Usage of perioperative anxiety neuromarker for improving the quality of life of a patient operated on for critical  stenosis of the internal carotid artery

Trystuła, Mariusz; Półrola, Paweł; Kropotov, Juri D.

doi:10.5604/12321966.1226855

Cited by 4 publications

(3 citation statements)

References 12 publications

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“…Nevertheless, the size of the two study cohorts was not sufficient to test the potential relationship between the post-revascularization evolution of disability [36] and HR-QoL evolution. Moreover, neuromarker release [37] or cranial nerve injury that may occur with CEA but not with CAS (and may affect the quality of life [11]) was not routinely assessed. Finally, the present findings, in relation to HR-QoL after symptomatic CS revascularization using CAS, are applicable only to conventional (i.e., first-generation) carotid stents.…”

Section: Discussionmentioning

confidence: 99%

Health-related quality of life in ischaemic stroke survivors after carotid endarterectomy (CEA) and carotid artery stenting (CAS): confounder-controlled analysis

Trystuła

Tomaszewski

Pąchalska

2019

pwki

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Introduction: Atherosclerotic carotid artery stenosis (CS)-related strokes are a significant overall stroke burden contributor. Aim: To evaluate the effect of surgical (carotid endarterectomy-CEA) vs. percutaneous (neuroprotected carotid artery stenting-CAS) carotid revascularization on health-related quality of life (HRQoL) in stroke survivors: analysis controlled for major HRQoL determinants beyond strokes. Material and methods: Our database of 856 carotid revascularization procedures (48.7% symptomatic CS) performed over 3 years showed 42 pairs (CEA-CAS) of right hemispheric stroke patients matched for age, sex, marital and educational status, hypertension, heart failure and diabetes, who underwent uneventful carotid revascularization, experienced no major adverse clinical events, and completed the Short Form Outcome Study (SF-36) questionnaire within 7 days before, 14 days after, 6 months after, and 12 months after carotid revascularization. Results: Baseline HRQoL was low and similar in both groups (30.8 ±4.6% vs. 29.1 ±3.9%, p = 0.68; data given for CEA vs. CAS). National Institute of Health Stroke Scale chronic severity was 5.4 ±2.8 vs. 5.9 ±3.1 (p = 0.44). Revascularization was associated with a major HRQoL improvement, that was significantly greater in CAS (60.4 ±9.2% vs. 71.5 ±6.2%, p < 0.001). At 6 months the CEA-CAS difference was narrower (70.7 ±9.7% vs. 74.6 ±5.9%, p = 0.026), becoming statistically insignificant at 12 months (72.6 ±6.7% vs. 75.1 ±5.1%, p = 0.062). The early CEA-CAS difference was driven by less bodily pain and better physical functioning/role-physical plus better role-emotional and higher general well-being scores in CAS (p < 0.05). Conclusions: Carotid revascularization has a major positive impact on stroke survivor patient-reported HRQoL. The improvement is initially greater in CAS, with the remaining difference small at 12 months and statistically insignificant.

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Section: Discussionmentioning

confidence: 99%

Health-related quality of life in ischaemic stroke survivors after carotid endarterectomy (CEA) and carotid artery stenting (CAS): confounder-controlled analysis

Trystuła

Tomaszewski

Pąchalska

2019

pwki

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“…stroke < 30 days post-procedural, myocardial infarction and 91 death) in patients undergoing carotid artery revascularisation, can provide information about 92 the quality of care and the impact of treatment on a patient's QoL including wound 93 complications, cranial nerve damage, drug side effects and anxiety associated with the 94 condition and treatments. 7 It is important to use PROMs that have followed best practice in 95 terms of their development and evaluation to ensure the PROMs are 'appropriate and 96 comprehensive relative to its intended measurement concept, population, and use'. 2…”

Section: Introductionmentioning

confidence: 99%

Patient-Reported Outcome Measures in Carotid Artery Revascularization: Systematic Review and Psychometric Analysis

Essat

Aber

Phillips

et al. 2018

Annals of Vascular Surgery

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This review highlighted a lack of evidence in validated PROMs used for patients undergoing carotid artery revascularization. As a result, the development and validation of a new PROM for this patient population is warranted to provide data which can supplement traditional clinical outcomes (stroke<30 days post-procedural, myocardial infarction, and death) and capture changes in health status and QoL to help inform treatment decisions.

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“…Only a minority of patients is diagnosed properly and even fewer are treated in the common clinical practice (Mirski et al, 2015;Trystuła et al, 2016). In recent years, diagnostic testing for depressive disorder has improved thanks to new neurotechnologies, particularly event-related potentials (ERPs) and neuromarker detection (Mirski et al, 2015;Kropotov, 2009).…”

Section: Introductionmentioning

confidence: 99%

CASE-REPORT Dysregulation of gene expression in a patient with depressive disorder after transient ischemic attack confirmed by a neurophysiological neuromarker

Trystuła

Żychowska²,

Wilk-Frańczuk³

et al. 2017

Genet. Mol. Res.

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ABSTRACT. The aim of this study was to evaluate dysregulation of gene expression associated with the cellular stress response in a patient with a post-"warning stroke" depressive disorder confirmed by the presence of a neurophysiological neuromarker through the use of quantitative EEG and event-related potentials. The patient was tested for seven genes associated with the stress reaction: HSPA1A, HSPB1, IL6, IL10, CRP, and HSF-1 along with NF-κB, compared to gene expression in health controls. A 54-year-old patient with a past history of schizophrenia (at the age of 20), and of transient ischemic attack (at the age of 53) and depressive disorder confirmed by functional, cognitive, emotional, and affectional diagnostics underwent additional testing for expression of the genes associated with stress response. The expression of genes coding for heat shock protein (HSPA1A, HSPB1), interleukins (IL6, IL10), and C-reactive protein was tested along with factors that regulate their expression. The results of the tests conducted on this patient were compared with 42 healthy control subjects. Diagnostic testing revealed upregulation in expression of these genes, presenting as increased expression of the target genes and of the regulatory genes. A post-"warning stroke" depressive disorder appears to be associated with overexpression of the genes coding for HSP and interleukins. Further research on larger groups of people may provide grounds for treatment modification.

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Usage of perioperative anxiety neuromarker for improving the quality of life of a patient operated on for critical stenosis of the internal carotid artery

Cited by 4 publications

References 12 publications

Health-related quality of life in ischaemic stroke survivors after carotid endarterectomy (CEA) and carotid artery stenting (CAS): confounder-controlled analysis

Health-related quality of life in ischaemic stroke survivors after carotid endarterectomy (CEA) and carotid artery stenting (CAS): confounder-controlled analysis

Patient-Reported Outcome Measures in Carotid Artery Revascularization: Systematic Review and Psychometric Analysis

CASE-REPORT Dysregulation of gene expression in a patient with depressive disorder after transient ischemic attack confirmed by a neurophysiological neuromarker

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