Article
Pharmacology & Pharmacy
Kirstin Meiners, Prisca Hamm, Marcus Gutmann, Jan Niedens, Agnieszka Nowak-Krol, Salvador Pane, Tessa Luehmann
Summary: The study developed three polyethylene glycol (PEG)ylated tPA bioconjugates based on the recombinant human tPA drug Alteplase using site-specific conjugation strategies. These bioconjugates showed improved proteolytic activity, slower inhibition kinetics by PAI-1, and increased hydrodynamic size.
EUROPEAN JOURNAL OF PHARMACEUTICS AND BIOPHARMACEUTICS
(2023)
Article
Neurosciences
Antoine Anfray, Camille Brodin, Antoine Drieu, Fanny Potzeha, Basile Dalarun, Veronique Agin, Denis Vivien, Cyrille Orset
Summary: The commercial form of rtPA has similar effects in promoting fibrinolysis and tissue reperfusion, with two-chains rtPA showing less efficiency compared to single chain rtPA, and associated with more severe blood brain barrier damage.
EXPERIMENTAL NEUROLOGY
(2021)
Article
Clinical Neurology
Jose G. Romano, Hannah Gardener, Iszet Campo-Bustillo, Yosef Khan, Sofie Tai, Nikesha Riley, Eric E. Smith, Ralph L. Sacco, Pooja Khatri, Heather M. Alger, Brian Mac Grory, Deepak Gulati, Navdeep S. Sangha, Jeffrey M. Craig, Karin E. Olds, Curtis G. Benesch, Adam G. Kelly, Scott S. Brehaut, Amit C. Kansara, Lee H. Schwamm
Summary: The study found that most patients with mild strokes had poor outcomes in the study. The primary outcome was a 90-day modified Rankin Scale score of 0 to 1, with secondary outcomes including good outcomes in the Barthel Index, Stroke Impact Scale-16, and European Quality of Life. Factors such as age, gender, race, and baseline NIHSS score were identified as predictors of worse outcomes.
Review
Biochemistry & Molecular Biology
Angela Godinez, Rashi Rajput, Nitin Chitranshi, Veer Gupta, Devaraj Basavarajappa, Samridhi Sharma, Yuyi You, Kanishka Pushpitha, Kunal Dhiman, Mehdi Mirzaei, Stuart Graham, Vivek Gupta
Summary: Neuroserpin is a crucial protein involved in neuronal development and various diseases, with mutations affecting its function and leading to pathological conditions. Understanding the alterations of neuroserpin and its cellular signaling networks is essential for studying its detrimental consequences and potential therapeutic targeting.
CELLULAR AND MOLECULAR LIFE SCIENCES
(2022)
Article
Immunology
Guangshuo Li, Yahui Hao, Chuanying Wang, Shang Wang, Yunyun Xiong, Xingquan Zhao
Summary: In this study, the relationship between neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) with in-hospital clinical outcomes in ischemic stroke patients treated with intravenous tissue plasminogen activator (IV tPA) was investigated. The results showed that NLR at 24 hours was associated with early neurological improvement (ENI), while NLR at 48 hours and LMR at 48 hours were closely related to favorable functional outcomes at discharge.
JOURNAL OF INFLAMMATION RESEARCH
(2022)
Article
Clinical Neurology
Erika Marulanda, Antonio Bustillo, Carolina M. Gutierrez, David Z. Rose, Angus Jameson, Hannah Gardener, Ayham Alkhachroum, Lili Zhou, Hao Ying, Chuanhui Dong, Dianne Foster, Ricardo Hanel, Brijesh Mehta, Maxim Mokin, Nils Mueller-Kronast, Mark Landreth, Charles Sand, Jose G. Romano, Tatjana Rundek, Negar Asdaghi, Ralph L. Sacco
Summary: This study evaluated the quality of ischemic stroke care in NC and SA stroke centers in Florida and found that NC centers performed better. These findings have important implications for stroke systems of care in Florida and support legislation updates requiring NC and removal of SA claims.
Article
Multidisciplinary Sciences
Abbas Moghanizadeh, Fakhreddin Ashrafizadeh, Jaleh Varshosaz, Antoine Ferreira
Summary: The study indicates that increasing the static magnetic field intensity can accelerate drug delivery by magnetic nanoparticles carrying thrombolytic agents, leading to faster dissolution of clots.
SCIENTIFIC REPORTS
(2021)
Article
Biochemistry & Molecular Biology
Tao Peng, Keith Booher, Melanie R. Moody, Xing Yin, Jaroslaw Aronowski, David D. Mcpherson, Sean I. Savitz, Hyunggun Kim, Shao-Ling Huang
Summary: This study demonstrates that the combination therapy of Xe-loaded liposomes and rtPA provides enhanced therapeutic efficacy in stroke treatment, leading to decreased neuronal cell death and mitigation of hemorrhagic side effects associated with late rtPA treatment.
Article
Clinical Neurology
Seung-Jae Lee, Tae-Kyeong Lee, Bum-Tae Kim, Dong-Seong Shin
Summary: Thrombus migration (TM) occurs in about 19.5% of patients undergoing thrombectomy, with intravenous thrombolysis (IVT) and female sex being associated with TM. TM is also associated with better functional outcomes in patients, regardless of the angiographic outcomes.
WORLD NEUROSURGERY
(2021)
Article
Clinical Neurology
Karim Mahawish, John Gommans, Timothy Kleinig, Bhavesh Lallu, Alicia Tyson, Annemarei Ranta
Summary: The switch from alteplase to tenecteplase for stroke thrombolysis was successfully implemented with stakeholder endorsement. Patients treated with tenecteplase showed better clinical outcomes, shorter door-to-needle time, and similar complication rates compared to alteplase.
Review
Clinical Neurology
Qiang Liu, Kaibin Shi, Yongjun Wang, Fu-Dong Shi
Summary: Intravenous thrombolysis with tPA is the approved treatment for acute ischemic stroke, but it has limited benefits and can lead to hemorrhagic transformation by exacerbating neuroinflammation and tissue injury.
Review
Neurosciences
Atsushi Mizuma, Midori A. Yenari
Summary: While treatments for acute stroke have improved, the focus has mainly been on revascularization strategies instead of neuroprotection. The lack of clinical translation of promising neuroprotective therapies may be attributed to historical oversight of comorbidities in stroke patients. Identifying effective treatments by incorporating comorbidities into stroke models could lead to new clinical level interventions.
EXPERIMENTAL NEUROLOGY
(2021)
Review
Clinical Neurology
Dmitri Nikitin, Seungbum Choi, Jan Mican, Martin Toul, Wi-Sun Ryu, Jiri Damborsky, Robert Mikulik, Dong-Eog Kim
Summary: Although mechanical thrombectomy has advanced, it will not be a universal treatment for ischemic stroke due to limited access, leaving thrombolytic therapy as an important option for hyperacute stroke. Improvements are needed in thrombolytic drugs to increase efficacy and decrease hemorrhagic complications.
Article
Biochemistry & Molecular Biology
Claire S. Whyte, Hadj Ahmed. Mostefai, Kim M. Baeten, Andrew J. Lucking, David E. Newby, Nuala A. Booth, Nicola J. Mutch
Summary: The resolution of arterial thrombi relies on the endogenous fibrinolytic system. tPA primarily localizes to the thrombus head in a free and active form. Thrombi formed under high shear conditions are more resistant to fibrinolysis due to less tPA and increased PAI-1 concentrations.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2021)
Article
Clinical Neurology
S. Iris Deeds, Andrew Barreto, Jordan Elm, Colin P. Derdeyn, Scott Berry, Pooja Khatri, Claudia Moy, Scott Janis, Joseph Broderick, James Grotta, Opeolu Adeoye
Summary: The study aims to determine the safety and efficacy of using argatroban or eptifibatide compared to placebo in acute ischemic stroke patients treated with intravenous recombinant tissue plasminogen activator. The primary efficacy outcome is improved modified Rankin score assessed at 90 days post-randomization.
INTERNATIONAL JOURNAL OF STROKE
(2021)
Article
Clinical Neurology
Joseph P. Broderick, James C. Grotta, Andrew M. Naidech, Thorsten Steiner, Nikola Sprigg, Kazunori Toyoda, Dar Dowlatshahi, Andrew M. Demchuk, Magdy Selim, J. Mocco, Stephan Mayer
Summary: Research in the acute management of intracerebral hemorrhage (ICH) over the past 35 years has shown that early treatment to control bleeding and minimize brain injury is crucial. However, current medical and surgical interventions have not yet shown significant benefits in large-scale trials, emphasizing the need for further research and improvement in the delivery of ICH therapies for better outcomes.
Article
Clinical Neurology
Andrew M. Naidech, James Grotta, Jordan Elm, Scott Janis, Dar Dowlatshahi, Kazunori Toyoda, Thorsten Steiner, Stephan A. Mayer, Pooja Khanolkar, Julie Denlinger, Heinrich J. Audebert, Carlos Molina, Pooja Khatri, Nikola Sprigg, Achala Vagal, Joseph P. Broderick
Summary: This study aims to evaluate the impact of rFVIIa on the quality of life of patients with acute intracerebral hemorrhage over 180 days, with safety endpoints including thrombotic events such as myocardial infarction. The research is being monitored by a Data Safety Monitoring Board, with enrollment of non-communicative patients without an immediately identifiable proxy allowed under Exception from Informed Consent in the US.
INTERNATIONAL JOURNAL OF STROKE
(2022)
Review
Clinical Neurology
Kazunori Toyoda, Sohei Yoshimura, Mayumi Fukuda-Doi, Adnan Qureshi, Renee' Hebert Martin, Yuko Y. Palesch, Masafumi Ihara, Jose Suarez, Yasushi Okada, Chung Y. Hsu, Ryo Itabashi, Yongjun Wang, Hiroshi Yamagami, Thorsten Steiner, Nobuyuki Sakai, Byung-Woo Yoon, Manabu Inoue, Kazuo Minematsu, Haruko Yamamoto, Masatoshi Koga
Summary: The study showed that rapid lowering of systolic blood pressure by continuous administration of intravenous nicardipine in patients with hyperacute intracerebral hemorrhage was associated with lower risks of hematoma expansion and 90-day death or disability, without increasing serious adverse events.
INTERNATIONAL JOURNAL OF STROKE
(2022)
Article
Clinical Neurology
Dearbhla M. Kelly, Zanfina Ademi, Wolfram Doehner, Gregory Y. H. Lip, Patrick Mark, Kazunori Toyoda, Christopher X. Wong, Mark Sarnak, Michael Cheung, Charles A. Herzog, Kirsten L. Johansen, Holger Reinecke, Manish M. Sood
Summary: Chronic kidney disease is a significant risk factor for cerebrovascular disease, with various potential mechanisms linking the two, including traditional and nontraditional risk factors. The presence of chronic kidney disease complicates stroke risk prediction, diagnosis, and management, leading to more severe strokes and a higher burden on patients.
Article
Clinical Neurology
Kazunori Toyoda, Katsuhiro Omae, Haruhiko Hoshino, Shinichiro Uchiyama, Kazumi Kimura, Kaori Miwa, Kazuo Minematsu, Keiji Yamaguchi, Yoshitaka Suda, Shuta Toru, Kazuo Kitagawa, Masafumi Ihara, Masatoshi Koga, Takenori Yamaguchi
Summary: This study explores the effectiveness of long-term dual antiplatelet therapy using cilostazol for secondary stroke prevention.
Article
Clinical Neurology
Shunsuke Kimura, Kazunori Toyoda, Sohei Yoshimura, Kazuo Minematsu, Masahiro Yasaka, Maurizio Paciaroni, David J. Werring, Hiroshi Yamagami, Takehiko Nagao, Shinichi Yoshimura, Alexandros Polymeris, Annaelle Zietz, Stefan T. Engelter, Bernd Kallmuenzer, Manuel Cappellari, Tetsuya Chiba, Takeshi Yoshimoto, Masayuki Shiozawa, Takanari Kitazono, Masatoshi Koga
Summary: In patients with nonvalvular atrial fibrillation after acute ischemic stroke or transient ischemic attack, starting direct oral anticoagulants (DOACs) early within 1, 2, 3, or 4 days according to stroke severity seems feasible to decrease the risk of recurrent stroke or systemic embolism without increasing major bleeding. These findings support ongoing randomized trials to determine the optimal timing of DOAC initiation.
Editorial Material
Clinical Neurology
Susumu Miyamoto, Kuniaki Ogasawara, Satoshi Kuroda, Ryo Itabashi, Kazunori Toyoda, Yoshiaki Itoh, Yasuyuki Iguchi, Yoshiaki Shiokawa, Yasushi Takagi, Toshiho Ohtsuki, Hiroyuki Kinouchi, Yasushi Okada, Jun C. Takahashi, Hiroyuki Nakase, Wataru Kakuda
Summary: The revised Japan Stroke Society Guidelines for the Treatment of Stroke provide comprehensive guidance on the prevention, management, and rehabilitation of stroke. This revision is in line with the recently enacted Basic Act on Stroke and Cardiovascular Disease in Japan.
INTERNATIONAL JOURNAL OF STROKE
(2022)
Article
Clinical Neurology
Kanta Tanaka, Masatoshi Koga, Mayumi Fukuda-Doi, Adnan Qureshi, Haruko Yamamoto, Kaori Miwa, Masafumi Ihara, Kazunori Toyoda
Summary: This study used group-based trajectory modeling to analyze blood pressure changes in patients with acute intracerebral hemorrhage receiving antihypertensive treatment, and found that different blood pressure trajectories were associated with different outcomes. Specifically, the high-to-low SBP group showed increased risks of death or disability and acute kidney injury.
Article
Clinical Neurology
Takeshi Yoshimoto, Kazunori Toyoda, Masafumi Ihara, Hiroshi Inoue, Takeshi Yamashita, Shinya Suzuki, Masaharu Akao, Hirotsugu Atarashi, Takanori Ikeda, Ken Okumura, Yukihiro Koretsune, Wataru Shimizu, Hiroyuki Tsutsui, Atsushi Hirayama, Masahiro Yasaka, Hirofumi Maruyama, Satoshi Teramukai, Tetsuya Kimura, Yoshiyuki Morishima, Atsushi Takita, Takenori Yamaguchi
Summary: The history of stroke/TIA in elderly patients increases the risk of stroke, bleeding, and death. Among patients with prior ischemic stroke/TIA, taking direct oral anticoagulants reduces the risk of bleeding events.
Article
Cardiac & Cardiovascular Systems
Victor J. Del Brutto, Han-Christoph Diener, J. Donald Easton, Christopher B. Granger, Lisa Cronin, Eva Kleine, Claudia Grauer, Martina Brueckmann, Kazunori Toyoda, Peter D. Schellinger, Philippe Lyrer, Carlos A. Molina, Aurauma Chutinet, Christopher F. Bladin, Conrado J. Estol, Ralph L. Sacco
Summary: This study used Cox proportional hazards models to identify recurrent stroke predictors among patients with embolic strokes of undetermined source (ESUS), finding that factors such as prior strokes or transient ischemic attacks, reduced creatinine clearance, male sex, and high CHA(2)DS(2)-VASc scores were independently associated with recurrence.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2022)
Article
Clinical Neurology
Shinichiro Uchiyama, Kazunori Toyoda, Satomi Okamura, Katsuhiro Omae, Haruhiko Hoshino, Kazumi Kimura, Kazuo Kitagawa, Kazuo Minematsu, Takenori Yamaguchi
Summary: This study investigated the benefit of DAPT in patients with extracranial arterial stenosis and those without arterial stenosis. The findings suggest that DAPT with cilostazol might be beneficial for preventing recurrent stroke and vascular events in patients without arterial stenosis, but not in those with extracranial arterial stenosis.
INTERNATIONAL JOURNAL OF STROKE
(2023)
Article
Clinical Neurology
Yasuhiro Nishiyama, Kazumi Kimura, Toshiaki Otsuka, Kazunori Toyoda, Shinichiro Uchiyama, Haruhiko Hoshino, Nobuyuki Sakai, Yasushi Okada, Hideki Origasa, Hiroaki Naritomi, Kiyohiro Houkin, Keiji Yamaguchi, Kazuo Minematsu, Masayasu Matsumoto, Teiji Tominaga, Hidekazu Tomimoto, Yasuo Terayama, Satoshi Yasuda, Takenori Yamaguchi
Summary: This study compared the safety and effectiveness of long-term dual antiplatelet therapy (DAPT) and single antiplatelet therapy (SAPT) in preventing recurrent strokes in patients with lacunar stroke. The results showed that DAPT using cilostazol significantly reduced the incidence of recurrent ischemic stroke without increasing the risk of severe or life-threatening bleeding.
News Item
Clinical Neurology
Kazunori Toyoda, Sohei Yoshimura, Kanta Tanaka, Kuniaki Ogasawara, Joung-Ho Rha
Article
Clinical Neurology
Keisuke Tokunaga, Kazunori Toyoda, Shunsuke Kimura, Kazuo Minematsu, Masahiro Yasaka, Yasushi Okada, Sohei Yoshimura, Masatoshi Koga, SAMURAI NVAF RELAXED Investigators
Summary: The association between atrial fibrillation (AF), insular involvement, and the risk of embolic events in patients with acute ischemic stroke is not well understood. This study found that patients with AF detected after stroke and insular cortex lesions had a lower risk of embolic events, regardless of insular involvement.
ANNALS OF NEUROLOGY
(2023)
Article
Clinical Neurology
Satoshi Namitome, Kazutaka Uchida, Seigo Shindo, Shinichi Yoshimura, Nobuyuki Sakai, Hiroshi Yamagami, Kazunori Toyoda, Yuji Matsumaru, Yasushi Matsumoto, Kazumi Kimura, Reiichi Ishikura, Manabu Inoue, Mikiya Beppu, Fumihiro Sakakibara, Manabu Shirakawa, Mitsuharu Ueda, Takeshi Morimoto
Summary: The increased risk of intracranial hemorrhage with multiple passes in endovascular therapy (EVT) for large vessel occlusion with a large ischemic core is a concern. This study explored the effect of the number of EVT passes on patients and found that successful reperfusion within 2 passes was associated with better clinical outcomes.
