Vagal Nerve Activity and Short-Term Clinical Outcomes after Stroke: What Is Left May Not Be Right
Stroke is a leading cause of death worldwide. Multiple factors influence the severity of stroke. Normal functional and biological differences seen between the hemispheres may also be related to stroke severity. In the present study, we examined the differences in the severity of stroke as a function...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/7/2446 |
| _version_ | 1797607668147290112 |
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| author | Samih Badarny Amal Abu Ayash Galina Keigler Chen Hanna Ryder Yori Gidron |
| author_facet | Samih Badarny Amal Abu Ayash Galina Keigler Chen Hanna Ryder Yori Gidron |
| author_sort | Samih Badarny |
| collection | DOAJ |
| description | Stroke is a leading cause of death worldwide. Multiple factors influence the severity of stroke. Normal functional and biological differences seen between the hemispheres may also be related to stroke severity. In the present study, we examined the differences in the severity of stroke as a function of stroke side, and whether patients’ vagal nerve activity moderated such differences. We included 87 patients with an ischemic stroke, whose medical records were retrospectively examined for background information (age, gender), stroke side and severity by NIHSS, length of stay in hospital, inflammation such as C-reactive protein, and vagal nerve activity. The vagal activity was indexed by patients’ heart-rate variability (HRV), fluctuations in the intervals between normal heartbeats, derived from patients’ ECG. Results revealed that patients with left-side stroke had significantly worse NIHSS scores (10.6) than those with right-sided stroke (7.6, <i>p</i> < 0.05). However, when dividing the sample into those with low versus high HRV (at the median), only when HRV was low, did patients with left-side stroke have a worse NIHSS score (10.9) compared to those with right-sided stroke (6.5, <i>p</i> < 0.05). In contrast, no differences in stroke severity were seen between left stroke (10.2) and right stoke (8.7, <i>p</i> > 0.05), when HRV was high. These results tended to remain the same when statistically controlling for age effects, which was related to NIHSS, but not to the stroke side. These findings suggest that patients with left-sided stroke may have more severe strokes than those with right-sided ones, but that adequate vagal nerve activity may protect against such differences. Possible mechanisms and suggestions for future directions are provided. |
| first_indexed | 2024-03-11T05:34:04Z |
| format | Article |
| id | doaj.art-aacdd7abe9964ff189443566557885e2 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T05:34:04Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-aacdd7abe9964ff189443566557885e22023-11-17T16:57:16ZengMDPI AGJournal of Clinical Medicine2077-03832023-03-01127244610.3390/jcm12072446Vagal Nerve Activity and Short-Term Clinical Outcomes after Stroke: What Is Left May Not Be RightSamih Badarny0Amal Abu Ayash1Galina Keigler2Chen Hanna Ryder3Yori Gidron4Department of Neurology, Galilee Medical Center, Nahariya 2210001, IsraelAzrieli Faculty of Medicine, Bar Ilan University, Safed 1311502, IsraelDepartment of Neurology, Galilee Medical Center, Nahariya 2210001, IsraelBrain & Behavior Research Institute, Western Galilee Academic College, Acre 2412101, IsraelDepartment of Nursing, Faculty of Social Welfare and Health Sciences, Haifa University, Haifa 3498838, IsraelStroke is a leading cause of death worldwide. Multiple factors influence the severity of stroke. Normal functional and biological differences seen between the hemispheres may also be related to stroke severity. In the present study, we examined the differences in the severity of stroke as a function of stroke side, and whether patients’ vagal nerve activity moderated such differences. We included 87 patients with an ischemic stroke, whose medical records were retrospectively examined for background information (age, gender), stroke side and severity by NIHSS, length of stay in hospital, inflammation such as C-reactive protein, and vagal nerve activity. The vagal activity was indexed by patients’ heart-rate variability (HRV), fluctuations in the intervals between normal heartbeats, derived from patients’ ECG. Results revealed that patients with left-side stroke had significantly worse NIHSS scores (10.6) than those with right-sided stroke (7.6, <i>p</i> < 0.05). However, when dividing the sample into those with low versus high HRV (at the median), only when HRV was low, did patients with left-side stroke have a worse NIHSS score (10.9) compared to those with right-sided stroke (6.5, <i>p</i> < 0.05). In contrast, no differences in stroke severity were seen between left stroke (10.2) and right stoke (8.7, <i>p</i> > 0.05), when HRV was high. These results tended to remain the same when statistically controlling for age effects, which was related to NIHSS, but not to the stroke side. These findings suggest that patients with left-sided stroke may have more severe strokes than those with right-sided ones, but that adequate vagal nerve activity may protect against such differences. Possible mechanisms and suggestions for future directions are provided.https://www.mdpi.com/2077-0383/12/7/2446strokestroke severityhemispheric differencesvegal nerve activityvegal nerve activity (HRV)stroke side |
| spellingShingle | Samih Badarny Amal Abu Ayash Galina Keigler Chen Hanna Ryder Yori Gidron Vagal Nerve Activity and Short-Term Clinical Outcomes after Stroke: What Is Left May Not Be Right Journal of Clinical Medicine stroke stroke severity hemispheric differences vegal nerve activity vegal nerve activity (HRV) stroke side |
| title | Vagal Nerve Activity and Short-Term Clinical Outcomes after Stroke: What Is Left May Not Be Right |
| title_full | Vagal Nerve Activity and Short-Term Clinical Outcomes after Stroke: What Is Left May Not Be Right |
| title_fullStr | Vagal Nerve Activity and Short-Term Clinical Outcomes after Stroke: What Is Left May Not Be Right |
| title_full_unstemmed | Vagal Nerve Activity and Short-Term Clinical Outcomes after Stroke: What Is Left May Not Be Right |
| title_short | Vagal Nerve Activity and Short-Term Clinical Outcomes after Stroke: What Is Left May Not Be Right |
| title_sort | vagal nerve activity and short term clinical outcomes after stroke what is left may not be right |
| topic | stroke stroke severity hemispheric differences vegal nerve activity vegal nerve activity (HRV) stroke side |
| url | https://www.mdpi.com/2077-0383/12/7/2446 |
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