Early effect of intra-arterial treatment in ischemic stroke on aphasia recovery in MR CLEAN
| Autor: | Crijnen, Y.S., Nouwens, F., Lau, L.M. de, Visch-Brink, E.G., Sandt-Koenderman, M.W. van de, Berkhemer, O.A., Fransen, P.S., Beumer, D., Berg, L.A. van den, Lingsma, H.F., Roos, Y.B., Lugt, A. van der, Oostenbrugge, R.J. van, Zwam, W.H. van, Majoie, C.B., Dippel, D.W., Dijk, E.J. van |
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| Přispěvatelé: | Radiology and Nuclear Medicine, ANS - Neurovascular Disorders, Other departments, Neurology, Biomedical Engineering and Physics, Rehabilitation Medicine, Radiology & Nuclear Medicine, Public Health, MUMC+: MA AIOS Neurologie (9), RS: CARIM - R3.03 - Cerebral small vessel disease, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, Klinische Neurowetenschappen, MUMC+: MA Med Staf Spec Neurologie (9), RS: CARIM - R3.11 - Imaging, Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9) |
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Movement disorders Severity of Illness Index law.invention Brain Ischemia Brain ischemia 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Aphasia Internal medicine Severity of illness medicine Journal Article Humans 030212 general & internal medicine Stroke Aged Netherlands Movement Disorders Endovascular Procedures Recovery of Function Middle Aged Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3] medicine.disease Confidence interval Treatment Outcome Cardiology Physical therapy Arm Female Neurology (clinical) medicine.symptom Motor Deficit Psychology 030217 neurology & neurosurgery |
| Zdroj: | Neurology, 86(22), 2049-2055. Lippincott Williams and Wilkins Neurology, 86(22), 2049-2055. Lippincott Williams & Wilkins Neurology, 86(22), 2049-2055. LIPPINCOTT WILLIAMS & WILKINS Neurology, 86, 2049-55 Neurology, 86, 22, pp. 2049-55 |
| ISSN: | 0028-3878 |
| Popis: | OBJECTIVE: To investigate the effect of intra-arterial treatment (IAT) on early recovery from aphasia in acute ischemic stroke. We hypothesized that the early effect of IAT on aphasia is smaller than the effect on motor deficits.METHODS: We included patients with aphasia from the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN), in which 500 patients with a proximal anterior circulation stroke were randomized to usual care plus IAT (RESULTS: Of the 288 patients with aphasia, 126 were assigned to IAT and 162 to usual care alone. The acOR for improvement of language score at 24 hours was 1.65 (95% confidence interval [CI] 1.05-2.60), and at 1 week 1.86 (95% CI 1.18-2.94). The acOR for improvement of motor deficit at 24 hours was 2.44 (95% CI 1.54-3.88), and at 1 week 2.32 (95% CI 1.43-3.77). The effect of IAT on language deficits was significantly different from the effect on motor deficits at 24 hours and 1 week (p = 0.005 and p = 0.011).CONCLUSIONS: IAT results in better early recovery from aphasia than usual care alone. The early effect of IAT on aphasia is smaller than the effect on motor deficits.CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that for patients with acute ischemic stroke IAT increases early recovery from aphasia and that the early effect on aphasia, as measured by the NIHSS, is smaller than the effect on motor deficits. |
| Databáze: | OpenAIRE |
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