Background: The prognosis of functional disability in patients with cerebrovascular disease has not been well established. Therefore, we conducted this study to determine the prognostic significance of high-sensitivity C-reactive protein (hs-CRP) and homocysteine (Hcy) levels in patients with functional disability after acute first-ever ischemic stroke. Method: A total of 309 patients with first-ever stroke were examined within 24 h after symptom onset. Hcy was measured at admission, and hs-CRP measurements were made at admission and on the seventh hospital day. The correlations between the concentration of hs-CRP or Hcy and functional disability at 1, 3, 6 and 12 months after stroke onset were analyzed. Results: The present study showed that both hs-CRP values on admission and on the seventh hospital day were significantly correlated with modified Rankin Scale (mRS) scores obtained at 4 times after the onset of stroke. These results also demonstrated that mRS scores are more closely associated with hs-CRP values on the seventh hospital day than on admission. However, there was no significant relationship between Hcy and mRS scores during the 12-month follow-up period. Conclusion: According to the present study, we cautiously suggest that hs-CRP values on the subacute phase have sufficient value as a predictor of the prognosis of functional disability after first-ever stroke.
Abstract:Parkinson's disease (PD) and Alzheimer's disease (AD) can coexist in severely affected; elderly patients. Since they have different pathological causes and lesions and consequently require different treatments; it is critical to distinguish PD-related dementia (PD-D) from AD. Conventional electroencephalograph (EEG) analysis has produced poor results. This study investigated the possibility of using relative wavelet energy (RWE) and wavelet coherence (WC) analysis to distinguish between PD-D patients; AD patients and healthy elderly subjects. In EEG signals; we found that low-frequency wavelet energy increased and high-frequency wavelet energy decreased in PD-D patients and AD patients relative to healthy subjects. This result suggests that cognitive decline in both diseases is potentially related to slow EEG activity; which is consistent with previous studies. More importantly; WC values were lower in AD patients and higher in PD-D patients compared with healthy subjects. In particular; AD patients exhibited decreased WC primarily in the γ band and in links related to frontal regions; while PD-D patients exhibited increased WC primarily in the α and β bands and in temporo-parietal links. Linear discriminant analysis (LDA) of RWE produced a maximum accuracy of 79.18% for diagnosing PD-D and 81.25% for diagnosing AD. The discriminant accuracy was 73.40% with 78.78% sensitivity and 69.47% specificity. In distinguishing between the two diseases; the maximum performance of LDA using WC was 80.19%. We suggest that using a wavelet approach to evaluate EEG results may facilitate discrimination between PD-D and AD. In particular; RWE is useful for differentiating individuals with and without dementia and WC is useful for differentiating between PD-D and AD.
Background: Microglia are involved in immune surveillance in intact brains and become activated in response to inflammation and neurodegeneration. Microglia have different functions, neuroprotective or neurotoxic, according to aging in patients with PD. The clinical effect of microglia in patients with Alzheimer's disease (AD) is poorly defined. This prospective study was conducted to investigate the clinical effects of microglia according to the aging process in newly diagnosed AD.Methods: We examined 532 patients with newly diagnosed AD and 119 healthy controls, and the differences in hs-CRP between these groups were investigated. The patients with AD were classified into 3 subgroups according to age of newly diagnosed AD to investigate the relationship between hs-CRP and the aging process in newly diagnosed AD.Results: There was significantly higher serum high-sensitivity C-reactive protein (hs-CRP), levels in patients with AD compared with healthy controls. A post-hoc analysis of the 3 AD subgroups showed no significant differences in serum hs-CRP level between each group.Conclusion: We assumed that neuroinflammation play a role in the pathogenesis of AD, but found no clinical evidence that microglia senescence underlies the microglia switch from neuroprotective in young brains to neurotoxic in aged brains. To clarify the role of microglia and aging in the pathogenesis of AD, future longitudinal studies involving a large cohort are required.
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