Ischemic Stroke Nutrition Intervention Study

Handgrip strength was measured in participants using an electronic dynamometer.

The change in handgrip strength from month 12 (end of intervention) to month 24 (end of follow-up) was assessed. This evaluation aimed to determine the sustained impact of the intervention on handgrip strength following the discontinuation of treatment.

The severity of neurological deficits in participants was evaluated using the National Institutes of Health Stroke Scale (NIHSS). This scale provides a standardized assessment, with total scores ranging from 0 (indicating no deficit) to 42 (representing severe neurological injury).

The functional neurological recovery of participants will be assessed using the Modified Rankin Scale (mRS). This scale (0-6) quantifies post-stroke disability, where lower scores indicate better outcomes.

The Mini-Mental State Examination (MMSE) will be administered to patients to evaluate cognitive function across multiple domains using a validated 30-point scale (0, severe impairment; 30, intact cognition), with higher scores indicating better cognitive performance.

This study will assess changes in head MRI of patients with ischemic stroke. Change in ischemic lesion volume includes enlargement or reduction of infarcts and the appearance of new ischemic lesions.

The progression of white matter lesions (especially in high-signal white matter and lesion expansion) will be detected through head MRI.

Cerebral blood flow and function (arterial blood supply and other ischemia-related imaging features) will be detected through head MRI.

The overall brain structural changes (brain atrophy and ventricular enlargement) will be detected through head MRI.

The body composition of patients will be measured using bioelectrical impedance analysis (BIA).

The Fugl-Meyer Assessment (FMA) was employed to evaluate motor function in the patient's upper and lower limbs, with total scores ranging from 0 to 100, where higher scores indicate better motor recovery.

The functional lower extremity strength of patients will be evaluated through the 30-second Chair Stand Test (CST).

The gait performance of patients will be measured using 6-meter walk tests.

The patients will receive carotid artery ultrasonography to quantify carotid intima-media thickness (IMT).

The patients will undergo carotid artery ultrasonography to detect changes in carotid plaques.

The Hospital Anxiety and Depression Scale (HADS) was administered to the patients, with the anxiety (HADS-A) and depression (HADS-D) subscales each yielding scores from 0 (asymptomatic) to 21 (severe symptoms).

The sleep quality of each patient will be evaluated by the Pittsburgh Sleep Quality Index (PSQI), with scores ranging from 0 to 21, with higher scores indicating poorer sleep quality

The SF-36 assesses 8 health domains (physical or mental function, pain, vitality, etc.) through 36 Likert-scale questions. Scores range from 0 (worst health) to 100 (best health) per domain.

Blood samples from the patients will be tested for biomarkers related to vitamin K2 (e.g., serum vitamin K2, dephosphorylated uncarboxylated matrix Gla-protein (dp-ucMGP)).

Blood samples from the patients will be tested for glycemic parameters (e.g., fasting blood glucose, fasting insulin).

Blood samples from the patients will be tested for lipid metabolism parameters (e.g., serum total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C)).

Blood samples from the patients will be tested for inflammation-related markers (e.g., IL-1β, IL-6, IL-8, IL-10, TNF-α, TGF-β, TNF-α-induced protein 3 (TNFAIP3), C-reactive protein (CRP)).

Blood samples from the patients will be tested for muscle damage and cardiovascular health indicators (e.g., creatine kinase (CK) and myoglobin (Mb)).

Transcriptomic sequencing will be performed on blood samples collected from the patients to observe changes in blood transcriptional levels.

Metabolomic sequencing will be performed on serum, urine, and fecal samples collected from the patients to observe changes in metabolic levels.

Microbiome sequencing will be conducted on fecal and saliva samples collected from the patients.

Cardiovascular and cerebrovascular events of the patients will be monitored during the follow-up.