Acta Neurologica Scandinavica最新文献

{"title":"Fatigue and Sleepiness in Multiple Sclerosis and Their Response to Short-Term Treatment With Modafinil","authors":"Ann-Katrine Roswalld Thomsen,&nbsp;Marit Otto,&nbsp;Thor Petersen,&nbsp;Kristina Bacher Svendsen","doi":"10.1155/2024/2269483","DOIUrl":"10.1155/2024/2269483","url":null,"abstract":"<p><b>Background:</b> Patients with multiple sclerosis (pwMS) often experience significant fatigue. Simultaneously, previous studies show that pwMS frequently suffer from sleepiness and sleep problems. We aimed to contribute to the understanding of correlations between sleep and sleepiness/fatigue in pwMS to better identify responders to the wake-inducing drug, modafinil.</p><p><b>Methods:</b> This open-label, two-centre study included 26 pwMS suffering from daytime tiredness. Sleepiness, fatigue, and sleep were evaluated by questionnaires (Epworth Sleepiness Scale [ESS], Modified Fatigue Impact Scale [MFIS]/Multidimensional Fatigue Inventory [MFI-20], and Pittsburgh), daily sleep diary, and a wrist-worn actigraph before and after 3-week modafinil treatment.</p><p><b>Results:</b> One-third of the pwMS fulfilled the criteria of excessive daytime sleepiness (EDS, defined as ESS ≥ 10). Eighty-two percent (MFIS) of the patients were fatigued, and a high proportion (96%) of the pwMS were poor sleepers. Sleepiness (ESS) was inverse correlated to the subjective sleep quality. Actigraph data did not relate to subjective sleep, but total sleep time (TST) and higher sleep efficacy (SE) estimated by actigraph were positively correlated to the degree of fatigue. Modafinil had a positive effect on EDS.</p><p><b>Discussion:</b> In the present study, we found that the tired multiple sclerosis (MS) patient may suffer from both EDS and fatigue. We found an inverse correlation between EDS and subjective sleep quality. On the contrary, fatigue was positively correlated with longer TST and higher SE, estimated by actigraph. Sleepiness and fatigue did not correlate, and thus, it is highly relevant to distinguish these two symptoms. Modafinil only showed an effect on fatigue when the patient also suffered from EDS, which could suggest that ESS is a possible screening tool for responders to modafinil treatment.</p><p><b>Conclusion:</b> Sleepiness and fatigue do not seem to correlate in pwMS, and we recommend screening tools for sleepiness as well as sleep quality before initiating modafinil treatment to identify potential responders to the treatment.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/2269483","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141777133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of Life After Endovascular Thrombectomy for Acute Ischemic Stroke in Northern Finland","authors":"Ulla Junttola,&nbsp;Janne Liisanantti,&nbsp;Juha-Matti Isokangas,&nbsp;Timo Kaakinen,&nbsp;Merja Vakkala,&nbsp;Sanna Lahtinen","doi":"10.1155/2024/6684746","DOIUrl":"https://doi.org/10.1155/2024/6684746","url":null,"abstract":"<p><b>Objectives:</b> Endovascular thrombectomy has demonstrated a major therapeutic improvement in the treatment of acute ischemic stroke. The benefit of endovascular thrombectomy is commonly reported by determining the functional outcome using the modified Rankin Scale (mRS). There is a lack of knowledge concerning the quality of life (QoL) and factors impacting the QoL after endovascular thrombectomy. The aim of this study was to assess the QoL of stroke survivors who underwent endovascular thrombectomy and to determine the variables associated with QoL.</p><p><b>Methods:</b> Prospective single-center analysis of 98 patients who underwent endovascular thrombectomy between 2015 and 2019. QoL was assessed by using the Rand 36-Item Health Survey (RAND-36), Beck’s Depression Inventory (BDI), Stroke Impact Scale-16 (SIS-16), and Alcohol Use Disorders Identification Test (AUDIT) questionnaires.</p><p><b>Results:</b> Of the 98 patients, 53 (54.1%) reported poor QoL. According to the logistic regression analysis, the National Institutes of Health Stroke Scale (NIHSS) score &gt; 6 on the first postprocedural day, right hemispheric infarction, and depression were independently associated with poor QoL. Depression was reported by 40.8% of all the respondents. QoL scores of the patients treated with endovascular thrombectomy were impaired in physical functioning, physical and emotional role functioning, social functioning, and general health compared to the age-adjusted values of the Finnish general population.</p><p><b>Conclusion:</b> Endovascular thrombectomy (EVT)-treated stroke survivors experience disability in multiple levels. More than half of the patients report poor QoL. Neurological disability, functional dependence, depression, and comorbidities are associated with poor QoL. Social capability is impaired and the difficulties are more distinct among individuals with age above 65 years.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/6684746","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141730288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating Inflammatory Markers in COVID-19-Related Ischemic Stroke: A Multicenter Retrospective Analysis","authors":"Yudi Li,&nbsp;Li Ling,&nbsp;Jie Li,&nbsp;Xiongjun He,&nbsp;Kaifeng Li,&nbsp;Yifan Wang,&nbsp;Fangming Li,&nbsp;Rucheng Huang,&nbsp;Li Yang,&nbsp;Yuxuan Ye,&nbsp;Yajie Liu","doi":"10.1155/2024/9022806","DOIUrl":"https://doi.org/10.1155/2024/9022806","url":null,"abstract":"<div>\u0000 <p>The novel coronavirus disease 2019 (COVID-19) causes severe respiratory illness and is involved in ischemic stroke. Aimed to investigate the inflammatory markers and possible prognosis of COVID-19-related ischemic stroke in a special outbreak period after lifting of COVID-19 control measures in China, we conducted a multicenter retrospective analysis in southern China at three centers in Shenzhen. We included patients diagnosed with acute ischemic stroke or transient ischemic attack after infection with COVID-19 as the COVID-19-related ischemic stroke group and those only diagnosed with acute ischemic stroke or transient ischemic attack as the control group. In this study, the proportion of female patients, admission heart rate, and comorbid coronary heart disease and the proportion of cryptogenic stroke were higher, while the history of prior stroke was lower in the COVID-19-related ischemic stroke group. The COVID-19-related ischemic stroke group also exhibited elevated levels of monocytes, fibrinogen, alanine aminotransferase, direct bilirubin, monocyte-to-lymphocyte ratio (MLR), and fibrinogen-to-albumin ratio (FAR) but decreased levels of lymphocytes, albumin, and high-density lipoprotein. However, there were no statistically significant differences in the modified Rankin scale (mRS), National Institutes of Health Stroke Scale (NIHSS), and mortality rate between the two groups at discharge. Our study is the first to show the alteration in inflammatory markers but no difference in discharge prognosis between the non-COVID-19 and the COVID-19-related ischemic stroke patients, during China’s COVID-19 relaxation period.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/9022806","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141439725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epileptic Network Surgery: From Network Basis to Clinical Practice","authors":"Di Wang,&nbsp;Huaqiang Zhang,&nbsp;Xiaotong Fan,&nbsp;Yanfeng Yang,&nbsp;Liankun Ren,&nbsp;Yongzhi Shan,&nbsp;Penghu Wei,&nbsp;Guoguang Zhao","doi":"10.1155/2024/1735404","DOIUrl":"https://doi.org/10.1155/2024/1735404","url":null,"abstract":"<div>\u0000 <p>Epilepsy is a common chronic neurologic disorder, with about 30%-40% of patients suffering from recurrent seizures despite receiving enough antiseizure medication. Growing evidence of extensive structural and functional research has revealed that epilepsy is a network disorder, and the network investigation is crucial in the presurgical evaluation. This narrative review is aimed at providing an overview of the conceptual development of epileptic surgery, the epileptic network formation, and the network-oriented strategy in clinical practice. We searched the PubMed database before October 2022 with no language or regional restrictions for studies of network exploration in epilepsy patients. The study eligibility criteria were original connectivity or network research studies using neuroimaging or neurophysiological approaches, focusing on seizure localization, neuropsychological evaluation, neuromodulation, or surgical prognosis. The initial search revealed 2046 studies. The selection process presented 746 papers that meet the inclusion criteria. The results indicated that epilepsy was characterized by the alternation of brain networks, which account for the clinical, electrographic, and neurocognitive phenomena related to human seizures and changes across different disease stages. Hubs have garnered significant attention due to their extensive connections, which make them prone to facilitating the spread of seizures to various brain regions. Unlike the seizure onset zone, the removal of the majority of these ictogenic nodes demonstrated a significant correlation with positive outcomes. Therefore, performing a network analysis during the epilepsy presurgical evaluation seems essential and will influence surgical decisions. It is hoped that studying the network of epilepsy will enhance our ability to determine the most appropriate surgical strategy for patients with epilepsy, thus contributing to success in terms of effective seizure control with maximal sparing or even improvement of brain functioning.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/1735404","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141424802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Quality of Life in Patients with Intracanalicular Vestibular Schwannomas after Gamma Knife Surgery Treatment: A Follow-Up Study","authors":"Mirosław Ząbek,&nbsp;Grzegorz Turek,&nbsp;Katarzyna Bieńkowska,&nbsp;Andrzej Kokoszka,&nbsp;Sebastian Dzierzęcki,&nbsp;Barbara Kostecka","doi":"10.1155/2024/5598225","DOIUrl":"https://doi.org/10.1155/2024/5598225","url":null,"abstract":"<div>\u0000 <p><i>Introduction</i>. Our previous research showed that the gamma knife surgery (GKS) is a highly effective treatment for intracanalicular vestibular schwannomas (IVS). In the current study, we aimed to evaluate long-term quality of life (QoL) as a follow-up to the assessment of baseline clinical and demographic parameters in the original study. Moreover, QoL outcomes were compared with norms for the general population and for patients who underwent different ear, nose, and throat (ENT) procedures. <i>Materials and Methods</i>. The follow-up study included 92 patients (59 women and 33 men; mean age, 61.71 ± 12.55 years; range: 32-85 years) with unilateral IVS who underwent GKS. Patients completed the <i>Assessment of Quality of Life</i>, Penn Acoustic Neuroma Quality-of-Life, Glasgow Benefit Inventory, and WHO-5 Well-being Index questionnaires as well as a demographic survey. Neurosurgical parameters were assessed using the Koos and House-Brackmann scales and the results of audiological examinations. <i>Results and Conclusions</i>. QoL scores were within or above the norm in 38% of patients. There were significant differences in terms of comorbidities and emotional well-being between patients with QoL scores within or above the norm and patients with QoL scores below the norm. Comorbidities were more common in patients with QoL scores below the norm, and they influenced reported QoL (<i>p</i> = 0.009). Patients with QoL scores within or above the norm reported better emotional well-being than those with QoL scores below the norm. Long-term QoL outcomes were satisfactory, consistent with the results of the original study. Although GKS is a complex procedure, patients reported higher QoL than those using hearing aids and the same QoL as those after ENT surgery or reassurance. However, they reported a slightly lower QoL than patients taking ENT medications. GKS appears to be a promising treatment option for patients with IVS.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/5598225","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141425115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intercultural Translation and Application of the German Version of King’s Parkinson’s Disease Pain Questionnaire in Fluctuating Parkinson’s Disease","authors":"Matthias Löhle,&nbsp;Wolfgang H. Jost,&nbsp;Alexander Bremer,&nbsp;Florin Gandor,&nbsp;Alexandra Rizos,&nbsp;Pablo Martinez-Martin,&nbsp;K. Ray Chaudhuri,&nbsp;Per Odin,&nbsp;Georg Ebersbach,&nbsp;Alexander Storch","doi":"10.1155/2024/6052552","DOIUrl":"https://doi.org/10.1155/2024/6052552","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Pain is common in Parkinson’s disease (PD) and impairs quality of life. The King’s PD pain questionnaire (KPPQ) is a standardized, reliable, and valid self-administered questionnaire for screening of pain in PD. We developed a linguistically validated German version of the KPPQ and applied it to a cohort with fluctuating PD. <i>Methods</i>. The interculturally adapted German translation was performed according to internationally accepted procedures in coordination with the authors of the original publication but without further psychometric validation. After final approval by all translators and original authors, the German version was then tested for feasibility and comprehension in 30 PD patients. After final adaption, the German KPPQ together with the German quantitative KPPS were applied to an independent cohort of fluctuating PD patients within the VALIDATE-PD study. <i>Results</i>. The use of the German version of the KPPQ in clinical practice or in the VALIDATE-PD study revealed no significant problems of understanding. Sufficient datasets were available from 47 patients with motor fluctuations (24 (51%) males, 23 (49%) females; median (interquartile range (IQR)) age: 65 (58-73) years; median (IQR) Hoehn and Yahr stage: 2.5 [2-3]). Total pain was reported by 43 (92%) of participants with a median number of 4 (IQR: 2-5) pain subtypes. We did not observe any associations of total pain frequency, neither with gender nor with other demographic or clinical parameters. <i>Conclusions</i>. The German version of the KPPQ is recommended as a questionnaire for assessing the frequency of pain and its subtypes in PD in clinical studies and/or routine care.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/6052552","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141308917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Five-Year Risk of Cardiovascular Events after Transient Ischemic Attack: Results from a Prospective Cohort","authors":"Fredrik Ildstad,&nbsp;Torgeir Wethal,&nbsp;Hanne Ellekjær,&nbsp;Stian Lydersen,&nbsp;Tom Eirik Mollnes,&nbsp;Thor Ueland,&nbsp;Pål Aukrust,&nbsp;Bent Indredavik","doi":"10.1155/2024/4982336","DOIUrl":"https://doi.org/10.1155/2024/4982336","url":null,"abstract":"<div>\u0000 <p><i>Objectives</i>. There are few contemporary, prospective studies reporting on the long-term risk of stroke and other cardiovascular (CV) events after transient ischemic attack (TIA). The primary aim was to examine the risk of new CV events within 5 years after TIA. The secondary aim was to identify baseline predictors of long-term CV events, including inflammatory biomarkers in a subgroup analysis. <i>Materials and Methods</i>. In a prospective, multicenter study, we enrolled 577 TIA patients between 2012 and 2014. The primary outcome was a composite of stroke, acute coronary syndrome, and CV death. We used data from the Norwegian Cardiovascular Disease Registry. In a subgroup of 112 patients, blood samples were analyzed for inflammatory biomarkers. <i>Results</i>. The primary outcome occurred in 108 patients (18.7%), of which 69 patients (12.0%) had a stroke. Sixty-one (56.5%) of the events occurred during year two through five. Increasing age (HR 1.05; 95% CI, 1.03-1.08), male sex (HR 1.82; 95% CI, 1.16-2.85), hypertension (HR 1.67; 95% CI, 1.04-2.67), and acute infarction on brain imaging (HR 1.84; 95% CI, 1.17-2.91) were significant predictors for the primary outcome. In the subgroup analysis, none of the blood inflammatory biomarkers were associated with CV events. <i>Conclusions</i>. The risk of CV events was highest during the first year after TIA, with a lower but sustained risk throughout the follow-up. This emphasizes the importance of both early initiation of and long-term continuation of secondary preventive treatment after TIA. Inflammatory biomarkers are probably not important as prognostic markers of cardiovascular disease in TIA patients.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/4982336","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141298429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New-Onset Refractory Status Epilepticus Caused by Autoimmune Encephalitis May Have a Better Prognosis than when due to Other Causes","authors":"Yu Zhang,&nbsp;Xinyue Zhang,&nbsp;Haijiao Wang,&nbsp;Ling Liu","doi":"10.1155/2024/6817696","DOIUrl":"https://doi.org/10.1155/2024/6817696","url":null,"abstract":"<div>\u0000 <p><i>Objective</i>. To explore whether the new-onset refractory status epilepticus caused by autoimmune encephalitis has a better prognosis. <i>Methods</i>. This retrospective observational study enrolled patients with NORSE who were admitted from January 2015 to February 2024. The clinical data and clinical outcomes of the patients were collected and analyzed, and the primary outcome was seizures still at follow-up. Statistical analyses were performed using SPSS software V.22.0. <i>Results</i>. Among the 42 patients with NORSE, 15 (35.7%) had autoimmune encephalitis (AE), 3 (7.1%) patients had central nervous system infections, 24 (57.1%) patients had an unknown etiology, and 4 (9.5%) patients died in the hospital. Modified Rankin scale (MRS) scores at discharge of NORSE patients in the autoimmune encephalitis group and non-AE group were compared (<i>P</i> = 0.339). After 4 years of follow-up, analysis of patients who still had seizures showed that the only risk factor was etiology and that patients with nonautoimmune encephalitis etiology were more prone to later epilepsy (<i>P</i> = 0.030 (OR = 16.767, 95% CI: 1.454-213.395)). The MRS scores of the AE group and non-AE group were compared (<i>P</i> ≤ 0.001), with the autoimmune group having a better functional outcome. <i>Significance</i>. The overall prognosis of patients with autoimmune encephalitis may be better than that of patients with other etiologies, and later epilepsy is more likely in patients with nonautoimmune encephalitis. However, this result requires further validation in larger studies with more data.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/6817696","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141246102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive Impairment and Fatigue in Intensive Care Patients Three Months after the Acute Phase of COVID-19 Infection: Follow-Up with Focus on Differences between the First and Later Waves of the Pandemic","authors":"M. C. Möller,&nbsp;A. K. Godbolt,&nbsp;Å. Ingvarsson,&nbsp;K. Borg,&nbsp;G. Markovic,&nbsp;E. Melin,&nbsp;M. Löfgren,&nbsp;C. Nygren Deboussard","doi":"10.1155/2024/9469769","DOIUrl":"10.1155/2024/9469769","url":null,"abstract":"<p><i>Background</i>. Cognitive symptoms and fatigue may persist after intensive care unit (ICU) care. It remains unclear whether post-COVID-19 symptoms are related to ICU care itself or the infection. <i>Objective</i>. The primary aim was to investigate the prevalence of residual cognitive impairment and fatigue after ICU care for COVID-19 and to evaluate the importance of demographic factors. A secondary aim was to investigate whether differences in ICU treatment between the first wave (March 2020 to July 2020) and later waves (August 2020 to January 2021) of COVID-19 were associated with differences in cognitive outcomes. <i>Design</i>. Prospective follow-up study. <i>Subjects/Patients</i>. Swedish cohort of COVID-19 patients referred from ICU<i>. Methods</i>. Montreal Cognitive Assessment (MoCA), Multidimensional Fatigue Inventory-20 (MFI-20), Hospital Anxiety and Depression Scale, Insomnia Severity Scale, and RAND-36 were administered approximately three months after admission to ICU. Mann–Whitney tests were used to investigate group differences, and multiple linear regression was used to investigate the relationship between fatigue and covarying factors. <i>Results</i>. 71 patients completed follow-up, and 60 patients underwent a cognitive screening of which 30% had MoCA scores indicative of cognitive impairment (&lt;26 points). Higher age was related to poorer cognitive performance. Patients scored above the normal range on all subscales on the MFI-20. There was a significant difference in length of ICU stay between wave one and following waves, but no statistically significant differences emerged on cognitive screening. Intubated patients’ fatigue ratings were lower compared to those not intubated—despite longer ICU stay. No difference in MoCA scores emerged between patients who were, or were not, intubated. <i>Conclusion</i>. Cognitive impairment and fatigue were evident in patients three months after a severe COVID-19 infection, but global cognitive functioning was not related to ICU length of stay. Less fatigue among patients who had been intubated merits further investigation.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140984258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimates and Predictors of Mortality, Stroke Recurrence, and Functional Dependency 1-Year after Ischemic Stroke: A Prospective Multicenter Longitudinal Cohort Study in Central Norway","authors":"Ailan Phan,&nbsp;Bent Indredavik,&nbsp;Stian Lydersen,&nbsp;Åse H. Morsund,&nbsp;Yngve M. Seljeseth,&nbsp;Fredrik Ildstad,&nbsp;Torgeir Wethal","doi":"10.1155/2024/8805152","DOIUrl":"10.1155/2024/8805152","url":null,"abstract":"<p><i>Background</i>. Stroke incidence and mortality have drastically decreased in high-income countries in the past twenty years. In this study, we provide updated estimates on mortality, recurrent stroke, and functional dependency among patients with first-ever ischemic stroke and assess predictors associated with poor outcomes with a focus on age, vascular factors, stroke severity, function, and comorbidity burden. <i>Methods</i>. MIDNOR STROKE is a multicenter prospective longitudinal study including patients with first-ever ischemic stroke admitted to stroke units in Central Norway during 2015-2017. Data on survival, stroke recurrence, and functional dependency were collected during hospital stay and follow-up. Multivariable Cox proportional hazard models and logistic regression models were used to analyze predictors of mortality, stroke recurrence, and functional dependency. <i>Results</i>. A total of 794 participants were included in the study. After a year, 7.6% of the participants had died, 5.8% had a recurrent stroke, and 13.6% experienced functional deterioration to dependency. Multivariable analysis revealed that age (HR: 1.07, 96% CI: 1.03, 1.10), stroke severity (HR: 1.10, 95% CI: 1.07, 1.13), comorbidity burden (low: HR: 4.05, 95% CI: 1.48, 11.10; moderate: HR: 5.44, 95% CI: 2.06, 14.40; and high: 7.72, 95% CI: 2.85, 21.00), and coronary artery disease (HR: 2.40, 95% CI: 1.32, 4.38) predicted all-cause death. Statin therapy predicted improved survival (HR: 0.39, 95% CI: 0.21, 0.75). High age (HR: 1.09, 95% CI: 1.05, 1.14) and increased stroke severity (OR: 1.26, 95% CI: 1.17, 1.38) predicted elevated risk of functional dependency at one year. <i>Conclusions</i>. In this study, we have demonstrated that 1-year survival following first-ever ischemic stroke was high compared to previous reports and that statin therapy predicted improved survival. The risk of recurrent stroke after one year was found to be low compared to previous studies. Approximately 14% of stroke survivors who were initially functionally independent experienced deterioration to functional dependency. In addition to older age and stroke severity, increased comorbidity burden and a history of coronary artery disease predicted poor stroke prognosis. Interventions aimed at reducing stroke severity may improve patient outcomes. Furthermore, prevention efforts targeting conditions such as CAD and reducing overall comorbidity burden in stroke patients may favorably improve survival. This trial is registered with NCT03962127.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141017028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}