Relation of exercise capacity to comprehensive physical functions in individuals with ischemic stroke

2021 ◽  
pp. 1-9
Author(s):  
So-Young Ahn ◽  
Nam-Gi Lee ◽  
Tae-Heon Lee
Keyword(s):  
Ischemic Stroke ◽  
Exercise Capacity ◽  
Motor Function ◽  
Significant Relationship ◽  
Motor Performance ◽  
Physical Parameters ◽  
Walk Test ◽  
Stroke Patients ◽  
Physical Functions ◽  
Control Balance

BACKGROUND: Impaired motor control, balance, muscle strength, and respiratory function may affect the exercise capacity related to motor performance and activities in individuals with stroke. OBJECTIVE: To identify a physical parameter that the exercise capacity has the most significant relationship among physical parameters related to motor function, trunk control, balance, and motor performance and activities in individuals with ischemic stroke. METHODS: In total, 241 ischemic stroke patients were recruited in this retrospective study. The clinical measurements included the 6-minute walk test (6 MWT), Montreal cognitive assessment (MoCA), Fugl-Meyer assessment-lower extremity motor function (FMA-LE), trunk impairment scale (TIS), Berg balance scale (BBS), timed up and go test (TUG), 10-meter walk test (10 MWT), functional ambulation category (FAC), and functional independence measure (FIM). RESULTS: The 6 MWT was significantly correlated with the FMA-LE, BBS, TUG, 10 MWT, FAC, and FIM, indicating negative or positive moderate correlations. Additionally, the FMA-LE, TIS, BBS, TUG, 10 MWT, FAC, and FIM, excluding the 6 MWT, showed moderate to strong correlations with all of the other outcome measures, whereas the MoCA showed significant correlations only with the BBS and FIM. CONCLUSIONS: In this study, the exercise capacity has the most significant relationship with the TUG parameter in stroke patients. Additionally, we suggest that significant relationships between 6 MWT and other comprehensive physical functions measurements are closely related to walking ability in individuals with stroke.

Combining inhibitory and facilitatory repetitive transcranial magnetic stimulation (rTMS) treatment improves motor function by modulating GABA in acute ischemic stroke patients

2021 ◽  
pp. 1-16
Author(s):  
Qing-Mei Chen ◽  
Fei-Rong Yao ◽  
Hai-Wei Sun ◽  
Zhi-Guo Chen ◽  
Jun Ke ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Treatment Group ◽  
Motor Function ◽  
Magnetic Stimulation ◽  
Sham Group ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Motor Dysfunction ◽  
Gaba Level ◽  
Stroke Patients ◽  
Before And After

Background: The combination of inhibitory and facilitatory repetitive transcranial magnetic stimulation (rTMS) can improve motor function of stroke patients with undefined mechanism. It has been demonstrated that rTMS exhibits a neuro-modulatory effect by regulating the major inhibitory neurotransmitter γ-aminobutyric acid (GABA) in other diseases. Objectives: To evaluate the effect of combined inhibitory and facilitatory rTMS on GABA in the primary motor cortex (M1) for treating motor dysfunction after acute ischemic stroke. Methods: 44 ischemic stroke patients with motor dysfunction were randomly divided into two groups. The treatment group was stimulated with 10 Hz rTMS at the ipsilesional M1 and 1 Hz rTMS at the contralesional M1. The sham group received bilateral sham stimulation at the motor cortices. The GABA level in the bilateral M1 was measured by proton magnetic resonance spectroscopy (1H-MRS) at 24 hours before and after rTMS stimulation. Motor function was measured using the Fugl-Meyer Assessment (FMA). The clinical assessments were performed before and after rTMS and after 3 months. Results: The treatment group exhibited a greater improvement in motor function 24 hours after rTMS compared to the sham group. The increased improvement in motor function lasted for at least 3 months after treatment. Following 4 weeks of rTMS, the GABA level in the ipsilesional M1 of the treatment group was significantly decreased compared to the sham group. Furthermore, the change of FMA score for motor function was negatively correlated to the change of the GABA:Cr ratio. Finally, the effect of rTMS on motor function outcome was partially mediated by GABA level change in response to the treatment (27.7%). Conclusions: Combining inhibitory and facilitatory rTMS can decrease the GABA level in M1, which is correlated to the improvement of motor function. Thus, the GABA level in M1 may be a potential biomarker for treatment strategy decisions regarding rTMS neuromodulatory interventions.

scholarly journals ASSOCIATION BETWEEN BLOOD PRESSURE VARIABILITY AND EARLY NEUROLOGICAL DETERIORATION IN ACUTE ISCHEMIC STROKE PATIENTS

2020 ◽  
Vol 7 (8) ◽  
pp. 94-99
Keyword(s):  
Blood Pressure ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Significant Relationship ◽  
Blood Pressure Variability ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Exact Test ◽  
Treatment Data

Background: Variability in blood pressure is a predictor of stroke severity and causes of poor functional outcome. Blood pressure variability is one of the main predictor of the prognosis acute ischemic stroke. Blood pressure variability were independently and linearly associated with the development of early neurologic deterioration (END) in acute ischemic stroke Objective: To determine the association between blood pressure variability and END in acute ischemic stroke patients. Method: This study uses a cross sectional design. Sampling was conducted at H. Adam Malik General Hospital Medan. Samples were taken as many as 40 subjects consecutively. Blood pressure checks were perform every hour for 72 hours then an assessment of the National Institute of Health Stroke Scale (NIHSS) score at admission and the third day of treatment. Data analysis used fisher’s exact test. Results: The demographic characteristics of the study subjects were an average age of 56-<71 years, high school education level, housewife occupation and Batak ethnicity. The mean of maximum systolic blood pressure (SBP) was 151±12.16 mmHg, minimum SBP 123.15±18 mmHg, delta SBP 25.35±10.66 mmHg, maximum diastolic blood pressure (DBP) 79.7±6.01 mmHg, minimum DBP 61.77±7.32 mmHg and delta DBP 17.97±8.48 mmHg. The NIHSS day 1 score had an average of 9.55±6.73, the NIHSS day 3 score was 11.25±7.93. Most subjects experienced END. There is a significant relationship between blood pressure variability and END with a p of 0.03 (p<0.05). Conclusion: There is a significant relationship between blood pressure variability and END in patients with acute ischemic stroke.

scholarly journals Effect and Safety of Transcutaneous Auricular Vagus Nerve Stimulation on Recovery of Upper Limb Motor Function in Subacute Ischemic Stroke Patients: A Randomized Pilot Study

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Dandong Wu ◽  
Jingxi Ma ◽  
Liping Zhang ◽  
Sanrong Wang ◽  
Botao Tan ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Adverse Effects ◽  
Vagus Nerve ◽  
Motor Function ◽  
Upper Limb ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Small Scale ◽  
Stroke Patients ◽  
Rehabilitation Training

Background. Transcutaneous auricular vagus nerve stimulation (taVNS) is regarded as a potential method for recovery in stroke. The effectiveness of taVNS in acute and subacute stroke should be further discussed as previously, only a few small-scale trials have focused on chronic stroke patients. The objective of this study is to investigate the effect and safety of taVNS on upper limb motor function in subacute ischemic stroke patients. Methods. Twenty-one subacute ischemia stroke patients with single upper limb motor function impairment were enrolled and randomly assigned to conventional rehabilitation training with real or sham taVNS, delivered for 15 consecutive days. Electrodes were fixed to the cymba conchae of the left ear with or without electrical stimulation. Conventional rehabilitation training was performed immediately after the end of real or sham taVNS by the same therapists. Baseline assessments were performed on day 0 of enrollment, and posttreatment evaluations were performed at 15 days, 4 weeks, and 12 weeks after the first intervention. The assessment included the upper limb Fugl-Meyer assessment (FMA-U), the Wolf motor function test (WMFT), the Functional Independence Measurement (FIM), and Brunnstrom stage. Heart rate (HR) and blood pressure (BP) were measured before and after each taVNS intervention. At the same time, any adverse effects were observed during the procedure. Outcomes were assessed by a blind evaluator. Results. There were no significant differences in FMA-U, WMFT, FIM, and Brunnstrom scores between the two groups at baseline (P>0.05). At the endpoint, the FMA-U, WMFT, and FIM scores were significantly higher than before treatment (P<0.05), and there was a significantly greater improvement of those measurements in taVNS group compared with sham-taVNS group (P<0.05). Significant improvements in FMA-U score were found between groups at follow-up. Only one case of skin redness occurred during the study. Conclusions. This study revealed that taVNS appeared to be beneficial to the recovery of upper limb motor function in subacute ischemia stroke patients without obvious adverse effects. Trial registration. This trial is registered with ChiCTR1800019635 on 20 November 2018 (http://www.chictr.org.cn/showproj.aspx?proj=32961).

scholarly journals HUBUNGAN KADAR S100B SERUM TERHADAP LUARAN KLINIS NEUROLOGIS PASIEN STROKE ISKEMIK AKUT

2018 ◽  
Vol 36 (1) ◽  
Author(s):  
Windri Kartikasari ◽  
Retnaningsih Retnaningsih ◽  
Amin Husni
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Significant Relationship ◽  
Serum Levels ◽  
Confounding Factors ◽  
Inclusion Criteria ◽  
Stroke Patients ◽  
Nihss Score ◽  
Cohort Design ◽  
Relationship Of

  RELATIONSHIP OF S100B SERUM WITH NEUROLOGIC CLINICAL OUTCOME IN ACUTE ISCHEMIC STROKE PATIENTSABSTRACTIntroduction: Biomarker levels of S100B serum have a correlation with the degree of damage to brain tissue so that it can be used as a marker to determine the clinical outcomes of patients with acute ischemic stroke.Aims: To determine the association of S100B serum levels 72 hours of onset to NIHSS score changes in acute ischemic stroke patients. Determine the association of confounding factors that affecting NIHSS score changes and S100B serum levels.Method: This research is an analytic observational study with prospective cohort design. Subjects were patients diagnosed with acute ischemic stroke who meet the inclusion criteria. This study used bivariate and multivariate analysis.Result: There was a significant relationship between S100B serum levels and changes in the NIHSS score. There was a significant relationship between BMI status and NIHSS score changes. There was a significant relationship between S100B serum levels with age ≥65 years, with hypertension, and with dyslipidemia to NIHSS score changes. There was a significant relationship between S100B serum levels in subject ≥65 years old with hypertension to NIHSS score changes. There was no significant relationship between S100B serum levels with dyslipidemia, hypertension, and diabetes mellitus to NIHSS score changes.Discussion: In this study, S100B serum levels were significant correlated with NIHSS score changes in acute ischemic stroke patients. There was a correlation  between S100B serum levels with age ≥65 years, hypertension, dyslipidemia. In subjects with age ≥65 years old and hypertension, S100 serum levels was significantly associated with NIHSS score changes in acute ischemic stroke patients.Keywords: Confounding factors, NIHSS score changes, S100B serumABSTRAKPendahuluan: Kadar penanda serum S100B berkorelasi dengan derajat kerusakan jaringan otak sehingga dapat digunakan sebagai petanda untuk mengetahui luaran klinis pasien stroke iskemik akut.Tujuan: Mengetahui hubungan kadar S100B serum 72 jam pasca-onset terhadap perubahan skor NIHSS pada pasien stroke iskemik akut dan faktor-faktor menjadi perancu.Metode: Penelitian ini merupakan penelitian observasional analitik dengan pendekatan kohort prospektif. Subjek adalah pasien yang didiagnosis stroke iskemik akut pertama kali. NIHSS dikatakan membaik jika perubahan skor antara hari ke-7 dan 3 perawatan ≥2. Analisis bivariat dilanjutkan dengan analisis multivariat dilakukan antara NIHSS dengan kadar S100B dan faktor-faktor perancu lainnya.Hasil: Didapatkan hubungan bermakna antara kadar S100B serum dengan perubahan  skor NIHSS. Didapatkan hubungan bermakna antara status BMI dengan perubahan skor NIHSS. Terdapat hubungan bermakna antara kadar S100B serum dengan umur ≥65 tahun, dengan hipertensi, dan dengan dislipidemia terhadap perubahan skor NIHSS. Terdapat hubungan bermakna antara kadar S100B serum pada subjek umur ≥65 tahun dengan hipertensi terhadap perubahan skor NIHSS. Tidak terdapat hubungan antara kadar S100B serum dengan dislipidemia, hipertensi, dan DM terhadap perubahan skor NIHSS.Diskusi: Terdapat hubungan antara kadar S100B serum terhadap perubahan skor NIHSS pasien stroke iskemik akut. Terdapat hubungan antara kadar S100B serum dengan dengan umur ≥ 65 tahun, hipertensi, dan dislipidemia. Pada umur ≥65 tahun dengan hipertensi, kadar S100B berhubungan terhadap perubahan skor NIHSS pasien stroke iskemik akut.Kata kunci: Faktor-faktor perancu, perubahan skor NIHSS, S100B serum  

scholarly journals CHANGES IN PLATELET AGGREGATION AND NIHSS AFTER ANTI-PLATELET THERAPY FOR ACUTE ISCHEMIC STROKE PATIENTS AT H. ADAM MALIK GENERAL HOSPITAL MEDAN

2020 ◽  
Vol 7 (8) ◽  
pp. 45-50
Keyword(s):  
Ischemic Stroke ◽  
Platelet Aggregation ◽  
Acute Ischemic Stroke ◽  
General Hospital ◽  
Significant Relationship ◽  
Cerebral Arteries ◽  
Platelet Activity ◽  
Stroke Patients ◽  
Positive Direction ◽  
Anti Platelet Therapy

Background: Acute ischemic stroke is caused by blockage of the cerebral arteries due to thrombus originating from excessive clotting of platelets. Increased platelet activity impacts the risk of atherothrombosis. The clinical impact of this blockage can be seen in changes in platelet aggregation and NIHSS after anti-platelet administration. Objectives: This study aims to determine changes in platelet aggregation and NIHSS after administration of anti-platelet therapy in acute ischemic stroke patients. Methods: This study was a Quasi Experimental Study with the method of Pre and Post-test Only Group selected by consecutive non-random sampling technique, in which patients diagnosed with ischemic stroke treated at H Adam Malik General Hospital Medan. The study began from March to July 2020. Results: The study was conducted on 38 samples consisting of 18 men and 20 women with an average age of 58.92(±7.539) years. There was a significant change between platelet aggregation and NIHSS (p<0.001). There was a significant relationship between platelet aggregation with NIHSS the first day before the administration of anti platelets (p=0.018) and correlation test (r=0.339) positive direction (unidirectional). There was no significant relationship between platelet aggregation with NIHSS in the seventh day after anti platelet administration (p=0.394). Conclusions: There were significant changes between platelet aggregation and NIHSS scores. There was a significant relationship between platelet aggregation and NIHSS the first day before anti platelet administration. There was no significant relationship between platelet aggregation and NIHSS in the seventh day after anti platelet administration.

scholarly journals PERBEDAAN GANGGUAN KOGNITIF SUBJEK STROKE ISKEMIK BERDASARKAN SISI HEMIPARESIS

2020 ◽  
Vol 37 (2) ◽  
Author(s):  
Gabriella Gabriella ◽  
Budi Riyanto Wreksoatmodjo ◽  
Andre Andre
Keyword(s):  
Ischemic Stroke ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Mental State ◽  
Significant Relationship ◽  
Mini Mental State Examination ◽  
P Value ◽  
Stroke Patients ◽  
Cross Sectional ◽  
State Examination

DIFFERENCE OF COGNITIVE IMPAIRMENT IN ISCHEMIC STROKE PATIENTS BASED ON HEMIPARESIS SIDEABSTRACTIntroduction: Cognitive impairment in stroke has a significant impact on the quality of life and is different from the location of the lesion. Patients with a lesion in the left cerebral hemisphere tend to have cognitive impairment and dementia.Aim: This study investigates the relationship between the location of the lesion, which is manifested by hemiparesis side, and the occurrence of cognitive impairment in ischemic stroke patients.Method: A cross-sectional study was conducted in the population of ischemic stroke patients at Atma Jaya Hospital, who were registered from January 2014 to December 2018. Cognitive function was measured by the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment Indonesian Version (MoCA-Ina). Data were analyzed univariate and bivariate with the software program, statistical package for the social sciences (SPSS) version 25.0.Result: There were 125 patients included in this study, which predominantly was 55 years old and older (62.4%) and had a low education level (58.4%). The proportion of patients with right-sided hemiparesis (54.4%) was slightly higher than the left-side one (45.6%). No significant relationship was observed between the hemiparesis side and every cognitive function domain measured by MMSE and MoCA-Ina (p-value >0.05).Discussion Hemiparesis side indicating hemisphere lateralization in ischemic stroke patients showed no significant relationship with the occurrence of cognitive impairment based on MMSE and MoCA-Ina score.   Keywords: Cognitive impairment, hemisphere lateralization, ischemic stroke, MMSE score, MoCA-Ina scoreABSTRAKPendahuluan: Gangguan kognitif pada stroke menyebabkan penurunan kualitas hidup dan berbeda berdasarkan letak lesi. Berdasarkan letak lesi, lesi di hemisfer serebri kiri lebih sering menyebabkan gangguan kognitif dan demensia.Tujuan: Tujuan penelitian untuk mengetahui pengaruh perbedaan letak lesi dilihat dari sisi hemiparesis terhadap gangguan kognitif pada subjek stroke iskemik.Metode: Studi potong lintang dilakukan pada pasien stroke iskemik di RS Atma Jaya periode tahun 2014- 2018. Fungsi kognitif dinilai dengan menggunakan Mini Mental State Examination(MMSE) danMontreal Cognitive Assesment Indonesian Version(MoCA-Ina). Analisis data dilakukan secara univariat dan bivariat menggunakan menggunakan program sStatistical pPackage for the sSocial sSciences (SPSS) versi 25.0.Hasil: Sebanyak 125 pasien tergabung dalam penelitian ini, yang sebagian besar berusia ≥55 tahun (62,4%) dan memiliki tingkat pendidikan <9 tahun (58,4%). Proporsi pasien dengan hemiparesis kanan (54,4%) lebih besar daripada kiri (45,6%). Tidak terdapat hubungan antara sisi hemiparesis dengan skor MMSE dan MoCA-Ina pada semua ranah (nilai p >0,05).Diskusi: Sisi hemiparesis pasien stroke iskemik yang menunjukkan lateralisasi hemisfer serebri tidak berhubungan dengan gangguan kognitif berdasarkan skor MMSE dan MoCA-Ina.Kata kunci: Gangguan kognitif, lateralisasi hemisfer, skor MMSE, skor MoCA-Ina, stroke iskemik

scholarly journals Platelet-Mediated NET Formation Exacerbates Ischemic Stroke Brain Injury

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 437-437
Author(s):  
Frederik Denorme ◽  
Irina Portier ◽  
Mark Cody ◽  
Ramesh Grandhi ◽  
Matthew D Neal ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Brain Injury ◽  
Board Of Directors ◽  
Motor Function ◽  
Platelet Activation ◽  
Research Funding ◽  
Stroke Patients ◽  
Dna Complexes ◽  
Advisory Committees ◽  
Stroke Outcomes

Abstract Background: Ischemic stroke provokes a strong inflammatory response which has been shown to exacerbate ischemic stroke brain injury in mice and is associated with worse outcomes in ischemic stroke patients. Classic anti-inflammatory strategies have been unsuccessful in clinical trials for ischemic stroke, implying other mechanisms contribute to injurious inflammation in ischemic stroke. Immunothrombosis is the interplay between coagulation, platelet activation and the innate immune system leading to thrombosis. A critical component of immunothrombosis is the formation of neutrophil extracellular traps (NETs). In this study, we investigated mechanistic regulators of NET formation in stroke and if they contribute to ischemic stroke outcomes. Methods: Markers of immunothrombosis were assessed in plasma from ischemic stroke patients and healthy matched donors. Flow cytometry was used to characterize platelet and neutrophil function. For murine studies, we used male and female C57Bl/6 mice that were subjected to transient middle cerebral artery occlusion. Stroke outcomes were assessed 24 hours or 7 days after stroke using neurological and motor function testing as well as brain infarct size analysis. Results: Ischemic stroke patients had significantly increased plasma biomarkers of immunothrombosis including D-Dimers (coagulation), platelet factor 4 (platelet activation) and calprotectin (neutrophil activation). Moreover, specific markers of NET formation including citrullinated histone H3 (H3cit) and MPO-DNA complexes were significantly elevated in ischemic stroke patients. Interestingly, H3cit and MPO-DNA complexes positively correlated with worse stroke outcomes at discharge while they did not correlate with stroke severity at admission. Next, we observed increased plasma and platelet surface expressed high mobility group box 1 (HMGB1) in ischemic stroke patients compared to matched healthy controls. NETs were found in platelet-rich areas in ischemic stroke thrombi, and HMGB1 colocalized with platelets in ischemic stroke thrombi. Blocking platelet-derived HMGB1 in vitro prevented platelet-induced NET formation. Mechanistically, depleting platelets in mice reduced plasma HMGB1 levels as well as NET formation and improved outcomes after ischemic stroke. In contrast, depleting neutrophils did not affect plasma HMGB1 levels, but reduced plasma NETs and improved stroke outcomes. Treatment of mice with a competitive HMGB1 inhibitor (BoxA) reduced NET formation and improved stroke outcomes. Combined, these results imply a causative role for platelet-derived HMGB1 in mediating detrimental NET formation after ischemic stroke. Finally, as NETs appeared injurious in ischemic stroke, we investigated the therapeutic potential of a recently discovered neonatal NET inhibitory factor (nNIF). nNIF is a cleavage fragment of alpha-1-antitrypsin and specifically blocks NET formation in human and murine neutrophils without affecting other critical neutrophil functions such as chemotaxis or phagocytosis. Mice treated with nNIF had reduced brain and plasma NETs after stroke while cerebral neutrophil recruitment remained unaffected. The reduction in NET formation after stroke was associated with reduced neuronal apoptosis and smaller brain infarcts. Furthermore, nNIF treated mice had improved neurological and motor function and enhanced 7-day survival after ischemic stroke. Conclusions: These results support a pathological role for NETs in acute ischemic stroke and warrant further investigation into nNIF as a therapeutic to improve stroke outcomes. Disclosures Neal: Instrumentation Laboratories: Research Funding; Janssen Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees, Research Funding; Haima Therapeutics: Membership on an entity's Board of Directors or advisory committees; Haemonetics: Honoraria, Research Funding.

scholarly journals Impacts of Perinatal Induced Photothrombotic Stroke on Sensorimotor Performance in Adult Rats

2013 ◽  
pp. 85-94 ◽  
Author(s):  
T. BRIMA ◽  
A. MIKULECKÁ ◽  
J. OTÁHAL
Keyword(s):  
Ischemic Stroke ◽  
Motor Function ◽  
Motor Performance ◽  
Functional Performance ◽  
Morphological Changes ◽  
Volume Ratio ◽  
Brain Regions ◽  
Adult Rats ◽  
The Impact ◽  
Exposition Time

Perinatal ischemic stroke is a leading cerebrovascular disorder occurring in infants around the time of birth associated with long term comorbidities including motor, cognitive and behavioral deficits. We sought to determine the impact of perinatal induced stroke on locomotion, behavior and motor function in rats. A photothrombotic model of ischemic stroke was used in rat at postnatal day 7. Presently, we induced two lesions of different extents, to assess the consequences of stroke on motor function, locomotion and possible correlations to morphological changes. Behavioral tests sensitive to sensorimotor changes were used; locomotion expressed as distance moved in the open field was monitored and histological changes were also assessed. Outcomes depicted two kinds of lesions of different shapes and sizes, relative to laser illumination. Motor performance of rats submitted to stroke was poor when compared to controls; a difference in motor performance was also noted between rats with small and large lesions. Correlations were observed between: motor performance and exposition time; volume ratio and exposition time; and in the rotarod between motor performance and volume ratio. Outcomes demonstrate that photothrombotic cerebral ischemic stroke induced in early postnatal period and tested in adulthood, indeed influenced functional performance governed by the affected brain regions.

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