Abstract Details

Title Change in Thyroid Hormones in Acute and Chronic Stage of Ischemic Stroke (IS) and Their Association with Stroke Severity

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S43 - Stroke Recovery and Outcomes (5:18 PM-5:30 PM)

Poster/Presentation
Number 010

Objective

To test the hypothesis that thyroid hormones change from acute to chronic stage of ischemic stroke (IS) and explore if this change has association with stroke severity.

Background Behavior and role of thyroid hormones during acute and chronic stages of IS is unknown. Previous studies have conflicting evidence on change of T3/T4 during cerebral ischemia. Some animal studies demonstrate that thyroid hormones in acute stage of IS may decrease the size of infarct core. This study examines the change of thyroid hormones and TSH at different stages of IS and evaluates their association with stroke severity.

Design/Methods This is a prospective study on previously euthyroid IS patients who presented as stroke alert. We collected TSH, freeT3, and freeT4 levels at 3 time points: within 30 minutes of presentation; 3-5 days after admission; and in chronic stage after 3-6 months. We fitted linear fixed regression model for these time points to evaluate changes in TSH,freeT3,freeT4 from acute to chronic stage. Then, we evaluated association of TSH,freeT3,freeT4 with stroke severity quantified by NIHSS.

Results

Study recruited 51 patients with IS. FreeT3 levels decreased significantly from presentation (4.02pg/mL) to days 3-5 (3.65pg/mL) and then returned to initial value (4.02pg/mL) in chronic stage [p<0.0001]. FreeT4 levels also decreased significantly from presentation (1.51ng/dL) to days 3-5 (1.01ng/dL), and increased in chronic stage (1.08ng/dL) [p<0.0001]. We found no significant change in TSH in acute and chronic stage of IS. The change in freeT3 was significantly associated with NIHSS. A 0.04 unit decrease in freeT3 accounted for one point increase in NIHSS [p=0.0001].

Conclusions

Thyroid hormones significantly decrease from time of IS presentation to days 3-5, but tend to return to baseline during the chronic stage of IS. Observed change in freeT3 inversely correlated with stroke severity. Further research is warranted to validate this association.

Authors/Disclosures
PRESENTER	No disclosure on file
Claire E. Delpirou Nouh, MD (University of Oklahoma Health Science Center, Department of Neurology)	Dr. Delpirou Nouh has a non-compensated relationship as a Volunteer/Board member with Oklahoma Alzheimer Association that is relevant to AAN interests or activities.
	No disclosure on file
Chao Xu	Chao Xu has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Blair Apple	No disclosure on file
	No disclosure on file
Juliane Chainakul, APRN-CNS (OU Health - Department of Neurology)	Juliane Chainakul has nothing to disclose.
Evgeny Sidorov, MD (University of Oklahoma Hlth Sci Ctr)	Dr. Sidorov has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Allergan. Dr. Sidorov has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for BioHaven .

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