Volume 14 Issue 8
Please find the February 2024 issue of the Stroke Horizon Scanning Bulletin below.
Thousands of lives saved by the NHS thanks to rapid rollout of blood thinners
Source: NHS England
Date of publication: 2 November 2023
In a nutshell: Thousands of lives have been saved and almost 17,000 strokes prevented, thanks to the rapid roll-out of blood-thinning drugs on the NHS, the head of the health service will announce today.
New data shows almost half a million people at increased risk of strokes have started taking life-saving direct oral anticoagulants (DOACs), in the last 18 months, following a major NHS drive to rapidly expand their use.
Type of article: News
Clinical predictors of prognosis in stroke patients after endovascular therapy
Source: Scientific Reports
Date of publication: January 2024
Endovascular therapy (EVT) is effective in the treatment of large vascular occlusive stroke. However, many factors are associated with the outcomes of acute ischemic stroke (AIS) after EVT. This study aimed to identify the main factors related to the prognosis of AIS patients after EVT.
Type of article: Cohort study
Source: Nature Journal
Date of publication: January 2024
In a nutshell: Elderly hypertensive patients diagnosed with transient ischemic attack (TIA) are at a heightened risk for developing acute ischemic stroke (AIS). This underscores the critical need for effective risk prediction and identification of predictive factors. In our study, we utilized patient data from peripheral blood tests and clinical profiles within hospital information systems. These patients were followed for a three-year period to document incident AIS.
Type of article: Cohort study
Source: Nature Journal
Date of publication: December 2023
In a nutshell: Despite the enormous health burden of lacunar stroke, data from low- and middle-income countries on lacunar stroke characteristics and its comparison with that of high-income countries are scarce. Thus, we aimed to investigate and compare the variable characteristics and vascular status in patients from Egypt and Germany suffering lacunar stroke. Two cohorts of lacunar stroke patients from Ain Shams University Hospital, Egypt and Goethe University Hospital Frankfurt, Germany were retrospectively collected between January 2019 and December 2020 and analyzed for demographics, risk factors, mode of presentation, neuroimaging features, treatment protocols and outcomes.
Type of article: Respective multi-cohort study
Omega-3 Fatty Acids and Markers of Thrombosis in Patients with Atrial Fibrillation
Source: Nutrients
Date of publication: January 2024
In a nutshell: Omega-3 fatty acids (n-3 FAs) are associated with a lower risk of ischemic stroke in patients with atrial fibrillation (AF). Antithrombotic mechanisms may in part explain this observation. Therefore, we examined the association of n-3 FAs with D-dimer and beta-thromboglobulin (BTG), markers for activated coagulation and platelets, respectively.
Type of article: Cross-sectional cohort study
Association between Vitamin D and Short-Term Functional Outcomes in Acute Ischemic Stroke
Source: Nutrients
Date of publication: November 2023
In a nutshell: Vitamin D (Vit D) affects musculoskeletal performance and central nervous system neuroprotection. We aimed to investigate the association between serum Vit D levels and short-term functional outcomes in patients with acute ischemic stroke.
Type of article: Retrospective study
Source: Journal of the neurological sciences
Date of publication: January 2024
In a nutshell: Antiplatelet agents are effective for secondary prevention of ischemic stroke and can reduce the severity of first-ever ischemic stroke. However, it is uncertain if prophylactic antiplatelet therapy reduces the severity of recurrent ischemic stroke. The aim of this study was to determine the effect of preceding antiplatelet treatment on the severity of thrombotic stroke (TS) in patients with a prior history of stroke.
Type of article: Prospective study
Source: Journal of Clinical Medicine
Date of publication: December 2023
In a nutshell: The mechanism responsible for stroke in patients younger than 50 often remains unknown. This study was designed to assess whether high-resolution intracranial vessel wall MR imaging (icVWI) may be instrumental in determining stroke cause.
Type of article: Prospective study
Stroke in the very old: A study from the Philippine Neurological Association One Database
Source: Australasian Journal on Ageing
Date of publication: January 2024
In a nutshell:
The very old, although a minority in many populations, experience stroke with distinct risk factors and more complications. We sought to understand the profile, stroke subtypes, risk factors and outcomes among the very old compared to younger stroke patients in our population in the Philippine Neurological Association One Database-Stroke (PNA1DB-Stroke).
Type of article: Prospective study
Apixaban for Stroke Prevention in Subclinical Atrial Fibrillation
Source: New England Journal of Medicine
Date of publication: January 2024
In a nutshell: Subclinical atrial fibrillation is short-lasting and asymptomatic and can usually be detected only by long-term continuous monitoring with pacemakers or defibrillators. Subclinical atrial fibrillation is associated with an increased risk of stroke by a factor of 2.5; however, treatment with oral anticoagulation is of uncertain benefit. Methods: We conducted a trial involving patients with subclinical atrial fibrillation lasting 6 minutes to 24 hours. Patients were randomly assigned in a double-blind, double-dummy design to receive apixaban at a dose of 5 mg twice daily (2.5 mg twice daily when indicated) or aspirin at a dose of 81 mg daily.
Type of article: Randomized Controlled Trial
Source: Journal of Stroke and Cerebrovascular Diseases
Date of publication: January 2024
In a nutshell: The effect of pre-stroke use of aspirin on small subcortical infarct dimensions or outcomes is not well described. We aimed to bridge this knowledge gap amongst a well-described and heterogeneous patient population. We performed a post-hoc analysis of the Secondary Prevention of Small Subcortical Stroke (SPS3) trial. The primary exposure was aspirin use ≤7 days of index stroke. The primary outcomes were infarct dimensions. Functional outcomes by modified Rankin Scale (mRS) was a secondary outcome. Age restricted (≥55 years) subgroup analyses were performed as a sensitivity analysis.
Type of article: Randomised Controlled Trial
Source: Journal of Stroke and Cerebrovascular Diseases
Date of publication: February 2024
In a nutshell: Thyroid hormones (THs) will affect the occurrence and prognosis of stroke, and the research on THs sensitivity index and stroke in patients with coronary heart disease (CHD) is scarce. The goal of this study is to look into the relationship between central and peripheral THs sensitivity index and stroke in patients with CHD.
Type of article: Research article
Stroke care
Source: Stroke
Date of publication: February 2024
In a nutshell: The effectiveness of intravenous thrombolysis (IVT) before endovascular treatment (EVT) has been investigated in randomized trials and meta-analyses. These studies mainly concerned anterior circulation occlusions. We aimed to investigate clinical, technical, and safety outcomes of IVT before EVT in posterior circulation occlusions in a nationwide registry.
Type of article: Prospective study
Vagus nerve stimulation as immunomodulatory therapy for stroke: A comprehensive review
Source: Experimental Neurology
Date of publication: February 2024
In a nutshell: Stroke is a devastating cerebrovascular pathology with high morbidity and mortality. Inflammation plays a central role in the pathophysiology of stroke. Vagus nerve stimulation (VNS) is a promising immunomodulatory method that has shown positive effects in stroke treatment, including neuroprotection, anti-apoptosis, anti-inflammation, antioxidation, reduced infarct volume, improved neurological scores, and promotion of M2 microglial polarization. In this review, we summarize the current knowledge about the vagus nerve’s immunomodulatory effects through the cholinergic anti-inflammatory pathway (CAP) and provide a comprehensive assessment of the available experimental literature focusing on the use of VNS in stroke treatment.
Type of article: Review
Source: Stroke
Date of publication: February 2024
In a nutshell: Understanding sex differences in stroke care is important in reducing potential disparities. Our objective was to explore sex differences in workflow efficiency, treatment efficacy, and safety in the AcT trial (Alteplase Compared to Tenecteplase).
Type of article: Randomized Controlled Trial
Source: Stroke
Date of publication: December 2023
In a nutshell: Reteplase is a more affordable new-generation thrombolytic with a prolonged half-life. We aimed to determine the safety dose range of reteplase for patients with acute ischemic stroke within 4.5 hours of onset.
Type of publication: Clinical trial
Source: Cardiovascular revascularization medicine
Date of publication: February 2024
In a nutshell: Our study aimed to evaluate safety, efficacy and clinical outcomes in patients with acute ischemic stroke with occlusion of M2 segment treated with thromboaspiration.
Type of publication: Retrospective study
Source: European Journal of Anaesthesiology
Date of publication: February 2024
In a nutshell: Background: Stroke patients admitted to an intensive care unit (ICU) follow a particular survival pattern with a high short-term mortality, but if they survive the first 30 days, a relatively favourable subsequent survival is observed.
Objectives: The development and validation of two prognostic models predicting 30-day mortality for ICU patients with ischaemic stroke and for ICU patients with intracerebral haemorrhage (ICH), analysed separately, based on parameters readily available within 24 h after ICU admission, and with comparison with the existing Acute Physiology and Chronic Health Evaluation IV (APACHE-IV) model.
Type of publication: Observational cohort study
Addressing disparities in the global epidemiology of stroke
Source: Nature Reviews Neurology
Date of publication: January 2024
In a nutshell: Stroke is the second leading cause of death and the third leading cause of disability worldwide. Though the burden of stroke worldwide seems to have declined in the past three decades, much of this effect reflects decreases in high-income countries (HICs). By contrast, the burden of stroke has grown rapidly in low-income and middle-income countries (LMICs), where epidemiological, socioeconomic and demographic shifts have increased the incidence of stroke and other non-communicable diseases. Furthermore, even in HICs, disparities in stroke epidemiology exist along racial, ethnic, socioeconomic and geographical lines. In this Review, we highlight the under-acknowledged disparities in the burden of stroke. We emphasize the shifting global landscape of stroke risk factors, critical gaps in stroke service delivery, and the need for a more granular analysis of the burden of stroke within and between LMICs and HICs to guide context-appropriate capacity-building. Finally, we review strategies for addressing key inequalities in stroke epidemiology, including improvements in epidemiological surveillance and context-specific research efforts in under-resourced regions, development of the global workforce of stroke care providers, expansion of access to preventive and treatment services through mobile and telehealth platforms, and scaling up of evidence-based strategies and policies that target local, national, regional and global stroke disparities.
Type of publication: Review
Source: Cardiovascular revascularization medicine
Date of publication: February 2024
In a nutshell: Our study aimed to evaluate safety, efficacy and clinical outcomes in patients with acute ischemic stroke with occlusion of M2 segment treated with thromboaspiration.
Type of publication: Retrospective study
Source: Journal of Clinical Medicine
Date of publication: February 2024
In a nutshell: Acute ischemic stroke (AIS), which represents 87% of all strokes, is caused by reduced blood supply to the brain associated with a prolonged inflammatory process that exacerbates brain damage. The composite containing co-ultramicronized Palmitoylethanolamide and luteolin (PEALut) is known to promote the resolution of neuroinflammation, being a promising nutritional approach to contrast inflammatory processes occurring in AIS. This study included 60 patients affected by acute ischemic stroke and undergoing thrombolysis. PEALut 770 mg was administered to 30 patients, twice daily for 90 days, in addition to the standard therapy. Neurological deficit, independence in activities of daily living, disability and cognitive impairment were investigated. In all patients, the severity of AIS defined by the NIHSS score evolved from moderate to minor (p < 0.0001). Patients’ independence in daily living activities and disability evaluated using BI and mRS showed a significant improvement over time, with a statistically significant difference in favor of PEALut-treated patients (p < 0.002 for BI, p < 0.0001 for mRS), who achieved also a marked improvement of cognitive function evaluated using MMSE and MoCA tests. PEALut proved to be a safe and effective treatment in addition to thrombolysis in the management of patients with acute ischemic stroke.
Type of publication: Prospective Randomized Controlled Trial
Body temperature in the acute phase and clinical outcomes after acute ischemic stroke
Source: PLOS One
Date of publication: Januuary 2024
In a nutshell: This study aimed to examine whether post-stroke early body temperature is associated with neurological damage in the acute phase and functional outcomes at three months.
Type of publication: Prospective study
Source: Translational Stroke Research
Date of publication: November 2023
In a nutshell: The pathophysiology and treatment of post-stroke cognitive impairment (PSCI) are not clear. Stroke triggers an inflammatory response, which might affect synapse function and cognitive status. We performed a systematic review and meta-analysis to assess whether patients with PSCI have increased levels of inflammatory markers and whether anti-inflammatory interventions in animals decrease PSCI. Inflammation is increased in stroke survivors with cognitive impairment and is negatively correlated with cognitive functioning. Anti-inflammatory interventions seem to improve cognitive functioning in animals. Complement inhibition and fingolimod are promising therapies on reducing PSCI.
Type of publication: Systematic Review, Meta-analysis
Source: Journal of Stroke and Cerebrovascular Diseases
Date of publication: February 2024
In a nutshell: The influence of Alberta Stroke Program Early CT Score (ASPECTS) on outcomes following mechanical thrombectomy (MT) for acute ischemic stroke (AIS) patients with low ASPECTS remains unknown. In this study, we compared the outcomes of AIS patients treated with MT for large vessel occlusion (LVO) categorized by ASPECTS value.
Type of publication: Retrospective study
Source: Journal of Stroke and Cerebrovascular Diseases
Date of publication: December 2023
In a nutshell: Poststroke complex regional pain syndrome (CRPS) is an important complication in stroke survivors. The identification of factors associated with post-stroke CRPS is important for preventive measures and early diagnosis. A total of 141 first-ever stroke survivors in the subacute stage were retrospectively analyzed.
Type of publication: Retrospective case-control study
Date of publication: February 2024
https://doi.org/10.1016/j.jstrokecerebrovasdis.2023.107522
In a nutshell:
Type of publication:
Type of publication:
Liver fibrosis index is associated with functional outcome among acute ischemic stroke patients
Source: Journal of Stroke and Cerebrovascular Diseases
Date of publication: February 2024
In a nutshell: The fibrosis-4 (FIB-4) index and the fibrosis-5 (FIB-5) index are noninvasive markers of liver fibrosis in patients with nonalcoholic fatty liver disease. Although liver fibrosis a potential risk factor for stroke development, it is uncertain whether liver fibrosis influences stroke outcomes. We investigated the associations between these two indices and stroke patient outcomes and compared their predictive accuracy.
Type of publication: Retrospective study
Clinical research
Source: Stroke
Date of publication: January 2024
In a nutshell: Exploratory analysis of the phase 2 PACIFIC-Stroke (Program of Anticoagulation via Inhibition of FXIa by the Oral Compound BAY 2433334—Non-Cardioembolic Stroke) randomized trial suggested that asundexian, an oral factor XIa inhibitor, prevents recurrent stroke and transient ischemic attacks in patients with atherosclerotic stroke. In this post hoc exploratory analysis, we hypothesized that asundexian would be more effective in patients enrolled with large, multiple, or cortical acute infarcts on magnetic resonance imaging than in patients enrolled with a single small subcortical acute infarct, and asundexian would prevent incident cortical covert infarcts.
Type of publication: Clinical trial
Source: Drug Delivery and Translational Research
Date of publication: February 2024
In a nutshell: Microglia are important cells that act on regulating neuroinflammation and neurofunction after the induction of ischemic stroke (IS). Consequently, the efficient accumulation of drugs within ischemic regions, particularly in microglia, serves as a valuable approach for achieving effective therapy by attenuating microglia-mediated cerebral ischemic injury. In this study, we designed mannose (man)-conjugated luteolin (lut)-loaded platelet-derived exosomes (lut/man-pEXO) as surface engineered multifunctional cascade-delivery drug carriers to target ischemic blood vessels and subsequent microglia to enhance drug accumulation and induce neuroprotection of neurovascular unit (NVU) against IS.
Type of publication: Clinical research study
Left ventricular thrombus and stroke: Are coronary interventions a safe path?
Source: International Journal of Cardiology
Date of publication: October 2023
In a nutshell: Left ventricular thrombus (LVT) is a significant complication of acute myocardial infarction (MI) as well as non-ischemic cardiomyopathies. Epidemiological evidence suggests that LVT incidences could be as high as 15% in patients with ST-segment elevation MI (STEMI), up to 25% in patients with previous anterior MI, and between 2 and 36% in patients with non-ischemic cardiomyopathies. Regardless of the cause, cerebral or systemic embolization from LVT can increase morbidity and mortality in patients with both ischemic and non-ischemic cardiomyopathies
Type of publication: Editorial
Source:
Date of publication: February 2024
In a nutshell:
Type of publication:
term Dual Antiplatelet treatment in Patients with ischemic stroke ischemic attack
Date of publication:
Source: medRxiv Preprint Server
Date of publication: Posted January 2024
In a nutshell: Clinical trials proved the efficacy of short-term dual antiplatelet therapy (DAPT) in secondary prevention of minor ischemic stroke or high-risk transient ischemic attack (TIA). In clinical practice, the use of short-term DAPT is broader than in clinical trials and procedures of clinical trials (i.e. loading dose, timely treatment start) are not always followed. We aimed at evaluating effectiveness and safety of short-term DAPT in real-world. READAPT (A REAl-life study on short-term Dual Antiplatelet treatment in Patients with ischemic stroke or Transient ischemic attack) was an observational multicenter real-world study with a 90-day follow-up.
Type of publication: Observational multi-centre clinical trial (Preprint)
Effects of brain atrophy and altered functional connectivity on poststroke cognitive impairment
Source: Brain Research
Date of publication: January 2024
In a nutshell: Brain atrophy and disrupted functional connectivity are often present in patients with poststroke cognitive impairment (PSCI). This study aimed to explore the relationship between remote brain atrophy, connectional diaschisis and cognitive impairment in ischemic stroke patients to provide valuable information about the mechanisms underlying cognitive function recovery.
Type of publication: Cohort study
Neuroprotection during Thrombectomy for Acute Ischemic Stroke: A Review of Future Therapies
Source: International Journal of Molecular Sciences
Date of publication: January 2024
In a nutshell: Stroke is a major cause of death and disability worldwide. Endovascular thrombectomy has been impactful in decreasing mortality. However, many clinical results continue to show suboptimal functional outcomes despite high recanalization rates. This gap in recanalization and symptomatic improvement suggests a need for adjunctive therapies in post-thrombectomy care. With greater insight into ischemia-reperfusion injury, recent preclinical testing of neuroprotective agents has shifted towards preventing oxidative stress through upregulation of antioxidants and downstream effectors, with positive results. Advances in multiple neuroprotective therapies, including uric acid, activated protein C, nerinetide, otaplimastat, imatinib, verapamil, butylphthalide, edaravone, nelonemdaz, ApTOLL, regional hypothermia, remote ischemic conditioning, normobaric oxygen, and especially nuclear factor erythroid 2-related factor 2, have promising evidence for improving stroke care. Sedation and blood pressure management in endovascular thrombectomy also play crucial roles in improved stroke outcomes. A hand-in-hand approach with both endovascular therapy and neuroprotection may be the key to targeting disability due to stroke.
Type of publication: Review
Circular RNAs: Promising Treatment Targets and Biomarkers of Ischemic Stroke
Source: International Journal of Molecular Sciences
Date of publication: December 2023
In a nutshell: Ischemic stroke is one of the most significant causes of morbidity and mortality worldwide. However, there is a dearth of effective drugs and treatment methods for ischemic stroke. Significant numbers of circular RNAs (circRNAs) exhibit abnormal expression following ischemic stroke and are considered potential therapeutic targets. CircRNAs have emerged as promising biomarkers due to their stable expression in peripheral blood and their potential significance in ischemic stroke diagnosis and prognosis. This review provides a summary of 31 circRNAs involved in the pathophysiological processes of apoptosis, autophagy, inflammation, oxidative stress, and angiogenesis following ischemic stroke. Furthermore, we discuss the mechanisms of action of said circRNAs and their potential clinical applications. Ultimately, circRNAs exhibit promise as both therapeutic targets and biomarkers for ischemic stroke.
Type of publication: Review
Source: International Journal of Molecular Sciences
Date of publication: November 2023
In a nutshell: Stroke remains a debilitating cerebrovascular condition associated with oxidative stress, while COVID-19 has emerged as a global health crisis with multifaceted systemic implications. This study investigates the hypothesis that patients experiencing acute ischemic stroke alongside COVID-19 exhibit elevated oxidative stress markers and altered antioxidant defense mechanisms compared to those with acute ischemic stroke. We conducted a single-center prospective cross-sectional study to investigate oxidative stress balance through oxidative damage markers
Type of publication: Prospective cross-sectional study
Source: Scientific Reports (Nature.com)
Date of publication: January 2024
In a nutshell: The study aimed to analyze the functional outcome and mobility in stroke patients depending on their cognitive state.
Type of publication: Observational study
Pathogenesis-adaptive polydopamine nanosystem for sequential therapy of ischemic stroke
Source: Nature Communications
Date of publication: November 2023
In a nutshell: Ischemic stroke is lethal cerebrovascular disease, and reperfusion as the main strategy of blood supply restoration can cause severe ischemic brain damage. Considered as the major obstacle in medication for stroke, neuroinflammation after reperfusion undergoes dynamic progression, making precision treatment for stroke a Herculean task. In this work, we report a pathogenesis-adaptive polydopamine nanosystem for sequential therapy of ischemic stroke. Intrinsic free radical scavenging and tailored mesostructure of the nanosystem can attenuate oxidative stress at the initial stage. Upon microglial overactivation at the later stage, minocycline-loaded nanosystem can timely reverse the pro-inflammatory transition in response to activated matrix metalloproteinase-2, providing on-demand regulation. Further in vivo stroke study demonstrates a higher survival rate and improved brain recovery of the sequential strategy, compared with mono-therapy and combined therapy. Complemented with satisfactory biosafety results, this adaptive nanosystem for sequential and on-demand regulation of post-stroke neuroinflammation is a promising approach to ischemic stroke therapy.
Type of publication: Research and in vivo study
Source: Journal of the neurological sciences
Date of publication: January 2024
In a nutshell: Initiation of SARS-CoV-2 (Severe acute respiratory syndrome coronavirus type 2) vaccinations aroused scepticism within the general-public about risks including stroke. Our aim was to explore temporal associations between vaccination and cerebrovascular events through an analysis of a prospective large-scale cohort of consecutive stroke and high-risk TIA (transitory ischaemic attack) patients.
Type of publication: Prospective cohort study
Source: Journal of Stroke and Cardiovascular Diseases
Date of publication: February 2024
In a nutshell: The impact of CHADS2 score on outcome in patients with stroke taking an oral anticoagulant (OAC) has not yet been fully elucidated. We investigated the association between pre-stroke CHADS2 score and outcome at discharge in patients with acute cardioembolic (CE) stroke due to atrial fibrillation (AF) who were prescribed OAC.
Type of publication: Multi-centre retrospective study
Post stroke and rehabilitation
Stiffer stroke target introduced – despite failure to meet old standard
Source: HSJ
Date of publication: November 2023
In a nutshell: The failure of trusts to offer stroke patients the level of rehab required by standards introduced 10 years ago has not prevented the publication of new guidance which demands even higher performance.
Type of publication: News
Source: Archives of gerontology and geriatrics
Date of publication: February 2024
In a nutshell: Pre-stroke impairment of activities of daily living (ADL) is considered a major determinant for functional outcome after stroke. However, findings are based on studies in stroke patients in which pre-stroke information is gathered retrospectively, with inherent risks of selection and recall bias. The objective of this study was to verify the predictive value of pre-stroke ADL with respect to ADL decline in a large prospective cohort of community dwelling older subjects with known vascular risk factors or vascular disease, thereby minimizing selection and recall bias.
Type of publication: Prospective cohort study
Endovascular Brain-Computer Interfaces in Poststroke Paralysis
Source: Stroke
Date of publication: February 2024
In a nutshell: Stroke is a leading cause of paralysis, most frequently affecting the upper limbs and vocal folds. Despite recent advances in care, stroke recovery invariably reaches a plateau, after which there are permanent neurological impairments. Implantable brain-computer interface devices offer the potential to bypass permanent neurological lesions. They function by (1) recording neural activity, (2) decoding the neural signal occurring in response to volitional motor intentions, and (3) generating digital control signals that may be used to control external devices. While brain-computer interface technology has the potential to revolutionize neurological care, clinical translation has been limited. Endovascular arrays present a novel form of minimally invasive brain-computer interface devices that have been deployed in human subjects during early feasibility studies. This article provides an overview of endovascular brain-computer interface devices and critically evaluates the patient with stroke as an implant candidate. Future opportunities are mapped, along with the challenges arising when decoding neural activity following infarction. Limitations arise when considering intracerebral hemorrhage and motor cortex lesions; however, future directions are outlined that aim to address these challenges.
Type of publication: Review
Source: Physiotherapy Theory and Practice
Date of publication: January 2024
In a nutshell: The psychometric qualities of the proprioception and dynamic trunk control tests have rarely been studied in individuals after stroke. This study of 32 participants investigated the reliability and validity of the Trunk Position Sense Test (TPS) and Modified Functional Reach Test (MFRT) in persons after stroke.
Type of publication: Descriptive Reports
Source: Neurological Research
Date of publication: February 2024
In a nutshell: This study examined the impact of improved trunk function on activities of daily living in stroke patients using the Functional Independence Measure (FIM).
Type of publication: Retrospective observational study
Source: Annals of Neurology
Date of publication: December 2023
In a nutshell: Telestroke (TS) service has been shown to improve stroke diagnosis timing and accuracy, facilitate treatment decisions, and decrease interfacility transfers. Expanding TS service to inpatient units at the community hospital provides an opportunity to follow up on stroke patients and optimize medical management. This study examines the outcome of expanding TS coverage from acute emergency room triage to incorporate inpatient consultation.
Type of publication: Research study
Source: Clinical Rehabilitation
Date of publication: February 2024
In a nutshell: Stroke has a major impact on a person’s life. While much research exists on stroke prevention and treatment, explorations into psychosocial recovery needs are lacking. This review critically consolidates the challenges and needs of stroke survivors and develops a trajectory that encapsulates their journey from illness to recovery.
Type of publication: Review
Source: medRxiv Preprint Server
Date of publication: Posted January 13, 2024.
In a nutshell: Stroke in childhood is a significant cause of morbidity and mortality. Neurologic impairments due to childhood stroke are associated with long-term disability and decreased quality of life. However, there are limited studies examining functional outcomes of childhood stroke. The goal of this study was to characterize functional outcomes of children and adolescents admitted to acute inpatient rehabilitation following stroke.
Type of publication: A retrospective cross-sectional study.
Source: medRxiv Preprint Server
Date of publication: Posted January 11, 2024.
In a nutshell: This feasibility study aimed to investigate the feasibility of applying a motivational instructional design model to stroke rehabilitation and its potential physical and mental health effects in occupational and swallowing therapy settings.
Type of publication: Feasibility study
Predicting individual long-term prognosis of spatial neglect based on acute stroke patient data
Source: medRxiv Preprint Server
Date of publication: Posted January 11, 2024.
In a nutshell: One of the most pressing questions after a stroke is whether an individual patient will recover in the long-term. Previous studies demonstrated that spatial neglect – a common behavioral deficit after right hemispheric stroke – is a strong predictor for poor performance on a wide range of everyday tasks and for resistance to rehabilitation. The possibility of predicting long-term prognosis of spatial neglect is therefore of great relevance. The aim of the present study was to test the prognostic value of different imaging and non-imaging features from right hemispheric stroke patients: individual demographics (age, sex), initial neglect severity, and acute lesion information (size, location).
Type of publication: Clinical study
Source: medRxiv Preprint Server
Date of publication: Posted January 09, 2024
In a nutshell: After discharged from the hospital for acute stroke, individuals typically receive rehabilitation in one of three settings: inpatient rehabilitation facilities (IRFs), skilled nursing facilities (SNFs), or home with community services (i.e., home health or outpatient clinics). The initial setting of post-acute care (i.e., discharge location) is related to mortality and hospital readmission; however, the impact of this setting on the change in functional mobility at 90-days after discharge is still poorly understood. The purpose of this work was to examine the impact of discharge location on the change in functional mobility between hospital discharge and 90-days post-discharge.
Type of publication: Retrospective cohort study
Source: medRxiv Preprint Server
Date of publication: Posted January 09, 2024.
In a nutshell: Depression and anxiety affects 1 in 3 stroke survivors. Performance on standardized objective cognitive tests and self-reported subjective cognitive complaints are associated with concurrent depression and anxiety, but it is unknown whether and how objective and subjective cognition relate to longer-term emotional outcomes.
Type of publication: Cohort study
Source: Scientific Reports (nature.com)
Date of publication: December 2023
In a nutshell: This study investigated the link between pre-stroke and acute-stage physical activity (PA) and sedentary behaviour.
Type of publication: Observational study
Source: Journal of Clinical Medicine
Date of publication: January 2024
In a nutshell: Evidence-informed interventions for stroke self-management support can influence functional capability and social participation. People with stroke should be offered self-management support after hospital discharge. However, in Portugal, there are no known programs of this nature. This study aimed to develop a person-centered and tailored blended care program for post-stroke self-management, taking into account the existing evidence-informed interventions and the perspectives of Portuguese people with stroke, caregivers, and health professionals.
Type of publication: Exploratory mixed methods study
Source: Journal of Clinical Medicine
Date of publication: January 2024
In a nutshell: Telerehabilitation (TR) seems to be a viable and feasible solution to face the rehabilitative challenges posed by neurological impairments and to improve patients’ quality of life (QoL). This review aims to synthesize and analyze the evidence on the impact of physiotherapy intervention through TR on QoL in patients with stroke, Parkinson’s disease (PD), and multiple sclerosis (MS), together with an evaluation of their satisfaction and technology acceptance levels.
Type of publication: Systematic review, meta-analysis.
Source: Journal of Stroke and Cerebrovascular Diseases
Date of publication: February 2024
In a nutshell: To investigate the safety and feasibility of an early initiated stroke-integrated Cardiac Rehabilitation program.
Type of publication: Prospective cohort feasibility study
Source: Journal of Stroke and Cerebrovascular Diseases
Date of publication: February 2024
In a nutshell: To evaluate the feasibility and usability of stroke survivor participation in an 8-week virtual environment intervention that provides opportunities for social support exchanges, social network interactions, and recovery education.
Type of publication: Pilot study
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Stroke Horizon Scanning 