THURSDAY NEWS TIPS
American Stroke Association Meeting Report - Embargo times as noted below on Thursday, Feb. 7, 2013
- Lowering blood pressure aggressively after bleeding stroke is safe
- Robotic/biofeedback therapy improves function, reduces hand impairment after stroke
- Magnetic brain stimulation relieves post-stroke pain
- Latino stroke survivors suffer more depression
- iPad app identifies neurological deficit among stroke survivors
- New 3-D software helps surgeons plan aneurysm treatment
NOTE ALL TIMES ARE HAWAII (HT). ALL TIPS ARE EMBARGOED UNTIL THE TIME OF PRESENTATION OR 11 A.M. HT/4 P.M. ET EACH DAY, WHICHEVER COMES FIRST. For more information Feb. 6-8, call the ASA News Media Staff Office at the Hawaii Convention Center: (808) 792-6506. Before or after these dates, call the Communications Office in Dallas at (214) 706-1173. For public inquiries, call (800) AHA-USA1 (242-8721).
7:40 a.m. HT/12:40 p.m. ET – Abstract 113
Lowering blood pressure aggressively after bleeding stroke is safe
Treating a bleeding stroke by aggressively lowering blood pressure is safe and doesn’t lower blood flow in the brain, according to research presented at the American Stroke Association’s International Stroke Conference 2013.
Researchers studied 75 patients with hemorrhagic stroke (when a blood vessel inside the brain ruptures and leaks blood into surrounding brain tissue). In one group of patients, researchers lowered blood pressure aggressively to slow bleeding into the brain. In the other group, they used more conservative treatment. They then measured blood flow to the brain and found:
- Blood flow around the hemorrhage decreased about 14 percent compared to the normal tissue on the opposite side of the brain.
- With aggressive treatment, researchers lowered blood pressure an average of 22 mm Hg compared to the conservative group.
- No notable difference in blood flow occurred either around the hemorrhage or anywhere in the brain between patients who had their blood pressure lowered aggressively and those who were managed conservatively.
The study’s results are reassuring to physicians who have been reluctant to aggressively lower blood pressure to treat hemorrhagic stroke for fear it could reduce blood flow to the brain, researchers said.
Note: Actual presentation is 7:40 a.m. HT, Thursday, Feb. 7, 2013.
8:04 a.m. HT/1:04 p.m. ET– Abstract 122
Robotic/biofeedback therapy improves function, reduces hand impairment after stroke
Robotic therapy combined with biofeedback may help hand function after stroke, according to research presented at the American Stroke Association’s International Stroke Conference 2013.
Assisted Movement with Enhanced Sensation (AMES) is a therapeutic approach and robotic device to open and close the affected hand, as well as moving the wrist or ankle, while patients use visual biofeedback and have mechanical vibration applied to the lengthening muscles.
The study involved 43 participants at least a year after their stroke, including 24 who couldn’t move the fingers of their affected hands. All participants received 30 minutes of AMES treatments for 10 weeks; 21 received biofeedback of their volitional finger force; and 22 received biofeedback of volitional finger electromyographic (EMG) activity.
- Both groups improved, regardless of the biofeedback type, with less hand impairment and better hand function.
- Four of the 24 who initially couldn’t extend their fingers recovered the ability to pick up and move one or more blocks.
- The EMG group increased hand strength and decreased contraction of inappropriate muscles.
Note: Actual presentation is 8:04 a.m. HT, Thursday, Feb. 7, 2013.
8:40 a.m. HT/1:40 p.m. ET – Abstract 125
Magnetic brain stimulation relieves post-stroke pain
Repetitive non-invasive magnetic brain stimulation relieved post-stroke pain for patients, according to research presented at the American Stroke Association’s International Stroke Conference 2013.
Researchers studied the use of the procedure that uses magnetic fields to stimulate nerve cells in the brain on 15 patients who had no pain relief with medication. Researchers focused treatment on the motor cortex, which controls voluntary muscles on the affected side of the brain. Therapy was repeated once a week for more than 12 weeks. The researchers found:
- Patients rated their pain an average 6.4 on a visual analog scale at the start of the study. By week 12, the average pain score was 3.4.
- Five patients suffering from paresthesia, an unexplained prickling, burning or tingling sensation, didn’t respond sufficiently to therapy as well as those with other pain.
- Pain relief continued in the five patients who continued transcranial magnetic stimulation for a year.
Researchers conclude transcranial magnetic stimulation of the motor cortex, when maintained once a week can provide long-term pain relief in patients with medication-resistant post-stroke pain, researchers said.
Note: Actual presentation is 8:40 a.m. HT, Thursday, Feb. 7, 2013.
11 a.m. HT/4 p.m. ET – Abstract 142
Latino stroke survivors suffer more depression
Latino stroke survivors suffer more depression than non-Latino stroke survivors, according to research presented at the American Stroke Association’s International Stroke Conference 2013.
Researchers recruited 600 New York City residents from Harlem and the South Bronx who had stroke in the previous five years. Participants in the recurrent stroke prevention program were on average 63 years old; 42 percent were black; 39 percent Latino; 60 percent female; 56 percent lived below poverty; 29 percent were on Medicaid; and 31 percent had less than a high school degree.
Researchers studied demographics, health status and used PHQ-8 scale to determine which participants were depressed. They found:
- Thirty percent had depression.
- Depressed stroke survivors were more likely young, Latino, on Medicaid and sicker than non-depressed participants.
- Latinos were 3.45 times more likely than whites and 2.22 more likely than blacks to be depressed.
- The comparison between Latinos and whites was more pronounced in “Institute of Medicine based disparity framework” with Latinos being 4.65 times more likely to be depressed.
More research is needed on the disparity and depression among Latinos, researchers said.
Note: Actual presentation is 12:42 p.m. HT, Thursday, Feb. 7, 2013.
11 a.m. HT/4 p.m. ET – Abstract TP218
iPad app identifies neurological deficit among stroke survivors
A new iPad application accurately identifies a neurological defect, according to research presented at the American Stroke Association’s International Stroke Conference 2013.
Unilateral neglect happens when a stroke survivor’s brain is damaged on the right side, and he or she fails to respond to stimuli on the left side. Profound neglect may affect recovery after stroke.
Researchers enrolled 22 ischemic stroke patients with unilateral neglect and compared them to a group of 20 stroke survivors without unilateral neglect and a group of 11 healthy people. They used the iNeglect application to ask those in all three groups to drag 12 food items from one place on the app’s virtual table. They measured and compared deviation to the right from midline and found patients with neglect showed larger deviation to the right side with the table setting test on iPad than those without neglect and the healthy group. Moreover, the iNeglect application was useful to demonstrate improvement in degree of neglect after 9 months.
The iNeglect application is feasible for identifying stroke patients with neglect and recognizing the right side deviation, researchers said.
Note: Actual presentation is 4:45 p.m. HT, Thursday, Feb. 7, 2013.
11 a.m. HT/4 p.m. ET – Abstract TP74
New 3-D software helps surgeons plan aneurysm treatment
New three-dimensional software helps surgeons accurately plan stent size and positioning for optimal results in treating weakened blood vessels in the brain, according to research presented at the American Stroke Association’s International Stroke Conference 2013.
The complicated structure of the brain’s arteries can make stent placement difficult.
Researchers studied Virtual Stent software (by Siemens AG, Forchheim, Germany) by analyzing 44 brain aneurysm patients previously treated with a procedure called stent-assisted coil embolization. They aligned the Virtual Stent with the ideal placement and studied the discrepancies in three patient groups, depending on the size of deployed stents
Discrepancy between the Virtual Stent and the ideal placement was minimal, and the Virtual Stent software appeared to predict the final landing position of each deployed stent. Virtual stent simulation provides acceptable accuracy for planning the stent size and its positioning, researchers said.
Note: Actual presentation is 4:45 p.m. HT, Thursday, Feb. 7, 2013.
Follow news from the American Stroke Association’s International Stroke Conference 2013 via Twitter @HeartNews; #ISC13.
Statements and conclusions of study authors that are presented at American Stroke Association scientific meetings are solely those of the study authors and do not necessarily reflect association policy or position. The association makes no representation or warranty as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at www.heart.org/corporatefunding.
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