INVESTIGATING THE ASSOCIATIONS BETWEEN THYROID HORMONES AND NEUROLOGICAL DEFICIT IN PATIENTS WITH ACUTE ISCHEMIC STROKE

Objective of the Review: To present data from the latest research studies focusing on anosognosia for neurological deficit in patients with acute ischemic stroke. Key Points: Anosognosia for motor and cognitive deficit is a quite common disorder in acute ischemic stroke patients. This condition is of interest for neurologists because it manifests itself in an unusual way and has a negative impact on patients’ medical rehabilitation. The understanding of the pathophysiology of anosognosia and its neuroanatomical underpinnings is changing and improving. New information about approaches to the diagnosis and treatment of this condition is becoming available, making this review timely. Conclusion: Patients with acute ischemic stroke may have reduced perception of their neurological deficit and cognitive, emotional, and behavioral disorders. Hemispatial neglect is the most common cognitive disorder associated with anosognosia for paralysis. Medical rehabilitation of post-stroke patients with anosognosia is challenging and requires the participation of a multidisciplinary team and a differentiated approach, tailored to the type of anosognosia. At present, rehabilitation specialists have started discussing the possibility of therapeutic application of instrumental investigation techniques, such as caloric vestibular stimulation and transcranial brain stimulation, in addition to cognitive behavioral therapy. Keywords: reduced perception of disease, anosognosia, regulatory dysfunction, neglect, ischemic stroke.

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Abstract WP317: Neutrophil Subtypes and Nets Changes in Diabetes With Acute Ischemic Stroke

Stroke ◽

10.1161/str.51.suppl_1.wp317 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Sanxin Liu ◽

Wei Cai ◽

Mengyan Hu ◽

Zhengqi Lu

Keyword(s):

Flow Cytometry ◽

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Neutrophil Count ◽

Neurological Deficit ◽

Infarct Volume ◽

Immunofluorescence Staining ◽

Neurological Deficit Score ◽

Immunological Mechanisms ◽

The Brain

Objective: Ischemic stroke (AIS) is a globally high-risk cerebrovascular disease. Diabetes can aggravate ischemic stroke, while its mechanism is still unknown, Neutrophils are the first peripheral immune cells that break through the blood-brain barrier and infiltrate the brain after AIS. They have two polarization states of N1 and N2 subtypes. N1 subtype neutrophils can release neutrophil extracellular traps (NETs) containing a large number of pro-inflammatory factors and exacerbate the neuroinflammatory response. This study will explore the immunological mechanisms of diabetes exacerbating ischemic stroke. Methods: Patients with acute ischemic stroke who were admitted to hospital from Jan 2012 to Dec 2018 were collected, compared blood neutrophil count and neutrophil/lymphocyte ratio in diabetic and non-diabetic AIS patients at 1 day; Middle cerebral artery infarction (MCAO) mice was used for animal model of AIS, high-fat diet and STZ-induced type 2 diabetes model. The neurological deficit score, TTC staining, flow cytometry and immunofluorescence staining were used to observe the infarct volume, neutrophil subtypes and NETs changes between AIS with and without diabetes. Results: The neutrophil count of AIS patients with diabetes was higher than that of non-diabetic AIS patients. Animal experiments found that AIS with diabetes increase neurological deficit score and infarct volume. Flow cytometry and immunofluorescence staining found that AIS with diabetes mice can promote neutrophils infiltration into the brain and promote the polarization of neutrophils to N1 subtype and increase NETs formation. Conclusion: Diabetes can promote the neutrophil polarization of N1 subtype which leads to increased NETs formation and exacerbate ischemic stroke.

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