Digital Commons Network^™

Intracerebral Hemorrhage In Sparcl: What Was The Relationship To Ldl-C?, J. David Spence

Department of Medicine Publications

No abstract provided.

Uses Of Ultrasound In Stroke Prevention, J. David Spence

Department of Medicine Publications

Ultrasound methods are useful in stroke prevention in several ways. Measurement of carotid plaque burden, as either total plaque area (TPA) or total plaque volume (TPV) are strong predictors of cardiovascular risk: much stronger than intima-media thickness, which does not represent true atherosclerosis, but a biologically and genetically distinct phenotype. Measurement of plaque burden is also useful for the study of genetics, and of new risk factors such as toxic products of the intestinal microbiome. Carotid plaque burden is highly correlated with and as predictive of risk as coronary calcium scores, but is less costly and does not require radiation. …

Impaired Renal Function And Cerebrovascular Disease, J. David Spence

Department of Medicine Publications

No abstract provided.

Stroke Prevention: A Lifetime Of Lessons, J. David Spence

Department of Medicine Publications

In 44 years of practicing stroke prevention, I have learned many lessons; in this article, I hope to impart some of them. Three areas of my research are discussed. Controlling resistant hypertension is markedly improved by physiologically individualized therapy based on renin/aldosterone phenotyping; this is particularly important in black patients. Measurement of carotid plaque burden strongly predicts cardiovascular risk and is useful for genetic research and for a process called treating arteries instead of risk factors. Doing so in high-risk patients with asymptomatic carotid stenosis was associated with a >80% reduction in the 2-year risk of stroke and myocardial infarction. …

Triglyceride Lowering Drugs: Not Just Icosapent Ethyl, J. David Spence

Department of Medicine Publications

No abstract provided.

Adding Insight To Injury!, A. R. Naylor, J. D. Spence

Department of Medicine Publications

No abstract provided.

Traffic-Related Air Pollution And Carotid Plaque Burden In A Canadian City With Low-Level Ambient Pollution, Markey Johnson, Jeffrey R. Brook, Robert D. Brook, Tor H. Oiamo, Isaac Luginaah, Paul A. Peters, J. David Spence

Department of Medicine Publications

BACKGROUND: The association between fine particulate matter and cardiovascular disease has been convincingly demonstrated. The role of traffic-related air pollutants is less clear. To better understand the role of traffic-related air pollutants in cardiovascular disease development, we examined associations between NO2, carotid atherosclerotic plaque, and cardiometabolic disorders associated with cardiovascular disease. METHODS AND RESULTS: Cross-sectional analyses were conducted among 2227 patients (62.9±13.8 years; 49.5% women) from the Stroke Prevention and Atherosclerosis Research Centre (SPARC) in London, Ontario, Canada. Total carotid plaque area measured by ultrasound, cardiometabolic disorders, and residential locations were provided by SPARC medical records. Long-term outdoor residential NO2 …

Asymptomatic Carotid Stenosis: High Risk With Suboptimal Treatment: Re: Five Year Outcomes In Men Screened For Carotid Artery Stenosis At 65 Years Of Age: A Population Based Cohort Study, J. David Spence

Department of Medicine Publications

No abstract provided.

A Randomized, Controlled Trial Of Alpha-Rhythm Eeg Neurofeedback In Posttraumatic Stress Disorder: A Preliminary Investigation Showing Evidence Of Decreased Ptsd Symptoms And Restored Default Mode And Salience Network Connectivity Using Fmri., Andrew A Nicholson, Tomas Ros, Maria Densmore, Paul A Frewen, Richard W J Neufeld, Jean Theberge, Rakesh Jetly, Ruth A Lanius

Department of Medicine Publications

OBJECTIVE: The default-mode network (DMN) and salience network (SN) have been shown to display altered connectivity in posttraumatic stress disorder (PTSD). Restoring aberrant connectivity within these networks with electroencephalogram neurofeedback (EEG-NFB) has been shown previously to be associated with acute decreases in symptoms. Here, we conducted a double-blind, sham-controlled randomized trial of alpha-rhythm EEG-NFB in participants with PTSD (n = 36) over 20-weeks. Our aim was to provide mechanistic evidence underlying clinical improvements by examining changes in network connectivity via fMRI.

METHODS: We randomly assigned participants with a primary diagnosis of PTSD to either the experimental group (n = 18) …