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Query: UMLS:C0015672 (
fatigue
)
51,768
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Background and objective:
The trajectories of long-term and domain-specific cognitive alterations over a decade after stroke are largely unknown. This study aims to investigate the dynamic alterations of domain-specific cognitive performance among young stroke survivors over 10 years after their first stroke.
Methods:
A prospective cohort study was carried out on 38 young stroke survivors (aged 18-65 at stroke onset) living in the community at 10 years after their first stroke. The cognitive outcomes were assessed repeatedly at 1 week, 7 months, and 10 years after their first stroke on the sub-domains: process speed
(Symbol search and Coding from WAIS,
TMT
-A)
, visual attention
(Bells test)
, visuospatial function
(Block design from WAIS, RCFT)
, executive function (
TMT
-B, verbal fluency
), verbal function
[Letter fluency (FAS) from D-KEFS and CD]
, working memory (
Digit Span from WAIS
), immediate memory (
RCFT and CD
), and delayed memory (
RCFT and CD
). Global cognition was evaluated with Mini mental state examination at the two later time-points.
Results:
We found a delayed significant improvement of working memory with total recovery 10 years after participants' stroke. Visuospatial function recovered already at 7 months and remained stable at 10-year follow-up. Process speed demonstrated a significant decrease at 10 years compared to 7 months after stroke onset, a decrease which could be compensated by enhancements of other cognitive domains. No further deterioration was found in verbal function, immediate-, and delayed memory, and executive function during 10-year follow-up. Global cognition improved by on average two points between 7 months and 10 years. Education level and
fatigue
showed low to moderate positive correlations with cognitive improvements.
Conclusions:
The concordance of cognitive improvements between domain-specific and global cognitions strongly suggest that some young stroke survivors do improve their cognitive outcome over a 10-year period following their first stroke. This finding fills a gap of knowledge with respect to the dynamic trajectory of post-stroke cognition, with important implications in clinical practice.
...
PMID:Dynamic Trajectory of Long-Term Cognitive Improvement Up to 10 Years in Young Community-Dwelling Stroke Survivors: A Cohort Study. 3085 30
Background and objective
: This is the first study to investigate the effect of high-flow oxygen therapy, using a normobaric chamber on cognitive, biochemical (oxidative stress parameters and the level of neurotrophins), cardiovascular and autonomic functioning.
Materials and methods
: 17 healthy volunteers, eight males and nine females, with a mean age of 37.5 years, were examined. The experimental study involved ten two-hour exposures in a normobaric chamber with a total pressure of 1500 hPa, in air adjusted to 37% oxygen, 1.079% carbon dioxide and 0.44% hydrogen. Cognitive function was assessed by using Trail Making Test parts A, B and difference in results of these tests (
TMT
A,
TMT
B and
TMT
B-A); California Verbal Learning Test (CVLT); Digit symbol substitution test (DSST); and Digit Span (DS).
Fatigue
(
Fatigue
Severity Scale (FSS)), cardiovascular, autonomic and baroreceptor functioning (Task Force Monitor) and biochemical parameters were measured before and after intervention.
Results
: After 10 sessions in the normobaric chamber, significant decreases in weight, caused mainly by body fat % decrease (24.86 vs. 23.93%,
p
= 0.04 were observed.
TMT
part A and B results improved (
p
= 0.0007 and
p
= 0.001, respectively). In contrast, there was no statistically significant influence on
TMT
B-A. Moreover, decrease in the number of symbols left after a one-minute test in DSST was noted (
p
= 0.0001). The mean number of words correctly recalled in the CVLT Long Delay Free Recall test improved (
p
= 0.002), and a reduction in
fatigue
was observed (
p
= 0.001). Biochemical tests showed a reduction in levels of malondialdehyde (
p
< 0.001), with increased levels of Cu Zn superoxide dismutase (
p
< 0.001), Neurotrophin 4 (
p
= 0.0001) and brain-derived neurotrophic factor (p = 0.001). A significant increase in nitric oxide synthase 2 (Z = 2.29,
p
= 0.02) and Club cell secretory protein (
p
= 0.015) was also noted. Baroreceptor function was significantly improved after normobaric exposures (
p
= 0.003). Significant effect of normobaric exposures and BDNF in CVLT Long Delay Free Recall was noted.
Conclusions
: This study demonstrates that 10 exposures in a normobaric chamber have a positive impact on visual information and set-shifting processing speed and increase auditory-verbal short-term memory, neurotrophic levels and baroreceptor function. A response of the respiratory tract to oxidative stress was also noted. There is a need to rigorously examine the safety of normobaric therapy. Further studies should be carried out with physician examination, both pre and post treatment.
...
PMID:Autonomic and Cognitive Function Response to Normobaric Hyperoxia Exposure in Healthy Subjects. Preliminary Study. 3229 Jan 64