The Effect of Endurance Training on Serum BDNF Levels in the Chronic Post-Stroke Phase: Current Evidence and Qualitative Systematic Review

Neurotoxic and cytoprotective mechanisms in the ischemic neocortex

Neuronal damage in ischemic stroke occurs due to permanent imbalance between the metabolic needs of the brain and the ability of the blood-vascular system to maintain glucose delivery and adequate gas exchange. Oxidative stress and excitotoxicity trigger complex processes of neuroinflammation, necrosis, and apoptosis of both neurons and glial cells. This review summarizes data on the structural and chemical changes in the neocortex and main cytoprotective effects induced by focal ischemic stroke. We focus on the expression of neurotrophins (NT) and molecular and cellular changes in neurovascular units in ischemic brain. We also discuss how these factors affect the apoptosis of cortical cells. Ischemic damage involves close interaction of a wide range of signaling molecules, each acting as an efficient marker of cell state in both the ischemic core and penumbra. NTs play the main regulatory role in brain tissue recovery after ischemic injury. Heterogeneous distribution of the BDNF, NT-3, and GDNF immunoreactivity is concordant with the selective response of different types of cortical neurons and glia to ischemic injury and allows mapping the position of viable neurons. Astrocytes are the central link in neurovascular coupling in ischemic brain by providing other cells with a wide range of vasotropic factors. The NT expression coincides with the distribution of reactive astrocytes, marking the boundaries of the penumbra. The development of ischemic stroke is accompanied by a dramatic change in the distribution of GDNF reactivity. In early ischemic period, it is mainly observed in cortical neurons, while in late one, the bulk of GDNF-positive cells are various types of glia, in particular, astrocytes. The proportion of GDNF-positive astrocytes increases gradually throughout the ischemic period. Some factors that exert cytoprotective effects in early ischemic period may display neurotoxic and pro-apoptotic effects later on. The number of apoptotic cells in the ischemic brain tissue correlates with the BDNF levels, corroborating its protective effects. Cytoprotection and neuroplasticity are two lines of brain protection and recovery after ischemic stroke. NTs can be considered an important link in these processes. To develop efficient pharmacological therapy for ischemic brain injury, we have to deepen our understanding of neurochemical adaptation of brain tissue to acute stroke.

Effects of a Single Bout of Endurance Exercise on Brain-Derived Neurotrophic Factor in Humans: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

We aimed to investigate the impact of a single bout of endurance exercise on the brain-derived neurotrophic factor (BDNF) in humans and analyze how a single bout of endurance exercise impacts the peripheral BDNF types by age group. We performed a systematic literature review by searching PubMed, Elsevier, and Web of Science for studies that included a single bout of endurance exercise in the experimental group and other exercise types in the control group. Eight interventions were included in the study. Overall, a single bout of endurance exercise significantly increased BDNF expression (SMD = 0.30; 95% CI = [0.08, 0.52]; p = 0.001), which was confirmed in the serum BDNF (SMD = 0.30; 95% CI = [0.04, 0.55]; p < 0.001). A non-significant trend was observed in the plasma BDNF (SMD = 0.31; 95% CI = [−0.13, 0.76]; p = 0.017). The serum and plasma BDNF levels significantly increased regardless of age (SMD = 0.35; 95% CI = [0.11, 0.58]; p = 0.004; I2 = 0%). In conclusion, a single bout of endurance exercise significantly elevates BDNF levels in humans without neurological disorders, regardless of age. The serum BDNF is a more sensitive index than the plasma BDNF in evaluating the impact of a single bout of endurance exercise on the BDNF.