scholarly journals Neurodegeneration and Vascular Burden on Cognition After Midlife: A Plasma and Neuroimaging Biomarker Study

2021 ◽  
Vol 15 ◽  
Author(s):  
Kuo-Lun Huang ◽  
Ing-Tsung Hsiao ◽  
Ting-Yu Chang ◽  
Shieh-Yueh Yang ◽  
Yeu-Jhy Chang ◽  
...  
Keyword(s):  
Cortical Thickness ◽  
Tau Protein ◽  
Cortical Atrophy ◽  
Imaging Biomarkers ◽  
Stroke Patients ◽  
Plasma Biomarkers ◽  
Post Stroke ◽  
Study Results ◽  
Composite Scores ◽  
Vascular Burden

Background and Objectives: Neurodegeneration and vascular burden are the two most common causes of post-stroke cognitive impairment. However, the interrelationship between the plasma beta-amyloid (Aβ) and tau protein, cortical atrophy and brain amyloid accumulation on PET imaging in stroke patients is undetermined. We aimed to explore: (1) the relationships of cortical thickness and amyloid burden on PET with plasma Aβ40, Aβ42, tau protein and their composite scores in stroke patients; and (2) the associations of post-stroke cognitive presentations with these plasma and neuroimaging biomarkers.Methods: The prospective project recruited first-ever ischemic stroke patients around 3 months after stroke onset. The plasma Aβ40, Aβ42, and total tau protein were measured with the immunomagnetic reduction method. Cortical thickness was evaluated on MRI, and cortical amyloid plaque deposition was evaluated by 18F-florbetapir PET. Cognition was evaluated with Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Dementia Rating Scale-2 (DRS-2).Results: The study recruited 24 stroke patients and 13 normal controls. The plasma tau and tau*Aβ42 levels were correlated with mean cortical thickness after age adjustment. The Aβ42/Aβ40 ratio was correlated with global cortical 18F-florbetapir uptake value. The DRS-2 and GDS scores were associated with mean cortical thickness and plasma biomarkers, including Aβ42/Aβ40, tau, tau*Aβ42, tau/Aβ42, and tau/Aβ40 levels, in stroke patients.Conclusion: Plasma Aβ, tau, and their composite scores were associated with cognitive performance 3 months after stroke, and these plasma biomarkers were correlated with corresponding imaging biomarkers of neurodegeneration. Further longitudinal studies with a larger sample size are warranted to replicate the study results.

scholarly journals Cortical atrophy and transcallosal diaschisis following isolated subcortical stroke

2019 ◽  
Vol 40 (3) ◽  
pp. 611-621 ◽  
Author(s):  
Bastian Cheng ◽  
Philipp Dietzmann ◽  
Robert Schulz ◽  
Marlene Boenstrup ◽  
Lutz Krawinkel ◽  
...  
Keyword(s):  
White Matter ◽  
Cortical Thickness ◽  
Diffusion Tensor ◽  
Brain Regions ◽  
White Matter Integrity ◽  
Cortical Atrophy ◽  
Fiber Tractography ◽  
Stroke Patients ◽  
Fiber Tracts ◽  
One Year

Following acute ischemic stroke, isolated subcortical lesions induce gray matter atrophy in anatomically connected, yet distant cortical brain regions. We expand on previous studies by analyzing cortical thinning in contralesional, homologous regions indirectly linked to primary stroke lesions via ipsilesional cortical areas. For this purpose, stroke patients were serially studied by magnetic resonance imaging (diffusion tensor imaging and high-resolution anatomical imaging) in the acute (days 3–5) and late chronic stage one year after stroke. We analyzed changes of gray and white matter integrity in 18 stroke patients (median age 68 years) with subcortical stroke. We applied probabilistic fiber tractography to identify brain regions connected to stroke lesions and contralesional homologous areas. Cortical thickness was quantified by semi-automatic measurements, and fractional anisotropy was analyzed. One year after stroke, significant decrease of cortical thickness was detected in areas connected to ischemic lesions (mean −0.15 mm; 95% CI −0.23 to −0.07 mm) as well as homologous contralateral brain regions (mean −0.13 mm; 95% CI −0.07 to −0.19 mm). We detected reduced white matter integrity of inter- and intrahemispheric fiber tracts. There were no significant associations with clinical recovery. Our results indicate that impact of subcortical lesions extends to homologous brain areas via transcallosal diaschisis.

Visualising Neuroinflammation in Post-Stroke Patients: A Comparative PET Study with the TSPO Molecular Imaging Biomarkers [11C]PK11195 and [11C]vinpocetine

2012 ◽  
Vol 5 (1) ◽  
pp. 19-28 ◽  
Author(s):  
Balazs Gulyas ◽  
Miklos Toth ◽  
Adam Vas ◽  
Evgeni Shchukin ◽  
Konstantinos Kostulas ◽  
...  
Keyword(s):  
Molecular Imaging ◽  
Imaging Biomarkers ◽  
Stroke Patients ◽  
Post Stroke

scholarly journals The Distinct Disrupted Plasticity in Structural and Functional Network in Mild Stroke With Basal Ganglia Region Infarcts

2021 ◽  
Author(s):  
Hua Zhu ◽  
Lijun Zuo ◽  
Wanlin Zhu ◽  
Jing Jing ◽  
Zhe Zhang ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Basal Ganglia ◽  
Functional Connectivity ◽  
Network Analysis ◽  
Structural Connectivity ◽  
Functional Network ◽  
Imaging Biomarkers ◽  
Functional Networks ◽  
Stroke Patients ◽  
Post Stroke

Abstract ObjectiveTo characterize brain structural and functional networks in post-stroke patients with or without cognitive impairment. MethodsGraph theory analysis was applied to diffusion-weighted imaging (DWI) data and resting-state functional MRI (fMRI) data from 23 post-stroke patients with cognitive impairment (PSCI), 17 post-stroke patients without cognitive impairment (NPSCI), and 29 healthy controls (HC). Structural and functional connectivity between 90 cortical and subcortical brain regions was estimated and thresholded to construct a set of undirected graphs. Network-based statistics (NBS) was used to characterize altered connectivity patterns among the three groups. ResultsCompared to HC, the PSCI group demonstrated substantial reductions in all three types of connections - rich club, feeder, and local - in structural and functional networks. Specifically, in structural network analysis, reduced connections were observed within basal ganglia and basal ganglia-frontal networks, whereas in the functional network analysis, reduced connections were observed in fronto-parietal network (FPN) and cingulo-opercular networks (CON). Meanwhile, compared to HC, the NPSCI group demonstrated reductions in both feeder and local connections only within occipital area and occipital-temporal structural networks. ConclusionsThe findings of reduced structural connectivity in regions stemming from a basal ganglia core and reduced functional connectivity in FPN and CON may indicate a bottom-up cognitive impairment induced by stroke. Graph analysis and connectomics may aid clinical diagnosis and serve as potential imaging biomarkers for post-stroke patients with cognitive impairment.

VP54 Costs And Benefits Of Intensive Inpatient Rehabilitation After Stroke

2017 ◽  
Vol 33 (S1) ◽  
pp. 172-173
Author(s):  
Youshin Suh ◽  
Jeonghoon Ahn
Keyword(s):  
Functional Status ◽  
Societal Perspective ◽  
Cost Savings ◽  
Inpatient Rehabilitation ◽  
Government Subsidy ◽  
Costs And Benefits ◽  
Stroke Patients ◽  
Post Stroke ◽  
Study Results ◽  
The Cost

INTRODUCTION:This study estimated, from the societal perspective, the costs and benefits of the intensive inpatient rehabilitation treatments (IIRT) on patients after stroke using the interim results of a large ongoing registry in Korea, the Korean Stroke Cohort for Functioning and Rehabilitation (KOSCO) (1).METHODS:Among others, the benefits were measured by two major cost savings: (i) decrease in government disability subsidy and (ii) caregiver savings. One of the KOSCO study results showed the functional status of the post-stroke patients, measured by the Korean Modified Barthel Index (K-MBI), improved significantly and the disability grades, which the government is using to classify the subsidy amount, reduced as well. Caregiver cost savings were calculated by K-MBI improvements, the average daily compensation of caregivers (USD58.33) and the average period of caregiving. To measure the cost of IIRT on post-stroke patients, the average costs reported by a National Evidence-based Healthcare Collaboration Agency (NECA) Health Technology Assessment report was used (2).RESULTS:The disability grade improvements showed savings of government subsidy by USD58.65 to USD478.39 depending on the patient income from the registry. The average caregiving cost decrease was USD6,042 annually. The average cost of IIRT on post-stroke patients was USD926.34 for the first year.CONCLUSIONS:This study estimated the cost-benefit of IIRT on post-stroke patients using the KOSCO study interim data. The intensive rehabilitation treatment improves patients functional status significantly enough to save two major cost items, the disability grades which also resulted in a decrease in government subsidy amounts and the caregiver costs which the patient family has to pay in Korea. The results warrant the use of IIRT for the post-stroke patients in Korea from the societal perspective.

scholarly journals Telerehabilitation of Post-Stroke Patients as a Therapeutic Solution in the Era of the Covid-19 Pandemic

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 654
Author(s):  
Paulina Magdalena Ostrowska ◽  
Maciej Śliwiński ◽  
Rafał Studnicki ◽  
Rita Hansdorfer-Korzon
Keyword(s):  
Hospital Admissions ◽  
Meta Analysis ◽  
Inpatient Rehabilitation ◽  
Functional Condition ◽  
Health Care Facilities ◽  
Stroke Patients ◽  
Post Stroke ◽  
Study Results ◽  
Neurological Patients ◽  
Randomised Control Trials

(1) Background: Due to the pandemic caused by the SARS-CoV-2 virus, rehabilitation centres have become less available for neurological patients. This is the result of efforts to physically distance society, to try to slow the spread of the pathogen. Health care facilities were mainly restricted to urgent cases, while most physiotherapy treatments, mainly for patients with chronic conditions, were suspended. Some countries have seen a reduction in acute stroke hospital admissions of from 50% to 80%. One solution to the above problem is the use of telerehabilitation in the home environment as an alternative to inpatient rehabilitation. (2) Aim of the study: The purpose of this review is to analyse the benefits and limitations of teletherapy in relation to the functional condition of post-stroke patients. (3) Methods: Selected publications from 2019 to 2021 on the telerehabilitation of stroke patients were reviewed. The review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist. (4) Results: Studies have proven that teletherapy significantly improves the functional condition of post-stroke patients, resulting in improved quality of life and faster return to independence (while maintaining maximum possible precautions related to the SARS-CoV-2 virus pandemic). (5) Conclusions: Analysis of the study results showed comparable effectiveness of rehabilitation in the tele system to inpatient therapy. However, it should be emphasised that patients undergoing telerehabilitation must meet strict conditions to be eligible for this type of treatment program. However, the strength of the evidence itself supporting the effectiveness of this method ranks low due to the limited number of randomised control trials (RCT), small number of participants, and heterogeneous trials.

KUALITAS HIDUP PASIEN STROKE DI POLIKLINIK RAWAT JALAN RUMAH SAKIT SWASTA YOGYAKARTA

2019 ◽  
Vol 7 (3) ◽  
pp. 232-237
Author(s):  
Hana Larasati ◽  
Theresia Titin Marlina
Keyword(s):  
Quality Of Life ◽  
Social Relations ◽  
Hemorrhagic Stroke ◽  
Poor Quality ◽  
Social Dimension ◽  
Stroke Patients ◽  
Sampling System ◽  
Post Stroke ◽  
Psychological Dimension

Background: stroke is a disorder of nervous system function that occurs suddenly and is caused by brain bleeding disorders that can affect the quality of life physical dimensions, social dimensions, psychological dimensions, environmental dimensions. Based on the result of Lumbu study (2015) the number of samples were 71 people collected data using the (WHOQOL-BREF). There were 56 people (78,9%) had the poor quality of life of post stroke. The mean of post-stroke quality of life domain was physical domain (45,27%), psychological domain (49,87%), social relations domain (48,15%) and environmental domain (50.01%). Objective: the purpose of the study was know the quality of life of the stroke patients in Outpatient Polyclinic of Private Hospital in Yogyakarta. Methods: used descriptive quantitative by using questionnaire test of purposive sampling system based on patients who have been affected of ischemic or hemorrhagic stroke before, number 30 respondents. Result: quality of life of stroke patient of medium physical dimension (67%), psychological dimension (71%), social dimension (67%), dimension good environment (63%). Conclusion: the quality of life of stroke patients of physical dimension, psychological dimension, and moderate social dimension, while the quality of life of stroke patients were good environmental dimension.   Keywords: Hemorrhagic stroke, ischemic stroke, quality of life

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