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Hemodynamic Characteristics Associated With Paraclinoid Aneurysm Recurrence in Patients After Embolization
Conclusions: High peak systolic WSS, OSI and velocity around aneurysm neck areas after embolization of paraclinoidal aneurysms may be important factors leading to recurrence. Introduction Paraclinoid aneurysms are defined as aneurysms arising from the segment of the internal carotid artery (ICA) between the distal dural ring and the origin of the posterior communicating artery. They account for approximately 1.3–5% of all intracranial aneurysms and they comprise the majority of such aneurysms in females (1–3). Hemodynamic characteristics are thought to be the most important risk factors for occurrence...
Source: Frontiers in Neurology - April 24, 2019 Category: Neurology Source Type: research

A Kinematic Study of Progressive Micrographia in Parkinson's Disease
This study has investigated the kinematic features of progressive micrographia during a repetitive writing task. Twenty-four PD patients with duration since diagnosis of <10 years and 24 age-matched controls wrote the letter “e” repeatedly. PD patients were studied in defined off states, with scoring of motor function on the Unified Parkinson's Disease Rating Scale Part III. A digital tablet captured x-y coordinates and ink-pen pressure. Customized software recorded the data and offline analysis derived the kinematic features of pen-tip movement. The average size of the first and the last fi...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

Robot-Assisted Therapy in Upper Extremity Hemiparesis: Overview of an Evidence-Based Approach
Conclusion Robotic therapy has matured and represents an embodiment of a paradigm shift in neurorehabilitation following a stroke: instead of focusing on compensation, it affords focus in ameliorating the impaired limb in line with concepts of neuroplasticity. This technology-based treatment provides intensity, interactivity, flexibility, and adaptiveness to patient's performance and needs. Furthermore, it increases the productivity of rehabilitation care. Of course, efficiency must be discussed within a local perspective. For example, following the cost containment shown in the VA ROBOTICS study (46), the UK Nati...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

Why is Clinical fMRI in a Resting State?
Conclusions Despite some perceived impediments to expanding clinical rs-fMRI use, neuroradiologists were generally enthusiastic about rs-fMRI in research and clinical applications, believing that their current workplace MRI systems are suitable for rs-fMRI acquisition. Many of the concerns associated with using rs-fMRI in clinical contexts are related to: (1) developing better methods for minimizing physiological noise effects, (2) improving methods for detecting the spatial characteristics of clinically-relevant brain processing systems in individual patients, and (3) overcoming remaining standardization, training, and r...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

A Novel Homozygous Non-sense Mutation in the Catalytic Domain of MTHFR Causes Severe 5,10-Methylenetetrahydrofolate Reductase Deficiency
Conclusion: We identified a novel non-sense mutation in MTHFR gene in a single Egyptian family with severe MTHFR deficiency. The present investigation is clinically important, as it adds to the growing list of MTHFR mutations, which might help in genetic counseling of families of affected children and proper genotype-phenotype correlation. Background Severe 5,10-Methylenetetrahydrofolate reductase (MTHFR; OMIM 236250) deficiency is a rare inborn error of metabolism and inherited in an autosomal recessive fashion. It is a very common disorder of folate metabolism and is clinically characterized with low plasma methion...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

World-Wide Efficacy of Bone Marrow Derived Mesenchymal Stromal Cells in Preclinical Ischemic Stroke Models: Systematic Review and Meta-Analysis
Conclusions: Our results show worldwide efficacy of BM-MSCs in improving functional outcomes in pre-clinical animal models of stroke and support testing these cells in clinical trials in various ranges of time windows using different delivery routes. The continued growing number of publications showing functional benefit of BM-MSCs are now adding limited value to an oversaturated literature spanning 18 years. Researchers should focus on identifying definitive mechanisms on how BM-MSCs lead to benefit in stroke models. Introduction Ischemic stroke is the 5th leading cause of death and the leading cause of long term di...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

The Predictive Capacity of the Buffalo Concussion Treadmill Test After Sport-Related Concussion in Adolescents
Conclusion This study found that the ΔHR (HRt minus resting HR) correlated with duration of clinical recovery in participants who were prescribed relative rest or a placebo-stretching program but not for participants prescribed sub-threshold aerobic exercise. A ΔHR of ≤50 bpm on the BCTT was 73% sensitive and 78% specific for predicting delayed recovery in concussed adolescents prescribed the current standard of care (i.e., cognitive and physical rest). This has implications for planning team and school activities in adolescents who sustain SRC. Ethics Statement This study was carried out in acco...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

Combination of Dexmedetomidine and Ketamine for Magnetic Resonance Imaging Sedation
Conclusions: The efficacy of DEX–KET sedation was comparable to that of midazolam for MRI examination. DEX–KET was related to shorter scan time and lower occurrence of complications compared to midazolam. Introduction Neurocritically ill patients often require brain magnetic resonance imaging (MRI) in addition to conventional neurological evaluations. Brain MRI can reveal structural lesions with a high sensitivity due to its excellent spatial resolution and enhanced soft tissue contrast (1–3). To acquire MRI images, patients' cooperation is imperative. However, keeping patients with ...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

Cryptotanshinone Attenuates Oxygen-Glucose Deprivation/ Recovery-Induced Injury in an in vitro Model of Neurovascular Unit
Conclusions Despite the above limitations, we indicate that the protective mechanism of CTs against OGD/R damage might exert via inhibiting neuron apoptosis and attenuating BBB disruption. Furthermore, we also clarified that CTs inhibited neuronal apoptosis possibly by blocking the activation of MAPK signaling pathways, and CTs alleviating BBB disruption may associated with the regulation of TJPs and MMP-9 in our experiment. Accordingly, CTs will represent a novel and potent candidate for the treatment of CIRI in the future. Ethics Statement This study was carried out in accordance with the recommendations of China�...
Source: Frontiers in Neurology - April 17, 2019 Category: Neurology Source Type: research

Anticipatory Postural Adjustments During Gait Initiation in Stroke Patients
Conclusion This systematic review provides an update on GI-APA reorganization following stroke. Stroke patients present atypical GI-APA patterns, longer GI-APA duration and lower GI-APA amplitude compared to healthy people, regardless of which leg is used as the leading or trailing leg. GI is facilitated when the non-paretic leg is used as the trailing leg because the weakness of the paretic leg leads to difficulties in supporting body weight during the upcoming stance phase. Further experiments should include distinct groups of patients in order to describe GI-APA features in acute, subacute and chronic stroke, and the i...
Source: Frontiers in Neurology - April 16, 2019 Category: Neurology Source Type: research

Asymptomatic Carotid Stenosis Is Associated With Circadian and Other Variability in Embolus Detection
Conclusions: Embolism associated with asymptomatic carotid stenosis shows circadian variation with highest rates 4–6 h before midday. This corresponds with peak circadian incidence of stroke and other vascular complications. These and ASED Study results show that monitoring frequency, duration, and time of day are important in ES detection. Introduction Transcranial Doppler (TCD) detected microembolism in the ipsilateral middle cerebral artery (MCA) may help stratify the risk of stroke and other arterial disease complications in persons with advanced (≥60%) asymptomatic carotid stenosis. If so, this t...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

Angiographical Identification of Intracranial, Atherosclerosis-Related, Large Vessel Occlusion in Endovascular Treatment
Conclusions Among only a few identification methods, the ICAS-LVO can be feasibly identified by angiographical findings. The identification of ICAS-LVO based on based on occlusion type, is a reliable and practical identification method for ICAS-LVO. Procedural details by occlusion type and its predictability to endovascular results were reported. Furthermore, occlusion type can be determined before or in the early stages of the procedure, which may be most helpful in setting up an optimal endovascular treatment strategy. Author Contributions J-HB established the study idea, designed the manuscript structure, acquired an...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

Postreperfusion Blood Pressure Variability After Endovascular Thrombectomy Affects Outcomes in Acute Ischemic Stroke Patients With Poor Collateral Circulation
Conclusion: Postreperfusion BP management by decreasing BPV may have influence on improving clinical outcome in cases of poor collateral circulation among patients achieving successful recanalization after ERT. Introduction Endovascular recanalization therapy (ERT) has been adopted as standard stroke care in patients with acute ischemic stroke (1–6). Time to recanalization and degree of recanalization are the most important predictors of clinical outcomes after ERT (7). Before recanalization, an effort to reduce the time from symptom onset to reperfusion is critical for penumbral salvage. After recanalization...
Source: Frontiers in Neurology - April 11, 2019 Category: Neurology Source Type: research

Characterizing the Penumbras of White Matter Hyperintensities and Their Associations With Cognitive Function in Patients With Subcortical Vascular Mild Cognitive Impairment
Conclusion In this study, reduced CBF and FA and increased MD in the inner NAWM layers for both PVWMH and DWMH suggested extensive WM alterations beyond the visible WM lesions commonly observed on clinical MRI of svMCI subjects. CBF penumbras cover more extensive WM at risk than DTI penumbras, suggesting the likelihood that compromised CBF precedes white matter integrity changes, and CBF penumbras may be a potential target for the prevention of further microstructural white matter damage. The imaging parameters investigated, however, did not correlate to cognition. Author Contributions YZ, QX, and XG conceived and desig...
Source: Frontiers in Neurology - April 11, 2019 Category: Neurology Source Type: research

The Young Male Syndrome —An Analysis of Sex, Age, Risk Taking and Mortality in Patients With Severe Traumatic Brain Injuries
Conclusion The willingness of young males to engage in dangerous situations might be adaptive in terms of fitness maximization. Nonetheless, for some individuals this intense sexual competition can be detrimental to health. The correspondence between the age distribution of the reproductively most active population and those suffering sTBI only partially supports the evolutionary hypothesis about risk-taking behavior. The prevalence of higher external mortality rates of young males, on the other hand, was not present in our data at all, nor did we find any support for the assumption that sTBI acquired from riskier behavio...
Source: Frontiers in Neurology - April 11, 2019 Category: Neurology Source Type: research

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