This Probiotic Combination Was Linked To Better Mood & Higher BDNF Levels by mindbodygreen

 Of course your competent? doctor already has EXACT PROTOCOLS that deliver all the BDNF you need. And has been for over a decade, right? But your doctor incompetently knew nothing and did nothing, right? Which means your board of directors is so incompetent they can't recognize incompetence in their staff!

• BDNF (208 posts to April 2011)

This Probiotic Combination Was Linked To Better Mood & Higher BDNF Levels

Validity of FuncUseRatio for ecological monitoring of functional arm use after stroke: toward precision neurorehabilitation

 Since you DID NOTHING to map EXACT recovery protocols to the deficits found; COMPLETELY FUCKING USELESS RESEARCH! You're fired! 

Comeuppance is going to be a real bitch for you when you are the 1 in 4 per WHO that has a stroke!

Validity of FuncUseRatio for ecological monitoring of functional arm use after stroke: toward precision neurorehabilitation

• Gaël Le Perf,
• Benoit Pratola,
• Denis Mottet,
• Isabelle Laffont &
• Karima Bakhti 

We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Abstract

Background

The use of the paretic arm in activities of daily living after stroke is critical to prevent further decline in function over time. Accelerometers offer the opportunity to monitor arm activity during real-life daily activities in home environments. However, commonly used accelerometric metrics may be influenced by passive movements unrelated to functional arm use. In this study, we evaluate the validity of FuncUseRatio for monitoring activities of daily living after stroke.

Methods

Two experiments were conducted. Experiment 1 enrolled 23 healthy participants who performed 22 arm functional movements representative of activities of daily living. Movements of both arms were simultaneously recorded using wrist-worn accelerometers and a Vicon motion capture system allowing a direct comparison between accelerometer-derived forearm orientation and Vicon measurements (gold standard). Experiment 2 included 25 individuals after stroke who performed ecological activities (meal preparation, eating, and dressing). Arm movements were recorded using accelerometers and synchronized video analysis (ground truth), enabling comparison between accelerometer-derived FuncUseRatio and structured video-based arm-use computation.

Results

In Experiment 1, forearm orientation estimated from accelerometer data showed excellent consistency with Vicon measurements under dynamic conditions required for FuncUse computation. The intraclass correlation coefficients (ICC) were ICC(C,1) = 0.92 (95% CI 0.82–0.96, p < 0.01) for the right forearm and ICC(C,1) = 0.94 (95% CI 0.86–0.97, p < 0.01) for the left forearm, confirming strong agreement between the two systems. In Experiment 2, FuncUseRatio derived from accelerometer data demonstrated excellent agreement with the structured video-based analysis ratio, considered the ground truth, with (ICC(A,1) = 0.96, 95% CI 0.90–0.98, p < 0.01).

Conclusion

The FuncUseRatio is a valid measure for assessing functional arm use during activities of daily living in ecologically relevant settings. Its implementation may enable early detection of reduced paretic arm use, including when the patient is at home, facilitate timely reassessment to understand its underlying causes, and thereby allow the implementation of specific arm rehabilitation strategies before any decline in function or participation occurs.

Experts call for integration of Physical Medicine and Rehabilitation into standard stroke care

My PMR doctor knew nothing and did nothing to get me recovered. As proof, he wrote three prescriptions of E. T.(Evaluate and Treat) to the OT, PT and ST; meaning he knew absolutely nothing about stroke recovery. I could train a chimpanzee to do that.

 Experts call for integration of Physical Medicine and Rehabilitation into standard stroke care

The glucose-to-potassium ratio: a predictor of poor functional outcomes in stroke patients receiving thrombolytic therapy

You described a possible problem, DID NOTHING TO SOLVE IT! YOU'RE FIRED! Predictions do nothing to get survivor's recovered; Are you that blitheringly stupid?

And you've known of this since October 2024 and DID NOTHING TO SOLVE THE PROBLEM. EXTREME INCOMPETENCE DISPLAYED!

Association between the serum glucose-to-potassium ratio and clinical outcomes in ischemic stroke patients after endovascular thrombectomy October 2024 

The latest here:

The glucose-to-potassium ratio: a predictor of poor functional outcomes in stroke patients receiving thrombolytic therapy

Dong Zhang1†, Ruinan Ma1†, Xiaoyan Qin2†, Zhizhang Li1, Xiaoguang Zhang1, Ying Ding1, Yunqi Hu1 and Yunhua Yue1*

1Department of Neurology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China

2Department of Geriatrics, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China

Edited by

Jinming Han, Capital Medical University, China

Reviewed by

Aleksandras Vilionskis, Vilnius University, Lithuania

Aikaterini Theodorou, University General Hospital Attikon, Greece

*Correspondence

Yunhua Yue, yunhua.yue@tongji.edu.cn

†These authors have contributed equally to this work and share first authorship

Received 25 March 2025

Accepted 13 May 2025

Published 05 June 2025

Citation

Zhang D, Ma R, Qin X, Li Z, Zhang X, Ding Y, Hu Y and Yue Y (2025) The glucose-to-potassium ratio: a predictor of poor functional outcomes in stroke patients receiving thrombolytic therapy. Front. Neurol. 16:1581747. doi: 10.3389/fneur.2025.1581747

Background: 

The glucose-to-potassium ratio has shown promise as a biomarker in neurological disorders, but its prognostic value in acute ischemic stroke (AIS) after intravenous thrombolysis (IVT) continues to be uncertain. The study explores the relationship between admission GPR and 90-day functional outcomes in AIS patients undergoing IVT treatment.

Methods: 

A retrospective analysis included 649 AIS patients undergoing IVT between May 2016 and December 2023. Baseline clinical, laboratory, and imaging data were analyzed. GPR was calculated from serum glucose and potassium levels at admission. A modified Rankin Scale score of 3 to 6 at 90 days was used to define poor functional outcomes. Logistic regression and restricted cubic splines assessed the GPR-outcome relationship, adjusting for confounders. Receiver operating characteristic (ROC) analysis evaluated GPR’s predictive value.

Results: 

Among 649 patients, 174 (26.8%) had poor outcomes. Median GPR was significantly higher in these patients (2.14 vs. 1.88, p < 0.001). Higher GPR independently predicted negative consequences (OR, 1.821; 95% CI, 1.340–2.473, p < 0.001). Subgroup analysis indicated a stronger association in non-diabetic patients. ROC analysis demonstrated an area under the curve (AUC) of 0.631 (95% CI, 0.585–0.677, p < 0.001) for GPR in predicting poor functional outcomes.

Conclusion: 

High GPR levels are independently linked to unfavorable 90-day functional outcomes in AIS patients who received IVT, suggesting its potential as a prognostic biomarker. Further studies are warranted to validate these findings.

Keywords

intravenous thrombolysis; GPR; functional outcome; acute ischemic stroke; biomarkers

Upper Limb Recovery After Stroke Is Associated With Ipsilesional Primary Motor Cortical Activity: A Meta-Analysis

10 years! What did your competent? doctor do to ensure your ipsilesional primary motor and medial-premotor cortices are functioning correctly? Oh, your doctor DID NOTHING? Well congratulations, you just found out you don't have a functioning stroke doctor! My doctor never bothered to tell me most of my premotor cortex was dead, he knew nothing and did nothing.

Upper Limb Recovery After Stroke Is Associated With Ipsilesional Primary Motor Cortical Activity: A Meta-Analysis

2014, Stroke

sabelle Favre, MD; Thomas A. Zeffiro, MD, PhD; Olivier Detante, MD, PhD; Alexandre Krainik, MD, PhD; Marc Hommel, MD; Assia Jaillard, MD, PhD

Background and Purpos

 

 Although neuroimaging studies have revealed specific patterns of reorganization in the sensorimotor control network after stroke, their role in recovery remains unsettled. To review the existing evidence systematically, we performed activation likelihood estimation meta-analysis of functional neuroimaging studies investigating upper limb movement-related brain activity after stroke. 

  Methods

 

 Twenty-four studies using sensorimotor tasks in standardized coordinates were included, totaling 255 patients and 145 healthy controls. Across the entire brain, we compared task-related activity patterns in good and poor recovery and assessed the magnitude of spatial shifts in sensorimotor activity in cortical motor areas after stroke.  

Results

 

 When compared with healthy controls, patients showed higher activation likelihood estimation values in contralesional primary motor soon after stroke that abated with time, but were not related to motor outcome. The observed activity changes were consistent with restoration of typical interhemispheric balance. In contrast, activation likelihood estimation values in ipsilesional medial-premotor and primary motor cortex were associated with good outcome, reorganization that may reflect vicarious processes associated with ventral activity shifts from BA4a to 4p. In the anterior cerebellum, a novel finding was the association of poor recovery with increased vermal activity, possibly reflecting behaviorally inadequate compensatory strategies engaging the fastigio-thalamo-cortical and corticoreticulospinal systems.  

 

Conclusions

 

Activity in ipsilesional primary motor and medial-premotor cortices in chronic stroke signals good motor recovery, whereas cerebellar vermis activity signals poor recovery. Functional MRI may be useful in identifying recovery biomarkers. (Stroke. 2014;45:1077-1083.) 

Addressing mood and fatigue in return-to-work programmes after stroke: a systematic review

 So mood and fatigue are poorly addressed in rehab. BUT YOU DID NOTHING TO SOLVE THAT! You're fired!

Addressing mood and fatigue in return-to-work programmes after stroke: a systematic review

Nicole Yun Ching Chen^1,2 YanHong Dong^2,3* Zaylea Zhong Jie Kua^1,2

• ¹Changi General Hospital, Singapore, Singapore
• ²Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
• ³Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

Introduction: Return-to-work is a key rehabilitation goal for many working aged stroke survivors, promoting an overall improvement of quality of life, social integration, and emotional wellbeing. Conversely, the failure to return-to-work contributes to a loss of identity, lowered self-esteem, social isolation, poorer quality of life and health outcomes. Return-to-work programmes have largely focused on physical and vocational rehabilitation, while neglecting to include mood and fatigue management. This is despite the knowledge that stroke results in changes in physical, cognitive, and emotional functioning, which all impact one’s ability to return to work. The purpose of this systematic review is to conduct a comprehensive and up-to-date search of randomised controlled trials (RCTs) of return-to-work programmes after stroke. The focus is especially on examining components of mood and fatigue if they were included, and to also report on the screening tools used to measure mood and fatigue.

Method: Searches were performed using 7 electronic databases for RCTs published in English from inception to 4 January 2023. A narrative synthesis of intervention design and outcomes was provided.

Results: The search yielded 5 RCTs that satisfied the selection criteria (n = 626). Three studies included components of mood and fatigue management in the intervention, of which 2 studies found a higher percentage of subjects in the intervention group returning to work compared to those in the control group. The remaining 2 studies which did not include components of mood and fatigue management did not find any significant differences in return-to-work rates between the intervention and control groups. Screening tools to assess mood or fatigue were included in 3 studies.

Conclusion: Overall, the findings demonstrated that mood and fatigue are poorly addressed in rehabilitation programmes aimed at improving return-to-work after stroke, despite being a significant predictor of return-to-work. There is limited and inconsistent use of mood and fatigue screening tools. The findings were generally able to provide guidance and recommendations in the development of a stroke rehabilitation programme for return-to-work, highlighting the need to include components addressing and measuring psychological support and fatigue management.

After 6 Brain Surgeries and a Stroke, Resident Aims to Inspire Others

 She was lucky with her PM&R doctor. In my opinion my PMR doctor knew nothing and did nothing for my stroke rehab.  He wrote 3 E.T.(Evaluate and Treat) prescriptions; OT, PT, ST, which proved he knew absolutely nothing about stroke rehab and washed his hands of the failed outcomes. 

Oops, I'm not playing by the polite rules of Dale Carnegie,  'How to Win Friends and Influence People'. 

Telling supposedly smart stroke medical persons they know nothing about stroke is a no-no even if it is true. 

Politeness will never solve anything in stroke. Yes, I'm a bomb thrower and proud of it. Someday a stroke 'leader' will try to ream me out for making them look bad by being truthful, I look forward to that day.

After 6 Brain Surgeries and a Stroke, Resident Aims to Inspire Others

Claudia Martinez, MD, always knew she wanted to become a doctor, she just took a different path

by Jennifer Henderson, Enterprise & Investigative Writer, MedPage Today August 11, 2022

Claudia Martinez, MD, a third-year resident at TIRR Memorial Hermann in Houston, always knew she wanted to become a physician.

Growing up, she envisioned being able to give back to small towns like the ones her parents were from. "I would see the disparity there not having access to medical care," she told MedPage Today.

However, about 10 years ago, during Martinez's senior year of college, her plans took a harrowing detour.

Martinez began having headaches as well as weakness in her arms and legs. An MRI of her brain led to a diagnosis of Chiari malformation, a condition in which brain tissue extends into the spinal canal.

The condition was pretty severe, Martinez explained. A neurosurgeon told her that if she didn't undergo immediate brain surgery, she could become paralyzed from the neck down.

On her first day of her senior year in college, Martinez underwent her first brain surgery.

She would need five more in the next few years to address ongoing health issues and complications. And during the sixth procedure, in 2017, she suffered a stroke.

Though Martinez had been able to complete much of the education she needed to become a physician from her hospital bed, having a stroke and needing rehabilitation care changed her career trajectory.

Martinez had initially planned to go into a surgical field, she said. But the stroke diminished function in her hands.

"That was a little hard to accept," Martinez said.

She suffered other deficits, too, and ended up at TIRR Memorial Hermann for a year of intensive follow-up care.

Martinez now credits the institution for inspiring a new passion.

"When I was here, I got to see what PM&R [physical medicine and rehabilitation] was all about," she said. "Once I was exposed to that, I really liked the attitude they had in seeing what patients could do instead of what they couldn't."

The physicians, therapists, and nurses take "all the broken pieces" after a patient has sustained a stroke, spinal cord injury, or car accident, "really putting them back together," she said.

"The big hospital saved their life, then they come to us and we restore their lives," she said.

Since then, she has gained back 90% of the function she lost.

Though Martinez said she doesn't always share her personal journey with patients, occasions arise that are well suited for that kind of support.

There may be a patient who is not motivated to do therapy, who has lost hope, she said.

"I remember sitting in that hospital bed not knowing what my future would look like," Martinez said.

Patients can feel alone, like there is no one else going through the same thing, and it can take a long time to get better, she said, noting that her stroke was 5 years ago and that she is still recovering function.

"When I have shared my story, I really do feel like that will make a difference," Martinez said.

Additionally, it's not only patients that Martinez is seeking to help.

Her residency program at TIRR Memorial Hermann has been incredibly supportive, she said, providing the necessary accommodations for her to succeed.

Residents with disabilities can be very successful, she said. They can still be a physician, and a good one at that.

She said she's all but settled on pursuing further training and a fellowship to become a specialist in spinal cord injuries.

Looking back on her journey, Martinez said she remembers asking her neurosurgeon whether she could put off her initial brain surgery, and the surgeon responded that, "'You can't take care of anyone else until you take care of yourself.'"

"We shouldn't necessarily change our goals," Martinez said, "sometimes it just takes a little different trajectory."