Medicine and Health Sciences Commons^™

Brain Artery Diameters And Risk Of Dementia And Stroke, Jesus D. Melgarejo, Kursat Gurel, Cassidy Rose Compton, Minghua Liu, Vanessa Guzman, Stephanie Assuras, Bonnie E. Levin, Mitchell S. V. Elkind, M. Kamran Ikram, Maryam Kavousi

School of Medicine Publications and Presentations

Introduction: We tested the association of brain artery diameters with dementia and stroke risk in three distinct population-based studies using conventional T2-weighted brain magnetic resonance imaging (MRI) images.

Methods: We included 8420 adults > 40 years old from three longitudinal population-based studies with brain MRI scans. We estimated and meta-analyzed the hazard ratios (HRs) of the brain and carotids and basilar diameters associated with dementia and stroke.

Result: Overall and carotid artery diameters > 95th percentile increased the risk for dementia by 1.74 (95% confidence interval [CI], 1.13-2.68) and 1.48 (95% CI, 1.12-1.96) fold, respectively. For stroke, meta-analyses yielded HRs of 1.59 …

Remnant Cholesterol Traits And Risk Of Stroke: A Multivariable Mendelian Randomization Study, Zhiyuan Wu, Yue Jiang, Zheng Guo, Pingan Li, Yulu Zheng, Yutao Wang, Haiping Zhang, Lois Balmer, Xingang Li, Lixin Tao, Qi Zhang, Bo Gao, Xiuhua Guo

Research outputs 2022 to 2026

Observational epidemiological studies have reported a relationship between remnant cholesterol and stroke. However, the results are inconclusive, and causality remains unclear due to confounding or reverse causality. Our objective in this study was to investigate the causal relevance of remnant cholesterol and the risk of stroke and its subtypes using the Mendelian randomization (MR) approach. Genome-wide association studies (GWASs) including 115,082 European individuals (UK Biobank) were used to identify instruments for remnant cholesterol, including intermediate-density lipoprotein (IDL) cholesterol and very-low-density lipoprotein (VLDL) cholesterol. Summary-level data for total stroke, intracerebral hemorrhage, subarachnoid hemorrhage, ischemic stroke (IS), and IS subtypes were obtained …

Brain Endothelial Cd200 Signaling Protects Brain Against Ischemic Damage, Afzal Misrani, Conelius Ngwa, Abdullah Al Mamun, Romana Sharmeen, Kanaka Valli Manyam, Rodney M Ritzel, Louise Mccullough, Fudong Liu

Journal Articles

Ischemic stroke induced inflammatory responses contribute significantly to neuronal damage and stroke outcomes. CD200 ligand and its receptor, CD200R, constitute an endogenous inhibitory signaling that is being increasingly recognized in studies of neuroinflammation in various central nervous system disorders. CD200 is a type 1 membrane glycoprotein that is broadly expressed by endothelia and neurons in the brain. In the present study, we have examined the role of endothelial CD200 signaling in acute ischemic stroke. Endothelial CD200 conditional knock out (CKO) mice were generated by breeding CD200 gene floxed mice with Cdh5^Cre mice. The mice were subjected to a 60-min …

What Is Task-Oriented Training? A Scoping Review, Erin Halford, Samantha Jakubiszak, Kassidy Krug, Amanda Umphress

Student Journal of Occupational Therapy

Task-Oriented Training (TOT) is an proven stroke rehabilitation intervention with significant evidence-based research that supports its effectiveness. The absence of a clear definition has led to variability in research reporting and subsequent confusion with practical implementation. A consistent definition seeks to remedy this ambiguity to facilitate knowledge translation. The objective of this study was to determine a comprehensive definition of TOT that encapsulates previous definitions and descriptions in the literature. In order to derive this definition, a two stage scoping review process was conducted across four databases searching for articles on the use of TOT in adult stroke rehabilitation therapy. …

Emerging Stroke Risk Factors: A Focus On Infectious And Environmental Determinants, Sajid Hameed, Nurose Karim, Mohammad Wasay, Narayanaswamy Venketasubramanian

Section of Neurology

This review focuses on emerging risk factors for stroke, including air pollution and climate change, gut microbiota, high altitude, and systemic infection. Up to 14% of all stroke-associated mortality is attributed to air pollution and is more pronounced in developing countries. Fine particulate matter and other air pollutants contribute to an increased stroke risk, and this risk appears to increase with higher levels and duration of exposure. Short term air pollution exposure has also been reported to increase the stroke risk. The gut microbiota is a complex ecosystem of bacteria and other microorganisms that reside in the digestive system and …

Inhibiting Metabotropic Glutamate Receptor 5 After Stroke Restores Brain Function And Connectivity, Jakob Hakon, Miriana J Quattromani, Carin Sjölund, Daniela Talhada, Byungchan Kim, Slavianka Moyanova, Federica Mastroiacovo, Luisa Di Menna, Roger Olsson, Elisabet Englund, Ferdinando Nicoletti, Karsten Ruscher, Adam Q Bauer, Tadeusz Wieloch

2020-Current year OA Pubs

Stroke results in local neural disconnection and brain-wide neuronal network dysfunction leading to neurological deficits. Beyond the hyper-acute phase of ischaemic stroke, there is no clinically-approved pharmacological treatment that alleviates sensorimotor impairments. Functional recovery after stroke involves the formation of new or alternative neuronal circuits including existing neural connections. The type-5 metabotropic glutamate receptor (mGluR5) has been shown to modulate brain plasticity and function and is a therapeutic target in neurological diseases outside of stroke. We investigated whether mGluR5 influences functional recovery and network reorganization rodent models of focal ischaemia. Using multiple behavioural tests, we observed that treatment with negative …

The Role Of Computed Tomography In Diagnosis Of A Stroke, Gabriella Gaglia

Student Research Poster Presentations 2024

A stroke can be defined as a neurological deficit attributed to an acute focal injury of the central nervous system (CNS). There are two types of strokes, and these include ischemic and hemorrhagic. An ischemic stroke is caused by a lack of blood flow to the brain. A hemorrhagic stroke is due to a burst or rupture of a blood vessel within the brain. Computed tomography (CT) is the ideal imaging study done when diagnosing strokes in patients. The importance of quickly diagnosing a stroke and determining which type the person has experienced is one reason why CT scans are …

Effect Of Acute Care Discharge Delays On Inpatient Rehabilitation Facility (Irf) Utilization, Eric Garrard

Student Dissertations

Discharge delays present hospitals with challenges in managing costs for Medicare admissions. Meanwhile, Inpatient Rehabilitation Facilities (IRF) are subject to strict pre-admission requirements that can complicate efficient transitions of care for patients with intensive rehabilitation needs. The purpose of this retrospective quantitative correlational study was to examine any relationship between acute care discharge delays and IRF utilization. This study investigated whether length of stay (LOS) and Medicare Advantage prior authorization requirements impact IRF referrals by reviewing 3,747 medical records of acute stroke patients aged 65 years and older at a regionally integrated healthcare system over a 3-year period (2020- 2022). …

Community Education: Impact On Earlier Recognition Of Stroke, Lauren Kahn

Doctor of Nursing Practice Projects

Cerebrovascular disease was identified as the fourth leading cause of death in Cleveland County, North Carolina from 2014 to 2018 (Cleveland County Public Health Center, 2020). Community education was identified as a potential solution to decreasing the number of community members affected by cerebrovascular disease and resulting death and disability. Five community classes were taught with 97 participants. Pre-, post-, and 1-week post-class surveys were distributed to assess baseline knowledge, knowledge gain, and knowledge retention, with 74 pre-class, 72 post-class, and 28 1-week post-class surveys returned. Of these surveys, after exclusionary criteria were used, 40 pre-class, 53 post-class, and 22 …

Dance Intervention For Stroke Rehabilitation: Restoring Occupational Performance Through Creative Movement, Olivia Paige Allen

Graduate Theses, Dissertations, and Problem Reports

Thousands of individuals are affected by cerebral vascular accidents, (CVA), also known as strokes in the United States each year, (CDC, 2023). Cerebral vascular accidents are one of the leading causes of death among the elderly population in the U.S. each year, (NIH et al., 2023). The deficits caused by a CVA can be global, from hemiparetic limbs and sensory loss to psychosocial impacts on an individual and their support system. In occupational therapy, the goal is to regain as much function and independence as possible for the individual who has experienced a CVA. Although many evidence-based intervention tools are …

A Stroke Of Fate: Overcoming Varicella Encephalitis’S Unexpected Consequences, Karissa Charles, Sean Gibbs

South Atlantic Division GME Research Day 2024

No abstract provided.

Stroke Chameleon: A Case Of High Grade Glioma, Zachary T. Lowery, Mary M. Carter

South Atlantic Division GME Research Day 2024

No abstract provided.

A Challenging Case Of Bilateral Medial Medullary Infarction Resembling Guillain-Barré Syndrome, Alexis Bialousz, Havird Mclean Skalak, Nicholas Carbo, Amanda Westbrook

South Atlantic Division GME Research Day 2024

No abstract provided.

Criteria And Indicators For Centers Of Clinical Excellence In Stroke Recovery And Rehabilitation: A Global Consensus Facilitated By Isrra, Rachel C. Stockley, Marion F. Walker, Margit A. Murphy, Noor A. A. Aziz, Philemon Amooba, Leonid Churliov, Amanda Farrin, Natalie A. Fini, Emma Ghaziani, Erin Godecke, Tania Gutierrez-Panchana, Jie Jia, Thoshenthri Kandasamy, Patrice Lindsay, John Solomon, Vincent Thijs, Tierney Tindall, Donna C. Tippett, Caroline Watkins, Elizabeth Lynch

Research outputs 2022 to 2026

Background: The aim of the International Stroke Recovery and Rehabilitation Alliance is to create a world where worldwide collaboration brings major breakthroughs for the millions of people living with stroke. A key pillar of this work is to define globally relevant criteria for centers that aspire to deliver excellent clinical rehabilitation and generate exceptional outcomes for patients. Objectives: This paper presents consensus work conducted with an international group of expert stroke recovery and rehabilitation researchers, clinicians, and people living with stroke to identify and define criteria and measurable indicators for Centers of Clinical Excellence (CoCE) in stroke recovery and rehabilitation. …

Implementation Of Viz.Ai Augmented Intelligence Software To Reduce Door To Puncture Times And Patient Outcomes At A Comprehensive Stroke Center, Cody Bryant, Brandon Womack, Mason Patel, Sanjay Sharma

North Texas GME Research Forum 2024

Introduction: Endovascular therapy (EVT) in the form of mechanical thrombectomy is the mainstay of treatment for acute large vessel occlusion (LVO) ischemic stroke, but its efficacy is highly time sensitive. It is crucial that stroke centers continue to implement process improvements that aim to streamline stroke workflow. Viz.AI is a platform that uses artificial intelligence to automatically detect LVOs with computed tomography (CT) imaging. It provides immediate access to the CT images as well as a platform for centralized communication through the mobile application. We sought to determine if the implementation of Viz.AI at our comprehensive stroke center improved stroke …

Isolated Case Of Alexia Following Cardiac Ablation: A Rare Stroke Presentation, Matthew M. Mason, Nantian Harsell, Bryan Kharbanda

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

Control Intervention Design For Preclinical And Clinical Trials: Consensus-Based Core Recommendations From The Third Stroke Recovery And Rehabilitation Roundtable, Kathryn S Hayward, Emily J Dalton, Jessica Barth, Marian Brady, Leora R Cherney, Leonid Churilov, Andrew N Clarkson, Jesse Dawson, Sean P Dukelow, Peter Feys, Maree Hackett, Steve R Zeiler, Catherine E Lang

2020-Current year OA Pubs

Control comparator selection is a critical trial design issue. Preclinical and clinical investigators who are doing trials of stroke recovery and rehabilitation interventions must carefully consider the appropriateness and relevance of their chosen control comparator as the benefit of an experimental intervention is established relative to a comparator. Establishing a strong rationale for a selected comparator improves the integrity of the trial and validity of its findings. This Stroke Recovery and Rehabilitation Roundtable (SRRR) taskforce used a graph theory voting system to rank the importance and ease of addressing challenges during control comparator design. "Identifying appropriate type of control" was …

Mnemonic Utilization In Stroke Education: Fast And Befast Adoption By Certified Comprehensive Stroke Centers., Christopher Hogge, Larry B Goldstein, Sushanth R Aroor

Journal Articles

Introduction

Symptom recognition and timely access to treatment are critical components of acute stroke care systems. Two mnemonics widely used in public educational campaigns for recognizing stroke symptoms include FAST (Face-Arm-Speech-Time) and BEFAST (Balance-Eyes-Face-Arm Speech-Time). The FAST mnemonic can miss up to 14% of strokes. BEFAST includes common posterior circulation stroke symptoms and has been implemented by several Comprehensive Stroke Centers (CSCs).

Methods

We sought to analyze the pattern of public educational materials available on the websites of US CSCs. The Joint Commission (JC) quality check website compiles a list containing the names and locations of the country’s 217 JC-certified …