Background: Acute Ischemic Stroke (AIS) represents an economic challenge for health
systems all over the globe. Changes of neuroactive steroids have been found in different neurological
diseases. We have previously demonstrated that old patients with AIS show changes of plasma
cortisol and estradiol concentrations, in that increased steroid levels are associated with a deterioration
of neurological status and a worse cognitive decline.
Objective: The present study assessed in patients with AIS if changes of behavior, Brain-Derived
Neurotrophic Factor (BDNF) and Nitrites (NO-2) bear a relationship with the degree of hypercortisolism.
Methods: We recruited patients hospitalized within the first 24 hours of AIS. Subjects were divided
into two groups, each one composed of 40 control subjects and 40 AIS patients, including men and
women. The neurological condition was assessed using the National Institute of Health Stroke Scale
(NIHSS) and the cognitive status with the Montreal Cognitive Assessment (MoCA). The emotional
status was evaluated using the Montgomery-Asberg Depression Rating Scale (MADRS), whereas
the Modified Rankin Scale (MRS) was used to determine the functional condition. BDNF and NO-2
plasma levels were measured by ELISA and the Griess reaction method, respectively.
Results: We found that in AIS patients, increased plasma cortisol was negatively correlated with
plasma BDNF and NO-2 levels, neurological condition, cognition, functional responses and emotional
status, suggesting a relationship between the declines of clinical, behavioral and blood parameters
with stress-induced cortisol elevation.
Conclusion: Nitrites and BDNF may represent potential biomarkers for cortisol negative effects on
the area of cerebral ischemia and penumbra, potentiating ischemic cell damage.