Subjects -> MEDICAL SCIENCES (Total: 8642 journals)
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PSYCHIATRY AND NEUROLOGY (833 journals)                  1 2 3 4 5 | Last

Showing 1 - 200 of 833 Journals sorted alphabetically
Academic Psychiatry     Full-text available via subscription   (Followers: 31)
Academic Psychiatry and Psychology Journal : APPJ     Open Access   (Followers: 13)
ACS Chemical Neuroscience     Hybrid Journal   (Followers: 23)
Acta Neurochirurgica     Hybrid Journal   (Followers: 7)
Acta Neurologica Belgica     Hybrid Journal   (Followers: 3)
Acta Neurológica Colombiana     Open Access   (Followers: 2)
Acta Neurologica Scandinavica     Hybrid Journal   (Followers: 6)
Acta Neuropathologica     Hybrid Journal   (Followers: 5)
Acta Neuropathologica Communications     Open Access   (Followers: 1)
Acta Neuropsychiatrica     Hybrid Journal   (Followers: 6)
Acta Psychiatrica Scandinavica     Hybrid Journal   (Followers: 44)
Actas Españolas de Psiquiatría     Free   (Followers: 2)
Activitas Nervosa Superior     Hybrid Journal  
ADHD Attention Deficit and Hyperactivity Disorders     Hybrid Journal   (Followers: 28)
ADHD Report The     Full-text available via subscription   (Followers: 12)
Administration and Policy in Mental Health and Mental Health Services Research     Partially Free   (Followers: 21)
Adolescent Psychiatry     Hybrid Journal   (Followers: 12)
Adolescent Research Review     Hybrid Journal   (Followers: 2)
Advances in Alzheimer's Disease     Open Access   (Followers: 16)
Advances in Clinical Neuroscience and Rehabilitation     Free   (Followers: 31)
Advances in Eating Disorders : Theory, Research and Practice     Hybrid Journal   (Followers: 17)
Advances in Mental Health     Hybrid Journal   (Followers: 91)
Advances in Parkinson's Disease     Open Access   (Followers: 1)
Advances in School Mental Health Promotion     Partially Free   (Followers: 12)
African Journal of Neurological Sciences     Open Access  
African Journal of Psychiatry     Full-text available via subscription   (Followers: 3)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 485)
Aggressive Behavior     Hybrid Journal   (Followers: 22)
Aging & Mental Health     Hybrid Journal   (Followers: 38)
Aging, Neuropsychology, and Cognition     Hybrid Journal   (Followers: 51)
AJOB Neuroscience     Hybrid Journal   (Followers: 5)
Aktuelle Neurologie     Hybrid Journal   (Followers: 9)
Alzheimer Disease & Associated Disorders     Hybrid Journal   (Followers: 19)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 60)
Alzheimer's Research & Therapy     Open Access   (Followers: 4)
American Journal of Alzheimer's Disease and Other Dementias     Hybrid Journal   (Followers: 18)
American Journal of Clinical Hypnosis     Hybrid Journal   (Followers: 6)
American Journal of Medical Genetics Part B: Neuropsychiatric Genetics     Hybrid Journal   (Followers: 4)
American Journal of Neuroprotection and Neuroregeneration     Full-text available via subscription   (Followers: 2)
American Journal of Psychiatric Rehabilitation     Hybrid Journal   (Followers: 13)
American Journal of Psychiatry     Full-text available via subscription   (Followers: 237)
Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration     Hybrid Journal   (Followers: 2)
Analitika : Jurnal Magister Psikologi Uma     Open Access  
Annales Médico-psychologiques, revue psychiatrique     Full-text available via subscription   (Followers: 5)
Annals of Behavioral Medicine     Hybrid Journal   (Followers: 15)
Annals of Child Neurology     Open Access   (Followers: 1)
Annals of Clinical and Translational Neurology     Open Access   (Followers: 1)
Annals of Clinical Psychiatry : The official Journal of the American Academy of Clinical Psychiatrists     Hybrid Journal   (Followers: 28)
Annals of General Psychiatry     Open Access   (Followers: 28)
Annals of Indian Academy of Neurology     Open Access   (Followers: 3)
Annals of Indian Psychiatry     Open Access  
Annals of Neurology     Hybrid Journal   (Followers: 61)
Annals of Neurosciences     Open Access   (Followers: 4)
Annals of Psychiatry and Treatment     Open Access   (Followers: 2)
Annual Review of Neuroscience     Full-text available via subscription   (Followers: 58)
Anxiety, Stress & Coping: An International Journal     Hybrid Journal   (Followers: 27)
Aphasiology     Hybrid Journal   (Followers: 55)
Applied Neuropsychology : Adult     Hybrid Journal   (Followers: 46)
Applied Neuropsychology : Child     Hybrid Journal   (Followers: 28)
Archives of Clinical Neuropsychology     Hybrid Journal   (Followers: 33)
Archives of Neuroscience     Open Access   (Followers: 6)
Archives of Psychiatric Nursing     Hybrid Journal   (Followers: 29)
Archives of Suicide Research     Hybrid Journal   (Followers: 8)
Archives of Women's Mental Health     Hybrid Journal   (Followers: 18)
Archivos de Neurociencias     Open Access   (Followers: 3)
Arquivos Brasileiros de Neurocirurgia : Brazilian Neurosurgery     Open Access  
Arquivos de Neuro-Psiquiatria     Open Access  
Art Therapy Online     Open Access   (Followers: 4)
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 11)
Asian Journal of Psychiatry     Hybrid Journal   (Followers: 2)
ASN Neuro     Open Access   (Followers: 2)
Assessment     Hybrid Journal   (Followers: 17)
Assessment and Treatment of Child Psychopathology and Developmental Disabilities     Full-text available via subscription   (Followers: 4)
Atherosclerosis     Hybrid Journal   (Followers: 12)
Atherosclerosis Supplements     Hybrid Journal   (Followers: 1)
Audiology and Neurotology     Full-text available via subscription   (Followers: 9)
Audiology and Neurotology Extra     Open Access   (Followers: 1)
Australasian Journal of Neuroscience     Open Access   (Followers: 2)
Australasian Psychiatry     Hybrid Journal   (Followers: 18)
Australian & New Zealand Journal of Psychiatry     Hybrid Journal   (Followers: 29)
Autism & Developmental Language Impairments     Open Access   (Followers: 12)
Autism and Developmental Disorders     Open Access   (Followers: 9)
Autism Research     Hybrid Journal   (Followers: 52)
Autism Research and Treatment     Open Access   (Followers: 34)
Autism's Own     Open Access   (Followers: 6)
Autism-Open Access     Open Access   (Followers: 8)
Autonomic Neuroscience     Hybrid Journal   (Followers: 10)
Autonomy, the Critical Journal of Interdisciplinary Autism Studies     Open Access   (Followers: 5)
Avicenna Journal of Neuro Psycho Physiology     Open Access  
Basal Ganglia     Hybrid Journal  
Basic and Clinical Neuroscience     Open Access   (Followers: 9)
Behavior Therapy     Hybrid Journal   (Followers: 53)
Behavioral and Brain Functions     Open Access   (Followers: 3)
Behavioral and Brain Sciences     Hybrid Journal   (Followers: 38)
Behavioral and Cognitive Neuroscience Reviews     Hybrid Journal   (Followers: 26)
Behavioral Healthcare     Full-text available via subscription   (Followers: 8)
Behavioral Medicine     Hybrid Journal   (Followers: 8)
Behavioral Sciences     Open Access   (Followers: 4)
Behavioral Sleep Medicine     Hybrid Journal   (Followers: 14)
Behavioural Brain Research     Hybrid Journal   (Followers: 19)
Behavioural Neurology     Open Access   (Followers: 9)
Behavioural Processes     Hybrid Journal   (Followers: 9)
Biological Psychiatry     Hybrid Journal   (Followers: 53)
Biological Psychiatry: Cognitive Neuroscience and Neuroimaging     Hybrid Journal   (Followers: 11)
Biologically Inspired Cognitive Architectures     Hybrid Journal   (Followers: 2)
Biology of Mood & Anxiety Disorders     Open Access   (Followers: 6)
Biomarkers in Neuropsychiatry     Open Access  
BioMolecular Concepts     Open Access   (Followers: 2)
Bipolar Disorders     Hybrid Journal   (Followers: 11)
BJPsych Advances     Full-text available via subscription   (Followers: 57)
BJPsych Bulletin     Full-text available via subscription   (Followers: 19)
BJPsych International     Open Access   (Followers: 2)
BJPsych Open     Open Access   (Followers: 3)
Blue Books of Neurology     Full-text available via subscription   (Followers: 1)
BMC Neurology     Open Access   (Followers: 22)
BMC Neuroscience     Open Access   (Followers: 17)
BMC Psychiatry     Open Access   (Followers: 38)
Borderline Personality Disorder and Emotion Dysregulation     Open Access   (Followers: 10)
Brain     Hybrid Journal   (Followers: 76)
Brain & Life     Full-text available via subscription   (Followers: 3)
Brain and Behavior     Open Access   (Followers: 16)
Brain and Cognition     Hybrid Journal   (Followers: 38)
Brain and Development     Full-text available via subscription   (Followers: 5)
Brain and Language     Hybrid Journal   (Followers: 67)
Brain and Mind     Hybrid Journal   (Followers: 5)
Brain and Neuroscience Advances     Open Access  
Brain Behavior and Evolution     Full-text available via subscription   (Followers: 9)
Brain Communications     Open Access   (Followers: 1)
Brain Disorders & Therapy     Open Access   (Followers: 1)
Brain Hemorrhages     Open Access   (Followers: 1)
Brain Imaging and Behavior     Hybrid Journal   (Followers: 8)
Brain Impairment     Full-text available via subscription   (Followers: 2)
Brain Informatics     Open Access   (Followers: 1)
Brain Injury     Hybrid Journal   (Followers: 31)
Brain Pathology     Hybrid Journal   (Followers: 5)
Brain Research     Hybrid Journal   (Followers: 25)
Brain Research Bulletin     Hybrid Journal   (Followers: 5)
Brain Sciences     Open Access   (Followers: 5)
Brain Stimulation     Hybrid Journal   (Followers: 8)
Brain Structure and Function     Partially Free   (Followers: 9)
Brain Topography     Hybrid Journal   (Followers: 2)
Brain, Behavior, and Immunity     Hybrid Journal   (Followers: 11)
Brazilian Journal of Pain (BrJP)     Open Access  
British Journal of Mental Health Nursing     Full-text available via subscription   (Followers: 23)
British Journal of Music Therapy     Hybrid Journal   (Followers: 8)
British Journal of Pain     Hybrid Journal   (Followers: 27)
British Journal of Psychiatry     Hybrid Journal   (Followers: 242)
British Journal of Social Psychology     Full-text available via subscription   (Followers: 41)
Canadian Journal of Behavioural Science     Full-text available via subscription   (Followers: 7)
Canadian Journal of Counselling and Psychotherapy / Revue canadienne de counseling et de psychothérapie     Hybrid Journal   (Followers: 10)
Canadian Journal of Neurological Sciences     Full-text available via subscription  
Canadian Journal of Psychiatry     Hybrid Journal   (Followers: 27)
Cannabis and Cannabinoid Research     Hybrid Journal   (Followers: 1)
Case Reports in Neurological Medicine     Open Access   (Followers: 1)
Case Reports in Neurology     Open Access   (Followers: 4)
Case Reports in Psychiatry     Open Access   (Followers: 17)
Cellular and Molecular Life Sciences (CMLS)     Hybrid Journal   (Followers: 5)
Central Nervous System Agents in Medicinal Chemistry     Hybrid Journal   (Followers: 1)
Cephalalgia     Hybrid Journal   (Followers: 7)
Cerebellum & Ataxias     Open Access   (Followers: 1)
Cerebral Cortex     Hybrid Journal   (Followers: 55)
Cerebrovascular Diseases     Full-text available via subscription   (Followers: 3)
Cerebrovascular Diseases Extra     Open Access  
Child and Adolescent Psychiatry and Mental Health     Open Access   (Followers: 28)
Child Neurology Open     Open Access   (Followers: 5)
Child Psychiatry & Human Development     Hybrid Journal   (Followers: 12)
Chinese Neurosurgical Journal     Open Access  
Chronic Stress     Open Access  
Ciencia Cognitiva     Open Access   (Followers: 3)
Clínica e Investigación en Arteriosclerosis     Full-text available via subscription  
Clinical and Experimental Neuroimmunology     Hybrid Journal   (Followers: 1)
Clinical and Translational Neuroscience     Open Access  
Clinical EEG and Neuroscience     Hybrid Journal   (Followers: 6)
Clinical Journal of Pain     Hybrid Journal   (Followers: 18)
Clinical Medicine Insights : Psychiatry     Open Access   (Followers: 10)
Clinical Neurology and Neurosurgery     Hybrid Journal   (Followers: 16)
Clinical Neuropathology     Full-text available via subscription   (Followers: 1)
Clinical Neuropharmacology     Hybrid Journal   (Followers: 3)
Clinical Neurophysiology     Full-text available via subscription   (Followers: 13)
Clinical Neurophysiology Practice     Open Access  
Clinical Neuropsychiatry     Open Access   (Followers: 2)
Clinical Practice & Epidemiology in Mental Health     Open Access   (Followers: 1)
Clinical Psychological Science     Hybrid Journal   (Followers: 12)
CNS & Neurological Disorders - Drug Targets     Hybrid Journal   (Followers: 3)
CNS Spectrums     Hybrid Journal   (Followers: 3)
Cognition     Hybrid Journal   (Followers: 224)
Cognitive and Behavioral Neurology     Hybrid Journal   (Followers: 9)
Cognitive and Behavioral Practice     Hybrid Journal   (Followers: 12)
Cognitive Neurodynamics     Hybrid Journal   (Followers: 2)
Cognitive Neuropsychiatry     Hybrid Journal   (Followers: 1)
Cognitive Neuropsychology     Hybrid Journal   (Followers: 40)
Cognitive Neuroscience     Hybrid Journal   (Followers: 29)
Cognitive Therapy and Research     Hybrid Journal   (Followers: 7)
Cognitive, Affective, & Behavioral Neuroscience     Full-text available via subscription   (Followers: 24)
Community Mental Health Journal     Hybrid Journal   (Followers: 17)
Comprehensive Psychiatry     Open Access   (Followers: 13)
Computational Brain & Behavior     Hybrid Journal  
Computational Psychiatry     Open Access   (Followers: 2)
Consciousness and Cognition     Hybrid Journal   (Followers: 39)
Contemporary Neurosurgery     Full-text available via subscription   (Followers: 3)

        1 2 3 4 5 | Last

Similar Journals
Journal Cover
Cerebrovascular Diseases Extra
Journal Prestige (SJR): 0.628
Citation Impact (citeScore): 1
Number of Followers: 0  

  This is an Open Access Journal Open Access journal
ISSN (Print) 1664-5456
Published by Karger Homepage  [120 journals]
  • Rates and Determinants for the Use of Anticoagulation Treatment before
           Stroke in Patients with Known Atrial Fibrillation

    • Abstract: Introduction and Objective: Even though the introduction of less cumbersome anticoagulant agents has improved, the rates ofoverall anticoagulant treatment in eligible patients with atrial fibrillation (AF) remain to be defined. We aimed to assess the rates of and determinants for the use of anticoagulation treatment before stroke in patients with known AF since the introduction of direct oral anticoagulants (DOAC) in clinical practice. Methods: Consecutive patients admitted to an individual stroke unit, from September 2013 through July 2019, for acute ischemic stroke or transient ischemic attack (TIA) with known AF before the event were included in the study. Logistic regression analysis was used to identify independent predictors of the use of anticoagulant treatment. Results: Overall, 155 patients with ischemic stroke/TIA and known AF were included in this study. Among 152 patients with a CHA2DS2-VASc score #x3e;1, 43 patients were not receiving any treatment, 47 patients were receiving antiplatelet agents, and the remaining 62 patients were on oral anticoagulants. Among 34 patients on DOAC, 13 were receiving a nonlabeled reduced dose and 18 out of 34 patients on vitamin K antagonists had an INR value #x3c;2 at the time of admission. Before stroke, only 34 out of 155 patients (21.9%) were adequately treated according to current guidelines. Previous stroke/TIA was the only independent predictor of the use of anticoagulant therapy. Conclusions: Only 21.9% of the patients hospitalized for a stroke or TIA with known AF before the event were adequately treated according to recent treatment guidelines. It is important to improve medical information about the risk of AF and the efficacy of anticoagulants in stroke prevention.
      Cerebrovasc Dis Extra 2020;10:44–49
      PubDate: Wed, 06 May 2020 09:20:38 +020
  • The Hyperdense Middle Cerebral Artery Sign in Drip-and-Ship Models of
           Acute Stroke Management

    • Abstract: Background: Large vessel occlusion (LVO) leads to debilitating stroke and responds modestly to recombinant tissue plasminogen activator (rt-TPA). Early thrombectomy improves functional outcomes in selected patients with proximal occlusion but it is not available in all medical facilities. The best imaging modality for triage in an acute stroke setting in drip-and-ship models is still the subject of debate. Objectives: We aimed to assess the diagnostic value of millimeter-sliced noncontrast computed tomography (NCCT) hyperdense middle cerebral artery sign (HMCAS) in itself or associated with clinical data for early detection of LVO in drip-and-ship models of acute stroke management. Methods: NCCT of patients admitted to the Erasme Hospital, ULB, Brussels, Belgium, for suspicion of acute ischemic stroke between January 1 and July 31, 2017, were collected. Patients with brain hemorrhages were excluded, leading to 122 cases. The presence of HMCAS on NCCT was determined via visual assessment by 6 raters blinded to all other data. An independent rater assessed the presence of LVO on digital subtraction angiography imaging or contrast-enhanced CT angiography (CTA). The sensitivity, false-positive rate (FPR), and accuracy of HMCAS and the dot sign to detect LVO were calculated. The interobserver agreement of HMCAS was assessed using Gwet’s AC1 coefficient. Then, on a separate occasion, the first 2 observers rereviewed all NCCT provided with clinical clues. The sensitivity, FPR, and accuracy of HMCAS were recalculated. Results: HMCAS was found in 21% of the cases and a dot sign was found in 9%. The mean HMCAS sensitivity was 62% (95% CI 45–79%) and its accuracy was 86% (95% CI 79–92%) for detecting LVO. The interobserver reliability coefficient was 80% for HMCAS. Combined with clinical information, HMCAS sensitivity increased to 81% (95% CI 68–94; p = 0.041) and accuracy increased to 91% (95% CI 86–96%). Conclusion: When clinical data are provided, detection of HMCAS on thinly sliced NCCT could be enough to decide on transfer for thrombectomy in drip-and-ship models of acute stroke management, especially in situations where CTA is less available and referral centers for thrombectomy fewer and further apart.
      Cerebrovasc Dis Extra 2020;10:36–43
      PubDate: Tue, 28 Apr 2020 14:48:20 +020
  • Does Intravenous Thrombolysis Influence the Time of Recanalization and
           Success of Mechanical Thrombectomy during the Acute Phase of Cerebral

    • Abstract: Objectives: Mechanical thrombectomy (MT) is an effective treatment for acute ischemic stroke (AIS) caused by large vessel occlusion. Recanalization time is a key factor in the treatment of AIS. It has previously been suggested that intravenous thrombolysis (IVT) may be associated with a shorter recanalization time. The aim of our study was to investigate whether IVT or other factors could be associated with shorter or longer MT procedure times. Methods: We performed a retrospective analysis of a local cohort of patients treated by MT. We collected procedure time (puncture to recanalization and clot visualization to recanalization), demographic data, localization of the thrombus, antithrombotic treatment at arrival, IVT infusion, and stroke subtype at discharge according to the TOAST classification. We planned to analyze the full cohort and the successful revascularization subgroup. Results: There was no difference in procedure times between patients who received IVT and those who did not. In the successful revascularization subgroup, patients presenting with cardioembolic stroke had a significantly shorter time between clot visualizations and revascularization than the other patients (41 vs. 56 min, p = 0.024), but this was not the case in the full cohort. Also in the successful revascularization subgroup, the revascularization time was 76 vs. 61 min (p = 0.075) in patients presenting with tandem occlusion vs. the others, but there was no difference between these groups in the full cohort. Conclusions: There was no difference in terms of procedure times in patients treated by IVT and MT vs. patients treated by MT alone either in the full cohort or in the successful revascularization subgroup. The data from the successful revascularization subgroup may be useful for studying revascularization times, provided that data from procedures that were stopped prematurely by the operator due to the length of time since symptom onset is removed.
      Cerebrovasc Dis Extra 2020;10:28–35
      PubDate: Tue, 28 Apr 2020 14:47:31 +020
  • Cognitive Impairment Correlates Linearly with Mean Flow Velocity by
           Transcranial Doppler below a Definable Threshold

    • Abstract: Introduction: Low cerebral blood flow can affect cognition in patients with high-grade asymptomatic internal carotid artery stenosis. Current clinical algorithms use stroke risk to determine which patients should undergo revascularization without considering cognitive decline. Although correlations between low-flow and cognitive impairment have been reported, it is not known whether a threshold exists below which such a correlation expresses itself. Such information would be critical in treatment decisions about whether to intervene in patients with high-grade carotid artery stenosis who are at risk for cognitive decline. Objective: To determine how reduced blood flow correlates with lower cognitive scores. Methods: Patients with ≥80% unilateral internal carotid artery stenosis with no history of stroke were recruited from inpatient and outpatient practices at a single, large, comprehensive stroke center. Patients underwent bilateral insonation of middle cerebral arteries with standard 2-Hz probes over the temporal windows with transcranial Doppler. Cognitive assessments were performed by an experienced neuropsychologist using a cognitive battery comprising 14 standardized tests with normative samples grouped by age. Z-scores were generated for each test and averaged to obtain a composite Z-score for each patient. Multivariable linear regression examined associations between mean flow velocity (MFV) and composite Z-score, adjusting for age, education, and depression. The Davies test was used to determine if there was a breakpoint for a non-zero difference in slope of a segmented relationship over the range of composite Z-score values. Results: Forty-two patients with unilateral high-grade internal carotid artery stenosis without stroke were enrolled (26 males, age = 74 ± 9 years, education = 16 ± 3 years). Average composite Z-score was –0.31 SD below the age-specific normative mean (range –2.8 to +1.2 SD). In linear regression adjusted for age, education, and depression, MFV correlated with cognitive Z-score (β = 0.308, p = 0.043). A single breakpoint in the range of composite Z-scores was identified at 45 cm/s. For MFV #x3c;45 cm/s, Z-score decreased 0.05 SD per cm/s MFV (95% CI: 0.01–0.10). For MFV #x3e;45 cm/s, Z-score change was nonsignificant (95% CI: –0.07 to 0.05). Conclusions: In high-grade, asymptomatic carotid artery stenosis, cognitive impairment correlated linearly with lower flow in the hemisphere fed by the occluded internal carotid artery, but only below a threshold of MFV = 45 cm/s. Identifying a hemodynamic threshold for cognitive decline using a simple, noninvasive method may influence revascularization decision-making in otherwise “asymptomatic” carotid disease.
      Cerebrovasc Dis Extra 2020;10:21–27
      PubDate: Tue, 14 Apr 2020 08:20:14 +020
  • Biomarkers Associated with Atrial Fibrillation in Patients with Ischemic
           Stroke: A Pilot Study from the NOR-FIB Study

    • Abstract: Background and Purpose: Cardioembolic stroke due to paroxysmal atrial fibrillation (AF) may account for 1 out of 4 cryptogenic strokes (CS) and transient ischemic attacks (TIAs). The purpose of this pilot study was to search for biomarkers potentially predicting incident AF in patients with ischemic stroke or TIA. Methods: Plasma samples were collected from patients aged 18 years and older with ischemic stroke or TIA due to AF (n = 9) and large artery atherosclerosis (LAA) with ipsilateral carotid stenosis (n = 8) and age- and sex-matched controls (n = 10). Analyses were performed with the Olink technology simultaneously measuring 184 biomarkers of cardiovascular disease. For bioinformatics, acquired data were analyzed using gene set enrichment analysis (GSEA). Selected proteins were validated using ELISA. Individual receiver operating characteristic (ROC) curves and odds ratios from logistic regression were calculated. A randomForest (RF) model with out-of-bag estimate was applied for predictive modeling. Results: GSEA indicated enrichment of proteins related to inflammatory response in the AF group. Interleukin (IL)-6, growth differentiation factor (GDF)-15, and pentraxin-related protein PTX3 were the top biomarkers on the ranked list for the AF group compared to the LAA group and the control group. ELISA validated increased expression of all tested proteins (GDF-15, PTX3, and urokinase plasminogen activator surface receptor [U-PAR]), except for IL-6. 19 proteins had the area under the ROC curve (AUC) over 0.85 including all of the proteins with significant evolution in the logistic regression. AUCs were very discriminant in distinguishing patients with and without AF (LAA and control group together). GDF-15 alone reached AUC of 0.95. Based on RF model, all selected participants in the tested group were classified correctly, and the most important protein in the model was GDF-15. Conclusions: Our results demonstrate an association between inflammation and AF and that multiple proteins alone and in combination may potentially be used as indicators of AF in CS and TIA patients. However, further studies including larger samples sizes are needed to support these findings. In the ongoing NOR-FIB study, we plan further biomarker assessments in patients with CS and TIA undergoing long-term cardiac rhythm monitoring with insertable cardiac monitors.
      Cerebrovasc Dis Extra 2020;10:11–20
      PubDate: Thu, 06 Feb 2020 07:54:39 +010
  • Weather Fluctuations May Have an Impact on Stroke Occurrence in a Society:
           A Population-Based Cohort Study

    • Abstract: Background: Stroke has been found to have a seasonally varying incidence; blood pressure, one of its risk factors, is influenced by humidity and temperature. The relationship between the incidence of stroke and meteorological parameters remains controversial. Objective: We investigated whether meteorological conditions are significant risk factors for stroke, focusing on the fluctuation of weather elements that triggers the onset of stroke. Methods: We collected ambulance transportation data recorded by emergency personnel from Gifu Prefecture. We included cases where the cause of the transportation was stroke and excluded cases of trauma. We combined these data with meteorological data as well as data on average temperature, average air pressure, and humidity provided publicly by the Japan Meteorological Agency. Our target period was from January 2012 to December 2016. Results: In the 5-year target period, there were 5,501 occurrences of ambulance transportation due to stroke. A seasonal tendency was confirmed, since ambulance transportation for stroke occurred more frequently at low temperatures (p #x3c; 0.001). Temperature (odds ratio: 0.91; p #x3c; 0.001) and humidity change (odds ratio: 1.50; p = 0.016) were identified as risk factors for ambulance transportation due to stroke. An increase in temperature incurs a lower risk than a decrease (odds ratio: 0.58; p = 0.09), although there is no statistically significant difference. Conclusions: Meteorological effects on the frequency of ambulance transportation due to stroke were studied. A lower temperature and radical humidity change were identified as risk factors for ambulance transportation due to stroke, and a decrease in temperature was also associated. We speculate on the possibilities of using meteorological data to optimize the assignment of limited medical resources in medical economics.
      Cerebrovasc Dis Extra 2020;10:1–10
      PubDate: Wed, 05 Feb 2020 08:10:37 +010
  • Comparison of ABC Methods with Computerized Estimates of Intracerebral
           Hemorrhage Volume: The INTERACT2 Study

    • Abstract: Background and Purpose: Hematoma volume is a key determinant of outcome in acute intracerebral hemorrhage (ICH). We aimed to compare estimates of ICH volume between simple (ABC/2, length, width, and height) and gold standard planimetric software approaches. Methods: Data are from the second Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2). Multivariable linear regression was used to compare ICH volumes on baseline CT scans using the ABC/2, modified ABC/2 (mABC/2), and MIStar software. Other aspects of ICH morphology examined included location, irregularity, heterogeneity, intraventricular and subarachnoid hemorrhage extension (SAH) of hematoma, and associated white matter lesions and brain atrophy. Results: In 2,084 patients with manual and semiautomated measurements, median (IQR) ICH volumes for each approach were: ABC/2 11.1 (5.11–20.88 mL), mABC/2 7.8 (3.88–14.11 mL), and MIStar 10.7 (5.59–18.66 mL). Median differences between ABC/2 and MIStar, and mABC/2 and MIStar were 0.34 (–1.01 to 2.96) and –2.4 (–4.95 to –0.7416), respectively. Hematoma volumes differed significantly with irregular shape (ABC/2 and MIStar, p #x3c; 0.001; mABC/2 and MIStar, p = 0.007) and larger volumes (mABC/2 and MIStar, p #x3c; 0.001; ABC/2 and MIStar, p = 0.07). ICH with SAH showed a significant discrepancy between ABC/2 and MIStar (p #x3c; 0.001). Conclusions: Overall, ABC/2 performs better than mABC/2 in estimating ICH volume. The largest discrepancies were evidenced against automated software for irregular-shaped and large ICH with SAH, but the clinical significance of this is uncertain.
      Cerebrovasc Dis Extra 2019;9:148–154
      PubDate: Fri, 13 Dec 2019 09:07:56 +010
  • Prevalence of and Risk Factors for Cerebral Microbleeds in Moyamoya
           Disease and Syndrome in the American Population

    • Abstract: Background and Purpose: Cerebral microbleeds (CMB) are reported to be frequent in moyamoya disease (MMD) and moyamoya syndrome (MMS) in the Asian population. It is associated with an increased risk of intracerebral hemorrhage. The significance of CMB in MMD/MMS in non-Asian populations has not been well established. Our study aimed to investigate the prevalence of CMB in MMD/MMS in a moymoya cohort with a majority of non-Asians and to identify risk factors for developing a CMB and its predictive value for subsequent vascular events. Methods: The moyamoya database was compiled by screening for MMD/MMS among patients admitted to the Zale-Lipshy University Hospital at the University of Texas Southwestern Medical Center. We identified and analyzed data of 67 patients with MMD or MMS. Patients were characterized as CMB+ or CMB– based on MRI findings. In CMB+ patients, the total number and location of CMB were identified. Univariate and multivariate logistic regression were used to identify risk factors for developing CMB and whether CMB are associated with the development of subsequent vascular events. Results: Out of a total of 67 patients, 11 (16%) had CMB. Males had significantly higher odds of having CMB as compared to females (OR 1.76; 95% CI 1.40–24.3, p = 0.021). The incidence of CMB was also associated with age at diagnosis (mean age of CMB+ patients vs. CMB– patients: 44 vs. 34 years, respectively, p = 0.024), smoking (p = 0.006), and hemorrhagic stroke at presentation (p = 0.034). Logistic regression with multivariate analysis found that gender and age at diagnosis remained statistically significant. New ischemic events occurred in 2 (20%) out of 10 CMB+ patients and 13 (23%) out of 55 CMB– patients, respectively (p = 0.79). While 2 (3%) CMB– patients had a new cerebral hemorrhage during follow-up, none of the CMB+ patients did. Conclusions: CMB are less prevalent in MMD/MMS in the USA than in Asia. An older age at diagnosis and male gender were associated with CMB. The presence of CMB was not associated with an increased risk of a subsequent ischemic or hemorrhagic stroke.
      Cerebrovasc Dis Extra 2019;9:139–147
      PubDate: Thu, 12 Dec 2019 08:45:39 +010
  • Active Cancer and Elevated D-Dimer Are Risk Factors for In-Hospital
           Ischemic Stroke

    • Abstract: Background and Purpose: Little attention has been paid to the pathogenesis of in-hospital stroke, despite poor outcomes and a longer time from stroke onset to treatment. We studied the pathophysiology and biomarkers for detecting patients who progress to in-hospital ischemic stroke (IHS). Methods: Seventy-nine patients with IHS were sequentially recruited in the period 2011–2017. Their characteristics, care, and outcomes were compared with 933 patients who had an out-of-hospital ischemic stroke (OHS) using a prospectively collected database of the Tokushima University Stroke Registry. Results: Active cancer and coronary artery disease were more prevalent in patients with IHS than in those with OHS (53.2 and 27.8% vs. 2.0 and 10.9%, respectively; p #x3c; 0.001), the median onset-to-evaluation time was longer (300 vs. 240 min; p = 0.015), and the undetermined etiology was significantly higher (36.7 vs. 2.4%; p #x3c; 0.001). Although there was no significant difference in stroke severity at onset between the groups, patients with IHS had higher modified Rankin Scale (mRS) scores (3–6) at discharge (67.1 vs. 50.3%; p = 0.004) and rates of death during hospitalization (16.5 vs. 2.9%; p #x3c; 0.001). D-dimer (5.8 vs. 0.8 µg/mL; p #x3c; 0.001) and fibrinogen (532 vs. 430 mg/dL; p = 0.014) plasma levels at the time of onset were significantly higher in patients with IHS after propensity score matching. Multivariate logistic regression analysis revealed that active cancer (odds ratio [OR] 2.30; 95% confidence interval [CI] 1.26–4.20), prestroke mRS scores 3–5 (OR 6.78; 95% CI 3.96–11.61), female sex (OR 1.57; 95% CI 1.19–2.08), and age ≥75 years (OR 2.36; 95% CI 1.80–3.08) were associated with poor outcomes. Conclusions: Patients with IHS had poorer outcomes than those with OHS because of a higher prevalence of active cancer and functional dependence before stroke onset. Elevated plasma levels of D-dimer and fibrinogen, especially with active cancer, can help identify patients who are at a higher risk of progression to IHS.
      Cerebrovasc Dis Extra 2019;9:129–138
      PubDate: Fri, 22 Nov 2019 11:58:40 +010
  • Infarct Patterns in Patients with Atherosclerotic Vertebrobasilar Disease
           in Relation to Hemodynamics

    • Abstract: Introduction: Distal territory blood flow is independently associated with subsequent strokes in symptomatic vertebrobasilar atherosclerotic disease. We aimed to assess infarct patterns in relation to hemodynamic status in the prospective Vertebrobasilar Flow Evaluation and Risk of Transient Ischemic Attack and Stroke (VERiTAS) study. Methods: Distal territory blood flow was measured using quantitative magnetic resonance angiography (MRA) in 72 patients with symptomatic atherosclerotic vertebrobasilar disease, and then dichotomized into normal (n = 54) and low (n = 18) flow. Patients were followed longitudinally on standard medical management. Two observers blinded to flow status independently reviewed the imaging performed at the time of subsequent strokes, in order to adjudicate the likely mechanism based on infarct patterns. The frequency of stroke mechanisms was qualitatively compared based on flow status. Results: During a median follow-up period of 23 months, 10/72 patients had a subsequent stroke; 5 of these had low distal flow. Infarct patterns were adjudicated to be consistent with hemodynamic (n = 2), embolic (n = 4), and junctional plaque/perforator (n = 4) infarcts. Hemodynamic infarcts were seen in 40% (2/5) low-flow patients, in comparison to 0% (0/5) normal-flow patients. Conclusion: In contrast to normal-flow patients, those with low distal flow seem to be uniquely susceptible to hemodynamic infarctions, although other patterns of infarction can also be seen in these hemodynamically impaired patients.
      Cerebrovasc Dis Extra 2019;9:123–128
      PubDate: Wed, 16 Oct 2019 11:29:48 +020
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