Abstracts / Journal of the Neurological Sciences 405S (2019) 116541
Parametric survival analysis is one of the survival analysis that
has a distribution of survival data that follows a certain distribution.
Weibull distribution is a distribution that is often used in parametric
survival analysis. The purpose of this study is to determine
parametric survival models using the Weibull distribution and to
determine the factors that can influence the recovery of stroke
patients. This study uses data on stroke patients in the Sultan Daeng
Raja Hospital, Bulukumba, Sulawesi Selatan, Indonesia in 2018. The
best model obtained in this study is a model that consists of two
predictor variables, namely the age and the body mass index (BMI).
Therefore the factors that can influence the recovery of stroke
patients are age and BMI.
doi:10.1016/j.jns.2019.10.684
WCN19-1759
Journal of the Neurological Sciences 405S (2019) 104347
Poster Session 1
The complex approach to the rehabilitation of patients with
motor deficit in the early recovery period of ischemic stroke
F. Devlikamovaa, F. Khabirova, T. Khaibullina, E. Granatovb
a
Kazan State Medical Academy, Department of Neurology, Kazan, Russia
b
Republican Clinical Neurological Center, Department of Neurophysiol-
ogy, Kazan, Russia
We aimed to evaluate the efficacy of complex rehabilitation:
kinesiotherapy, navigation TCMS (nTCMC), and Cerebrolysin (neu-
ropeptide preparation drug proved to contain fragments of neuro-
trophic factors), in patients with ischemic stroke (IS).
110 patients (34–71 years) with IS and motor deficit (at least 2
points on motor functions of the NIHSS) were randomized into 4
groups (G): G1 (n = 33) only kinesiotherapy (PNF, 1 session/day, 14
days); G2 (n = 32) kinesiotherapy and cerebrolysin (20.0 ml IV
daily, 14 days); G3 (n = 25) kinesiotherapy and nTCMS (precentral
gyrus, 5 Hz, 5 sec., 20 sec. rest, 500 pulses, 1 session/day, 14 days);
G4 (n = 20) kinesiotherapy, cerebrolysin, nTCMS. Indicators (EEG,
STREAM, Bartel Index) were evaluated at the beginning of treatment
and after 6 months.
The nonparametric Kruskal-Wallis ANOVA statistics showed most
pronounced recovery in G4 (p b0.05): STREAMS (Me [LQ; UQ] - 17
[12,5; 22], 19 [14; 24], 23 [18; 25,5], 29 [26; 31] points in G1-4) and
the Bartel Index (Me [LQ; UQ] - 75 [60; 80], 75 [65; 80], 80 [70; 85],
90 [85; 95] points in G1-4). Most pronounced decrease in the
spectral power of the delta rhythm and the increase in the spectral
power of the alpha rhythm in the affected hemisphere were
observed in G4 (391, 355, 394, 234 and 101, 111, 96, 131 μV2/ Hz
in G1-4 (p b0.05).
The complex combination therapy including kinesiotherapy, nTCMS,
and cerebrolysin proved to be most effective in restoring motor
disorders and normalizing the functional state of the brain
doi:10.1016/j.jns.2019.10.685
131
WCN19-1766
Journal of the Neurological Sciences 405S (2019) 104348
Poster Session 1
High frequency RTMS on cortical reorganization of chronic stroke
N. Kuthiala, P. Srivastava MV, R. Sharma, S. Sharma
All India Institute of Medical Sciences, Neurology, New Delhi, India
Background
The purpose of the study was to investigate the effect of
high frequency rTMS with Rehabilitation on cortical reorgani-
zation of chronic stroke patients with upper extremity motor
deficits. fMRI as a technique provides a window into functional
activity in multiple brain areas, and has good accessibility,
safety, and spatial resolution. The evidence of cortical reorga-
nization was used to assess in response to intensive physio-
therapy treatment with rTMS using blood oxygenation-level
dependent (BOLD)
Methodology
This study is a RCT. This included (N=60) chronic stroke
patients from 3 to 18 months of index event. Patients were
randomized to CIMT alone (Group A n=30) & rTMS with CIMT
(Group B n=30). rTMS (10 Hz, 750 pulses with 110%RMT) was
administered for 3 weeks (5days/week). Radiological Assessment
of the patients was done with fMRI (BOLD) along with assessment
of Fugl Meyer (FM), Barthel Index, and modified Rankin Scales, at
baseline, 15th & 90th day
Results
The mean FMA score at baseline, 15th and 90th day in Group A
was 34.53+6.02, 42.47+6.1, 42.50+6.0 in comparison to Group B
34.07+6.4, 51.47+7.7&52.07+7.6 showing the significant im-
provement (pb.000) in Group B. there was no statistical significant
improvement seen in other two scales. The BOLD cluster activation
was compared between two groups.
Conclusion
Alterations in cortical activations (fMRI-BOLD) was observed after
intensive rehabilitation with rTMS (Group B) in patients with
chronic stroke. Activation and functional changes in fMRI and TMS
correlated significantly with the degree of clinical improvement in
upper extremity function.
doi:10.1016/j.jns.2019.10.686
WCN19-1777
Journal of the Neurological Sciences 405S (2019) 104349
Poster Session 1
‘Prehospital’ delay in acute stroke reperfusion therapy in Delhi:
Time for introspection