Annals of Indian Academy of Neurology最新文献

Background and objectives: Secondary Prevention by Structured Semi-Interactive Stroke Prevention Package in India (SPRINT INDIA) trial was a randomized control trial that enrolled 4298 stroke patients and administered educational interventions at 31 centers across India, with the aim to reduce recurrent stroke through increased stroke knowledge. This SPRINT INDIA trial post hoc study aims to investigate the incidence of recurrent stroke, high-risk transient ischemic attack (TIA), acute coronary syndrome (ACS), death, and lifestyle behavioral factors at 1 year. In addition, it examines the relationship between patients' baseline characteristics and education levels, risk factors, and outcomes and performs subgroup analysis within the intervention and control groups.

Methods: Participants were randomly assigned (1:1) to either intervention or control group through computer-based randomization on web. Intervention included stroke prevention Short Message Service messages, short-duration videos, and printed workbooks. Baseline assessments captured demographic and educational data, classifying patients into three categories: no schooling, less than high school, and high school or above. Primary outcome was a composite of recurrent stroke, high-risk TIA, ACS, and mortality at 1 year. Chi-square tests and analysis of variance were used to evaluate educational disparities across various variables.

Results: The intervention did not reduce primary outcomes at 1 year among patients with different educational levels. Higher educational group was associated with enhanced medication adherence (94.3% vs 85.4%; P < 0.001), increased physical activity (5497.91 ± 4117.7 vs 6169.91±4828.8; P < 0.001), lower triglyceride levels, and decreased engagement in behavioral risk factors like alcohol intake (5.1% vs 6.8%; P = 0.013) and tobacco use (smoked and chewed) (4% vs 7.9%; P < 0.001 and 5.8% vs 11.6%; P = 0.020).

Conclusions: Personalized secondary stroke prevention, tailored to educational levels, is crucial for effective stroke management.

Posterior inferior cerebellar artery (PICA) occlusion (with or without vertebral artery occlusion) may result in severe disability and even mortality. Patients who underwent mechanical thrombectomy (MT) for PICA occlusion (with or without vertebral artery occlusion) between 2021 and 2023 were included in the study. All five patients who underwent MT were male, aged between 45 and 68 years, with National Institute of Health Stroke Scale scores ranging from 3 to 10. The successful recanalization rate in our cases with PICA occlusion was 60%. As the MT technique, an isolated stent retriever was used in two cases, and a combined technique was used in three cases. Retrograde approach (via asymptomatic vertebral artery) was used in two cases, and an anterograde approach was used in three cases. Two cases had isolated PICA occlusion, and three cases had PICA occlusion with vertebral artery involvement. MT is a treatment option that should be considered in PICA occlusions causing severe disability.

Background objectives: Remote memory assessment in epilepsy is often limited by challenges in construct and measurement. We aimed to study quantified autobiographical memory (AM) scores in patients with temporal lobe epilepsy (TLE) and idiopathic generalized epilepsy (IGE), as well as healthy controls.

Methods: We studied 30 patients in each of three groups - TLE, IGE, and healthy controls. Standardized tests were used to assess the intelligence quotient, verbal memory, and visual memory. AM Interview (AMI) was used to assess total AM as well as AM sub-scores. Automated volumetric imaging was done to assess grey matter volumes in areas of interest. ANOVA was used to compare memory scores across the groups.

Results: Verbal and visual memory scores were lower in TLE compared to controls. Total AMI scores were lower in TLE and IGE when compared to controls. Total personal semantic AMI and total autobiographical incidents-AMI scores were lower in both IGE and TLE compared to controls. Recent life personal semantic AMI was lower in both TLE and IGE compared to controls, while other sub-scores were similar in all three groups. Childhood personal semantic memory scores were significantly correlated with right hippocampal and amygdala grey matter volumes, while total autobiographical AMI scores correlated with hippocampal grey matter volumes in IGE.

Conclusions: This study demonstrates AM deficits in persons with epilepsy. Further studies are required to clarify the AMI deficits in right and left TLE, as well as post-resective surgery for TLE.

Background and objectives: Sarcopenia is associated with an increased risk of cognitive impairment. The current study aims to explore the cognitive profiles of individuals with sarcopenia in an urban Indian cohort.

Methods: Cognitively healthy participants (N = 1119) aged ≥45 years from the Tata Longitudinal Study of Aging were considered for the study. Sarcopenia was screened using two parameters: calf circumference (M < 34 cm, F < 33 cm) and handgrip strength (M < 28 kg, F < 18 kg). Based on these, participants were classified into three groups, namely healthy (satisfying neither criterion), intermediate (satisfying one criterion), and sarcopenia (satisfying both criteria). Detailed clinical assessments were done. Cognitive functioning was assessed using the Hindi Mental State Examination and Addenbrooke's Cognitive Examination-III (ACE-III).

Results: The mean age of the participants was 62.03 ± 9.33 years. Of these, 405 (36.2%) participants were healthy controls, 502 (44.9%) were in the intermediate group, and 212 (18.9%) participants belonged to the sarcopenia group. Sarcopenia was significantly associated with diabetes. A generalized linear model, adjusted for sociodemographic features and comorbidities, revealed that the intermediate group had lower scores in the ACE-III fluency test ( P = 0.025), while the sarcopenia group had lower scores in the ACE-III total ( P = 0.002), ACE-III attention ( P = 0.031), and ACE-III fluency ( P < 0.001) tests when compared to the healthy group.

Conclusions: Our study found an important link between sarcopenia and impaired cognitive performance, particularly in attention and verbal fluency. These findings highlight the importance of early detection and interventions targeting physical activity and nutrition, with an effort to mitigate or prevent age-related muscle loss and cognitive impairment.