Publicaciones: octubre 2024

The proteomic signature of circulating extracellular vesicles following intracerebral hemorrhage: Novel insights into mechanisms underlying recovery

Casado-Fernández L,Laso-García F, Piniella D et al.  Neurobiol Dis. 2024 Oct 15;201:106665. doi: 10.1016/j.nbd.2024.106665. Epub 2024 Sep 12. PMID: 39277144.

https://pubmed.ncbi.nlm.nih.gov/39277144/

Abstract: Circulating extracellular vesicles (EVs) can participate in innate repair processes triggered after intracerebral hemorrhage (ICH). We aimed to describe changes in the proteomic profile of circulating EVs between the acute and subacute phases of ICH and to compare the findings depending on outcomes, as an approach to unraveling such repair mechanisms. This was a prospective observational study including patients with non-traumatic supratentorial ICH. Exclusion criteria were previous disability, signs of herniation on baseline computed tomography, or limited life expectancy. EVs were isolated from blood samples at 24 h and 7 days after symptom onset. After 6-months’ follow- up, patients were dichotomized into poor and good outcomes, defining good as an improvement of >10 points or >50 % on the National Institutes of Health Stroke Scale and a modified Rankin Scale of 0–2. The protein cargo was analyzed by quantitative mass spectrometry and compared according to outcomes. Forty-four patients completed follow-up, 16 (35.5 %) having good outcomes. We identified 1321 proteins in EVs, 37 with differential abundance. In patients with good outcomes, proteins related to stress response (DERA, VNN2, TOMM34) and angiogenesis (RHG01) had increased abundance at 7 days. EVs from patients with poor outcomes showed higher levels of acute-phase reactants (CRP, SAA2) at 7 days compared with 24 h. In conclusion, the protein content of circulating EVs in patients with ICH changes over time, the changes varying depending on the clinical outcome, with greater abundance of proteins potentially involved in the repair processes of patients with good outcomes.

Funding: This work was supported by Carlos III Health Institute (ISCIII) and co-funded by the European Union (European Regional Development Fund-FEDER) under grant PI17/01922 and PI20/00243, Invictus plus network under grant RD16/0019/0005, RICORS ICTUS network under grant RD21/0006/0012 and the Next Generation EU fundig for actions in the Recovery and Resilience Mechanism, Miguel Servet under grant CPII20/00002 to MG-F; CP20/00024 to LO-O, Ministerio de Universidades, Plan de Recuperaci´ on, Transformaci´ on y Resiliencia y la Universidad Aut´ onoma de Madrid under grant CA1/RSUE/2021-00753 to DP, and the Spanish Ministry of Health- (ISCIII) under grant CM20/ 00047 to EA-L, CM23/00022 to LC-F, FI18/00026 to FL-G and FI17/ 00188 to MG-dF. We also thank the editing assistance of Morote Traducciones.

Dubbing language-therapy CINEma-based in aphasia post-stroke (DULCINEA): A feasibility randomized crossover controlled trial

Fuentes B, Jordi-Perea P, Sempere-Iborra C et al. Digit Health. 2024 Oct 10;10:20552076241288311. doi: 10.1177/20552076241288311. PMID: 39421311.

https://pubmed.ncbi.nlm.nih.gov/39421311/

Abstract: Background: Helping people recover from aphasia is among the top 10 research priorities relating to life after stroke. Objective: We aimed to evaluate the feasibility of dubbing techniques (using newly developed software) for post-stroke aphasia therapy and explore its potential efficacy. Methods: Randomised, crossover, interventional, feasibility trial that included patients with chronic post-stroke non-fluent aphasia. The intervention consisted of an individualised programme (16 sessions; 8 weeks) based on dubbing words and sentences progressively adapted to the severity of the aphasia. Patients were allocated to groups that underwent therapy within the first 3 months, or between 3 and 6 months from inclusion, each group serving as the control during the nontherapy periods. Outcomes were the pre-post differences in the Communicative Activity Log, the Boston Diagnostic Aphasia Examination, the General Health Questionnaire-12, the Stroke Aphasia Quality of Life Scale, and the Western Aphasia Battery Revised, administered by psychologists blinded to the patients’ allocation. Results: Recruitment was limited due to COVID-19 and prematurely stopped because of funding coming to an end. A total of 23 patients were randomised, 20 of whom completed the study (1 withdrew consent, and 2 dropped out). The adherence rate to the allocated group was 95.3%. No statistically significant differences were found in any of the outcomes; however, 17 (85%) patients reported subjective improvements in communication skills. Conclusions: This trial shows the feasibility of dubbing therapy (using dedicated software) for patients with post-stroke nonf luent aphasia. Although it lacks statistical power, certain effects on language and communication cannot be ignored.

Funding: This study was promoted by the Research Foundation of La Paz University Hospital, which hosted a research consortium joined by the Department of Neurology at La Paz University Hospital, the Department of Psychology at Comillas Pontifical University, and the patients’ association, Afasia Activa. This project has received funding from “la Caixa” Banking Foundation under the project code LCF/PR/HR19/52160009. The funder was not involved in any of the following processes: design of the trial, data collection, analysis, or interpretation, or writing the manuscript. BF, EdC-R, RR, GR-A, JR-P, EA and MA-L are members of the Spanish Stroke Research Network RICORS ICTUS (RD21/0006/0012) funded by the Carlos III Institute of Health and the European Union (NextGenerationEU). ‘la Caixa’ Foundation, Instituto de Salud Carlos III, (grant number LCF/PR/ HR19/52160009, RD21/0006/0012).