Primitive reflexes in cerebrovascular disease: a community study of older people with stroke and carotid stenosis

Rao, Rahul; Jackson, Stephen; Howard, Robert

doi:10.1002/(sici)1099-1166(199911)14:11<964::aid-gps51>3.0.co;2-g

Cited by 20 publications

(13 citation statements)

References 40 publications

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“…Second, populations of TIA/ minor stroke patients are found to possess neurological, neuropsychological, and physical performance deficits that may endure for days to weeks before resolving, despite normal CBF and fully reversed hyperacute DWI lesions. 1,[27][28][29] Last, indirect evidence of incomplete infarction has been discovered days to weeks after transient ischemic episodes characterized by no neuroimaging abnormalities, 30 which is similar to the results of this study, although we are unaware of any published study incorporating histopathological analysis of human brain tissue after TIA for conclusive detection of incomplete infarction.…”

Section: Discussionmentioning

confidence: 99%

“…Second, the data argue that normal DWI, PWI, T2WI, and fMRI after transient ischemia may not indicate normal tissue status, as histology and behavior remain abnormal, which may help explain persisting neurological deficits in subsets of patients with transient ischemia and a normal MRI battery. [27][28][29] Last, because incomplete infarction and changes in brain metabolism have been shown to have prognostic impact on clinical outcome in TIA patients, 31 our results suggest that adjunct neuroimaging modalities capable of detecting such events may aid in the development of more effective treatment strategies for this patient population. Furthermore, our data emphasize that even brief transient ischemia induces neuronal cell death and behavioral impairment that warrant development of treatment strategies beyond reducing risk factors.…”

Section: Discussionmentioning

confidence: 99%

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Long-Term Changes of Functional MRI–Based Brain Function, Behavioral Status, and Histopathology After Transient Focal Cerebral Ischemia in Rats

Sicard

Henninger

Fisher

et al. 2006

Stroke

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Background and Purpose-The relation between recovery of brain function and neurological status after clinical and experimental cerebral ischemia is incompletely characterized. We assessed the evolution of ischemic injury, behavioral status, and brain activity at acute to chronic periods after transient middle cerebral artery occlusion (tMCAO) in rats. Methods-Male Sprague-Dawley rats were subjected to 20-minute tMCAO (nϭ10) or sham operation (nϭ10).Sensorimotor behavioral testing and multimodal (diffusion, perfusion, T2, and functional) MRI, as well as postmortem hematoxylin-eosin staining, were performed before and up to 21 days after tMCAO. MRI and histological parameters were evaluated in 5 regions of interest within the sensorimotor network. Diffusion, perfusion, and T2 lesion volumes were calculated according to previously established viability thresholds. Results-Diffusion and perfusion lesions were present during occlusion but disappeared completely and permanently within 30 minutes after reperfusion, with no T2 lesions seen. Functional MRI and behavioral deficits did not normalize until 1 and 21 days after tMCAO, respectively. Histology demonstrated selective neuronal cell death at 7 and 21 days after reperfusion. Conclusions-Twenty-minute tMCAO produced distinct changes on multimodal MRI, histology, and behavioral parameters acutely and chronically.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Long-Term Changes of Functional MRI–Based Brain Function, Behavioral Status, and Histopathology After Transient Focal Cerebral Ischemia in Rats

Sicard

Henninger

Fisher

et al. 2006

Stroke

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“…A fuller description is provided elsewhere (Rao et al, 1999a). After contacting patients' general practitioners (GPs) by letter, documentation was made of patients whose GP refused for the patient to be interviewed, as well as those patients considered by their GP to be too frail/cognitively impaired/uncommunicative.…”

Section: Methodsmentioning

confidence: 99%

“…A more detailed description of patient selection has been described elsewhere (Rao et al, 1999a). Groups comprised patients with ®rst anterior circulation stroke (who had undergone a period of rehabilitation and had been admitted to hospital between six months and a year prior to interview), patients on the waiting list for carotid endarterectomy (suering one or more transient ischaemic attacks) and patients with peripheral vascular disease awaiting femoro-popliteal bypass.…”

Section: Samplementioning

confidence: 99%

“…Other scales comprised the London handicap scale (Harwood et al, 1994) and social support scale (Livingston et al, 1990). A fuller description of these scales is provided elsewhere (Rao et al, 1999a). Sociodemographic data, blood pressure and a physical illness checklist (Livingston et al, 1990) were also incorporated.…”

Section: Hamilton Rating Scale For Depression (Hrsd)mentioning

confidence: 99%

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Depression in older people with mild stroke, carotid stenosis and peripheral vascular disease: a comparison with healthy controls

Rao

Jackson

Howard

2001

Int. J. Geriat. Psychiatry

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Background Although depression has a recognised association with stroke, the role of ‘silent’ cerebrovascular pathology associated with carotid stenosis and peripheral vascular disease remains unexplored. Methods Four groups of 25 community residents aged 65 and over were recruited, comprising first anterior circulation stroke, carotid stenosis accompanied by transient ischaemic attack, peripheral vascular disease and a non‐vascular control group. All participants were interviewed using the Hamilton Rating Scale for Depression [HRSD] (including a modified version) and Geriatric Depression Scale. DSM IV criteria for major depression and measures of handicap, social support and physical illness were also administered. Head computerised tomography (CT) scans were performed on stroke patients to examine the relationship between lesion location and depression. Results One hundred patients were interviewed. Stroke patients were more likely to live in a nursing home and had less social support than other groups. Mean scores on the modified Hamilton and Geriatric Depression Scales were higher in stroke and carotid stenosis groups than controls. Patients with stroke did not show a higher prevalence of DSM IV major depressive disorder than those with carotid stenosis. There was no relationship between the presence of lesions affecting the frontal/subcortical system and prevalence/severity of depression. Limitations Small numbers, mortality of stroke patients in hospital, possible selection bias in the control group and use of a previously unvalidated depression rating scale all limit the study. Conclusions A possible role for carotid stenosis in the pathogenesis of depressive disorder is suggested. Larger studies incorporating brain imaging may be required to examine the mechanism of this association more closely. The use of a shorter version of the HRSD in older people with cerebrovascular disease may warrant further exploration. Copyright © 2001 John Wiley & Sons, Ltd.

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Current Awareness

2000

Int J Geriat Psychiatry

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of geriatric psychiatry. Each bibliography is divided into 9 sections: 1 Books, Reviews & Symposia; 2 General; 3 Assessment; 4 Epidemiology; 5 Therapy; 6 Care; 7 Dementia; 8 Depression; 9 Psychology. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted

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Primitive reflexes in cerebrovascular disease: a community study of older people with stroke and carotid stenosis

Cited by 20 publications

References 40 publications

Long-Term Changes of Functional MRI–Based Brain Function, Behavioral Status, and Histopathology After Transient Focal Cerebral Ischemia in Rats

Long-Term Changes of Functional MRI–Based Brain Function, Behavioral Status, and Histopathology After Transient Focal Cerebral Ischemia in Rats

Depression in older people with mild stroke, carotid stenosis and peripheral vascular disease: a comparison with healthy controls

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