Uric Acid and Cu/Zn Superoxide Dismutase: Potential Strategies and Biomarkers in Functional Recovery of Post-Acute Ischemic Stroke Patients after Intensive Neurorehabilitation

No evidence is currently provided on the involvement of uric acid (UA) and Cu/Zn Superoxide Dismutase (Cu/Zn SOD) in functional recovery of stroke patients after neurorehabilitation. For this purpose, the relationship between UA and Cu/Zn SOD plasma levels and clinical and functional outcome measures were analysed in twenty-five post-acute stroke patients undergoing intensive neurorehabilitation. UA and Cu/Zn SOD plasma levels were evaluated in fifteen healthy subjects as control values. Neurorehabilitation was associated with improved scores (P< 0.05) of the National Institutes of Health Stroke Scale (NIHSS), the modified Rankin Scale (mRS), and the mPULSES profile. UA plasma levels were higher before neurorehabilitation, decreased after, but were still higher than control values. Conversely, Cu/Zn SOD plasma levels were lower than control values before neurorehabilitation and increased after, even though the absolute values were still lower than controls. An inverse correlation was found between variations of UA plasma levels observed before and after neurorehabilitation (Delta UA) and those of Cu/Zn SOD (Delta Cu/Zn SOD) (r= -0.386; P< 0.001). No significant correlations were observed between Delta UA and the variations of the scores observed in all clinical outcome measures before and after neurorehabilitation (Delta scores of clinical outcome measures). Delta Cu/Zn SOD correlated positively with Delta NIHSS, Delta mRS and Delta mPULSES scores. Our data provide evidence of neurorehabilitation effectiveness on modulating UA and Cu/Zn SOD plasma levels and suggest that Cu/Zn SOD could assume the significance of biomarker of functional recovery, rather than UA that could be a marker of the magnitude of oxidative injury.