Probabilistic sequence learning in mild cognitive impairment

Mild Cognitive Impairment (MCI) causes slight but noticeable disruption in cognitive systems, primarily executive and memory functions. However, it is not clear if the development of sequence learning is affected by an impaired cognitive system and, if so, how. The goal of our study was to investigate the development of probabilistic sequence learning, from the initial acquisition to consolidation, in MCI and healthy elderly control groups. We used the Alternating Serial Reaction Time task (ASRT) to measure probabilistic sequence learning. Individuals with MCI showed weaker learning performance than the healthy elderly group. However, using the reaction times only from the second half of each learning block – after the reactivation phase - we found intact learning in MCI. Based on the assumption that the first part of each learning block is related to reactivation/recall processes, we suggest that these processes are affected in MCI. The 24-hour offline period showed no effect on sequence-specific learning in either group but did on general skill learning: the healthy elderly group showed offline improvement in general reaction times while individuals with MCI did not. Our findings deepen our understanding regarding the underlying mechanisms and time course of sequence acquisition and consolidation

Implant for Augmentation of Cerebral Blood Flow Trial-1 (ImpACT-1). A single-arm feasibility study evaluating the safety and potential benefit of the Ischemic Stroke System for treatment of acute ischemic stroke

Background The Ischemic Stroke System is a novel device designed to deliver stimulation to the sphenopalatine ganglion(SPG).The SPG sends parasympathetic innervations to the anterior cerebral circulation. In rat stroke models, SPG stimulation results in increased cerebral blood flow, reduced infarct volume, protects the blood brain barrier, and improved neurological outcome. We present here the results of a prospective, multinational, single-arm, feasibility study designed to assess the safety, tolerability, and potential benefit of SPG stimulation inpatients with acute ischemic stroke(AIS). Methods Patients with anterior AIS, baseline NIHSS 7–20 and ability to initiate treatment within 24h from stroke onset, were implanted and treated with the SPG stimulation. Patients were followed up for 90 days. Effect was assessed by comparing the patient outcome to a matched population from the NINDS rt-PA trial placebo patients. Results Ninety-eight patients were enrolled (mean age 57years, mean baseline NIHSS 12 and mean treatment time from stroke onset 19h). The observed mortality rate(12.2%), serious adverse events (SAE)incidence(23.5%) and nature of SAE were within the expected range for the population. The modified intention to treat cohort consisted of 84 patients who were compared to matched patients from the NINDS placebo arm. Patients treated with SPG stimulation had an average mRS lower by 0.76 than the historical controls(CMH test p = 0.001). Conclusion The implantation procedure and the SPG stimulation, initiated within 24hr from stroke onset, are feasible, safe, and tolerable. The results call for a follow-up randomized trial (funded by BrainsGate; clinicaltrials.gov number, NCT03733236)

High circulating osteoprotegerin levels are associated with non-zero blood groups

Background: Osteoprotegerin (OPG) and von Willebrand factor (VWF) form complex within endothelial cells and following secretion. The nature of blood group antigens strongly influences the levels of circulating VWF, but there is no available data concerning its ascendancy on OPG levels. We aimed to assess the relationship of AB0 blood groups with OPG, VWF levels (VWF: Ag) and collagen binding activity (VWF: CB) in peripheral arterial disease (PAD) patients. Methods: Functional and laboratory parameters of 105 PAD patients and 109 controls were examined. Results of OPG, VWF: Ag, VWF: CB (ELISA-s) were analysed by comparative statistics, together with clinical data. Results: OPG levels were higher in patients than in controls (4.64 ng/mL vs. 3.68 ng/mL, p < 0.001). Among patients elevation was marked in the presence of critical limb ischemia (5.19 ng/mL vs. 4.20 ng/mL, p = 0.011). The OPG in patients correlated positively with VWF: Ag and VWF: CB (r = 0.26, p = 0.008; r = 0.33, p = 0.001) and negatively with ankle-brachial pressure index (r = -0.22, p = 0.023). Furthermore, OPG was significantly elevated in non-0 blood groups compared to 0-groups both in patients and controls (4.95 ng/mL vs. 3.90 ng/mL, p = 0.012 and 4.09 ng/mL vs. 3.40 ng/mL, p = 0.002). Conclusions: OPG levels are associated to blood group phenotypes and higher in non-0 individuals. Increased OPG levels in PAD characterize disease severity. The significant correlation between OPG and VWF: CB might have functional importance in an atherothrombosis-prone biological environment

Additional file 1: Table S1. of High circulating osteoprotegerin levels are associated with non-zero blood groups

Clinical and laboratory parameters of patients and controls by 0/non-0 blood groups. (DOCX 24 kb

AbobotulinumtoxinA (Dysport) in the treatment of adults with upper limb spasticity in a randomized, double-blind, placebo-controlled study

Introduction and Objectives: Few extensive studies have assessed the effects of botulinum neurotoxin A in adults with upper limb spasticity (ULS) poststroke/traumatic brain injury (TBI) on muscle tone, spasticity, active range of motion (AROM), and function. The aim of this study was to assess the efficacy and safety of abobotulinumtoxinA (Dysport) in hemiparetic adults with ULS poststroke/TBI. Methods: In this phase 3, prospective, double-blind, placebo-controlled study, 243 patients (34 sites, 9 countries) were randomly assigned (1:1:1) to Dysport 500 or 1000 U or placebo. The primary objective was assessment of upper limb muscle tone (Modified Ashworth Scale; MAS) in the primary targeted muscle group (PTMG; finger, wrist, or elbow flexors). Other measures included spasticity (Tardieu Scale), AROM, ease of applying splint (EOS), clinical benefit (Physician Global Assessment; PGA), and subjective function (Disability Assessment Scale; DAS). Results: Four weeks postinjection, a higher proportion of patients achieved a ≥1 point improvement in MAS with both Dysport doses compared with placebo (placebo, 22.8%; 500 U, 73.8%; 1000 U, 78.5%; P<0.0001 vs placebo). Finger flexors were the most common PTMG across treatment groups (52% to 61%). For finger flexors, mean (standard error of mean; SEM) gain in spasticity angle was significantly improved with Dysport vs placebo at 500 U (27.3° [5.9]; P<0.01) and at 1000 U (29.5° [5.9]; P<0.01). This was associated with significantly improved active finger extension (23.9° [4.2]; P<0.0001 for 500 U and 17.6° [4.5]; P<0.01 for 1000 U). Similar results were observed for wrist and elbow flexors. EOS and PGA significantly improved at both doses; 50% (500 U) and 62% (1000 U) of patients improved on DAS (≥1 grade decrease from baseline) for the principal treatment target. Both doses were well tolerated, and the safety profile was consistent with previous experience with Dysport. Conclusions: Dysport improved muscle tone, spasticity, and AROM in the spastic upper limb at week 4; clinical benefit was also observed, based on PGA and DAS