Frontal and parietal lesions may cause depression, and cortical thinning of the right frontal and parietal lobes has been shown to be a marker of risk for familial major depression. We studied biological offspring within a three-generation cohort, in which risk was defined by the depression status of the first ...

OBJECTIVE: To report on the outcome of cases of refractory depression treated with a combination of three antidepressant agents. METHOD: Retrospective case series.Results: Three of the four patients made a good recovery. One patient developed transient increased agitation and exacerbation of pre-existing confusion. CONCLUSION: The use of a triple antidepressant ...

OBJECTIVES:: Clinically significant minor depression is among the most common mental disorders in the elderly individuals and is associated with considerable medical and psychosocial morbidity. Despite its clinical impact, the biological basis of minor depression in the elderly individuals remains poorly understood. The purpose of our current study was to ...

Statins are postulated as candidate drugs for the treatment of acute stroke. The aim of this study was to critically appraise the evidence for the efficacy of statins administered after the onset of experimental focal cerebral ischemia. We undertook a systematic review and meta-analysis of animal studies reporting the efficacy ...

BACKGROUND: Intracerebral hemorrhage accounts for up to 15% of all strokes and is frequently associated with poor functional outcome and high mortality. So far, there is no clear evidence for a specific therapy, apart from general stroke unit or neurointensive care and management of secondary complications. Promising experimental and pilot ...

Objective: To investigate the predictors related to upper extremity functional recovery, with special emphasis on neuromuscular electrical stimulation dose-response in patients after stroke. Subjects: Ninety-five patients with stroke who received a 4-week neuromuscular electrical stimulation intervention. Design: Prospective predictive analysis. Methods: The change score of the Action Research Arm Test ...

Objective: To compare the effects of unilateral and bilateral training on upper limb function after stroke with regard to two key factors: severity of upper limb paresis and time of intervention post-stroke. Design: Systematic review and meta-analysis of randomized controlled trials. Methods: Two authors independently selected trials for inclusion, assessed ...

RATIONALE: Environmental enrichment, a paradigm investigated extensively in animal models, is an intervention, which by design facilitates motor, sensory, social, and cognitive activity. It has been shown to improve poststroke motor and cognitive function in animal models of stroke. This is the first study to attempt to translate this intervention ...

BACKGROUND: Acute treatment of ischemic stroke patients presenting more than eight-hours after symptom onset remains limited and largely unproven. Partial aortic occlusion using the NeuroFlo catheter can augment cerebral perfusion in animals. We investigated the safety and feasibility of employing this novel catheter to treat ischemic stroke patients eight-hours to ...

BACKGROUND: Stroke survivors often experience poststroke depression and suicidal ideation. PURPOSE: to determine the frequency and odds ratio of depression and suicidal ideation among stroke survivors, in comparison to those without stroke, and to identify demographic factors associated with elevated odds of depression and suicidal ideation among stroke survivors. METHODS: ...

BACKGROUND: Stroke in young adults is etiologically diverse and may represent a diagnostic challenge remaining cryptogenic in one-fourth of cases. Limited information is available on the prevalence of Fabry's disease, a treatable multisystem inherited lysosomal storage disorder, and disability in young patients with cryptogenic stroke. DESIGN AND METHODS: The Canadian ...

Purpose: To explore the experience of post-stroke fatigue in community-dwelling stroke survivors with and without post-stroke mood disturbance within one year of stroke. Methods: This was a prospective qualitative cohort study including semistructured interviews undertaken at baseline (stroke onset), 3, 6, 9 and 12 months in 23 stroke survivors; eight ...

Objective: To evaluate individual finger synchronized robot-assisted hand rehabilitation in stroke patients.Design: Prospective parallel group randomized controlled clinical trial.Subjects: The study recruited patients who were ≥18 years old, more than three months post stroke, showed limited index finger movement and had weakened and impaired hand function. Patients with severe sensory ...

BACKGROUND: . Proof-of-principle studies have demonstrated transient beneficial effects of transcranial direct current stimulation (tDCS) on motor function in stroke patients, mostly after single treatment sessions. OBJECTIVE: . To assess the efficacy of multiple treatment sessions on motor outcome. METHODS: The authors examined the effects of two 5-day intervention periods ...

Objective: To compare the effects of the Bobath Concept and constraint-induced movement therapy on arm functional recovery among stroke patients with a high level of function on the affected side.Design: A single-blinded, randomized controlled trial.Setting: Outpatient physiotherapy department of a stroke unit.Subjects: A total of 24 patients were randomized to ...

OBJECTIVE:To investigate the long-term behavioral and neurophysiologic effects of combined time-locked repetitive transcranial magnetic stimulation (rTMS) and physical therapy (PT) intervention in chronic stroke patients with mild motor disabilities. METHODS:Thirty patients were enrolled in a double-blind, randomized, single-center clinical trial. Patients received 10 daily sessions of 1 Hz rTMS over ...

To determine whether unihemispheral hemodynamic failure is independently associated with cognitive impairment among participants in the National Institute of Neurological Disorders and Stroke-sponsored, multicenter, randomized clinical trial, Randomized Evaluation of Carotid Occlusion and Neurocognition (RECON). Forty-three patients were randomized into RECON after recent symptomatic carotid artery occlusion and asymmetrically increased ...

Blood biomarkers may improve the performance in predicting early stroke outcome beyond well-established clinical factors. We investigated the value of growth-differentiation factor-15 (GDF-15) to predict functional outcome after 90 days in a prospectively collected patient cohort with symptoms of acute ischemic stroke. Two hundred eighty-one patients with symptoms of acute ischemic ...

OBJECTIVE: . A randomized controlled observer-blind trial was designed to evaluate the effectiveness of action observation as an add-on treatment to the standard rehabilitation of upper-limb function, early after stroke. METHODS: . Stroke survivors (N = 102) were consecutively recruited from 13 centers 30 days (±7) after a first-ever stroke ...

Background and purpose:  Ginsenoside-Rd is a receptor-operated calcium channel antagonist and has shown promise as a neuroprotectant in our phase II study. As an extended work, we sought to confirm its efficacy and safety of Ginsenoside-Rd in patients with acute ischaemic stroke. Methods:  We conducted a randomized, double-blind, placebo-controlled trial ...

BACKGROUND: Although randomized clinical trials have reported significant improvement in mortality and functional outcome as measured with modified Rankin Scale (mRS) or Barthel index (BI) in stroke patients with space-occupying anterior circulation infarctions treated with hemicraniectomy, many clinicians are still concerned about the long-term health-related quality of life (HRQoL). AIM: ...

Background: Several clinical scales have been developed for predicting stroke recurrence. These clinical scores could be extremely useful to guide triage decisions. Our goal was to compare the very early predictive accuracy of the most relevant clinical scores [age, blood pressure, clinical features and duration of symptoms (ABCD) score, ABCD ...

ABSTRACT The process of adaptation to the physical and psychosocial consequences after stroke is a major challenge for many individuals affected. The aim of this study was to examine if stroke patients within 1 month of admission (n = 153) and followed up at 1 year (n = 107) engage in selection, optimization, and ...

Upper limb apraxia, a disorder of higher motor cognition, is a common consequence of left-hemispheric stroke. Contrary to common assumption, apraxic deficits not only manifest themselves during clinical testing but also have delirious effects on the patients' everyday life and rehabilitation. Thus, a reliable diagnosis and efficient treatment of upper ...

OBJECTIVE:The state-of-the-art tools of neurology, in particular modern neuroimaging techniques, have yet to benefit from the revolution in mobile technologies that provide new insights into the mechanisms underlying clinical syndromes. This study demonstrates the manner in which mobile technologies may provide information that is complementary to MRI data, using the ...

Evaluation of: Pan A, Okereke OI, Sun Q et al. Depression and incident stroke in women. Stroke 42(10), 2770-2775 (2011). In the Nurses' Health Study, 80,574 women aged between 54 and 79 years, without a history of stroke, were followed-up from 2000 to 2006. In this cohort, depressive symptoms were ...

BACKGROUND AND HYPOTHESIS: Thrombolytic therapy with tissue plasminogen activator is effective for acute ischaemic stroke within 4·5 h of onset. Patients who wake up with stroke are generally ineligible for stroke thrombolysis. We hypothesized that ischaemic stroke patients with significant penumbral mismatch on either magnetic resonance imaging or computer tomography at ...

van Vliet PM, Wimperis A, Creak J, Taylor A, Vandereijk C. Feedback device for improvement of coordination of reach-to-grasp after stroke. To describe a novel feedback device (Grasp Rehabilitation Accessory for Stroke Patients [GRASP]) that gives feedback on the time lag between the start of hand opening and the start ...

Object Sonothrombolysis has recently been considered an emerging modality for the treatment of stroke. The purpose of the present paper was to review randomized clinical studies concerning the effects of sonothrombolysis associated with tissue plasminogen activator (tPA) on acute ischemic stroke. Methods Systematic searches for literature published between January 1996 ...

The AIM-HIGH trial (Atherothrombosis Intervention in Metabolic Syndrome With Low HDL/High Triglycerides: Impact on Global Health Outcomes) found, in an interim analysis, no cardiovascular benefit from taking extended-release niacin (Niaspan). In fact, there was a trend toward a greater risk of ischemic stroke, which did not reach statistical significance. But ...

To elucidate the differences between carotid angioplasty stent placement (CAS) and antidepressants on post-stroke depression (PSD) in high-grade carotid artery stenosis patients. In this prospective, controlled study, 182 cerebral ischemia stroke patients with high-grade carotid artery stenosis who were admitted to the Southwest Hospital of the Third Military Medical University, ...

External counterpulsation (ECP) may improve cerebral blood flow, and it has been proposed as a potential therapy for patients with ischaemic stroke. To assess the efficacy and safety of ECP for acute ischaemic stroke. We searched the Cochrane Stroke Group Trials Register (June 2011), Cochrane Central Register of Controlled Trials ...

TACT is an National Institutes of Health-sponsored, randomized, double-blind, placebo-controlled, 2 × 2 factorial clinical trial testing the benefits and risks of 40 infusions of a multicomponent disodium EDTA chelation solution compared with placebo and of an oral, high-dose multivitamin and mineral supplement. TACT has randomized and will follow up ...

BACKGROUND: Published data regarding the effect of concomitant clopidogrel and proton pump inhibitor (PPI) therapy on cardiovascular outcomes have been conflicting. AIM: To perform an updated meta-analysis in order to determine changes in risk differences (RD) between primary and secondary outcome analyses. METHODS: Primary analysis was based on definite vascular ...

BACKGROUND AND PURPOSE: Granulocyte-colony stimulating factor (G-CSF) is neuroprotective in experimental stroke and mobilizes CD34(+) peripheral blood stem cells into the circulation. We assessed the safety of G-CSF in recent stroke in a phase IIb single-center randomized, controlled trial. METHODS: G-CSF (10 μg/kg) or placebo (ratio 2:1) was given SC ...

Background and purpose:  Post-stroke depression (PSD) is one of the most frequent complications of stroke, with a prevalence ranging 20-60%. As PSD seems to be related to stroke severity, we hypothesized that the prevalence of PSD would be lower in patients with minor stroke. Methods:  We investigated the prevalence and ...

Low-frequency repetitive transcranial magnetic stimulation (rTMS) of the unaffected hemisphere can enhance function of the paretic hand in patients with mild motor impairment. Effects of low-frequency rTMS to the contralesional motor cortex at an early stage of mild to severe hemiparesis after stroke are unknown. In this pilot, randomized, double-blind ...

Objective: To investigate two approaches to treating patients with persistent dressing problems and cognitive difficulties following stroke.Design: Pilot randomized controlled trial.Setting: Inpatient stroke rehabilitation service.Subjects: Seventy consecutive stroke patients with persistent dressing problems and accompanying cognitive difficulties at two weeks after their stroke.Interventions: Patients were randomly allocated to six weeks ...

BACKGROUND AND PURPOSE:MMD has been shown to result in impairment of executive functioning in adults. The purpose of this study was to correlate presurgical neuropsychological assessments with the severity of primary MMD as measured by CBF and CVR and with secondary damage from MMD as estimated by cortical stroke and ...

Objective: To evaluate the effectiveness of lifestyle group intervention on well-being, occupation and social participation.Design: A randomized controlled trial.Setting: Senior centres in the community.Subjects: Of 204 stroke survivors screened, 99 (49%) were randomized three months after stroke whereby 86 (87%) participants (mean (SD) age 77.0 (7.1) years) completed all assessments ...

OBJECTIVE:Cortico-cortical circuits originating from the posterior parietal cortex (PPC) of the intact left hemisphere (LH) may become hyperexcitable in patients with hemispatial neglect due to a right hemispheric (RH) stroke. METHODS:In the current randomized, double-blind, sham-controlled study, we investigated safety and efficacy of continuous theta-burst stimulation (cTBS) in 10 sessions ...

Purpose: The purpose of this study was to develop an ICF core set for post-stroke disability assessment and verification of bio-psycho-social problems. Method: Using the Delphi method, a consensus process was conducted. In total, 24 multidisciplinary experts from different institutions completed the consensus process. The questionnaire for the study comprised ...

BACKGROUND AND PURPOSE: The early detection of poststroke depression is essential for optimizing recovery after stroke. A prospective study was conducted to investigate the diagnostic value of the 9-item and the 2-item Patient Health Questionnaire (PHQ-9, PHQ-2). METHODS: One hundred seventy-one consecutive patients with stroke who could communicate adequately were ...

Purpose: To develop screening protocols to detect depression and anxiety after stroke in a community setting and train therapists to administer them. Method: Psychologists and a community therapist met to design a system suitable for screening for anxiety and depression in all those with stroke, including people with cognitive and/or ...

AIM: The study aims to examine the association between major depression, healthcare behaviors, and quality of life indices among adults with stroke. METHODS: Data from 5869 participants with stroke in the 2006 Behavioral Risk Factor Surveillance Survey were examined. Multiple logistic regression was used to assess the independent association between ...

RATIONALE: An ankle-foot cast may enable people to repeatedly practice walking with a more normal movement pattern early after stroke. AIMS: To evaluate the clinical efficacy of using an ankle-foot cast [soft scotch ankle-foot (SWIFT) Cast] to enhance walking recovery and to find whether site of stroke lesion and/or baseline ...

The purpose of this study was to assess the predictors of functional outcome after right hemisphere stroke at 6-month follow up in patients with or without thrombolytic treatment. Thrombolysis did not predict functional outcome in instrumental activities of daily living (IADL). Lower acute phase basic activities of daily living (ADL) ...

ABSTRACT: BACKGROUND: There are a number of gaps in the evidence base for the use of ankle-foot orthoses for stroke patients. Three dimensional motion analysis offers an ideal method for objectively obtaining biomechanical gait data from stroke patients, however there are a number of major barriers to its use in ...

The National Institute for Health and Clinical Excellence (NICE) invited the manufacturer of dronedarone (Multaq®, Sanofi-Aventis Limited, UK) to submit evidence on the clinical and cost effectiveness of the anti-arrhythmic drug (AAD) for the treatment of atrial fibrillation (AF) and atrial flutter, as part of the Institute's single technology appraisal ...

Background: Stroke is the most feared complication of atrial fibrillation (AF). Dronedarone is an antiarrhythmic drug with multichannel-blocking properties. Recently, a post hoc analysis of a large randomized trial has suggested a reduction of stroke risk in patients with paroxysmal or persistent AF receiving dronedarone. Objective: We performed a systematic ...