Mean Platelet Volume During Ischemic Stroke is a Potential Pro-inflammatory Biomarker in the Acute Phase and During Neurorehabilitation Not Directly Linked to Clinical Outcome

Abstract

The prognostic role of increased mean platelet volume (MPV), as an indicator of platelet activation and large, more reactive platelets, in clinical and functional outcome of ischemic stroke is still conflicting. Studies are not currently available on the association between MPV and stroke recovery after neurorehabilitation. The relationship between MPV and clinical and functional outcome measures was assessed in twenty-four patients in the acute phase of first-ever ischemic stroke, and before and after 8-week intensive multifunctional neurorehabilitation. Neurorehabilitation was associated with improved scores of the National Institutes of Health Stroke Scale (NIHSS), the modified Rankin Scale (mRS), and the modified PULSES profile (mPULSES). When compared with apparently healthy subjects, higher MPV values were observed in stroke patients 24 hours after stroke and before neurorehabilitative treatment started not later than 14 days after stroke. Decreased MPV values were found after neurorehabilitation, even if the absolute values were still higher than those detected in control subjects. No correlation was observed between MPV values and scores of the NIHSS and mRS scales evaluated in stroke acute phase. No correlation was also observed before and after neurorehabilitative treatment between MPV and NIHSS, mRS and mPULSES scores. Our data provide evidence of the effectiveness of neurorehabilitation on modulating MPV values and support the hypothesis that high MPV could represent an expression of proinflammatory condition of the stroke patients, realistically pre-existent to acute ischemic event, than a marker of neurologic deficit and disability or of stroke recovery including motor performance and functional independence.

Platelet count and mean volume in acute stroke: a systematic review and meta-analysis

“…We corresponded with authors for five studies, but data were not available. Therefore, 34 articles were included in the meta-analysis [10][11][12][13][14][15]. Three studies were carried out in the United States, 12 in Europe, ten in Asia, one in Africa, and eight studies were intercontinental.…”

“…Some authors consider a possible use of MPV assessments as a potential biomarker of AS or as a prognostic marker in patients after AS [10,12]. An association of MPV with stroke is possibly due to higher platelet activity, aggregation, and turnover in patients with elevated MPV.…”

“…However, these studies have yielded inconsistent findings. Some groups reported that patients with AS had significantly increased MPV or PC compared with controls [10,11], whereas other studies found decreased MPV or PC values in AS patients [12,13]. Additionally, some studies have observed no association between these parameters and AS [14,15].…”

<p>The mean platelet volume on admission predicts unfavorable stroke outcomes in patients treated with IV thrombolysis</p>

“…Contrasting results have also been published. Ciancarelli et al found no relationship between MPV values at baseline and NIHSS and mRS at 2 months, but they revealed that MPV decreases following 8 weeks of neurorehabilitation 37. Ntaios et al described no significant difference in the frequency of minor strokes and good functional outcome at 3 and 12 months across MPV quartiles 38.…”

Mean Platelet Volume, C-Reactive Protein, and Prognosis in Patients with Acute Ischemic Stroke Following Intravenous Thrombolytic Treatment

“…Ntaios et al evaluated the associations between MPV values and NIH Stroke Scale scores but did not detect any significant correlations [ 25 ]. In another recently published study, Ciancarelli et al reported that no significant correlation was found between MPV values and NIH Stroke Scale and MRS scores [ 26 ]. Chen et al, investigated thrombocyte microparticles and MPV values in 112 patients with AIS, in which patients were divided into two groups, as large artery occlusion, and small artery occlusion group, but in both groups, MPV was found to be increased [ 27 ].…”