Lower serum BDNF as a predictor of post-stroke cognitive impairment in acute ischemic stroke patients

Abstract

Background Reduced level of serum brain-derived neurotrophic factor (BDNF) in acute stroke patients is associated with poor outcomes. We aimed to identify the role of serum BDNF level as a predictor for post-stroke cognitive impairment (PSCI). Methods This was a prospective study. We recruited acute ischemic stroke patients in Dr. Sardjito General Hospital Yogyakarta, Indonesia followed them up for 90 days (3 months). Serum BDNF was collected at day 5 and day 30 of stroke onset and measured by enzyme-linked immunosorbent assay (ELISA). Montreal Cognitive Assessment (MoCA) was used to measure the cognitive function at 90 days of follow up. Receiver operating characteristic (ROC) curve was conducted to measure the cut-off point of the BDNF level. Factors independently associated with PSCI were analyzed by using stepwise regression. Results Among 89 patients recruited, 60 patients (67.41%) developed PSCI. The mean age of PSCI and non-PSCI patients was 62.7 ± 9.5 and 57.5 ± 8.7, respectively (p = 0.01). Patients with dyslipidemia were less likely to develop PSCI (OR 0.10, 95%CI 0.02-0.51, p < 0.05). In addition, patients with day 5-serum BDNF level < 23.29 ng/mL were five times more likely to develop PSCI compared with their counterparts (OR 5.15, 95%CI 1.26-21.09, p < 0.05). Conclusions Among acute ischemic stroke patients, those with serum BDNF <23.29 ng/mL had a higher risk of developing PSCI. This study suggests that BDNF could be a predictor of PSCI, allowing for earlier detection and better preventive strategies.