Flash Visual Evoked Potentials in Conscious Horses: A Preliminary Study.

The visual evoked potential (VEP) has many applications in veterinary neurology, but the test is not routinely used in a clinical setting. The aim of this study was to describe a reliable method for recording flash visual evoked potentials (F-VEPs) in nonsedated horses. F-VEPs were recorded from both eyes in 20 healthy and calm, adult horses. Recordings were accomplished without sedation, anaesthesia, or the use of mydriatic drugs. The mean and standard deviation of the latency of the most evident positive peak was 52.76±2.37 ms (P53). The mean latencies of the preceding and following negative peaks were 38.14±4.62 (N38) and 72.35±5.33 ms (N72), respectively. There were 2 mean peak-to-peak amplitudes (N38 - P53 and P53 - N72), and they were 11.85±6.21 and 22.81±11.50 µV, respectively. F-VEP was also recorded from 3 horses (6 eyes) before and during sedation with 2 doses each of xylazine (0.4 and 1.1 mg/kg) or detomidine (0.005 and 0.014 mg/kg). It was possible to obtain a reliable F-VEP with a P53 latency in horses without sedation that was similar to the P2 peak described in previous studies, and these data can be used in the future as a normal reference for comparisons in horses with different diseases using a similar methodology. Sedation affected the results by depressing peak amplitudes and increasing latencies or by completely obscuring any response. The exact impact of sedation on VEPs must be evaluated with much caution due to the small sample size.

Analysis of patients with obstructive sleep apnea with and without pharyngeal myopathy using brain neuroimaging.

STUDY OBJECTIVES: Elements impairing upper airway anatomy or muscle function (e.g. pharyngeal neuromyopathy) contribute to obstructive sleep apnea syndrome (OSAS). Structural brain imaging may differ in patients with OSAS according to dilator muscle dysfunction. Magnetic resonance imaging (MRI) with voxel-based morphometry (VBM) and surface-based morphometry (SBM) was used to investigate this hypothesis. METHODS: Eighteen patients with OSAS and 32 controls underwent 3T brain MRI. T1 volumetric images were used for structural analysis. Pharyngeal electroneuromyography was performed; patients with OSAS were classified as with or without neuromyopathy. VBM and SBM analyses were conducted using SPM12 and CAT12 software. Image processing was standard. Cortical surface parameters and gray and white matter volumes from participants with OSAS with and without neuromyopathy were compared with those from controls. RESULTS: Eleven patients had OSAS with neuromyopathy and seven patients had OSAS without neuromyopathy (normal pharyngeal electroneuromyography). Comparing these groups to the controls, VBM revealed: four clusters (total volume 15,368 mm3) for patients with neuromyopathy, the largest cluster in the left cerebellum (9,263 mm3, p = 0.0001), and three clusters (total 8,971 mm3) for patients without neuromyopathy, the largest cluster in the left cerebellum (5,017 mm3, p = 0.002). Patients with OSAS with neuromyopathy showed increased proportion of atrophy (p < 0.0001). SBM showed abnormalities in patients without neuromyopathy (decreased cortical thickness, left precentral gyrus [672 vertices, p = 0.04]; increased cortical complexity, right middle temporal gyrus [578 vertices, p = 0.032]). CONCLUSION: Damaged areas were larger in patients with OSAS with than in those without neuromyopathy, suggesting differences in brain involvement. Patients with OSAS and neuromyopathy may be more susceptible to cerebral damage.

Crossed Leg Sign Is Associated With Severity of Unilateral Spatial Neglect After Stroke.

BACKGROUND: The crossed leg sign in patients with right hemisphere stroke is thought to be associated with perceptual disorders, such as unilateral spatial neglect (USN). The aim of this study was to compare the crossed leg sign with the severity of USN during the acute phase of stroke. EXPERIMENTAL PROCEDURES: This was an observational and prospective clinical study of individuals with a diagnosis of right parietal stroke, as confirmed by neuroimaging. The occurrence of the crossed leg sign, the time at which this occurred after the stroke, and a clinical diagnosis of USN were measured and recorded. The patients' age, sex, and lesion severity, as determined by the National Institutes of Health Stroke Scale and Glasgow coma scale, were included in the analyses as confounding variables. The outcome of interest was the degree of USN, as measured by the cancellation and bisection tests. Binary logistic regression was used to analyze the effect of crossed leg syndrome on the severity of USN. In the adjusted multiple regression model, a p-value of <0.05 was considered statistically significant. RESULTS: Overall, 60 patients were included in this study. There were no associations between patient demographics and the presence of the crossed leg sign. There was, however, an association between the crossed leg sign and the absolute value of the deviation in the line bisection test (B = -0.234; p = 0.039). The crossed leg sign was not associated with other measures of USN. CONCLUSION: Based on the results of our study, we can conclude that a crossed leg sign in the acute phase of stroke is associated with USN severity, specifically the misinterpretation of the midline.

Unilateral spatial neglect in the acute phase of ischemic stroke can predict long-term disability and functional capacity.

OBJECTIVE: The aim of this study was to assess the relationship between the degree of unilateral spatial neglect during the acute phase of stroke and long-term functional independence. METHODS: This was a prospective study of right ischemic stroke patients in which the independent variable was the degree of spatial neglect and the outcome that was measured was functional independence. The potential confounding factors included sex, age, stroke severity, topography of the lesion, risk factors, glycemia and the treatment received. Unilateral spatial neglect was measured using the line cancellation test, the star cancellation test and the line bisection test within 48 hours of the onset of symptoms. Functional independence was measured using the modified Rankin and Barthel scales at 90 days after discharge. The relationship between unilateral spatial neglect and functional independence was analyzed using multiple logistic regression that was corrected for confounding factors. RESULTS: We studied 60 patients with a median age of 68 (34-89) years, 52% of whom were male and 74% of whom were Caucasian. The risk for moderate to severe disability increased with increasing star cancellation test scores (OR=1.14 [1.03-1.26], p=0.01) corrected for the stroke severity, which was a confounding factor that had a statistically positive association with disability (OR=1.63 [1.13-2.65], p=0.01). The best chance of functional independence decreased with increasing star cancellation test scores (OR=0.86 [0.78-0.96], p=0.006) corrected for the stroke severity, which was a confounding factor that had a statistically negative association with independence (OR=0.66 [0.48-0.92], p=0.017). CONCLUSION: The severity of unilateral spatial neglect in acute stroke worsens the degree of long-term disability and functional independence.

Unilateral spatial neglect in the acute phase of ischemic stroke can predict long-term disability and functional capacity

OBJECTIVE: The aim of this study was to assess the relationship between the degree of unilateral spatial neglect during the acute phase of stroke and long-term functional independence. METHODS: This was a prospective study of right ischemic stroke patients in which the independent variable was the degree of spatial neglect and the outcome that was measured was functional independence. The potential confounding factors included sex, age, stroke severity, topography of the lesion, risk factors, glycemia and the treatment received. Unilateral spatial neglect was measured using the line cancellation test, the star cancellation test and the line bisection test within 48 hours of the onset of symptoms. Functional independence was measured using the modified Rankin and Barthel scales at 90 days after discharge. The relationship between unilateral spatial neglect and functional independence was analyzed using multiple logistic regression that was corrected for confounding factors. RESULTS: We studied 60 patients with a median age of 68 (34-89) years, 52% of whom were male and 74% of whom were Caucasian. The risk for moderate to severe disability increased with increasing star cancellation test scores (OR=1.14 [1.03-1.26], p=0.01) corrected for the stroke severity, which was a confounding factor that had a statistically positive association with disability (OR=1.63 [1.13-2.65], p=0.01). The best chance of functional independence decreased with increasing star cancellation test scores (OR=0.86 [0.78-0.96], p=0.006) corrected for the stroke severity, which was a confounding factor that had a statistically negative association with independence (OR=0.66 [0.48-0.92], p=0.017). CONCLUSION: The severity of unilateral spatial neglect in acute stroke worsens the degree of long-term disability and functional independence.

Effects of Canine and Murine Mesenchymal Stromal Cell Transplantation on Peripheral Nerve Regeneration.

BACKGROUND AND OBJECTIVES: Maintaining a permissive microenvironment is essential for adequate nerve regeneration. Cell-based therapy has the potential based cell replacement and promotion of axonal growth. The adipose tissue derived mesenchymal stromal cells (Ad-MSC) attract interest because neuroregenerative and anti-inflammatory properties. The aim of this study was to evaluate the effects of canine and murine Ad-MSC transplantation on the sciatic nerve regeneration. METHODS: Forty Wistar rats were divided randomly into: control group - CG (n=8); denervated group - DG (n=8); decellularized vein group - VG (n=8); decellularized vein＋canine MSC-cMSC (n=8); descellularized vein＋murine MSC-mMSC (n=8). After 10-mm nerve gap, the tubulation technique was performed with decellularized vein filled with 106 MSC labeled with quantum dots (Qtracker 665®). The sciatic nerve functional index (SFI) and electroneuromyography (ENMG) measurements were carried and morphometric and immunohistochemistry analysis of the tissue. RESULTS: The SFI values were higher in the cMSC and mMSC groups at day 27 (p<0.020) and day 35 (p<0.011). The ENMG analysis also revealed better results in the mMSC group. Density, number, and total area of the fibers were increased in the mMSC and cMSC groups. Brain-derived neurotrophic factor BDNF and S-100 protein positive immunoreactivity showed a higher expression for both in the nerve of the mMSC and cMSC groups. The MSC labeled with quantum dots were detected at day 35, indicating neuronal survival long after the nerve damage. CONCLUSIONS: Murine and canine Ad-MSC associated with decellularized vein scaffold had positive effects on sciatic nerve regeneration in rats.

Potencial evocado visual em cães e ovinos / Visual evoked potential in dogs and sheep

O potencial evocado visual (PEV) é técnica eletrodiagnóstica que permite avaliação das vias visuais. O PEV de 20 cães e 20 ovinos adultos, de ambos os sexos, foram obtidos para estudo normativo. Foram utilizados eletrodos de agulha monopolar posicionados em O1 e O2 (ativos), em Fpz (referência comum) e em Cz (terra). O estímulo foi na forma de flash a 1Hz. Dezessete cães e 17 ovinos foram incluídos no estudo, pois apresentaram potenciais auditivos com boa qualidade técnica. Os resultados da avaliação dos dois olhos foram agrupados, totalizando 34 exames em cada espécie. O achado mais consistente em todos os exames foi uma deflexão eletropositiva, com latência média de 55,4ms em cães (P55) e 63,75ms em ovinos (P63). Outras duas ondas eletronegativas também foram identificadas: N31 e N75 em cães; e N42 e N86 em ovinos. A metodologia utilizada neste estudo permitiu obtenção de potenciais visuais com pequena variabilidade, sendo útil para avaliação de animais com suspeita de alteração nas vias visuais centrais.(AU)

The visual evoked potential (VEP) is an electro-diagnostic technique that allows assessment of visual pathways. The VEP from 20 adult dogs and 20 adult sheep of both gender was obtained for normative study. Monopolar electrode needles were placed in O1 and O2 (active), Fpz (common reference) and Cz (ground). The stimuli were flash at 1Hz. Seventeen dogs and 17 sheep were included in the study because they had auditory potentials with good technical quality. The results from both eyes were grouped, totaling 34 results in each species. The most consistent result in all tests was an electropositive deflection, with a mean latency 55.4ms in dogs (P55) and 63.75ms in sheep (P63). Two negative deflections were also identified: N31 and N75 in dogs, and N42 and N86 in sheep. The methodology used in this study allowed to obtain potential similar to those described in other studies, with little variability, and is useful for evaluation of animals with suspected changes in the central visual pathways.(AU)

Standardization of the face-hand test in a Brazilian multicultural population: prevalence of sensory extinction and implications for neurological diagnosis

OBJECTIVE: The face-hand test is a simple, practical, and rapid test to detect neurological syndromes. However, it has not previously been assessed in a Brazilian sample; therefore, the objective of the present study was to standardize the face-hand test for use in the multi-cultural population of Brazil and identify the sociodemographic factors affecting the results. METHODS: This was a cross sectional study of 150 individuals. The sociodemographic variables that were collected included age, gender, race, body mass index and years of education. Standardization of the face-hand test occurred in 2 rounds of 10 sensory stimuli, with the participant seated to support the trunk and their vision obstructed in a sound-controlled environment. The face-hand test was conducted by applying 2 rounds of 10 sensory stimuli that were applied to the face and hand simultaneously. The associations between the face-hand test and sociodemographic variables were analyzed using Mann-Whitney tests and Spearman correlations. Binomial models were adjusted for the number of face-hand test variations, and ROC curves evaluated sensitivity and specificity of sensory extinction. RESULTS: There was no significant relationship between the sociodemographic variables and the number of stimuli perceived for the face-hand test. There was a high relative frequency of detection, 8 out of 10 stimuli, in this population. Sensory extinction was 25.3%, which increased with increasing age (OR=1.4[1:01–1:07]; p=0.006) and decreased significantly with increasing education (OR=0.82[0.71-0.94]; p=0.005). CONCLUSION: In the Brazilian population, a normal face-hand test score ranges between 8–10 stimuli, and the results indicate that sensory extinction is associated with increased age and lower levels of education.

Association between clinical condition and F-waves changes in the acute phase of stroke.

OBJECTIVE: To relate F-waves with clinical and laboratory exams in the acute phase of stroke. METHODS: Inclusion criteria for this cross-sectional study were: hemiplegia, absence of previous cranial trauma, myopathy, diabetes, alcoholism or other known causes of peripheral neuropathy, and normal sensory and motor conduction. The National Institutes of Health Stroke Scale (NIHSS) score, glycemia, glucosilate hemoglobin, and CPK were obtained at admission by routine blood exams. After hospital admission, the F-wave latencies and persistence were obtained from the deep peroneal nerve using symmetrical techniques. RESULTS: Evaluation of 20 individuals - mean age 66 years, 50% male and 85% Caucasian - showed association of F-wave persistence with glycemia (r = 0.71; p < 0.001) and NIHSS categorized (NIHSS 1-7 = 65.0 x NIHSS 9-23 = 100; p = 0.004). Multivariate analysis found only association of F-wave persistence with glycemia ß = 0.59 (0.44-0.74); p < 0.001. CONCLUSION: The increase in the persistence of F-waves are associated with hyperglycemia in the acute phase of stroke.

Association between clinical condition and F-waves changes in the acute phase of stroke / Associação entre condição clínica e alterações das ondas-F na fase aguda do acidente vascular cerebral

ABSTRACT Objective To relate F-waves with clinical and laboratory exams in the acute phase of stroke. Methods Inclusion criteria for this cross-sectional study were: hemiplegia, absence of previous cranial trauma, myopathy, diabetes, alcoholism or other known causes of peripheral neuropathy, and normal sensory and motor conduction. The National Institutes of Health Stroke Scale (NIHSS) score, glycemia, glucosilate hemoglobin, and CPK were obtained at admission by routine blood exams. After hospital admission, the F-wave latencies and persistence were obtained from the deep peroneal nerve using symmetrical techniques. Results Evaluation of 20 individuals – mean age 66 years, 50% male and 85% Caucasian – showed association of F-wave persistence with glycemia (r = 0.71; p < 0.001) and NIHSS categorized (NIHSS 1-7 = 65.0 x NIHSS 9-23 = 100; p = 0.004). Multivariate analysis found only association of F-wave persistence with glycemia β = 0.59 (0.44–0.74); p < 0.001. Conclusion The increase in the persistence of F-waves are associated with hyperglycemia in the acute phase of stroke.

RESUMO Objetivo Relacionar as ondas-F com exames clínicos e laboratoriais na fase aguda do acidente vascular cerebral (AVC). Os critérios de inclusão para este estudo transversal foram: hemiplegia, ausência de trauma craniano, miopatia, diabetes, alcoolismo ou outra causa conhecida de neuropatia periférica, além de condução sensorial e motora normal. O National Institutes of Health Stroke Scale (NIHSS), glicemia, hemoglobina glicada e CPK foram obtidos na admissão por meio de exames de rotina. Após a admissão hospitalar, a latência e persistência das ondas-F foram obtidas por meio da estimulação do nervo fibular profundo utilizando técnicas simétricas. Foram avaliados 20 indivíduos – média de idade 66 anos, 50% homem e 85% caucasianos – apresentaram associação univariada da persistência das ondas-F com glicemia (r = 0.71; p < 0.001) e NIHSS categorizado (NIHSS 1–7 = 65.0 x NIHSS 9-23 = 100; p = 0.004). Na regressão multivariada foi encontrado associação somente entre persistência de ondas-F com glicemia β = 0.59(0.44–0.74); p < 0.001. Conclusão O aumento da persistência de ondas-F está associado com maior nível de glicemia na fase aguda do AVC.

Brainstem auditory evoked potentials in horses / Potencial evocado auditivo de tronco encefálico em equinos

ABSTRACT: The brainstem auditory evoked potential (BAEP) evaluates the integrity of the auditory pathways to the brainstem. The aim of this study was to evoke BAEPs in 21 clinically normal horses. The animals were sedated with detomidine hydrochloride (0.013mg.kg-1 BW). Earphones were inserted and rarefaction clicks at 90 dB and noise masking at 40 dB were used. After performing the test, the latencies of waves (I, II, III, IV, and V) and interpeaks(I-III, III-V, and I-V) were identified. The mean latencies of the waves were as follows: wave I, 2.4 ms; wave II, 2.24 ms; wave III, 3.61ms; wave IV, 4.61ms; and wave V, 5.49ms. The mean latencies of the interpeaks were as follows: I-III, 1.37ms; III-V, 1.88ms; and I-V, 3.26ms. This is the first study using BAEPs in horses in Brazil, and the observed latencies will be used as normative data for the interpretation of tests performed on horses with changes related to auditory system or neurologic abnormalities.

RESUMO: O Potencial Evocado Auditivo de Tronco Encefálico (BAEP-Brainstem Auditory Evoked Potential) avalia a integridade das vias auditivas até o tronco encefálico. O objetivo da pesquisa foi padronizar o uso do BAEP em 21 equinos, sem aparente anormalidade auditiva. Os animais foram sedados com cloridrato de detomidina (0,013mg.kg-1 de PV). Foram utilizados fones de inserção,cliques de rarefação a 90 dB e um ruído de mascaramento de 40 dB. Foram identificadas as latências das ondas I, II, III, IV e V e dos interpicos I-III, III-V e I-V. As médias das latências das ondas foram: onda I 2,24ms; onda II 2,74ms; onda III 3,61ms; onda IV 4,61ms; e onda V 5,49ms. As médias das latências dos interpicos foram: I-III 1,37ms; III-V 1,88ms; e I-V 3,26ms. Este é o primeiro estudo utilizando o BAEP em equinos no Brasil e as latências observadas serão utilizadas como dados normativos para interpretação de exames de cavalos com anormalidades auditivas ou neurológicas.

Standardization of the face-hand test in a Brazilian multicultural population: prevalence of sensory extinction and implications for neurological diagnosis.

OBJECTIVE:: The face-hand test is a simple, practical, and rapid test to detect neurological syndromes. However, it has not previously been assessed in a Brazilian sample; therefore, the objective of the present study was to standardize the face-hand test for use in the multi-cultural population of Brazil and identify the sociodemographic factors affecting the results. METHODS:: This was a cross sectional study of 150 individuals. The sociodemographic variables that were collected included age, gender, race, body mass index and years of education. Standardization of the face-hand test occurred in 2 rounds of 10 sensory stimuli, with the participant seated to support the trunk and their vision obstructed in a sound-controlled environment. The face-hand test was conducted by applying 2 rounds of 10 sensory stimuli that were applied to the face and hand simultaneously. The associations between the face-hand test and sociodemographic variables were analyzed using Mann-Whitney tests and Spearman correlations. Binomial models were adjusted for the number of face-hand test variations, and ROC curves evaluated sensitivity and specificity of sensory extinction. RESULTS:: There was no significant relationship between the sociodemographic variables and the number of stimuli perceived for the face-hand test. There was a high relative frequency of detection, 8 out of 10 stimuli, in this population. Sensory extinction was 25.3%, which increased with increasing age (OR=1.4[1:01-1:07]; p=0.006) and decreased significantly with increasing education (OR=0.82[0.71-0.94]; p=0.005). CONCLUSION:: In the Brazilian population, a normal face-hand test score ranges between 8-10 stimuli, and the results indicate that sensory extinction is associated with increased age and lower levels of education.

Pharmacological interventions for unilateral spatial neglect after stroke.

BACKGROUND: Unilateral spatial neglect (USN) is characterized by the inability to report or respond to people or objects presented on the side contralateral to the lesioned side of the brain and has been associated with poor functional outcomes and long stays in hospitals and rehabilitation centers. Pharmacological interventions (medical interventions only, use of drugs to improve the health condition), such as dopamine and noradrenergic agonists or pro-cholinergic treatment, have been used in people affected by USN after stroke, and effects of these treatments could provide new insights for health professionals and policy makers. OBJECTIVES: To evaluate the effectiveness and safety of pharmacological interventions for USN after stroke. SEARCH METHODS: We searched the Cochrane Stroke Group Trials Register (April 2015), the Cochrane Central Register of Controlled Trials (April 2015), MEDLINE (1946 to April 2015), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1982 to April 2015), EMBASE (1980 to April 2015), PsycINFO (1806 to April 2015) and Latin American Caribbean Health Sciences Literature (LILACS) (1982 to April 2015). We also searched trials and research registers, screened reference lists, and contacted study authors and pharmaceutical companies (April 2015). SELECTION CRITERIA: We included randomized controlled trials (RCTs) and quasi-randomized controlled trials (quasi-RCTs) of pharmacological interventions for USN after stroke. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed risk of bias in the included studies and extracted data. MAIN RESULTS: We included in the review two studies with a total of 30 randomly assigned participants. We rated the quality of the evidence as very low as the result of study limitations, small numbers of events, and small sample sizes, with imprecision in the confidence interval (CI). We were not able to perform meta-analysis because of heterogeneity related to the different interventions evaluated between included studies. Very low-quality evidence from one trial (20 participants) comparing effects of rivastigmine plus rehabilitation versus rehabilitation on overall USN at discharge showed the following: Barrage (mean difference (MD) 0.30, 95% confidence interval (CI) -0.18 to 0.78); Letter Cancellation (MD 10.60, 95% CI 2.07 to 19.13); Sentence Reading (MD 0.20, 95% CI -0.69 to 1.09), and the Wundt-Jastrow Area Illusion Test (MD -4.40, 95% CI -8.28 to -0.52); no statistical significance was observed for the same outcomes at 30 days' follow-up. In another trial (10 participants), study authors showed statistically significant reduction in omissions in the three cancellation tasks under transdermal nicotine treatment (mean number of omissions 2.93 ± 0.5) compared with both baseline (4.95 ± 0.8) and placebo (5.14 ± 0.9) (main effect of treatment condition: F (2.23) = 11.06; P value < 0.0001). One major adverse event occurred in the transdermal nicotine treatment group, and treatment was discontinued in the affected participant. None of the included trials reported data on several of the prespecified outcomes (falls, balance, depression or anxiety, poststroke fatigue, and quality of life). AUTHORS' CONCLUSIONS: The quality of the evidence from available RCTs was very low. The effectiveness and safety of pharmacological interventions for USN after stroke are therefore uncertain. Additional large RCTs are needed to evaluate these treatments.

Aspects correlates with Scandinavian Stroke Scale for predicting early neurological impairment.

OBJECTIVE: To investigate the correlation between the Alberta Program Early CT Score (ASPECTS) and the Scandinavian Stroke Scale (SSS) for the evaluation of neurological impairment in patients with acute stroke. METHOD: 59 patients with a first acute ischemic stroke were evaluated. The ASPECTS were evaluated by 2 neurologists at admission and by another neurologist after 48 hours. The NIHSS and SSS was applied to determinate stroke severity. Correlations and agreements were analysed statistically by Spearman and Kappa tests. RESULTS: ASPECTS was correlated with National Institute of Health Stroke Scale (NIHSS) at admission (r = -0.52; p < 0.001) and SSS (r = 0.50; p < 0.001). The ASPECTS and SSS items were most correlated with arm (r = 0.52; p < 0.001) and hand (r = 0.49; p < 0.001) motor power, and speech (r = 0.51; p < 0.001). The SSS of 25.5 shows sensitivity (68%) and specificity (72%) when associated with ASPECTS ≤ 7. CONCLUSION: The SSS can predict worst neurological impairment when associated with lower values of ASPECTS.

Aspects correlates with Scandinavian Stroke Scale for predicting early neurological impairment / Correlação do ASPECTS com a escala Escandinava de AVC para predizer comprometimento neurológico precoce

Objective To investigate the correlation between the Alberta Program Early CT Score (ASPECTS) and the Scandinavian Stroke Scale (SSS) for the evaluation of neurological impairment in patients with acute stroke. Method 59 patients with a first acute ischemic stroke were evaluated. The ASPECTS were evaluated by 2 neurologists at admission and by another neurologist after 48 hours. The NIHSS and SSS was applied to determinate stroke severity. Correlations and agreements were analysed statistically by Spearman and Kappa tests. Results ASPECTS was correlated with National Institute of Health Stroke Scale (NIHSS) at admission (r = -0.52; p < 0.001) and SSS (r = 0.50; p < 0.001). The ASPECTS and SSS items were most correlated with arm (r = 0.52; p < 0.001) and hand (r = 0.49; p < 0.001) motor power, and speech (r = 0.51; p < 0.001). The SSS of 25.5 shows sensitivity (68%) and specificity (72%) when associated with ASPECTS ≤ 7. Conclusion The SSS can predict worst neurological impairment when associated with lower values of ASPECTS. .

Objetivo Investigar a relação entre o Alberta Program Early CT Score (ASPECTS) e a Scandinavian Stroke Scale (SSS) para avaliação da incapacidade neurológica de pacientes na fase aguda do acidente vascular cerebral (AVC). Método 59 pacientes com diagnóstico de primeiro AVC foram avaliados. O ASPECTS foi avaliado por 2 neurologistas na admissão e por outro neurologista após 48 horas. O National Institute of Health Stroke Scale (NIHSS) e SSS foram aplicadas para determinar a gravidade do AVC. As correlação e concordâncias foram analisadas estatisticamente pelos testes de Spearman e Kappa. Resultados ASPECTS foi correlacionado com o NIHSS na admissão (r = -0,52; p < 0,001) e SSS (r = 0,50; p < 0,001). O ASPECTS e os itens do SSS que mais se relacionaram foram força do braço (r = 0,52; p < 0,001), da mão (r = 0,49; p < 0,001) e fala (r = 0,51; p < 0,001). A pontuação da SSS de 25,5 mostrou sensibilidade (68%) e especificidade (72%) quando associado ao ASPECTS ≤ 7. Conclusão A SSS pode predizer pior incapacidade neurológica quando associado a baixos valores do ASPECTS. .

Low haemoglobin levels increase unilateral spatial neglect in acute phase of stroke.

OBJECTIVE: The objective of this study was to evaluate the relationship between unilateral spatial neglect (USN) and haemoglobin (Hb) level in acute phase of stroke. METHOD: Cross-sectional study was performed after right hemisphere ischemic stroke. INDEPENDENT VARIABLE: Hb level (mg/dL); OUTCOME: USN; Potential confounding factors: Age, National Institutes of Health Stroke Scale (NIHSS), and glycaemia (mg/dL); Characterization variables were obtained from electronic medical records, Hb, mean corpuscular volume (MCV) and glycaemia by laboratory exams, and USN by cancellation and bisection tasks. The relationship between Hb and USN was assessed by Spearman correlation and linear regression model. RESULTS: 40 individuals were evaluated; it was observed that the higher the Hb level, the better the USN test performance, with the two being negatively correlated. There was no significant correlation between VCM level and USN performance. CONCLUSION: Low hemoglobin levels may indicate a worse performance in USN cancellation and bissection tests in acute phase of stroke.

Brainstem auditory-evoked potential in Boxer dogs / Potencial evocado auditivo de tronco encefálico em cães da raça Boxer

Brainstem auditory-evoked potential (BAEP) has been widely used for different purposes in veterinary practice and is commonly used to identify inherited deafness and presbycusis. In this study, 43 Boxer dogs were evaluated using the BAEP. Deafness was diagnosed in 3 dogs (2 bilateral and 1 unilateral) allowing the remaining 40 Boxers to be included for normative data analysis including an evaluation on the influence of age on the BAEP. The animals were divided into 2 groups of 20 Boxers each based on age. The mean age was 4.54 years (range, 1-8) in group I, and 9.83 years (range, 8.5-12) in group II. The mean latency for I, III, and V waves were 1.14 (±0.07), 2.64 (±0.11), and 3.48 (±0.10) ms in group I, and 1.20 (±0.12), 2.73 (±0.15), and 3.58 (±0.22) ms in group II, respectively. The mean inter-peak latencies for the I-III, III-V and I-V intervals were 1.50 (±0.15), 0.84 (±0.15), and 2.34 (±0.11) ms in group I, and 1.53 (±0.16), 0.85 (±0.15), and 2.38 (±0.19) ms in group II, respectively. Latencies of waves I and III were significant different between group I and II. For the I-III, III-V and I-V intervals, no significant differences were observed between the 2 groups. As far as we know, this is the first normative study of BAEP obtained from Boxer dogs.

O potencial evocado auditivo de tronco encefálico (PEATE) tem sido amplamente utilizado com diferentes finalidades na prática veterinária e é comumente usado para identificar a surdez hereditária e a presbiacusia. No presente estudo, 43 cães da raça Boxer foram pelo teste PEATE. Foi diagnosticada surdez em 3 cães (2 bilaterais e 1 unilateral), e 40 Boxers foram usados no estudo normativo incluindo avaliação da influência da idade no PEATE. Os animais foram divididos de acordo com a idade em 2 grupos de 20 Boxers cada. A idade media foi 4,54 anos (variação de 1-8) no grupo I e 9,83 anos (variação de 8,5-12) no grupo II. A latência media das ondas I, III e V foram: 1,14 (±0,07); 2,64 (±0,11) e 3,48 (±0,10) ms no grupo I; e 1,20 (±0,12); 2,73 (±0,15) e 3,58 (±0,22) ms no grupo II, respectivamente. A latência media para os intervalos I-III, III-V e I-V foram 1,50 (±0,15); 0,84 (±0,15) e 2,34 (±0,11) ms no grupo I; e 1,53 (±0,16); 0,85 (±0,15) e 2,38 (±0,19) ms no grupo II, respectivamente. As latências das ondas I e III foram estatisticamente diferentes entre os grupos I e II. Não foram observadas diferenças estatísticas entre os dois grupos para os intervalos I-III, III-V e I-V. De acordo com a revisão realizada, este é o primeiro estudo normativo de BAEP realizado em cães da raça Boxer.

Low haemoglobin levels increase unilateral spatial neglect in acute phase of stroke / Níveis baixos de hemoglobina aumentam a negligência espacial unilateral na fase aguda do acidente vascular cerebral

Objective The objective of this study was to evaluate the relationship between unilateral spatial neglect (USN) and haemoglobin (Hb) level in acute phase of stroke. Method Cross-sectional study was performed after right hemisphere ischemic stroke. Independent variable: Hb level (mg/dL); Outcome: USN; Potential confounding factors: Age, National Institutes of Health Stroke Scale (NIHSS), and glycaemia (mg/dL); Characterization variables were obtained from electronic medical records, Hb, mean corpuscular volume (MCV) and glycaemia by laboratory exams, and USN by cancellation and bisection tasks. The relationship between Hb and USN was assessed by Spearman correlation and linear regression model. Results 40 individuals were evaluated; it was observed that the higher the Hb level, the better the USN test performance, with the two being negatively correlated. There was no significant correlation between VCM level and USN performance. Conclusion Low hemoglobin levels may indicate a worse performance in USN cancellation and bissection tests in acute phase of stroke. .

Objetivo O objetivo do estudo foi avaliar a relação entre a negligência espacial unilateral (NEU) e hemoglobina (Hb) na fase aguda do acidente vascular cerebral (AVC). Método Foi realizado estudo transversal em pacientes com AVC de hemisfério direito dentro das primeiras 48 horas do ictus. Variáveis independentes: nível de Hb (mg/dL); Desfecho: NEU; Fatores potenciais de confundimento: Idade, National Institutes of Health Stroke Scale (NIHSS) e glicemia (mg/dL); A caracterização das variáveis foram obtidas por meio de prontuários eletrônicos, Hb e glicemia por exames laboratoriais, e NEU por meio do Line Cancellation (LCT), Star Cancelation (SCT), e Line Bisection Tasks (LBT). Resultados 40 indivíduos foram avaliados e foi observado que quanto maior os níveis de Hb, melhor o desempenho nos testes de NEU, demonstrando correlação negativa entre eles. Conclusão Níveis baixos de hemoglobina podem indicar pior desempenho nos testes de NEU na fase aguda do AVC. .

A sedação sobre os potenciais evocados auditivos em cães / The sedation on the auditory brainstem responses in dogs

O potencial evocado auditivo de tronco encefálico (Brainstem Auditory Evoked Potential - BAEP) avalia a atividade elétrica do sistema auditivo, desde a cóclea até o tronco encefálico, permitindo diagnóstico de surdez em cães. Como alguns animais não permitem a obtenção do BAEP sem contenção química, o objetivo deste trabalho foi analisar a influência da sedação com morfina e acepromazinano BAEP de 16 cães com audição normal. Os potenciais foram obtidos antes e durante a sedação com administração intramuscular de morfina (0,5mgkg-1) e acepromazina (0,05mgkg-1). O protocolo de sedação utilizado permitiu contenção efetiva e segurança dos animais. A sedação causou prolongamento nas latências das ondas II, III e intervalos I-III e I-V, mas não dificultou as suas identificações. O uso deste protocolo de sedação não interferiu com a interpretação do potencial evocado e pode ser útil em cães. Pelo que se pode observar na literatura compilada, este é o primeiro estudo avaliando a influência da sedação no BAEP em cães no Brasil.

Brainstem auditory evoked potential (BAEP) reflects the electrical activity along the auditory pathway, from the cochlea to the brainstem, and contributes for the diagnosis of deafness in dogs. BAEP recording may require chemical restraint in some cases, so this study was designed to analyze the impact of sedation with morphine and acepromazine on the BAEP recordings of 16 dogs with normal hearing. BAEPs were recorded before and during sedation with a combination of morphine (0.5mgkg-1) and acepromazine (0.05mgkg-1) given intramuscularly. The protocol employed allowed safe and effective animal restraint. Sedation increased the latency of waves II and III and intervals I-III and I-V but did not interfere with wave identification. and showed to be safe in the dogs tested. Based on the current literature this is the first study which assessed the impact of sedation on BAEPs in dogs in Brazil.

Motor nerve conduction and repetitive nerve stimulation in captive ring-tailed coati (Nasua nasua).

There are few electrophysiologic studies in wild animals. The aim of this study was to determine normal data for motor nerve conduction studies and repetitive stimulation in sciatic-tibial and ulnar nerves in clinically normal captive coati. Eight adult ring-tailed coatis (Nasua nasua), two females and six males weighing 6-8 kg, were used. Average nerve conduction velocity was 70.81 m/sec (standard deviation [SD] = 3.98) and 56.93 m/ sec (SD = 4.31) for the sciatic-tibial and ulnar nerves, respectively. Repetitive stimulation responses demonstrated minimal variations of the area of the compound muscle action potentials at low (3 Hz) and high (20 Hz) frequencies. The maximal obtained decremental area response was 8%. These normal data of conduction studies may be used in assessing abnormalities for clinical diagnosis. In addition, the obtained normal repetitive stimulation data were similar to dogs and humans and may be used for post- and presynaptic disturbances of the neuromuscular transmission in coatis.