The relationship between serum neurotransmitters and injury-related markers and sleep disorders in patients with acute ischemic stroke

Mi Huanjin; Liu Bin; Deng Chunying; Ma Yuanyuan; Wang Yanan; Ren Bo; Mao Wenjing

doi:10.3760/j.issn.1673-4777.2024.07.011

Abstract：Objective To investigate the relationship between the levels of serum neurotransmitters,5-hydroxytryptamine(5-HT),norepinephrine(NE),neuron-specific enolase(NSE),neurofilament heavy chain protein(NfH),S100β protein and sleep disorders in patients with acute ischemic stroke.Methods A total of 358 patients with acute ischemic stroke hospitalized in the Department of Neurology,North China University of Science and Technology Affiliated Hospital from November 2022 to October 2023 were selected.The Pittsburgh Sleep Quality Index(PSQI)scale was completed within 3 days after admission to evaluate the sleep condition of patients.According to PSQI score and results,the patients were divided into sleep disorder group(276 cases)and non-sleep disorder group(82 cases).The sleep disorder group was further divided into mild sleep disorder group(147 cases),moderate sleep disorder group(96 cases)and severe sleep disorder group(33 cases).The serum levels of 5-HT,NE,NSE,NfH and S100β were compared among the groups.Logistic regression method was used to analyze the risk factors of sleep disorders after acute ischemic stroke.Spearman correlation method was used to analyze the correlation between serum 5-HT,NE,NSE,NfH,S100β protein and the severity of sleep disorder in patients with acute ischemic stroke.Results The serum levels of 5-HT and NE in sleep disorder group were lower than those in non-sleep disorder group[(248±90)ng/L vs(422±48)ng/L,(147±50)ng/L vs(270±46)ng/L],and the levels of NSE,NfH and S100β protein in the sleep disorder group were higher than those in the non-sleep disorder group[(9.2±3.0)μg/L vs(5.2±1.6)μg/L,(85±24)ng/L vs(51±12)ng/L,(798±174)ng/L vs(480±98)ng/L](all P＜0.001).Logistic regression analysis showed that 5-HT,NE,NSE,NfH and S100βprotein were independent risk factors for sleep disorders after acute ischemic stroke(all P＜0.05).Among them,5-HT and NE were protective factors,and NSE,NfH and S100β protein were risk factors.Spearman correlation analysis showed that the severity of sleep disorders was negatively correlated with the levels of 5-HT and NE in patients with acute ischemic stroke(r=-0.902,-0.942,both P＜0.001),and positively correlated with the levels of NSE,NfH and S100β(r=0.774,0.775,0.878,all P＜0.001).Conclusions The serum levels of 5-HT,NE,NSE,NfH and S100β protein were correlated with sleep disorders and their severity in patients with acute ischemic stroke.The severity of sleep disorders was negatively correlated with serum levels of 5-HT and NE,and positively correlated with serum levels of NSE,NfH and S100β protein.