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Gao J, Wang X, Wan Q. One nanoparticle delivers two different neuroprotective amino acids into ischemic brain and protects against neuronal death in rat cerebral ischemia injury. Mol Cell Neurosci 2025; 133:104009. [PMID: 40194569 DOI: 10.1016/j.mcn.2025.104009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2025] [Revised: 04/02/2025] [Accepted: 04/03/2025] [Indexed: 04/09/2025] Open
Abstract
Previous studies have proven that glycine and proline are neuroprotective but have very low permeability through the blood-brain barrier (BBB), which is a major barrier to the application of these neuroprotective amino acids in the therapy of brain injury. In this study, we aimed to develop a therapeutic strategy by which one chitosan nanoparticle could deliver two different neuroprotective amino acids, glycine and proline, into the rat ischemic brain to confer neuroprotection in a rat model of cerebral ischemia-reperfusion (I/R) injury. Using the ion cross-linking method, we developed a preparation in which one chitosan nanoparticle was simultaneously loaded with glycine and proline (AA-NPs). We evaluated the therapeutic potential of AA-NPs in both cell and animal models of cerebral ischemic stroke. We found that the levels of glycine and proline were decreased in the brain tissues of I/R rats. AA-NPs delivered both glycine and proline into the ischemic brain and reduced ischemic neuronal death in both in vitro and in vivo. These results indicated that the dual delivery of glycine and proline via AA-NPs mediated neuroprotective effects, as evidenced by the reduction of neuronal death in both cellular and animal models of ischemic stroke. AA-NPs provide an efficient and potential delivery strategy by which multiple neuroprotective amino acids can be transported into the ischemic brain simultaneously for the treatment of ischemic stroke.
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Affiliation(s)
- Jingchen Gao
- Faculty of Life and Health Sciences, Shenzhen University of Advanced Technology, Shenzhen, China
| | - Xiyuran Wang
- Faculty of Life and Health Sciences, Shenzhen University of Advanced Technology, Shenzhen, China
| | - Qi Wan
- Faculty of Life and Health Sciences, Shenzhen University of Advanced Technology, Shenzhen, China.
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Siotto M, Guerrini A, Cocco C, Germanotta M, Fasano A, Cipollini V, Cortellini L, Pavan A, Insalaco S, Antonacci E, Ruco E, Mosca R, Graziosi A, Spatola P, Malanga MR, Campana B, Aprile IG. Malnutrition Diagnosis and Food Consumption in Subacute Post-Stroke Patients During Rehabilitation. Nutrients 2024; 16:3589. [PMID: 39519422 PMCID: PMC11547535 DOI: 10.3390/nu16213589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2024] [Revised: 10/16/2024] [Accepted: 10/18/2024] [Indexed: 11/16/2024] Open
Abstract
BACKGROUND Stroke survivors frequently encounter malnutrition, adversely impacting clinical outcomes. Nevertheless, malnutrition and food consumption in post-stroke patients have not been frequently assessed, and their correlation with rehabilitation outcomes remains inadequately explored. The objective of this observational study was to evaluate malnutrition at admission in these patients, assess food consumption during a six-week rehabilitation program, and analyze their correlation with rehabilitation outcomes. METHODS Subacute post-stroke patients were evaluated at admission (T0) and after a six-week rehabilitation treatment (T1). At T0, we assessed clinical and demographic characteristics, and we diagnosed malnutrition according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. Weight, BMI, hematochemical parameters, and activities of daily living with the modified Barthel Index (mBI) were evaluated at both T0 and T1; recovery was registered as a change in the mBI (ΔmBI = mBIT1 - mBIT0). Patients' food consumption was recorded through visual plate waste estimation of three meals a day, 5 days a week, for six weeks of hospitalization for rehabilitation. RESULTS A total of 109 patients completed the study (51 women, mean age 69 ± 11). According to the GLIM criteria, 105 of these patients were at risk of malnutrition, while 43 were malnourished, with 15 severely malnourished. Malnourished patients wasted more food, with respect to non-malnourished patients, as measured by visual plate waste of total meals (25 ± 17% vs. 15 ± 14%; p = 0.001) and reached a lower ΔmBI. A linear regression analysis found a significant correlation between the ΔmBI, the waste of a "second dish", which contained mainly protein, and serum albumin at admission, even after controlling for age. CONCLUSIONS Malnutrition assessed with the GLIM criteria at admission and food consumption are two important nutritional parameters to evaluate in post-stroke patients hospitalized for rehabilitation due to their association with recovery.
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Affiliation(s)
- Mariacristina Siotto
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143 Florence, Italy; (A.G.); (C.C.); (M.G.); (A.F.); (V.C.); (L.C.); (A.P.); (S.I.); (E.A.); (E.R.); (R.M.); (A.G.); (P.S.); (M.R.M.); (B.C.); (I.G.A.)
| | - Alessandro Guerrini
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143 Florence, Italy; (A.G.); (C.C.); (M.G.); (A.F.); (V.C.); (L.C.); (A.P.); (S.I.); (E.A.); (E.R.); (R.M.); (A.G.); (P.S.); (M.R.M.); (B.C.); (I.G.A.)
- Department of Science and Technology for Humans and the Environment, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Carola Cocco
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143 Florence, Italy; (A.G.); (C.C.); (M.G.); (A.F.); (V.C.); (L.C.); (A.P.); (S.I.); (E.A.); (E.R.); (R.M.); (A.G.); (P.S.); (M.R.M.); (B.C.); (I.G.A.)
| | - Marco Germanotta
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143 Florence, Italy; (A.G.); (C.C.); (M.G.); (A.F.); (V.C.); (L.C.); (A.P.); (S.I.); (E.A.); (E.R.); (R.M.); (A.G.); (P.S.); (M.R.M.); (B.C.); (I.G.A.)
| | - Alessio Fasano
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143 Florence, Italy; (A.G.); (C.C.); (M.G.); (A.F.); (V.C.); (L.C.); (A.P.); (S.I.); (E.A.); (E.R.); (R.M.); (A.G.); (P.S.); (M.R.M.); (B.C.); (I.G.A.)
| | - Valeria Cipollini
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143 Florence, Italy; (A.G.); (C.C.); (M.G.); (A.F.); (V.C.); (L.C.); (A.P.); (S.I.); (E.A.); (E.R.); (R.M.); (A.G.); (P.S.); (M.R.M.); (B.C.); (I.G.A.)
| | - Laura Cortellini
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143 Florence, Italy; (A.G.); (C.C.); (M.G.); (A.F.); (V.C.); (L.C.); (A.P.); (S.I.); (E.A.); (E.R.); (R.M.); (A.G.); (P.S.); (M.R.M.); (B.C.); (I.G.A.)
| | - Arianna Pavan
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143 Florence, Italy; (A.G.); (C.C.); (M.G.); (A.F.); (V.C.); (L.C.); (A.P.); (S.I.); (E.A.); (E.R.); (R.M.); (A.G.); (P.S.); (M.R.M.); (B.C.); (I.G.A.)
| | - Sabina Insalaco
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143 Florence, Italy; (A.G.); (C.C.); (M.G.); (A.F.); (V.C.); (L.C.); (A.P.); (S.I.); (E.A.); (E.R.); (R.M.); (A.G.); (P.S.); (M.R.M.); (B.C.); (I.G.A.)
| | - Erika Antonacci
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143 Florence, Italy; (A.G.); (C.C.); (M.G.); (A.F.); (V.C.); (L.C.); (A.P.); (S.I.); (E.A.); (E.R.); (R.M.); (A.G.); (P.S.); (M.R.M.); (B.C.); (I.G.A.)
| | - Elisabetta Ruco
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143 Florence, Italy; (A.G.); (C.C.); (M.G.); (A.F.); (V.C.); (L.C.); (A.P.); (S.I.); (E.A.); (E.R.); (R.M.); (A.G.); (P.S.); (M.R.M.); (B.C.); (I.G.A.)
| | - Rita Mosca
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143 Florence, Italy; (A.G.); (C.C.); (M.G.); (A.F.); (V.C.); (L.C.); (A.P.); (S.I.); (E.A.); (E.R.); (R.M.); (A.G.); (P.S.); (M.R.M.); (B.C.); (I.G.A.)
| | - Adriana Graziosi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143 Florence, Italy; (A.G.); (C.C.); (M.G.); (A.F.); (V.C.); (L.C.); (A.P.); (S.I.); (E.A.); (E.R.); (R.M.); (A.G.); (P.S.); (M.R.M.); (B.C.); (I.G.A.)
| | - Piera Spatola
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143 Florence, Italy; (A.G.); (C.C.); (M.G.); (A.F.); (V.C.); (L.C.); (A.P.); (S.I.); (E.A.); (E.R.); (R.M.); (A.G.); (P.S.); (M.R.M.); (B.C.); (I.G.A.)
| | - Maria Rosaria Malanga
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143 Florence, Italy; (A.G.); (C.C.); (M.G.); (A.F.); (V.C.); (L.C.); (A.P.); (S.I.); (E.A.); (E.R.); (R.M.); (A.G.); (P.S.); (M.R.M.); (B.C.); (I.G.A.)
| | - Biagio Campana
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143 Florence, Italy; (A.G.); (C.C.); (M.G.); (A.F.); (V.C.); (L.C.); (A.P.); (S.I.); (E.A.); (E.R.); (R.M.); (A.G.); (P.S.); (M.R.M.); (B.C.); (I.G.A.)
| | - Irene Giovanna Aprile
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143 Florence, Italy; (A.G.); (C.C.); (M.G.); (A.F.); (V.C.); (L.C.); (A.P.); (S.I.); (E.A.); (E.R.); (R.M.); (A.G.); (P.S.); (M.R.M.); (B.C.); (I.G.A.)
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Madsen TE, Liu S. Amino acid neurotransmitters and prognosis after stroke: nutrition as a modifiable factor to improve stroke outcomes. Am J Clin Nutr 2023; 118:737-738. [PMID: 37793741 DOI: 10.1016/j.ajcnut.2023.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 07/21/2023] [Indexed: 10/06/2023] Open
Affiliation(s)
- Tracy E Madsen
- Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI, United States; Department of Epidemiology and Center for Global Cardiometabolic Health, Brown University School of Public Health, Providence, RI, United States.
| | - Simin Liu
- Department of Epidemiology and Center for Global Cardiometabolic Health, Brown University School of Public Health, Providence, RI, United States; Department of Medicine, Alpert Medical School of Brown University, Providence, RI, United States; Department of Surgery, Alpert Medical School of Brown University, Providence, RI, United States
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Gao Z, Chen H. Advances in the beneficial effects of nutrition on stroke-related Sarcopenia: A narrative review. Medicine (Baltimore) 2023; 102:e34048. [PMID: 37327307 PMCID: PMC10270533 DOI: 10.1097/md.0000000000034048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 05/30/2023] [Indexed: 06/18/2023] Open
Abstract
Stroke is one of the most common causes of disability in adults. Sarcopenia is a syndrome characterized by progressive systemic muscle loss and functional decline. The decrease in skeletal muscle mass and muscle function throughout the body after stroke cannot be explained by neurological motor disorders due to brain injury alone, it is considered to be a secondary sarcopenia known as stroke-related sarcopenia. Mounting evidences showed that stroke-related sarcopenia might promote the occurrence and development of sarcopenia through various pathogenesis such as muscle atrophy, dysphagia, inflammation, and malnutrition, etc. At present, the main indicators used to assess malnutrition in patients with stroke-related sarcopenia include temporalis muscle thickness, calf circumference, phase angle, geriatric nutritional risk index and mini-nutritional assessment short-form, etc. Currently, there is no particularly effective method to curb its progression, but supplementation with essential amino acids, whey protein combined with vitamin D, high energy diet, avoiding Polypharmacy, as well as increasing physical activity level and reducing sedentary lifestyle may improve the malnutrition status of stroke patients, and increase the muscle mass and skeletal muscle index, further delay or even prevent the development of stroke-related sarcopenia. This article reviews the latest research progress on the characteristics, epidemiology, pathogenesis and the role of nutrition in stroke-related sarcopenia, so as to provide reference for the clinical treatment and rehabilitation of stroke-related sarcopenia.
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Affiliation(s)
- Zhiqiang Gao
- School of Public Health, Hubei University of Medicine, Shiyan, China
| | - Hongxia Chen
- Institute of Biomedical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, China
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Lu HY, Ho UC, Kuo LT. Impact of Nutritional Status on Outcomes of Stroke Survivors: A Post Hoc Analysis of the NHANES. Nutrients 2023; 15:nu15020294. [PMID: 36678164 PMCID: PMC9864300 DOI: 10.3390/nu15020294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 12/19/2022] [Accepted: 12/28/2022] [Indexed: 01/11/2023] Open
Abstract
Stroke, a neurological emergency, is a leading cause of death and disability in adults worldwide. In acute or rehabilitative stages, stroke survivors sustain variable neurological recovery with long-term disabilities. The influence of post-stroke nutritional status on long-term survival has not been confirmed. Using the United States National Health and Nutrition Examination Survey data (2001−2010), we conducted a matched-cohort analysis (929 and 1858 participants in stroke and non-stroke groups, respectively) to investigate the influence of nutritional elements on post-stroke survival. With significantly lower nutrient consumption, the mortality risk was 2.2 times higher in stroke patients compared to non-stroke patients (Kaplan−Meier method with Cox proportional hazards model: adjusted hazard ratio, 2.208; 95% confidence interval: 1.887−2.583; p < 0.001). For several nutritional elements, the lower consumption group had significantly shorter survival than the higher consumption stroke subgroup; moreover, stroke patients with the highest 25% nutritional intake for each nutritional element, except moisture and total fat, had significantly shorter survival than non-stroke patients with the lowest 25% nutrition. Malnutrition is highly prevalent in stroke patients and is associated with high mortality rates. The dynamic change in energy requirements throughout the disease course necessitates dietary adjustment to ensure adequate nutritional intake.
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Affiliation(s)
- Hsueh-Yi Lu
- Department of Industrial Engineering and Management, National Yunlin University of Science and Technology, Yunlin 640, Taiwan
| | - Ue-Cheung Ho
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital Yunlin Branch, Yunlin 640, Taiwan
| | - Lu-Ting Kuo
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital Yunlin Branch, Yunlin 640, Taiwan
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei 100, Taiwan
- Correspondence: ; Tel.: +886-2-2312-3456
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Fang WJ, Zheng F, Zhang LZ, Wang WH, Yu CC, Shao J, Wu YJ. Research progress of clinical intervention and nursing for patients with post-stroke dysphagia. Neurol Sci 2022; 43:5875-5884. [PMID: 35661279 PMCID: PMC9166186 DOI: 10.1007/s10072-022-06191-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 05/31/2022] [Indexed: 11/29/2022]
Abstract
Post-stroke dysphagia (PSD) is a common and costly complication of stroke and is associated with increased mortality, morbidity, and hospitalization. Although most patients can spontaneously resume swallowing, there are still many patients who do not recover and even die. Despite multiple advances in the acute treatment and secondary prevention of stroke, the effective treatment of PSD remains a neglected area. Studies have shown that repair mechanisms of neurostimulation techniques and increased cortical activity play an important role in the treatment of PSD. In addition, nutritional interventions are also crucial for the treatment of malnutrition in PSD patients. Therefore, this article reviews the effects of the current main clinical treatment methods and nutritional interventions on the treatment and rehabilitation of PSD patients. It also emphasized the necessity of developing an individualized care plan for PSD patients, which is of great significance to promote the clinical treatment, nutritional status, prognosis, and quality of life of PSD patients.
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Affiliation(s)
- Wen-Juan Fang
- Department of Neurology, The Second People's Hospital of Hefei, Heifei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, 230011, China
| | - Fei Zheng
- Department of Neurology, The Second People's Hospital of Hefei, Heifei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, 230011, China
| | - Lin-Zhi Zhang
- Department of Neurology, The Second People's Hospital of Hefei, Heifei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, 230011, China
| | - Wen-Hui Wang
- Department of Neurology, The Second People's Hospital of Hefei, Heifei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, 230011, China
| | - Cheng-Chen Yu
- Department of Neurology, The Second People's Hospital of Hefei, Heifei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, 230011, China
| | - Juan Shao
- Department of Neurology, The Second People's Hospital of Hefei, Heifei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, 230011, China
| | - Yi-Jin Wu
- The Second Affiliated Hospital of Wannan Medical College, Wuhu, 241000, Anhui, China.
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Sallehuddin H, Ong T, Md. Said S, Ahmad Tarmizi NA, Loh SP, Lim WC, Nadarajah R, Lim HT, Mohd Zambri NH, Ho YY, Shariff Ghazali S. Non-pharmacological interventions for bone health after stroke: A systematic review. PLoS One 2022; 17:e0263935. [PMID: 35196338 PMCID: PMC8865685 DOI: 10.1371/journal.pone.0263935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 01/30/2022] [Indexed: 11/26/2022] Open
Abstract
Objective To examine the effectiveness and safety of non-pharmacological interventions to reduce bone loss among post-stroke adult patients. Data sources Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database for Systematic Reviews, MEDLINE, CINAHL, ScienceDirect, Scopus, PubMed and PeDRO databases were searched from inception up to 31st August 2021. Methods A systematic review of randomized controlled trials, experimental studies without randomization and prospective cohort studies with concurrent control of non-pharmacological interventions for adult stroke patients compared with placebo or other stroke care. The review outcomes were bone loss, fall and fracture. The Cochrane Risk of Bias Tools were used to assess methodological quality, and Grading of Recommendations, Assessment, Development and Evaluations Framework to assess outcome quality. Synthesis Without Meta-Analysis (SWiM) was used for result synthesis. Results Seven studies (n = 453) were included. The methodological and outcome qualities varied from low to moderate. There were statistically significant changes between the intervention and parallel/placebo group in bone mineral density, bone mineral content, cortical thickness and bone turnover markers with specific physical and vibration therapies (p<0.05). Falls were higher in the intervention group, but no fracture was reported. Conclusion There was low to moderate evidence that physical and vibration therapies significantly reduced bone loss in post-stroke patients at the expense of a higher falls rate. The sample size was small, and the interventions were highly heterogeneous with different duration, intensities and frequencies. Despite osteoporosis occurring with ageing and accelerated by stroke, there were no studies on vitamin D or protein supplementation to curb the ongoing loss. Effective, high-quality non-pharmacological intervention to improve post-stroke bone health is required.
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Affiliation(s)
- Hakimah Sallehuddin
- Geriatric Medicine Unit, Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
- Malaysian Research Institute on Ageing (MyAgeingTM), Universiti Putra Malaysia, Selangor, Malaysia
- * E-mail:
| | - Terence Ong
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Salmiah Md. Said
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | | | - Siew Ping Loh
- Department of Internal Medicine, Malacca Hospital, Malacca, Malaysia
| | - Wan Chieh Lim
- Department of Internal Medicine, Taiping Hospital, Perak, Malaysia
| | - Reena Nadarajah
- Department of Internal Medicine, Selayang Hospital, Selangor, Malaysia
| | - Hong Tak Lim
- Department of Internal Medicine, Tuanku Jaafar Hospital, Negeri Sembilan, Malaysia
| | | | - Yun Ying Ho
- Department of Internal Medicine, Tengku Ampuan Rahimah Hospital, Selangor, Malaysia
| | - Sazlina Shariff Ghazali
- Malaysian Research Institute on Ageing (MyAgeingTM), Universiti Putra Malaysia, Selangor, Malaysia
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
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Nutritional Supplements and Neuroprotective Diets and Their Potential Clinical Significance in Post-Stroke Rehabilitation. Nutrients 2021; 13:nu13082704. [PMID: 34444864 PMCID: PMC8399756 DOI: 10.3390/nu13082704] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/29/2021] [Accepted: 08/03/2021] [Indexed: 12/23/2022] Open
Abstract
Nutrition and rehabilitation are crucial in post-stroke recovery, especially in the elderly. Since stroke is the leading cause of long-term disability, there is a need to promote special, individually tailored nutrition strategies targeting older patients with low motor ability. Chronic stroke survivors have higher risk of developing nutrition-related chronic diseases, such as sarcopenia, anemia, type 2 diabetes mellitus and osteoporosis. Moreover, reduced motor activity, cognitive impairment and depression might be aggravated by poor malnutrition status. Accumulated data suggest that nutritional supplements and neuroprotective diets can be associated with better effectiveness of post-stroke rehabilitation as well as brain recovery. Therefore, this review focuses on preventive strategies that can improve dietary intake and change dietary patterns. We highlight the importance of neuroprotective diets, the problem of dysphagia and the role of nutrition in rehabilitation. This article focuses on potential nutritional supplements and neuroprotective diets that may have an impact on functional recovery during and after rehabilitation. Moreover, a new approach to post-stroke neuroplasticity including the use of agents from marine sources such as fucoxanthin and tramiprosate as compounds that might be used as potential neuroprotectants with antioxidative and anti-inflammatory properties is introduced.
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Serotonin Levels and Cognitive Recovery in Patients with Subacute Stroke after Rehabilitation Treatment. Brain Sci 2021; 11:brainsci11050642. [PMID: 34063444 PMCID: PMC8156601 DOI: 10.3390/brainsci11050642] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/04/2021] [Accepted: 05/11/2021] [Indexed: 11/29/2022] Open
Abstract
Post-stroke depression and cognitive impairment are common conditions affecting patients after stroke. Serotonin is a neurotransmitter involved in modulating, among others, mood, cognition, learning, and memory. Sub-optimal serotonin activity may be in part responsible for cognitive deficits seen in depression. In this pilot study serotonin levels were evaluated in 29 patients with sub-acute stroke before and after a rehabilitation treatment (consisting of a program of upper limb robotic rehabilitation in addition to conventional physical therapy treatment). We employed the Back Depression Inventory scale to evaluate symptoms of depression, and specific tools to evaluate cognitive functions. We found a significant reduction of the serotonin levels after rehabilitation in the whole group (T0: 85.9 ± 92.4 ng/mL; T1: 61.9 ± 58.4 ng/mL; p = 0.0018), as well as in the subgroup of patients untreated with Selective Serotonin Reuptake Inhibitors (SRRI), (mean serotonin at T0: 154.0 ± 102.3 ng/mL; mean serotonin at T1: 92.9. ± 68.7 ng/mL at T1; p = 0.005). We also found a correlation with cognitive assessment: in particular, the change from baseline of the serotonin (ΔSerotonin) was correlated with the changes from baseline of the Rey’s Figure (ΔROCF) (r = 0.535; p < 0.05), the Tower of London (ΔToL) (subscore point: r = 0.621; p < 0.005; subscore time: r = −0.619; p < 0.005) meaning that a serotonin levels decrease is associated with a worsening of cognitive functions. Considering patients treated and untreated with SSRIs separately, in patients treated with SSRIs (n = 16) we found only a positive correlation between ∆Serotonin and ∆ToL (subscore point: r= 0.587; p = 0.045), whereas in patients untreated with SSRIs (n = 13) we found a positive correlations between ΔSerotonin and ΔROCF (r = 0.700; p = 0.036), ∆Stroop (subscore time: r = 0.750; p = 0.020) and ∆Tol (subscore point: r = 0.740; p = 0.023) and a negative correlation between ΔSerotonin and ∆Tol (subscore time: r= −0.833; p = 0.005). These results suggest that variation of serotonin levels should be monitored in patients during a rehabilitation program, not only for their relationship with depression symptoms, but also for the correlation with cognitive performance.
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The Identification and Verification of Key Long Noncoding RNAs in Ischemic Stroke. BIOMED RESEARCH INTERNATIONAL 2021; 2020:2094320. [PMID: 33490236 PMCID: PMC7789472 DOI: 10.1155/2020/2094320] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 11/30/2020] [Accepted: 12/21/2020] [Indexed: 12/13/2022]
Abstract
Stroke is a neurological disease with high rates of mortality and disability. The pathogenesis of stroke is acute focal injury of the central nervous system, leading to impaired neural function. Ischemic stroke accounts for the majority of cases. At present, the exact molecular mechanism of ischemic stroke remains unclear. Studies have shown that long noncoding RNAs (lncRNAs) have an important regulatory role in biological processes, participating in the regulation of transcription and affecting the processing and splicing of mRNAs. Abnormal lncRNA expression is associated with various diseases, including diseases of the nervous system. To identify and verify the key lncRNAs in ischemic stroke, we downloaded gene expression data from the National Center for Biotechnology Information Gene Expression Omnibus (NCBI GEO) and obtain differentially expressed lncRNAs, miRNAs, and mRNAs by bioinformatics analysis. Cytoscape was used to reconstruct a lncRNA-miRNA-mRNA network on the basis of the competitive endogenous RNA theory. We performed Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses of the mRNAs regulated by lncRNAs in the lncRNA-miRNA-mRNA network. The resulting lncRNA-miRNA-mRNA network was composed of 91 lncRNA nodes, 70 mRNA nodes, 21 miRNA nodes, and 288 edges. GO analysis and KEGG pathway analysis have shown that 191 GO terms and 23 KEGG pathways were enriched. Finally, we found that four key lncRNAs were highly correlated with ischemic stroke and could be used as potential new targets for treatment.
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