400 Section - The effect of Exposome on Biodiversity and Human Functioning after Acquired Cerebrovascular Lesions

The exposome represents the complex set of environmental conditions (internal and external) to which an individual is exposed throughout their entire life. Studies correlating the exposome with human functioning outcomes in post-stroke patients are limited. The aim was to identify whether and in which way the exposome influences post-stroke recovery.

Design: The study was a multicenter, observational study and 109 post stroke and their caregivers living in rural and metropolitan areas were included. Patients were evaluated using 6 minutes walking test (6MWT), Box and blocks test (BBT), Timed up and go (TUG), MOCA test and biological markers (cortisol, melatonin and catecholamines, inflammatory cytokines, inflammasome and NK cell response, genetic polymorphisms and microRNAs).

Results:

73 men and 36 women were enrolled, 86 ischemic (79%) and 23 hemorrhagic (21%), 60 (55%) living in a metropolitan area and 49 (45%) in rural areas. Age was 66.8 ± 10.4 (43 - 89) years. Distance from acute event was 1 year (34%), 5 years (35%) and 10 years (31%). 6MWT was 361±143 vs 267±185 meters (p=0.004), BBT was 45±22 vs 15±15 blocks (p< 0.001), TUG 11.8±8.3 vs 29±39 seconds (p< 0.001), MOCA 20.9±4.2 vs 20.6±6.8 (p=0.491), TNF 46.5±90.3 vs 5.4±7.7 (p< 0.001), beta-endorphin 85.9±60.5 vs 105.9±59.2 (p=0.042)  in the metropolitan and rural groups respectively.

Conclusion:

The impact that the exposome can have on the rehabilitation outcomes of post-stroke patients define an important scientific context to be explored to propose new models for assessing health status resulting from integrated multimodal rehabilitation processes. The study of the exposome to which post-stroke patients and their caregivers are exposed is very important to ensure the persistence and potential improvement of clinical outcomes and long-term psychophysical well-being.