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Implementing a Standardized Language Evaluation in the Acute Phases of Aphasia: Linking Evidence-Based Practice and Practice-Based Evidence
We report on the feasibility of implementing such standardized assessments into routine clinical care via measures of adherence. We also report on initial analyses of the data within the database that provide insights into the opportunities to track change. This initiative highlights the feasibility of collecting clinical data using a standardized assessment measure across acute and inpatient rehabilitation care settings. Practice-based evidence may inform future research by contributing pilot data and systematic observations that may lead to the development of empirical studies, which can then feed back into clinical practice.
Source: Frontiers in Neurology - June 1, 2020 Category: Neurology Source Type: research

Follow-Up in Aphasia Caused by Acute Stroke in a Prospective, Randomized, Clinical, and Experimental Controlled Noninvasive Study With an iPad-Based App (Neolexon ®): Study Protocol of the Lexi Study
Discussion: This trial will determine whether speech therapy with the use of Neolexon® is superior to standard logopedic therapy. Subgroups with the greatest response to Neolexon® will be described. The trial was prospectively registered on the “EU Clinical Trials Register” (NCT04080817)1.
Source: Frontiers in Neurology - April 29, 2020 Category: Neurology Source Type: research

Predicting Early Post-stroke Aphasia Outcome From Initial Aphasia Severity
Conclusions: Initial aphasia severity was the best predictor of early post-stroke aphasia outcome, whereas lesion measures, though highly correlated, show less influence on the prediction model. We suggest that factors predicting early recovery may differ from those involved in long-term recovery.
Source: Frontiers in Neurology - February 20, 2020 Category: Neurology Source Type: research

Facilitation of Auditory Comprehension After Theta Burst Stimulation of Wernicke's Area in Stroke Patients: A Pilot Study
Conclusion: We demonstrated that a single session of excitatory iTBS over Wernicke's area was safe and led to a transient facilitation of auditory comprehension in chronic stroke patients with lesions in the same area. Further studies are needed to establish whether TBS-induced modulation can be enhanced and transformed into longer-lasting effects by means of repeated TBS sessions and by combining TBS with speech and language therapy.
Source: Frontiers in Neurology - January 7, 2020 Category: Neurology Source Type: research

Delirium Screening in Aphasic Patients With the Intensive Care Delirium Screening Checklist (ICDSC): A Prospective Cohort Study
Conclusion: For the purpose of delirium screening in patients with aphasia, increasing the ICDSC cut-off value to ≥ 5 points enables effective screening. Further studies are necessary to characterize post-stroke delirium.
Source: Frontiers in Neurology - November 11, 2019 Category: Neurology Source Type: research

Transcranial Direct Current Stimulation to Enhance Training Effectiveness in Chronic Post-Stroke Aphasia: A Randomized Controlled Trial Protocol
Discussion: Positive results will increase the quality of life for persons with aphasia and their families while reducing societal costs. After trial completion, a workshop with relevant stakeholders will ensure transfer into best-practice guidelines and successful integration within clinical routine.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT03930121.
Source: Frontiers in Neurology - October 21, 2019 Category: Neurology Source Type: research

Notification Strategy and Predictors of Outcome in Stroke Ineligible for Reperfusion Therapies
Conclusions: EMS notification is influenced by AF, stroke severity, psychiatric disease, aphasia, and residence type. Early disability depends on age, the type and severity of the stroke, and pre-stroke mRS. Predictors of disability at 1 year after stroke are age, stoke severity, mRS at discharge, and recurrent ischemic stroke. Higher NIHSS and older age are associated with higher case fatality. In patients ineligible for recanalization, EMS notification had no significant effect on outcome, regarding both disability and survival.
Source: Frontiers in Neurology - October 9, 2019 Category: Neurology Source Type: research

Endovascular Therapy for Concurrent Cardio-Cerebral Infarction in a Patient With Trousseau Syndrome
Only a few patients have been reported to undergo endovascular therapy for Trousseau syndrome. This is the first report of a patient with Trousseau syndrome who developed synchronous cardiocerebral infarction and underwent endovascular therapy for both. A 55-year-old woman with Trousseau syndrome arising from stage IV ovarian cancer presented with consciousness disturbance, aphasia, and right hemiparesis. Magnetic resonance imaging showed acute cerebral infarction limited to the left basal ganglia and occlusion of the left middle cerebral artery (MCA). Electrocardiography showed ST elevation in leads II, III, and aVF with ...
Source: Frontiers in Neurology - September 5, 2019 Category: Neurology Source Type: research

Post-stroke Depression Increases Disability More Than 15% in Ischemic Stroke Survivors: A Case-Control Study
We performed a retrospective, case-control study in consecutive ischemic stroke patients admitted to our stroke rehabilitation unit. Patients were matched for severity of neurological impairment (evaluated with the Canadian Neurological Scale, CNS), age (difference within 1 year) and onset admission interval (difference within 3 days). Participants were divided into two subgroups according to the presence or absence of PSD. Aim was to assess the specific influence of post-stroke depression (PSD) and antidepressant treatment on both basal functional status and rehabilitation outcomes. All PSD patients were treated primarily...
Source: Frontiers in Neurology - August 26, 2019 Category: Neurology Source Type: research

Association of Lesion Location With Long-Term Recovery in Post-stroke Aphasia and Language Deficits
Conclusions: We identified specific brain lesions associated with long-term outcomes in four dimensions of aphasia, in patients with post-stroke aphasia. Our findings may be useful for advancing understanding for the pathophysiology of aphasia in stroke patients.
Source: Frontiers in Neurology - July 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

Conveniently-Grasped Field Assessment Stroke Triage (CG-FAST): A Modified Scale to Detect Large Vessel Occlusion Stroke
Conclusions: CG-FAST scale could be an effective and simple scale for accurate identification of LVOS among AIS patients. Introduction Large vessel occlusion stroke (LVOS) often leads to severe disability and mortality. Although endovascular therapy (EVT) has been proved to be effective for LVOS patients (1–9), especially in anterior circulation, its benefit is highly time-dependent (10, 11). As hospitals with around-the-clock endovascular capability are scarce in many parts of the world and patients admitted directly to a CSC would have better outcomes than those receiving drip and ship treatment (12, 13), t...
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

Robotic Arm Rehabilitation in Chronic Stroke Patients With Aphasia May Promote Speech and Language Recovery (but Effect Is Not Enhanced by Supplementary tDCS)
Adam Buchwald, Carolyn Falconer, Avrielle Rykman-Peltz, Mar Cortes, Alvaro Pascual-Leone, Gary W. Thickbroom, Hermano Igo Krebs, Felipe Fregni, Linda M. Gerber, Clara Oromendia, Johanna Chang, Bruce T. Volpe, Dylan J. Edwards
Source: Frontiers in Neurology - October 22, 2018 Category: Neurology Source Type: research

Moving Beyond the Brain: Transcutaneous Spinal Direct Current Stimulation in Post-Stroke Aphasia
Paola Marangolo, Valentina Fiori, Jacob Shofany, Tommaso Gili, Carlo Caltagirone, Gabriella Cucuzza, Alberto Priori
Source: Frontiers in Neurology - August 8, 2017 Category: Neurology Source Type: research

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