Joana Ferreira Pinto, Mariana Santos, Ana Rita Silva, Diana Matos, Vera Fernandes, Ana Filipa Santos
{"title":"Motor Neuron Disease-Frontotemporal Dementia Spectrum Disorder: A Different Phenotype Related With a Novel TBK1 Gene Variant","authors":"Joana Ferreira Pinto, Mariana Santos, Ana Rita Silva, Diana Matos, Vera Fernandes, Ana Filipa Santos","doi":"10.14740/jnr765","DOIUrl":"https://doi.org/10.14740/jnr765","url":null,"abstract":"","PeriodicalId":16489,"journal":{"name":"Journal of Neurology Research","volume":"2 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141235063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ahsen Songul Tutar Kizilkan, Derya Azim, E. Kaya Mutlu, H. Taskiran
{"title":"Effectiveness of Relaxation and Respiratory Exercise on Sleep Quality, Depression and Spasticity in Hemiplegic Stroke Patients: Preliminary Findings","authors":"Ahsen Songul Tutar Kizilkan, Derya Azim, E. Kaya Mutlu, H. Taskiran","doi":"10.14740/jnr756","DOIUrl":"https://doi.org/10.14740/jnr756","url":null,"abstract":"","PeriodicalId":16489,"journal":{"name":"Journal of Neurology Research","volume":"66 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141231484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alexander Mauskop, Elizabeth Seng, Jordan Van Zyl, Russell K. Portenoy, Helena Knotkova
Background: The outcomes of drug therapies in migraine vary and the development of novel non-pharmacological treatments is a priority. Non-invasive neuromodulation using transcranial direct current stimulation (tDCS) in small-sample studies with brief treatment protocols has shown preliminary efficacy in management of migraine symptoms. We have piloted a use of tDCS modified for applications of longer treatment protocols in home settings and conducted a pilot randomized sham-controlled study involving 60 daily at-home tDCS applications in migraine patients (targeted N = 60). The COVID-19 pandemic precipitated early study closure, and the final enrollment (N = 22) was insufficient to test efficacy. Here we report findings on treatment feasibility, adherence, and satisfaction. Methods: Participants were enrolled from the New York metropolitan area in 2018 - 2020. Main eligibility criteria included diagnosis of episodic or chronic migraine, history of headache for ≥ 1 year and ≥ 4 days with headache per month during a 30-day baseline period. At-home tDCS with remote supervision delivered the current at intensity of 1.5 mA or sham for one 20-min session per day on 60 consecutive days. The feasibility was determined by the drop-out rate after treatment started. Adherence was measured as the proportion of days during the 60-day study period that the patient activated the device. Satisfaction was evaluated from the satisfaction survey completed after the 60-day use of the device. Results: Thirty-six patients provided consent and were assessed for eligibility; 22 of them (17 F, 5 M, age of 38.4 ± 11.0 years) met eligibility criteria and were enrolled. Six patients dropped out after the intervention started; 16 patients (73% of enrolled) continued through the 60-day treatment. In this group, adherence was high; the mean (standard deviation (SD)) number of sessions per patient was 49.3 (13.1); the median was 52.5. All 16 patients were satisfied with education about tDCS and 13 (81%) found the use of the tDCS device easy. No significant adverse events occurred. Conclusions: At-home tDCS with remote supervision is feasible in migraine patients. If efficacy is confirmed in future research, at-home tDCS could become a useful tool for patients with severe migraine headache.
{"title":"Non-Invasive Neuromodulation for Episodic and Chronic Migraine Headache: Preliminary Findings on Feasibility of At-Home Transcranial Direct Current Stimulation With Remote Supervision","authors":"Alexander Mauskop, Elizabeth Seng, Jordan Van Zyl, Russell K. Portenoy, Helena Knotkova","doi":"10.14740/jnr760","DOIUrl":"https://doi.org/10.14740/jnr760","url":null,"abstract":"Background: The outcomes of drug therapies in migraine vary and the development of novel non-pharmacological treatments is a priority. Non-invasive neuromodulation using transcranial direct current stimulation (tDCS) in small-sample studies with brief treatment protocols has shown preliminary efficacy in management of migraine symptoms. We have piloted a use of tDCS modified for applications of longer treatment protocols in home settings and conducted a pilot randomized sham-controlled study involving 60 daily at-home tDCS applications in migraine patients (targeted N = 60). The COVID-19 pandemic precipitated early study closure, and the final enrollment (N = 22) was insufficient to test efficacy. Here we report findings on treatment feasibility, adherence, and satisfaction. Methods: Participants were enrolled from the New York metropolitan area in 2018 - 2020. Main eligibility criteria included diagnosis of episodic or chronic migraine, history of headache for ≥ 1 year and ≥ 4 days with headache per month during a 30-day baseline period. At-home tDCS with remote supervision delivered the current at intensity of 1.5 mA or sham for one 20-min session per day on 60 consecutive days. The feasibility was determined by the drop-out rate after treatment started. Adherence was measured as the proportion of days during the 60-day study period that the patient activated the device. Satisfaction was evaluated from the satisfaction survey completed after the 60-day use of the device. Results: Thirty-six patients provided consent and were assessed for eligibility; 22 of them (17 F, 5 M, age of 38.4 ± 11.0 years) met eligibility criteria and were enrolled. Six patients dropped out after the intervention started; 16 patients (73% of enrolled) continued through the 60-day treatment. In this group, adherence was high; the mean (standard deviation (SD)) number of sessions per patient was 49.3 (13.1); the median was 52.5. All 16 patients were satisfied with education about tDCS and 13 (81%) found the use of the tDCS device easy. No significant adverse events occurred. Conclusions: At-home tDCS with remote supervision is feasible in migraine patients. If efficacy is confirmed in future research, at-home tDCS could become a useful tool for patients with severe migraine headache.","PeriodicalId":16489,"journal":{"name":"Journal of Neurology Research","volume":"80 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141231004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Neuro-Abilities and a Good Life","authors":"Gregor Wolbring","doi":"10.14740/jnr770","DOIUrl":"https://doi.org/10.14740/jnr770","url":null,"abstract":"","PeriodicalId":16489,"journal":{"name":"Journal of Neurology Research","volume":"58 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141231837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Small Number of Coils With Extended Length in the Endovascular Treatment of Cerebral Aneurysm: Experience of 108 Cases in a Single-Center","authors":"B. Prasetyo, Beny Rilianto, R. Kurniawan","doi":"10.14740/jnr777","DOIUrl":"https://doi.org/10.14740/jnr777","url":null,"abstract":"","PeriodicalId":16489,"journal":{"name":"Journal of Neurology Research","volume":"34 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141233013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The objective was to identify the gaps in understanding and management of functional neurological disorders (FNDs) that could be negatively impacting its incidence, prevalence, prognosis, and preventive tools. A narrative review was performed to synthetize evidence from multiple fields including genetic, epidemiological, functional neuroimaging and clinical studies, paying close attention to FND historical trends and recurring themes in nomenclature, classification, epidemiology, therapeutic tools, outcomes, prognosis, and pathophysiology. References included in this review were sourced from PubMed, covering January 1, 2000 to June 30, 2022, and from the references of relevant articles. Multiple problems associated with the current status of approach and management of FNDs were identified, including six major knowledge gaps. To overcome such shortfalls, we recommend the collaborative creation of a multi-network management algorithm that integrates all pathophysiological mechanisms involved in FND onset and perpetuation. It is hoped that an integrative model will facilitate the development of a biographically focused, biopsychosocial-spiritual management and preventive protocol, which incorporates key concepts and skills from the fields of neurology, psychiatry, psychology, and physiotherapy. Such comprehensive and concise protocol could be distributed through upskill programs across several medical specialties. Multidisciplinary collaboration is needed to fill current knowledge gaps, with multispecialty teams helping to overcome the deficits in outcomes and prognosis still affecting FND, one of the commonest and most expensive neurological disorders currently affecting humankind. J Neurol Res. 2023;13(1):12-32 doi: https://doi.org/10.14740/jnr754
{"title":"Functional Neurological Disorder: Historical Trends and Urgent Directions","authors":"Yadira Velazquez-Rodriquez, Brooke Fehily","doi":"10.14740/jnr754","DOIUrl":"https://doi.org/10.14740/jnr754","url":null,"abstract":"The objective was to identify the gaps in understanding and management of functional neurological disorders (FNDs) that could be negatively impacting its incidence, prevalence, prognosis, and preventive tools. A narrative review was performed to synthetize evidence from multiple fields including genetic, epidemiological, functional neuroimaging and clinical studies, paying close attention to FND historical trends and recurring themes in nomenclature, classification, epidemiology, therapeutic tools, outcomes, prognosis, and pathophysiology. References included in this review were sourced from PubMed, covering January 1, 2000 to June 30, 2022, and from the references of relevant articles. Multiple problems associated with the current status of approach and management of FNDs were identified, including six major knowledge gaps. To overcome such shortfalls, we recommend the collaborative creation of a multi-network management algorithm that integrates all pathophysiological mechanisms involved in FND onset and perpetuation. It is hoped that an integrative model will facilitate the development of a biographically focused, biopsychosocial-spiritual management and preventive protocol, which incorporates key concepts and skills from the fields of neurology, psychiatry, psychology, and physiotherapy. Such comprehensive and concise protocol could be distributed through upskill programs across several medical specialties. Multidisciplinary collaboration is needed to fill current knowledge gaps, with multispecialty teams helping to overcome the deficits in outcomes and prognosis still affecting FND, one of the commonest and most expensive neurological disorders currently affecting humankind. J Neurol Res. 2023;13(1):12-32 doi: https://doi.org/10.14740/jnr754","PeriodicalId":16489,"journal":{"name":"Journal of Neurology Research","volume":"87 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135638341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This review discusses mechanisms for the development of cerebral aneurysms. Endothelial cells exhibit a variety of structural and functional changes when they come into contact with normal laminar flow. In response to laminar shear stress, endothelial cells modify their potassium ion channels, go through cytoskeletal rearrangements and shape modifications and create prostacyclin. In cerebral arteries, aneurysmal dilatation most frequently starts at locations with substantial wall shear stress, which include arterial bifurcations and vascular branch sites, where blood flow abruptly switches to turbulent flow. At this point, high shear stress frequently arises, placing increased strain on the vasculature. As the vascular branch points and arterial bifurcations are the initial sites of cerebral aneurysm genesis, this helps confirm the role of high wall shear stress in the development of cerebral aneurysms. Low wall shear stress increases the initial proinflammatory effect already present in the vasculature, which furthers the formation of cerebral aneurysms. In fact, regions of aneurysmal regions with low wall shear stress grow more quickly and are more prone to rupture compared to regions with high wall shear stress. Therefore, it seems plausible to assume that turbulent blood flow inside a dilated cerebral aneurysm causes low wall shear stress, thereby encouraging aneurysmal growth. J Neurol Res. 2023;13(1):1-11 doi: https://doi.org/10.14740/jnr749
{"title":"High Wall Shear Incites Cerebral Aneurysm Formation and Low Wall Shear Stress Propagates Cerebral Aneurysm Growth","authors":"Vivig Shantha Kumar, Vignarth Shantha Kumar","doi":"10.14740/jnr749","DOIUrl":"https://doi.org/10.14740/jnr749","url":null,"abstract":"This review discusses mechanisms for the development of cerebral aneurysms. Endothelial cells exhibit a variety of structural and functional changes when they come into contact with normal laminar flow. In response to laminar shear stress, endothelial cells modify their potassium ion channels, go through cytoskeletal rearrangements and shape modifications and create prostacyclin. In cerebral arteries, aneurysmal dilatation most frequently starts at locations with substantial wall shear stress, which include arterial bifurcations and vascular branch sites, where blood flow abruptly switches to turbulent flow. At this point, high shear stress frequently arises, placing increased strain on the vasculature. As the vascular branch points and arterial bifurcations are the initial sites of cerebral aneurysm genesis, this helps confirm the role of high wall shear stress in the development of cerebral aneurysms. Low wall shear stress increases the initial proinflammatory effect already present in the vasculature, which furthers the formation of cerebral aneurysms. In fact, regions of aneurysmal regions with low wall shear stress grow more quickly and are more prone to rupture compared to regions with high wall shear stress. Therefore, it seems plausible to assume that turbulent blood flow inside a dilated cerebral aneurysm causes low wall shear stress, thereby encouraging aneurysmal growth. J Neurol Res. 2023;13(1):1-11 doi: https://doi.org/10.14740/jnr749","PeriodicalId":16489,"journal":{"name":"Journal of Neurology Research","volume":"107 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135638219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The association between diabetic neuropathy, cognitive impairment, and sexual dysfunction together in patients with diabetes mellites (DM) is not assessed in prior studies. This study aimed to investigate the association between all these microvascular complications of DM. Methods: A cross-sectional study was conducted on 162 participants (110 diabetic patients and 52 non-diabetic subjects). Neuropathy was evaluated by neuropathy disability score (NDS) and neuropathy symptom score (NSS). Nerve conduction study (NCS), sural and radial sensory nerve action potential, sural/radial nerve amplitude ratio (SRAR), and tibial compound muscle action potential were measured. Participants underwent cognitive and sexual assessments by Montreal cognitive assessment (MoCA), Beck depression score, female sexual function index, and the male sexual function index questionnaires. Results: Both groups showed a decline in cognitive functions; however, diabetic patients had a significantly lower score in MoCA compared to the non-diabetic group (mean ± standard deviation: 20.98 ± 5.07, 23.17 ± 4.47; P value < 0.001). No statistical difference was observed regarding sexual activity (P value = 0.12 and 0.39 for female and male sexual function index), and Beck score (mean ± standard deviation: 8.56 ± 6.47, 8.96 ± 4.74; P value = 0.451) between the two groups. The NCS parameters were notably different in both groups. There were no differences between NCS, NDS, and NSS findings and sexual function. Conclusions: Our data suggest that NCS parameters, even SRAR, do not necessarily correlate with cognitive performance and sexual function. Sexual dysfunction was not correlated with diabetic neuropathy, but clinical findings of NDS and NSS showed a modestly negative correlation with cognitive function. J Neurol Res. 2023;13(1):50-55 doi: https://doi.org/10.14740/jnr752
{"title":"Measurement of Electrophysiology, Sexual Dysfunction, and Cognitive Impairment in Patients With Diabetes Referred for Neuropathy Symptoms: A Case-Control Study","authors":"Leila Simani, Muhanna Kazempour, Mahtab Ramezani, Faezeh Maghsudloo, Hasan Kazazi, Sahar Abedi, Zahra Fatehi, Fatemeh Ghorbani, Ehsan Karimialavijeh","doi":"10.14740/jnr752","DOIUrl":"https://doi.org/10.14740/jnr752","url":null,"abstract":"Background: The association between diabetic neuropathy, cognitive impairment, and sexual dysfunction together in patients with diabetes mellites (DM) is not assessed in prior studies. This study aimed to investigate the association between all these microvascular complications of DM. Methods: A cross-sectional study was conducted on 162 participants (110 diabetic patients and 52 non-diabetic subjects). Neuropathy was evaluated by neuropathy disability score (NDS) and neuropathy symptom score (NSS). Nerve conduction study (NCS), sural and radial sensory nerve action potential, sural/radial nerve amplitude ratio (SRAR), and tibial compound muscle action potential were measured. Participants underwent cognitive and sexual assessments by Montreal cognitive assessment (MoCA), Beck depression score, female sexual function index, and the male sexual function index questionnaires. Results: Both groups showed a decline in cognitive functions; however, diabetic patients had a significantly lower score in MoCA compared to the non-diabetic group (mean ± standard deviation: 20.98 ± 5.07, 23.17 ± 4.47; P value < 0.001). No statistical difference was observed regarding sexual activity (P value = 0.12 and 0.39 for female and male sexual function index), and Beck score (mean ± standard deviation: 8.56 ± 6.47, 8.96 ± 4.74; P value = 0.451) between the two groups. The NCS parameters were notably different in both groups. There were no differences between NCS, NDS, and NSS findings and sexual function. Conclusions: Our data suggest that NCS parameters, even SRAR, do not necessarily correlate with cognitive performance and sexual function. Sexual dysfunction was not correlated with diabetic neuropathy, but clinical findings of NDS and NSS showed a modestly negative correlation with cognitive function. J Neurol Res. 2023;13(1):50-55 doi: https://doi.org/10.14740/jnr752","PeriodicalId":16489,"journal":{"name":"Journal of Neurology Research","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135638221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Komal Usha Chowdary Madineni, Naveen Prasad S V, Vengamma Bhuma
Background: Multiple sclerosis (MS) is a chronic autoimmune, inflammatory, demyelinating disease of the central nervous system (CNS) mediated by an inappropriate immune response within the body against the insulating myelin sheath. Methods: Between January 2016 and March 2019, 20 diagnosed cases of MS were recruited for the study. Patient history was collected using a pre-designed standardized clinical proforma. Results: The outcomes of the present study reveal a resemblance of MS patterns in Andhra Pradesh with India and with the West. MS is more common in women. The second and third decades are the most common. The incidence of the disease decreased with age. In comparison to relapsing-remitting MS (RRMS), primary-progressive MS (PPMS) had a younger onset age. The most common type of MS is RRMS. Individuals had different relapse rates. Relapses are more common in patients who first develop the disease at a young age. In PPMS patients, oligoclonal band (OCB) positivity is higher than in RRMS patients. A considerable number of individuals exhibited aberrant visual evoked potential (VEP) even in the absence of visual complaints. Disease-modifying drugs decreased the disease frequency and severity. Patients who started these drugs after 1 - 2 relapses had good results. Conclusion: According to the findings, larger data sets are needed to completely characterize disease patterns. Given the rising prevalence of MS across India, it has become necessary to establish regional and national MS registries. J Neurol Res. 2023;13(1):43-49 doi: https://doi.org/10.14740/jnr750
{"title":"The Clinical Spectrum of Multiple Sclerosis in a Tertiary Care Hospital","authors":"Komal Usha Chowdary Madineni, Naveen Prasad S V, Vengamma Bhuma","doi":"10.14740/jnr750","DOIUrl":"https://doi.org/10.14740/jnr750","url":null,"abstract":"Background: Multiple sclerosis (MS) is a chronic autoimmune, inflammatory, demyelinating disease of the central nervous system (CNS) mediated by an inappropriate immune response within the body against the insulating myelin sheath. Methods: Between January 2016 and March 2019, 20 diagnosed cases of MS were recruited for the study. Patient history was collected using a pre-designed standardized clinical proforma. Results: The outcomes of the present study reveal a resemblance of MS patterns in Andhra Pradesh with India and with the West. MS is more common in women. The second and third decades are the most common. The incidence of the disease decreased with age. In comparison to relapsing-remitting MS (RRMS), primary-progressive MS (PPMS) had a younger onset age. The most common type of MS is RRMS. Individuals had different relapse rates. Relapses are more common in patients who first develop the disease at a young age. In PPMS patients, oligoclonal band (OCB) positivity is higher than in RRMS patients. A considerable number of individuals exhibited aberrant visual evoked potential (VEP) even in the absence of visual complaints. Disease-modifying drugs decreased the disease frequency and severity. Patients who started these drugs after 1 - 2 relapses had good results. Conclusion: According to the findings, larger data sets are needed to completely characterize disease patterns. Given the rising prevalence of MS across India, it has become necessary to establish regional and national MS registries. J Neurol Res. 2023;13(1):43-49 doi: https://doi.org/10.14740/jnr750","PeriodicalId":16489,"journal":{"name":"Journal of Neurology Research","volume":"181 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135638226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Evidence of seasonal variations in the number of stroke admission is inconsistent with some studies reporting no association and some a significant rise in different months of the year. In addition, less is known about how seasonality impacts the admission according to stroke subtype. Methods: This was a cross-sectional, observational study of data from a hospital-based registry (n = 40 hospitals) affiliated with Providence Health and Services in Alaska, California, Montana, Oregon, Texas, and Washington state. We included all cases with acute ischemic stroke admitted from March 1, 2017, to February 29, 2020. Admission data were categorized according to four meteorological seasons: winter, spring, summer, and fall. Acute ischemic stroke was categorized into two sub-types as large vessel occlusion (LVO) or non-LVO. We calculated the aggregate number of individuals admitted with stroke by season. Using linear regression models with generalized estimating equations (GEEs), we assessed the relationship between meteorological season and daily hospitalization number. We used R version 4.0.4 (2021-02-15) for both the descriptive and inferential analyses and the R gee pack package (version 1.2-1) to perform GEEs. Results: During the study period, we identified 18,886 patients with acute ischemic stroke (median age: 73; 48.7% women). Acute ischemic stroke was more commonly observed during winter compared with other seasons with some variations between the selected regions. Based on a GEE model, stroke hospitalization increased during winter, with an additional 3.3 cases per day in comparison with spring in the whole population (beta: 3.3, 95% confidence interval (CI): (2.4, 4.1), P < 0001). Winter is also associated with a higher number of LVO. Conclusions: The total number of ischemic stroke admissions, including cases of LVO, increased during the winter months. The results are important for human resource allocation for better management of cases with ischemic strokes. J Neurol Res. 2023;13(1):33-42 doi: https://doi.org/10.14740/jnr745
背景:季节性卒中入院人数变化的证据不一致，一些研究报告没有关联，一些研究报告在一年中的不同月份显著上升。此外，季节性因素对脑卒中亚型入院的影响尚不清楚。方法:这是一项横断面观察性研究，数据来自阿拉斯加、加利福尼亚州、蒙大拿州、俄勒冈州、德克萨斯州和华盛顿州普罗维登斯健康服务中心附属的医院登记(n = 40家医院)。我们纳入了2017年3月1日至2020年2月29日收治的所有急性缺血性卒中病例。录取数据按冬、春、夏、秋四个气象季节进行分类。急性缺血性脑卒中分为大血管闭塞(LVO)和非大血管闭塞(LVO)两种亚型。我们按季节计算了中风入院的总人数。利用广义估计方程(GEEs)的线性回归模型，评估了气象季节与日住院人数之间的关系。我们使用R版本4.0.4(20121-02-15)进行描述性和推断性分析，并使用R gee pack包(版本1.2-1)执行GEEs。结果:在研究期间，我们确定了18886例急性缺血性卒中患者(中位年龄:73岁;48.7%的女性)。与其他季节相比，急性缺血性中风在冬季更为常见，并且在所选地区之间存在一定差异。根据GEE模型，冬季卒中住院人数增加，与春季相比，整个人群每天增加3.3例(β值:3.3,95%置信区间(CI):(2.4, 4.1)， P <0001)。冬季也与较高的LVO数量有关。结论:缺血性卒中住院总人数，包括LVO病例，在冬季有所增加。研究结果对人力资源配置、更好地管理缺血性脑卒中病例具有重要意义。中华神经科杂志，2013;13(1):33-42 doi: https://doi.org/10.14740/jnr745
{"title":"Seasonal Variation in Ischemic Stroke Hospitalization: Results From a Large Health System in Six Western States of the United States","authors":"Reza Bavarsad Shahripour, Datis Azarpazhooh, Elizabeth Baraban, Horia Marginean, Sima Osouli Meinagh, Sholeh Faezi, Jasen Tarpley","doi":"10.14740/jnr745","DOIUrl":"https://doi.org/10.14740/jnr745","url":null,"abstract":"Background: Evidence of seasonal variations in the number of stroke admission is inconsistent with some studies reporting no association and some a significant rise in different months of the year. In addition, less is known about how seasonality impacts the admission according to stroke subtype. Methods: This was a cross-sectional, observational study of data from a hospital-based registry (n = 40 hospitals) affiliated with Providence Health and Services in Alaska, California, Montana, Oregon, Texas, and Washington state. We included all cases with acute ischemic stroke admitted from March 1, 2017, to February 29, 2020. Admission data were categorized according to four meteorological seasons: winter, spring, summer, and fall. Acute ischemic stroke was categorized into two sub-types as large vessel occlusion (LVO) or non-LVO. We calculated the aggregate number of individuals admitted with stroke by season. Using linear regression models with generalized estimating equations (GEEs), we assessed the relationship between meteorological season and daily hospitalization number. We used R version 4.0.4 (2021-02-15) for both the descriptive and inferential analyses and the R gee pack package (version 1.2-1) to perform GEEs. Results: During the study period, we identified 18,886 patients with acute ischemic stroke (median age: 73; 48.7% women). Acute ischemic stroke was more commonly observed during winter compared with other seasons with some variations between the selected regions. Based on a GEE model, stroke hospitalization increased during winter, with an additional 3.3 cases per day in comparison with spring in the whole population (beta: 3.3, 95% confidence interval (CI): (2.4, 4.1), P < 0001). Winter is also associated with a higher number of LVO. Conclusions: The total number of ischemic stroke admissions, including cases of LVO, increased during the winter months. The results are important for human resource allocation for better management of cases with ischemic strokes. J Neurol Res. 2023;13(1):33-42 doi: https://doi.org/10.14740/jnr745","PeriodicalId":16489,"journal":{"name":"Journal of Neurology Research","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135638217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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