scholarly journals Positive Correlation between Left Hemisphere Lesion and Erectile Dysfunction in Post-Stroke Patients

2019 ◽  
Vol 7 (3) ◽  
pp. 363-368 ◽  
Author(s):  
Thomas Eko Purwata ◽  
Dedy Andaka ◽  
AABN Nuartha ◽  
Candra Wiratni ◽  
Ketut Sumada
Keyword(s):  
Erectile Dysfunction ◽  
Left Hemisphere ◽  
Parasympathetic Nervous System ◽  
Longitudinal Research ◽  
Health Condition ◽  
Stroke Patients ◽  
Positive Correlation ◽  
Post Stroke ◽  
Hemisphere Lesion ◽  
Subsequent Risk

BACKGROUND: Stroke is a serious health condition and the leading cause of disability, including erectile dysfunction (ED). The mechanisms and factors that predict ED in stroke are not fully elucidated. Several studies have shown a relationship between the location of the lesion in stroke with the onset of ED. The left hemispheric lesion was believed to disrupt the parasympathetic nervous system which is responsible for the regulation of erection. Stroke attack in this region therefore can be the underlying reason for ED. However, there are still contradictory findings in this area, and very few studies attempted to look at this problem, particularly among Asian male. AIM: We would like to evaluate the association between left hemisphere lesion after ischemic stroke and the subsequent risk of developing ED. METHODS: The study was conducted in the neurology polyclinic of Sanglah and Wangaya Hospital from February to August 2013. Subjects are all post-stroke patients who visited the neurology polyclinic of Sanglah and Wangaya Hospital that met inclusion and exclusion criteria. RESULTS: There is a significant positive correlation (p < 0.05) between left hemisphere lesions and ED in stroke patients with a correlation coefficient (r) = 0.361 which means weak correlation and p = 0.032. CONCLUSION: Left hemisphere lesions positively correlated with ED in stroke patients. Further longitudinal research is needed to see whether left hemisphere lesion in post-stroke patients is a risk factor for ED.

scholarly journals Recovery of Apraxia of Speech and Aphasia in Patients With Hand Motor Impairment After Stroke

2021 ◽  
Vol 12 ◽  
Author(s):  
Helena Hybbinette ◽  
Ellika Schalling ◽  
Jeanette Plantin ◽  
Catharina Nygren-Deboussard ◽  
Marika Schütz ◽  
...  
Keyword(s):  
Left Hemisphere ◽  
Motor Impairment ◽  
Stroke Recovery ◽  
Similar Amount ◽  
Apraxia Of Speech ◽  
Stroke Patients ◽  
Post Stroke ◽  
Language Functions ◽  
Brain Recovery ◽  
Recovery Mechanisms

Objective: Aphasia and apraxia of speech (AOS) after stroke frequently co-occur with a hand motor impairment but few studies have investigated stroke recovery across motor and speech-language domains. In this study, we set out to test the shared recovery hypothesis. We aimed to (1) describe the prevalence of AOS and aphasia in subacute stroke patients with a hand motor impairment and (2) to compare recovery across speech-language and hand motor domains. In addition, we also explored factors predicting recovery from AOS.Methods: Seventy participants with mild to severe paresis in the upper extremity were assessed; 50% of these (n = 35) had left hemisphere (LH) lesions. Aphasia, AOS and hand motor assessments and magnetic resonance imaging were conducted at 4 weeks (A1) and at 6 months (A2) after stroke onset. Recovery was characterized in 15 participants showing initial aphasia that also had complete follow-up data at 6 months.Results: All participants with AOS and/or aphasia had LH lesions. In LH lesioned, the prevalence of aphasia was 71% and of AOS 57%. All participants with AOS had aphasia; 80% of the participants with aphasia also had AOS. Recovery in aphasia (n = 15) and AOS (n = 12) followed a parallel pattern to that observed in hand motor impairment and recovery correlated positively across speech-language and motor domains. The majority of participants with severe initial aphasia and AOS showed a limited but similar amount of recovery across domains. Lesion volume did not correlate with results from behavioral assessments, nor with recovery. The initial aphasia score was the strongest predictor of AOS recovery.Conclusion: Our findings confirm the common occurrence of AOS and aphasia in left hemisphere stroke patients with a hand motor impairment. Recovery was similar across speech-language and motor domains, even in patients with severe impairment, supporting the shared recovery hypothesis and that similar brain recovery mechanisms are involved in speech-language and motor recovery post stroke. These observations contribute to the knowledge of AOS and its relation to motor and language functions and add information that may serve as a basis for future studies of post stroke recovery. Studies including neuroimaging and/or biological assays are required to gain further knowledge on shared brain recovery mechanisms.

scholarly journals Acupuncture for erectile dysfunction in post-stroke patients

Medicine ◽  
2020 ◽  
Vol 99 (15) ◽  
pp. e19718
Author(s):  
Yanfeng Li ◽  
Xudong Yu ◽  
Ruijia Liu ◽  
Jisheng Wang ◽  
Sheng Deng ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Stroke Patients ◽  
Post Stroke

Abstract T P123: Impairment in Cognitively Demanding Driving Situations after Acute Mild Ischemic Stroke

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Megan A Hird ◽  
Kristin A Vesely ◽  
Leah E Christie ◽  
Melissa A Alves ◽  
Jitphapa Pongmoragot ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Phase ◽  
Driving Simulator ◽  
Longitudinal Research ◽  
Driving Performance ◽  
Stroke Patients ◽  
Post Stroke ◽  
Mild Stroke ◽  
Left Turns ◽  
Right Turns

Introduction: Guidelines established by prominent governing bodies recommend that patients should wait a minimum of one month before resuming driving after stroke; however, these guidelines are not based on empirical evidence. Furthermore, many patients report resuming driving within the one-month period post-stroke. The aim of this study was to investigate the driving performance of mild stroke patients within the acute phase of injury. It was hypothesized that patients with acute stroke would exhibit more errors in general (e.g. collisions, speed exceedances, centre line crossings) and during cognitively demanding aspects of driving (i.e. left turns with traffic), but not routine aspects of driving (i.e. straight driving and right turns). Methods: The current study used driving simulator technology (STISIM) to compare the driving performance of 10 patients with acute mild ischemic stroke (NIHSS<7, within 7 days post-stroke) to that of 10 healthy, age- and education-matched controls. Patients and controls completed several driving tasks that increased in complexity, from routine right and left turns to cognitively demanding left turns with traffic, where most accidents occur, and a bus following task, which requires a high degree of sustained attention. Results: On average, stroke patients committed over twice as many errors as controls (12.4 vs 6.0, p< 0.01). Although there was no difference between patients and controls in the number of errors committed during routine right and left turns, patients committed more errors during left turns with traffic (2.4 vs 1.3, p<0.05) and a bus following task (8.2 vs 2.1, p<0.05). Conclusions: Patients with acute mild ischemic stroke may be able to maintain driving performance during basic tasks (e.g. straight driving, right turns) and deficits may become apparent during cognitively complex tasks (e.g. left turns with traffic and bus following). The results highlight the importance of healthcare professionals providing driving advice to their patients post-stroke, particularly in the acute phase of injury. Future longitudinal research is required to determine when patients with mild stroke can safely resume driving.

scholarly journals Post-Stroke Treatment with Neuromuscular Functional Electrostimulation of Antagonistic Muscles and Kinesiotherapy Evaluated with Electromyography and Clinical Studies in a Two-Month Follow-Up

2022 ◽  
Vol 19 (2) ◽  
pp. 964
Author(s):  
Juliusz Huber ◽  
Katarzyna Kaczmarek ◽  
Katarzyna Leszczyńska ◽  
Przemysław Daroszewski
Keyword(s):  
Large Population ◽  
Manual Muscle Testing ◽  
Stroke Patients ◽  
Positive Correlation ◽  
Post Stroke ◽  
Positive Effects ◽  
Muscle Testing ◽  
Neurophysiological Studies ◽  
Scale Scores ◽  
Ashworth Scale

The aim of this study was to determine the sustained influence of personalized neuromuscular functional electrical stimulation (NMFES) combined with kinesiotherapy (mainly, proprioceptive neuromuscular facilitation (PNF)) on the activity of muscle motor units acting antagonistically at the wrist and the ankle in a large population of post-stroke patients. Clinical evaluations of spasticity (Ashworth scale), manual muscle testing (Lovett scale), and surface electromyography recordings at rest (rEMG) and during attempts of maximal muscle contraction (mcEMG) were performed three times in 120 post-stroke patients (T0: up to 7 days after the incidence; T1: after 21 days of treatment; T2: after 60 days of treatment). Patients (N = 120) were divided into two subgroups—60 patients received personalized NMFES and PNF treatment (NMFES+K), and the other 60 received only PNF (K). The NMFES+K therapy resulted in a decrease in spasticity and an increase in muscle strength of mainly flexor muscles, in comparison with the K group. A positive correlation between the increase of rEMG amplitudes and high Ashworth scale scores and a positive correlation between low amplitudes of mcEMG and low Lovett scale scores were found in the wrist flexors and calf muscles on the paretic side. Negative correlations were found between the rEMG and mcEMG amplitudes in the recordings. The five-grade alternate activity score of the antagonists’ actions improved in the NMFES+K group. These improvements in the results of controlled NMFES treatment combined with PNF in patients having experienced an ischemic stroke, in comparison to the use of kinesiotherapy alone, might justify the application of conjoined rehabilitation procedures based on neurophysiological approaches. Considering the results of clinical and neurophysiological studies, we suppose that NMFES of the antagonistic muscle groups acting at the wrist and the ankle may evoke its positive effects in post-stroke patients by the modulation of the activity more in the spinal motor centers, including the level of Ia inhibitory neurons, than only at the muscular level.

P5345Association and prevalence of post-stroke erectile dysfunction with cardiovascular risk factors and co-morbidities

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Trofenciuc ◽  
A Pop-Moldovan ◽  
M Onel ◽  
M Puticiu ◽  
M Tomescu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Erectile Dysfunction ◽  
Ace Inhibitors ◽  
Erectile Function ◽  
Oral Anticoagulants ◽  
Severe Depression ◽  
Control Group ◽  
Stroke Patients ◽  
P Values ◽  
Post Stroke

Abstract Objectives The aim of this study was to establish a correlation between prevalence and severity of erectile dysfunction (ED) and cardiovascular (CV) co-morbidities and ongoing medication and other risk factors associated with post-stroke ED. Materials and methods For 153 patients (57.04±6.54 years) with ischemic stroke, we evaluated the pre- and post-stroke prevalence of ED using the five-item International Index of Erectile Function questionnaire (IIEF5). Erectile Function questionnaire (IIEF5). Within 5 days of admission we determined the stroke site location and severity using the National Institute of Health Stroke Scale (NIHSS). The pre- and post-stroke data obtained were compared with those of 30 control non-stroke patients (52.27±8.35). Additional cardiovascular co-morbidities, medication and risk factors were asset and analyzed. Results The IIEF5 scores were much lower [median 17 interquartile range (IQR) 10–20] post stroke than pre-stroke (median 22 IQR 12–23) and lower than in control group (median 22.5 IQR 21–24). From the analysis of comorbidities and risk factors for stroke of post- stroke group and the control group, we infer that diabetes (p=0.003), hypercholesterolemia (p<0.001), and hypertension (p<0.001) were more common in patients with stroke than those in the control group. (Table 1). From the statistical analysis of data on medication use by patients, results that more patients have used ACE inhibitors, calcium antagonists, beta blocking agents, diuretics, statins, oral agents, antiplatelet and oral anticoagulants after the stoke than before, and in terms of consumption of drugs before stroke compared with the control group, differences were not significant. Lot 1 Lot 2 Lot 3 P values P values P values post-stoke patients pre-stroke patients control group [1 vs 3] [2 vs 3] [1 vs 2] No. of Patients 153 153 30 Age, mean ± SD 57.04±6.54 57.04±6.54 52.27±8.35 Pacient with ED, N (%) 127 (83%) 76 (49.67%) 9 (30%) <0.001 0.048 <0.001 Severity of ED, N (%)   Mild 74 (48.37%) 29 (18.95%) 7 (23.33%) 0.015 0.581 <0.001   Mild to moderate 1 (0.01%) 11 (7.19%) 1 (3.33%) 0.302* 0.694* 0.127*   Moderate 28 (18.30%) 21 (13.73%) 1 (3.33%) 0.052* 0.134* <0.001*   Severe 24 (15.69%) 15 (9.80%) 0 0.016* 0.136* <0.001* IIEF5 (Erectile function)   Mean ± SD 15.53±5.89 17.83±6.18 21.83±3.31 <0.001 <0.001 <0.001   Median (Q1–Q3) 17 (10–20) 22 (12–23) 22.5 (21–24) Hamilton Score   Normal 91 (59.4%) 144 (94.1%) 23 (76.6%)   Mild depression 40 (26.1%) 1 (0.6%) 5 (16.6%)   Moderate depression 11 (7.1%) 0 (0.0%) 1 (3.3%)   Severe depression 9 (5.8%) 6 (3.9%) 1 (3.3%)   Very severe depression 2 (1.3%) 2 (1.3%) 0 (0.0%) Comorbidities   Diabetes mellitus 59 (38.5%) 3 (10.0%) 0.003*   Hypercholesterolemia 104 (67.9%) 6 (20.0%) <0.001   Hypertension 121 (79.0%) 8 (26.6%) <0.001   Obesity 36 (23.5%) 6 (20.0%) 0.674   Smoking 53 (34.6%) 5 (16.6%) 0.056*   Atrial fibrillation 22 (14.3%) 2 (6.6%) 0.377*   Carotid artery stenosis 18 (11.7%) 1 (3.3%) 0.321*   Coronary hearth disease 26 (16.9%) 1 (3.3%) 0.086* Medication   ACE inhibitors 72 (47.0%) 32 (20.9%) 2 (6.6%) <0.001* 0.075* <0.001   Calcium Antagonists 49 (32.0%) 17 (11.1%) 4 (13.3%) 0.047* 0.755* <0.001   Beta-Blokers 65 (42.4%) 36 (23.5%) 3 (10.0%) 0.001* 0.142* <0.001   Diuretics 43 (28.1%) 14 (9.1%) 3 (10.0%) 0.039* >0.999* <0.001   Statins 99 (64.7%) 25 (16.3%) 4 (13.3%) <0.001* 0.791* <0.001   Oral antidiabetics 39 (25.4%) 25 (16.3%) 1 (10.0%) 0.007* 0.084* 0.442   Insulin 20 (13.0%) 15 (9.8%) 0 (0.0%) 0.048* 0.136* 0.369   Antiplatelet drugs 131 (85.6%) 14 (9.1%) 2 (6.6%) <0.001* >0.999* <0.001   Oral anticoagulants 22 (14.3%) 8 (5.2%) 0 (0.0%) 0.028* 0.357* 0.007   Antidepressants 28 (18.3%) 12 (7.84%) 2 (6.6%) 0.176* >0.999* 0.007 Conclusions The prevalence and severity of ED increase after stroke due to disruption of autonomous central structures. The depression, functional impairment, CV co-morbidities and medication used after stroke may contribute to ED.

scholarly journals Spiritual Needs of Post-Stroke Patients in the Rehabilitation Phase

2018 ◽  
Vol 6 (3) ◽  
Author(s):  
Sri Hartati Pratiwi ◽  
Eka Afrima Sari ◽  
Ristina Mirwanti
Keyword(s):  
Sampling Technique ◽  
Health Condition ◽  
Spiritual Needs ◽  
Religious Activities ◽  
Stroke Patients ◽  
Post Stroke ◽  
The Past ◽  
Validity Coefficient ◽  
Stroke Center ◽  
Patients Experience

Post-stroke patients experience in various disturbances including physical, psychological and spiritual aspect. Post-stroke patients in the rehabilitation phase focus more on physical needs while the unfulfilled spiritual needs can reduce the patient's health condition. Therefore, it takes action to meet the spiritual needs of patients. This study was conducted to identify the spiritual needs among post-stroke patients.The descriptive quantitative was used among post-stroke patients in Neurological Polyclinic and stroke center in one of the Hospital in Bandung in 2017. The sampling technique used was consecutive sampling with 83 samples included post-stroke patients who have full awareness and didnot experience of aphasia. The instrument of this study used Spiritual Needs Questionnaire (SpNQ) which consists of 4 dimensions including religious, peace, self-existence, and dimension of the giving needs. SpNQ had a validity coefficient of 0.73 and r 0.75. Data were analyzed using frequency distribution. The results showed that the most of respondents feel the spiritual need in all dimensions. In the religious dimension, the majority of respondents desired to pray with others, to move closer to God and participate in various religious activities (98.8%). In the dimension of peace showed the most of respondents desired to be more cherished by others (96.4%). The most perceived item of respondents were forgiving someone from the past in the dimension of self-existence (98.8%) and a solace for others in the dimension of the giving needs (98.8%). The conclusion from this study was most respondents feel the spiritual needs in all dimensions. Based on these results, nurses are expected to provide advice to people around the patients to invite them in various religious activities. Nurses supposed more expressing affection to them and involving the patients in some family activities.

scholarly journals Significant Increase of Erectile Dysfunction in Men With Post-stroke: A Comprehensive Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Shankun Zhao ◽  
Weizhou Wu ◽  
Panxing Wu ◽  
Chao Ding ◽  
Bingxiang Xiao ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
General Population ◽  
Erectile Function ◽  
Meta Analysis ◽  
Quantitative Result ◽  
Stroke Patients ◽  
Comprehensive Review ◽  
Post Stroke ◽  
High Prevalence ◽  
Mean Differences

Men with erectile dysfunction (ED) are considered to be at risk from stroke events. Conversely, post-stroke patients are also at high risk of ED, whereas a quantitative result from all the relevant studies has not been previously addressed. Therefore, we have performed a comprehensive review and meta-analysis on this issue. This study was registered on PROSPERO (ID No. CRD42021226618). Twenty studies with a total of 3,382 stroke events were included, of which six studies were included for quantitative analysis, and the remaining 14 studies were calculated for the ratio of ED. Synthetic results from four eligible studies providing the ED cases showed that stroke patients were associated with a significantly higher risk of ED than the general population [pooled relative risk (RR) = 3.32, 95% confidence interval (CI): 1.25–8.82, P = 0.016]. Men with stroke were also found to be associated with a significant decline in International Index of Erectile Function −5 (IIEF-5) score as compared with the healthy controls [three studies, standard mean differences (SMD) = −1.8, 95% CI: −2.94 to −0.67, P = 0.002]. The prevalence of ED in post-stroke patients among 14 studies ranged from 32.1 to 77.8%, which was dramatically higher than that of the general population. The result of the GRADE-pro revealed that the quality of the evidence in this study was moderate. The present study has confirmed the high prevalence of ED in men with stroke. ED in stroke patients is a result of both neurological and psychological factors. Rehabilitative interventions rather than phosphodiesterase-5 (PDE-5) inhibitors are recommended to improve the erectile function for those survivors with ED.

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