Systemic immune-inflammation index upon admission correlates to post-stroke cognitive impairment in patients with acute ischemic stroke.

BACKGROUND: The purpose of this prospective study was to evaluate the association of systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI), with PSCI in patients with acute ischemic stroke (AIS). METHODS: First-onset AIS patients were consecutively included from January 1, 2022 to March 1, 2023. The baseline information was collected at admission. Fasting blood was drawn the next morning. Cognitive function was assessed by the Montreal Cognitive Assessment (MoCA) 3 months after onset. Logistic regression analysis was performed to explore the correlation between SII, SIRI, and PSCI. Receiver operating characteristic (ROC) was conducted to evaluate the predictive ability of SII. RESULTS: 332 participants were recruited, and 193 developed PSCI. Compared with patients without PSCI, the patients with PSCI had higher SII (587.75 (337.42, 988.95) vs. 345.66 (248.44, 572.89), P<0.001) and SIRI (1.59 (0.95, 2.84) vs. 1.02 (0.63, 1.55), P=0.007). SII and SIRI negatively correlated with MoCA scores (both P<0.05). The multivariable logistic regression analysis indicated that SII was independently associated with PSCI (P<0.001), while SIRI was not. The optimal cutoff for SII to predict PSCI was 676.83×109/L. CONCLUSIONS: A higher level of SII upon admission was independently correlated to PSCI three months later in AIS patients.

High triglyceride-glucose index at admission is a predictor of post-stroke cognitive impairment in patients with acute ischemic stroke.

BACKGROUND: Post-stroke cognitive impairment (PSCI) is a very common complication of ischemic stroke (IS). Triglyceride-glucose (TyG) index was an effective alternative marker of insulin resistance (IR). This prospective study was designed to explore the correlation between TyG index and PSCI. METHODS: Between January 1 2021 to June 30 2022, consecutive patients with first onset IS were enrolled prospectively. Baseline information was collected at admission and fasting blood was drawn the next morning. Montreal Cognitive Assessment (MoCA) was used to evaluate cognitive function at three months after stroke. Multiple regression analysis was used to explore the correlation between PSCI and TyG. Receiver operating characteristic (ROC) was performed to evaluate the predictive ability. RESULTS: Ultimately, 313 patients were enrolled in this study. The TyG index was higher in patients with PSCI than those without PSCI (8.99 (8.55, 9.54) vs. 8.61(8.25, 8.87), P<0.001). The spearman correlation analysis indicated that TyG index was negatively correlated with MoCA score (r=-0.272, P<0.001). The multivariate logistic regression analysis demonstrated that TyG index was correlated with PSCI independently (P<0.001) regardless of whether the patients had diabetes or not. The area under curve (AUC) of the ROC was 0.684 (95%CI=0.635-0.768, P<0.001). The optimal cutoff value of TyG index for predicting PSCI was 8.81, with a sensitivity of 61.7% and a specificity of 73.6%. CONCLUSION: A higher TyG index level at admission was independently correlated with increased risk of PSCI three months later and could be used as a predictor.

Distribution pattern of iron deposition in the basal ganglia of different motor subtypes of Parkinson's disease.

OBJECTIVE: The quantitative susceptibility mapping (QSM) technique was used to analyze the distribution pattern of iron deposition in the basal ganglia region of patients with motor subtypes of Parkinson's disease (PD) and to explore the difference in iron content in the basal ganglia region of PD motor subtypes on the major motor symptomatic side. METHODS: The study included 76 patients with PD and 37 healthy controls (HC). Patients with PD were divided into two groups: postural instability/gait disorder (PIGD)(n = 48), and tremor dominance (TD)(n = 28). We classified patients with PD according to the side of the major motor symptoms as left PIGD (n = 23), left TD (n = 14), right PIGD (n = 25), and right TD (n = 14). All subjects underwent brain magnetic resonance scanning to obtain QSM and susceptibility values in the corresponding regions of interest (ROI). RESULTS: (1) Compared with the HC, the bilateral SN in the PD-PIGD and TD group showed greater susceptibility values. The susceptibility values in the left CN, bilateral PUT were also greater in the PD-PIGD group than the HC. (2) Compared with the TD, the left PUT susceptibility values were greater in the PIGD group, especially in patients whose major symptomatic side were on the right limb. (3) Correlation analysis showed that in the PD group, bilateral SN was positively correlated with the unified Parkinson's disease rating scale III part scores of the Movement Disorder Society (MDS-UPDRS III) and the Hoehn-Yahr stage. Bilateral dentate nucleus (DN) susceptibility values were significantly positively correlated with TD scores, and left PUT susceptibility values were positively correlated with PIGD scores. The left SN within the PIGD group was positively correlated with the PIGD score. CONCLUSION: There were different iron deposition patterns in the basal ganglia between the PD-PIGD and TD groups. There also seems to be a difference in iron deposition in PD motor subtypes on different major motor symptom sides.

Serum TG/HDL-C level at the acute phase of ischemic stroke is associated with post-stroke cognitive impairment.

BACKGROUND: The ratio of triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C) bears a relation with poor outcomes of acute ischemic stroke (AIS), but the impact of serum TG/HDL-C level on post-stroke cognitive impairment (PSCI) remains unknown. We conducted this prospective study to explore the association between TG/HDL-C and PSCI. METHODS: Consecutive AIS patients from the Stroke Units of our hospital were prospectively enrolled between July 1, 2020, and June 30, 2021. Blood samples were collected within 24 h after admission. Cognition function was evaluated by the Montreal Cognitive Assessment (MoCA) at 3 months after stroke. We used logistic regression analyses to explore the relationship between TG/HDL-C and PSCI, and then used a receiver operating characteristic (ROC) analysis to assess the ability of acute TG/HDL-C for predicting PSCI. RESULTS: A total of 227 AIS patients were recruited. Compared with patients without PSCI, those with PSCI had a higher level of TG/HDL-C at admission (P < 0.01). The multivariate logistic regression analyses showed that TG/HDL-C level was independently associated with PSCI (P < 0.01). The area under the curve of the ROC for TG/HDL-C as predictor of PSCI was 0.701 (95%CI 0.635-0.768). The optimal cutoff value of TG/HDL-C to indicate PSCI was 1.564, which gave a sensitivity of 55.2% and specificity of 80.6%. CONCLUSIONS: Our study demonstrated that a higher level of TG/HDL-C at the acute phase of ischemic stroke predicted the presence of PSCI at 3 months after stroke.

[Effects of Microplastic Exposure on Crucian Growth, Liver Damage, and Gut Microbiome Composition].

Microplastics (MPs), which are widely present in the natural environment, may be harmful to the growth and health of aquatic organisms, though studies in this area are lacking. In this study, the crucian carp (Carassius carassius), a type of omnivorous freshwater fish, was chosen as the target, which was fed with fish food containing different concentrations of MPs for a 30-day food exposure experiment to study the effects of MPs on crucian growth, liver damage, and gut microbiome composition. Compared with that in the control group, the body length of the crucians in the environmental groups did not change significantly. The weight of the crucians in the low PE-MPs group increased significantly, but the weight of crucians in the medium and high PE-MPs groups decreased markedly. The liver tissues of the low PE-MPs group of crucians were basically normal, whereas crucians in the medium and high PE-MPs groups had varying degrees of liver damage, and crucians in the high PE-MPs group had the most serious liver damage. At the phylum level, Proteobacteria, Fusobacteria, Firmicutes, and Bacteroides were the dominant species in the gut of the crucians. Pathogens such as Staphylococcus and Ralstonia were present in the crucian gut of environmental groups. Alpha diversity results showed that the gut microbiome of crucians in the high PE-MPs group was the most abundant. PCoA results indicated that the gut microbiome of crucians in the control and environmental groups had obvious clustering characteristics.

Effects of secondary polyethylene microplastic exposure on crucian (Carassius carassius) growth, liver damage, and gut microbiome composition.

Microplastics (MPs) have been found in the natural environment and even in the organs of fish, which is attracting worldwide attention. In this study, agricultural film was milled to simulate secondary polyethylene microplastics (PE-MPs) to evaluate their effect and toxicity on the growth, liver damage, and gut microbiome composition of crucian (Carassius carassius), a common freshwater fish, after 30 days of feed exposure. Three fish feed treatments with different PE-MPs concentrations, low, medium, and high, whose PE-MPs intake was 6.38, 12.18, and 22.33 mg MPs/fish/day, respectively, were used. The results indicated that crucian growth was promoted in the low and medium PE-MPs groups due to the increase in Firmicutes and decrease in Bacteroidetes, probably resulting in obesity and lipid accumulation, while the growth rate of crucians in the high PE-MPs group showed a clear downward trend. Severe liver damage was observed in PE-MPs-treated groups. Disordered liver tissue and necrosis of pancreatic acinar epithelial cells were observed in the medium and high PE-MPs groups compared with those of the control group. The gut microbiome composition of crucians showed significant alteration, and some harmful bacteria were found in the gut following PE-MPs exposure. Alpha diversity indices revealed that the diversity of the gut microbiome rose markedly in the low, medium, and high PE-MPs groups. This study suggests that MPs adversely affect crucian growth and health, with increased disease risk.

Effect of PICALM rs3851179 polymorphism on the default mode network function in mild cognitive impairment.

Alterations in default mode network (DMN) functional connectivity (FC) might accompany the dysfunction of Alzheimer's disease (AD). Indeed, episodic memory impairment is a hallmark of AD, and mild cognitive impairment (MCI) has been associated with a high risk for AD. Phosphatidylinositol-binding clathrin assembly protein (PICALM) (rs3851179) has been associated with AD; in particular, the A allele may serve a protective role, while the G allele serves as a strong genetic risk factor. Therefore, the identification of genetic polymorphisms associated with the DMN is required in MCI subjects. In all, 32 MCI subjects and 32 healthy controls (HCs) underwent resting-state functional magnetic resonance imaging (rs-fMRI) and a genetic imaging approach. Subjects were divided into four groups according to the diagnosis (i.e., MCI and HCs) and the PICALM rs3851179 polymorphism (i.e., AA/AG genotype and GG genotype). The differences in FC within the DMN between the four subgroups were explored. Furthermore, we examined the relationship between our neuroimaging measures and cognitive performance. The regions associated with the genotype-by-disease interaction were in the left middle temporal gyrus (LMTG) and left middle frontal gyrus (LMFG). These changes in LMFG FC were generally manifested as an "inverse U-shaped curve", while a "U-shaped curve" was associated with the LMTG FC between these four subgroups (all P<0.05). Furthermore, higher FC within the LMFG was related to better episodic memory performance (i.e., AVLT 20min DR, rho=0.72, P=0.044) for the MCI subgroups with the GG genotype. The PICALM rs3851179 polymorphism significantly affects the DMN network in MCI. The LMFG and LMTG may be associated with opposite patterns. However, the altered LMFG FC in MCI patients with the GG genotype was more sensitive to episodic memory impairment, which is more likely to lead to a high risk of AD.

Low serum BDNF may indicate the development of PSD in patients with acute ischemic stroke.

OBJECTIVE: This study was to test whether serum BDNF or tissue plasminogen activator (tPA) is correlated with the development of depression at the acute stage of stroke. METHODS: Hundred ischemic stroke patients admitted to the hospital within the first 24 h of stroke onset were consecutively recruited and followed up for 14 days. The 17-item HDRS and MADRS were used to assess the severity of major depressive symptoms on day 3, day 7, and day 14 after admission. The diagnoses of depression were made in accordance with DSM-IV criteria for post-stroke depression (PSD). Serum BDNF and tPA of all the patients were determined by ELISA both on day 1 and day 7 after admission. Meanwhile, 50 healthy control subjects were also recruited and underwent measurement of serum BDNF and tPA once. RESULTS: We found that 37 patients (37.0%) were diagnosed of major depression at the end of the follow-up. Serum BDNF on day 1 was significantly higher in non-PSD stroke patients than in normal controls, while PSD patients had significantly lower BDNF than non-PSD patients. There was a significant negative correlation between serum BDNF and tPA on day 1 only in PSD patients (r = -0.440, p = 0.006). Serum BDNF < 5.86 ng/ml on day 1 was independently associated with incident PSD at the acute stage of stroke (OR = 28.992; 95% CI, 8.014-104.891; p < 0.001 after adjustment). CONCLUSION: There was a significant elevation of BDNF early after ischemic stroke. Serum BDNF on day 1 after admission may predict the risk of subsequent PSD. Moreover, tPA may be involved in the change of BDNF.

The serum interleukin-18 is a potential marker for development of post-stroke depression.

OBJECTIVE: Depression is a common mood disorder affecting stroke patients. It is associated with poorer outcome and increased mortality in stroke patients. The aim of this work was to test whether serum levels of proinflammatory cytokines are correlated with the development of depression after stroke. METHODS: One hundred ischemic stroke patients admitted to the hospital within the first 24 hours after stroke onset were consecutively recruited and followed up for 6 months. The 17-item Hamilton Depression Rating Scale (HDRS) and Montgomery-Asberg Depression Rating Scale (MADRS) were used to screen for depressive symptoms on days 3, 7 and 14 after admission and at 6 months after stroke onset. Based on the symptoms elicited from these two scales, diagnoses of depression were made in accordance with DSM-IV criteria for post-stroke depression. Serum levels of proinflammatory cytokines (IL-6, IL-18 and TNF-alpha) of all the patients were determined by ELISA on both days 1 and 7 after admission. Meanwhile, 50 healthy control subjects were also recruited; they underwent measurement of serum levels of proinflammatory cytokines once. RESULTS: Thirty-seven patients (37.0%) were diagnosed as having major depression at 2 weeks. Serum IL-18 on both days 1 and 7 was significantly higher in both post-stroke depression patients and non-post-stroke depression patients than in normal controls. Serum IL-18 on day 7 was significantly higher in post-stroke depression patients than in non-post-stroke depression patients. Serum IL-18 >377.84 pg/ml on day 7 was independently associated with incident post-stroke depression at the acute stage of stroke (odds ratio: 12.280, 95% confidence interval: 3.848-39.190, p<0.001 after adjustment). At 6 months, 31 patients (33.0%) were diagnosed with major depression. Serum IL-18 >376.67 pg/ml on day 7 was independently associated with post-stroke depression at 6 months (odds ratio: 7.431, 95% confidence interval: 1.741-31.712, p=0.007 after adjustment). CONCLUSIONS: Serum IL-18 on day 7 after admission may predict the risk of post-stroke depression both at the acute stage of stroke and at 6 months post-stroke.