Reorganisation of motor pathways in hemispheric stroke patients

1997 ◽  
Vol 103 (1) ◽  
pp. 75
Author(s):  
P Th. Vogt
Keyword(s):  
Stroke Patients ◽  
Motor Pathways ◽  
Hemispheric Stroke

Abstract TMP22: Intravenous Glyburide Treatment is Associated with Reduced Matrix Metalloproteinase-9 in Human Acute Stroke

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Ly Pham ◽  
Sydney O’Connor ◽  
Karen Yarbrough ◽  
Sven Jacobson ◽  
Barney J Stern ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Matrix Metalloproteinase ◽  
Active Form ◽  
Pilot Trial ◽  
Specific Inhibitor ◽  
Matrix Metalloproteinase 9 ◽  
Stroke Patients ◽  
Hemispheric Stroke ◽  
Intravenous Tissue Plasminogen Activator ◽  
Metalloproteinase 9

Background: Elevated matrix metalloproteinase-9 (MMP-9) following acute ischemic stroke is associated with blood-brain barrier breakdown and hemorrhagic conversion. Prior retrospective evidence suggests that sulfonylurea use may be associated with reduced risk of hemorrhagic conversion. We hypothesized that sulfonylureas may reduce MMP-9 level in stroke patients. Methods: Using serial plasma samples from six subjects in the Glyburide Advantage in Malignant Edema and Stroke Pilot trial (GAMES-Pilot), we evaluated the level of MMP-9 in human subjects presenting with large hemispheric stroke who were treated with intravenous glyburide (RP-1127). MMP-9 was measured in a control cohort with large ischemic stroke who were not treated with glyburide. Commercially available ELISA kits and gel zymography were used to measure MMP-9 at baseline and at approximately 48 hours after stroke. GAMES subjects had additional time points analyzed until approximately 84 hours after stroke. Results: Average MMP-9 level in glyburide-treated stroke patients was 47.2 ± 8.0 ng/mL compared to 143.4 ± 60.35 ng/mL in untreated control subjects (p=0.004). Zymography analysis demonstrated a significant decrease in the pro-enzyme but no change in the active form of MMP-9. There was no difference in the level of the MMP-9 specific inhibitor, TIMP-1. No subjects exhibited parenchymal hemorrhagic conversion on 24 hour head CT scan. Conclusions: Glyburide treatment in human stroke patients with large hemispheric stroke is associated reduced level of MMP-9. Elucidating the underlying mechanism of glyburide’s effect on MMP-9 and the risk of hemorrhagic conversion may highlight future directions of therapy, including in combination with intravenous tissue plasminogen activator (IV t-PA).

scholarly journals Test-Retest-Reliability of Video-Oculography During Free Visual Exploration in Right-Hemispheric Stroke Patients With Neglect

2020 ◽  
Vol 14 ◽  
Author(s):  
Brigitte Charlotte Kaufmann ◽  
Dario Cazzoli ◽  
René Martin Müri ◽  
Tobias Nef ◽  
Thomas Nyffeler
Keyword(s):  
Visual Exploration ◽  
Stroke Patients ◽  
Retest Reliability ◽  
Video Oculography ◽  
Hemispheric Stroke ◽  
Test Retest Reliability

Effects of bilateral arm training on upper extremity function in right and left hemispheric stroke

2020 ◽  
pp. 1-9
Author(s):  
Humera Ambreen ◽  
Hina Tariq ◽  
Imran Amjad
Keyword(s):  
Upper Extremity ◽  
Motor Function ◽  
Recovery Of Function ◽  
Hand Function ◽  
Group Analysis ◽  
Stroke Patients ◽  
Hemispheric Stroke ◽  
Beneficial Effects ◽  
Significant Difference ◽  
Bilateral Arm Training

Abstract Objective: This experimental study on 24 stroke patients aimed at evaluating and comparing the effects of bilateral arm training on upper extremity (UE) motor function between right and left hemispheric chronic stroke patients. Methods: Both groups received the same intervention involving 5 functional tasks for 1 hour, 3 days per week, for a total of 6 weeks. Fugl-Meyer Assessment-Upper Extremity and Wolf-Motor Function Test were applied as outcome measures at baseline and after 6 weeks of training to assess the recovery of function in the affected area. Results: Intra-group analysis showed no significant improvement in the wrist and hand function in the left hemispheric stroke (LHS) (p>0.05), while right hemispheric stroke (RHS) patients did not improve significantly in the coordination/speed domain (p>0.05). Inter-group analysis showed no significant difference between right and left hemispheric stroke patients (p>0.05). Conclusion: Bilateral arm training showed beneficial effects in improving UE function in both RHS and LHS patients. Distal UE function in LHS and coordination and speed of movement in RHS patients did not show any significant improvement. Key Words: Stroke, Upper extremity, Recovery of function, Bilateral arm training. Continuous...

scholarly journals Feasibility of the Cognitive Assessment scale for Stroke Patients (CASP) vs. MMSE and MoCA in aphasic left hemispheric stroke patients

2014 ◽  
Vol 57 (6-7) ◽  
pp. 422-435 ◽  
Author(s):  
J.-L. Barnay ◽  
G. Wauquiez ◽  
H.Y. Bonnin-Koang ◽  
C. Anquetil ◽  
D. Pérennou ◽  
...  
Keyword(s):  
Cognitive Assessment ◽  
Assessment Scale ◽  
Stroke Patients ◽  
Hemispheric Stroke

Altered Resting-State Functional and White Matter Tract Connectivity in Stroke Patients With Dysphagia

2013 ◽  
Vol 28 (3) ◽  
pp. 260-272 ◽  
Author(s):  
Shasha Li ◽  
Zhenxing Ma ◽  
Shipeng Tu ◽  
Muke Zhou ◽  
Sihan Chen ◽  
...  
Keyword(s):  
White Matter ◽  
Functional Connectivity ◽  
Fractional Anisotropy ◽  
Resting State ◽  
Structural Connectivity ◽  
White Matter Tract ◽  
Stroke Patients ◽  
Hemispheric Stroke ◽  
Swallowing Dysfunction ◽  
The Mean

Background. Swallowing dysfunction is intractable after acute stroke. Our understanding of the alterations in neural networks of patients with neurogenic dysphagia is still developing. Objective. The aim was to investigate cerebral cortical functional connectivity and subcortical structural connectivity related to swallowing in unilateral hemispheric stroke patients with dysphagia. Methods. We combined a resting-state functional connectivity with a white matter tract connectivity approach, recording 12 hemispheric stroke patients with dysphagia, 12 hemispheric stroke patients without dysphagia, and 12 healthy controls. Comparisons of the patterns in swallowing-related functional connectivity maps between patient groups and control subjects included ( a) seed-based functional connectivity maps calculated from the primary motor cortex (M1) and the supplementary motor area (SMA) to the entire brain, ( b) a swallowing-related functional connectivity network calculated among 20 specific regions of interest (ROIs), and ( c) structural connectivity described by the mean fractional anisotropy of fibers bound through the SMA and M1. Results. Stroke patients with dysphagia exhibited dysfunctional connectivity mainly in the sensorimotor-insula-putamen circuits based on seed-based analysis of the left and right M1 and SMA and decreased connectivity in the bilateral swallowing-related ROIs functional connectivity network. Additionally, white matter tract connectivity analysis revealed that the mean fractional anisotropy of the white matter tract was significantly reduced, especially in the left-to-right SMA and in the corticospinal tract. Conclusions. Our results indicate that dysphagia secondary to stroke is associated with disruptive functional and structural integrity in the large-scale brain networks involved in motor control, thus providing new insights into the neural remodeling associated with this disorder.

scholarly journals The influence of nicergoline on cerebral, systemic and cardiac hemodynamics in patients who have had an ischemic stroke

2021 ◽  
pp. 17-26
Author(s):  
Viktor Kuznetsov
Keyword(s):  
Ischemic Stroke ◽  
Recovery Period ◽  
Peripheral Resistance ◽  
Cerebral Hemodynamics ◽  
Stroke Patients ◽  
Hemispheric Stroke ◽  
Cardiac Hemodynamics ◽  
Before And After ◽  
Blood Flow Velocities ◽  
The Right

The Aim of study was analysis of the effect of nicergoline on the cerebral, cardiac, systemic hemodynamics of patients after ischemic stroke, taking into account the hemispheric localization of the ischemic focus. Materials and methods. A comprehensive clinical and neurological examination was carried out in 38 elderly patients (mean age 64.3 ± 2.5 years) who had undergone atherothrombotic ischemic stroke in the carotid system (recovery period). There were 20 patients with left hemispheric stroke and 18 with right hemispheric stroke. All patients had arterial hypertension (AH). These were ACE inhibitors (enalapril 10-20 mg 1 tablet 2 times a day) and hydrochlorothiazide at a dose of 12.5 mg. Patients received nicergoline at a dose of 4 mg IV drip for 10 days. A comprehensive examination was carried out before and after treatment with nicergoline. The Results of the study allowed us to conclude that the course of nicergoline intake in patients after ischemic atherothrombotic stroke improves the subjective state and reduces the severity of neurological disorders, cerebral hemodynamics, increases linear systolic blood flow velocities (LBFVsys) and reduces peripheral resistance in individual extra- and intracranial vessels of the carotid and vertebro-basilar basins. In patients with right and left hemispheric localization of stroke under the influence of nicergoline, LBFVsys increases in the right and left ICA, PCA, and VA. In addition, LBFVsys increases in patients with right hemispheric stroke in the right MBA; in patients with left hemisphere - in two MBA and BA. In ischemic stroke patients, nicergoline affects systemic and cardiac hemodynamics: it reduces the systemic and cardiac hemodynamics, decreases the systemic vascular resistance and increases the ejection fraction, changes the structure of the relationship between systemic and cerebral hemodynamics, forming a positive relationship between blood pressure and hemodynamics in the vessels of the vertebro-basilar basin. Thus, the complex positive effect of nicergoline on various levels of cerebral, systemic and cardiac hemodynamics in ischemic stroke patients gives grounds to recommend the inclusion of this drug in the rehabilitation system of this category of patients.

scholarly journals Video-Oculography During Free Visual Exploration to Detect Right Spatial Neglect in Left-Hemispheric Stroke Patients With Aphasia: A Feasibility Study

2021 ◽  
Vol 15 ◽  
Author(s):  
Brigitte C. Kaufmann ◽  
Dario Cazzoli ◽  
Monica Koenig-Bruhin ◽  
René M. Müri ◽  
Tobias Nef ◽  
...  
Keyword(s):  
Spatial Neglect ◽  
Visual Exploration ◽  
Healthy Controls ◽  
Stroke Patients ◽  
Calibration And Validation ◽  
Video Oculography ◽  
Hemispheric Stroke ◽  
The Mean ◽  
Highly Correlated ◽  
Exploration Area

Spatial neglect has been shown to occur in 17–65% of patients after acute left-hemispheric stroke. One reason for this varying incidence values might be that left-hemispheric stroke is often accompanied by aphasia, which raises difficulties in assessing attention deficits with conventional neuropsychological tests entailing verbal instructions. Video-oculography during free visual exploration (FVE) requires only little understanding of simple non-verbal instruction and has been shown to be a sensitive and reliable tool to detect spatial neglect in patients with right-hemispheric stroke. In the present study, we aimed to investigate the feasibility of FVE to detect neglect in 10 left-hemispheric stroke patients with mild to severe aphasia as assessed by means of the Token Test, Boston Naming Test and Aachener Aphasie Test. The patient’s individual deviation between eye movement calibration and validation was recorded and compared to 20 age-matched healthy controls. Furthermore, typical FVE parameters such as the landing point of the first fixation, the mean gaze position (in ° of visual angle), the number and duration of visual fixations and the mean visual exploration area were compared between groups. In addition, to evaluate for neglect, the Bells cancellation test was performed and neglect severity in daily living was measured by means of the Catherine Bergego Scale (CBS). Our results showed that the deviation between calibration and validation did not differ between aphasia patients and healthy controls highlighting its feasibility. Furthermore, FVE revealed the typical neglect pattern with a significant leftward shift in visual exploration bahaviour, which highly correlated with neglect severity as assessed with CBS. The present study provides evidence that FVE has the potential to be used as a neglect screening tool in left-hemispheric stroke patients with aphasia in which compliance with verbal test instructions may be compromised by language deficits.

What is the Role of Hyperosmolar Therapy in Hemispheric Stroke Patients?

2019 ◽  
Vol 32 (2) ◽  
pp. 609-619
Author(s):  
Nathan Mohney ◽  
Omar Alkhatib ◽  
Sebastian Koch ◽  
Kristine O’Phelan ◽  
Amedeo Merenda
Keyword(s):  
Stroke Patients ◽  
Hyperosmolar Therapy ◽  
Hemispheric Stroke
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