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Collyer E, Blanco-Suarez E. Astrocytes in stroke-induced neurodegeneration: a timeline. FRONTIERS IN MOLECULAR MEDICINE 2023; 3:1240862. [PMID: 39086680 PMCID: PMC11285566 DOI: 10.3389/fmmed.2023.1240862] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/22/2023] [Indexed: 08/02/2024]
Abstract
Stroke is a condition characterized by sudden deprivation of blood flow to a brain region and defined by different post-injury phases, which involve various molecular and cellular cascades. At an early stage during the acute phase, fast initial cell death occurs, followed by inflammation and scarring. This is followed by a sub-acute or recovery phase when endogenous plasticity mechanisms may promote spontaneous recovery, depending on various factors that are yet to be completely understood. At later time points, stroke leads to greater neurodegeneration compared to healthy controls in both clinical and preclinical studies, this is evident during the chronic phase when recovery slows down and neurodegenerative signatures appear. Astrocytes have been studied in the context of ischemic stroke due to their role in glutamate re-uptake, as components of the neurovascular unit, as building blocks of the glial scar, and synaptic plasticity regulators. All these roles render astrocytes interesting, yet understudied players in the context of stroke-induced neurodegeneration. With this review, we provide a summary of previous research, highlight astrocytes as potential therapeutic targets, and formulate questions about the role of astrocytes in the mechanisms during the acute, sub-acute, and chronic post-stroke phases that may lead to neurorestoration or neurodegeneration.
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Affiliation(s)
| | - Elena Blanco-Suarez
- Department of Neuroscience, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, PA, United States
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Kim Y, Park C, Yoon B, You J(SH. Bolstering Cognitive and Locomotor Function in Post-Stroke Dementia Using Human-Robotic Interactive Gait Training. J Clin Med 2023; 12:5661. [PMID: 37685727 PMCID: PMC10488393 DOI: 10.3390/jcm12175661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/25/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
Studies have reported inconclusive results regarding the effectiveness and clinical indications of the exclusive use of human-robotic interactive gait training (HIT) in patients with post-stroke dementia (PSD). This study aimed to compare the effects of human-robotic interactive gait training (HIT) and conventional physiotherapy (CPT) on cognitive and sensorimotor functions, trunk balance and coordination, dynamic and static balance, and activities related to daily living performance in patients with PSD. Forty-eight patients with PSD who received 60-minute therapy sessions three times per week for 6 weeks were assigned to either the CPT (n = 25) or HIT (n = 23) group. The clinical outcomes included the scores of the mini-mental state examination (MMSE), Fugl-Meyer assessment (FMA), trunk impairment scale (TIS), Berg balance scale (BBS), and modified Barthel index (MBI). Friedman tests were conducted at p < 0.05. The Friedman tests showed that HIT had superior effects to CPT in relation to MMSE, FMA, and TIS (p < 0.05), but not in relation to BBS and MBI (p > 0.05). Our results provide promising clinical evidence that HIT significantly improves cognitive and sensorimotor recovery functions, as well as trunk balance and coordination, in patients with PSD who cannot concurrently perform dual cognitive-locomotor tasks.
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Affiliation(s)
| | | | | | - Joshua (Sung) H. You
- Sports Movement Artificial Robotics Technology (SMART) Institute, Department of Physical Therapy, Yonsei University, Wonju 26943, Republic of Korea; (Y.K.); (C.P.); (B.Y.)
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Prajjwal P, Marsool MDM, Inban P, Sharma B, Asharaf S, Aleti S, Gadam S, Al Sakini AS, Hadi DD. Vascular dementia subtypes, pathophysiology, genetics, neuroimaging, biomarkers, and treatment updates along with its association with Alzheimer's dementia and diabetes mellitus. Dis Mon 2023; 69:101557. [PMID: 37031059 DOI: 10.1016/j.disamonth.2023.101557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2023]
Abstract
Dementia is a chronic progressive cognitive decline illness that results in functional impairment. Vascular dementia (VaD), second only to Alzheimer's disease (AD), is one of the most prevalent forms of dementia in the elderly (aged over 65 years), with a varied presentation and unpredictable disease development caused by cerebrovascular or cardiovascular illness. To get a better understanding of the changes occurring in the brain and to drive therapy efforts, new biomarkers for early and precise diagnosis of AD and VaD are required. In this review, Firstly, we describe the subtypes of vascular dementia, their clinical features, pathogenesis, genetics implemented, and their associated neuroimaging and biomarkers, while describing extensively the recent biomarkers discovered in the literature. Secondly, we describe some of the well-documented and other less-defined risk factors and their association and pathophysiology in relation to vascular dementia. Finally, we follow recent updates in the management of vascular dementia along with its association and differentiation from Alzheimer's disease. The aim of this review is to gather the scattered updates and the most recent changes in blood, CSF, and neuroimaging biomarkers related to the multiple subtypes of vascular dementia along with its association with Alzheimer's dementia and diabetes mellitus.
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Affiliation(s)
| | | | - Pugazhendi Inban
- Internal Medicine, Government Medical College, Omandurar, Chennai, India
| | | | - Shahnaz Asharaf
- Internal Medicine, Travancore Medical College, Kollam, Kerala, India
| | - Soumya Aleti
- PGY-2, Internal Medicine, Berkshire Medical Center, Pittsfield, MA, USA
| | - Srikanth Gadam
- Internal Medicine, Postdoctoral Research Fellow, Mayo Clinic, USA
| | | | - Dalia Dhia Hadi
- University of Baghdad, Al-Kindy College of Medicine, Baghdad, Iraq
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Dove A, Marseglia A, Shang Y, Grande G, Vetrano DL, Laukka EJ, Fratiglioni L, Xu W. Cardiometabolic multimorbidity accelerates cognitive decline and dementia progression. Alzheimers Dement 2023; 19:821-830. [PMID: 35708183 DOI: 10.1002/alz.12708] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 05/02/2022] [Accepted: 05/04/2022] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Cardiometabolic diseases (CMDs) have been individually associated with adverse cognitive outcomes, but their combined effect has not been investigated. METHODS A total of 2577 dementia-free participants 60 years of age or older were followed for 12 years to observe changes in cognitive function and to detect incident cognitive impairment, no dementia (CIND) and dementia. CMDs (including type 2 diabetes, heart disease, and stroke) were assessed at baseline through medical records and clinical examinations. Cardiometabolic multimorbidity was defined as the presence of two or more CMDs. Data were analyzed using multi-adjusted linear mixed-effects models, Cox regression, and Laplace regression. RESULTS CMD multimorbidity was associated with cognitive decline, CIND (hazard ratio [HR] 1.73; 95% confidence interval CI 1.23 to 2.44), and its progression to dementia (HR 1.86; 95% CI 1.17 to 2.97). CMD multimorbidity accelerated the onset of CIND by 2.3 years and dementia by 1.8 years. CONCLUSIONS CMD multimorbidity accelerates cognitive decline and increases the risk of both CIND and its conversion to dementia. HIGHLIGHTS We explored the combined impact of cardiometabolic diseases (CMDs) on cognition. An increasing number of CMDs dose-dependently accelerated cognitive decline. CMD multimorbidity increased the risk of both cognitive impairment and dementia. Co-morbid CMDs could be ideal targets for interventions to protect cognitive health.
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Affiliation(s)
- Abigail Dove
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Anna Marseglia
- Department of Neurobiology, Care Sciences, and Society, Center for Alzheimer Research, Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden
| | - Ying Shang
- Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Giulia Grande
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Davide Liborio Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Erika J Laukka
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Weili Xu
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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Xie Y, Acosta JN, Ye Y, Demarais ZS, Conlon CJ, Chen M, Zhao H, Falcone GJ. Whole-Exome Sequencing Analyses Support a Role of Vitamin D Metabolism in Ischemic Stroke. Stroke 2023; 54:800-809. [PMID: 36762557 PMCID: PMC10467223 DOI: 10.1161/strokeaha.122.040883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 12/22/2022] [Indexed: 02/11/2023]
Abstract
BACKGROUND Ischemic stroke (IS) is a highly heritable trait, and genome-wide association studies have identified several commonly occurring susceptibility risk loci for this condition. However, there are limited data on the contribution of rare genetic variation to IS. METHODS We conducted an exome-wide study using whole-exome sequencing data from 152 058 UK Biobank participants, including 1777 IS cases. We performed single-variant analyses for rare variants and gene-based analyses for loss-of-function and deleterious missense rare variants. We validated these results through (1) gene-based testing using summary statistics from MEGASTROKE-a genome-wide association study of IS that included 67 162 IS cases and 454 450 controls, (2) gene-based testing using individual-level data from 1706 IS survivors, including 142 recurrent IS cases, enrolled in the VISP trial (Vitamin Intervention for Stroke Prevention); and (3) gene-based testing against neuroimaging phenotypes related to cerebrovascular disease using summary-level data from 42 310 UK Biobank participants with available magnetic resonance imaging data. RESULTS In single-variant association analyses, none of the evaluated variants were associated with IS at genome-wide significance levels (P<5×10-8). In the gene-based analysis focused on loss-of-function and deleterious missense variants, rare genetic variation at CYP2R1 was significantly associated with IS risk (P=2.6×10-6), exceeding the Bonferroni-corrected threshold for 16 074 tests (P<3.1×10-6). Validations analyses indicated that CYP2R1 was associated with IS risk in MEGASTROKE (gene-based test, P=0.003), with IS recurrence in the VISP trial (gene-based test, P=0.001) and with neuroimaging traits (white matter hyperintensity, mean diffusivity, and fractional anisotropy) in the UK Biobank neuroimaging study (all gene-based tests, P<0.05). CONCLUSIONS Because CYP2R1 plays an important role in vitamin D metabolism and existing observational evidence suggests an association between vitamin D levels and cerebrovascular disease, our results support a role of this pathway in the occurrence of IS.
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Affiliation(s)
- Yuhan Xie
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Julián N. Acosta
- Department of Neurology, Yale School of Medicine, New Haven, CT, USA
| | - Yixuan Ye
- Program of Computational Biology and Bioinformatics, Yale School of Medicine, New Haven, CT, USA
| | - Zachariah S. Demarais
- Frank H. Netter M.D. School of Medicine, Quinnipiac University, North Haven, CT, USA
| | - Carolyn J. Conlon
- Frank H. Netter M.D. School of Medicine, Quinnipiac University, North Haven, CT, USA
| | - Ming Chen
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Hongyu Zhao
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
- Program of Computational Biology and Bioinformatics, Yale School of Medicine, New Haven, CT, USA
| | - Guido J. Falcone
- Department of Neurology, Yale School of Medicine, New Haven, CT, USA
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Left-truncated health insurance claims data: theoretical review and empirical application. ASTA ADVANCES IN STATISTICAL ANALYSIS 2023. [DOI: 10.1007/s10182-023-00471-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
AbstractFrom the inventory of the health insurer AOK in 2004, we draw a sample of a quarter million people and follow each person’s health claims continuously until 2013. Our aim is to estimate the effect of a stroke on the dementia onset probability for Germans born in the first half of the 20th century. People deceased before 2004 are randomly left-truncated, and especially their number is unknown. Filtrations, modelling the missing data, enable circumventing the unknown number of truncated persons by using a conditional likelihood. Dementia onset after 2013 is a fixed right-censoring event. For each observed health history, Jacod’s formula yields its conditional likelihood contribution. Asymptotic normality of the estimated intensities is derived, related to a sample size definition including the number of truncated people. The standard error results from the asymptotic normality and is easily computable, despite the unknown sample size. The claims data reveal that after a stroke, with time measured in years, the intensity of dementia onset increases from 0.02 to 0.07. Using the independence of the two estimated intensities, a 95% confidence interval for their difference is [0.053, 0.057]. The effect halves when we extend the analysis to an age-inhomogeneous model, but does not change further when we additionally adjust for multi-morbidity.
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Kao YS, Yeh CC, Chen YF. The Relationship between Cancer and Dementia: An Updated Review. Cancers (Basel) 2023; 15:cancers15030640. [PMID: 36765598 PMCID: PMC9913793 DOI: 10.3390/cancers15030640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 01/22/2023] Open
Abstract
The risk of cancer and dementia increases with age, raising complex questions about whether it is appropriate to continue cancer treatment in older patients. There is emerging research suggesting the association between cancer and dementia. However, the mechanistic underpinnings are still under investigation. Progress has already been made toward understanding the cognitive effects associated with cancer therapy. Such associations raise awareness about the need to establish better prevention methods and early screening in clinical practice. Additionally, recent studies have suggested possible therapeutic strategies for better preserving cognitive function and reducing the risk for dementia before patients start cancer treatment. We review the current literature and summarize the incidence and mechanisms of cognitive impairment in patients with lung cancer, breast cancer, head and neck cancer, gastric cancer, prostate cancer, colorectal cancer, and brain tumor/brain metastasis following different kinds of therapies. Possible risk factors are suggested to identify the early onset of cognitive changes in cancer patients and provide more insight into the pathophysiological process of dementia.
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Affiliation(s)
| | - Cheng-Chang Yeh
- Department of Oral Hygiene Care, Ching-Kuo Institute of Management and Health, Keelung 203, Taiwan
| | - Yi-Fang Chen
- Department of Senior Citizen Service Management, National Taichung University of Science and Technology, Taichung 403, Taiwan
- Correspondence:
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Matsuzono K, Suzuki M, Anan Y, Ozawa T, Mashiko T, Koide R, Tanaka R, Fujimoto S. Spontaneous Echo Contrast in the Left Atrium and Aortic-Arch Atheroma, Detected by Transesophageal Echocardiography, Was Negatively Correlated with Cognitive Function. J Alzheimers Dis 2023; 91:673-681. [PMID: 36463447 DOI: 10.3233/jad-220763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
BACKGROUND The relationship between transesophageal echocardiography findings and cognitive function. OBJECTIVE This study aimed to establish an association between transesophageal echocardiography findings and cognitive function in stroke survivors. METHODS A single-center study was conducted between April 1, 2017 and March 31, 2022. All subjects that were included had a past history of ischemic stroke and were admitted after >21 days from onset. The participants underwent cognitive function tests including a Mini-Mental State Examination, Revised Hasegawa Dementia Scale, Frontal Assessment Battery, and transesophageal echocardiography. RESULTS The results of 126 participants were analyzed. The cognitive function of participants with a spontaneous echo contrast (+) in the left atrium including appendage or of those with an aorta-arch plaque with a maximum thickness ≥4 mm significantly worse while neither the patent foramen ovale nor the branch extending plaque influenced cognitive function (The median cognitive scores of the spontaneous echo contrast (-) versus (+) were 26 versus 22, p < 0.01**, 26 versus 21, p < 0.001***, and 14 versus 11, p < 0.01**. Those of the aortic-arch plaque max thickness (<4 mm) versus (≥4 mm) were 26 versus 25, p < 0.05*, 27 versus 24, p < 0.05*, and 15 versus 13, p < 0.05*). CONCLUSION Our findings show that spontaneous echo contrast in the left atrium and aortic-arch atheroma detected by transesophageal echocardiography, were negatively associated with cognitive function.
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Affiliation(s)
- Kosuke Matsuzono
- Division of Neurology, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Masayuki Suzuki
- Division of Neurology, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Yuhei Anan
- Division of Neurology, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Tadashi Ozawa
- Division of Neurology, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Takafumi Mashiko
- Division of Neurology, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Reiji Koide
- Division of Neurology, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Ryota Tanaka
- Division of Neurology, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Shigeru Fujimoto
- Division of Neurology, Department of Medicine, Jichi Medical University, Tochigi, Japan
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Cova I, Mele F, Zerini F, Maggiore L, Rosa S, Cucumo V, Brambilla M, Nicotra A, Maestri G, Bertora P, Pomati S, Pantoni L. The Clock Drawing Test as a predictor of cognitive decline in non-demented stroke patients. J Neurol 2022; 269:342-349. [PMID: 34095964 PMCID: PMC8739305 DOI: 10.1007/s00415-021-10637-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND The early detection of patients at risk of post-stroke cognitive impairment (PSCI) may help planning subacute and long-term care. We aimed to determine the predictivity of two screening cognitive tests on the occurrence of mild cognitive impairment or dementia in acute stroke patients. METHODS A cognitive assessment within a few days of ischemic or hemorrhagic stroke was performed in patients consecutively admitted to a stroke unit over 14 months by means of the Clock Drawing Test (CDT) and the Montreal Cognitive Assessment-Basic (MoCA-B). RESULTS Out of 191 stroke survivors who were non-demented at baseline, 168 attended at least one follow-up visit. At follow-up (mean duration ± SD 12.8 ± 8.7 months), 28 (18.9%) incident cases of MCI and 27 (18%) cases of dementia were recorded. In comparison with patients who remained cognitively stable at follow-up, these patients were older, less educated, had more comorbidities, a higher score on the National Institutes of Health Stroke Scale (NIHSS) at admission, more severe cerebral atrophy, and lower MoCA-B and CDT scores at baseline. In multi-adjusted (for age, education, comorbidities score, NIHSS at admission and atrophy score) model, a pathological score on baseline CDT (< 6.55) was associated with a higher risk of PSCI at follow-up (HR 2.022; 95% CI 1.025-3.989, p < 0.05) with respect to non-pathological scores. A pathological baseline score on MoCA-B (< 24) did not predict increased risk of cognitive decline at follow-up nor increased predictivity of stand-alone CDT. CONCLUSION A bedside cognitive screening with the CDT helps identifying patients at higher risk of PSCI.
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Affiliation(s)
- Ilaria Cova
- grid.144767.70000 0004 4682 2907Neurology Unit, Luigi Sacco University Hospital, Milan, Italy
| | - Francesco Mele
- grid.144767.70000 0004 4682 2907Neurology Unit, Luigi Sacco University Hospital, Milan, Italy
| | - Federica Zerini
- grid.4708.b0000 0004 1757 2822Stroke and Dementia Lab, “Luigi Sacco” Department of Biomedical and Clinical Sciences, University of Milan, Via Giovanni Battista Grassi 74, 20157 Milan, Italy
| | - Laura Maggiore
- grid.144767.70000 0004 4682 2907Neurology Unit, Luigi Sacco University Hospital, Milan, Italy
| | - Silvia Rosa
- grid.144767.70000 0004 4682 2907Neurology Unit, Luigi Sacco University Hospital, Milan, Italy
| | - Valentina Cucumo
- grid.144767.70000 0004 4682 2907Neurology Unit, Luigi Sacco University Hospital, Milan, Italy
| | - Michela Brambilla
- grid.144767.70000 0004 4682 2907Neurology Unit, Luigi Sacco University Hospital, Milan, Italy
| | - Alessia Nicotra
- grid.144767.70000 0004 4682 2907Neurology Unit, Luigi Sacco University Hospital, Milan, Italy
| | - Giorgia Maestri
- grid.144767.70000 0004 4682 2907Neurology Unit, Luigi Sacco University Hospital, Milan, Italy
| | - Pierluigi Bertora
- grid.144767.70000 0004 4682 2907Neurology Unit, Luigi Sacco University Hospital, Milan, Italy ,grid.4708.b0000 0004 1757 2822Stroke and Dementia Lab, “Luigi Sacco” Department of Biomedical and Clinical Sciences, University of Milan, Via Giovanni Battista Grassi 74, 20157 Milan, Italy
| | - Simone Pomati
- grid.144767.70000 0004 4682 2907Neurology Unit, Luigi Sacco University Hospital, Milan, Italy
| | - Leonardo Pantoni
- Neurology Unit, Luigi Sacco University Hospital, Milan, Italy. .,Stroke and Dementia Lab, "Luigi Sacco" Department of Biomedical and Clinical Sciences, University of Milan, Via Giovanni Battista Grassi 74, 20157, Milan, Italy.
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Cai H, Zhao Z, Ni L, Han G, Hu X, Wu D, Ding X, Wang J. Structural and Functional Deficits in Patients with Poststroke Dementia: A Multimodal MRI Study. Neural Plast 2021; 2021:3536234. [PMID: 34777496 PMCID: PMC8580696 DOI: 10.1155/2021/3536234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/25/2021] [Accepted: 10/12/2021] [Indexed: 11/30/2022] Open
Abstract
Although many neuroimaging studies have reported structural and functional abnormalities in the brains of patients with cognitive impairments following stroke, little is known about the pattern of such brain reorganization in poststroke dementia (PSD). The present study was aimed at investigating alterations in spontaneous brain activity and gray matter volume (GMV) in PSD patients. We collected T1-weighted and resting-state functional magnetic resonance imaging data from 20 PSD patients, 24 poststroke nondementia (PSND) patients, and 21 well-matched normal controls (NCs). We compared the differences among the groups in GMV and the fractional amplitude of low-frequency fluctuations (fALFF). Then, we evaluated the relationship between these brain measures and cognitive assessments and explored the possible distinguisher for PSD by receiver operating characteristic (ROC) curve analysis. PSD patients showed smaller GMV in the right superior temporal gyrus and lower fALFF values in the right inferior frontal gyrus than both PSND patients and NCs, but such differences were not observed between PSND patients and NCs. Moreover, GMV in the left medial prefrontal cortex showed a significant positive correlation with the Mini-Cog assessment in PSD patients, and GMV in the left CPL displayed the highest area under the ROC curve among all the features for classifying PSD versus PSND patients. Our findings suggest that PSD patients show dementia-specific structural and functional alteration patterns, which may help elucidate the pathophysiological mechanisms underlying PSD.
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Affiliation(s)
- Huaying Cai
- Department of Neurology, Neuroscience Center, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China
| | - Zhiyong Zhao
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, China
| | - Linhui Ni
- Department of Neurology, Neuroscience Center, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China
| | - Guocan Han
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China
| | - Xingyue Hu
- Department of Neurology, Neuroscience Center, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China
| | - Dan Wu
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, China
| | - Xianjun Ding
- Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China
| | - Jin Wang
- Department of Neurology, Neuroscience Center, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China
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11
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Sung PS, Lee KP, Lin PY, Su HC, Yu RL, Tsai KJ, Lin SH, Chen CH. Factors Associated with Cognitive Outcomes After First-Ever Ischemic Stroke: The Impact of Small Vessel Disease Burden and Neurodegeneration. J Alzheimers Dis 2021; 83:569-579. [PMID: 34334409 DOI: 10.3233/jad-210587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Differences exist regarding post-stroke cognitive outcomes. OBJECTIVE The aim of this study investigates the potential factors associated with post-stroke cognitive performance and trajectories. METHODS We performed a prospective cohort study using serial monitoring of cognitive function over a 1-year period after a first-ever ischemic stroke. Small vessel disease (SVD) burden and hippocampal atrophy (HA) were evaluated using the modified cerebral small vessel disease scores (mCSVD) and medial temporal atrophy score (MTA) scores. A generalized estimating equation (GEE) model and a group-based trajectory model (GBTM) was used to analyze the potential factors associated with post-stroke cognitive outcomes. RESULTS A total of 112 patients were enrolled. The GEE model showed that all patients, regardless of initial cognitive performance, had a tendency to show an increase in the Montreal Cognitive Assessment over time. The cognitive performance was better in male patients with higher education levels (p = 0.046 and p < 0.001, respectively), but tended to be worse in patients with higher SVD burden and HA. The GBTM model grouped patients into low, intermediate, and high performance (LP, IP, and HP) after stroke. A higher SVD burden, rather than HA and initial stroke severity and location, independently predicted a higher odds of poor post-stroke cognitive trajectory (being in the LP group) after stroke (adjusted odds ratio 2.74, 95%CI 1.09-6.86). CONCLUSION In patients with first-ever mild stroke, cognitive improvement over time was evident. The detrimental impact of the SVD burden may outweigh the effect of HA or acute stroke insult on the post-stroke cognitive trajectory during the 1-year follow-up.
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Affiliation(s)
- Pi-Shan Sung
- Institute of Clinical Medicine, College ofMedicine, National Cheng Kung University, Tainan, Taiwan.,Department of Neurology, National Cheng KungUniversity Hospital, College of Medicine, National Cheng KungUniversity, Tainan, Taiwan
| | - Kang-Po Lee
- Department of Neurology, National Cheng KungUniversity Hospital, College of Medicine, National Cheng KungUniversity, Tainan, Taiwan
| | - Po-Yu Lin
- Department of Neurology, National Cheng KungUniversity Hospital, College of Medicine, National Cheng KungUniversity, Tainan, Taiwan
| | - Hui-Chen Su
- Department of Neurology, National Cheng KungUniversity Hospital, College of Medicine, National Cheng KungUniversity, Tainan, Taiwan
| | - Rwei-Ling Yu
- Institute ofBehavioral Medicine, College of Medicine, National Cheng KungUniversity, Tainan, Taiwan.,Institute of AlliedHealth Sciences, College of Medicine, National Cheng KungUniversity, Tainan, Taiwan
| | - Kuen-Jer Tsai
- Institute of Clinical Medicine, College ofMedicine, National Cheng Kung University, Tainan, Taiwan
| | - Sheng-Hsiang Lin
- Institute of Clinical Medicine, College ofMedicine, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Hung Chen
- Department of Neurology, National Cheng KungUniversity Hospital, College of Medicine, National Cheng KungUniversity, Tainan, Taiwan
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Droś J, Klimkowicz-Mrowiec A. Current view on post-stroke dementia. Psychogeriatrics 2021; 21:407-417. [PMID: 33608997 DOI: 10.1111/psyg.12666] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 01/25/2021] [Accepted: 02/01/2021] [Indexed: 12/18/2022]
Abstract
Dementia is one of the leading complications after stroke affecting about one third of survivors. Prevalence of post-stroke dementia (PSD) differs between studies due to variability in methodology, characteristics of included patients, type of stroke, diagnostic tools used to identify patients with dementia, or time when the assessment was performed. Patients diagnosed with PSD are at higher risk of mortality, disability, and institutionalization. Aetiology of PSD may include mixed overlapping processes such as vascular brain pathology or Alzheimer's disease. Several risk factors have been found to increase PSD incidence, involving demographics, vascular factors, stroke characteristics, abnormalities on neuroimaging, and stroke complications. However, the influence of some other factors still remains unclear. PSD may coexist with other neuropsychiatric disorders and its association with post-stroke depression seems to be the most significant. There is a strong need for further research on possible genetic, biological, and inflammatory biomarkers. Also, there are no unambiguously efficacious methods of management. Continuing to address these issues will help to find more effective interventions directly targeting prevention and treatment of PSD in the future.
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Affiliation(s)
- Jakub Droś
- Doctoral School in Medical and Health Sciences, Jagiellonian University Medical College, Kraków, Poland
| | - Aleksandra Klimkowicz-Mrowiec
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
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Turana Y, Tengkawan J, Chia YC, Nathaniel M, Wang J, Sukonthasarn A, Chen C, Minh HV, Buranakitjaroen P, Shin J, Siddique S, Nailes JM, Park S, Teo BW, Sison J, Ann Soenarta A, Hoshide S, Tay JC, Prasad Sogunuru G, Zhang Y, Verma N, Wang T, Kario K. Hypertension and stroke in Asia: A comprehensive review from HOPE Asia. J Clin Hypertens (Greenwich) 2021; 23:513-521. [PMID: 33190399 PMCID: PMC8029540 DOI: 10.1111/jch.14099] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 10/16/2020] [Accepted: 10/20/2020] [Indexed: 02/06/2023]
Abstract
Stroke is the primary cause of disability and vascular death worldwide, including Asia. Asian characteristics that differ from the West lead to higher stroke incidence. Stroke epidemiology studies in Asia have shown varying levels of mortality, incidence, prevalence, and burden of disease. Hypertension is the most prevalent risk factor found in Asia. Besides ethnicity that is associated with stroke incidence, both systolic blood pressure, diastolic blood pressure, and blood pressure variability are positively correlated with stroke incidence. Post-stroke cognitive impairment is one of the sequelae that affect one-third of stroke survivors and has become a significant public health concern that is often neglected despite its increasing prevalence. Therefore, it is very important to prevent recurrence by treating stroke optimally and effectively. Increasing awareness and treatment adherence to hypertension, the leading risk factor for stroke, became the main goal in several countries in Asia.
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Affiliation(s)
- Yuda Turana
- School of Medicine and Health SciencesAtma Jaya Catholic University of IndonesiaJakartaIndonesia
| | - Jeslyn Tengkawan
- School of Medicine and Health SciencesAtma Jaya Catholic University of IndonesiaJakartaIndonesia
| | - Yook Chin Chia
- Department of Medical SciencesSchool of Healthcare and Medical SciencesSunway UniversityBandar SunwayMalaysia
- Department of Primary Care MedicineFaculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Michael Nathaniel
- School of Medicine and Health SciencesAtma Jaya Catholic University of IndonesiaJakartaIndonesia
| | - Ji‐Guang Wang
- Department of HypertensionCentre for Epidemiological Studies and Clinical TrialsThe Shanghai Institute of HypertensionShanghai Key Laboratory of HypertensionRuijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Apichard Sukonthasarn
- Cardiology DivisionDepartment of Internal MedicineFaculty of MedicineChiang Mai UniversityChiang MaiThailand
| | - Chen‐Huan Chen
- Department of MedicineFaculty of MedicineNational Yang‐Ming UniversityTaipeiTaiwan
| | - Huynh Van Minh
- Department of CardiologyHue University HospitalHue UniversityHue CityVietnam
| | - Peera Buranakitjaroen
- Division of HypertensionDepartment of MedicineFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Jinho Shin
- Faculty of Cardiology ServiceHanyang University Medical CenterSeoulKorea
| | | | - Jennifer M. Nailes
- University of the East Ramon Magsaysay Memorial Medical Center Inc.Quezon CityPhilippines
| | - Sungha Park
- Division of CardiologyCardiovascular HospitalYonsei Health SystemSeoulKorea
| | - Boon Wee Teo
- Division of NephrologyDepartment of MedicineYong Loo Lin School of MedicineNational University of SingaporeSingapore CitySingapore
- Division of NephrologyDepartment of MedicineNational University Health SystemSingapore CitySingapore
| | - Jorge Sison
- Section of CardiologyDepartment of MedicineMedical Center ManilaManilaPhilippines
| | - Arieska Ann Soenarta
- Department of Cardiology and Vascular MedicineFaculty of MedicineUniversity of Indonesia‐National Cardiovascular CenterHarapan KitaJakartaIndonesia
| | - Satoshi Hoshide
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Jam Chin Tay
- Department of General MedicineTan Tock Seng HospitalSingaporeSingapore
| | - Guru Prasad Sogunuru
- MIOT International HospitalChennaiIndia
- College of Medical SciencesKathmandu UniversityBharatpurNepal
| | - Yuqing Zhang
- Divisions of Hypertension and Heart FailureFu Wai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Narsingh Verma
- Department of PhysiologyKing George's Medical UniversityLucknowIndia
| | - Tzung‐Dau Wang
- Cardiovascular Center and Division of CardiologyDepartment of Internal MedicineNational Taiwan University Hospital and National Taiwan University College of MedicineTaipei CityTaiwan
| | - Kazuomi Kario
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
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14
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Lotfian M, Noroozi S, Dadashi F, Kharazi MR, Mirbagheri MM. Therapeutic effects of robotic rehabilitation on Neural and Muscular Abnormalities associated with the Spastic Ankle in Stroke Survivors. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:3860-3863. [PMID: 33018843 DOI: 10.1109/embc44109.2020.9175374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Spasticity is a common ailment following stroke, which can cause pain, contracture, abnormal limb posture and functional limitation. Early management of post-stroke spasticity is vital to reduce these complications, and improve function and help patients become independent. We propose a therapeutic program based on applying a series of vibrations to the ankle joints at specific ankle position as well as over the range of motion using a rehabilitation robotic system to reduce the neural and muscular abnormalities associated with spasticity. We provided a 30-minute perturbation training, 3 times a week for 10 sessions for 8 stroke survivor subjects. Ankle stiffness was calculated using the hysteresis curves. Other kinematic and kinetic parameters were also used to evaluate the mechanical abnormalities. We evaluated participants before starting the therapeutic program, immediately after first session of training and after 10 sessions of training.Our results showed that all subjects had substantial improvements in stiffness, max voluntary contraction, energy loss, passive range of motion, and voluntary movement after both short- and long-term therapeutic program. Surprisingly, for most of these measures the maximum improvement obtained at short-term training. Interestingly, these improvements became persistent over the long-term training. These findings suggest that vibration therapy can be considered as an effective rehabilitation intervention to reduce neuromuscular abnormalities associated with the spasticity in stroke.
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15
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Filipska K, Wiśniewski A, Biercewicz M, Ślusarz R. Are Depression and Dementia a Common Problem for Stroke Older Adults? A Review of Chosen Epidemiological Studies. Psychiatr Q 2020; 91:807-817. [PMID: 32277403 DOI: 10.1007/s11126-020-09734-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Stroke is the second leading cause of death in the world. It is often associated with various long-term physical and neuropsychological consequences. The aim of this article is to present the results of research on the occurrence of dementia and post-stroke depression. Using the keywords: post-stroke dementia, post-stroke depression, post-stroke cognitive impairment, stroke, Polish and foreign bibliographic databases were searched: PubMed, Science Direct, Wiley, Google Scholar. Documents that met the eligibility criteria were selected for inclusion in this review. After the conducted analyses, 7 Polish articles and 13 English-language articles were qualified for the review. In the group of people after stroke, there is an increased risk of depression and dementia. According to the data, up to every third person can deal with one of these neuropsychiatric disorders. The presented research analyses indicate that the results obtained by the respondents, at any time after the stroke, indicate the presence of mild cognitive impairment or slight degree dementia among the majority of respondents. It was also shown that people with a stroke in the dominant hemisphere are more likely to experience post-stroke depression. Depression and post-stroke dementia are a common and significant complication of stroke that negatively affects the functional outcome. The huge focus on neuropsychiatric disorders occurring after stroke in modern research is very important because of their negative impact on recovery, quality of life and survival after stroke.
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Affiliation(s)
- Karolina Filipska
- Department of Neurological and Neurosurgical Nursing, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Łukasiewicza street 1, 85-821 Bydgoszcz, Toruń, Poland.
| | - Adam Wiśniewski
- Department of Neurology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland
| | - Monika Biercewicz
- Department of Geriatrics, Faculty of Health Science, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland
| | - Robert Ślusarz
- Department of Neurological and Neurosurgical Nursing, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Łukasiewicza street 1, 85-821 Bydgoszcz, Toruń, Poland
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Stroke to Dementia Associated with Environmental Risks-A Semi-Markov Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061944. [PMID: 32188138 PMCID: PMC7143936 DOI: 10.3390/ijerph17061944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/05/2020] [Accepted: 03/09/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Most stroke cases lead to serious mental and physical disabilities, such as dementia and sensory impairment. Chronic diseases are contributory risk factors for stroke. However, few studies considered the transition behaviors of stroke to dementia associated with chronic diseases and environmental risks. OBJECTIVE This study aims to develop a prognosis model to address the issue of stroke transitioning to dementia associated with environmental risks. DESIGN This cohort study used the data from the National Health Insurance Research Database in Taiwan. SETTING Healthcare data were obtained from more than 25 million enrollees and covered over 99% of Taiwan's entire population. PARTICIPANTS In this study, 10,627 stroke patients diagnosed from 2000 to 2010 in Taiwan were surveyed. METHODS A Cox regression model and corresponding semi-Markov process were constructed to evaluate the influence of risk factors on stroke, corresponding dementia, and their transition behaviors. MAIN OUTCOME MEASURE Relative risk and sojourn time were the main outcome measure. RESULTS Multivariate analysis showed that certain environmental risks, medication, and rehabilitation factors highly influenced the transition of stroke from a chronic disease to dementia. This study also highlighted the high-risk populations of stroke patients against the environmental risk factors; the males below 65 years old were the most sensitive population. CONCLUSION Experiments showed that the proposed semi-Markovian model outperformed other benchmark diagnosis algorithms (i.e., linear regression, decision tree, random forest, and support vector machine), with a high R2 of 90%. The proposed model also facilitated an accurate prognosis on the transition time of stroke from chronic diseases to dementias against environmental risks and rehabilitation factors.
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17
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Donnellan C, Werring D. Cognitive impairment before and after intracerebral haemorrhage: a systematic review. Neurol Sci 2019; 41:509-527. [PMID: 31802344 DOI: 10.1007/s10072-019-04150-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 11/12/2019] [Indexed: 02/01/2023]
Abstract
INTRODUCTION There is increasing interest in understanding cognitive dysfunction before and after Intracerebral haemorrhage (ICH), given the higher prevalence of dementia reported (ranging from 5 to 44%) for this stroke type. Much of the evidence to date examining cognitive impairment associated with cerebrovascular disease has tended to focus more on ischaemic stroke. The aim of this review was to identify and quantify studies that focused on cognitive dysfunction pre and post ICH. METHODS We conducted a systematic search using databases PubMed, Science Direct, Scopus and PsycINFO to identify studies that exclusively assessed cognitive function pre and post ICH. Studies were included in the review if used a measure of global cognition and/or a neuropsychological battery to assess cognitive function. Nineteen studies were deemed relevant for inclusion, where n = 8 studies examined cognitive impairment pre ICH and n = 11 post ICH. RESULTS Prevalence of cognitive impairment ranged between 9-29% for pre ICH and 14-88% for post ICH. Predictive factors identified for pre and post ICH were previous stroke, ICH volume and location and markers of cerebral amyloid angiopathy (CAA). Most common cognitive domains affected post ICH were information processing speed, executive function, memory, language and visuo-spatial abilities. Most common cognitive assessments tools were the Informant Questionnaire for Cognitive Decline in the Elderly (IQCODE) for pre-existing cognitive impairment and the Mini-Mental State Examination for global cognition post ICH and the Trail Making Test where neuropsychological tests were used. CONCLUSION Cognitive impairment and dementia affected almost one-third of patients, whether assessed pre or post ICH.
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Affiliation(s)
- Claire Donnellan
- School of Nursing and Midwifery, Faculty of Health Sciences, University of Dublin Trinity College, 2 Clare Street, Dublin 2, Ireland.
| | - David Werring
- Stroke Research Centre, UCL Institute of Neurology, First Floor, Russell Square House, 10-12 Russell Square, London, WC1B 5EH, UK
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18
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Cuartero MI, de la Parra J, Pérez-Ruiz A, Bravo-Ferrer I, Durán-Laforet V, García-Culebras A, García-Segura JM, Dhaliwal J, Frankland PW, Lizasoain I, Moro MÁ. Abolition of aberrant neurogenesis ameliorates cognitive impairment after stroke in mice. J Clin Invest 2019; 129:1536-1550. [PMID: 30676325 DOI: 10.1172/jci120412] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 01/17/2019] [Indexed: 12/23/2022] Open
Abstract
Poststroke cognitive impairment is considered one of the main complications during the chronic phase of ischemic stroke. In the adult brain, the hippocampus regulates both encoding and retrieval of new information through adult neurogenesis. Nevertheless, the lack of predictive models and studies based on the forgetting processes hinders the understanding of memory alterations after stroke. Our aim was to explore whether poststroke neurogenesis participates in the development of long-term memory impairment. Here, we show a hippocampal neurogenesis burst that persisted 1 month after stroke and that correlated with an impaired contextual and spatial memory performance. Furthermore, we demonstrate that the enhancement of hippocampal neurogenesis after stroke by physical activity or memantine treatment weakened existing memories. More importantly, stroke-induced newborn neurons promoted an aberrant hippocampal circuitry remodeling with differential features at ipsi- and contralesional levels. Strikingly, inhibition of stroke-induced hippocampal neurogenesis by temozolomide treatment or using a genetic approach (Nestin-CreERT2/NSE-DTA mice) impeded the forgetting of old memories. These results suggest that hippocampal neurogenesis modulation could be considered as a potential approach for treatment of poststroke cognitive impairment.
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Affiliation(s)
- María Isabel Cuartero
- Departamento de Farmacología y Toxicología, Facultad de Medicina, Universidad Complutense de Madrid (UCM), and Instituto de Investigación Hospital 12 de Octubre (i+12), Madrid, Spain.,Instituto Universitario de Investigación en Neuroquímica (IUIN), UCM, Madrid, Spain
| | - Juan de la Parra
- Departamento de Farmacología y Toxicología, Facultad de Medicina, Universidad Complutense de Madrid (UCM), and Instituto de Investigación Hospital 12 de Octubre (i+12), Madrid, Spain.,Instituto Universitario de Investigación en Neuroquímica (IUIN), UCM, Madrid, Spain
| | - Alberto Pérez-Ruiz
- Departamento de Farmacología y Toxicología, Facultad de Medicina, Universidad Complutense de Madrid (UCM), and Instituto de Investigación Hospital 12 de Octubre (i+12), Madrid, Spain.,Instituto Universitario de Investigación en Neuroquímica (IUIN), UCM, Madrid, Spain
| | - Isabel Bravo-Ferrer
- Departamento de Farmacología y Toxicología, Facultad de Medicina, Universidad Complutense de Madrid (UCM), and Instituto de Investigación Hospital 12 de Octubre (i+12), Madrid, Spain.,Instituto Universitario de Investigación en Neuroquímica (IUIN), UCM, Madrid, Spain
| | - Violeta Durán-Laforet
- Departamento de Farmacología y Toxicología, Facultad de Medicina, Universidad Complutense de Madrid (UCM), and Instituto de Investigación Hospital 12 de Octubre (i+12), Madrid, Spain.,Instituto Universitario de Investigación en Neuroquímica (IUIN), UCM, Madrid, Spain
| | - Alicia García-Culebras
- Departamento de Farmacología y Toxicología, Facultad de Medicina, Universidad Complutense de Madrid (UCM), and Instituto de Investigación Hospital 12 de Octubre (i+12), Madrid, Spain.,Instituto Universitario de Investigación en Neuroquímica (IUIN), UCM, Madrid, Spain
| | - Juan Manuel García-Segura
- Instituto Universitario de Investigación en Neuroquímica (IUIN), UCM, Madrid, Spain.,Departamento de Bioquímica y Biología Molecular, Facultad de Ciencias Químicas, UCM, Madrid, Spain
| | - Jagroop Dhaliwal
- Program in Neuroscience & Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Paul W Frankland
- Program in Neuroscience & Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ignacio Lizasoain
- Departamento de Farmacología y Toxicología, Facultad de Medicina, Universidad Complutense de Madrid (UCM), and Instituto de Investigación Hospital 12 de Octubre (i+12), Madrid, Spain.,Instituto Universitario de Investigación en Neuroquímica (IUIN), UCM, Madrid, Spain
| | - María Ángeles Moro
- Departamento de Farmacología y Toxicología, Facultad de Medicina, Universidad Complutense de Madrid (UCM), and Instituto de Investigación Hospital 12 de Octubre (i+12), Madrid, Spain.,Instituto Universitario de Investigación en Neuroquímica (IUIN), UCM, Madrid, Spain
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Kuo CL, Hu GC. Post-stroke Spasticity: A Review of Epidemiology, Pathophysiology, and Treatments. INT J GERONTOL 2018. [DOI: 10.1016/j.ijge.2018.05.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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20
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Statin Use and the Risk of Dementia in Patients with Stroke: A Nationwide Population-Based Cohort Study. J Stroke Cerebrovasc Dis 2018; 27:3001-3007. [DOI: 10.1016/j.jstrokecerebrovasdis.2018.06.036] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 05/27/2018] [Accepted: 06/24/2018] [Indexed: 11/21/2022] Open
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Risk Factors for the Progression of Mild Cognitive Impairment in Different Types of Neurodegenerative Disorders. Behav Neurol 2018; 2018:6929732. [PMID: 29971138 PMCID: PMC6008817 DOI: 10.1155/2018/6929732] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 03/24/2018] [Accepted: 04/05/2018] [Indexed: 12/24/2022] Open
Abstract
Objective Mild cognitive impairment (MCI) is a transitional state between normal aging and early dementia. It has a heterogeneous etiology and clinical course. This study aimed to examine the factors associated with the progression of MCI in different types of dementia disorders. Method A retrospective, longitudinal, observational study of outpatients with MCI was conducted at a medical center in northern Taiwan. Patient medical records were reviewed, and risk factors were analyzed by multivariate analysis. Results Among 279 patients with MCI, 163 (58.4%), 68 (24.4%), and 48 (17.2%) were diagnosed with Alzheimer's disease, vascular cognitive impairment, and Lewy body diseases, respectively. During the observation period, 37.2% of patients progressed to dementia. Older age and a higher Clinical Dementia Rating Scale-Sum of Boxes were associated with the risk of progression. Hyperlipidemia was associated with a decreased risk. Converters were more likely to receive an antidementia prescription. Conclusion Our study suggests the importance of comprehensive clinical profiling, risk factor assessment, and detailed drug history evaluations in improving our understanding and management of dementia subtypes.
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Habtemariam S. Molecular Pharmacology of Rosmarinic and Salvianolic Acids: Potential Seeds for Alzheimer's and Vascular Dementia Drugs. Int J Mol Sci 2018; 19:E458. [PMID: 29401682 PMCID: PMC5855680 DOI: 10.3390/ijms19020458] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 01/31/2018] [Accepted: 02/01/2018] [Indexed: 12/20/2022] Open
Abstract
Both caffeic acid and 3,4-dihydroxyphenyllactic acid (danshensu) are synthesized through two distinct routs of the shikimic acid biosynthesis pathway. In many plants, especially the rosemary and sage family of Lamiaceae, these two compounds are joined through an ester linkage to form rosmarinic acid (RA). A further structural diversity of RA derivatives in some plants such as Salvia miltiorrhiza Bunge is a form of RA dimer, salvianolic acid-B (SA-B), that further give rise to diverse salvianolic acid derivatives. This review provides a comprehensive perspective on the chemistry and pharmacology of these compounds related to their potential therapeutic applications to dementia. The two common causes of dementia, Alzheimer's disease (AD) and stroke, are employed to scrutinize the effects of these compounds in vitro and in animal models of dementia. Key pharmacological mechanisms beyond the common antioxidant and anti-inflammatory effects of polyphenols are highlighted with emphasis given to amyloid beta (Aβ) pathologies among others and neuronal regeneration from stem cells.
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Affiliation(s)
- Solomon Habtemariam
- Pharmacognosy Research Laboratories & Herbal Analysis Services, University of Greenwich, Central Avenue, Chatham-Maritime, Kent ME4 4TB, UK.
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