Exploring metabolic and functional changes in stroke patients: insights from a urinary and blood-derived metabolomic study

Abstract

The neuropathological sequelae of stroke and subsequent process of recovery are incompletely understood. The manuscript-based thesis presented herein used a clinical pilot population to elucidate changes in cellular metabolic dynamics following stoke, thereby contributing to the existing knowledge base on the pathophysiological mechanisms orchestrating stroke recovery. The investigation explores these biochemical profiles via a nuclear magnetic resonance (NMR)-driven metabolomic profiling approach. The objective of this research was to determine if this powerful technique can (1) uncover the biochemical pathways underlying stroke repair and functional recovery and (2) yield novel biomarkers indicative of diagnosis, prognosis, and treatment efficacy subsequent to stroke. Urine samples and serum samples along with clinical stroke assessments were collected during the acute phase of stroke and the chronic phase, six months later. Employing a 700MHz 1H NMR spectrometer, the metabolomic profiles of the patients were acquired. Following NMR post-processing, a combination of univariate and multivariate statistical analysis, along with biological pathway analysis was conducted. Lastly, clinical correlations illustrated the relationship between significant metabolite concentrations and clinical measures. Ultimately, NMR-based metabolomics provided valuable insights into post-stroke cellular functions and established a foundational framework for future investigations to develop standardized clinical assays, advance personalized neurorehabilitation regimens, and enhance overall quality of life for stroke-afflicted individuals.