THURSDAY – NEWS TIPS

American Stroke Association Meeting Report - See embargo times below

February 02, 2012

NOTE ALL TIMES ARE CENTRAL. ALL TIPS ARE EMBARGOED UNTIL THE TIME OF PRESENTATION OR 3 P.M. CT/4 P.M. ET EACH DAY, WHICHEVER COMES FIRST. For more information Feb. 1-3, call Karen Astle, Bridgette McNeill, Julie Del Barto or Carrie Thacker at the New Orleans Convention Center at (504) 670-6010. Before or after these dates, call the Communications Office in Dallas at (214) 706-1396. For public inquiries call (800) AHA-USA1 (242-8721).

3 p.m. CT – Abstract 2332

Physical activity prior to stroke may result in better outcomes

For people who suffer a stroke, an active lifestyle before the stroke is linked to a better chance of recovering motor skills, a higher rate of success in restoring blood flow to the brain, and a smaller amount of brain damage from the stroke.

Researchers studied 159 consecutive patients with an acute anterior territory artery occlusion of less than eight hours duration. Prestroke physical activity was measured with the International Physical Activity Questionnaire (IPQ), the Physical Activity Scale for the Elderly (PASE) and the Metabolic Equivalent Task Scale (METS).

Compared with the 69 patients with low physical activity, the 45 patients with medium level of physical activity and the 45 patients with high level of physical activity were younger and had lower blood pressure, glucose blood levels and frequency of proximal arterial occlusion and less stroke severity. The higher the level of prestroke physical activity the better functional recovery, the higher rate of early blood flow restoration and the smaller infarct size.

Researchers found:

Eighty-nine percent of stroke patients with the highest level of physical activity had good functional outcomes compared to 69 percent with mid-levels of physical activity and only 4 percent of those with low levels of physical activity.
Those with the highest level of activity also were more likely to have blood flow restored after intravenous tPA with 62 percent having early recanalization for those in the highest level, 35 percent in the middle range and none in the lowest level.
Those with high and medium levels of physical activity also had smaller infarct size.

Note: Actual presentation is 6:15 p.m. CT, Thursday, Feb. 2, 2012.

3 p.m. CT – Abstract 2554

After stroke, children have lower IQs, visual-motor and language skills

Children who have survived an arterial ischemic stroke often have lower intelligence quotients, and impaired visual-motor and language skills compared to healthy children, researchers report.

The study included 42 pediatric stroke patients who had neuropsychological testing at least 10 months after stroke diagnosis from March 2006 to August 2011. The children underwent neuropsychological testing that evaluated cognitive abilities, academic skills, memory, language and visual-motor skills.

The average IQ for children with arterial ischemic stroke was about 94, still in the average range, but significantly lower than the average for all children (i.e., 100). More importantly, children who survived stroke had significantly lower visual-motor function and language scores than other children as well, and their performance in the latter domains was lower than their general cognitive skills.

By contrast, academic and memory profiles were not reduced significantly.

Even when excluding children who had neuropsychological abnormalities before stroke, visual-motor and language skills remained significantly reduced in stroke survivors as compared to the whole population of children. Stroke type, size or location were not significant predictors of long-term neuropsychological outcome.

In light of the findings, researchers recommend that children who have survived stroke be comprehensively evaluated for the need for targeted interventions to improve visual-motor and language skills. The effectiveness of these interventions should be evaluated in future studies.

Note: Actual presentation is 6:15 p.m. CT, Thursday, Feb. 2, 2012

3 p.m. CT – Abstract 2800

Stroke damage to brain may affect threat perception

The damage left by stroke to areas of the forebrain (basal ganglia) may leave some survivors with impaired ability to detect threat-related emotions, including anger, fear and disgust.

Researchers compared basic facial emotional identification in 23 young patients with basal ganglia stroke to 68 matched healthy controls.

Magnetic resonance imaging was used to assess the relationship between basal ganglia location and basic emotion identification. A wide range of cognitive and motor abilities and social behaviors were assessed and patients were screened for co-morbidities such as depression and anxiety.

Basic emotion identification was impaired following focal lesions limited to the basal ganglia. The identification impairment was limited to threat-related emotions, including anger, fear and disgust identification, suggesting a role for the basal ganglia in threat detection. Emotion identification skills may be important and should be considered in clinical assessment and rehabilitation of patients with ganglia lesions, the researchers said.

The stroke-related lesions in dorsal basal ganglia may disrupt communication between parts of the brain that associate threat detection with the selection of appropriate escape or defensive actions required for safety, the researchers said.

Note: Actual presentation is 6:15 p.m. CT, Thursday, Feb. 2, 2012.

3 p.m. CT – Abstract 3196

Men experiencing a stroke call for emergency help quicker than women, especially if married

Married men call for emergency help quicker than married women when the symptoms of acute stroke occur, researchers report.

The study was a retrospective review of 91 patients with acute stroke symptoms brought by emergency medical services to Mayo Clinic Hospital in Phoenix, Arizona, during a seven-month period ending June 30, 2011. Researchers collected participants’ age, gender, marital status, time of symptom awareness and time of emergency medical services (EMS) dispatch. They compared the time from symptoms awareness to EMS dispatch between married and single participants and between men and women.

Married men called within 26 minutes of symptoms compared to married women who called an average of 72 minutes after their first stroke symptoms. Single men activated EMS earlier than single women, but the difference was not significant.

The average age of the patients was 76 years; half were women, half were men. Approximately half were married and about half were single. The researchers found that, overall, the group of married patients called for emergency services more quickly than their single counterparts, but the difference wasn’t significant.

The researchers plan a future study of the reasons why married men with stroke symptoms seek medical attention earlier.

Note: Actual presentation is 6:15 p.m. CT, Thursday, Feb. 2, 2012.

3 p.m. CT – Abstract 3339

Wii-based Movement Therapy results in cardiovascular benefits

A new study found that Wii-based Movement Therapy, such as baseball, boxing or tennis, improves cardiovascular and upper body fitness in stroke patients.

The study included 15 men and three women, average age 61, with an average time post-stroke of 22 months. All patients completed a two-week program of formal therapy on 10 consecutive days with additional home practice using standard Wii Sports games such as baseball, bowling, boxing, golf and tennis. Heart rate was recorded during the formal sessions early-, mid- and late-therapy. The number of steps during tennis and boxing were counted from video recordings. Functional ability was assessed before and after therapy.

Peak heart rates in the stroke patients were 38 percent higher than resting rates at the end of daily one-hour formal therapy with additional Wii gaming. Exercise tolerance also improved.

Functional ability improved by 23 percent, which when applied to everyday tasks, resulted in a 127 percent improvement.

The results suggest that Wii-based Movement Therapy not only improves upper limb function but also provides a cardiovascular challenge, mitigating the marked reduction in fitness commonly reported post-stroke. The differential effect on heart rate of the basic sports games provides a further avenue to tailor therapy for individual patients, researchers said.

Note: Actual presentation is 6:15 p.m. CT, Thursday, Feb. 2, 2012.

3 p.m. CT – Abstract 3354

Vitamin therapy may lower risk of subsequent events in younger stroke patients

High dose vitamin therapy appears to be associated with a lower risk of subsequent vascular events in younger stroke patients with elevated homocysteine.

Homocysteine is an amino acid linked to hardening of the arteries. Although homocysteine lowering has not been shown to lower the risk of vascular events, researchers hypothesized that younger individuals or individuals with high blood pressure may have a greater benefit than older individuals or those without high blood pressure.

The researchers performed a post-hoc analysis of 1,425 stroke patients, aged 45 to 64 years old, enrolled in the Vitamin Intervention for Stroke prevention trial. The participants, all with elevated homocysteine levels, were randomized into groups of high versus low doses of folic acid, pyridoxine (B6) and cobalamin (B12). Time to stroke, heart attack, or death was the primary outcome and stroke was the secondary outcome.

High dose vitamin therapy trended toward a reduced risk of stroke, heart attack or death from any cause in individuals aged 45 to 54. However, this benefit was not seen in those aged 55 to 64. Participants with hypertension did not have different outcomes compared to those without hypertension. Vitamin therapy had no effect on the secondary outcome of stroke alone in either age group.

Among younger individuals with a history of stroke and elevated homocysteine, high-dose vitamin therapy is linked to a lower trend in the risk of subsequent major vascular events. Future randomized trials with adequate power will be required to determine whether vitamin therapy reduces the risk of vascular events in people under age 55, researchers said.

Note: Actual presentation is 6:15 p.m. CT, Thursday, Feb. 2, 2012.

3 p.m. CT – Abstract 3356

Stroke survivors have poorly controlled high blood pressure

One in two stroke survivors have poorly controlled hypertension and equally poor rates of antihypertensive therapy, researchers said.

According to the American Heart Association, people with high blood pressure have twice the risk of stroke than people with normal blood pressure, and treating or reducing blood pressure is associated with reduced stroke risk.

The researchers reviewed the prevalence and control of hypertension among 490 adult stroke survivors who participated in the National Health and Nutrition Examination Survey from 1999 to 2004 with mortality follow-up through 2006. The researchers determined predictors of poorly-controlled blood pressure and non-treatment and found:

72 percent had known hypertension, 47 percent had poorly controlled high blood pressure and 8 percent had undiagnosed hypertension.
Age, female sex, Hispanic ethnicity and diabetes were associated with poorly controlled blood pressure.
Participants who had a previous heart attack, drank alcohol or were overweight were less likely to have poorly controlled blood pressure.
Among those with poorly controlled blood pressure, high cholesterol levels and male sex were predictors of non-treatment, whereas current smoking or being overweight was linked to treatment.
Those who were on antihypertensive medications had lower rates of death from all-causes, but this did not reach statistical significance.

Several medical and lifestyle modification factors could be potential targets of intervention to bridge the gap, researchers said.

Note: Actual presentation is 6:05 p.m. CT, Thursday, Feb. 2, 2012.

###

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 science content. Revenues from pharmaceutical and device corporations are available at www. heart.org/corporatefunding.

NR12-1013 (ISC 2012/ Thursday tips)

Additional resources:

All downloadable video/audio interviews, B-roll, animation and images related to this news release are located on the right column of the release link located at http://newsroom.heart.org/pr/aha/_prv-sleep-apnea-linked-to-silent-strokes-221516.aspx. Video clips with researchers/authors of studies will be added to this link after embargo. General ISC video and ISC photos will be updated during the meeting at newsroom.heart.org/ISC12-Video or newsroom.heart.org/ISC12-Photos.
Follow news from ASA International Stroke Conference 2012 via Twitter: http://twitter.com/#!/heartnews . Follow #ASANews12.

CONTACT:

ASA News Media Office in Dallas: (214) 706-1396

ASA News Media Office in New Orleans (Feb. 1-3): (504) 670-6010

For public inquiries: (800)-AHA-USA1 (242-8721)

Other AHA/ASA Newsrooms and Programs

Simple Science @Heart

Simple Science

Simple Science @Heart is science, told simply, so you can share in the revelation of new ideas that bring knowledge, treatments and cures for heart disease and stroke.

Learn more.