Greater effect of stroke thrombolysis in the presence of arterial obstruction.

Abstract:

OBJECTIVE:Recanalization of arterial obstruction is associated with improved clinical outcomes. There are no controlled data demonstrating whether arterial obstruction status predicts the treatment effect of intravenous (IV) tissue plasminogen activator (tPA). We aimed to determine if the presence of arterial obstruction improves the treatment effect of IV tPA over placebo in attenuating infarct growth. METHODS:We analyzed 175 ischemic stroke patients treated in the 3-6 hour time window from the Echoplanar Imaging Thrombolytic Evaluation Trial (EPITHET) trial (randomized to IV tPA or placebo) and Diffusion and perfusion imaging Evaluation For Understanding Stroke Evolution (DEFUSE) study (all treated with IV tPA). Infarct growth was calculated as the difference between baseline diffusion-weighted imaging (DWI) and final T2 lesion volumes. Baseline arterial obstruction of large intracranial arteries was graded on magnetic resonance angiography (MRA). RESULTS:Among the 116 patients with adequate baseline MRA and final lesion assessment, 72 had arterial obstruction (48 tPA, 24 placebo) and 44 no arterial obstruction (33 tPA, 11 placebo). Infarct growth was lower in the tPA than placebo group (median difference 26ml, 95% confidence interval [CI], 1-50) in patients with arterial obstruction, but was similar in patients with no arterial obstruction (median difference 5ml, 95%CI, -3 to 9). Infarct growth attenuation with tPA over placebo treatment was greater among patients with arterial obstruction than those without arterial obstruction by a median of 32ml (95%CI, 21-43, p < 0.001). INTERPRETATION:The treatment effect of IV tPA over placebo was greater with baseline arterial obstruction, supporting arterial obstruction status as a consideration in selecting patients more likely to benefit from IV thrombolysis.

journal_name

Ann Neurol

journal_title

Annals of neurology

authors

De Silva DA,Churilov L,Olivot JM,Christensen S,Lansberg MG,Mlynash M,Campbell BC,Desmond P,Straka M,Bammer R,Albers GW,Davis SM,Donnan GA,EPITHET-DEFUSE Investigators.

doi

10.1002/ana.22444

subject

Has Abstract

pub_date

2011-10-01 00:00:00

pages

601-5

issue

4

eissn

0364-5134

issn

1531-8249

journal_volume

70

pub_type

杂志文章,随机对照试验
  • Physiology of hypokinetic and hyperkinetic movement disorders: model for dyskinesia.

    abstract::Although the basal ganglia have been implicated in the development of movement disorders since the 1940s, the exact role played by these structures has remained elusive. The development of the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-monkey model of parkinsonism, and the recent resurgence of surgical therapy for t...

    journal_title:Annals of neurology

    pub_type: 杂志文章,评审

    doi:

    authors: Vitek JL,Giroux M

    更新日期:2000-04-01 00:00:00

  • Late-onset metachromatic leukodystrophy: molecular pathology in two siblings.

    abstract::We report on a new allele at the arylsulfatase A (ARSA) locus causing late-onset metachromatic leukodystrophy (MLD). In that allele arginine84, a residue that is highly conserved in the arylsulfatase gene family, is replaced by glutamine. In contrast to alleles that cause early-onset MLD, the arginine84 to glutamine s...

    journal_title:Annals of neurology

    pub_type: 杂志文章

    doi:10.1002/ana.410310305

    authors: Kappler J,von Figura K,Gieselmann V

    更新日期:1992-03-01 00:00:00

  • Inflammatory intrathecal profiles and cortical damage in multiple sclerosis.

    abstract:OBJECTIVE:Gray matter (GM) damage and meningeal inflammation have been associated with early disease onset and a more aggressive disease course in multiple sclerosis (MS), but can these changes be identified in the patient early in the disease course? METHODS:To identify possible biomarkers linking meningeal inflammat...

    journal_title:Annals of neurology

    pub_type: 杂志文章

    doi:10.1002/ana.25197

    authors: Magliozzi R,Howell OW,Nicholas R,Cruciani C,Castellaro M,Romualdi C,Rossi S,Pitteri M,Benedetti MD,Gajofatto A,Pizzini FB,Montemezzi S,Rasia S,Capra R,Bertoldo A,Facchiano F,Monaco S,Reynolds R,Calabrese M

    更新日期:2018-04-01 00:00:00

  • Interictal spiking increases 2-deoxy[14C]glucose uptake and c-fos-like reactivity.

    abstract::Although interictal spikes are thought to share pathophysiological mechanisms with partial-onset seizure discharges, positron emission tomographic studies of the interictal state have paradoxically shown focal hypometabolism whereas seizures produce hypermetabolism. To address this question, we performed functional ma...

    journal_title:Annals of neurology

    pub_type: 杂志文章

    doi:10.1002/ana.410350614

    authors: Handforth A,Finch DM,Peters R,Tan AM,Treiman DM

    更新日期:1994-06-01 00:00:00

  • Quinolinic acid catabolism is increased in cerebellum of patients with dominantly inherited olivopontocerebellar atrophy.

    abstract::We measured the activities of the enzymes responsible for the metabolism of the excitotoxin quinolinic acid, 3-hydroxyanthranilate oxygenase and quinolinic acid phosphoribosyltransferase, in autopsied brain of 11 patients with olivopontocerebellar atrophy. In cerebellar cortex, severe Purkinje cell loss was evident bu...

    journal_title:Annals of neurology

    pub_type: 杂志文章

    doi:10.1002/ana.410290119

    authors: Kish SJ,Du F,Parks DA,Robitaille Y,Ball MJ,Schut L,Hornykiewicz O,Schwarcz R

    更新日期:1991-01-01 00:00:00

  • Haploinsufficiency of Cyfip2 Causes Lithium-Responsive Prefrontal Dysfunction.

    abstract:OBJECTIVE:Genetic variants of the cytoplasmic FMR1-interacting protein 2 (CYFIP2) encoding an actin-regulatory protein are associated with brain disorders, including intellectual disability and epilepsy. However, specific in vivo neuronal defects and potential treatments for CYFIP2-associated brain disorders remain lar...

    journal_title:Annals of neurology

    pub_type: 杂志文章

    doi:10.1002/ana.25827

    authors: Lee SH,Zhang Y,Park J,Kim B,Kim Y,Lee SH,Kim GH,Huh YH,Lee B,Kim Y,Lee Y,Kim JY,Kang H,Choi SY,Jang S,Li Y,Kim S,Jin C,Pang K,Kim E,Lee Y,Kim H,Kim E,Choi JH,Kim J,Lee KJ,Choi SY,Han K

    更新日期:2020-09-01 00:00:00

  • Acute conduction block associated with experimental antiserum-mediated demyelination of peripheral nerve.

    abstract::Intraneural injection of antisera from rabbits with high antigalactocerebroside antibody levels into rat sciatic nerve produced acute nerve conduction block. This was first apparent in some motor axons between 30 and 60 minutes after injection and progressed to completion within 2 to 4 hours. Concurrent morphological ...

    journal_title:Annals of neurology

    pub_type: 杂志文章

    doi:10.1002/ana.410110506

    authors: Sumner AJ,Saida K,Saida T,Silberberg DH,Asbury AK

    更新日期:1982-05-01 00:00:00

  • Botulism in a patient with jejunoileal bypass.

    abstract::A 45-year-old woman was diagnosed as having the unclassified form of botulism. Her intestines may have been predisposed to colonization with Clostridium botulinum because of a jejunoileal bypass procedure that had been done several years earlier. One other similar case has been reported. ...

    journal_title:Annals of neurology

    pub_type: 杂志文章

    doi:10.1002/ana.410200516

    authors: Freedman M,Armstrong RM,Killian JM,Boland D

    更新日期:1986-11-01 00:00:00

  • Electrophysiology in Guillain-Barré syndrome.

    abstract::Clinical electrophysiological studies are important in the evaluation of patients with Guillain-Barré syndrome. Physiological evidence of demyelination occurs in almost all patients with Guillain-Barré syndrome, especially if serial studies are performed. Criteria for demyelination are proposed. Prognostic information...

    journal_title:Annals of neurology

    pub_type: 杂志文章,评审

    doi:10.1002/ana.410270706

    authors: Cornblath DR

    更新日期:1990-01-01 00:00:00

  • Microinfarcts, brain atrophy, and cognitive function: the Honolulu Asia Aging Study Autopsy Study.

    abstract:OBJECTIVE:This study was untaken to investigate the association of micro brain infarcts (MBIs) with antemortem global cognitive function (CF), and whether brain weight (BW) and Alzheimer lesions (neurofibrillary tangles [NFTs] or neuritic plaques [NPs]) mediate the association. METHODS:Subjects were 436 well-character...

    journal_title:Annals of neurology

    pub_type: 杂志文章

    doi:10.1002/ana.22520

    authors: Launer LJ,Hughes TM,White LR

    更新日期:2011-11-01 00:00:00

  • Prenatal testing for late infantile neuronal ceroid lipofuscinosis.

    abstract::Classic late infantile neuronal ceroid lipofuscinosis (LINCL) is a neurodegenerative disease in which autofluorescent "curvilinear" storage bodies accumulate in tissues from affected patients. Recently, the LINCL gene (CLN2) has been found to code for a pepstatin-insensitive lysosomal protease whose activity is defici...

    journal_title:Annals of neurology

    pub_type: 杂志文章

    doi:

    authors: Berry-Kravis E,Sleat DE,Sohar I,Meyer P,Donnelly R,Lobel P

    更新日期:2000-02-01 00:00:00

  • Soluble ST2 links inflammation to outcome after subarachnoid hemorrhage.

    abstract:OBJECTIVE:To investigate whether soluble growth stimulation expressed gene 2 (sST2), a prognostic marker in cardiovascular and inflammatory disorders, is associated with neurological injury after aneurysmal subarachnoid hemorrhage (SAH). METHODS:We studied SAH patients from 2 independent cohorts. Outcome assessments i...

    journal_title:Annals of neurology

    pub_type: 杂志文章,多中心研究

    doi:10.1002/ana.25545

    authors: Bevers MB,Wolcott Z,Bache S,Hansen C,Sastre C,Mylvaganam R,Koch MJ,Patel AB,Møller K,Kimberly WT

    更新日期:2019-09-01 00:00:00

  • Depletion of corticotrophin-releasing factor neurons in the pontine micturition area in multiple system atrophy.

    abstract::We sought to determine whether the putative pontine micturition center in the human dorsal pons contains corticotrophin-releasing factor (CRF) neurons, and whether these neurons are depleted in patients with multiple system atrophy and bladder dysfunction. Brains were obtained at autopsy from 4 control subjects and 4 ...

    journal_title:Annals of neurology

    pub_type: 杂志文章

    doi:10.1002/ana.1258

    authors: Benarroch EE,Schmeichel AM

    更新日期:2001-11-01 00:00:00

  • Intranuclear inclusions in oculopharyngeal muscular dystrophy contain poly(A) binding protein 2.

    abstract::Intranuclear inclusions are one of the ultrastructural hallmarks of oculopharyngeal muscular dystrophy (OPMD), a disorder caused by small polyalanine (GCG) expansions in the gene that codes for a ubiquitous nuclear protein called poly(A) binding protein 2 (PABP2). We studied OPMD skeletal muscle and found that 1.0 to ...

    journal_title:Annals of neurology

    pub_type: 杂志文章

    doi:

    authors: Becher MW,Kotzuk JA,Davis LE,Bear DG

    更新日期:2000-11-01 00:00:00

  • Cerebral hypoperfusion and clinical onset of dementia: the Rotterdam Study.

    abstract::Cerebral blood flow (CBF) velocity is decreased in patients with Alzheimer's disease. It is being debated whether this reflects diminished demand because of advanced neurodegeneration or that cerebral hypoperfusion contributes to dementia. We examined the relation of CBF velocity as measured with transcranial Doppler ...

    journal_title:Annals of neurology

    pub_type: 杂志文章

    doi:10.1002/ana.20493

    authors: Ruitenberg A,den Heijer T,Bakker SL,van Swieten JC,Koudstaal PJ,Hofman A,Breteler MM

    更新日期:2005-06-01 00:00:00

  • Tetrabenazine has properties of a dopamine receptor antagonist.

    abstract::Tetrabenazine is considered to act in a manner similar to reserpine to reduce the involuntary movements of tardive dyskinesia or Huntington's disease and to improve psychoses. We determined that tetrabenazine also has properties of a dopamine receptor antagonist by testing the ability of tetrabenazine to block the inh...

    journal_title:Annals of neurology

    pub_type: 杂志文章

    doi:10.1002/ana.410120308

    authors: Login IS,Cronin MJ,MacLeod RM

    更新日期:1982-09-01 00:00:00

  • Comparative Effectiveness of Prestroke Aspirin on Stroke Severity and Outcome.

    abstract:OBJECTIVE:The effect of prestroke aspirin use on initial severity, hemorrhagic transformation, and functional outcome of ischemic stroke is uncertain. METHODS:Using a multicenter stroke registry database, patients with acute ischemic stroke of three subtypes (large artery atherosclerosis [LAA], small vessel occlusion ...

    journal_title:Annals of neurology

    pub_type: 杂志文章

    doi:10.1002/ana.24602

    authors: Park JM,Kang K,Cho YJ,Hong KS,Lee KB,Park TH,Lee SJ,Ko Y,Han MK,Lee J,Cha JK,Kim DH,Kim DE,Kim JT,Choi JC,Yu KH,Lee BC,Lee JS,Lee J,Gorelick PB,Bae HJ,CRCS-5 Investigators.

    更新日期:2016-04-01 00:00:00

  • Clinical features and response to treatment in Guillain-Barré syndrome associated with antibodies to GM1b ganglioside.

    abstract::GM1b is a minor ganglioside in human peripheral nerves. Serum anti-GM1b antibodies frequently are present in patients with Guillain-Barré syndrome (GBS). In this collaborative study, we investigated the antecedent infections, clinical features, and response to treatment of GBS patients with anti-GM1b antibodies. Of 13...

    journal_title:Annals of neurology

    pub_type: 杂志文章

    doi:

    authors: Yuki N,Ang CW,Koga M,Jacobs BC,van Doorn PA,Hirata K,van der Meché FG

    更新日期:2000-03-01 00:00:00

  • Duodenal and gastric delivery of levodopa in parkinsonism.

    abstract::To clarify the influence of gastric emptying on levodopa-related motor fluctuations in Parkinson's disease, we assessed mobility and plasma levodopa concentrations in 10 patients during five modes of levodopa administration: (1) standard intermittent oral (SIO), (2) intermittent duodenal (ID), (3) continuous duodenal ...

    journal_title:Annals of neurology

    pub_type: 杂志文章

    doi:10.1002/ana.410230611

    authors: Kurlan R,Nutt JG,Woodward WR,Rothfield K,Lichter D,Miller C,Carter JH,Shoulson I

    更新日期:1988-06-01 00:00:00

  • Natural History of Adult Patients with GM2 Gangliosidosis.

    abstract:OBJECTIVE:GM2 gangliosidoses are lysosomal diseases due to biallelic mutations in the HEXA (Tay-Sachs disease [TS]) or HEXB (Sandhoff disease [SD]) genes, with subsequent low hexosaminidase(s) activity. Most patients have childhood onset, but some experience the first symptoms during adolescence/adulthood. This study a...

    journal_title:Annals of neurology

    pub_type: 杂志文章

    doi:10.1002/ana.25689

    authors: Masingue M,Dufour L,Lenglet T,Saleille L,Goizet C,Ayrignac X,Ory-Magne F,Barth M,Lamari F,Mandia D,Caillaud C,Nadjar Y

    更新日期:2020-04-01 00:00:00

  • Loss-of-function mutations of SURF-1 are specifically associated with Leigh syndrome with cytochrome c oxidase deficiency.

    abstract::Mutations of SURF-1, a gene located on chromosome 9q34, have recently been identified in patients affected by Leigh syndrome (LS), associated with deficiency of cytochrome c oxidase (COX), the terminal component of the mitochondrial respiratory chain. To investigate to what extent SURF-1 is responsible for human disor...

    journal_title:Annals of neurology

    pub_type: 杂志文章

    doi:10.1002/1531-8249(199908)46:2<161::aid-ana4>3.0.co

    authors: Tiranti V,Jaksch M,Hofmann S,Galimberti C,Hoertnagel K,Lulli L,Freisinger P,Bindoff L,Gerbitz KD,Comi GP,Uziel G,Zeviani M,Meitinger T

    更新日期:1999-08-01 00:00:00

  • Quantitative cerebrospinal fluid cytology in patients receiving intracavitary chemotherapy.

    abstract::Cytological evaluation of cerebrospinal fluid (CSF) is an important means of following response to intracavitary chemotherapy for leptomeningeal malignancy. We studied the feasibility of quantitative cytological evaluation by retrospective analysis of serial CSF specimens from 7 patients receiving phase I intracavitar...

    journal_title:Annals of neurology

    pub_type: 杂志文章

    doi:10.1002/ana.410340118

    authors: Russack V,Kim S,Chamberlain MC

    更新日期:1993-07-01 00:00:00

  • Polymorphonuclear neutral protease activity in multiple sclerosis and other diseases.

    abstract::Polymorphonuclear neutral protease activity (PMN-NPA) was examined in 87 patients with definite multiple sclerosis (MS) (48 active, 39 inactive), 49 patients with other neurological diseases (OND), 24 patients with immune-mediated non-neurological diseases (INND), and 32 normal subjects. PMN-NPA was found to be signif...

    journal_title:Annals of neurology

    pub_type: 杂志文章

    doi:10.1002/ana.410180519

    authors: Guarnieri B,Lolli F,Amaducci L

    更新日期:1985-11-01 00:00:00

  • Carbamazepine-induced heart block in a child with tuberous sclerosis and cardiac rhabdomyoma: implications for evaluation and follow-up.

    abstract::We describe a young child with tuberous sclerosis and cardiac rhabdomyoma who developed reversible heart block after being placed on carbamazepine treatment for seizures. Patients of any age with known or suspected intrinsic cardiac disease should be monitored for conduction disturbance if they are treated with carbam...

    journal_title:Annals of neurology

    pub_type: 杂志文章

    doi:10.1002/ana.410340417

    authors: Weig SG,Pollack P

    更新日期:1993-10-01 00:00:00

  • Benzodiazepine receptors and diazepam-binding inhibitor in human cerebral tumors.

    abstract::Benzodiazepines can regulate neoplastic growth and immune response through specific peripheral benzodiazepine receptors. We investigated the presence of peripheral and classic central benzodiazepine receptors as well as diazepam-binding inhibitor, an endogenous ligand of both types of receptors, in different human cer...

    journal_title:Annals of neurology

    pub_type: 杂志文章

    doi:10.1002/ana.410260411

    authors: Ferrarese C,Appollonio I,Frigo M,Gaini SM,Piolti R,Frattola L

    更新日期:1989-10-01 00:00:00

  • Phenobarbital modifies seizure-related brain injury in the developing brain.

    abstract::To investigate the potential role of drug therapy in preventing or exacerbating seizure-related brain injury in the prepubescent brain, we administered kainic acid to rats at postnatal day 35. Therapy with daily phenobarbital was started directly before or 1 day after kainic acid was administered, and was continued th...

    journal_title:Annals of neurology

    pub_type: 杂志文章

    doi:10.1002/ana.410360314

    authors: Mikati MA,Holmes GL,Chronopoulos A,Hyde P,Thurber S,Gatt A,Liu Z,Werner S,Stafstrom CE

    更新日期:1994-09-01 00:00:00

  • Successful treatment with tocainide of recessive generalized congenital myotonia.

    abstract::A patient with recessive generalized congenital myotonia and severe, disabling weakness underwent various forms of treatment while being monitored electrophysiologically. Phenytoin, verapamil, and acetazolamide were ineffective, but tocainide yielded good results. Improvement was dose-dependent, and was limited by irr...

    journal_title:Annals of neurology

    pub_type: 杂志文章

    doi:10.1002/ana.410190515

    authors: Streib EW

    更新日期:1986-05-01 00:00:00

  • Spreading depolarizations trigger caveolin-1-dependent endothelial transcytosis.

    abstract:OBJECTIVE:Cortical spreading depolarizations (CSDs) are intense and ubiquitous depolarization waves relevant for the pathophysiology of migraine and brain injury. CSDs disrupt the blood-brain barrier (BBB), but the mechanisms are unknown. METHODS:A total of six CSDs were evoked over 1 hour by topical application of 30...

    journal_title:Annals of neurology

    pub_type: 杂志文章

    doi:10.1002/ana.25298

    authors: Sadeghian H,Lacoste B,Qin T,Toussay X,Rosa R,Oka F,Chung DY,Takizawa T,Gu C,Ayata C

    更新日期:2018-09-01 00:00:00

  • Protein modification by the lipid peroxidation product 4-hydroxynonenal in the spinal cords of amyotrophic lateral sclerosis patients.

    abstract::We report increased modification of proteins by 4-hydroxynonenal (HNE), a product of membrane lipid peroxidation, in the lumbar spinal cord of sporadic amyotrophic lateral sclerosis (ALS) patients versus that of neurologically normal controls. By immunohistochemistry, HNE-protein modification was detected in ventral h...

    journal_title:Annals of neurology

    pub_type: 杂志文章

    doi:10.1002/ana.410440518

    authors: Pedersen WA,Fu W,Keller JN,Markesbery WR,Appel S,Smith RG,Kasarskis E,Mattson MP

    更新日期:1998-11-01 00:00:00

  • Epidemiology of mutations in superoxide dismutase in amyotrophic lateral sclerosis.

    abstract::We registered 366 families in a study of dominantly inherited amyotrophic lateral sclerosis. Two hundred ninety families were screened for mutations in the gene encoding copper-zinc cytosolic superoxide dismutase (SOD1). Mutations were detected in 68 families. The most common SOD1 mutation is an alanine for valine sub...

    journal_title:Annals of neurology

    pub_type: 杂志文章

    doi:10.1002/ana.410410212

    authors: Cudkowicz ME,McKenna-Yasek D,Sapp PE,Chin W,Geller B,Hayden DL,Schoenfeld DA,Hosler BA,Horvitz HR,Brown RH

    更新日期:1997-02-01 00:00:00