The relationship between rehabilitation outcomes and extracellular thiol-disulphide and intracellular oxidized-reduced glutathione homeostasis in patients with subacute stroke

Background & Objective: To evaluate the relationship between the clinical outcome of subacute stroke patients and extracellular thiol-disulphide (SH-SS) and intracellular oxidized-reduced glutathione (GSSG-GSH) homeostasis and the effect of the rehabilitation program on these homeostasis.Methods: In this prospective observational study, outcome assessments (National Institutes of Health Stroke Scale Scores (NIHSS), modified Rankin Scale (mRS), and Barthel Daily Living Activities Index (BI)) and SH-SS and GSSG-GSH homeostasis parameters were investigated from 42 patients with subacute stroke before and after 4-week rehabilitation treatment protocol. Also, SH-SS and GSSG-GSH homeostasis parameters were measured from 35 healthy volunteers.Results: SS/SH and GSSG/GSH ratios were significantly higher in the patient group at baseline and post-rehabilitation than the control group (p<0.05). SS/SH ratio, GSSG/GSH ratio, NIHSS and mRS values significantly decreased with the rehabilitation (p<0.05). The baseline SS/SH and GSSG/GSH ratios were correlated with baseline and post-rehabilitation NIHSS, mRS and BI scores (p<0.05).Conclusions: The better outcomes of patients with higher baseline antioxidant thiol groups suggest that active thiol groups may play a role in achieving better outcomes in subacute stroke. In addition, rehabilitation treatment increased clinical scores and additionally shifted intracellular and extracellular thiol groups to the antioxidant side.

Automated summary

This study evaluated the relationship between the clinical outcome of subacute stroke patients and extracellular thiol-disulphide (SH-SS) and intracellular oxidized-reduced glutathione (GSSG-GSH) homeostasis and the effect of the rehabilitation program on these homeostasis. The results showed that patients had higher SH-SS and GSSG-GSH ratios compared to the control group, and these ratios decreased significantly after rehabilitation. Furthermore, the baseline ratios were correlated with clinical scores before and after rehabilitation. This suggests that active thiol groups may contribute to better outcomes in subacute stroke patients, and rehabilitation treatment can improve clinical scores and shift thiol groups towards the antioxidant side.