Comprehensive Rehabilitation of Acupuncture Combined with Sequential Therapy of DL-3 n-Butylphthalide for Subacute Stroke

2021 ◽  
Author(s):  
Le Yang ◽  
Hongdan Zhang ◽  
Hui Li ◽  
Yankun Chen
Keyword(s):  
Ischemic Stroke ◽  
Acupuncture Treatment ◽  
Sequential Therapy ◽  
Acupuncture Group ◽  
Stroke Patients ◽  
Significant Side Effect ◽  
Serious Adverse Events ◽  
Subacute Stroke ◽  
Comprehensive Rehabilitation ◽  
Additional Therapy

The purpose of this trial was to examine the effect of acupuncture combined with 90 days’ NBP continuous habitual therapy and routine rehabilitation training could more effectively improve the physical movement, life activities, cognitive and psychological disorders of stroke patients. Our trial was a double-center trial and retrospective cohort study. The Acupuncture group received additional bedside acupuncture treatment and was given NBP injection 100ml twice a day in the first 14 days, and Sequential NBP soft capsule 200mg three times a day in the next 76 days. The No Acupuncture group only received conventional rehabilitation treatment. Primary outcomes were NIHSS, ADL and mRS which were evaluated in 6 months. Secondary outcomes included MMSE, MoCA, HAMA and HAMD; all were evaluated in 6 months. And the adverse reaction or other serious adverse events were evaluated at each time. We found that this therapy could significantly increase the scores of ADL, MMSE, MoCA, decreased the scores of NIHSS, mRS and the incidence of HAMA, HAMD of patients with ischemic stroke (P<0.05), which indicated that comprehensive rehabilitation of acupuncture as an additional therapy combined with the 90 days’ NBP sequential therapy could improve the cognitive, psychological and behavioral functions of ischemic stroke without significant side effect.

scholarly journals Paracrine Mechanisms of Intravenous Bone Marrow-Derived Mononuclear Stem Cells in Chronic Ischemic Stroke

2016 ◽  
Vol 6 (3) ◽  
pp. 107-119 ◽  
Author(s):  
Ashu Bhasin ◽  
M.V. Padma Srivastava ◽  
Sujata Mohanty ◽  
Sivasubramaniam Vivekanandhan ◽  
Sakshi Sharma ◽  
...  
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Stem Cell ◽  
Ischemic Stroke ◽  
Growth Factors ◽  
Growth Factor ◽  
Stroke Patients ◽  
Bdnf Expression ◽  
Serious Adverse Events ◽  
Significant Difference

Background: The emerging role of stem cell technology and transplantation has helped scientists to study their potential role in neural repair and regeneration. The fate of stem cells is determined by their niche, consisting of surrounding cells and the secreted trophic growth factors. This interim report evaluates the safety, feasibility and efficacy (if any) of bone marrow-derived mononuclear stem cells (BM-MNC) in chronic ischemic stroke by studying the release of serum vascular endothelial growth factor (VEGF) and brain-derived neurotrophic growth factor (BDNF). Methods: Twenty stroke patients and 20 age-matched healthy controls were recruited with the following inclusion criteria: 3 months to 1.5 years from the index event, Medical Research Council (MRC) grade of hand muscles of at least 2, Brunnstrom stage 2-5, conscious, and comprehendible. They were randomized to one group receiving autologous BM-MNC (mean 60-70 million) and to another group receiving saline infusion (placebo). All patients were administered a neuromotor rehabilitation regime for 8 weeks. Clinical assessments [Fugl Meyer scale (FM), modified Barthel index (mBI), MRC grade, Ashworth tone scale] were carried out and serum VEGF and BDNF levels were assessed at baseline and at 8 weeks. Results: No serious adverse events were observed during the study. There was no statistically significant clinical improvement between the groups (FM: 95% CI 15.2-5.35, p = 0.25; mBI: 95% CI 14.3-4.5, p = 0.31). VEGF and BDNF expression was found to be greater in group 1 compared to group 2 (VEGF: 442.1 vs. 400.3 pg/ml, p = 0.67; BDNF: 21.3 vs. 19.5 ng/ml) without any statistically significant difference. Conclusion: Autologous mononuclear stem cell infusion is safe and tolerable by chronic ischemic stroke patients. The released growth factors (VEGF and BDNF) in the microenvironment could be due to the paracrine hypothesis of stem cell niche and neurorehabilitation regime.

scholarly journals DLBS1033 treatment for ischemic stroke patients and clinical outcomes: systematic review of randomized controlled trial study

2020 ◽  
Vol 11 (3) ◽  
pp. 4412-4417
Author(s):  
Rizaldy Taslim Pinzon ◽  
Vanessa Veronica
Keyword(s):  
Systematic Review ◽  
Ischemic Stroke ◽  
Clinical Outcomes ◽  
Standard Therapy ◽  
Controlled Trial ◽  
Lumbricus Rubellus ◽  
Stroke Patients ◽  
Bleeding Events ◽  
Serious Adverse Events ◽  
Male Patients

DLBS1033 is a lumbrokinase earned from extraction of earthworms, Lumbricus rubellus. Lumbrokinase has 2 main activities: fibrinolytic and fibrinogenolytic – these activities reduce blood viscosity and platelet aggregation. With all of those properties, DLBS1033 will be a promising agent in patients with ischemic stroke. The objective of this research is to identify the advantage of DLBS1033 in ischemic stroke patients' clinical outcome. We used Pub Med, Cochrane, and Clinical Key as our major database for this systematic review. &quot;DLBS1033&quot;, &quot;lumbrokinase&quot;, and &quot;stroke&quot; keywords selected to particularize the search. The 2 authors calculated each of the studies using Jadad score. Only certain studies with scores above 3 will be included for further review using PRISMA checklist. There were 27 studies relating to DLBS1033 or lumbrokinase and stroke. Further examination by 2 authors resulted in 23 articles being removed leaving 2 studies. Subjects in all of the said studies are ischemic stroke patients; predominantly male patients. All of the said studies compare DLBS1033 with standard therapy; either utilizing DLBS1033 as an additional therapy or as a separate therapy. Clinical outcomes were measured using NIHSS and BI. Compared to standard therapy, DLBS1033 proved successful in improving clinical outcomes among patients with ischemic stroke. It's also found to be safe with none serious adverse events and significantly has lower bleeding events.

scholarly journals Degeneration of structural brain networks is associated with cognitive decline after ischaemic stroke

2020 ◽  
Author(s):  
Michele Veldsman ◽  
Hsiao-ju Cheng ◽  
Fang Ji ◽  
Emilio Werden ◽  
Mohamed Khlif ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Brain Networks ◽  
Higher Order ◽  
Cognitive Networks ◽  
Stroke Patients ◽  
Domain Specific ◽  
Subacute Stroke ◽  
Structural Brain

Abstract One third of ischemic stroke patients develop cognitive impairment. It is not known whether topographical secondary neurodegeneration within distributed brain structural covariance networks (SCNs) underlies this cognitive decline. We examined longitudinal changes in SCNs and their relationship to domain-specific cognitive decline in 73 ischemic stroke patients. Patients were scanned with magnetic resonance imaging (MRI) and assessed on five cognitive domains at subacute (3-months) and chronic (1-year) timepoints. Individual-level SCN scores of major cognitive networks were derived from MRI data at each timepoint. We found that distributed degeneration in higher-order cognitive networks was associated with cognitive impairment in subacute stroke. Importantly, faster degradation in these major cognitive SCNs over time was associated with greater decline in attention, memory, and language domains. Our findings suggest that subacute ischemic stroke is associated with degeneration of higher-order structural brain networks and degradation of these networks contribute to individual trajectories of longitudinal domain-specific cognitive dysfunction.

scholarly journals A Retrospective Cohort Study Comparing Stroke Recurrence Rate in Ischemic Stroke Patients With and Without Acupuncture Treatment

Medicine ◽  
2015 ◽  
Vol 94 (39) ◽  
pp. e1572 ◽  
Author(s):  
Chun-Chuan Shih ◽  
Chien-Chang Liao ◽  
Mao-Feng Sun ◽  
Yi-Chang Su ◽  
Chi-Pang Wen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Ischemic Stroke ◽  
Recurrence Rate ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Acupuncture Treatment ◽  
Stroke Recurrence ◽  
Stroke Patients

scholarly journals Application of Wireless Dynamic Sleep Monitor in Acupuncture Treatment of Insomnia after Ischemic Stroke: A Retrospective Study

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Yujuan Song ◽  
Xuebing Wang ◽  
Friedrich Schubert
Keyword(s):  
Ischemic Stroke ◽  
Usual Care ◽  
Acupuncture Treatment ◽  
Drug Group ◽  
The Self ◽  
Acupuncture Group ◽  
Control Group ◽  
Self Rating ◽  
Monitor Data

Purpose. Retrospective analysis of the clinical effect of acupuncture on insomnia after ischemic stroke by using a wireless sleep monitor as an innovative evaluation method. Methods. From March 1, 2018, to September 30, 2019, 105 cases of insomnia after ischemic stroke were extracted from the inpatient medical record system of Shenzhen Longhua District Central Hospital. According to differences in the treatment plan, the cases were divided into an acupuncture group (57 cases) and a drug group (48 cases). The acupuncture group was given acupuncture treatment on the basis of usual care, while the drug group was given estazolam oral treatment on the basis of usual care. Under the ICF framework, the related items of sleep function and emotion function were selected for evaluation. As outcome parameters, the alterations of the Pittsburgh sleep quality index (PSQI), the self-rating anxiety scale (SAS), and the self-rating depression scale (SDS) were used before the treatment, after treatment, and in a follow-up; meanwhile, the ActiSleep-BT wireless sleep monitor was used to measure total sleep time (TST), sleep efficiency (SE), and sleep arousal (SA) of the two groups before and after treatment and at follow-up. Results. Within-group comparison showed significant differences in the acupuncture group before treatment and after treatment on the ActiSleep-BT wireless dynamic sleep monitor data as well as in PSQI and ICF. Comparing the acupuncture group with the control group also showed significant differences in the ActiSleep-BT wireless dynamic sleep monitor data, PSQI, and ICF. Conclusion. By evaluation using ActiSleep-BT wireless sleep monitor, acupuncture treated insomnia after ischemic stroke; the effect is better than usual care.

scholarly journals The Dynamic of Extracellular Vesicles in Patients With Subacute Stroke: Results of the “Biomarkers and Perfusion—Training-Induced Changes After Stroke” (BAPTISe) Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Ruben A. Jödicke ◽  
Shufan Huo ◽  
Nicolle Kränkel ◽  
Sophie K. Piper ◽  
Martin Ebinger ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Functional Outcome ◽  
Cardiovascular Events ◽  
Mixed Model ◽  
Annexin V ◽  
Regression Analyses ◽  
Stroke Patients ◽  
Post Stroke ◽  
Subacute Stroke ◽  
Before And After

Objective: Extracellular vesicles (EV) are sub-1 μm bilayer lipid coated particles and have been shown play a role in long-term cardiovascular outcome after ischemic stroke. However, the dynamic change of EV after stroke and their implications for functional outcome have not yet been elucidated.Methods: Serial blood samples from 110 subacute ischemic stroke patients enrolled in the prospective BAPTISe study were analyzed. All patients participated in the PHYS-STROKE trial and received 4-week aerobic training or relaxation sessions. Levels of endothelial-derived (EnV: Annexin V+, CD45–, CD41–, CD31+/CD144+/CD146+), leukocyte-derived (LV: Annexin V+, CD45+, CD41–), monocytic-derived (MoV: Annexin V+, CD41–, CD14+), neuronal-derived (NV: Annexin V+, CD41–, CD45–, CD31–, CD144–, CD146–, CD56+/CD171+/CD271+), and platelet-derived (PV: Annexin V+, CD41+) EV were assessed via fluorescence-activated cell sorting before and after the trial intervention. The levels of EV at baseline were dichotomized at the 75th percentile, with the EV levels at baseline above the 75th percentile classified as “high” otherwise as “low.” The dynamic of EV was classified based on the difference between baseline and post intervention, defining increases above the 75th percentile as “high increase” otherwise as “low increase.” Associations of baseline levels and change in EV concentrations with Barthel Index (BI) and cardiovascular events in the first 6 months post-stroke were analyzed using mixed model regression analyses and cox regression.Results: Both before and after intervention PV formed the largest population of vesicles followed by NV and EnV. In mixed-model regression analyses, low NV [−8.57 (95% CI −15.53 to −1.57)] and low PV [−6.97 (95% CI −13.92 to −0.01)] at baseline were associated with lower BI in the first 6 months post-stroke. Patients with low increase in NV [8.69 (95% CI 2.08–15.34)] and LV [6.82 (95% CI 0.25–13.4)] were associated with reduced BI in the first 6 months post-stroke. Neither baseline vesicles nor their dynamic were associated with recurrent cardiovascular events.Conclusion: This is the first report analyzing the concentration and the dynamic of EV regarding associations with functional outcome in patients with subacute stroke. Lower levels of PV and NV at baseline were associated with a worse functional outcome in the first 6 months post-stroke. Furthermore, an increase in NV and LV over time was associated with worse BI in the first 6 months post-stroke. Further investigation of the relationship between EV and their dynamic with functional outcome post-stroke are warranted.Clinical Trial Registration:clinicaltrials.gov/, identifier: NCT01954797.

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