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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2020; 78(05): 262-268
DOI: 10.1590/0004-282X20200001
Article

Clinical and molecular correlates of the ASPECTS in the acute phase of stroke

Correlação clínica e molecular com a ASPECTS na fase aguda do acidente vascular cerebral

Authors

  • Aline Mansueto MOURÃO 

    1   Universidade Federal de Minas Gerais, Hospital Risoleta Tolentino Neves, Unidade de Acidente Vascular Cerebral, Belo Horizonte MG, Brazil.
    2   Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Fonoaudiologia, Belo Horizonte MG, Brazil.

  • Laélia Cristina Caseiro VICENTE 

    2   Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Fonoaudiologia, Belo Horizonte MG, Brazil.

  • Mery Natali Silva ABREU 

    3   Universidade Federal de Minas Gerais, Departamento de Enfermagem Aplicada, Belo Horizonte MG, Brazil.

  • Romeu Vale SANT’ANNA 

    1   Universidade Federal de Minas Gerais, Hospital Risoleta Tolentino Neves, Unidade de Acidente Vascular Cerebral, Belo Horizonte MG, Brazil.

  • Fidel Castro Alves DE MEIRA 

    1   Universidade Federal de Minas Gerais, Hospital Risoleta Tolentino Neves, Unidade de Acidente Vascular Cerebral, Belo Horizonte MG, Brazil.

  • Rodrigo Menezes de Brito XAVIER 

    1   Universidade Federal de Minas Gerais, Hospital Risoleta Tolentino Neves, Unidade de Acidente Vascular Cerebral, Belo Horizonte MG, Brazil.

  • Marco Túlio de Azevedo TANURE 

    1   Universidade Federal de Minas Gerais, Hospital Risoleta Tolentino Neves, Unidade de Acidente Vascular Cerebral, Belo Horizonte MG, Brazil.

  • Erica Leandro Marciano VIEIRA 

    4   Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório Interdisciplinar de Investigação Médica, Belo Horizonte MG, Brazil.

  • Leonardo Cruz DE SOUZA 

    4   Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório Interdisciplinar de Investigação Médica, Belo Horizonte MG, Brazil.

  • Aline Silva de MIRANDA 

    4   Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório Interdisciplinar de Investigação Médica, Belo Horizonte MG, Brazil.

  • Milene Alvarenga RACHID 

    4   Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório Interdisciplinar de Investigação Médica, Belo Horizonte MG, Brazil.

  • Antônio Lucio TEIXEIRA 

    4   Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório Interdisciplinar de Investigação Médica, Belo Horizonte MG, Brazil.
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ABSTRACT

Background: The Alberta Stroke Program Early CT Score (ASPECTS) scale was developed for monitoring early ischemic changes on CT, being associated with clinical outcomes. The ASPECTS can also associate with peripheral biomarkers that reflect the pathophysiological response of the brain to the ischemic stroke. Objective: To investigate the association between peripheral biomarkers with the Alberta Stroke Program Early CT Score (ASPECTS) in individuals after ischemic stroke. Methods: Patients over 18 years old with acute ischemic stroke were enrolled in this study. No patient was eligible for thrombolysis. The patients were submitted to non-contrast CT in the first 24 hours of admission, being the Alberta Stroke Program Early CT Score and clinical and molecular evaluations applied on the same day. The National Institutes of Health Stroke Scale (NIHSS), modified Rankin scale and the Mini-Mental State Examination for clinical evaluation were also applied to all subjects. Plasma levels of BDNF, VCAM-1, VEGF, IL-1β, sTNFRs and adiponectin were determined by ELISA. Results: Worse neurological impairment (NIHSS), cognitive (MEEM) and functional (Rankin) performance was observed in the group with changes in the NCTT. Patients with NCTT changes also exhibited higher levels of IL-1β and adiponectin. In the linear multivariate regression, an adjusted R coefficient of 0.515 was found, indicating adiponectin and NIHSS as independent predictors of ASPECTS. Conclusion: Plasma levels of adiponectin are associated with the ASPECTS scores.

RESUMO

Introdução: A Alberta Stroke Early Score (ASPECTS) foi desenvolvida para monitorização de alterações isquêmicas precoces na tomografia computadorizada de crânio, estando associada a desfechos clínicos. A ASPECTS também pode se associar aos biomarcadores periféricos que refletem a resposta fisiopatológica do cérebro ao AVC isquêmico. Objetivo: Investigar à associação entre os parâmetros periféricos com a Alberta Stroke Early Score (ASPECTS) em indivíduos após acidente vascular cerebral isquêmico. Métodos: Pacientes acima de 18 anos com AVC isquêmico agudo foram incluídos neste estudo. Nenhum paciente foi elegível para trombólise. Os pacientes foram submetidos à tomografia computadorizada sem contraste nas primeiras 24 horas da admissão, a ASPECTS e as avaliações clínicas e moleculares aplicadas no mesmo dia. O National Institutes of Health Stroke Scale (NIHSS), a escala de Rankin modificada e o Mini Exame do Estado Mental para avaliação clínica também foram aplicados a todos os indivíduos. Os níveis plasmáticos de BDNF, VCAM-1, VEGF, IL-1β, sTNFRs e adiponectina foram determinados por ELISA. Resultados: Pior desempenho neurológico (NIHSS), cognitivo (MEEM) e funcional (Rankin) foram observados no grupo com alterações na ASPECTS. Pacientes com alterações na ASPECTS também exibiram níveis mais altos de IL-1β e adiponectina. Na regressão multivariada linear, foi encontrado um coeficiente R ajustado de 0,515, indicando adiponectina e NIHSS como preditores independentes para a ASPECTS. Conclusão: Os níveis plasmáticos de adiponectina estão associados aos escores da ASPECTS.

Keywords:

Brain Ischemia - Neurology - Biomarkers - Neurologic Examination - Prognosis

Palavras-chave:

Isquemia Encefálica - Neurologia - Biomarcadores - Exame Neurológico - Prognóstico

Support:

This study was funded by Fundação de Amparo à Pesquisa do Estado de Minas Gerais - FAPEMIG [grant number APQ-03539-13].




Publikationsverlauf

Eingereicht: 01. November 2019

Angenommen: 08. Dezember 2019

Artikel online veröffentlicht:
13. Juni 2023

© 2020. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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