學院

醫學院

系所

職能治療學系

題名

Potential predictive values of inflammatory biomarkers for stroke rehabilitation outcomes

作者

Korivi, M., Wu, C-Y., & Lin, K-C.*

期刊名稱

Journal of the Formosan Medical Association. (SCI 期刊)

發表日期

2013

著作性質

原著

語文

英文

關鍵字

Biomarkers, inflammation, oxidative stress, upper-limb, disabilities.

摘要

Stroke is the third leading cause of death, and a major contributor to permanent disability among stroke survivors. Stroke-related disabilities are projected to increase globally, with effects on the financial status of families and national healthcare policies. Disabilities due to impaired motor functions, particularly the hemiplegic upper extremity (UE), affects activities of daily living (ADLs) and quality of life (QOL) in stroke survivors. Despite the tremendous efforts devoted to stroke rehabilitation, a large number of stroke survivors are still suffering with significant UE impairments. This fact urges the need to develop effective treatment regimens and predictive models of treatment outcomes using behavioral and biological markers.

Knowledge about how stroke outcomes are stratified is necessary for prognostication in the early stages of stroke to rational planning of rehabilitation. The Copenhagen Q4 Stroke Study measured the primary (death, discharge to nursing home) and secondary (neurologic deficits, functional disabilities) outcomes after rehabilitation, and results were used as a reliable tool for predicting the risks of various outcomes in patients characterized by the initial degree of stroke severity and/or functional disability. However, further research on the prognosis of stroke recovery is necessary to shed light on the possible mechanisms of change after stroke. Mounting evidence has demonstrated that fluctuations in inflammatory biomarkers contribute to poor outcomes. Activated inflammatory cells in brain increase the production of interleukins (ILs), tumor necrosis factor-a, and highsensitivity C-reactive protein (hs-CRP). Furthermore, stroke survivors have a greater prevalence of diabetes that leads to severe oxidative stress, thus confining the benefits of rehabilitation on these comorbidities. Knowledge in this area is still insufficient; thus, studying the dynamics of inflammatory biomarkers during rehabilitation is worthwhile to better understand the mechanism and also to innovate the treatment protocols.