Abstract TMP28: Upper Extremity Motor Impairment After Ischemic Stroke - Implications for Stem Cell Therapy
Introduction: Experimental studies show that stem cells can improve motor recovery in animal stroke models. In humans, upper extremity motor impairment (UEMI) is a major consequence following stroke and can entail substantial disability. As stem cell therapy (SCT) may become clinically applicable to promote arm/hand motor recovery after stroke, we aimed to examine the frequency and recovery of UEMI, as well as its’ correlation to functional status and health-related quality of life (HRQoL), in a selected sample of stroke patients potentially suitable for SCT.
Methods: Consecutive first-ever ischemic stroke patients (n=108) were included in the Lund Stroke Recovery Study in 2009-2011 if: they were aged 20-75 years; underwent brain DW-MRI within 4 days of stroke onset; and their baseline stroke severity was 1-18 according to the National Institutes of Health Stroke Scale (NIHSS). All survivors were invited to a clinical follow-up after 3.5-5.5 years, including: NIHSS arm and extended NIHSS hand items to assess UEMI; Fugl-Meyer upper extremity section (FM-UE) to thoroughly examine UEMI; Action Research Arm Test (ARAT) to evaluate arm/hand function; Modified Rankin Scale (mRS) to assess functional status; and Stroke Impact Scale (SIS) to evaluate HRQoL. UEMI was defined as ≥1 on NIHSS arm/hand items. UEMI recovery was assessed by the change in NIHSS arm/hand scores between baseline and follow-up (ΔNIHSS arm/hand).
Results: Of 97 stroke survivors, 83 participated in the follow-up. Among survivors without recurrent stroke (n=76), 54% had UEMI at baseline and 28% had remaining UEMI at follow-up. The median ΔNIHSS arm/hand was [-1] (range=[-4] - 1). FM-UE scores were strongly correlated to ARAT (rs=0.68, p<0.01), mRS (rs=[-0.67], p<0.01), SIS strength domain (items 1a+1b; rs=0.68, p<0.01), and SIS hand function domain (rs=0.71, p<0.01).
Conclusions: UEMI may be an appropriate target for SCT in stroke as UEMI is prevalent, and strongly correlates to long-term functional status and HRQoL. Our findings confirm previously reported heterogeneity in UEMI recovery, the mechanisms of which need to be addressed in future studies to optimize patient selection for SCT.
Author Disclosures: H. Delavaran: None. J. Aked: None. A. Arvidsson: None. O. Lindvall: None. Z. Kokaia: None. B. Norrving: None. A. Lindgren: Other Research Support; Modest; Gore, Bayer. Honoraria; Modest; Bristol Myers Squibb/Pfizer. Consultant/Advisory Board; Modest; Bayer, Boehringer Ingelheim, Bristol Myers Squibb. Other; Modest; Participant in Effect of F2695 on Functional Recovery After Ischemic Stroke, National leader and participant NAVIGATE-ESUS study Bayer, Participant REDUCE study Gore.
- © 2016 by American Heart Association, Inc.