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Cognitive functioning in ischemic stroke patients with physical disability
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Abstracts / Journal of the Neurological Sciences 333 (2013) e152–e214
Abstract — WCN 2013 No: 1609 Topic: 3 — Stroke Cognitive functioning in ischemic stroke patients with physical disability J. Maa, Y. Zhanga, Q. Guob, R. Jinc, X. Zhena. aStroke Unit, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, China; b Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology, Fudan University, China; c Department of Preventive Medicine and Medical Statistics, Shanghai University of Traditional Chinese Medicine, Shanghai, China Background: Stroke is a major cause of disability in the elderly. It is also related to a wide spectrum of cognitive deficits. Post-stroke cognitive impairment is particularly important and frequent. Whether there is relationship between cognitive functioning and physical disability in ischemic stroke patients is unclear. Objective: To access the relationship between cognitive functioning and physical disability in ischemic stroke patients. Patients and methods: We prospectively evaluated consecutive patients with acute ischemic stroke. 145 patients were administered by tests of Modified Rankin Scale (MRS), Mini-Mental State Examination (MMSE) and National Institute of Health Stroke Scale (NIHSS) and the Barthel Index (BI). We accessed the relationship between MRS and MMSE and compared the cognitive functioning with mild to moderate physical disability (MRS ≤ 3) and severe physical disability (MRS N 3) in ischemic stroke patients across 4 weeks while observing the changes both in MMSE and NIHSS/BI. Results: MMSE scores were significantly different among different degree of MRS over time with p b 0.05. The change of MMSE in MRS ≤ 3 group was different from that in MRS N 3 group after 2 and 4 weeks (p b 0.01), the improvement of MMSE scores was 0.75 ± 3.78 in MRS ≤ 3 group and 3.10 ± 5.68 in MRS N 3 group after 2 weeks (p b 0.001), and 0.58 ± 4.10 in MRS ≤ 3 group and 3.71 ± 5.59 in MRS N 3 group after 4 weeks. The change of MMSE was linear for NIHSS or BI scores after 2 and 4 weeks. Conclusion: Physical disability correlated with cognitive functioning in ischemic stroke patients. The improvement in cognitive functioning correlated with the degree of physical disability. doi:10.1016/j.jns.2013.07.841
Abstract — WCN 2013 No: 1721 Topic: 3 — Stroke Ischemic stroke and migraine N. Radojkovic Gligica, S. Aticb, R. Amanovic Curuvijab. aStroke Unit, Belgrade, Serbia; bHospital for Cerebrovascular Disease Sveti Sava, Belgrade, Serbia Background: Migraine is recognised as a cardiovascular risk factor and connection with stroke especially migraine with aura. Objectives: Relationship between migraine and stroke and compared to other types of headache. Methods: The study included 135 patients with stroke and headache After statistical adjustment for age, gender and affected vascular brain system, we formed two groups 15 patients with stroke and migraine and second 17 patients with stroke and other types of headache All of them had MRI. Welch criteria were applied for the relationship between migraine and stroke. Results: I group 15 pts, mean age 45 + − 11 years, 9 pts had migraine with aura and 6 pts without aura. The II group 16 pts, mean age 53 + −8 years, 12 pts tension tape headache, 3 headache
attributed to HTA and one unclassified. There were no differences between groups on main vascular risk factors (blood pressure, cholesterol level and ischemic cardiopathy). According to Welch criteria 2 pts had stroke which occurs in patients with migraine but not during an attacks, 9 pts had migraine induced stroke with risk factors. Migraine with aura produced stroke in the presence of another risk factor and 5 pts had uncertain history of migraine without aura and stroke during a migraine attack The Rankin disability scale was significantly worse compared to stroke and other types of headache. Conclusion: A patient with migraine had high probability to have severe stroke than other types of headache. Relationship between migraine and stroke is complex and difficult. doi:10.1016/j.jns.2013.07.842
Abstract — WCN 2013 No: 1733 Topic: 3 — Stroke Insular and caudate lesions release abnormal yawning in stroke patients H. Krestela, C. Weisstannerb, C.W. Hessc, C.L. Bassettic, R. Wiestb. a Neurology and Pediatric Neurology, Inselspital, Bern, Switzerland; b Neuroradiology, Inselspital, Bern, Switzerland; cNeurology, Inselspital, Bern, Switzerland Background: Abnormal yawning (chasm) is a rare phenomenon in patients in anterior circulation stroke. Objective: We aimed at identifying core regions involved in abnormal yawning in an attempt to assign abnormal yawning to lesions in the anterior circulation. Patients and methods: We analyzed the extent of brain areas encompassing restricted diffusion after ischemic stroke in ten patients presenting with at least three yawns per 15 min associated with stroke symptoms. All patients were classified according to the NIH stroke scale (NIHSS), daytime of symptom onset, yawning duration, Glasgow Coma Scale (GCS), partial oxygen pressure, body temperature, blood pressure, pulse, and modified Rankin scale. Lesion maps were segmented on diffusion weighted images in native space using MRIcroN and spatially normalized using the unified segmentation algorithm in SPM5. The extent of overlap between the different stroke patterns was calculated. Results: Abnormal yawning persisted for 2.8 ± 1.3 days. Average GCS and NIHSS scores were 12.8 ± 2.6 and 10.5 ± 6.5, respectively. Oxygen saturation, body temperature, blood pressure, and heart rate were within normal limits. Ischemic brain lesions overlapped in eight out of ten patients: in six patients in the insula and in six in the caudate nucleus. The decrease of the apparent diffusion coefficient within the lesions correlated moderately with the duration of abnormal yawing (insula; r2 = 0.58; caudate nucleus; r2 = 0.32). Conclusion: The intensity of targeted ischemic lesions in the insula and the caudate nucleus correlates with the duration of abnormal yawning in anterior circulation stroke. doi:10.1016/j.jns.2013.07.843
Abstract — WCN 2013 No: 1736 Topic: 3 — Stroke Poststroke depression A. Alajbegovica, J. Djelilovic-Vranica, L. Todorovica, S. Alajbegovicb, A. Nakicevica, M. Tiric-Camparaa. aNeurology Clinic, Clinical Center of Sarajevo University, Sarajevo, Bosnia and Herzegovina; bCantonal Hospital Zenica, Zenica, Bosnia and Herzegovina
Abstracts / Journal of the Neurological Sciences 333 (2013) e152–e214
Abstract — WCN 2013 No: 1609 Topic: 3 — Stroke Cognitive functioning in ischemic stroke patients with physical disability J. Maa, Y. Zhanga, Q. Guob, R. Jinc, X. Zhena. aStroke Unit, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, China; b Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology, Fudan University, China; c Department of Preventive Medicine and Medical Statistics, Shanghai University of Traditional Chinese Medicine, Shanghai, China Background: Stroke is a major cause of disability in the elderly. It is also related to a wide spectrum of cognitive deficits. Post-stroke cognitive impairment is particularly important and frequent. Whether there is relationship between cognitive functioning and physical disability in ischemic stroke patients is unclear. Objective: To access the relationship between cognitive functioning and physical disability in ischemic stroke patients. Patients and methods: We prospectively evaluated consecutive patients with acute ischemic stroke. 145 patients were administered by tests of Modified Rankin Scale (MRS), Mini-Mental State Examination (MMSE) and National Institute of Health Stroke Scale (NIHSS) and the Barthel Index (BI). We accessed the relationship between MRS and MMSE and compared the cognitive functioning with mild to moderate physical disability (MRS ≤ 3) and severe physical disability (MRS N 3) in ischemic stroke patients across 4 weeks while observing the changes both in MMSE and NIHSS/BI. Results: MMSE scores were significantly different among different degree of MRS over time with p b 0.05. The change of MMSE in MRS ≤ 3 group was different from that in MRS N 3 group after 2 and 4 weeks (p b 0.01), the improvement of MMSE scores was 0.75 ± 3.78 in MRS ≤ 3 group and 3.10 ± 5.68 in MRS N 3 group after 2 weeks (p b 0.001), and 0.58 ± 4.10 in MRS ≤ 3 group and 3.71 ± 5.59 in MRS N 3 group after 4 weeks. The change of MMSE was linear for NIHSS or BI scores after 2 and 4 weeks. Conclusion: Physical disability correlated with cognitive functioning in ischemic stroke patients. The improvement in cognitive functioning correlated with the degree of physical disability. doi:10.1016/j.jns.2013.07.841
Abstract — WCN 2013 No: 1721 Topic: 3 — Stroke Ischemic stroke and migraine N. Radojkovic Gligica, S. Aticb, R. Amanovic Curuvijab. aStroke Unit, Belgrade, Serbia; bHospital for Cerebrovascular Disease Sveti Sava, Belgrade, Serbia Background: Migraine is recognised as a cardiovascular risk factor and connection with stroke especially migraine with aura. Objectives: Relationship between migraine and stroke and compared to other types of headache. Methods: The study included 135 patients with stroke and headache After statistical adjustment for age, gender and affected vascular brain system, we formed two groups 15 patients with stroke and migraine and second 17 patients with stroke and other types of headache All of them had MRI. Welch criteria were applied for the relationship between migraine and stroke. Results: I group 15 pts, mean age 45 + − 11 years, 9 pts had migraine with aura and 6 pts without aura. The II group 16 pts, mean age 53 + −8 years, 12 pts tension tape headache, 3 headache
attributed to HTA and one unclassified. There were no differences between groups on main vascular risk factors (blood pressure, cholesterol level and ischemic cardiopathy). According to Welch criteria 2 pts had stroke which occurs in patients with migraine but not during an attacks, 9 pts had migraine induced stroke with risk factors. Migraine with aura produced stroke in the presence of another risk factor and 5 pts had uncertain history of migraine without aura and stroke during a migraine attack The Rankin disability scale was significantly worse compared to stroke and other types of headache. Conclusion: A patient with migraine had high probability to have severe stroke than other types of headache. Relationship between migraine and stroke is complex and difficult. doi:10.1016/j.jns.2013.07.842
Abstract — WCN 2013 No: 1733 Topic: 3 — Stroke Insular and caudate lesions release abnormal yawning in stroke patients H. Krestela, C. Weisstannerb, C.W. Hessc, C.L. Bassettic, R. Wiestb. a Neurology and Pediatric Neurology, Inselspital, Bern, Switzerland; b Neuroradiology, Inselspital, Bern, Switzerland; cNeurology, Inselspital, Bern, Switzerland Background: Abnormal yawning (chasm) is a rare phenomenon in patients in anterior circulation stroke. Objective: We aimed at identifying core regions involved in abnormal yawning in an attempt to assign abnormal yawning to lesions in the anterior circulation. Patients and methods: We analyzed the extent of brain areas encompassing restricted diffusion after ischemic stroke in ten patients presenting with at least three yawns per 15 min associated with stroke symptoms. All patients were classified according to the NIH stroke scale (NIHSS), daytime of symptom onset, yawning duration, Glasgow Coma Scale (GCS), partial oxygen pressure, body temperature, blood pressure, pulse, and modified Rankin scale. Lesion maps were segmented on diffusion weighted images in native space using MRIcroN and spatially normalized using the unified segmentation algorithm in SPM5. The extent of overlap between the different stroke patterns was calculated. Results: Abnormal yawning persisted for 2.8 ± 1.3 days. Average GCS and NIHSS scores were 12.8 ± 2.6 and 10.5 ± 6.5, respectively. Oxygen saturation, body temperature, blood pressure, and heart rate were within normal limits. Ischemic brain lesions overlapped in eight out of ten patients: in six patients in the insula and in six in the caudate nucleus. The decrease of the apparent diffusion coefficient within the lesions correlated moderately with the duration of abnormal yawing (insula; r2 = 0.58; caudate nucleus; r2 = 0.32). Conclusion: The intensity of targeted ischemic lesions in the insula and the caudate nucleus correlates with the duration of abnormal yawning in anterior circulation stroke. doi:10.1016/j.jns.2013.07.843
Abstract — WCN 2013 No: 1736 Topic: 3 — Stroke Poststroke depression A. Alajbegovica, J. Djelilovic-Vranica, L. Todorovica, S. Alajbegovicb, A. Nakicevica, M. Tiric-Camparaa. aNeurology Clinic, Clinical Center of Sarajevo University, Sarajevo, Bosnia and Herzegovina; bCantonal Hospital Zenica, Zenica, Bosnia and Herzegovina