Dr. Weeks’ Comment: Given the epidemic if SADS and clotting problems, the incidence of stroke and heart attacks has skyrocketed. Here are some options for stroke rehabilitation. Ask your doctor about stroke and heart attack prevention and if you are not satisfied, give us a call at The Weeks Center for Corrective Health – 360-341-2303 or email md@weeksmd.com.
POTASSIUM
Potassium intake and risk of stroke in hypertensive and non-hypertensive women in the Women’s Health Initiative
Abstract
Dietary potassium has been associated with lower risk of stroke.
Conclusions
High potassium intake is associated with a lower risk of all stroke and ischemic stroke as well as all-cause mortality in older women, particularly those who are not hypertensive.
NIACIN
Niacin Treatment of Stroke Increases Synaptic Plasticity and Axon Growth in Rats
Abstract
Niacin is the most effective medication in current clinical use for increasing high-density lipoprotein cholesterol (HDL-C). We tested the hypothesis that Niacin treatment of stroke promotes synaptic plasticity and axon growth in the ischemic brain.
Results
Niaspan treatment of stroke significantly increased Synaptophysin, Bielschowsky silver, BDNF/TrkB expression, and decreased NgR expression in the ischemic brain compared with MCAo control animals (p<0.05, n=8/group). Niacin and HDL treatment significantly increased neurite outgrowth, and BDNF/TrkB expression in PCNs. TrkB-inhibitor attenuated Niacin-induced neurite outgrowth (p<0.05, n=6/group).
Conclusions
Niacin treatment of stroke promotes synaptic plasticity and axon growth, which is mediated, at least partially, by the BDNF/TrkB pathways.
NICOTINAMIDE
Nicotinamide administration improves remyelination after stroke via the NAD+/BDNF/TrkB pathway.
PROGESTERONE (not “progestin” or “medroxyprogesterone”)_
Progesterone and stroke recovery: a match ultimately won by survivin?
Stroke represents one of the most important causes of injury and disability worldwide.1,2 It is commonly connected with an obstruction of blood flow in a major cerebral vessel, which, if not quickly resolved, will lead to an infarcted area of tissue that cannot be therapeutically salvaged.1 There are currently no effective therapeutic strategy for stroke. A growing body of evidence indicates that progesterone (PROG), given in the acute stage of stroke, limits tissue damage and improves functional outcome.
Progesterone as a neuroprotective factor in traumatic and ischemic brain injury
Abstract
The search for a “magic bullet” drug targeting a single receptor for the treatment of stroke or traumatic brain injury (TBI) has failed thus far for a variety of reasons. The pathophysiology of ischemic brain injury and TBI involves a number of mechanisms leading to neuronal injury, including excitotoxicity, free radical damage, inflammation, necrosis, and apoptosis. Brain injury also triggers auto-protective mechanisms, including the up-regulation of anti-inflammatory cytokines and endogenous antioxidants. In these conditions an agent with pleiotropic consequences is more likely to provide effective neuroprotection and repair than one operating primarily on a single, or a small number of, injury mechanisms. There is growing evidence, including recently published clinical trials, that progesterone and perhaps its metabolite allopregnanolone exert neuroprotective effects on the injured central nervous system (CNS). Laboratories around the world have shown that progesterone and allopregnanolone act through numerous metabolic and physiological pathways that can affect the injury response in many different tissues and organ systems. Furthermore, progesterone is a natural hormone, synthesized in both males and females, that can act as a pro-drug for other metabolites with their own distinct mode of action in CNS repair. These properties make progesterone a unique and compelling natural agent to consider for testing in clinical trial for CNS injuries including TBI and stroke.
HYPERBARIC OXYGEN
Hyperbaric oxygen therapy improves neurocognitive functions of post-stroke patients – a retrospective analysis
Abstract
Previous studies have shown that hyperbaric oxygen therapy (HBOT) can improve the motor functions and memory of post-stroke patients in the chronic stage.
Conclusions:
HBOT induces significant improvements in all cognitive domains even in the late chronic stage. The selection of post-stroke patients for HBOT should be based on functional analysis and baseline cognitive scores rather than the stroke type, location or side of lesion.
TRANSCRANIAL MAGNETIC STIMULATION
Narrative Review of Noninvasive Brain Stimulation in Stroke Rehabilitation
Abstract
Stroke is a disease with a high incidence and disability rate, resulting in changes in neural network and corticoid-subcortical excitability and various functional disabilities. The aim of the present study was to discuss the current status of research and limitations and potential direction in the application of noninvasive brain stimulation (NIBS) on post-stroke patients. This literature review focused on clinical studies and reviews. Literature retrieval was conducted in PubMed, Cochrane, Scopus, and CNKI, using the following keywords: Repeated transcranial magnetic stimulation, Transcranial direct current stimulation, Transcranial alternating current stimulation, Transcranial alternating current stimulation, Transcranial focused ultrasound, Noninvasive vagus nerve stimulation, Stroke, and Rehabilitation. We selected 200 relevant publications from 1985 to 2022. An overview of recent research on the use of NIBS on post-stroke patients, including its mechanism, therapeutic parameters, effects, and safety, is presented. It was found that NIBS has positive therapeutic effects on dysfunctions of motor, sensory, cognitive, speech, swallowing, and depression after stroke, but standardized stimulus programs are still lacking. The literature suggests that rTMS and tDCS are more beneficial to post-stroke patients, while tFUS and tVNS are currently less studied for post-stroke rehabilitation, but are also potential interventions.