Predictive value of melatonin and serotonin levels in early recovery period of cerebral ischemic hemispheric stroke
DOI:
https://doi.org/10.14739/2310-1237.2017.2.109292Keywords:
cerebral infarction, serotonin, melatonin, prognosisAbstract
The aim was developing of criteria for prediction of the early recovery period outcome of cerebral ischemic hemispheric stroke (CIHS) on the base of the identification of serum concentration of melatonin and plasma level of serotonin.
Materials and methods: complex clinical and paraclinical investigation was carried out in 77 patients (the average age of patients was 57.9 ± 0.9 years) on early recovery period of CHIS using of clinical scales (National Institute of Health Stroke Scale, Barthel Index, modified Rankin Scale) on the 10th, 30th, 90th and 180th day of disease, and visualization of cerebral structures by CT scan, and identification of the serum concentration of melatonin and serotonin plasma level on the 10th, 30th day of disease, and also by the calculation of the melatonin/serotonin ratio (MSR) as serum concentration of melatonin divided by serotonin plasma level.
Results. Using the comparative ROC-analysis it was defined that the most informative parameters for prediction of moderate and severe disability as for value according to mRS ≥ 3 points on the 180th day are the level of MSR on the 30th day (AUC = 0.78, p < 0.05), serotonin plasma level on the 30th day (AUC = 0.74, p < 0.05), dynamics of serum concentration of melatonin on the 30th day (AUC = 0.67, p < 0.05), dynamics of serotonin plasma level on the 30th day (AUC = 0.67, p < 0.05), dynamics of MSR on the 30th day (AUC = 0.66, p < 0.05) and serum concentration of melatonin on the 30th day (AUC = 0.66, p < 0.05).
Conclusions. The level of MSR ˃212,0 on the 30th day was the predictor of moderate and profound disability for modified Rankin's scale ≥3 points on the 90th (AUC = 0.81, p ˂ 0.05; sensitivity = 100.0 %, specificity = 75.0 %) and on the 180th day of disease was (AUC = 0.78, p ˂ 0.05; sensitivity = 100.0 %, specificity = 73.3 %); the serotonin plasma level ≤0.15 mcmol/l on the 30th day of CIHS was the predictor of moderate and profound disability for modified Rankin's scale ≥3 points on the 180th day of disease (AUC = 0.74, p ˂ 0.05; sensitivity = 60.0 %, specificity = 86.7 %).
References
Shilonosova, I. V. (2012) Serotonintransportnaya sistema v ostrejshem periode tyazhologo aterotromboticheskogo ishemicheskogo insul'ta [Serotonin a transport system in an acute period jf a serious atherothrombotic ischemic stroke]. Vrach-aspirant, 51(2.2), 335–339. [in Russian].
Reuter, B., Gumbinger, C., Sauer, T., Wiethölter, H., Bruder, I., Diehm, C., et al. (2016) Access, timing and frequency of very early stroke rehabilitation - insights from the Baden-Wuerttemberg stroke registry. BMC Neurol, 16, 222. doi: 10.1186/s12883-016-0744-7.
Wu, L., Wang, A., Wang, X., Zhao, X., Wang, C., Liu, L., et al. (2015) Factors for short-term outcomes in patients with a minor stroke: results from China National Stroke Registry. BMC Neurol, 15, 253. doi: 10.1186/s12883-015-0505-z.
Qin, L., Zhao, D., Xu, J., Ren, X., Terwilliger, E.F., Parangi, S., et al. (2013). The vascular permeabilizing factors histamine and serotonin induce angiogenesis through TR3/Nur77 and subsequently truncate it through thrombospondin–1. Blood, 121(11), 2154–2164. doi: 10.1182/blood-2012-07-443903.
Juan, W. S., Huang, S. Y., Chang, C. C., Hung, Y. C., Lin, Y. W., Chen, T. Y., et al. (2014) Melatonin improves neuroplasticity by upregulating the growth-associated protein-43 (GAP-43) and NMDAR postsynaptic density-95 (PSD-95) proteins in cultured neurons exposed to glutamate excitotoxicity and in rats subjected to transient focal cerebral ischemia even during a long-term recovery period. J Pineal Res, 56(2), 213–223. doi: 10.1111/jpi.12114.
Chumboatong, W., Thummayot, S., Govitrapong, P., Tocharus, C., Jittiwat, J., & Tocharus, J. (2017) Neuroprotection of agomelatine against cerebral ischemia/reperfusion injury through an antiapoptotic pathway in rat. Neurochem Int, 102, 114–122. doi: 10.1016/j.neuint.2016.12.011.
Parada, E., Buendia, I., León, R., Negredo, P., Romero, A., Cuadrado, A., et al. (2014) Neuroprotective effect of melatonin against ischemia is partially mediated by alpha-7 nicotinic receptor modulation and HO-1 overexpression. J Pineal Res, 56(2), 204–212. doi: 10.1111/jpi.12113.
Sangha, R. S., Caprio, F. Z., Askew, R., Corado, C., Bernstein, R., Curran, Y., et al. (2015) Quality of life in patients with TIA and minor ischemic stroke. Neurology, 85(22), 1957–63. doi: 10.1212/WNL.0000000000002164.
Audhya, T., Adams, J. B., & Johansen, L. (2012) Correlation of serotonin levels in CSF, platelets, plasma, and urine. Biochim Biophys Acta, 820(10), 1496–501. doi: 10.1016/j.bbagen.2012.05.012.
Paterniti, I., Cordaro, M., Esposito, E., & Cuzzocrea, S. (2016) The antioxidative property of melatonin against brain ischemia. Expert Rev Neurother, 2016, 16(7), 841–848. doi: 10.1080/14737175.2016.1182020.
Downloads
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (SeeThe Effect of Open Access).
