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Skin capillary amylin deposition resembles brain amylin vasculopathy in rats
Human amylin is a 37 amino-acid pancreatic peptide that forms neuro-toxic aggregates that deposit in the endothelium of brain capillaries of patients with diabetes, potentially contributing to cerebral small vessel ischemic injury. Pathogenic amylin also deposits in the capillary endothelium in other organs, including the skin. The aim of this study was to test the hypothesis that skin capillary amylin deposition correlates with cerebral small vessel amylin deposition, potentially providing a clinically useful marker of cerebral amylin deposition.
Source: Journal of Stroke and Cerebrovascular Diseases - August 11, 2023 Category: Neurology Authors: Saurav Das, Nirmal Verma, Larry B. Goldstein, Florin Despa Source Type: research

Perivascular spaces mediate a relationship between diabetes and other cerebral small vessel disease markers in cerebrovascular and neurodegenerative diseases
Cerebral small vessel disease (SVD) is used to describe heterogeneous pathological changes in perforating arterioles, venules, and capillaries that supply blood to subcortical structures.1 These pathological changes manifest on magnetic resonance imaging (MRI) as quantifiable volumetric measures. Established markers of SVD identified on MRI include deep white matter hyperintensities (dWMH) and periventricular white matter hyperintensities (pWMH) of presumed vascular origin and lacunes, and MRI visible enlarged perivascular spaces (PVS) in the white matter (wmPVS) or basal ganglia (bgPVS).
Source: Journal of Stroke and Cerebrovascular Diseases - August 3, 2023 Category: Neurology Authors: Julia Zebarth, Radia Kamal, George Perlman, Michael Ouk, Lisa Y. Xiong, Di Yu, William Z. Lin, Joel Ramirez, Mario Masellis, Maged Goubran, Bradley J. MacIntosh, Sandra E. Black, Hugo Cogo-Moreira, Christopher J.M. Scott, Robert Bartha, Sean Symons, Seyye Source Type: research

Impact of age on mechanical thrombectomy and clinical outcome in patients with acute ischemic stroke
Mechanical thrombectomy (MT) has proven to be an effective and safe treatment for patients with acute ischemic stroke due to large vessel occlusion and its use has therefore rapidly increased over the past decade.1 –3 Although MT has been demonstrated to be effective independent of age, age seems to strongly affect clinical outcome after MT.1. The reasons are manifold. Besides the natural process of aging, elderly patients tend to have more significant comorbidities, such as atherosclerosis, arterial hyperte nsion and diabetes mellitus, all influencing brain plasticity, arterial collateral network and the ability to recover in general.
Source: Journal of Stroke and Cerebrovascular Diseases - July 11, 2023 Category: Neurology Authors: Nadine Rhiner, Mara Z. Thut, Patrick Thurner, Jawid Madjidyar, Tilman Schubert, Christoph Globas, Susanne Wegener, Andreas R. Luft, Lars Michels, Zsolt Kulcsar Source Type: research

Mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes diagnosed after metformin-triggered stroke-like episodes
A 40-year-old man with sensorineural hearing loss and diabetes mellitus was hospitalized with acute-onset impaired consciousness and clumsiness in his left hand. He had been taking metformin (750 mg/day) for 4 months. He had no febrile illness, energy failure, or use of mitochondria-toxic drugs other than metformin. The patient had a family history of diabetes mellitus (maternal uncle and aunt). His weight and height were 35 kg and 1.58 m, respectively. A neurological examination revealed confusion and weakness in the left upper limb.
Source: Journal of Stroke and Cerebrovascular Diseases - March 16, 2023 Category: Neurology Authors: Keishu Murakami, Ken Sakamoto, Hiroshi Ishiguchi, Hidefumi Ito Tags: Case Report Source Type: research

Endothelial function and arterial stiffness indexes in subjects with carotid plaque and carotid plaque length: A subgroup analysis showing the relationship with hypertension and diabetes
Stroke is a leading cause of death and disability globally. A large proportion of ischemic strokes are caused by carotid atherosclerotic plaques. However, the relationship between vascular health status (arterial stiffness and endothelial dysfunction) and carotid plaque remains unclear.
Source: Journal of Stroke and Cerebrovascular Diseases - January 18, 2023 Category: Neurology Authors: Yan Zhang, Meng Wang, Xiaofeng Jing, Qiongfang Cao, Peng Zhang, Yuhan Wang, Fangfang Liu, Xuejun Xu, Jian Wang, Lanying He, Fan Xu Source Type: research

Cost-effectiveness of carotid artery stenting vs endarterectomy: A simulation
Clinical trials conducted before the introduction of modern medical management to prevent stroke demonstrated that carotid endarterectomy (CEA) and carotid artery stenting (CAS) prevent stroke following transient ischemic attack (TIA). We compared the cost-effectiveness of CEA, CAS, and modern medical management in two secular settings of medical management in individuals with incident TIA and type 2 diabetes.
Source: Journal of Stroke and Cerebrovascular Diseases - November 30, 2022 Category: Neurology Authors: Deanna J. Marriott, Shihchen Kuo, Wen Ye, Deborah A. Levine, William H. Herman Source Type: research

Differential associations between pre-diabetes, diabetes and stroke occurrence among West Africans
There are limited data from Africa on the burden and associations between pre-diabetes (pre-DM), diabetes mellitus (DM) and stroke occurrence in a region experiencing a profound rise in stroke burden.
Source: Journal of Stroke and Cerebrovascular Diseases - October 1, 2022 Category: Neurology Authors: Fred Stephen Sarfo, Bruce Ovbiagele, Joshua Akinyemi, Onoja Akpa, Albert Akpalu, Kolawole Wahab, Godwin Ogbole, Reginald Obiako, Morenikeji Komolafe, Lukman Owolabi, Godwin Osaigbovo, Carolyn Jenkins, Adekunle Fakunle, Abiodun Adeoye, Dan Lackland, Donna Source Type: research

Effect of metformin on outcome after acute ischemic stroke in patients with type 2 diabetes mellitus
Diabetes mellitus is a well-known risk factor for ischemic stroke and is associated with unfavorable outcome after stroke. Metformin is recommended as first-line treatment in these patients. Pre-stroke metformin use might have neuroprotective properties resulting in reduced stroke severity. However, results of the effects of pre-stroke metformin use on functional outcome are conflicting and has not been previously described in patients with type 2 diabetes mellitus regardless of stroke severity or revascularization treatment.
Source: Journal of Stroke and Cerebrovascular Diseases - August 1, 2022 Category: Neurology Authors: C.J.B.A. Kersten, I.L.H. Knottnerus, E. Heijmans, M. Haalboom, A.A.M. Zandbergen, H.M. den Hertog Source Type: research

Diabetes is an Independent Growth Factor of Ischemic Stroke During Reperfusion Phase Leading to Poor Clinical Outcome
In stroke patients, clinical prognosis is conditioned by final infarct volume.1 –3 In the setting of large vessel occlusion, ischemic core increases over time to the detriment of ischemic penumbra, depending mainly on quality of collaterality sustaining penumbra tissue until complete recanalization.4 So, final volume is determined by early recanalization and penumbra salvage. 5 Bridging therapy (endovascular thrombectomy in addition to thrombolysis with IV rt-PA) leads to a significant improvement of the functional outcome within 6 h of ischemic stroke due to higher recanalization rate of large vessel occlusion.
Source: Journal of Stroke and Cerebrovascular Diseases - April 23, 2022 Category: Neurology Authors: Jean-Daniel Dehondt, Quentin Holay, Sacha Brohee, H élène Mourre, Jean-François Hak, Ophélie Osman, Laurent Suissa, Emilie Doche Source Type: research

Taking the Obesity Paradox to New Heights in Cerebral Atherosclerosis
Obesity typically worsens many of the major cardiovascular disease (CVD) risk factors, such as elevating blood pressure, worsening dyslipidemia, increasing impaired plasma glucose metabolism (leading to metabolic syndrome and diabetes mellitus), and increasing systemic inflammation, increasing the risk of most CVD, including hypertension, coronary heart disease (CHD), heart failure, atrial fibrillation and cerebrovascular diseases.1 –3 However, in patients with established CVD, many studies published by my colleagues and I and others have demonstrated a consistent paradox, where obese patients with established CVD seem t...
Source: Journal of Stroke and Cerebrovascular Diseases - February 1, 2022 Category: Neurology Authors: Carl J. Lavie, Salvatore Carbone, Ian J. Neeland Tags: Editorial Source Type: research

Sodium-Glucose Co-Transporter-2 Inhibitors Decrease the Odds for Atrial Fibrillation in Subjects with Heart Failure
Ong et al. have shown in their very informative, recently published meta-analysis that sodium-glucose co-transporter-2 (SGLT-2) inhibitors result in a significant decrease in the odds for atrial fibrillation (AF) regardless of status of diabetes mellitus or cardiovascular disease at baseline.1 However, the authors failed to show that this effect is sustained in subjects with heart failure (HF).1
Source: Journal of Stroke and Cerebrovascular Diseases - December 22, 2021 Category: Neurology Authors: Dimitrios Patoulias, Christodoulos Papadopoulos, Michael Doumas Tags: Letter to the Editor Source Type: research

Effects of Sodium/Glucose Cotransporter Inhibitors on Atrial Fibrillation and Stroke: A Meta-Analysis
Globally, the number of people estimated to have diabetes mellitus (DM) in 2019 was 463 million, and the estimated number is expected to rise to 578 million people by 2030.1 DM is also associated with an increased risk of atrial fibrillation (AF), 2 and has shown to be an independent risk factor for stroke in patients with AF.3 A meta-analysis of 102 studies further showed that patients with diabetes have a higher risk of all subtypes of stroke (ischemic, hemorrhagic and unclassified stroke).4 This has generated great interest in anti-hyperglycemic agents and their ability to reduce the cardiovascular complications of diabetes.
Source: Journal of Stroke and Cerebrovascular Diseases - October 22, 2021 Category: Neurology Authors: How Ting Ong, Yao Hao Teo, Yao Neng Teo, Nicholas LX Syn, Caitlin Fern Wee, Shariel Leong, Alicia Swee Yan Yip, Ray Meng See, Adriel Zhi Hen Ting, Alys ZQ Chia, Alex Jia Yang Cheong, Benjamin Yong-Qiang Tan, Jamie Sin-Ying Ho, Leonard Leong-Litt Yeo, Aloy Source Type: research

Understanding Coordinator Roles in Acute Stroke Care: A National Survey
Globally, stroke is a major contributor to death and disability.1 Evidence-based care in hospital after an acute stroke ensures improved survival and reduced disability, but care quality can vary.2,3 Clinical coordinators have an essential role in improving best-practice in trauma, cancer, diabetes, and heart failure conditions.4-7 Within stroke, coordinator roles are not new; in 1970, a study outlining the ‘Stroke Team’ model was published, which included a physician, nurse-coordinator and physical therapist.
Source: Journal of Stroke and Cerebrovascular Diseases - September 29, 2021 Category: Neurology Authors: Tara Purvis, Sandy Middleton, Anne W. Alexandrov, Monique F. Kilkenny, Skye Coote, Sarah Kuhle, Dominique A. Cadilhac Source Type: research

Quality of Care and One-Year Outcomes in Patients with Diabetes Hospitalised for Stroke or TIA: A Linked Registry Study
To evaluate key quality indicators for acute care and one-year outcomes following acute ischaemic stroke (IS), intracerebral haemorrhage (ICH), or transient ischaemic attack (TIA) by diabetes status.
Source: Journal of Stroke and Cerebrovascular Diseases - September 10, 2021 Category: Neurology Authors: Muideen T. Olaiya, Dominique A. Cadilhac, Joosup Kim, Amanda G. Thrift, Barbora de Courten, Nadine E. Andrew, Rohan Grimley, Craig S. Anderson, Vijaya Sundararajan, Natasha A. Lannin, Christopher Levi, Helen M. Dewey, Monique F. Kilkenny Source Type: research

Skin Autofluorescence is an Independent Predictor of Post Stroke Infection in Diabetes
Post stroke infection occurs in 15 –20% of acute stroke patients and is associated with a poor longterm outcome. In a prospective study on 113 acute ischemic stroke patients with diabetes mellitus 15.9% suffered nosocomial infection. We found chronic hyperglycemia measured by skin autofluorescence in arbitrary units to be an indepe ndent predictor of a nosocomial infection post stroke (OR = 3.24 [CI 95%: 1.13; 9.26], p = 0.029). Skin autofluorescence represents the glycemic memory beyond HbA1c. Potential mechanisms leading from increased skin autofluorescence to vulnerability for infectious complications include ...
Source: Journal of Stroke and Cerebrovascular Diseases - June 26, 2021 Category: Neurology Authors: Alexandra Filipov, Heike Fuchshuber, Josephine Kraus, Anne D. Ebert, Vesile Sandikci, Angelika Alonso Source Type: research

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