GLORIA

GEOMAR Library Ocean Research Information Access

X

Ihre E-Mail wurde erfolgreich gesendet. Bitte prüfen Sie Ihren Maileingang.

Leider ist ein Fehler beim E-Mail-Versand aufgetreten. Bitte versuchen Sie es erneut.

Vorgang fortführen?

Exportieren
Filter
  • Ovid Technologies (Wolters Kluwer Health)  (87)
Materialart
Verlag/Herausgeber
  • Ovid Technologies (Wolters Kluwer Health)  (87)
Person/Organisation
Sprache
Erscheinungszeitraum
Fachgebiete(RVK)
  • 1
    Online-Ressource
    Online-Ressource
    Genetic and lifestyle risk factors for MRI-defined brain infarcts in a population-based setting
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Neurology Vol. 92, No. 5 ( 2019-01-29)
    Details
    In: Neurology, Ovid Technologies (Wolters Kluwer Health), Vol. 92, No. 5 ( 2019-01-29)
    Materialart: Online-Ressource
    ISSN: 0028-3878 , 1526-632X
    URL: Article
    DOI: 10.1212/WNL.0000000000006851
    RVK:
    XA 10000
    Sprache: Englisch
    Verlag: Ovid Technologies (Wolters Kluwer Health)
    Publikationsdatum: 2019
    Standort Signatur Einschränkungen Verfügbarkeit
    BibTip Andere fanden auch interessant ...
    Online-Ressource
  • 2
    Online-Ressource
    Online-Ressource
    Abstract 3319: Prediction Of Lesion Expansion In Stroke Patients Using Acute MRI
    Ovid Technologies (Wolters Kluwer Health) ; 2012
    In:  Stroke Vol. 43, No. suppl_1 ( 2012-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 43, No. suppl_1 ( 2012-02)
    Kurzfassung: Background: We investigated whether MRI-based algorithms combining acute DWI & PWI can be used to identify patients likely to experience lesion expansion. Methods: We analyzed MRI from 181 unilateral stroke patients who underwent DWI & PWI ≤ 12h from last seen well and had follow-up imaging (F/u) ≥4 days with lesions ≥ 1 cm 3 . Apparent diffusion coefficient, T2, DWI, CBF, CBV, MTT and Tmax (time of peak of deconvolved residue function) maps were co-registered, normalized and used as covariates in a model that produced infarction risk maps. Coefficients were calculated from 111 non-lysed patients and applied to 70 patients who received mechanical or drug lysis. Area under generated receiver operating characteristic curves (AUC) were calculated. Regional analyses were performed comparing mean risk values in Core (acute DWI), Growth (F/u - Core), Reverse (Core - F/u) and Normal (ipsilesional hemisphere - F/u) regions. Predicted lesion volumes (PLV) using a 50% risk threshold and post-hoc artifact removal for classifying infarcted tissue were correlated with the measured lesion volumes (MLV) on F/u. Values are median [IQR] or mean±SD. Results: The thrombolysis-treated group differed significantly from the non-lysis group in admission NIH Stroke Scale scores (12 [9-16] vs 6 [3-13] ; P 〈 0.001), time-to-MRI (4.8±1.9 h vs 5.9±2.8 h; P=0.005), acute DWI lesion volumes (21 [7-56] vs 11 [3-36] cm 3 ; P=0.02) and F/u lesion volumes (39 [12-72] vs 17 [6-56] cm 3 ; P=0.02). No significant difference was found between age (67±15 vs 65±17 years old), male sex (59% vs 67%) and time to F/u (15 [6-47] vs 10 [6-46] days). Significant differences in predicted risk between the 4 regions were found for both lysed (Core: 0.72±0.15; Growth: 0.41±0.13; Reverse: 0.64±0.16; Normal: 0.25±0.06; P 〈 0.0001) and non-lysed groups (Core: 0.72±0. 15; Growth:0.42±0.12; Reverse: 0.64±0.15; Normal: 0.22±0.05; P 〈 0.0001). AUCs of the prediction for the non-lysed group were higher than for the lysed group (0.86±0.09 vs 0.81±0.11; P 〈 0.001). Correlations between PLV and MLV were significant for both lysed (R=0.57, P 〈 0.001) and non-lysed groups (R=0.85, P 〈 0.001). Mismatch between PLV and Core volumes (i.e. predicted lesion growth) was significantly correlated with actual lesion growth for the non-lysed group (R=0.49, P 〈 0.001) but not for the lysed group (R=0.04, P=0.72). Conclusion: Mismatch in PLV and core can be used to identify patients most likely to experience lesion expansion if not given reperfusion therapy. The performance of the models was reduced in thrombolysed patients, which we propose is due to salvage of tissue that would have otherwise infarcted. MRI-based algorithms may identify patients who are not candidates for thrombolysis, yet have tissue to salvage. This may be useful as imaging selection criteria for future investigational trials of reperfusion therapy in extended time windows or for patients with unclear onsets.
    Materialart: Online-Ressource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.43.suppl_1.A3319
    RVK:
    XA 10000
    Sprache: Englisch
    Verlag: Ovid Technologies (Wolters Kluwer Health)
    Publikationsdatum: 2012
    ZDB Id: 1467823-8
    Standort Signatur Einschränkungen Verfügbarkeit
    BibTip Andere fanden auch interessant ...
    Online-Ressource
  • 3
    Online-Ressource
    Online-Ressource
    Neurophysiology State Dynamics Underlying Acute Neurologic Recovery After Cardiac Arrest
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Neurology Vol. 101, No. 9 ( 2023-08-29), p. e940-e952
    Details
    In: Neurology, Ovid Technologies (Wolters Kluwer Health), Vol. 101, No. 9 ( 2023-08-29), p. e940-e952
    Kurzfassung: Epileptiform activity and burst suppression are neurophysiology signatures reflective of severe brain injury after cardiac arrest. We aimed to delineate the evolution of coma neurophysiology feature ensembles associated with recovery from coma after cardiac arrest. Methods Adults in acute coma after cardiac arrest were included in a retrospective database involving 7 hospitals. The combination of 3 quantitative EEG features (burst suppression ratio [BSup], spike frequency [SpF] , and Shannon entropy [En]) was used to define 5 distinct neurophysiology states: epileptiform high entropy (EHE: SpF ≥4 per minute and En ≥5); epileptiform low entropy (ELE: SpF ≥4 per minute and 〈 5 En); nonepileptiform high entropy (NEHE: SpF 〈 4 per minute and ≥5 En); nonepileptiform low entropy (NELE: SpF 〈 4 per minute and 〈 5 En), and burst suppression (BSup ≥50% and SpF 〈 4 per minute). State transitions were measured at consecutive 6-hour blocks between 6 and 84 hours after return of spontaneous circulation. Good neurologic outcome was defined as best cerebral performance category 1–2 at 3–6 months. Results One thousand thirty-eight individuals were included (50,224 hours of EEG), and 373 (36%) had good outcome. Individuals with EHE state had a 29% rate of good outcome, while those with ELE had 11%. Transitions out of an EHE or BSup state to an NEHE state were associated with good outcome (45% and 20%, respectively). No individuals with ELE state lasting 〉 15 hours had good recovery. Discussion Transition to high entropy states is associated with an increased likelihood of good outcome despite preceding epileptiform or burst suppression states. High entropy may reflect mechanisms of resilience to hypoxic-ischemic brain injury.
    Materialart: Online-Ressource
    ISSN: 0028-3878 , 1526-632X
    URL: Article
    DOI: 10.1212/WNL.0000000000207537
    RVK:
    XA 10000
    Sprache: Englisch
    Verlag: Ovid Technologies (Wolters Kluwer Health)
    Publikationsdatum: 2023
    Standort Signatur Einschränkungen Verfügbarkeit
    BibTip Andere fanden auch interessant ...
    Online-Ressource
  • 4
    Online-Ressource
    Online-Ressource
    Design and rationale for examining neuroimaging genetics in ischemic stroke : The MRI-GENIE study
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Neurology Genetics Vol. 3, No. 5 ( 2017-10), p. e180-
    Details
    In: Neurology Genetics, Ovid Technologies (Wolters Kluwer Health), Vol. 3, No. 5 ( 2017-10), p. e180-
    Kurzfassung: To describe the design and rationale for the genetic analysis of acute and chronic cerebrovascular neuroimaging phenotypes detected on clinical MRI in patients with acute ischemic stroke (AIS) within the scope of the MRI–GENetics Interface Exploration (MRI-GENIE) study. Methods: MRI-GENIE capitalizes on the existing infrastructure of the Stroke Genetics Network (SiGN). In total, 12 international SiGN sites contributed MRIs of 3,301 patients with AIS. Detailed clinical phenotyping with the web-based Causative Classification of Stroke (CCS) system and genome-wide genotyping data were available for all participants. Neuroimaging analyses include the manual and automated assessments of established MRI markers. A high-throughput MRI analysis pipeline for the automated assessment of cerebrovascular lesions on clinical scans will be developed in a subset of scans for both acute and chronic lesions, validated against gold standard, and applied to all available scans. The extracted neuroimaging phenotypes will improve characterization of acute and chronic cerebrovascular lesions in ischemic stroke, including CCS subtypes, and their effect on functional outcomes after stroke. Moreover, genetic testing will uncover variants associated with acute and chronic MRI manifestations of cerebrovascular disease. Conclusions: The MRI-GENIE study aims to develop, validate, and distribute the MRI analysis platform for scans acquired as part of clinical care for patients with AIS, which will lead to (1) novel genetic discoveries in ischemic stroke, (2) strategies for personalized stroke risk assessment, and (3) personalized stroke outcome assessment.
    Materialart: Online-Ressource
    ISSN: 2376-7839
    URL: Article
    DOI: 10.1212/NXG.0000000000000180
    Sprache: Englisch
    Verlag: Ovid Technologies (Wolters Kluwer Health)
    Publikationsdatum: 2017
    ZDB Id: 2818607-2
    Standort Signatur Einschränkungen Verfügbarkeit
    BibTip Andere fanden auch interessant ...
    Online-Ressource
  • 5
    Online-Ressource
    Online-Ressource
    Multiparametric Magnetic Resonance Imaging of Brain Disorders
    Ovid Technologies (Wolters Kluwer Health) ; 2010
    In:  Topics in Magnetic Resonance Imaging Vol. 21, No. 2 ( 2010-04), p. 129-138
    Details
    In: Topics in Magnetic Resonance Imaging, Ovid Technologies (Wolters Kluwer Health), Vol. 21, No. 2 ( 2010-04), p. 129-138
    Materialart: Online-Ressource
    ISSN: 0899-3459
    URL: Article
    DOI: 10.1097/RMR.0b013e31821e56c2
    Sprache: Englisch
    Verlag: Ovid Technologies (Wolters Kluwer Health)
    Publikationsdatum: 2010
    ZDB Id: 2052832-2
    Standort Signatur Einschränkungen Verfügbarkeit
    BibTip Andere fanden auch interessant ...
    Online-Ressource
  • 6
    Online-Ressource
    Online-Ressource
    Combined Diffusion-Weighted and Perfusion-Weighted Flow Heterogeneity Magnetic Resonance Imaging in Acute Stroke
    Ovid Technologies (Wolters Kluwer Health) ; 2000
    In:  Stroke Vol. 31, No. 5 ( 2000-05), p. 1097-1103
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 31, No. 5 ( 2000-05), p. 1097-1103
    Kurzfassung: Background and Purpose —The heterogeneity of microvascular flows is known to be an important determinant of the efficacy of oxygen delivery to tissue. Studies in animals have demonstrated decreased flow heterogeneity (FH) in states of decreased perfusion pressure. The purpose of the present study was to assess microvascular FH changes in acute stroke with use of a novel perfusion-weighted MRI technique and to evaluate the ability of combined diffusion-weighted MRI and FH measurements to predict final infarct size. Methods —Cerebral blood flow, FH, and plasma mean transit time (MTT) were measured in 11 patients who presented with acute ( 〈 12 hours after symptom onset) stroke. Final infarct size was determined with follow-up MRI or CT scanning. Results —In normal brain tissue, the distribution of relative flows was markedly skewed toward high capillary flow velocities. Within regions of decreased cerebral blood flow, plasma MTT was prolonged. Furthermore, subregions were identified with significant loss of the high-flow component of the flow distribution, thereby causing increased homogeneity of flow velocities. In parametric maps that quantify the acute deviation of FH from that of normal tissue, areas of extreme homogenization of capillary flows predicted final infarct size on follow-up scans of 10 of 11 patients. Conclusions —Flow heterogeneity and MTT can be rapidly assessed as part of a routine clinical MR examination and may provide a tool for planning of individual stroke treatment, as well as in targeting and evaluation of emerging therapeutic strategies.
    Materialart: Online-Ressource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/01.STR.31.5.1097
    RVK:
    XA 10000
    Sprache: Englisch
    Verlag: Ovid Technologies (Wolters Kluwer Health)
    Publikationsdatum: 2000
    ZDB Id: 1467823-8
    Standort Signatur Einschränkungen Verfügbarkeit
    BibTip Andere fanden auch interessant ...
    Online-Ressource
  • 7
    Online-Ressource
    Online-Ressource
    MRI Detection of Early Blood-Brain Barrier Disruption : Parenchymal Enhancement Predicts Focal Hemorrhagic Transformation After Thrombolysis
    Ovid Technologies (Wolters Kluwer Health) ; 2008
    In:  Stroke Vol. 39, No. 3 ( 2008-03), p. 1025-1028
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 39, No. 3 ( 2008-03), p. 1025-1028
    Kurzfassung: Background and Purpose— Blood-brain barrier disruption may be a predictor of hemorrhagic transformation (HT) in ischemic stroke. We hypothesize that parenchymal enhancement (PE) on postcontrast T1-weighted MRI predicts and localizes subsequent HT. Methods— In a prospective study, 33 tPA-treated stroke patients were imaged by perfusion-weighted imaging, T1 and FLAIR before thrombolytic therapy and after 2 and 24 hours. Results— Postcontrast T1 PE was found in 5 of 32 patients (16%) 2 hours post-thrombolysis. All 5 patients subsequently showed HT compared to 11 of 26 patients without PE ( P =0.043, specificity 100%, sensitivity 31%), with exact anatomic colocation of PE and HT. Enhancement of cerebrospinal fluid on FLAIR was found in 4 other patients, 1 of which developed HT. Local reperfusion was found in 4 of 5 patients with PE, whereas reperfusion was found in all cases of cerebrospinal fluid hyperintensity. Conclusions— PE detected 2 hours after thrombolytic therapy predicts HT with high specificity. Contrast-enhanced MRI may provide a tool for studying HT and targeting future therapies to reduce risk of hemorrhagic complications.
    Materialart: Online-Ressource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.107.497719
    RVK:
    XA 10000
    Sprache: Englisch
    Verlag: Ovid Technologies (Wolters Kluwer Health)
    Publikationsdatum: 2008
    ZDB Id: 1467823-8
    Standort Signatur Einschränkungen Verfügbarkeit
    BibTip Andere fanden auch interessant ...
    Online-Ressource
  • 8
    Online-Ressource
    Online-Ressource
    Abstract 3917: High-sensitivity C reactive Protein Levels Predict Infarct Growth in Acute Ischemic Stroke
    Ovid Technologies (Wolters Kluwer Health) ; 2012
    In:  Stroke Vol. 43, No. suppl_1 ( 2012-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 43, No. suppl_1 ( 2012-02)
    Kurzfassung: Objectives: There is controversy over whether the inflammatory biomarkers detected after focal cerebral ischemia represent a mechanism of tissue injury or simply reflects the extent of ischemic brain injury. In this study we sought to establish whether levels of an inflammatory biomarker (high sensitivity c-reactive protein, hs-CRP) correlate with and predict infarct growth. Methods: We prospectively measured hs-CRP in consecutive acute stroke patients ( 〈 9 hours from symptom onset) in a multicenter acute ischemic stroke biomarker study. Clinical and demographic data including NIHSS scores at baseline, 48 hours, and discharge, stroke subtype, imaging, and 3 month mRS were collected. Patients with acute infection, active malignancy, or systemic inflammatory disorder were excluded. Infarct growth (IG) was defined as the difference between baseline and t48 hour DWI infarct volume. Multivariate logistic regression model was used to adjust for the effects of potential confounding variables. Results: Of 528 subjects enrolled in the biomarker study we included 220 patients with IG, mean age 74 (s.d. 13.8), for whom imaging data were available, in the analysis. The mean IG was 39.9 (s.d.66) cc. We identified cut-off values of IG based on quartiles 50 percentile (15 cc). Subject with IG were more likely to be older, have a higher baseline NIHSS score, a history of carotid stenosis or AF, an anterior circulation stroke, a large vessel occlusion, and larger baseline MTT perfusion deficit. Subjects with IG ≥15cc had a higher mean hs-CRP levels at 48 hours compared to those with an IG 〈 15cc (41.7 mg/L, s.d. 49.6 vs 23 mg/L s.d. 37.7, p=0.011). At multivariate analyses after adjustment for all the confounding variables, 48-hour hsCRP remained independenttly correlated with IG≥15cc. Conclusions: High 48 hour levels of hs-CRP were independently associated with larger IG in acute ischemic stroke patients. Hence, if validated, high hs-CRP might be helpful in routine clinical practice to monitor infarct growth and could become a valuable specific surrogate marker of stroke progression.
    Materialart: Online-Ressource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.43.suppl_1.A3917
    RVK:
    XA 10000
    Sprache: Englisch
    Verlag: Ovid Technologies (Wolters Kluwer Health)
    Publikationsdatum: 2012
    ZDB Id: 1467823-8
    Standort Signatur Einschränkungen Verfügbarkeit
    BibTip Andere fanden auch interessant ...
    Online-Ressource
  • 9
    Online-Ressource
    Online-Ressource
    Role of Acute Lesion Topography in Initial Ischemic Stroke Severity and Long-Term Functional Outcomes
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Stroke Vol. 46, No. 9 ( 2015-09), p. 2438-2444
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 46, No. 9 ( 2015-09), p. 2438-2444
    Kurzfassung: Acute infarct volume, often proposed as a biomarker for evaluating novel interventions for acute ischemic stroke, correlates only moderately with traditional clinical end points, such as the modified Rankin Scale. We hypothesized that the topography of acute stroke lesions on diffusion-weighted magnetic resonance imaging may provide further information with regard to presenting stroke severity and long-term functional outcomes. Methods— Data from a prospective stroke repository were limited to acute ischemic stroke subjects with magnetic resonance imaging completed within 48 hours from last known well, admission NIH Stroke Scale (NIHSS), and 3-to-6 months modified Rankin Scale scores. Using voxel-based lesion symptom mapping techniques, including age, sex, and diffusion-weighted magnetic resonance imaging lesion volume as covariates, statistical maps were calculated to determine the significance of lesion location for clinical outcome and admission stroke severity. Results— Four hundred ninety subjects were analyzed. Acute stroke lesions in the left hemisphere were associated with more severe NIHSS at admission and poor modified Rankin Scale at 3 to 6 months. Specifically, injury to white matter (corona radiata, internal and external capsules, superior longitudinal fasciculus, and uncinate fasciculus), postcentral gyrus, putamen, and operculum were implicated in poor modified Rankin Scale. More severe NIHSS involved these regions, as well as the amygdala, caudate, pallidum, inferior frontal gyrus, insula, and precentral gyrus. Conclusions— Acute lesion topography provides important insights into anatomic correlates of admission stroke severity and poststroke outcomes. Future models that account for infarct location in addition to diffusion-weighted magnetic resonance imaging volume may improve stroke outcome prediction and identify patients likely to benefit from aggressive acute intervention and personalized rehabilitation strategies.
    Materialart: Online-Ressource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.115.009643
    RVK:
    XA 10000
    Sprache: Englisch
    Verlag: Ovid Technologies (Wolters Kluwer Health)
    Publikationsdatum: 2015
    ZDB Id: 1467823-8
    Standort Signatur Einschränkungen Verfügbarkeit
    BibTip Andere fanden auch interessant ...
    Online-Ressource
  • 10
    Online-Ressource
    Online-Ressource
    A Pragmatic Approach Using Magnetic Resonance Imaging to Treat Ischemic Strokes of Unknown Onset Time in a Thrombolytic Trial
    Ovid Technologies (Wolters Kluwer Health) ; 2012
    In:  Stroke Vol. 43, No. 9 ( 2012-09), p. 2331-2335
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 43, No. 9 ( 2012-09), p. 2331-2335
    Kurzfassung: Toward the goal of designing a clinical trial using imaging parameters to treat stroke patients with unknown onset time, we investigated the timing of changes on MRI in patients with well-defined stroke onset. Methods— Hypothesis-generating (n=85) and confirmatory (n=111) samples were scored by blinded readers for fluid-attenuated inversion recovery (FLAIR) hyperintensity in diffusion-positive regions. Reader-measured signal intensity ratio (SIR) of the lesion to contralateral tissue was compared with SIR measured by coregistration. Results— Lesion conspicuity increased with time on FLAIR ( P =0.006). Qualitative assessment of FLAIR-negative vs FLAIR hyperintensity (k=0.7091; 95% CI, 0.61–0.81) showed good interrater agreement. Subtle hyperintensity was less reliably categorized (k=0.59; 95% CI, 0.47–0.71). Reader-measured SIR 〈 1.15 can identify patients within the treatable time window of 4.5 hours (positive predictive value=0.90). The SIR was greater for right hemisphere lesions ( P =0.04) for a given reported time from stroke symptom onset. Conclusion— The SIR on FLAIR provides a quantitative tool to identify early ischemic strokes. In developing SIR thresholds, right hemisphere lesions may confound the accurate estimate of stroke onset time. Image coregistration for thrombolytic trial enrollment is not necessary. A SIR 〈 1.15 on FLAIR yields a practical estimate of stroke onset within 4.5 hours.
    Materialart: Online-Ressource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.111.630947
    RVK:
    XA 10000
    Sprache: Englisch
    Verlag: Ovid Technologies (Wolters Kluwer Health)
    Publikationsdatum: 2012
    ZDB Id: 1467823-8
    Standort Signatur Einschränkungen Verfügbarkeit
    BibTip Andere fanden auch interessant ...
    Online-Ressource
Schließen ⊗
Diese Webseite nutzt Cookies und das Analyse-Tool Matomo. Weitere Informationen finden Sie hier...