Serum cytokine and glucose levels as predictors of poststroke fatigue in acute ischemic stroke patients

Fatigue is a common but often overlooked symptom after stroke. This study investigated whether stroke type, infarct volume, and laterality, as well as the levels of various cytokines and other blood components in the acute phase of acute ischemic stroke (AIS), can predict the level of fatigue at 6, 12, and 18 months after its onset. In 45 patients with acute stroke, serum levels of C-reactive protein, hemoglobin, glucose, and 13 cytokines were measured within 72 h of stroke onset. The cytokine measurements were performed using BioPlex XMap technology (Luminex). The acute serum levels of interleukin (IL)-1β and glucose were positively correlated with the score on the Fatigue Severity Scale (FSS) at 6 months after the stroke (r = 0.37, p = 0.015, and r = 0.37, p = 0.017, respectively). The acute serum levels of IL-ra and IL-9 were negatively correlated with FSS score at 12 months after the stroke (r = −0.38, p = 0.013, and r = −0.36, p = 0.019, respectively). The FSS score at 12 months after stroke was significantly lower in patients with radiologically confirmed infarction than in those without such confirmation (p = 0.048). The FSS score at 18 months was not correlated with any of the measured variables. High acute serum levels of glucose and IL-1β, and low IL1-ra and IL-9 may predict fatigue after AIS, indicating that the development of poststroke fatigue can be accounted for by the proinflammatory response associated with AIS. These novel findings support a new cytokine theory of fatigue after stroke. However, more research is needed to validate the results of this study

Serum levels of cytokines and C-reactive protein in acute ischemic stroke patients, and their relationship to stroke lateralization, type, and infarct volume

There is increasing evidence that inflammation plays an important role in the progression of acute ischemic stroke (AIS). The primary aims of this study were to examine the serum levels of 13 cytokines, C-reactive protein (CRP), glucose, and hemoglobin in AIS patients, and their relationship to stroke lateralization, type, and infarct volume. Forty-five patients with AIS were evaluated. Blood samples were taken within 72 h, and volumetric analyses performed within 1–7 days after AIS onset. Cytokines were measured in serum from all patients and from 40 control subjects using Luminex Bio-Plex XMap technology. The levels of interleukin (IL)-1ra (p < 0.001), IL-6 (p < 0.001), IL-8 (p < 0.001), IL-9 (p = 0.038), IL-10 (p = 0.001), IL-12 (p = 0.001), IL-18 (p < 0.001), and GRO-α (CXCL1) (p = 0.017) were significantly higher in the AIS patients than in the controls. The IL-8 level was significantly correlated with age in the patient group (r = 0.52, p < 0.001). None of the variables were found to be associated with stroke lateralization. Infarct volume was significantly positively correlated with CRP level (r = 0.47, p = 0.005). Patients with radiologically confirmed infarctions had significantly elevated serum levels of GRO-α (p = 0.023). The cytokine profile of the AIS patients supports not only earlier findings of a proinflammatory response but also early activation of endogenous immunosuppressive mechanisms. Novel findings of this study are elevated serum levels of IL-9 and GRO-α. Elevated GRO-α in AIS patients with radiologically confirmed infarctions suggests that GRO-α is specific for stroke of known etiology. Our results indicate that CRP plays an important role in the progression of cerebral tissue injury

Validert oversettelse av NIHSS med kulturell tilpasning

Bakgrunn: National Institutes of Health Stroke Scale (NIHSS) er et anerkjent amerikansk skåringsverktøy som benyttes av helsepersonell for å kartlegge nevrologiske utfall ved mistanke om hjerneslag. Testen har vært anvendt av sykepleiere og leger på slagenheter i Norge siden 1990-tallet. Den norske versjonen av NIHSS som brukes i dag, er ikke validert. Hensikt: Å redegjøre for validert oversettelse og kulturell tilpasning av NIHSS. Metode: En prosjektgruppe bestående av sykepleiere og leger fra slagenheter i Vestre Viken HF gjennomførte, i samarbeid med Universitetet i Sørøst-Norge og en profesjonell translatør, en validert oversettelse av NIHSS med kulturell tilpasning. Oversettelsesprosessen fulgte trinnene i ReKS' modifiserte oversettelsesmetode. Vi gjennomførte en pilottest der flere slagenheter deltok. Resultat: Den validerte NIHSS-versjonen samsvarte i stor grad med den ikke-validerte når det gjaldt begrepsbruken. Beskrivelsen IT (ikke testbar) i validert NIHSS samsvarer med den originale NIHSS-versjonen. Bilder og tekstark fra original NIHSS ble inkludert i den validerte NIHSS-versjonen med noen justeringer. Totalskår og tidsbruk ved skåring var sammenliknbare med den ikke-validerte NIHSS-versjonen. Konklusjon: Validering av NIHSS var påkrevd for å sikre kulturell tilpasning og språk fra den amerikanske originalversjonen. Viktige faktorer i valideringsprosessen var å involvere slagenheter, prøve ut et pilotprosjekt og sette sammen prosjektgruppen med erfarne leger og sykepleiere. Resultatet er en norsk validert versjon av NIHSS med veileder som er tro mot den originale amerikanske versjonen og samtidig harmonisert i henhold til den ikkevaliderte eksisterende versjonen