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1.
Wei-Chieh Weng Wen-Yi Huang Feng-Chieh Su Yu-Yi Chien Chia-Lun Wu Tsong-Hai Lee Tsung-I Peng 《Clinical neurology and neurosurgery》2013
Objectives
We aimed to investigate the effect of hypercholesterolemia on recovery after acute ischemic stroke.Methods
Data of 3048 patients admitted for acute ischemic stroke from January to December 2009 were collected from the Stroke Registry in the Chang Gung Healthcare System. Baseline characteristics of patients with and without hypercholesterolemia were compared. The association of hypercholesterolemia with neurological severity and recovery was analyzed using multivariate logistic regression. The patients were then divided on the basis of age for subgroup analysis.Results
The number of patients with and without a history of hypercholesterolemia was 474 (15.6%) and 2574 (84.4%), respectively. Univariate analysis showed that patients with hypercholesterolemia had a lower National Institutes of Health Stroke Scale (NIHSS) score on admission (p = 0.004). However, during hospitalization, these patients displayed less improvement in their NIHSS score (p = 0.002). These results remained significant in multivariate logistic regression analysis (p < 0.001 and p = 0.002, respectively). Subgroup analysis showed a similar association for hypercholesterolemia in both younger (age < 70) and older (age ≥ 70) age groups.Conclusions
Acute ischemic stroke in patients with hypercholesterolemia was correlated with reduced severity on admission and less favorable recovery during hospitalization, regardless of age. 相似文献2.
So-Young Park Mi-Hwa Kim Ok-Joon Kim Hee-Jung Ahn Ji-Ye Song Ju-Yeon Jeong Seung-Hun Oh 《Clinical neurology and neurosurgery》2013
Objectives
Heart-type fatty acid binding protein (H-FABP) is enriched in neuronal cell body as well as myocardium, and is rapidly released from damaged neuron into circulation in cerebral ischemia. We performed a comparative analysis between plasma H-FABP and S100B levels in the acute phase of ischemic stroke.Methods
The present study included 111 consecutive patients with acute ischemic stroke and 127 control subjects. Measurement of plasma H-FABP and S100B levels was conducted during acute phase (<24 h) of stroke. Clinical severities were evaluated by the use of NIHSS scores at admission and mRS score at 3 months after symptom onset.Results
Both the plasma H-FABP and S100B levels were significantly higher in stroke group than control group. In multiple logistic regression analysis, statistical significance of both markers remained significant after adjusting the vascular risk factors. In the receiver operator characteristic (ROC) curve analysis, neither H-FABP (area under curve [AUC] = 0.71, P < 0.001, sensitivity: 59.5%, specificity: 79.5%) nor S100B (AUC = 0.70, P < 0.001, sensitivity: 54.0%, specificity: 83.5%) showed a favorable degree of diagnostic value to discriminate stroke from stroke mimic. Plasma H-FABP (r = 0.46, P < 0.01) and S100B (r = 0.45, P < 0.01) were correlated with initial NIHSS score, and both marker were significantly higher in patients with poor clinical outcome.Conclusion
Although plasma H-FABP is elevated in the acute phase of ischemic stroke, the diagnostic accuracy of H-FABP as a sole marker is not sufficient to be applied in the clinical setting. Plasma H-FABP can be used as a potential marker for stroke prognosis. 相似文献3.
Jennifer E. Stevenson Elizabeth Colantuoni O. Joseph Bienvenu Thiti Sricharoenchai Amy Wozniak Carl Shanholtz Pedro A. Mendez-Tellez Dale M. Needham 《Journal of psychosomatic research》2013
Objective
Acute lung injury (ALI) is common in the intensive care unit (ICU), typically requiring life support ventilation. Survivors often experience anxiety after hospital discharge. We evaluated general anxiety symptoms 3 months after ALI for: (1) associations with patient characteristics and ICU variables, and (2) cross-sectional associations with physical function and quality of life (QOL).Methods
General anxiety was assessed as part of a prospective cohort study recruiting patients from 13 ICUs at four hospitals in Baltimore, MD using the Hospital Anxiety and Depression Scale — Anxiety Subscale (HAD-A), with associations evaluated using multivariable linear and logistic regression models.Results
Of 152 patients, 38% had a positive screening test for general anxiety (HAD-A ≥ 8). Pre-ICU body mass index and psychiatric comorbidity were associated with general anxiety (OR, 95% confidence interval (CI): 1.06 (1.00, 1.13) and 3.59 (1.25, 10.30), respectively). No ICU-related variables were associated with general anxiety. General anxiety was associated with the number of instrumental ADL dependencies (Spearman's rho = 0.22; p = 0.004) and worse overall QOL as measured by EQ-5D visual analog scale (VAS) (rho = − 0.34; p < 0.001) and utility score (rho = − 0.30; p < 0.001), and by the SF-36 mental health domain (rho = − 0.70; p < 0.001) and Mental Component Summary score (rho = − 0.73; p < 0.001).Conclusion
Many patients have substantial general anxiety symptoms 3 months after ALI. General anxiety was associated with patient characteristics and impaired physical function and quality of life. Early identification and treatment of general anxiety may enhance physical and emotional function in patients surviving critical illnesses. 相似文献4.
Mark Connolly Arzu Bilgin-Freiert Benjamin Ellingson Joshua R. Dusick David Liebeskind Jeff Saver Nestor R. Gonzalez 《Clinical neurology and neurosurgery》2013
Objectives
Remote ischemic preconditioning (RIPC) is a powerful endogenous mechanism whereby a brief period of ischemia is capable of protecting remote tissues from subsequent ischemic insult. While this phenomenon has been extensively studied in the heart and brain in animal models, little work has been done to explore the effects of RIPC in human patients with acute cerebral ischemia. This study investigates whether chronic peripheral hypoperfusion, in the form of pre-existing arterial peripheral vascular disease (PVD) that has not been surgically treated, is capable of inducing neuroprotective effects for acute ischemic stroke.Methods
Individuals with PVD who had not undergone prior surgical treatment were identified from a registry of stroke patients. A control group within the same database was identified by matching patient's demographics and risk factors. The two groups were compared in terms of outcome by NIH Stroke Scale (NIHSS), modified Rankin scale (mRS), mortality, and volume of infarcted tissue at presentation and at discharge.Results
The matching algorithm identified 26 pairs of PVD-control patients (9 pairs were female and 17 pairs were male). Age range was 20–93 years (mean 73). The PVD group was found to have significantly lower NIHSS scores at admission (NIHSS ≤ 4: PVD 47.1%, control 4.35%, p < 0.003), significantly more favorable outcomes at discharge (mRS ≤ 2: PVD 30.8%, control 3.84%, p < 0.012), and a significantly lower mortality rate (PVD 26.9%, control 57.7%, p = 0.024). Mean acute stroke volume at admission and at discharge were significantly lower for the PVD group (admission: PVD 39.6 mL, control 148.3 mL, p < 0.005 and discharge: PVD 111.7 mL, control 275 mL, p < 0.001).Conclusion
Chronic limb hypoperfusion induced by PVD can potentially produce a neuroprotective effect in acute ischemic stroke. This effect resembles the neuroprotection induced by RIPC in preclinical models. 相似文献5.
Koichi Otani Akihito SuzukiYoshihiko Matsumoto Ryoichi SadahiroMasanori Enokido Fumikazu KuwahataNana Takahashi 《Comprehensive psychiatry》2014
Background
Beck's cognitive theory of depression postulates personality vulnerability factors termed sociotropy and autonomy, which are accompanied by characteristic interpersonal styles. Meanwhile, Bartholomew contends that negative working models of the self and other built through insecure attachment relationships are externalized as distinctive interpersonal styles. The present study examined the relationships of sociotropy and autonomy with the self- and other-models, and attempted to promote understanding of the two personality traits from an attachment perspective.Methods
The subjects were 510 healthy Japanese medical students or hospital staffs. Sociotropy and autonomy were assessed by the Sociotropy–Autonomy Scale, and working models of the self and other were evaluated by the Relationship Scales Questionnaire.Results
The sociotropy score was correlated negatively with the self-model score (β = −0.52, p < 0.001) and positively with the other-model score (β = 0.11, p < 0.01). The autonomy score was correlated positively with the self-model score (β = 0.10, p < 0.05) and negatively with the other-model score (β = −0.33, p < 0.001).Limitations
It may be risky to generalize the present results to general populations or other ethnic groups.Conclusions
The present study suggests that both sociotropy and autonomy are associated with attachment insecurity, but the marked difference in their correlation patterns with the self- and other-models leads to the distinctive interpersonal styles of the two personality orientations. 相似文献6.
Sheng-Feng Sung Yu-Wei Chen Mei-Chiun Tseng Cheung-Ter Ong Huey-Juan Lin 《Clinical neurology and neurosurgery》2013
Objective
Atrial fibrillation (AF) is associated with poor outcome after intravenous thrombolysis probably due to greater pretreatment stroke severity. We conducted this retrospective study to determine whether AF is an independent predictor for clinical outcome in patients stratified by initial stroke severity.Methods
A total of 143 acute ischemic stroke patients who received intravenous thrombolysis within 3 h after onset were enrolled. The patients were categorized according to the baseline stroke severity by National Institute of Health Stroke Scale (NIHSS) score (≤10 vs. >10) and the presence of AF or not. Favorable 90-day outcome was defined as a modified Rankin Scale (mRS) score < 2.Results
Among the 100 patients with severe stroke (NIHSS > 10), those with AF (n = 52) had a higher proportion of favorable 90-day outcome than those without AF (31% vs. 8%, P = 0.005). After adjustment for age, baseline glucose level, and onset to treatment time, the difference remained significant (odds ratio 5.80, 95% confidence interval 1.63–20.68). In patients with mild stroke (NIHSS ≤ 10), no difference in clinical outcome was found between AF (n = 20) and non-AF (n = 23) groups.Conclusion
Presence of AF was associated with favorable 90-day outcome following intravenous thrombolysis in patients with severe stroke at baseline, while the association did not exist in patients with mild stroke. 相似文献7.
P. Sobolewski G. Kozera R. Kaźmierski S. Michalak W. Szczuchniak M. Śledzińska-Dźwigał W.M. Nyka 《Clinical neurology and neurosurgery》2013
Objective
Renal dysfunction (RD) increases risk for ischaemic stroke (IS). The impact of RD on the effects of iv-thrombolysis in the Caucasian population has not been fully determined.Aims
To evaluate the associations between RD and the outcome of iv-thrombolysis in Caucasian patients with IS.Methods
The observational, multicentre study included 404 patients with IS who were treated with iv-thrombolysis. RD was defined as estimated glomerular filtration rate ≤60 ml/min/1.73 m2. Outcome was assessed with modified Rankin Score at 3 months after the stroke onset.Results
Medians baseline NIHSS score did not differ between groups of patients with and without RD (12.0 vs. 11.0 pts, p = 0.33). Unfavourable outcome was found in 52.1% of patients with and in 41.2% of patients without RD (p = 0.05), mortality was higher in patients with RD (29.9% vs. 14.3%, p < 0.001), and the presence of haemorrhagic transformation (HT) did not differ between the groups (17.1% vs. 17.1% respectively, p = 0.996). A multivariate analysis showed no impact of RD on the unfavourable outcome (OR 0.98; 95%CI 0.88–1.10), mortality (OR 0.92; 95%CI 0.81–1.05) or presence of HT (OR 1.03; 95%CI 0.90–1.18).Conclusions
We found no impact of RD on the safety and efficacy of iv-thrombolysis in Caucasian patients with IS. 相似文献8.
Objective
Irradiation induced extracranial carotid occlusive disease has been recognized as a potential cause of post-irradiation stroke in nasopharyngeal carcinoma (NPC) patients. Our study aims to investigate the prevalence of extracranial CA disease in post-irradiated Taiwanese NPC ischemic stroke patients.Methods
Forty-three NPC patients with ischemic stroke were retrospectively selected from the stroke registration of the study hospital and compared with 276 first-ever ischemic stroke patients from the same database, of which 31 patients underwent carotid duplex sonography (CDS). Significant atherosclerotic lesions of the carotid arteries were defined as a >50% stenosis or an occlusion according to CDS.Results
Significant carotid lesions occurred in 13 of 31 (42%) NPC patients. Stroke was more frequently caused by large artery disease (44% versus 23%; p < 0.01) in NPC patients than in first-ever stroke patients without NPC. Carotid artery disease (odds ratio 7.22, 95% confidence interval 2.51–20.77; p < 0.0001) and absence of diabetes mellitus (odds ratio 0.26, 95% confidence interval 0.07–0.93; p = 0.039) were the strongest independent discriminators between NPC stroke patients and non-NPC stroke patients in a multivariate logistic regression analysis.Conclusion
Patients who received neck irradiation are at risk for the delayed development of diffused atherosclerosis but also for carotid occlusion within years, although the mechanism remains elusive and probably multifactorial. 相似文献9.
Background
To assess the value of baseline clinical severity and perfusion–diffusion mismatch as predictors for further infarct growth and clinical outcome.Methods
Patients with acute ischemic stroke and initial perfusion–diffusion mismatch within 72 h were enrolled. Baseline perfusion defects on time-to-peak (TTP) and cerebral blood volume (CBV) maps were measured. Infarct volume and stroke severity were assessed by diffusion-weighted image (DWI) and NIHSS, and were repeatedly assessed 7 days later. The predictive value of baseline NIHSS and perfusion defects on further infarct growth and neurologic deterioration was determined.Results
Fifty-two patients (mean age 68.3 ± 12.8 years, 42% women) were enrolled. CBV defects were significantly associated with infarct growth (CBV, p = 0.02). Initial stroke severity, but not TTP and CBV mismatch (p = 0.65 and 0.76, respectively), significantly inversely correlated with neurologic deterioration (p = 0.001).Conclusions
In patients with mismatch, those with severe symptoms initially are more likely to have infarct growth, while those with minor symptoms tend to suffer from larger extent of neurologic deterioration within 1 week. CBV is associated with further infarct growth but not clinical deterioration. 相似文献10.
S. Peric V. Rakocevic StojanovicI. Basta M. PericM. Milicev S. PavlovicD. Lavrnic 《Clinical neurology and neurosurgery》2013
Aim
To assess health-related quality of life (HRQoL) in patients with DM1, to identify muscular, multisystemic, central and social factors that may affect QoL and to define a DM1 patient in risk of poor QoL.Patients and method
This cross-sectional study comprised 120 DM1 consecutive patients. The following scales were used: Multidimensional Scale of Perceived Social Support (MSPSS), Muscular Impairment Rating Scale (MIRS), battery of neuropsychological tests, acceptance of illness scale (AIS), Hamilton rating scale for depression (Ham-D), Krupp's Fatigue Severity Scale (FSS), Daytime Sleepiness Scale (DSS) and SF-36 questionnaire.Results
HRQoL was impaired in DM1 patients in both physical and mental domains (PCS was 41.8 ± 23.5, MCS 47.0 ± 24.3 and total SF-36 score 45.6 ± 24.0). The most significant factors correlating with better SF-36 total score were younger age (β = −0.45, p < 0.001), shorter duration of disease (β = −0.27, p = 0.001), higher education (β = 0.20, p = 0.009), less severe muscular weakness (β = −0.52, p < 0.001), normal swallowing (β = 0.22, p = 0.005), absence of fainting (β = 0.31, p = 0.002), absence of snoring (β = 0.21, p = 0.036), better acceptance of disease (β = −0.17, p = 0.036), lower depressiveness (β = −0.46, p = 0.001), lower fatigue (β = −0.32, p = 0.001), absence of cataract (β = −0.21, p = 0.034), absence of kyphosis (β = 0.31, p = 0.004) and absence of constipation (β = 0.24, p = 0.016). Second linear regression analysis revealed that depressed (β = −0.38, p < 0.001) and elder patients (β = −0.27, p = 0.007) and as well as those with poor acceptance of illness (β = −0.21, p = 0.006) were in especially higher risk of having poor HRQoL (R2 = 0.68).Conclusion
We identified different central, social, muscular, cardiorespiratory and other factors correlating with HRQoL. It is of great importance that most of these factors are amenable to treatment. 相似文献11.
Ali Zandieh Zahra Zeynali Kahaki Homa Sadeghian Mohammad Fakhri Maryam Pourashraf Sara Parviz Majid Ghaffarpour Mojdeh Ghabaee 《Clinical neurology and neurosurgery》2013
Objectives
The aim of the current study was to design a new simpler form of National Institutes of Health Stroke Scale (NIHSS) for use in emergency settings, and compare its predictive ability with original NIHSS score for mortality.Methods
A total of 152 consecutive patients with first ever ischemic stroke admitted to a university affiliated hospital were recruited. NIHSS score on admission was estimated and the predictive ability of NIHSS items for mortality at 28 days was evaluated by logistic regression. Stepwise discriminant analysis was performed on NIHSS items to obtain a discriminant function with the best discriminative ability for mortality. Further, receiver operating characteristics (ROC) curves were depicted to compare the new determined discriminant function with the original NIHSS score.Results
Cumulative rate of mortality was 11.8% for 28-day follow-up period. Among NIHSS items, scores of visual field, limb ataxia and extinction neglect were not associated with mortality (P > 0.05). On the contrary, level of consciousness-commands, language and gaze were determined as independent indicators of mortality (P < 0.05), and their coefficients on discriminant function were equal to 0.65, 0.44 and 0.30, respectively. In addition, area under the ROC curve of the calculated discriminant function was not statistically different from NIHSS score (P > 0.05).Conclusions
The suggested discriminant function, comprising NIHSS items of level of consciousness-commands, language and gaze, can predict 28-day mortality after ischemic stroke in a similar way to the original NIHSS score and can provide a baseline for stroke severity in emergency settings. 相似文献12.
Vuk Milosevic Miroslava Zivkovic Stojanka Djuric Vladimir Vasic Tatjana Pekmezovic 《Clinical neurology and neurosurgery》2010
Objectives
Weekly variability in stroke occurrence could be related to the change in behaviors of patients or medical personnel that occur during certain periods of the week. The aim of the present study was to examine the weekly variation in hospital admissions for stroke in Nis (Serbia), as well as to investigate how the demographic factors influenced these changes.Patients and methods
The main data source for this study was the Nis Stroke Registry. During the study period (1996–2007) a total of 9675 stroke patients were registered. According to stroke subtypes, all registered patients were divided into three groups: patients with subarachnoid hemorrhage (SAH) (438 or 4.5%), patients with intracerebral hemorrhage (ICH) (1576 or 16.3%) and patients with ischemic stroke (IS) (6946 or 71.8%). Analyses were conducted separately for SAH, ICH and IS. Each stroke type was stratified by gender, age group and education level.Results
We have showed that there is a significant weekly variability in the number of SAH (p = 0.028) and IS (p < 0.001) admissions, with the minimum number of admissions on Sundays (39.27 and 14.04% less than expected), and the maximum one on Tuesdays (21.46% more than expected) and Wednesdays (10.96% more than expected), respectively. We have also registered more SAH (p = 0.015) and IS (p < 0.001) admissions on weekdays than on weekend days.Conclusion
Results of this hospital-based study confirm that there is a pattern in the variation of the number of stroke admissions on the weekly level. Reasons for the weekly variation of hospital admissions for stroke cannot be determined from the present study. 相似文献13.
Christine Kremer Fabienne Perren Johan Kappelin Eufrozina Selariu Kasim Abul-Kasim 《Clinical neurology and neurosurgery》2013
Objective
Stroke patients with aphasia have a high long-term morbidity. Intravenous rt-PA (iv) thrombolysis is given more deliberately to these patients. Early outcome data is lacking. Aim of this study was to determine early benefit from rt-PA in patients with aphasia.Methods
Data of stroke patients treated by iv thrombolysis was scrutinized for the presence of aphasia defined as ≥1 point for aphasia on the National Institute of Health Stroke Scale (NIHSS). Improvement was defined as a gain of ≥1 point within 24 h. Cranial computed tomography (CT) scans were evaluated regarding early ischemic changes (EICs), infarct volume and localization.Results
Fifty patients with aphasia were included. 16 (32%) of patients improved (4 (36%) minor, 7 (41%) moderate, 5 (23%) major stroke patients), while 44 (62%) remained unchanged. Of 28 patients with EICs, 10 (36%) improved compared to 7 out of 22 (32%) patients without (p = 0.773). Aphasia outcome was significantly associated with infarct volume at admission and at 24 h (Kruskal–Wallis, p = 0.033, p ≤ 0.001, respectively).Conclusion
EICs are not predictive of aphasia outcome and patients with improvement showed smaller infarct volumes. One third improved within 24 h, while two thirds remained unchanged. This might justify a closer follow-up of aphasia in stroke patients at the acute stage. 相似文献14.
Objective
Optimism has been linked with an array of positive health outcomes at the individual level. However, researchers have not examined how a spouse's optimism might impact an individual's health. We hypothesized that being optimistic (and having an optimistic spouse) would both be associated with better health.Methods
Participants were 3940 adults (1970 couples) from the Health and Retirement Study, a nationally representative panel study of American adults over the age of 50. Participants were tracked for four years and outcomes included: physical functioning, self-rated health, and number of chronic illnesses. We analyzed the dyadic data using the actor–partner interdependence model.Results
After controlling for several psychological and demographic factors, a person's own optimism and their spouse's optimism predicted better self-rated health and physical functioning (bs = .08–.25, ps < .01). More optimistic people also reported better physical functioning (b = −.11, p < .01) and fewer chronic illnesses (b = −.01, p < .05) over time. Further, having an optimistic spouse uniquely predicted better physical functioning (b = − .09, p < .01) and fewer chronic illnesses (b = − .01, p < .05) over time. The strength of the relationship between optimism and health did not diminish over time.Conclusions
Being optimistic and having an optimistic spouse were both associated with better health. Examining partner effects is important because such analyses reveal the unique role that spouses play in promoting health. These findings may have important implications for future health interventions. 相似文献15.
Julien Joux Stéphane OlindoAnnette Girard-Claudon Nicolas ChaussonMartine Saint-Vil Aissatou SignateMireille Edimonana Severine JeanninMathieu Aveillan Philippe CabreDidier Smadja 《Clinical neurology and neurosurgery》2013
Objectives
Narrow therapeutic window is a major cause of thrombolysis exclusion in acute ischemic stroke. Whether prehospital medicalization increases t-PA treatment rate is investigated in the present study.Patients and methods
Intrahospital processing times and t-PA treatment were analyzed in stroke patients calling within 6 h and admitted in our stoke unit. Patients transferred by our mobile medical team (SAMU) and by Fire Department (FD) paramedics were compared.Results
193 (61.6%) SAMU patients and 120 (38.4%) FD patients were included within 30 months. Clinical characteristics and onset-to-call intervals were similar in the two groups. Mean door-to-imaging delay was deeply reduced in the SAMU group (52 vs. 159 min, p < 0.0001) and was <25 min in 50% of SAMU patients and 14% of FD patients (p < 0.0001). SAMU management was the only independent factor of early imaging (p = 0.0006). t-PA administration rate was higher in SAMU group than in FD group (42% vs. 28%, p = 0.04). Proportion of patients with delayed therapeutic window was higher in FD group than in SAMU group (38% vs. 26%, p < 0.0001).Conclusion
Prehospital transfer medicalization promotes emergency room bypass, direct radiology room admission and high thrombolysis rate in acute ischemic stroke. 相似文献16.
Hernàn J. Picard Isabelle Amado Marie-Chantal Bourdel Steffen Landgraf Jean-Pierre Olié Marie-Odile Krebs 《Progress in neuro-psychopharmacology & biological psychiatry》2009
Objective
Neurological Soft Signs (NSS) and impairments in oculomotor saccadic paradigms are both frequent in patients with schizophrenia but their correlation has never been explored.Methods
78 patients with DSM-IV schizophrenia (including 43 non-treated) and 41 matched healthy controls were tested for NSS, and on three saccadic tasks: prosaccades, predictive saccades and memory-guided saccades) using infrared oculometry. We analyzed correlations between NSS scores and latencies in all three tasks, rate of errors in memory-guided saccades, and rate of anticipated predictive saccades.Results
No correlations were found in healthy controls. In the patient group, the NSS total and motor coordination scores were positively correlated with three saccadic variables: the latency of prosaccades (r = 0.36, p < 0.01 and r = 0.36, p < 0.01 respectively), of memory-guided saccades (r = 0.35, p < 0.01 and r = 0.32, p < 0.05 respectively) and, negative correlations were found, with the rate of anticipated predictive saccades (r = − 0.33, p < 0.01; r = − 0.35, p < 0.01 respectively). NSS total, motor coordination and sensory integration scores were correlated to the latency of non-anticipated predictive saccades (r = 0.34, p < 0.01; r = 0.24, p < 0.05 and r = 0.40, p < 0.001 respectively). The NSS total, motor integration and sensory integration scores were correlated with the rate of errors in memory-guided saccades (r = 0.38, p < 0.01; r = 0.37, p < 0.01 and r = 0.34, p < 0.01 respectively).Conclusions
These results support a common pathological mechanism with partial overlapping neural substrates between NSS and saccades in schizophrenia. 相似文献17.
Bo Jiang Chengyun Ding Guoen Yao Cunshan Yao Yunyan Zhang Junling Ge Enchao Qiu Maurizio Elia Raffaele Ferri 《Sleep medicine》2013,14(11):1071-1075
Objectives
We aimed to investigate subjective sleep quality and polysomnographic sleep structure features in patients with vascular cognitive impairment-no dementia (VCIND).Methods
Fifty-six patients with VCIND, 48 patients with simple stroke (without cognitive impairment), and 48 control subjects were included. The Pittsburgh Sleep Quality Index (PSQI) and polysomnography (PSG) were used to analyze their sleep characteristics. The Montreal Cognitive Assessment (MoCA) was conducted to assess mental state.Results
Patients with VCIND had higher PSQI scores compared with control subjects and simple stroke patients (P < .01). PSG revealed that patients with VCIND or stroke were more likely to experience prolonged sleep latency (SL), decreased sleep efficiency (SE), increased arousal, and reduced deep sleep and rapid eye movement (REM) sleep than controls. Patients with VCIND had significantly longer SL, increased periodic leg movements in sleep (PLMS), decreased SE, and increased arousal and sleep fragmentation compared to patients with simple stroke (P < .05). In VCIND patients, a significant positive correlation was found between SE and MoCA scores (r = 0.632; P < .001), though PSQI, SL, and arousal index were significantly negatively associated with MoCA scores (r = −0.787, −0.740, −0.772, respectively; P < .001 for all).Conclusions
VCIND patients had different abnormal sleep features, including decreased SE, increased PLMS, and prolonged SL and sleep fragmentation. Abnormal sleep in VCIND may be associated with cognitive impairment. 相似文献18.
J.A. Matias-Guiu C. Serna-Candel J.M. Espejo-Domínguez M. Fernández-Matarrubia P. Simal J. Matias-Guiu 《Neurología (Barcelona, Spain)》2014
Introduction
Demonstrating artery occlusion in ischaemic stroke has gained importance due to the increasing availability of endovascular therapies. This study evaluates the frequency of artery occlusion, its associated factors, and complications following the use of CT-angiography in acute stroke.Methods
We retrospectively analysed a cohort of patients who suffered acute ischaemic stroke between July and-December 2011.Results
We included 157 patients (mean age, 74 ± 11; mean NIHSS score, 5 [2-13]). Of that total, 56.7% of the patients were admitted to hospital during the first 8 hours. CT-angiography was performed in 71 cases (45.2%); arterial large-vessel occlusion was detected in 37 (52.1%) of these cases, and the most frequent site was M1 (40%). Univariate analysis showed that the NIHSS score (17 vs 7, P < .001) and atrial fibrillation (64% vs 32%, P = .006) were associated with artery occlusion. A logistic regression analysis was performed subsequently, confirming these associations. There were no cases of contrast-induced nephropathy. Door-to-needle time for intravenous thrombolysis was 61.2 ± 24.5 minutes in patients who underwent CT-angiography, and 53.5 ± 34.3 minutes in those who did not (P = .495).Conclusions
Arterial occlusions are seen in 23.6% of patients, especially in those who are admitted during the first few hours. NIHSS score serves as a useful predictive factor. 相似文献19.
Objective
To determine whether there is altered autonomic function associated with elevated heart rate increments on head-up tilt (HUT) in younger individuals.Methods
A total of 149 subjects were enrolled in this study. Subjects underwent the autonomic reflex screen including HUT and completed the Autonomic Symptom Profile.Results
Heart rate increment on HUT did not show a correlation with Composite Autonomic Severity Score (CASS) and the individual CASS scores were low (score 0/10, n = 103; score 1/10, n = 27; score 2/10, n = 1; score 3/10, n = 2). There was no correlation with multiple autonomic domains assessed by the Autonomic Symptom Profile. However, there were significant inverse correlations between heart rate increment and total COMPASS score including male sexual dysfunction (r = −0.318; p = 0.011; n = 64), bladder (r = −0.209; p = 0.014; n = 138), pupillomotor (r = −0.235; p = 0.006; n = 138) and male sexual dysfunction (r = −0.554; p < 0.0001; n = 64). These domains showed a positive correlation with age and a significant effect of age but not heart rate increment with regression analysis (except pupillomotor domain).Conclusions
These results argue against a reduction in autonomic function underlying the higher heart rate increments seen on HUT in younger individuals.Significance
These findings argue that the development of Postural Tachycardia Syndrome involves mechanisms that potentially occur independently of heart rate increment. 相似文献20.
Adam Kirton Gabrielle deVeber Carolyn Gunraj Robert Chen 《Clinical neurophysiology》2010,121(11):1922-1929