Long-Term NSAID Use Linked to Lower Dementia Risk

Be aware of these problems:

What are symptoms of too much ibuprofen long-term?
Long-term effects:

impaired hearing. kidney and liver damage. bleeding in the stomach and bowels. increased risk of heart attack. 

The main types of NSAIDs include:

• ibuprofen.
• naproxen.
• diclofenac.
• celecoxib.
• mefenamic acid.
• etoricoxib.
• indomethacin.
• aspirin for pain relief (low-dose aspirin is not normally considered to be an NSAID)

Long-Term NSAID Use Linked to Lower Dementia Risk

Summary: A new study finds that long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) is associated with a lower risk of developing dementia. Researchers followed 11,745 adults over 14.5 years and found that those who used NSAIDs long-term had a 12% reduced dementia risk.

However, short- and intermediate-term NSAID use did not provide the same benefit, nor was the total cumulative dose linked to risk reduction. These findings suggest that sustained anti-inflammatory effects may play a role in protecting against dementia.

Key Facts

• Long-Term NSAID Use: Associated with a 12% lower risk of dementia.
• Short-Term Use: No significant protective effect was observed.
• Anti-Inflammatory Role: Findings support inflammation’s role in dementia progression.

Source: Wiley

Past research has suggested that inflammation may contribute to the development and progression of dementia and that non-steroidal anti-inflammatory (NSAID) medications may help protect against dementia due to their anti-inflammatory effects.

Long-term NSAID use was associated with a 12% reduced risk of developing dementia. Short- and intermediate-term use did not provide benefits. Credit: Neuroscience News

A new large prospective study published in the Journal of the American Geriatrics Society provides additional evidence, showing that long-term NSAID use is linked to a decreased risk of developing dementia.

In the population-based study of 11,745 adults with an average follow-up of 14.5 years, 9,520 participants had used NSAIDs at any given time, and 2,091 participants developed dementia. Long-term NSAID use was associated with a 12% reduced risk of developing dementia. Short- and intermediate-term use did not provide benefits.

Also, the cumulative dose of NSAIDs was not associated with decreased dementia risk.

The findings suggest that prolonged, rather than intensive, use of anti-inflammatory medications may help protect against dementia.

“Our study provides evidence on possible preventive effects of anti-inflammatory medication against the dementia process.

“There is a need for more studies to further consolidate this evidence and possibly develop preventive strategies,” said corresponding author M. Arfan Ikram, MSc, MD, PhD, of Erasmus MC University Medical Center Rotterdam, in the Netherlands.

About this neuropharmacology and dementia research news

Author: Sara Henning-Stout
Source: Wiley
Contact: Sara Henning-Stout – Wiley
Image: The image is credited to Neuroscience News

Original Research: The findings will appear in Journal of the American Geriatrics Society

Vote for your favorite Stroke Hero

 Since I'm not available to vote for as an anti-hero, you'll have to choose someone else. Write in candidates don't seem to be allowed, that would disrupt their incorrect ideas on how to solve stroke! The name is Dean Reinke for those wishing to disrupt the stroke medical world and save their children and grandchildren from the consequences of stroke.  I have never been contacted by anyone of consequence in stroke because they are afraid of me.

Vote for your favorite Stroke Hero

Introducing our 2025 Stroke Hero Voters’ Choice finalists! Learn about these individuals and groups in the stroke community who have shown resilience and outstanding progress. Then vote for your favorite and share to encourage others to vote!

Voting Ends

March 18, 2025

8:00 PM CT

You must be 18 or older to vote. You can vote one time per 24 hours using one email address. If you try to vote more often or with multiple email addresses, your votes could be removed. Thank you for helping us make this a fair event.

This year, the voting contest is available only in English. We appreciate your understanding. / Este año, la votación está disponible solo en inglés. Agradecemos tu comprensión.

Amy Booth

Baton Rouge, Louisiana

50 votes

Ann Alston

Bear Creek, North Carolina

34 votes

Baton Rouge Rehab Hospital Stroke Support Group

Baton Rouge, Louisiana

71 votes

Dileep Yavagal

Miami, Florida

228 votes

Don Spohn

Grand Ledge, Michigan

240 votes

Kathie Johnson

Waynesville, North Carolina

19 votes

Kathy O’Leary

Buffalo, New York

243 votes

Lauren Cinnamon

Kewanee, Illinois

135 votes

Lexi Frederick

Ankeny, Iowa

48 votes

Nikki Juvan

Middlebury, Vermont

116 votes

The RiverBend Stroke Survivor and Caregiver Support Group

Springfield, Oregon

48 votes

Tyler Sacco

Baton Rouge, Louisiana

30 votes                 

Survivors of Ischaemic, Haemorrhagic Stroke at High Long-Term Risk of Dementia

 I've been writing about this for years and you're finally catching up to me? Tells a lot about the complete fucking failure of the stroke medical world when a stroke survivor knows more than they do! 

1. A documented 33% dementia chance post-stroke from an Australian study?   May 2012.

2. Then this study came out and seems to have a range from 17-66%. December 2013.`    

3. A 20% chance in this research.   July 2013.

4. Dementia Risk Doubled in Patients Following Stroke September 2018

5. Brain Bleeds Double Dementia Risk February 2025

Survivors of Ischaemic, Haemorrhagic Stroke at High Long-Term Risk of Dementia

Survivors of intracerebral haemorrhage and subarachnoid haemorrhage are at particularly high long-term risk of post-stroke dementia, according to a study published in the journal Stroke.

“In this nationwide cohort of stroke survivors aged 18 years and older, 11.5% received dementia diagnoses up to 30 years after their stroke,” reported Priscila Corraini, PhD, Aarhus University Hospital, Aarhus, Denmark, and colleagues. “This risk was increased almost 2-fold compared with the general population. The risks for post-stroke dementia were substantially higher for haemorrhagic forms of stroke than for ischaemic stroke and for stroke occurring at younger ages than at older ages. Risks among survivors were persistently high even after 10 years.”

The increased risk of post-stroke dementia was not altered appreciably by vascular factors or by other measured factors associated with both stroke and dementia risk.

For the study, the researchers conducted a 30-year nationwide population-based cohort study using data from Danish medical databases (1982-2013) covering all Danish hospitals. They identified 84,220 ischaemic stroke survivors, 16,723 intracerebral haemorrhage survivors, 9,872 subarachnoid haemorrhage survivors, and 104,303 survivors of unspecified stroke types. Patients were matched (by age and sex) and compared with a cohort from the general population (1,075,588 patients without stroke).

The 30-year absolute risk of dementia among stroke survivors was 11.5%. Compared with the general population, the hazard ratio for dementia among stroke survivors was 1.80 (95 confidence interval [CI], 1.77-1.84) after any stroke, 1.72 (95% CI, 1.66-1.77) after ischaemic stroke, 2.70 (95% CI, 2.53-2.89) after intracerebral haemorrhage, and 2.74 (95% CI, 2.45-3.06) after subarachnoid haemorrhage.

Younger patients regardless of stroke type faced higher risks of post-stroke dementia than older patients, a finding that suggests that younger survivors also represent important targets for planning dementia prevention strategies in the future.

“Our findings extend those of earlier cohort studies based on first-time ischaemic strokes or any type of stroke,” the authors wrote. “Most were restricted to older individuals and to shorter follow-up periods. In the present study, relative risks for any stroke were comparable to the 2-fold increased risk within 10 years of follow-up reported for the Framingham and Rotterdam cohorts.”

The authors noted that the validity of their findings is enhanced by the use of a nationwide cohort with universal healthcare coverage, standard practices for treating stroke, and virtually complete follow-up.

Reference: https://www.ahajournals.org/doi/10.1161/STROKEAHA.116.015242

SOURCE: Stroke

A new nomogram for predicting 90-day outcomes of intravenous thrombolysis in patients with acute ischaemic stroke

Predictions DO NOTHING TO GET SURVIVORS RECOVERED! I'd have you all fired!

 A new nomogram for predicting 90-day outcomes of intravenous thrombolysis in patients with acute ischaemic stroke

Yingjie ZhaoRui ZhangPan LiZhen ZhangHuan YuZhaoya SuYandong XiaAiguo Meng^*

• Department of Clinical Laboratory, North China University of Science and Technology Affiliated Hospital, Tangshan, China

Background: The aim of this study was to construct and validate a new nomogram to predict the risk of poor outcome in patients with acute ischemic stroke (AIS) after intravenous thrombolytic therapy (IVT).

Methods: A total of 425 patients who received IVT within 4.5 h of stroke onset were included in a retrospective study. All the patients were divided into training (70%, n = 298) and validation cohorts (30%, n = 127). Poor outcome (defined as a 90-day modified Rankin Scale score 3–5) was the primary outcome. Logistic regression was used for analysis of independent risk factors for poor outcome in patients with AIS. Nomograms of poor outcome in AIS patients were constructed using R software. Discrimination and calibration of the models were assessed using area under the receiver operating characteristic (ROC) curve (AUC) and calibration plots.

Results: Multifactorial logistic regression analysis showed that SII (OR = 1.001, 95% CI: 1.000–1.002, p = 0.008), SIRI (OR = 1.584, 95% CI: 1.122–2.236, p = 0.009), NIHSS (OR = 1.101, 95% CI: 1.044–1.160, p < 0.001), and history of diabetes mellitus (OR = 2.582, 95% CI: 1.285–5.188, p = 0.008) were the independent risk factors for the occurrence of poor outcome in AIS patients. The poor outcome nomogram for AIS patients was constructed based on the above independent risk factors. The training and validation cohort AUCs of the nomogram were 0.854 (95% CI: 0.807–0.901) and 0.855 (95% CI: 0.783–0.927), respectively. The prediction models were well calibrated in both the training and validation cohorts. The net benefit of the nomograms was better when the threshold probability ranges were 4.28–66.4% and 4.01–67.8% for the training and validation cohorts, respectively.

Conclusion: New nomogram includes NIHSS, SII, SIRI and diabetes as variables with the potential to predict the risk of 90-day outcomes in patients with AIS following IVT.

1 Introduction

Stroke, a sudden neurological disorder, is a leading cause of disability and death in adults (1). Among stroke cases, acute ischemic stroke (AIS) accounts for 60 to 80% (2). Intravenous thrombolysis with recombinant tissue-type plasminogen activator (rt-PA) within 4.5 h of onset of symptoms is the treatment of choice and significantly improves neurological function in patients (3). However, a certain percentage of patients continue to experience poor prognostic outcomes (4). Therefore, the early identification of patients at risk for poor outcome, along with timely and accurate therapeutic interventions, is crucial for improving patient recovery and outcomes (5, 6). A nomogram is a visual scoring model that utilizes biological and clinical variables to accurately calculate the probability of an individual patient’s risk for a specific clinical event (7). The chart is widely used for clinical decision-making in a wide range of conditions (8, 9). Nomograms surpass traditional scoring systems in their ability to more accurately identify patients with poor outcome, assist in selecting optimal treatment options, and enhance the quality of patient survival (10). The aim of this study was to construct a nomogram to predict the risk probability of poor outcome in AIS patients following intravenous thrombolytic therapy.

More at link.

Tenecteplase No Longer Off-Label as Stroke Lytic

 Ask your competent? doctor if this is any better than the abysmal failure rate of tPA at 88% failure to get to 100% recovery! If your doctor isn't working on 100% recovery YOU DON'T HAVE A FUNCTIONING STROKE DOCTOR!

Tenecteplase No Longer Off-Label as Stroke Lytic

FDA approves clot-dissolving drug after years of real-world use

by Nicole Lou, Senior Staff Writer, MedPage Today March 3, 2025

The FDA approved tenecteplase (TNKase) for adult stroke patients, Genentech announced on Monday.

A clot-dissolving tissue plasminogen activator (tPA), tenecteplase is now indicated for acute ischemic stroke on top of its older approval in acute ST-elevation myocardial infarction. Tenecteplase thus officially joins the other stroke thrombolytic approved stateside, alteplase (Activase), which is also marketed by Genentech.

Notably, off-label tenecteplase had already become the preferred thrombolytic for acute ischemic stroke before the expanded indication.

"TNKase provides a faster and simpler administration, which can be critical for anyone who is dealing with an acute stroke," said Levi Garraway, MD, PhD, Genentech's chief medical officer, in a statement. "Today's approval is a significant step forward and underscores our commitment to advancing stroke treatment options for patients."

FDA approval was based on the AcT noninferiority trial that found tenecteplase (at 0.25 mg/kg) to be at least on par(The tyranny of low expectations rears its' ugly head once again. You'll want 100% recovery when you 

are the 1 in 4 per WHO that has a stroke so, you better start working on it now.)with alteplase for safety and efficacy in acute ischemic stroke in Canadians presenting within 4.5 hours of symptom onset.

Tenecteplase's updated label calls for IV administration as a single bolus over 5 seconds. Treatment should be initiated as soon as possible and within 3 hours of stroke onset.

For later-presenting stroke patients, however, this excludes the possibility of an extended window for IV thrombolysis in select stroke patients for whom thrombectomy is not available or indicated. Earlier, the TRACE-III trial had found that late administration of tenecteplase was of clinical benefit in the 4.5- to 24-hour window after a stroke in situations where thrombectomy was not available immediately.

Genentech noted that tenecteplase is the first stroke medicine approved by the FDA in nearly 30 years.

The label for the drug warns of bleeding, hypersensitivity, and arrhythmias with its use. There have also been reports of cholesterol embolization among lytic recipients and thromboembolism in those with a left heart thrombus.

Tenecteplase is contraindicated for stroke patients with active internal bleeding, active intracranial hemorrhage, and severe uncontrolled hypertension, among other criteria.

Kinematic descriptions of upper limb function using simulated tasks in activities of daily living after stroke

 Describing something without having protocols to fix anything is ABSOLUTELY FUCKING WORTHLESS!

Send me hate mail on this: oc1dean@gmail.com. I'll print your complete statement with your name and my response in my blog. Or are you afraid to engage with my stroke-addled mind? No excuses are allowed! You're medically trained; it should be simple to precisely state EXACTLY WHAT GOOD 'Kinematic descriptions' do for recovery with NO EXCUSES! Your definition of competence in stroke is obviously much lower than stroke survivors' definition of your competence! Swearing at me is allowed, I'll return the favor. Don't even attempt to use the excuse that brain research is hard.

Kinematic descriptions of upper limb function using simulated tasks in activities of daily living after stroke

Author links open overlay panel, , ,

https://doi.org/10.1016/j.humov.2021.102834

Get rights and content

Highlights

• •
  Stroke survivors show impairment of spatial and temporal upper limb control.
• •
  Upper limb function is assessed by a simulated task in activities of daily living.
• •
  Changes in relative timing of the task suggest changes in motor strategies.
• •
  Increased variability could imply the tendency toward less stable patterns.
• •
  Improving temporal control of movements should be considered in rehabilitation.

Abstract

Assessment of upper limb function poststroke is critical for clinical management and determining the efficacy of interventions. We designed a unilateral upper limb task to simulate activities of daily living to examine how chronic stroke survivors manage reaching, grasping and handling skills simultaneously to perform the functional task using kinematic analysis. The aim of the study was to compare the motor strategies for performing a functional task between paretic and nonparetic arms. Sixteen chronic stroke survivors were instructed to control an ergonomic spoon to transfer liquid from a large bowl to a small bowl using paretic or nonparetic arm. Kinematic data were recorded using a Vicon motion capture system. Outcome measures included movement duration, relative timing, path length, joint excursions, and trial-to-trial variability. Results showed that movement duration, spoon path length, and trunk path length increased significantly when participants used paretic arm to perform the task. Participants tended to reduce shoulder and elbow excursions, and increase trunk excursions to perform the task with paretic arm and altered the relative timing of the task. Although participants used different motor strategies to perform the task with their paretic arms, we did not find the significant differences in trial-to trial variability of joint excursions between paretic and nonparetic arms. The results revealed differences in temporal and spatial aspects of motor strategies between paretic and nonparetic arms. Clinicians should explore the underlying causes of pathological movement patterns and facilitate preferred movement patterns of paretic arm.(And what are the EXACT PROTOCOLS TO DO THAT? You don't seem to have any, so fucking worthless! I'd have you all fired for incompetence!)

Introduction

Stroke is a leading cause of long-term disability and most stroke survivors have chronic upper limb dysfunction. Dysfunction in upper limbs is a combination of muscle weakness, paralysis, spasticity, sensory loss and abnormal motor synergies, which impairs the performance of activities of daily living (ADLs). Therefore, assessment of upper limb function is critical for clinical management and determining the efficacy of interventions.

Assessment of upper limb function in stroke patients is usually performed using standardized clinical scales, such as Fugl-Meyer Assessment (FMA), Wolf Motor Function Test (WMFT), Motor Activity Log (MAL), and Action Research Arm Test (ARAT). These clinical scales are reliable measures, but could lack sensitivity to detect minor changes in motor performance due to the nature of ordinal scales, especially when patients are close to full recovery. Detecting minor changes in motor performance could provide a more comprehensive view of recovery process and help clinicians evaluate the efficacy of interventions (van Dokkum et al., 2014).

Apart from clinical scales, researchers use motion capture systems to evaluate upper limb function via kinematic analysis. Over the past decade, there was an increasing trend of using kinematic analysis, which provides detailed spatiotemporal information of limbs movements (Santisteban et al., 2016). Kinematic analysis represents the best way to distinguish behavioral restitution from substitution, which is essential to assess motor performance in stroke recovery(Kwakkel et al., 2017; Schwarz Anne, Kanzler, Olivier, Luft, & Veerbeek, 2019). Behavioral restitution is defined as a return pre-lesion movement pattern or function of the affected limb. Behavioral substitution is defined as the emergence of new movement strategies that differ from the original, which is referred to as compensation. Unlike gait analysis which primarily examine cyclical movements of the lower limbs, assessment of upper limb movements is challenging due to a large repertoire of upper limbs movement for ADLs. Previous studies used forward reaching (Massie, Malcolm, Greene, & Browning, 2012; Robertson & Roby-Brami, 2011), side reaching (Verheyden et al., 2011), and grasping (Alt Murphy, Willén, & Sunnerhagen, 2012) to measure upper limb kinematics. Results showed that stroke patients had greater movement duration, greater reach path ratio, reduced shoulder and elbow excursions, and greater trunk displacement during reaching tasks with paretic arms(Collins, Kennedy, Clark, & Pomeroy, 2018). While these studies contain a wealth of information about upper limb control, there is a gap between real-life activities and the simple tasks used in research settings. Those simple tasks may not reflect the level of abilities to perform ADLs because movements in simple tasks are primarily performed in two-dimensional plane and one or two steps. Since most ADLs involving upper limbs are performed in three-dimensional space and multi-steps, three-dimensional tasks that require the coordination of shoulder, elbow and hand should be favored to assess behavioral restitution(Schwarz Anne et al., 2019). Here, we designed a unilateral upper limb task to simulate ADLs and examined how chronic stroke survivors control serial movements of reaching, grasping and handling an ergonomic spoon to transfer liquid from a large bowl to a small personal bowl in three-dimensional space. Moreover, we intended to examine both temporal and spatial aspects of kinematics between paretic and nonparetic arms when chronic stroke survivors perform the unilateral upper limb task with an ergonomic spoon.

A movement pattern is coordinated if individuals can perform the movement pattern consistently in repeated trials to accomplish a desired task, reflecting the stability of a movement pattern (Magill, 2011). The term “stability” refers to the consistency of the spatiotemporal pattern of movement, which can be measured by the variability of kinematic variables. If the motor system is perturbed due to stroke, the variability of kinematic variables may be increased (Thies et al., 2009). We intended to examine the variability of kinematic variables by testing whether the movement patterns of upper limbs could be reproduced with consistency when participants use their paretic arm to perform the task.

The purpose of this study was to 1) examine temporal aspects of kinematics between paretic and nonparetic arms when chronic stroke survivors perform the unilateral upper limb task with an ergonomic spoon, 2) examine the spatial aspects of kinematics between paretic and nonparetic arms during the task, and 3) compare the kinematic variability of paretic arm movements to the kinematic variability of nonparetic arm movements during the task. Outcome measures included movement duration, relative timing, path length, joint excursions, and trial-to-trial variability.

High Fibrinogen Levels Linked to Cognitive Decline in Ischemic Cerebrovascular Disease Patients

Your competent? doctor has been working on fibrinogen for a long time, right? Oh no, you don't have a functioning stroke doctor implementing research to get you recovered and prevent dementia! RUN AWAY!

fibrinogen (6 posts to December 2016)

High Fibrinogen Levels Linked to Cognitive Decline in Ischemic Cerebrovascular Disease Patients

Read at link.

 

Kinematic descriptions of upper limb function using simulated tasks in activities of daily living after stroke

 ABSOLUTELY NOTHING here gets survivors recovered! Describing something DOESN'T DO ONE DAMN THING! I'd have you all fired!

Kinematic descriptions of upper limb function using simulated tasks in activities of daily living after stroke

Author links open overlay panel, , ,

https://doi.org/10.1016/j.humov.2021.102834

Get rights and content

Highlights

• •
  Stroke survivors show impairment of spatial and temporal upper limb control.
• •
  Upper limb function is assessed by a simulated task in activities of daily living.
• •
  Changes in relative timing of the task suggest changes in motor strategies.
• •
  Increased variability could imply the tendency toward less stable patterns.
• •
  Improving temporal control of movements should be considered in rehabilitation.

Abstract

Assessment of upper limb function poststroke is critical for clinical management and determining the efficacy of interventions. We designed a unilateral upper limb task to simulate activities of daily living to examine how chronic stroke survivors manage reaching, grasping and handling skills simultaneously to perform the functional task using kinematic analysis. The aim of the study was to compare the motor strategies for performing a functional task between paretic and nonparetic arms. Sixteen chronic stroke survivors were instructed to control an ergonomic spoon to transfer liquid from a large bowl to a small bowl using paretic or nonparetic arm. Kinematic data were recorded using a Vicon motion capture system. Outcome measures included movement duration, relative timing, path length, joint excursions, and trial-to-trial variability. Results showed that movement duration, spoon path length, and trunk path length increased significantly when participants used paretic arm to perform the task. Participants tended to reduce shoulder and elbow excursions, and increase trunk excursions to perform the task with paretic arm and altered the relative timing of the task. Although participants used different motor strategies to perform the task with their paretic arms, we did not find the significant differences in trial-to trial variability of joint excursions between paretic and nonparetic arms. The results revealed differences in temporal and spatial aspects of motor strategies between paretic and nonparetic arms. Clinicians should explore the underlying causes of pathological movement patterns and facilitate preferred movement patterns of paretic arm.

Introduction

Stroke is a leading cause of long-term disability and most stroke survivors have chronic upper limb dysfunction. Dysfunction in upper limbs is a combination of muscle weakness, paralysis, spasticity, sensory loss and abnormal motor synergies, which impairs the performance of activities of daily living (ADLs). Therefore, assessment of upper limb function is critical for clinical management and determining the efficacy of interventions.

Assessment of upper limb function in stroke patients is usually performed using standardized clinical scales, such as Fugl-Meyer Assessment (FMA), Wolf Motor Function Test (WMFT), Motor Activity Log (MAL), and Action Research Arm Test (ARAT). These clinical scales are reliable measures, but could lack sensitivity to detect minor changes in motor performance due to the nature of ordinal scales, especially when patients are close to full recovery. Detecting minor changes in motor performance could provide a more comprehensive view of recovery process and help clinicians evaluate the efficacy of interventions (van Dokkum et al., 2014).

Apart from clinical scales, researchers use motion capture systems to evaluate upper limb function via kinematic analysis. Over the past decade, there was an increasing trend of using kinematic analysis, which provides detailed spatiotemporal information of limbs movements (Santisteban et al., 2016). Kinematic analysis represents the best way to distinguish behavioral restitution from substitution, which is essential to assess motor performance in stroke recovery(Kwakkel et al., 2017; Schwarz Anne, Kanzler, Olivier, Luft, & Veerbeek, 2019). Behavioral restitution is defined as a return pre-lesion movement pattern or function of the affected limb. Behavioral substitution is defined as the emergence of new movement strategies that differ from the original, which is referred to as compensation. Unlike gait analysis which primarily examine cyclical movements of the lower limbs, assessment of upper limb movements is challenging due to a large repertoire of upper limbs movement for ADLs. Previous studies used forward reaching (Massie, Malcolm, Greene, & Browning, 2012; Robertson & Roby-Brami, 2011), side reaching (Verheyden et al., 2011), and grasping (Alt Murphy, Willén, & Sunnerhagen, 2012) to measure upper limb kinematics. Results showed that stroke patients had greater movement duration, greater reach path ratio, reduced shoulder and elbow excursions, and greater trunk displacement during reaching tasks with paretic arms(Collins, Kennedy, Clark, & Pomeroy, 2018). While these studies contain a wealth of information about upper limb control, there is a gap between real-life activities and the simple tasks used in research settings. Those simple tasks may not reflect the level of abilities to perform ADLs because movements in simple tasks are primarily performed in two-dimensional plane and one or two steps. Since most ADLs involving upper limbs are performed in three-dimensional space and multi-steps, three-dimensional tasks that require the coordination of shoulder, elbow and hand should be favored to assess behavioral restitution(Schwarz Anne et al., 2019). Here, we designed a unilateral upper limb task to simulate ADLs and examined how chronic stroke survivors control serial movements of reaching, grasping and handling an ergonomic spoon to transfer liquid from a large bowl to a small personal bowl in three-dimensional space. Moreover, we intended to examine both temporal and spatial aspects of kinematics between paretic and nonparetic arms when chronic stroke survivors perform the unilateral upper limb task with an ergonomic spoon.

A movement pattern is coordinated if individuals can perform the movement pattern consistently in repeated trials to accomplish a desired task, reflecting the stability of a movement pattern (Magill, 2011). The term “stability” refers to the consistency of the spatiotemporal pattern of movement, which can be measured by the variability of kinematic variables. If the motor system is perturbed due to stroke, the variability of kinematic variables may be increased (Thies et al., 2009). We intended to examine the variability of kinematic variables by testing whether the movement patterns of upper limbs could be reproduced with consistency when participants use their paretic arm to perform the task.

The purpose of this study was to 1) examine temporal aspects of kinematics between paretic and nonparetic arms when chronic stroke survivors perform the unilateral upper limb task with an ergonomic spoon, 2) examine the spatial aspects of kinematics between paretic and nonparetic arms during the task, and 3) compare the kinematic variability of paretic arm movements to the kinematic variability of nonparetic arm movements during the task. Outcome measures included movement duration, relative timing, path length, joint excursions, and trial-to-trial variability.

Cognitive gains and cortical thickness changes after 12 weeks of resistance training in older adults with low and high risk of mild cognitive impairment: Findings from a randomized controlled trial

 Ask you competent? doctor if this is enough to recover your 5 lost years of brain cognition due to your stroke AND what are the EXACT PROTOCOLS to accomplish this.  The keyword there is: 'EXACT'!

Cognitive gains and cortical thickness changes after 12 weeks of resistance training in older adults with low and high risk of mild cognitive impairment: Findings from a randomized controlled trial

Simona Kušleikienė  ¹ , Gal Ziv  ² , Wouter A J Vints  ³ , Erika Krasinskė  ¹ , Milda Šarkinaite  ⁴ , Orgesa Qipo  ⁵ , Ivan Bautmans  ⁶ , Uwe Himmelreich  ⁷ , Nerijus Masiulis  ⁸ , Vida J Česnaitienė  ¹ , Oron Levin  ⁹

Affiliations

• PMID: 39954817
• DOI: 10.1016/j.brainresbull.2025.111249

Free article

Abstract

Background: In this randomized controlled trial, we assessed the neuroprotective effect of a 12-week resistance training (RT) program on executive control and cortical thickness of the prefrontal, temporal, parietal, and central cortex, regions prone to structural decline in individuals with mild cognitive impairment (MCI).

Methods: Seventy older adults (aged 60-85 y old, 38 females and 32 males) were randomly allocated to a 12-week lower limb RT program or a waiting list control group. The Montreal Cognitive Assessment (MoCA) was used to stratify participants screened for high (< 26) or low (≥ 26) MCI risk. Cognitive measurements consisted of the two-choice reaction time, Go/No-go, mathematical processing, and memory search tests. Cortical thickness was estimated from 3D T1-weighted MR images.

Results: Complete randomized controlled trial data was obtained from 50 individuals (24 with high MCI risk). Significant Group x Time interactions were found for response on the Go/No-go task and cortical thickness of the right parahippocampal gyrus [F ≥ 5.3, p ≤ 0.03; η²_p ≥ 0.12]. An inspection of these observations revealed an increase in cortical thickness (+1.18 %) and a decrease in response time (-4.35 %) in individuals with high MCI risk allocated to the exercise group (both uncorrected p = 0.08). Decreased response time on the Go/No-go task was associated with increased cortical thickness in the right entorhinal gyrus (uncorrected p = 0.01).

Conclusions: Our study demonstrated that 12 weeks of RT intervention may effectively improve cognitive performance and slow neuronal loss in the hippocampal complex of older adults at high MCI risk. Findings support evidence for the neuroprotective effects of resistance training and its potential role in cognitive health.

Keywords: Brain; Cognition; Cortical thickness; Imaging; Older age; Resistance exercise; Strength.

Copyright © 2025 The Authors. Published by Elsevier Inc. All rights reserved.

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