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Evidence suggests stroke recovery depends on metabolic stress levels

High-density lipoprotein (HDL), homocysteine and diabetes have been linked to poorer cognitive function and greater disability after stroke. This supports the view that metabolic stress plays a significant role in the post-stroke period. These conclusions were made by researchers from the USA and were published in the November 27 issue of Neurology. The results were drawn using data from the Vitamin Intervention for Stroke Prevention (VISP) trial, which used a linear mixed effects model. A total of 3680 subjects were analyzed; all over 35 years of age and entered into the VISP database between 1996 and 2003. Cognitive and motor function during a 2-year post-stroke period were assessed using scores from the MiniMental State Examination (MMSE) and modified Rankin Scale (mRS). Subjects with lower levels of both HDL and homocysteine were more likely to have memory difficulties and reduced motor activity following a stroke episode. The aim of the study was, “To delineate factors associated with cognitive function following stroke and test the hypothesis that vascular risk factors associated with oxidative stress impair recovery.” In addition to the metabolic stress factors, increased age, recurrent stroke and left hemisphere cortical lesions were independent predictors of less successful cognitive recovery. George Newman, who worked on the study, commented that, “It’s currently unclear why these factors are contributing to a slower stroke recovery and more research is needed. We need to focus our attention on identifying and treating these vascular risk factors since they can be modified.”