Neural Mechanisms of Swallowing Dysfunction and Apraxia of Speech in Acute Stroke

AbstractSpeech and swallowing utilize overlapping anatomy and are thus inherently related processes. We sought to identify common neural mechanisms between risk of swallowing dysfunction and apraxia of speech (AOS). This was a retrospective analysis using data from a prospectively collected cohort. Left hemisphere stroke patients (68 subjects) tested with the Apraxia Battery for Adults II, a swallow screen, and MRI were included in the study. Main outcome measure was the presence of AOS or aspiration risk after stroke. We identified a significant association between AOS measures and increased aspiration risk (defined by failed swallow screen;p = 0.04; OR 5.2). Lesions in pars opercularis of Broca’s area (BA 44) were associated with both AOS (p = 0.044; OR 9.7) and increased aspiration risk (p = 0.04; OR 5) but deficits rarely co-occurred in the same cases. Lesions in left premotor cortex (BA 6) were not significantly associated with increased aspiration risk (p = 0.06; OR 3.3) but were significantly associated with AOS (p = 0.008; OR 7). Impaired swallowing function was also associated with lesions in Wernicke’s area (BA 22;p = 0.05; OR 3.5) and pars triangularis (BA 45;p = 0.02; OR 6.8). AOS and risk of aspiration are associated in patients with acute left hemisphere stroke. Acute infarct in the pars opercularis of Broca’s area is associated with both deficits, though they rarely co-occur...
Source: Dysphagia - Category: Speech-Language Pathology Source Type: research

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ConclusionInterventions involving repetitive practice improve strength after stroke, and these improvements are accompanied by improvements in activity.Review registrationPROSPERO CRD42017068658. [de Sousa DG, Harvey LA, Dorsch S, Glinsky JV (2018) Interventions involving repetitive practice improve strength after stroke: a systematic review. Journal of Physiotherapy XX: XX–XX]
Source: Journal of Physiotherapy - Category: Physiotherapy Source Type: research
Publication date: Available online 21 September 2018Source: Medical Mycology Case ReportsAuthor(s): Taher Sabobeh, Kamran Mushtaq, Ahmed Elsotouhy, Adham A. Ammar, Sameera RashidAbstractImmunocompromised status is associated with invasive fungal infections including mucormycosis. These infections are challenging to treat and associated with high overall mortality.Here we report a fatal case of invasive mucormycosis in a cirrhotic, diabetic patient. Despite the swift diagnosis and management; the fungal invasion of the right internal carotid artery lead to massive ischemic stroke.Timely diagnosis and management is crucial f...
Source: Medical Mycology Case Reports - Category: Biology Source Type: research
In this report, we managed general anesthesia for a 74-year-old male patient with nonobstructive HCM who developed circulatory instability intraoperatively. Severe bradycardia measuring 35 beats/min and hypotension measuring 78 mm Hg systolic were observed during surgery. Using stroke volume variation and stroke volume from the FloTrac as indices, successful circulatory management was performed with dopamine. The hypotension and bradycardia were thought to be the result of methyldigoxin and possibly associated with our perioperative management. Cardiology consult should have been obtained. We demonstrated that the FloTrac ...
Source: Anesthesia Progress - Category: Anesthesiology Tags: Anesth Prog Source Type: research
Authors: Yin Y, Wang Z Abstract Age and apolipoprotein E (ApoE) are the mightiest risk factors for dementia and cardiovascular diseases, but the underlying mechanisms remain unclear. In human, ApoE has three isoforms, ApoE2, ApoE3, and ApoE4, which are expressed by the polymorphic alleles: ɛ2, ɛ3, and ɛ4. Among the three polymorphic alleles, apoE ε4 is the most risk gene. ApoE is the main ligand for the low-density lipoprotein (LDL) receptor and the LDL receptor-related protein (LRP), functioning as the component of plasma lipoproteins in the transportation of lipids. Physiologically, ApoE is a multifunc...
Source: Advances in Experimental Medicine and Biology - Category: Research Tags: Adv Exp Med Biol Source Type: research
Authors: You J, Wang X, Wu J, Gao L, Wang X, Du P, Liu H, Li J, Wang Y, Liang Y, Guo W, Zhang Q Abstract Background: We aimed to investigate the predictors and prognosis of left ventricular thrombus (LVT) in patients admitted for post-myocardial infarction (MI) and left ventricular dysfunction after contemporary percutaneous coronary intervention (PCI). Methods: We prospectively enrolled 267 consecutive post-MI patients with left ventricular ejection fraction (LVEF)
Source: Journal of Thoracic Disease - Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research
Publication date: Available online 20 September 2018Source: Brain StimulationAuthor(s): Cécile Magnin, Pierre Nicolo, Elena Pedrazzini, Anh Nguyen-Danse, Adrian G. Guggisberg
Source: Brain Stimulation - Category: Neurology Source Type: research
We present two cases of successful endovascular intervention for emergent occlusion of a FPCA, one of which is only the second reported case of a mechanical thrombectomy of a FPCA. We review the embryology of FPCA, the controversy regarding its association with cerebral infarcts, and various approaches used in the treatment of such occlusive lesions. PMID: 30231797 [PubMed - as supplied by publisher]
Source: Interventional Neuroradiology - Category: Radiology Tags: Interv Neuroradiol Source Type: research
In this study, effects of melatonin on cognitive impairment and related mechanisms were investigated in an animal model of ischemic vascular dementia (IVD). Melatonin was intraperitoneally administered to adult gerbils after transient global cerebral ischemia (tGCI) for 25 days beginning 5 days after tGCI. Cognitive impairment was examined using a passive avoidance test and the Barnes maze test. To investigate mechanisms of restorative effects by melatonin, neuronal damage/death, myelin basic protein (MBP, a marker for myelin), Rip (a marker for oligodendrocyte), extracellular signal-regulated protein kinase1/2 (ERK1/2) an...
Source: Biomedicine and Pharmacotherapy - Category: Drugs & Pharmacology Source Type: research
In this study, male SD rats were subjected to transient middle cerebral artery occlusion (MCAO) followed by reperfusion and ICA/MSC treatment. Results showed that ICA and MSCs combined treatment greatly reduced brain infarction volume, improved neurologic deficits of motor and somatosensory function and neurobehavioral outcomes. The combined therapy increased expression of VEGF and BDNF to a maximum through activating PI3K and ERK1/2 pathways in the hippocampus and frontal cortex in response to transient MCAO. They notably promoted angiogenesis and neurogenesis in vivo. Thus, ICA and MSCs combined treatment may represent a...
Source: Biomedicine and Pharmacotherapy - Category: Drugs & Pharmacology Source Type: research
Authors: Overtchouk P, Modine T Abstract INTRODUCTION: Alternative TAVI approaches offer the possibility of valve replacement in patients ineligible to the transfemoral route. Authors provide an updated review of the existing alternative approaches. Areas covered: A systematic review of alternative approaches for TAVI was undertaken. The feasibility, safety, efficacy and technical requirements of the transapical, transaortic, transcarotid, transsubclavian and transcaval approaches have been compared. A multi-slice computed tomography is often necessary for pre-operative planning. Although the first developed, the t...
Source: Expert Review of Cardiovascular Therapy - Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research
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