Hubungan antara faktor demografik dan klinikal dengan kefungsian fizikal pesakit strok

Strok adalah antara punca penyakit yang menyebabkan berlakunya kecelaan fizikal dan limitasi aktiviti kepada pesakit dalam melaksanakan tugasan harian mereka sehinggakan kepada satu peringkat, pesakit akan mengalami ketidakupayaan. Kajian ini bertujuan untuk mengkaji perkaitan setiap faktor demografik dan klinikal yang dipercayai terlibat dengan status kefungsian fizikal pesakit yang telah mengalami strok. Kajian ini juga cuba untuk melihat perbezaan kefungsian fizikal pesakit mengikut faktor-faktor tersebut dan juga melihat hubungan antara faktor-faktor tadi dengan kefungsian fizikal. Seramai 147 orang responden yang lulus ujian saringan kognitif terlibat. Alat ujian Indeks Aktiviti Kehidupan Seharian Barthel (ADL) telah ditadbirkan kepada responden selepas enam minggu serangan strok bagi mengukur tahap kefungsian fizikal mereka. Hasil kajian mendapati terdapat perbezaan yang signifikan [F(3, 143) = 4.06; p < 0.01) antara tahap pendidikan yang berbeza dengan tahap kefungsian fizikal pesakit. Faktor klinikal pula menunjukkan perbezaan kefungsian fizikal lebih tinggi secara signifikan (p < 0.01) pada serangan otak kanan berbanding kiri.Terdapat perbezaan yang signifikan (p < 0.01) pada kefungsian fizikal pesakit dalam kepercayaan pemulihan mereka. Di samping itu, bilangan serangan strok pesakit juga menunjukkan perbezaan yang signifikan [F(1, 145)= 11.19; p < 0.01] pada kefungsian fizikal mereka. Ujian korelasi yang dijalankan menunjukkan bahagian otak yang diserang mempunyai hubungan positif yang signifikan (r = 0.24; p < 0.01) dengan kefungsian fizikal pesakit strok. Kesimpulannya, faktor demografik dan klinikal turut memainkan peranan dalam menentukan tahap kefungsian fizikal pesakit strok dan faktor-faktor tersebut perlu dipertimbangkan dalam usaha untuk meningkatkan kefungsian fizikal pesakit pada masa hadapan

A Review of Risk Factors for Cognitive Impairment in Stroke Survivors

In this review, we aimed to identify the risk factors that may influence cognitive impairment among stroke survivors, namely, demographic, clinical, psychological, and physical determinants. A search from Medline, Scopus, and ISI Web of Science databases was conducted for papers published from year 2004 to 2015 related to risk factors of cognitive impairment among adult stroke survivors. A total of 1931 articles were retrieved, but only 27 articles met the criteria and were reviewed. In more than half of the articles it was found that demographical variables that include age, education level, and history of stroke were significant risk factors of cognitive impairment among stroke survivors. The review also indicated that diabetes mellitus, hypertension, types of stroke and affected region of brain, and stroke characteristics (e.g., size and location of infarctions) were clinical determinants that affected cognitive status. In addition, the presence of emotional disturbances mainly depressive symptoms showed significant effects on cognition. Independent relationships between cognition and functional impairment were also identified as determinants in a few studies. This review provided information on the possible risk factors of cognitive impairment in stroke survivors. This information may be beneficial in the prevention and management strategy of cognitive impairments among stroke survivors

Alteration in the functional organization of the default mode network following closed non-severe traumatic brain injury

The debilitating effect of traumatic brain injury (TBI) extends years after the initial injury and hampers the recovery process and quality of life. In this study, we explore the functional reorganization of the default mode network (DMN) of those affected with non-severe TBI. Traumatic brain injury (TBI) is a wide-spectrum disease that has heterogeneous effects on its victims and impacts everyday functioning. The functional disruption of the default mode network (DMN) after TBI has been established, but its link to causal effective connectivity remains to be explored. This study investigated the differences in the DMN between healthy participants and mild and moderate TBI, in terms of functional and effective connectivity using resting-state functional magnetic resonance imaging (fMRI). Nineteen non-severe TBI (mean age 30.84 ± 14.56) and twenty-two healthy (HC; mean age 27.23 ± 6.32) participants were recruited for this study. Resting-state fMRI data were obtained at the subacute phase (mean days 40.63 ± 10.14) and analyzed for functional activation and connectivity, independent component analysis, and effective connectivity within and between the DMN. Neuropsychological tests were also performed to assess the cognitive and memory domains. Compared to the HC, the TBI group exhibited lower activation in the thalamus, as well as significant functional hypoconnectivity between DMN and LN. Within the DMN nodes, decreased activations were detected in the left inferior parietal lobule, precuneus, and right superior frontal gyrus. Altered effective connectivities were also observed in the TBI group and were linked to the diminished activation in the left parietal region and precuneus. With regard to intra-DMN connectivity within the TBI group, positive correlations were found in verbal and visual memory with the language network, while a negative correlation was found in the cognitive domain with the visual network. Our results suggested that aberrant activities and functional connectivities within the DMN and with other RSNs were accompanied by the altered effective connectivities in the TBI group. These alterations were associated with impaired cognitive and memory domains in the TBI group, in particular within the language domain. These findings may provide insight for future TBI observational and interventional research

Harmonized-Multinational qEEG norms (HarMNqEEG)

This paper extends frequency domain quantitative electroencephalography (qEEG) methods pursuing higher sensitivity to detect Brain Developmental Disorders. Prior qEEG work lacked integration of cross-spectral information omitting important functional connectivity descriptors. Lack of geographical diversity precluded accounting for site-specific variance, increasing qEEG nuisance variance. We ameliorate these weaknesses. (i) Create lifespan Riemannian multinational qEEG norms for cross-spectral tensors. These norms result from the HarMNqEEG project fostered by the Global Brain Consortium. We calculate the norms with data from 9 countries, 12 devices, and 14 studies, including 1564 subjects. Instead of raw data, only anonymized metadata and EEG cross-spectral tensors were shared. After visual and automatic quality control, developmental equations for the mean and standard deviation of qEEG traditional and Riemannian DPs were calculated using additive mixed-effects models. We demonstrate qEEG "batch effects" and provide methods to calculate harmonized z-scores. (ii) We also show that harmonized Riemannian norms produce z-scores with increased diagnostic accuracy predicting brain dysfunction produced by malnutrition in the first year of life and detecting COVID induced brain dysfunction. (iii) We offer open code and data to calculate different individual z-scores from the HarMNqEEG dataset. These results contribute to developing bias-free, low-cost neuroimaging technologies applicable in various health settings