Review Article on adult neurogenesis in humans

Maybe, just maybe you want your doctor to analyze this to create protocols for neurogenesis AND migration of those new neurons to the needed areas. At least if they are competent they can do this. Since we have fucking failures of stroke associations each stroke doctor in the world has to do this individually. Hope your doctor is good at creating protocols from research. There is no way to tell if this is being done properly so good luck. 

Review Article on adult neurogenesis in humans

DabaAbdissa

https://doi.org/10.1016/j.tria.2020.100074Get rights and content

Under a Creative Commons license

open access

Highlights on adult neurogenesis in humans

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Investigators have confirmed that neurogenesis occurs in discrete areas of the adult brain.

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This occurs primarily in the subventricular zone of the lateral ventricles and the subgranular zone of the dentate gyrus.

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Growth factors, neurotrophins, cytokines and hormones are the major regulators of adult neurogenesis.

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Much progress was made over the past decade on adult neurogenesis.

Abstract

The concept of neurogenesis in the adult human brain was conceived in the 1960s, revisited in the 1980s and confirmed in the 1990s. It was a controversial area of research due to methodological challenges. It is now widely accepted that new neurons are continually generated in specific regions in the adult brain. This occurs primarily in the subventricular zone of the lateral ventricles and the subgranular zone of the dentate gyrus in the hippocampus. Neuroblasts from the subventricular zone migrate along the rostral migratory stream into the olfactory bulb, whereas neuroblasts from the subgranular zone show relatively little migratory behavior, and differentiate into dentate gyrus granule cells. Growth factors, neurotrophins, cytokines, and hormones are also major regulators of adult neurogenesis.

Much progress was made over the past decade, but many questions were remain unanswered, new insights are emerging at a stunning rate and made the investigation of neurogenesis in the adult human brain an intense area of research. In this review, I tried to present recent research findings regarding basic concept, historical background, primary site, factors influencing, clinical implications and functions of adult neurogenesis. Literatures searched for this paper were carried out by accessing PubMed, Google scholar, Web of science and other databases.

More at link.

Kessler researchers test trunk-strengthening program for hemiplegia post stroke

Do you really think your hospital is going to buy this expensive equipment? Your doctor needs to have stroke protocols that deliver trunk strengthening without this high tech piece of equipment. At least if your doctor is competent. 

Kessler researchers test trunk-strengthening program for hemiplegia post stroke 

Rakesh Pilkar, Ph.D., will conduct a pilot study of the AllCore360º device for improving core strength, posture and balance in individuals with hemiplegia following chronic stroke

Kessler Foundation

IMAGE: Dr. Pilkar monitors a demo of the ALLCore360, the electromechanical device being tested for stroke rehabilitation at Kessler Foundation. view more 

Credit: Kessler Foundation/Carolann Murphy

East Hanover, NJ. February 26, 2020. Researchers at Kessler Foundation are studying a potential application of a trunk-strengthening program to improve posture, balance, and mobility in individuals recovering from stroke. They will test the feasibility of using an electromechanical device called the AllCore360º Core Therapy and Training System in the rehabilitation of stroke survivors with hemiplegia. Rakesh Pilkar, PhD, research scientist in the Center for Mobility and Rehabilitation Engineering Research, is the principal investigator for the study, titled, "A novel trunk-strengthening program for improving posture and balance for individuals with hemiplegia post stroke," which is supported by AllCore360º (Alpharetta, GA) and Kessler Foundation.
The impact of weakness of trunk muscles after stroke is substantial. Adverse effects on posture and balance impair the performance of activities of daily living, impede recovery, and limit independence. Poor trunk control is associated with longer hospital stays, increased risk for falls, and poorer function at discharge. "Despite evidence for the importance of trunk control to functional outcomes in this population, there is a lack of a standardized approach to trunk strengthening in stroke rehabilitation," said Dr. Pilkar, "and little information on the application of electromechanical devices for this type of therapy.(Don't allow this lack be the excuse your doctor uses for doing nothing on protocols for this.) This pilot study enables us to test a trunk-strengthening protocol using the AllCore360º in individuals with hemiplegia, examine the underlying neuromuscular mechanisms, and measure the effects on posture, balance, and walking ability," he explained. "If preliminary findings are promising, further studies of this protocol may be warranted."
The AllCore360º is an adjustable system that leverages gravity to engage all trunk muscles in a 10-minute session. While seated in the AllCore360º, the person uses isometric contraction of their trunk muscles to hold their position while the device rotates clockwise, then counterclockwise, at different angles and positions.
Participants will be recruited from the stroke rehabilitation program at Kessler Institute for Rehabilitation. All participants (10 in stroke group and 10 controls) will undergo baseline and follow-up assessments of trunk function, balance, posture, and ambulation. The stroke group will undergo the 4-week trunk-strengthening program, including neuromuscular assessment using electromyography.
"We are pleased to partner with the Kessler Foundation on this pilot study aimed at expanding options for stroke rehabilitation," said Scott Bertrand, DC, founder and inventor of AllCore360º. "Having witnessed the benefits of core strengthening in people seeking to improve their health and fitness, we are optimistic that the Kessler team will see improved outcomes in individuals recovering from stroke."

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About AllCore360º
The Patented AllCore360° Rehabilitation Core Training System allows patients, seniors, athletes and everyday people, to balance and strengthen the more than 50 muscles that comprise the core in an innovative efficient way. In multiple facilities throughout the United States, therapists and leading edge trainers utilize the System to promote faster recovery, improve fitness, and enhance physical performance. The AllCore360° harnesses the forces of gravity to challenge all of the body's core muscles in a no impact, coordinated, isometric fashion designed to improve athletic or daily performance regardless of ability. For more information, please visit http://www.AllCore360.com.

Inconsistent classification of mild stroke and implications of health services delivery

I have seen absolutely nothing that even remotely suggests that there is ANY objective determination of stroke damage. Without that we will never be able to competently assign stroke protocols to fix such damage. All your stroke medical 'professionals' are 'flailing in the dark' right now. But yet you are paying them for what? 

Inconsistent classification of mild stroke and implications of health services delivery

Archives of Physical Medicine and Rehabilitation — Roberts PS, et al. | January 30, 2020

Researchers sought to perform a scoping review of mild stroke definitions based on stroke severity evaluations and/or clinical signs and symptoms reported in the literature. They searched PubMed, PsycINFO (Ovid), and CINAHL (EBSCO) databases added keyword combinations of a mild stroke, minor stroke, mini-stroke, mild cerebrovascular, minor cerebrovascular, transient ischemic attack, or TIA. For the final review, 62 studies were selected. Between January 2003 and February 2018, inclusion criteria were limited to articles published. It was noted that inequalities in the classification of mild stroke are evident with varying use of stroke severity assessments, measurement cut-off scores, imaging tools, and clinical or functional outcomes. Moreover, continued work is needed to establish a consensus definition of mild stroke(all strokes!), which directly influences treatment receipt, referral for services, and health service delivery.

Read the full article on Archives of Physical Medicine and Rehabilitation

Alirocumab may reduce stroke risk without increasing odds of hemorrhage

 For discussion with your doctor. Do you really think your doctor and stroke hospital keep up-to-date on stroke related research? Hell, I probably get at least twenty pieces of stroke research daily and I only can read the abstracts. So your hospital should have a dedicated employee whose only job is to summarize and distribute such research to all therapists and doctors with clear instructions on how to apply such research to get survivors 100% recovered. THAT IS WHAT A COMPETENT STROKE HOSPITAL WOULD BE DOING. Ask your stroke president if they are competent and doing such research implementation. And if not, WHY NOT? 

Their reasons for doing nothing?

Laziness? Incompetence? Or just don't care? No leadership? No strategy? Not my job?

I take no prisoners in my focus on survivors, shouldn't your hospital do the same?

Alirocumab may reduce stroke risk without increasing odds of hemorrhage

 

Jukema JW, et al. Circulation. 2019;doi:10.1161/CIRCULATIONAHA.119.043826.
Michos ED, et al. Circulation. 2019;doi:10.1161/CIRCULATIONAHA.119.044275.

December 22, 2019

New data from the ODYSSEY Outcomes trial show that alirocumab is effective at reducing risk for any stroke without increasing risk for hemorrhagic stroke.
In a cohort of 18,924 patients with recent ACS and elevated LDL despite intensive statin therapy, alirocumab (Praluent, Sanofi/Regeneron) was effective in reducing the risk for any stroke (HR = 0.72; 95% CI, 0.57-0.91) and ischemic stroke (HR = 0.73; 95% CI, 0.57-0.93), compared with placebo, during a follow-up of 2.8 years. According to the study, these effects were achieved without increasing the patients’ risk for hemorrhagic stroke (HR = 0.83; 95% CI, 0.42-1.65).

Moreover, researchers noted that the effect of alirocumab on stroke appeared greater for patients with higher baseline LDL but found no formal evidence of heterogeneity (P for interaction = .31).
“This analysis of the ODYSSEY Outcomes trial shows that in patients with recent ACS and dyslipidemia despite intensive statin therapy, the PCSK9 inhibitor alirocumab decreased the risk of stroke, irrespective of baseline LDL and of history of cerebrovascular disease, over a median follow-up of 2.8 years,” J. Wouter Jukema, MD, PhD, professor of cardiology in the department of cardiology at Leiden University Medical Center in the Netherlands, and colleagues wrote. “Furthermore, the present findings indicate that the risk of hemorrhagic stroke did not depend on achieved LDL levels in the alirocumab group.”
In other findings, the effect of alirocumab on stroke was similar among individuals with previous cerebrovascular disease and those without (P for interaction = .37).
Alirocumab effect on baseline LDL
In addition, researchers found no adverse relationship between lower achieved LDL and incidence of hemorrhagic stroke in the alirocumab group compared with placebo.
“The treatment effect appeared numerically greater with lower HRs for patients with higher baseline LDL, suggesting that patients with a higher risk at baseline have a larger benefit of alirocumab,” the researchers wrote. “However, this linear trend was not statistically significant.”
In this double-blind trial, researchers randomly assigned patients with ACS and elevated LDL to alirocumab or placebo, with target LDL levels of 25 mg/dL to 50 mg/dL, avoiding sustained levels below 15 mg/dL. Patients were randomly assigned to alirocumab or placebo 1 to 12 months after ACS. The aim of this analysis was to evaluate nonfatal, fatal ischemic or hemorrhagic stroke and stratified by baseline LDL level and prior cerebrovascular disease. As Healio previously reported, in the main results of ODYSSEY Outcomes, alirocumab reduced risk for major adverse CV events by 15% compared with placebo in this population.

The Influence of Applying Additional Weight to the Affected Leg on Gait Patterns During Aquatic Treadmill Walking in People Poststroke

Massive gobbledegook, so no idea what this is trying to say. I know that when I practised walking movements in the pool I had much better movement and the resistance forced the spasticity to lessen. 

The Influence of Applying Additional Weight to the Affected Leg on Gait Patterns During Aquatic Treadmill Walking in People Poststroke

 Taeyou Jung, PhD, ATC, DoKyeong Lee, MS, Charalambos Charalambous, MS, Konstantinos Vrongistinos, PhD
ABSTRACT. Jung T, Lee D, Charalambous C, VrongistinosK. The influence of applying additional weight to the affectedleg on gait patterns during aquatic treadmill walking in people poststroke. Arch Phys Med Rehabil 2010;91:129-36.
Objective:
 To investigate how the application of additional weights to the affected leg influences gait patterns of people post stroke during aquatic treadmill walking.(Wrong objective, the only objective is to create stroke protocols. Don't you have competent mentors and senior researchers that tell you that?)
Design:
 Comparative gait analysis.
Setting:
 University-based aquatic therapy center.
Participants:
 Community-dwelling volunteers (n=22) with chronic hemiparesis caused by stroke.
Interventions:
 Not applicable.
Main Outcome Measures:
 Spatiotemporal and kinematic gait parameters.
Results:
 The use of an ankle weight showed an increase in the stance phase percentage of gait cycle (3%,
 P=.015) when compared with no weight. However, the difference was not significant after a Bonferroni adjustment was applied for a more stringent statistical analysis. No significant differences were found in cadence and stride length. The use of an ankle weight showed a significant decrease of the peak hip flexion(7.9%, P=.001) of the affected limb as compared with no weight condition. This decrease was marked as the reduction of unwanted limb flotation because people poststroke typically show excessive hip flexion of the paretic leg in the late swingphase followed by fluctuating hip movements during aquatictreadmill walking. The frontal and transverse plane hip motionsdid not show any significant differences but displayed a trendof a decrease in the peak hip abduction during the swing phasewith additional weights. The use of additional weight did notalter sagittal plane kinematics of the knee and ankle joints.
Conclusions:
 The use of applied weight on the affected limb can reduce unwanted limb flotation on the paretic side duringaquatic treadmill walking. It can also assist the stance stabilityby increasing the stance phase percentage closer to 60% of gaitcycle. Both findings can contribute to the development of moreefficient motor patterns in gait training for people poststroke.The use of a cuff weight does not seem to reduce the limbcircumduction during aquatic treadmill walking.
Key Words:
 Exercise therapy; Gait; Hemiparesis; Rehabil-itation; Stroke.©
 2010 by the American Congress of Rehabilitation Medicine

Can Aspirin Decrease the Rate of Intracranial Aneurysm Growth?

A question SPECIFICALLY  for your doctor to answer. Doesn't know, then the competent thing to do is get research going to find the answer.  DOING NOTHING IS NOT OK.

Can Aspirin Decrease the Rate of Intracranial Aneurysm Growth?

In patients with multiple intracranial aneurysms, aspirin may significantly decrease the rate of aneurysm growth over time, according to a study published in the Journal of Neurosurgery.

While aneurysms >7 mm are more likely to rupture, some small aneurysms grow, increasing the risk that they may rupture. Therefore, physicians observe small, unruptured aneurysms over time by asking patients to undergo regularly scheduled imaging examinations.

While there has been some evidence that aspirin may reduce the risk of aneurysm rupture due to the drug’s anti-inflammatory effect on the weakened aneurysm wall, “to date, there is no medical treatment to arrest aneurysm growth and subsequent progression to rupture,” the authors wrote.

For the current study, Mario Zanaty, MD, University of Iowa Hospitals and Clinics, Iowa City, Iowa, and colleagues identified 146 patients harbouring multiple intracranial aneurysms, ≤5 mm in diameter, which had been observed for at least 5 years. The researchers also gathered information on the patients’ demographics, earlier medical history, the rupture status of designated primary aneurysms, aneurysms’ angiographic features, and treatment modalities.

In the cohort of patients, the researchers identified a total of 375 intracranial aneurysms. At the initial encounter, 146 aneurysms were treated and the remaining 229 aneurysms (2 to 5 mm) were observed.

During the follow-up period, 10.48% of the aneurysms grew. All aneurysms observed to grow later underwent treatment. None of the observed aneurysms ruptured.

Multivariate analysis showed that aspirin was significantly associated with a decreased rate of growth (odds ratio [OR] = 0.19; 95% confidence interval [CI], 0.05-0.63).

Variables associated with an increased rate of growth included hypertension (OR =14.38; 95% CI, 3.83-53.94), drug abuse (OR = 11.26; 95% CI, 1.21-104.65), history of polycystic kidney disease (OR = 9.48; 95% CI, 1.51-59.35), and subarachnoid haemorrhage at presentation (OR = 5.91; 95% CI, 1.83-19.09).

On the basis of the statistical analyses, use of aspirin appears to exert a protective effect against aneurysm growth and very likely against future rupture.

The authors point out that their findings are observational and that future interventional studies should be conducted.

“This study is very promising, as it outlines for the first time the potential therapeutic effect of aspirin in decreasing aneurysm growth,” concluded David Hasan, MD, University of Iowa Hospitals and Clinics. “If proven in a larger study, this could offer the first cheap, effective, over-the-counter therapeutic agent that could halt aneurysm growth and prevent rupture.”

Reference: https://thejns.org/view/journals/j-neurosurg/aop/article-10.3171-2019.6.JNS191273/article-10.3171-2019.6.JNS191273.xml

SOURCE: Journal of Neurosurgery Publishing Group

Robotic Care: A Low Cost Design to Assist Therapy for Brain Stroke Rehabilitation

Your doctor can contact this researcher for protocols and how to fashion this for your use. That is assuming your doctor is competent; 

A. To know about this research.

B. To follow through and get the necessary information for the stroke patients use.  

I really really like this idea, combining mirror therapy with passive movement and action observation.

Robotic Care: A Low Cost Design to Assist Therapy for Brain 

Cite this article: Prieto, P., Auat, F., Escobar, M., Vallejos, R., Maldonado, P., Larrain, C., Serey, M. (2019) ‘Robotic Care: A Low Cost Design to Assist Therapy for Brain Stroke Rehabilitation’, in Proceedings of the 22nd International Conference on Engineering Design (ICED19), Delft, The Netherlands, 5-8 August 2019. DOI:10.1017/dsi.2019.103 
ICED19INTERNATIONAL CONFERENCE ON ENGINEERING DESIGN, ICED19 5-8AUGUST 2019, DELFT, THE NETHERLANDS ICED19
 1 Prieto, Pablo (1); Auat, Fernando (2); Escobar, Maria (2); Vallejos, Ronny (3); Maldonado, Paula (4); Larrain, Cristobal (4); Serey, Martin (1) 1: Universidad Técnica Federico Santa María. Engineering Design Department.; 2: Universidad Técnica Federico Santa María. Department of Electronic; 3: Universidad Técnica Federico Santa María. Department of Mathematics; 4: Peñablanca Hospital.  

ABSTRACT  

A low cost robotic-assisted prototype for finger and hand rehabilitation of people affected by a stroke is presented. The system was developed by a team of undergraduate students led by a Design lecturer in collaboration with the Rehabilitation Unit of the Peñablanca Public Hospital in Chile. The system consists of a flexion sensor equipped glove, a hand exoskeleton and an Arduino control unit. The patient wears the glove in his healthy hand. When s/he performs movements with the healthy hand, the sensors register the flexion of the fingers and send this information to the servo motors installed in an exoskeleton attached to the affected hand. In this way, the affected hand reproduces the movement of the healthy hand. The system uses a combination of the mirror therapy (the patient sees his/her affected hand moving in the same way that the healthy hand does) and passive exercising (as the exoskeleton produces the movement of the hand affected by the stroke). The combination of two types of therapy in a single low cost system makes the present work unique. In the near future, the developed prototype will be used to validate the effectiveness of the new proposed robotic therapy. Keywords: Open source design, Design for health, Social responsibility, Biomedical design Contact: Prieto, Pablo Universidad Técnica Federico Santa María Engineering Design Department Chile pablo.prieto@usm.cl

MEPO promotes neurogenesis and angiogenesis but suppresses gliogenesis in mice with acute ischemic stroke

So your doctors, stroke hospital and stroke association should followup with human research testing this out. That is the minimum a competent doctor, stroke hospital and stroke association should be doing.  But you already know that nothing will be done unless you do this testing yourself.

 

MEPO promotes neurogenesis and angiogenesis but suppresses gliogenesis in mice with acute ischemic stroke

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https://doi.org/10.1016/j.ejphar.2019.01.066Get rights and content

Abstract

Previously study has proved the non-erythropoietic mutant erythropoietin (MEPO) exerted neuroprotective effects against ischemic cerebral injury, with an efficacy similar to that of wild-type EPO. This study investigates its effects on neurogenesis, angiogenesis, and gliogenesis in cerebral ischemic mice. Male C57BL/6 mice were subjected to middle cerebral artery occlusion (MCAO) and reperfusion. EPO (5000 U/kg), MEPO (5000 U/kg) or equal volume of normal saline was injected intraperitoneally. Neurological function was evaluated by Rota-rod test, Neurological severity scores (NSS) and Adhesive removal test. After ischemia and reperfusion (I/R), the survival rate, brain tissue loss, neurogenesis, angiogenesis and gliogenesis were detected by Nissl staining, Immunofluorescence and Western blot, respectively. The results shown that MEPO significantly increased survival rate, reduced brain tissue loss, and improved neurological function after MCAO (P<0.05). Furthermore, MEPO obviously enhanced the proliferation of neuronal precursors (DCX) and promoted its differentiation into mature neurons (NeuN) (P<0.05). In addition, compared to normal saline treatment mice, MEPO increased the number of BrdU-positive cells in the cerebral vasculature (P<0.05). Whereas, MEPO treatment also reduced the numbers of newly generated astrocytes (GFAP) and microglia (Iba1) (P<0.05). Among all the tests in this study, there was no significant difference between EPO group and MEPO group. Taken together, MEPO promoted the regeneration of neurons and blood vessels in peripheral area of infarction, and suppressed the gliogenesis, thus promoting neurogenesis, improving neurological function and survival rate. Our findings suggest that the MEPO may be a therapeutic drug for ischemic stroke intervention.

Alzheimer’s Memory Loss Dramatically Reversed in Mice

So your doctors, stroke hospital and stroke association should followup with human research testing this out. That is the minimum a competent doctor, stroke hospital and stroke association should be doing.  But you already know that nothing will be done unless you do this testing yourself. Hope you don't die. You would be in good company;

10 Scientists Who Experimented on Themselves | Mental Floss

 

Alzheimer’s Memory Loss Dramatically Reversed in Mice

Mouse study reverses memory loss in mice with Alzheimer’s.

Memory loss caused by Alzheimer’s disease has been reversed in mice, reports a new study.
Alzheimer’s disease — the most common form of dementia –results from both genetic and environmental factors, and is currently untreatable.

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Scientists have discovered, though, that the disease interferes with electrical signalling in part of the brain responsible for memory.
Using techniques based on epigenetics, the researchers were able to reverse the memory loss.
Epigenetics involves how instructions contained in DNA are expressed in cells.
Professor Zhen Yan, the study’s first author, said:

“We have not only identified the epigenetic factors that contribute to the memory loss, we also found ways to temporarily reverse them in an animal model of AD.”

The scientists found that Alzheimer’s caused neurons in the frontal cortex to gradually lose glutamate receptors.
By inhibiting an enzyme, they were able to restore memory in mice.
Professor Yan said:

“When we gave the Alzheimer’s animals this enzyme inhibitor, we saw the rescue of cognitive function confirmed through evaluations of recognition memory, spatial memory and working memory.
We were quite surprised to see such dramatic cognitive improvement.
At the same time, we saw the recovery of glutamate receptor expression and function in the frontal cortex.”

While the drug only worked on the mice for one week, it is hoped the method can be refined to make it more powerful.
Epigenetics is powerful because it can target the effects of more than one gene, said Professor Yan:

“An epigenetic approach can correct a network of genes, which will collectively restore cells to their normal state and restore the complex brain function.
We have provided evidence showing that abnormal epigenetic regulation of glutamate receptor expression and function did contribute to cognitive decline in Alzheimer’s disease.
If many of the dysregulated genes in AD are normalized by targeting specific epigenetic enzymes, it will be possible to restore cognitive function and behavior.”

→ Explore PsyBlog’s ebooks, all written by Dr Jeremy Dean:

• Accept Yourself: How to feel a profound sense of warmth and self-compassion
• The Anxiety Plan: 42 Strategies For Worry, Phobias, OCD and Panic
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The study was published in the journal Brain (Yan et al., 2019).