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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

Acute stroke in the field: iTREAT, you treat, we all one day will treat ... better
The use of telemedicine in the ambulance for more precise and rapid prehospital/emergency medical service (EMS) care of patients with acute stroke dates back to 1988 by the University of Maryland TeleBAT (telemedicine for the Brain Attack Team) system.1 The TeleBAT Team, which used this approach to determine the patient's NIH Stroke Scale (NIHSS) score, prophetically described a novel approach that could shorten the time to treatment because emergency medical technicians can transmit their videotaped assessment to the emergency room, providing emergency medicine physicians and neurologists with earlier viewing of the strok...
Source: Neurology - July 3, 2016 Category: Neurology Authors: Levine, S. R., Switzer, J. A. Tags: Clinical neurology examination, All Cerebrovascular disease/Stroke EDITORIALS Source Type: research

Novel Treatments in Neuroprotection for Aneurysmal Subarachnoid Hemorrhage
Opinion statement New neuroprotective treatments aimed at preventing or minimizing “delayed brain injury” are attractive areas of investigation and hold the potential to have substantial beneficial effects on aneurysmal subarachnoid hemorrhage (aSAH) survivors. The underlying mechanisms for this “delayed brain injury” are multi-factorial and not fully understood. The most ideal treatment strategies would have the potential for a pleotropic effect positively modulating multiple implicated pathophysiological mechanisms at once. My personal management (RFJ) of patients with aneurysmal subarachnoid hemorrhage...
Source: Current Treatment Options in Neurology - June 19, 2016 Category: Neurology Source Type: research

Quality of Care for Patients with TIA with an Eye towards Quality Improvement: How Are We Doing? (P6.036)
Conclusion: Overall, care provided was guideline-concordant, but some patients with TIA are receiving suboptimal care, even among those admitted to a Stroke Center who are routinely admitted or seen by neurology. There are opportunities for improvement in TIA care, especially in statin treatment of eligible TIA patients.Disclosure: Dr. Kalaria has nothing to disclose. Dr. Flair has nothing to disclose. Dr. Cronin has nothing to disclose. Dr. Kittner has nothing to disclose. Dr. Phipps has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Kalaria, C., Flair, Z., Cronin, C., Kittner, S., Phipps, M. Tags: Telestroke and Other Innovations and TIA Source Type: research

Preliminary Assessment of the Motor Activity Log-28 in Patients with Chronic Stroke (P5.174)
CONCLUSIONS: MAL-28 was an acceptable self-report measure of baseline ability for less impaired stroke participants. Quality of arm use in a non-clinical setting detected by the MAL-28 was sensitive to qualitative changes assessed by clinical evaluation. Study Supported by: University of Maryland School of Medicine NIA Short-Term Training Program on Aging Grant T35AG036679;VA Department of Research & Development Merit Grant B6935R. Disclosure: Dr. Simpson has nothing to disclose. Dr. Conroy has nothing to disclose. Dr. Bever has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Simpson, A., Conroy, S., Bever, C. Tags: Neuro-rehabilitation: Stroke Source Type: research

Sequencing bilateral and unilateral task-oriented training versus task oriented training alone to improve arm function in individuals with chronic stroke
Conclusions: Sequentially combining a proximal bilateral before a unilateral task-oriented training may be an effective way to facilitate gains in arm and hand function in those with moderate to severe paresis post-stroke compared to unilateral task oriented training alone.
Source: BMC Neurology - December 14, 2014 Category: Neurology Authors: Sandy WallerJill WhitallToye JenkinsLaurence MagderDaniel HanleyAndrew GoldbergAndreas Luft Source Type: research

Correction to Wendell, Waldstein, and Zonderman (2013).
Conclusions: Overall, results indicate nonlinear longitudinal relations of total cholesterol to cognitive decline. Whereas higher cholesterol levels were associated with cognitive decline in the middle-aged or young-old, lower cholesterol levels were related to cognitive decline among old-old participants. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
Source: Neuropsychology - September 22, 2014 Category: Neurology Authors: No authorship indicated Source Type: research

Understanding brain function through small vessel disease: What zebras can teach us about horses
So goes the adage attributed to Dr. Theodore Woodward of the University of Maryland. But perhaps considering the habits of zebras could teach us about their more common equine cousins. Traditionally, our knowledge about the correlation of normal structure and function in the brain has relied, to a large extent, on studying the disruption wrought by disease processes on normal function, whether this disrupted structure was detected at autopsy or more recently by CT and MRI. This led to the common dictum that neurology was learned "stroke by stroke" (lesion-symptom mapping). In the last 5 years, higher-resolution MRI scanner...
Source: Neurology - June 2, 2014 Category: Neurology Authors: Seshadri, S., de Leeuw, F.-E. Tags: MRI, All Cerebrovascular disease/Stroke, Executive function, Vascular dementia, All epidemiology EDITORIALS Source Type: research

Ethnic Differences in Ischemic Stroke Subtypes: The Stroke Prevention in Young Adults Study (P2.112)
CONCLUSIONS: Our population-based data demonstrate ethnic differences in ischemic stroke subtypes. These findings may help clarify mechanisms of young-onset stroke which appear to be partially driven by ethnic differences in early stroke risk factors, thereby indicating differing workup and treatment.Disclosure: Dr. Cole has received research support from the University of Maryland.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Trivedi, M., Cole, J. Tags: Cerebrovascular Disease and Interventional Neurology: Childhood and Young Adult Source Type: research

Low Density Lipoprotein Receptor Related Protein-1 and 6 Gene Variants and Ischemic Stroke Risk (P6.279)
CONCLUSIONS: Based on these results, further data is needed to elucidate whether a true association between the LRP1 and 6 genes and acute ischemic stroke exists.Study Supported by: NINDS R01NS39987, R01NS42733 Disclosure: Dr. Harriott has nothing to disclose. Dr. Heckman has nothing to disclose. Dr. Rayaprolu has nothing to disclose. Dr. Soto-Ortolaza has nothing to disclose. Dr. Malik for METASTROKE Consortium has nothing to disclose. Dr. Cole has received research support from the University of Maryland. Dr. Meschia has nothing to disclose. Dr. Ross has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Harriott, A., Heckman, M., Rayaprolu, S., Soto-Ortolaza, A., Malik, R., Cole, J., Meschia, J., Ross, O. Tags: Cerebrovascular Disease and Interventional Neurology: Risk Factors Source Type: research

Marijuana Use and the Risk of Ischemic Stroke: The Stroke Prevention in Young Adults Study (S55.003)
CONCLUSION: Our data does not demonstrate a risk of ischemic stroke as associated with marijuana use. Additional studies are warranted examining the effect of heavy or frequent use.Disclosure: Dr. Dutta has nothing to disclose. Dr. Ryan has nothing to disclose. Dr. Cheng has nothing to disclose. Dr. Kittner has nothing to disclose. Dr. Cole has received research support from the University of Maryland.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Dutta, T., Ryan, K., Cheng, Y., Kittner, S., Cole, J. Tags: Pediatric Stroke and Stroke in the Young Source Type: research