Genetically-defined deficiency of mannose-binding lectin is associated with protection after experimental stroke in mice and outcome in human stroke

The complement system is a major effector of innate immunity that has been involved in stroke brain damage. Complement activation occurs through the classical, alternative and lectin pathways. The latter is initiated by mannose-binding lectin (MBL) and MBL-associated serine proteases (MASPs). Here we investigated whether the lectin pathway contributes to stroke outcome in mice and humans.

Pilot study about the effect of rt-PA administration on the excitotoxicity mediated brain damage and its repercussion on the functional prognosis of patients with ischaemic stroke: research protocol

Fibrinolytic therapy with Recombinant Tissue-Plasminogen Activator (rt-PA) is currently the only effective treatment for ischaemic stroke in its acute phase. Even though its use generally improves the prognosis of those patients likely to receive it, rt-PA administration is associated to several risks, such as haemorrhagic transformation ofthe ischaemic lesion and activation of excitotoxic mechanisms that may contribute to an increase in mortality or to a poor outcome in certain occasions, specially when arterial recanalization is not achieved or the rt-PA is lately administrated. Since in the last few years the role of glutamate in the neurotoxicity associated toischaemia has been widely studied and it is known that high plasma glutamate levels are predictors of ischaemic lesion growth and poor neurological outcome, it is necessary to find out which factors can contribute to glutamate release in the brain. The aim of this study is to determine if rt-PA administration is related to an increase in plasma glutamate levels, as well as to define if higher plasma glutamate levels at admission are related to different evolution and prognosis of our patients, both in those in which recanalisation is achieved and not. A series of cases of patients with hemispheric cerebral infarction admitted in our hospital during a year will be studied, and the data obtained from them will be compared to the data obtained from a control group, the samples of wich were takenyears ago, before rt-PA was routinely used

Music-supported training is more efficient than functional motor training for recovery of fine motor skills in stroke patients

MOTOR IMPAIRMENTS ARE COMMON AFTER STROKE but efficacious therapies for these dysfunctions are scarce. Extending an earlier study on the effects of music-supported training (MST), behavioral indices of motor function were obtained before and after a series of training sessions to assess whether this new treatment leads to improved motor functions. Furthermore, music-supported training was contrasted to functional motor training according to the principles of constraint-induced therapy (CIT). In addition to conventional physiotherapy, 32 stroke patients with moderately impaired motor function and no previous musical experience received 15 sessions of MST over a period of three weeks, using a manualized, step-bystep approach. A control group consisting of 15 patients received 15 sessions of CIT in addition to conventional physiotherapy. A third group of 30 patients received exclusively conventional physiotherapy and served as a control group for the other three groups. Fine as well as gross motor skills were trained by using either a MIDI-piano or electronic drum pads programmed to emit piano tones. Motor functions were assessed by an extensive test battery. MST yielded significant improvement in fine as well as gross motor skills with respect to speed, precision, and smoothness of movements. These improvements were greater than after CIT or conventional physiotherapy. In conclusion, with equal treatment intensity, MST leads to more pronounced improvements of motor functions after stroke than CIT.

TCDI vs TCD for stroke risk prevention in children with sickle cell anemia: a cross-sectional study

Children with sickle cell anemia (SCA) are at increased risk of stroke. Elevated blood-flow velocities in the middle cerebral artery detected by Transcranial Doppler (TCD) are a good predictor of stroke risk in these children. Velocities obtained by TCD are measured by using a specific parameter, the time-averaged mean of the maximum velocity (TAMM). Children with TAMM velocities ≥200 cm/sec are at high risk of stroke, and transfusions as primary prevention might be done. Transcranial Doppler-imaging (TCDI) is now widely available and it allows the visualization of intracranial vessels.Few studies have compared the TAMM in TCD and TCDI, and no studies have established a cutoff point for TAMM in TCDI equivalent to the STOP criteria of “normal”, “conditional” and “abnormal”, which could predict a high risk of stroke in children with SCAObjectives: To compare the TAMM velocity obtained by TCDI with the TAMM velocity obtained with TCD in the middle cerebral artery, and to determine a cutoff point for TAMM in TCDI that could predict a high risk of stroke in children with SCAMethods: This study is a cross-sectional study of a diagnostic test. 78 children with sickle cell anemia between 2 to 16 years will be evaluated with both TCD and TCDI in order to determinate the TAMM with the two devices. Velocities obtained with both Doppler techniques will be compared using an intraclass correlation coefficient

Language recovery and evidence of residual deficits after nonthalamic subcortical stroke: A 1 year follow-up study

A variety of language disturbances including aphasia have been described after subcortical stroke but less is known about the factors that influence the long-term recovery of stroke-induced language dysfunction. We prospectively examined the role of the affected hemisphere and the lesion site in the occurrence and recovery of language deficits in nonthalamic subcortical stroke. Forty patients with unilateral basal gangliastroke underwent language assessment within 1 week, 3 months and 1 year after stroke. Disturbances in at least one language domain were observed in 35 patients during the first week post stroke including aphasia diagnosed in 11 patients. Importantly, the appearance of deficits after stroke onset and the improvement of language function were not determined by the site of subcortical lesion, but instead were critically influenced by the affected hemisphere. In fact, the language impairments following left and right basal ganglia stroke mirrored the language dysfunction observed after cortical lesions in the same hemisphere. A significant overall language improvement was observed at 3 months after stroke, although residual deficits in languageexecutive function were the most commonly observed impairment at 1 year follow-up. Although a substantial improvement of language function can be expected after nonthalamic subcortical stroke, our findings suggest that language recovery may not be fully achieved at 1 year post