Altered structural connectivity associated with motor improvement in chronic supratentorial ischemic stroke

Neuroreport ◽  
2019 ◽  
Vol 30 (9) ◽  
pp. 688-693 ◽  
Author(s):  
Seung Hwa Lee ◽  
Sunghyon Kyeong ◽  
Hyunkoo Kang ◽  
Sohyon Kyeong ◽  
Dae Hyun Kim
Keyword(s):  
Ischemic Stroke ◽  
Structural Connectivity ◽  
Motor Improvement

scholarly journals Serum BDNF’s Role as a Biomarker for Motor Training in the Context of AR-Based Rehabilitation after Ischemic Stroke

2020 ◽  
Vol 10 (9) ◽  
pp. 623
Author(s):  
Ekaterina S. Koroleva ◽  
Ivan V. Tolmachev ◽  
Valentina M. Alifirova ◽  
Anastasiia S. Boiko ◽  
Lyudmila A. Levchuk ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Functional Disability ◽  
Motor Impairment ◽  
Motor Training ◽  
Training Methods ◽  
Motion Sensors ◽  
Early Recovery ◽  
Active Rehabilitation ◽  
Motor Improvement ◽  
Serum Bdnf

Background: brain-derived neurotrophic factor (BDNF) may play a role during neurorehabilitation following ischemic stroke. This study aimed to elucidate the possible role of BDNF during early recovery from ischemic stroke assisted by motor training. Methods: fifty patients were included after acute recovery from ischemic stroke: 21 first received classical rehabilitation followed by ‘motor rehabilitation using motion sensors and augmented reality’ (AR-rehabilitation), 14 only received AR-rehabilitation, and 15 were only observed. Serum BDNF levels were measured on the first day of stroke, on the 14th day, before AR-based rehabilitation (median, 45th day), and after the AR-based rehabilitation (median, 82nd day). Motor impairment was quantified clinically using the Fugl–Meyer scale (FMA); functional disability and activities of daily living (ADL) were measured using the Modified Rankin Scale (mRS). For comparison, serum BDNF was measured in 50 healthy individuals. Results: BDNF levels were found to significantly increase during the phase with AR-based rehabilitation. The pattern of the sequentially measured BDNF levels was similar in the treated patients. Untreated patients had significantly lower BDNF levels at the endpoint. Conclusions: the fluctuations of BDNF levels are not consistently related to motor improvement but seem to react to active treatment. Without active rehabilitation treatment, BDNF tends to decrease.

scholarly journals A Connectome-Based Approach to Assess Motor Outcome after Neonatal Arterial Ischemic Stroke

2020 ◽  
Author(s):  
Mariam Al Harrach ◽  
Pablo Pretzel ◽  
Samuel Groeschel ◽  
François Rousseau ◽  
Thijs Dhollander ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Structural Changes ◽  
Structural Connectivity ◽  
Multiple Linear Regression Model ◽  
Brain Regions ◽  
Motor Deficit ◽  
Healthy Controls ◽  
Arterial Ischemic Stroke ◽  
Motor Outcome ◽  
Motor Areas

AbstractObjectivestudies of motor outcome after Neonatal Arterial Ischemic Stroke (NAIS) often rely on lesion mapping using MRI. However, clinical measurements indicate that motor deficit can be different than what would solely be anticipated by the lesion extent and location. Because this may be explained by the cortical disconnections between motor areas due to necrosis following the stroke, the investigation of the motor network can help in the understanding of visual inspection and outcome discrepancy. In this study, we propose to examine the structural connectivity between motor areas in NAIS patients compared to healthy controls in order to define the cortical and subcortical connections that can reflect the motor outcomeMethods30 healthy controls and 32 NAIS patients with and without Cerebral Palsy (CP) underwent MRI acquisition and manual assessment. The connectome of all participants was obtained from T1-weighted and diffusion-weighted imaging.Resultssignificant disconnections in the lesioned and contra-lesioned hemispheres of patients were found. Furthermore, significant correlations were detected between the structural connectivity metric of specific motor areas and manuality assessed by the Box and Block Test (BBT) scores in patients.Interpretationusing the connectivity measures of these links the BBT score can be estimated using a multiple linear regression model. In addition, the presence or not of CP can also be predicted using the KNN classification algorithm. According to our results, the structural connectome can be an asset in the estimation of gross manual dexterity and can help uncover structural changes between brain regions related to NAIS.

scholarly journals THE EFFECT OF CITICOLIN IN MOTORIC IMPROVEMENT OF ACUTE ISCHEMIC STROKE PATIENTS IN SITI KHODIJAH SEPANJANG HOSPITAL

2020 ◽  
Vol 4 (2) ◽  
pp. 76-82
Author(s):  
Dza’wan Maula Iwanatud Diana ◽  
Laily Irfana ◽  
Yelvi Levani ◽  
Uning Marlina
Keyword(s):  
Ischemic Stroke ◽  
Cell Membranes ◽  
Neuronal Cell ◽  
Case Control ◽  
Wilcoxon Test ◽  
Stroke Patients ◽  
Chi Square ◽  
Brain Reperfusion ◽  
Main Component ◽  
Motor Improvement

ABSTRACT Background: According to WHO, stroke is the leading cause of morbidity and the second cause of death with a mortality rate of around 5.54 million. Stroke, based on its etiology, consists of ischemic and hemorrhagic. Ischemic stroke is caused by a blockage in the blood-brain, whereas hemorrhagic stroke occurs due to the rupture of brain blood vessels. Based on the pathophysiology of ischemic stroke, its therapy consists of thrombolytic in thrombus for brain reperfusion and anticoagulants or antiplatelet in strokes due to embolization because it is grown in a collateral-containing lavatory and neuroprotectant assistance to trace cytotoxic nerves. Neuroprotectants that are often used are piracetam and citicoline. Citicoline improves neuronal cell membranes by increasing synthesis of the main component of cell membranes, phosphatidylcholine, then repaired neuronal cell membranes. Objective: To find out motor improvement in stroke patients at Siti Khodijah Sepanjang Hospital by giving 500mg of citicoline per day orally for 5 days. Methods: A case-control observational analytic study using medical record data. Consists of a group with standard therapy, antiplatelets, and another group with 500mg/day antiplatelet and citicoline therapy for 5 days. Patients were examined for MRC motor on the first day and the fifth day. Results: The statistical test used the Chi-Square test  and wilcoxon test with a significance value of 0.00 and 0,01 (<0.05). Conclusion: obtained significant motor improvement in stroke patients 500mg/day for 5 days at Siti Khodijah Sepanjang Hospital. Keywords: Citicoline, Motoric Repair, Ischemic Stroke   ABSTRAK Latar belakang: Menurut WHO stroke menjadi penyebab utama morbiditas dan sebab kematian nomor dua dengan angka kematian sekitar 5,54 juta. Stroke berdasarkan etiologinya diklasifikasikan menjadi stroke iskemik dan stroke hemoragik. Stroke iskemik merupakan stroke yang diakibatkan oleh adanya sumbatan pada pembuluh darah di otak sedangkan stroke hemoragik akibat adanya pecahnya pebuluh darah otak. Berdasarkan patofisiologinya terapi stroke iskemik terdiri dari trombolitik pada iskemik akibat trombus untuk reperfusi otak dan antikoagulan atau antiplatelet pada stroke akibat emboli sebagai pencegahan terbentuknya trombus pada pembuluh darah kolateral serta pemberian neuroprotektan untuk menghambat penyebaran kerusakan neuroglia pada penumbra akibat proses sitotoksik. Neuroprotektan yang sering digunakan adalah pirasetam dan citicolin. citicolin berfungsi memperbaiki membran sel neuron dengan meningkatkan sintesis komponen utama membran sel yaitu phosphatidylcholine sehingga terjadi peningkatan perbaikan membran sel neuron. Tujuan: Untuk mengetahui perbaikan motorik pada pasien stroke iskemik akut di RS Siti Khodijah Sepanjang. Metode: Jenis penelitian analitik observasional case-control bersifat retrospektif menggunakan data rekam medis. Terdiri dari kelompok dengan terapi standar yaitu antiplatelet dan kelompok lain dengan terapi antiplatelet dan citicolin 500mg/hari selama 5 hari. Pasien dilakukan pemeriksan motorik MRC di hari pertama dan hari kelima. Hasil: Uji statistik menggunakan uji Chi-Square dan uji wilcoxon dengan nilai signifikansi masing-masing 0,00 dan 0,01 (<0,05). Kesimpulan: didapatkan perbaikan motorik yang signifikan pada pasien stroke iskemik akut dengan pemberian citicoline 500mg/hari selama 5 hari di Rumah Sakit Siti Khodijah Sepanjang. Kata Kunci: Citicolin, Perbaikan Motorik, Stroke Iskemik

scholarly journals Predictors for early motor improvement in patients with ischemic stroke

2019 ◽  
Vol 10 (Vol.10, No.3) ◽  
pp. 236-242 ◽  
Author(s):  
Ioana C. STANESCU ◽  
Angelo C. BULBOACA ◽  
Gabriela B. DOGARU ◽  
Gabriel GUSETU ◽  
Dana M. FODOR
Keyword(s):  
Ischemic Stroke ◽  
Motor Evoked Potentials ◽  
Continuous Process ◽  
Complete Recovery ◽  
Motor Recovery ◽  
Motor Deficit ◽  
Motor Deficits ◽  
Key Words Ischemic Stroke ◽  
Clinical Methods ◽  
Motor Improvement

Disability as a stroke consequence is reported by 3% males and 2% females in general population. Motor deficits are common in stroke patients, but their complete recovery is seen only in a minority of cases. Assessment of motor deficits uses clinical methods, especially standardized scales, but also electrophysiological and imagistic methods. The motor recovery is a continuous process, maximal in the first month after stroke, decreasing gradually over the first 6 months. Most powerful predictors for motor recovery are clinical parameters: severity of motor deficit, onset of first voluntary movements after stroke in the first 48-72 hours, a continuous improvement in motor function during the first 8 weeks, a good postural control during the first month, young age, male sex, left hemispheric stroke and absence of other neurological impairments are strong positive predictors. Presence of motor-evoked potentials in paretic muscles and imagistic parameters as location, stroke volume and motor pathways integrity are paraclinical predictors for recovery. There are no specific biomarker which is efficient in predicting recovery. In patients with poor chances for recovery according to actual predictors, the development of more precise algorithms to assess functional outcome is needed, in order to support the choice of appropriate methods and intensity of rehabilitation treatment. Key words: ischemic stroke rehabilitation, functional assessment, motor improvement, recovery predictors, prognostic factors,

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