Low Plasma Antioxidant Activity Is Associated With High Lesion Volume and Neurological Impairment in Stroke

Abstract

Background and Purpose-Oxidative stress is probably involved in neuronal damage induced by ischemia-reperfusion.The purpose of this study was to assess the role of antioxidant activity in cerebral ischemic stroke. Methods-Antioxidant activity of blood plasma and cerebrospinal fluid was assessed in 22 patients with cerebral hemisphere infarction that was verified and quantified by MRI. Results-Low total peroxyl radical trapping potential of plasma, but not of cerebrospinal fluid, was associated with high lesion volume and high neurological impairment assessed by scores on NIH Stroke Scale, Barthel Index, and Hand Motor Score tests. The plasma concentrations of ascorbic acid, ␣-tocopherol, and protein thiols were also associated with the degree of neurological impairment. Conclusions-These data suggest that the antioxidant activity of plasma may be an important factor providing protection from neurological damage caused by stroke-associated oxidative stress. (Stroke. 2000;31:33-39.)

Plasma Antioxidant Activity as a Marker for a Favourable Outcome in Acute Ischemic Stroke

“…It was shown that concentration of GSH decreases early after ischemia (Cooper et al, 1980;Rehncrona et al, 1980) in rats, plasma concentration of protein thiols is associated with the degree of neurological impairment (Leinonen et al, 2000), ischemic outcome is worsened by pharmacological depletion of GSH (Vanella et al, 1993). Depletion of the total GSH and decrease of GSH/GSSG ratio are markers for oxidative stress in ischemic brain and as long as 72 h may be required to restore concentrations to normal values following an ischemic insult according to (Namba et al,2001;Park et al, 2000).…”

Antioxidant supplementation enhances antioxidant capacity and mitigates oxidative damage following acute ischaemic stroke

“…A recent uncontrolled study of 22 ischaemic stroke patients reported an association between the plasma concentration of ascorbic acid and a-tocopherol and the degree of neurological impairment after ischaemic stroke (Leinonen et al, 2000). The same study demonstrated an association between plasma total antioxidant activity and the volume of ischaemic cerebral infarction and the degree of subsequent neurological impairment.…”

“…There is evidence that free radical production is an important mechanism of brain injury after exposure to ischaemia and reperfusion (Traystman et al, 1991). While it is not possible to make direct measurements of antioxidant activity and oxidant damage in this target tissue, concentrations of antioxidants and products of oxidative damage in plasma have proved informative in other studies of stroke (Cherubini et al, 2000;Leinonen et al, 2000).…”

“…This effect is enhanced by poor a-tocopherol (vitamin E) and ascorbic acid (vitamin C) status (Cooper et al, 1980), and can be mitigated by supplementation with vitamin E (Yoshida et al, 1984). Recent studies in humans have reported an association between the plasma concentration of ascorbic acid and a-tocopherol and early clinical outcome after acute ischaemic stroke (Cherubini et al, 2000;Leinonen et al, 2000). A study by Leinonen et al (2000) reported an association between the plasma concentration of ascorbic acid and a-tocopherol and the degree of neurological impairment after ischaemic stroke .…”

“…Recent studies in humans have reported an association between the plasma concentration of ascorbic acid and a-tocopherol and early clinical outcome after acute ischaemic stroke (Cherubini et al, 2000;Leinonen et al, 2000). A study by Leinonen et al (2000) reported an association between the plasma concentration of ascorbic acid and a-tocopherol and the degree of neurological impairment after ischaemic stroke . Cherubini et al (2000) also found evidence of reduced plasma antioxidant concentrations in ischaemic stroke patients and that higher plasma vitamin A and uric acid concentrations and lower plasma ascorbic acid concentrations and erythrocyte superoxide dismutase activity were associated with poor early clinical outcome.…”