22. European Stroke Conference 490 Vascular biology THE HEMOSTATIC PARAMETERS IN PATIENTS WITH ACUTE ISCHEMIC STROKE R. Raicevic1, S. Mandic-Radic2, D. Veljancic3, B. Labovic4, T. Lepic5 Military Medical Academy, Clinic of neurology, Belgrade, SERBIA1, Military Medical Acade-my, Department of Clinical Chemistry, Belgrade, SERBIA2, Military Medical Academy, Department of Neurology, Belgrade, SERBIA3, Military Medical Academy, Department of Neurology, Belgrade, SERBIA4, Military Medical Academy, Department of Neurology, Belgrade, SERBIA5 Introduction. Blood coagulation and fibrinolytic process are involved in thrombotic vessel obstruc-tion. It is accepted that are association among dysfunction of vascular endothelium and changes of coagulation proteins. The aim of this study was to examine wheter the natural anticoagulants and inhibitors of hemostatic system are involved in activation hemostatic system in patients with acute ischemic stroke (AIS). Methods. The study was performed in 120 patients (77 males and 43 females), average 67 years (range 44-82) with AIS confirmed by standard clinical and radiological criteria. The citrate blood was taken within 24-72 hours after acute event. The activities of protein C (PC), antithrombin III (ATIII), protein S (PS), a2 antiplasmin (AP), and plasminogen activator inhibitor (PAI1) were measured by commercial reagents (Behring,Marburg and Instrumentation Labaratory, Milan). The results were compared with the values of 41 matched (26 males and 15 fe-males) nonvascular neurological patients. Results: It was found that value of PC, ATIII and PAI1 were significantly decreased compared to the control group (p<0,01).There were no significantly changes of AP and PS activities. The results suggest there were an increased activation state of co-agulation process during AIS, where PC and PS took the part. Decreased levels of PAI1 represent decreased fibrinolytic inhibition and possibly PC involvement in regulation of PAI1 activity. Con-clusions. It is concluded that essential anticoagulants and inhibitors are important in regulation of hemostasis in patients with AIS. Translational stroke research (PO 491 - 503) 548 © 2013 S. Karger AG, Basel Scientific Programme 491Translational stroke research Combined central and peripheral magnetic stimulation to facilitate motor recovery after stroke S.M. Kuznetsova1, V.V. Kuznetsov2, N.A. Skachkova3 State Institution «Institute of Gerontology of NAMS of Ukraine», Kiev, UKRAINA1, State In-stitution «Institute of Gerontology of NAMS of Ukraine», Kiev, UKRAINA2, State Institution «In-stitute of Gerontology of NAMS of Ukraine», Kiev, UKRAINA3 Background. Both repetitive transcranial magnetic stimulation (rTMS) and peripheral magnetic stimulation (rPMS) independently lead to functional cortical reorganization. In this sham-controlled randomized trial we investigated effects of combined rTMS and rPMS in post-stroke patients. Methods. The study involved 42 patients with cerebral hemispheric ischemic stroke (mean age - 64,55±1,07 years). Patients received 10 daily sessions of 1 Hz rTMS and rPMS. In different groups, stimulation was either real or sham. We evaluated the Motor Club Assessment Scale (MCAS) and cortical excitability before and after the end of the treatment. Motor evoked potential (MEP) and resting motor threshold (rMT) were measured as parameters of cortical excitability with single-pulse TMS methods. Single-pulse, rTMS and rPMS performed using magnetic stimulator MagPro R100 (Medtronic A/S, Denmark). Results. The improvement of motor function was greater in the real stimulation group (28,5% in MCAS) when compared to the sham group (18,3% in MCAS). Real stimulation group showed sta-tistically significant increase of MEP amplitude (before – 0,82±0,29, after - 1,36±0,23, retrospec-tively) and reduce rMT (before - 81,00±3,29, after - 73,67±3,72, retrospectively) of the affected hemisphere. No significant changes were observed of cortical excitability of both affected and intact hemispheres of sham group, as well as the intact hemisphere of real stimulation group. Conclusion. The combination of rTMS and rPMS improved motor functions and increased cortical excitability of the affected hemisphere in post-stroke patients. This novel approach may potentiate cerebral adaptive processes that facilitate motor recovery after stroke.
Karger_ESC London_2013
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