Query: stroke

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Source: JAMA Neurology
Condition: Dementia

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Total 13 results found since Jan 2013.

Prevention of Dementia —Thinking Beyond the Age and Amyloid Boxes
It is increasingly recognized that the declines in brain structure and function in persons with no clinical brain disease that we call brain aging and the 2 brain diseases that most frequently affect older adults (dementia and stroke) are the theoretically predictable consequences of a lifetime of injury that overcomes genetically and environmentally determined reserve and resilience, a concept encapsulated in the shorthand phrase life-course illness. Despite this insight, details of the various factors that adversely affect the brain health of older adults (and clarity on which times during life have the greatest effect a...
Source: JAMA Neurology - November 4, 2019 Category: Neurology Source Type: research

Potential New Horizons for the Prevention of Cerebrovascular Diseases and Dementia
In this issue ofJAMA Neurology, Spence et al discuss the effect of pioglitazone, an insulin-sensitizing agent that has been shown to reduce the risk of recurrent stroke and myocardial infarction in patients with insulin resistance, in patients with prediabetes. Prediabetes was defined according to the American Diabetes Association criteria, ie, a hemoglobin A1c level of 5.7% to 6.4% or a fasting plasma glucose level of 100 to 125 mg/dL. Data were taken from the Insulin Resistance Intervention after Stroke (IRIS) study, an international randomized clinical trial performed in patients with previous stroke or transient ischem...
Source: JAMA Neurology - February 7, 2019 Category: Neurology Source Type: research

Clinical Significance of Magnetic Resonance Imaging Markers of Vascular Brain Injury
This systematic review and meta-analysis investigates the clinical and therapeutic significance of magnetic resonance imaging markers of covert vascular brain injury (white matter hyperintensities, brain infarcts, and cerebral microbleeds) associated with stroke, dementia, and death in community-dwelling older adults.
Source: JAMA Neurology - October 22, 2018 Category: Neurology Source Type: research

Birth in a High Stroke Mortality State, Race, and Risk of Dementia
This cohort study examines the risk of dementia in individuals who are born in the Stroke Belt but later reside in California.
Source: JAMA Neurology - July 31, 2017 Category: Neurology Source Type: research

Crowdsourcing the Million Brains Initiative —Reply
In Reply The enthusiasm expressed for the Million Brains Initiative and the thoughtful consideration of ethical facets by Byram and Illes are much appreciated. The authors underscore a few of the inevitable ramifications that will undoubtedly parallel the realization of precision stroke medicine and the transformation from blissful ignorance to big data in stroke medicine. The current paradigm for cerebrovascular disorders from stroke to dementia is founded on individual clinical symptoms that prompt the acquisition, routine interpretation, and archiving of neuroimaging results. Impressions are readily generated and docume...
Source: JAMA Neurology - June 12, 2017 Category: Neurology Source Type: research

Association Between CV Risk Factors and Familial Alzheimer Disease
This cohort study investigates associations between coronary risk factors, stroke, and late-onset Alzheimer dementia in patients with familial disease.
Source: JAMA Neurology - August 15, 2016 Category: Neurology Source Type: research

Phenotypic Destiny in Mitochondrial Disease?
Mitochondrial diseases are a group of heterogeneous disorders caused by inherited mutations in the mitochondrial genome (mtDNA) and nuclear genome. Typically, mutations in the mtDNA are maternally inherited and cause respiratory chain defects and account for a substantial fraction of childhood and adult neurometabolic disease, with an estimated prevalence of 1:5000 (0.02%). The most common mtDNA mutation is the mitochondrial 3243A>G mutation (m.3243A>G) in the MTTL1 gene (OMIM 590050), which encodes the transfer RNA tRNALeu(UUR). This mutation is associated with multiple clinical and psychiatric manifestations, including d...
Source: JAMA Neurology - June 20, 2016 Category: Neurology Source Type: research

Proton Pump Inhibitors and Dementia Incidence
To the Editor I read with interest the article by Gomm and colleagues, which examined the association between the use of proton pump inhibitors (PPIs) and incident dementia in elderly individuals in a prospective study. The authors adopted time-dependent Cox regression analysis, and the time-dependent covariates were polypharmacy and the comorbidities of depression, diabetes, ischemic heart disease, and stroke. Age and sex were also used as confounding factors. The hazard ratio of PPIs for incident dementia was 1.44 (95% CI, 1.36-1.52), and the authors recommended randomized clinical trials to confirm the causal associatio...
Source: JAMA Neurology - June 20, 2016 Category: Neurology Source Type: research

Dementia After Intracerebral Hemorrhage
As acute management of intracerebral hemorrhage (ICH) has improved, more patients survive ICH but are left with significant deficits. In the past, primary evaluations of outcomes after ICH have focused on mortality and levels of functional dependence, with a relatively modest number of patients experiencing true functional independence after ICH or returning to their previous level of functioning. Cognitive outcomes after ICH have thus not been a primary focus of either treatment or natural history studies of ICH, despite their known importance after ischemic stroke and their importance in predicting return to previous functioning.
Source: JAMA Neurology - June 13, 2016 Category: Neurology Source Type: research

Cerebral Microbleeds, Cognition and Therapeutic Implications
A recent major clinical advance in magnetic resonance imaging (MRI) of the brain is the development of paramagnetic-sensitive sequences such as T2-weighted gradient-recalled echo and susceptibility-weighted images for the detection of cerebral microbleeds (CMBs). On brain MRI, CMBs are small (≤5 to 10 mm in diameter), round, dark-signaled lesions that consist of extravasation of blood components through fragile microvascular walls that neuropathologically represent hemosiderin-laden macrophages. Magnetic resonance imaging–detected CMBs are common in elderly individuals, coexist with ischemic stroke and intracerebral he...
Source: JAMA Neurology - June 6, 2016 Category: Neurology Source Type: research

Potential Association Between Atrial Fibrillation and Dementia
In Reply We thank Chen and colleagues for their interest in our work and are pleased that our report triggers debate about the optimal treatment of atrial fibrillation (AF) to prevent dementia, in addition to stroke and other thromboembolic complications of AF.
Source: JAMA Neurology - March 21, 2016 Category: Neurology Source Type: research

Microbleeds, Mortality, and Stroke in Alzheimer Disease The MISTRAL Study
Conclusions and RelevanceIn patients with AD, the presence of nonlobar microbleeds was associated with an increased risk for cardiovascular events and cardiovascular mortality. Patients with lobar microbleeds had an increased risk for stroke and stroke-related mortality, indicating that these patients should be treated with the utmost care.
Source: JAMA Neurology - March 23, 2015 Category: Neurology Source Type: research