BackgroundCognitive impairment after stroke is common and can cause disability with major impacts on quality of life and independence. Transcranial direct current stimulation may represent a promising tool for reconstitution of cognitive functions in stroke patients.ObjectivesThis study aimed to investigate the effect of transcranial direct current stimulation on cognitive functions in stroke patients.Patients and methodsForty male stroke patients were included. Patients were divided randomly into two equal groups (A and B). Group A received transcranial direct current stimulation (tDCS) in combination with selected cognitive training program by RehaCom. Group B received sham transcranial direct current stimulation in combination with the same cognitive training program.Cognitive evaluation and functional independence measure (FIM) were done for all patients before and after treatment.ResultsThere was a significant improvement in the scores of attention and concentration, figural memory, logical reasoning, reaction behavior, and FIM post treatment in both groups; the improvement was significantly higher in group A compared to group B.ConclusiontDCS is a safe and effective neuro-rehabilitation modality that improves post stroke cognitive dysfunctions. Moreover, tDCS has a positive impact on performance of daily activities.

Serum homocysteine may play a role in cognitive dysfunction in MS patients.

Corticobasal syndrome (CBS) is a sporadic tauopathy that manifests by a various combination of motor and cognitive deficits, which makes its diagnosis challenging. Treatment of CBS is symptomatic and based on evidence from other similar disorders due to the lack of studies on CBS. The aim of the study was to investigate low-frequency repetitive transcranial magnetic stimulation (rTMS) as a therapeutic tool in CBS. Twenty-six patients with clinically evident CBS according to Cambridge criteria were followed for 12-18 months while receiving low-frequency rTMS combined with pharmacological, rehabilitation treatment and botulinum toxin injection. The majority of patients are manifested with akinetic-rigid syndrome and cognitive dysfunction. There was improvement of the UPDRS and quality of life after 3 months of therapeutic interventions (P < 0.001 and <0.05, respectively). No significant deterioration in cognitive functions was detected over the study period. There was a significant reduction of caregiver burden after 3 months of interventions (P < 0.01); this improvement was maintained up to 18 months. Cognitive dysfunction is a frequent manifestation of CBS. CBS patients can benefit from multidisciplinary therapeutic approach employing low-frequency rTMS.

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Background: A growing body of evidence indicated that vitamin D has a potential protective role against neurovascular injury. Low serum vitamin D has been associated with increased risk for incident stroke and stroke fatality.Objective: This study aimed to investigate vitamin D status among acute ischemic stroke patients and examine its relation to initial severity and short-term outcome. Subjects and methods: Forty-eight acute ischemic stroke patients and 48 matched healthy control subjects participated in the study. Subjects were divided according to vitamin D level into deficient, insufficient, and sufficient groups. National Institute of Health Stroke Scale (NIHSS) on admission and after 72 h and modified Rankin Scale (mRS) on discharge and after 3 months were performed for all patients. Results: Stroke patients had significantly lower serum vitamin D levels compared to healthy subjects. Vitamin D deficiency and insufficiency were significantly prevalent among patients compared to healthy controls. Significant negative correlation was detected between serum vitamin D and NIHSS scores on admission and after 72 h. Significant negative correlation was also detected between serum vitamin D and mRS scores on discharge and after 3 months. An increased risk of stroke of 2.88 times was found in patients with insufficient vitamin D in comparison to sufficient subgroup, and this likelihood increases to be 13.78 times in the deficient compared to sufficient subgroups. Conclusion: Vitamin D deficiency increases the risk of acute ischemic stroke and is associated with increased initial stroke severity and worse short-term outcome.