Use the labels in the right column to find what you want. Or you can go thru them one by one, there are only 34,148 posts. Searching is done in the search box in upper left corner. I blog on anything to do with stroke. DO NOT DO ANYTHING SUGGESTED HERE AS I AM NOT MEDICALLY TRAINED, YOUR DOCTOR IS, LISTEN TO THEM. BUT I BET THEY DON'T KNOW HOW TO GET YOU 100% RECOVERED. I DON'T EITHER BUT HAVE PLENTY OF QUESTIONS FOR YOUR DOCTOR TO ANSWER.
Changing stroke rehab and research worldwide now.Time is Brain!trillions and trillions of neuronsthatDIEeach day because there areNOeffective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.
What this blog is for:
My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.
Showing posts with label not solving stroke. Show all posts
Showing posts with label not solving stroke. Show all posts
With NO protocols produced, YOU DID NOTHING USEFUL; YOU'RE FIRED!
Not solving stroke is the absolute stupidity out there, this is just a lazy desription of something! You're all fired! Your comeuppance/screaming when you are the 1 in 4 per WHO that has a stroke will be soul satisfying.
We’re sharing this article early to provide faster access to peer-reviewed, accepted research. It is citable and carries a permanent DOI. This version is subject to further edits and will be replaced automatically by the final Version of Record. All legal disclaimers apply.
Abstract
Stroke often results in long-term motor impairments, necessitating innovative rehabilitation strategies. Neurofeedback (NF) has emerged as a promising tool to promote functional recovery after stroke by enabling patients to modulate targeted brain activity. In this study, we investigated how NF training influences whole-brain functional connectivity in chronic stroke patients using a data-driven, network-level approach. The analysis was conducted on the same dataset as a previously reported clinical study, focusing here on the effects of NF through the lens of functional connectivity. Thirty chronic stroke patients underwent either multimodal NF training (combining EEG-fMRI and EEG-only feedback targeting motor regions) or a matched motor imagery (MI) control condition without feedback. Pre- and post-intervention fMRI data were analyzed using Network-Based Statistics (NBS) to identify distributed changes in connectivity. Within-group analyses revealed significant reductions in connectivity within motor networks and the default mode network (DMN) in the NF group, while no significant effects were found in the MI control group. These connectivity reductions, particularly in contralesional motor network, were significantly correlated with motor function improvement. These findings highlight the relevance of network-level mechanisms in NF-induced plasticity and support the development of connectivity-informed NF strategies in stroke rehabilitation.
School of Continuing Education, Zhejiang Vocational College of Special Education, Hangzhou, Zhejiang, China
Abstract
Introduction:
Post-stroke cognitive impairment (PSCI) affects 30%–70% of stroke survivors and represents a significant barrier to functional recovery and quality of life. This systematic review synthesizes current evidence on multimodal interventions targeting neuroplastic mechanisms to ameliorate cognitive dysfunction following stroke.
Methods:
Following PRISMA 2020 guidelines, we systematically searched PubMed, Web of Science, Cochrane Library, and Embase for randomized controlled trials published between January 2020 and October 2025. Forty-seven studies met inclusion criteria, encompassing 3,842 participants across diverse intervention modalities including non-invasive brain stimulation (transcranial direct current stimulation, repetitive transcranial magnetic stimulation), cognitive rehabilitation, virtual reality training, computer-assisted cognitive training, and combined multimodal approaches.
Results:
Narrative synthesis revealed that transcranial direct current stimulation combined with cognitive training consistently yielded the largest improvements in global cognitive function across included trials, followed by repetitive transcranial magnetic stimulation protocols. Several studies also explored pharmacological agents (e.g., cholinesterase inhibitors) as adjunctive components within multimodal protocols.
Discussion:
Neuroplasticity mechanisms underlying these improvements include enhanced synaptic plasticity, modulation of long-term potentiation, neurogenesis in perilesional regions, functional reorganization of cortical networks, and restoration of interhemispheric balance. Early intervention initiation (within 3 months post-stroke) was associated with enhanced outcomes across modalities. Virtual reality and computer-assisted training demonstrated moderate efficacy with superior patient engagement and accessibility. Evidence supports multimodal, personalized rehabilitation protocols integrating brain stimulation with behavioral interventions to optimize neuroplastic potential. Future research should evaluate combined rehabilitation approaches at the neural level, assess pharmacological treatment effects on neural plasticity, and investigate long-term maintenance of cognitive gains. This review provides evidence-based guidance for clinicians implementing neuroplasticity-informed rehabilitation strategies for post-stroke cognitive recovery.
Not solving stroke is the absolute stupidity out there! You're all fired! Your comeuppance/screaming when you are the 1 in 4 per WHO that has a stroke will be soul satisfying.
Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
Abstract
Objectives:
To identify the latent profile classification of cognitive function in elderly patients with chronic pain after stroke and explore the associated factors for patients in different categories.
Methods:
Elderly patients with chronic pain after stroke hospitalized in the Department of Neurology of a hospital in Nanjing from August 2025 to January 2026 were selected as research subjects. Data were collected using a General Information Questionnaire, the Montreal Cognitive Assessment (MoCA), Hamilton Anxiety Scale (HAMA), Center for Epidemiological Studies Depression Scale (CES-D), Pain Catastrophizing Scale (PCS), and Elderly Social Participation Scale. Latent Profile Analysis (LPA) was used for patient classification, and multivariate logistic regression analysis was performed to identify predictive factors for different groups (P < 0.05).
Results:
Patients’ cognitive function was classified into three latent profiles: High Cognitive Function-Low Abstraction Group, Moderate Cognitive Function-Low Orientation Group, and Low Cognitive Function Group. Logistic regression analysis showed that gender, pain type, pain intensity, anxiety, and depression were significant influencing factors of cognitive function across different categories (P < 0.05).
Conclusion:
There is significant population heterogeneity in the cognitive function of elderly patients with chronic pain after stroke. Medical staff should implement precise interventions for patients in different categories to delay cognitive decline and improve their quality of life.
Survivors don't give a flying fuck about monitoring; WHERE ARE THE EXACT RECOVERY PROTOCOLS?
Not solving stroke is the absolute stupidity out there! You're all fired! Your comeuppance/screaming when you are the 1 in 4 per WHO that has a stroke will be soul satisfying.
We’re sharing this article early to provide faster access to peer-reviewed, accepted research. It is citable and carries a permanent DOI. This version is subject to further edits and will be replaced automatically by the final Version of Record. All legal disclaimers apply.
Abstract
Background
Home rehabilitation for stroke survivors is crucial for promoting upper extremity (UE) movements, improving functional ability, and enhancing independence and quality of life.
(100% recovery protocols would accomplish all this and deliver what the survivors want; 100% recovery! And you're too fucking stupid to see this?) Wearable sensors enable monitoring of movement trends and progress during home rehabilitation. The feasibility of using sensors in the homes of stroke survivors depends both on user acceptability and the accuracy of the sensors in capturing the complexity of movement. The aim of this study was to identify a reduced and more practical sensor configuration that preserves the ability to capture movement complexity for monitoring UE movements in stroke survivors during daily activities at home. This was informed by aligning user acceptability data with movement complexity measures derived from a nine-sensor reference configuration in a home-like environment.
Methods
Eleven chronic stroke survivors were observed in a natural or simulated home environment while attempting to attach and detach sensors and wearing them while performing self-chosen activities of daily living. Nine inertial measurement unit sensors were placed on the participants’ UEs and sternum. Acceptability was assessed with a custom-made questionnaire consisting of 14 items scored on a 1–5 Likert scale, and five open-ended questions. Furthermore, information entropy was calculated to determine the minimal number of sensors needed to capture movement complexity.
Results
Total acceptability of wearing the 9 sensors was high, with a median score of 57 out of 70 (81%; IQR = 11), whereas usability was moderate, with a median score of 11 out of 20 (55%; IQR = 5.5). The usability challenges were related mostly to attaching and detaching sensors on the hands and non-affected UE. The minimal sensor configuration to capture behavior complexity consisted of three-to-four sensors, placed on the sternum, non-affected and affected forearms, with or without affected upper arm.
Conclusions
The 9-sensor configuration had high acceptability, but lower usability. A reduced configuration with three-to-four sensors was sufficient to maintain the accuracy of the sensors, while potentially increasing stroke survivors’ usability. In turn, this may increase the feasibility of wearing sensors at home for stroke survivors.
Describing this problem DOES NOTHING TO PREVENT COGNITIVE IMPAIRMENT! I'd have everyone involved fired for incompetence in not knowing that the only goal of survivors IS RECOVERY!
Check how long incompetence has prevailed in NOT SOLVING THE PROBLEM!
Cluster of differentiation 147 (CD147) is a multifunctional transmembrane glycoprotein, but its effect on poststroke cognitive impairment (PSCI) is unclear.
Methods
The current study included 612 patients with ischemic stroke with plasma CD147 levels from a preplanned ancillary study of CATIS (China Antihypertensive Trial in Acute Ischemic Stroke). Mini‐Mental State Examination and Montreal Cognitive Assessment were used to evaluate cognitive function at the 3‐month follow‐up visit. PSCI was defined as a score of <27 for Mini‐Mental State Examination or <25 for Montreal Cognitive Assessment. Logistic regression models and restricted cubic spline analyses were used to assess the associations between CD147 and PSCI.
Results
As defined by Mini‐Mental State Examination, 317 participants developed PSCI. After multivariate adjustment, elevated plasma CD147 levels were significantly associated with higher odds of PSCI (odds ratio, 1.75 [95% CI, 1.21–2.51]). Multiple‐adjusted spline regression model showed a linear association between plasma CD147 level and PSCI (P for linearity=0.038). Furthermore, adding plasma CD147 to conventional risk factors improved the discriminatory power (C statistics, 0.695 versus 0.711; P=0.047). Similar findings were observed when PSCI was defined by the Montreal Cognitive Assessment.
Conclusions
Elevated plasma CD147 levels at admission were associated with higher odds of cognitive impairment at 3 months after stroke among patients with acute ischemic stroke, suggesting its potential role in the pathophysiological processes of PSCI.
Competent persons would research preventing depression by have EXACT 100% RECOVERY PROTOCOLS! But there seems to be no functioning brains anywhere in stroke! Not solving stroke is the absolute stupidity out there! Your comeuppance/screaming when you are the 1 in 4 per WHO that has a stroke will be soul satisfying.
1. Department of Child Psychiatry, Shaoxing Seventh People’s Hospital, Affiliated Mental Health Center, Shaoxing University, Shaoxing, Zhejiang, China
2. Department of Neurology, Shaoxing People’s Hospital, The First Affiliated Hospital, Shaoxing University, Shaoxing, Zhejiang, China
Abstract
Background:
Post-stroke depression (PSD) affects approximately one-third of stroke survivors and significantly impacts functional recovery. This study aimed to develop and validate a prediction model for PSD using polysomnography (PSG) parameters combined with clinical characteristics.
Methods:
We conducted a prospective cohort study enrolling 437 acute ischemic stroke patients who underwent PSG assessment within 7 days of stroke onset between January 2022 and December 2024. The primary outcome was PSD at 3-month follow-up, defined as Patient Health Questionnaire-9 (PHQ-9) score ≥10. Multivariate logistic regression identified independent predictors, and machine learning algorithms were compared for model performance.
Results:
Among 390 patients completing follow-up, 139 (35.6%) developed PSD. Independent predictors included sleep latency (OR = 2.14, 95% CI: 1.68–2.73), arousal index (OR = 2.13, 95% CI: 1.65–2.94), sleep efficiency (OR = 0.74, 95% CI: 0.55–0.96), heart rate variability RMSSD (OR = 0.77, 95% CI: 0.61–0.96), NIHSS score (OR = 1.35, 95% CI: 1.04–1.76), and prior stroke history (OR = 1.35, 95% CI: 1.09–1.71). The gradient boosting model achieved the highest discriminative performance (AUC = 0.763; bootstrap-validated AUC = 0.738, 95% CI: 0.682–0.794). Risk stratification demonstrated a five-fold gradient in PSD rates across probability categories (14.3 to 70.3%).
Conclusion:
PSG parameters, particularly sleep efficiency, sleep latency, and arousal index, are significant independent predictors of PSD. Integrating objective sleep assessment into early stroke management may facilitate identification of high-risk patients for targeted preventive interventions.
Will your competent? doctor and hospital ENSURE FURTHER RESEARCH OCCURS that will determine the best way to prevent the bleeding risk? Oh NO; the plan is TO DO NOTHING! Everyone there needs to be fired! I take no prisoners in trying to get stroke solved!
Ischemic stroke remains a leading cause of mortality and long-term disability worldwide(Yeah and the solution is 100% recovery protocols! Or are you too blitheringly stupid to see that?), with recurrent cerebrovascular events contributing substantially to cumulative neurologic injury, functional decline, and health care burden. Although major advances in acute stroke management have significantly improved survival, secondary prevention following an index ischemic stroke continues to represent a critical challenge in contemporary cerebrovascular care.
Of the more than 800,000 strokes in the US every year, 1 in 4 are recurrent events.1 The risk for recurrent stroke varies widely across patient populations and stroke phenotypes, ranging from 10% to 15% within 12 months among patients with advanced microvascular disease or large artery atherosclerosis.2
This risk persists despite advances in risk factor modification and the widespread availability of evidence-based guidelines and online resources, highlighting gaps between recommended care and real-world implementation. Barriers including health care access, treatment adherence, economic burden, patient engagement, and uncertainty in individualized risk assessment continue to limit the effectiveness of secondary prevention strategies.
Closing the gap between clinical evidence and real-world implementation remains essential to reducing recurrent stroke burden and improving functional outcomes among stroke survivors.
Despite these challenges, most funding in cerebrovascular research continues to emphasize innovative technologies and pharmacotherapies, with comparatively less emphasis on translational research and implementation gaps.
Present Day Stroke Care
Persistent Risk After Index Stroke
The risk for recurrent ischemic stroke remains substantial throughout both early and late periods following the index event. After the acute period — when recurrent stroke risk is highest, typically within the first few weeks after stroke — the underlying mechanism (eg atrial fibrillation or an unstable atherosclerotic plaque) is often identified, and individualized treatment is initiated. However, long-term risk persists well beyond the immediate post-stroke period.
Longitudinal cohort studies consistently demonstrate sustained elevation in recurrent stroke risk over subsequent years, driven by persistent and uncontrolled vascular risk factors, including hypertension, dyslipidemia, obesity, diabetes mellitus, atrial fibrillation, obstructive sleep apnea, substance use (including tobacco and alcohol), and systemic vascular dysfunction.3 Without effective risk factor modification, the likelihood of recurrent stroke or other vascular events remains considerable.
Perhaps more importantly, recurrent cerebrovascular events often result in greater cumulative disability than the initial stroke, contributing to progressive neurologic impairment, reduced functional independence, dementia, and diminished quality of life. These events also have substantial downstream consequences, including increased caregiver burden and higher health care costs for patients and health systems.
Barriers to Effective Secondary Prevention
Among the many limitations in successful secondary stroke prevention strategies is fragmentation of post-discharge care delivery. Stroke survivors frequently transition from hospitalization to outpatient care characterized by delayed or unscheduled stroke specialist follow-up, inadequate coordination between inpatient and ambulatory care teams, and limited access to multidisciplinary prevention services. These structural barriers are particularly pronounced in geographically underserved and rural populations, where access to vascular neurology, cardiology, rehabilitation medicine, and comprehensive stroke centers remains limited.
Follow-up care is essential for reinforcing the benefits of antithrombotic therapy, lipid-lowering treatments, dietary and lifestyle modifications, and recognition of stroke warning signs and symptoms. Because many stroke risk factors are clinically silent, particularly hypertension, dyslipidemia, and diabetes, ongoing follow-up with primary and subspecialty care providers is necessary to ensure patients achieve target blood pressure, cholesterol, and glycemic goals.
Economic and Structural Challenges in Long-Term Care
The whole fucking problem here is you're referring to 'care' NOT RECOVERY!
The economic burden of long-term stroke management represents another important challenge to successful secondary prevention. Effective post-stroke care often requires prolonged pharmacotherapy, outpatient specialist visits, repeat diagnostic testing, rehabilitation services, and management of multiple chronic conditions. Out-of-pocket costs, insurance limitations, prescription drug costs, transportation challenges, geographic barriers to subspecialty care, and restricted access to rehabilitation services can all impair adherence to recommended care.
Although strategies such as out-of-network exemptions, teleneurology appointments, and partially subsidized pharmacy coverage may help address some barriers, they do not fully resolve challenges to effective secondary prevention. These financial and structural barriers disproportionately affect socioeconomically vulnerable populations and contribute to persistent disparities in recurrent stroke outcomes.
