Subjective Memory Complaints and Sensitivity of the Subjective Memory Complaint Questionnaire in Post-Stroke Dementia Patients.

INTRODUCTION: Subjective memory complaints (SMCs) among stroke patients are common. To date, reports on SMCs using the Subjective Memory Complaint Questionnaire (SMCQ) are limited. We provided descriptive information on SMCs using the SMCQ alongside objective neuropsychological function assessment in stroke patients and established the sensitivity of SMCQ for post-stroke dementia. METHODS: In total, 419 consecutive stroke patients who were admitted to a stroke unit for younger populations (age <65 years) at a rehabilitation hospital from June 1, 2014, to January 1, 2020, were reviewed. SMCs were measured using the SMCQ. Objective neuropsychological function was assessed using protocols of the Vascular Cognitive Impairment Harmonization Standards. RESULTS: SMCs were significantly correlated with objective neuropsychological functions including memory, executive function, language, and depression. SMCs were not significantly correlated with visuospatial function. The SMCQ exhibited comparable sensitivity to that of Mini-Mental Status Examination for evaluating post-stroke dementia. CONCLUSIONS: The SMCQ may be a valid measure of cognitive function among patients with stroke, is sensitive for post-stroke dementia, and may assume a complementary role for assessing patients with stroke.

Urological disturbance and its neuroanatomical correlate in patients with chronic brainstem stroke.

AIMS: Few studies have depicted urological disturbances among patients with chronic brainstem stroke, and little is known about the exact location of the micturition center or its role in humans. The aim of the present study was to retrospectively investigate urological disturbances and their neuroanatomical correlates among consecutively admitted patients with chronic brainstem stroke. METHODS: Urodynamic studies, brain images, and urological symptoms questionnaires were reviewed from consecutive patients suffering from brainstem stroke, who had been admitted to a stroke unit at a rehabilitation hospital between June 1, 2013 and January 31, 2015. For further comparison, consecutive data from urodynamic studies of patients with upper cervical spinal cord injury (admitted to a hospital between January 1, 2008 and January 31, 2015) were reviewed. RESULTS: Patients with chronic pontine stroke manifested more frequent detrusor underactivity, lower maximal detrusor pressure, and higher compliance than patients with upper cervical spinal cord injury. The most frequently involved lesions associated with detrusor underactivity were located around the central portion of the bilateral pons along the entire sagittal level. Urinary incontinence and symptoms associated with lower urinary tract dysfunction were reported in 10% and 95% of patients with brainstem stroke, respectively. No difference was found between genders or stroke subtypes in patients with brainstem stroke. CONCLUSIONS: The present study identified a relationship between chronic pontine stroke and detrusor underactivity. Thus, detrusor underactivity might be associated with lesions localized to central portions of the bilateral pons. The prevalence of lower urinary tract symptoms was also revealed to be high among patients with chronic brainstem stroke. Neurourol. Urodynam. 36:136-141, 2017. © 2015 Wiley Periodicals, Inc.

Botulinum Toxin A Injection into the Subscapularis Muscle to Treat Intractable Hemiplegic Shoulder Pain.

OBJECTIVE: To evaluate the beneficial effect of botulinum toxin A (Botox) injection into the subscapularis muscle on intractable hemiplegic shoulder pain. METHODS: Six stroke patients with intractable hemiplegic shoulder pain were included. Botulinum toxin A was injected into the subscapularis muscle. Intractable hemiplegic shoulder pain was evaluated using an 11-point numerical rating scale. Pain-free range of motion was assessed for shoulder abduction and external rotation. The spasticity of the shoulder internal rotator was measured using the modified Ashworth scale. Assessments were carried out at baseline and at 1, 2, 4, and, if possible, 8 weeks. RESULTS: Intractable hemiplegic shoulder pain was improved (p=0.004) after botulinum toxin injection into the subscapularis muscle. Restricted shoulder abduction (p=0.003), external rotation (p=0.005), and spasticity of the shoulder internal rotator (p=0.005) were also improved. Improved hemiplegic shoulder pain was correlated with improved shoulder abduction (r=-1.0, p<0.001), external rotation (r=-1.0, p<0.001), and spasticity of the internal rotator (r=1.0, p<0.001). CONCLUSION: Botulinum toxin A injection into the subscapularis muscle appears to be valuable in the management of intractable hemiplegic shoulder pain.