22. European Stroke Conference 717 Acute cerebrovascular events (ACE): TIA and minor strokes Assessment of Minor stroke and TIA with the KINARM Robot – A pilot study J.A. Desai1, S.B. Coutts2, S.H. Scott3, M. Metzler4, A.Y. Jin5, S.P. Dukelow6 University of Calgary,, Calgary, CANADA1, Hotchkiss Brain Institute, University of Calgary, Cal-gary, CANADA2, Queen’s University,, Kingston, CANADA3, University of Calgary, Calgary, CAN-ADA4, Queen’s University, Kingston, CANADA5, Hotchkiss Brain Institute, University of Calgary, Calgary, CANADA6 Background: Neurological tools for quantifying brain function in subjects with stroke often do not identify impairments in subjects with minor stroke or transient ischemic attack (TIA), due to course rating scales and ceiling effects. The objective of the present study is to identify whether robot-based assessment can identify sensory and motor deficits in subjects with minor stroke National institutes of health stroke scale (NIHSS) score <4 and TIA. Methods: We used a KINARM exoskeleton robot to quantify movement of the subject’s arms in the horizontal plane, within 7 days of symptom onset. A virtual reality display presented visual feedback of hand position and spatial objects in the workspace. Subjects performed 3 tasks. 1) Object hit task that required subjects to hit virtual balls moving towards them with virtual paddles attached to each hand. 2) Position-Matching task where the robot moved a limb to different spatial locations with subjects being asked to match the limb geometry with their contralateral limb without vision. 3) Vi-sual guided reaching task where subjects were instructed to reach as “quickly and accurately” from a central target to one of eight peripheral targets. Patients were compared to healthy age, sex and handedness matched controls. Results: 14 patients with TIA and Minor stroke were included in this study. 50% of patients were male with a median age of 61.5 years. The median NIHSS score at time of robotic assessment was 1 (IQR 2). We found 64.3%, 42.9% and 78.6% of patients compared to healthy controls failed the ob-ject hit, position matching, and visual guided reaching tasks, respectively. As well, 85.7% of patients had abnormalities in at least one of the 3 tasks, and 14.3%, 42.9%, and 28.6% of patients failed one, two or all three tasks, respectively. Conclusion: The KINARM robot detects deficits in sensorimotor and visuomotor pathways in pa-tients with clinically absent or mild deficits following TIA and minor stroke. 724 © 2013 S. Karger AG, Basel Scientific Programme 718 Acute cerebrovascular events (ACE): TIA and minor strokes THE RECOVERY PROCESS IN PATIENTS WITH ISCHEMIC STROKE WITH TRAN-SIENT ISCHEMIC ATTACKS IN THE PAST E. Costru-Tasnic1, M. Gavriliuc2 State University of Medicine and Pharmacy “Nicolae Testemitanu”, Chisinau, MOLDOVA1, State University of Medicine and Pharmacy “Nicolae Testemitanu”, Chisinau, MOLDOVA2 Background: Transient ischemic attacks (TIAs) are important predictive factors of future stroke. After a first TIA approximately 5% of patients develop a stroke during the next 2 days and about 20- 30% - over the next 90 days. Recent studies show that TIAs in the history of patients presenting an actual stroke can stimulate the cerebral resistance, presenting a preconditioning effect. The purpose of our study was to underline the differences of stroke recovery process in patients with and without TIAs in the past. Methods: The study was conducted on 33 consecutive patients with ischemic stroke in the acute, early and late recovery phases, with (group A) and without TIAs (group B) in the past, and included: neurological examination of the patients; assessment of functional independence degree after stroke, using the Barthel score; statistical evaluation of obtained data by comparative analysis and graphics. Results: In our research the incidence of TIAs was 36,36%. TIAs occurred at different time before stroke: 2 weeks - 2 years. According to Barthel score, the average score obtained in examined pa-tients was 37,87±4,3 points, with 31,9±4,9 points in group B, and 48,3±7,5 points in the group A. The highest Barthel score was obtained in patients with TIA at 12 months before stroke (72,5±5,64 points).We also analyzed the functional independence degree depending on the time of ischemic stroke occurrence and Barthel score achievement. The highest score was obtained in patients eval-uated during the early post-stroke recovery phase (4-6 moths distance from the ischemic stroke) - 52,5±5,21points, explained by the presence of TIAs in the past of 2 patients from this subgroup who accumulated 72,5±1,88points. Conclusions: The independence degree in patients with ischemic stroke is higher in persons with TIAs in the past than in patients without history of TIAs. TIAs might be considerate as precondition-ing factors that induce cerebral ischemic tolerance in humans.
Karger_ESC London_2013
To see the actual publication please follow the link above