SH-SS and GSH-GSSG Homeostasis in Post-stroke Patients
Study Details
Study Description
Brief Summary
In patients undergoing physical therapy after stroke, extracellular thiol-disulfide balance and intracellular oxidized-reduced glutathione balance levels will be monitored. The main objectives of this study are; (1) to determine the differences between thiol-disulfide and GSH-GSSG balances in stroke patients compared to healthy volunteers, (2) to evaluate the relationship of these balances with the severity of stroke, (3) to determine the predictive value of the levels of these balances on clinical prognosis and functional recovery outcomes, and (4) to investigate and to examine the effects of the physical therapy process on these parameters and functional recovery and their relationship with each other.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Detailed Description
Stroke is among the most common causes of all deaths and Disability-Adjusted Life Years (DALYs) in the world. There is a close relationship between stroke pathophysiology and post-stroke clinic with oxidative stress. Thiol-disulfide homeostasis systems, which is one of the important extracellular and intracellular oxidative stress markers, showing antioxidant capacity with SH form, and oxidative status with disulfide (SS) form. In this study, we aimed to evaluate the relationship between the clinical outcome of subacute stroke patients and extracellular thiol-disulfide (SH-SS) and intracellular oxidized-reduced glutathione (GSSG-GSH) homeostasis and the comparison of these with healthy volunteers. In addition, the effect of the rehabilitation program on these oxidative stress markers and clinical scores and the predictive value of these oxidative stress parameters on prognosis were also evaluated. The main objectives of this study are; (1) to determine the differences between thiol-disulfide and GSH-GSSG balances in stroke patients compared to healthy volunteers, (2) to evaluate the relationship of these balances with the severity of stroke, (3) to determine the predictive value of the levels of these balances on clinical prognosis and functional recovery outcomes, and (4) to investigate and to examine the effects of the physical therapy process on these parameters and functional recovery and their relationship with each other.
In this study, which is designed as a prospective observational study, patients with subacute stroke who have a stroke for the first time and are admitted to the hospital for the first rehabilitation treatment and healthy volunteers (control group) will be included. The clinical conditions of the patients will be evaluated at the beginning and after the 4-week rehabilitation program at the time of discharge by National Institutes of Health Stroke Scale Scores (NIHSS), modified Rankin Scale (mRS) and Barthel Daily Living Activities Index (BI). Serum and whole blood samples will be obtained from the patient group at the beginning and at discharge, and from the control group. The SH-SS homeostasis parameters (SH, Total SH, SS and SS / SH percent ratio) from serum samples and GSSG-GSH homeostasis parameters (GSH, Total GSH, GSSG and GSSG / GSH percentage ratio) from whole blood samples will be determined. Age, gender, hemiplegic side, type of stroke will be noted. Later, statistical analysis will be conducted.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| post-stroke patient patients with subacute stroke who have a stroke for the first time and admitted to the hospital for the first rehabilitation treatments |
Other: Standard neurorehabilitation
Routine post-stroke rehabilitation
Diagnostic Test: Thiol-Disulphide Homeostasis
Monitoring the levels of thiol and disulphide in serum
Diagnostic Test: Oxidized-reduced Glutathione Homeostasis
Monitoring the levels of intracellular oxidized glutathione and reduced glutathione in whole blood samples
|
| Control healthy volunteers who have not got any known disease and any sign in physical examination |
Diagnostic Test: Thiol-Disulphide Homeostasis
Monitoring the levels of thiol and disulphide in serum
Diagnostic Test: Oxidized-reduced Glutathione Homeostasis
Monitoring the levels of intracellular oxidized glutathione and reduced glutathione in whole blood samples
|
Outcome Measures
Primary Outcome Measures
- NIHSS Scores [at baseline (pre-treatment)]
National Institutes Of Health Stroke Scale Scores
- NIHSS Scores [after 4 weeks of treatment (post-treatment)]
National Institutes Of Health Stroke Scale Scores
- mRS [at baseline (pre-treatment)]
modified Rankin Scales
- mRS [after 4 weeks of treatment (post-treatment)]
modified Rankin Scales
- BI [at baseline (pre-treatment)]
Barthel Index for Activities of Daily Living
- BI [after 4 weeks of treatment (post-treatment)]
Barthel Index for Activities of Daily Living
Eligibility Criteria
Criteria
Inclusion Criteria:
-
diagnosis of a first-ever stroke verified by computed tomography (CT) or magnetic resonance imaging (MRI) reports
-
admitted to the hospital for standard neurorehabilitation within 1 to 6 months of stroke onset
-
healthy individuals (for control group)
Exclusion Criteria:
-
significant acute medical illness (e.g., autoimmune disease, infection, tumor, heart failure, renal or liver dysfunction)
-
significant acute neurological illness other than stroke (e.g., head trauma, brain abscess, brain tumor, migraine attack, seizure)
-
cannot adapt to work
-
previous history of neurorehabilitation therapy
-
taking the antioxidant supplements
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Bolu Abant Izzet Baysal University | Bolu | Turkey |
Sponsors and Collaborators
- Abant Izzet Baysal University
Investigators
- Principal Investigator: Tugba Alisik, MD, Abant Izzet Baysal University
Study Documents (Full-Text)
None provided.More Information
Publications
- Alisik, M., Neselioglu, S., & Erel, O. (2019). A colorimetric method to measure oxidized, reduced and total glutathione levels in erythrocytes, Journal of Laboratory Medicine, 43(5), 269-277
- Broderick JP, Adeoye O, Elm J. Evolution of the Modified Rankin Scale and Its Use in Future Stroke Trials. Stroke. 2017 Jul;48(7):2007-2012. doi: 10.1161/STROKEAHA.117.017866. Epub 2017 Jun 16. Review.
- Brott T, Adams HP Jr, Olinger CP, Marler JR, Barsan WG, Biller J, Spilker J, Holleran R, Eberle R, Hertzberg V, et al. Measurements of acute cerebral infarction: a clinical examination scale. Stroke. 1989 Jul;20(7):864-70.
- Erel O, Neselioglu S. A novel and automated assay for thiol/disulphide homeostasis. Clin Biochem. 2014 Dec;47(18):326-32. doi: 10.1016/j.clinbiochem.2014.09.026. Epub 2014 Oct 7.
- Küçükdeveci AA, Yavuzer G, Tennant A, Süldür N, Sonel B, Arasil T. Adaptation of the modified Barthel Index for use in physical medicine and rehabilitation in Turkey. Scand J Rehabil Med. 2000 Jun;32(2):87-92.
- AIBU-FTR-TA-01