Publications by authors named "Dongwha Kang"

Background: Detection of atrial fibrillation (AF) in patients with embolic stroke of undetermined source (ESUS) is important for the secondary prevention of stroke. We investigated the factors associated with the detection of newly diagnosed AF in ESUS patients during follow-up.

Methods: Patients with acute ischemic stroke classified as ESUS were included.

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Although cognitive training has been proposed as a possible therapeutic modality for mild cognitive impairment (MCI), most serious games focus on specific tasks. This study aimed to investigate the feasibility and efficacy of narrative video game-based cognitive intervention for MCI. A four-week (± 1-week) mobile game intervention was given to 17 MCI participants (mean age (SD) = 72.

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  • - The study focused on intracranial vertebral artery dissecting aneurysms (iVADAs), which pose a risk for serious complications like subarachnoid hemorrhage, highlighting the importance of identifying risk factors for their growth.
  • - Researchers analyzed 124 patients, noting that 43.5% experienced iVADA growth; factors such as being a current smoker and having a higher vertebral artery tortuosity index (VTI) were linked to this growth.
  • - The findings indicate that a higher VTI is independently associated with iVADA growth, suggesting that monitoring VTI could be crucial for managing patients with iVADA.
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  • Vertebrobasilar artery stent placement (VBS) is used to prevent posterior circulation strokes, but little is known about the differences in outcomes based on whether the stent is placed intracranially or extracranially.
  • In a study of 105 patients, those with intracranial VBS experienced significantly higher rates of in-stent restenosis (21.9% vs 4.9%) and stented-territory ischemic events (32.8% vs 7.3%) compared to those with extracranial VBS.
  • The procedure for intracranial VBS took longer and had a higher rate of residual stenosis immediately after the procedure, indicating more complications associated with intracranial st
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  • This study investigates the effectiveness of an 8-week customized visual discrimination training program for improving visual field defects in patients who have suffered a chronic stroke.
  • Participants first underwent an 8-week no-training phase, followed by training that focused on specific visual tasks designed for their individual needs, leading to significant improvements in visual detection sensitivity.
  • Results indicated that the custom training not only enhanced visual function but also positively impacted the quality of life related to vision, as observed through improvements in specific survey scores post-study.
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Background: Atrial fibrillation detected after stroke (AFDAS) refers to the identification of newly diagnosed atrial fibrillation (AF) following an ischemic stroke in patients without known AF (KAF). The objective of this study was to compare the functional outcomes of patients diagnosed with AFDAS and those with KAF who underwent mechanical thrombectomy.

Methods And Results: We conducted a retrospective analysis of patients who underwent mechanical thrombectomy and with either new AF diagnosed during hospitalization or KAF.

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Cognitive impairment (CI) is prevalent in central nervous system demyelinating diseases, such as multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD). We developed a novel tablet-based modified digital Symbol Digit Modalities Test (MD-SDMT) with adjustable protocols that feature alternating symbol-digit combinations in each trial, lasting one or two minutes. We assessed 144 patients (99 with MS and 45 with NMOSD) using both MD-SDMT protocols and the traditional paper-based SDMT.

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Background And Purpose: The accurate prediction of functional outcomes in patients with acute ischemic stroke (AIS) is crucial for informed clinical decision-making and optimal resource utilization. As such, this study aimed to construct an ensemble deep learning model that integrates multimodal imaging and clinical data to predict the 90-day functional outcomes after AIS.

Methods: We used data from the Korean Stroke Neuroimaging Initiative database, a prospective multicenter stroke registry to construct an ensemble model integrated individual 3D convolutional neural networks for diffusion-weighted imaging and fluid-attenuated inversion recovery (FLAIR), along with a deep neural network for clinical data, to predict 90-day functional independence after AIS using a modified Rankin Scale (mRS) of 3-6.

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Introduction: Visual field defects (VFDs) represent a debilitating poststroke complication, characterized by unseen parts of the visual field. Visual perceptual learning (VPL), involving repetitive visual training in blind visual fields, may effectively restore visual field sensitivity in cortical blindness. This current multicenter, double-blind, randomized, controlled clinical trial investigated the efficacy and safety of VPL-based digital therapeutics (Nunap Vision [NV]) for treating poststroke VFDs.

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Background: Carotid artery stenting (CAS) has been the standard treatment for carotid stenosis because it is less invasive; however, the risk of periprocedural thromboembolism is high. We investigated the predictors for silent brain infarcts (SBIs), focusing on embolic protection in CAS.

Methods: This study was single-center retrospective study, and we obtained baseline demographics and clinical, laboratory, and periprocedural variables of patients who underwent CAS.

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Background: Posterior reversible encephalopathy syndrome (PRES) is characterized by cerebral blood flow dysregulation and the blood-brain barrier (BBB) disruption. While renal insufficiency has been considered a factor in BBB fragility, the relationship between renal insufficiency and the PRES lesions volume remains unclear.

Methods: This observational study was performed retrospectively.

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Background And Purpose: Atrial fibrillation-related stroke (AF-stroke) is associated with an adverse prognosis, characterized by a high incidence of progression, recurrence, and hemorrhagic transformation. Our study aims to investigate the potential benefits of stratified early administration of apixaban, taking into account infarct size during the acute phase, in order to enhance functional outcomes.

Methods: We conducted this study at a tertiary referral stroke center, enrolling acute AF-stroke patients who received apixaban during the acute phase.

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A reciprocal relationship between perceptual learning and functional brain changes towards perceptual learning effectiveness has been demonstrated previously; however, the underlying neural correlates remain unclear. Further, visual perceptual learning (VPL) is implicated in visual field defect (VFD) recovery following chronic stroke. We investigated resting-state functional connectivity (RSFC) in the visual cortices associated with mean total deviation (MTD) scores for VPL-induced VFD recovery in chronic stroke.

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Background And Purpose: The additive effects of intravenous thrombolysis (IVT) before mechanical thrombectomy (MT) remain unclear. We aimed to investigate the efficacy and safety of IVT prior to MT depending on the location of M1 occlusion.

Methods: We reviewed the cases of patients who underwent MT for emergent large-vessel occlusion of the M1 segment.

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Background: Therapeutic-induced hypertension treatment (iHTN) is helpful for alleviating early neurological deterioration (END) in acute small vessel occlusive stroke. We examined the time parameters related to iHTN effectiveness in these patients.

Methods: We retrospectively reviewed patients with acute small vessel occlusive stroke who underwent iHTN for END, defined as an increase of ≥2 points in total National Institutes of Health Stroke Scale (NIHSS) score or ≥1 point in motor items of NIHSS.

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Early neurological deterioration (END) in lenticulostriate artery (LSA) infarction is associated with perforating artery hypoperfusion. As middle cerebral artery (MCA) tortuosity may alter hemodynamics, we investigated the association between MCA tortuosity and END in LSA infarction. We reviewed patients with acute LSA infarction without significant MCA stenosis.

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Background And Purpose: Cardiac biomarkers including, elevated troponin (ET) and prolonged heart rate-corrected QT (PQTc) interval on electrocardiography are known to frequent and have a prognostic significance in patients with acute ischemic stroke (AIS). However, it is still challenging to practically apply the results for appropriate risk stratification. This study evaluate whether combining ET and PQTc interval can better assess the long-term prognosis in AIS patients.

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Background: Video head impulse tests (vHITs), assessing the vestibulo-ocular reflex (VOR), may be helpful in the differential diagnosis of acute dizziness. We aimed to investigate vHITs in patients with acute posterior circulation stroke (PCS) to examine whether these findings could exhibit significant abnormalities based on lesion locations, and to evaluate diagnostic value of vHIT in differentiating dizziness between PCS and vestibular neuritis (VN).

Methods: We prospectively recruited consecutive 80 patients with acute PCS and analyzed vHIT findings according to the presence of dorsal brainstem stroke (DBS).

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Introduction: Patients with atrial fibrillation-related stroke (AF-stroke) are prone to developing rapid ventricular response (RVR). We investigated whether RVR is associated with initial stroke severity, early neurological deterioration (END) and poor outcome at 3 months.

Methods: We reviewed patients who had AF-stroke between January 2017 and March 2022.

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Background And Purpose: Top-of-basilar artery occlusion (TOB) is one of the most devastating strokes despite successful mechanical thrombectomy (MT). We aimed to investigate the impact of initial low cerebellum perfusion delay on the outcomes of TOB treated with MT.

Methods: We included patients who underwent MT for TOB.

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Article Synopsis
  • - The study explored how changes in lipid profiles, specifically levels of LDL-C, HDL-C, total cholesterol, and triglycerides, impact the risk of in-stent restenosis (a narrowing of the artery after a stent is placed) in ischemic stroke patients who underwent intracranial stenting.
  • - Researchers tracked 100 patients over 12 months and found that improvements in HDL-C levels and reductions in TC/HDL-C and LDL-C/HDL-C ratios were linked to a significantly lower risk of restenosis.
  • - The results suggest that regularly monitoring and managing these lipid levels could be crucial for preventing complications in patients with intracranial stents.
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Background:  We investigated the association between the reaction time (R), a thromboelastography (TEG) parameter for hypercoagulability, and functional outcomes based on the occurrence of hemorrhagic transformation (HT) and early neurological deterioration (END).

Methods:  We enrolled ischemic stroke patients and performed TEG immediately after the patients' arrival. The baseline characteristics, occurrence of HT and END, stroke severity, and etiology were compared according to the R.

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