scholarly journals Low oxygen post conditioning improves stroke-induced cognitive impairment

2018 ◽  
Author(s):  
Zidan Zhao ◽  
Lin Kooi Ong ◽  
Giovanni Pietrogrande ◽  
Sonia Sanchez Bezanilla ◽  
Kirby Warren ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Learning Task ◽  
Experimental Stroke ◽  
Low Oxygen ◽  
Absolute Level ◽  
Associate Learning ◽  
Air Exposure ◽  
Post Stroke ◽  
Biochemical Analyses

AbstractPost-stroke cognitive impairment has proven to be notoriously difficult to treat. In the current study, we sought to both better understand cellular changes that underpin cognitive deficits and to consider the potential restorative benefits of low oxygen post conditioning (LOPC). We were motivated to use LOPC as an intervention as it is one of the few experimental interventions previously shown to improve cognitive function post-stroke. Experimental stroke was induced by photothrombotic occlusion in adult male C57BL/6 mice. Mice were randomly assigned to either a normal atmospheric air exposure or low oxygen (11% O2) exposure groups three days post-occlusion. On day 17 post-stroke, mice were euthanized for histology or biochemical analyses. Stroked mice exposed to LOPC was associated with marked reductions in amyloid-beta both in its absolute level and in the extent of its oligomerization. Exposure to LOPC post-stroke also improved cellular deficits induced by stroke including an increase in vessel density, a reduction in vascular leakage, and restoration of AQP4 polarisation. Critically, stroked mice exposed to LOPC exhibited robust improvements in cognitive function post-stroke, assessed using a touchscreen based paired- associate learning task. These findings provide compelling pre-clinical evidence of the potential clinical utility of LOPC for enhancing recovery post-stroke.

scholarly journals Exploring How Low Oxygen Post Conditioning Improves Stroke-Induced Cognitive Impairment: A Consideration of Amyloid-Beta Loading and Other Mechanisms

2021 ◽  
Vol 12 ◽  
Author(s):  
Zidan Zhao ◽  
Rebecca J. Hood ◽  
Lin Kooi Ong ◽  
Giovanni Pietrogrande ◽  
Sonia Sanchez Bezanilla ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Amyloid Beta ◽  
Neuronal Loss ◽  
Treatment Phase ◽  
Experimental Stroke ◽  
Low Oxygen ◽  
Associate Learning ◽  
Atmospheric Air ◽  
Post Stroke ◽  
Cognitive Benefits

Cognitive impairment is a common and disruptive outcome for stroke survivors, which is recognized to be notoriously difficult to treat. Previously, we have shown that low oxygen post-conditioning (LOPC) improves motor function and limits secondary neuronal loss in the thalamus after experimental stroke. There is also emerging evidence that LOPC may improve cognitive function post-stroke. In the current study we aimed to explore how exposure to LOPC may improve cognition post-stroke. Experimental stroke was induced using photothrombotic occlusion in adult, male C57BL/6 mice. At 72 h post-stroke animals were randomly assigned to either normal atmospheric air or to one of two low oxygen (11% O2) exposure groups (either 8 or 24 h/day for 14 days). Cognition was assessed during the treatment phase using a touchscreen based paired-associate learning assessment. At the end of treatment (17 days post-stroke) mice were euthanized and tissue was collected for subsequent histology and biochemical analysis. LOPC (both 8 and 24 h) enhanced learning and memory in the 2nd week post-stroke when compared with stroke animals exposed to atmospheric air. Additionally we observed LOPC was associated with lower levels of neuronal loss, the restoration of several vascular deficits, as well as a reduction in the severity of the amyloid-beta (Aβ) burden. These findings provide further insight into the pro-cognitive benefits of LOPC.

scholarly journals Similar cognitive deficits in mice and humans in the chronic phase post-stroke identified using the touchscreen-based paired-associate learning task

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Wei Zhen Chow ◽  
Lin Kooi Ong ◽  
Murielle G. Kluge ◽  
Prajwal Gyawali ◽  
Frederick R. Walker ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Paired Associate ◽  
Chronic Phase ◽  
Learning Task ◽  
Paired Associate Learning ◽  
Chronic Stroke ◽  
Stroke Survivors ◽  
Associate Learning ◽  
Cross Sectional ◽  
Post Stroke

Abstract For many chronic stroke survivors, persisting cognitive dysfunction leads to significantly reduced quality of life. Translation of promising therapeutic strategies aimed at improving cognitive function is hampered by existing, disparate cognitive assessments in animals and humans. In this study, we assessed post-stroke cognitive function using a comparable touchscreen-based paired-associate learning task in a cross-sectional population of chronic stroke survivors (≥ 5 months post-stroke, n = 70), age-matched controls (n = 70), and in mice generated from a C57BL/6 mouse photothrombotic stroke model (at six months post-stroke). Cognitive performance of stroke survivors was analysed using linear regression adjusting for age, gender, diabetes, systolic blood pressure and waist circumference. Stroke survivors made significantly fewer correct choices across all tasks compared with controls. Similar cognitive impairment was observed in the mice post-stroke with fewer correct choices compared to shams. These results highlight the feasibility and potential value of analogous modelling of clinically meaningful cognitive impairments in chronic stroke survivors and in mice in chronic phase after stroke. Implementation of validated, parallel cross-species test platforms for cognitive assessment offer the potential of delivering a more useful framework for evaluating therapies aimed at improving long-term cognitive function post-stroke.

scholarly journals Combination of isoflurane and propofol, a means for general anesthesia in the orthopedic surgery of perioperative cerebral hypoperfusion rats to avoid cognitive impairment Anesthesia of perioperative cerebral hypoperfusion

2020 ◽  
Author(s):  
Xinyue Bu ◽  
Tang Li ◽  
Haiyun Wang ◽  
Zhengyuan Xia ◽  
Di Guo ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Er Stress ◽  
General Anesthesia ◽  
Underlying Mechanism ◽  
Cerebral Hypoperfusion ◽  
Nissl Staining ◽  
Aging Rats ◽  
Biochemical Analyses ◽  
Common Carotid Arteries

Abstract Background: Perioperative cerebral hypoperfusion often occurs. However, the underlying mechanism of cognitive impairment resulting when perioperative cerebral hypoperfusion occurs remain mostly to be determined. Anesthetic isoflurane induces neuronal injury via endoplasmic reticulum (ER) stress, whereas sub-anesthetic dose of propofol improves postoperative cognitive function. However, the effects of the combination of isoflurane plus propofol, which is a common combination of anesthesia for patient, on ER stress and the associated cognitive function remain unknown. Methods: We therefore set out to determine the effects of isoflurane plus propofol on the ER stress and cognitive function in the rats insulted by cerebral hypoperfusion. A ligation of bilateral common carotid arteries (CCA) surgery was adopted to prepare rats as cerebral hypoperfusion (CH) animal model. A second surgery, open reduction and internal fixation (ORIF), requiring general anesthesia, was operated 30 days later so that the effects of anesthetics on cognitive function of these CH rats could be assessed. The rats received isoflurane alone (1.9%), propofol alone (40 mg·kg -1 ·h -1 ) or a combination of isoflurane and propofol (1% and 20 mg·kg -1 ·h -1 or 1.4% and 10 mg·kg -1 ·h -1 ). Behavior studies (Fear Conditioning test), histological analyses (Nissl staining) and biochemical analyses (western blotting for the harvested rat brain tissues) were employed in the studies. Results: We found that the combination of 1% isoflurane plus 20 mg·kg -1 ·h -1 propol did not aggravate the cognitive impairment and the ER stress in aging rats with cerebral hypoperusion and being subjected to an ORIF surgery. Conclusions: These data suggest that ER stress contributes to the underlying mechanism of cognitive impairment and the combination of isoflurane and propofol did not aggravate the cognitive impairment and the ER stress in aging rats with cerebral hypoperfusion and being subjected to an ORIF surgery.

scholarly journals Gambaran Fungsi Kognitif Pasien Pasca Stroke

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Reinaldi O. Boletimi ◽  
Mieke A. H. N. Kembuan ◽  
Junita M. Pertiwi
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Literature Review ◽  
Stroke Patients ◽  
Post Stroke ◽  
Low Education ◽  
History Of ◽  
Male Patients ◽  
Abstract Domains ◽  
And Gender

Abstract: Stroke or brain attack occurs directly and its incidence is still very high until now. It is reported that two-thirds of stroke patients suffered from cognitive impairment leading to dementia within three months after stroke that can interfere with one’s daily activities if left untreated. This study was aimed to obtain the description of cognitive function in post-stroke patients. This was a literature review study using three databases, as follows: Goggle Scholar, Pubmed, and Clinical Key, and the keywords were cognitive impairment, cognitive decline, post-stroke, and MoCA. There were 10 literatures that met the inclusion and exclusion criteria. The results showed that many post-stroke patients showed cognitive function decline in the visuospatial/executive, memory, language, attention, and abstract domains. Cognitive impairment occured mostly in male patients, age 60 years and over, low education, ischemic stroke, left hemisphere lesion, with a history of hypertension. In conclusion, there is a relationship between post-stroke cognitive impairment and the location of lesion, age, and education level, albeit, there was no relationship between the cognitive impairment and gender as well as diabetes mellitus.Keywords: cognitive impairment, post-stroke, MoCA Abstrak: Stroke menyerang otak secara langsung dengan angka kejadian yang masih sangat tinggi sampai saat ini. Dua pertiga pasien stroke dilaporkan mengalami gangguan fungsi kognitif yang berujung pada demensia dalam tiga bulan pasca stroke serta dapat mengganggu aktivitas sehari-hari bila dibiarkan. Penelitian ini bertujuan untuk mendapatkan gambaran fungsi kognitif pasien pasca stroke. Jenis penelitian ialah literature review, dengan pencarian literatur pada tiga database yaitu Goggle Scholar, Pubmed, dan Clinical Key. Kata kunci yang digunakan ialah penurunan fungsi kognitif, pasca stroke, dan MoCA. Hasil seleksi mendapatkan 10 literatur yang memenuhi kriteria inklusi dan eksklusi. Hasil penelitian menunjukkan bahwa pada pasien pasca stroke sering terjadi penurunan fungsi kognitif dengan domain visuospasial/eksekutif, memori, bahasa, atensi, dan abstrak yang paling sering terganggu. Penurunan fungsi kognitif banyak ditemukan pada pasien laki-laki, usia 60 tahun ke atas, jenjang pendidikan rendah, stroke iskemik, lesi hemisfer kiri, dengan riwayat hipertensi. Simpulan penelitian ini ialah adanya hubungan antara penurunan fungsi kognitif dengan lokasi lesi, usia, dan jenjang pendidikan namun tidak terdapat hubungan dengan jenis kelamin dan diabetes melitus.Kata kunci: gangguan kognitif, pasca stroke, MoCA

scholarly journals T2 heterogeneity as an in vivo marker of microstructural integrity in medial temporal lobe subfields in ageing and mild cognitive impairment

2020 ◽  
Author(s):  
Alfie R. Wearn ◽  
Volkan Nurdal ◽  
Esther Saunders-Jennings ◽  
Michael J. Knight ◽  
Christopher R. Madan ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Temporal Lobe ◽  
Medial Temporal Lobe ◽  
Learning Task ◽  
Quantitative Mri ◽  
Associate Learning ◽  
Age Related ◽  
Brain Changes

ABSTRACTA better understanding of early brain changes that precede loss of independence in diseases like Alzheimer’s disease (AD) is critical for development of disease-modifying therapies. Quantitative MRI, such as T2 relaxometry, can identify microstructural changes relevant to early stages of pathology. Recent evidence suggests heterogeneity of T2 may be a more informative measure of early pathology than absolute T2. Here we test whether T2 markers of brain integrity precede the volume changes we know are present in established AD and whether such changes are most marked in medial temporal lobe (MTL) subfields known to be most affected early in AD. We show that T2 heterogeneity was greater in people with mild cognitive impairment (MCI; n=49) compared to healthy older controls (n=99) in all MTL subfields, but this increase was greatest in MTL cortices, and smallest in dentate gyrus. This reflects the spatio-temporal progression of neurodegeneration in AD. T2 heterogeneity in the entorhinal cortex also predicted cognitive decline over a year in people with MCI, where measures of volume or T2 in any other subfield or whole hippocampus could not. Increases in T2 heterogeneity in MTL cortices may reflect localised pathological change and may present as one of the earliest detectible brain changes prior to atrophy. Finally, we describe a mechanism by which memory, as measured by accuracy and reaction time on a paired associate learning task, deteriorates with age. Age-related memory deficits were explained in part by lower subfield volumes, which in turn were directly associated with greater T2 heterogeneity. We propose that tissue with high T2 heterogeneity represents extant tissue at risk of permanent damage but with the potential for therapeutic rescue. This has implications for early detection of neurodegenerative disease.

scholarly journals Effects of different acupuncture treatment methods on post-stroke cognitive impairment: study protocol for a multicenter randomized controlled trial

2020 ◽  
Author(s):  
Kai-Qi Su ◽  
Su-Tong Liu ◽  
Jie-Ying Li ◽  
Rui-Qing Li ◽  
Hui-Li Feng ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Cognitive Rehabilitation ◽  
Acupuncture Treatment ◽  
Controlled Trial ◽  
Secondary Outcome ◽  
Treatment Methods ◽  
Post Stroke ◽  
Randomized Controlled

Abstract Background: Cognitive impairment is one of common dysfunctions after stroke, which seriously affects the overall recovery of patients. Cognitive rehabilitation training is currently the main treatment to improve cognitive function, but its curative effect is limited. Acupuncture is a core component of traditional Chinese medicine (TCM) and some previous clinical studies have shown that it might be effective in treating post-stroke cognitive impairment (PSCI), but further evidence from large-sample studies is needed. The overall objective of this trial is to obtain further data for forming an optimized acupuncture treatment for PSCI by comparing the effects of different acupuncture treatment methods on cognitive function in PSCI patients.Methods/Design: In this multicenter, prospective, randomized controlled trial, 206 eligible stroke inpatients who meet the trial criteria will be randomly assigned to 2 groups: Electroacupuncture (EA) plus needle retaining (NR) group and EA group, both groups of patients undergo the same routine cognitive rehabilitation treatments. All treatments will be given 6 times per week for 8 weeks. The primary outcomes will be assessed using the Mini Mental State Scale (MMSE) and the Montreal Cognition Assessment Scale (MOCA). The secondary outcome will be measured by the Bathel Index (BI). All outcomes will be evaluated at baseline, week 4, week 8, and the third and sixth month after the end of treatments.Discussion: Our aim is to evaluate the effects of two different acupuncture treatment methods for treating PSCI patients. This study is expected to provide data to be used in developing an optimized acupuncture treatment method for PSCI treatment.Trial registration: Chinese Clinical Trial Registry, ChiCTR1900027849. Registered on 30 November 2019, http://www.chictr.org.cn/showproj.aspx?proj=46316

scholarly journals Cognitive Impairment At 3, 6 and 12 Month After the First-Ever Stroke Among Lebanese Survivors: Incidence and Risk Factors

2021 ◽  
Author(s):  
Celina Boutros ◽  
Walaa Khazaal ◽  
Maram Taliani ◽  
Pascale Salameh ◽  
Hassan Hosseini ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Length Of Hospital Stay ◽  
Epileptic Seizures ◽  
Protective Role ◽  
P Value ◽  
Post Stroke ◽  
Physical Disorders ◽  
History Of

Abstract Cognitive impairment is a prevalent outcome of stroke, affecting the quality of life and increasing the disability. Its risk factors are unknown in Lebanon. Therefore, the aims of this study were to evaluate the cognitive impairment incidence among Lebanese stroke survivors at 3, 6 and 12 month post stroke, and to identify the associated factors. A multicenter longitudinal prospective study was conducted in 10 hospitals of Beirut and Mount Lebanon among 150 subjects aged ≥ 18 years old between February 2018 until May 2019. The Mini-Mental State Examination assessed the cognitive function. Univariate and Multivariable analyses were performed to identify the predictors of the post stroke cognitive impairment. A p-value <0.05 was considered statistically significant. At 3 month post stroke, 74.8% were cognitively impaired versus 46.7% and 37.6% at 6 and 12 month post stroke respectively. Older age, past smoking, presence of a caregiver, sedentary ≥ 12 hours, aphasia at the time of stroke occurrence, the length of hospital stay, severe stroke, high disability degree, post stroke anxiety and depression, epileptic seizures and physical disorders were the risk factors inducing cognitive decline. Whereas, the high education level, the employment and the history of diabetes mellitus played a protective role for the cognitive function. Findings reveal levels of cognitive impairment post-stroke that are concerning. Thus, primary and secondary prevention is essential to reduce its incidence and to cope with its burden.

scholarly journals Effects of different acupuncture treatment methods on post-stroke cognitive impairment: study protocol for a multicenter randomized controlled trial

2020 ◽  
Author(s):  
Kai-Qi Su ◽  
Su-Tong Liu ◽  
Jie-Ying Li ◽  
Rui-Qing Li ◽  
Hui-Li Feng ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Cognitive Rehabilitation ◽  
Acupuncture Treatment ◽  
Controlled Trial ◽  
Secondary Outcome ◽  
Treatment Methods ◽  
Post Stroke ◽  
Randomized Controlled

Abstract Background: Cognitive impairment is a common dysfunction after stroke that seriously affects the overall recovery of patients. Cognitive rehabilitation training is currently the main treatment to improve cognitive function, but its curative effect is limited. Acupuncture is a core component of traditional Chinese medicine (TCM), and some previous clinical studies have shown that it might be effective in treating post-stroke cognitive impairment (PSCI), but further evidence from large-sample studies is needed. The overall objective of this trial is to obtain further data to develop an optimized acupuncture treatment for PSCI by comparing the effects of different acupuncture treatment methods on cognitive function in PSCI patients.Methods/Design: In this multicenter, prospective, randomized controlled trial, 206 eligible stroke inpatients who meet the trial criteria will be randomly assigned to 2 groups: an electroacupuncture (EA) plus needle retention (NR) group and an EA group. Both groups of patients will undergo the same routine cognitive rehabilitation treatments. All treatments will be given 5 times per week for 8 weeks. The primary outcomes will be assessed using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment scale (MOCA). The secondary outcome will be measured by the Barthel Index (BI). All outcomes will be evaluated at baseline, and week 4, week 8 and at the third and sixth month after the end of treatment.Discussion: Our aim is to evaluate the effects of two different acupuncture treatment methods for treating PSCI patients. This study is expected to provide data to be used in developing an optimized acupuncture treatment method for PSCI treatment.Trial registration: Chinese Clinical Trial Registry, ChiCTR1900027849. Registered on 30 November 2019, http://www.chictr.org.cn/showproj.aspx?proj=46316

scholarly journals Very Early Cognitive Screening and Self-Reported Feeling of Fatigue Three Months After Stroke

2021 ◽  
Vol 15 ◽  
Author(s):  
Josefin Holmberg ◽  
Beatrice Jondell ◽  
Tamar Abzhandadze ◽  
Katharina S. Sunnerhagen
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Health Care Professionals ◽  
Stroke Unit ◽  
Binary Logistic Regression ◽  
Cognitive Screening ◽  
Stroke Patients ◽  
Post Stroke ◽  
Outcome Severity

Stroke is a major cause of disability and the second leading cause of death worldwide. Post-stroke fatigue has been reported as one of the most limiting symptoms after a stroke. Early identification of risk factors for developing post-stroke fatigue is important for providing timely rehabilitation. A correlation has been found between fatigue and cognitive impairment after stroke, but 2 months after stroke at the earliest. In the present study, we examined whether cognitive function screening using the Montreal Cognitive Assessment (MoCA) very early after stroke could explain fatigue 3 months after stroke. A total of 311 stroke patients admitted to a comprehensive stroke unit in Sweden between 2011 and 2016 were included in this longitudinal study. Cognition was screened within 2 days after admission to the stroke unit. Data on self-reported feeling of fatigue were retrieved from Riksstroke’s 3-month follow-up form. The data were analyzed using binary logistic regression. We found that the cognitive function in an acute phase after stroke could not explain self-reported feeling of fatigue in a later stage. The correlation between cognitive impairment and fatigue that has been reported may be detectable no earlier than the subacute phase of stroke. As previous studies have shown that functional outcome, severity of stroke, and sex also correlate with fatigue after stroke, we controlled for these variables in our analysis. In line with previous studies, we found that female patients had higher odds of experiencing fatigue. This is something that health care professionals should be aware of when working with stroke patients.

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