The literature on stroke reveals an increasing interest in the role played by social and emotional factors in rehabilitation after stroke. A comprehensive literature survey shows profiles of spontaneous recovery, the significance of a team approach to rehabilitation, patterns of prognostic significance for long-term recovery and adaptation and formulations of rehabilitation models for the Western world. The importance of depression as a major factor in demotivation to participate in rehabilitation and achieve long-term quality of life post-stroke emerges. From the literature survey a research design was formulated for the ecological study of a sample of 51 stroke patients at Ga-Rankuwa Hospital near Pretoria. The questionnaire was structured according to the Synchronous Systems Model, and data gathered from the biological, personal and environmental spheres of patients. Data was collected by a multidisciplinary team at three assessment times, three days, two weeks and three months post-stroke. These corresponded to the acute physical phase of stroke, the end of the hospitalisation period, and an assessment of patients once they had been discharged back into the community. Descriptive statistics were obtained on all variables and principle axis factor analysis was performed to verify the factorial structure of the tests. In order to establish whether group scores changed between assessments, t-tests for dependent measures were applied. Pearson Product Moment correlations were computed for the purpose of establishing relationships between variables. The results revealed dramatically differing biographical characteristics of the sample of stroke patients both premorbidly and at three months after the stroke. Significant recovery profiles emerged in both the physical and neuropsychological spheres at both the 14 day and 3 month assessments. Depression and the functioning at home and at work social sphere of role emerged as profiles of deterioration. At 14 days, depression was related to physical and cerebral functioning. This changed at three months, with depression also being significantly related to aspects of social functioning. On the basis of these results, depression after stroke was conceptualised as a severance of relational connectedness in the social ecological functioning of stroke patients. An ecological approach to rehabilitation is proposed that would seek to reframe the identity of stroke patients and establish relational connectedness post-stroke. / Psychology / D. Litt. et Phil. (Psychology)

INTRODUCTION: Myocardial infarction causes parasympathetic dysfunction in cardiovascular tissue, where central parasympathetic drive decreases but local acetylcholine levels are unchanged. The muscarinic acetylcholine receptor M3 (AChM3R) is shown to have mediating effects in cardiac tissue and vasculature, such as regulation of heart rate and vasodilation of coronary arteries. The objective of this study is to determine the association between AChM3R levels in the heart wall and in the coronary vasculature with self-reported disease states from cadaver donor records. METHODS: Biopsies of the left anterior descending (LAD) artery and the underlying anterior interventricular septum (AIVS) were taken from 14 cadavers. A 5 mm biopsy of the LAD and its underlying AIVS were harvested 2.54-3.81cm from the bifurcation point of the left coronary artery, depending on the tissue integrity of the cadaver specimen. The tissues were immunostained for AChM3R (CHRM3 NB100-58975 at 1:2000) and visualized using a DAB chromogen. Slides were digitally scanned into a virtual image at 20x using the Motic Easyscan (Motic, Inc.). Images were segmented for tunica media and myocardium using Adobe Photoshop CS (Adobe, Inc.). We developed code in Python to calculate the strong positive and positive staining of the tissues. The number of pixels stained was normalized to the tissue area. The donors from which tissue was biopsied were classified into cardiovascular, cerebrovascular, Alzheimer’s disease dementia (AD), or both cerebrovascular and AD disease categories based on self-reported donor declarations. We used SPSS (v27, IBM, Inc.) to run a Pearson correlation to determine the association of staining positivity in the anatomical regions and a MANOVA to determine significant differences in the amount of pixel positivity in the tunica media and myocardium as a function of disease classification. RESULTS: Strong positive and positive staining of the myocardium were not correlated with strong positive in the tunica media. There was a significant positive relationship between strong myocardium staining and positive tunica media staining (r =.727, n=14, p=.003) as well as positive myocardium and positive tunica media staining (r=.674, n=14, p=.008). There was no significant difference between the amount of AChM3R staining and disease classification. CONCLUSIONS: The lack of correlation between strong positive in the myocardium and positive and strong positive in the tunica media suggests that the AChM3R state in the heart wall is independent of changes in the AChM3R of coronary vascular smooth muscle. However, significant correlation between strong positive in the myocardium and positive in the tunica media indicates that changes in AChM3R in the myocardium could be dependent on the presence of a baseline amount of AChM3R in the coronary vascular smooth muscle. Categorization of donor disease states may be too broad to provide statistical significance. Many donors reported co-morbid diseases, which could have affected the influence of cardiovascular disease and dementia on AChM3R modulation. These findings highlight that interventions targeting parasympathetic dysfunction of coronary vasculature may leave the underlying heart wall unaffected. Future studies should consider cardiovascular disease diagnoses to assess AChM3R distribution in the heart wall and coronary vasculature.

Stroke is the third leading cause of death and survivors suffer motor impairments. The rodent sensorimotor system is similar to the human's, making rodents a good model to study the effects of stroke. Transgenic technology makes the mouse a desirable stroke model, however, there are few behavioural tests to assess behavioural outcome. This thesis evaluates mice subjected to permanent or temporary occlusion focal motor cortex strokes in a skilled reaching task. The first experiment documents changes in skilled movements in mice with a permanent occlusion focal motor cortex stroke. The second experiment is identical but uses a temporary occlusion focal motor cortex stroke. The third experiment compares the two strokes. The results indicate permanent occlusion mice suffer great impairments, and a larger injury, than temporarily occluded animals. The mice with the largest insults were most impaired. Mice make an excellent behavioural and genetic model for studying motor system stroke. / viii, 115 leaves : ill. ; 29 cm.

The purpose of this thesis is to describe the organization of the movements of skilled reaching. Our knowledge of reaching behaviour has been limited to an understanding of specific actions. Results from this thesis describe how reaching is the product of interactions of various parameters that assemble in an integrative way in ontogeny, yet can become dismantled on one level, or generally, throughout multiple levels of what constitutes the behaviour after stroke in adults. These findings demonstrate that skilled reaching constitutes motor parameters that may not be visible in a healthy adult, but that function through development, and by inhibitory systems in adults, to create a smooth and finely articulated action. An examination of the movement patterns of reaching within the full context of the behaviour can be applied to therapeutic strategies for motor disorders and, most importantly, deepen our understanding of the relations between reaching and cognition. / xiii, 254 leaves : ill. (some col.) ; 29 cm

Lu, Jinyan. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 75-86). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese; some appendixes in Chinese.

Stroke remains a leading cause of disability in the western world, with symptoms ranging in severity from mild congnitive or motor impairments, to severe impairments in both cognitive and motor domains. Despite ongoing research aimed at helping stroke patients the disease cannot be prevented or cured, therefore a large body of research has been aimed at identifying effective rehabilitative strategies. Based on our understanding of normal brain function, and the meachanisms mediating the limited spontaneous recovery that is observed following injury, factors that promote brain plasticity are likely to be effective treatments for stroke symptoms. The current thesis investigated three novel treatments (COX-2 inhibitor drug, vitamin supplement diet, and social experience) in a rat model of focal ischemia in the motor cortex. All three treatments have been previously shown to alter plasticity in the normal brain, however the current experiments show that the treatments have differential effects following stroke. The COX-2 inhibitors provided limited improvement in functional performance, whereas the vitamin supplement treatment had no effect. Social experience on the other hand was found to block the usually observed spontaneous improvements following the stroke. These results suggest that factors that alter dendritic plasticity may in fact serve as effective stroke treatments depending on the site and the mechanisms whereby the plastic changes are induced. / ix, 149 leaves : ill. ; 29 cm.

Middle cerebral artery (MCA) stroke can produce chronic incapacitating motor impairments. Understanding the neural basis of the motor syndromes is complicated by the diversity of neural structures damaged but the problem can be addressed in laboratory rats by inducing selective infarcts. Nevertheless, the motor syndromes that ensue from stroke in rats remain poorly understood and undermine its potential as a model for clinical stroke. The objective of the present thesis was to document the skilled reaching impairments from neocortical and subcortical MCA infarcts in rats. In addition, the integrity of the motor system components spared by the infarct was assessed neurophysiologically and neuroanatomically. Characteristic reaching impairments emerged from each infarct but there were also some overlapping features that might be explained by neural dysfunction extending beyond the boundaries of the infarct. The present studies showed that the laboratory rat is an ideal animal model for studying stroke, which should be of interest to both clinical and research scientists studying stroke. / xiii, 345 leaves : ill. ; 29 cm. + 1 CD-ROM

The purpose of this study was to elucidate the indifferent passive behavior described in persons with right cerebral hemisphere dysfunction (Bear & Fedio, 1977; Critchley, 1966; Denny-Brown, Meyer & Horenstein, 1952). The process of caring for another person encompasses an interpersonal relationship with that person. Passive behavior may interfere with that relationship (Fried, 1970), and therefore jeopardize care. This correlational descriptive study was based on an explanatory model which included hemispheric side of lesion, attention, neglect of extrapersonal hemispace, passive behavior, and mood/emotion. The following indicators of outcome variables were used: attention--bilateral skin conductance level and skin conductance response; neglect--line bisection and cancellation tasks; passive behavior--a modification of Mays' (1973) Activity Passivity Scale; mood/emotion--the anxiety and depression subscales of Kellner and Sheffield's (1973) Symptom Rating Test. The sample comprised 10 persons with a single right hemisphere stroke and 10 persons with a left hemisphere stroke. The strength of the relationships among the variables was assessed only for persons with right hemisphere stroke. The data from this sample support some of the theorized links in the conceptual model, but not others. The predicted positive relationship between right hemisphere stroke and neglect, and the negative relationship between right hemisphere stroke and anxiety were demonstrated (r = .3177 and r = -.4353, respectively). The predicted negative relationship between right hemisphere stroke and attention was not demonstrated. Unexpected significant positive correlations existed between right hemisphere stroke and estimates of attention from the left hand (r = .3111 to r = .4472). No demonstrable relationship existed between right hemisphere stroke and passive behavior. Another unexpected finding was that the scale to scale and part to whole correlations for the concepts mood/emotion and passive behavior were strikingly different for the two groups. The fact that the two groups of subjects did not interpret the contents of the two scales similarly indicated that persons with right hemisphere dysfunction view the world quite differently from those with left hemisphere dysfunction. Appreciation of these differences may allow formulation and implementation of effective care plans which will reduce frustration in both client and caregiver.

No description available.

This thesis explores the links between emotion processing and social participation in the acute and chronic phases of stroke. Three aspects of emotion processing are examined: 1) Emotion Perception 2) Emotion Regulation 3) Depression and Anxiety. Social Participation refers to engagement in life situations including a range of social activities and social networks. Stroke survivors are known to experience a reduction in social participation, independently of activity limitations. The current research tests the hypothesis that impairments in any of the aspects of emotion processing may affect social participation. Previous research has established that following stroke, difficulties in emotion perception and depression and anxiety occur, but there is little research on post stroke emotion regulation difficulties. While the link between post stroke depression and anxiety and social participation has been explored, this is not the case with emotion perception or emotion regulation. In a pilot study, emotion processing and social participation measures were administered to stroke patients. Emotion processing difficulties were shown to occur in stroke survivors and were significantly correlated with social participation. In the main study participants’ emotion processing, social participation and activity limitations were assessed at 2 and 18 months post stroke. In the acute phase, all three aspects of emotion processing correlated with social participation, but only emotion regulation predicted social participation restrictions independently of activity limitations. In the chronic phase, emotion processing correlated with social participation, with emotion regulation and depression predicting social participation independently of activity limitations. Further analyses revealed acute phase problems with emotion perception predicted chronic phase social participation limitations, while acute phase social participation restrictions predicted chronic phase depression and emotion regulation. These findings highlight the importance of the links between emotion processing and social participation post stroke. Future research priorities in this field are outlined.