Brain Circulation最新文献

{"title":"Paradoxical embolic stroke during catheter-directed thrombolytics in a patient with massive pulmonary embolism","authors":"Atefeh Ghorbanzadeh, Emily C. Bendel, Damon E. Houghton","doi":"10.4103/bc.bc_115_23","DOIUrl":"https://doi.org/10.4103/bc.bc_115_23","url":null,"abstract":"\u0000 Paradoxical embolism represents a critical and potentially fatal complication that can be associated with pulmonary embolism (PE). This case details a unique case of massive PE, further complicated by embolic stroke occurring during catheter-directed thrombolytic therapy. There was no evidence of thrombosis during the initial evaluation with lower extremity Doppler ultrasound, abdominal computed tomography scan, and transthoracic echocardiography. Differentials for the source of the emboli include unrecognized left atrial appendage thrombus, pulmonary arteriovenous malformations, and a patent left foramen ovale. Our findings highlight the complexities and treatment challenges of massive PE.","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141649353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ca2+/cAMP ratio in age-related diseases","authors":"L. Bergantin","doi":"10.4103/bc.bc_3_24","DOIUrl":"https://doi.org/10.4103/bc.bc_3_24","url":null,"abstract":"","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141660228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of tirofiban in preventing neurological deterioration in acute ischemic stroke (TREND): Protocol for an investigator-initiated, multicenter, prospective, randomized, open-label, masked endpoint trial.","authors":"Jing Wang, Sijie Li, Chuanhui Li, Chuanjie Wu, Haiqing Song, Qingfeng Ma, Xunming Ji, Wenbo Zhao","doi":"10.4103/bc.bc_93_23","DOIUrl":"10.4103/bc.bc_93_23","url":null,"abstract":"<p><strong>Introduction: </strong>Antithrombotic therapy prevents adverse ischemic events following acute ischemic stroke (AIS). Intravenous tirofiban provides desirable antiplatelet effects, especially in patients who are vulnerable to neurological deterioration (ND).</p><p><strong>Aim: </strong>The aim of the study was to test the hypothesis that intravenous administration of tirofiban, initiated within 24 h of ictus and continued for consecutive 72 h, would be more effective than aspirin in reducing the risk of ND within 72 h of enrollment among patients with potentially atherothrombotic ischemic stroke.</p><p><strong>Methods: </strong>The Safety and Efficacy of Tirofiban in Preventing Neurological Deterioration in Acute Ischemic Stroke (TREND) trial is an investigator-initiated, multicenter, prospective, randomized, open-label, masked endpoint study. Its eligibility criteria included AIS secondary to potential atherosclerosis, a National Institutes of Health Stroke Scale (NIHSS) score ranging from 4 to 20 points, ineligibility for recanalization therapy, and administration within 24 h postsymptom onset. Randomization was performed at a 1:1 ratio to allocate 420 patients into two groups to receive an intravenous tirofiban bridge to oral antiplatelet drugs or direct oral antiplatelet drugs.</p><p><strong>Outcomes: </strong>The primary outcome is the proportion of patients with a ≥4-point increase in NIHSS score within 72 h of intervention compared to the score at enrollment. The key secondary outcomes include changes in NIHSS score, modified Rankin scale (mRS) score at 90 days, and dichotomized mRS scores (0-2 vs. 3-6 and 0-1 vs. 2-6) at 90 days. The safety variables are symptomatic intracerebral hemorrhage, any intracerebral hemorrhage, and systemic hemorrhage within 72 h after randomization and 90-day mortality.</p><p><strong>Conclusions: </strong>The TREND trial may identify the suitability of intravenous tirofiban as a routine clinical strategy to prevent ND in patients with AIS within 24 h of the onset of symptoms.</p><p><strong>Trial registration: </strong>http://www.clinicaltrials.gov (identifier: NCT04491695).</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11259324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing the research deficiencies in selective brain cooling methods in prehospital care for stroke patients.","authors":"Komal Rehman, Myra Sohail, Muskaan Saleem, Ahmad Akhtar","doi":"10.4103/bc.bc_90_23","DOIUrl":"10.4103/bc.bc_90_23","url":null,"abstract":"","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11259328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Restoring brain health: Electroacupuncture at GB20 and LR3 for migraine mitigation through mitochondrial restoration.","authors":"Jianchang Luo, Liyao Feng, Luodan Wang, Zhenyu Fang, Jiawang Lang, Boxu Lang","doi":"10.4103/bc.bc_95_23","DOIUrl":"10.4103/bc.bc_95_23","url":null,"abstract":"<p><strong>Background: </strong>Electroacupuncture (EA) is a promising alternative therapy for migraine, with mitochondrial dysfunction hypothesized as a pivotal mechanism in migraine pathophysiology. This research endeavors to investigate the therapeutic potential of EA in addressing migraines and shed light on the associated mechanisms linked to mitochondrial anomalies.</p><p><strong>Materials and methods: </strong>Migraine in rats was induced by 10 mg/kg nitroglycerin, followed by 2/15 Hz EA treatment at GB20 and LR3. Nociceptive behavior was recorded via a camera and analyzed using EthoVision XT 12.0 software. The hind-paw withdrawal threshold was assessed using the von Frey test. We assessed the levels of calcitonin gene-related peptide (CGRP), nitric oxide (NO), and endothelin (ET) - key parameters in migraine pathophysiology using immunohistochemistry and enzyme-linked immunosorbent assay. Mitochondrial morphology in brain tissues was observed through transmission electron microscopy. Reactive oxygen species (ROS) level in mitochondria was measured by flow cytometry. The levels of PINK1 and Parkin were assessed using Western blot analysis.</p><p><strong>Results: </strong>EA at GB20 and LR3 decreased nociceptive behaviors (resting and grooming) and increased exploratory and locomotor behaviors in migraine rats. The hind-paw withdrawal threshold in migraine rats was significantly elevated following EA treatment. Post-EA treatment, levels of CGRP and NO decreased, while ET level increased, suggesting an alteration in pain and vascular physiology. Notably, EA treatment mitigated the mitochondrial damage and reduced ROS level in the brain tissues of migraine rats. EA treatment upregulated the expression of PINK1 and Parkin in migraine rats.</p><p><strong>Conclusion: </strong>EA at GB20 and LR3 may treat migraine by alleviating PINK1/Parkin-mediated mitochondrial dysfunction.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11259319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilization of wearable technology to track functional changes in a patient with myopathy.","authors":"Adeel S Zubair","doi":"10.4103/bc.bc_104_23","DOIUrl":"10.4103/bc.bc_104_23","url":null,"abstract":"","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11259317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of coma arousal therapy on patients with disorders of consciousness - A systematic review and meta-analysis.","authors":"Sanjiv Kumar, Nupur Agarwal, Thankappan S Sanal","doi":"10.4103/bc.bc_112_23","DOIUrl":"10.4103/bc.bc_112_23","url":null,"abstract":"<p><strong>Background: </strong>Disorders of consciousness (DOC) incorporate stages of awareness and arousal. Through coma arousal therapy sensory deprivation experienced by patients with DOC can be mitigated. Nevertheless, consensus concerning its effectiveness on these patients is still fractional.</p><p><strong>Purpose: </strong>This review aims to investigate the effectiveness of coma arousal therapies on patients with DOC.</p><p><strong>Methods: </strong>A meta-analysis was performed by searching electronic databases using search terms, the studies investigating the effect of coma arousal therapy in patients with DOC using the Coma Recovery Scale-Revised and Glasgow Coma Scale as outcome measures were included. The risk of bias was assessed, using Cochrane and Joanna Briggs Institute critical appraisal tools. Further, analysis was conducted for the included studies.</p><p><strong>Results: </strong>Out of 260 studies, 45 trials were reviewed and assessed for bias, with 31 studies included for analysis. The analysis demonstrates a significant difference in pre- and post - sensory stimulation, vagus nerve stimulation, transcranial magnetic stimulation, and transcranial direct current stimulation. Sensory stimulation showed the greatest mean difference of -4.96; 95% CI = -5.76 to - 4.15. The patients who underwent intervention after 3 months of illness showed significant improvement.</p><p><strong>Conclusion: </strong>The result shows that sensory stimulation, transcranial magnetic stimulation, and transcranial direct stimulation can improve behavioral outcomes of patients with DOC, wherein sensory stimulation is found to be more effective.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11259325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood-brain barrier disruption and edema formation due to prolonged starvation in wild-type mice.","authors":"M Ibrahim Hossain, Mehjabeen Haque, Maria Akter, Sabrina Sharmin, Asif Ahmed","doi":"10.4103/bc.bc_88_23","DOIUrl":"10.4103/bc.bc_88_23","url":null,"abstract":"<p><strong>Introduction: </strong>Different types of diseases have been treated by restricted caloric intake or fasting. Although during this long time, fasting protective measures, for example, supplements, are given to the patients to protect vital organs such as the liver and kidney, little attention is given to the brain. The current research aims to investigate hypoglycemia due to prolonged fasting disrupts blood-brain barrier (BBB) in mice.</p><p><strong>Materials and methods: </strong>Immunohistochemistry (IHC) and <i>in situ</i> hybridization (ISH) techniques were used to examine the expression of different genes. Evans blue extravasation and wet-dry technique were performed to evaluate the integrity of BBB and the formation of brain edema, respectively.</p><p><strong>Results: </strong>We confirmed that hypoglycemia affected mice fasting brain by examining the increased expression of glucose transporter protein 1 and hyperphosphorylation of tau protein. We subsequently found downregulated expression of some genes, which are involved in maintaining BBB such as vascular endothelial growth factor (<i>VEGF</i>) in astrocytes and <i>claudin-5</i> (a vital component of BBB) and <i>VEGF</i> receptor (<i>VEGFR1</i>) in endothelial cells by ISH. We also found that prolonged fasting caused the brain endothelial cells to express lipocalin-2, an inflammatory marker of brain endothelial cells. We performed Evans blue extravasation to show more dye was retained in the brain of fasted mice than in control mice as a result of BBB disruption. Finally, wet-dry method showed that the brain of prolonged fasted mice contained significantly higher amount of water confirming the formation of brain edema. Therefore, special attention should be given to the brain during treatment with prolonged fasting for various diseases.</p><p><strong>Conclusions: </strong>Our results demonstrated that hypoglycemia due to prolonged fasting disrupts BBB and produces brain edema in wild-type mice, highlighting the importance of brain health during treatment with prolonged fasting.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11259321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of emotions on learning, memory, and disorders associated with the changes in expression levels: A narrative review.","authors":"Jaivarsini Johnson","doi":"10.4103/bc.bc_86_23","DOIUrl":"10.4103/bc.bc_86_23","url":null,"abstract":"<p><p>Emotions, in general, have no scientific definition. Emotions can be denoted as the mental state because of the neurophysiological changes. Emotions are related to mood, personality, temperament, and consciousness. People exhibit different emotions in different situations causing changes in cognitive functions. One of the major cognitive functions is the ability to learn, to store the acquired information in the parts of the brain such as the hippocampus, amygdala, cortex, and cerebellum. Learning and memory are affected by different types of emotions. Emotional responses such as fear, depression, and stress have impaired effects on cognitive functions such as learning and memory, whereas optimistic and happy emotions have positive effects on long-term memory. Certain disorders have greater effects on the regions of the brain which are also associated with synaptic plasticity and Learning and Memory(LM). Neuroimaging techniques are involved in studying the changing regions of the brain due to varied emotions and treatment strategies based on the changes observed. There are many drugs, and in advancements, nanotechnology is also utilized in the treatment of such psychiatric disorders. To improve mental health and physical health, emotional balance is most important, and effective care should be provided for people with less emotional quotient and different types of disorders to inhibit cognitive dysfunctions. In this review, emotions and their varied effects on a cognitive function named learning and memory, disorders associated with the defects of learning due to emotional instability, the areas of the brain that are in control of emotions, diagnosis, and treatment strategies for psychiatric disorders dependent on emotions are discussed.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11259327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of stress hyperglycemia in diabetic and nondiabetic patients with large vessel occlusions undergoing mechanical thrombectomy.","authors":"Brittany M Kasturiarachi, Omar Saeed, Leila Gachechiladze, Diana Alsbrook, Savdeep Singh, Ghaida Zaid, Prasanna Eswaradass, Nitin Goyal, Cheran Elangovan, Adam S Arthur, Andrei V Alexandrov, Balaji Krishnaiah","doi":"10.4103/bc.bc_97_23","DOIUrl":"10.4103/bc.bc_97_23","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetes and hyperglycemia are major risk factors that can increase infarction volume and contribute to poor functional status. Our study aim was to investigate the effect of stress hyperglycemia on various safety and efficacy outcomes in patients with large vessel occlusions (LVOs) undergoing mechanical thrombectomy (MT) with or without diabetes.</p><p><strong>Methods: </strong>A retrospective analysis of consecutive LVO patient data treated with MT at a Comprehensive Stroke Center in the Mid-South was conducted. Adult patients with LVO on computed tomography angiography (CTA) and treated with MT within 24 h of symptom onset were included. The primary outcome was to determine if there was an association in collateral flow or infarct size in the setting of hyperglycemia. Secondary outcomes included National Institute of Health Sciences Score (NIHSS) and Modified Rankin Score (mRS).</p><p><strong>Results: </strong>A total of 450 patients underwent MT, out of which 433 had baseline hemoglobin A1c recorded: mean age: 64 ± 15 years, 47% women, pretreatment NIHSS median 15 points (interquartile range 10-19), 323 (75%) with good collaterals grades >2 on multiphasic CTA, 326 (75%) were non-diabetic, and 107 (25%) were diabetic. Nondiabetics with stress hyperglycemia had a tendency toward higher pre-treatment NIHSS scores (mean 17.5 ± 7.6, <i>P</i> = 0.02) and at 24-h (12.9 ± 9.0, <i>P</i> = 0.02), poor collaterals (multiphasic CTA score ≥2; 21.4% vs. 34.5%, <i>P</i> = 0.02), larger infarct volumes (50.7 ± 63.6 vs. 24.4 ± 33.8 cc, <i>P</i> < 0.0001), and had poorer functional outcomes (good mRS 0-2 47.7% vs. good mRS 0-2 36.8%) when compared to nondiabetics without stress hyperglycemia. For every 1 mg/dL increase in admission blood glucose, there was a 0.3 cc increase in infarct volume (95% confidence intervals for β =0.2-0.4; <i>P</i> < 0.0001) after adjusting for the final thrombolysis in cerebral infarction score.</p><p><strong>Conclusions: </strong>LVO patients with stress hyperglycemia without previously diagnosed diabetes had more severe strokes, developed larger infarct volumes, poorer collaterals, and had worse functional outcomes at 90 days post-MT. In addition, LVO patients with diabetes and stress hyperglycemia exhibited more passes during MT and worse functional outcomes.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11259316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}