Prolactin, cortisol secretion and thyroid function in patients with stroke of mild severity

Area of Science:

• Neuroendocrinology
• Neurology
• Internal Medicine

Background:

• The clinical significance of neuroendocrine changes and post-stroke depression (PSD) in mild stroke severity (SMS) is not well understood.
• Investigating these factors is crucial for understanding the recovery process after stroke.

Purpose of the Study:

• To evaluate neuroendocrine changes during the acute and post-acute phases of mild stroke severity (SMS).
• To determine the potential role of these changes in patient convalescence.
• To explore the relationship between neuroendocrine changes and post-stroke depression (PSD).

Main Methods:

• Measured serum cortisol, thyroid hormones (T4, T3, FT4, FT3), TSH, and PRL in 17 euthyroid patients.
• Assessed TSH and PRL secretion after TRH stimulation test.
• Evaluated stroke severity using the Scandinavian Stroke Scale (SSS) and depression with the Montgomery-Asberg Depression Rating Scale (Madrs).

Main Results:

• Lower basal TSH and reduced TSH response to TRH on day 2 correlated with greater stroke severity.
• Elevated Delta-PRL after TRH on day 2 was observed in patients who developed PSD.
• Thyroid hormone changes in SMS resembled those in non-thyroidal illness, with mild hypothalamic-pituitary-adrenal axis stimulation detected.

Conclusions:

• Neuroendocrine changes, particularly thyroid hormone fluctuations, reflect non-thyroidal illness in mild stroke.
• The prolactin (PRL) response to TRH in the acute phase of stroke may serve as an early indicator for detecting post-stroke depression (PSD).