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Stroke recovery

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https://www.readbyqxmd.com/read/28645895/multiparity-improves-outcomes-after-cerebral-ischemia-in-female-mice-despite-features-of-increased-metabovascular-risk
#1
Rodney M Ritzel, Anita R Patel, Monica Spychala, Rajkumar Verma, Joshua Crapser, Edward C Koellhoffer, Anna Schrecengost, Evan R Jellison, Liang Zhu, Venugopal Reddy Venna, Louise D McCullough
Females show a varying degree of ischemic sensitivity throughout their lifespan, which is not fully explained by hormonal or genetic factors. Epidemiological data suggest that sex-specific life experiences such as pregnancy increase stroke risk. This work evaluated the role of parity on stroke outcome. Age-matched virgin (i.e., nulliparous) and multiparous mice were subjected to 60 min of reversible middle cerebral artery occlusion and evaluated for infarct volume, behavioral recovery, and inflammation. Using an established mating paradigm, fetal microchimeric cells present in maternal mice were also tracked after parturition and stroke...
June 23, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28645780/salvia-miltiorrhiza-bunge-danshen-extract-attenuates-permanent-cerebral-ischemia-through-inhibiting-platelet-activation-in-rats
#2
Yu-Xiang Fei, Si-Qi Wang, Li-Jian Yang, Yan-Ying Qiu, Yi-Ze Li, Wen-Yuan Liu, Tao Xi, Wei-Rong Fang, Yun-Man Li
ETHNOPHARMACOLOGICAL RELEVANCE: Danshen is a crude herbal drug isolated from dried roots of Salvia miltiorrhiza Bunge. This plant is widely used in oriental medicine for the treatment of cardiovascular and cerebrovascular diseases. The supercritical CO2 extract from Danshen (SCED) (57.85%, 5.67% and 4.55% for tanshinone IIA, tanshinone I and cryptotanshinone respectively) was studied in this article, whose potential molecular mechanism remains unclear, especially in anti-thrombosis. AIM OF THE STUDY: The present study was designed to observe the protective effect of SCED on ischemic stroke in rats and to explore the underlying anti-thrombosis mechanism...
June 20, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/28644260/intravenous-alteplase-for-acute-stroke-and-pulmonary-embolism-in-a-patient-with-recent-abdominoplasty
#3
Michael E Christiansen, Gyanendra Kumar, Raman C Mahabir, Richard A Helmers, Bernard R Bendok, Cumara B O'Carroll
INTRODUCTION: Major surgery in the past 14 days is a relative contraindication to treatment of acute stroke with intravenous (IV) alteplase. The 2016 American Heart Association/American Stroke Association scientific statement discussing inclusion and exclusion criteria for alteplase in acute stroke allows for provider judgment citing a lack of evidence to support surgery as an absolute contraindication. CASE REPORT: A 59-year-old woman presented with acute left hemiparesis, dysarthria, and acute respiratory failure...
July 2017: Neurologist
https://www.readbyqxmd.com/read/28643999/dexmedetomidine-and-general-anesthesia-a-narrative-literature-review-of-its-major-indications-for-use-in-adults-undergoing-non-cardiac-surgery
#4
Arthur Davy, Julien Fessler, Marc Fischler, Morgan le Guen
BACKGROUND: In Europe, dexmedetomidine has marketing approval only for sedation in intensive care units. However, its use during general anesthesia has been widely reported. The aim of this narrative review is to draw a picture of potential indications in anesthesia. METHODS: We searched in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials using the keywords "Dexmedetomidine, Dexdor, Precedex and Dexdomitor". The research ended in December 2016...
June 22, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28643802/optogenetic-rewiring-of-thalamocortical-circuits-to-restore-function-in-the-stroke-injured-brain
#5
Kelly A Tennant, Stephanie L Taylor, Emily R White, Craig E Brown
To regain sensorimotor functions after stroke, surviving neural circuits must reorganize and form new connections. Although the thalamus is critical for processing and relaying sensory information to the cortex, little is known about how stroke affects the structure and function of these connections, or whether a therapeutic approach targeting these circuits can improve recovery. Here we reveal with in vivo calcium imaging that stroke in somatosensory cortex dampens the excitability of surviving thalamocortical circuits...
June 23, 2017: Nature Communications
https://www.readbyqxmd.com/read/28642286/brain-regions-important-for-recovery-after-severe-post-stroke-upper-limb-paresis
#6
Jane M Rondina, Chang-Hyun Park, Nick S Ward
Background The ability to predict outcome after stroke is clinically important for planning treatment and for stratification in restorative clinical trials. In relation to the upper limbs, the main predictor of outcome is initial severity, with patients who present with mild to moderate impairment regaining about 70% of their initial impairment by 3 months post-stroke. However, in those with severe presentations, this proportional recovery applies in only about half, with the other half experiencing poor recovery...
June 22, 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/28640888/mechanisms-of-acute-neurovascular-protection-with-at1-blockade-after-stroke-effect-of-prestroke-hypertension
#7
Ahmed Alhusban, Anna Kozak, Bindu Pillai, Heba Ahmed, Mohammed A Sayed, Maribeth H Johnson, Tauheed Ishrat, Adviye Ergul, Susan C Fagan
Stroke is a leading cause of adult disability worldwide. Improving stroke outcome requires an orchestrated interplay that involves up regulation of pro-survival pathways and a concomitant suppression of pro-apoptotic mediators. In this investigation, we assessed the involvement of eNOS in the AT1 blocker-mediated protective and pro-recovery effects in animals with hypertension. We also evaluated the effect of acute eNOS inhibition in hypertensive animals. To achieve these goals, spontaneously hypertensive rats (SHR) were implanted with blood pressure transmitters, and randomized to receive either an eNOS inhibitor (L-NIO) or saline one hour before cerebral ischemia induction...
2017: PloS One
https://www.readbyqxmd.com/read/28640722/stroke-ineffective-tube-securement-reduces-nutrition-and-drug-treatment
#8
Sophie Brazier, Stephen J Taylor, Kaylee Allan, Rowan Clemente, Deirdre Toher
Stroke patients with dysphagia often depend on nutrition, hydration and medication via nasogastric (NG) feeding tubes. Securing tubes using tape is associated with repeated tube loss. In this study, the authors determined cause and effect by auditing tube placement methods, delays incurred, duration and costs. Of 202 NG tube placements in 75 patients, 67 placements occurred in 17 patients over a full course of enteral nutrition (EN) and 40 of these placements were tracked. Tubes were secured by tape in 100%, mittens 31% and special observation 5...
June 22, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28639376/mfat-1-transgene-protects-cultured-adult-neural-stem-cells-against-cobalt-chloride-mediated-hypoxic-injury-by-activating-nrf2-are-pathways
#9
Junfeng Yu, Haiyuan Yang, Bin Fang, Zhengwei Zhang, Ying Wang, Yifan Dai
Ischemic stroke is a devastating neurological disorder and one of the leading causes of death and serious disability in adults. Adult neural stem cell (NSC) replacement therapy is a promising treatment for both structural and functional neurological recovery. However, for the treatment to work, adult NSCs must be protected against hypoxic-ischemic damage in the ischemic penumbra. In the present study, we aimed to investigate the neuroprotective effects of the mfat-1 transgene on cobalt chloride (CoCl2 )-induced hypoxic-ischemic injury in cultured adult NSCs as well as its underlying mechanisms...
June 22, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/28638025/-music-therapy-as-an-effective-method-of-neurorehabilitation
#10
E Z Yakupov, A V Nalbat, M V Semenova, K A Tlegenova
AIM: To assess the role of music therapy in the recovery of motor, speech and autonomic functions in patients with ischemic stroke (II). MATERIAL AND METHODS: Forty-five patients with II in the middle cerebral artery were examined. The patients were randomized into three groups (main, comparison and control) of 15 individuals each. With patients of the first and the second groups on the 3rd, 5th, 7th and 9th days of the rehabilitation period the special set of exercises with music and without that respectively was fulfilled...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28637814/effective-assessments-of-electroencephalography-during-stroke-recovery-contemporary-approaches-and-considerations
#11
Kartik K Iyer
Stroke is one of the leading causes of permanent disability worldwide, relying conventionally on extended periods of physiotherapy to recover functional ability. While neuroimaging techniques and emerging neurorehabilitation paradigms have advanced our understanding of pathophysiological mechanisms underlying stroke, recent evidence has renewed focus on quantifying cortical features of electroencephalography to greatly enhance our understanding of stroke recovery. This Neuro Forum article reviews these key advances and discusses the importance of quantifying electroencephalography in future assessments of stroke survivors...
June 21, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28637125/bilateral-movements-increase-sustained-extensor-force-in-the-paretic-arm
#12
Nyeonju Kang, James H Cauraugh
PURPOSE: Muscle weakness in the extensors poststroke is a common motor impairment. Unfortunately, research is unclear on whether bilateral movements increase extensor force production in the paretic arm. This study investigated sustained force production while stroke individuals maximally extended their wrist and fingers on their paretic arm. Specifically, we determined isometric force production in three conditions: (a) unilateral paretic arm, (b) unilateral nonparetic arm, and (c) bilateral (both arms executing the same movement simultaneously)...
February 6, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28635374/sepsis-favors-high-on-clopidogrel-platelet-reactivity
#13
Karolina Akinosoglou, Angelos Perperis, Spyridoula Theodoraki, Dimitrios Alexopoulos, Charalambos Gogos
High-on-treatment platelet reactivity (HPR) is associated with ischemic events in patients on antiplatelet therapy with a history of cardiovascular disease. On the other hand, recent data have associated sepsis with adverse cardiovascular events in patients admitted with bacteremia or respiratory infection. We aimed to assess P2Y12-mediated platelet reactivity (PR) during sepsis and recovery in patients under clopidogrel. This was a prospective observational study. Incoming patients presenting with signs/symptoms of sepsis already on a maintenance dose of clopidogrel of 75 mg qd for cardiovascular events were included in this study...
June 21, 2017: Platelets
https://www.readbyqxmd.com/read/28634890/ccl11-eotaxin-1-levels-predict-long-term-functional-outcomes-in-patients-following-ischemic-stroke
#14
Meaghan Roy-O'Reilly, Rodney M Ritzel, Sarah E Conway, Ilene Staff, Gilbert Fortunato, Louise D McCullough
Circulating levels of the pro-inflammatory cytokine C-C motif chemokine 11 (CCL11, also known as eotaxin-1) are increased in several animal models of neuroinflammation, including traumatic brain injury and Alzheimer's disease. Increased levels of CCL11 have also been linked to decreased neurogenesis in mice. We hypothesized that circulating CCL11 levels would increase following ischemic stroke in mice and humans, and that higher CCL11 levels would correlate with poor long-term recovery in patients. As predicted, circulating levels of CCL11 in both young and aged mice increased significantly 24 h after experimental stroke...
June 21, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/28633996/effects-of-monoaminergic-drugs-on-training-induced-motor-cortex-plasticity-in-older-adults
#15
Trisha M Kesar, Samir R Belagaje, Paola Pergami, Marc W Haut, Gerald Hobbs, Cathrin M Buetefisch
Primary motor cortex (M1) plasticity is involved in motor learning and stroke motor recovery, and enhanced by increasing monoaminergic transmission. Age impacts these processes but there is a paucity of systematic studies on the effects of monoaminergic drugs in older adults. Here, in ten older adults (age 61+ 4 years, 4 males), we determine the effects of a single oral dose of carbidopa/levodopa (DOPA), d-amphetamine (AMPH), methylphenidate (MEPH) and placebo (PLAC) on M1 excitability and motor training-induced M1 plasticity...
June 17, 2017: Brain Research
https://www.readbyqxmd.com/read/28633329/mid-term-blood-pressure-variability-is-associated-with-clinical-outcome-after-ischemic-stroke
#16
Yibo Wang, Jin'e Wang, Pin Meng, Na Liu, Niu Ji, Guanghui Zhang, Bingchao Xu, Xinyu Zhou, Yong'an Sun, Yingda Xu, Rutai Hui, Mingli He
BACKGROUND: The aim of this study was to investigate the relation between mid-term blood pressure (BP) variability (BPV) within 7 days of onset and the prognosis in acute stroke patients. METHODS: Total 873 acute ischemic stroke patients were included in this study. Mid-term BPV was evaluated through the calculations of coefficient of variation (CV) of the systolic BP (SBP) and diastolic BP (DBP) within 7 days of onset. Clinical outcomes were assessed using the recovery situations of neurological function at 3 months, the primary outcome (symptomatic recurrent stroke) and the secondary outcomes (recurrent stroke, all-cause mortality, and the composite of cardiovascular events) within 12 months...
June 13, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28632508/combined-dextroamphetamine-and-transcranial-direct-current-stimulation-in-poststroke-aphasia
#17
Zafer Keser, Michelle Weber Dehgan, Shaparak Shadravan, Nuray Yozbatiran, Lynn M Maher, Gerard E Francisco
There is a growing need for various effective adjunctive treatment options for speech recovery after stroke. A pharmacological agent combined with noninvasive brain stimulation has not been previously reported for poststroke aphasia recovery. In this "proof of concept" study, we aimed to test the safety of a combined intervention consisting of dextroamphetamine, transcranial direct current stimulation, and speech and language therapy in subjects with nonfluent aphasia. Ten subjects with chronic nonfluent aphasia underwent two experiments where they received dextroamphetamine or placebo along with transcranial direct current stimulation and speech and language therapy on two separate days...
June 20, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28630233/motor-recovery-prediction-with-clinical-assessment-and-local-diffusion-homogeneity-after-acute-subcortical-infarction
#18
Gang Liu, Shuangquan Tan, Chao Dang, Kangqiang Peng, Chuanmiao Xie, Shihui Xing, Jinsheng Zeng
BACKGROUND AND PURPOSE: Initial clinical assessment or conventional diffusion tensor imaging parameters alone do not reliably predict poststroke recovery of motor function. Recently, local diffusion homogeneity (LDH) has been proposed to represent the local coherence of water molecule diffusion and can serve as a complementary marker for investigating white matter alterations of the brain. We aimed to determine whether a combination of initial clinical assessment and LDH could predict motor recovery after acute subcortical infarction...
June 19, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28629519/erythropoietin-endogenous-protection-of-ischemic-brain
#19
Robert T Mallet, Myoung-Gwi Ryou
The human brain requires uninterrupted delivery of blood-borne oxygen and nutrients to sustain its function. Focal ischemia, particularly, ischemic stroke, and global ischemia imposed by cardiac arrest disrupt the brain's fuel supply. The resultant ATP depletion initiates a complex injury cascade encompassing intracellular Ca(2+) overload, glutamate excitotoxicity, oxido-nitrosative stress, extracellular matrix degradation, and inflammation, culminating in neuronal and astroglial necrosis and apoptosis, neurocognitive deficits, and even death...
2017: Vitamins and Hormones
https://www.readbyqxmd.com/read/28628946/structural-plasticity-of-the-ventral-stream-and-aphasia-recovery
#20
Emilie T McKinnon, Julius Fridriksson, G Russell Glenn, Jens H Jensen, Joseph A Helpern, Alexandra Basilakos, Christopher Rorden, Andy Y Shih, M Vittoria Spampinato, Leonardo Bonilha
Re-strengthening of the residual language network is likely crucial for speech recovery in post-stroke aphasia. Eight participants with chronic aphasia received intensive speech therapy for three weeks, with standardized naming tests and brain MRIs before and after therapy. Kurtosis-based diffusion tensor tractography was used to measure mean kurtosis (MK) along a segment of the inferior longitudinal fasciculus (ILF). Therapy related reduction in the number of semantic but not phonemic errors was associated with strengthening (renormalization) of ILF MK (r=-0...
June 19, 2017: Annals of Neurology
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