Remote Ischemic Conditioning May Improve Disability and Cognition After Acute Ischemic Stroke: A Pilot Randomized Clinical Trial.
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In this article, a double-blind randomized controlled trial was conducted to explore the efficiency and safety of remote ischemic conditioning (RICA) in patients with acute ischemi stroke.Abstract:
Background and Aim: Remote ischemic conditioning is a procedure purported to reduce the ischemic injury of an organ. This study aimed to explore the efficiency and safety of remote ischemic conditioning in patients with acute ischemic stroke. We hypothesized that remote ischemic conditioning administered from the first day of hospital admission would improve the infarct volume and clinical outcome at 180 days. Material and Methods: We performed a unicentric double-blind randomized controlled trial. We included all patients consecutively admitted to an Emergency Neurology Department with acute ischemic stroke, ineligible for reperfusion treatment, up to 24 hours from onset. All subjects were assigned to receive secondary stroke prevention treatment along with remote ischemic conditioning on the non-paretic upper limb during the first 5 days of hospitalization, twice daily - a blood pressure cuff placed around the arm was inflated to 20 mmHg above the systolic blood pressure (up to 180 mmHg) in the experimental group and 30 mmHg in the sham group. The primary outcome was the difference in infarct volume (measured on brain CT scan) at 180 days compared to baseline, whereas the secondary outcomes included differences in clinical scores (NIHSS, mRS, IADL, ADL) and cognitive/mood changes (MoCA, PHQ-9) at 180 days compared to baseline. Results: We enrolled 40 patients; the mean age was 65 years and 60% were men. Subjects in the interventional group had slightly better recovery in terms of disability, as demonstrated by the differences in disability scores between admission and 6 months (e.g., the median difference score for Barthel was -10 in the sham group and -17.5 in the interventional group, for ADL -2 in the sham group and -2.5 in the interventional group), as well as cognitive performance (the median difference score for MoCA was -2 in the sham group and -3 in the interventional group), but none of these differences reached statistical significance. The severity of symptoms (median difference score for NIHSS = 5 for both groups) and depression rate (median difference score for PHQ-9 = 0 for both groups) were similar in the two groups. The median difference between baseline infarct volume and final infarct volume at 6 months was slightly larger in the sham group compared to the interventional group (p = 0.4), probably due to an initial larger infarct volume in the former. Conclusion: Our results suggest that remote ischemic conditioning might improve disability and cognition. The difference between baseline infarct volume and final infarct volume at 180 days was slightly larger in the sham group.read more
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Journal ArticleDOI
Effect of Remote Ischemic Conditioning vs Usual Care on Neurologic Function in Patients With Acute Moderate Ischemic Stroke: The RICAMIS Randomized Clinical Trial.
Hui-sheng Chen,Yu Cui,Xiao-Qiu Li,Xin-Hong Wang,Yupeng Ma,Yong Zhao,Jing Han,Changlei Deng,Mei Hong,Ying-Cun Bao,Li-Hong Zhao,Ting-Guang Yan,Ren-Lin Zou,Hui Wang,Zhuo Li,Lianbu Wan,Li Zhang,Lian-Qiang Wang,Li-yan Guo,Ming-Nan Li,Dong Wang,Qiang Zhang,Dah-Wei Chang,Hong-li Zhang,Jing Sun,Chong Meng,Zailiang Zhang,Li-Ying Shen,Li Ma,Guixue Wang,Runhui Li,Bing Zhang,Cheng Bi,Liying Wang,Duolao Wang +34 more
TL;DR: Among adults with acute moderate isChemic stroke, treatment with remote ischemic conditioning compared with usual care significantly increased the likelihood of excellent neurologic function at 90 days, but these findings require replication in another trial before concluding efficacy for this intervention.
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Cerebral protection by remote ischemic post-conditioning in patients with ischemic stroke: A systematic review and meta-analysis of randomized controlled trials
TL;DR: A meta-analysis of eligible randomized controlled trials showed that RIPostC is safe and effective and has a positive cerebral protective effect in patients with ischemic stroke, which issafe and effective, and future large-sample, multicenter trials are needed to validate the cerebral Protective effect of RIPost C.
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A review of remote ischemic conditioning as a potential strategy for neural repair poststroke
TL;DR: In this paper , the authors provided a hypothesis that remote ischemic conditioning (RIC) is a potential therapeutic strategy on stroke rehabilitation by evaluating the existing evidence and put forward some remaining questions to clarify and future researches to be performed in the field.
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Remote ischemic conditioning-induced hyperacute and acute responses of plasma proteome in healthy young male adults: a quantitative proteomic analysis
TL;DR: In this paper , the immediate effects of remote ischemic conditioning (RIC) on plasma proteome in healthy young adults to exclude confounding factors of disease entity, such as medications and gender were explored.
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Effects of remote ischemic conditioning on cognitive performance: A systematic review
Samuel Amorim,André Carvalho Felícioa Per Aagaard,Charlotte Suetta,Rolf Ankerlund Blauenfeldt,Grethe Andersen +4 more
TL;DR: In this paper , a systematic review was conducted to identify relevant studies through six healthcare science databases (Cochrane, PubMed, EMBASE, EBSCO, Scopus, and Web of Science) up to December 2021.
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