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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ageing causes changes to the brain size, vasculature, and cognition. The brain shrinks with increasing age and there are changes at all levels from molecules to morphology. Incidence of stroke, white matter lesions, and dementia also rise with age, as does level of memory impairment and there are changes in levels of neurotransmitters and hormones. Protective factors that reduce cardiovascular risk, namely regular exercise, a healthy diet, and low to moderate alcohol intake, seem to aid the ageing brain as does increased cognitive effort in the form of education or occupational attainment. A healthy life both physically and mentally may be the best defence against the changes of an ageing brain. Additional measures to prevent cardiovascular disease may also be important.
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PMID:Ageing and the brain. 1646 69

Epileptogenesis, i.e. the process leading to epilepsy with spontaneous recurrent seizures, can be initiated by a number of brain damaging insults, including traumatic brain injury, status epilepticus (SE), and stroke. Such acquired epilepsy is often associated with memory impairment and behavioral problems. There has been a growing interest in the use of antiepileptic drugs (AEDs) for neuroprotection and prevention or modification of epileptogenesis induced by such brain insults. One promising candidate in this respect is valproic acid (VPA), a widely used AED that has been reported to exert neuroprotective activity in a number of in vitro and in vivo models. The present study investigated whether VPA reduces brain damage and improves functional outcome in a rat model of post-SE epilepsy. A self-sustaining SE was induced by prolonged electrical stimulation of the basal amygdala via a depth electrode. SE was terminated after 4 h by diazepam, immediately followed by onset of treatment with VPA. VPA was injected i.p. at a bolus dose of 400 mg/kg, followed by three times daily administration of 200 mg/kg for 4 weeks. A control group received vehicle instead of VPA after SE. Spontaneous seizures were recorded in all rats of both groups following termination of treatment, without significant inter-group difference in seizure frequency or severity. However, treatment with VPA after SE prevented the hyperexcitability and locomotor hyperactivity observed in vehicle-treated epileptic rats. Furthermore, VPA completely counteracted the neuronal damage in the hippocampal formation, including the dentate hilus. The data demonstrate that, although VPA does not prevent the occurrence of spontaneous seizures after SE, it exerts powerful neuroprotective effects and prevents part of the behavioral alterations, demonstrating that administration of VPA immediately after SE exerts a favorable effect on long-term functional outcome.
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PMID:Treatment with valproate after status epilepticus: effect on neuronal damage, epileptogenesis, and behavioral alterations in rats. 1680 97

Only two cases connecting Sildenafil reception and acute memory impairment have been published. Two similar cases were observed in our clinic last year. Sildenafil is a potent inhibitor of cyclic guanosine monophosphate in the corpus cavernosum and therefore, increases the penile response to sexual stimulation and is used for erectile dysfunction. The most severe and life-threatening complications of Sildenafil are associated with combined administration with nitrates. The incidence of nonfatal myocardial infarction, stroke and death did not significantly differ between Sildenafil-treated and placebo-treated patients; therefore, Sildenafil does not appear contraindicated in subjects with ischemic heart disease (IHD). Scanty data are available regarding Sildenafil and cerebrovascular disease and there are only a few case reports regarding transient global amnesia (TGA) after Sildenafil use. Two cases of TGA are described immediately following the use of one dose of Sildenafil. The etiology of TGA is not yet completely understood but one of the hypothesizes suggests that the pathophysiology of this condition is related to intracranial vasomotor changes, especially due to venous congestion and venous ischemia of bilateral hippocampal structures. It is also well known that Sildenafil stimulates the relaxation of smooth muscle and causes vasomotor changes. Based on this report, as well as previous reports, it is suggested that a single dose of Sildenafil may stimulate TGA.
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PMID:[Two cases of transient global amnesia (TGA) following sildenafil use]. 1707 26

Neurological syndromes secondary to acute aortic dissection (AAD) are uncommon and usually consist of focal deficits after an embolic cerebral infarction. This article reports the observation of an AAD with the chief complaint of transient acute memory impairment-that is, a non-usual stroke-like symptom.
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PMID:Transient global amnesia caused by painless aortic dissection. 1718 52

3-n-Butylphthalide (NBP) may be beneficial for the treatment of ischemic stroke with multiple actions on different pathophysiological processes. In the present study, we investigated the effect of NBP isomers on learning and memory impairment induced by chronic cerebral hypoperfusion in rats. Male Wistar rats were orally administered 10 and 30 mg/kg l-, d-, or dl-NBP daily for 23 days after bilateral permanent occlusion of the common carotid arteries. Rats receiving 10 mg/kg l-NBP performed significantly better in tests for spatial learning and memory, and they had attenuated cerebral pathology, including neuronal damage, white matter rarefaction, and glial activation compared with controls. Furthermore, 10 mg/kg l-NBP-treated rats had significantly higher choline acetyltransferase activity, decreased cortical lipid peroxide, and reduced hippocampal superoxide dismutase activity, compared with vehicle controls. However, d- and dl-NBP did not show significant beneficial effects. The present findings demonstrate that the beneficial effects of l-NBP on hypoperfusion-induced cognitive deficits may be due to preventing neuropathological alterations, inhibiting oxidative damage and increasing acetylcholine synthesis. Our results strongly suggest that l-NBP has therapeutic potential for the treatment of dementia caused by decreased cerebral blood flow.
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PMID:l-3-n-Butylphthalide improves cognitive impairment induced by chronic cerebral hypoperfusion in rats. 1737 47

The conventional cognitive rehabilitation was the technique for the patients with the neuropsychological disorders such as aphasia, apraxia, agnosia, attentional disorder, memory impairment, and executive function disorder. These disorders were induced by the organic brain damages due to the traumatic brain injury or the stroke. The aim of the conventional cognitive rehabilitation was to recover their impaired function and improve their quality of life. Recently, subjects of cognitive rehabilitation were not only the patients with the organic brain damages but also the patients with the functional brain impairment including a dementia. Kawashima et al. developed "The learning therapy" as a cognitive rehabilitation for the senile dementia through the top-down approach, the concept of which was derived from the knowledge of the functional brain imaging. The learning therapy is defined as a training of simple arithmetic calculation and reading aloud communicating with a trainer. The effect of The learning therapy is to keep and improve the prefrontal function including cognitive function, ability of communication and independence. It was confirmed that The learning therapy was an effective cognitive rehabilitation for the senile dementia patients by improving their prefrontal function. The effect of prevention against dementia is also being studied. Furthermore, we propose a new educational program for the cognitive development disorders to improve their prefrontal functions.
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PMID:[Cognitive rehabilitation--the learning therapy for the senile dementia]. 1744 22

Spatial cognitive impairment is common after stroke insults. Voluntary exercise could improve the impaired spatial memory. Newly generated neurons in the dentate gyrus are necessary for the acquisition of new hippocampus-dependent memories. However, it is not well known whether voluntary exercise after stroke promotes neurogenesis in the adult dentate gyrus, thereby promoting spatial memory recovery. Here, we examined in mice subjected to focal cerebral ischemia the effect of voluntary or forced exercise on neurogenesis in the ischemic dentate gyrus and spatial memory. Exposure to voluntary wheel running after stroke enhanced newborn cell survival and up-regulated the phosphorylation of cAMP response element binding protein (CREB) in the dentate gyrus and reversed ischemia-induced spatial memory impairment. However, the enhanced newborn cell survival and CREB phosphorylation in the dentate gyrus and improved spatial memory were not observed in the mice exposed to forced swimming. Moreover, there was a significant correlation between the total number of surviving newborn cells in the dentate gyrus and the ability of mice to locate the platform in the Morris water maze. These results suggest that, in the adult mice, exposure to voluntary exercise after ischemic stroke may promote newborn cells survival in the dentate gyrus by up-regulating CREB phosphorylation and consequently restore impaired hippocampus-dependent memory.
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PMID:Voluntary exercise-induced neurogenesis in the postischemic dentate gyrus is associated with spatial memory recovery from stroke. 1746 31

Chronic cerebral hypoperfusion is related to neurological disorders and contributes to a cognitive decline. Its experimental model in rats is permanent, bilateral common carotid artery occlusion. The cyclooxygenase (COX) system plays a pivotal role in the evolution of ischemic brain damage. Several COX inhibitors have proved to be neuroprotective in stroke models. We set out to characterize the effects of COX inhibitors in rats with permanent cerebral hypoperfusion. Some of the animals were exposed to two-vessel occlusion (n=72), while the others served as sham-operated controls (n=54). This was followed by a 3-day post-treatment with the nonselective COX inhibitor indomethacin (3 mg/kg) or with the selective COX-2 inhibitor NS-398 (15 mg/kg) or with the solvent. Some groups of the animals were sacrificed after 3 days, while the remainder were tested in the Morris watermaze for 5 days, and were sacrificed after 2 weeks. Neurons in the hippocampus were subjected to immunocytochemical labeling with cresyl violet, the dendrites with microtubule-associated protein-2, astrocytes with glial fibrillary acidic protein and microglia activation with OX-42 antibody. Two-vessel occlusion induced a learning impairment, mild neuronal damage, marked dendritic injury and moderate astrocytic reaction in the hippocampus. NS-398, but not indomethacin improved the survival rate and abolished the learning disability. However, both drugs increased the proportion of animals displaying neuronal damage. Glial markers revealed a time-dependent elevation in both the sham and the two-vessel occluded group, and were unaffected by the treatments. In summary, NS-398 prevented the hypoperfusion-induced memory impairment, but not by protecting the hippocampal neurons.
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PMID:Effects of cyclooxygenase (COX) inhibition on memory impairment and hippocampal damage in the early period of cerebral hypoperfusion in rats. 1771 73

Lithium is a major drug used for the treatment of bipolar mood disorder and has recently been shown to have neuroprotective properties. In this study we investigated the neuroprotective effects of lithium in gerbils subjected to global cerebral ischemia, an animal model of stroke. The ischemia-induced exploratory behavior changes, measured by open field testing, were largely suppressed by lithium treatment for 7 days prior to ischemic onset. Similarly, memory impairments, measured by T-maze testing, were prevented by lithium pretreatment. This is believed to be the first report of lithium-induced protection against hyperactivity in a novel open field and memory impairment in a gerbil model of global ischemia. These behavioral benefits were associated with an increase in viable cells as measured by hematoxylin and eosin staining and a decrease in apoptotic TUNEL-positive cells in the CA1 hippocampal area of ischemic gerbils. Moreover, the lithium-induced neuroprotection was accompanied by down-regulation of pro-apoptotic p53 in the CA1 but up-regulation of anti-apoptotic Bcl-2 and heat shock protein 70 (HSP70) in the ischemic brain. These results underscore the ability of lithium to improve functional behavioral outcome in gerbil and rodent cerebral ischemic models and further indicate the potential therapeutic use of lithium in certain human stroke conditions.
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PMID:Lithium reduces ischemia-induced hippocampal CA1 damage and behavioral deficits in gerbils. 1802 86

Over the past two decades, there has been a growing interest in understanding the neural underpinnings of memory of the past. Numerous patients with retrograde amnesia after acute brain damage have been described, but often the causative lesions are bilateral and/or fairly diffuse and one question that has arisen is whether a unilateral lesion is sufficient to cause retrograde memory impairment. In addition, the impact of lesion side and site on the material specificity and temporal extent of retrograde memory deficits has remained unclear. We set out to investigate these issues by comparing 20 patients who had recently had a unilateral stroke that involved (but was not necessarily limited to) either the frontal or temporal lobe to a group of 10 matched normal control subjects on tests of memory of events and semantic details from the autobiographical and public domains. Results indicated that a unilateral lesion was sufficient to cause significant retrograde memory impairment, with right-sided lesions affecting recall of autobiographical events more than left-sided lesions. The memory deficits in these patients were most often relatively mild, but temporally pervasive rather than characterised by a traditional temporal gradient. Furthermore, memory of events (both autobiographical and public) was impaired in patients who had had a stroke that included the hippocampus, but not in those whose strokes spared this region. Finding that patients with mesial temporal lesions had difficulty remembering details related to public events, even when offered recognition choices, raises the possibility that part of their memory storage network (and not just their retrieval abilities) was compromised.
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PMID:Retrograde memory after unilateral stroke. 1838 46


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