Research of Neurophysiological Basis of Stroke

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Systems Neuroscience".

Deadline for manuscript submissions: closed (15 July 2022) | Viewed by 16195

Special Issue Editor


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Guest Editor
Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 511495, China
Interests: stroke; pontine infarction

Special Issue Information

Dear Colleagues,

Stroke leads to neurological dysfunction including neurophysiological disease, which in turn influences the recovery and rehabilitation of stroke. Recently, progress has been made on post-stroke neurophysiology, including the prevalence, mechanism, evaluation tools and clinical management.

The principal aims of this Special Issue are to address four core features of the neurophysiological basis of stroke:

  • Presentations: the prevalence and manifestation of post-stroke depression or other neurophysiological diseases (especially subtypes of stroke such as small-vessel disease, posterior circulation stroke or patients who received thrombolysis or thrombectomy);
  • Mechanisms: basic research about neurophysiology in stroke animal models;
  • Screening and assessments: neurophysiological scales, EMG, EEG, MEG, evoked potentials, coherence, accelerometry, posturography (balance), gait, sleep studies, and functional MRI (fMRI);
  • Interventions: special focus on non-pharmacological and pharmacological treatments.

Special attention will be reserved for original research on basic, translational and clinical research, but reviews, systematic reviews and meta-analyses will also be welcomed.

Dr. Yongjun Jiang
Guest Editor

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Keywords

  • Stroke
  • Neurophysiological
  • Scale
  • EMG
  • Treatment

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Published Papers (7 papers)

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Research

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8 pages, 1109 KiB  
Article
Increased Proximal Wall Shear Stress of Basilar Artery Plaques Associated with Ruptured Fibrous Cap
by Ruiyun Huang, Hongbing Chen, Chenghao Li, Chaowei Lie, Zhihua Qiu and Yongjun Jiang
Brain Sci. 2022, 12(10), 1397; https://doi.org/10.3390/brainsci12101397 - 17 Oct 2022
Cited by 2 | Viewed by 1514
Abstract
Plaque rupture of the basilar artery is one of the leading causes of posterior circulation stroke. The present study aimed to investigate the role of fluid dynamics in the ruptured fibrous cap of basilar artery plaques. Patients with basilar artery plaques (50–99% stenosis) [...] Read more.
Plaque rupture of the basilar artery is one of the leading causes of posterior circulation stroke. The present study aimed to investigate the role of fluid dynamics in the ruptured fibrous cap of basilar artery plaques. Patients with basilar artery plaques (50–99% stenosis) were screened. Integrity of the fibrous cap was assessed by high-resolution MRI. Computational fluid dynamics models were built based on MR angiography to obtain the wall shear stress and velocity. A total of 176 patients were included. High-resolution MRI identified 35 ruptured fibrous caps of basilar artery plaques. Ruptured fibrous cap was significantly associated with acute infarction (27/35 vs. 96/141, p < 0.05) in the territory of the basilar artery. Proximal wall shear stress of stenosis was positively related with the ruptured fibrous cap (OR 1.564; 95% CI, 1.101–2.222; p = 0.013). The threshold of wall shear stress for the ruptured fibrous cap of basilar artery plaques was 4.84 Pa (Area under ROC 0.732, p = 0.008, 95%CI 0.565–0.899). The present study demonstrated that increased proximal wall shear stress of stenosis was associated with ruptured fibrous caps of basilar artery plaques. Full article
(This article belongs to the Special Issue Research of Neurophysiological Basis of Stroke)
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14 pages, 515 KiB  
Article
Microsurgical Management of Posterior Circulation Aneurysms: A Retrospective Study on Epidemiology, Outcomes, and Surgical Approaches
by Wanchun You, Jiahao Meng, Xingyu Yang, Jie Zhang, Guannan Jiang, Zeya Yan, Feng Gu, Xinyu Tao, Zhouqing Chen, Zhong Wang and Gang Chen
Brain Sci. 2022, 12(8), 1066; https://doi.org/10.3390/brainsci12081066 - 11 Aug 2022
Cited by 8 | Viewed by 2001
Abstract
Posterior circulation aneurysms have been regarded as the most challenging for endovascular coiling and microsurgical occlusion. The role of microsurgical treatment is gradually being overlooked and diminishing in the trend of endovascular treatment. As microsurgical occlusion of posterior circulation aneurysms is decreasing, we [...] Read more.
Posterior circulation aneurysms have been regarded as the most challenging for endovascular coiling and microsurgical occlusion. The role of microsurgical treatment is gradually being overlooked and diminishing in the trend of endovascular treatment. As microsurgical occlusion of posterior circulation aneurysms is decreasing, we present our relevant experience to evaluate treatment options and surgical approaches. A retrospective study was conducted in the Department of Neurosurgery of the First Affiliated Hospital of Soochow University between 2016 and 2021. Patients with posterior circulation aneurysms treated by clipping, bypass, and trapping were enrolled and followed up for at least six months. We included 50 patients carrying 53 posterior circulation aneurysms, 43 of whom had aneurysm ruptures. The posterior cerebral artery and posterior inferior cerebellar artery were the most common aneurysm locations. Direct clipping was performed in 43 patients, while bypass and trapping was performed in six patients. The retrosigmoid, far-lateral, and midline or paramedian suboccipital approaches were performed for those aneurysms in the middle and lower thirds. Aneurysms in the upper third required the lateral supraorbital approach, pterional approach, subtemporal approach, and occipital craniotomy. The lateral supraorbital approach was utilized in seven patients for aneurysms above the posterior clinoid process. Thirty-four patients recovered well with modified Rankin score 0–3 at discharge. No patient experienced aneurysm recurrence during the mean follow-up period of 3.57 years. Microsurgery clipping and bypass should be considered in conjunction with endovascular treatment as a treatment option in posterior circulation aneurysms. The lateral supraorbital approach is a feasible, safe, and simple surgical approach for aneurysms above the posterior clinoid process. Full article
(This article belongs to the Special Issue Research of Neurophysiological Basis of Stroke)
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11 pages, 1621 KiB  
Article
Higher Plasma Fibrinogen Level at Admission Is Associated with Post-Stroke Depression at Discharge
by Juehua Zhu, Li Wang, Han Shao, Xiang Tang, Lulu Zhang, Yun Zhou, Yongjun Jiang, Qi Fang and Xiuying Cai
Brain Sci. 2022, 12(8), 1032; https://doi.org/10.3390/brainsci12081032 - 3 Aug 2022
Cited by 4 | Viewed by 2047
Abstract
Background: Post-stroke depression (PSD) is a common complication of stroke, which seriously affects the functional outcome of patients. Systemic low-grade inflammation associated with PSD has been shown to occur at several months to years, however, whether these inflammatory markers predicted PSD at an [...] Read more.
Background: Post-stroke depression (PSD) is a common complication of stroke, which seriously affects the functional outcome of patients. Systemic low-grade inflammation associated with PSD has been shown to occur at several months to years, however, whether these inflammatory markers predicted PSD at an acute stage of stroke is controversial. Method: A total of 625 patients with acute ischemic stroke (219 female, 35.40%) were included in this study. PSD was diagnosed using the 17-item Hamilton depression scale (HAMD) at 7 days following discharge (7–14 days after stroke onset). Multivariable logistic regression analysis was applied to build a prediction model for PSD at discharge. Discrimination and calibration of the model were assessed by C-index, calibration plot. Internal validation was conducted using bootstrapping validation. Results: At discharge of hospitalization, 95 patients (15.20%) were diagnosed with PSD. Multivariable logistic regression suggested that female gender (OR = 2.043, 95% CI = 1.287–3.245, p = 0.002), baseline NIHSS (OR = 1.108, 95% CI = 1.055–1.165, p < 0.001) and fibrinogen (OR = 1.388, 95% CI = 1.129–1.706, p = 0.002) were independent predictors for PSD at discharge. The cut-off of the fibrinogen plasma level was 3.08 g/L. These predictors were included in the nomogram. The model displayed good discrimination, with a C-index of 0.730 (95% CI = 0.683–0.777) and good calibration. Conclusion: Female gender, baseline stroke severity and a higher level of fibrinogen were independently associated with PSD at discharge. A nomogram based on these three predictors can be used to provide an individual, visual prediction of the risk probability of PSD. Full article
(This article belongs to the Special Issue Research of Neurophysiological Basis of Stroke)
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9 pages, 710 KiB  
Article
Site and Mechanism of Recurrent Pontine Infarction: A Hospital-Based Follow-Up Study
by Li Wu, Youfu Li, Zeming Ye, Dezhi Liu, Zheng Dai, Juehua Zhu, Hongbing Chen, Chenghao Li, Chaowei Lie and Yongjun Jiang
Brain Sci. 2022, 12(5), 520; https://doi.org/10.3390/brainsci12050520 - 20 Apr 2022
Cited by 3 | Viewed by 2132
Abstract
Although pontine infarction is the most common subtype of posterior circulation stroke, there has been little research focusing on recurrent pontine infarction. Our study aimed to investigate the factors associated with site and mechanism of recurrent pontine infarction. Patients with acute isolated pontine [...] Read more.
Although pontine infarction is the most common subtype of posterior circulation stroke, there has been little research focusing on recurrent pontine infarction. Our study aimed to investigate the factors associated with site and mechanism of recurrent pontine infarction. Patients with acute isolated pontine infarction were enrolled and followed up for one year. Lesion topography was determined by diffusion-weighted imaging. Mechanisms were determined based on lesion topography and other vascular, cardiologic and laboratory results. A total of 562 patients with pontine infarction were included, with 67 patients experiencing recurrence during the follow-up period. Forty-one recurrences occurred at the same site as index pontine infarction (41/67, 61.2%). Results indicated that the mechanism of index pontine infarction was significantly associated with the recurrent sites (p = 0.041, OR 2.938, 95% CI 1.044–8.268), and also with the mechanisms of recurrence (p = 0.004, OR 6.056, 95% CI 1.774–20.679). Branch atheromatous disease-induced index pontine infarction was likely to recur at the same site and with the same mechanism. Moreover, if recurrence occurred at the same site, the mechanism was probably the same as that of the index stroke (p = 0.000). Our study may help physicians treat patients with pontine infarction by predicting the site and mechanism of recurrence. Full article
(This article belongs to the Special Issue Research of Neurophysiological Basis of Stroke)
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Review

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12 pages, 302 KiB  
Review
Association of Trimethylamine N-Oxide with Normal Aging and Neurocognitive Disorders: A Narrative Review
by Xiangliang Chen, Mengmeng Gu, Ye Hong, Rui Duan and Junshan Zhou
Brain Sci. 2022, 12(9), 1203; https://doi.org/10.3390/brainsci12091203 - 6 Sep 2022
Cited by 3 | Viewed by 2777
Abstract
Aging-related neurocognitive disorder (NCD) is a growing health concern. Trimethylamine-N-oxide (TMAO), a gut microbiota-derived metabolite from dietary precursors, might emerge as a promising biomarker of cognitive dysfunction within the context of brain aging and NCD. TMAO may increase among older adults, Alzheimer’s disease [...] Read more.
Aging-related neurocognitive disorder (NCD) is a growing health concern. Trimethylamine-N-oxide (TMAO), a gut microbiota-derived metabolite from dietary precursors, might emerge as a promising biomarker of cognitive dysfunction within the context of brain aging and NCD. TMAO may increase among older adults, Alzheimer’s disease patients, and individuals with cognitive sequelae of stroke. Higher circulating TMAO would make them more vulnerable to age- and NCD-related cognitive decline, via mechanisms such as promoting neuroinflammation and oxidative stress, and reducing synaptic plasticity and function. However, these observations are contrary to the cognitive benefit reported for TMAO through its positive effects on blood–brain barrier integrity, as well as from the supplementation of TMAO precursors. Hence, current disputable evidence does not allow definite conclusions as to whether TMAO could serve as a critical target for cognitive health. This article provides a comprehensive overview of TMAO documented thus far on cognitive change due to aging and NCD. Full article
(This article belongs to the Special Issue Research of Neurophysiological Basis of Stroke)
10 pages, 508 KiB  
Review
Astrocyte-Derived Neuronal Transdifferentiation as a Therapy for Ischemic Stroke: Advances and Challenges
by Siqi Gong, Han Shao, Xiuying Cai and Juehua Zhu
Brain Sci. 2022, 12(9), 1175; https://doi.org/10.3390/brainsci12091175 - 1 Sep 2022
Cited by 4 | Viewed by 2731
Abstract
After the onset of ischemic stroke, ischemia–hypoxic cascades cause irreversible neuronal death. Neurons are the fundamental structures of the central nervous system, and mature neurons do not renew or multiply after death. Functional and structural recovery from neurological deficits caused by ischemic attack [...] Read more.
After the onset of ischemic stroke, ischemia–hypoxic cascades cause irreversible neuronal death. Neurons are the fundamental structures of the central nervous system, and mature neurons do not renew or multiply after death. Functional and structural recovery from neurological deficits caused by ischemic attack is a huge task. Hence, there remains a need to replace the lost neurons relying on endogenous neurogenesis or exogenous stem cell-based neuronal differentiation. However, the stem cell source difficulty and the risk of immune rejection of the allogeneic stem cells might hinder the wide clinical application of the above therapy. With the advancement of transdifferentiation induction technology, it has been demonstrated that astrocytes can be converted to neurons through ectopic expression or the knockdown of specific components. The progress and problems of astrocyte transdifferentiation will be discussed in this article. Full article
(This article belongs to the Special Issue Research of Neurophysiological Basis of Stroke)
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Other

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12 pages, 2228 KiB  
Systematic Review
Efficacy and Safety of Different Bioactive Coils in Intracranial Aneurysm Interventional Treatment, a Systematic Review and Bayesian Network Meta-Analysis
by Jie Zhang, Guannan Jiang, Zhaoming Song, Wei Cheng, Wenxue Wu, Zhouqing Chen, Zhong Wang, Wanchun You and Gang Chen
Brain Sci. 2022, 12(8), 1062; https://doi.org/10.3390/brainsci12081062 - 10 Aug 2022
Cited by 4 | Viewed by 1885
Abstract
Background: Bioactive coils have been used for nearly 20 years to improve aneurysm treatments. Previous studies are inadequate for comparing the efficacy and safety between different coils. The aim of this study was to investigate the safety and efficacy of different coils by [...] Read more.
Background: Bioactive coils have been used for nearly 20 years to improve aneurysm treatments. Previous studies are inadequate for comparing the efficacy and safety between different coils. The aim of this study was to investigate the safety and efficacy of different coils by comparing the percentage of people with different modified Raymond scale grades, re-rupture rates, and mortality in patients with intracranial aneurysms embolized with different coils. Method: Randomized controlled trials (RCTs) containing coils for aneurysm interventional treatment were collected from Web of Science, PubMed, and the Cochrane Library up to December 2021. Bayesian network meta-analysis with a randomized or fixed model was performed to compare the efficacy and safety among different bioactive coils and bare platinum coils. Results: We pooled 3362 patients from eight RCTs. No significant differences were found between coils in the proportion of patients with a three-grade classification assessed with the modified Raymond scale immediately after surgery. Hydrogel coils did not show a significant difference in the percentage of patients with a modified Raymond scale grade I postoperatively compared with bare platinum coils (OR, −0.1080; 95% CI, −0.4201–0.2423), but at follow-up, the percentage of patients with modified Raymond scale grade I was significantly higher with hydrogel coils than with bare platinum coils (OR, 0.4957; 95% CI, 0.0060–0.9442). There were no statistical differences between these four coils in terms of aneurysm rupture or re-rupture rate and mortality. Conclusion: Though there was no significant difference in the embolization effect between the several coils in the postoperative period, complete embolization was more likely to be achieved with hydrogel coils compared to bare platinum coils at follow-up. There were no significant differences in safety between the several coil materials. Full article
(This article belongs to the Special Issue Research of Neurophysiological Basis of Stroke)
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