Depressive Disorders in Long-Term Survivors of Stroke

1994 ◽  
Vol 164 (3) ◽  
pp. 380-386 ◽  
Author(s):  
Michael Sharpe ◽  
Keith Hawton ◽  
Valerie Seagroatt ◽  
John Bamford ◽  
Allan House ◽  
...  
Keyword(s):  
Major Depression ◽  
Depressive Disorders ◽  
Functional Dependence ◽  
Brain Lesion ◽  
Lesion Volume ◽  
Community Based ◽  
A Prospective Study ◽  
Long Term Survivors ◽  
Stroke Register

Sixty surviving patients from a community-based stroke register who had computerised tomography (CT) scan evidence of a single brain lesion were interviewed three to five years after their first ever stroke. Depression (DSM–III–R major depression, partially resolved major depression, and dysthymia) was present in 11 (18%) of the patients and was associated with impaired physical and cognitive functioning, greater age, residence in an institution, absence of a close personal relationship, and larger original brain lesion. Of these variables, only functional dependence (odds ratio 16.4; confidence interval 1.6–170), larger lesion volume (6.6; 1–50), and female sex (8; 1.1–56) remained significantly associated with depression after controlling for all other variables. We conclude that depression in long-term survivors of stroke has many of the same associations as depression in non-stroke elderly populations. Depression in long-term stroke survivors may also be associated with larger original brain lesions, although this requires confirmation in a prospective study.

Mood disorders in long-term survivors of stroke: associations with brain lesion location and volume

1990 ◽  
Vol 20 (4) ◽  
pp. 815-828 ◽  
Author(s):  
M. Sharpe ◽  
K. Hawton ◽  
A. House ◽  
A. Molyneux ◽  
P. Sandercock ◽  
...  
Keyword(s):  
Depressive Disorder ◽  
Cerebral Hemisphere ◽  
Depressive Disorders ◽  
Brain Lesion ◽  
Brain Lesions ◽  
Standardized Measures ◽  
Lesion Location ◽  
Left Cerebral Hemisphere ◽  
Long Term Survivors

SynopsisSixty surviving patients from a community-based stroke register who had CT scan evidence of a single brain lesion and neurological signs appropriate to it were interviewed three to five years following their first-ever stroke. Mood disorder (anxiety and depression), physical disability, and intellectual impairment were assessed using standardized measures. The position and volume of the brain lesion was determined from CT scans performed soon after the stroke. The prevalence of depressive disorder was lower in this sample than that reported in previous studies (DSM-IIIR major depression 8 3 %; all DSM-IIIR depressive disorders 183%). Reports by other workers for an association of depressive disorder either with left-sided brain lesions, or with anteriorly placed lesions in the left cerebral hemisphere, were not supported. Neither was there evidence of a correlation between symptom score and proximity of the lesion to the anterior pole of the left cerebral hemisphere. Psychiatric symptom scores were however greater with larger volume brain lesions. Anxiety disorders, especially agoraphobia, were relatively common (20 % if diagnosed in the presence of depressive disorder), but were not related to lesion location or volume.

scholarly journals Neuroprotective role of lactate in rat neonatal hypoxia-ischemia

2020 ◽  
pp. 0271678X2090835 ◽  
Author(s):  
Hélène Roumes ◽  
Ursule Dumont ◽  
Stéphane Sanchez ◽  
Leslie Mazuel ◽  
Jordy Blanc ◽  
...  
Keyword(s):  
Neuroprotective Effect ◽  
Waste Product ◽  
Brain Lesion ◽  
Complete Recovery ◽  
Long Term Memory ◽  
Lesion Volume ◽  
Apparent Diffusion Coefficients ◽  
Hypoxia Ischemia

Hypoxic-ischemic (HI) encephalopathy remains a major cause of perinatal mortality and chronic disability in newborns worldwide (1–6 for 1000 births). The only current clinical treatment is hypothermia, which is efficient for less than 60% of babies. Mainly considered as a waste product in the past, lactate, in addition to glucose, is increasingly admitted as a supplementary fuel for neurons and, more recently, as a signaling molecule in the brain. Our aim was to investigate the neuroprotective effect of lactate in a neonatal (seven day old) rat model of hypoxia-ischemia. Pups received intra-peritoneal injection(s) of lactate (40 μmol). Size and apparent diffusion coefficients of brain lesions were assessed by magnetic resonance diffusion-weighted imaging. Oxiblot analyses and long-term behavioral studies were also conducted. A single lactate injection induced a 30% reduction in brain lesion volume, indicating a rapid and efficient neuroprotective effect. When oxamate, a lactate dehydrogenase inhibitor, was co-injected with lactate, the neuroprotection was completely abolished, highlighting the role of lactate metabolism in this protection. After three lactate injections (one per day), pups presented the smallest brain lesion volume and a complete recovery of neurological reflexes, sensorimotor capacities and long-term memory, demonstrating that lactate administration is a promising therapy for neonatal HI insult.

Relevance of hypointense brain MRI lesions for long-term worsening of clinical disability in relapsing multiple sclerosis

2013 ◽  
Vol 20 (2) ◽  
pp. 214-219 ◽  
Author(s):  
Antonio Giorgio ◽  
Maria Laura Stromillo ◽  
Maria Letizia Bartolozzi ◽  
Francesca Rossi ◽  
Marco Battaglini ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Brain Mri ◽  
Univariate Analysis ◽  
Brain Lesion ◽  
Brain Magnetic Resonance Imaging ◽  
Stepwise Multiple Regression ◽  
Lesion Volume ◽  
Magnetic Resonance Imaging Mri ◽  
Relapsing Remitting Multiple Sclerosis

Background: The accrual of brain focal pathology is considered a good substrate of disability in relapsing–remitting multiple sclerosis (RRMS). However, knowledge on long-term lesion evolution and its relationship with disability progression is poor. Objective: The objective of this paper is to evaluate in RRMS the long-term clinical relevance of brain lesion evolution. Methods: In 58 RRMS patients we acquired, using the same scanner and protocol, brain magnetic resonance imaging (MRI) at baseline and 10±0.5 years later. MRI data were correlated with disability changes as measured by the Expanded Disability Status Scale (EDSS). Results: The annualized 10-year lesion volume (LV) growth was +0.25±0.5 cm3 (+6.7±8.7%) for T2-weighted (T2-W) lesions and +0.20±0.31 cm3 (+11.5±12.3%) for T1-weighted (T1-W) lesions. The univariate analysis showed moderate correlations between baseline MRI measures and EDSS at 10 years ( p < 0.001). Also, 10-year EDSS worsening correlated with LV growth and the number of new/enlarging lesions measured over the same period ( p < 0.005). In the stepwise multiple regression analysis, EDSS worsening over 10 years was best correlated with the combination of baseline T1-W lesion count and increasing T1-W LV ( R = 0.61, p < 0.001). Conclusion: In RRMS patients, long-term brain lesion accrual is associated with worsening in clinical disability. This is particularly true for hypointense, destructive lesions.

scholarly journals Major Depression and its Association with Long-Term Medical Conditions

2002 ◽  
Vol 47 (2) ◽  
pp. 149-152 ◽  
Author(s):  
Lisa M Gagnon ◽  
Scott B Pat ten
Keyword(s):  
Major Depression ◽  
Depressive Disorders ◽  
Short Form ◽  
Community Sample ◽  
Self Report ◽  
Medical Conditions ◽  
Cross Sectional ◽  
Major Depressive Episodes ◽  
Depressive Episodes

Objective: To replicate previously re ported as sociations between major depressive episodes (MDEs) and long-term medical conditions in a Canadian community sample. Methods: A sample of 2542 house hold residents was selected using random digit dialing (RDD). Data were collected by tele phone in ter view. The Composite International Diagnostic In ter view (CIDI)-Short Form for major depression (CIDI-SFMD) was used to identify MDEs occurring in the previous 12 months. Long-term medical conditions were identified by self-report. Results: The prevalence of MDE was elevated in those subjects who re ported 1 or more long-term medical conditions. The association was not due to con founding by age, sex, social support, or stressful recent life events. Conclusion: This study replicates a previously re ported as sociation between depressive disorders and long-term medical conditions. These cross-sectional associations suggest that medical conditions may increase the risk of major depression or that major depression may in crease the risk of medical conditions. Alternatively, comorbid medical conditions may influence the duration of depressive episodes, or vice versa. These explanations are not mutually exclusive.

scholarly journals From frail to fit after allogeneic hematopoietic cell transplantation: Scope of the problem and a strength-based solution

2019 ◽  
Author(s):  
Jason Sweetnam ◽  
Eric Twohey ◽  
Sasha Skendzel ◽  
John Stingle ◽  
Mukta Arora ◽  
...  
Keyword(s):  
Pilot Study ◽  
Strength Training ◽  
Cell Transplantation ◽  
Hematopoietic Cell Transplantation ◽  
Hematopoietic Cell ◽  
Allogeneic Hematopoietic Cell Transplantation ◽  
Community Based ◽  
Allogeneic Hct ◽  
Long Term Survivors

AbstractBackgroundFrailty is a common but underdiagnosed syndrome among long-term survivors of allogeneic hematopoietic cell transplantation (HCT). Conditions such as malnutrition, fatigue, and weakness may suggest frailty despite patients not receiving a formal diagnosis. Furthermore, the optimal interventions to overcome frailty in long-term survivors of allogeneic HCT is not yet established.Patients and MethodsThis study consists of a retrospective and prospective component. First, we completed a retrospective review using diagnosis data from the electronic medical record to estimate the prevalence of components of frailty in 1077 recipients of allogeneic HCT through 5 years post-transplant. Second, we developed a community-based pilot study of strength training for long-term survivors of allogeneic HCT that addressed several common barriers exercise engagement and adherence. Four allogeneic HCT recipients (2 males, 2 females) and 4 controls (2 males, 2 females) completed the strength training pilot study, consisting of a baseline assessment, 10 weeks of personalized and supervised strength programming at least once weekly as a group, and an end-of-study assessment to measure progress in strength, body composition, and a standardized measure of self-efficacy.ResultsDespite a lack of a formal diagnosis, approximately 80% of HCT recipients in this series received a diagnosis of a component of frailty (weakness, fatigue, or malnutrition), and over 1/3 of HCT recipients had symptoms extending beyond 1 year. Over the course of the strength training pilot study, both pre-frail/frail allogeneic HCT recipients and healthy controls doubled their total strength, lost body fat, and gained muscle mass. Self-efficacy improved from baseline in allogeneic HCT recipients after the strength training pilot program.DiscussionBased upon the prevalence of frailty-related diagnoses among long-term survivors of HCT, a comprehensive mitigation strategy needs to be developed for this population. A community-based strength training program that includes a personalized component, a group setting, and caregiver/partner involvement appears feasible and overcomes several established barriers to exercise engagement and adherence.

scholarly journals Association of baseline hematoma and edema volumes with one-year outcome and long-term survival after spontaneous intracerebral hemorrhage: A community-based inception cohort study

2020 ◽  
pp. 174749302097428
Author(s):  
James JM Loan ◽  
Angus B Gane ◽  
Laura Middleton ◽  
Brendan Sargent ◽  
Tom James Moullaali ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Lesion Volume ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Community Based ◽  
Term Survival ◽  
Brain Ct ◽  
Edema Volume ◽  
Hemorrhage Volume ◽  
One Year

Background Hospital-based studies have reported variable associations between outcome after spontaneous intracerebral hemorrhage and peri-hematomal edema volume. Aims In a community-based study, we aimed to investigate the existence, strength, direction, and independence of associations between intracerebral hemorrhage and peri-hematomal edema volumes on diagnostic brain CT and one-year functional outcome and long-term survival. Methods We identified all adults, resident in Lothian, diagnosed with first-ever, symptomatic spontaneous intracerebral hemorrhage between June 2010 and May 2013 in a community-based, prospective inception cohort study. We defined regions of interest manually and used a semi-automated approach to measure intracerebral hemorrhage volume, peri-hematomal edema volume, and the sum of these measurements (total lesion volume) on first diagnostic brain CT performed at ≤3 days after symptom onset. The primary outcome was death or dependence (scores 3–6 on the modified Rankin Scale) at one-year after intracerebral hemorrhage. Results Two hundred ninety-two (85%) of 342 patients (median age 77.5 y, IQR 68–83, 186 (54%) female, median time from onset to CT 6.5 h (IQR 2.9–21.7)) were dead or dependent one year after intracerebral hemorrhage. Peri-hematomal edema and intracerebral hemorrhage volumes were colinear ( R2 = 0.77). In models using both intracerebral hemorrhage and peri-hematomal edema, 10 mL increments in intracerebral hemorrhage (adjusted odds ratio (aOR) 1.72 (95% CI 1.08–2.87); p = 0.029) but not peri-hematomal edema volume (aOR 0.92 (0.63–1.45); p = 0.69) were independently associated with one-year death or dependence. 10 mL increments in total lesion volume were independently associated with one-year death or dependence (aOR 1.24 (1.11–1.42); p = 0.0004). Conclusion Total volume of intracerebral hemorrhage and peri-hematomal edema, and intracerebral hemorrhage volume alone on diagnostic brain CT, undertaken at three days or sooner, are independently associated with death or dependence one-year after intracerebral hemorrhage, but peri-hematomal edema volume is not. Data access statement Anonymized summary data may be requested from the corresponding author.

Rebirth

2016 ◽  
Vol 60 (4) ◽  
pp. 2-3
Author(s):  
Kia Labeija
Keyword(s):  
New York ◽  
Fine Arts ◽  
Active Member ◽  
Community Based ◽  
Community Politics ◽  
Multidisciplinary Practice ◽  
The Subject ◽  
Living With Hiv ◽  
Long Term Survivors

Kia Labeija was born and raised in the heart of New York City’s theatre district, Hellz Kitchen. Her multidisciplinary practice explores the intersections of community, politics, fine arts, and activism. Her digital portraits offer theatrical and cinematic re-imaginings of nonfictional events. As a member of the iconic House of Labeija and an active member of NYC’s ballroom scene, she offers the art of Voguing as both a performance and community-based practice. Labeija speaks publicly on the subject of HIV/AIDS as an advocate for the underrepresented living with HIV, including long-term survivors, women, minorities, and children born with the virus.

Psychopathological predictors of suicide in patients with major depression during a 5-year follow-up

2001 ◽  
Vol 16 (5) ◽  
pp. 283-288 ◽  
Author(s):  
B. Schneider ◽  
M. Philipp ◽  
M.J. Müller
Keyword(s):  
Major Depression ◽  
Depressive Disorders ◽  
Suicide Attempts ◽  
Psychotic Symptoms ◽  
Mortality Data ◽  
Course Of Illness ◽  
Early Predictors ◽  
Increased Risk ◽  
A Prospective Study

SummaryObjective. It is widely known that the risk of suicide is higher in cases of major depressive disorders in comparison to the general population. The purpose of this study was to examine which psychopathologic symptoms during the index episode are predictors for an increased risk of suicide in the further course of major depression. Method. Mortality data were determined from a prospective study of 280 patients with major depression (DSM-III-R, single episode or recurrent) during a follow-up period of 5 years. The predictive power of different depressive symptoms including psychotic symptoms for suicide risk was investigated. Results. Patients who committed suicide (N = 16) during the follow-up period had reported significantly more often hypochondriacal preoccupations or delusions (but not delusions or preoccupations of impoverishment, guilt or sin), suicidal thoughts and suicide attempts as well as feelings of severe hopelessness during the index episode than still living patients or patients who had died from natural causes. Conclusion. These symptoms seem to be helpful early predictors for the risk of suicide during the further course of illness. This should be taken into account for suicide prevention in the course of major depression.

Maximizing Outcomes in Group Treatment of Aphasia: Lessons Learned From a Community-Based Center

2014 ◽  
Vol 24 (3) ◽  
pp. 100-105 ◽  
Author(s):  
Darlene Williamson
Keyword(s):  
Group Treatment ◽  
Treatment Protocol ◽  
Lessons Learned ◽  
Group Program ◽  
Community Based ◽  
Multiple Treatment ◽  
Use Of Technology ◽  
Communication Impairments ◽  
Treatment Settings

Given the potential of long term intervention to positively influence speech/language and psychosocial domains, a treatment protocol was developed at the Stroke Comeback Center which addresses communication impairments arising from chronic aphasia. This article presents the details of this program including the group purposes and principles, the use of technology in groups, and the applicability of a group program across multiple treatment settings.

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