The NHS will “pay the price” if it does not embrace at-home rehabilitation, a former health minister has warned

Totally wrong focus. Availability of rehab doesn't mean it actually works. You need to campaign for EXACT STROKE PROTOCOLS THAT DELIVER 100% RECOVERY.

The NHS will “pay the price” if it does not embrace at-home rehabilitation, a former health minister has warned

The NHS will “pay the price” if it does not embrace at-home rehabilitation, a former health minister has warned.

Community rehabilitation provides tailored support for patients outside hospital to allow them to continue their recovery from emergencies, such as stroke and heart failure, or to enable them to manage conditions such as lung disease and arthritis.
Tory Steve Brine called for a “real improvement” to support people with long-term health conditions outside of hospitals.
He added: “I know that the NHS does so much good for the people of this country, but I also know that rehab matters, and this is an area where real improvement is needed.
“It is vital that people get the rehabilitation they need, or the NHS will pay the price in the long term.”

A new report published by the Chartered Society of Physiotherapy, Royal College of Occupational Therapists and Sue Ryder, urges the Government to offer patients a “right to rehabilitation”.

Its research shows almost half (44%) of people with neurological conditions do not have access to community rehabilitation.
Labour MP Emma Hardy (Hull West and Hessle), who is hosting an event in Parliament with Mr Brine on Wednesday to raise awareness of at-home rehabilitation, called for greater funding.
She said: “The NHS does a fantastic job of treating and caring for patients and it is important that this care continues and is carried over into rehabilitation and ongoing care for people with long-term health conditions.
“The Government needs to ensure that proper funding is provided to our NHS so essential at-home care (Not results.)for patients can be provided.
“It is often just has important as the treatment received in hospital.”
The report warns that failing to provide these services can have devastating consequences for people’s lives, and bring greater costs for the NHS and social care systems.
Karin Orman, assistant director at Royal College of Occupational Therapists (RCOT) said: “We need a national approach that structures rehabilitation around people, allowing them to fully participate in life and keeping them connected with family, friends and their community.
“Having so many national organisations coming together to highlight the value of rehabilitation is an important first step.
“We now need a commitment from the relevant government departments, commissioners and providers to ensure rehabilitation is available for everyone who needs it.”

Study Shows Hyperbaric Oxygen Therapy (HBOT) Protocols Can Improve Cognitive Function in Stroke Patients

I don't trust this since it could easily be biased since the study backers own HBOT services. 

Normobaric oxygen would be much easier and cheaper to deliver.

There is this from March, 2005:

A Pilot Study of Normobaric Oxygen Therapy in Acute Ischemic Stroke

 And this in October, 2010

Normobaric oxygen therapy in acute ischemic stroke: A pilot study in Indian patients

And this from October 2012:

Normobaric Oxygen Therapy

But all this other research shows no help for HBOT.

HBOT hasn't had any earlier success in either TBI or stroke.

Oxygen therapy no better than placebo for treating concussion, study finds

Can Hyperbaric Oxygen Repair the Damaged Brain?

Mayo clinics take:

Agency Research for Healthcare and Quality:

hbot as stroke therapy - quackery?

Peter Levine talking about problems of HBOT here:Stroke and Hyperbaric Oxygen Therapy

Enormous Inferno Kills Man Who Tried Smoking a Cigarette in a Hyperbaric Chamber

 

 The latest on HBOT here:

Study Shows Hyperbaric Oxygen Therapy (HBOT) Protocols Can Improve Cognitive Function in Stroke Patients

TEL AVIV, Israel, Feb. 27, 2020 /PRNewswire/ -- The Sagol Center for Hyperbaric Medicine and Research at Shamir Medical Center, one of the largest hyperbaric medicine centers in the world, announced study results indicating its hyperbaric oxygen therapy (HBOT) protocols induce significant improvement in most cognitive domains of patients who suffered stroke – even months to years after the event.

The retrospective analysis study, published in Restorative Neurology and Neuroscience, demonstrated that through elevating oxygen concentration in the blood and injured brain tissue, the Sagol Center's HBOT protocols supply the energy needed for brain tissue recovery – regardless of the stroke location or cause.
"Despite nearly half of stroke survivors suffering from differing degrees of cognitive dysfunction, most rehabilitative efforts focus on restoring motor functions," said Shai Efrati, MD, Director of the Sagol Center for Hyperbaric Medicine and Research, Shamir Medical Center, and study co-author. "Our study shows that stroke-related cognitive deficits can be treated as brain wounds, regardless of the stroke's location or origin – ischemic or hemorrhagic. The rehabilitation potential lies in the metabolic characteristics of the chronic damage, or brain wound. By utilizing our HBOT protocols, the injured but viable brain tissue can be recovered even years after the acute insult."
Stroke is the second highest cause of mortality and the third leading cause of disability worldwide. When stroke occurs, whether ischemic or hemorrhagic, dysfunction typically presents in the affected brain region and impacts more than one cognitive domain such as memory or attention. Cognitive recovery after stroke mainly transpires within the first 30 days, with some patients gaining additional mild improvement up to 90 days after.
The study evaluated the sustained impact of Sagol's HBOT protocols on all aspects of cognitive function including memory, executive function, visuospatial skills, verbal function, attention, information processing and motor skills. Results demonstrated clinically significant improvement in cognitive function in most evaluated cognitive domains after HBOT.
The study found the following:

• 86% of the stroke patients achieved clinically significant improvement in their cognitive function
• The memory domain had the most prominent improvements
• Baseline cognitive function was a significant predictor of rehabilitation potential
• Hemorrhagic strokes had significantly higher improvement in information processing compared to ischemic strokes, though ischemic stroke patients still showed improvement
• Left hemisphere strokes had a greater increase in the motor domain, compared to right hemisphere strokes

Of the 351 patients assessed for eligibility, a total of 162 patients met the inclusion criteria for the final analysis. Criteria comprised the receipt of treatment after more than three months post-injury, the completion of the Sagol Center HBOT protocols and at least two cognitive evaluations, conducted using a fully computerized cognitive testing battery (NeuroTrax test battery^®). Patients were treated in a multi-place hyperbaric chamber at the Sagol Center.
"This is the largest cohort of stroke patients who have undergone strict cognitive, imaging and neurological assessments to evaluate the rehabilitation potential of HBOT treatment," said Amir Hadanny, MD, Chief Medical Research Officer at the Sagol Center for Hyperbaric Medicine and Research, Shamir Medical Center, and lead author of the study. "To identify the true cognitive and clinical impact of our protocols, all patients were evaluated with two validated alternate forms of the cognitive test battery prior to and post-HBOT. Significant improvements were demonstrated in all cognitive domains including memory, information processing speed, attention and executive functions. We are thrilled to bring a new hope to stroke patients worldwide."
About the Sagol Center for Hyperbaric Medicine and Research at Shamir Medical Center
The Sagol Center for Hyperbaric Medicine and Research at Shamir Medical Center (formerly Assaf Harofeh Medical Center), is a leader in advancing our understanding of the impact of hyperbaric medicine on cognitive and physical function. Serving as one of the largest Hyperbaric centers worldwide, the Sagol Center offers highly advanced large multi-place chambers, treating more than 200 patients daily. Research conducted at the Center has proven that brain rejuvenation is possible across a wide range of neurological pathologies and illnesses.
Media Contact:Nicole Grubner
Finn Partners for The Sagol Center for Hyperbaric Medicine and Research
+1-929-222-8011
nicole.grubner@finnpartners.com

View original content:http://www.prnewswire.com/news-releases/study-shows-hyperbaric-oxygen-therapy-hbot-protocols-can-improve-cognitive-function-in-stroke-patients-301012441.html

SOURCE The Sagol Center for Hyperbaric Medicine and Research

Application of Virtual Reality in Neuro-Rehabilitation: An Overview

We don't need an overview, we need EXACT DEFINED STROKE PROTOCOLS. When the hell will you get there?

Maybe after you are the 1 in 4 per WHO that has a stroke? Will that finally get you to do your job properly?

Application of Virtual Reality in Neuro-Rehabilitation: An Overview

 Lucia F Lucca
1
, Antonio Candelieri
1,2
 and Loris Pignolo
1

1
S. Anna Institute and RAN - Research in Advanced Neuro-rehabilitation, Crotone,
2
Laboratory of Decision Engineering for Health Care Delivery, University of Cosenza, Italy
1. Introduction
Virtual reality (VR) collectively refers to the realistic, albeit artificial environments that are simulated by computer and are experienced by end-users via human-machine interfaces involving multiple sensory channels. In this respect, comparable technical solutions are applicable across different domains such as cyberspace, virtual environments, teleoperation, telerobotics, augmented reality,
 and synthetic environments.
This makes application possible in a variety of conditions such as (1) design, engineering, manufacturing, and marketing; (2) medicine and healthcare; (3) online monitoring of children and the elderly at home and accident prevention; (4) hazardous operations in extreme or hostile surroundings; and (5) training in military and industrial machine operation, medical teaching and surgery planning/training. An implement of VR with live direct or indirect view of a physical real-world environment whose elements are purportedly enhanced (augmented) by virtual computer-generated imagery to meet the viewer needs, Augmented Reality is extensively used in open surgery, virtual endoscopy, radiosurgery, neuropsychological assessment and medical rehabilitation. Application in psychotherapy ranked 3rd among 38 psychotherapy interventions predicted to increase in use in the next future (Gorini & Riva, 2008a; Gorini & Riva, 2008b). Application in rehabilitation is increasing and expanding; innovative technical solutions in motor and sensory-cognitive rehabilitation result in substantial developments from the available procedures and in prototypes for clinical testing. The clinical results appear promising.
2. Rationale for VR-mediated neuro-rehabilitation
The rationale for application mainly rests on the available evidence that a functional re-arrangement of the injured motor cortex can be induced with the mediation of the mirror neurons system (Eng et al, 2007; Holden, 2005; Rose et al, 2005) or through the subject’s motor imagery and learning (Gaggioli et al, 2006). Intensive training (repetition) facilitating re-arrangement of cortical function and motivation reinforced by feedback information about the ongoing improvement are necessary for motor learning to be possible after brain damage. These conditions are easily made available in VR-mediated neuro-rehabilitation paradigms. Motor impairment and recovery can be measured in real time (e.g. at the end of each trial or a series of trials) to give the user the knowledge-of-performance (about his/her movement patterns) and knowledge-of-results (about the outcome predictable at each time point during rehabilitation) that reinforce motivation and the training procedure itself. VR allows online or offline feedback, that has been extensively investigated with a general agreement that it improves learning (Bilodeau & Bilodeau, 1962; Gentile, 1972; Khan & Franks, 2000; Newell & Carlton, 1987; Winstein, 1991; Young & Schmidt, 1992; Woldag & Hummelsheim, 2002). The expectation is, that VR-mediated rehabilitation should improve the approach efficacy and the outcome by making tasks easier, less demanding and less tedious/distractive, and more informative for the subject. Interactive VR environments are flexible and customizable for different therapeutic purposes; individual treatments can be personalized in order to facilitate movement retraining, to force the user to focus on the task key elements, and to facilitate transfer of motor patters learned in VR environments to the real world.
3. Studies
3.1 VR in the upper limb motor rehabilitation
VR was first applied in the rehabilitation of the paretic upper-limb after stroke in a setting designed to promote motor (re)learning for different movements (hand, elbow and shoulder) and functional tasks or goals (Holden et al, 1999). The approach implemented a learning-by-imitation paradigm through three components: a motion tracking device to record the trajectories to be performed in the VR environment, a desktop computer display and a VR editing software specifically developed to create suitable 3D-simulated tasks at varying level of complexity. Once the scenario had been defined, the programmed motor learning tasks to be performed within the virtual environment were stored into the motion tracking device. Patients were then requested to reproduce the trajectories set by the
virtual teacher or to devise appropriate trajectories in the absence of it, while the upper limb movements were monitored by the virtual teacher, displayed in real time and recorded. The approach also assessed the degree of matching between the virtual teacher  and the patient’s trajectories and provided trainer and trainee with a measure of each trial efficency. In a pilot study (Holden et al, 1999), two chronic patients with massive stroke were trained on a reach-and-grasp task involving shoulder flexion, elbow extension and forearm supination at six increasing levels of complexity. Efficacy was assessed through a 3D kinematic reach test performed in the real world before and after VR-supported rehabilitation; the Fugl-Meyer Test of Motor Recovery for Stroke test (Fugl-Meyer et al, 1975) and the motor task section of the Structured Assessment of Independent Living Skills (SAILS) test of UE function (Mahurin et al, 1991) were used for clinical evaluation. The patients were able to export the abilities learned in VR to the real world and to similar but untrained activities, but hand orientation proved difficult to learn. In successive studies (Holden et al, 2001; Holden et al, 2002), information about the specific (as measured in real tasks designed to evaluate generalization in space, gravitoinertial force, combined spatial/gravitoinertial force, and in tasks requiring novel recombination of trained movement elements, and control tasks with untrained elements) and non-specific (as measured by variations in motor recovery tests after VR supported training activity) motor generalization was used to measure in detail the ability to transfer to the real world what learned in VR. Patients improved in three standard clinical tests of function, even if practicing in two movements only during VR training. It was suggested that VR mediated rehabilitation is an effective and efficient approach to (re)train a set of basic tasks with upgrading to a wide variety of skilled movements (Holden, 2005). Piron et al. (2005) replicated these results in a study on 50 patients with impaired upper limb motion after stroke. The VR supported rehabilitation system included a virtual environment (a PC workstation with a wall screen), a motion tracking device and the dedicated software for editing 3D-scenarios in a learning-by-imitation rehabilitation process with a
virtual teacher. Therapists set the virtual scenarios characteristics and the motor training complexity to match each patient’s motor impairment and rehabilitation protocol, set the starting position, target location and orientation, designed simple/complex tasks, added or removed non-pertinent virtual objects (distractive elements) to increase/reduce the task level of difficulty, recorded trajectory of the desired movement to be (re)learned by the subject, with the virtual teacher visible or hidden as advisable. The degree of motor impairment or recovery and the attained levels of autonomy in daily living activities were measured by the Fugel-Meyer (FM) UE score and the Functional Independence Measure scale (FIM) before and after the therapy, and by means of kinematic measures such as the movement morphology and mean duration and speed. Improvement was observed in the FM UE and FIM mean scores (with 15% and 6% increases, respectively) and in the movement mean duration (18%) and speed (23%), with better regularity of trajectories. Improvements do not appear to have been influenced by age, time since stroke or site of brain damage, as already noted in previous studies (Jeffery & Good, 1995; Johnston et al, 1992; Bagg et al, 2002; Tangeman et al, 1990; Dam et al, 1993). Instead, the severity of impairment was crucial for the outcome and a severe initial impairment was more difficult to rehabilitate. Comparison between the degrees of recovery attained after standard or VR-reinforced learning in two randomly assigned post-stroke patient groups (Turolla et al, 2007) showed significantly increased FM UE scores in all 30 patients, but improvement was greater after VR-supported therapy. The different outcome was ascribed, at least in part, to the feedback information about knowledge-of-results and knowledge-of-performance provided by the system (Todorov et al, 1997; Schmidt & Young, 1991; Winstein et al, 1996) and to the reinforced learning provided by the VR-based rehabilitation approach (Barto, 1994; Doya, 2000; Fagg & Arbib, 1992; Rummelhart et al, 1986).
3.2 VR in the lower limb motor rehabilitation
Several VR applications were designed to recover efficient walking in patients with lower limb motor impairment after stroke (Deutsch et al, 2002 and Deutsch et al, 2004). Fung, et al. (Fung, et al 2004, 2006), performed studies on gait training by using a treadmill mounted on a 6-degree-of-freedom motion platform with a motion-coupled VR environment. The system provided the unique feature of simulated turning within the environment; also provided auditory and visual cues as positive/negative feedback. Subjects were required to wear 3D stereo glasses to visualize the virtual environment. Test results from this project demonstrated improved gait speed with training. More recently, Mirelman et al. studied the effects on impaired gait kinetics of robot-assisted rehabilitation with or without VR support (Mirelman et al, 2007). Subjects in the two subgroups were trained with the same exercises; requested movements were inversion and eversion, dorsiflexion and plantar flexion, or combinations of these. A motion capture system was used to measure movements in association with a force-feedback system permitting navigation within a virtual environment displayed on a computer screen. Gait was estimated at baseline, one week after the training session, and three months after end of the therapy. Feedback information was provided directly by the system to the patients treated in the VR setting and by the therapist to those undergoing rehabilitation withouth VR support. Both groups improved, but patients treated with VR support did better, with increased ankle strenght at the end of treatment and at follow-up. Patients undergoing robotic- assisted rehabilitation without VR support reported fatigue earlier. Park and colleagues (Park et al, 2007) developed a VR system for motor rehabilitation with a PC camera and two markers of movement in a very simple virtual scenario with a crossing-stepping stone task. The success rate in 9 hemiplegic patients with stiff-knee gait after stroke was computed as the ratio of successful trials to the total gait cycles, with a ~30% improvement after treatment.
3.3 VR and telemedicine: the upper limb tele-rehabilitation
VR settings are usable in the transfer of available occupational treatments to a platform for rehabilitation at home, with remote control by therapist. Broeren and coworkers have emphasized the reduced labor, logistics and costs of the state-of art web-based video/audio systems for telemedicine and tested their protocol in a case study, with VR associated to the haptic force feedback necessary for VR object manipulation. The hand fine dexterity and grip improved after treatment (Broeren et al, 2002). More recently, Trotti and colleagues proposed VR-supported training as an integration of the conventional rehabilitation protocols (Trotti et al, 2009). They used kinematics indexes (such as movement execution time and precision) and validated clinical scales, such as Nine-Hole Peg Test (NHPT) (Mathiowetz, 1985), Frenchay Arm Test (FAT) (Heller, 1987), Medical Research Council (MRC) (Florence, 1992), Motricity Index (MI) (Bohannon, 1999), and the Motor Evaluation Scale for Upper extremity in Stroke Patients (MESUPES) (Van de Winckel, 2006) to measure the upper limb impairment in a patient with stroke before and after therapy with VR-supported upper limb rehabilitation. Kinematic analysis and most clinical scales (MRC of fingers, MESUPES and NHPT time, but not MI and FAT) showed a decrease in movement execution time and increase in precision, with improved muscle strenght and movement control (Trotti et al, 2009). VR-mediated telerehabilitation was further investigated (Piron et al, 2009) by comparing two groups (18 subjects each) of patients with stroke treated for four weeks by a VR-assisted rehabilitation program operated through Internet or by conventional therapy. Motor impairment was assessed one month before, at the beginning and end of therapy, and one month later by means of the Fugl-Meyer Upper Extremity (FM EU), Abilhand (Penta et al, 2001) and Ashworth (Bohannon & Smith, 1987) scales. The setting included a virtual teacher showing the correct trajectories as set by the therapist in association with the patient’s actual movement. The knowledge-of-performance was provided via videoconference. No differences were observed when comparing the assessments one month before and at beginning of therapy, but both groups improved after therapy and the improvement was evident also one month after the end of therapy. The FM UE showed better recovery for patients treated through VR-based telerehabilitation.
4. Systems and applications
4.1 Systems and applications for VR-supported upper limb rehabilitation
A VR system purported to measure the impairment in speed, strength, fractionation and range of fingers movements was designed to be distributed over three sites connected via Internet (for rehabilitation, data storage and data access, respectively) (Boian et al, 2002). At the rehabilitation site, the system featured a workstation and two sensing (cyber and haptic) gloves; the data storage site organized the information acquired during the VR-supported rehabilitation; open access to data was through Internet. An algorithm was implemented to increase or decrease according to the achieved performance the difficulty of the target task. The system was tested in a pilot study on 4 patients with stroke. A screen provided the patients with knowledge-of-results and performance (feedback) through a transparent hand representing the target and numerical scores about the trial execution. Trained patients achieved various degrees of improvement, with a good retention in gains and a positive evaluation of the system both by patients and therapists. A virtual tabletop environment for the upper limb rehabilitation after traumatic brain injury was developed (Wilson et al, 2007) to measure the residual function and kinematic markers like speed, precision, distance, accuracy of targeting. The system was innovative because flexible, automated, and relatively inexpensive, with components specifically designed to be user-friendly: LCD panels easy to carry and reducing the set-up time were favored; the virtual environment was displayed on the LCD panel placed horizontally on a tabletop surface, and users could interact with the system by moving sensing-objects over it; knowledge of results was provided to the patient via another LCD panel. Distractive elements appeared on the LCD to increase or decrease the task difficulty. Low-cost implements, such as commercial game controllers and marker tracking were used. Wilson and coworkers suggested that psychometric measures should be preferred in the future and predicted broad application in assessing movement impairment after stroke and ischemic or traumatic brain damage or in movement disorders (e.g. Parkinson or Huntington’s diseases). Therapy WREX (T-WREX) was designed by Reinkensmeyer and Housman (2007) for the hand and arm rehabilitation after stroke to make rehabilitation possible also in the absence of the therapist, with exercises mimiking the daily living activities in VR environment and a feedback information procedure. The system featured a passive gravity-balancing orthosis based on the Wilmington Robotic Esoskeleton (WREX) (Rahman et al, 2007), a hand grip sensor and the software needed for VR and performance evaluation, but was not a robotics/VR integration because WREX assisted patients only against gravity and by elastic bands. It focused on the re-training of function on a plane, therefore displaying the movement on the plane of interest. The system bypassed the problems of 3D complexity, but limitated the movements to be re-learned. Most patients nevertheless found T-WREX less boring than conventional therapy and their progress during rehabilitation easier to track. Reiteration of motor training by T-WREX reduced motor impairment (as measured by the Fugl-Meyer scale) in a preliminary randomized controlled study (Reinkensmaeyer & Housman, 2007).
4.2 Low-cost and open source systems for VR-supported tele-rehabilitation
Interest on tele-rehabilitation as a possible alternative to the traditional treatment of inpatients in hospital increased in recent years with the increment of costs and commitment by the private and public healthcare. Sugarman and colleagues assumed it is impossible for the therapist to monitor patients performing rehabilitation at home, emphasized the therapist’s role in motivating the patient and the need of efficient communication between the therapist and patients at any time and place, including home (Sugarman et al, 2006). Approaches combining VR and mechanical devices for rehabilitation (Fasoli et al, 2004; Coote & Sokes, 2005; Broeren et al, 2004; Reinkensmeyer et al, 2002; Jadhav & Krovi, 2004) appear encouraging, but the systems specifically developed for these purposes have high costs. In alternative, Sugarman and colleagues adopted a commercial feedback joystick in association with a specifically designed armrest and a PC with Internet connection. Their proposed VR solution could be operated in two different modes: stand-alone or cooperative. In the former, patients exercised at home without Internet connection; in the latter, the patient and therapist were online and the therapist could monitor and tutor the patient performing.

Cardiovascular health in 20s could impact midlife brain health

I'm sure my cardiovascular health in my 20s was pretty good, biking to work every day nine months of the year in Minneapolis.  At age 53, 3 years after stroke my heart rate was 54, which is the cardiovascular equivalent of an athlete, even after doing no exercise for 3 years.  Which is part of the reason I survived.  And now my brain health is great, no problems with cognition.

Cardiovascular health in 20s could impact midlife brain health

Cardiovascular health in a person’s 20s may impact brain health later in life, according to research to be presented at the American Academy of Neurology Annual Meeting.
“These results indicate that people need to pay close attention to their health, even in their early 20s,” Farzaneh A. Sorond, MD, PhD, chief of stroke and neurocritical care in the department of neurology at the Northwestern University Feinberg School of Medicine, said in a press release.

“We’ve known that vascular risk factors such as high blood pressure and high blood glucose levels are linked to cerebrovascular damage and problems with thinking skills in older people, but this study shows that these factors may be linked decades earlier and injury may start much earlier,” she said.
Sorond and colleagues evaluated 189 participants enrolled in the Coronary Artery Risk Development in Young Adults study. Participants were followed for 30 years — the mean age was 24 years at enrollment and 54 years at the end of the follow-up period.

 

Cardiovascular health in a person’s 20s may impact brain health later in life, according to research to be presented at the American Academy of Neurology Annual Meeting.

Source: Adobe Stock

Researchers assessed participants’ vascular risks at eight in-person visits during the follow-up period with an overall cardiovascular health score that was based on smoking status, BMI, blood pressure, total cholesterol and fasting glucose.
At 30 years, researchers conducted a transcranial Doppler ultrasound to determine the brain’s ability to regulate blood flow, or dynamic cerebral autoregulation. They also conducted multiple neuropsychological tests to evaluate cognition. Multivariate linear regression models were used to determine the association of cardiovascular health at each in-person visit during follow-up with cognition and dynamic cerebral autoregulation.
The researchers found that better dynamic cerebral autoregulation at 30 years was associated with better cardiovascular health at baseline ( = 3.55; P = .006) and at 7 years ( = 3.48; P = .005). In addition, better cardiovascular health at baseline was associated with better cognitive testing performance in memory, attention and executive domains. The results were similar after adjusting for sociodemographic characteristics and education.
In the press release, Sorond noted the results demonstrate an association between better cardiovascular health during people’s 20s and better midlife cognitive skills and dynamic cerebral autoregulation. However, she said the results do not prove causation.
“More focus on a life-course research approach is needed to help us better understand how these vascular risk factors affect brain health as we age,” she said in the release. – by Erin Michael 
Reference:
Sorond FA, et al. Cardiovascular health across young adulthood, cerebral autoregulation and cognitive function in midlife. Presented at: American Academy of Neurology Annual Meeting; April 25 to May 1, 2020; Toronto.
Disclosure: The study was supported by the Kaiser Foundation Research Institute, NIH, NHLBI, Northwestern University, the University of Alabama at Birmingham and the University of Minnesota.

Changes in leg cycling muscle synergies after training augmented by functional electrical stimulation in subacute stroke survivors: a pilot study

Notice that there is nothing on recovery, NO PROTOCOLS, NOTHING USEFUL. And you lazily suggest further studies because you didn't do yours correctly the first time.

Changes in leg cycling muscle synergies after training augmented by functional electrical stimulation in subacute stroke survivors: a pilot study

• Emilia Ambrosini,
• Monica Parati,
• Elisabetta Peri,
• Cristiano De Marchis,
• Claudia Nava,
• Alessandra Pedrocchi,
• Giorgio Ferriero &
• Simona Ferrante 

Journal of NeuroEngineering and Rehabilitation volume 17, Article number: 35 (2020) Cite this article

• Metrics details

Abstract

Background

Muscle synergies analysis can provide a deep understanding of motor impairment after stroke and of changes after rehabilitation. In this study, the neuro-mechanical analysis of leg cycling was used to longitudinally investigate the motor recovery process coupled with cycling training augmented by Functional Electrical Stimulation (FES) in subacute stroke survivors.

Methods

Subjects with ischemic subacute stroke participated in a 3-week training of FES-cycling with visual biofeedback plus usual care. Participants were evaluated before and after the intervention through clinical scales, gait spatio-temporal parameters derived from an instrumented mat, and a voluntary pedaling test. Biomechanical metrics (work produced by the two legs, mechanical effectiveness and symmetry indexes) and bilateral electromyography from 9 leg muscles were acquired during the voluntary pedaling test. To extract muscles synergies, the Weighted Nonnegative Matrix Factorization algorithm was applied to the normalized EMG envelopes. Synergy complexity was measured by the number of synergies required to explain more than 90% of the total variance of the normalized EMG envelopes and variance accounted for by one synergy. Regardless the inter-subject differences in the number of extracted synergies, 4 synergies were extracted from each patient and the cosine-similarity between patients and healthy weight vectors was computed.

Results

Nine patients (median age of 75 years and median time post-stroke of 2 weeks) were recruited. Significant improvements in terms of clinical scales, gait parameters and work produced by the affected leg were obtained after training. Synergy complexity well correlated to the level of motor impairment at baseline, but it did not change after training. We found a significant improvement in the similarity of the synergy responsible of the knee flexion during the pulling phase of the pedaling cycle, which was the mostly compromised at baseline. This improvement may indicate the re-learning of a more physiological motor strategy.

Conclusions

Our findings support the use of the neuromechanical analysis of cycling as a method to assess motor recovery after stroke, mainly in an early phase, when gait evaluation is not yet possible. The improvement in the modular coordination of pedaling correlated with the improvement in motor functions and walking ability achieved at the end of the intervention support the role of FES cycling in enhancing motor re-learning after stroke but need to be confirmed in a controlled study with a larger sample size.

Trial registration

ClinicalTrial.gov, NCT02439515. Registered on May 8, 2015, .

Is Taking Aspirin Daily Healthy Or Harmful To The Body?

The correct solution is to determine EXACTLY what indicators exist for those that would be harmed by aspirin. Rather than this blanket prohibition. And if we had survivor led stroke associations we would do the research to determine that.

Is Taking Aspirin Daily Healthy Or Harmful To The Body?

Aspirin may be an affordable way of preventing heart attacks or stroke

ADVERTISEMENT

, but research suggests that there are risks in taking the round white pill, especially if it is not recommended by health care specialists or if there is no prior history of cardiovascular diseases."Baby" Aspirin No Longer A Primary Prevention
In 2014, the FDA reversed its stance on daily low-dose aspirin as a primary source of heart disease prevention, citing clearly established side effects such as brain and stomach bleeding, as well as a lack of clear benefit for patients who have never experienced a heart attack, stroke or cardiovascular disease.
In 2019, the American Heart Association (AHA) and American College of Cardiology updated their clinical guidelines on the primary cardiovascular disease prevention based on many of the controversial findings on the use of prophylactic aspirin.
However, it should be noted that the AHA's recommendation applies only to primary heart disease prevention in those with no history of heart problems, or at least those with low to moderate heart disease risk.
Aspirin And Heart Diseases
Although daily low-dose aspirin continues to be recommended for patients who already have heart disease, evidence suggests that it is not ideal for them either.
A 2004 study assessed the risks and benefits of aspirin and the blood thinner warfarin in heart failure patients, and found that daily aspirin intake (300 mg) resulted in the worst cardiac outcomes, which include worsening heart failure. The study authors then added that there was "no evidence that aspirin is effective or safe in patients with heart failure." A similar study, published in 2010, found that older heart disease patients with a prior history of aspirin use had more comorbidities and a higher heart attack risk compared to those who had not been on aspirin therapy.
The risks of taking aspirin extends to diabetics, who are at increased risk of heart disease and are more likely to be put on an aspirin regimen. One meta-analysis of six studies found no clear evidence that aspirin effectively prevents cardiovascular events in diabetics, although men may have some benefits. A study published in 2009, which examined the effects of aspirin therapy on diabetic patients, found that it "significantly increased mortality in diabetic patients without cardiovascular disease from 17 percent at age 50 years to 29 percent at age 85 years."
Aspirin And Lower Mortality Risk
Interestingly enough, a 2019 study found that prophylactic aspirin may lower the risk of all-cause cancer, gastrointestinal (GI) cancer and colorectal cancer among older adults.
The study involved over 140,000 participants with a mean age of 66.3 years who participated in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. It found that aspirin intake of at least three times a week resulted in:

• 19 percent lower death risk from all-cause
• 15 percent lower death risk from any cancer type 
• 25 percent lower death risk from GI cancer
• 29 percent lower death risk from colorectal cancer 

A higher body mass index (BMI) of 25 to 29.9 lowered these risks by one percent, with the exception of colorectal cancer, the risk of which was decreased by 34 percent.
Among underweight people, with a BMI of 20 or less, no noticeable benefit of aspirin use was found, leading the researchers to hypothesize that "the efficacy of aspirin as a cancer preventive agent may be associated with BMI," although future studies are needed to confirm this theory. The authors also warned that prophylactic aspirin therapy as key to preventing cancer would need to be weighed against the increased risk of bleeding.
Other Health Risks Associated With Aspirin Use
Overall, there is a lot of evidence that make the case against long-term aspirin use. One major concern is the risk of internal bleeding,
magnified when taking antidepressants or blood-thinning medications.
In addition, routine aspirin use has been linked to GI tract damage, increased cataract risk and, for males, hearing loss.

Management of Spasticity After Traumatic Brain Injury in Children

The word management, not cure or results, already tells me this is useless.  No one wants a chronic condition managed, they want it cured.

Management of Spasticity After Traumatic Brain Injury in Children

Johannes M. N. Enslin^1,2*, Ursula K. Rohlwink^1,2,3 and Anthony Figaji^1,2

• ¹Paediatric Neurosurgery Unit, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
• ²Division of Neurosurgery, University of Cape Town, Cape Town, South Africa
• ³Neuroscience Institute, University of Cape Town, Cape Town, South Africa

Traumatic brain injury is a common cause of disability worldwide. In fact, trauma is the second most common cause of death and disability, still today. Traumatic brain injury affects nearly 475 000 children in the United States alone. Globally it is estimated that nearly 2 million people are affected by traumatic brain injuries every year. The mechanism of injury differs between countries in the developing world, where low velocity injuries and interpersonal violence dominates, and high-income countries where high velocity injuries are more common. Traumatic brain injury is not only associated with acute problems, but patients can suffer from longstanding consequences such as seizures, spasticity, cognitive and social issues, often long after the acute injury has resolved. Spasticity is common after traumatic brain injury in children and up to 38% of patients may develop spasticity in the first 12 months after cerebral injury from stroke or trauma. Management of spasticity in children after traumatic brain injury is often overlooked as there are more pressing issues to attend to in the early phase after injury. By the time the spasticity becomes a priority, often it is too late to make meaningful improvements without reverting to major corrective surgical techniques. There is also very little written on the topic of spasticity management after traumatic brain injury, especially in children. Most of the information we have is derived from stroke research. The focus of management strategies are largely medication use, physical therapy, and other physical rehabilitative strategies, with surgical management techniques used for long-term refractory cases only. With this manuscript, the authors aim to review our current understanding of the pathophysiology and management options, as well as prevention, of spasticity after traumatic brain injury in children.

Predicting Early Post-stroke Aphasia Outcome From Initial Aphasia Severity

Survivors don't care about predictions, they want rehab interventions that lead to recovery results. DO THE DAMN RESEARCH THAT WILL GET THERE. Not this lazy prediction crapola.  Have you ever talked to patients about what they want?

Predicting Early Post-stroke Aphasia Outcome From Initial Aphasia Severity

Alberto Osa García^1,2, Simona Maria Brambati^3,4, Amélie Brisebois^1,2, Marianne Désilets-Barnabé^1,2, Bérengère Houzé³, Christophe Bedetti³, Elizabeth Rochon^5,6,7,8, Carol Leonard^5,7,9, Alex Desautels^1,10,11 and Karine Marcotte^1,2*

• ¹Centre de Recherche du Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada
• ²École d'Orthophonie et d'Audiologie, Université de Montréal, Montreal, QC, Canada
• ³Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
• ⁴Département de Psychologie, Université de Montréal, Montreal, QC, Canada
• ⁵Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada
• ⁶Toronto Rehabilitation Institute, Toronto, ON, Canada
• ⁷Heart and Stroke Foundation, Canadian Partnership for Stroke Recovery, Ottawa, ON, Canada
• ⁸Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
• ⁹School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada
• ¹⁰Département de Neurosciences, Université de Montréal, Montreal, QC, Canada
• ¹¹Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de Montréal, Montreal, QC, Canada

Background: The greatest degree of language recovery in post-stroke aphasia takes place within the first weeks. Aphasia severity and lesion measures have been shown to be good predictors of long-term outcomes. However, little is known about their implications in early spontaneous recovery. The present study sought to determine which factors better predict early language outcomes in individuals with post-stroke aphasia.

Methods: Twenty individuals with post-stroke aphasia were assessed <72 h (acute) and 10–14 days (subacute) after stroke onset. We developed a composite score (CS) consisting of several linguistic sub-tests: repetition, oral comprehension and naming. Lesion volume, lesion load and diffusion measures [fractional anisotropy (FA) and axial diffusivity (AD)] from both arcuate fasciculi (AF) were also extracted using MRI scans performed at the same time points. A series of regression analyses were performed to predict the CS at the second assessment.

Results: Among the diffusion measures, only FA from right AF was found to be a significant predictor of early subacute aphasia outcome. However, when combined in two hierarchical models with FA, age and either lesion load or lesion size, the initial aphasia severity was found to account for most of the variance (R² = 0.678), similarly to the complete models (R² = 0.703 and R² = 0.73, respectively).

Conclusions: Initial aphasia severity was the best predictor of early post-stroke aphasia outcome, whereas lesion measures, though highly correlated, show less influence on the prediction model. We suggest that factors predicting early recovery may differ from those involved in long-term recovery.

OSF HealthCare offering stroke support group - Ottawa

This is a direct acknowledgement that this hospital is a complete failure at getting survivors 100% recovered. The board of directors needs to be removed. 

OSF HealthCare offering stroke support group - Ottawa

OSF HealthCare St. Elizabeth Medical Center is offering a Stroke Support Group with the first session from 9 to 10 a.m. Friday, March 6.
The group provides support for people who have had a stroke, their families and friends. This informal meeting allows attendees to share experiences, solve problems they may encounter and answer questions for those who are or have been in similar circumstances.

Participants will learn about stroke recovery, rehabilitation and prevention. Also, explore resources and support available to live a satisfying life while coping with any losses and disabilities associated with stroke.
The group will meet from 9 to 10 a.m. the first Friday of every month in the hospital's Meeting Room 4. No reservations are required. For questions, call Mary Yuhas, speech-language pathologist, at 815-431-5316.

MiR-34a Interacts with Cytochrome c and Shapes Stroke Outcomes

In mice so your stroke hospital needs to engage researchers to do human testing. That will never occur because survivors are not in charge at your hospital. 

MiR-34a Interacts with Cytochrome c and Shapes Stroke Outcomes

• Heng Hu,
• Emily A. Hone,
• Edward A. P. Provencher,
• Samuel A. Sprowls,
• Imran Farooqi,
• Deborah R. Corbin,
• Saumyendra N. Sarkar,
• John M. Hollander,
• Paul R. Lockman,
• James W. Simpkins &
• Xuefang Ren 

Scientific Reports volume 10, Article number: 3233 (2020) Cite this article

• 88 Accesses
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Abstract

Blood-brain barrier (BBB) dysfunction occurs in cerebrovascular diseases and neurodegenerative disorders such as stroke. Opening of the BBB during a stroke has a negative impact on acute outcomes. We have recently demonstrated that miR-34a regulates the BBB by targeting cytochrome c (CYC) in vitro. To investigate the role of miR-34a in a stroke, we purified primary cerebrovascular endothelial cells (pCECs) from mouse brains following 1 h transient middle cerebral artery occlusion (tMCAO) and measured real-time PCR to detect miR-34a levels. We demonstrate that the miR-34a levels are elevated in pCECs from tMCAO mice at the time point of BBB opening following 1 h tMCAO and reperfusion. Interestingly, knockout of miR-34a significantly reduces BBB permeability, alleviates disruption of tight junctions, and improves stroke outcomes compared to wild-type (WT) controls. CYC is decreased in the ischemic hemispheres and pCECs from WT but not in miR-34a^−/− mice following stroke reperfusion. We further confirmed CYC is a target of miR-34a by a dural luciferase reporter gene assay in vitro. Our study provides the first description of miR-34a affecting stroke outcomes and may lead to discovery of new mechanisms and treatments for cerebrovascular and neurodegenerative diseases such as stroke.

Oxygen Cost During Walking in Individuals With Stroke: Hemiparesis Versus Cerebellar Ataxia

Useless, no solution. So how do you increase the oxygen carrying capacity? 

Maybe this?

Chronic cannabis users have higher cerebral blood flow and extract more oxygen from brain blood flow than nonusers.

Or this?

Sesquiterpenes, a natural compound found in essential oils of Vetiver, Patchouli, Cedarwood, Sandalwood and Frankincense, can increase levels of oxygen in the brain by up to 28 percent 

Or maybe beet juice?

 The study showed that beet juice with high amounts of nitrate made the blood vessels relax and return to normal function

Or this?

How to Improve Your Brain Function with An Oxygen Concentrator April 2018 

Or this?

University of Glasgow Study Demonstrates the Ability of Oxycyte® to Supply Oxygen to Critical Penumbral Tissue in Acute Ischemic Stroke  August 2012

Or this? having red blood cells release more oxygen.

Methylene blue shows promise for improving short-term memory

 

 

The latest here:

Oxygen Cost During Walking in Individuals With Stroke: Hemiparesis Versus Cerebellar Atax/ia

Show all authors

Maxence Compagnat, Jean-Christophe Daviet, Charles Batcho, ...

First Published February 24, 2020 Research Article

https://doi.org/10.1177/1545968320907076

Article information

Abstract

Background.
Understanding the factors that limit mobility in stroke patients is fundamental for proposing appropriate rehabilitation strategies. A high oxygen cost during walking (Cw) has a strong impact on the community ambulation of hemiparetic patients. The Cw in poststroke cerebellar ataxia is poorly evaluated, unlike hemiparetic gait.  
Objective.
To compare the oxygen cost/self-selected walking speed (S) relationship in stroke individuals with cerebellar ataxia or hemiparetic gait.  
Methods.
Thirty-three subjects were included (14 cerebellar stroke, 19 hemispheric stroke), with stroke confirmed by brain imaging and able to walk without human assistance. We measured Cw using the Metamax3B. The relationship between Cw and self-selected walking speed was modelled by logistic regression and then compared between the cerebellar and hemispheric groups.  
Results.
No significant difference was found between the 2 groups for all characteristics of the population, except motor impairments, spasticity, and ataxia (P < .01). We identified 2 separate Cw/S relationships with different logistic regression equations for the 2 groups. Faster than 0.4 m s⁻¹, Cw was 30.6% to 39.9% higher in patients with cerebellar stroke in comparison with hemispheric stroke individuals. The Cw was correlated with ataxia (r = 0.88; P < .001) in the cerebellar group, whereas there was a correlation with motor impairments (r = −0.61; P < .01), spasticity (r = 0.59; P < .01), and ataxia (r = 0.81; P < .01) in hemispheric stroke individuals.  
Conclusion.
 The Cw in poststroke cerebellar ataxia is significantly higher compared with hemiparetic patients at an equivalent walking speed. The impact on community walking needs to be explored in stroke survivors with cerebellar stroke.

Adherence to a Rehabilitation Regimen in Stroke Patients: A Concept Analysis

My analysis is incredibly simple. No protocol(start here, do this x times, get this result) means why would stroke survivors adhere to what is at best a complete shot in the dark?

Adherence to a Rehabilitation Regimen in Stroke Patients: A Concept Analysis

Maryam Khoshbakht Pishkhani¹, Asghar Dalvandi², Abbas Ebadi³, Mohammad Ali Hosseini^4
1 Department of Nursing, School of Rehabilitation, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
² School of Rehabilitation, University of Social Welfare and Rehabilitation Sciences; School of Nursing and Midwifery, Islamic Azad University of Tehran, Central Branch, Tehran, Iran
³ Behavioral Sciences Research Center, Life Style Institute, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
⁴ Department of Rehabilitation Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

Date of Submission	14-Oct-2018
Date of Decision	07-Dec-2019
Date of Acceptance	23-Dec-2019
Date of Web Publication	24-Feb-2020

Correspondence Address:
Dr. Asghar Dalvandi
University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; School of Nursing and Midwifery, Islamic Azad University of Tehran, Central Branch, Tehran, Postcode: 1985713834
Iran

Source of Support: None, Conflict of Interest: None

Effectiveness of mirror therapy in stroke rehabilitation

We wouldn't need this waste of research if we had a complete database of stroke protocols and stroke research updated every time something new came in. But NO, our fucking failures of stroke associations can't even manage that simple task. 

 

Effectiveness of mirror therapy in stroke rehabilitation

Arch Neurocien 2019; 24 (4)

Language: Español
References: 22
Page: 48-58
PDF: 394.79 Kb.

Full text

ABSTRACT

Background: Stroke is the leading cause of neurological disability worldwide. It affects the motor or cognitive level and needs to be treated as early as possible. One of the therapies most commonly used to restore the sequelae of stroke is mirror therapy.
Objective: To find out the effectiveness of mirror therapy in stroke rehabilitation.
Method: Three databases were chosen for the search: Pubmed, Medline and Cinahl. The search equation contained three terms ("Stroke", "Treatment outcome" and "Mirror therapy") and articles were included in English. Once the reviews were excluded, the articles without access and those that do not fit the objective, we analyzed a total of 13 articles.
Results: 11 of the studies are RCTs and the remaining two are pilot studies. Most of the patients were men over 60 years of age who suffered an ischaemic stroke more than 3 weeks ago.
Discussion: We analysed the duration of the treatment, what it consisted of and its effects on the sequelae of the stroke that affect the functional capacities of the subjects who have suffered them.
Conclusion: motor function is one of the characteristics that best responds to experimental treatment although other less evaluated variables such as balance and negligence also obtained positive results.

An Exploration of Patient Perspectives on Factors Affecting Participation in Stroke Rehabilitation

This is so damned simple. Patient engagement is less than optimal because you fucking idiots have NO PROTOCOLS LEADING TO 100% RECOVERY.  Talk to some intelligent patients sometime, I'm available.

An Exploration of Patient Perspectives on Factors Affecting Participation in Stroke Rehabilitation

Authors: Last, Nicole
Advisor: Harris, Jocelyn
 Department: Rehabilitation Science
Keywords: stroke rehabilitation;participation;facilitator;barrier;qualitative;interpretive description
Publication Date: 2019

Abstract: 

Though patient participation is recognized as an important element of rehabilitation, few studies have used a qualitative lens to specifically examine factors influencing patient-participation in stroke rehabilitation. Thus, the purpose of this work was to explore factors perceived by service users to influence their participation in hospital-based stroke rehabilitation activities and to use this information to generate knowledge relevant for the clinical context of stroke rehabilitation. The following research gaps provided rationale for this work: 1) no published studies from the patients’ perspective on influencers of participating in hospital-based stroke rehabilitation programs, and 2) limited studies about influences on participation in hospital-based stroke rehabilitation. The first manuscript (chapter two) was designed to specifically address these gaps while the second manuscript (chapter three) was developed to highlight important findings surrounding rehabilitation intensity from chapter two. This thesis has discussed a number of patient-perceived barriers and facilitators to participating in stroke rehabilitation, which the final chapter conceptualizes into a framework of personalized rehabilitation representing a patient-centred approach to providing rehabilitation that encourages patient participation. Together, this thesis contributes knowledge about: 1) patient perspectives on factors affecting participation in stroke rehabilitation, 2) promoting patient participation, 3) shortcomings in closing the evidence-to-practice gap with respect to therapy intensity during inpatient stroke rehabilitation, and 4) insights into an exploratory framework of personalized rehabilitation developed from service users’ perspectives of stroke rehabilitation. In addition, this work emphasizes a call to action for the delivery of user-centered stroke care, specifically in regard to rehabilitation intensity during inpatient stroke rehabilitation. The implications of this work are directed at stroke rehabilitation providers as well as policy makers and stroke health system planners in order to develop appropriate and effective services and strategies for optimal recovery and successful implementation of best practice recommendations.URI: http://hdl.handle.net/11375/25303Appears in Collections:Open Access Dissertations and Theses

Molecular 'switch' reverses chronic inflammation and aging

I would much rather use this route to reduce the risk of stroke and heart attacks since inflammation is the reason cholesterol is grabbed out of the bloodstream and packed into plaque. Now if we can get our doctors and stroke hospitals to ensure further research is done to create an intervention for this. But since your hospital has never ensured earlier research is done, this will not be completed either. Oh well, we'll just have to wait until stroke survivors are in charge.

Molecular 'switch' reverses chronic inflammation and aging

ScienceDaily | February 07, 2020

Chronic inflammation, which results when old age, stress or environmental toxins keep the body's immune system in overdrive, can contribute to a variety of devastating diseases, from Alzheimer and Parkinson to diabetes and cancer.
Now, scientists at the University of California, Berkeley, have identified a molecular "switch" that controls the immune machinery responsible for chronic inflammation in the body. The finding, which appears online Feb. 6 in the journal Cell Metabolism, could lead to new ways to halt or even reverse many of these age-related conditions.
"My lab is very interested in understanding the reversibility of aging," said senior author Danica Chen, associate professor of metabolic biology, nutritional sciences and toxicology at UC Berkeley. "In the past, we showed that aged stem cells can be rejuvenated. Now, we are asking: to what extent can aging be reversed? And we are doing that by looking at physiological conditions, like inflammation and insulin resistance, that have been associated with aging-related degeneration and diseases."
In the study, Chen and her team show that a bulky collection of immune proteins called the NLRP3 inflammasome—responsible for sensing potential threats to the body and launching an inflammation response—can be essentially switched off by removing a small bit of molecular matter in a process called deacetylation.
Overactivation of the NLRP3 inflammasome has been linked to a variety of chronic conditions, including multiple sclerosis, cancer, diabetes and dementia. Chen's results suggest that drugs targeted toward deacetylating, or switching off, this NLRP3 inflammasome might help prevent or treat these conditions and possibly age-related degeneration in general.

• See Also: Memory games: Eating well to remember

"This acetylation can serve as a switch," Chen said. "So, when it is acetylated, this inflammasome is on. When it is deacetylated, the inflammasome is off."
By studying mice and immune cells called macrophages, the team found that a protein called SIRT2 is responsible for deacetylating the NLRP3 inflammasome. Mice that were bred with a genetic mutation that prevented them from producing SIRT2 showed more signs of inflammation at the ripe old age of two than their normal counterparts. These mice also exhibited higher insulin resistance, a condition associated with type 2 diabetes and metabolic syndrome.
The team also studied older mice whose immune systems had been destroyed with radiation and then reconstituted with blood stem cells that produced either the deacetylated or the acetylated version of the NLRP3 inflammasome. Those who were given the deacetylated, or "off," version of the inflammasome had improved insulin resistance after six weeks, indicating that switching off this immune machinery might actually reverse the course of metabolic disease.
"I think this finding has very important implications in treating major human chronic diseases," Chen said. "It's also a timely question to ask, because in the past year, many promising Alzheimer's disease trials ended in failure. One possible explanation is that treatment starts too late, and it has gone to the point of no return. So, I think it's more urgent than ever to understand the reversibility of aging-related conditions and use that knowledge to aid a drug development for aging-related diseases."

 

Researchers discover Mediterranean diet ingredient may extend life

Now we just need to know EXACTLY  how much to consume daily. I dip bread in olive oil and balsamic vinegar sometimes for my evening meal. Yeah, I know gluten, but I don't care about gluten. Well, I'm also continuing my red wine consumption since food research gets reversed so often.  

Researchers discover Mediterranean diet ingredient may extend life

MedicalXpress Breaking News-and-Events | February 21, 2020

Researchers at the University of Minnesota Medical School discover a potential new way in which diet influences aging-related diseases.

Doug Mashek, PhD, a professor in the Departments of Medicine and Biochemistry, Molecular Biology and Biophysics, leads a team of researchers who discovered that olive oil in the Mediterranean diet may hold the key to improving lifespan and mitigating aging-related diseases. Over the last 8 years, with the help of multiple grants from the National Institutes of Health, their research findings were recently published in Molecular Cell.

Early studies on the diet suggested red wine was a major contributor to the health benefits of the Mediterranean diet because it contains a compound called resveratrol, which activated a certain pathway in cells known to increase lifespan and prevent aging-related diseases. However, work in Mashek's lab suggests that it is the fat in olive oil, another component of the Mediterranean diet, that is actually activating this pathway.
According to Mashek, merely consuming olive oil is not enough to elicit all of the health benefits. His team's studies suggest that when coupled with fasting, limiting caloric intake and exercising, the effects of consuming olive oil will be most pronounced.

• See Also: Molecular 'switch' reverses chronic inflammation and aging

"We found that the way this fat works is it first has to get stored in microscopic things called lipid droplets, which is how our cells store fat. And then, when the fat is broken down during exercising or fasting, for example, is when the signaling and beneficial effects are realized," Mashek said.
The next steps for their research are to translate it to humans with the goal of discovering new drugs or to further tailor dietary regimens that improve health, both short-term and long-term.
"We want to understand the biology, and then translate it to humans, hopefully changing the paradigm of healthcare from someone going to eight different doctors to treat his or her eight different disorders," Mashek said. "These are all aging-related diseases, so let's treat aging."