43 results match your criteria: "Helsinki University Hospital and Clinical Neurosciences[Affiliation]"

Introduction: Based on recent trials regarding the early time window, omitting intravenous thrombolysis (IVT) before endovascular thrombectomy (EVT) in eligible patients seems unjustified. Whether this also concerns the extended time window, 4.5 to 9 h from last seen well, is yet unclear.

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Impact of therapeutic plasma exchange on intact protein S, apolipoproteins, and thrombin generation.

Transfus Apher Sci

June 2024

Department of Hematology, Coagulation Disorders Unit, Helsinki University Hospital, Helsinki, Finland, and Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Finland.

Introduction: Therapeutic plasma exchange (TPE), with solvent/detergent (S/D)-treated plasma as replacement fluid, is an extracorporeal blood purification technique with major impact on both coagulation and lipids. Our previous in vitro study showed that S/D-plasma enhances thrombin generation by lowering intact protein S (PS) levels.

Aims: To evaluate the impact of altered lipid balance on coagulation phenotype during heparin-anticoagulated TPE with S/D-plasma, and to investigate whether the lowered intact PS levels with concomitant procoagulant phenotype, are recapitulated in vivo.

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More than 10 million Europeans show signs of mild cognitive impairment (MCI), a transitional stage between normal brain aging and dementia stage memory disorder. The path MCI takes can be divergent; while some maintain stability or even revert to cognitive norms, alarmingly, up to half of the cases progress to dementia within 5 years. Current diagnostic practice lacks the necessary screening tools to identify those at risk of progression.

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MANF protein expression is upregulated in immune cells in the ischemic human brain and systemic recombinant MANF delivery in rat ischemic stroke model demonstrates anti-inflammatory effects.

Acta Neuropathol Commun

January 2024

Drug Research Program, Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Viikinkaari 5E, P.O. Box 56, 00014, Helsinki, Finland.

Mesencephalic astrocyte-derived neurotrophic factor (MANF) has cytoprotective effects on various injuries, including cerebral ischemia, and it can promote recovery even when delivered intracranially several days after ischemic stroke. In the uninjured rodent brain, MANF protein is expressed almost exclusively in neurons, but post-ischemic MANF expression has not been characterized. We aimed to investigate how endogenous cerebral MANF protein expression evolves in infarcted human brains and rodent ischemic stroke models.

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New biomarkers are urgently needed for many brain disorders; for example, the diagnosis of mild traumatic brain injury (mTBI) is challenging as the clinical symptoms are diverse and nonspecific. EEG and MEG studies have demonstrated several population-level indicators of mTBI that could serve as objective markers of brain injury. However, deriving clinically useful biomarkers for mTBI and other brain disorders from EEG/MEG signals is hampered by the large inter-individual variability even across healthy people.

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In complex regional pain syndrome (CRPS), the representation area of the affected limb in the primary sensorimotor cortex (SM1) reacts abnormally during sensory stimulation and motor actions. We recorded 3T functional magnetic resonance imaging resting-state data from 17 upper-limb CRPS type 1 patients and 19 healthy control subjects to identify alterations of patients' SM1 function during spontaneous pain and to find out how the spatial distribution of these alterations were related to peripheral symptoms. Seed-based correlations and independent component analyses indicated that patients' upper-limb SM1 representation areas display (i) reduced interhemispheric connectivity, associated with the combined effect of intensity and spatial extent of limb pain, (ii) increased connectivity with the right anterior insula that positively correlated with the duration of CRPS, (iii) increased connectivity with periaqueductal gray matter, and (iv) disengagement from the other parts of the SM1 network.

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Sensor-level MEG combined with machine learning yields robust classification of mild traumatic brain injury patients.

Clin Neurophysiol

September 2023

BioMag Laboratory, HUS Medical Imaging Center, Helsinki University Hospital, Helsinki University and Aalto University School of Science, P.O. Box 340, 00029 HUS Helsinki, Finland; Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Aalto University, P.O. Box 12200, 00760 AALTO, Finland; Department of Neurology, Helsinki University Hospital and Clinical Neurosciences, Neurology, University of Helsinki, P.O. Box 340, 00029 HUS, Helsinki, Finland.

Objective: Diagnosis of mild traumatic brain injury (mTBI) is challenging despite its high incidence, due to the unspecificity and variety of symptoms and the frequent lack of structural imaging findings. There is a need for reliable and simple-to-use diagnostic tools that would be feasible across sites and patient populations.

Methods: We evaluated linear machine learning (ML) methods' ability to separate mTBI patients from healthy controls, based on their sensor-level magnetoencephalographic (MEG) power spectra in the subacute phase (<2 months) after a head trauma.

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Introduction: Hyperglycemia in acute ischemic stroke (AIS) is frequent and associated with worse outcome. Yet, strict glycemic control in AIS patients has failed to yield beneficial outcome. So far, the underlying pathophysiological mechanisms of admission hyperglycemia in AIS have remained not fully understood.

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Introduction: Computed tomography perfusion (CTP) imaging has become an important tool in evaluating acute recanalization treatment candidates. Large clinical trials have successfully used RAPID automated imaging analysis software for quantifying ischemic core and penumbra, yet other commercially available software vendors are also on the market. We evaluated the possible difference in ischemic core and perfusion lesion volumes and the agreement rate of target mismatch between OLEA, MIStar, and Syngo.

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Background: Patients with stroke secondary to isolated anterior cerebral artery (ACA) occlusions have poor outcomes. Whether tandem occlusions (TO) of the extracranial internal carotid (ICA) and the ACA carry even worse outcomes that remain unknown.

Methods: Patients with TO involving ICA and ACA occlusions were identified from 14 participating centers from the EndoVascular treatment And ThRombolysis in Ischemic Stroke Patients (EVATRISP) project which is a multicenter, observational, cohort study with prospective accrual of data followed by retrospective data analysis.

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Background And Purpose: We aimed to assess the association between covert atherosclerosis, arterial stiffness, and early-onset cryptogenic ischemic stroke (CIS) in a prospective case-control study.

Methods: We enrolled 123 young CIS patients (median age 41 years; 42% women) and 123 age- and sex-matched controls. Carotid intima-media thickness (CIMT), Augmentation Index (AIx), central pulse wave velocity (PWV), and subendocardial viability ratio (SEVR) were compared between patients and controls.

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Glutamine synthetase in human carotid plaque macrophages associates with features of plaque vulnerability: An immunohistological study.

Atherosclerosis

July 2022

Department of Neurology, Neurocenter, Helsinki University Hospital and Clinical Neurosciences, University of Helsinki, Haartmaninkatu 4, 15th floor, P.O. Box 340, 00029, HUS, Helsinki, Finland.

Background And Aims: Glutamine synthetase (GLUL), the sole generator of glutamine, is a metabolic nexus molecule also involved in atherosclerosis. We recently demonstrated a 2.2-fold upregulation of GLUL mRNA in stroke-causing carotid plaques when compared with plaques from asymptomatic patients.

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Article Synopsis
  • Stenosing atherosclerosis in coronary and carotid arteries can impact cognitive function, and their surgical treatments (CABG and CEA) may lead to different cognitive outcomes.
  • A study involving 100 CABG patients and 44 CEA patients analyzed cognitive changes before and after surgery compared to healthy controls, using neuropsychological assessments.
  • Results indicated that CEA patients had worse executive functioning before surgery, but experienced greater postoperative cognitive improvement in executive functions than CABG patients, although CABG patients initially faced more cognitive dysfunction.
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Objectives: Current guidelines for recanalization treatment are based on the time elapsed between symptom onset and treatment and visualization of existing penumbra in computed tomography perfusion (CTP) imaging. The time window for treatment options relies on linear growth of infarction although individual infarct growth rate may vary. We aimed to test how accurately the estimated follow-up infarct volume (eFIV) can be approximated by using a linear growth model based on CTP baseline imaging.

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The Rolandic beta rhythm, at ∼20 Hz, is generated in the somatosensory and motor cortices and is modulated by motor activity and sensory stimuli, causing a short lasting suppression that is followed by a rebound of the beta rhythm. The rebound reflects inhibitory changes in the primary sensorimotor (SMI) cortex, and thus it has been used as a biomarker to follow the recovery of patients with acute stroke. The longitudinal stability of beta rhythm modulation is a prerequisite for its use in long-term follow-ups.

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To personalize the prognostication of post-stroke outcome using MRI-detected cerebrovascular pathology, we sought to investigate the association between the excessive white matter hyperintensity (WMH) burden unaccounted for by the traditional stroke risk profile of individual patients and their long-term functional outcomes after a stroke. We included 890 patients who survived after an acute ischemic stroke from the MRI-Genetics Interface Exploration (MRI-GENIE) study, for whom data on vascular risk factors (VRFs), including age, sex, atrial fibrillation, diabetes mellitus, hypertension, coronary artery disease, smoking, prior stroke history, as well as acute stroke severity, 3- to-6-month modified Rankin Scale score (mRS), WMH, and brain volumes, were available. We defined the unaccounted WMH (uWMH) burden modeling of expected WMH burden based on the VRF profile of each individual patient.

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CMC is more than a measure of corticospinal tract integrity in acute stroke patients.

Neuroimage Clin

January 2022

Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, P.O. Box 12200, 00760 AALTO, Espoo, Finland; Aalto NeuroImaging, Aalto University School of Science, P.O. Box 12200, 00760 AALTO, Espoo, Finland; Department of Neurology, Helsinki University Hospital and Clinical Neurosciences, Neurology, University of Helsinki, P.O. Box 340, 00029 HUS, Helsinki, Finland.

In healthy subjects, motor cortex activity and electromyographic (EMG) signals from contracting contralateral muscle show coherence in the beta (15-30 Hz) range. Corticomuscular coherence (CMC) is considered a sign of functional coupling between muscle and brain. Based on prior studies, CMC is altered in stroke, but functional significance of this finding has remained unclear.

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Article Synopsis
  • The study aimed to assess the safety and effectiveness of sonothrombolysis (ultrasound-enhanced thrombolysis) in patients experiencing acute ischemic stroke (AIS) caused by large vessel occlusion, using data from randomized controlled trials.
  • Out of 7 trials involving 1102 patients, those receiving sonothrombolysis showed a significantly higher rate of complete recanalization (40.3%) compared to those treated with standard intravenous thrombolysis (22.4%).
  • The risk of symptomatic intracranial hemorrhage was not significantly different between the two groups, and there were no notable differences in other outcomes like asymptomatic hemorrhage or functional independence at three months.
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Beta rhythm modulation has been used as a biomarker to reflect the functional state of the sensorimotor cortex in both healthy subjects and patients. Here, the effect of reduced alertness and active attention to the stimulus on beta rhythm modulation was investigated. Beta rhythm modulation to tactile stimulation of the index finger was recorded simultaneously with MEG and EEG in 23 healthy subjects (mean 23, range 19-35 years).

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Article Synopsis
  • The study aimed to examine how blood pressure (BP) spikes after receiving tissue plasminogen activator (tPA) influence the risk of intracranial hemorrhage (ICH) and functional recovery in patients with acute ischemic stroke (AIS).
  • In the analysis of 674 patients, about 34% experienced significant BP excursions (over 185 systolic/105 diastolic) within the first 24 hours post-treatment, primarily within the first 75 minutes.
  • Higher rates of these BP excursions correlated with worse outcomes, including lower chances of independence after 90 days and higher likelihood of ICH, highlighting the need for careful BP monitoring after tPA administration.
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Background: An acute ischemic stroke carries a substantial risk of further recurrences. We aimed at developing and validating a prognostic tool to predict one-year stroke recurrence after acute ischemic stroke.

Methods: An integer score was derived by Cox regression analysis on a hospital-referred cohort of 3246 acute ischemic stroke patients from Switzerland, and tested for external validity in three similar independent cohorts from Athens ( = 2495), Milan ( = 1279), and Helsinki ( = 714) by means of calibration and discrimination.

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Background And Purpose: Blood pressure (BP) variability has been associated with worse neurological outcomes in acute ischaemic stroke (AIS) patients receiving treatment with intravenous thrombolysis (IVT). However, no study to date has investigated whether pulse pressure (PP) variability may be a superior indicator of the total cardiovascular risk, as measured by clinical outcomes.

Methods: Pulse pressure variability was calculated from 24-h PP measurements following tissue plasminogen activator bolus in AIS patients enrolled in the Combined Lysis of Thrombus using Ultrasound and Systemic Tissue Plasminogen Activator for Emergent Revascularization (CLOTBUST-ER) trial.

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Comparing MEG and EEG in detecting the ~20-Hz rhythm modulation to tactile and proprioceptive stimulation.

Neuroimage

July 2020

Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, P.O.BOX 12200, 00760 AALTO, Espoo, Finland; Department of Neurology, Helsinki University Hospital and Clinical Neurosciences, Neurology, University of Helsinki, P.O. Box 340, 00029 HUS, Helsinki, Finland.

Modulation of the ~20-Hz brain rhythm has been used to evaluate the functional state of the sensorimotor cortex both in healthy subjects and patients, such as stroke patients. The ~20-Hz brain rhythm can be detected by both magnetoencephalography (MEG) and electroencephalography (EEG), but the comparability of these methods has not been evaluated. Here, we compare these two methods in the evaluating of ~20-Hz activity modulation to somatosensory stimuli.

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Feasibility study of using high-throughput drug sensitivity testing to target recurrent glioblastoma stem cells for individualized treatment.

Clin Transl Med

December 2019

Vilhelm Magnus Laboratory for Neurosurgical Research, Institute for Surgical Research and Department of Neurosurgery, Oslo University Hospital, P.O. Box 4950, Nydalen, 0424, Oslo, Norway.

Background: Despite the well described heterogeneity in glioblastoma (GBM), treatment is standardized, and clinical trials investigate treatment effects at population level. Genomics-driven oncology for stratified treatments allow clinical decision making in only a small minority of screened patients. Addressing tumor heterogeneity, we aimed to establish a clinical translational protocol in recurrent GBM (recGBM) utilizing autologous glioblastoma stem cell (GSC) cultures and automated high-throughput drug sensitivity and resistance testing (DSRT) for individualized treatment within the time available for clinical application.

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