Serum brain-derived neurotrophic factor and superoxide dismutase in post-stroke trunk control: a clinical correlation study

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Introduction. Post-stroke trunk control is crucial for functional recovery; however, its relationship with neuroplasticity and oxidative stress biomarkers remains unclear. This study investigated whether serum brain-derived neurotrophic factor (BDNF) and superoxide dismutase (SOD) levels correlate with trunk performance in chronic stroke survivors undergoing rehabilitation.

Materials and methods. In this randomized controlled trial, 69 participants (aged 45–85 years, with a minimum of 6 months post-stroke) were randomized into one of four groups: trunk rehabilitation exercises, transcranial direct current stimulation, combined therapy, or conventional therapy (control). Serum BDNF and SOD were measured pre- and post-intervention. Trunk control was assessed using the Trunk Impairment Scale (TIS), Postural Assessment Stroke Scale (PASS), and Rivermead Mobility Index (RMI). Pearson correlations and group comparisons were analysed.

Results. BDNF showed moderate positive correlations with PASS (r = 0.368, p < 0.001) and TIS (r = 0.263; p = 0.015), but no association with RMI (p = 0.270). SOD exhibited no significant correlations with any outcome (all p > 0.05). The combined therapy group achieved greater TIS improvements versus controls (Δ = 4.2 ± 1.8 vs. 2.1 ± 1.2; p = 0.030), though biomarker levels did not differ significantly between the groups (BDNF: p = 0.120; SOD: p = 0.450).

Conclusion. Serum BDNF, but not SOD, may serve as a biomarker for trunk recovery in chronic stroke, supporting its role in neuroplasticity-mediated rehabilitation. The dissociation between functional improvements and biomarker responses suggests complex recovery mechanisms beyond peripheral biochemical changes. These findings highlight BDNF’s potential for stratifying rehabilitation strategies while underscoring the need for further research on temporal biomarker dynamics.

About the authors

Abdulkareem M. Umar

Universiti Sultan Zainal Abidin; Federal University Dutse

Email: abdulkareemu54@gmail.com
ORCID iD: 0009-0000-7732-532X

PhD candidate, Department of orthopedics and rehabilitation, Faculty of Medicine, physiotherapist, Department of human physiology

Malaysia, Kuala Terengganu; Jigawa, Nigeria

Mohd A. Sharifudin

Universiti Sultan Zainal Abidin

Author for correspondence.
Email: dr.ariff.s@gmail.com
ORCID iD: 0000-0002-6796-2904

M.B.B.S., M.Med., Head, Medicine and Healthcare Research Cluster, lecturer, Department of orthopedics and rehabilitation, Faculty of medicine

Malaysia, Kuala Terengganu

Naresh B. Raj

Universiti Sultan Zainal Abidin

Email: bnaresh@unisza.edu.my
ORCID iD: 0000-0003-3367-2914

PhD, physiotherapist, lecturer, School of rehabilitation science, Faculty of health sciences

Malaysia, Kuala Terengganu

Aisha A. Ahmad

Bayero University

Email: aaahmad.pth@buk.edu.ng
ORCID iD: 0000-0003-1864-7091

PhD candidate, physiotherapist, Department of physiotherapy, Faculty of allied health science

Nigeria, Kano

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