Dissecting the cognitive phenotype of post-stroke fatigue using computerized assessment and computational modeling of sustained attention.

Post-stroke fatigue (PSF) is prevalent among stroke patients, but its mechanisms are poorly understood. Many patients with PSF experience cognitive difficulties, but studies aiming to identify cognitive correlates of PSF have been largely inconclusive. With the aim of characterizing the relationship between subjective fatigue and attentional function, we collected behavioral data using the attention network test (ANT) and self-reported fatigue scores using the fatigue severity scale (FSS) from 53 stroke patients. In order to evaluate the utility and added value of computational modeling for delineating specific underpinnings of response time (RT) distributions, we fitted a hierarchical drift diffusion model (hDDM) to the ANT data. Results revealed a relationship between fatigue and RT distributions. Specifically, there was a positive interaction between FSS score and elapsed time on RT. Group analyses suggested that patients without PSF increased speed during the course of the session, while patients with PSF did not. In line with the conventional analyses based on observed RT, the best fitting hDD model identified an interaction between elapsed time and fatigue on non-decision time, suggesting an increase in time needed for stimulus encoding and response execution rather than cognitive information processing and evidence accumulation. These novel results demonstrate the significance of considering the sustained nature of effort when defining the cognitive phenotype of PSF, intuitively indicating that the cognitive phenotype of fatigue entails an increased vulnerability to sustained effort, and suggest that the use of computational approaches offers a further characterization of specific processes underlying behavioral differences.

[Study on therapeutic mechanism of Rehmanniae Radix Praeparata- Corni Fructus in sequelae of ischemic stroke based on network pharmacology technology].

In ischemic stroke sequela phase, Rehmanniae Radix Praeparata-Corni Fructus drug pair has the effect in protecting damaged neurons, but its mechanism has not been clear. In this study, network pharmacology was used to predict the mechanism of Rehmanniae Radix Praeparata-Corni Fructus in the treatment of ischemic stroke sequela. Through database search and literature retrie-val, 40 active ingredients of Rehmanniae Radix Praeparata and Corni Fructus were obtained, and their targets were obtained through STITCH and TCMSP databases. The targets of ischemic stroke sequela were obtained through OMIM,GAD,TTD and DrugBank databases. By screening the intersections of active ingredients targets and stroke treatment targets, 21 potential targets were obtained. The DAVID database was used for GO enrichment analysis and KEGG pathway analysis of potential targets. GO enrichment analysis showed that Rehmanniae Radix Praeparata-Corni Fructus were mainly involved in regulation of blood pressure, negative regulation of extrinsic apoptotic signaling and positive regulation of angiogenesis. KEGG pathway analysis showed that Rehmanniae Radix Praeparata-Corni Fructus could inhibit inflammatory response and apoptosis signaling pathway by regulating HIF-VEGFA signaling pathway in neural stem cell proliferation, TNF signaling pathway and NF-kappaB signaling pathway. Molecular docking technique was used to verify that Rehmanniae Radix Praeparata-Corni Fructus component has a good binding activity with potential targets. The results showed that in ischemic stroke sequela phase, Rehmanniae Radix Praeparata-Corni Fructus drug pair could play an important role in recovering neural function, promoting the proliferation of neural stem cells, angiogenesis, preventing neural cells apoptosis and regulating inflammatory factors.

Study on therapeutic mechanism of Rehmanniae Radix Praeparata- Corni Fructus in sequelae of ischemic stroke based on network pharmacology technology / 中国中药杂志

In ischemic stroke sequela phase, Rehmanniae Radix Praeparata-Corni Fructus drug pair has the effect in protecting damaged neurons, but its mechanism has not been clear. In this study, network pharmacology was used to predict the mechanism of Rehmanniae Radix Praeparata-Corni Fructus in the treatment of ischemic stroke sequela. Through database search and literature retrie-val, 40 active ingredients of Rehmanniae Radix Praeparata and Corni Fructus were obtained, and their targets were obtained through STITCH and TCMSP databases. The targets of ischemic stroke sequela were obtained through OMIM,GAD,TTD and DrugBank databases. By screening the intersections of active ingredients targets and stroke treatment targets, 21 potential targets were obtained. The DAVID database was used for GO enrichment analysis and KEGG pathway analysis of potential targets. GO enrichment analysis showed that Rehmanniae Radix Praeparata-Corni Fructus were mainly involved in regulation of blood pressure, negative regulation of extrinsic apoptotic signaling and positive regulation of angiogenesis. KEGG pathway analysis showed that Rehmanniae Radix Praeparata-Corni Fructus could inhibit inflammatory response and apoptosis signaling pathway by regulating HIF-VEGFA signaling pathway in neural stem cell proliferation, TNF signaling pathway and NF-kappaB signaling pathway. Molecular docking technique was used to verify that Rehmanniae Radix Praeparata-Corni Fructus component has a good binding activity with potential targets. The results showed that in ischemic stroke sequela phase, Rehmanniae Radix Praeparata-Corni Fructus drug pair could play an important role in recovering neural function, promoting the proliferation of neural stem cells, angiogenesis, preventing neural cells apoptosis and regulating inflammatory factors.

Observations on the Efficacy of Jin’s Three Needles plus Twelve Jing-Well Points in Treating Post-stroke Shoulder-hand Syndrome / 上海针灸杂志

Objective To investigate the clinical efficacy of Jin’s Three Needles plus twelve Jing-Well points in treating post-stroke shoulder-hand syndrome. Methods Sixty patients meeting the inclusion criteria of post-stroke shoulder-hand syndrome were randomly allocated to treatment and control groups, 30 cases each. The treatment group received acupuncture with Jin’s Three Needles plus twelve Jing-Well points and the control group, conventional acupuncture. The Clinical Neurological Disfunction Scale (CNDS) score, the Fugl-Meyer Assessment (FMA) score, the Visual Analogue Scale (VAS) score and the Functiional Comprehensive Assessment (FCA) score were observed in the two groups before and after two weeks of treatment. The clinical therapeutic effects were compared between the two groups. Results There were statistically significant pre-/post-treatment differences in the CNDS, FMA, VAS and FCA scores in the two groups (P<0.05). The total efficacy rate and the cure and marked efficacy rate were 96.7%and 55.7%in the combination group, respectively, in the treatment group and 83.3%and 26.7%, respectively, in the control group;there were statistically significant differences between the two groups (P<0.05). Conclusion Acupuncture with Jin’s Three Needles plus twelve Jing-Well points is an effective way to treat post-stroke shoulder-hand syndrome.

Treatment therapy comparison of older patients with stroke sequela combined hip fracture in the elderly / 中国综合临床

Objective To investigate therapeutic effect for older patients suffering from stroke sequela combined hip fracture and discuss the influence factors of prognosis.Methods The clinical data of 62 older patients suffering from stroke sequela combined with hip fracture were retrospectively analyzed.The therapy approach included the conservative treatment group (12 cases),the joint replacement group (18 cases) and the internal fixation group (32 cases).The data of the American association of anaesthetists (ASA) score,daily life activities ability index (Barthel life index),complications,mini-mental state examination (MMSE) scale score,proximal femur trabecular bone type index (Singh index),complications after fracture (infection,recurrent stroke,bedsore,deep vein thrombosis,heart failure) were collected and analyzed.Results There was no statistical significance in terms of age,gender,ASA grade,and complications among three groups.In the conservative treatment group,the joint replacement group,and the internal fixation group,the Bart index were (52.1 ± 11.4),(74.5 ± 21.3) and (63.8 ± 15.7) respectively,and the cases of postoperative complications were 10,3 and 13.There were significant difference in terms of Bart index and complication rate among the three groups (F =2.45,P ＜ 0.05 ; x2 =9.32,P ＜ 0.05).The differences of Singh index (x2 =11.05,P ＜ 0.05) and MMSE scale score (x2 =7.40,P ＜ 0.05) were statistically significant between the conservative treatment group and the two surgical treatment groups.No significant difference were found regarding of Singh index and MMSE scale score between the two surgical treatment groups.The relationship between ASA score,complication,MMSE scale score,treatment strategies and Bart index after fracture were found (OR =5.726,7.152,0.047,1.221,and 5.312 respectively ;P ＜ 0.05).Conclusion Joint replacement treatment is a preferred choice for older patients suffering from stroke sequela combined hip fracture.The prognosis is strongly influenced by the physical and mental state of patients.Comprehensive evaluation is an indispensable step to choose treatment strategies.

Effects of Partial Body Weight Support Treadmill Training on Sequela of Stroke / 中国康复理论与实践

@#Objective To explore the effects of partial body weight support treadmill training (PBWSTT) on motor function of lower extremities, walking ability and activities of daily living (ADL) in chronic hemiplegic patients after stroke. Methods28 patients with stable stroke (hemiplegic limbs Brunstrom s' scale≥Ⅲ) exceed 12 months after the onset were divided into PBWSTT group (n=14) and control group (n=14) randomly. Routine rehabilitation were used in the control group, and the PBWSTT group received PBWSTT in addition. They were assessed with Ashworth Spasticity Scale （ASS）, Functional Ambulation Category (FAC), Fugl-Meyer Assessment (FMA), and the Functional Independence Measurement (FIM) before and 8 weeks after the treatment. ResultsThe ASS,FAC, FMA and FIM scores were all improved after treatment in both groups (P<0.05). The scores of FMA, FAC and FIM in the PBWSTT group after treatment exceeded that of control group (P<0.05), but there was no difference in the ASS (P>0.05). ConclusionPBWSTT may improve the motor function of lower extremities, walking ability, and ADL in chronic hemiplegic patients after stroke.