Timing of Neurological Improvement after Acute Ischemic Stroke and Functional Outcome

Abstract

Background: The time of neurological improvement (TNI) after acute ischemic stroke may have a predictive value. Methods: We evaluated 410 consecutive patients who were admitted within 12 hours of stroke onset. The National Institutes of Health Stroke Scale (NIHSS) was measured on admission and at 1, 3, 7, and 14 days. Neurological improvement was defined as an improvement in the NIHSS score by ≥2 points (NI2) or ≥4 points (NI4) or an NIHSS score of 0. Patients with a Modified Rankin scale (mRS) score of ≤2 were considered to have a good outcome. Results: Patients with earlier TNIs had a lower 3-month mRS score and a higher probability for a good outcome. In the binary and ordinal regression analyses, age, NIHSS score, atrial fibrillation and TNI were independently associated with a good outcome. Receiver operating characteristic curve analyses demonstrated that TNI2 had higher sensitivity and lower specificity than TNI4. The best threshold for predicting outcome was day 3 for TNI2 and day 14 for TNI4. Conclusions: These results suggest that TNI is independently associated with functional outcome at 90 days. TNI2 may be more useful than TNI4 for early prediction of stroke outcome.

Anti‐ApoA‐1 IgG serum levels predict worse poststroke outcomes

“…However, despite the association with increased CV risk, their prognostic role in functional recovery and immune system activation after AIS remains largely unexplored. Therefore, in this study, we aimed at investigating the potential of anti-ApoA-1 IgG in predicting functional handicap [as determined by modified Rankin Scale (mRS) and National Institute of Health Stroke Scale (NIHSS)] [20] and ischaemic lesion volume [21]. Finally, to explore the possible impact of anti-ApoA-1 IgG on human glioma cell survival, we evaluated their ability to promote necrosis and apoptosis on cells derived from U251 astrocytoma cell line using flow cytometry.…”

“…The primary endpoint of this study was to test the ability of serum anti-ApoA-1 IgG to predict 90-day disability according to the mRS. As previously validated, [20] mRS ≤ 2 at day 90 after AIS onset identified patients with recovered autonomy in carrying out usual activities, whereas persistent long-term disability was defined by mRS > 2. The secondary endpoint of this study was to explore the relationship of circulating anti-ApoA-1 IgG with stroke severity at day 1 by NIHSS.…”

“…Furthermore, in vitro and animal studies pointed to Tolllike receptor (TLR)-2, -4 and CD14 signalling as key receptors underlying the inflammatory and pro-atherogenic response of anti-ApoA-1 IgG [16][17][18][19]. Therefore, in this study, we aimed at investigating the potential of anti-ApoA-1 IgG in predicting functional handicap [as determined by modified Rankin Scale (mRS) and National Institute of Health Stroke Scale (NIHSS)] [20] and ischaemic lesion volume [21]. Therefore, in this study, we aimed at investigating the potential of anti-ApoA-1 IgG in predicting functional handicap [as determined by modified Rankin Scale (mRS) and National Institute of Health Stroke Scale (NIHSS)] [20] and ischaemic lesion volume [21].…”

Effect of Acupuncture vs Sham Acupuncture on Patients With Poststroke Motor Aphasia

“…Regarding neurological function, after 6 weeks of treatment, there was a 2.22-point reduction in the NIHSS scores in the MA group compared with the SA group, indicating a clinical improvement in neurological impairment. 59 The effects of acupuncture in enhancing neurological function in patients with stroke have been validated in clinical studies. 60 , 61 Moreover, acupuncture is recommended by clinical practices and treatment guidelines for at least 15 poststroke symptoms worldwide.…”

Twenty-four-hour National Institute of Health Stroke Scale predicts short- and long-term outcomes of basilar artery occlusion after endovascular treatment

“…Two binary definitions of ENI were applied based on the NIHSS at 24 h after EVT, as previously described: (1) NIHSS improvement ≥4 points from baseline (common ENI) ( Song et al, 2015 ), (2) NIHSS improvement ≥8 points from baseline (major ENI) ( Broderick et al, 2000 ; Brown et al, 2004 ), and (3) NIHSS improvement ≥10 points from baseline (dramatic ENI) ( Meyer et al, 2020 ). We calculated the cut-off values for the NIHSS score at admission, the NIHSS score at 24 h, absolute NIHSS change (ΔNIHSS), and NIHSS percentage change [% NIHSS: (NIHSS admission − NIHSS 24 h) / NIHSS admission] with the predictive values of highest sensitivity and specificity (Youden index) for a favorable functional outcome (mRS 0–3) and mortality at 90-day and 1-year follow-up using receiver operator characteristics (ROCs).…”