Stroke remains to be a leading cause of severe long-term disability and mortality worldwide.  Studies have shown that inflammatory mechanisms are closely associated with a stroke and the release of inflammatory markers such as TNF-α and interleukin 1-β, following stroke injury aggravates the condition. The presence of certain inflammatory markers post-stroke serves as a predictor of disease severity and clinical outcomes. 
Tocotrienol and neuroprotective effects
The neuroprotective effects of alpha-tocotrienol have been demonstrated in several pre-clinical and epidemiological studies:
- Stroke-dependent brain tissue damage was studied in 12-Lox-deficient mice and spontaneously hypertensive rats orally supplemented with alpha-tocotrienol. Rats fed with tocotrienol showed more protection against stroke-induced injury compared with controls. Such protection was associated with lower c-Src activation and 12-Lox phosphorylation at the stroke site suggesting that the natural vitamin E, tocotrienol, acts on key molecular checkpoints to protect against stroke-induced neurodegeneration. 
- In a pre-clinical trial by scientists at the Ohio State University, canines were given palm tocotrienol supplements at 200 mg twice daily for 10 weeks before a stroke was induced in the transient middle cerebral artery, one of the major blood vessels in the brain. Results showed that tocotrienol supplementation significantly reduced ischemic stroke-induced lesion volume and prevented loss of nerve tissue connectivity. 
- Results from the AdNeuroMed Study, an European multicentre study on the relation of tocotrienol levels and markers of vitamin E damage to mild cognitive impairment (MCI) and Alzheimer’s disease (AD) showed that low tocotrienol levels are associated with MCI and AD. Further, both disorders were associated with increased vitamin E damage. 
- Results from the AdNeuroMed Study also showed that plasma levels of alpha and gamma tocotrienols when taken together with MRI measurements can prospectively predict the progression of MCI to AD. This study highlights tocotrienol’s role as a potential nutritional biomarker in patients with MCI and AD. 
- A clinical trial in Malaysia (results to be published) showed that oral supplementation with palm tocotrienols reduced the number of white matter lesions (WML) whilst the placebo controlled showed increase incidence of WML.
Results from these studies suggests alpha tocotrienol’s potential in maintaining brain and nerve health and supporting overall mental health through inhibition of nerve cell death  , and acting on key molecular pathways associated with stroke-induced nerve damage. 
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