to those with lower BDNF levels. The assessment of cognitive function at 3-month follow-up was carried out by means of the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MOCA). In this study, PSCI was defined by MMSE score <27 or MOCA score <25 and classified as follows: severe cognitive impairment, mild cognitive impairment, and no cognitive impairment.
According to the MMSE score, 312 participants exhibited cognitive impairment, whereof 151 patients with mild cognitive impairment and 161 patients with severe cognitive impairment. After adjustment for age, sex, education, and other potential cofounders, the odds ratio of PSCI associated with the highest tertile of serum BDNF was 0.60 (95% CI) compared to the lowest tertile. Thus, patients in the highest tertile of serum BDNF had 40% decreased risk of 3-month PSCI compared with the lowest tertile. Similar findings were observed when cognitive function was measured through the MOCA score (Figure).
Figure. Association of serum BDNF with 3-mo poststroke cognitive impairment among patients with ischemic stroke with hypertension.
By investigating age-stratified subgroups, the authors found out that high serum BDNF levels were associated with decreased risk of PSCI in most categories, independently of age. Based on data illustrated within the present study, the authors speculated that patients with low BDNF levels at admission might be at high risk of PSCI. Putative biological mechanisms implied in the association of BDNF with PSCI could refer to the TrkB-mediated neuroregeneration and neuroprotection. Therefore, BDNF/TrkB activation might mitigate the ischemic damage and foster angiogenesis, thus exerting a putative protective role.
The present research is strengthened by being the first multicenter study to investigate the association between serum BDNF and cognitive impairment after ischemic stroke, in light of a randomized clinical trial with standardized protocols and rigid quality control procedures in data collection and outcome assessment. However, the study suffers from some limitations dealing with the relatively young age of participants, the absence of data on mood disorders and sensory impairment, and the unavailability of data on cognitive function at baseline.
Comprehensively, the authors of the present study suggested that BDNF might serve as a valuable predictive biomarker for PSCI among patients with ischemic stroke with hypertension. Thus, further investigations are needed to deeply investigate the association of BDNF and PSCI, unveiling a potential role in clinical utility.
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