Biomarkers for prognostic functional recovery poststroke: A narrative review

Abstract

Background and objective: Prediction of poststroke recovery can be expressed by prognostic biomarkers that are related to the pathophysiology of stroke at the cellular and molecular level as well as to the brain structural and functional reserve after stroke at the systems neuroscience level. This study aimed to review potential biomarkers that can predict poststroke functional recovery.Methods: A narrative review was conducted to qualitatively summarize the current evidence on biomarkers used to predict poststroke functional recovery.Results: Neurophysiological measurements and neuroimaging of the brain and a wide diversity of molecules had been used as prognostic biomarkers to predict stroke recovery. Neurophysiological studies using resting-state electroencephalography (EEG) revealed an interhemispheric asymmetry, driven by an increase in low-frequency oscillation and a decrease in high-frequency oscillation in the ipsilesional hemisphere relative to the contralesional side, which was indicative of individual recovery potential. The magnitude of somatosensory evoked potentials and event-related desynchronization elicited by movement in task-related EEG was positively associated with the quantity of recovery. Besides, transcranial magnetic stimulation (TMS) studies revealed the potential values of using motor-evoked potentials (MEP) and TMS-evoked EEG potentials from the ipsilesional motor cortex as prognostic biomarkers. Brain structures measured using magnetic resonance imaging (MRI) have been implicated in stroke outcome prediction. Specifically, the damage to the corticospinal tract (CST) and anatomical motor connections disrupted by stroke lesion predicted motor recovery. In addition, a wide variety of molecular, genetic, and epigenetic biomarkers, including hemostasis, inflammation, tissue remodeling, apoptosis, oxidative stress, infection, metabolism, brain-derived, neuroendocrine, and cardiac biomarkers, etc., were associated with poor functional outcomes after stroke. However, challenges such as mixed evidence and analytical concerns such as specificity and sensitivity have to be addressed before including molecular biomarkers in routine clinical practice.Conclusion: Potential biomarkers with prognostic values for the prediction of functional recovery after stroke have been identified; however, a multimodal approach of biomarkers for prognostic prediction has rarely been studied in the literature. Future studies may incorporate a combination of multiple biomarkers from big data and develop algorithms using data mining methods to predict the recovery potential of patients after stroke in a more precise way.

Neural Mechanisms underlying Bimanual Coordination in Healthy and Stroke Individuals and Application of Non-Invasive Brain Stimulation: A Scoping Review

“…Speci cally, stimulation over the M1 on the impaired hemisphere than on the unimpaired hemisphere led to signi cant improvement in bimanual coordination in stroke patients with mild impairment. This is because, compared with other impairment levels, stimulation over the ipsilateral M1 leads to a great response, which is positively associated with motor recovery [71,72], which is also consistent with our ndings that reduced positive neural coupling between ipsilateral M1 and ipsilateral SMA was observed when performed BMCG in stroke patients compared with healthy individuals (Table S2). However, stroke patients with severe impairment did not bene t from simulation over the ipsilateral M1 because strong transcallosal inhibition from the unaffected hemisphere to the affected hemisphere reduced patient response to NIBS [28].…”

Correlation between the ERD in grasp/open tasks of BCIs and hand function of stroke patients: a cross-sectional study

“…A higher magnitude of ERD activity is related to larger cortical activation during motor tasks. ERD/ERS is triggered by the voluntary movement of the hemiparetic hand [ 27 ], movement-related beta ERD over the affected SMC has been investigated in many studies [ 28 , 29 ]. ERD in the alpha band (α-ERD, frequencies ranging from 8 to 13 Hz) has been hypothesized to reflect cortical activation or disinhibition.…”

Possibilities neuroimaging and neurophysiological research methods to objectify rehabilitation potential in patients with ischemic stroke (analytical review of the literature)

“…ВП также могут рассматриваться как дополнительный инструмент оценки РП. Особое внимание направлено на изучение возможностей использования слуховых и соматосенсорных вызванных потенциалов для прогноза неблагоприятных реабилитационных исходов [35][36][37]. Исследования, направленные на изучение возможностей использования ЭЭГ и ВП для прогноза реабилитационных исходов у пациентов с ИИ, несмотря на их многочисленность, в основном сконцентрированы на остром периоде инсульта, проведены на малочисленных и разнородных выборках, трудно сравнимы в связи с методологическими различиями.…”