Multimorbidity in Stroke

Gallacher, Katie; Jani, Bhautesh; Hanlon, Peter; Nicholl, Barbara I; Mair, Frances S

doi:10.1161/strokeaha.118.020376

Cited by 56 publications

(54 citation statements)

References 38 publications

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“…A long-term condition can be defined as a health condition lasting one year or longer and having an impact on a person's everyday life (The Scottish Government, 2015). The worldwide prevalence of long-term conditions is increasing (Gallacher et al, 2019). In the UK, the management of long-term conditions is a "central task" of the NHS and accounts for 70% of the health service budget (NHS England, 2014).…”

Section: Introductionmentioning

confidence: 99%

Goal adjustment by people living with long-term conditions: A scoping review of literature published from January 2007 to June 2018.

Scobbie

Thomson

Pollock

et al. 2020

Neuropsychological Rehabilitation

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Long-term health conditions can limit achievement of personal goals. We aimed to map and synthesize definitions of goal adjustment, theoretical underpinnings, associations with recovery and supportive interventions for adults with long-term conditions. We searched multiple databases (January 2007-June 2018) and identified peer-reviewed research relating to goal adjustment. Data were charted, mapped and synthesized using content analysis and descriptive summaries. Two stakeholder consultations informed the review. Ninety-one articles were included. A range of long-term conditions were represented including cancer (22%), stroke (12%) and mixed neurological conditions (8%). Goal adjustment was one available option when faced with unattainable goals; other options were goal disengagement and goal re-engagement. Most studies were quantitative (58%), reporting mainly positive associations between goal adjustment, disengagement, reengagement and recovery. The Dual Process Model, Goal Adjustment Model and Self-Regulation Theory were most cited underpinning models/theory. Five interventions were identified; only one (self-system therapy) was evaluated in a randomized controlled trial. Our review provides original and significant insights into goal adjustment definitions, theoretical underpinnings and association with recovery. Effective interventions to support goal adjustment, disengagement and reengagement are lacking. This research-practice gap warrants attention to ensure people with long-term conditions are optimally supported when facing unattainable goals.

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Section: Introductionmentioning

confidence: 99%

Goal adjustment by people living with long-term conditions: A scoping review of literature published from January 2007 to June 2018.

Scobbie

Thomson

Pollock

et al. 2020

Neuropsychological Rehabilitation

View full text Add to dashboard Cite

show abstract

“…Because our findings suggest that their expression is poorly restricted to brain, they may be limited in their ability to accurately detect damage to brain tissue in the presence of concurrent damage to peripheral tissues and organs, which is often a feature in many neurological conditions. For example, in stroke, common comorbidities such as diabetes and atherosclerosis cause cellular damage to the vasculature and kidneys (37). In Alzheimer's disease, a multitude of common age-related maladies and general atrophy cause similar cellular damage across the body (38).…”

mentioning

confidence: 99%

Large-scale informatic analysis to algorithmically identify blood biomarkers of neurological damage

O’Connell

Alder

Smothers

et al. 2020

Proc. Natl. Acad. Sci. U.S.A.

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The identification of precision blood biomarkers which can accurately indicate damage to brain tissue could yield molecular diagnostics with the potential to improve how we detect and treat neurological pathologies. However, a majority of candidate blood biomarkers for neurological damage that are studied today are proteins which were arbitrarily proposed several decades before the advent of high-throughput omic techniques, and it is unclear whether they represent the best possible targets relative to the remainder of the human proteome. Here, we leveraged mRNA expression data generated from nearly 12,000 human specimens to algorithmically evaluate over 17,000 protein-coding genes in terms of their potential to produce blood biomarkers for neurological damage based on their expression profiles both across the body and within the brain. The circulating levels of proteins associated with the top-ranked genes were then measured in blood sampled from a diverse cohort of patients diagnosed with a variety of acute and chronic neurological disorders, including ischemic stroke, hemorrhagic stroke, traumatic brain injury, Alzheimer’s disease, and multiple sclerosis, and evaluated for their diagnostic performance. Our analysis identifies several previously unexplored candidate blood biomarkers of neurological damage with possible clinical utility, many of which whose presence in blood is likely linked to specific cell-level pathologic processes. Furthermore, our findings also suggest that many frequently cited previously proposed blood biomarkers exhibit expression profiles which could limit their diagnostic efficacy.

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“…Importantly, most in vitro and in vivo studies regarding ischemic stroke were performed at the level of a single disease, not including comorbidities, such as hyperglycemia or diabetes. It was reported that most patients with stroke have comorbidities (169). Therefore, future studies should address ischemic stroke using models that mimic the disease, as well as its comorbidities, similar to patients, in order to develop more specific and accurate therapeutics.…”

Section: Anti-inflammatory Drugs Related To Monocytes and Macrophagesmentioning

confidence: 99%

Monocyte Transmodulation: The Next Novel Therapeutic Approach in Overcoming Ischemic Stroke?

et al. 2020

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The immune response following neuroinflammation is a vital element of ischemic stroke pathophysiology. After the onset of ischemic stroke, a specialized vasculature system that effectively protects central nervous system tissues from the invasion of blood cells and other macromolecules is broken down within minutes, thereby triggering the inflammation cascade, including the infiltration of peripheral blood leukocytes. In this series of processes, blood-derived monocytes have a significant effect on the outcome of ischemic stroke through neuroinflammatory responses. As neuroinflammation is a necessary and pivotal component of the reparative process after ischemic stroke, understanding the role of infiltrating monocytes in the modulation of inflammatory responses may offer a great opportunity to explore new therapies for ischemic stroke. In this review, we discuss and highlight the function and involvement of monocytes in the brain after ischemic injury, as well as their impact on tissue damage and repair.

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Multimorbidity in Stroke

Cited by 56 publications

References 38 publications

Goal adjustment by people living with long-term conditions: A scoping review of literature published from January 2007 to June 2018.

Goal adjustment by people living with long-term conditions: A scoping review of literature published from January 2007 to June 2018.

Large-scale informatic analysis to algorithmically identify blood biomarkers of neurological damage

Monocyte Transmodulation: The Next Novel Therapeutic Approach in Overcoming Ischemic Stroke?

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