Review
Medicine, General & Internal
Bei-lei Lin, Yong-xia Mei, Wen-na Wang, Shan-shan Wang, Ying-shuang Li, Meng-ya Xu, Zhen-xiang Zhang, Yao Tong
Summary: Understanding the unmet needs of community-dwelling stroke survivors is crucial for intervention. A systematic review summarised their unmet needs quantitatively, revealing high prevalence of issues related to information support, physical function, and mental health. Standard, effective tools for assessing unmet needs are essential for addressing these concerns.
Article
Medicine, General & Internal
Caroline Bulsara, Rosemary Saunders, Laura Emery, Christopher Etherton-Beer
Summary: This study identified barriers and enablers to care experiences from the perspectives of stroke survivors, carers, and staff. Findings showed a mismatch between staff and patient/family expectations, but highlighted the positive impact of specialized rehabilitation units on patient experience. Further research with diverse hospital settings is needed to address rehabilitation care reality and patient readiness when returning home.
Article
Geriatrics & Gerontology
Marten Segerdahl, Per-Olof Hansson, Carina M. Samuelsson, Carina U. Persson
Summary: This study found that four out of five stroke survivors (79%) reported impaired HRQoL five years after stroke, with pain/discomfort being the main issue. Higher age and longer hospital stay during the index stroke were associated with impaired HRQoL.
Article
Rehabilitation
Janet K. Freburger, Aileen Chou, Tracey Euloth, Beth Matcho, Andrew Bilderback
Summary: This study found an inverse relationship between the number of physical and occupational therapist visits received in acute care hospital and the risk of hospital readmission or death for stroke patients. The effects differed by time to the event, discharge location, and mobility limitations on admission.
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION
(2021)
Review
Clinical Neurology
Sarah A. Moore, Pierce Boyne, George Fulk, Geert Verheyden, Natalie A. Fini
Summary: This narrative review explores the current state of walking recovery research after stroke and its potential for development. The importance of targeting walking capacity and performance in relation to individual stroke survivor gait recovery is discussed, along with the need for a common language, measurement, classification, prediction, and current and future intervention development and healthcare delivery. The findings are summarized in a model of current and future stroke walking recovery research, and a mission statement is set to drive the field forward and improve the lives of stroke survivors and their caregivers.
Article
Medicine, General & Internal
Cristina Fernandez-Garcia, Laura Ternent, Tara Marie Homer, Helen Rodgers, Helen Bosomworth, Lisa Shaw, Lydia Aird, Sreeman Andole, David Cohen, Jesse Dawson, Tracy Finch, Gary Ford, Richard Francis, Steven Hogg, Niall Hughes, H. Krebs, Christopher Price, Duncan Turner, Frederike Van Wijck, Scott Wilkes, Nina Wilson, Luke Vale
Summary: The study found that neither robot-assisted training nor EULT were likely to be cost-effective compared to usual care in terms of healthcare resource use and QALYs. Although EULT group had the highest QALYs value among participants, it did not show better cost-effectiveness compared to robot-assisted training or usual care.
Article
Public, Environmental & Occupational Health
H. L. Michelle Chiang, Audrey Yoke Poh Wong, Serene Leong Hwee Tan, Litali Mohapatra, Olivia Harmony Chan, Andy Hau Yan Ho
Summary: Physicians, nurses, social workers, and allied health professionals, such as physiotherapists and occupational therapists, have important roles in improving functional independence and quality of life for stroke survivors. However, little is known about their perspectives on quality stroke care based on their clinical experiences in Singapore.
QUALITATIVE HEALTH RESEARCH
(2023)
Article
Rehabilitation
Julie A. DiCarlo, Galina Gheihman, David J. Lin
Summary: This study conducted a multidisciplinary interactive workshop to identify major challenges facing stroke recovery and proposed unique solutions, including new technologies, healthcare system changes, and the creation of new support roles. Analysis revealed that a comprehensive stroke clinic with follow-up programs, cutting edge treatments, patient advocation, and research was the single proposed solution that solved the most identified challenges.
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION
(2021)
Article
Medicine, General & Internal
Matthew Gittins, David Gibran Lugo-Palacios, Andy Vail, Audrey Bowen, Lizz Paley, Benjamin Bray, Brenda Gannon, Sarah Tyson
Summary: This study investigates the relationship between the amount of therapy received by stroke inpatients and key patient outcomes. The results suggest that the relationship between therapy dose and outcomes is complex, and different types of therapy have different effects on patient recovery.
Article
Medicine, General & Internal
Ruby Lipson-Smith, Luis Pflaumer, Marie Elf, Sarah-May Blaschke, Aaron Davis, Marcus White, Heidi Zeeman, Julie Bernhardt
Summary: This study aimed to identify, appraise, and synthesise existing design evidence for inpatient stroke rehabilitation facilities. Results suggest that attractive and accessible communal areas are important for patient activity and well-being, highlighting the need for further targeted research in this area.
Article
Clinical Neurology
Mathew J. Reeves, Bernadette Boden-Albala, Dominique A. Cadilhac
Summary: In many countries, most of a person's recovery from stroke occurs in the community, as the hospital stay after an acute stroke admission is typically short. Care transitions, such as transferring between care settings or providers, pose challenges and vulnerability for stroke patients and caregivers. Underserved and minority populations, due to exposure to poor conditions and discrimination, are particularly susceptible to complicated care transitions, which can negatively impact stroke recovery. Evidence on how to support post-acute stroke care, especially for underserved communities, remains limited.
Article
Public, Environmental & Occupational Health
Yi Wang, Shilpa Tyagi, Helen Hoenig, Kim En Lee, Narayanaswamy Venketasubramanian, Edward Menon, Deidre Anne De Silva, Philip Yap, Boon Yeow Tan, Sherry H. Young, Yee Sien Ng, Tian Ming Tu, Yan Hoon Ang, Keng He Kong, Rajinder Singh, Reshma A. Merchant, Hui Meng Chang, Chou Ning, Angela Cheong, Gerald Choon-Huat Koh
Summary: Informal care burden remains high up to 12-months post-stroke, with factors such as functional dependency, stroke severity, informal caregiver gender, and co-caring with foreign domestic workers being associated with informal care burden.
Article
Medicine, General & Internal
Lisa Anemaat, Victoria J. Palmer, David A. Copland, Kathryn Mainstone, Kent Druery, Julia Druery, Bruce Aisthorpe, Geoffrey Binge, Penelope Mainstone, Sarah J. Wallace
Summary: Aphasia is a common language impairment in stroke survivors, affecting 30%-40% of individuals. This study proposes a coproduced approach using EBCD to develop aphasia services with input from individuals with aphasia, their families, and speech pathologists. Through exploring experiences and unmet needs in aphasia rehabilitation, priorities for service development will be established and later codesigned.
Article
Clinical Neurology
Abdel Douiri, Walter Muruet, Ajay Bhalla, Martin James, Lizz Paley, Kaili Stanley, Anthony G. Rudd, Charles D. A. Wolfe, Benjamin D. Bray
Summary: The initial wave of the COVID-19 pandemic in the UK led to a decrease in admissions for acute stroke patients, with older patients and those with less severe strokes being more affected. While quality of stroke care was maintained and even improved in some aspects, there was an increase in inpatient case fatality, especially among patients with confirmed or suspected COVID-19 infections. These findings suggest that hospital avoidance during the pandemic may have resulted in untreated stroke patients with poorer outcomes, highlighting the need for resilient healthcare systems.
Article
Medicine, General & Internal
Rebecca J. Fisher, Adrian Byrne, Niki Chouliara, Sarah Lewis, Lizz Paley, Alex Hoffman, Anthony Rudd, Thompson Robinson, Peter Langhorne, Marion Walker
Summary: This study investigated the impact of early supported discharge (ESD) on length of hospital stay for stroke patients, and found that receiving ESD led to a significant increase in hospital stay, particularly in the 2015-2016 analysis with an increase of 15.8%. However, further research is needed to explore the long-term benefits of ESD.
Article
Clinical Neurology
Gregory W. Albers, Bruce C. Campbell, Maarten G. Lansberg, Joseph Broderick, Ken Butcher, Michael T. Froehler, Lee H. Schwamm, Amre M. Nouh, David S. Liebeskind, Florence Toy, Ming Yang, Lori Massaro, Megan Schoeffler, Barbara Purdon
Summary: The TIMELESS trial aims to investigate the safety and efficacy of tenecteplase for patients with large vessel occlusion stroke, particularly those who present beyond 4.5 hours after symptom onset.
INTERNATIONAL JOURNAL OF STROKE
(2023)
Article
Clinical Neurology
Andrew W. Kraft, Amine Awad, Joseph A. Rosenthal, Adam A. Dmytriw, Justin E. Vranic, Anna K. Bonkhoff, Martin Bretzner, Joshua A. Hirsch, James D. Rabinov, Christopher J. Stapleton, Lee H. Schwamm, Natalia S. Rost, Thabele M. Leslie-Mazwi, Aman B. Patel, Robert W. Regenhardt
Summary: This study found that spoke-administered intravenous thrombolysis (IVT) in patients with large vessel occlusion stroke can reduce the procedure time, fluoroscopy time, and number of passes during mechanical thrombectomy (MT), while also improving reperfusion.
INTERVENTIONAL NEURORADIOLOGY
(2023)
Article
Clinical Neurology
Carter H. Nakamoto, Andrew D. Wilcock, Lee H. Schwamm, Jennifer J. Majersik, Kori S. Zachrison, Ateev Mehrotra
Summary: The proportion of AIS/TIA episodes receiving consultations from neurologists with vascular neurology certifications or high volumes has significantly increased over the study period.
STROKE AND VASCULAR NEUROLOGY
(2023)
Article
Clinical Neurology
Amy Ying Xin Yu, Peter C. Austin, Mohammed Rashid, Jiming Fang, Joan Porter, Manav V. Vyas, Eric E. Smith, Raed A. Joundi, Jodi D. Edwards, Mathew J. Reeves, Moira K. Kapral
Summary: This study examined whether sex differences in stroke care and outcomes varied with age. Among 61,442 patients with ischemic stroke, female patients had higher odds of receiving endovascular thrombectomy, but between the ages of 50-70 years, the hazard of death was higher in female patients than male patients.
Article
Clinical Neurology
Maryam Ghahremani, Meng Wang, Hung-Yu Chen, Henrik Zetterberg, Eric Smith, Zahinoor Ismail
Summary: This study investigated the association between mild behavioral impairment (MBI) and plasma p-tau181 levels, cognitive function changes, and the risk of developing Alzheimer's disease (AD). The findings showed that compared to individuals with no behavioral symptoms, those with MBI had higher levels of p-tau181, which was associated with declined memory and executive function, and an increased risk of developing AD.
Article
Endocrinology & Metabolism
Julie Ottoy, Miracle Ozzoude, Katherine Zukotynski, Min Su Kang, Sabrina Adamo, Christopher Scott, Joel Ramirez, Walter Swardfager, Benjamin Lam, Aparna Bhan, Parisa Mojiri, Alex Kiss, Stephen Strother, Christian Bocti, Michael Borrie, Howard Chertkow, Richard Frayne, Robin Hsiung, Robert Laforce, Michael D. Noseworthy, Frank S. Prato, Demetrios J. Sahlas, Eric E. Smith, Phillip H. Kuo, Jordan A. Chad, Ofer Pasternak, Vesna Sossi, Alexander Thiel, Jean-Paul Soucy, Jean-Claude Tardif, Sandra E. Black, Maged Goubran
Summary: This study investigated the relationship between A beta-PET signal in white matter (WM) regions and diffusion MRI-based microstructural alterations. The results showed that decreased A beta-PET signal in WMH regions was closely associated with higher free water and higher WMH volume, while increased A beta-PET signal in normal-appearing WM was closely associated with higher cortical A beta and lower free water-adjusted FA. Furthermore, cognitive impairment was more closely related to higher free water than to either free water-adjusted FA or WM PET.
JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM
(2023)
Article
Clinical Neurology
Maryam Ghahremani, Santhosh Nathan, Eric E. E. Smith, Alexander McGirr, Bradley Goodyear, Zahinoor Ismail
Summary: Mild behavioral impairment (MBI) is a syndrome that uses neuropsychiatric symptoms (NPS) to identify individuals at high risk for dementia. The study used rs-fMRI to investigate the functional connectivity (FC) within the default mode network (DMN) and salience network (SN) in MBI. The results showed reduced FC within the DMN and SN in MBI patients, providing insights into the early mechanisms of the disease.
ALZHEIMERS & DEMENTIA-TRANSLATIONAL RESEARCH & CLINICAL INTERVENTIONS
(2023)
Article
Cardiac & Cardiovascular Systems
Amgad Mentias, Eric D. Peterson, Neil Keshvani, Dharam J. Kumbhani, Clyde W. Yancy, Alanna A. Morris, Larry A. Allen, Saket Girotra, Gregg C. Fonarow, Randall C. Starling, Paulino Alvarez, Milind Y. Desai, Peter Cram, Ambarish Pandey
Summary: This study found that using race-specific risk adjustment models can more accurately represent hospital performance for patients of Black and other races in terms of heart failure hospitalization and 30-day risk-standardized readmission rate and risk-standardized mortality rate.
Editorial Material
Cardiac & Cardiovascular Systems
Javed Butler, Khawaja M. Talha, Gregg C. Fonarow
Article
Clinical Neurology
Nada El Husseini, Irene L. Katzan, Natalia S. Rost, Margaret Lehman Blake, Eeeseung Byun, Sarah J. Pendlebury, Hugo J. Aparicio, Maria J. Marquine, Rebecca F. Gottesman, Eric E. Smith
Summary: Cognitive impairment after stroke is a common consequence with significant implications for poststroke functioning and quality of life. This scientific statement critically appraises the literature on the prevalence, diagnosis, and management of poststroke cognitive impairment (PSCI) and provides a framework for clinical care while highlighting areas that need further research.
Article
Geriatrics & Gerontology
Ipinuoluwakiye Fatokun, Myrlene Gee, Krista Nelles, Fang Ba, Mahsa Dadar, Simon Duchesne, Breni Sharma, Mario Masellis, Sandra E. Black, Quincy J. Almeida, Eric E. Smith, Frederico Pieruccini-Faria, Manuel Montero-Odasso, Richard Camicioli
Summary: This study aimed to investigate the relationship between dual task cost (DTC) and white matter hyperintensities (WMH) in Lewy body disorders. The results showed that increased DTC was associated with higher frontal WMH burden, and increased age was associated with higher DTC. This indicates the importance of the association between DTC and WMH in Lewy body disorders.
FRONTIERS IN AGING NEUROSCIENCE
(2023)
Article
Medicine, General & Internal
Mitchell Tang, Carter H. Nakamoto, Ariel D. Stern, Jose R. Zubizarreta, Felippe O. Marcondes, Lori Uscher-Pines, Lee H. Schwamm, Ateev Mehrotra
Summary: Remote patient monitoring (RPM) has shown positive impacts on hypertension care outcomes, but it also leads to increased spending.
ANNALS OF INTERNAL MEDICINE
(2023)
Editorial Material
Cardiac & Cardiovascular Systems
Nicholas K. Brownell, Gregg C. Fonarow
EUROPEAN HEART JOURNAL
(2023)
Article
Clinical Neurology
Meaghan Reid, George S. Tadros, Connor C. McDougall, Noaah Reaume, Brooklyn McDougall, Rani Gupta Sah, Meng Wang, Eric E. Smith, Richard Frayne, Shelagh B. Coutts, Tolulope Sajobi, R. Stewart Longman, Christoper D. d'Esterre, Philip Barber
Summary: This exploratory study aimed to investigate whether patients with transient ischemic attack (TIA) have measurable regional cerebral hypoperfusion unrelated to the location of ischemia, and to determine the relationship between regional cerebral blood flow (rCBF) and their cognitive profiles. The results showed that TIA patients had significantly lower cognitive scores and regional hypoperfusion in certain brain regions, which may serve as early markers of future cognitive decline.
CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR
(2023)
Article
Clinical Neurology
Morgan J. Schaeffer, Noaah Reaume, Meng Wang, Arooj Aftab, Alexander Pan, Sana Tariq, Meaghan Reid, Eric E. Smith, Chris D'Esterre, Philip A. Barber
Summary: Transient ischaemic attack (TIA) is associated with increased risk of cognitive decline and dementia as early as one-year post-event. Regional brain atrophy measurements may predict future cognitive decline. This study aimed to determine whether Medial Temporal Atrophy (MTA) scores and interseptal distance (ISD) measurements are greater in TIA patients compared to controls, and whether MTA and ISD predicts cognitive change one year after TIA.
CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR
(2023)