Using routine HbA1c measurements in stroke and the associations of dysglycaemia with stroke outcomes.

AIMS: Diabetes is a major risk factor for stroke. We aimed to investigate the prevalence of diabetes and pre-diabetes within a stroke cohort and examine the association of glycaemia status with mortality and morbidity. METHODS: Inpatients aged ≥54 who presented with a diagnosis of stroke had a routine HbA1c measurement as part of the Austin Health Diabetes Discovery Initiative. Additional data were attained from hospital databases and Australian Stroke Clinical Registry. Outcomes included diabetes and pre-diabetes prevalence, length of stay, 6-month and in-hospital mortality, 28-day readmission rates, and 3-month modified Rankin scale score. RESULTS: Between July 2013 and December 2015, 610 patients were studied. Of these, 31% had diabetes while 40% had pre-diabetes. Using multivariable regression analyses, the presence of diabetes was associated with higher odds of 6-month mortality (OR = 1.90, p = 0.022) and higher expected length of stay (IRR = 1.29, p = 0.004). Similarly, a higher HbA1c was associated with higher odds of 6-month mortality (OR = 1.27, p = 0.005) and higher expected length of stay (IRR = 1.08, p = 0.010). CONCLUSIONS: 71% of this cohort had diabetes or pre-diabetes. Presence of diabetes and higher HbA1c were associated with higher 6-month mortality and length of stay. Further research is necessary to determine if improved glycaemic control may improve stroke outcomes.

Dynamic sculpting of brain functional connectivity is correlated with performance.

In this study, we examined the relationship between cortical coupling, reflected in event related partial coherence (ERPC) and cognitive processing speed while subjects performed a set of Raven's Progressive Matrices (RPM), a task used to measure IQ. Fifty-five participants (29 males) performed a computerized version of the RPM where they were required to identify the shape (probe) that is consistent with a matrix of displayed shapes. Participants indicated a match or non-match by pressing a micro-switch with either the right or left hand. The steady state visually evoked potential (SSVEP) was elicited by a 13 Hz uniform visual flicker superimposed over the visual fields and the SSVEP event-related coherence (SSVEP-ERPC) calculated for all 2016 unique electrode pairs. The linear correlation between SSVEP-ERPC and processing speed (the inverse of reaction time) was calculated for all electrode pairs for all time points during the 3 sec interval that the probes were on the screen. Using correlation coeffident thresholds corresponding to p=0.001 we identified those electrode pairs where SSVEP-ERPC or neural synchronization was significantly correlated with processing speed. At a point 0.8 sec before the appearance of the probe we observed that the synchronization between specific prefrontal, frontal and central sites was correlated with processing speed. We suggest that this relationship may reflect the efficiency of working memory processes and speed of information processing.