To investigate the effect of treating patients with acute ischemic stroke with rt-PA, on the level of brain derived neurotrophic factor (BDNF) as a marker of neuroplasticity.

Recombinant tissue plasminogen activator (rt-PA) is known to greatly eliminate the disability of patients with acute ischemic stroke through its thrombolytic action.  Recently, much concern pointed to the crucial role of rt-PA in improving neuroplasticity.

This is a prospective observational case control study that was conducted on 47 patients presenting with acute ischemic stroke; 26 patients of them eligible for receiving rt-PA (during the first 4.5 hours from stroke onset)  (patient group) and 21 patients having contraindications for treatment with rt-PA (during the first 12 hours from stroke onset) (control group). Neurological and radiological assessment were done for both groups at the onset of stroke (before receiving rt-PA) and at day 7. BDNF serum level was also measured for both groups at the onset of stroke (before receiving rt-PA) and at day 7.

There was a statistically significant increase in BDNF serum level from day 1 to day 7 in rt-PA patients in comparison to control group (P-value? 0.001). Serum level of BDNF is significantly higher at the onset of stroke in female patients and non smokers than males or smokers (P-value= 0.011, 0.01 respectively). There was no effect of either age, body mass index, hypertension, diabetes, drug abuse, past or family history of stroke, valvular heart diseases, atrial fibrillation, cardiomyopathy, ejection fraction, carotid atherosclerotic changes, hematocrit, platelets, white blood cells, lipid profile or uric acid, on BDNF serum level measured at the onset of stroke.