The Role of the Lipid Profile and Oxidative Stress in Fatigue, Sleep Disorders and Cognitive Impairment in Patients with Multiple Sclerosis.

The aim of this study is to investigate the relationship of the lipid profile, dysfunctional high-density lipoprotein, ischaemia-modified albumin and thiol-disulfide homeostasis with cognitive impairment, fatigue and sleep disorders in patients with multiple sclerosis. The cognitive functions of patients were evaluated with the Brief International Cognitive Assessment for Multiple Sclerosis battery. Fatigue was evaluated with the Fatigue Severity Scale and the Fatigue Impact Scale. The Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale were used to assess patients' sleep disturbance. Peripheral blood samples were collected, and lipid levels and myeloperoxidase and paraoxonase activity were measured. The myeloperoxidase/paraoxonase ratio, which indicates dysfunctional high-density lipoprotein, was calculated. Thiol-disulfide homeostasis and ischaemia-modified albumin were measured.
We did not identify any relationship between dysfunctional high-density lipoprotein and the physical disability, cognitive decline, fatigue and sleep problems of multiple sclerosis. Thiol-disulfide homeostasis was associated with cognitive scores. The shift of the balance towards disulfide was accompanied by a decrease in cognitive scores. On the other hand, we did not detect any relationship between fatigue and sleep disorders and thiol-disulfide homeostasis. Our findings revealed a possible correlation between cognitive dysfunction and thiol-disulfide homeostasis in multiple sclerosis patients.

Relationship between pattern reversal visual evoked potential P100 wave latency and dysfunctional HDL in patients with multiple sclerosis subjected to an optic neuritis attack: A case-control study.

Optic neuritis frequently occurs during the clinical course of multiple sclerosis (MS). In this condition, demyelination of the optic nerve occurs, which electrophysiologically causes a delay in P100 wave latency. Sensitive cholesterol homeostasis is critical for the formation of the myelin sheath and for myelin to become functionally mature. High-density lipoprotein (HDL) becomes dysfunctional under oxidative stress and plays an important role in the pathogenesis of MS. In this study, HDL levels of MS patients suffering from optic neuritis were compared with those of healthy individuals, and the relationship between pattern reversal visual evoked potential (PRVEP) P100 wave latency and HDL levels in patients with optic neuritis attacks was analyzed. PRVEP studies were performed in patients with MS who had an episode of optic neuritis, and P100 wave latencies were measured. Peripheral blood samples were collected from healthy participants and patients. Lipid levels and myeloperoxidase (MPO) and paraoxonase (PON) activities were measured, and the MPO/PON ratio was then calculated. The lipid profiles and dysfunctional HDL levels in the healthy and patient groups were compared. Finally, the relationship between these parameters and the PRVEP-P100 wave latency was examined. Total cholesterol and low-density lipoprotein (LDL) levels were significantly higher in the patient group (P = .044; P = .038, respectively). There was no statistically significant difference in HDL levels between groups (P = .659). The distribution of MPO values was similar between groups (P = .452). PON values were significantly lower, whereas the MPO/PON ratios were significantly higher in the patient group than in the control group (P = .025; P = .028, respectively). A statistically significant positive correlation was found between the elevated MPO/PON ratio, representing dysfunctional HDL, and both the mean and maximum PRVEP-P100 wave latencies (P < .001, R = 0.690; P < .001, R = 0.815, respectively). A dysfunctional form of HDL may lead to poor deactivation of remyelination-limiting factors and may ultimately be associated with poor outcomes in optic neuritis.

Investigation of small fiber neuropathy in patients with diabetes mellitus by corneal confocal microscopy.

OBJECTIVES: Corneal confocal microscopy (CCM) is a non-invasive technique that examines the corneal cellular structure. Its use in the detection of small fiber neuropathy is being researched. In our study, we examined the role of CCM in the detection of small fiber neuropathy in diabetic patients, as well as the differences between CCM findings in diabetic patients with and without overt polyneuropathy with neuropathic symptoms. METHODS: 56 Diabetes Mellitus (DM) patients and 18 healthy controls were included in the study. The individuals included in the study were divided into three groups. Patients with diabetes who were found to have polyneuropathy according to electrophysiological diagnostic criteria were classified as Group 1, patients with diabetes and neuropathic symptoms without overt polyneuropathy according to electrophysiological diagnostic criteria were classified as Group 2, and healthy individuals were classified as Group 3. Electrophysiological examination and corneal imaging with CCM were performed in all groups. RESULTS: The CNFD and CNFL values of individuals in the diabetic group were discovered to be lower. CNFD values differ statistically between the groups (p = 0.047). Group 1-Group 3 differs from Group 2-Group 3 (respectively; p = 0.018, p = 0.048). CONCLUSION: Our study demonstrates that CCM can be used in patients with neuropathic symptoms and no polyneuropathy detected in EMG and thought to have small fiber neuropathy. CCM provides an opportunity for early diagnosis in small fiber neuropathy.

Association Between Guillain-Barré Syndrome and COVID-19 Infection: Experience of a Turkish Neurophysiology Laboratory.

Introduction: Coronavirus disease 2019 (COVID-19) has affected the practice of neurology and other medical fields. The neurological complications associated with SARS-CoV-2 infection are remarkable. In this study, we investigated the clinical and electrophysiological characteristics of patients with Guillain-Barré syndrome (GBS) caused by COVID-19 diagnosed between 1 September 2020 and 30 November 2020. Methods: This study included patients diagnosed with GBS clinically and electrophysiologically between September-November 2020 (pandemic period) and September-November 2019 (prepandemic period). Patients with GBS during the pandemic period, who were diagnosed with COVID-19 within 6 weeks before neuropathic symptoms developed, were included in the study. Pandemic period GBS patients were grouped as GBS associated with COVID-19 (n=13), and prepandemic period patients were grouped as GBS non-associated with COVID-19 (n=7). Demographic, clinical, electrophysiological and laboratory data of these two patient groups were compared. Results: The most common symptoms were fever and cough (46.2%) in GBS associated with COVID-19 group and diarrhoea (71.4%) in GBS non-associated with COVID-19 group during active infection period. In the GBS associated with COVID-19 patients, lung involvement was apparent in 12 (92.3%) during active viral infection. A positive and significant correlation was observed in GBS associated with COVID-19 patients between comorbid factors and a need for ventilation support. Conclusion: GBS cases associated with COVID-19 may have a more severe course, especially if they have comorbidities. It is important to define the unique clinical, electrophysiological, and laboratory findings of such patients to optimise follow-up, treatment and management.

Aquaporin-4 protein antibody-associated optic neuritis related to neuroendocrine tumor after receiving an inactive COVID-19 vaccine.

Neuromyelitis optica (NMO), also known as Devic's disease, is a rare, autoimmune, and recurrent demyelinating disorder that primarily affects the spinal cord and optic nerve. We report a case with recurrent optic neuritis caused by the paraneoplastic NMO spectrum disorder in the setting of a gastric neuroendocrine tumor 2 weeks after receiving an inactive COVID-19 vaccine.

Event-Related Potentials Elicited by Face and Face Pareidolia in Parkinson's Disease.

BACKGROUND: Parkinson's disease is associated with impaired ability to recognize emotional facial expressions. In addition to a visual processing disorder, a visual recognition disorder may be involved in these patients. Pareidolia is a type of complex visual illusion that permits the interpretation of a vague stimulus as something known to the observer. Parkinson's patients experience pareidolic illusions. N170 and N250 waveforms are two event-related potentials (ERPs) involved in emotional facial expression recognition. OBJECTIVE: In this study, we investigated how Parkinson's patients process face and face-pareidolia stimuli at the neural level using N170, vertex positive potential (VPP), and N250 components of event-related potentials. METHODS: To examine the response of face and face-pareidolia processing in Parkinson's patients, we measured the N170, VPP, and N250 components of the event-related brain potentials in a group of 21 participants with Parkinson's disease and 26 control participants. RESULTS: We found that the latencies of N170 and VPP responses to both face and face-pareidolia stimuli were increased along with their amplitudes, and the amplitude of N250 responses decreased in Parkinson's patients compared to the control group. In both control and Parkinson's patients, face stimuli generated greater ERP amplitude and shorter latency in responses than did face-pareidolia stimuli. CONCLUSION: The results of our study showed that ERPs associated with face and also face-pareidolia stimuli processing are changed in early-stage neurophysiological activity in the temporoparietal cortex of Parkinson's patients.

Changes in face and face pareidolia processing in patients with migraine: an ERP study.

Migraine is a multifactorial brain disorder characterized by recurrent disabling headache attacks. One of the possible mechanisms in the pathogenesis of migraine may be a decrease in inhibitory cortical stimuli in the primary visual cortex attributable to cortical hyperexcitability. The aim of this study was to investigate the neural correlates underlying face and face pareidolia processing in terms of the event-related potential (ERP) components, N170, vertex positive potential (VPP), and N250, in patients with migraine. In total, 40 patients with migraine without aura, 23 patients with migraine and aura, and 30 healthy controls were enrolled. We recorded ERPs during the presentation of face and face pareidolia images. N170, VPP, and N250 mean amplitudes and latencies were examined. N170 was significantly greater in patients with migraine with aura than in healthy controls. VPP amplitude was significantly greater in patients with migraine without aura than in healthy controls. The face stimuli evoked significantly earlier VPP responses to faces (168.7 ms, SE = 1.46) than pareidolias (173.4 ms, SE = 1.41) in patients with migraine with aura. We did not find a significant difference between N250 amplitude for face and face pareidolia processing. A significant difference was observed between the groups for pareidolia in terms of N170 [F(2,86) = 14,75, P < 0.001] and VPP [F(2,86) = 16.43, P < 0.001] amplitudes. Early ERPs are a valuable tool to study the neural processing of face processing in patients with migraine to demonstrate visual cortical hyperexcitability.NEW & NOTEWORTHY Event-related potentials (ERPs) are important for understanding face and face pareidolia processing in patients with migraine. N170, vertex positive potential (VPP), and N250 ERPs were investigated. N170 was revealed as a potential component of cortical excitability for face and face pareidolia processing in patients with migraine.

Man-In-The-Barrel Syndrome: Acute bilateral brachial plexopathy after recurrent microtrauma.

The presence of brachial diplegia despite the normal muscular strength of the lower extremities is called the man-in-the-barrel syndrome (MIBS). Although this rare syndrome often occurs due to the bilateral supratentorial brain lesions, it may also rarely occur as a result of infratentorial causes. In this report, we describe a case presenting with MIBS of which etiological underlying cause was bilateral brachial plexopathy developed secondarily to recurrent microtrauma. A 51-year-old male patient presented to our clinic with complaints of pain and weakness on both arms. After electrodiagnostic examination, bilateral brachial plexopathy was identified. The findings of the patient improved following methylprednisolone therapy. It is very important to determine the treatable causes of this syndrome at an early stage.

Dynamic thiol-disulphide homeostasis in patients with Guillain-Barre Syndrome.

OBJECTIVE: The aim of this study was to evaluate dynamic thiol-disulphide homeostasis as a novel oxidative stress parameter in patients with Guillain-Barre syndrome (GBS). METHODS: A total of 130 participants were included in this study, 70 of whom were diagnosed with GBS. Total thiol (-SH+-S-S-) and native thiol (-SH) levels in serum were measured in all patients and healthy individuals. Amount of dynamic disulphide bond were calculated from these values. In the GBS patients, disability status was determined by the Hughes and Medical Research Center (MRC) sum scores at the time of admission and 3 months thereafter. RESULTS: Total and native thiol levels were significantly lower in patients with GBS compared with healthy individuals. There was no statistically significant difference in the number of dynamic disulphide bonds between groups. There was a negative correlation between total thiol levels in patients with GBS and Hughes scores at month 3. DISCUSSION: Oxidative stress is among the molecular changes underlying the pathogenesis of GBS. In this study, we have investigated the dynamic thiol-disulfide homeostasis in patients with epilepsy using a new method in the literature. Also, functional recovery in Guillain-Barré syndrome patients could be promoted by increasing antioxidant activity.

Relationship between thiol-disulphide homeostasis and visual evoked potentials in patients with multiple sclerosis.

PURPOSE: To examine the thiol-disulphide homeostasis during an optic neuritis episode in patients with multiple sclerosis and the relationship between this homeostasis and P100 wave latency. MATERIALS AND METHOD: Visual evoked potential reviews of multiple sclerosis patients who presented with an optic neuritis episode were conducted and P100 latencies were measured. Peripheral blood samples were collected from all patients. Native thiol and total thiol concentrations were measured with the automated method that was recently developed. Their amount of disulphide bonds, disulphide/native thiol, disulphide/total thiol and native thiol/total thiol ratios were calculated. The relationship between P100 latency and thiol-disulphide homeostasis was investigated. RESULTS: A significant positive correlation was determined between the disulphide/native thiol ratio and both mean P100 latency and maximum P100 latency (p = 0.021, r = 0.136; p = 0.030, r = 0.177, respectively). DISCUSSION: As the balance of the plasma dominated by antioxidants moves towards the oxidant side, in other words as a higher rate of thiol is oxidised from the thiol pool, P100 latency is extended. N-acetylcysteine and alpha lipoic acid as well as thiol supplements can improve the thiol-disulphide balance, reinforce antioxidant defence and it can help in slowing down the demyelinating damage.

Thiol-Disulfide Homeostasis in Cerebral Venous Sinus Thrombosis.

BACKGROUND: The objective of this study is to examine thiol-disulfide homeostasis in patients with cerebral venous sinus thrombosis. METHODS: Fifty-three patients diagnosed with cerebral venous sinus thrombosis and 80 healthy volunteers were included in the study. The native thiol and total thiol concentrations were measured with the newly developed automated method. In addition, their amount of disulfide bonds was calculated. RESULTS: The total thiol and native thiol levels of the patients with cerebral venous sinus thrombosis were significantly lower than the healthy volunteers (p = 0.001, p = 0.001, respectively). In terms of dynamic disulfide bond formation, there was no statistically significant difference between the groups (p > 0.05). A significant negative correlation was determined between native thiol and total thiol levels and the number of sinuses that had thrombosis (r = -0.136, p = 0.033; r = -0.141, p = 0.015, respectively). There was no correlation between National Institutes of Health Stroke Scale score and thiol-disulfide homeostasis parameters. CONCLUSIONS: This study is the first study to examine thiol-disulfide homeostasis in patients with cerebral venous sinus thrombosis. The thiol-disulfide balance is impaired under oxidative stress. This study revealed that this balance is disrupted in correlation with widespread thrombosis in patients with cerebral venous sinus thrombosis. Therefore, fortification of thiol deficiency with N-acetyl cysteine or alpha-lipoic acid can prevent the progress of thrombosis and can be beneficial in cerebral venous sinus thrombosis treatment.

Monocyte-to-high density lipoprotein ratio is associated with a decreased compound muscle action potential amplitude in patients with diabetic axonal polyneuropathy.

The monocyte-to-high density lipoprotein ratio (MHR) has recently been implemented as an indicator of inflammation and oxidative stress. The present study characterized MHR in patients with diabetic polyneuropathy (DPN), in which oxidative stress and microvascular damage play a role in pathogenesis, relative to patients with non-DPN, diabetic patients without polyneuropathy, and healthy individuals. We further aimed to evaluate the association between MHR and the decreased compound muscle action potential (CMAP) amplitude of patients with diabetic axonal polyneuropathy.We enrolled 90 patients with DPN, 75 patients with nonDPN, 92 diabetic patients without polyneuropathy, and 67 healthy individuals; The monocyte, high-density lipoprotein cholesterol (HDL-C) values were obtained for all participants and MHR was calculated for each individual. Intergroup comparison was performed. The relationship between MHR and the posterior tibial nerve CMAP amplitudes was examined.Statistically significant negative correlation was observed between MHR and the posterior tibial nerve CMAP amplitudes of patients with DPN. The MHR values of the patients with DPN were significantly higher than those of the patients with non-DPN, diabetic patients without polyneuropathy and the control group.This study demonstrated that diabetic patients with higher MHR values may be more likely to develop polyneuropathy.

Differences in diffusion tensor imaging changes between narcolepsy with and without cataplexy.

OBJECTIVE: The distinctive clinical finding of Type 1 narcolepsy compared to Type 2 is the presence of cataplexy. Several neuroimaging studies have also reported abnormalities in narcolepsy patients with or without cataplexy. However, there are conflicting results to differentiate them. In this study, we aimed to clarify the white matter changes in narcolepsy patients both with and without cataplexy and compared them with healthy adults to evaluate microstructural differences in the brain. METHODS: Eleven narcolepsy patients with cataplexy (NC), 12 narcolepsy patients without cataplexy (NOC) and healthy age- and gender-matched controls (N = 16) were studied. Whole-brain diffusion tensor imaging (DTI) was obtained and tract-based spatial statistics were used to localize white matter abnormalities. RESULTS: Compared with the healthy controls, both NC and NOC patients exhibited significant fractional anisotropy (FA) decreases in the bilateral cerebellar hemispheres, bilateral thalami, the corpus callosum and left anterior-medial temporal white matter. Compared with the controls, the NC patients' FA values were also decreased in the midbrain. No significant correlations were found between FA values and clinical-polysomnographic variables. CONCLUSION: This DTI study has demonstrated white matter abnormalities in the midbrain-brainstem regions as a distinctive finding of narcolepsy patients with cataplexy. Involvement of bilateral temporal lobes with greater changes on the left lobe is also a supporting finding of patients with cataplexy. DTI changes in the midbrain-brainstem and bilateral temporal lobes can be signs of different pathological mechanisms in these patients.

Impaired thiol-disulphide homeostasis in patients with axonal polyneuropathy.

OBJECTIVE: The objective of this study is to examine thiol-disulphide homeostasis in patients with polyneuropathy dominated by diabetic or non-diabetic axonal degeneration. MATERIALS-METHODS: Fifty-four patients diagnosed with polyneuropathy dominated by axonal damage and 41 healthy subjects were included in the study. The patients were grouped into two groups according to whether or not they had diabetes. The native thiol and total thiol concentrations were measured with the newly developed automated method. RESULTS: While there was no significant difference between the patients with diabetic and non-diabetic polyneuropathy in terms of native thiol and total thiol levels (p > 0.05), the native thiol and total thiol levels of the groups with both diabetic polyneuropathy and non-diabetic polyneuropathy were significantly low compared to the control group (p < 0.01). The level of disulphides in the patients with diabetic polyneuropathy was significantly higher than that of the patients with non-diabetic polyneuropathy and the healthy individuals (p < 0.05). The loss in the sural nerve sensory neural action potential amplitude was positively correlated with the decrease in the levels of both native thiol and total thiol (p < 0.05). DISCUSSION: In our study, we observed that the thiol-disulphide balance was also impaired in patients with non-diabetic polyneuropathy similar to patients with diabetic polyneuropathy, and we therefore considered that impaired the thiol-disulphide homeostasis could be the last common path in patients with polyneuropathy with axonal damage, regardless of the aetiology. Therefore, fortification of thiol deficiency with N-acetyl cysteine or alpha-lipoic acid can fix the thiol-disulphide balance and help decelerate the axonal damage.

Impairment of dynamic thiol-disulphide homeostasis in patients with idiopathic Parkinson's disease and its relationship with clinical stage of disease.

OBJECTIVE: The aim of this study was to investigate dynamic thiol-disulphide homeostasis in patients with idiopathic Parkinson's disease and to determine its relationship with the clinical stage as assessed by the modified Hoehn and Yahr scale. DESIGN AND METHODS: Fifty-two patients with Parkinson's disease (PD), diagnosed according to the United Kingdom Brain Bank Criteria for idiopathic PD, and 41 healthy individuals were included in the study. Clinical staging of patients was performed according to the Hoehn and Yahr scale. Peripheral blood samples were taken from all participants, and their native thiol and total thiol concentrations were measured using the newly developed automated method. In addition, their amount of disulphide bonds, disulphide/native thiol, disulphide/total thiol and native thiol/total thiol ratios were calculated. RESULTS: Considering the data obtained from Parkinson's patients and the control group, both native thiol (-SH) and total thiol (-SH+-S-S) levels were found significantly lower in patients with Parkinson's disease. A negative and statistically significant relationship was found between both disease duration and disease stage and native thiol (-SH), total thiol (-SH+-S-S) levels and -SH/(-SH+-S-S-) ratio. A positive and statistically significant relationship was found between both disease duration and stage and -S-S-/-SH and -S-S-/(-SH+-S-S-) ratios. CONCLUSION: In patients with Parkinson's disease, dynamic thiol-disulphide homeostasis is disrupted, according to disease stage and duration. This balance, easily measured by using the newly developed automated method, can be used in monitoring disease progression. To our knowledge, our study will be the first report in the literature.

The temporal relation between seizure onset and arousal-awakening in temporal lobe seizures.

PURPOSE: Our main aim was to determine the time interval between the seizure onsets and arousal-awakening related to these seizures in patients with temporal lobe epilepsy (TLE) and to discuss the role of lateralization on arousal-awakening mechanisms. METHODS: Thirty-three TLE patients who underwent video-EEG monitoring with simultaneous polysomnography (PSG) and had recorded nocturnal seizures were retrospectively examined. These TLE patients had 64 seizures during sleep. The onsets of seizures and arousal-awakening related to these seizures were marked according to clinical and electrophysiological features. The time interval between the seizure onset and arousal-awakening related to the seizure was compared in patients with right- or left-sided temporal lobe seizures. RESULTS: In our TLE patients nocturnal seizures mostly followed arousal-awakening (64%). The time interval between the seizure onset and arousal-awakening related to the seizure was significantly shorter in patients with left-sided temporal lobe seizures (p=0.01). CONCLUSION: Video-EEG monitoring and PSG with scalp electrodes in our TLE patients showed that nocturnal seizures mostly followed arousal-awakening, and it was more pronounced in those with left-sided seizures. Arousal-awakening might be a signal for subsequent seizures in patients with TLE.

A novel oxidative stress marker in migraine patients: dynamic thiol-disulphide homeostasis.

The aim of this study was to investigate dynamic thiol-disulphide homeostasis as a novel oxidative stress parameter in migraine patients. A total of 115 participants were included in the study, and 63 of whom were diagnosed with migraine. The total thiol (-SH+-S-S-) and native thiol (-SH) levels in the serum were measured in all patients and healthy individuals. The dynamic disulphide bond (-S-S-) and (-S-S-) × 100/(-SH), (-S-S-) × 100/(-SH+-S-S-), and -SH × 100/(-SH+-S-S-) ratios were calculated from these values. The total and native thiol levels of migraine patients participating in the study were found to be significantly higher than the total and native thiol levels of healthy individuals. No statistically significant difference was determined in terms of the dynamic disulphide bond amounts or (-S-S-) × 100/(-SH), (-S-S-) × 100/(-SH+-S-S-), and -SH × 100/(-SH+-S-S-) ratios. The total thiol, native thiol, and dynamic disulphide bond levels, and (-S-S-) × 100/(-SH), (-S-S-) × 100/(-SH+-S-S-), and -SH × 100/(-SH+-S-S-) ratios were not correlated with attack frequency, pain intensity, or migraine type. Oxidative stress is considered to be one of the molecular changes underlying the pathogenesis of migraine.

A novel oxidative stress marker in patients with Alzheimer's disease: dynamic thiol-disulphide homeostasis.

OBJECTIVE: The aim of this study was to evaluate the dynamic thiol-disulphide homeostasis as an oxidative stress parameter, using a newly proposed method, in patients with Alzheimer's disease. METHODS: In total, 97 participants were included in the study. Among them, 51 had been diagnosed with Alzheimer's disease, and the remaining 46 were healthy individuals. Total thiol (-SH+-S-S-) levels and native thiol (-SH) levels in serum of each participant were measured. The amount of dynamic disulphide bonds (-S-S-) and (-S-S-) ×100/(-SH), (-S-S-) ×100/(-SH+-S-S-), and -SH×100/(-SH+-S-S-) ratios were calculated from these values. The obtained data were used to compare Alzheimer's disease patients with healthy individuals. RESULTS: The average total thiol and native thiol levels of patient with Alzheimer's disease in the study were found to be significantly lower than those levels of healthy individuals. In addition, in the patient group, the -S-S-×100/-S-S+-SH ratio was found to be significantly higher, whereas the -SH×100/-S-S+-SH ratio was found to be significantly lower compared with healthy individuals. Total thiol and native thiol levels, dynamic disulphide bond amount, and -S-S-×100/-SH, -S-S-×100/-S-S+-SH, and -SH×100/-S-S+-SH ratios were not found to be correlated with mini mental state examination score or duration of disease. CONCLUSION: Recent studies have shown that oxidative stress is the one of the molecular changes underlying the pathogenesis of Alzheimer's disease. In this study, we have investigated the dynamic thiol-disulphide homeostasis in patients with Alzheimer's disease, using a novel method.

Dynamic thiol-disulfide homeostasis in acute ischemic stroke patients.

Dynamic thiol-disulfide homeostasis plays a critical role in the cellular protection provided by antioxidation. The aim of this study was to investigate whether there is a change in thiol-disulfide homeostasis in acute ischemic stroke patients. Patients diagnosed with acute ischemic stroke that had undergone magnetic resonance diffusion-weighted imaging within the first 24 h were prospectively included in this study. The thiol, disulfide, and total thiol levels were measured during the first 24 and 72 h, and the National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), and Barthel Index (BI) of the patients were recorded. Overall, the relationships between the thiol-disulfide levels of the patients and the infarct volumes, NIHSS, mRS, and BI scores were investigated. In this study, 54 patients and 53 healthy controls were included. The mean of the native thiol levels in the stroke group was 356.572 ± 61.659 µmol/L (min/max 228.00/546.40), while it was 415.453 ± 39.436 µmol/L (min/max 323.50/488.70) in the control group (p < 0.001). A negative, significant correlation was observed between the infarct volumes and native thiol levels (ρ = -0.378; p = 0.005), and the disulfide levels were similar between the groups (Z = 0.774; p = 0.439). Significant difference was found between the thiol levels of the mild and moderate-severe NIHSS groups (p = 0.026). The changes in the thiol levels under oxidative stress may be associated with the severity of the stroke. Substitution of thiol deficiency and correction of thiol-disulfide imbalance may be beneficial in ischemic stroke.