22. European Stroke Conference 472 Experimental studies Health Related Quality of Life Trends among Stroke Survivors: Analysis from the Prospective South London Stroke Register 1995-2011 A. Sheldenkar1, A. Douiri2, A.G. Rudd3, C.D.A. Wolfe4, R. Chen5 Kings College London, London, UNITED KINGDOM1, Kings College London, London, UNIT-ED KINGDOM2, Kings College London, London, UNITED KINGDOM3, Kings College London, London, UNITED KINGDOM4, Kings College London, London, UNITED KINGDOM5 Background: There has been a global rise in stroke prevalence and hence potentially on longer term outcomes after stroke, including health related quality of life (HRQOL). This study investigated long-term trends in mental and physical HRQOL among stroke survivors as evidence on this top-ic is lacking. Methods: Data were obtained from the South London Stroke Register between 1995 and 2011. Using the Short Form-12 Health Survey (SF-12), trends in self-reported HRQOL were assessed over 17 years at 3 months and 1 year after stroke using linear regression models and adjust-ing for socio-demographics, risk factors, case-mix and processes of care. Stratified analyses by func-tional impairment level were also performed using Barthel Index at 3 months and 1 year after stroke respectively. Results: Overall mental HRQOL trends remained relatively unchanged over 17 years 3 months after stroke (β= -0.16, 95% CI=0.75 to 0.43, p=0.59), although perceived mental HRQOL scores improved from 1995-2007 and fell in 2008-2011. Similar results were found 1 year after stroke. Physical HRQOL showed significant worsening trends at 3 months post-stroke (β=-0.62, -1.10 to -0.13, p=0.01), however this decline was not found at 1 year after stroke. Stratifying by functional impairment, physical HRQOL scores worsened overtime in stroke survivors with no/mild functional impairment but remained stable in those with severe functional impairment. No trends were found in mental HRQOL by functional impairment. Similar results were found at 1 year after stroke. Conclusion: Overall mental HRQOL has remained fairly stable overtime for stroke survi-vors, however physical HRQOL has worsened. The decline in physical HRQOL was seen in stroke survivors with no/mild functional impairment, which has been found in general population trends; but not in those with severe functional impairment which remained unchanged. This requires further investigation. 538 © 2013 S. Karger AG, Basel Scientific Programme 473 Experimental studies Homing of mesenchymal stem cells in rat brain after MCAO induced stroke monitored by 9.4 T MRI S. Grudzenski1, A. Lemke2, P. Heiler3, A. Alonso4, K. Bieback5, L. Schad6, M. Fatar7 Dept. of Neurology, UniversitätsMedizin Mannheim, University of Heidelberg, Mannheim, GERMANY1, Dept. of Computer Assisted Clinical Medicine, UniversitätsMedizin Mannheim, University of Heidelberg, Mannheim, GERMANY2, Dept. of Computer Assisted Clinical Medi-cine, UniversitätsMedizin Mannheim, University of Heidelberg, Mannheim, GERMANY3, Dept. of Neurology, UniversitätsMedizin Mannheim, University of Heidelberg, Mannheim, GERMANY4, Insitute of Transfusion Medicine and Immunology, UniversitätsMedizin Mannheim, University of Heidelberg, Mannheim, GERMANY5, Dept. of Computer Assisted Clinical Medicine, Universitäts- Medizin Mannheim, University of Heidelberg, Mannheim, GERMANY6, Dept. of Neurology, Uni-versitätsMedizin Mannheim, University of Heidelberg, Mannheim, GERMANY7 Background: Mesenchymal stem cells (MSCs) are considered as new therapy method after stroke but still few is known about the influence of administered cell numbers, infarct size or occlusion time on cell homing. Aim of this study was therefore to analyse these parameters by in vivo MRI and post-mortem histology in an animal model of stroke. Methods: Human MSCs were labeled with very small superparamagnetic iron oxide particles (VSOPs) and injected post reperfusion via the internal carotid artery into 33 male Wistar rats that underwent middle cerebral artery occlusion (MCAO) by a nylon thread for 45 or 90 min. Groups were saline without (n=14; 45 min n=5; 90 min n=9) or with 1 Mio (n=6; 45 min n=3; 90 min n=3) or 300.000 MSCs (n=13; 45 min n=6; 90 min n=7). 48h post MCAO infarct size and MSC locali-sation was measured by 9.4 T MRI. Histology 14d post stroke included evaluation of MSC number, localisation and viability by analysis of VSOP fluorescence, iron uptake, human nuclei and fibronec-tin. Results: MSCs visualized as hypo-intensive dots in T2* images (fig.1) and in histology were mainly located in the affected hemisphere (>95%). Cell membranes were still intact. The 1 Mio MSC group had larger infarct sizes compared to the 300.000 and control group (314.5+/-186.3 vs. 154.1+/-109.7 vs. 112.8+/-104.4 mm³, p<0.05). Parenchymal MSC numbers after 45 and 90 min MCAO were 72.9+/-27.9x10³ vs. 96.8+/-109.6x10³ in the 1 Mio MSC group and 44.2+/-29.0x10³ vs. 34.5+/- 22.3x10³ in the 300.000 MSC group. MSC numbers correlate to infarct size after 45 min MCAO (R²=0.94 for 1 Mio; R²=0.6 for 300.000 MSCs). Conclusion: MSCs remain in the affected hemisphere vital up to 14d after MCAO. Larger infarct sizes in the 1 Mio MSC group can’t yet be explained but could be due to additional vessel occlu-sions by cell clusters. Parenchymal MSC numbers depend more on injected cell numbers than on occlusion time and correlate with infarct size as a possible consequence of blood-brain-barrier open-ing.
Karger_ESC London_2013
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