DNA methylation predicts stroke outcome better: The epigenetic clock is ticking

As a leading cause of disability worldwide, stroke renders people disabled through several mechanisms. Over half of patients have sensorimotor and cognitive deficits, one-third experience depression and social disability, and half never return to work. Our ability to predict recurrent stroke and disability poststroke remains poor despite modern medical advances.1 The uncertainty surrounding the recovery process creates critical knowledge gaps for clinicians deciding on the most appropriate care plan, and leads to substantial anxiety for patients and their families. Identification of factors that affect prognosis after stroke will not only help clinicians make more comprehensive care plans but also help engage the patient and family early in the recovery process. Recanalization rate and time to recanalization have recently joined age and stroke severity as major predictors of outcome after ischemic strokes.1 Although other factors such as ischemic stroke mechanism and comorbidities also play a role, their value in predicting recovery is not as clear.
Source: Neurology - Category: Neurology Authors: Tags: EDITORIALS Source Type: research

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This study aimed to address these questions.MethodsThis study included 219 patients with acute ischemic stroke consecutively admitted to a regional hospital in Hong Kong. BDES was defined as a Chinese version of the Dysexecutive Questionnaire (DEX) score of ≥20 assessed at three months after stroke. The HRQoL was assessed with the Chinese version of the Stroke-Specific Quality of Life (SSQoL) questionnaire encompassing 12 domains. Multivariate linear regression models were employed to examine the association between BDES symptoms and the SSQoL total and domain scores. Structural equation model (SEM) was further construc...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
Conclusions: Successful improvements in one-year functioning in both country-regions may result from optimising long-term rehabilitation services to address cognitive, emotional, and social functioning. Stroke-Specific Quality of Life one-year post-stroke could be explained by individual factors, such as pre-stroke dependency and mental health, rather than differences in the organisation of subacute rehabilitation services.IMPLICATIONS FOR REHABILITATIONThe stroke-specific health related quality of life (SS-QOL) assessment tool captures multidimensional effects of a stroke from the perspective of the patient, which is clin...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
Abstract Stroke remains a leading cause of disability in the United States. Despite recent advances, interventions to reduce damage and enhance recovery after stroke are lacking. P2X4R, a receptor for adenosine triphosphate (ATP), regulates activation of myeloid immune cells (infiltrating monocytes/macrophages and brain-resident microglia) after stroke injury. However, over-stimulation of P2X4Rs due to excessive ATP release from dying or damaged neuronal cells can contribute to ischemic injury. Therefore, we pharmacologically inhibited P2X4R to limit the over-stimulated myeloid cell immune response and improve bot...
Source: Experimental Neurology - Category: Neurology Authors: Tags: Exp Neurol Source Type: research
CONCLUSIONS: We found no reliable evidence that SSRIs should be used routinely to promote recovery after stroke. Meta-analysis of the trials at low risk of bias indicate that SSRIs do not improve recovery from stroke. We identified potential improvements in disability only in the analyses which included trials at high risk of bias. A further meta-analysis of large ongoing trials will be required to determine the generalisability of these findings. PMID: 31769878 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Conclusions: Our findings show that disability assessment late in the first week after onset of stroke using NIHSS accurately forecast outcome at one month after onset of stroke. The MMSE too is not expected to change at 1 month. Those with aphasia are expected to have greater disability. Based on or study we recommend that stroke patients should be assessed with NIHSS and MMSE before discharge, to explain the prognosis of the patient. Also more intense counselling on controlling blood pressure and diabetes as well as abstinence from smoking should be undertaken routinely. PMID: 31309796 [PubMed - in process]
Source: Journal of the Association of Physicians of India - Category: General Medicine Tags: J Assoc Physicians India Source Type: research
Wei Li1†, Wei-Min Xiao1†, Yang-Kun Chen1*, Jian-Feng Qu1, Yong-Lin Liu1, Xue-Wen Fang2, Han-Yu Weng1 and Gen-Pei Luo11Department of Neurology, Dongguan People’s Hospital, Dongguan, China2Department of Radiology, Dongguan People’s Hospital, Dongguan, ChinaBackground: Anxiety is prevalent after a stroke. The pathophysiological mechanisms underlying the development of poststroke anxiety (PSA) remain unclear. The aim of this study was to investigate the clinical and neuroimaging risk factors for development of PSA and examine the effects of PSA on activities of daily living (ADL) and quality of life (...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
Authors: Chen CY, Chen CL, Yang YH, Ho CH, Tseng WC Abstract Poststroke depression is independently associated with poor health outcomes, such as increased mortality, disability, anxiety, and lower quality of life. Identifying the potential biomarkers and detailed mechanisms of poststroke depression may improve the effectiveness of therapeutic intervention. In this cross-sectional study, the authors recruited patients with subacute ischemic stroke who were consecutively admitted for neurorehabilitation. Depression was assessed with the Patient Health Questionnaire-9 (PHQ-9), with a cutoff based on a summed-items sc...
Source: Journal of Neuropsychiatry and Clinical Neurosciences - Category: Psychiatry Tags: J Neuropsychiatry Clin Neurosci Source Type: research
This article does not contain any studies with human participants or animals performed by the author. Data Availability All national (MagIran, Science Information Database (SID) and Iranmedex) and international (PubMed, Scopus) databases were searched from November 2010 to November 2016 using keywords both in English and Persian: Afghan immigrants, Afghan refugees, Iran, infectious diseases, tuberculosis, HIV, Hepatitis B and C, non-communicable disease, food security, mental health, barriers, health insurance, access to health service. All related websites and webpages were also searched by Google with the same keywords ...
Source: PLOS Currents Disasters - Category: International Medicine & Public Health Authors: Source Type: research
This article does not contain any studies with human participants or animals performed by the author. Data Availability All national (MagIran, Science Information Database (SID) and Iranmedex) and international (PubMed, Scopus) databases were searched from November 2010 to November 2016 using keywords both in English and Persian: Afghan immigrants, Afghan refugees, Iran, infectious diseases, tuberculosis, HIV, Hepatitis B and C, non-communicable disease, food security, mental health, barriers, health insurance, access to health service. All related websites and webpages were also searched by Google with the same keywords ...
Source: PLOS Currents Disasters - Category: International Medicine & Public Health Authors: Source Type: research
CONCLUSION: The practice of aquatic exercises promotes improvements in the levels of depression and anxiety in people who suffered an ischemic stroke. PMID: 28488825 [PubMed - as supplied by publisher]
Source: Medical Physics - Category: Physics Authors: Tags: J Sports Med Phys Fitness Source Type: research
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