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Stroke recovery

Deok Su Sin, Myoung Hyoun Kim, Soon-Ah Park, Min Cheol Joo, Min Su Kim
Objective: The purpose of this study is to investigate predictors of crossed cerebellar diaschisis (CCD), and the effects of CCD on functional outcomes including motor function, activities of daily living, cognitive function, and ambulation 6 months after onset in patients with intracerebral hemorrhage (ICH). Methods: A total of 74 patients experiencing their first ICH were recruited. If the asymmetric index was more than 10% using single photon emission computed tomography (SPECT), a diagnosis of CCD was confirmed...
February 2018: Annals of Rehabilitation Medicine
Kelly M Goedert, Peii Chen, Anne L Foundas, A M Barrett
Spatial neglect commonly follows right hemisphere stroke. It is defined as impaired contralesional stimulus detection, response, or action, causing functional disability. While prism adaptation treatment is highly promising to promote functional recovery of spatial neglect, not all individuals respond. Consistent with a primary effect of prism adaptation on spatial movements, we previously demonstrated that functional improvement after prism adaptation treatment is linked to frontal lobe lesions. However, that study was a treatment-only study with no randomised control group...
March 20, 2018: Neuropsychological Rehabilitation
Song Luo, Lijuan Yang, Yanfei Luo
Susceptibility-weighted imaging (SWI) is a non-invasive technique that can reveal venous structures and iron in the brain. This retrospective study evaluated SWI, relative to other imaging techniques, for determining cerebral infarct size and early-stage clinical prognosis in patients with acute ischemic stroke. Within 3 days after onset, 22 patients with acute ischemic stroke underwent SWI, diffusion-weighted imaging (DWI), perfusion-weighted imaging (PWI), fluid-attenuated inversion recovery (FLAIR), and magnetic resonance angiography (MRA)...
March 20, 2018: Neurological Sciences
Rebecca Lewthwaite, Carolee J Winstein, Christianne J Lane, Sarah Blanton, Burl R Wagenheim, Monica A Nelsen, Alexander W Dromerick, Steven L Wolf
BACKGROUND: Task-oriented therapies have been developed to address significant upper extremity disability that persists after stroke. Yet, the extent of and approach to rehabilitation and recovery remains unsatisfactory to many. OBJECTIVE: To compare a skill-directed investigational intervention with usual care treatment for body functions and structures, activities, participation, and quality of life outcomes. METHODS: On average, 46 days poststroke, 361 patients were randomized to 1 of 3 outpatient therapy groups: a patient-centered Accelerated Skill Acquisition Program (ASAP), dose-equivalent usual occupational therapy (DEUCC), or usual therapy (UCC)...
February 2018: Neurorehabilitation and Neural Repair
Yosuke Tomita, Aditi A Mullick, Mindy F Levin
Kinematic redundancy of the human body provides abundant movement patterns to accomplish the same motor goals (motor equivalence). Compensatory movement patterns such as excessive trunk displacement in stroke subjects during reaching can be viewed as a consequence of the motor equivalent process to accomplish a task despite limited available ranges in some joints. However, despite compensations, the ability to adapt reaching performance when perturbations occur may still be limited when condition-specific changes of joint angles are required...
February 2018: Neurorehabilitation and Neural Repair
Moniek A M Munneke, Chantal D Bakker, Eline A Goverde, Jaco W Pasman, Dick F Stegeman
After stroke, motor pathways are often affected, leading to paresis. It remains difficult to reliably predict motor recovery of the upper extremity, for which transcranial magnetic stimulation (TMS) may add to clinical examination. Placement of the surface electromyography (sEMG) electrodes in TMS is essential for information about specific muscle groups and corticospinal pathways. This study primarily aimed to determine the optimal sEMG electrode positions for recording activity of forearm flexor and extensor muscles...
March 1, 2018: Journal of Electromyography and Kinesiology
Wudan Yan
After suffering a stroke-perhaps a blood clot gets lodged in the brain or a blood vessel near the brain bursts-a person may suddenly not be able to hear, talk, or see. He or she might have trouble walking or exhibit a speech impediment. In fact, one of the greatest challenges of treating patients affected by stroke is that it's a heterogeneous condition, says Joel Stein, a physiatrist specializing in physical medicine and rehabilitation at Columbia University and Weill Cornell Medical College in New York City (Figure 1)...
March 2018: IEEE Pulse
Roberto Colombo, Alessandra Mazzone, Carmen Delconte, Fabrizio Pisano
Proprioception plays a fundamental role in maintaining posture and executing movement, and the quantitative evaluation of proprioceptive deficits in poststroke patients is important. But currently it is not widely performed due to the complexity of the evaluation tools required for a reliable assessment. The aims of this pilot study were to (a) develop a system architecture for upper limb evaluation and training of proximal and distal sense of position in the horizontal plane and (b) test the system in healthy and pathological subjects...
2018: Computational Intelligence and Neuroscience
Attila Kiss, Huaqing Shu, Ouafa Hamza, David Santer, Eva Verena Tretter, Shanglong Yao, Klaus Markstaller, Seth Hallström, Bruno K Podesser, Klaus Ulrich Klein
OBJECTIVES: Previous studies demonstrated that preconditioning with argon gas provided a marked reduction in inflammation and apoptosis and increased myocardial contractility in the setting of acute myocardial ischaemia-reperfusion (IR). There is substantial evidence that myocardial IR injury following cardioplegic arrest is associated with the enhancement of apoptosis and inflammation, which is considered to play a role in cardiac functional impairment. Therefore, the present study was designed to clarify whether preconditioning with argon gas enhances recovery of cardiac function following cardioplegic arrest...
March 13, 2018: European Journal of Cardio-thoracic Surgery
Khaled Elshazly, Varun R Kshettry, Christopher J Farrell, Gurston Nyquist, Marc Rosen, James J Evans
BACKGROUND: Giant pituitary adenomas represent a surgical challenge. We present the results of the endoscopic endonasal approach (EEA) for giant pituitary adenomas. METHODS: We retrospectively reviewed medical records of 55 patients with giant pituitary adenomas (> 4 cm in maximum diameter) that underwent an EEA from 2008 - 2016. Factors affecting the extent of resection (EOR) were evaluated. RESULTS: Mean age was 55.5 years. All tumors were non-functional except in four patients (GH-secreting [2], ACTH-secreting [1], prolactinoma [1])...
March 12, 2018: World Neurosurgery
Vera Leo, Aleksi J Sihvonen, Tanja Linnavalli, Mari Tervaniemi, Matti Laine, Seppo Soinila, Teppo Särkämö
Coupling novel verbal material with a musical melody can potentially aid in its learning and recall in healthy subjects, but this has never been systematically studied in stroke patients with cognitive deficits. In a counterbalanced design, we presented novel verbal material (short narrative stories) in both spoken and sung formats to stroke patients at the acute poststroke stage and 6 months poststroke. The task comprised three learning trials and a delayed recall trial. Memory performance on the spoken and sung tasks did not differ at the acute stage, whereas sung stories were learned and recalled significantly better compared with spoken stories at the 6 months poststroke stage...
March 15, 2018: Annals of the New York Academy of Sciences
Jacqueline S Laures-Gore, Penelope Leonard Lambert, Ann Cale Kruger, Jennifer Love, Don E Davis
The role of spirituality in post-stroke aphasia recovery has been ignored despite its potential contribution to positive health outcomes, particularly stroke recovery. The present study examines the spiritual experience of adults with aphasia in an effort to better understand the role of one's spirituality in the aphasia recovery process. Thirteen adults with aphasia completed a modified spirituality questionnaire and participated in semi-structured interviews. All participants considered themselves spiritual and reported improvements in communication during post-stroke recovery...
March 15, 2018: Journal of Religion and Health
Michelle Livne, Jens K Boldsen, Irene K Mikkelsen, Jochen B Fiebach, Jan Sobesky, Kim Mouridsen
BACKGROUND AND PURPOSE: Stroke imaging is pivotal for diagnosis and stratification of patients with acute ischemic stroke to treatment. The potential of combining multimodal information into reliable estimates of outcome learning calls for robust machine learning techniques with high flexibility and accuracy. We applied the novel extreme gradient boosting algorithm for multimodal magnetic resonance imaging-based infarct prediction. METHODS: In a retrospective analysis of 195 patients with acute ischemic stroke, fluid-attenuated inversion recovery, diffusion-weighted imaging, and 10 perfusion parameters were derived from acute magnetic resonance imaging scans...
March 14, 2018: Stroke; a Journal of Cerebral Circulation
Fang Wu, Haiqing Song, Qingfeng Ma, Jiayu Xiao, Tao Jiang, Xiaoqin Huang, Xiaoming Bi, Xiuhai Guo, Debiao Li, Qi Yang, Xunming Ji, Zhaoyang Fan
BACKGROUND AND PURPOSE: The aim of the present study was to investigate atherosclerotic plaque characteristics in patients with artery-to-artery (A-to-A) embolic infarction by whole-brain high-resolution magnetic resonance imaging. METHODS: Seventy-four patients (mean age, 54.7±12.1 years; 59 men) with recent stroke in the territory of middle cerebral artery because of intracranial atherosclerotic disease were prospectively enrolled. Whole-brain high-resolution magnetic resonance imaging was performed in all the patients both precontrast and postcontrast administration by using a 3-dimensional T1-weighted vessel wall magnetic resonance imaging technique known as inversion-recovery prepared sampling perfection with application-optimized contrast using different flip angle evolutions...
March 14, 2018: Stroke; a Journal of Cerebral Circulation
Mary E Orczykowski, Kevin R Arndt, Lauren E Palitz, Brian C Kramer, Monica A Pessina, Adrian L Oblak, Seth P Finklestein, Farzad Mortazavi, Douglas L Rosene, Tara L Moore
Stroke results in enduring damage to the brain which is accompanied by innate neurorestorative processes, such as reorganization of surviving circuits. Nevertheless, patients are often left with permanent residual impairments. Cell based therapy is an emerging therapeutic that may function to enhance the innate neurorestorative capacity of the brain. We previously evaluated human umbilical tissue-derived cells (hUTC) in our non-human primate model of cortical injury limited to the hand area of primary motor cortex...
March 11, 2018: Experimental Neurology
William J Pearce
In this issue of Acta Physiologica, Ansar et al. study the role of MAPK in ischemic stroke1 . The mitogen activated protein kinase (MAPK) pathways have long been recognized as major common mediators of stimuli that lead to cell growth and proliferation in numerous cell types. MAPK pathways also influence diverse cell processes such as differentiation, motility, and survival, often through activation of secondary downstream kinases (MAPKAP kinases)2 . This article is protected by copyright. All rights reserved...
March 14, 2018: Acta Physiologica
Zdeňka Hajšmanová, Pavla Šigutová, Alena Lavičková
Idarucizumab is designed to reverse the anticoagulant effect of dabigatran. This case report describes the administration of three independent doses of idarucizumab to a 76-year-old man suffering from atrial flutter being treated with dabigatran to prevent ischaemic stroke. The last dose of dabigatran was administered in the morning of the same day the patient was transferred to hospital because of the need for urgent pericardium puncture. Baseline dTT (dilute thrombin time) reached 700 ng/mL as glomerular filtration (GF) dropped to 0...
February 2018: Hämostaseologie
David Stevens, Rodrigo Tomazini Martins, Sutapa Mukherjee, Andrew Vakulin
Sleep-disordered breathing (SDB), encompassing both obstructive and central sleep apnea, is prevalent in at least 50% of stroke patients. Small studies have shown vast improvements in post-stroke functional recovery outcomes after the treatment of SDB by continuous positive airway pressure. However, compliance to this therapy is very poor in this complex patient group. There are alternative therapy options for SDB that may be more amenable for use in at least some post-stroke patients, including mandibular advancement, supine avoidance, and oxygen therapy...
2018: Frontiers in Surgery
Han-Gil Jeong, Beom Joon Kim, Jay Chol Choi, Keun-Sik Hong, Mi Hwa Yang, Cheolkyu Jung, Moon-Ku Han, Hee-Joon Bae
BACKGROUND AND PURPOSE: The majority of ischemic stroke patients receiving endovascular recanalization therapy (EVT) experience variable changes of neurological severities during the hyperacute period. We hypothesized that the National Institutes of Health Stroke Scale (NIHSS) score after EVT is a better prognostic factor compared with the initial NIHSS score or revascularization status. METHODS: We identified 566 stroke patients who received EVT at Seoul National University Bundang Hospital between April 2008 and December 2015...
March 13, 2018: Stroke; a Journal of Cerebral Circulation
Patrick D Ganzer, Michael J Darrow, Eric C Meyers, Bleyda R Solorzano, Andrea D Ruiz, Nicole M Robertson, Katherine S Adcock, Justin T James, Han S Jeong, April M Becker, Mark P Goldberg, David T Pruitt, Seth A Hays, Michael P Kilgard, Robert L Rennaker
Recovery from serious neurological injury requires substantial rewiring of neural circuits. Precisely-timed electrical stimulation could be used to restore corrective feedback mechanisms and promote adaptive plasticity after neurological insult, such as spinal cord injury (SCI) or stroke. This study provides the first evidence that closed-loop vagus nerve stimulation (CLV) based on the synaptic eligibility trace leads to dramatic recovery from the most common forms of SCI. The addition of CLV to rehabilitation promoted substantially more recovery of forelimb function compared to rehabilitation alone following chronic unilateral or bilateral cervical SCI in a rat model...
March 13, 2018: ELife
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