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1.
Neuropsychology ; 35(3): 310-322, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33970664

RESUMEN

Objective: Right brain-damaged patients may show omissions and/or additional marks in target cancellation. The latter is classified as perseverative behavior and has been attributed to defective response inhibition or attentional disengagement deficit. This study aimed at (a) verifying that consecutive (immediate) and return (temporally distant) motor perseverations could be due to different mechanisms; (b) investigating the relationships among different types of perseveration (e.g., consecutive, return, scribble), spatial neglect and the impairment in specific components of executive functioning. Method: Seventeen right brain-damaged patients underwent letter, star, bell, and apple cancellation tasks. A global index for each type of perseveration found and Mean Position of Hits, as a neglect index, were calculated. The following components of executive functioning were evaluated: motor programming (Frontal Assessment Battery [FAB] subtest), inhibitory control FAB, interference sensitivity (FAB and Stroop color-word interference test), set-shifting (Weigl sorting test, Phonemic/semantic alternate fluencies), and working memory (Backward Digit span). Results: Ten patients out of 17 showed some degree of perseveration. Regularized linear regression analyses demonstrated that interference sensitivity and Stroop test performances were related to return perseverations and backward digit to scribble ones. No significant relationships were found for consecutive perseverations and between neglect and any type of perseverations. Conclusions: The present study showed that return perseverations might have a distinct etiology from consecutive ones, being related to an inability to update and shift between action programs according to the visual stimuli. A finer classification of perseverations could help in unveiling the neuropsychological mechanisms underlying each type of behavior. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Asunto(s)
Lesiones Encefálicas/fisiopatología , Lateralidad Funcional , Trastornos de la Percepción/fisiopatología , Adulto , Anciano , Anciano de 80 o más Años , Lesiones Encefálicas/psicología , Isquemia Encefálica/fisiopatología , Isquemia Encefálica/psicología , Neoplasias Encefálicas/fisiopatología , Neoplasias Encefálicas/psicología , Corteza Cerebral , Función Ejecutiva , Femenino , Humanos , Hemorragias Intracraneales/fisiopatología , Hemorragias Intracraneales/psicología , Masculino , Memoria a Corto Plazo , Persona de Mediana Edad , Pruebas Neuropsicológicas , Trastornos de la Percepción/psicología , Estudios Prospectivos , Desempeño Psicomotor/fisiología , Test de Stroop
2.
J Alzheimers Dis ; 80(1): 331-335, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33523013

RESUMEN

BACKGROUND: Cerebral microbleeds (CMBs) in patients with Parkinson's disease (PD) or dementia with Lewy bodies (DLB) have not been adequately studied. OBJECTIVE: This study aims to find a difference in the total number, prevalence, and common locations of CMBs between PD and DLB and evaluate 99 mTc-ECD SPECT subtraction images of these two diseases. METHODS: We examined 112 patients with PD (53 males and 59 females; age: 77.4±3.6 years) and 28 age-matched patients with DLB (15 males and 13 females; age: 77.1±6.7 years) using brain magnetic resonance imaging (MRI) and 99 mTc-ECD SPECT subtraction imaging. RESULTS: The total number of CMBs was higher in patients with DLB (41.2%) than in those with PD (11.5%), and the prevalence was significantly higher in the former (0.7±1.1) than the latter (0.2±0.5, p < 0.05). The odds ratio was 5.4 (95% confidence interval [CI]: 1.7-17.4). Furthermore, CMBs were commonly located in the basal ganglia of patients with PD (6 out of 87 patients) but in the occipital lobe of patients with DLB (8 out of 17 patients). 99 mTc-ECD SPECT subtraction imaging indicated lower cerebral blood flow in the posterior cingulate gyrus among the patients with CMB-positive DLB than among those with CMB-positive PD; additionally, the cerebral blood flow was lower in the bilateral basal ganglia and midbrain among patients with CMB-positive DLB compared to those with CMB-negative DLB. CONCLUSION: A reduction in occipital glucose metabolism may be related to CMBs in the occipital lobe of patients with DLB.


Asunto(s)
Hemorragias Intracraneales/diagnóstico por imagen , Enfermedad por Cuerpos de Lewy/diagnóstico por imagen , Enfermedad de Parkinson/diagnóstico por imagen , Anciano , Anciano de 80 o más Años , Angiografía de Substracción Digital , Ganglios Basales/diagnóstico por imagen , Circulación Cerebrovascular , Cisteína/análogos & derivados , Femenino , Glucosa/metabolismo , Giro del Cíngulo/diagnóstico por imagen , Humanos , Hemorragias Intracraneales/complicaciones , Hemorragias Intracraneales/psicología , Enfermedad por Cuerpos de Lewy/complicaciones , Enfermedad por Cuerpos de Lewy/psicología , Angiografía por Resonancia Magnética , Masculino , Pruebas de Estado Mental y Demencia , Mesencéfalo/diagnóstico por imagen , Pruebas Neuropsicológicas , Lóbulo Occipital/diagnóstico por imagen , Compuestos de Organotecnecio , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/psicología , Prevalencia , Tomografía Computarizada de Emisión de Fotón Único
3.
J Stroke Cerebrovasc Dis ; 29(9): 105082, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32807479

RESUMEN

BACKGROUND: There is relatively limited information on the risk factors and outcome of new onset Poststroke Anxiety (PSA) in Low- and Middle-Income Countries. We estimated incidence, cumulative incidence, risk factors and outcome of new onset anxiety in the first year of stroke among African stroke survivors. METHODS: We analyzed the dataset of a completed clinical trial comprising patients enrolled to test an intervention designed to improve one-year blood pressure control among recent (≤ one month) stroke survivors in Nigeria. Anxiety was measured using the Hospital Anxiety and Depression Scale. Outcomes were assessed using the modified Rankin Scale (mRS), Community screening instrument for dementia (CSID) and Health Related Quality of Life in Stroke Patients (HRQOLISP-26). RESULTS: Among 322 stroke survivors who were free of anxiety at baseline, we found a one-year cumulative incidence of 34% (95% CI = 28.6-39.3). Rates were 36.2% (95% CI =29.6-42.7) for men and 29.2% (95% CI =19.9-38.3) for women. In multivariate Cox regression analyses, haemorrhagic stroke type was associated with higher risk of new onset PSA (Hazard Ratio=1.52, 95% CI =1.01-2.29). New onset PSA was independently associated with cognitive [(mean difference (MD) in CSID scores=1.1, 95% C.I=0.2, 1.9)] and motor decline (MD in mRS scores= -0.2, 95% C.I= -0.4, -0.02), as well as poorer quality of life overtime (MD in total HRQOLISP-26 scores=3.6, 95% C.I=1.0, 6.2). CONCLUSION: One in 3 stroke survivors in Nigeria had PSA at one year. Clinicians in SSA should pay special attention to survivors of haemorrhagic stroke as they are at higher risk of incident anxiety and therefore its consequences.


Asunto(s)
Ansiedad/psicología , Población Negra/psicología , Hemorragias Intracraneales/psicología , Accidente Cerebrovascular/psicología , Anciano , Ansiedad/diagnóstico , Ansiedad/etnología , Ansiedad/fisiopatología , Cognición , Evaluación de la Discapacidad , Emociones , Femenino , Humanos , Incidencia , Hemorragias Intracraneales/diagnóstico , Hemorragias Intracraneales/etnología , Hemorragias Intracraneales/fisiopatología , Masculino , Persona de Mediana Edad , Actividad Motora , Nigeria/epidemiología , Pronóstico , Calidad de Vida , Medición de Riesgo , Factores de Riesgo , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/etnología , Accidente Cerebrovascular/fisiopatología , Encuestas y Cuestionarios , Factores de Tiempo
4.
J Stroke Cerebrovasc Dis ; 29(2): 104582, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31859033

RESUMEN

BACKGROUND AND PURPOSE: Post-stroke anxiety (PSA) is common and disabling. PSA should be considered as an important outcome in stroke. However, there is a lack of understanding of factors that may be linked to PSA. The purpose of this study was to determine the frequency of PSA and sociodemographic and clinical factors associated with PSA in a cohort of racially and ethnically diverse stroke patients. METHODS: We conducted a retrospective study of ischemic and hemorrhagic stroke patients seen in a stroke outpatient clinic from August 1, 2017 to June 30, 2018. Patients were eligible if a Generalized Anxiety Disorder 7-Item (GAD-7) instrument was available. GAD-7 scores greater than or equal to 10 indicated the presence of moderate to severe PSA. Multivariable logistic regression was used to identify independent sociodemographic and clinical factors associated with PSA. RESULTS: Records from 289 stroke patients with a GAD-7 instrument were analyzed. PSA was common (21%; GAD-7 ≥ 10). Fifty-seven percent of females had a GAD-7 greater than or equal to 10 compared to 41% of females who had a GAD-7 less than 10 (P = .03). Multivariable analysis found that self-reported nonmarried status (odds ratio, 3.27; 95% confidence interval, 1.44-7.44), excessive fatigue (odds ratio, 4.46; 95% confidence interval, 1.87-10.63), and depression (odds ratio, 1.24; 95% confidence interval, 1.16-1.33) were independently associated with PSA. CONCLUSIONS: PSA may occur more frequently in those who report non-married, excessive fatigue, or depression. Trials of PSA interventions should consider the potential impact of social support, depression, and comorbid conditions contributing to post-stroke fatigue, including sleep apnea.


Asunto(s)
Ansiedad/psicología , Isquemia Encefálica/psicología , Hemorragias Intracraneales/complicaciones , Ataque Isquémico Transitorio/psicología , Accidente Cerebrovascular/psicología , Adulto , Anciano , Ansiedad/diagnóstico , Ansiedad/epidemiología , Isquemia Encefálica/diagnóstico , Isquemia Encefálica/epidemiología , Comorbilidad , Depresión/epidemiología , Depresión/psicología , Fatiga/epidemiología , Fatiga/psicología , Femenino , Humanos , Hemorragias Intracraneales/diagnóstico , Hemorragias Intracraneales/psicología , Ataque Isquémico Transitorio/diagnóstico , Ataque Isquémico Transitorio/epidemiología , Masculino , Salud Mental , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Persona Soltera/psicología , Aislamiento Social , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/epidemiología , Texas/epidemiología
5.
J Neuropsychol ; 13(3): 432-461, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-29667317

RESUMEN

The results of previous studies are inconsistent in regard to the relationship between the Iowa Gambling Task (IGT), working-memory (WM), and executive tasks, and whether these cognitive processes could be considered as mechanisms underlying a decision-making deficit. Moreover, the relationship between the IGT and executive measures is examined based on a limited number of executive tasks, within different populations showing diffuse damage. In addition, there are fewer studies carried out within control participants, with those studies also being inconclusive. It is also suggested that the association of the IGT performance with executive tasks depends on whether the IGT was running under ambiguity or under risk. In this work, all of these issues are studied. Results showed that both patients with ventromedial (VMPFC, N = 10) and dorsolateral (DLPFC, N = 10) prefrontal cortex lesions are significantly impaired on almost all executive tasks, WM tasks, and the IGT. Furthermore, when the IGT is run under risk, there are significant correlations between executive measures and the IGT for the DLPFC patients and the control participants (N = 34) but not the VMPFC patients. No correlation was found between WM tasks and the IGT for both frontal subgroups and control participants. These findings suggested that the mechanisms underlying the IGT deficit differ according to the lesion locations.


Asunto(s)
Toma de Decisiones , Función Ejecutiva , Juego de Azar/psicología , Memoria a Corto Plazo , Pruebas Neuropsicológicas , Corteza Prefrontal/lesiones , Adulto , Contusión Encefálica/patología , Contusión Encefálica/psicología , Neoplasias Encefálicas/patología , Neoplasias Encefálicas/psicología , Femenino , Humanos , Hemorragias Intracraneales/patología , Hemorragias Intracraneales/psicología , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Corteza Prefrontal/diagnóstico por imagen , Corteza Prefrontal/patología , Desempeño Psicomotor , Adulto Joven
6.
Neuroreport ; 29(15): 1239-1243, 2018 10 17.
Artículo en Inglés | MEDLINE | ID: mdl-30096131

RESUMEN

Hemorrhagic stroke is a major risk factor for cognitive impairment. Our study aimed to measure the effect of ginkgo biloba extract (EGB761) on the cognitive ability and inflammatory expression in hemorrhagic stroke model SD rats and to analyze their relationship. Forty SD rats were divided randomly into an SD group (normal control SD rats), an SD+EGB761 group (normal control SD rats supplemented with 45 mg/kg EGB761), a CO group (hemorrhagic stroke model SD rats using collagenase), and a CO+EGB761 group (hemorrhagic stroke model SD rats supplemented with 45 mg/kg EGB761) consisting of 10 rats, respectively. The Y-electric maze test was selected to measure the cognitive function in four groups. Furthermore, enzyme-linked immunosorbent assay and real-time PCR were, respectively, applied for detecting the protein and gene expression profiles of inflammatory factors in primary cultured microglia. Compared with rats in the SD group, the average time of electrical simulation for mastering criteria was prolonged in the CO group (P<0.05). Furthermore, expression levels of proinflammatory cytokines interleukin-1ß (IL-1ß), IL-6, and tumor necrosis factor-α and anti-inflammatory cytokines IL-4, IL-10, and tumor necrosis factor-ß were significantly increased and decreased, respectively, in rats of the CO group compared with the SD group (P<0.05). The results of electrical simulation time, inflammatory factors protein, and gene expression profile in rats of the CO+EGB761 group compared with the CO group were opposite to above contrast (P<0.05). Ginkgo biloba extract could alleviate the cognitive dysfunction after hemorrhagic stroke in SD rats; this is associated with regulating the expression of inflammatory factors secreted by microglia.


Asunto(s)
Antiinflamatorios no Esteroideos/farmacología , Cognición/efectos de los fármacos , Hemorragias Intracraneales/tratamiento farmacológico , Nootrópicos/farmacología , Extractos Vegetales/farmacología , Accidente Cerebrovascular/tratamiento farmacológico , Animales , Células Cultivadas , Cognición/fisiología , Disfunción Cognitiva/tratamiento farmacológico , Disfunción Cognitiva/inmunología , Disfunción Cognitiva/patología , Modelos Animales de Enfermedad , Expresión Génica/efectos de los fármacos , Ginkgo biloba , Hemorragias Intracraneales/inmunología , Hemorragias Intracraneales/patología , Hemorragias Intracraneales/psicología , Masculino , Aprendizaje por Laberinto/efectos de los fármacos , Microglía/efectos de los fármacos , Microglía/inmunología , Microglía/patología , Distribución Aleatoria , Ratas Sprague-Dawley , Accidente Cerebrovascular/inmunología , Accidente Cerebrovascular/patología , Accidente Cerebrovascular/psicología
7.
J Cereb Blood Flow Metab ; 38(3): 433-446, 2018 03.
Artículo en Inglés | MEDLINE | ID: mdl-28318366

RESUMEN

Cerebellar haemorrhage accounts for 5-10% of all intracerebral haemorrhages and leads to severe, long-lasting functional deficits. Currently, there is limited research on this stroke subtype, which may be due to the lack of a suitable composite neuroscoring system specific for cerebellar injury in rodents. The purpose of this study is to develop a comprehensive composite neuroscore test for cerebellar injury using a rat model of cerebellar haemorrhage. Sixty male Sprague-Dawley rats were subjected to either sham surgery or cerebellar haemorrhage. Twenty-four hours post-injury, neurological behaviour was evaluated using 17 cost-effective and easy-to-perform tests, and a composite neuroscore was developed. The composite neuroscore was then used to assess functional recovery over seven days after cerebellar haemorrhage. Differences in the composite neuroscore deficits for the mild and moderate cerebellar haemorrhage models were observed for up to five days post-ictus. Until now, a composite neuroscore for cerebellar injury was not available for rodent studies. Herein, using mild and moderate cerebellar haemorrhage rat models a composite neuroscore for cerebellar injury was developed and used to assess functional deficits after cerebellar haemorrhage. This composite neuroscore may also be useful for other cerebellar injury models.


Asunto(s)
Conducta Animal/efectos de los fármacos , Enfermedades Cerebelosas/psicología , Hemorragias Intracraneales/psicología , Accidente Cerebrovascular/psicología , Animales , Agua Corporal , Química Encefálica , Enfermedades Cerebelosas/patología , Hematoma/patología , Hemorragias Intracraneales/patología , Masculino , Fuerza Muscular , Desempeño Psicomotor , Ratas , Ratas Sprague-Dawley , Recuperación de la Función , Reflejo , Accidente Cerebrovascular/patología
8.
J Neurochem ; 140(5): 776-786, 2017 03.
Artículo en Inglés | MEDLINE | ID: mdl-28054340

RESUMEN

Fingolimod, a sphingosine-1-phosphate receptor (S1PR) agonist, is clinically available to treat multiple sclerosis and is showing promise in treating stroke. We investigated if fingolimod provides long-term protection from experimental neonatal germinal matrix hemorrhage (GMH), aiming to support a potential mechanism of acute fingolimod-induced protection. GMH was induced in P7 rats by infusion of collagenase (0.3 U) into the right ganglionic eminence. Animals killed at 4 weeks post-GMH received low- or high-dose fingolimod (0.25 or 1.0 mg/kg) or vehicle, and underwent neurocognitive testing before histopathological evaluation. Subsequently, a cohort of animals killed at 72 h post-GMH received 1.0 mg/kg fingolimod; the specific S1PR1 agonist, SEW2871; or fingolimod co-administered with the S1PR1/3/4 inhibitor, VPC23019, or the Rac1 inhibitor, EHT1864. All drugs were injected intraperitoneally 1, 24, and 48 h post-surgery. At 72 h post-GMH, brain water content, extravasated Evans blue dye, and hemoglobin were measured as well as the expression levels of phospho-Akt, Akt, GTP-Rac1, Total-Rac1, ZO1, occludin, and claudin-3 determined. Fingolimod significantly improved long-term neurocognitive performance and ameliorated brain tissue loss. At 72 h post-GMH, fingolimod reduced brain water content and Evans blue dye extravasation as well as reversed GMH-induced loss of tight junctional proteins. S1PR1 agonism showed similar protection, whereas S1PR or Rac1 inhibition abolished the protective effect of fingolimod. Fingolimod treatment improved functional and morphological outcomes after GMH, in part, by tempering acute post-hemorrhagic blood-brain barrier disruption via the activation of the S1PR1/Akt/Rac1 pathway.


Asunto(s)
Clorhidrato de Fingolimod/farmacología , Hemorragias Intracraneales/tratamiento farmacológico , Fármacos Neuroprotectores/farmacología , Proteína de Unión al GTP rac1/metabolismo , Animales , Agua Corporal/metabolismo , Encéfalo/patología , Química Encefálica/efectos de los fármacos , Edema Encefálico/tratamiento farmacológico , Edema Encefálico/etiología , Cognición/efectos de los fármacos , Femenino , Hemorragias Intracraneales/metabolismo , Hemorragias Intracraneales/psicología , Recuento de Leucocitos , Masculino , Oxadiazoles/farmacología , Fosfoserina/análogos & derivados , Fosfoserina/farmacología , Embarazo , Pironas/farmacología , Quinolinas/farmacología , Ratas , Ratas Sprague-Dawley , Tiofenos/farmacología , Proteínas de Uniones Estrechas/metabolismo , Proteína de Unión al GTP rac1/antagonistas & inhibidores
9.
J Crit Care ; 36: 154-159, 2016 12.
Artículo en Inglés | MEDLINE | ID: mdl-27546765

RESUMEN

PURPOSE: The purpose of the study is to examine the associations of patients' and their informal caregivers' psychosocial resiliency factors with their own and their partners' emotion domains (distress, anxiety, depression, and anger) after admission to the neuroscience intensive care unit (Neuro-ICU). MATERIALS AND METHODS: Eighty-three dyads of patients (total n = 87) and their informal caregivers (total n = 99) participated in this observational, cross-sectional study by self-reporting demographics and measures of resiliency factors (mindfulness [Cognitive and Affective Mindfulness Scale Revised], coping [Measure of Coping Status-A], intimate bond [Intimate Bond Measure], self-efficacy [patients: General Self-Efficacy Scale; caregivers: Revised Caregiver Self-Efficacy Scale]) and emotion domains (Emotion Thermometers) within 2 weeks of Neuro-ICU admission. RESULTS: There were no differences between patients' and caregivers' levels of psychosocial resiliency, distress, or anxiety. Patients reported greater depression and anger relative to their caregivers. Overall, roughly half of patients (50.6%) and caregivers (42.4%) reported clinically significant emotional distress. Patients' and caregivers' own psychosocial resiliency factors were associated with their own, but not their partner's, emotion domains. CONCLUSIONS: Findings of high distress among both patients and caregivers at admission emphasize the importance of attending to the mental health of both patients and caregivers in the Neuro-ICU. As modifiable psychosocial resiliency factors were associated with emotion domains for both patients and caregivers, interventions to enhance these factors may ameliorate emotional distress among these vulnerable populations.


Asunto(s)
Ansiedad/psicología , Lesiones Traumáticas del Encéfalo/psicología , Neoplasias Encefálicas/psicología , Cuidadores/psicología , Depresión/psicología , Hemorragias Intracraneales/psicología , Resiliencia Psicológica , Estrés Psicológico/psicología , Accidente Cerebrovascular/psicología , Adaptación Psicológica , Adulto , Anciano , Ira , Estudios Transversales , Emociones , Femenino , Humanos , Unidades de Cuidados Intensivos , Relaciones Interpersonales , Masculino , Persona de Mediana Edad , Atención Plena , Neurociencias , Autoeficacia
10.
Int J Palliat Nurs ; 22(7): 317-23, 2016 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-27444160

RESUMEN

The provision of quality end-of-life care is essential when a neonate is dying. End-of-life care delivered in a neonatal intensive care unit (NICU) must consider the needs of both the newborn and their family. The purpose of this paper is to demonstrate how comfort theory and its associated taxonomic structure can be used as a conceptual framework for nurses and midwives providing end-of-life care to neonates and their families. Comfort theory and its taxonomic structure are presented and issues related to end-of-life care in the NICU are highlighted. A case study is used to illustrate the application of comfort theory and issues related to implementation are discussed. The delivery of end-of-life care in the NICU can be improved through the application of comfort.


Asunto(s)
Unidades de Cuidado Intensivo Neonatal , Cuidados Paliativos/métodos , Cuidado Terminal/métodos , Necesidades y Demandas de Servicios de Salud , Humanos , Recien Nacido Extremadamente Prematuro/psicología , Recién Nacido , Hemorragias Intracraneales/enfermería , Hemorragias Intracraneales/psicología , Relaciones Enfermero-Paciente , Teoría de Enfermería , Cuidados Paliativos/psicología , Relaciones Profesional-Familia , Medio Social , Apoyo Social , Cuidado Terminal/psicología , Privación de Tratamiento
11.
J Neurooncol ; 128(2): 225-33, 2016 06.
Artículo en Inglés | MEDLINE | ID: mdl-27021492

RESUMEN

Stem cell therapies are being developed for radiotherapy-induced brain injuries (RIBI). Magnetic resonance imaging (MRI) offers advantages for imaging transplanted stem cells. However, most MRI cell-tracking techniques employ superparamagnetic iron oxide particles (SPIOs), which are difficult to distinguish from hemorrhage. In current preclinical RIBI models, hemorrhage occurs concurrently with other injury markers. This makes the evaluation of the recruitment of transplanted SPIO-labeled stem cells to injury sites difficult. Here, we developed a RIBI model, with early injury markers reflective of hippocampal dysfunction, which can be detected noninvasively with MRI and behavioral tests. Lesions were generated by sub-hemispheric irradiation of mouse hippocampi with single X-ray beams of 80 Gy. Lesion formation was monitored with anatomical and contrast-enhanced MRI and changes in memory and learning were assessed with fear-conditioning tests. Early injury markers were detected 2 weeks after irradiation. These included an increase in the permeability of the blood-brain barrier, demonstrated by a 92 ± 20 % contrast enhancement of the irradiated versus the non-irradiated brain hemispheres, within 15 min of the administration of an MRI contrast agent. A change in short-term memory was also detected, as demonstrated by a 40.88 ± 5.03 % decrease in the freezing time measured during the short-term memory context test at this time point, compared to that before irradiation. SPIO-labeled stem cells transplanted contralateral to the lesion migrated toward the lesion at this time point. No hemorrhage was detected up to 10 weeks after irradiation. This model can be used to evaluate SPIO-based stem cell-tracking agents, short-term.


Asunto(s)
Escala de Evaluación de la Conducta , Aprendizaje , Imagen por Resonancia Magnética , Memoria , Traumatismos Experimentales por Radiación/diagnóstico por imagen , Traumatismos Experimentales por Radiación/psicología , Animales , Hipocampo/diagnóstico por imagen , Hipocampo/lesiones , Hipocampo/efectos de la radiación , Hemorragias Intracraneales/diagnóstico por imagen , Hemorragias Intracraneales/etiología , Hemorragias Intracraneales/psicología , Masculino , Ratones Endogámicos BALB C , Traumatismos Experimentales por Radiación/terapia , Trasplante de Células Madre , Células Madre , Rayos X
12.
Int J Clin Exp Pathol ; 8(6): 6772-8, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26261561

RESUMEN

OBJECTIVE: This study aimed to evaluate the therapeutic potential of human amniotic epithelial cell (HAEC) transplantation in the management of brain hemorrhage in an animal model. METHODS: New Zealand white rabbits were induced to develop cerebral hemorrhage through autologous blood injection. Animals with confirmed brain hemorrhage were randomized to receive transplantation of, respectively, vehicle (n=15) and primary HAECs (n=15) that were expressing embryonic stem cell- and neuron-specific markers and were transfected with a retroviral vector carrying the green fluorescent protein (GFP). Behavioral and histological changes, survival of transplanted HAECs, and expression of glial fibrillary acidic protein (GFAP) and MAP-2 in transplanted perifocal tissue were assessed at various time points after transplantation. RESULTS: At 2-3 weeks after transplantation, walking, body weight-supporting and movement coordinating capacities of limbs were improved mostly level II-III hemorrhage lesion cases in HAEC transplantation group but mostly in level I-II hemorrhage lesion cases in the vehicle control group. The Tarlov scores were significantly difference between the two groups (P<0.05). GFAP- and MAP-2-positive cells were observed in the neural tissue in animals transplanted with hAECs but not in animals in the control group (P<0.05). CONCLUSION: These preliminary observations suggest that hAEC transplantation possess both embryonic stem cell features and a neuron differentiation potential and thus may offer a promising treatment for hemorrhage-associated neurological damage.


Asunto(s)
Amnios/trasplante , Células Madre Embrionarias/trasplante , Células Epiteliales/trasplante , Hemorragias Intracraneales/cirugía , Regeneración Nerviosa , Células-Madre Neurales/trasplante , Amnios/citología , Amnios/metabolismo , Animales , Conducta Animal , Biomarcadores/metabolismo , Forma de la Célula , Células Cultivadas , Modelos Animales de Enfermedad , Células Madre Embrionarias/metabolismo , Células Epiteliales/metabolismo , Proteína Ácida Fibrilar de la Glía/metabolismo , Proteínas Fluorescentes Verdes/biosíntesis , Proteínas Fluorescentes Verdes/genética , Humanos , Hemorragias Intracraneales/metabolismo , Hemorragias Intracraneales/fisiopatología , Hemorragias Intracraneales/psicología , Proteínas Asociadas a Microtúbulos/metabolismo , Actividad Motora , Células-Madre Neurales/metabolismo , Fenotipo , Conejos , Recuperación de la Función , Factores de Tiempo , Transfección
13.
J Clin Neurosci ; 22(2): 398-9, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25124646

RESUMEN

Structural lesions of the basal ganglia may lead to obsessive compulsive disorder (OCD). We report a 31-year-old woman who developed OCD after a previously asymptomatic left caudate intracerebral cavernous malformation (ICM) hemorrhaged. Her neurologic examination was normal. Her OCD required hospitalization and improved with medication and therapy. The pathophysiology of this psychiatric disorder probably reflects a frontal cortex deafferentation mechanism. In patients with known ICM, any abrupt change in neurologic or psychiatric symptoms should prompt repeat imaging to assess for hemorrhage.


Asunto(s)
Núcleo Caudado , Hemangioma Cavernoso del Sistema Nervioso Central/complicaciones , Hemorragias Intracraneales/complicaciones , Trastorno Obsesivo Compulsivo/etiología , Adulto , Femenino , Hemangioma Cavernoso del Sistema Nervioso Central/psicología , Hospitalización , Humanos , Hemorragias Intracraneales/psicología , Imagen por Resonancia Magnética , Trastorno Obsesivo Compulsivo/psicología , Trastorno Obsesivo Compulsivo/terapia , Corteza Prefrontal/patología , Resultado del Tratamiento
14.
Zh Vopr Neirokhir Im N N Burdenko ; 77(1): 46-52; discussion 52, 2013.
Artículo en Inglés, Ruso | MEDLINE | ID: mdl-23659120

RESUMEN

Sixty-two year old man was admitted to the department of neurosurgery after stroke episode. CT-scan revealed non-traumatic, non-hypertensive intracerebral hemorrhage in the left temporal lobe; cerebral amyloid angiopathy was suspected. Initially, according to Boston criteria, intracerebral hematoma was interpreted as a result of a "probable" cerebral amyloid angiopathy. Surgical evacuation of the hematoma lead to the partial recourse of speech and cognitive deficit. Four weeks after stroke onset and 3 weeks after surgery CT was performed, which revealed intracerebral hematoma in the right parietal lobe; this fact let to diagnose "probable" cerebral amyloid angiopathy. The second hematoma was evacuated, and surgical treatment together with medical therapy improved patient's quality of life. Treatment strategy for the intracerebral hematomas resulting from cerebral amyloid angiopathy has not been justified yet, which requires further investigations.


Asunto(s)
Angiopatía Amiloide Cerebral/diagnóstico , Hemorragias Intracraneales/cirugía , Angiopatía Amiloide Cerebral/complicaciones , Angiopatía Amiloide Cerebral/psicología , Humanos , Hemorragias Intracraneales/diagnóstico , Hemorragias Intracraneales/etiología , Hemorragias Intracraneales/psicología , Angiografía por Resonancia Magnética , Masculino , Persona de Mediana Edad , Tomografía Computarizada Multidetector , Procedimientos Neuroquirúrgicos/métodos , Calidad de Vida , Resultado del Tratamiento
15.
Neurocrit Care ; 18(3): 313-7, 2013 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-23553251

RESUMEN

BACKGROUND: Patients in medical, surgical, and trauma intensive care units (ICUs) are at risk for later development of symptoms of post-traumatic stress disorder (PTSD). Because acute brain injury can impair recall; we sought to show that neuroscience patients undergoing prolonged neuroscience ICU admission have limited memory of their ICU stay and thus are less likely to develop symptoms of PTSD. METHODS: We surveyed patients >18 years admitted for 10 days or more to our neuroscience ICU over a 10-year period. RESULTS: The survey response rate was 50.5% (47/93). Forty percent (19/47) of respondents presented with coma. Recall of details of the ICU admission was limited. Fewer than 10% of patients who required mechanical ventilation recalled being on a ventilator. Only five patients (11%) had responses suggestive of possible post-traumatic stress syndrome. The most commonly experienced symptoms following discharge were difficulty sleeping, difficulty with concentration, and memory loss. CONCLUSION: Patients requiring prolonged neuroscience ICU admission do not appear to be traumatized by their ICU stay.


Asunto(s)
Lesiones Encefálicas/psicología , Cuidados Críticos/psicología , Hemorragias Intracraneales/psicología , Recuerdo Mental , Sobrevivientes/psicología , Adolescente , Adulto , Anciano , Neoplasias Encefálicas/psicología , Infecciones del Sistema Nervioso Central/psicología , Femenino , Estudios de Seguimiento , Humanos , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Respiración Artificial/psicología , Trastornos por Estrés Postraumático/psicología , Encuestas y Cuestionarios , Adulto Joven
16.
Behav Brain Res ; 244: 82-9, 2013 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-23403282

RESUMEN

Stroke causes disability and mortality worldwide and is divided into ischemic and hemorrhagic subtypes. Although clinical trials suggest distinct recovery profiles for ischemic and hemorrhagic events, this is not conclusive due to stroke heterogeneity. The aim of this study was to produce similar brain damage, using experimental models of ischemic (IS) and hemorrhagic (HS) stroke and evaluate the motor spontaneous recovery profile. We used 31 Wistar rats divided into the following groups: Sham (n=7), ischemic (IS) (n=12) or hemorrhagic (HS) (n=12). Brain ischemia or hemorrhage was induced by endotelin-1 (ET-1) and collagenase type IV-S (collagenase) microinjections, respectively. All groups were evaluated in the open field, cylinder and ladder walk behavioral tests at distinct time points as from baseline to 30 days post-surgery (30 PS). Histological and morphometric analyses were used to assess the volume of lost tissue and lesion length. Present results reveal that both forms of experimental stroke had a comparable long-term pattern of damage, since no differences were found in volume of tissue lost or lesion size 30 days after surgery. However, behavioral data showed that hemorrhagic rats were less impaired at skilled walking than ischemic ones at 15 and 30 days post-surgery. We suggest that experimentally comparable stroke design is useful because it reduces heterogeneity and facilitates the assessment of neurobiological differences related to stroke subtypes; and that spontaneous skilled walking recovery differs between experimental ischemic and hemorrhagic insults.


Asunto(s)
Isquemia Encefálica/psicología , Encéfalo/patología , Hemorragias Intracraneales/psicología , Recuperación de la Función , Accidente Cerebrovascular/patología , Accidente Cerebrovascular/psicología , Animales , Isquemia Encefálica/inducido químicamente , Isquemia Encefálica/complicaciones , Isquemia Encefálica/patología , Colagenasas/administración & dosificación , Endotelina-1/administración & dosificación , Hemorragias Intracraneales/inducido químicamente , Hemorragias Intracraneales/complicaciones , Hemorragias Intracraneales/patología , Masculino , Microinyecciones , Actividad Motora/efectos de los fármacos , Destreza Motora/efectos de los fármacos , Ratas , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/diagnóstico
17.
Neurol Sci ; 34(1): 99-101, 2013 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-22215142

RESUMEN

We know little about effective treatment for patients suffering from partial or complete Klüver-Bucy Syndrome (KBS) and other disruptive behaviors following a stroke. Reported cases have shown that certain medication, given alone or combined, can be partially effective. In this specific case study, we will try to demonstrate the effectiveness of a combination of carbamazepine, clonidine, quetiapine and methylphenidate in the alleviating of these symptoms. The wide range of symptoms found in KBS led us to use several kinds of psychotropic medication in spite of the inherent risks associated to polypharmacy.


Asunto(s)
Déficit de la Atención y Trastornos de Conducta Disruptiva/etiología , Déficit de la Atención y Trastornos de Conducta Disruptiva/terapia , Hemorragias Intracraneales/terapia , Síndrome de Kluver-Bucy/terapia , Agonistas alfa-Adrenérgicos/uso terapéutico , Trastorno por Déficit de Atención con Hiperactividad/tratamiento farmacológico , Trastorno por Déficit de Atención con Hiperactividad/etiología , Trastorno por Déficit de Atención con Hiperactividad/psicología , Déficit de la Atención y Trastornos de Conducta Disruptiva/psicología , Estimulantes del Sistema Nervioso Central/uso terapéutico , Angiografía Cerebral , Clonidina/uso terapéutico , Coma/etiología , Electroencefalografía , Femenino , Humanos , Hemorragias Intracraneales/complicaciones , Hemorragias Intracraneales/psicología , Síndrome de Kluver-Bucy/complicaciones , Síndrome de Kluver-Bucy/psicología , Metilfenidato/uso terapéutico , Pruebas Neuropsicológicas , Lóbulo Parietal/patología , Conducta Sexual , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/psicología , Accidente Cerebrovascular/terapia , Lóbulo Temporal/patología , Tomografía Computarizada de Emisión de Fotón Único , Tomografía Computarizada por Rayos X , Adulto Joven
18.
Pediatr Emerg Care ; 28(4): 376-9, 2012 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-22472657

RESUMEN

Evans syndrome is a rare disease characterized by autoimmune hemolytic anemia and thrombocytopenia. Its initial presentation with intracranial hemorrhage is rare. We report a case of a 12-year-old girl who presented to the emergency department with altered mental status secondary to an intracranial hemorrhage and later diagnosed to have Evans syndrome.


Asunto(s)
Anemia Hemolítica Autoinmune/complicaciones , Hemorragias Intracraneales/complicaciones , Trastornos Mentales/etiología , Trombocitopenia/complicaciones , Enfermedad Aguda , Adolescente , Anemia Hemolítica Autoinmune/diagnóstico , Biopsia , Niño , Diagnóstico Diferencial , Femenino , Estudios de Seguimiento , Humanos , Hemorragias Intracraneales/diagnóstico , Hemorragias Intracraneales/psicología , Trastornos Mentales/diagnóstico , Trastornos Mentales/psicología , Escala del Estado Mental , Piel/patología , Trombocitopenia/diagnóstico , Tomografía Computarizada por Rayos X
19.
Stroke ; 43(3): 844-50, 2012 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-22207510

RESUMEN

BACKGROUND AND PURPOSE: Perihematomal edema formation and consequent cell death contribute to the delayed brain injury evoked by intracerebral hemorrhage (ICH). We aimed to evaluate the effect of α7 nicotinic acetylcholine receptor (α7nAChR) stimulation on behavior, brain edema, and neuronal apoptosis. Furthermore, we aimed to determine the role of the proapoptotic glycogen synthase kinase-3ß (GSK-3ß) after experimental ICH. METHODS: Male CD-1 mice (n=109) were subjected to intracerebral infusion of autologous blood (n=88) or sham surgery (n=21). ICH animals received vehicle administration, 4 or 12 mg/kg of α7nAChR agonist PHA-543613, 12 mg/kg of α7nAChR agonist PNU-282987, 6 mg/kg of α7nAChR antagonist methyllycaconitine (MLA), 15 µg/kg of phosphatidylinositol 3-kinase (PI3K) inhibitor wortmannin, or PHA-543613 combined with MLA or wortmannin. Behavioral deficits and brain water content were evaluated at 24 and 72 hours after surgery. Western blotting and immunofluorescence staining were used for the quantification and localization of activated Akt (p-Akt), GSK-3ß (p-GSK-3ß), and cleaved caspase-3 (CC3). Neuronal cell death was quantified through terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL). RESULTS: α7nAChR stimulation improved neurological outcome and reduced brain edema at 24 and 72 hours after surgery (P<0.05 compared with vehicle). Furthermore, PHA-543613 treatment increased p-Akt and decreased p-GSK-3ß and CC3 expressions in the ipsilateral hemisphere (P<0.05, respectively), which was reversed by MLA and wortmannin. P-Akt, p-GSK-3ß, and CC3 were generally localized in neurons. PHA-543613 reduced neuronal cell death in the perihematomal area (P<0.05). CONCLUSIONS: α7nAChR stimulation improved functional and morphological outcomes after experimental ICH in mice. PHA-543613 reduced the expression of proapoptotic GSK-3ß through the PI3K-Akt signaling pathway.


Asunto(s)
Benzamidas/farmacología , Compuestos Bicíclicos Heterocíclicos con Puentes/farmacología , Compuestos Bicíclicos con Puentes/farmacología , Glucógeno Sintasa Quinasa 3/antagonistas & inhibidores , Hemorragias Intracraneales/tratamiento farmacológico , Fármacos Neuroprotectores , Agonistas Nicotínicos/farmacología , Quinuclidinas/farmacología , Receptores Nicotínicos/fisiología , Animales , Apoptosis/efectos de los fármacos , Conducta Animal/efectos de los fármacos , Western Blotting , Agua Corporal/metabolismo , Química Encefálica/efectos de los fármacos , Edema Encefálico/etiología , Edema Encefálico/patología , Caspasa 3/fisiología , Inhibidores de Caspasas , Técnica del Anticuerpo Fluorescente , Glucógeno Sintasa Quinasa 3 beta , Hemorragias Intracraneales/psicología , Masculino , Ratones , Neuronas/efectos de los fármacos , Fosfatidilinositol 3-Quinasas/fisiología , Inhibidores de las Quinasa Fosfoinosítidos-3 , Receptores Nicotínicos/efectos de los fármacos , Transducción de Señal/efectos de los fármacos , Transducción de Señal/fisiología , Accidente Cerebrovascular/tratamiento farmacológico , Accidente Cerebrovascular/psicología , Resultado del Tratamiento , Receptor Nicotínico de Acetilcolina alfa 7
20.
J Pharmacol Exp Ther ; 338(3): 741-9, 2011 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-21610140

RESUMEN

Intracerebral hemorrhage (ICH) resulting from the leakage of blood into the brain parenchyma triggers severe tissue damage involving neurodegeneration and inflammation. Increasing lines of evidence indicate that the stimulation of central nicotinic acetylcholine receptors affords neuroprotection against various insults and also suppresses the proinflammatory activation of microglia. Therefore, the present study aimed to determine whether the administration of nicotine modifies the pathological consequences of ICH, using a mouse model of ICH induced by intrastriatal injection of collagenase. Daily intraperitoneal administration of nicotine (2 mg/kg), starting from 3 h after the induction of ICH, inhibited apoptosis and decreased the number of remaining striatal neurons at 3 days after the insult. We also found that nicotine administration increased the relative expression level of the antiapoptotic protein B cell lymphoma-2 versus that of the proapoptotic protein Bax in the brain. In addition, nicotine administration attenuated the activation of microglia/macrophages, infiltration of neutrophils, and increases in oxidative stress associated with ICH, without affecting hematoma expansion and brain edema. It is noteworthy that mice treated with nicotine exhibited improved sensorimotor performance and a marked increase in survival rate after ICH. These results indicate that nicotinic acetylcholine receptors may serve as a novel target for emergency therapy for ICH.


Asunto(s)
Hemorragias Intracraneales/tratamiento farmacológico , Nicotina/uso terapéutico , Agonistas Nicotínicos/uso terapéutico , Animales , Conducta Animal/efectos de los fármacos , Western Blotting , Agua Corporal/metabolismo , Encéfalo/patología , Química Encefálica/efectos de los fármacos , Edema Encefálico/etiología , Edema Encefálico/patología , Técnica del Anticuerpo Fluorescente , Inmunohistoquímica , Etiquetado Corte-Fin in Situ , Hemorragias Intracraneales/patología , Hemorragias Intracraneales/psicología , Macrófagos/efectos de los fármacos , Masculino , Ratones , Ratones Endogámicos C57BL , Microglía/efectos de los fármacos , Neuronas/patología , Neutrófilos/efectos de los fármacos , Estrés Oxidativo , Equilibrio Postural/efectos de los fármacos , Desempeño Psicomotor/efectos de los fármacos , Sobrevida , Proteína X Asociada a bcl-2/metabolismo
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