scholarly journals A robotic device as a sensitive quantitative tool to assess upper limb impairments in stroke patients: A preliminary prospective cohort study

2012 ◽  
Vol 44 (3) ◽  
pp. 210-217 ◽  
Author(s):  
M Gilliaux ◽  
T Lejeune ◽  
C Detrembleur ◽  
J Sapin ◽  
B Dehez ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Upper Limb ◽  
Prospective Cohort ◽  
Robotic Device ◽  
Stroke Patients ◽  
Quantitative Tool

Serum Periostin and Cognitive Impairment in Ischemic Stroke Patients: a Prospective Cohort Study

2021 ◽  
Author(s):  
Guangzong Li ◽  
Jie Li ◽  
Chen Zhu ◽  
Jing Ye ◽  
Bin Wang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Ischemic Stroke ◽  
Cognitive Impairment ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Enzyme Linked Immunosorbent Assay ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Increased Risk ◽  
Serum Periostin

Abstract Background. Recent evidence suggest elevated periostin is associated with cardiovascular diseases. The aim of this study was to investigate the relationship between serum periostin and post-stroke cognitive impairment (PSCI) at 3 months. Methods. In this prospective cohort study, we enrolled patients with ischemic stroke and hospitalized within 7 days of symptoms onset from January 2019 to January 2020. Serum periostin levels were measured using enzyme-linked immunosorbent assay after admission. Cognitive function assessment was performed at 3-month follow-up visit using the Montreal Cognitive Assessment (MoCA). We defined the PSCI as total MoCA score < 25. Results. A total of 315 ischemic stroke patients were enrolled for the study. PSCI was observed in 173 patients, which accounted for 54.9% (95% confidence interval [CI] 52.1%–57.7%) of the cohort. Serum periostin levels were higher in patients with PSCI than in those without PSCI (median 19.6 vs 14.8 ng/mL; P = 0.001). In logistic regression analysis, the highest quartile of periostin levels were significantly correlated to PSCI (odds ratio [OR], 9.69; 95% CI, 5.06–25.61; P = 0.001), as compared with the lowest quartile. This association remained significant after adjustment for age, gender, educational years, stroke severity, and vascular risk factors. Subgroup analyses further confirmed these results. Furthermore, restricted cubic spline regression demonstrated a linear association between periostin levels and PSCI (P = 0.001 for linearity).Conclusions. This study found that higher serum periostin levels are associated with an increased risk of PSCI at 3 months after ischemic stroke onset.

scholarly journals Early parietofrontal network upregulation relates to future persistent deficits after severe stroke – a prospective cohort study

2021 ◽  
Author(s):  
Winifried Backhaus ◽  
Hanna Braaß ◽  
Focko L Higgen ◽  
Christian Gerloff ◽  
Robert Schulz
Keyword(s):  
Cohort Study ◽  
Functional Connectivity ◽  
Motor Cortex ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Primary Motor Cortex ◽  
Motor Recovery ◽  
Intraparietal Sulcus ◽  
Stroke Patients ◽  
Correlative Models

Abstract Recent brain imaging has evidenced that parietofrontal networks show alterations after stroke which also relate to motor recovery processes. There is converging evidence for an upregulation of parietofrontal coupling between parietal brain regions and frontal motor cortices. The majority of studies though have included only moderately to mildly affected patients, particularly in the subacute or chronic stage. Whether these network alterations will also be present in severely affected patients and early after stroke and whether such information can improve correlative models to infer motor recovery remains unclear. In this prospective cohort study, nineteen severely affected first-ever stroke patients (mean age 74 years, 12 females) were analysed which underwent resting-state functional MRI and clinical testing during the initial week after the event. Clinical evaluation of neurological and motor impairment as well as global disability was repeated after three and six months. Nineteen healthy participants of similar age and gender were also recruited. MRI data were used to calculate functional connectivity values between the ipsilesional primary motor cortex, the ventral premotor cortex, the supplementary motor area and the anterior and caudal intraparietal sulcus of the ipsilesional hemisphere. Linear regression models were estimated to compare parietofrontal functional connectivity between stroke patients and healthy controls and to relate them to motor recovery. The main finding was a significant increase in ipsilesional parietofrontal coupling between anterior intraparietal sulcus and the primary motor cortex in severely affected stroke patients (P &lt; 0.003). This upregulation significantly contributed to correlative models explaining variability in subsequent neurological and global disability as quantified by National Institute of Health Stroke Scale and modified Rankin Scale, respectively. Patients with increased parietofrontal coupling in the acute stage showed higher levels of persistent deficits in the late subacute stage of recovery (P &lt; 0.05). This study provides novel insights that parietofrontal networks of the ipsilesional hemisphere undergo neuroplastic alteration already very early after severe motor stroke. The association between early parietofrontal upregulation and future levels of persistent functional deficits and dependence from help in daily living might be useful in models to enhance clinical neurorehabilitative decision making.

scholarly journals Transition of care in stroke patients discharged home: a single-center prospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M. J. de Mooij ◽  
I. Ahayoun ◽  
J. Leferink ◽  
M. J. Kooij ◽  
F. Karapinar-Çarkit ◽  
...  
Keyword(s):  
Cohort Study ◽  
Ischemic Stroke ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Descriptive Analysis ◽  
Clinical Information ◽  
National Guidelines ◽  
Stroke Patients ◽  
Discharge Letter

Abstract Introduction Approximately two-thirds of the patients admitted to the hospital with an ischemic stroke are discharged directly home. Discontinuity of care may result in avoidable patient harm, re-admissions and even death. We hypothesized that the transfer of information is most essential in this patient group since any future care for these patients relies solely on the information that is available to the care provider responsible at that time. Aim The objective of this study was to evaluate the continuity of transmural care in ischemic stroke patients by assessing 1) the transfer of clinical information through discharge letters to general practitioners (GPs), 2) subsequent documentation of this information and early follow-up by GPs and 3) the documentation of medication-related information in discharge letters, at GPs and community pharmacies (CPs). Methods This prospective cohort study was conducted from September 2019 through March 2020 in OLVG, Amsterdam, the Netherlands, in patients with a first stroke discharged directly home. Outcome measures were derived from national guidelines and regional agreements. Results were analyzed using descriptive analysis. Results A total of 33 patients were included. Discharge letters (n = 33) and outpatient clinic letters (n = 24) to GPs contained most of the essential items, but 16% (n = 9) of the letters were sent in time. GPs (n = 31) infrequently adhered to guidelines since 10% (n = 3) of the diagnoses were registered using the correct code and 55% (n = 17) of the patients received follow-up shortly after discharge. Medication overviews were inaccurately communicated to GPs since 62% (n = 150) of all prescriptions (n = 243) were correctly noted in the discharge letter. Further loss of information was seen as only 39% (n = 95) of all prescriptions were documented correctly in GP overviews. We found that 59% (n = 144) of the prescriptions were documented correctly in CP overviews. Conclusion In this study, we found that discontinuity of care occurred to a varying extent throughout transmural care in patients with a first stroke who were discharged home.

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