The Influence of Strength and Skill Parameters on the Evolution of Dysphagia Post Stroke: A Prospective Study.

The role of pathophysiological deficits in the evolution of dysphagia post-stroke is unclear. This observational, longitudinal study aimed to document the evolution and relationship between strength and precision of submental contraction, and swallowing outcomes at six months. Participants were recruited from a tertiary acute hospital after a first acute stroke.

Upper extremity function and disability recovery with vibration therapy after stroke: a systematic review and meta-analysis of RCTs.

Background: This study aimed to investigate the therapeutic effects of vibration therapy for improving upper extremity motor impairment, function, and disability recovery in people with stroke.

Design: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. PubMed, EMBASE, the Cochrane Library Database, Physiotherapy Evidence Database (PEDro), China Knowledge Resource Integrated Database, and Google Scholar were searched from inception to May 31, 2024.

Associative brain computer interface training increases wrist extensor corticospinal excitability in subacute stroke patients.

In a recently developed associative rehabilitative brain computer interface system, electroencephalography is used to identify the most active phase of the motor cortex during attempted movement and deliver precisely timed peripheral stimulation during training. This approach has been demonstrated to facilitate corticospinal excitability and functional recovery in patients with lower limb weakness following stroke. The current study expands those findings by investigating changes in corticospinal excitability following the associative BCI intervention in post-stroke patients with upper limb weakness.

Evaluating inter- and intra-rater reliability in assessing upper limb compensatory movements post-stroke: creating a ground truth through video analysis?

Background: Compensatory movements frequently emerge in the process of motor recovery after a stroke. Given their potential for unfavorable long-term effects, it is crucial to assess and document compensatory movements throughout rehabilitation. However, clinically applicable assessment tools are currently limited.

Suppressing the Inflammatory Prostaglandin Signaling after Thrombotic Stroke Ameliorates Ischemic Brain Injury and Facilitates Poststroke Recovery.

Acute cerebral ischemia is a leading cause of death and disability, particularly among old adults. The narrow therapeutic window and risk of hemorrhagic transformation largely limit patient eligibility for the current treatment. The neuroinflammatory signaling pathway involving the prostaglandin E2 (PGE) receptor subtype EP2 has now been clarified to contribute to the secondary neurotoxicity following ischemic stroke.

Rewiring the disordered connectome with circuit-based paired stimulation after stroke-a randomized, double-blind and controlled Phase II trial.

The cortico-cortical paired associative stimulation, a combined stimulation based on two brain regions, may be an effective strategy for stroke rehabilitation. Our aim was to confirm that the cortico-cortical paired associative stimulation strengthens the connection between brain regions in the motor circuit and promotes improvements in motor function. This was a randomized double-blind, controlled Phase II trial.

Deep brain stimulation combined with morroniside promotes neural plasticity and motor functional recovery after ischemic stroke.

Background And Objective: Until now, there has been an unmet need for treatments promoting chronic-phase post-stroke functional recovery. We previously found that morroniside promoted endogenous neurogenesis in ischemic stroke, but its therapeutic window was limited to the first 48 h. Here, we aimed to explore whether deep brain stimulation (DBS) combined with morroniside could enhance neurogenesis in rats subjected to focal ischemic stroke and contributes to functional recovery.

CT perfusion for lesion-symptom mapping in large vessel occlusion ischemic stroke.

Background: Identifying eloquent regions associated with poor outcomes based on CT perfusion (CTP) may help inform personalized decisions on selection for endovascular therapy (EVT) in patients with large vessel occlusion (LVO) ischemic stroke. This study aimed to characterize the relationship between CTP-defined hypoperfusion and National Institutes of Health Stroke Scale (NIHSS) subitem deficits.

Methods: Patients with anterior circulation LVO, baseline CTP, itemized NIHSS at presentation and 24 hours were included.

Upper-extremity motor recovery after stroke: A systematic review and meta-analysis of usual care in trials and observational studies.

Background: A better knowledge of upper-extremity (UE) recovery in patients with stroke receiving usual care (UC) is crucial for informing clinicians on expected recovery and serves as reference for future studies.

Objectives: This systematic review and meta-analysis aimed to assess rate and amount of recovery of UE with UC in the subacute phase of stroke and identify covariates of UE recovery.

Methods: PRISMA-guidelines were used for search in PubMed, Cinahl and PEDro.

Cortical Hand Knob Stroke: A Case Report of Isolated Hand Weakness and Recovery.

Cortical hand knob stroke is a rare form of stroke that affects the motor cortex responsible for controlling fine hand movements. This condition, most commonly caused by ischemia in the "hand knob" region of the precentral gyrus, can present with isolated hand weakness, often mimicking peripheral neuropathies and leading to diagnostic delays. We report a case of a 65-year-old right-handed woman who experienced a sudden onset of left-hand weakness, along with resolving slurred speech and facial droop, while she was working at her office.

Motivation in veterans with an acute/subacute ischemic stroke did not improve cognition and functional motor recovery but reduced deaths.

Background: The role of motivation per se in the presence or absence of depression in stroke-related cognitive and functional motor recovery has not been studied.

Aim: This study aimed to determine the role of motivation on cognition and functional motor recovery in patients after an acute and subacute ischemic stroke.

Design: Prospective, observational, single-center study.

Robot-assisted gait training in stroke.

Stroke is the second most common cause of mortality and disability worldwide. Most of the patients cannot regain their walking ability after a stroke. Impaired gait and mobility negatively affect the activities of daily living and quality of life of stroke survivors.

Effect of low-frequency repetitive magnetic transcranial stimulation in hemichorea-hemiballismus with ipsilateral basal ganglia hemorrhage: A case report.

Post-stroke hemichorea-hemiballismus (HCHB) typically manifests as hyperkinetic movements contralateral to the lesion, but rarely occurs ipsilaterally. In this article, we present a rare case who initially presented with left hemiparesis and developed right HCHB after right basal ganglia hemorrhage. To facilitate motor recovery in the left hemiparesis, we applied low-frequency repetitive transcranial magnetic stimulation (rTMS) over the left primary motor cortex.

Assessment of corticospinal tract damage and cytokines response in early and late stages of acute unilateral brainstem infarction patients.

Background: Acute brainstem infarction is associated with high morbidity and mortality, the integrity of corticospinal tract (CST) detected via diffusion tensor imaging (DTI) can assist in predicting the motor recovery of the patients. In addition to the damage caused by ischemia and reperfusion, sterile inflammation also contributes to the brain injury after stroke. However, the changes in CST integrity detected by DTI in acute brainstem infarction have yet to be fully elucidated, and it is still unclear whether sterile inflammation can cause damage to the CST.

Association that Neuroimaging and Clinical Measures Have with Change in Arm Impairment in a Phase 3 Stroke Recovery Trial.

Objective: Vagus nerve stimulation (VNS) paired with rehabilitation therapy improved motor status compared to rehabilitation alone in the phase III VNS-REHAB stroke trial, but treatment response was variable and not associated with any clinical measures acquired at baseline, such as age or side of paresis. We hypothesized that neuroimaging measures would be associated with treatment-related gains, examining performance of regional injury measures versus global brain health measures in parallel with clinical measures.

Methods: Baseline magnetic resonance imaging (MRI) scans in the VNS-REHAB trial were used to derive regional injury measures (extent of injury to corticospinal tract, the primary regional measure; plus extent of injury to precentral gyrus and postcentral gyrus; lesion volume; and lesion topography) and global brain health measures (degree of white matter hyperintensities, the primary global brain measure; plus volumes of cerebrospinal fluid, cortical gray matter, white matter, each thalamus, and total brain).

Development and validation of clinical prediction model for functional independence measure following stroke rehabilitation.

Objectives: To develop and internally validate a clinical prediction model that includes balance ability and nutritional indices for the motor-functional independence measure (M-FIM) at 90 days post-stroke stroke.

Materials And Methods: This retrospective, single-center study included 566 patients with stroke undergoing rehabilitation at our rehabilitation hospital. The primary outcome was the M-FIM score of >61 at 3 months post-strokes onset.

Preferential Synaptic Type of GABA-A Receptor Ligands Enhancing Neuronal Survival and Facilitating Functional Recovery After Ischemic Stroke.

Selective enhancement of synaptic GABA signaling mediated by GABA-A receptors has been previously reported to promote functional recovery after ischemic stroke, while tonic GABA signaling has been detrimental. To identify agents that enhance synaptic signaling, we synthesized GABA-A ligands based on three chemotypes with affinity values p= 6.44-8.

Therapeutic effects of low-intensity transcranial focused ultrasound stimulation on ischemic stroke in rats: an in vivo evaluation using electrical impedance tomography.

Although previous studies have demonstrated that transcranial focused ultrasound stimulation protects the ischemic brain, clear criteria for the stimulation time window and intensity are lacking. Electrical impedance tomography enables real-time monitoring of changes in cerebral blood perfusion within the ischemic brain, but investigating the feasibility of using this method to assess post-stroke rehabilitation in vivo remains critical. In this study, ischemic stroke was induced in rats through middle cerebral artery occlusion surgery.

Transcutaneous electrical acupoint stimulation for upper limb motor recovery after stroke: a systematic review and meta-analysis.

Background: Transcutaneous electrical acupoint stimulation (TEAS) is an innovative, non-invasive therapy that stimulates the contraction of paralyzed muscles in the upper limbs, promoting functional recovery. Several studies have demonstrated the efficacy of TEAS in restoring upper limb function. This study aims to evaluate the impact of TEAS on upper limb motor recovery after stroke.

Current implications of EEG and fNIRS as functional neuroimaging techniques for motor recovery after stroke.

Persistent motor deficits are highly prevalent among post-stroke survivors, contributing significantly to disability. Despite the prevalence of these deficits, the precise mechanisms underlying motor recovery after stroke remain largely elusive. The exploration of motor system reorganization using functional neuroimaging techniques represents a compelling yet challenging avenue of research.

Role of BDNF-TrkB signaling in the improvement of motor function and neuroplasticity after ischemic stroke in rats by transcranial direct current stimulation.

Background: Transcranial direct current stimulation (tDCS) has an impact on improving cognitive and motor dysfunction induced by ischemia-reperfusion injury. However, to use this technology more rationally in clinical practice, a deepened understanding of the molecular mechanisms behind its therapeutic effects is needed. This study explored the role of the brain-derived neurotrophic factor(BDNF) and its associated receptor tropomyosin-receptor kinase B(TrkB) while deciphering the underlying mechanisms in transcranial direct current therapy to treat ischemic stroke.

The Use of Extrinsic Performance Feedback and Reward to Enhance Upper Limb Motor Behavior and Recovery Post-Stroke: A Scoping Review.

Background: During post-stroke motor rehabilitation, patients often receive feedback from therapists or via rehabilitation technologies. Research suggests that feedback may benefit motor performance, skill acquisition, and action selection. However, there is no consensus on how extrinsic feedback should be implemented during stroke rehabilitation to best leverage specific neurobehavioral mechanisms to optimize recovery.

Impact of Neglect on the Relationship Between Upper Limb Motor Function and Upper Limb Performance in the (Hyper)acute Poststroke Phase.

Visuospatial neglect (VSN) is a negative, strong, and independent predictor of poor outcome after stroke, and is associated with poorer upper limb (UL) motor recovery in terms of function or capacity (ie, in standardized, lab-based testing). Although the main aim of stroke rehabilitation is to re-establish optimal functioning in daily life, the impact of VSN on UL performance (ie, in unstructured, everyday environments) is largely unknown. In this proof of principle study, the impact of VSN on the strength of the association between UL motor function (Jamar Hand Dynamometer) and UL performance (Upper Limb Lucerne ICF-based Multidisciplinary Observation Scale) was investigated in 65 (hyper)acute first-ever stroke patients.

Bloodletting at the ear apex for acute stroke: A systematic review and meta-analysis of randomized controlled trials.

Background: Stroke is a major cause of death and disability worldwide. Despite innovative developments in acute stroke treatment techniques in modern society, many stroke survivors still experience complications, leading to a demand for complementary and alternative medicines, including traditional medicine. Bloodletting at the ear apex (BLEA) is a nonpharmacological intervention used for various diseases, including acute stroke, in traditional medicine in East Asian countries, including China and Korea.