Abstract
Introduction: Insomnia is a sleep disorder in about 20% - 56% of patients. Insomnia is an indicator that predicts a poor prognosis of functional recovery. There is growing evidence about the importance of sleep in neuroplasticity and learning in stroke recovery, but sleep management has not generally been considered in stroke management and rehabilitation protocols.
Aims: To determine the relationship between insomnia severity and serum BDNF levels and other factors, namely stroke location, stroke severity, gender, age and depression with motor clinical outcomes in ischemic stroke patients.
Methods: Cross-sectional study. Insomnia was evaluated by the Insomnia Severity Index (ISI) score, clinical motor output was evaluated by the Barthel Index (BI) score and the Short-Fugl Mayer Assessment (S-FMA) score. Depression was evaluated with the Beck Depression Inventory score. Serum BDNF levels were measured at 5 - 7 days of onset. Stroke severity was assessed by the NIHSS score and the location of the stroke lesion was assessed by a non-contrast head CT scan. Bivariate and multivariate analysis of each factor on motor clinical outcome and multiple linear regression of all factors associated with motor clinical outcome, to assess the magnitude of the influence of these factors on motor clinical outcome in stroke patients. The results were significant if the p-value <0.05.
Results: There was no significant relationship between insomnia severity and motor clinical outcome (p = 0.936 and p = 0.116). There was no significant relationship between serum BDNF levels and motor clinical output (p = 0.183 and p = 0.819). There was a statistically significant relationship between age, stroke location and NIHSS with motor clinical outcome (Barthel Index) where age and NIHSS were more influential (p = 0.030 and p = 0.035) and had an effect of 48.5%. There was a significant relationship between gender, stroke location and NIHSS with motor clinical outcome (Short Fugl Mayer Assessment / S-FMA) where NIHSS was more influential (p = 0.002) and had an effect of 62.2%.
Discussion: There is no relationship between insomnia severity and motor clinical outcome in ischemic stroke patients. There is no relationship between serum BDNF levels and motor clinical outcomes in ischemic stroke patients. It was found that the relationship between other factors, namely age, gender, location of stroke lesions and NIHSS with motor clinical outcome of ischemic stroke patients, where age and NIHSS were the most influencing factors on the clinical outcome of ischemic stroke patients.

Key words: Insomnia, age, NIHSS, motor clinical outcome, ischemic stroke