Stroke, Cognition and Dementia

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neurorehabilitation".

Deadline for manuscript submissions: closed (25 July 2023) | Viewed by 7994

Special Issue Editors


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Guest Editor
Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
Interests: human performance; stroke rehabilitation; cognitive rehabilitation; neural plasticity
National Institute of Neurological Disorders and Stroke, National Institutes of Health (NIH), Bethesda, MD, USA
Interests: stroke; synapse; memory; neural plasticity; cognition

Special Issue Information

Dear Colleagues,

Stroke is the second leading cause of death and the third most common cause of disability worldwide. Post-stroke cognitive impairment (PSCI), including attention, memory, executive functioning and information processing deficits, is one of the major clinical features of functional impairment after stroke. PSCI affects long-term quality of life and notably is linked with post-stroke vascular dementia. Despite the growing health, social, and economic burden of PSCI, compared to post-stroke physical impairments, treatment for PSCI is receiving less attention. Therefore, it is important to explore the pathophysiology of stroke-associated cognitive impairment and to develop therapeutic strategies which promote stroke recovery and thereby improve cognitive function.

In this Special Issue, we would like to invite investigators to contribute original research articles, reviews and commentaries on all aspects related to cognitive deficits after stroke. Relevant topics include, but are not limited to, the following: (1) risk factors for cognitive impairment and dementia after stroke; (2) cellular and molecular mechanisms, neuroimaging and assessments underlying the pathogenesis of cognitive impairment associated with stroke; and (3) interventions or therapies contributing to cognitive rehabilitation after stroke, such as translational clinical studies and innovative non-pharmacological interventions.

Prof. Dr. Kenneth Fong
Dr. Kunwei Wu
Guest Editors

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Keywords

  • cognitive impairment
  • ischemic stroke
  • hemorrhagic stroke
  • vascular dementia
  • post-stroke dementia
  • neuroprotection
  • neurovascular
  • neurodegeneration
  • neuroplasticity
  • blood–brain barrier

Published Papers (4 papers)

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Research

13 pages, 1433 KiB  
Article
Determining the Optimal Stimulation Sessions for TMS-Induced Recovery of Upper Extremity Motor Function Post Stroke: A Randomized Controlled Trial
by Yichen Lv, Jack Jiaqi Zhang, Kui Wang, Leilei Ju, Hongying Zhang, Yuehan Zhao, Yao Pan, Jianwei Gong, Xin Wang and Kenneth N. K. Fong
Brain Sci. 2023, 13(12), 1662; https://doi.org/10.3390/brainsci13121662 - 30 Nov 2023
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Abstract
To find out the optimal treatment sessions of repetitive transcranial magnetic stimulation (TMS) over the primary motor cortex (M1) for upper extremity dysfunction after stroke during the 6-week treatment and to explore its mechanism using motor-evoked potentials (MEPs) and resting-state functional magnetic resonance [...] Read more.
To find out the optimal treatment sessions of repetitive transcranial magnetic stimulation (TMS) over the primary motor cortex (M1) for upper extremity dysfunction after stroke during the 6-week treatment and to explore its mechanism using motor-evoked potentials (MEPs) and resting-state functional magnetic resonance imaging (rs-fMRI), 72 participants with upper extremity motor dysfunction after ischemic stroke were randomly divided into the control group, 10-session, 20-session, and 30-session rTMS groups. Low-frequency (1 Hz) rTMS over the contralesional M1 was applied in all rTMS groups. The motor function of the upper extremity was assessed before and after treatment. In addition, MEPs and rs-fMRI data were analyzed to detect its effect on brain reorganization. After 6 weeks of treatment, there were significant differences in the Fugl-Meyer Assessment of the upper extremity and the Wolf Motor Function Test scores between the 10-session group and the 30-session group and between the 20- and 30-session groups and the control group, while there was no significant difference between the 20-session group and the 30-session group. Meanwhile, no significant difference was found between the 10-session group and the control group. The 20-session group of rTMS decreased the excitability of the contralesional corticospinal tract represented by the amplitudes of MEPs and enhanced the functional connectivity of the ipsilesional M1 or premotor cortex with the the precentral gyrus, postcentral gyrus, and cingulate gyrus, etc. In conclusion, the 20-session of rTMS protocol is the optimal treatment sessions of TMS for upper extremity dysfunction after stroke during the 6-week treatment. The potential mechanism is related to its influence on the excitability of the corticospinal tract and the remodeling of corticomotor functional networks. Full article
(This article belongs to the Special Issue Stroke, Cognition and Dementia)
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14 pages, 2176 KiB  
Article
The Effect of Mirror Visual Feedback on Spatial Neglect for Patients after Stroke: A Preliminary Randomized Controlled Trial
by Kenneth N. K. Fong, K. H. Ting, Xinfei Zhang, Christina S. F. Yau and Leonard S. W. Li
Brain Sci. 2023, 13(1), 3; https://doi.org/10.3390/brainsci13010003 - 20 Dec 2022
Cited by 1 | Viewed by 2368
Abstract
We investigated the effects of mirror visual feedback (MVF), with reference to using a glass wall or a covered mirror, on the reduction of spatial neglect for patients with stroke. A total of 21 subacute patients with left spatial neglect after right-hemispheric stroke [...] Read more.
We investigated the effects of mirror visual feedback (MVF), with reference to using a glass wall or a covered mirror, on the reduction of spatial neglect for patients with stroke. A total of 21 subacute patients with left spatial neglect after right-hemispheric stroke were randomly assigned to 3 groups: MVF, sham 1 (viewing the hemiparetic arm through the transparent glass during bilateral arm movement) and sham 2 (using a covered mirror). The 3-week treatment program for all groups consisted of 12 sessions of movement tasks for the hemiparetic arm graded according to the severity of arm impairments. Blinded assessments were administered at pre/post and a three-week follow-up. The results showed that there was no significant advantage for MVF than sham 1; however, MVF was more beneficial than sham 2, as shown by the line crossing (p = 0.022). Improvement in discriminating the left-gap figures on the left and right side of the page in the Gap Detection Test was greater in MVF than using the covered mirror (p = 0.013; p = 0.010), showing a slight advantage of MVF in alleviating allocentric symptoms. Our study confirms that MVF was superior to using a covered mirror as a method for reducing spatial neglect and in alleviating its allocentric symptoms, but no significant advantage over bilateral arm movement through transparent glass was found. Further research in comparing their therapeutic effects is warranted. Full article
(This article belongs to the Special Issue Stroke, Cognition and Dementia)
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8 pages, 582 KiB  
Article
The D-Dimer/Albumin Ratio Is a Prognostic Marker for Aneurysmal Subarachnoid Hemorrhage
by Wei Wu, Xunzhi Liu, Qi Zhu, Xiangxin Chen, Bin Sheng, Jiatong Zhang, Wei Li, Dingding Zhang and Chunhua Hang
Brain Sci. 2022, 12(12), 1700; https://doi.org/10.3390/brainsci12121700 - 12 Dec 2022
Cited by 4 | Viewed by 1827
Abstract
Background: Aneurysmal subarachnoid hemorrhage (aSAH) is a severe neurological event with limited treatment options, and little is known about its pathophysiology. There are few objective tools for predicting outcomes of aSAH patients and further aiding in directing clinical therapeutic programs. This study [...] Read more.
Background: Aneurysmal subarachnoid hemorrhage (aSAH) is a severe neurological event with limited treatment options, and little is known about its pathophysiology. There are few objective tools for predicting outcomes of aSAH patients and further aiding in directing clinical therapeutic programs. This study aimed to determine whether an elevated serum D-dimer/albumin ratio (DAR) reflects disease severity and predicts aSAH outcomes. Methods: We included 178 patients with aSAH. Data included demographics; clinical severity of aSAH (World Federation of Neurological Societies (WFNS) grade and Hunt–Hess grade); levels of D-dimer, albumin, and c-reactive protein (CRP); leukocyte counts on admission; and three-month outcomes. The outcomes were dichotomized into good and poor. The predictive ability of DAR for outcomes was determined using receiver operating characteristic (ROC) curve analysis. Results: Serum DAR showed a positive correlation with disease severity. Univariate analysis revealed that DAR, WFNS grade, Hunt–Hess grade, delayed cerebral infarction (DCI), age, neutrophil-to-lymphocyte ratio (NLR), and CRP/albumin ratio (CAR) were associated with unfavorable outcomes. Multivariate regression analysis further revealed that elevated DAR predicted poor outcomes after adjusting for WFNS grade, Hunt–Hess grade, DCI, age, NLR, and CRP/albumin ratio. Receiver operating characteristic curve analysis revealed that DAR predicted outcomes at a level comparable with NLR and CAR and had superior predictivity than D-dimer alone. Conclusion: DAR is a promising objective tool for aSAH outcome prediction. A high content DAR was associated with disease severity and unfavorable short-term outcomes. Full article
(This article belongs to the Special Issue Stroke, Cognition and Dementia)
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10 pages, 6118 KiB  
Article
Neuroprotective Effect of Angiopoietin2 Is Associated with Angiogenesis in Mouse Brain Following Ischemic Stroke
by Ling-Ling Lv, Yi-Ting Du, Xiao Chen, Yu Lei and Feng-Yan Sun
Brain Sci. 2022, 12(11), 1428; https://doi.org/10.3390/brainsci12111428 - 24 Oct 2022
Cited by 6 | Viewed by 1557
Abstract
Angiogenic factors play an important role in protecting, repairing, and reconstructing vessels after ischemic stroke. In the brains of transient focal cerebral ischemic mice, we observed a reduction in infarct volume after the administration of Angiopoietin 2 (Angpt2), but whether this process is [...] Read more.
Angiogenic factors play an important role in protecting, repairing, and reconstructing vessels after ischemic stroke. In the brains of transient focal cerebral ischemic mice, we observed a reduction in infarct volume after the administration of Angiopoietin 2 (Angpt2), but whether this process is promoted by Angpt2-induced angiogenesis has not been fully elaborated. Therefore, this study explored the angiogenic activities, in reference to CD34 which is a marker of activated ECs and blood vessels, of cultured ECs in vitro and in ischemic damaged cerebral area in mice following Angpt2 administration. Our results demonstrate that Angpt2 administration (100 ng/mL) is neuroprotective by significantly increasing the CD34 expression in in vitro-cultured ECs, reducing the infarct volume and mitigating neuronal loss, as well as enhancing CD34+ vascular length and area. In conclusion, these results indicate that Angpt2 promotes repair and attenuates ischemic injury, and that the mechanism of this is closely associated with angiogenesis in the brain after stroke. Full article
(This article belongs to the Special Issue Stroke, Cognition and Dementia)
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