scholarly journals COMPARISON OF THE DYNAMIC CHANGES OF AMINO ACID BLOOD PLASMA SPECTRUM IN PATIENTS WITH THE PRIMARY CEREBRAL ISCHEMIC STROKE DEPENDING ON THE POSTAPOPLECTIC SPASTICITY DEVELOPMENT IN THE RECOVERY PERIOD

2016 ◽  
Vol 3 ◽  
pp. 17-23
Author(s):  
Anzhelika Payenok ◽  
Maria Bilobryn ◽  
Iryna Mitelman
Keyword(s):  
Ischemic Stroke ◽  
Blood Plasma ◽  
Recovery Period ◽  
Control Group ◽  
Cerebral Stroke ◽  
Early Recovery ◽  
Dynamic Changes ◽  
Acute Period ◽  
Cerebral Ischemic Stroke ◽  
Cerebral Ischemic

The aim of research was to reveal the dynamic changes of the level of excitatory and inhibitory neuroamino acids in patients with the primary cerebral ischemic stroke depending on postapoplectic spasticity presence at the end of the early recovery period. For this aim was studied the concentration of excitatory and inhibitory neuroamino acids in the blood plasma in first 72 hours in 97 patients with the primary ischemic cerebral stroke depending on postapoplectic spasticity on the sixth month after ischemic event. The control group included 15 patients with diagnosed chronic cerebral ischemia. In the result of research we revealed that the common sign for the two groups (with spasticity on the sixth month and without it) was the reliable rise of the level of excitatory amino acids comparing with the control. In patients without spasticity the heightened level of excitatory neurotransmitters in the most acute period of ischemic cerebral stroke was attended with the heightened level of inhibitory neuroamino acids. The distinctive feature of patients with postapoplectic spasticity was the decreased or stable level of transmitters of inhibitory action. During 6th moth after ischemic stroke was detected the rise of all studied neuroamino acids in patients with spasticity unlike to the ones without spasticity who were characterized only with the rise of taurine level and decrease of glycine and aspartate levels. So, the received results allow assume the insufficient activation of the inhibitory neuroamino acids system in the most acute period of the ischemic stroke in certain category of patients that in future are inclined to the spasticity development after stroke.

scholarly journals Comparative Characterization of Candidate Molecular Markers in Ischemic and Hemorrhagic Stroke

2021 ◽  
Vol 17 (5) ◽  
pp. 23-34
Author(s):  
A. M. Golubev ◽  
A. V. Grechko ◽  
V. E. Zakharchenko ◽  
M. M. Kanarsky ◽  
M. V. Petrova ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Molecular Markers ◽  
Neurotrophic Factor ◽  
Hemorrhagic Stroke ◽  
Recovery Period ◽  
Control Group ◽  
Early Recovery ◽  
Acute Period ◽  
S 100 ◽  
Early Recovery Period

According to epidemiological studies, the leading cause of morbidity, disability and mortality are cerebrovascular diseases, in particular ischemic and hemorrhagic strokes. In recent years considerable attention has been given to the study of molecular markers of ischemic and hemorrhagic strokes. These studies are relevant because brain-specific protein biomarkers of neurons and glial cells can provide valuable and timely diagnostic information necessary for clinical decision-making.The aim of the study was to reveal the differences in the serum level of molecular markers in acute, subacute and early recovery periods of ischemic and hemorrhagic strokes.Material and methods. The study included 59 patients. Twenty patients were diagnosed with hemorrhagic stroke and 39 had ischemic stroke. The control group included 20 volunteers. Serum levels of molecular CNS markers were determined in acute, subacute, and early recovery stages of stroke. The serum levels of CNS molecular markers of patients with ischemic and hemorrhagic stroke was measured quantitatively by enzyme immunoassay. Statistical analysis was performed by nonparametric Mann-Whitney method.Results. The level of brain-derived neurotrophic factor (BDNF) in the control volunteers was 574.5 [455.5; 615] pg/ml. Significant differences were found for acute and subacute periods of hemorrhagic stroke: it was 674 [560; 749] pg/ml (P=0.003) and 664 [616; 762] pg/ml (P=0.0001).The level of neuron-specific enolase was significantly increased in all periods of the study: it was 4.15 [3.53; 4.8] ng/ml in the control group, 5.4 [4.4; 6.4] ng/ml in acute period of ischemic stroke (P<0.001), 5.4 [4.4; 6.4] ng/ml in early recovery period of ischemic stroke (P=0.001), 5.1 [4.6; 6.4] ng/ml in acute period of hemorrhagic stroke (P=0.014), 664 [616; 762] ng/ml in subacute period of hemorrhagic stroke (P=0.003).In the control group, the serum S-100 protein level was 4.5 [3.8; 5.4] ng/ml. In the acute and early recovery periods of ischemic stroke, S-100 protein level has significantly fallen down to 4.1 [3.4; 4.6] ng/ml (P<0.031) and 3.9 [3.4; 6] ng/ml (P=0.014), respectively. Glial-cell derived neurotrophic factor level was 1.98 [1.64; 2.1] ng/ml in the controls and increased up to 2.4 [2.2; 5] ng/ml (P=0.002) in the acute period and 2.4 [2.3; 2.6] ng/ml (P<0.001) in the subacute period of hemorrhagic stroke.The vascular endothelial growth factor receptor-1 (VEGFR-1) was significantly lower in the subacute period of hemorrhagic stroke: 485 [211; 945] pg/ml in the subacute period vs 903.5 [626; 1115] pg/ml in the controls (P=0.001).Conclusion. We found differences in the serum level of molecular markers in patients with ischemic and hemorrhagic strokes. In the acute period, early recovery period of ischemic stroke, and subacute period of hemorrhagic stroke, there was an increase in the serum level of neuron-specific enolase. The level of brain-derived neurotrophic factor increased significantly in the acute and subacute periods of hemorrhagic stroke. In the acute and early recovery periods of ischemic stroke, the level of S-100 protein decreased. The level of glial cell-derived neurotrophic factor increased in the acute and subacute periods of hemorrhagic stroke. In the subacute period of hemorrhagic stroke, the level of endothelial growth factor receptor-1 significantly decreased. Moreover, there was significant difference between values of this parameter in the subacute period of hemorrhagic stroke and in the early recovery period of ischemic stroke.

scholarly journals Cerebral Ischemic Stroke: is Gender Important?

2013 ◽  
Vol 33 (9) ◽  
pp. 1355-1361 ◽  
Author(s):  
Claire L Gibson
Keyword(s):  
Ischemic Stroke ◽  
Developed Countries ◽  
Cerebral Stroke ◽  
Clinical Investigations ◽  
Neuroprotective Strategies ◽  
Cerebral Ischemic Stroke ◽  
Cerebral Ischemic ◽  
Gender Influences ◽  
Gender Specific

Cerebral stroke continues to be a major cause of death and the leading cause of long-term disability in developed countries. Evidence reviewed here suggests that gender influences various aspects of the clinical spectrum of ischemic stroke, in terms of influencing how a patients present with ischemic stroke through to how they respond to treatment. In addition, this review focuses on discussing the various pathologic mechanisms of ischemic stroke that may differ according to gender and compares how intrinsic and hormonal mechanisms may account for such gender differences. All clinical trials to date investigating putative neuroprotective treatments for ischemic stroke have failed, and it may be that our understanding of the injury cascade initiated after ischemic injury is incomplete. Revealing aspects of the pathophysiological consequences of ischemic stroke that are gender specific may enable gender relevant and effective neuroprotective strategies to be identified. Thus, it is possible to conclude that gender does, in fact, have an important role in ischemic stroke and must be factored into experimental and clinical investigations of ischemic stroke.

scholarly journals Efficiency of Leg Exoskeleton Use in Rehabilitation of Cerebral Stroke Patients

2021 ◽  
Vol 22 (3) ◽  
pp. 257-264
Author(s):  
Sergey V. Kotov ◽  
Alexander I. Romanov ◽  
Ekaterina V. Silina ◽  
Victor A. Stupin ◽  
Elena V. Isakova ◽  
...  
Keyword(s):  
Recovery Period ◽  
Rehabilitation Program ◽  
Control Group ◽  
Cerebral Stroke ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Early Recovery ◽  
Lower Limb Exoskeleton ◽  
Group 2 ◽  
Early Recovery Period

Abstract The study aimed to evaluate the effectiveness of functional and motor activity restoration, including the walking function, in patients after an ischemic stroke using the ExoAtlet lower limb exoskeleton. Patients and methods. A clinical study was carried out on 42 patients who had undergone a cerebral infarction in the mid cerebral artery system with a post-stroke paresis of the leg, and who had undergone a rehabilitation course in a round-theclock hospital during the early recovery period. Patients were randomized into two equal groups comparable in terms of the stroke severity: the patients in group 1 were receiving a standard rehabilitation program (control group), the patients in group 2 were additionally receiving a course of gait rehabilitation using the ExoAtlet exoskeleton - 10 sessions, 5 sessions per week for 14 days. Results. The study demonstrated the effectiveness of the ExoAtlet exoskeleton used in the rehabilitation of stroke patients over the standard course of rehabilitation. The advantages include a decrease in the hemiparesis degree, an increase in the muscle strength of the paretic limb, an improvement in balance, an improvement and acceleration of the walking process. The obtained results of the instrumental study confirmed the benefits of physical training on the Exoskeleton, which was demonstrated through an increase in stability and balance, as well as through a decrease in the energy consumption index for maintaining the stable verticalization. Conclusion. The usage of the ExoAtlet exoskeleton increases the effectiveness of rehabilitation measures and improves motor and functional activities of patients who have suffered a cerebral stroke.

scholarly journals A Study of Biofeedback Gait Training in Cerebral Stroke Patients in the Early Recovery Phase with Stance Phase as Target Parameter

Sensors ◽  
2021 ◽  
Vol 21 (21) ◽  
pp. 7217
Author(s):  
Dmitry V. Skvortsov ◽  
Sergey N. Kaurkin ◽  
Galina E. Ivanova
Keyword(s):  
Stance Phase ◽  
Recovery Period ◽  
Biomechanical Analysis ◽  
Control Group ◽  
Cerebral Stroke ◽  
Stroke Patients ◽  
Early Recovery ◽  
Phase Duration ◽  
Gait Symmetry ◽  
Early Recovery Period

Walking function disorders are typical for patients after cerebral stroke. Biofeedback technology (BFB) is currently considered effective and promising for training walking function, including in patients after cerebral stroke. Most studies recognize that BFB training is a promising tool for improving walking function; however, the data on the use of highly selective walking parameters for BFB training are very limited. The aim of our study was to investigate the feasibility of using BFB training targeting one of the basic parameters of gait symmetry—stance phase duration—in cerebral stroke patients in the early recovery period. The study included 20 hemiparetic patients in the early recovery period after the first hemispheric ischemic stroke. The control group included 20 healthy subjects. The BFB training and biomechanical analysis of walking (before and after all BFB sessions) were done using an inertial system. The mean number of BFB sessions was nine (from 8 to 11) during the three weeks in clinic. There was not a single negative response to BFB training among the study patients, either during the sessions or later. The spatiotemporal parameters of walking showed the whole syndrome complex of slow walking and typical asymmetry of temporal walking parameters, and did not change significantly as a result of the study therapy. The changes were more significant for the functioning of hip and knee joints. The contralateral hip amplitude returned to the normal range. For the knee joint, the amplitude of the first flexion increased and the value of the amplitude of hyperextension decreased in the middle of the stance phase. Concerning muscle function, the observed significant decrease in the function of m. Gastrocnemius and the hamstring muscles on the paretic side remained without change at the end of the treatment course. We obtained positive dynamics of the biomechanical parameters of walking in patients after the BFB training course. The feasibility and efficacy of their use for targeted correction need further research.

scholarly journals Intra-Arterial Tirofiban Infusion for Partial Recanalization with Stagnant Flow in Hyperacute Cerebral Ischemic Stroke

2011 ◽  
Vol 17 (4) ◽  
pp. 442-451 ◽  
Author(s):  
S.K. Baik ◽  
S.J. Oh ◽  
K-P. Park ◽  
J-H. Lee
Keyword(s):  
Blood Flow ◽  
Ischemic Stroke ◽  
Clinical Status ◽  
Cerebral Stroke ◽  
Cerebral Ischemic Stroke ◽  
Cerebral Ischemic ◽  
Antegrade Flow ◽  
Stagnant Flow ◽  
Iv Tpa

Early reocclusion is a major concern associated with poor clinical outcomes in patients with an ischemic cerebral stroke. This occurs most frequently in patients with partial initial recanalization. This study focuses on partial recanalization with stagnant antegrade flow after intravenous (IV) tPA or spontaneously, treated with the administration of intra-arterial (IA) tirofiban. Three patients with initial M1 occlusion on diagnostic studies had an occluded segment that was recanalized with stagnant flow after IV tPA or spontaneously. In all cases, IA tirofiban was administrated. We evaluated the distal blood flow and the degree of vascular narrowing in the pre and post-procedure angiography and at follow-up in addition to the clinical status. In all patients, severe vascular narrowing with stagnation of blood flow was detected in the initial M1. After infusion of IA tirofiban, improvement of the distal blood flow was achieved rapidly within 40 minutes in all patients. The severe vascular narrowing resolved rapidly in two patients without residual stenosis. In one patient, moderate vascular narrowing was still present. The median baseline National Institutes of Health Stroke Scale (NIHSS) scores were 18 and the median post-procedural NIHSS scores were 2 at two weeks. No intracerebral hemorrhage occurred in any of the patients. Treatment with IA tirofiban was safe and effective in patients with partial initial recanalization. It can be suggested that detection of any partial recanalization is time for administration of glycoprotein IIb-IIIa receptor inhibitor in hyperacute ischemic stroke.

scholarly journals Matrix metalloproteinase-9 blood level as a predictor of post-stroke cognitive impairment

2018 ◽  
Vol 20 (2) ◽  
pp. 48-54
Author(s):  
D P Kalinsky ◽  
V Yu Lobzin ◽  
I G Ulyanov
Keyword(s):  
Ischemic Stroke ◽  
Cognitive Impairment ◽  
Matrix Metalloproteinase ◽  
Recovery Period ◽  
Speech Disorders ◽  
Matrix Metalloproteinase 9 ◽  
Early Recovery ◽  
Acute Period ◽  
Post Stroke ◽  
Metalloproteinase 9

Ischemic stroke is one of the leading causes of disability of the population. Among the consequences of stroke besides motor, speech disorders, the most important cause of cognitive impairments, it’s frequency is variable between 25-40%. Post-stroke cognitive disorders are pathogenetically heterogeneous conditions. The nature, modality and severity are determined by the clinical subtype of it’s development. So, cognitive impairment most often can be a consequence of a strategic infarcts, multi-infarct damage, decompensation of chronic cerebrovascular pathology against the background of an acute condition or neurodegenerative process that existed earlier and diagnosed before the appearance of any signs of stroke. In addition, the subtype of ischemic stroke also matters. In stroke, a family of zinc-binding proteolytic enzymes, in particular matrix metalloproteinase-9, plays a significant role in the development of damage of the brain tissue, which is of great importance in the reconstruction of the extracellular matrix. A high serum concentration of metalloproteinase-9 increases the severity of ischemic damage, the severity of the stroke and worsens the functional outcome of the disease. In addition, metalloproteinase-9 is also considered as a biomarker for Alzheimer’s disease, since it acts as a proteolytic enzyme, which, along with neprilizine, cleaves the amyloid protein. The results of a survey of 135 patients in the acute and early recovery period of ischemic stroke are presented. The level of metalloproteinase-9 and cognitive impairment have been studied on 1-2 and 21-22 days of the disease. It was found that a higher level of metalloproteinase-9 in blood plasma reflects a high probability of post-stroke cognitive impairment at the end of an acute period of ischemic stroke. The increase in metalloproteinase-9 did not depend on the localization of the focus of the stroke and its volume. Thus, metalloproteinase-9 investigation in the acute period of the ischemic stroke can predict the development of post-stroke cognitive decline.

scholarly journals Electromagnetic Field as a Treatment for Cerebral Ischemic Stroke

2021 ◽  
Vol 8 ◽  
Author(s):  
Amanda Moya Gómez ◽  
Lena Pérez Font ◽  
Bert Brône ◽  
Annelies Bronckaers
Keyword(s):  
Ischemic Stroke ◽  
Treatment Options ◽  
Cell Types ◽  
Cerebral Stroke ◽  
Signal Pathways ◽  
Extensive Literature ◽  
New Therapeutic Approaches ◽  
Cerebral Ischemic Stroke ◽  
Cerebral Ischemic

Cerebral stroke is a leading cause of death and adult-acquired disability worldwide. To this date, treatment options are limited; hence, the search for new therapeutic approaches continues. Electromagnetic fields (EMFs) affect a wide variety of biological processes and accumulating evidence shows their potential as a treatment for ischemic stroke. Based on their characteristics, they can be divided into stationary, pulsed, and sinusoidal EMF. The aim of this review is to provide an extensive literature overview ranging from in vitro to even clinical studies within the field of ischemic stroke of all EMF types. A thorough comparison between EMF types and their effects is provided, as well as an overview of the signal pathways activated in cell types relevant for ischemic stroke such as neurons, microglia, astrocytes, and endothelial cells. We also discuss which steps have to be taken to improve their therapeutic efficacy in the frame of the clinical translation of this promising therapy.

Irisin Ameliorates Hypoxia/Reoxygenation-Induced Inflammation and Apoptosis in PC12 Cells by Inhibiting TLR4/MYD88 Signaling Pathway

2019 ◽  
Vol 17 (3) ◽  
pp. 329-336
Author(s):  
Wang Jinli ◽  
Xu Fenfen ◽  
Zheng Yuan ◽  
Cheng Xu ◽  
Zhang Piaopiao ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Signaling Pathway ◽  
Pc12 Cells ◽  
Major Complication ◽  
Lactic Dehydrogenase ◽  
Dependent Manner ◽  
Cerebral Ischemic Stroke ◽  
Cerebral Ischemic ◽  
Myd88 Signaling ◽  
Hypoxia Reoxygenation

Cardiovascular disease including cerebral ischemic stroke is the major complication that increases the morbidity and mortality in patients with diabetes mellitus as much as four times. It has been well established that irisin, with its ability to regulate glucose and lipid homeostasis as well as anti-inflammatory and anti-apoptotic properties, has been widely examined for its therapeutic potentials in managing metabolic disorders. However, the mechanism of irisin in the regulation of cerebral ischemic stroke remains unclear. Using PC12 cells as a model, we have shown that hypoxia/reoxygenation inhibits cell viability and increases lactic dehydrogenase. Irisin, in a dose-dependent manner, reversed these changes. The increase in inflammatory mediators (IL-1β, IL-6, and TNF-α) by hypoxia/reoxygenation was reversed by irisin. Furthermore, the cell apoptosis promoted by hypoxia/reoxygenation was also inhibited by irisin. Irisin suppressed TLR4/MyD88 signaling pathway leading to amelioration of inflammation and apoptosis in PC12 cells. Thus, inhibition of TLR4/MyD88 signaling pathway via irisin could be an important mechanism in the regulation of hypoxia/reoxygenation-induced inflammation and apoptosis in PC12 cells.

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