Abstract Background and aims Glial cell line-derived neurotrophic factor (GDNF), predominantly expressed in astrocytes, plays an important role in regulating microglial activation, limiting neuroinflammation, and protecting against neurodegeneration in hemorrhagic stroke. To investigate the role of GDNF in the acute phase of hemorrhagic stroke as a predictor of disease outcome. Methods Eighty-three patients with hemorrhagic stroke of various localizations in the acute phase were examined, including 45 men (54.2%) and 38 women (45.7%), with a mean age of 62.3 years. Neurological status and stroke severity were assessed using the NIHSS, FOUR score, Barthel Index, and modified Rankin Scale. Patients were classified according to stroke severity. Serum GDNF levels were measured and compared with a control group. Results The mean GDNF level in the control group was 28.1 pg/mL. In patients with hemorrhagic stroke, GDNF levels increased significantly to 46.7 pg/mL within the first 3 hours after onset (p0.05). By day 14, GDNF levels decreased to 35.3 pg/mL (p0.05 compared with control), and by day 30 to 32.1 pg/mL (p0.05 compared with the 3-hour value). Patients with an unfavorable clinical course showed stable or decreasing GDNF levels during the acute phase. In contrast, patients with a favorable course demonstrated a significant increase in GDNF levels on day 14. Conclusions Neuroplasticity processes remain active even in severe hemorrhagic stroke. Dynamic changes in GDNF levels reflect neuroinflammatory and neuroplastic responses and may serve as predictors of disease outcome and potential therapeutic targets. Conflict of interest Fayzullo Mallayev: nothing to disclose
Mallaev et al. (2026) studied this question.