Joe Senda1, Keiichi Ito2, Tomomitsu Kotake2, Masahiko Kanamori2, Hideo Kishimoto2, Izumi Kadono2, Yoshiro Suzuki2, Masahisa Katsuno2, Yoshihiro Nishida2, Naoki Ishiguro2, Gen Sobue2. 1. From the Departments of Neurology (J.S., M. Katsuno, G.S.) and Orthopaedic Surgery (Y.N., N.I.), Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Neurology and Rehabilitation, Komaki City Hospital, Komaki, Japan (J.S.); Division of Rehabilitation, Kami-iida Rehabilitation Hospital, Nagoya, Japan (J.S., K.I., T.K., M. Kanamori, H.K.); and Division of Rehabilitation, Nagoya University Hospital, Nagoya, Japan (I.K., Y.S., Y.N., N.I.). senda1@med.nagoya-u.ac.jp. 2. From the Departments of Neurology (J.S., M. Katsuno, G.S.) and Orthopaedic Surgery (Y.N., N.I.), Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Neurology and Rehabilitation, Komaki City Hospital, Komaki, Japan (J.S.); Division of Rehabilitation, Kami-iida Rehabilitation Hospital, Nagoya, Japan (J.S., K.I., T.K., M. Kanamori, H.K.); and Division of Rehabilitation, Nagoya University Hospital, Nagoya, Japan (I.K., Y.S., Y.N., N.I.).
Abstract
BACKGROUND AND PURPOSE: We investigated the factors influencing inpatient convalescent rehabilitation outcomes in patients with ischemic stroke, particularly severity of leukoaraiosis on magnetic resonance imaging. METHODS: Participants included 520 patients with ischemic stroke (317 men and 203 women; mean age, 72.8±8.4 years) who were transferred from acute care hospitals for inpatient convalescent rehabilitation. Ischemic stroke subtypes included lacunar infarction (n=41), atherothrombosis (n=223), artery-to-artery embolism (n=67), cardiogenic embolism (n=97), undetermined embolism (n=76), and uncategorized ischemic stroke (n=16). Leukoaraiosis was graded according to periventricular hyperintensity (PVH) and deep white matter hyperintensity on magnetic resonance imaging. Functional Independence Measure scores were assessed on admission and at discharge. RESULTS: Multiple regression analysis revealed that rehabilitation outcomes, measured as total Functional Independence Measure scores, were significantly associated with leukoaraiosis estimated by PVH grade. This association was observed after adjustment for factors such as severity, age, and poststroke history. In all patients, PVH grades were associated with Functional Independence Measure motor scores (P<0.001), whereas in patients with artery-to-artery embolism or cardiogenic embolism and deep white matter hyperintensity grades were associated with Functional Independence Measure cognitive scores (P<0.05). CONCLUSIONS: Our study revealed that the degree of leukoaraiosis was associated with inpatient convalescent rehabilitation outcome in patients with ischemic stroke. Furthermore, the PVH grade was associated with motor function outcome, whereas the deep white matter hyperintensity grade correlated with cognitive function outcome, likely because the progression patterns and anatomic backgrounds of PVH and deep white matter hyperintensity differ according to ischemic stroke subtype.
BACKGROUND AND PURPOSE: We investigated the factors influencing inpatient convalescent rehabilitation outcomes in patients with ischemic stroke, particularly severity of leukoaraiosis on magnetic resonance imaging. METHODS:Participants included 520 patients with ischemic stroke (317 men and 203 women; mean age, 72.8±8.4 years) who were transferred from acute care hospitals for inpatient convalescent rehabilitation. Ischemic stroke subtypes included lacunar infarction (n=41), atherothrombosis (n=223), artery-to-artery embolism (n=67), cardiogenic embolism (n=97), undetermined embolism (n=76), and uncategorized ischemic stroke (n=16). Leukoaraiosis was graded according to periventricular hyperintensity (PVH) and deep white matter hyperintensity on magnetic resonance imaging. Functional Independence Measure scores were assessed on admission and at discharge. RESULTS: Multiple regression analysis revealed that rehabilitation outcomes, measured as total Functional Independence Measure scores, were significantly associated with leukoaraiosis estimated by PVH grade. This association was observed after adjustment for factors such as severity, age, and poststroke history. In all patients, PVH grades were associated with Functional Independence Measure motor scores (P<0.001), whereas in patients with artery-to-artery embolism or cardiogenic embolism and deep white matter hyperintensity grades were associated with Functional Independence Measure cognitive scores (P<0.05). CONCLUSIONS: Our study revealed that the degree of leukoaraiosis was associated with inpatient convalescent rehabilitation outcome in patients with ischemic stroke. Furthermore, the PVH grade was associated with motor function outcome, whereas the deep white matter hyperintensity grade correlated with cognitive function outcome, likely because the progression patterns and anatomic backgrounds of PVH and deep white matter hyperintensity differ according to ischemic stroke subtype.
Authors: Lara A Boyd; Kathryn S Hayward; Nick S Ward; Cathy M Stinear; Charlotte Rosso; Rebecca J Fisher; Alexandre R Carter; Alex P Leff; David A Copland; Leeanne M Carey; Leonardo G Cohen; D Michele Basso; Jane M Maguire; Steven C Cramer Journal: Int J Stroke Date: 2017-07 Impact factor: 5.266
Authors: Mark R Etherton; Ona Wu; Pedro Cougo; Anne-Katrin Giese; Lisa Cloonan; Kaitlin M Fitzpatrick; Allison S Kanakis; Gregoire Boulouis; Hasan H Karadeli; Arne Lauer; Jonathan Rosand; Karen L Furie; Natalia S Rost Journal: Neurology Date: 2017-04-05 Impact factor: 9.910
Authors: Yan Liang; Yang-Kun Chen; Min Deng; Vincent C T Mok; De-Feng Wang; Gabor S Ungvari; Chiu-Wing W Chu; Akane Kamiya; Wai-Kwong Tang Journal: Front Aging Neurosci Date: 2017-11-13 Impact factor: 5.750