Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective 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 yranny of low expectations. Show all posts
Showing posts with label yranny of low expectations. Show all posts

Wednesday, March 19, 2025

Turn Back Your Brain’s Bioenergetic Clock to Reduce Alzheimer’s Risk

 Whoops, lecanemab is not for me. With my damaged brain already running with millions to billions less neurons I'll pass on more brain shrinkage. But I'm not medically trained so don't listen to me.

From this article comes the following paragraphs:

YIKES! FDA Approves Lecanemab Against Alzheimer’s

But there is a new and disturbing fly in the ointment.. A study published in the journal Neurology (March 27, 2023) reveals that anti-amyloid drugs like lecanemab can cause brain shrinkage. The researchers call this accelerated “brain atrophy.” 


Now if we could just get our stroke medical 'professionals' to do their jobs on this research and create EXACT PROTOCOLS on this, that would be excellent. But that won't occur; I've never seen any sign of excellence in stroke in the 15 years I've been writing this blog. Excellence is getting survivors to 100% recovery; NOT the tyranny of low expectations your stroke medical 'professionals' try to foist off on you since they incompetently haven't done a damn thing to get survivors to 100% recovery.

Turn Back Your Brain’s Bioenergetic Clock to Reduce Alzheimer’s Risk

Summary: Researchers have discovered that a person’s “bioenergetic age,” reflecting how efficiently cells produce energy, strongly predicts Alzheimer’s risk and progression. High blood levels of molecules called acylcarnitines, markers of aging metabolism, were linked to faster cognitive decline and greater Alzheimer’s symptoms.

However, lifestyle choices like plant-based diets and regular exercise can effectively lower these molecules, reducing bioenergetic age and potentially delaying Alzheimer’s onset. This bioenergetic approach could help identify individuals at risk earlier and provide personalized strategies to maintain brain health without relying solely on medication.

Key Facts:

  • Bioenergetic Clock: High acylcarnitine levels indicate an older bioenergetic age, significantly linked to Alzheimer’s risk.
  • Lifestyle Benefits: Healthy living, including diet and exercise, can lower bioenergetic age, potentially offering protective benefits similar to Alzheimer’s medications.
  • Personalized Prevention: About 30% of study participants with genetic risks but favorable bioenergetic profiles may especially benefit from lifestyle interventions.

Source: Weill Cornell University

A person’s “bioenergetic age”—or how youthfully their cells generate energy—might be a key indicator of whether they’re at risk of developing Alzheimer’s disease, new research from Weill Cornell Medicine shows.

The study, published Feb. 24 in Nature Communications, suggests healthy living can turn back the bioenergetic clock for some people, helping them fend off Alzheimer’s as effectively as a new drug called lecanemab.

This shows an older woman, a clock and fresh foods.
The benefit is on par with the Alzheimer’s drug lecanemab. Credit: Neuroscience News

“That’s quite big because it means some people can lower their risk without the uncertain side effects of current treatments,” said senior author Dr. Jan Krumsiek, associate professor of physiology and biophysics and computational genomics in the Institute for Computational Biomedicine at Weill Cornell Medicine. The study’s first author, Dr. Matthias Arnold, is head of the computational neurobiology team at Helmholtz Munich.

The new findings bring us a step closer to solving a long-standing puzzle. One of the early warning signs of Alzheimer’s is that brain cells start losing their ability to produce and use energy efficiently, such as metabolizing glucose (sugar). But some people don’t show disease symptoms for years.

This delay between abnormalities in energy pathways and the onset of symptomatic disease suggests there is a “bioenergetic capacity” that provides a buffer for these individuals. Their bodies and brains are better at keeping energy levels up even when problems start.

“In these cases, people can be unusually healthy when we look at their cognition,” said Dr. Krumsiek, who is also a member of the Englander Institute for Precision Medicine. “They make it to old age without the kind of declines that usually creep in.” 

But could the researchers identify individuals with this beneficial higher bioenergetic capacity and help those without it?

A New Tool to Predict Risk of Alzheimer’s

Dr. Krumsiek and his colleagues turned to a group of molecules called acylcarnitines, which are associated with declining cognition and breaking down or metabolizing fats and proteins for energy.

To test if high acylcarnitine levels in the blood could predict who’s at risk of developing Alzheimer’s, the researchers used data from a large-scale study called the Alzheimer’s Disease Neuroimaging Initiative.

“It was fascinating,” Dr. Krumsiek said.

“Dividing research participants into groups based on their specific acylcarnitine levels highlighted people with more severe Alzheimer’s disease and others with fewer symptoms.”

This led the researchers to define a bioenergetic clock based on acylcarnitines—how old a person’s metabolism acts, compared to actual age. Higher bioenergetic age is linked to higher acylcarnitine levels, worsened Alzheimer’s pathology, cognitive decline and brain atrophy.

The researchers also quantified cognitive decline using a common test called the mini-mental state examination, on which a score below 24 out of 30 points indicates impairment.

They found that people with low acylcarnitine levels to begin with declined more slowly, losing about 0.5 points less per year than people with high acylcarnitine levels. The benefit is on par with the Alzheimer’s drug lecanemab.

To some degree, a person’s bioenergetic clock ticks forward at a rate determined by their genetics, but having a healthy lifestyle—for example, eating a plant-based diet and exercising —can help keep acylcarnitine levels low, which means a younger bioenergetic age, Dr. Krumsiek explained.

They went on to identify a subgroup of participants, about 30% of the Alzheimer’s Disease Neuroimaging Initiative, with older bioenergetic age but favorable genetic background.

These individuals may benefit more from early lifestyle interventions designed to decrease their bioenergetic age and potentially delay or prevent the onset of Alzheimer’s.

Next Steps

Moving forward, Dr. Krumsiek hopes to home in on the lifestyle interventions most effective for lowering bioenergetic age. For example, eating a low-carb diet may help maintain metabolic health, but just how low would carbohydrate consumption have to be for a person to see benefits?

The study also points to an inexpensive, rapid test that could determine a person’s acylcarnitine levels.

“It’s fortunate that these blood tests—originally developed to identify metabolic and mitochondrial disorders in newborns—can also help assess a person’s bioenergetic age,” Dr. Krumsiek said.

“If we can repurpose this technology for older adults, that could provide a way to start personalized treatment earlier.”

About this bioenergetic age and Alzheimer’s disease research news

Author: Barbara Prempeh
Source: Weill Cornell University
Contact: Barbara Prempeh – Weill Cornell University
Image: The image is credited to Neuroscience News

Friday, December 30, 2022

The Role of Baseline Functional MRI as a Predictor of Post-Stroke Rehabilitation Efficacy in Patients with Moderate to Severe Upper Extremity Dysfunction

I can see no use in predicting failure to recover.

 The Role of Baseline Functional MRI as a Predictor of Post-Stroke Rehabilitation Efficacy in Patients with Moderate to Severe Upper Extremity Dysfunction 

Reza Almasi Ghaleh1, Sarvenaz Rahimibarghani1, Niloofar Shirzad1, Ailar Ahangari1, Mohammad-Reza Nazem-Zadeh2, Abolfazl Mahmoudi Aqeel Abadi2, Abbas Tafakhori3, Hamid R. Fateh1,4*
1Physical Medicine and Rehabilitation Department, Shariati Hospital, Tehran University of Medical Science, Tehran, Iran.
2Medical Physics and Biomedical Engineering Department, Research Center for Molecular and Cellular Imaging, Advanced Medical Technologies and Equipment Institute, Tehran University of Medical Sciences, Tehran, Iran.
3Neurology Department, Iranian Center of Neurological Research, Neuroscience Institute, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
4Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran.
DOI: 10.4236/jbbs.2022.1212039   PDF   HTML   XML   18 Downloads   104 Views  

Abstract

Introduction: Upper extremity impairment is one of the common complications following a stroke. There are numerous rehabilitation strategies to address this problem. However, patients with moderate to severe upper limb disabilities respond differently to the same rehabilitation protocol. Apart from each patient’s unique characteristics, there are specific brain reorganizing patterns that affect the post-rehabilitation response rate. Functional magnetic resonance imaging (fMRI) determines brain activation area and connectivity patterns and has been utilized in the neurorehabilitation field.  

Material and Methods: Six stroke patients who suffered from moderate to severe upper extremity dysfunction were enrolled in this pilot study. Upper extremity function tests including the Fugl-Meyer assessment test for upper extremity (FMA-UE), and Wolf Motor Function Test (WMFT) were utilized before and after completing an intensive rehabilitation. The intensive rehabilitation program was conducted one hour a day for five days per week for four weeks. Moreover, fMRI was applied before initiating rehabilitation. The regions of interest were those associated with movement, including Brodmann areas (BA) BA1-BA6. 

Results: Six stroke patients in the sub-acute to chronic phase and ages ranging between 33 - 75 years were enrolled. All patients showed an improvement in upper limb function after four weeks of rehabilitation. Patient number one (Pt1) had the most improvement in FMA-UE, while patient number four (Pt4) recovered the most measured by WMFT. Pt1 demonstrated increased activity in all contralesional regions, whereas Pt4 had only increased activity in ipsilesional areas. Furthermore, patients with greater activation in the ipsilesional BA6 (Pt1, Pt4, Pt5, and Pt6) had better responses to the rehabilitation therapy.  

Conclusion: Patients with greater activation in the baseline fMRI, particularly ipsilesional BA6, had a better response to the intensive rehabilitation therapy. However, the patients with the most severe hand dysfunction showed lesser improvement despite the same brain activity as others in the initial fMRI.

Share and Cite:

Ghaleh, R. , Rahimibarghani, S. , Shirzad, N. , Ahangari, A. , Nazem-Zadeh, M. , Aqeel Abadi, A. , Tafakhori, A. and Fateh, H. (2022) The Role of Baseline Functional MRI as a Predictor of Post-Stroke Rehabilitation Efficacy in Patients with Moderate to Severe Upper Extremity Dysfunction. Journal of Behavioral and Brain Science, 12, 658-669. doi: 10.4236/jbbs.2022.1212039.

1. Introduction

Stroke is one of the most important causes of disability worldwide. The incidence and mortality of stroke are increasing due to the growing elderly population [1] [2]. Contralateral upper limb hemiparesis is the most prevalent impairment following a stroke, affecting more than 80% of acute stroke patients and more than 40% of chronic ones. Upper-extremity motor paresis may be accompanied by additional neurological symptoms that impede motor function recovery, necessitating targeted rehabilitation therapy [3].

The primary goal of post-stroke management is to re-establish daily activities through different rehabilitation methods despite the residual impairments [4]. Neurological recovery follows a nonlinear, logarithmic pattern, meaning that most recovery is expected in the first three months after a stroke. Furthermore, recovery from a stroke can be characterized as an improvement in several outcomes, starting with biological and neurologic changes that appear to improve performance and activity-based behavioral measures. Adaptation, regeneration, and neuroplasticity are the three fundamental mechanisms in brain recovery following a stroke. Adaptation happens by using alternate physical movements or equipment to compensate for functional loss. Regeneration is known as the growth of damaged neural cells into new tissue to restore function. The main recovery mechanism is neuroplasticity, characterized by alterations or rewiring within the neural network [3] [4] [5].

Functional disabilities after a stroke affect the patient’s quality of life and leave a significant financial burden on society [6]. In addition, only a few patients with severe hand dysfunction will show promising results after the rehabilitation program [7]. However, it is relatively difficult to predict the recovery outcome and success rate only based on the clinical data in severely disabled patients. Thus, a prognostic tool to determine long-term motor recovery in terms of rehabilitation efficacy costs many expenses. Previous clinical studies have suggested the effectiveness of intensive motor training paired with repetitive transcranial magnetic stimulation (rTMS), muscular electrical stimulation, brain-computer interfaces, and robotic devices in upper limb rehabilitation in stroke patients [8] [9].

Notably, stroke patients are more likely to have permanent functional deficits because the non-activated brain has a limited neuroplasticity capacity. Neuroplasticity is also affected by the type of intervention, the patient’s age, the location of the lesion, and handedness. Therefore, tools like functional magnetic resonance imaging (fMRI) are utilized to investigate brain activity and the influence of neurorehabilitation methods on neuroplasticity in addition to clinical disability assessment tools. FMRI has an excellent spatial resolution, allowing researchers to gain insight into the brain reorganization process and its associated functional recovery after stroke neurorehabilitation [10]. In general, fMRI captures the blood oxygen level-dependent (BOLD) signal is captured using T2*-weighted imaging. Higher neuron activity is associated with higher blood flow in the related areas, increasing the oxyhemoglobin-to ratio and the signal [11]. Task performance during fMRI causes hemodynamic response function (HRF) in the motor cortex area, which changes the BOLD signal recorded by the MRI machine.

We conducted this study using the fMRI as a prognostic tool for upper limb functional recovery after intensive rehabilitation from a stroke. Although these findings should not exclude the most severe patients from rehabilitation therapy, but also help to define the realistic rehab consequences for both therapist and patients.(So you're pushing the tyranny of low expectations because you have completely failed at your job of getting survivors 100% recovered. I'd fire you all as failures.)

More at link.