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P1.004 Diastolic failure in young adults affected by ischemic stroke
S11
Poster Session I
Clinical issues P1.001 NeuroExplore: a wireless high speed sensing system for human kinematic recordings E.W. Block° , M.G. Jones, W.A. Fletcher, B. Hu Calgary, AB, Canada We describe a wireless, wearable, high speed inertial sensing system for human movement recordings as well as a variety of basic and clinical applications. NeuroExplore ITM has two basic modules: (1) the sensor system consisting of a wearable Personal Digital Assistant (PDA) and 4 inertial sensors, and (2) the base computer station that communicates wirelessly with the PDA. Add-on modules useful for I/O and high speed video are available. The sensors are wired to the PDA and wirelessly transmitted to the base computer. The base computer connects camera(s) with video rates up to 200 fps, synchronizing each video frame with data from the PDA. Custom software is used to interpret/analyze the data. One application concerns Timed Up and Go (TUG) testing. TUG is a standard rating score widely used for neurological conditions that affect mobility. NeuroExplore ITM detects the precise timing of foot and body movements throughout the procedure. A random auditory “go” tone is generated, avoiding cueing and anticipatory effects. A second application comprises a graphic interface which allows four gait parameters as well as walking patterns of a subject to be displayed in two-dimensions. Specifically, gait parameters such as cadence, stride length, foot velocity, and acceleration can be projected onto a two dimensional map in a novel form described here as the electro-podograph (EPG).
P1.003 Gait apraxia: discussing clinical and neuropsychological issues L. Cardoso° , L. Guimar˜aes Pena, L. Paladino de Souza, L. Lustosa, A. Freire Rio de Janeiro, Brazil Walking difficulties are major cause of hand cap and distress, and are particularly common in brain injured people, with many etiologies such as stroke, traumatisms or encephalitis. Whilst many causes of impaired walking are easily recognized, for example those associated to Parkinson disease, spastic paraparesis. A great part of gait impairment is not so easily recognized: those who are associated with parietal/frontal disorder: the gait apraxis. This paper aimed at addressing the issue of the nature of gait apraxia and the cerebral dysfunction associated to it. We present a case of a female 45 year old patient who suffered a bilateral stroke in medial cerebral artery territory. The patient’s ability to walk was assessed by standardized test. Patient’s lesion was localized n the supplementary motor regions of both hemispheres; she had clear signs of gait apraxia that could not be accounted for her hemiparetic condition. We also found constructional apraxia by the assessment that was done. The clinical profile of the patient and the literature review may suggest that gait apraxia should be considered a clinical entity in its own right and lesions to the supplementary motor areas are responsible for it.
P1.004 Diastolic failure in young adults affected by ischemic stroke P. de Campora° , L. Ragozzino, M.L.E. Vicario, R. Sangiuolo Napoli, Italy
P1.002 Impact of cognitive decline on falls risk: results of a 1-year prospective study R.M. Camicioli° , S.R. Majumdar Edmonton, Alberta, Canada Background and Aims: Falls are common in older people and those with Parkinson’s disease (PD). Our aim was to determine if potentially modifiable factors, such as cognitive decline, predict prospective falls in older people with and without Parkinson’s disease (PD). Methods: 52 older (>64 years) non-demented people with PD and 50 matched community-dwelling controls underwent an informant interview and assessment of cognitive and motor function. None were demented. Total informant rated clinical dementia rating score >0 defined cognitive impairment. Falls, functional and cognitive status, were reviewed every 6 months. 2 patients died and one dropped out before the 6 month interview, all in the PD group. Linear and logistic regression models were examined to determine factors associated with risk of falls. Results: One fifth of the cohort fell: 15/49 (31%) of PD compared with 6/50 (12%) controls had fallen more than once over 12 months. This difference was significant (p = 0.04), but not statistically significant after including cognitive decline in logistic models. Motor freezing was the only significant predictive factor when cognitive function, disease duration, depression and disease severity were considered together in logistic models. Conclusions: Falls were 3 times more common in older PD patients and associated with cognitive impairment. Our data highlight cognitive impairment and freezing of gait as identifiable and potentially coupled risk factor for falls in non-demented older PD patients.
Background and Aims: Our objective was to identify, in a group of 50 young out-patients suffering of previous ischemic stroke, compared with 50 matched healthy controls, the presence of cardiac disorders to define cardiac involvement in cryptogenetic stroke etiologies. In this study we evaluated cardiac parameters assessed by Color-Doppler Echocardiography (TTE). Stroke diagnoses was able according to NMR evidence of ischemic lesions. Methods: 50 patients (25 males, 25 women; 29±5 yrs) and 50 age– gender matched controls underwent complete TTE examinations. All the patients were studied 1, 3 and 6 months after hospital discharging. Ejection Fraction (EF), chamber volumes were measured. Diastolic function was evaluated by four chambers echographic window in order to better define mitral valve plane. Results: In Stroke-Patients as well as in control group, cardiac chambers volumes and Left Ventricular Ejection Fraction showed normal parameters according with the age of patients. No distinctions between sexes was found. In Patients, Diastolic Function (DF) parameters showed a significative impairment (33/50: 66%) vs control group (13/50: 26.6%). Stroke etiology did not influence DF parameters behaviour. Stroke-Patients have an Odds Ratio of 2.53 for blunted diastolic function in comparison to controls. Conclusions: Echocardiographic examinations are routinely performed in patients affected by ischemic stroke to investigate cardiac performance. In young stroke patients, failure of systolic function or cardiac chambers enlargement is rarely found. Conversely, in old patients cardiac disfunction is not unfrequent. Our hyphotesis support the involvement of different cardiac haemodynamic mechanisms to explain undetermined stroke etiologies. Diastolic failure might favour cardio-embolic phenomena.
Poster Session I
Clinical issues P1.001 NeuroExplore: a wireless high speed sensing system for human kinematic recordings E.W. Block° , M.G. Jones, W.A. Fletcher, B. Hu Calgary, AB, Canada We describe a wireless, wearable, high speed inertial sensing system for human movement recordings as well as a variety of basic and clinical applications. NeuroExplore ITM has two basic modules: (1) the sensor system consisting of a wearable Personal Digital Assistant (PDA) and 4 inertial sensors, and (2) the base computer station that communicates wirelessly with the PDA. Add-on modules useful for I/O and high speed video are available. The sensors are wired to the PDA and wirelessly transmitted to the base computer. The base computer connects camera(s) with video rates up to 200 fps, synchronizing each video frame with data from the PDA. Custom software is used to interpret/analyze the data. One application concerns Timed Up and Go (TUG) testing. TUG is a standard rating score widely used for neurological conditions that affect mobility. NeuroExplore ITM detects the precise timing of foot and body movements throughout the procedure. A random auditory “go” tone is generated, avoiding cueing and anticipatory effects. A second application comprises a graphic interface which allows four gait parameters as well as walking patterns of a subject to be displayed in two-dimensions. Specifically, gait parameters such as cadence, stride length, foot velocity, and acceleration can be projected onto a two dimensional map in a novel form described here as the electro-podograph (EPG).
P1.003 Gait apraxia: discussing clinical and neuropsychological issues L. Cardoso° , L. Guimar˜aes Pena, L. Paladino de Souza, L. Lustosa, A. Freire Rio de Janeiro, Brazil Walking difficulties are major cause of hand cap and distress, and are particularly common in brain injured people, with many etiologies such as stroke, traumatisms or encephalitis. Whilst many causes of impaired walking are easily recognized, for example those associated to Parkinson disease, spastic paraparesis. A great part of gait impairment is not so easily recognized: those who are associated with parietal/frontal disorder: the gait apraxis. This paper aimed at addressing the issue of the nature of gait apraxia and the cerebral dysfunction associated to it. We present a case of a female 45 year old patient who suffered a bilateral stroke in medial cerebral artery territory. The patient’s ability to walk was assessed by standardized test. Patient’s lesion was localized n the supplementary motor regions of both hemispheres; she had clear signs of gait apraxia that could not be accounted for her hemiparetic condition. We also found constructional apraxia by the assessment that was done. The clinical profile of the patient and the literature review may suggest that gait apraxia should be considered a clinical entity in its own right and lesions to the supplementary motor areas are responsible for it.
P1.004 Diastolic failure in young adults affected by ischemic stroke P. de Campora° , L. Ragozzino, M.L.E. Vicario, R. Sangiuolo Napoli, Italy
P1.002 Impact of cognitive decline on falls risk: results of a 1-year prospective study R.M. Camicioli° , S.R. Majumdar Edmonton, Alberta, Canada Background and Aims: Falls are common in older people and those with Parkinson’s disease (PD). Our aim was to determine if potentially modifiable factors, such as cognitive decline, predict prospective falls in older people with and without Parkinson’s disease (PD). Methods: 52 older (>64 years) non-demented people with PD and 50 matched community-dwelling controls underwent an informant interview and assessment of cognitive and motor function. None were demented. Total informant rated clinical dementia rating score >0 defined cognitive impairment. Falls, functional and cognitive status, were reviewed every 6 months. 2 patients died and one dropped out before the 6 month interview, all in the PD group. Linear and logistic regression models were examined to determine factors associated with risk of falls. Results: One fifth of the cohort fell: 15/49 (31%) of PD compared with 6/50 (12%) controls had fallen more than once over 12 months. This difference was significant (p = 0.04), but not statistically significant after including cognitive decline in logistic models. Motor freezing was the only significant predictive factor when cognitive function, disease duration, depression and disease severity were considered together in logistic models. Conclusions: Falls were 3 times more common in older PD patients and associated with cognitive impairment. Our data highlight cognitive impairment and freezing of gait as identifiable and potentially coupled risk factor for falls in non-demented older PD patients.
Background and Aims: Our objective was to identify, in a group of 50 young out-patients suffering of previous ischemic stroke, compared with 50 matched healthy controls, the presence of cardiac disorders to define cardiac involvement in cryptogenetic stroke etiologies. In this study we evaluated cardiac parameters assessed by Color-Doppler Echocardiography (TTE). Stroke diagnoses was able according to NMR evidence of ischemic lesions. Methods: 50 patients (25 males, 25 women; 29±5 yrs) and 50 age– gender matched controls underwent complete TTE examinations. All the patients were studied 1, 3 and 6 months after hospital discharging. Ejection Fraction (EF), chamber volumes were measured. Diastolic function was evaluated by four chambers echographic window in order to better define mitral valve plane. Results: In Stroke-Patients as well as in control group, cardiac chambers volumes and Left Ventricular Ejection Fraction showed normal parameters according with the age of patients. No distinctions between sexes was found. In Patients, Diastolic Function (DF) parameters showed a significative impairment (33/50: 66%) vs control group (13/50: 26.6%). Stroke etiology did not influence DF parameters behaviour. Stroke-Patients have an Odds Ratio of 2.53 for blunted diastolic function in comparison to controls. Conclusions: Echocardiographic examinations are routinely performed in patients affected by ischemic stroke to investigate cardiac performance. In young stroke patients, failure of systolic function or cardiac chambers enlargement is rarely found. Conversely, in old patients cardiac disfunction is not unfrequent. Our hyphotesis support the involvement of different cardiac haemodynamic mechanisms to explain undetermined stroke etiologies. Diastolic failure might favour cardio-embolic phenomena.