Nutrition for Brain Recovery After Ischemic Stroke: An Added Value to Rehabilitation

被引:52
作者
Aquilani, Roberto [2 ]
Sessarego, Paolo [3 ]
Iadarola, Paolo [4 ]
Barbieri, Annalisa [1 ]
Boschi, Federica [1 ]
机构
[1] Univ Pavia, Dipartimento Sci Farmaco, I-27100 Pavia, Italy
[2] Ist Sci Montescano, IRCCS, Serv Fisiopatol Metab Nutr & Nutr Clin, Fdn S Maugeri, Pavia, Italy
[3] Ist Sci Genova Nervi, Div Neuroriabilitaz, Genoa, Italy
[4] Univ Pavia, Dipartimento Biochim A Castellani, I-27100 Pavia, Italy
关键词
stroke; rehabilitation; dietary supplements; proteins; zinc; oxidative stress; CEREBRAL-ARTERY OCCLUSION; PROTEIN-SYNTHESIS; GENE-EXPRESSION; AMINO-ACIDS; BLOOD-FLOW; SUPPLEMENTATION; ZINC; METABOLISM; ION; TRANSLATION;
D O I
10.1177/0884533611405793
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
In patients who undergo rehabilitation after ischemic stroke, nutrition strategies are adopted to provide tube-fed individuals with adequate nutrition and/or to avoid the body wasting responsible for poor functional outcome and prolonged stay in the hospital. Investigations have documented that nutrition interventions can enhance the recovery of neurocognitive function in individuals with ischemic stroke. Experimental studies have shown that protein synthesis is suppressed in the ischemic penumbra. In clinical studies on rehabilitation patients designed to study the effects of counteracting or limiting this reduction of protein synthesis by providing protein supplementation, patients receiving such supplementation had enhanced recovery of neurocognitive function. Cellular damage in cerebral ischemia is also partly caused by oxidative damage secondary to free radical formation and lipid peroxidation. Increased oxidative stress negatively affects a patient's life and functional prognosis. Some studies have documented that nutrition supplementation with B-group vitamins may mitigate oxidative damage after acute ischemic stroke. Experimental investigations have also shown that cerebral ischemia changes synaptic zinc release and that acute ischemia increases zinc release, aggravating neuronal injury. In clinical practice, patients with ischemic stroke were found to have a lower than recommended dietary intake of zinc. Patients in whom daily zinc intake was normalized had better recovery of neurological deficits than subjects given a placebo. The aim of this review is to highlight those brain metabolic alterations susceptible to nutrition correction in clinical practice. The mechanisms underlying the relationship between cerebral ischemia and nutrition metabolic conditions are discussed. (Nutr Clin Pract. 2011;26:339-345)
引用
收藏
页码:339 / 345
页数:7
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