Skip to main content
Erschienen in: Current Neurology and Neuroscience Reports 11/2022

10.10.2022 | Stroke (B. Ovbiagele, Section Editor)

Pre-diabetes, Diabetes, Hyperglycemia, and Stroke: Bittersweet Therapeutic Opportunities

verfasst von: Askiel Bruno

Erschienen in: Current Neurology and Neuroscience Reports | Ausgabe 11/2022

Einloggen, um Zugang zu erhalten

Abstract

Purposeof Review

Diabetes mellitus (DM) causes systemic vascular complications. Chronic hyperglycemia is a hallmark of DM and appears to be at least partially responsible for the vascular complications. In addition, hyperglycemia during acute tissue injury has been postulated to augment the injury. This review addresses the potential therapeutic benefits related to ischemic stroke from lowering hyperglycemia in two settings, in chronic hyperglycemia and during acute ischemic stroke.

Recent Findings

A recent efficacy trial to lower hyperglycemia during acute ischemic stroke showed no significant benefit overall as well as in patient subgroups. This finding helps to establish good clinical practice protocols for patients with acute ischemic stroke and hyperglycemia.

Summary

Hyperglycemia appears to be a key mediator of the systemic vascular complications of DM. Despite current lack of evidence that lowering hyperglycemia during acute ischemic stroke improves functional outcome, unanswered questions remain in specific acute ischemic stroke settings that warrant additional research.
Literatur
2.
Zurück zum Zitat Sarwar N, Gao P, KondapallySeshasai SR, Gobin R, Kaptoge S, Di Angelantonio E, et al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet. 2010;375(9733):2215–22.CrossRefPubMed Sarwar N, Gao P, KondapallySeshasai SR, Gobin R, Kaptoge S, Di Angelantonio E, et al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet. 2010;375(9733):2215–22.CrossRefPubMed
3.
Zurück zum Zitat Mitsios JP, Ekinci EI, Mitsios GP, Churilov L, Thijs V. Relationship between glycated hemoglobin and stroke risk: a systematic review and meta-analysis. J Am Heart Assoc. 2018;7(11):007858.CrossRef Mitsios JP, Ekinci EI, Mitsios GP, Churilov L, Thijs V. Relationship between glycated hemoglobin and stroke risk: a systematic review and meta-analysis. J Am Heart Assoc. 2018;7(11):007858.CrossRef
4.
Zurück zum Zitat Luitse MJA, Biessels GJ, Rutten GEHM, Kappelle LJ. Diabetes, hyperglycaemia, and acute ischaemic stroke. Lancet Neurol. 2012;11:261–71.CrossRefPubMed Luitse MJA, Biessels GJ, Rutten GEHM, Kappelle LJ. Diabetes, hyperglycaemia, and acute ischaemic stroke. Lancet Neurol. 2012;11:261–71.CrossRefPubMed
5.
Zurück zum Zitat Lau LH, Lew J, Borschmann K, Thijs V, Ekinci EI. Prevalence of diabetes and its effects on stroke outcomes: a meta-analysis and literature review. J Diabetes Investig. 2019;10(3):780–92.CrossRefPubMed Lau LH, Lew J, Borschmann K, Thijs V, Ekinci EI. Prevalence of diabetes and its effects on stroke outcomes: a meta-analysis and literature review. J Diabetes Investig. 2019;10(3):780–92.CrossRefPubMed
6.
Zurück zum Zitat Ntaios G, Papavasileiou V, Bargiota A, Makaritsis K, Michel P. Intravenous insulin treatment in acute stroke: a systematic review and meta-analysis of randomized controlled trials. Int J Stroke. 2014;9(4):489–93.CrossRefPubMed Ntaios G, Papavasileiou V, Bargiota A, Makaritsis K, Michel P. Intravenous insulin treatment in acute stroke: a systematic review and meta-analysis of randomized controlled trials. Int J Stroke. 2014;9(4):489–93.CrossRefPubMed
7.
Zurück zum Zitat • Cai X, Zhang Y, Li M, Wu JHY, Mai L, Li J, et al. Association between prediabetes and risk of all cause mortality and cardiovascular disease: updated meta-analysis. BMJ. 2020;370:848–9. This report summarizes the major vascular complications associated with prediabetes. • Cai X, Zhang Y, Li M, Wu JHY, Mai L, Li J, et al. Association between prediabetes and risk of all cause mortality and cardiovascular disease: updated meta-analysis. BMJ. 2020;370:848–9. This report summarizes the major vascular complications associated with prediabetes.
8.
Zurück zum Zitat Spence JD, Viscoli CM, Inzucchi SE, Dearborn-Tomazos J, Ford GA, Gorman M, et al. Pioglitazone therapy in patients with stroke and prediabetes: a post hoc analysis of the IRIS randomized clinical trial. JAMA Neurol. 2019;76(5):526–35.CrossRefPubMedPubMedCentral Spence JD, Viscoli CM, Inzucchi SE, Dearborn-Tomazos J, Ford GA, Gorman M, et al. Pioglitazone therapy in patients with stroke and prediabetes: a post hoc analysis of the IRIS randomized clinical trial. JAMA Neurol. 2019;76(5):526–35.CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Ago T, Matsuo R, Hata J, Wakisaka Y, Kuroda J, Kitazono T, et al. Insulin resistance and clinical outcomes after acute ischemic stroke. Neurology. 2018;90(17):E1470–7.CrossRefPubMed Ago T, Matsuo R, Hata J, Wakisaka Y, Kuroda J, Kitazono T, et al. Insulin resistance and clinical outcomes after acute ischemic stroke. Neurology. 2018;90(17):E1470–7.CrossRefPubMed
10.
Zurück zum Zitat Zhou M, Pan Y, Jing J, Wang Y, Zhao X, Liu L, et al. Association between β-cell function estimated by HOMA-β and prognosis of non-diabetic patients with ischaemic stroke. Eur J Neurol. 2018;25(3):549–55.CrossRefPubMed Zhou M, Pan Y, Jing J, Wang Y, Zhao X, Liu L, et al. Association between β-cell function estimated by HOMA-β and prognosis of non-diabetic patients with ischaemic stroke. Eur J Neurol. 2018;25(3):549–55.CrossRefPubMed
11.
Zurück zum Zitat • Pan Y, Chen W, Wang Y. Prediabetes and outcome of ischemic stroke or transient ischemic attack a systematic review and meta-analysis. J Stroke Cerebrovasc Dis. 2019;28(3):683–92. This report summarizes the functional outcomes after cerebral ischemic events associated with prediabetes. • Pan Y, Chen W, Wang Y. Prediabetes and outcome of ischemic stroke or transient ischemic attack a systematic review and meta-analysis. J Stroke Cerebrovasc Dis. 2019;28(3):683–92. This report summarizes the functional outcomes after cerebral ischemic events associated with prediabetes.
12.
Zurück zum Zitat Mannucci E, Monami M, Lamanna C, Gori F, Marchionni N. Prevention of cardiovascular disease through glycemic control in type 2 diabetes: a meta-analysis of randomized clinical trials. Nutr Metab Cardiovasc Dis. 2009;19(9):604–12.CrossRefPubMed Mannucci E, Monami M, Lamanna C, Gori F, Marchionni N. Prevention of cardiovascular disease through glycemic control in type 2 diabetes: a meta-analysis of randomized clinical trials. Nutr Metab Cardiovasc Dis. 2009;19(9):604–12.CrossRefPubMed
13.
Zurück zum Zitat Ma J, Yang W, Fang N, Zhu W, Wei M. The association between intensive glycemic control and vascular complications in type 2 diabetes mellitus: a meta-analysis. Nutr Metab Cardiovasc Dis. 2009;19(9):596–603.CrossRefPubMed Ma J, Yang W, Fang N, Zhu W, Wei M. The association between intensive glycemic control and vascular complications in type 2 diabetes mellitus: a meta-analysis. Nutr Metab Cardiovasc Dis. 2009;19(9):596–603.CrossRefPubMed
14.
Zurück zum Zitat Despa F, Goldstein LB. Amylin dyshomeostasis hypothesis: small vessel-type ischemic stroke in the setting of type-2 diabetes. Stroke. 2021;52:E244–9.CrossRefPubMedPubMedCentral Despa F, Goldstein LB. Amylin dyshomeostasis hypothesis: small vessel-type ischemic stroke in the setting of type-2 diabetes. Stroke. 2021;52:E244–9.CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Desilles JP, Meseguer E, Labreuche J, Lapergue B, Sirimarco G, Gonzalez-Valcarcel J, et al. Diabetes mellitus, admission glucose, and outcomes after stroke thrombolysis: a registry and systematic review. Stroke. 2013;44:1915–23.CrossRefPubMed Desilles JP, Meseguer E, Labreuche J, Lapergue B, Sirimarco G, Gonzalez-Valcarcel J, et al. Diabetes mellitus, admission glucose, and outcomes after stroke thrombolysis: a registry and systematic review. Stroke. 2013;44:1915–23.CrossRefPubMed
16.
Zurück zum Zitat Baird TA, Parsons MW, Phanh T, Butcher KS, Desmond PM, Tress BM, et al. Persistent poststroke hyperglycemia is independently associated with infarct expansion and worse clinical outcome. Stroke. 2003;34(9):2208–14.CrossRefPubMed Baird TA, Parsons MW, Phanh T, Butcher KS, Desmond PM, Tress BM, et al. Persistent poststroke hyperglycemia is independently associated with infarct expansion and worse clinical outcome. Stroke. 2003;34(9):2208–14.CrossRefPubMed
17.
Zurück zum Zitat Kruyt ND, Biessels GJ, Devries JH, Roos YB. Hyperglycemia in acute ischemic stroke: pathophysiology and clinical management. Nat Rev Neurol Nat Pub Group. 2010;6:145–55.CrossRef Kruyt ND, Biessels GJ, Devries JH, Roos YB. Hyperglycemia in acute ischemic stroke: pathophysiology and clinical management. Nat Rev Neurol Nat Pub Group. 2010;6:145–55.CrossRef
18.
Zurück zum Zitat Garg R, Chaudhuri A, Munschauer F, Dandona P. Hyperglycemia, insulin, and acute ischemic stroke: a mechanistic justification for a trial of insulin infusion therapy. Stroke. 2006;37:267–73.CrossRefPubMed Garg R, Chaudhuri A, Munschauer F, Dandona P. Hyperglycemia, insulin, and acute ischemic stroke: a mechanistic justification for a trial of insulin infusion therapy. Stroke. 2006;37:267–73.CrossRefPubMed
19.
Zurück zum Zitat Suh SW, Shin BS, Ma H, Van Hoecke M, Brennan AM, Yenari MA, et al. Glucose and NADPH oxidase drive neuronal superoxide formation in stroke. Ann Neurol. 2008;64(6):654–63.CrossRefPubMedPubMedCentral Suh SW, Shin BS, Ma H, Van Hoecke M, Brennan AM, Yenari MA, et al. Glucose and NADPH oxidase drive neuronal superoxide formation in stroke. Ann Neurol. 2008;64(6):654–63.CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Rosso C, Pires C, Corvol JC, Baronnet F, Crozier S, Leger A, et al. Hyperglycaemia, insulin therapy and critical penumbral regions for prognosis in acute stroke: further insights from the INSULINFARCT trial. PLoS ONE. 2015;10(3): e0120230.CrossRefPubMedPubMedCentral Rosso C, Pires C, Corvol JC, Baronnet F, Crozier S, Leger A, et al. Hyperglycaemia, insulin therapy and critical penumbral regions for prognosis in acute stroke: further insights from the INSULINFARCT trial. PLoS ONE. 2015;10(3): e0120230.CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Ribo M, Molina C, Montaner J, Rubiera M, Delgado-Mederos R, Arenillas JF, et al. Acute hyperglycemia state is associated with lower tPA-induced recanalization rates in stroke patients. Stroke. 2005;36(8):1705–9.CrossRefPubMed Ribo M, Molina C, Montaner J, Rubiera M, Delgado-Mederos R, Arenillas JF, et al. Acute hyperglycemia state is associated with lower tPA-induced recanalization rates in stroke patients. Stroke. 2005;36(8):1705–9.CrossRefPubMed
22.
Zurück zum Zitat Saqqur M, Shuaib A, Alexandrov AV, Sebastian J, Khan K, Uchino K. The correlation between admission blood glucose and intravenous rt-PA-induced arterial recanalization in acute ischemic stroke: a multi-centre TCD study. Int J Stroke. 2015;10(7):1087–92.CrossRefPubMed Saqqur M, Shuaib A, Alexandrov AV, Sebastian J, Khan K, Uchino K. The correlation between admission blood glucose and intravenous rt-PA-induced arterial recanalization in acute ischemic stroke: a multi-centre TCD study. Int J Stroke. 2015;10(7):1087–92.CrossRefPubMed
23.
Zurück zum Zitat Ahmed N, Dávalos A, Eriksson N, Ford GA, Glahn J, Hennerici M, et al. Association of admission blood glucose and outcome in patients treated with intravenous thrombolysis: results from the Safe Implementation of Treatments in Stroke International Stroke Thrombolysis Register (SITS-ISTR). Arch Neurol. 2010;67(9):1123–30.CrossRefPubMed Ahmed N, Dávalos A, Eriksson N, Ford GA, Glahn J, Hennerici M, et al. Association of admission blood glucose and outcome in patients treated with intravenous thrombolysis: results from the Safe Implementation of Treatments in Stroke International Stroke Thrombolysis Register (SITS-ISTR). Arch Neurol. 2010;67(9):1123–30.CrossRefPubMed
24.
Zurück zum Zitat Masrur S, Cox M, Bhatt DL, Smith EE, Ellrodt G, Fonarow GC, et al. Association of acute and chronic hyperglycemia with acute ischemic stroke outcomes post-thrombolysis: findings from get with the guidelines-stroke. J Am Heart Assoc. 2015;4(10):e002193.CrossRefPubMedPubMedCentral Masrur S, Cox M, Bhatt DL, Smith EE, Ellrodt G, Fonarow GC, et al. Association of acute and chronic hyperglycemia with acute ischemic stroke outcomes post-thrombolysis: findings from get with the guidelines-stroke. J Am Heart Assoc. 2015;4(10):e002193.CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Rocco A, Heuschmann PU, Schellinger PD, Köhrmann M, Diedler J, Sykora M, et al. Glycosylated hemoglobin a1 predicts risk for symptomatic hemorrhage after thrombolysis for acute stroke. Stroke. 2013;44(8):2134–8.CrossRefPubMed Rocco A, Heuschmann PU, Schellinger PD, Köhrmann M, Diedler J, Sykora M, et al. Glycosylated hemoglobin a1 predicts risk for symptomatic hemorrhage after thrombolysis for acute stroke. Stroke. 2013;44(8):2134–8.CrossRefPubMed
26.
Zurück zum Zitat Bruno A, Biller J, Adams HP Jr, Clarke WR, Woolson RF, Williams LS, et al. Acute blood glucose level and outcome from ischemic stroke. Neurology. 1999;52(2):280–4. Bruno A, Biller J, Adams HP Jr, Clarke WR, Woolson RF, Williams LS, et al. Acute blood glucose level and outcome from ischemic stroke. Neurology. 1999;52(2):280–4.
27.
Zurück zum Zitat • Zang L, Zhang D, Yao Y, Wang Y. Symptomatic intracranial hemorrhage in patients with admission hyperglycemia and diabetes after mechanical thrombectomy: a systematic review and meta-analysis. Am J Emerg Med WB Saunders. 2021;45:23–8. This report summarizes the risk of symptomatic hemorrhagic transformation of acute brain infarcts after mechanical thrombectomy in relation to hyperglycemia. • Zang L, Zhang D, Yao Y, Wang Y. Symptomatic intracranial hemorrhage in patients with admission hyperglycemia and diabetes after mechanical thrombectomy: a systematic review and meta-analysis. Am J Emerg Med WB Saunders. 2021;45:23–8. This report summarizes the risk of symptomatic hemorrhagic transformation of acute brain infarcts after mechanical thrombectomy in relation to hyperglycemia.
28.
Zurück zum Zitat • Perez-Vega C, Domingo RA, Tripathi S, Ramos-Fresnedo A, Kashyap S, Quinones-Hinojosa A, et al. Influence of glucose levels on clinical outcome after mechanical thrombectomy for large-vessel occlusion: a systematic review and meta-analysis. J Neurointerv Surg. 2022;14:17–21. This report sumamrizes the functional outcomes after mechanical thrombectomy for acute stroke in relation to hyperglycemia. • Perez-Vega C, Domingo RA, Tripathi S, Ramos-Fresnedo A, Kashyap S, Quinones-Hinojosa A, et al. Influence of glucose levels on clinical outcome after mechanical thrombectomy for large-vessel occlusion: a systematic review and meta-analysis. J Neurointerv Surg. 2022;14:17–21. This report sumamrizes the functional outcomes after mechanical thrombectomy for acute stroke in relation to hyperglycemia.
29.
Zurück zum Zitat Wu MY, Yiang GT, Liao WT, Tsai APY, Cheng YL, Cheng PW, et al. Current mechanistic concepts in ischemia and reperfusion injury. Cell Physiol Biochem. 2018;46:1650–67.CrossRefPubMed Wu MY, Yiang GT, Liao WT, Tsai APY, Cheng YL, Cheng PW, et al. Current mechanistic concepts in ischemia and reperfusion injury. Cell Physiol Biochem. 2018;46:1650–67.CrossRefPubMed
30.
Zurück zum Zitat Bruno A, Kent TA, Coull BM, Shankar RR, Saha C, Becker KJ, et al. Treatment of hyperglycemia in ischemic stroke (THIS): a randomized pilot trial. Stroke. 2008;39(2):384–9.CrossRefPubMed Bruno A, Kent TA, Coull BM, Shankar RR, Saha C, Becker KJ, et al. Treatment of hyperglycemia in ischemic stroke (THIS): a randomized pilot trial. Stroke. 2008;39(2):384–9.CrossRefPubMed
31.
Zurück zum Zitat Johnston KC, Hall CE, Kissela BM, Bleck TP, Conaway MR. Glucose regulation in acute stroke patients (GRASP) trial: a randomized pilot trial. Stroke. 2009;40(12):3804–9. Johnston KC, Hall CE, Kissela BM, Bleck TP, Conaway MR. Glucose regulation in acute stroke patients (GRASP) trial: a randomized pilot trial. Stroke. 2009;40(12):3804–9.
32.
Zurück zum Zitat Gray CS, Hildreth AJ, Sandercock PA, O’Connell JE, Johnston DE, Cartlidge NE, et al. Glucose-potassium-insulin infusions in the management of post-stroke hyperglycaemia: the UK glucose insulin in stroke trial (GIST-UK). Lancet Neurol. 2007;6(5):397–406.CrossRefPubMed Gray CS, Hildreth AJ, Sandercock PA, O’Connell JE, Johnston DE, Cartlidge NE, et al. Glucose-potassium-insulin infusions in the management of post-stroke hyperglycaemia: the UK glucose insulin in stroke trial (GIST-UK). Lancet Neurol. 2007;6(5):397–406.CrossRefPubMed
33.
Zurück zum Zitat •• Johnston KC, Bruno A, Pauls Q, Hall CE, Barrett KM, Barsan W, et al. Intensive vs standard treatment of hyperglycemia and functional outcome in patients with acute ischemic stroke: the SHINE randomized clinical trial. JAMA - J Am Med Assoc. 2019;322(4):326–35. This is the latest efficacy trial of intensive hyperglycemia lowering during acute ischemic stroke. •• Johnston KC, Bruno A, Pauls Q, Hall CE, Barrett KM, Barsan W, et al. Intensive vs standard treatment of hyperglycemia and functional outcome in patients with acute ischemic stroke: the SHINE randomized clinical trial. JAMA - J Am Med Assoc. 2019;322(4):326–35. This is the latest efficacy trial of intensive hyperglycemia lowering during acute ischemic stroke.
34.
Zurück zum Zitat • Torbey MT, Pauls Q, Gentile N, Falciglia M, Meurer W, Pettigrew CL, et al. Intensive versus standard treatment of hyperglycemia in acute ischemic stroke patient: a randomized clinical trial subgroups analysis. Stroke. 2022;53(5):1510–5. This post hoc analysis of the SHINE efficacy trial focuses on patient subgroups with glycemic parameters of special interest.CrossRefPubMedPubMedCentral • Torbey MT, Pauls Q, Gentile N, Falciglia M, Meurer W, Pettigrew CL, et al. Intensive versus standard treatment of hyperglycemia in acute ischemic stroke patient: a randomized clinical trial subgroups analysis. Stroke. 2022;53(5):1510–5. This post hoc analysis of the SHINE efficacy trial focuses on patient subgroups with glycemic parameters of special interest.CrossRefPubMedPubMedCentral
35.
Zurück zum Zitat Quast MJ, Wei J, Huang NC, Brunder DG, Sell SL, Gonzalez JM, et al. Perfusion deficit parallels exacerbation of cerebral ischemia/reperfusion injury in hyperglycemic rats. J Cereb Blood Flow Metab. 1997;17(5):553–9.CrossRefPubMed Quast MJ, Wei J, Huang NC, Brunder DG, Sell SL, Gonzalez JM, et al. Perfusion deficit parallels exacerbation of cerebral ischemia/reperfusion injury in hyperglycemic rats. J Cereb Blood Flow Metab. 1997;17(5):553–9.CrossRefPubMed
36.
Zurück zum Zitat Liu L, Wang Z, Wang X, Song L, Chen H, Bémeur C, et al. Comparison of two rat models of cerebral ischemia under hyperglycemic conditions. Microsurg Wiley-Liss, Inc Microsurg. 2007;27(4):258–62. Liu L, Wang Z, Wang X, Song L, Chen H, Bémeur C, et al. Comparison of two rat models of cerebral ischemia under hyperglycemic conditions. Microsurg Wiley-Liss, Inc Microsurg. 2007;27(4):258–62.
37.
Zurück zum Zitat Kim JT, Jahan R, Saver JL. Impact of glucose on outcomes in patients treated with mechanical thrombectomy: a post hoc analysis of the solitaire flow restoration with the intention for thrombectomy study. Stroke. 2016;47(1):120–7.CrossRefPubMed Kim JT, Jahan R, Saver JL. Impact of glucose on outcomes in patients treated with mechanical thrombectomy: a post hoc analysis of the solitaire flow restoration with the intention for thrombectomy study. Stroke. 2016;47(1):120–7.CrossRefPubMed
38.
Zurück zum Zitat Lee SJ, Hwang YH, Hong JM, Choi JW, Yoon BS, Kang DH, et al. Impact of varying levels of hyperglycemia on clinicoradiographic outcomes after endovascular reperfusion treatment. Sci Rep. 2018;8(1):1–9. Lee SJ, Hwang YH, Hong JM, Choi JW, Yoon BS, Kang DH, et al. Impact of varying levels of hyperglycemia on clinicoradiographic outcomes after endovascular reperfusion treatment. Sci Rep. 2018;8(1):1–9.
39.
Zurück zum Zitat Rinkel LA, Nguyen TTM, Guglielmi V, Groot AE, Posthuma L, Roos YBWEM, et al. High admission glucose is associated with poor outcome after endovascular treatment for ischemic stroke. Stroke. 2020;51:3215–23.CrossRefPubMed Rinkel LA, Nguyen TTM, Guglielmi V, Groot AE, Posthuma L, Roos YBWEM, et al. High admission glucose is associated with poor outcome after endovascular treatment for ischemic stroke. Stroke. 2020;51:3215–23.CrossRefPubMed
40.
Zurück zum Zitat Rha JH, Saver JL. The impact of recanalization on ischemic stroke outcome: a meta-analysis. Stroke. 2007;38(3):967–73.CrossRefPubMed Rha JH, Saver JL. The impact of recanalization on ischemic stroke outcome: a meta-analysis. Stroke. 2007;38(3):967–73.CrossRefPubMed
Metadaten
Titel
Pre-diabetes, Diabetes, Hyperglycemia, and Stroke: Bittersweet Therapeutic Opportunities
verfasst von
Askiel Bruno
Publikationsdatum
10.10.2022
Verlag
Springer US
Erschienen in
Current Neurology and Neuroscience Reports / Ausgabe 11/2022
Print ISSN: 1528-4042
Elektronische ISSN: 1534-6293
DOI
https://doi.org/10.1007/s11910-022-01236-0

Weitere Artikel der Ausgabe 11/2022

Current Neurology and Neuroscience Reports 11/2022 Zur Ausgabe

Dementia (K.S. Marder, Section Editor)

Vascular Considerations for Amyloid Immunotherapy

Demyelinating Disorders (J. Bernard and M. Cameron, Section Editors)

Bruton’s Tyrosine Kinase Inhibition in Multiple Sclerosis

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Frühe Alzheimertherapie lohnt sich

25.04.2024 AAN-Jahrestagung 2024 Nachrichten

Ist die Tau-Last noch gering, scheint der Vorteil von Lecanemab besonders groß zu sein. Und beginnen Erkrankte verzögert mit der Behandlung, erreichen sie nicht mehr die kognitive Leistung wie bei einem früheren Start. Darauf deuten neue Analysen der Phase-3-Studie Clarity AD.

Viel Bewegung in der Parkinsonforschung

25.04.2024 Parkinson-Krankheit Nachrichten

Neue arznei- und zellbasierte Ansätze, Frühdiagnose mit Bewegungssensoren, Rückenmarkstimulation gegen Gehblockaden – in der Parkinsonforschung tut sich einiges. Auf dem Deutschen Parkinsonkongress ging es auch viel um technische Innovationen.

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.