Neurodegeneration After Stroke: Is the Grass Really Greener on the Other Side?

 How EXACTLY is this research going to be used to prevent dementia? No answer, then this was useless research.

Neurodegeneration After Stroke: Is the Grass Really Greener on the Other Side?

Author links open overlay panelNuviaCortezKelseyBaker

https://doi.org/10.1016/j.apmr.2022.01.055Get rights and content

Research Objectives

The purpose of this project was to use magnetic resonance imaging of the brain and determine how the size and location of a stroke can affect neurodegeneration on the non-lesioned side of the brain. In hypothesis, we believe that both hemispheres will experience neurodegeneration but there will be a significantly higher amount of neurodegeneration in the lesioned side.

Design

T1-weighted magnetic resonance imaging and diffusion weighted imaging (DWI) of the brain was collected in 23 patients with chronic stroke and 14 healthy controls. We quantified the amount of neurodegeneration in the lesioned and non-lesioned hemisphere in the cerebral peduncles (CP) and the posterior limb of the internal capsule (PLIC). The size and the white matter integrity in the region of interest were determined. The amount of neurodegeneration between groups was statistically compared, a p<0.05 was considered statistically significant.

Setting

General Community.

Participants

Random selection of stroke patients and healthy controls.

Interventions

Not applicable.

Main Outcome Measures

Fractional anisotropy (FA) of the brain, upper extremity fugyl-meyer score.

Results

We observed that CPs in the lesioned hemisphere were smaller compared to the non-lesioned hemisphere and healthy controls (304mm3 vs 488 mm3 vs 374 mm3). In addition, patients with stroke had reduced white matter integrity in both the lesioned (255.99±35.43) and non-lesioned (257.36 ± 39.21) hemispheres compared to controls (329.98 ± 23.45). Thus, both sides of the brain experience neurodegeneration after a stroke.

Conclusions

Our results indicated that the stroke caused neurodegeneration on both sides of the brain with damage being significantly higher in the lesioned side. This suggests that therapists should consider targeting both sides of the body rather than just the more affected limb.

 

Changes in Structural Integrity Are Correlated With Motor and Functional Recovery After Post-stroke Rehabilitation

 There is absolutely nothing here that is going to help survivors recover. Useless.

Changes in Structural Integrity Are Correlated With Motor and Functional Recovery After Post-stroke Rehabilitation

  Restorative Neurology and Neuroscience 33 (2015) 835–844DOI 10.3233/RNN-150523IOS Press
 Yang-teng Fan a,1, 

Keh-chung Lin a,b,1, 

Ho-ling Liu c, 

Yao-liang Chen d

and Ching-yi Wu e,f,∗
a School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
b  Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
c  Department of Imaging Physics, Division of Diagnostic Imaging, The University of Texas MD AndersonCancer Center, Houston, TX, USA
d  MRI Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
e  Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine,Chang Gung University, Taoyuan, Taiwan
f  Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan

Abstract

Purpose:
Diffusion tensor imaging (DTI) studies indicate the structural integrity of the ipsilesional corticospinal tract (CST) and the transcallosal motor tract, which are closely linked to stroke recovery. However, the individual contribution of these 2 fiberson different levels of outcomes remains unclear. Here, we used DTI tractography to investigate whether structural changes of the ipsilesional CST and the transcallosal motor tracts associate with motor and functional recovery after stroke rehabilitation.
Methods:
 Ten participants with post-acute stroke underwent the Fugl-Meyer Assessment (FMA), the Wolf Motor Function Test(WMFT), the Functional Independence Measure (FIM), and DTI before and after bilateral robotic training.
Results:
 All participants had marked improvements in motor performance, functional use of the affected arm, and independence in daily activities. Increased fractional anisotropy (FA) in the ipsilesional CST and the transcallosal motor tracts was noted from pre-treatment to the end of treatment. Participants with higher pre-to-post differences in FA values of the transcallosal motor tracts had greater gains in the WMFT and the FIM scores. A greater improvement on the FMA was coupled with increased FAchanges along the ipsilesional CST.
Conclusions:
These findings suggest 2 different structural indicators for post stroke recovery separately at the impairment based and function based levels.

Contralesional Hemisphere Control of the Proximal Paretic Upper Limb following Stroke

'Can' and 'may' are not good enough. There is nothing here that I can take to any doctor and therapists to get any survivor recovered. Useless. 

Contralesional Hemisphere Control of the Proximal Paretic Upper Limb following Stroke

Lynley V. Bradnam1,2, Cathy M. Stinear2,3, P. Alan Barber2,3 and Winston D. Byblow 1,21Movement Neuroscience Laboratory, Department of Sport & Exercise Science, and 2Centre for Brain Research and Neurology Research Group, Department of Medicine, The University of Auckland, Auckland, New Zealand 1142. Address correspondence to Winston D. Byblow, Movement Neuroscience Laboratory, Department of Sport & Exercise Science, The University of  Auckland, Auckland, New Zealand 1142. Email: w.byblow@auckland.ac.nz.

Cathodal transcranial direct current stimulation (c-tDCS) can reduce excitability of neurons in primary motor cortex (M1) and may facilitate motor recovery after stroke. However, little is known about the neurophysiological effects of tDCS on proximal upper limb function. We hypothesized that suppression of contralesional M1 (cM1) excitability would produce neurophysiological effects that depended on the severity of upper limb impairment. Twelve patients with varying upper limb impairment after subcortical stroke were assessed on clinical scales of upper limb spasticity, impairment, and function. Magnetic resonance imaging was used to determine lesion size and  (FA) within the posterior limbs of the internal capsules indicative of corticospinal tract integrity. Excitability within paretic M1 biceps brachii representation was determined from motor-evoked potentials during selective isometric tasks, after cM1 sham stimulation and after c-tDCS. These neurophysiological data indicate that c-tDCS improved selective proximal upper limb control for mildly impaired patients and worsened it for moderate to severely impaired patients. The direction of the neurophysiological after effects of c-tDCS was strongly related to upper limb spasticity, impairment,function, and FA asymmetry between the posterior limbs of the internal capsules. These results indicate systematic variation of cM1 for proximal upper limb control after stroke and that suppression of cM1 excitability is not a ‘‘one size fits all’’ approach.(But you don't tell us EXACTLY which patients it does fit. What damage diagnosis would this work for? Useless. )

Mechanisms of white matter changes induced by meditation

4 weeks of mindfulness meditation produced white matter efficiency. Do you really think your doctor is going to incorporate this into your stroke protocol? Then you are not smart.
Amy, I believe.
http://www.pnas.org/content/109/26/10570.abstract

1. Yi-Yuan Tang^a,^b,^c,¹,
2. Qilin Lu^b,
3. Ming Fan^d,
4. Yihong Yang^e, and
5. Michael I. Posner^c,¹

Author Affiliations

1. Contributed by Michael I. Posner, May 9, 2012 (sent for review April 6, 2012)

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Abstract

Using diffusion tensor imaging, several recent studies have shown that training results in changes in white matter efficiency as measured by fractional anisotropy (FA). In our work, we found that a form of mindfulness meditation, integrative body–mind training (IBMT), improved FA in areas surrounding the anterior cingulate cortex after 4-wk training more than controls given relaxation training. Reductions in radial diffusivity (RD) have been interpreted as improved myelin but reductions in axial diffusivity (AD) involve other mechanisms, such as axonal density. We now report that after 4-wk training with IBMT, both RD and AD decrease accompanied by increased FA, indicating improved efficiency of white matter involves increased myelin as well as other axonal changes. However, 2-wk IBMT reduced AD, but not RD or FA, and improved moods. Our results demonstrate the time-course of white matter neuroplasticity in short-term meditation. This dynamic pattern of white matter change involving the anterior cingulate cortex, a part of the brain network related to self-regulation, could provide a means for intervention to improve or prevent mental disorders.