Review
Medicine, General & Internal
Rajeel Imran, Ghada A. Mohamed, Fadi Nahab
Summary: The field of acute stroke treatment has seen significant progress, particularly in understanding the pathophysiology of acute ischemic injury and neuroimaging thrombolysis therapy.
JOURNAL OF CLINICAL MEDICINE
(2021)
Review
Pharmacology & Pharmacy
T. Marc Eastin, Justin A. Dye, Promod Pillai, Miguel A. Lopez-Gonzalez, Lei Huang, John H. Zhang, Warren W. Boling
Summary: Stroke is a significant cause of death and disability worldwide, with post-stroke cognitive impairment causing a decline in the quality of life. Currently, only pharmacological and mechanical thrombolysis interventions are advised for revascularization. However, these treatments are limited to the acute phase of stroke. Advances in neuroimaging and interventional devices have expanded the potential revascularization window, with delayed revascularization showing positive outcomes beyond the recommended therapeutic window. This review discusses the understanding of ischemic stroke, the latest revascularization doctrine, and evidence from clinical studies on effective delayed revascularization.
FRONTIERS IN PHARMACOLOGY
(2023)
Article
Medicine, General & Internal
Annika Nordanstig, Sami Curtze, Henrik Gensicke, Sanne M. Zinkstok, Hebun Erdur, Camilla Karlsson, Jan-Erik Karlsson, Nicolas Martinez-Majander, Gerli Sibolt, Philippe Lyrer, Christopher Traenka, Merih Baharoglu, Jan F. Scheitz, Nicolas Bricout, Hilde Henon, Didier Leys, Ashraf Eskandari, Patrik Michel, Christian Hametner, Peter Arthur Ringleb, Marcel Arnold, Urs Fischer, Hakan Sarikaya, David J. Seiffge, Alessandro Pezzini, Andrea Zini, Visnja Padjen, Dejana R. Jovanovic, Andreas Luft, Susanne Wegener, Lars Kellert, Katharina Feil, Georg Kagi, Alexandros Rentzos, Kimmo Lappalainen, Ronen R. Leker, Jose E. Cohen, John Gomori, Alex Brehm, Jan Liman, Marios Psychogios, Andreas Kastrup, Panagiotis Papanagiotou, Jan Gralla, Mauro Magoni, Charles B. L. M. Majoie, Georg Bohner, Ivan Vukasinovic, Vladimir Cvetic, Johannes Weber, Zsolt Kulcsar, Martin Bendszus, Markus Mohlenbruch, George Ntaios, Eftychia Kapsalaki, Katarina Jood, Christian H. Nolte, Paul J. J. Nederkoorn, Stefan Engelter, Daniel Strbian, Turgut Tatlisumak
Summary: The TRISP collaboration aims to address research questions on the effectiveness and safety of IVT, and has expanded to include the EVT part. By prospectively collecting data, the collaboration hopes to provide answers to some unanswered questions in the field.
Article
Medicine, General & Internal
Hao Li, Jinbo Huang, Shisheng Ye, Hai Chen, Li Yuan, Geng Liao, Weijie Du, Chaomao Li, Ling Fang, Sheng Liu, Pengfei Yang, Yongwei Zhang, Pengfei Xing, Xiaoxi Zhang, Xiaofei Ye, Ya Peng, Jie Cao, Liyong Zhang, Zhi Yang, Jianmin Liu
Summary: This study aimed to identify predictors of 90-day mortality in acute ischemic stroke patients treated with mechanical thrombectomy. The results showed that symptomatic intracranial hemorrhage, high post-thrombectomy NIHSS score, high NIHSS score on admission, and high glucose level at hospital arrival were significant independent predictors of mortality. Smoking may also be associated with mortality, but further research is needed to confirm this.
Article
Clinical Neurology
Helene E. K. Sundelin, Torbjorn Tomson, Johan Zelano, Jonas Soderling, Peter Bang, Jonas F. Ludvigsson
Summary: The study found that the risk of epilepsy increases in children after ischemic stroke, especially after perinatal ischemic stroke. The highest risk of epilepsy occurs during the first 6 months after the stroke, and remains elevated even 20 years later. Siblings and parents of children with ischemic stroke also have an increased risk of epilepsy.
Article
Hematology
Takaya Kitano, Yumiko Hori, Shuhei Okazaki, Yuki Shimada, Takanori Iwamoto, Hideaki Kanki, Shintaro Sugiyama, Tsutomu Sasaki, Hajime Nakamura, Naoki Oyama, Taku Hoshi, Goichi Beck, Hiroki Takai, Shunji Matsubara, Hiroya Mizuno, Hirotake Nishimura, Ryo Tamaki, Junichi Iida, Jiro Iba, Masaaki Uno, Haruhiko Kishima, Hiroaki Fushimi, Satoshi Hattori, Shigeo Murayama, Eiichi Morii, Manabu Sakaguchi, Yoshiki Yagita, Takeshi Shimazu, Hideki Mochizuki, Kenichi Todo
Summary: Older thrombi delay reperfusion after mechanical thrombectomy for ischemic stroke, requiring more treatment passes and associated with poorer prognosis. Improving efficacy of mechanical thrombectomy may involve targeting therapies for thrombus maturation.
THROMBOSIS AND HAEMOSTASIS
(2022)
Review
Clinical Neurology
Ahmed Mohamed, Ashfaq Shuaib, Maher Saqqur, Nida Fatima
Summary: The study found that good collateral blood flow in acute stroke is associated with a higher likelihood of favorable clinical outcomes, successful recanalization, and lower risk of symptomatic intracranial hemorrhage and mortality.
NEUROLOGICAL SCIENCES
(2023)
Article
Clinical Neurology
Adrien ter Schiphorst, Roxane Peres, Cyril Dargazanli, Raphael Blanc, Benjamin Gory, Sebastien Richard, Gaultier Marnat, Igor Sibon, Benoit Guillon, Romain Bourcier, Christian Denier, Laurent Spelle, Julien Labreuche, Arturo Consoli, Bertrand Lapergue, Vincent Costalat, Michael Obadia, Caroline Arquizan
Summary: This study found that EVT is effective in improving cerebral recanalization in patients with acute ischemic stroke due to CICAO, with a 40% rate of favorable outcome at 3 months. However, there is a high rate of procedural complications, and further randomized controlled trials are needed to evaluate the superiority of EVT in CICAO patients.
JOURNAL OF NEUROLOGY
(2022)
Article
Emergency Medicine
Zane Elfessi, Danielle Dressler, Sara Johnson, Katerina Antonishina, Melody Suh
Summary: Strokes are a significant cause of death in the United States, resulting in approximately 800,000 patients seeking emergency care annually. Acute ischemic strokes can be caused by emboli in diseases like atrial fibrillation or thrombus formation due to atherosclerotic disease. While platelet activation by certain immunomodulators has been extensively studied, the role of hormones such as prolactin in stroke is a recent revelation. We present the first known case of an acute ischemic stroke in a patient with known hyperprolactinemia due to medication non-compliance.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2023)
Article
Health Care Sciences & Services
Lidia M. V. R. Moura, Zhiyu Yan, Maria A. Donahue, Louisa H. Smith, Lee H. Schwamm, John Hsu, Joseph P. Newhouse, Sebastien Haneuse, Deborah Blacker, Sonia Hernandez-Diaz
Summary: This study examines the association between benzodiazepine use and poststroke mortality in older adults after acute ischemic stroke. The use of benzodiazepines within 7 days after stroke is associated with an increased risk of mortality within 30 days, but this association is likely biased.
JOURNAL OF CLINICAL EPIDEMIOLOGY
(2023)
Review
Clinical Neurology
Diana Slawski, Jeremy J. Heit
Summary: Patients with acute ischemic stroke may have minor neurologic deficits, and decisions on acute treatment depend on the disability from symptoms, radiographic features, and the need for intravenous thrombolysis or endovascular therapy. Identifying patients at risk for neurologic deterioration is crucial for preventing poor outcomes.
FRONTIERS IN NEUROLOGY
(2021)
Review
Chemistry, Multidisciplinary
Shanshan Zhang, Yuan Zhou, Ruoqi Li, Zhong Chen, Xiang Fan
Summary: Ischemic stroke is a serious disease and the drug delivery systems (DDS) may be an effective way to enhance treatment outcomes.
JOURNAL OF CONTROLLED RELEASE
(2022)
Article
Clinical Neurology
Wolfgang Haupt, Lukas Meyer, Maximilian Wagner, Rosalie McDonough, Sarah Elsayed, Matthias Bechstein, Gerhard Schoen, Helge Kniep, Andre Kemmling, Jens Fiehler, Uta Hanning, Gabriel Broocks
Summary: This study suggests that the reduction of relative cerebral blood volume (rCBV) is predictive of irreversible tissue injury and functional outcome in patients with ischemic stroke, particularly in those with core volumes > 50 ml. Thus, analyzing rCBV reduction within ischemic lesions may provide additional information for acute stroke management.
TRANSLATIONAL STROKE RESEARCH
(2023)
Article
Clinical Neurology
Hongyu Zhou, Weiqi Chen, Yuesong Pan, Yue Suo, Xia Meng, Hao Li, Yongjun Wang
Summary: The study found that for Chinese patients with ischemic stroke, although women are older and more severe at the time of onset, the prognosis after intravenous thrombolysis is not significantly different from men. There were no significant differences in terms of functional recovery and the occurrence of symptomatic intracranial haemorrhage and mortality between women and men.
STROKE AND VASCULAR NEUROLOGY
(2021)
Article
Clinical Neurology
Katharina Feil, Marius Matusevicius, Moriz Herzberg, Steffen Tiedt, Clemens Kuepper, Johannes Wischmann, Sonja Schoenecker, Annerose Mengel, Jennifer Sartor-Pfeiffer, Katharina Berger, Konstantin Dimitriadis, Thomas Liebig, Marianne Dieterich, Michael Mazya, Niaz Ahmed, Lars Kellert
Summary: This study compares the effectiveness of endovascular thrombectomy (EVT) with intravenous thrombolysis (IVT) or IVT alone in minor stroke patients. The results suggest similar functional outcomes between IVT alone and EVT with or without IVT.
EUROPEAN JOURNAL OF NEUROLOGY
(2022)
Review
Clinical Neurology
Melanie Filser, Axel Buchner, Gereon Rudolf Fink, Stefan M. Gold, Iris-Katharina Penner
Summary: Patients with multiple sclerosis (MS) are at increased risk of experiencing mental health problems, including depression and anxiety. However, there is limited knowledge about the assessment and association of these affective symptoms in MS. Further research is needed to improve diagnosis and care.
JOURNAL OF NEUROLOGY
(2023)
Article
Oncology
Michael M. Wollring, Jan-Michael Werner, Elena K. Bauer, Caroline Tscherpel, Garry S. Ceccon, Philipp Lohmann, Gabriele Stoffels, Christoph Kabbasch, Roland Goldbrunner, Gereon R. Fink, Karl-Josef Langen, Norbert Galldiks
Summary: This study evaluated the use of FET PET and MRI for early response assessment in recurrent glioma patients treated with lomustine-based chemotherapy. The results suggest that FET PET provides complementary information to RANO criteria for response evaluation early after treatment initiation.
Article
Environmental Sciences
Lara Lindert, Sabrina Zeike, Kyung-Eun (Anna) Choi, Holger Pfaff
Summary: Managers play a key role in creating a humane work environment. Transformational leadership is associated with increased employee awareness of task outcomes and values, but its impact on psychological wellbeing varies. Based on longitudinal data from a German company, this study found that transformational leadership and gender had a significant impact on future transformational leadership, while psychological wellbeing, social capital, and age did not. However, psychological wellbeing and social capital significantly influenced future psychological wellbeing. Therefore, companies should invest in social capital and consider gender aspects in the workplace, and conduct mental risk assessments to identify and address potential issues.
INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
(2023)
Article
Environmental Sciences
Laura Seinsche, Kristina Schubin, Jana Neumann, Holger Pfaff
Summary: This study investigates the implementation of working from home in the German public sector one year after the COVID-19 outbreak. It finds that working from home can serve as a resource to mitigate various pressures and health issues in the workplace.
INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
(2023)
Article
Neurosciences
Anja Schaffrath, Sophia Schleyken, Aline Seger, Hannah Jergas, Pelin Ozduzenciler, Marlene Pils, Lara Bloemeke, Anneliese Cousin, Johannes Willbold, Tuyen Bujnicki, Oliver Bannach, Gereon R. Fink, Dieter Willbold, Michael Sommerauer, Michael T. Barbe, Gultekin Tamguney
Summary: This study used surface-based fluorescence intensity distribution analysis (sFIDA) to detect and quantify single particles of alpha-synuclein aggregates in stool samples of 94 PD patients, 72 isolated rapid eye movement sleep behavior disorder (iRBD) patients, and 51 healthy controls. The results showed significantly elevated concentrations of alpha-synuclein aggregates in stool samples of iRBD patients compared to controls (p = 0.024) or PD patients (p < 0.001). The study suggests that measuring alpha-synuclein aggregates in stool using the sFIDA assay could support the diagnosis of prodromal synucleinopathies.
NPJ PARKINSONS DISEASE
(2023)
Editorial Material
Radiology, Nuclear Medicine & Medical Imaging
Isabelle Stetter, Jan-Michael Werner, Michael Schroeter, Claudia Baumann, Janina Neuneier, Marc Schlamann, Matthias Schmidt, Alexander Drzezga, Gereon R. Fink, Norbert Galldiks
Summary: Differentiating brain tumors from nonneoplastic lesions using conventional MRI may be challenging. Clinical symptoms often remain unspecific, and imaging findings from MRI may be inconclusive. PET with the radiolabeled somatostatin receptor ligand DOTATATE was performed, and it facilitated the diagnosis of a falcine meningioma consistent with its value for the differential diagnosis of meningioma.
CLINICAL NUCLEAR MEDICINE
(2023)
Article
Clinical Neurology
Anja Ophey, Ezequiel Farrher, Nora Pagel, Aline Seger, Christopher E. J. Doppler, N. Jon Shah, Elke Kalbe, Gereon R. Fink, Michael Sommerauer
Summary: Cognitive decline is a common and debilitating symptom in patients with Parkinson's disease. Metabolic changes in the occipital cortex during visual processing may serve as a biomarker for cognitive decline in these patients.
EUROPEAN JOURNAL OF NEUROLOGY
(2023)
Article
Oncology
Sandra Salm, Stefanie Houwaart, Natalia Cecon-Stabel, Antje Dresen, Holger Pfaff, Nadine Scholten, Theresia Krieger
Summary: The isPO OG service in Germany is an important component of integrated, cross-sectoral psycho-oncology care. Cancer survivors called isPO onco-guides provide information and support to newly diagnosed cancer patients. The service has been evaluated from the perspectives of patients, isPO OGs, and professional service providers, and has been found to have positive effects.
JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY
(2023)
Article
Oncology
Alexander Heinzel, Felix M. Mottaghy, Christian Filss, Gabriele Stoffels, Philipp Lohmann, Michel Friedrich, Nadim J. Shah, Svenja Caspers, Carolin Weiss Lucas, Maximilian I. Ruge, Norbert Galldiks, Gereon R. Fink, Karl-Josef Langen, Martin Kocher
Summary: This study investigated the impact of tumor development and multimodality therapy on health-related quality of life (HRQoL) in glioma patients. The results showed that right hemisphere gliomas were associated with less favorable outcomes in most functional domains except communication ability. This relationship was mainly observed in T2/FLAIR lesions involving structural and functional networks in the right hemisphere.
JOURNAL OF NEURO-ONCOLOGY
(2023)
Article
Clinical Neurology
Felix Kohle, Marie Madlener, Emanuel F. Bruno, Gereon R. Fink, Volker Limmroth, Lothar Burghaus, Michael P. Malter
Summary: This study revealed that most patients with status epilepticus (SE) were not effectively treated with benzodiazepines (BZDs) according to current guidelines. Sufficient dosing of BZDs was found to be beneficial for patients with generalised convulsive SE, but not for other types of SE. Treatment decisions guided by the semiology of SE are crucial, and further evidence is urgently needed for the management of non-generalised convulsive SE.
SEIZURE-EUROPEAN JOURNAL OF EPILEPSY
(2023)
Article
Clinical Neurology
Ann-Katrin Schild, Daniel Scharfenberg, Lukas Kirchner, Kim Klein, Anton Regorius, Yasemin Goereci, Dix Meiberth, Lena Sannemann, Joachim Luelling, Finja Schweitzer, Gereon R. Fink, Frank Jessen, Christiana Franke, Oezguer Onur, Stefanie Jost, Clemens Warnke, Franziska Maier
Summary: Cognitive impairment is a common symptom of post-COVID syndrome (PCS), but there is inconsistency between subjective cognitive complaints (SCC) and objective results. This study investigated this discrepancy and found a 40% difference between subjective reports and test results. Patients with SCC and objective impairment showed elevated fatigue and reduced quality of life. The study suggests that more patients will likely request neuropsychological assessments even after mild infections.
ZEITSCHRIFT FUR NEUROPSYCHOLOGIE
(2023)
Article
Health Care Sciences & Services
Holger Pfaff, Jochen Schmitt
Summary: To reduce decisional uncertainty in urgent situations, a new approach called the EbM+theory approach is proposed, which integrates empirical and theoretical evidence in a context-sensitive way. This approach aims to provide decision-makers with urgent and sound recommendations based on evidence-based medicine principles. Two roadmaps are provided within this framework, one for simple interventions and the other for complex interventions, each consisting of multiple steps including applying theory, conducting mechanistic studies, and conducting experiments.
JOURNAL OF EVALUATION IN CLINICAL PRACTICE
(2023)
Article
Clinical Neurology
Ji-Won Kim, Henning R. Stetefeld, Gereon R. Fink, Michael P. Malter
Summary: This study reports on the clinical practice in managing stroke patients with seizures at onset (SaO) from a large tertiary stroke center in Germany. The data show that SaO is rare in stroke patients but associated with more extensive strokes and increased in-hospital mortality.
SEIZURE-EUROPEAN JOURNAL OF EPILEPSY
(2023)
Article
Chemistry, Analytical
Christina van der Linden, Thea Berger, Gregor A. Brandt, Joshua N. Strelow, Hannah Jergas, Juan Carlos Baldermann, Veerle Visser-Vandewalle, Gereon R. Fink, Michael T. Barbe, Jan Niklas Petry-Schmelzer, Till A. Dembek
Summary: Clinical rating scales for tremor have limitations, and reliable quantitative approaches are needed. This study investigated the use of accelerometry metrics to objectively classify tremor amplitude and compared them to clinical ratings. The results showed that accelerometry can reliably quantify tremor amplitude, with finger-worn accelerometry performing slightly better.
Article
Clinical Neurology
Stefan J. J. Blaschke, Susan Vlachakis, Niklas Pallast, Helene L. L. Walter, Lukas J. J. Volz, Dirk Wiedermann, Gereon R. R. Fink, Mathias Hoehn, Markus Aswendt, Michael Schroeter, Maria A. A. Rueger
Summary: In this study, the researchers investigated whether transcranial direct current stimulation (tDCS) can alter the network changes caused by cerebral ischemia and whether functional network parameters can predict the therapeutic efficacy of tDCS. The results showed that tDCS reversed the increased connectivity and reduced characteristic path length caused by ischemia. Additionally, early network changes and the network configuration prior to stroke predicted motor recovery.