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Byline: R. Colombo, MEng ('Salvatore Maugeri' Foundation, IRCCS, Service of Bioengineering Veruno (NO), Italy, rcolombo@fsm.it); F. Pisano, MD (Division of Neurology, Veruno (NO), Italy); S. Micera, PhD (ARTS Lab, Scuola [...]

Byline: Enkhsaihan Jigjid, MD, PhD (Department of Rehabilitation Medicine, Graduate School of Medicine, University of Tokyo, Department of Rehabilitation for the Movement Functions, Research Institute of the National Rehabilitation Center [...]

Byline: Cathrin M. Butefisch, MD (Neurological Therapeutic Center, Heinrich-Heine University Dusseldorf, cbuetefisch@hsc.wvu.edu, Department of Neurology Heinrich-Heine University Dusseldorf, Department of Neurology, West Virginia University, Morgantown); Marion Wessling, MD (Neurological Therapeutic [...]

Byline: Nuray Yozbatiran, PT, PhD (Departments of Neurology and Anatomy and Neurobiology, University of California, Irvine); Lucy Der-Yeghiaian, MA, OTR/L (Departments of Neurology and Anatomy and Neurobiology, University of California, [...]

Background. Recovery of motor function after stroke may be associated with changes in inhibitory and facilitatory circuits within the motor cortex. Objective. We explored such changes longitudinally after stroke, using transcranial magnetic stimulation (TMS). Methods. Subjects (N = 27) with a single cerebral infarction affecting movement of either hand were studied at < 10 days poststroke, 1 month, and 6 months. Age-matched control subjects (N = 9) were studied at 2 times. Results. In contrast to previous studies, paired-pulse inhibition was increased in patients with a subcortical stroke compared to control subjects. After a cortical stroke, paired-pulse facilitation was also increased. Stroke location affected the time course of inhibition. Subcortical stroke resulted in increased inhibition initially that decreased over time, whereas cortical stroke had no significant effect on inhibition and a more immediate and lasting effect on facilitation. Conclusions. The time course of a decline in inhibition based on TMS after sub-cortical stroke followed the gain in motor recovery. Increased facilitation in cortical stroke patients is more likely to represent the effect of early cortical circuit disruption and may not play a role in subacute changes in motor function. Key Words: Motor recovery--Transcranial magnetic stimulation--Human--Stroke., Recovery of motor function after cerebral infarction is a complex process. Ischemic damage to the corticospinal tract irreversibly removes upper motor neurons from the final common pathway for movement and [...]

Objective: To determine whether serum N-terminal pro-B-type natriuretic peptide (N-BNP), a biomarker of myocardial wall stress, is specific to acute heart failure (HF) in patients hospitalized with stroke. Design: Case-control study. Setting: Tertiary hospital, Neurosciences Critical Care Unit and Stroke Unit. Patients: Consecutive patients with acute ischemic or hemorrhagic stroke who were evaluated for HF. Intervention: None. Measurements and results: Cases and controls were classified, respectively, as patients with or without HF, defined according to modified Framingham criteria. Seventy-two patients were evaluated, 39 with ischemic stroke, 22 with aneurysmal subarachnoid hemorrhage (SAH), and 11 with intracerebral hemorrhage (ICH). Thirty-four patients (47%) met criteria for HF, and 47 patients (65%) had systolic or diastolic left ventricular (LV) dysfunction on echocardiogram. Serum N-BNP was measured a median of 48 h following the onset of stroke and was increased (> 900 pg/ml) in 56 patients (78%), with higher levels in non-survivors (11898 ± 12741 vs 4073 ± 5691; p = 0.001). In a multiple regression model, N-BNP elevation was not independently associated with HF (OR 5.4, 95% CI 0.8-36.0, p = 0.084). At a cut-off of 900 pg/ml, the sensitivity of N-BNP for HF was 94%, specificity 37%, positive predictive value (PPV) 57%, and negative predictive value (NPV) 88%. For systolic or diastolic LV dysfunction, the sensitivity of N-BNP was 89%, specificity 44%, PPV 75%, and NPV 69%. Conclusions: These results demonstrate that N-BNP elevation is not specific to HF or LV dysfunction in patients with acute ischemic stroke, SAH, and ICH. Keywords Stroke * Subarachnoid hemorrhage * Intracerebral hemorrhage * Heart failure * B-type natriuretic peptide, Introduction Cardiac disturbances are common in patients hospitalized with ischemic or hemorrhagic stroke and may present as arrhythmias, conduction abnormalities, acute coronary syndromes, neurogenic myocardial injury, and heart failure (HF) [...]

Nurses working in acute settings can help stroke survivors gain access to vital long-term communication support, says the author of a Stroke Association report. The charity's report revealed that nine [...]

Stroke survivors are not getting the vital information they need on leaving hospital which is severely jeopardising their future health, claims a study by the Stroke Association. In its new [...]