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Ran N, Wang H. Predictive value of early serum ACSL4 and ASITN/SIR grade for motor function recovery in patients with post-ischemic stroke lower limb neurological sequelae after modified constraint-induced movement therapy. Clin Neurol Neurosurg 2024; 245:108464. [PMID: 39089201 DOI: 10.1016/j.clineuro.2024.108464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 01/19/2024] [Accepted: 07/20/2024] [Indexed: 08/03/2024]
Abstract
BACKGROUND Ischemic stroke accounts for over 85 % of all stroke types. Acyl-CoA synthetase long chain family member 4 (ACSL4) is considered to promote myocardial and cerebral ischaemia/ reperfusion. However, up to now, no study focused on the role of ACSL4 in patients with post-stroke lower limb neurological sequelae. OBJECTIVE The present study aimed to investigate the predictive value of ACSL4 and collateral circulation for lower limb neurological sequelae of ischemic stroke patients after modified constraint-induced movement therapy (mCIMT). METHODS This is a prospective cohort study which included 99 ischemic stroke patients with lower limb neurological sequelae who were admitted to our hospital during January 2021 to December 2022. All patients received mCIMT after the admission. Collateral circulation was evaluated by digital subtraction angiography (DSA) and graded by the American Society of Interventional and Therapeutic Neuroradiology/ Society of Interventional Radiology (ASITN/SIR) grading system. Enzyme linked immunosorbent assay (ELISA) was used to detect serum ACSL4. Basic characteristics were collected and lower limb motor function was measured by Fugl-Meyer score (FMS), modified Ashworth score (MAS) and Brunnstrom stage, as well as timed up and go (TUG) test, ten-Meter walk test (10MWT), and six-minute walk test (6MWT) before and after treatment. RESULTS Serum ACSL4 and percentage of patients with ASITN/SIR 0-1 decreased significantly after treatment compared with the values before treatment. Patients with higher baseline serum ACSL4 values at admission showed significantly lower FMS scores, higher TUG and 10MWT, as well as lower 6MWT. Patients with ASITN/SIR grade 0-1 at admission only showed significantly higher TUG and 10MWT, as well as lower 6MWT. Receiver operating characteristic (ROC) curves showed ACSL4 and ASITN/SIR grade could be used to predict the prognosis. Logistic regression found only national institutes of health stroke scores (NIHSS) was the independent risk factor for post-treatment motor impairment after mCIMT. CONCLUSION Higher levels of ACSL4 and ASITN/SIR 0-1 are associated with poor recovery of motor functions of patients with post-stroke sequelae after mCIMT.
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Affiliation(s)
- Ningning Ran
- Department of Rehabilitation, The Second Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Hongxing Wang
- Department of Rehabilitation, Xiangya Hospital, Central South University, Changsha, Hunan, China.
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Wang XP, Yan D, Jin XP, Zhang WY, Shi T, Wang X, Song W, Xiong X, Guo D, Chen S. The role of amino acid metabolism alterations in acute ischemic stroke: From mechanism to application. Pharmacol Res 2024; 207:107313. [PMID: 39025169 DOI: 10.1016/j.phrs.2024.107313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Revised: 07/10/2024] [Accepted: 07/15/2024] [Indexed: 07/20/2024]
Abstract
Acute ischemic stroke (AIS) is the most prevalent type of stroke, and due to its high incidence, disability rate, and mortality rate, it imposes a significant burden on the health care system. Amino acids constitute one of the most crucial metabolic products within the human body, and alterations in their metabolic pathways have been identified in the microenvironment of AIS, thereby influencing the pathogenesis, severity, and prognosis of AIS. The amino acid metabolism characteristics in AIS are complex. On one hand, the dynamic progression of AIS continuously reshapes the amino acid metabolism pattern. Conversely, changes in the amino acid metabolism pattern also exert a double-edged effect on AIS. This interaction is bidirectional, dynamic, heterogeneous, and dose-specific. Therefore, the distinctive metabolic reprogramming features surrounding amino acids during the AIS process are systematically summarized in this paper, aiming to provide potential investigative strategies for the early diagnosis, treatment approaches, and prognostic enhancement of AIS.
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Affiliation(s)
- Xiang-Ping Wang
- First People's Hospital of Linping District; Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 311100, China
| | - Dan Yan
- Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou 311202, China
| | - Xia-Ping Jin
- First People's Hospital of Linping District; Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 311100, China
| | - Wen-Yan Zhang
- First People's Hospital of Linping District; Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 311100, China
| | - Tao Shi
- First People's Hospital of Linping District; Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 311100, China
| | - Xiang Wang
- First People's Hospital of Linping District; Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 311100, China
| | - Wenjuan Song
- First People's Hospital of Linping District; Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 311100, China
| | - Xing Xiong
- Traditional Chinese Medical Hospital of Xiaoshan, The Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province 311200, China
| | - Duancheng Guo
- Cancer Institute, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
| | - Sheng Chen
- First People's Hospital of Xiaoshan District, Hangzhou, Zhejiang Province 311200, China.
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Zhu Q, Long Q, Wei C, Chen J, Nong L, Qin J, Huang Z, Zheng Y, Li S. Lactate dehydrogenase-1 may play a key role in the brain energy disturbance caused by cryptococcal meningitis. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2024:S1684-1182(24)00153-1. [PMID: 39214781 DOI: 10.1016/j.jmii.2024.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 08/14/2024] [Accepted: 08/19/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Cryptococcal meningitis (CM) may affect the conversion of lactate to pyruvate in the brain, resulting in abnormal levels of adenosine triphosphate (ATP) throughout the brain. Lactate conversion to pyruvate is mainly caused by lactic dehydrogenase 1 (LDH1), which is composed of four LDHB subunits. However, the underlying mechanism of LDH1 in CM remains unclear. METHODS Cerebrospinal fluid (CSF) from 17 patients was collected, including eight patients with non-infectious diseases of the central nervous system and nine patients with CM. Based on clinical data and laboratory reports, data regarding intracranial pressure, CSF white cell counts, lactate dehydrogenase (LDH), adenosine deaminase, glucose, protein, and chloridion were collected. Meanwhile, LDH1, LDH5, lactate, pyruvate, and ATP levels were detected in CSF. Whereafter, the levels of lactate, pyruvate, ATP, and the amplitude and frequency of action potentials in the neurons with low expression of LDHB were explored. RESULTS Intracranial pressure and white cell count in CSF were significantly increased in patients with CM. In patients with CM, the LDH1, pyruvate, and ATP levels in the CSF were significantly decreased, and the levels of lactate were found to be increased. Furthermore, pyruvate and ATP levels were decreased, while lactate was increased in the neurons with low expression of LDHB. The amplitude and frequency of APs in the neurons with low expression of LDHB were significantly decreased. CONCLUSION Reduced levels of LDH1 in the brain of patients with CM may lead to increased lactate levels, decreased pyruvate and ATP levels, and negatively affect neuronal activity.
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Affiliation(s)
- Qingdong Zhu
- Department of Tuberculosis, Guangxi AlDs Clinical Treatment Center (Nanning)/The Fourth People's Hospital of Nanning, Nanning, Guangxi, China
| | - Qian Long
- Key Laboratory of Infectious Diseases of Nanning Municipal Health Commission, Guangxi AlDs Clinical Treatment Center (Nanning)/The Fourth People's Hospital of Nanning, Nanning, Guangxi, China
| | - Cailing Wei
- Infectious Disease Laboratory, Guangxi AlDs Clinical Treatment Center (Nanning)/The Fourth People's Hospital of Nanning, Nanning, Guangxi, China
| | - Jieling Chen
- Infectious Disease Laboratory, Guangxi AlDs Clinical Treatment Center (Nanning)/The Fourth People's Hospital of Nanning, Nanning, Guangxi, China
| | - Lanwei Nong
- Infectious Disease Laboratory, Guangxi AlDs Clinical Treatment Center (Nanning)/The Fourth People's Hospital of Nanning, Nanning, Guangxi, China
| | - Jianglong Qin
- Department of Infectious Disease, Guangxi AlDs Clinical Treatment Center (Nanning)/The Fourth People's Hospital of Nanning, Nanning, Guangxi, China
| | - Zhizhong Huang
- Department of Liver, Guangxi AlDs Clinical Treatment Center (Nanning)/The Fourth People's Hospital of Nanning, Nanning, Guangxi, China
| | - Yanqing Zheng
- Infectious Disease Laboratory, Guangxi AlDs Clinical Treatment Center (Nanning)/The Fourth People's Hospital of Nanning, Nanning, Guangxi, China.
| | - Sijun Li
- Infectious Disease Laboratory, Guangxi AlDs Clinical Treatment Center (Nanning)/The Fourth People's Hospital of Nanning, Nanning, Guangxi, China; Department of Internal Medicine, Guangxi AlDs Clinical Treatment Center (Nanning)/The Fourth People's Hospital of Nanning, Nanning, Guangxi, China.
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Xie H, Zhang Q, Zhan J, Dong J, Chen J, Kang G, Liu H, Huang Q, Zhu L, Onoda K, Maruyama H, Liu S, Huo M. The relationship between the ratio of the supraspinatus muscle thickness measured by ultrasound imaging and glenohumeral subluxation in stroke patients: a cross-sectional study. Front Neurol 2024; 15:1407638. [PMID: 39246610 PMCID: PMC11380153 DOI: 10.3389/fneur.2024.1407638] [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: 03/28/2024] [Accepted: 08/05/2024] [Indexed: 09/10/2024] Open
Abstract
Introduction Glenohumeral subluxation (GHS) is a common complication in stroke patients with hemiplegia, occurring in approximately 17-81% of cases. This study aims to evaluate the relationship between shoulder muscle thickness and the degree of subluxation using ultrasound imaging. Methods A cross-sectional study of 61 stroke patients with hemiplegia was conducted, measuring supraspinatus muscle thickness, deltoid muscle thickness, and acromion-greater tuberosity (AGT). Logistic regression and ROC analyses were used. ROC curves, calibration plots, and decision curves were drawn on the training and validation sets. Results According to logistic regression analysis, the ratio of supraspinatus muscle thickness was statistically significant (OR: 0.80; 95% CI: 0.70-0.92; p < 0.01), and it was an independent factor for evaluating the presence or absence of GHS. An AUC of 0.906 (95% CI, 0.802-1.000) was found in the training set; meanwhile, the AUC in the validation set was 0.857 (95% CI, 0.669-1.000), indicating good performance. According to the training set ROC curve, the most effective statistical threshold was 93%, with a sensitivity of 84% and a specificity of 96%. Discussion The ratio of supraspinatus muscle thickness is a valuable criterion for evaluating GHS risk, supporting targeted rehabilitation interventions.
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Affiliation(s)
- Hualong Xie
- Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Qing Zhang
- Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Jiawen Zhan
- Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Jige Dong
- Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Jing Chen
- The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Guoxin Kang
- Beijing Chaoyang Integrative Medicine Emergency Medical Center, Beijing, China
| | - Huilin Liu
- China Rehabilitation Research Center, Beijing, China
| | - Qiuchen Huang
- China Rehabilitation Research Center, Beijing, China
| | - Liguo Zhu
- Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Ko Onoda
- Department of Physical Therapy, International University of Health and Welfare, Otawara, Japan
| | - Hitoshi Maruyama
- Department of Physical Therapy, International University of Health and Welfare, Otawara, Japan
| | - Shan Liu
- School of Rehabilitation Sciences and Engineering, University of Health and Rehabilitation Sciences, Qingdao, China
| | - Ming Huo
- School of Rehabilitation Sciences and Engineering, University of Health and Rehabilitation Sciences, Qingdao, China
- Jilin Province Power Hospital, Changchun, China
- Shaanxi Provincial Rehabilitation Hospital, Xi'an, China
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Pang L, Zheng Z, Su P, Xu Z, Chen Y, Liao Z, Jia P, Zhang X, Lv C. Mendelian randomization of stroke risk after total hip and knee replacements. Front Genet 2024; 15:1435124. [PMID: 39055256 PMCID: PMC11270026 DOI: 10.3389/fgene.2024.1435124] [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: 05/19/2024] [Accepted: 06/21/2024] [Indexed: 07/27/2024] Open
Abstract
Objective Previous epidemiological studies have indicated an increased risk of neurovascular diseases in patients following total hip and knee replacements. However, definitive conclusions regarding the increased risk of stroke post-replacement remain elusive. Therefore, we conducted a two-sample Mendelian randomization study to investigate the causal relationship between total hip and knee replacements and stroke. Methods We utilized summary data from publicly available genome-wide association studies (GWAS). Data concerning total hip replacements (THR, N = 319,037) and total knee replacements (TKR, N = 252,041) were sourced from the Genetics of Osteoarthritis (GO) Consortium. Stroke-related data were obtained from the International Stroke Genetics Consortium, encompassing any stroke (AS), any ischemic stroke (AIS), large vessel ischemic stroke (LV-IS), cardioembolic ischemic stroke (CE-IS), and small vessel ischemic stroke (SV-IS). Our primary causal inference method was the inverse variance weighted (IVW) approach, supplemented by weighted median and MR-Egger regression as secondary inference methods. We utilized the MR-PRESSO global test for outlier detection, Cochran's Q statistic to assess heterogeneity, and assessed the multiplicity and stability of our findings using p-values from MR-PRESSO and MR-Egger regressions, and the leave-one-out method, respectively. Results We identified significant genetic associations between THR and both AS (IVW p = 0.0001, OR = 1.08, 95% CI = 1.04-1.12) and AIS (IVW p = 0.0016, OR = 1.07, 95% CI = 1.03-1.12). Significant associations were also observed between TKR and AS (IVW p = 0.0002, OR = 1.08, 95% CI = 1.04-1.12), as well as AIS (IVW p = 0.0005, OR = 1.15, 95% CI = 1.06-1.24). Conclusion Our findings genetically support an increased risk of stroke following total hip and knee replacements. However, further studies are necessary to elucidate the specific mechanisms underlying stroke episodes post-replacement.
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Affiliation(s)
- Liang Pang
- Wenzhou TCM Hospital of Zhejiang Chinese Medical University, Wenzhou, China
| | - Zhihui Zheng
- Wenzhou TCM Hospital of Zhejiang Chinese Medical University, Wenzhou, China
| | - Pingping Su
- Wenzhou TCM Hospital of Zhejiang Chinese Medical University, Wenzhou, China
| | - Zhouhengte Xu
- Wenzhou TCM Hospital of Zhejiang Chinese Medical University, Wenzhou, China
| | - Yirui Chen
- Wenzhou TCM Hospital of Zhejiang Chinese Medical University, Wenzhou, China
| | - Zhicheng Liao
- Wenzhou TCM Hospital of Zhejiang Chinese Medical University, Wenzhou, China
| | - Pengcheng Jia
- Wenzhou TCM Hospital of Zhejiang Chinese Medical University, Wenzhou, China
| | - Xiuling Zhang
- The Eighth Clinical Medical College of Guangzhou University of Chinese Medicine, Foshan, China
| | - Cunxian Lv
- Wenzhou TCM Hospital of Zhejiang Chinese Medical University, Wenzhou, China
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Chen Y, Wang D, Yin J, Krafft PR, Luo X, Hao D, Li C, Liu Y, Li L, Zhang Y, Zhu C. Increased TMEM166 Level in Patients with Postoperative Stroke after Carotid Endarterectomy. Neuroscience 2024; 549:138-144. [PMID: 38734302 DOI: 10.1016/j.neuroscience.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 04/21/2024] [Accepted: 05/05/2024] [Indexed: 05/13/2024]
Abstract
Postoperative stroke is a challenging and potentially devastating complication after elective carotid endarterectomy (CEA). We previously demonstrated that transmembrane protein 166 (TMEM166) levels were directly related to neuronal damage after cerebral ischemia-reperfusion injury in rats. In this subsequent clinical study, we aimed to evaluate the prognostic value of TMEM166 in patients suffering from post-CEA strokes. Thirty-five patients undergoing uncomplicated elective CEA and 8 patients who suffered ischemic strokes after CEA were recruited. We evaluated the protein level and expression of TMEM166 in patients diagnosed with postoperative strokes and compared it to those in patients who underwent uncomplicated elective CEA. Blood samples and carotid artery plaques were collected and analyzed. High expressions of TMEM166 were detected by immunofluorescence staining and Western Blot in carotid artery plaques of all patients who underwent CEA. Furthermore, circulating TMEM166 concentrations were statistically higher in post-CEA stroke patients than in patients allocated to the control group. Mean plasma concentrations of inflammatory markers, including interleukin 6 (IL-6) and C-reactive protein (CRP), were also elevated in patients with postoperative strokes. Therefore, based on these findings, we hypothesize that elevated TMEM166 levels, accompanied by a strong inflammatory response, serve as a useful biomarker for risk assessment of postoperative stroke following CEA.
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Affiliation(s)
- Yifei Chen
- Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Danyang Wang
- Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jie Yin
- Department of Anesthesiology, the First Affiliated Hospital of Xinxiang Medical University, Henan, China
| | - Paul R Krafft
- Department of Neurosurgery and Brain Repair, University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | - Xin Luo
- Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Dandan Hao
- Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Chengwen Li
- Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ye Liu
- Department of Anaesthesiology, Beijing Obstetrics and Gynecology Hospital,Capital Medical University, Beijing, China.
| | - Li Li
- Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
| | - Yongbo Zhang
- Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
| | - Chen Zhu
- Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
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Qin J, Nong L, Zhu Q, Huang Z, Wu F, Li S. A Retrospective Analysis of Central and Peripheral Metabolic Characteristics in Patients with Cryptococcal Meningitis. Neurol Ther 2024; 13:763-784. [PMID: 38643256 PMCID: PMC11136911 DOI: 10.1007/s40120-024-00610-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 03/19/2024] [Indexed: 04/22/2024] Open
Abstract
INTRODUCTION Most current treatment strategies and investigations on cryptococcal meningitis (CM) focus primarily on the central nervous system (CNS), often overlooking the complex interplay between the CNS and the peripheral system. This study aims to explore the characteristics of central and peripheral metabolism in patients with CM. METHODS Patients diagnosed with CM as per the hospital records of the Fourth People's Hospital of Nanning were retrospectively analyzed. Patients were divided into two groups, non-structural damage of the brain (NSDB) and structural damage of the brain (SDB), according to the presence of brain lesions as detected with imaging. Based on the presence of enlarged cerebral ventricles, the cases in the SDB group were classified into non-ventriculomegaly (NVM) and ventriculomegaly (VM). Various parameters of cerebrospinal fluid (CSF) and peripheral blood (PB) were analyzed. RESULTS A significant correlation was detected between CSF and PB parameters. The levels of CSF-adenosine dehydrogenase (ADA), CSF-protein, CSF-glucose, and CSF-chloride ions were significantly correlated with the levels of PB-aminotransferase, PB-bilirubin, PB-creatinine (Cr), PB-urea nitrogen, PB-electrolyte, PB-protein, and PB-lipid. Compared with NSDB, the levels of CSF-glucose were significantly decreased in the SDB group, while the levels of CSF-lactate dehydrogenase (LDH) and CSF-protein were significantly increased in the SDB group. In the SDB group, the levels of PB-potassium, PB-hemoglobin(Hb), and PB-albumin were significantly decreased in the patients with VM, while the level of PB-urea nitrogen was significantly increased in these patients. CONCLUSION Metabolic and structural alterations in the brain may be associated with peripheral metabolic changes.
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Affiliation(s)
- Jianglong Qin
- The Fourth People's Hospital of Nanning, 1 Chang-Gang-Two-Li Road, Nanning, Guangxi, 530023, People's Republic of China
| | - Lanwei Nong
- The Fourth People's Hospital of Nanning, 1 Chang-Gang-Two-Li Road, Nanning, Guangxi, 530023, People's Republic of China
| | - Qingdong Zhu
- The Fourth People's Hospital of Nanning, 1 Chang-Gang-Two-Li Road, Nanning, Guangxi, 530023, People's Republic of China
| | - Zhizhong Huang
- The Fourth People's Hospital of Nanning, 1 Chang-Gang-Two-Li Road, Nanning, Guangxi, 530023, People's Republic of China
| | - Fengyao Wu
- The Fourth People's Hospital of Nanning, 1 Chang-Gang-Two-Li Road, Nanning, Guangxi, 530023, People's Republic of China
| | - Sijun Li
- The Fourth People's Hospital of Nanning, 1 Chang-Gang-Two-Li Road, Nanning, Guangxi, 530023, People's Republic of China.
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Ding Y, Peng YY, Li S, Tang C, Gao J, Wang HY, Long ZY, Lu XM, Wang YT. Single-Cell Sequencing Technology and Its Application in the Study of Central Nervous System Diseases. Cell Biochem Biophys 2024; 82:329-342. [PMID: 38133792 DOI: 10.1007/s12013-023-01207-3] [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: 08/21/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023]
Abstract
The mammalian central nervous system consists of a large number of cells, which contain not only different types of neurons, but also a large number of glial cells, such as astrocytes, oligodendrocytes, and microglia. These cells are capable of performing highly refined electrophysiological activities and providing the brain with functions such as nutritional support, information transmission and pathogen defense. The diversity of cell types and individual differences between cells have brought inspiration to the study of the mechanism of central nervous system diseases. In order to explore the role of different cells, a new technology, single-cell sequencing technology has emerged to perform specific analysis of high-throughput cell populations, and has been continuously developed. Single-cell sequencing technology can accurately analyze single-cell expression in mixed-cell populations and collect cells from different spatial locations, time stages and types. By using single-cell sequencing technology to compare gene expression profiles of normal and diseased cells, it is possible to discover cell subsets associated with specific diseases and their associated genes. Therefore, scientists can understand the development process, related functions and disease state of the nervous system from an unprecedented depth. In conclusion, single-cell sequencing technology provides a powerful technology for the discovery of novel therapeutic targets for central nervous system diseases.
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Affiliation(s)
- Yang Ding
- College of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing, 400054, China
- State Key Laboratory of Trauma and Chemical Poisoning, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Yu-Yuan Peng
- College of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing, 400054, China
| | - Sen Li
- State Key Laboratory of Trauma and Chemical Poisoning, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Can Tang
- College of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing, 400054, China
| | - Jie Gao
- College of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing, 400054, China
| | - Hai-Yan Wang
- State Key Laboratory of Trauma and Chemical Poisoning, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Zai-Yun Long
- State Key Laboratory of Trauma and Chemical Poisoning, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Xiu-Min Lu
- College of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing, 400054, China.
| | - Yong-Tang Wang
- State Key Laboratory of Trauma and Chemical Poisoning, Daping Hospital, Army Medical University, Chongqing, 400042, China.
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Zhang A, Xing Y, Zheng J, Li C, Hua Y, Hu J, Tian Z, Bai Y. Constraint-Induced Movement Therapy Modulates Neuron Recruitment and Neurotransmission Homeostasis of the Contralesional Cortex to Enhance Function Recovery after Ischemic Stroke. ACS OMEGA 2024; 9:21612-21625. [PMID: 38764659 PMCID: PMC11097180 DOI: 10.1021/acsomega.4c02537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/18/2024] [Accepted: 04/24/2024] [Indexed: 05/21/2024]
Abstract
Stroke often results in long-term and severe limb dysfunction for a majority of patients, significantly limiting their activities and social participation. Constraint-induced movement therapy (CIMT) is a rehabilitation approach aimed explicitly at enhancing upper limb motor function following a stroke. However, the precise mechanism remains unknown. This study explores how CIMT may alleviate forelimb paralysis in ischemic mice, potentially through structural and functional remodeling of brain regions beyond the infarct area, especially the contralateral cortex. We demonstrated that CIMT recruits neurons from the contralesional cortex into the network that innervates the affected forelimb, as evidenced by PRV retrograde nerve tracing. Additionally, we investigated how CIMT influences synaptic plasticity in the contralateral cortex by evaluating synaptic growth marker levels and neurotransmission's homeostatic regulation. Our findings uncover a rehabilitative mechanism by which CIMT treats ischemic stroke, characterized by increased recruitment of neurons from the contralateral cortex into the network that innervates the affected forelimb, facilitated by homeostatic regulation of neurotransmission.
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Affiliation(s)
- Anjing Zhang
- Department
of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China
- Department
of Neurological Rehabilitation Medicine, The First Rehabilitation Hospital of Shanghai, Shanghai 200093, P.R. China
| | - Ying Xing
- Department
of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China
| | - Jiayuan Zheng
- Department
of Integrative Medicine and Neurobiology, School of Basic Medical
Sciences, State Key Laboratory of Medical Neurobiology and MOE Frontiers
Center for Brain Science, Institutes of Brain Science, Institute of
Acupuncture Research, Academy of Integrative Medicine, Shanghai Key
Laboratory for Acupuncture Mechanism and Acupoint Function, Shanghai
Medical College, Fudan University, Shanghai 200433, China
| | - Congqin Li
- Department
of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China
| | - Yan Hua
- Department
of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China
| | - Jian Hu
- Department
of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China
| | - Zhanzhuang Tian
- Department
of Integrative Medicine and Neurobiology, School of Basic Medical
Sciences, State Key Laboratory of Medical Neurobiology and MOE Frontiers
Center for Brain Science, Institutes of Brain Science, Institute of
Acupuncture Research, Academy of Integrative Medicine, Shanghai Key
Laboratory for Acupuncture Mechanism and Acupoint Function, Shanghai
Medical College, Fudan University, Shanghai 200433, China
| | - Yulong Bai
- Department
of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China
- National
Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China
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Rigon L, Genovese D, Piano C, Brunetti V, Guglielmi V, Cimmino AT, Scala I, Citro S, Bentivoglio AR, Rollo E, Di Iorio R, Broccolini A, Morosetti R, Monforte M, Frisullo G, Caliandro P, Pedicelli A, Caricato A, Masone G, Calabresi P, Marca GD. Movement disorders following mechanical thrombectomy resulting in ischemic lesions of the basal ganglia: An emerging clinical entity. Eur J Neurol 2024; 31:e16219. [PMID: 38299441 PMCID: PMC11235728 DOI: 10.1111/ene.16219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/20/2023] [Accepted: 01/04/2024] [Indexed: 02/02/2024]
Abstract
BACKGROUND AND PURPOSE Post-stroke movement disorders (PMDs) following ischemic lesions of the basal ganglia (BG) are a known entity, but data regarding their incidence are lacking. Ischemic strokes secondary to proximal middle cerebral artery (MCA) occlusion treated with thrombectomy represent a model of selective damage to the BG. The aim of this study was to assess the prevalence and features of movement disorders after selective BG ischemia in patients with successfully reperfused acute ischemic stroke (AIS). METHODS We enrolled 64 consecutive subjects with AIS due to proximal MCA occlusion treated with thrombectomy. Patients were clinically evaluated by a movement disorders specialist for PMDs onset at baseline, and after 6 and 12 months. RESULTS None of the patients showed an identifiable movement disorder in the subacute phase of the stroke. At 6 and 12 months, respectively, 7/25 (28%) and 7/13 (53.8%) evaluated patients developed PMDs. The clinical spectrum of PMDs encompassed parkinsonism, dystonia and chorea, either isolated or combined. In most patients, symptoms were contralateral to the lesion, although a subset of patients presented with bilateral involvement and prominent axial signs. CONCLUSION Post-stroke movement disorders are not uncommon in long-term follow-up of successfully reperfused AIS. Follow-up conducted by a multidisciplinary team is strongly advisable in patients with selective lesions of the BG after AIS, even if asymptomatic at discharge.
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Affiliation(s)
- Leonardo Rigon
- Dipartimento di NeuroscienzeUniversità Cattolica del Sacro CuoreRomeItaly
| | - Danilo Genovese
- Dipartimento di neuroscienze, Organi di Senso e ToraceFondazione Policlinico Universitario A. Gemelli IRCCS – UOC NeurologiaRomeItaly
- The Marlene and Paolo Fresco Institute for Parkinson's Disease and Movement DisordersNew York University Langone HealthNew YorkNew YorkUSA
| | - Carla Piano
- Dipartimento di neuroscienze, Organi di Senso e ToraceFondazione Policlinico Universitario A. Gemelli IRCCS – UOC NeurologiaRomeItaly
| | - Valerio Brunetti
- Dipartimento di neuroscienze, Organi di Senso e ToraceFondazione Policlinico Universitario A. Gemelli IRCCS – UOC NeurologiaRomeItaly
| | - Valeria Guglielmi
- Dipartimento di neuroscienze, Organi di Senso e ToraceFondazione Policlinico Universitario A. Gemelli IRCCS – UOC NeurologiaRomeItaly
| | | | - Irene Scala
- Dipartimento di NeuroscienzeUniversità Cattolica del Sacro CuoreRomeItaly
| | - Salvatore Citro
- Dipartimento di NeuroscienzeUniversità Cattolica del Sacro CuoreRomeItaly
| | - Anna Rita Bentivoglio
- Dipartimento di NeuroscienzeUniversità Cattolica del Sacro CuoreRomeItaly
- Dipartimento di neuroscienze, Organi di Senso e ToraceFondazione Policlinico Universitario A. Gemelli IRCCS – UOC NeurologiaRomeItaly
| | - Eleonora Rollo
- Dipartimento di NeuroscienzeUniversità Cattolica del Sacro CuoreRomeItaly
| | - Riccardo Di Iorio
- Dipartimento di neuroscienze, Organi di Senso e ToraceFondazione Policlinico Universitario A. Gemelli IRCCS – UOC NeurologiaRomeItaly
| | - Aldobrando Broccolini
- Dipartimento di NeuroscienzeUniversità Cattolica del Sacro CuoreRomeItaly
- Dipartimento di neuroscienze, Organi di Senso e ToraceFondazione Policlinico Universitario A. Gemelli IRCCS – UOC NeurologiaRomeItaly
| | - Roberta Morosetti
- Dipartimento di neuroscienze, Organi di Senso e ToraceFondazione Policlinico Universitario A. Gemelli IRCCS – UOC NeurologiaRomeItaly
| | - Mauro Monforte
- Dipartimento di neuroscienze, Organi di Senso e ToraceFondazione Policlinico Universitario A. Gemelli IRCCS – UOC NeurologiaRomeItaly
| | - Giovanni Frisullo
- Dipartimento di neuroscienze, Organi di Senso e ToraceFondazione Policlinico Universitario A. Gemelli IRCCS – UOC NeurologiaRomeItaly
| | - Pietro Caliandro
- Dipartimento di neuroscienze, Organi di Senso e ToraceFondazione Policlinico Universitario A. Gemelli IRCCS – UOC NeurologiaRomeItaly
| | - Alessandro Pedicelli
- UOC Radiologia e Neuroradiologia, Dipartimento di diagnostica per immagini, radioterapia oncologica ed ematologiaFondazione Policlinico Universitario A. Gemelli IRCCSRomaItaly
| | - Anselmo Caricato
- Neuro Intensive Care Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCSUniversità Cattolica del Sacro CuoreRomeItaly
| | - Giovanna Masone
- Dipartimento di neuroscienze, Organi di Senso e ToraceFondazione Policlinico Universitario A. Gemelli IRCCS – UOC NeurologiaRomeItaly
| | - Paolo Calabresi
- Dipartimento di NeuroscienzeUniversità Cattolica del Sacro CuoreRomeItaly
- Dipartimento di neuroscienze, Organi di Senso e ToraceFondazione Policlinico Universitario A. Gemelli IRCCS – UOC NeurologiaRomeItaly
| | - Giacomo Della Marca
- Dipartimento di NeuroscienzeUniversità Cattolica del Sacro CuoreRomeItaly
- Dipartimento di neuroscienze, Organi di Senso e ToraceFondazione Policlinico Universitario A. Gemelli IRCCS – UOC NeurologiaRomeItaly
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11
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García-Bravo C, Delgado-Lobete L, Montes-Montes R, Rodríguez-Pérez MP, Trugeda-Pedrajo N, Fernández-Gómez G, García-Bravo S. Effects of Neuropilates on Functional Outcomes in Chronic Stroke: A Randomized Clinical Trial. Healthcare (Basel) 2024; 12:850. [PMID: 38667612 PMCID: PMC11049962 DOI: 10.3390/healthcare12080850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 04/05/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Neuropilates is an intervention approach that was developed as a modified version of the Pilates Method to be used for neurological rehabilitation. The main objective of this study was to analyze the effectiveness of regular physiotherapy and occupational therapy rehabilitation in comparison to a combination of traditional rehabilitation with Neuropilates in adults with post-stroke motor disabilities. This was a rater- and analyst-blinded randomized clinical trial with a three-month intervention and a one-month follow up. Participants were randomly allocated to either the experimental group (EG, receiving a combination of conventional therapy and Neuropilates; n = 15) or the control group (CG, receiving solely conventional therapy; n = 15). Once adjusted for baseline FIM scores, the results showed significant differences favoring the EG in daily functioning (FIM), static balance (FRT), right-hand manual dexterity (NHPT) and right-upper limb coordination (BBT). Satisfaction with the received treatment as measured with the CSQ-8 was significantly higher for the EG. In conclusion, the incorporation of Neuropilates, facilitated by a single experienced therapist, can be a valuable complement to conventional physical and occupational therapy. However, Neuropilates-based interventions should be supervised and tailored to each individual by a professional specifically trained in the method.
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Affiliation(s)
- Cristina García-Bravo
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Research Group of Humanities and Qualitative Research in Health Science (Hum&QRinHS), Universidad Rey Juan Carlos, 28922 Alcorcón, Spain;
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Research Group in Evaluation and Assessment of Capacity, Functionality and Disability (TO+IDI), Universidad Rey Juan Carlos, 28922 Alcorcón, Spain; (M.P.R.-P.); (N.T.-P.); (G.F.-G.)
| | - Laura Delgado-Lobete
- Departamento de Atención Sociosanitaria, Facultad de Ciencias Sociosanitarias, Universidad de Murcia, 30900 Lorca, Spain;
| | - Rebeca Montes-Montes
- Departamento de Atención Sociosanitaria, Facultad de Ciencias Sociosanitarias, Universidad de Murcia, 30900 Lorca, Spain;
| | - Mª Pilar Rodríguez-Pérez
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Research Group in Evaluation and Assessment of Capacity, Functionality and Disability (TO+IDI), Universidad Rey Juan Carlos, 28922 Alcorcón, Spain; (M.P.R.-P.); (N.T.-P.); (G.F.-G.)
| | - Nuria Trugeda-Pedrajo
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Research Group in Evaluation and Assessment of Capacity, Functionality and Disability (TO+IDI), Universidad Rey Juan Carlos, 28922 Alcorcón, Spain; (M.P.R.-P.); (N.T.-P.); (G.F.-G.)
| | - Gemma Fernández-Gómez
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Research Group in Evaluation and Assessment of Capacity, Functionality and Disability (TO+IDI), Universidad Rey Juan Carlos, 28922 Alcorcón, Spain; (M.P.R.-P.); (N.T.-P.); (G.F.-G.)
| | - Sara García-Bravo
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain;
- Physiocare Madrid, Physiotherapy Clinic, 28026 Madrid, Spain
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12
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Zhang L, Xue S, Fei C, Yu C, Li J, Li Y, Wang N, Chu F, Pan L, Duan X, Peng D. Protective effect of Tao Hong Si Wu Decoction against inflammatory injury caused by intestinal flora disorders in an ischemic stroke mouse model. BMC Complement Med Ther 2024; 24:124. [PMID: 38500092 PMCID: PMC10946105 DOI: 10.1186/s12906-024-04417-1] [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: 08/16/2023] [Accepted: 02/27/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND AND AIMS Recent studies have shown that intestinal flora are involved in the pathological process of ischemic stroke (IS). The potential protective effect of the traditional Chinese prescription, Tao Hong Si Wu Decoction (THSWD), against inflammatory injury after IS and its underlying mechanisms of action were investigated in the current study. METHODS Fifty SPF(Specefic pathogen Free) male C57 mice were randomly assigned to sham operation, model, THSWD low-dose (6.5 g/kg), medium-dose (13 g/kg) and high-dose (26 g/kg) groups (10 mice per group). Mouse models of transient middle cerebral artery occlusion were prepared via thread embolism. Neurological function score, hematoxylin-eosin (HE) staining, immunohistochemistry, enzyme-linked immunosorbent assay (ELISA), 16S ribosomal DNA (rDNA) sequencing, quantitative reverse transcription PCR (qRT-PCR) and other methods were employed to elucidate the underlying molecular mechanisms. RESULTS Notably, THSWD induced a reduction in the neurological function score (P < 0.01) and neuronal injury in brain tissue, increase in protein expression of Claudin-5 and zonula occludens-1 (ZO-1) in brain tissue(P < 0.01), and decrease in serum lipopolysaccharide (LPS)(P < 0.01), diamine oxidase (DAO)(P < 0.01) and D-lactic acid(P < 0.01, P < 0.05) levels to a significant extent. THSWD also inhibited the levels of tumor necrosis factor-α (TNF-α)(P < 0.01) and interleukin - 1β (IL-1β)(P < 0.01) in brain tissue, and increased alpha and beta diversity in ischemic stroke mice, along with a certain reversal effect on different microflora. Finally, THSWD inhibited the polarization of microglia cells(P < 0.01) and decreased the protein and gene expression of toll-like receptor-4 (TLR-4)(P < 0.01, P < 0.05) and nuclear factor kappa B (NF-κB)(P < 0.01) in brain tissue. CONCLUSION Our data indicate that THSWD may interfere with inflammatory response in ischemic stroke by regulating intestinal flora and promoting intestinal barrier repair.
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Affiliation(s)
- Lijuan Zhang
- Department of Pharmacy, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, 230031, China
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei, 230012, China
| | - Sujun Xue
- Department of Pharmacy, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, 230031, China
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei, 230012, China
| | - Changyi Fei
- Department of Pharmacy, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, 230031, China
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei, 230012, China
| | - Chao Yu
- Department of Pharmacy, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, 230031, China
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei, 230012, China
| | - Jingjing Li
- Department of Pharmacy, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, 230031, China
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei, 230012, China
| | - Yumeng Li
- Department of Pharmacy, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, 230031, China
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei, 230012, China
| | - Ni Wang
- Department of Pharmacy, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, 230031, China
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei, 230012, China
| | - Furui Chu
- Department of Pharmacy, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, 230031, China
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei, 230012, China
| | - Lingyu Pan
- Department of Pharmacy, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, 230031, China
| | - Xianchun Duan
- Department of Pharmacy, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, 230031, China.
- Key Laboratory of Chinese Medicinal Formula Research, Anhui University of Chinese Medicine, Hefei, 230012, China.
| | - Daiyin Peng
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei, 230012, China.
- Key Laboratory of Chinese Medicinal Formula Research, Anhui University of Chinese Medicine, Hefei, 230012, China.
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13
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Rodriguez-Porcel F, Sarva H, Joutsa J, Falup-Pecurariu C, Shukla AW, Mehanna R, Śmiłowska K, Lanza G, Filipović SR, Shalash A, Ferris M, Jankovic J, Espay AJ, Pandey S. Current opinions and practices in post-stroke movement disorders: Survey of movement disorders society members. J Neurol Sci 2024; 458:122925. [PMID: 38340409 DOI: 10.1016/j.jns.2024.122925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/03/2024] [Accepted: 02/06/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Post-stroke movement disorders (PSMD) encompass a wide array of presentations, which vary in mode of onset, phenomenology, response to treatment, and natural history. There are no evidence-based guidelines on the diagnosis and treatment of PSMD. OBJECTIVES To survey current opinions and practices on the diagnosis and treatment of PSMD. METHODS A survey was developed by the PSMD Study Group, commissioned by the International Parkinson's and Movement Disorders Society (MDS). The survey, distributed to all members, yielded a total of 529 responses, 395 (74.7%) of which came from clinicians with experience with PSMD. RESULTS Parkinsonism (68%), hemiballismus/hemichorea (61%), tremor (58%), and dystonia (54%) were by far the most commonly endorsed presentation of PSMD, although this varied by region. Basal ganglia stroke (76% of responders), symptoms contralateral to stroke (75%), and a temporal relationship (59%) were considered important factors for the diagnosis of PSMD. Oral medication use depended on the phenomenology of the PSMD. Almost 50% of respondents considered deep brain stimulation and ablative surgeries as options for treatment. The lack of guidelines for the diagnosis and treatment was considered the most important gap to address. CONCLUSIONS Regionally varying opinions and practices on PSMD highlight gaps in (and mistranslation of) epidemiologic and therapeutic knowledge. Multicenter registries and prospective community-based studies are needed for the creation of evidence-based guidelines to inform the diagnosis and treatment of patients with PSMD.
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Affiliation(s)
| | - Harini Sarva
- Parkinson's Disease and Movement Disorders Institute, Department of Neurology, Weill Cornell Medicine, NY, New York, USA
| | - Juho Joutsa
- Turku Brain and Mind Center, Clinical Neurosciences, University of Turku; Turku PET Centre, Neurocenter, Turku University Hospital, Turku, Finland
| | | | - Aparna Wagle Shukla
- Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
| | - Raja Mehanna
- Department of Neurology, University of Texas Health Science Center at Houston, TX, USA
| | | | - Giuseppe Lanza
- Department of Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy; Clinical Neurophysiology Research Unit, Oasi Research Institute-IRCCS, Troina, Italy
| | - Saša R Filipović
- University of Belgrade, Institute for Medical Research, Human Neuroscience Group, Belgrade, Serbia
| | - Ali Shalash
- Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Margaret Ferris
- Department of Neurology Stanford University, Palo Alto, CA, USA
| | - Joseph Jankovic
- Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | - Alberto J Espay
- James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, OH, USA
| | - Sanjay Pandey
- Department of Neurology and Stroke Medicine, Amrita Hospital, Mata Amritanandamayi Marg Sector 88, Faridabad, Delhi National Capital Region, India
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14
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Saleh RO, Majeed AA, Margiana R, Alkadir OKA, Almalki SG, Ghildiyal P, Samusenkov V, Jabber NK, Mustafa YF, Elawady A. Therapeutic gene delivery by mesenchymal stem cell for brain ischemia damage: Focus on molecular mechanisms in ischemic stroke. Cell Biochem Funct 2024; 42:e3957. [PMID: 38468129 DOI: 10.1002/cbf.3957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/02/2024] [Accepted: 02/12/2024] [Indexed: 03/13/2024]
Abstract
Cerebral ischemic damage is prevalent and the second highest cause of death globally across patient populations; it is as a substantial reason of morbidity and mortality. Mesenchymal stromal cells (MSCs) have garnered significant interest as a potential treatment for cerebral ischemic damage, as shown in ischemic stroke, because of their potent intrinsic features, which include self-regeneration, immunomodulation, and multi-potency. Additionally, MSCs are easily obtained, isolated, and cultured. Despite this, there are a number of obstacles that hinder the effectiveness of MSC-based treatment, such as adverse microenvironmental conditions both in vivo and in vitro. To overcome these obstacles, the naïve MSC has undergone a number of modification processes to enhance its innate therapeutic qualities. Genetic modification and preconditioning modification (with medications, growth factors, and other substances) are the two main categories into which these modification techniques can be separated. This field has advanced significantly and is still attracting attention and innovation. We examine these cutting-edge methods for preserving and even improving the natural biological functions and therapeutic potential of MSCs in relation to adhesion, migration, homing to the target site, survival, and delayed premature senescence. We address the use of genetically altered MSC in stroke-induced damage. Future strategies for improving the therapeutic result and addressing the difficulties associated with MSC modification are also discussed.
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Affiliation(s)
- Raed Obaid Saleh
- Department of Medical Laboratory Techniques, Al-Maarif University College, Al-Anbar, Iraq
| | - Ali A Majeed
- Department of Pathological Analyses, Faculty of Science, University of Kufa, Najaf, Iraq
| | - Ria Margiana
- Department of Anatomy, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Master's Programme Biomedical Sciences, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Ola Kamal A Alkadir
- Department of Medical Engineering, Al-Nisour University College, Baghdad, Iraq
| | - Sami G Almalki
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - Pallavi Ghildiyal
- Uttaranchal Institute of Pharmaceutical Sciences, Uttaranchal University, Dehradun, India
| | - Vadim Samusenkov
- Department of Prosthetic Dentistry, Sechenov First Moscow State Medical University, Moscow, Russia
| | | | - Yasser Fakri Mustafa
- Department of Pharmaceutical Chemistry, College of Pharmacy, University of Mosul, Mosul, Iraq
| | - Ahmed Elawady
- College of Technical Engineering, The Islamic University, Najaf, Iraq
- College of Technical Engineering, The Islamic University of Al Diwaniyah, Al Diwaniyah, Iraq
- College of Technical Engineering, The Islamic University of Babylon, Babylon, Iraq
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15
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Fernández-Solana J, Álvarez-Pardo S, Moreno-Villanueva A, Santamaría-Peláez M, González-Bernal JJ, Vélez-Santamaría R, González-Santos J. Efficacy of a Rehabilitation Program Using Mirror Therapy and Cognitive Therapeutic Exercise on Upper Limb Functionality in Patients with Acute Stroke. Healthcare (Basel) 2024; 12:569. [PMID: 38470680 PMCID: PMC10931296 DOI: 10.3390/healthcare12050569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/26/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024] Open
Abstract
Applying evidence-based therapies in stroke rehabilitation plays a crucial role in this process, as they are supported by studies and results that demonstrate their effectiveness in improving functionality, such as mirror therapy (MT), cognitive therapeutic exercise (CTE), and task-oriented training. The aim of this study was to assess the effectiveness of MT and CTE combined with task-oriented training on the functionality, sensitivity, range, and pain of the affected upper limb in patients with acute stroke. A longitudinal multicenter study recruited a sample of 120 patients with acute stroke randomly and consecutively, meeting specific inclusion and exclusion criteria. They were randomly allocated into three groups: a control group only for task-oriented training (TOT) and two groups undergoing either MT or CTE, both combined with TOT. The overall functionality of the affected upper limb, specific functionality, sensitivity, range of motion, and pain were assessed using the Fugl-Meyer Assessment Upper Extremity (FMA-UE) scale validated for the Spanish population. An initial assessment was conducted before the intervention, a second assessment after completing the 20 sessions, and another three months later. ANCOVA analysis revealed statistically significant differences between the assessments and the experimental groups compared to the control group, indicating significant improvement in the overall functionality of the upper limb in these patients. However, no significant differences were observed between the two experimental groups. The conclusion drawn was that both therapeutic techniques are equally effective in treating functionality, sensitivity, range of motion, and pain in the upper limb following a stroke.
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Affiliation(s)
- Jessica Fernández-Solana
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (J.F.-S.); (M.S.-P.); (J.J.G.-B.); (R.V.-S.); (J.G.-S.)
| | | | - Adrián Moreno-Villanueva
- Faculty of Health Science, University Isabel I, 09003 Burgos, Spain;
- BioVetMed & SportSci Research Group, Department of Physical activity and Sport, Faculty of Sport Sciences, University of Murcia, San Javier, 30720 Murcia, Spain
| | - Mirian Santamaría-Peláez
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (J.F.-S.); (M.S.-P.); (J.J.G.-B.); (R.V.-S.); (J.G.-S.)
| | - Jerónimo J. González-Bernal
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (J.F.-S.); (M.S.-P.); (J.J.G.-B.); (R.V.-S.); (J.G.-S.)
| | - Rodrigo Vélez-Santamaría
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (J.F.-S.); (M.S.-P.); (J.J.G.-B.); (R.V.-S.); (J.G.-S.)
| | - Josefa González-Santos
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (J.F.-S.); (M.S.-P.); (J.J.G.-B.); (R.V.-S.); (J.G.-S.)
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16
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Zhu T, Zhou Y, Dai A, Li S, Zhou L, Zhang X, Zhang W, Shi J. Efficacy of acupuncture and rehabilitation therapy on brain function activation area and neurological function in ischemic stroke: A systematic review and meta-analysis. PLoS One 2024; 19:e0298547. [PMID: 38394111 PMCID: PMC10889652 DOI: 10.1371/journal.pone.0298547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 01/23/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The probability of motor deficits after stroke is relatively high. At the same time many studies have reported that acupuncture and rehabilitation therapy have a significant effect on the treatment of stroke. OBJECTIVE This systematic review and meta-analysis aimed to evaluate the clinical value of acupuncture and rehabilitation therapy on brain eloquent areas and neurological function in ischemic stroke. METHODS Seven databases were electronically searched to screen randomized controlled trials (RCTs) of different intervention methods (acupuncture, rehabilitation) in the treatment of ischemic stroke. The search time is from January 1, 2000 to April 20, 2023, and the search languages are limited to Chinese and English. Two researchers independently screened literature and extracted data. The methodological quality of the studies was assessed using the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS A total of 17 randomized controlled studies were included, including 699 patients, with a maximum sample size of 144 cases and a minimum sample size of 11 cases. Among them, 3 studies reported the brain function in SM1 area. The effective rate of the experimental group was higher than that of the control group [relative risk (OR) = 3.24, 95%CI: 1.49 to 7.05, P < 0.05]. The FMA score of patients in the experimental group was higher than that in the control group [mean difference (MD) = 4.79, 95% CI: 3.86 to 5.71, P < 0.00001]. The NIHSS score of patients in the experimental group was lower than that in the control group [mean difference (MD) = -4.12, 95% CI: -6.99 to -1.26, P < 0.05].None of studies reported adverse events. CONCLUSIONS Acupuncture rehabilitation for ischemic stroke can activate corresponding brain functional areas and improve neurological deficits. The therapeutic effect of acupuncture rehabilitation treatment is better than that of basic western medicine treatment, and it is more effective in improving neurological deficits. At the same time, clinical research needs to use high-quality randomized double-blind controlled trials with more detailed and larger sample designs, long-term efficacy evaluation and evidence-based research methods.
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Affiliation(s)
- Tao Zhu
- Yunnan University of Chinese Medicine, Kunming, China
- The First Affiliated Hospital of Yunnan University of Chinese Medicine, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, China
| | - Yihao Zhou
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Anhong Dai
- Yan’ an Hospital Affiliated to Kunming Medical University, Kunming, China
| | - Song Li
- Yunnan University of Chinese Medicine, Kunming, China
| | - Li Zhou
- Yunnan University of Chinese Medicine, Kunming, China
| | - Xiahui Zhang
- The First Affiliated Hospital of Yunnan University of Chinese Medicine, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, China
| | - Wei Zhang
- Yan’ an Hospital Affiliated to Kunming Medical University, Kunming, China
| | - Jing Shi
- Yunnan University of Chinese Medicine, Kunming, China
- The First Affiliated Hospital of Yunnan University of Chinese Medicine, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, China
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Wang XD, Li X, Pan CL. Hemichorea in patients with temporal lobe infarcts: Two case reports. World J Clin Cases 2024; 12:806-813. [PMID: 38322679 PMCID: PMC10841122 DOI: 10.12998/wjcc.v12.i4.806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/08/2023] [Accepted: 01/08/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Hemichorea and other hyperkinetic movement disorders are uncommon presentations of stroke and are usually secondary to deep infarctions affecting the basal ganglia and thalamus. Therefore, temporal ischemic lesions causing hemichorea are rare. We report the cases of two patients with acute ischemic temporal lobe infarct strokes that presented as hemichorea. CASE SUMMARY Patient 1: An 82-year-old woman presented with a 1-mo history of involuntary movement of the left extremity, which was consistent with hemichorea. Her diffusion-weighted imaging (DWI) revealed an acute ischemic stroke that predominantly affected the right temporal cortex, and magnetic resonance angiography of the head showed significant stenosis of the right middle cerebral artery (MCA). Treatment with 2.5 mg of olanzapine per day was initiated. When she was discharged from the hospital, her symptoms appeared to have improved compared with those previously observed. Twenty-seven days after the first admission, she was readmitted due to acute ischemic stroke. Computed tomography perfusion showed marked hypoperfusion in the right MCA territory. An emergency transfemoral cerebral angiogram was performed and showed severe stenosis in the M1 segment of the right MCA. After percutaneous transluminal angioplasty was successfully performed, abnormal movements or other neurologic problems did not occur. Patient 2: A 76-year-old man was admitted to our hospital for a 7-d history of right-upper-sided involuntary movements. DWI showed an acute patchy ischemic stroke in the left temporal lobe without basal ganglia involvement. Subsequent diffusion tensor imaging confirmed fewer white matter fiber tracts on the left side than on the opposite side. Treatment with 2.5 mg of olanzapine per day improved his condition, and he was discharged. CONCLUSION When acute hemichorea suddenly appears, temporal cortical ischemic stroke should be considered a possible diagnosis. In addition, hemichorea may be a sign of impending cerebral infarction with MCA stenosis.
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Affiliation(s)
- Xu-Dong Wang
- Department of Neurology, Puren Hospital Affiliated to Wuhan University of Science and Technology, Wuhan 430081, Hubei Province, China
- School of Medicine, Wuhan University of Science and Technology, Wuhan 430065, Hubei Province, China
| | - Xing Li
- Department of Neurology, Puren Hospital Affiliated to Wuhan University of Science and Technology, Wuhan 430081, Hubei Province, China
| | - Chun-Lian Pan
- Department of Neurology, Puren Hospital Affiliated to Wuhan University of Science and Technology, Wuhan 430081, Hubei Province, China
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Trinchillo A, D'Asdia MC, De Luca A, Habetswallner F, Iorillo F, Esposito M. Cervical dystonia following brain tumor: description of an unreported case and a systematic review of literature. Acta Neurol Belg 2023; 123:2357-2360. [PMID: 36630079 DOI: 10.1007/s13760-023-02179-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 01/05/2023] [Indexed: 01/12/2023]
Affiliation(s)
- Assunta Trinchillo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Federico II" University, Naples, Italy
| | - Maria Cecilia D'Asdia
- Division of Medical Genetics, Fondazione IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Alessandro De Luca
- Division of Medical Genetics, Fondazione IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Francesco Habetswallner
- Clinical Neurophysiology Unit, Cardarelli Hospital, Via A. Cardarelli, 9, 80131, Naples, Italy
| | - Filippo Iorillo
- Clinical Neurophysiology Unit, Cardarelli Hospital, Via A. Cardarelli, 9, 80131, Naples, Italy
| | - Marcello Esposito
- Clinical Neurophysiology Unit, Cardarelli Hospital, Via A. Cardarelli, 9, 80131, Naples, Italy.
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Candelaresi P, Di Monaco C, Pisano E. Stroke chameleons: Diagnostic challenges. Eur J Radiol Open 2023; 11:100533. [PMID: 38028188 PMCID: PMC10652115 DOI: 10.1016/j.ejro.2023.100533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- P Candelaresi
- Neurology and Stroke Unit, AORN Antonio Cardarelli, Naples, Italy
| | - C Di Monaco
- Neurology and Stroke Unit, AORN Antonio Cardarelli, Naples, Italy
- Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University, Naples, Italy
| | - E Pisano
- Neurology and Stroke Unit, AORN Antonio Cardarelli, Naples, Italy
- Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University, Naples, Italy
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20
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Li XW, Xin YF, Chang AH, Zhang XG, Weng Y, Yang JH, Fu QZ. Correlation study between motor rehabilitation level and psychological state in patients with limb movement disorders after stroke. World J Psychiatry 2023; 13:912-918. [DOI: 10.5498/wjp.v13.i11.912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/09/2023] [Accepted: 10/27/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND The psychological state of patients with post stroke limb movement disorders undergoes a series of changes that affect rehabilitation training and recovery of limb motor function.
AIM To determine the correlation between motor rehabilitation and the psychological state of patients with limb movement disorders after stroke.
METHODS Eighty patients with upper and lower limb dysfunction post stroke were retrospectively enrolled in our study. Based on Hospital Anxiety and Depression Scale (HADS) scores measured before rehabilitation, patients with HADS scores ≥ 8 were divided into the psychological group; otherwise, the patients were included in the normal group. Motor function and daily living abilities were compared between the normal and psychological groups. Correlations between the motor function and psychological status of patients, and between daily living ability and psychological status of patients were analyzed.
RESULTS After 1, 2, and 3 wk of rehabilitation, both the Fugl-Meyer assessment and Barthel index scores improved compared to their respective baseline scores (P < 0.05). A greater degree of improvement was observed in the normal group compared to the psychological group (P < 0.05). There was a negative correlation between negative emotions and limb rehabilitation (-0.592 ≤ r ≤ -0.233, P < 0.05), and between negative emotions and daily living ability (-0.395 ≤ r ≤ -0.199, P < 0.05).
CONCLUSION There is a strong correlation between motor rehabilitation and the psychological state of patients with post stroke limb movement disorders. The higher the negative emotions, the worse the rehabilitation effect.
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Affiliation(s)
- Xiao-Wan Li
- Department of Medical Rehabilitation, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, Henan Province, China
| | - Yu-Fu Xin
- Department of Medical Rehabilitation, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, Henan Province, China
| | - Ai-Hui Chang
- Department of Medical Rehabilitation, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, Henan Province, China
| | - Xiao-Ge Zhang
- Department of Medical Rehabilitation, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, Henan Province, China
| | - Yan Weng
- Department of Medical Rehabilitation, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, Henan Province, China
| | - Jia-Hao Yang
- Department of Logistics, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, Henan Province, China
| | - Qi-Zhi Fu
- Department of Medical Intensive Care Unit, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, Henan Province, China
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21
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Carretero VJ, Ramos E, Segura-Chama P, Hernández A, Baraibar AM, Álvarez-Merz I, Muñoz FL, Egea J, Solís JM, Romero A, Hernández-Guijo JM. Non-Excitatory Amino Acids, Melatonin, and Free Radicals: Examining the Role in Stroke and Aging. Antioxidants (Basel) 2023; 12:1844. [PMID: 37891922 PMCID: PMC10603966 DOI: 10.3390/antiox12101844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 09/23/2023] [Accepted: 09/26/2023] [Indexed: 10/29/2023] Open
Abstract
The aim of this review is to explore the relationship between melatonin, free radicals, and non-excitatory amino acids, and their role in stroke and aging. Melatonin has garnered significant attention in recent years due to its diverse physiological functions and potential therapeutic benefits by reducing oxidative stress, inflammation, and apoptosis. Melatonin has been found to mitigate ischemic brain damage caused by stroke. By scavenging free radicals and reducing oxidative damage, melatonin may help slow down the aging process and protect against age-related cognitive decline. Additionally, non-excitatory amino acids have been shown to possess neuroprotective properties, including antioxidant and anti-inflammatory in stroke and aging-related conditions. They can attenuate oxidative stress, modulate calcium homeostasis, and inhibit apoptosis, thereby safeguarding neurons against damage induced by stroke and aging processes. The intracellular accumulation of certain non-excitatory amino acids could promote harmful effects during hypoxia-ischemia episodes and thus, the blockade of the amino acid transporters involved in the process could be an alternative therapeutic strategy to reduce ischemic damage. On the other hand, the accumulation of free radicals, specifically mitochondrial reactive oxygen and nitrogen species, accelerates cellular senescence and contributes to age-related decline. Recent research suggests a complex interplay between melatonin, free radicals, and non-excitatory amino acids in stroke and aging. The neuroprotective actions of melatonin and non-excitatory amino acids converge on multiple pathways, including the regulation of calcium homeostasis, modulation of apoptosis, and reduction of inflammation. These mechanisms collectively contribute to the preservation of neuronal integrity and functions, making them promising targets for therapeutic interventions in stroke and age-related disorders.
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Affiliation(s)
- Victoria Jiménez Carretero
- Department of Pharmacology and Therapeutic, Teófilo Hernando Institute, Faculty of Medicine, Universidad Autónoma de Madrid, Av. Arzobispo Morcillo 4, 28029 Madrid, Spain
| | - Eva Ramos
- Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Complutense University of Madrid, 28040 Madrid, Spain
| | - Pedro Segura-Chama
- Investigador por México-CONAHCYT, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñiz", Calzada México-Xochimilco 101, Huipulco, Tlalpan, Mexico City 14370, Mexico
| | - Adan Hernández
- Institute of Neurobiology, Universidad Nacional Autónoma of México, Juriquilla, Santiago de Querétaro 76230, Querétaro, Mexico
| | - Andrés M Baraibar
- Department of Neurosciences, Universidad del País Vasco UPV/EHU, Achucarro Basque Center for Neuroscience, Barrio Sarriena, s/n, 48940 Leioa, Spain
| | - Iris Álvarez-Merz
- Department of Pharmacology and Therapeutic, Teófilo Hernando Institute, Faculty of Medicine, Universidad Autónoma de Madrid, Av. Arzobispo Morcillo 4, 28029 Madrid, Spain
| | - Francisco López Muñoz
- Faculty of Health Sciences, University Camilo José Cela, C/Castillo de Alarcón 49, Villanueva de la Cañada, 28692 Madrid, Spain
- Neuropsychopharmacology Unit, Hospital 12 de Octubre Research Institute (i + 12), Avda. Córdoba, s/n, 28041 Madrid, Spain
| | - Javier Egea
- Molecular Neuroinflammation and Neuronal Plasticity Research Laboratory, Hospital Universitario Santa Cristina, Health Research Institute, Hospital Universitario de la Princesa, 28006 Madrid, Spain
| | - José M Solís
- Neurobiology-Research Service, Hospital Ramón y Cajal, Carretera de Colmenar Viejo, Km. 9, 28029 Madrid, Spain
| | - Alejandro Romero
- Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Complutense University of Madrid, 28040 Madrid, Spain
| | - Jesús M Hernández-Guijo
- Department of Pharmacology and Therapeutic, Teófilo Hernando Institute, Faculty of Medicine, Universidad Autónoma de Madrid, Av. Arzobispo Morcillo 4, 28029 Madrid, Spain
- Ramón y Cajal Institute for Health Research (IRYCIS), Hospital Ramón y Cajal, Carretera de Colmenar Viejo, Km. 9, 28029 Madrid, Spain
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22
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Shao H, Li S. A new perspective on HIV: effects of HIV on brain-heart axis. Front Cardiovasc Med 2023; 10:1226782. [PMID: 37600062 PMCID: PMC10436320 DOI: 10.3389/fcvm.2023.1226782] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/25/2023] [Indexed: 08/22/2023] Open
Abstract
The human immunodeficiency virus (HIV) infection can cause damage to multiple systems within the body, and the interaction among these various organ systems means that pathological changes in one system can have repercussions on the functions of other systems. However, the current focus of treatment and research on HIV predominantly centers around individual systems without considering the comprehensive relationship among them. The central nervous system (CNS) and cardiovascular system play crucial roles in supporting human life, and their functions are closely intertwined. In this review, we examine the effects of HIV on the CNS, the resulting impact on the cardiovascular system, and the direct damage caused by HIV to the cardiovascular system to provide new perspectives on HIV treatment.
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Affiliation(s)
| | - Sijun Li
- Department of Internal Medicine, The Fourth People's Hospital of Nanning, Nanning, China
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23
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Rodríguez-Rubio HA, López-Rodríguez R, Ramos-Escalante J, Bonilla-Suastegui A, Balcázar-Padrón JC, Rodríguez-Hernández LA, Nicolas-Cruz CF, Piñón-Jiménez F, Siller Uvalle MA, Arritola-Uriarte A, Leal-Galvan A, Ferrufino-Mejia BR. Risk Factors Associated With Neurological and Extra-Neurological Complications and Mortality in Patients With Stroke. Cureus 2023; 15:e40706. [PMID: 37485158 PMCID: PMC10359178 DOI: 10.7759/cureus.40706] [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] [Accepted: 06/20/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction Understanding when and how systemic complications can occur after an acute stroke is crucial. It is important to identify patients who are at higher risk for these complications. Early and effective treatment based on this knowledge can significantly improve patient outcomes. The objective of this study was to identify the risk factors associated with neurological and extra-neurological complications and mortality in stroke patients treated at a secondary care hospital. Methods Of a total of 170 patients diagnosed with hemorrhagic/ischemic stroke and transient cerebral ischemia at a secondary care hospital in Mexico, the records of 125 were reviewed and of these, 86 were included in the study. The study group comprised 86 adult patients (> 18 years of age) diagnosed with ischemic or hemorrhagic stroke or transient cerebral ischemia. Their demographics, clinical characteristics, in-hospital complications, and mortality were retrospectively analyzed. Results Of the 86 patients examined, 34.9% experienced complications, regardless of the type of stroke. The most significant factor associated with mortality and complications during hospitalization in patients with stroke was previous diseases. Other factors that were linked to higher mortality were pre-existing medical conditions. The most common neurological complication among patients with stroke during hospitalization was intracranial hypertension (3.5%). As for extra-neurological complications, pressure ulcers and nosocomial pneumonia had an occurrence rate of 4.7%. Conclusions The main neurological complication during hospitalization of patients with stroke was intracranial hypertension, while the extra neurological complications were pressure ulcers and nosocomial pneumonia.
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Affiliation(s)
- Héctor A Rodríguez-Rubio
- Neurological Surgery, Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez", Mexico City, MEX
- Neurology, Hospital General de Tampico "Dr. Carlos Canseco", Tampico, MEX
| | - Rodrigo López-Rodríguez
- Neurological Surgery, Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez", Mexico City, MEX
| | - Jonathan Ramos-Escalante
- Neurological Surgery, Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez", Mexico City, MEX
| | - Alfredo Bonilla-Suastegui
- Neurological Surgery, Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez", Mexico City, MEX
| | - Juan Carlos Balcázar-Padrón
- Neurological Surgery, Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez", Mexico City, MEX
| | - Luis A Rodríguez-Hernández
- Neurological Surgery, Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez", Mexico City, MEX
| | - Carlos F Nicolas-Cruz
- Neurological Surgery, Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez", Mexico City, MEX
| | - Fernando Piñón-Jiménez
- Neurological Surgery, Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez", Mexico City, MEX
| | - Miguel Angel Siller Uvalle
- Neurological Surgery, Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez", Mexico City, MEX
| | - Aleida Arritola-Uriarte
- Neurological Surgery, Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez", Mexico City, MEX
| | | | - Bill R Ferrufino-Mejia
- Neurological Surgery, Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez", Mexico City, MEX
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Doumbouya I, Barry SD, Toure ML, Barry DN, Diawara K, Traoré M, Diallo MH, Cissé FA, Cissé A. Post-stroke Chorea in the Neurology Department of Ignace Deen Hospital of Conakry, Guinea. Cureus 2023; 15:e35515. [PMID: 37007400 PMCID: PMC10051035 DOI: 10.7759/cureus.35515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2023] [Indexed: 03/03/2023] Open
Abstract
INTRODUCTION Chorea is an uncommon complication of stroke. The pathophysiology, the exact location of the lesions, and the evolution of this type of chorea are still poorly understood. The objective was to describe the epidemiological, clinical, and imaging profile of post-stroke chorea in a tropical environment in the context of a stroke epidemic. MATERIAL AND METHODS We conducted a five-year retrospective observational study from 2015 to 2020 on stroke patients who presented with chorea in our department. Epidemiological, clinical, and imaging data were registered. RESULTS Fourteen patients presented with chorea after their stroke, a frequency of 0.6%. The average age was 57.1 years with a male predominance. Hypertension was the cardiovascular risk factor in half of the patients; three patients (21.4) were diabetic. Chorea was the initial manifestation of the stroke in eight patients (57.1%). Thirteen patients (92.9%) had an ischaemic stroke and one had a cerebral haemorrhage. The middle cerebral artery (MCA) was involved in nine patients (64.3%), the anterior cerebral artery (ACA) in three patients (21.4%), and two patients (14.3%) had posterior cerebral artery (PCA) involvement. The lesions were cortical in five patients (35.7%), five other patients (35.7%) had a deep location, and four patients (28.6%) had both deep and cortical locations of their lesions. The structures affected were the lentiform nucleus (50%), the insula (35.7%), the caudate nucleus (14.3%), and the thalamus (14.3%). CONCLUSION Post-stroke chorea is poorly studied in the tropics. In the presence of any acute abnormal movement associated with cardiovascular risk factors, post-stroke chorea should be considered. Recovery is rapid when treated early.
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Effect of Three Weeks of High-Intensity, Long-Term Preoperative Rehabilitation for Esophageal Cancer Patients with Stroke Sequelae Who Were Considered Unfit for Surgery Due to Low Activity: A Case Report. Healthcare (Basel) 2023; 11:healthcare11050665. [PMID: 36900669 PMCID: PMC10000851 DOI: 10.3390/healthcare11050665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/09/2023] [Accepted: 02/21/2023] [Indexed: 03/12/2023] Open
Abstract
Treatment of esophageal cancer is based on tumor-node-metastasis (TNM) classification, and surgical treatment is chosen based on the patient's ability to tolerate surgery. Surgical endurance partly depends on activity status, with performance status (PS) generally used as an indicator. This report describes a 72-year-old man with lower esophageal cancer and an 8-year history of severe left hemiplegia. He had sequelae of cerebral infarction and a TNM classification of T3, N1, and M0, and was judged ineligible for surgery because his PS was grade three; he underwent preoperative rehabilitation with hospitalization for 3 weeks. He had been able to walk with a cane in the past, but once he was diagnosed with esophageal cancer, he began using a wheelchair and was dependent on assistance from his family in his daily life. Rehabilitation consisted of strength training, aerobic exercise, gait training, and activities of daily living (ADL) training for 5 h a day, according to the patient's condition. After 3 weeks of rehabilitation, his ADL ability and PS improved sufficiently for surgical indication. No complications occurred postoperatively, and he was discharged when his ADL ability was higher than that before preoperative rehabilitation. This case provides valuable information for the rehabilitation of patients with inactive esophageal cancer.
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Zhang H, Liu G, Zhang L, Wei W. Personalized Biomarkers and Neuropsychological Status Can Predict Post-Stroke Fatigue. Brain Sci 2023; 13:brainsci13020295. [PMID: 36831838 PMCID: PMC9953956 DOI: 10.3390/brainsci13020295] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/02/2023] [Accepted: 02/06/2023] [Indexed: 02/12/2023] Open
Abstract
Post-stroke fatigue (PSF) is a common complication of stroke that has a negative impact on prognosis and recovery. We aimed to investigate the relationship between PSF and demographics, mood disorders, sleep disorders, and other clinical characteristics of patients with stroke. In this exploratory cross-sectional study, we collected data on sociodemographic characteristics, biological indicators, and imaging features and evaluated patients using neuropsychological scales. Patients were assessed using the Fatigue Severity Scale, Hamilton Depression Rating Scale, Hamilton Anxiety Scale, and Pittsburgh Sleep Quality Index. Magnetic resonance imaging scans were primarily used to evaluate infarctions and white matter lesions. The correlation between the PSF of patients with stroke and clinical indicators was obtained by logistic regression analysis and power analysis. We observed an independent association between fatigue severity and female sex (odds ratio [OR], 2.12; 95% confidence interval [CI], 1.14-3.94), depressive state (OR, 1.50; 95% CI, 1.01-1.73), and sleep disorders (OR, 1.58; 95% CI, 1.01-1.98). High levels of blood glucose, serum uric acid, and homocysteine and low levels of serum triiodothyronine were strongly associated with poor functional outcomes in patients with stroke. Further studies are needed to elucidate how specific structural lesions and anxiety symptoms are related to early PSF.
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Affiliation(s)
| | | | | | - Wenshi Wei
- Correspondence: ; Tel.: +86-138-1839-6027
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Tan M, Li H, Wang X. Analysis of the current status of rehabilitation motivation and its influencing factors in older adults with stroke: a cross-sectional study. Front Aging Neurosci 2023; 15:1186681. [PMID: 37181623 PMCID: PMC10174289 DOI: 10.3389/fnagi.2023.1186681] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 04/10/2023] [Indexed: 05/16/2023] Open
Abstract
Objective Among stroke patients, exercise adherence is an important factor in reducing the rate of physical disability and mortality. Rehabilitation exercise after stroke is a safe and effective measure to restore normal body functions, but the analysis of factors influencing patients' motivation for rehabilitation is not well established. Therefore, this study will explore the influencing factors of rehabilitation motivation in older adults with stroke so as to reduce the disability rate of stroke. Method A convenience sampling method was used to study 350 patients in a stroke ward of a tertiary care hospital in Jinzhou, Liaoning Province. Patients' general demographic data, Multidimensional Scale of Perceived Social Support (PSSS), Questionnaire of Exercise Adherence (EAQ), Tampa scale of kinesiophobia (TSK-11), and Motivation in stroke patients for rehabilitation scale (MORE) were assessed. ANOVA or t-test analysis, correlation analysis, and linear regression analysis were used to explore the factors influencing the motivation for rehabilitation in older adults with stroke. Results The results showed that stroke patients' motivation for rehabilitation was at a moderate level. Perceived social support, exercise adherence, and stroke motivation were positively correlated (r = 0.619, p < 0.01; r = 0.569, p < 0.01), and kinesiophobia was negatively correlated with stroke motivation (r = -0.677, p < 0.01). Time of stroke, location of the lesion, perceived social support, exercise adherence, and kinesiophobia are influential factors affecting patients' motivation to recover. Conclusion In the rehabilitation program for older adult patients with stroke, healthcare providers should specify targeted rehabilitation measures according to the different degrees of the patient's condition, so as to improve the effectiveness of rehabilitation medical implementation.
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Affiliation(s)
- Mingyang Tan
- Department of Nursing, Jinzhou Medical University, Jinzhou, China
| | - Hongyu Li
- Department of Nursing, Jinzhou Medical University, Jinzhou, China
- *Correspondence: Hongyu Li,
| | - Xiuli Wang
- Department of Radiotherapy, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
- Xiuli Wang,
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Pandey S, Joutsa J, Mehanna R, Shukla AW, Rodriguez‐Porcel F, Espay AJ. Gaps, Controversies, and Proposed Roadmap for Research in Poststroke Movement Disorders. Mov Disord 2022; 37:1996-2007. [DOI: 10.1002/mds.29218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/14/2022] [Accepted: 08/19/2022] [Indexed: 11/08/2022] Open
Affiliation(s)
- Sanjay Pandey
- Department of Neurology Govind Ballabh Pant Institute of Postgraduate Medical Education and Research New Delhi India
- Department of Neurology, Amrita Hospital, Mata Amritanandamayi Marg Sector 88, Faridabad Delhi National Capital Region India
| | - Juho Joutsa
- Turku Brain and Mind Center, Clinical Neurosciences, University of Turku, Neurocenter Turku University Hospital Turku Finland
| | - Raja Mehanna
- UT Move, Department of Neurology University of Texas Health Science Center at Houston‐McGovern Medical School Houston Texas USA
| | - Aparna Wagle Shukla
- Fixel Institute for Neurological Diseases University of Florida Gainesville Florida USA
| | | | - Alberto J. Espay
- Gardner Family Center for Parkinson's Disease and Movement Disorders University of Cincinnati Academic Health Center Cincinnati Ohio USA
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Effect of Salvia Miltiorrhiza Polyphenolic Acid Injection on Improving Limb Use and Cognitive Impairment in Patients with Acute Stroke. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:1481294. [PMID: 35983530 PMCID: PMC9381215 DOI: 10.1155/2022/1481294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/05/2022] [Accepted: 07/08/2022] [Indexed: 11/18/2022]
Abstract
Aims. To investigate the effect of injectable salvia polyphenolic acid on the improvement of limb movement and cognitive dysfunction in acute stroke patients. Materials and Methods. The clinical data of 90 acute stroke patients were collected for retrospective study and divided into 45 cases each in the comparison group and the observation group according to the different treatment methods; using basic treatment + salvianolic acid, the comparison group implemented conventional alteplase and butalbital treatment, and the observation group used injectable salvianolic acid treatment, to observe and compare the clinical efficacy, changes in neurological deficits, cognitive function, and motor function scores before and after treatment in the two groups. Results. The NIHSS (National Institute of Health stroke scale) score, cerebral infarct volume, NSE (neuron-specific enolase), and S100β (A neurotrophic factor) levels were reduced after treatment compared with those before treatment in this group, and the NIHSS score, cerebral infarct volume, NSE, and S100β levels in the observation group were lower than those in the comparison group after treatment, and the difference was statistically significant (
). Compared with the clinical efficacy of the comparison group and the observation group, the treatment effect of the observation group was better than that of the comparison group, and the difference was statistically significant (
). After treatment, the cognitive function and motor function scores of both groups were significantly improved compared with those before treatment, and the degree of improvement of each score in the observation group was significantly better than that in the comparison group (
). During the trial, two patients in the comparison group developed a generalized rash and withdrew from the experiment, and the rash subsided after anti-allergic treatment, and no significant adverse events were observed in the remaining participants. There was no statistically significant difference in liver and kidney function and cardiac enzyme test indexes between the two groups of patients at 14 days of treatment (
). Conclusion. Danshen polyphenolic acid for injection has definite clinical efficacy in the treatment of acute ischemic stroke, and it can effectively improve cognitive and motor functions and promote neurological recovery in patients with high safety.
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CysLT2R Antagonist HAMI 3379 Ameliorates Post-Stroke Depression through NLRP3 Inflammasome/Pyroptosis Pathway in Gerbils. Brain Sci 2022; 12:brainsci12080976. [PMID: 35892417 PMCID: PMC9330558 DOI: 10.3390/brainsci12080976] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/04/2022] [Accepted: 07/20/2022] [Indexed: 01/25/2023] Open
Abstract
Post-stroke depression (PSD) is a kind of prevalent emotional disorder following stroke that usually results in slow functional recovery and even increased mortality. We had reported that the cysteinyl leukotriene receptor 2 (CysLT2R) antagonist HAMI3379 (HM3379) contributes to the improvement of neurological injury. The present study was designed to investigate the role of HM3379 in PSD-induced chronic neuroinflammation and related mechanisms in gerbils. The gerbils were subjected to transient global cerebral ischemia (tGCI) and spatial restraint stress to induce the PSD model. They were randomized to receive the vehicle or HM3379 (0.1 mg/kg, i.p.) for a consecutive 14 days. In the PSD-treated gerbils, HM3379 had noteworthy efficacy in improving the modified neurological severity score (mNSS) and depression-like behaviors, including the sucrose preference test and the forced swim test. HM3379 administration significantly mitigated neuron loss, lessened TUNEL-positive neurons, and reduced the activation of microglia in the cerebral cortex. Importantly, HM3379 downregulated protein expressions of the NOD-like receptor pyrin domain containing 3 (NLRP3) inflammasome and pyroptosis including NLRP3, cleaved caspase-1, interleukin-1β (IL-1β), IL-18, cleaved gasdermin-N domain (GSDMD-N), and apoptosis-associated speck-like protein containing a caspase activation and recruitment domain (ASC). Mechanistically, HM3379 could repress pyroptosis via inhibiting NLRP3 inflammasome activation under oxygen-glucose deprivation (OGD) stimulation. Knockdown of CysLT2R by short hairpin RNA (shRNA) or overexpression of CysLT2R by lentivirus (LV)-CysLT2R could abolish or restore the anti-depression effect of HM3379. Our results demonstrated that the selective CysLT2R antagonist HM3379 has beneficial effects on PSD, partially by suppressing the NLRP3 inflammasome/pyroptosis pathway.
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Effective Analysis of Multichannel Functional Electrical Stimulation plus Early Rehabilitation Training for Hemiplegic Patients after Stroke. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:6061652. [PMID: 35845583 PMCID: PMC9283049 DOI: 10.1155/2022/6061652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/09/2022] [Accepted: 05/12/2022] [Indexed: 11/18/2022]
Abstract
Purpose The research paper aims to investigate the value of multichannel functional electrical stimulation (FES) plus early rehabilitation training for hemiplegic patients after stroke attacks and assesses the impact of the combined therapy on walking capacity and daily life activities of patients. Methods Totally, 100 hemiplegic patients after stroke treated in No. 215 Hospital of Shaanxi Nuclear Industry from March 2019 to July 2020 were recruited and randomized into the control group and study group, with 50 cases in each group. The control group received early rehabilitation training, and the study group received multiple channel FES plus early rehabilitation. The rehabilitation effective rate, the Fugl-Meyer Assessment (FMA), the Berg Balance Scale (BBS), National Institutes of Health Stroke Scale (NIHSS), Barthel index (BI), the Quality of Life index (QLI), Mental Status Scale in Nonpsychiatric Settings (MSSNS), Self-rating Anxiety Scale (SAS), Self-rating depression scale (SDS), and the incidence of adverse response were evaluated. Results The study group patients had higher scores in FMA, BBS, BI, and QLI than the control group. Multiple channel FES plus early rehabilitation adopted in the study group resulted in a higher rehabilitation efficacy and a longer walking duration at 1, 2, and 4 weeks after the treatment. NIHSS score, MSSNS score, SAS score, SDS score, and incidence rate of adverse response in the study group were significantly lower compared to those of the control group. Conclusions Multichannel FES plus early rehabilitation training effectively enhances the rehabilitation of patients after stroke attacks.
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Tynterova A, Perepelitsa S, Golubev A. Personalized Neurophysiological and Neuropsychological Assessment of Patients with Left and Right Hemispheric Damage in Acute Ischemic Stroke. Brain Sci 2022; 12:brainsci12050554. [PMID: 35624940 PMCID: PMC9139366 DOI: 10.3390/brainsci12050554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/12/2022] [Accepted: 04/23/2022] [Indexed: 02/04/2023] Open
Abstract
The leading factors of post-stroke disability are motor disorders and cognitive dysfunctions. The aim of the study was to identify and provide a rationale for the variable early cognitive dysfunction in right and left hemispheric damage in patients with acute stroke. The study included 80 patients diagnosed with ischemic stroke. All patients were assessed for cognitive status, depression, fatigue and anxiety. For objectification, the method of evoked potentials (P300) and neuroimaging were used. Our findings revealed distinguishing features of cognitive dysfunction and identified a combination of the most informative markers characteristic of right and left hemispheric damage in patients with acute ischemic stroke. In patients with damage to the left hemisphere, a predominance of dysregulation syndrome (decrease in executive function and attention) was revealed, accompanied by various disorders such as severe anxiety and fatigue. The causes of this cognitive dysfunction may be directly related to stroke (damage to subcortical structures), as well as to a preexisting reduction in higher mental functions associated with age and vascular conditions. Cognitive impairments in patients with lesions of the right hemisphere were characterized by polymorphism and observed in the mental praxis, speech (with predominant semantic component) and abstract thinking domains. They are closely linked to each other and are more related to the lateralization of the lesion and preexisting neurodegeneration than to the localization of the ischemic lesion. The study of P300-evoked potentials is a good tool for confirming cognitive dysfunction. The latent period of the P300 wave is more sensitive to neurodegeneration, while the amplitude factor characterizes vascular pathology to a greater extent. The results of the study provide a rationale for a comprehensive assessment of lateralization, stroke localization, underlying diseases, neurophysiological parameters and identified cognitive impairments when developing a plan of rehabilitation and neuropsychological measures aimed at cognitive and emotional recovery of patients both in the acute phase of ischemic stroke and when selecting further personalized rehabilitation programs.
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Affiliation(s)
- Anastasia Tynterova
- Immanuel Kant Baltic Federal University, 14 Alexander Nevsky St., 236041 Kaliningrad, Kaliningrad Oblast, Russia;
- Correspondence:
| | - Svetlana Perepelitsa
- Immanuel Kant Baltic Federal University, 14 Alexander Nevsky St., 236041 Kaliningrad, Kaliningrad Oblast, Russia;
- V. A. Negovsky Research Institute of General Reanimatology, Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, 25 Petrovka Str., Build. 2, 107031 Moscow, Moskovskaya Oblast, Russia;
| | - Arкady Golubev
- V. A. Negovsky Research Institute of General Reanimatology, Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, 25 Petrovka Str., Build. 2, 107031 Moscow, Moskovskaya Oblast, Russia;
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