scholarly journals Hypersomnia and excessive daytime sleepiness in ischemic stroke

2021 ◽  
Vol 27 (5) ◽  
pp. 488-498
Author(s):  
I. K. Ternovykh ◽  
T. M. Alekseeva ◽  
L. S. Korostovtseva ◽  
Yu. V. Sviryaev ◽  
Yu. V. Gavrilov
Keyword(s):  
Ischemic Stroke ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Sleep Disturbances ◽  
Neuroprotective Effect ◽  
High Incidence ◽  
Relationship Of ◽  
The Relationship ◽  
The Brain ◽  
Current Terminology

A number of studies have demonstrated a high incidence of sleep disturbances in patients with stroke. The paper reviews the variants of wakefulness disorders observed in ischemic stroke, taking into account the current terminology, as well as methods for their diagnosis. Currently, the origin of post-stroke hypersomnolence and its pathophysiology remain debatable. Various mechanisms including orexin ligand deficiency, degeneration of orexin neurons, as well as disruption of the links between the histaminergic and orexinergic systems are considered as links in the pathogenesis of hypersomnolence caused by ischemic stroke. The paper discusses the pathophysiology of hypersomnia and excessive daytime sleepiness in patients with ischemic stroke, demonstrates various points of view on the relationship of these pathological phenomena with ischemic stroke. A hypothesis on the compensatory nature of hypersomnia and excessive daytime sleepiness in acute ischemic stroke and their possible neuroprotective effect on the brain in patients with stroke is presented.

Abstract WP190: Excessive Daytime Sleepiness and Depression in Stroke Survivors

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Quynh Huong Pham ◽  
Anjail Sharrief ◽  
Sean Savitz ◽  
Amrou Sarraj ◽  
Lauren Fournier ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Severe Depression ◽  
Stroke Survivors ◽  
Stroke Patients ◽  
Patient Health ◽  
Post Stroke Depression ◽  
The Relationship ◽  
Concentration Table

Introduction: Excessive daytime sleepiness (EDS) and post-stroke depression (PSD) are risk factors for stroke morbidity and mortality. EDS is commonly seen after stroke, but is not routinely assessed after stroke. EDS may be related to sleep disordered breathing (SDB) including obstructive and central sleep apneas, but can also occur in the absence of SDB. The relationship between EDS and PSD is not well understood. Hypothesis: We sought to assess the association between EDS and PSD. We hypothesized that patients with EDS are more likely to demonstrate symptoms of moderate to severe depression compared to patients without EDS. Methods: We identified ischemic stroke patients from the outpatient clinic registry (06/2014 - 10/2015). We screened for depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9; range 0-27, higher worse), and for EDS using the Epworth Sleepiness Scale (ESS; range 0-24, higher worse). Univariate and multivariate analyses were used to evaluate association between EDS and PHQ-9 (moderate to severe depression = PHQ-9 > 9). Regression analysis was also used to evaluate association between EDS and symptoms included in the PHQ-9. Results: Among 200 ischemic stroke patients, 166 completed ESS and PHQ-9 within 90 days of stroke occurrence. Mean age was 61.5 and 54.8% were male. EDS (ESS>9) and moderate to severe depression were each present in 28.9% of patients. Patients with EDS had 3.5 times odds of moderate to severe depression compared to patients without EDS (table 1). Moreover, EDS was associated with higher odds of anhedonia, impaired mood, sleep disturbance, low energy, poor appetite, and impaired concentration (table 1). Conclusion: The presence of EDS is associated with moderate to severe depression in stroke survivors. This is not related solely to SDB symptoms. Patients with fatigue and EDS should be screened for depression. Future studies are also needed to explore the role that SDB plays in this relationship.

Polymeric Nanoparticles for Brain Drug Delivery - A Review

2020 ◽  
Vol 21 (9) ◽  
pp. 649-660
Author(s):  
Subashini Raman ◽  
Syed Mahmood ◽  
Ayah R. Hilles ◽  
Md Noushad Javed ◽  
Motia Azmana ◽  
...  
Keyword(s):  
Drug Delivery ◽  
Surface Modification ◽  
Polymeric Nanoparticles ◽  
Drug Loading ◽  
Preparation Methods ◽  
Brain Drug Delivery ◽  
Polymeric Nanoparticle ◽  
Relationship Of ◽  
The Relationship ◽  
The Brain

Background: Blood-brain barrier (BBB) plays a most hindering role in drug delivery to the brain. Recent research comes out with the nanoparticles approach, is continuously working towards improving the delivery to the brain. Currently, polymeric nanoparticle is extensively involved in many therapies for spatial and temporal targeted areas delivery. Methods: We did a non-systematic review, and the literature was searched in Google, Science Direct and PubMed. An overview is provided for the formulation of polymeric nanoparticles using different methods, effect of surface modification on the nanoparticle properties with types of polymeric nanoparticles and preparation methods. An account of different nanomedicine employed with therapeutic agent to cross the BBB alone with biodistribution of the drugs. Results: We found that various types of polymeric nanoparticle systems are available and they prosper in delivering the therapeutic amount of the drug to the targeted area. The effect of physicochemical properties on nanoformulation includes change in their size, shape, elasticity, surface charge and hydrophobicity. Surface modification of polymers or nanocarriers is also vital in the formulation of nanoparticles to enhance targeting efficiency to the brain. Conclusion: More standardized methods for the preparation of nanoparticles and to assess the relationship of surface modification on drug delivery. While the preparation and its output like drug loading, particle size, and charge, permeation is always conflicted, so it requires more attention for the acceptance of nanoparticles for brain delivery.

scholarly journals The relationship of morphometric changes of the brain with IL-6 levels, systemic inflammation and immune disturbances in the patients with schizophrenia

2021 ◽  
Vol 190 ◽  
pp. 553-559
Author(s):  
Irina K. Malashenkova ◽  
Vadim L. Ushakov ◽  
Sergey A. Krynskiy ◽  
Daniil P. Ogurtsov ◽  
Nikita A. Khailov ◽  
...  
Keyword(s):  
Systemic Inflammation ◽  
Relationship Of ◽  
The Relationship ◽  
The Brain

scholarly journals The Relationship of Psychiatric Symptoms with Performance-Based and Self-Reported Cognitive Function After Ischemic Stroke

2021 ◽  
pp. 1-13
Author(s):  
Elisabeth Kliem ◽  
Elise Gjestad ◽  
Truls Ryum ◽  
Alexander Olsen ◽  
Bente Thommessen ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Executive Function ◽  
Depressive Symptoms ◽  
Cognitive Function ◽  
Psychiatric Symptoms ◽  
Post Stroke ◽  
Cognitive Difficulties ◽  
Memory And Attention ◽  
Relationship Of ◽  
The Relationship

Abstract Objective: Findings on the relationship of psychiatric symptoms with performance-based and self-reported cognitive function post-stroke are inconclusive. We aimed to (1) study the relation of depression and anxiety to performance-based cognitive function and (2) explore a broader spectrum of psychiatric symptoms and their association with performance-based versus self-reported cognitive function. Method: Individuals with supratentorial ischemic stroke performed neuropsychological examination 3 months after stroke. For primary analyses, composite scores for memory and attention/executive function were calculated based on selected neuropsychological tests, and the Hospital Anxiety and Depression Scale (HADS) was used. Psychiatric symptoms and self-reported cognitive function for secondary aims were assessed using the Symptom-Checklist-90 – Revised (SCL-90-R). Results: In a sample of 86 patients [mean (M) age: 64.6 ± 9.2; Mini-Mental State Examination (MMSE), 3–7 days post-stroke: M = 28.4 ± 1.7; National Institutes of Health Stroke Scale (NIHSS) after 3 months: M = 0.7 ± 1.6] depressive symptoms (HADS) were associated with poorer memory performance after controlling for age, sex, and education (p ≤ .01). In a subsample (n = 41; Age: M = 65.7 ± 8.1; MMSE: M = 28.4 ± 1.8; NIHSS: M = 1.0 ± 1.9), symptoms of phobic anxiety (SCL-90-R) were associated with poorer performance-based memory and attention/executive function, and symptoms of anxiety (SCL-90-R) with lower attention/executive function. Higher levels of self-reported cognitive difficulties were associated with higher scores in all psychiatric domains (p ≤ .05). Conclusion: Even in relatively well-functioning stroke patients, depressive symptoms are associated with poorer memory. The results also suggest that various psychiatric symptoms are more related to self-reported rather than to performance-based cognitive function. Screening for self-reported cognitive difficulties may not only help to identify patients with cognitive impairment, but also those who need psychological treatment.

Chronic stress and brain-derived neurotrophic factor

2021 ◽  
Vol 19 (2) ◽  
pp. 19-27
Author(s):  
A. V. DUBOVAYA ◽  
◽  
S. Ya. IAROSHENKO ◽  
O. A. PRILUTSKAYA ◽  
◽  
...  
Keyword(s):  
Neurotrophic Factor ◽  
Signal Transmission ◽  
Active Agent ◽  
Brain Derived Neurotrophic Factor ◽  
Relationship Of ◽  
The Relationship ◽  
The Brain ◽  
Pituitary Adrenal Axis ◽  
Transmission Information ◽  
Class Representative

The article discusses the influence of stress on the development of nervous tissue, in particular, on the synthesis of neurotrophins (by the example of the brain-derived neurotrophic factor (BDNF), as the most studied class representative). The biological functions of BDNF are discussed as well as its influence on neuroplasticity and the mechanisms by which the protection of neurons is carried out. The article covers the relationship of the stress-implementing system (hypothalamic-pituitary-adrenal axis) and its main active agent (cortisol) with the BDNF synthesis system at its various levels: from the inhibition of mRNA formation to the mechanisms of postsynaptic signal transmission. Information is also provided on changes of BDNF levels due to the maternal deprivation. Epigenetic changes under the influence of glucocorticoids are also reported. However, it is not only glucocorticoids that alter the functioning of the neurotrophin system. The article provides examples of the reverse effect, enabling to consider neurotrophins as a substance with an anti-stress function. In conclusion, the authors give examples of activities that, according to research, can stimulate the synthesis of neurotrophic factor in the brain.

Intake of Anti-Epileptic Drugs and their Influences on Sexual Dysfunctions

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Roheela Yasmeen ◽  
Nida Mobeen ◽  
Muhammad Amjad Khan ◽  
Irfan Aslam ◽  
Samia Chaudhry
Keyword(s):  
Quality Of Life ◽  
Sexual Dysfunction ◽  
Neurological Disorders ◽  
Penile Erection ◽  
The Central Nervous System ◽  
Relationship Of ◽  
The Relationship ◽  
The Brain ◽  
Psychiatric Problems

Epilepsy which is also called seizures disorder is an uncontrolled action of the central nervous system. Itis not a single disease but a set of neurological disorders. Actually in this situation, the brain does notreceive a precise signal and as a result an abnormal condition is produced that is usually involuntary inaction. In this review, we aimed to focus on the relationship of anti-epileptic drugs with sexual dysfunctionand adaptation of better remedies that improve a patient’s family life. Sexual dysfunction is a commoncomorbidity in people with epilepsy which badly affects their quality of life. Sexual dysfunction is causedby different factors like psychiatric problems, anti-epileptic drugs (AEDs) and social factors etc. Sexualdysfunctions include ejaculatory failure, lessen libido, penile erection in men and irregular menstrual cyclein women. Common drugs such as Topiramate, Gabapentin (GBP), Valproate (VA), Carbamazepine (CBZ),Olanzapine (OL) and Risperidone (RTG) that are in practice to treat epilepsy usually produced adverseeffect on sexual dysfunction. Even though a lot of studies have been carried out to control sexualdysfunction in epilepsy’s patient, but still research is going on. Medicine such as Cyproheptadine,Mianserin, Buspirone, Yohimbine were found better to treat epilepsy with minimum side effects of sexualdysfunction. Moreover, it is also seen that certain vasodilators, folate , and vitamin supplements areeffective in improving the quality of life.

Abstract 90: Socioeconomic Status Is Associated With Disability Following Acute Ischemic Stroke: Findings From The Adherence eValuation After Ischemic stroke-Longitudinal (AVAIL) Registry

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Janet Prvu Bettger ◽  
Xin Zhao ◽  
Cheryl Bushnell ◽  
Louise Zimmer ◽  
Ying Xian ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Ischemic Stroke ◽  
Household Income ◽  
Work Status ◽  
Stroke Patients ◽  
Level Of Education ◽  
Post Stroke ◽  
Relationship Of ◽  
The Relationship ◽  
Education Work

Background: Socioeconomic status (SES) is widely recognized as an area of inequity that affects health outcomes. However, social determinants of health are less frequently measured in longitudinal studies of acute stroke patients. The relationship of SES on disability 3-months post-stroke is unknown. Methods: We analyzed ischemic stroke patients in the AVAIL registry who were enrolled at 98 hospitals participating in Get With The Guidelines-Stroke. Patients who died (n=64) or did not complete a modified Rankin Scale (mRS) at 3-months (n=154) were excluded. Multivariable logistic regression was used to examine the relationship of SES (defined by level of education, work status, and perceived adequacy of household income to meet needs) and disability (mRS scores 3-5). Results: Among the 2092 stroke patients who met eligibility criteria, the mean age was 65.5 ± 13.7, 44.2% were female, and 82.7% were White. Fifty seven percent had a high school or less education, 11.4% were not working post-stroke and were home not by choice, and 25.7% were without an adequate household income. A third of the sample had some level of disability at 3-months (34.6% mRS 3-5). Those with disability were more likely to be older, non-White, female, single, less educated, have inadequate income, and were home not by choice. In the multivariable analysis, lower education, inadequate income, and being home but not by choice (compared with those who returned to work) were independently associated with disability (p<0.01; Table ). Conclusion: In this national cohort of stroke survivors, socioeconomic status as measured by level of education, work status, and income were independently associated with post-stroke disability.

scholarly journals Excessive daytime sleepiness in the elderly: association with cardiovascular risk, obesity and depression

2013 ◽  
Vol 16 (4) ◽  
pp. 872-879 ◽  
Author(s):  
Johnnatas Mikael Lopes ◽  
Fábio Galvão Dantas ◽  
Jovany Luis Alves de Medeiros
Keyword(s):  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
The Elderly ◽  
Cardiovascular Dysfunction ◽  
Chi Square ◽  
Chi Square Test ◽  
The Relationship ◽  
Health Districts

OBJECTIVE: To observe the relationship between Excessive Daytime Sleepiness (EDS) and the presence of risk factors for cardiovascular dysfunction, depression and obesity in the elderly. METHODS: We interviewed 168 elderly from the community of Campina Grande, Paraíba. They were selected according to health districts in the period of 2010. We used the Epworth Sleepiness Scale to diagnose excessive daytime sleepiness (> 10 points); waist circumference for the risk of cardiovascular dysfunction (> 94 or > 80 cm); Geriatric Depression Scale for depression (>10 points) and body mass index for obesity (> 25 kg/m2). Association analysis was performed by the Chi-square test adjusted for sex and age group, adopting α < 0.05. RESULTS: One hundred and sixty eight elderly individuals with mean age of 72.34 ± 7.8 years old participated in this study, being 122 (72.6%) women. EDS was identified in 53 (31.5%) of them; depression, in 72 (42.9%); overweight/obesity, in 95 (64.46%); and risk of cardiovascular dysfunction, in 129 (79.6%). Depressed men (78.6%, p = 0.0005) and risk of cardiovascular dysfunction (57.1%, p = 0.02) were more prone to EDS. In women, only obesity was related to sleepiness (42.1%, p = 0.01). Only those aged between 70 - 79 years old showed association between sleepiness and obesity. CONCLUSION: It was found that obesity for women, and depression and cardiovascular dysfunction risking for men were associated with EDS in the elderly. The variable sex is a confusion condition for the association with sleepiness.

scholarly journals Characteristics of emotional state and cognitive processes in patients with ischemic stroke in acute period

2019 ◽  
Vol 3 (24) ◽  
pp. 40-44
Author(s):  
Yu. V. Kotsyubinskaya ◽  
A. V. Kazakov ◽  
N. Yu. Safonova
Keyword(s):  
Ischemic Stroke ◽  
Cognitive Processes ◽  
Emotional State ◽  
Therapeutic Process ◽  
Anxiety And Depression ◽  
Anterior Cortex ◽  
Acute Period ◽  
Relationship Of ◽  
The Relationship ◽  
Different Levels

Currently, studies aimed at assessing the emotional state and cognitive processes associated with the processing of emotionally determined information in patients with ischemic stroke, as well as finding the relationship between them are particularly relevant, mainly for the subsequent optimization of the therapeutic process. In order to identify the features of the emotional state and cognitive processes, a group of patients with ischemic stroke in the acute period in the amount of 25 people was examined. It was established that in patients with a lesion in the anterior cortex, depressive states in the acute period of stroke are more pronounced. Patients successfully reproduce emotionally significant words in comparison with neutral words; an interrelation between the level of anxiety and depression was found, which indicates that these states are comorbid. But, in turn, the relationship of the severity of anxiety and depression with the cognitive processes of recognition and reproduction, as well as differences in mnestic and gnostic activity in patients with different levels of anxiety and depression were not identified. After the treatment with Semax an improvement was noted.

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