Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0599766 (functional recovery)
 13,441 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Apathy is defined as lack of feeling, emotion, or concern. The objective of this study was to examine the frequency of apathy after a first-ever stroke and to prospectively study the impact of apathy on functional recovery. The patients enrolled in this study had the following characteristics: (i) they had experienced a first ischemic or hemorrhagic stroke; (ii) they ranged from 45 to 90 years of age; (iii) the interval from onset to admission ranged from 21 to 90 days; and (iv) they did not demonstrate either marked dementia or aphasia. The functional status was assessed by the Barthel index and the functional independence measures on admission and after a 3-month rehabilitation period. On the basis of the apathy scale, the patients were grouped into those experiencing apathy and those who did not. Next, the scores of the functional measures in the two groups were compared. A total of 67 patients--38 males and 29 females--were analyzed. Fourteen patients (21%) were diagnosed as being apathetic. The apathetic patients tended to be older and more cognitively impaired than the nonapathetic patients. The severity of neurological deficits, the frequency of depression, and the functional status on admission did not differ substantially in the patients with or without apathy. Although the difference was marginal, apathetic patients showed less improvement in the Barthel index or the subscore of functional independence measures than nonapathetic patients after rehabilitation. Thus, we concluded that apathy is not a rare condition after first-ever stroke and it may impair stroke recovery.
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PMID:Apathy and functional recovery following first-ever stroke. 1900 81

The authors examined apathy symptoms, their improvement, and their association with functional recovery after a hip fracture. Of 126 participants, 37% had clinically significant apathy symptoms, which predicted functional outcome (i.e., poorer recovery from the fracture among those with higher baseline apathy). Of participants with high baseline apathy, approximately one-third improved; these participants had a better functional outcome than those with persistently high apathy scores. It is concluded that apathy symptoms are common after a hip fracture, but improve in one-third of individuals, with a concomitant functional recovery after hip surgery. Interventions to prevent or improve apathy in elderly persons deserve further attention.
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PMID:Apathy after hip fracture: a potential target for intervention to improve functional outcomes. 1977 6

Depression and apathy are often observed after stroke and are often confused with one another. In the present review, we argue that the current concept of 'post-stroke depression' (PSD) in fact consists of two core symptoms or syndromes: (i) affective (depressive) PSD; and (ii) apathetic PSD. We argue that these two core symptoms are each associated with a different underlying neuroanatomical mechanism, a pattern that influences functional recovery. Post-stroke disabilities can provoke several distinct emotional responses, some of which are associated with severe depression. We examined one of these emotional responses previously, namely 'insistence on recovery', which was believed to be a negative indicator of functional improvement in disabled stroke patients. However, an appropriate level of insistence on recovery may, in fact, be associated with reduced depression and apathy, resulting in enhanced recovery from stroke-related disabilities. Improvements in physical disabilities (trunk stability or activities of daily living, such as walking) also reduce depression and apathy. Therefore, the experience of PSD/apathy may be intertwined with various initial emotional responses and improvements in physical functioning. Effective treatment of PSD/apathy requires a multidisciplinary approach, such that neuroanatomical/neurobiological, emotional, and physical (rehabilitation) domains are all addressed.
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PMID:Post-stroke depression and apathy: Interactions between functional recovery, lesion location, and emotional response. 2144 12

Depression is the most common neuropsychiatric complication of a stroke (Post Stroke DepressionPSD) and has been shown to impede the recovery and rehabilitation of these patients. Prevalence rates of PSD vary between 6% and 79%. Direct comparison between studies is limited due to their different methodology. Etiology of PSD is determined by biological and psychosocial factors. Symptoms of PSD appear in three areas: affective, somatic and cognitive. Differential diagnosis includes post-stroke fatigue and pseudo-depressive manifestations of ischemic infarctions (apathy, aprosody, athymhormia, pseudobulbar palsy). Mortality in post-stroke patients is higher than in non-depressed stroke patients and suicide ideation is observed in 6.6-11.3% of stroke patients. Selective serotonin reuptake inhibitors (SSRI) are considered as the first choice treatment of PSD. Other therapeutic approaches include cognitive and functional rehabilitation. PSD is a potentially treatable condition, yet under-diagnosed, and has a negative effect on functional recovery and survival of stroke patients.
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PMID:[Post-stroke depression: recognition and treatment interventions]. 2197 Nov 99

Psychiatric syndromes are common in the patients with cerebrovascular disease. Poststroke depression (PSD) is a most frequent complication of after cerebrovascular disease. Depression affects 20-50% of patients within a year after stroke. PSD has a negative impact on functional recovery. Poststroke anxiety disorder, apathy and pathological laughing and crying are also frequent and under-detected symptoms. In this chapter, we described an outline mainly on treatment of PSD among these symptoms, in paticular, about antidepressant medications. There is an association between depression and atherosclerosis. Several trials have shown evidence that antidepressants may prevent depressive symptoms after stroke. The concept of "vascular depression" will suggest that the establishment of a new treatment strategy is demanded in future.
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PMID:[A psychotropic drug treatment of psychiatric symptoms after stroke]. 2241 99

Apathy is a motivational disturbance that can be defined as a quantitative reduction of goal-directed behaviour. Patients present with loss of motivation, concern, interest, and emotional response, resulting in a loss of initiative, decreased interaction with their environment, and a reduced interest in social life. Apathy not only appears to be common in stroke patients, but it has also been related to a wide range of negative consequences for the patients and their caregivers, including poor functional recovery, loss of social independence, and caregiver distress. Clear definition and consensus diagnostic criteria for apathy are needed to accomplish an accurate assessment and an individualised treatment plan. Although there have been reports of successful behavioural therapy treatment of apathetic states, there is a paucity of controlled clinical trials on the efficacy of apathetic behaviours using pharmacotherapy.
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PMID:[Post-stroke apathy]. 2652 89

Poststroke apathy is relatively common and has negative effects on the functional recovery of the patient; however, few reports have demonstrated the existence of effective treatments for poststroke apathy. Here, we describe a case of poststroke apathy that was successfully treated with repetitive transcranial magnetic stimulation (rTMS). Using resting-state functional magnetic resonance imaging, we detected improved interhemispheric functional connectivity that was correlated with the patient's recovery from poststroke apathy. Our case suggests that rTMS can improve the transfer of information through the corpus callosum, which is crucial for helping patients recover from poststroke apathy.
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PMID:The Effectiveness of Repetitive Transcranial Magnetic Stimulation for Poststroke Apathy Is Associated with Improved Interhemispheric Functional Connectivity. 2777 Nov 95

Mood disorders (e.g. depression, apathy, and anxiety) are often observed in stroke patients, exhibiting a negative impact on functional recovery associated with various physical disorders and cognitive dysfunction. Consequently, post-stroke symptoms are complex and difficult to understand. In this study, we aimed to clarify the cross-sectional relationship between mood disorders and motor/cognitive functions in stroke patients. An artificial neural network architecture was devised to predict three types of mood disorders from 36 evaluation indices obtained from functional, physical, and cognitive tests on 274 patients. The relationship between mood disorders and motor/cognitive functions were comprehensively analysed by performing input dimensionality reduction for the neural network. The receiver operating characteristic curve from the prediction exhibited a moderate to high area under the curve above 0.85. Moreover, the input dimensionality reduction retrieved the evaluation indices that are more strongly related to mood disorders. The analysis results suggest a stress threshold hypothesis, in which stroke-induced lesions promote stress vulnerability and may trigger mood disorders.
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PMID:Relationships between motor and cognitive functions and subsequent post-stroke mood disorders revealed by machine learning analysis. 3317 75