Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:

Thursday, April 19, 2018

Resolution of Crossed Cerebellar Diaschisis by 6 Months Predicts Good Motor Outcome After Stroke

Who fucking cares about recovery predictions? Except for researchers needing a subject to study? Survivors care about one thing, 100% recovery. If your research doesn't get closer to that, why the hell are you doing it?
April 13, 2018
By Chris Berrie
ATHENS, Greece -- April 13, 2018 -- Resolution of crossed cerebellar diaschisis (CCD) between 1 and 6 months predicts good motor outcome for patients who have suffered a stroke, as indicated by resting-state functional magnetic resonance imaging (rs-fMRI), according to a study presented here at the 27th European Stroke Conference (ESC).
CCD was initially defined more than 100 years ago.
“This is when a vascular lesion affects one cerebral hemisphere while hypometabolism occurs both at the site of anatomic lesion and in the contralateral cerebellar hemisphere,” explained Aliénor Jaillard, MD, Stroke Unit, CHU Grenoble Alpes, France, on April 11.
However, although CCD is known to persist over time and has been correlated with poor outcome, no firm data have been obtained in terms of stroke severity and functional outcome.
The researchers acquired rs-fMRIs from 25 patients in the Intravenous Stem Cells After Ischaemic Stroke (ISIS)-HERMES phase 2 study (study group) and 25 aged-matched healthy controls. The main regions of interest were the primary motor area (M1), which was divided as 4a (dorsal) and 4p (ventral), and the cerebellum.
The reorganisation of the corticocerebellar connectivity at 1 month (before any stem cell treatment) and 6 months poststroke was used to determine correlation with motor performance, assessed by the Fugl-Meyer score (FMS).
The study group was 72.0% male and had the following means of characteristics: age, 52.7 years; total lesion volume, 97.08 cm3; National Institutes of Health Stroke Scale (NIHSS) score, 13.24; Barthel Index, 47.80; and motor FMS, 37.6. Treatments included thrombolysis (36.0%), no stem cell treatment (48.0%), and low-dose (20.0%) and high-dose (32.0%) mesenchymal stem cells.
At 6 months, the mean NIHSS score was 8.16, Barthel Index was 83.60, and motor FMS was 51.52.
The rs-fMRI analysis of the functional CCD initially demonstrated significantly decreased (P< .01) connectivity between M1 and the contralateral cerebellum for study group versus control patients. Furthermore, within the study group, connectivity decreased over time, between 1 and 6 months.
Although the best predictor was FMS at 1 month (71.7%), CCD predicted 8.1% of the total variance, according to multiple linear regression analysis for the prediction model for outcome.
Also, beneficial treatment effects were seen for connectivity for mesenchymal stem cell treatments, with prediction of 9.0% of the total variance.
“Motor recovery was associated with a reconnection between ipsilesional M1 and contralateral cerebellum, or CCD resolution, in treated patients compared with nontreated patients,” said Drs Jaillard.
“CCD can be used as a biomarker of stroke recovery,” concluded Dr. Jaillard for motor recovery assessed by rs-fMRI.
[Presentation title: Crossed Cerebellar Diaschisis Predicts Motor Recovery in Stroke -- A Longitudinal Resting State fMRI Study. Abstract OP031]

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