Effects of Aerobic Exercise on Tau and Related Proteins in Rats with Photochemically-Induced Infarction.

BACKGROUND: Recent evidence indicates brain ischemia is associated with accumulations of abnormal tau and related proteins. However, the effects of aerobic training on these proteins have not been evaluated. OBJECTIVE: We aimed to evaluate the effect of aerobic exercise on the phosphorylation and acetylation of tau and on the expressions of tau related proteins in a rat stroke model and to compare the effects of aerobic exercise with those observed in our previous study on task specific training (TST). METHODS: Twenty-four Sprague- Dawley rats with photothrombotic cortical infarction were used in the current study. The rehabilitation group (RG) received treadmill training 40 min/day for 28 days, whereas the sedentary group (SG) did not receive any type of training. Functional tests such as the single pellet reaching task, rotarod, and radial arm maze tests were performed weekly for 4 weeks post-infarction. RESULTS: Levels of p-taus396 and p-AMPK were found to be lower in ipsilateral cortices in the RG than in the SG (p < 0.05). Levels of p-taus262, Ac-tau, p-GSK3ßS9, p-Akt, p-Sin1, and p-P70-S6K were significantly lower in ipsilateral than in contralateral cortices in the RG (p < 0.05). Aerobic training also improved motor, balance, and memory functions. CONCLUSION: Aerobic training inhibited the phosphorylation and acetylation of tau and modulated the expressions of tau related proteins after stroke by modifying the p70-S6K pathway and p-AMPK. By comparison with our previous study on the effects of TST, we have evidence to suggest that TST and aerobic exercise differ, although both types of rehabilitation inhibit tau phosphorylation and acetylation.

Use of the maximal phonation test for the screening of dysphagia in stroke patients: a preliminary study.

BACKGROUND: Dysphagia is a commonly developed complication after stroke and may lead to pneumonia. Several screening tests for dysphagia have been introduced, but no consensus has been reached regarding the test that best detects dysphagia or swallowing difficulties. Maximum phonation time (MPT) can measure laryngeal and pharyngeal function indirectly by providing a means of assessing vocal cord integrity. Because vocal cords play a role in sound production and also protect the airways, we considered MPT might be used to screen for penetration and aspiration into airways in stroke patients. AIM: The purpose of this study was to investigate the ability of MPT to differentiate between stroke patients with or without penetration/aspiration and the relationships between MPT and videofluoroscopic swallowing study (VFSS) findings and those of other swallowing screening tests. DESIGN: Prospective observational study. SETTING: Korean tertiary hospital. POPULATION: One hundred six Patients with acute stroke patients with suspected dysphagia referred for VFSS from January 2016 to December 2017. METHODS: MPT differences among a normal group, a penetration group, and an aspiration group were analyzed, and correlations between MPT and age, Penetration Aspiration Scale (PAS), American Speech-Language-Hearing Association National Outcome Measurement System Swallowing Scale (ASHA-NOMS), Functional Dysphagia Scale (FDS) scores were investigated. RESULTS: MPTs were found to be significantly different in normal, penetration, and aspiration groups in stroke patients (P<0.01). Furthermore, MPT was highly correlated with PAS, ASHA-NOMS, and FDS scores. ROC analysis provided MPT cut off values for the presence of penetration and aspiration in stroke patients of 9.08 and 7.98 sec, respectively. CONCLUSIONS: In stroke patients, MPT could be used to detect penetration or aspirations while swallowing. and seems to have appropriate validity and sensitivity. CLINICAL REHABILITATION IMPACT: MPT is proposed as a new screening tool for detecting dysphagia in stroke patients, especially airway aspiration.

Objective and subjective sleep problems and quality of life of rehabilitation in patients with mild to moderate stroke.

Objective: The principal objectives of this study were to investigate relationships between objective sleep parameters, that is, sleep onset latency, wake after sleep onset, number of awakenings, sleep efficiency, and sleep duration, and quality of life after mild to moderate stroke.Methods: The subjects were 112 first-time mild to moderate stroke patients admitted to a rehabilitation unit. Physical functions, depression, anxiety, quality of life, subjective insomnia, quality of sleep, and fatigue were assessed at about 20 days after stroke. Objective sleep parameters were also assessed using a wrist-worn Actiwatch.Results: Patients with insomnia had greater sleep onset latencies (p = .001), wake after sleep onset (p = .005), awoke more frequently (p = .013), and slept less efficiency (p < .001) than patients without insomnia, but total sleep durations were similar. In all participants, lower overall domain of quality of life was significantly associated with sleep onset latency (p = .009), and total insomnia severity index (p < .001), total Epworth Sleepiness Scale (p < .001), the National Institute's Health Stroke Scale (p = .004), the Modified Barthel Index (p = .034), and Screening Tests for Aphasia and Neurologic-Communication Disorders (p = .044) scores.Conclusion: Objective sleep parameters (sleep onset latency and sleep efficiency) were found to be associated with quality of life during the early stage of rehabilitation in mild to moderate stroke patients.