ACCEPTANCE AND COMMITMENT THERAPY MODULATES IMMUNEINFLAMMATORY RESPONSES AND NEUROTROPHIC FACTORS HOMEOSTASIS IN ELDERLY STROKE PATIENTS: A RANDOMIZED CONTROLLED TRIAL
Abstract
Objective: This study examined the regulatory effects of Acceptance and Commitment Therapy (ACT) on T lymphocyte subsets, serum inflammatory cytokines, neurotransmitters, and oxidative stress markers in elderly cerebral stroke (CS) patients, providing insights into the multi-dimensional pathophysiological interactions and potential intervention strategies for chronic stroke recovery.
Methods: In this randomized controlled trial, 120 elderly stroke patients were allocated to either an ACT group (ACT intervention; n=60) or a routine group (conventional treatment; n=60). Comprehensive assessments were performed to quantify: (1) peripheral T lymphocyte distribution (CD3+, CD4+, CD8+ subsets, and CD4+/CD8+ ratio), (2) serum inflammatory cytokines (IL-1β, IL-6, IL-10, and TNF-α), (3) neurotransmitters (5-HT, NE, BDNF, and IGF-1), and (4) oxidative stress markers (SOD, MDA, CAT, and NO) using flow cytometry, HPLC-ECD, and ELISA. Statistical analyses were conducted with SPSS 22.0.
Results: Following treatment, CS patients exhibited reduced CD3+ and CD4+ T-cell levels along with a decreased CD4+/CD8+ ratio, while CD8+ T-cell proportions were elevated (P<0.05). Proinflammatory cytokine levels (IL-1β, IL-6, and TNF-α) were significantly suppressed, whereas anti-inflammatory IL-10 expression increased (P<0.05). Notably, ACT demonstrated superior efficacy in restoring immune balance and attenuating inflammation compared to conventional intervention (P<0.05). Furthermore, neurotransmitter levels were elevated, and oxidative stress markers were ameliorated in CS after treatment (P<0.05), suggesting that ACT enhances neurotrophic activity and mitigates oxidative injury.
Conclusion: ACT likely confers neuroprotection through multi-target mechanisms, including modulation of T-cell subset homeostasis, upregulation of neurotrophic factors, and suppression of oxidative stress. These findings provide a scientific foundation for integrating ACT into a psychobiological rehabilitation framework for elderly CS patients.
Copyright (c) 2025 Lingling Wu, Jing Wang, Haiyan Gu, Xiaorong Hu, Yanjie Zhou
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