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.