EXPRESS: Neural correlates of cricopharyngeal dysfunction after supratentorial stroke: A voxel-based lesion-symptom mapping with propensity score matched case-control

2021 ◽  
pp. 174749302110063
Author(s):  
Jun Yup Kim ◽  
Seo Yeon Yoon ◽  
Jinna Kim ◽  
Yong Wook Kim
Keyword(s):  
Propensity Score ◽  
Case Control ◽  
Middle Frontal Gyrus ◽  
Stroke Patients ◽  
Lentiform Nucleus ◽  
Corona Radiata ◽  
Post Stroke ◽  
Lesion Symptom Mapping ◽  
Cricopharyngeal Dysfunction ◽  
The Right

Background: Post-stroke cricopharyngeal dysfunction (CPD) has been reported to occur in 50% of brainstem strokes; however, CPD also occurs commonly in patients with supratentorial stroke. The hemispheric neuroanatomical location of this dysfunction has not been clearly identified. Aims: We aimed to analyze the relationship between CPD and supratentorial lesion location in post-stroke patients through this retrospective case-control voxel-based lesion-symptom mapping study. Methods: CPD was diagnosed when the residue after swallowing (PSR) accounted for more than 25% of volume of pyriform sinus. Medical records and the video fluoroscopic swallowing studies of first-ever stroke patients who were admitted to our hospital during acute to subacute phase from 2009 to 2019 were reviewed. After propensity score matching to reduce the likelihood of selection bias, 50 patients per group were included in the CPD and control groups. We used a P-threshold of 0.01 corrected for multiple comparisons with permutation thresholding (5,000 permutations). Dichotomized diagnosis of CPD and the magnitude of PSR were used as dependent variables. Results: Analysis using the Liebermeister statistics indicated that lesions of the right lentiform nucleus were associated with the development of CPD. After adjustment for age and total lesion volume, which are known effectors for the development of dysphagia, statistically significant correlations were found between PSR and lesions of the right lentiform nucleus and anterior corona radiata beneath the right middle frontal gyrus. Conclusion: Thus, our study demonstrated for the first time that damages to the right lentiform nucleus, especially globus pallidus externa, and anterior corona radiata beneath the right middle frontal gyrus are associated with the development and severity of CPD.

scholarly journals Are visual working memory and episodic memory distinct processes? Insight from stroke patients by lesion-symptom mapping

2021 ◽  
Author(s):  
Selma Lugtmeijer ◽  
◽  
Linda Geerligs ◽  
Frank Erik de Leeuw ◽  
Edward H. F. de Haan ◽  
...  
Keyword(s):  
Working Memory ◽  
Episodic Memory ◽  
Visual Working Memory ◽  
Visual Memory ◽  
Right Hemisphere ◽  
Memory Task ◽  
Stroke Patients ◽  
Lesion Symptom Mapping ◽  
Criterion Setting ◽  
The Right

AbstractWorking memory and episodic memory are two different processes, although the nature of their interrelationship is debated. As these processes are predominantly studied in isolation, it is unclear whether they crucially rely on different neural substrates. To obtain more insight in this, 81 adults with sub-acute ischemic stroke and 29 elderly controls were assessed on a visual working memory task, followed by a surprise subsequent memory test for the same stimuli. Multivariate, atlas- and track-based lesion-symptom mapping (LSM) analyses were performed to identify anatomical correlates of visual memory. Behavioral results gave moderate evidence for independence between discriminability in working memory and subsequent memory, and strong evidence for a correlation in response bias on the two tasks in stroke patients. LSM analyses suggested there might be independent regions associated with working memory and episodic memory. Lesions in the right arcuate fasciculus were more strongly associated with discriminability in working memory than in subsequent memory, while lesions in the frontal operculum in the right hemisphere were more strongly associated with criterion setting in subsequent memory. These findings support the view that some processes involved in working memory and episodic memory rely on separate mechanisms, while acknowledging that there might also be shared processes.

Abstract NS2: Effect of Volume-Viscosity Swallow Test (V-VST) in Acute Ischemic Stroke Patients With Dysphagia: A Hospital-Based Case-Control Study

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Ting Ye ◽  
Yi Dong ◽  
Shengyan Huang
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Case Control Study ◽  
Tube Feeding ◽  
Case Control ◽  
Stroke Patients ◽  
Post Intervention ◽  
Post Stroke ◽  
Volume Viscosity ◽  
Control Study

Background: The dysphagia screening in acute ischemic stroke plays an important role in patients with risk of dysphagia. The aim of this hospital-based case-control study is to explore if V-VST, as a new nurse-driven dysphagia screening tool for AIS patients, might help to reduce the rate of post-stroke pneumonia and early withdraw of feeding tube. Methods: 1598 acute ischemic stroke patients were enrolled in this study. The standard protocol in AIS patients were assessed by WST (before intervention and plus with V-VST after intervention). The V-VST assessment were be trained in two senior nurses and all AIS patients were assessed by V-VST during July 1and Dec 30 th , 2017. Among 299 AIS patients with suspected, all clinical data were analyzed. The comparison of their rate of pneumonia in hospital and withdraw rate of tubefeeding before discharge were performed between patients post-intervention (January 1, 2018-June 30, 2019)and those admitted before the intervention (January 1, 2016-June 30, 2017). Results: The baseline characteristics of the pre- and post- intervention AIS groups were similar in age, gender, NIHSS. The implementation of V-VST have a statistically significant reducing the risk of pneumonia with an adjusted HR (0.60, 95% CI 0.43-0.84, P=0.003). Additionally, follow-up V-VST were likely to be associated the withdraw rate of tube-feeding at discharge (29/168 vs 38/131 P=0.016).There is also a trend of length of tube-feeding decreasing (8.32±12.27 vs 6.84±8.61 P=0.241). Conclusion: In our study, the V-VST is a feasible bedside tool. The implemental might be associated with the reduction of post-stroke pneumonia. Therefore, it meets the requirements of a clinical screening test for dysphagia in acute stroke patients at bedside. Large prospective interventional study is needed to confirm our findings. V-VST: Volume-viscosity Swallow Test WST: Water Swallow Test AIS: Acute Ischemic Stroke HR: hazard ratio

scholarly journals A study on the right unilateral spatial neglect in left hemispheric lesions - The difference between right-handed and left-handed post stroke patients.

1990 ◽  
Vol 27 (5) ◽  
pp. 363-373
Author(s):  
Shinichiro MAESHIMA ◽  
Nobuyuki DOHI ◽  
Toshio KAJIWARA ◽  
Yoshimi KONDO ◽  
Etsuko MAESHIMA ◽  
...  
Keyword(s):  
Spatial Neglect ◽  
Stroke Patients ◽  
Unilateral Spatial Neglect ◽  
Post Stroke ◽  
Left Handed ◽  
The Difference ◽  
The Right

scholarly journals Disruptions of Anaerobic Gut Bacteria Are Associated with Stroke and Post-stroke Infection: a Prospective Case–Control Study

2020 ◽  
Author(s):  
Bastiaan W. Haak ◽  
Willeke F. Westendorp ◽  
Tjitske S. R. van Engelen ◽  
Xanthe Brands ◽  
Matthijs C. Brouwer ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Hemorrhagic Stroke ◽  
Case Control Study ◽  
Case Control ◽  
Gut Bacteria ◽  
Stroke Patients ◽  
Post Stroke ◽  
The Impact ◽  
Control Study ◽  
Prospective Case Control Study

Abstract In recent years, preclinical studies have illustrated the potential role of intestinal bacterial composition in the risk of stroke and post-stroke infections. The results of these studies suggest that bacteria capable of producing volatile metabolites, including trimethylamine-N-oxide (TMAO) and butyrate, play opposing, yet important roles in the cascade of events leading to stroke. However, no large-scale studies have been undertaken to determine the abundance of these bacterial communities in stroke patients and to assess the impact of disrupted compositions of the intestinal microbiota on patient outcomes. In this prospective case–control study, rectal swabs from 349 ischemic and hemorrhagic stroke patients (median age, 71 years; IQR: 67–75) were collected within 24 h of hospital admission. Samples were subjected to 16S rRNA amplicon sequencing and subsequently compared with samples obtained from 51 outpatient age- and sex-matched controls (median age, 72 years; IQR, 62–80) with similar cardiovascular risk profiles but without active signs of stroke. Plasma protein biomarkers were analyzed using a combination of nuclear magnetic resonance (NMR) spectroscopy and liquid chromatography–mass spectrometry (LC-MS). Alpha and beta diversity analyses revealed higher disruption of intestinal communities during ischemic and hemorrhagic stroke compared with non-stroke matched control subjects. Additionally, we observed an enrichment of bacteria implicated in TMAO production and a loss of butyrate-producing bacteria. Stroke patients displayed two-fold lower plasma levels of TMAO than controls (median 1.97 vs 4.03 μM, Wilcoxon p < 0.0001). Finally, lower abundance of butyrate-producing bacteria within 24 h of hospital admission was an independent predictor of enhanced risk of post-stroke infection (odds ratio 0.77, p = 0.005), but not of mortality or functional patient outcome. In conclusion, aberrations in trimethylamine- and butyrate-producing gut bacteria are associated with stroke and stroke-associated infections.

Prevalence of Hypertension among Post Stroke Patients in Africa: A Case-Control Study (P04.069)

Neurology ◽  
2012 ◽  
Vol 78 (Meeting Abstracts 1) ◽  
pp. P04.069-P04.069
Author(s):  
M. Kaddumukasa ◽  
L. Goldstein ◽  
P. Duncan ◽  
E. Ddumba
Keyword(s):  
Case Control Study ◽  
Case Control ◽  
Stroke Patients ◽  
Post Stroke ◽  
Control Study

scholarly journals Brain Network Underlying Executive Functions in Gambling and Alcohol Use Disorders: An Activation Likelihood Estimation Meta-Analysis of fMRI Studies

2020 ◽  
Vol 10 (6) ◽  
pp. 353 ◽  
Author(s):  
Alessandro Quaglieri ◽  
Emanuela Mari ◽  
Maddalena Boccia ◽  
Laura Piccardi ◽  
Cecilia Guariglia ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Executive Functions ◽  
Meta Analysis ◽  
Likelihood Estimation ◽  
Brain Network ◽  
Middle Frontal Gyrus ◽  
Activation Likelihood Estimation ◽  
Lentiform Nucleus ◽  
Study Approach ◽  
The Right

Background: Neuroimaging and neuropsychological studies have suggested that common features characterize both Gambling Disorder (GD) and Alcohol Use Disorder (AUD), but these conditions have rarely been compared. Methods: We provide evidence for the similarities and differences between GD and AUD in neural correlates of executive functions by performing an activation likelihood estimation meta-analysis of 34 functional magnetic resonance imaging studies involving executive function processes in individuals diagnosed with GD and AUD and healthy controls (HC). Results: GD showed greater bilateral clusters of activation compared with HC, mainly located in the head and body of the caudate, right middle frontal gyrus, right putamen, and hypothalamus. Differently, AUD showed enhanced activation compared with HC in the right lentiform nucleus, right middle frontal gyrus, and the precuneus; it also showed clusters of deactivation in the bilateral middle frontal gyrus, left middle cingulate cortex, and inferior portion of the left putamen. Conclusions: Going beyond the limitations of a single study approach, these findings provide evidence, for the first time, that both disorders are associated with specific neural alterations in the neural network for executive functions.

scholarly journals Acupuncture Reduced the Risk for Insomnia in Stroke Patients: A Propensity-Score Matched Cohort Study

2021 ◽  
Vol 13 ◽  
Author(s):  
Xuan Qiu ◽  
Nan Sheng Han ◽  
Jie Xiao Yao ◽  
Fang Rui Yu ◽  
Yan Yan Lin ◽  
...  
Keyword(s):  
Propensity Score ◽  
Sample Size ◽  
Lower Risk ◽  
Cox Regression ◽  
Acupuncture Treatment ◽  
Stroke Patients ◽  
Confidential Interval ◽  
Post Stroke ◽  
Number Of Patients ◽  
Stroke Type

Background: Post-stroke insomnia (PSI) affects the quality of life for stroke patients, reduces the likelihood of successful rehabilitation, and produces additional complications following stroke. Previous reports have provided some information regarding PSI risk factors, but little is known concerning protective factors for PSI. This study analyzed the relationship between acupuncture and insomnia in stroke patients and explored the use of acupuncture as a preventive treatment.Methods: Patients diagnosed with stroke from 2010 to 2019 were identified in the case database of the First Affiliated Hospital of Guangzhou University of Chinese These patients followed until 2020, and numerous factors were examined, including gender, age, stroke type, stroke location, and baseline comorbidities. A 1:1 propensity score was used to match an equal number of patients receiving acupuncture with stroke patients who did not receive acupuncture (N = 1,680 for each group). The purpose of the study was to compare the incidence of insomnia in these two stroke cohorts. We used the Cox regression model and Kaplan-Meier method to estimate the risk of insomnia as the outcome event.Results: Compared with the non-acupuncture cohort in general, stroke patients who received acupuncture treatment exhibited a lower risk of insomnia after adjusting for age, gender, stroke type, stroke location, and comorbidities (adjusted hazard ratio HR = 0.27, 95% confidential interval = 0.23 to 0.32). Acupuncture also reduced the risk of PSI for both genders. The respective risks were HR = 0.28 (adjusted) for males and HR = 0.26 (adjusted) for females. Acupuncture also lowered the risk for PSI for different age groups. The risks were HR = 0.22 (adjusted) for individuals 18 to 39 years of age, HR = 0.31 (adjusted) for individuals 40 to 59 years of age, HR = 0.28 (adjusted) for those 60 to 79 years of age, and HR = 0.18 (adjusted) for individuals 80 years of age and older. Concerning the stroke type, regardless of whether the stroke was ischemic, hemorrhagic, or a combination of the two stroke types, patients who received acupuncture exhibited lower risk (adjusted HR = 0.28, 0.17, and 0.49, respectively). Concerning stroke location, except for the cerebral hemispheres (adjusted HR = 1.10, 95% confidential interval = 0.12 to 1.01), the risk of PSI after receiving acupuncture was lower for the frontal lobe (adjusted HR = 0.42), the basal ganglia (adjusted HR = 0.22), the radiation crown (adjusted HR = 0.42), the diencephalon (adjusted HR = 0.20), or multiple partial strokes (adjusted HR = 0.26), the risk of PSI after receiving acupuncture was lower. For all baseline complications, acupuncture reduced the risk of insomnia. The cumulative incidence of insomnia in the acupuncture cohort was significantly lower than the non-acupuncture cohort (log-rank test, P = 0.000).Limitations: First, our research only included patients from a single center. Second, we did not classify the post-stroke insomnia severity. Second, the information was extracted manually. Overall, the sample size was small, and we needed to increase the sample size to strengthen the conclusions.Conclusion: Acupuncture treatment reduced the risk of insomnia in stroke patients. Future research be conducted with increased sample sizes and further elaboration on the specific acupuncture protocols that were used.

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