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BACKGROUND: Ischemic stroke is a common type of stroke associated with reorganization of functional network of the brain. OBJECTIVE: This pilot study aimed to investigate the characteristics of functional brain networks based on EEG in patients with acute ischemic stroke. METHODS: Seven patients with ischemic stroke within 72 hours of onset and seven healthy controls were enrolled in the study. Dynamic EEG monitoring and clinical information were repeatedly collected within 72 hours (T1), on the 5th day (T2), and on the 7th day (T3) of stroke onset. A directed transfer function was employed to construct functional brain connection patterns. Graph theoretical analysis was performed to evaluate the characteristics of functional brain networks. RESULTS: First, we found that the brain networks of ischemic stroke patients were quite different from the healthy controls. The clustering coefficient (0.001

The present study aims to investigate the correlation between EEG features and short-term prognosis in patients who have experienced an acute ischemic stroke.The present study included 29 patients who had experienced an acute ischemic stroke and were treated at the Beijing Dongzhimen Hospital affiliated with Beijing University of Chinese Medicine between January 2010 and January 2012. Patients were evaluated using the revised Brain Symmetry Index (r-BSI), National Institutes of Health Stroke Scale, and Glasgow Coma Scale. Functional outcomes were assessed 21 days after admission using the Barthel Index and modified Rankin Scale. Two groups were created based on the Barthel Index (60 vs. ≥60) and modified Rankin Scale (3 vs. ≥3).Significant differences were observed in r-BSI, National Institutes of Health Stroke Scale, and Glasgow Coma Scale scores between the two groups. Poor functional outcomes were associated with higher r-BSI and National Institutes of Health Stroke Scale scores as well as lower Glasgow Coma Scale scores in comparison with those obtained for patients with good prognosis. Logistic regression analysis revealed that r-BSI scores at admission exhibited significant negative correlation with Barthel Index scores (-2.070, P = 0.049) and significant positive correlation with modified Rankin Scale scores (2.256, P = 0.033).The r-BSI may be a valuable prognostic tool in the prediction of short-term outcomes for patients who have experienced acute ischemic stroke.The early prediction of functional outcomes after stroke may enhance clinical management and minimize short-term mortality.

Ethnopharmacological relevance Xuesaitong (XST) is a traditional Chinese medicine injection with neuroprotective properties and has been extensively used to treat stroke for many years. The main component of XST is Panax notoginseng saponins (PNS), which is the main extract of the Chinese herbal medicine Panax notoginseng. Aim of the study In this study, we investigated whether XST provided long-term neuroprotection by inhibiting neurite outgrowth inhibitor-A (Nogo-A) and the ROCKII pathway in experimental rats after middle cerebral artery occlusion (MCAO) and in SH-SY5Y cells exposed to oxygen-glucose deprivation/reperfusion (OGD/R). Materials and methods Rats with permanent MCAO were administered XST, Y27632, XST plus Y27632, and nimodipine for 14 and 28 days. Successful MCAO onset was confirmed by 2,3,5-triphenyl tetrazolium chloride (TTC) staining. Neurological deficit score (NDS) was used to assess neurological impairment. Hematoxylin-eosin (HE) staining and immunohistochemical (IHC) analysis of synaptophysin (SYN) and postsynaptic density protein-95 (PSD-95) were performed to evaluate cerebral ischemic injury and the neuroprotective capability of XST. Nogo-A levels and the ROCKII pathway were detected by IHC analysis, western blotting, and quantitative real-time polymerase chain reaction (qRT-PCR) to explore the protective mechanism of XST. OGD/R model was established in SH-SY5Y cells. Cell counting kit 8 (CCK8) was applied to detect the optimum OGD time and XST concentration. The expression levels Nogo-A and ROCKII pathway were determined using western blotting. Results Our results showed that XST reduced neurological dysfunction and pathological damage, promoted weight gain and synaptic regeneration, reduced Nogo-A mRNA and protein levels, and inhibited the ROCKII pathway in MCAO rats. CCK8 assay displayed that the optimal OGD time and optimal XST concentration were 7 h and 20 μg/mL respectively in SH-SY5Y cells. XST could evidently inhibit OGD/R-induced Nogo-A protein expression and ROCKII pathway activation in SH-SY5Y cells. Conclusions The present study suggested that XST exerted long-term neuroprotective effects that assisted in stroke recovery, possibly through inhibition of the ROCKII pathway.

Highlights • The left UF damage is associated with PSSA language impairment severity. • The left UF FA is decreased and correlated with language impairment in PSSA. • The left temporal pole ALFF is associated with PSSA language impairment and recovery. • Our results support the disconnection theory in PSSA pathology and recovery., Aphasia, one of the most common cognitive impairments after stroke, is commonly considered to be a cortical deficit. However, many studies have reported cases of post subcortical stroke aphasia (PSSA). The pathology and recovery mechanism of PSSA remain unclear. This study aimed to investigate PSSA mechanism through a multimodal magnetic resonance imaging (MRI) approach and a two-session study design (baseline and one month after treatment). Thirty-six PSSA patients and twenty-four matched healthy controls (HC) were included. All patients had subcortical infarctions involving left subcortical white matter for 1 to 6 months. The patients underwent MRI scan and Western Aphasia Battery (WAB) examination before and after one month’s comprehensive treatment. Region-wise lesion-symptom mapping (RLSM), tractography, fractional anisotropy (FA), and amplitude of low-frequency fluctuations (ALFF) analysis were conducted. After MRI preprocessing and exclusion, FA analysis included 35 patients pre-treatment and 16 patients post-treatment. ALFF analysis included 30 patients pre-treatment and 14 patients post-treatment. We found: 1) the amount of damage in the left uncinate fasciculus (UF) was associated with WAB aphasia quotient (AQ); 2) the left UF FA and left temporal pole (TP) ALFF were decreased and positively correlated with WAB-AQ, spontaneous speech, and naming in PSSA patients; and 3) PSSA patients showed increased left TP ALFF when their language ability recovered after treatment. The left TP ALFF change was positively correlated with AQ change. Our results demonstrate the importance of left UF and left TP (one of the cortical terminals of the left UF) in PSSA pathology and recovery. These results may further provide support for the disconnection theory in the mechanism of PSSA.

In this study we investigated the neurolinguistic and neuroimaging characteristics of post-stroke motor aphasia patients. The effects of acupuncture on cortex activation by using magnetic resonance imaging (MRI) in patients with motor aphasia were also studied. In this study 43 patients with motor aphasia after stroke were assessed according to Clinical Rehabilitation Research Center aphasia examination (CRRCAE) for linguistic evaluation and MRI and computed tomography (CT) were used for the analyses of brain lesions. The MRI imaging data were also examined using statistical parametric mapping (SPM8) software. Cortex activation images during acupuncture were analyzed using generalized linear model analysis. The results of MRI and CT showed diverse brain lesion regions of post-stroke motor aphasia including the cortex, subcortex and cortex together with the subcortex. The language-related brain areas are activated by acupuncture including frontal, temporal, parietal and occipital lobes as well as insula, precuneus and other wide range of brain function areas as shown by MRI. Our study showed that the brain lesion regions in post-stroke motor aphasia were not completely consistent with the classical motor speech center. By using MRI our study results suggest that the formation of cognitive language may be involved with the cortical-subcortical functional networks. Acupuncture may be useful for treatment of motor aphasia after stroke.

In this meta-analysis the authors evaluated the effectiveness of acupuncture in improving functional communication and language function in post-stroke aphasia (PSA) patients. Data sources: MEDLINE, EMBASE, CENTRAL, AMED, SinoMed, CNKI, VIP, and Wanfang databases, ICTRP, ISRCTN, EUCTR, ClinicalTrials.gov, and Stroke Trials Registries. A search was carried out for randomized controlled trials (RCTs) investigating the effects of acupuncture compared with no treatment or placebo acupuncture on post-stroke aphasia (PSA). The searched records were independently screened by two authors, who extracted the data, and assessed risk of bias of the included RCTs. Data aggregation and risk of bias evaluation were conducted on Review Manager Version 5.3. The protocol was registered in the PROSPERO database (CRD42016037543). A total of 28 RCTs involving 1747 patients (883 patients in the treatment group and 864 patients in the control group) were included in the quantitative synthesis. The results demonstrated significant effects of acupuncture in improving PSA functional communication (P

To explore the relativity between heart-brain and post-stroke anxiety disorder by analyzing the pathogenesis of post-stroke anxiety disorder combined with the physiology and pathology of organs. The acupoint selection thought was explored by its selection rule according to literature. Post-stroke anxiety belongs to the brain organic anxiety disorder, whose basic pathogenesis is mind injury. The crucial cause is heart and brain disorder at the same time. Thus, Baihui (GV 20), Fengfu (GV 16) for brain and Xinshu (BL 15), Shenmen (HT 7) for heart can improve anxiety disorder according to the theories such as five organ

Language is an essential higher cognitive function supported by large-scale brain networks. In this study, we investigated functional connectivity changes in the left frontoparietal network (LFPN), a language-cognition related brain network in aphasic patients. We enrolled thirteen aphasic patients who had undergone a stroke in the left hemisphere and age-, gender-, educational level-matched controls and analyzed the data by integrating independent component analysis (ICA) with a network connectivity analysis method. Resting state functional magnetic resonance imaging (fMRI) and clinical evaluation of language function were assessed at two stages: one and two months after stroke onset. We found reduced functional connectivity between the LFPN and the right middle frontal cortex, medial frontal cortex and right inferior frontal cortex in aphasic patients as compared to controls. Correlation analysis showed that stronger functional connectivity between the LFPN and the right middle frontal cortex and medial frontal cortex coincided with more preserved language comprehension ability after stroke. Network connectivity analysis showed reduced LFPN connectivity as indicated by the mean network connectivity index of key regions in the LFPN of aphasic patients. The decreased LFPN connectivity in stroke patients was significantly associated with the impairment of language function in their comprehension ability. We also found significant association between recovery of comprehension ability and the mean changes in intrinsic LFPN connectivity. Our findings suggest that brain lesions may influence language comprehension by altering functional connectivity between regions and that the patterns of abnormal functional connectivity may contribute to the recovery of language deficits.