Too Much Time on a Computer, Watching TV or Other Sedentary Activities Raises Stroke Risk

Adults younger than age 60 whose days are filled with sedentary leisure time (which includes using the computer, TV, or reading) and little physical activity have a higher stroke risk than people who are more physically active, according to new research published in Stroke, a journal of the American Stroke Association, a division of the American Heart Association.

According to American Heart Association statistics, U.S. adults spend an average of 10.5 hours a day connected to media such as smartphones, computers or television watching, and adults ages 50 to 64 spend the most time of any age group connected to media. Data also indicate that stroke-related deaths decreased in 2010 among adults 65 years and older. However, death from stroke appears to be on the rise among younger adults, ages 35 to 64 years – increasing from 14.7 in every 100,000 adults in 2010 to 15.4 per 100,000 in 2016. Previous research suggests the more time adults spend sedentary, the greater their risk of cardiovascular disease including stroke, and nearly 9 in 10 strokes could be attributed to modifiable risk factors such as sedentary behaviors.

“Sedentary time is increasing in the United States and Canada,” said study author Raed A. Joundi, M.D., D.Phil., a stroke fellow in the department of clinical neurosciences at the Cumming School of Medicine at the University of Calgary in Canada. “Sedentary time is the duration of awake activities that are done sitting or lying down. Leisure sedentary time is specific to the sedentary activities done while not at work. It is important to understand whether high amounts of sedentary time can lead to stroke in young individuals, as a stroke can cause premature death or significantly impair function and quality of life.”

In this study, researchers reviewed health and lifestyle information for 143,000 adults with no prior stroke, heart disease or cancer who participated in the Canadian Community Health Survey in years 2000, 2003, 2005, 2007-2012. Researchers followed the participants for an average of 9.4 years (until Dec. 31, 2017) and identified strokes through linkages with hospital records.

They reviewed the amount of time spent each day in leisure sedentary activities (hours spent on computer, reading and watching TV) and divided them into categories of less than four hours per day; four to less than six hours per day; six to less than eight hours per day; and eight hours or more a day. They also divided physical activity into quartiles, or four equal categories, where the lowest quartile was the least physically active and equivalent to going for a walk for 10 minutes or less daily. “A walk of 10 minutes or less per day is lower than half of what the American Heart Association’s physical activity guidelines recommend,” Joundi said.

The American Heart Association recommends adults get at least 150 minutes, or 2.5 hours, of moderate-intensity physical activity per week.

Analysis of study participants found:

  • During the follow-up period, an average of 9.4 years, 2,965 strokes occurred. Nearly 90% of those were ischemic strokes, the most common stroke type, which occurs when a vessel supplying blood to the brain is obstructed.
  • The average daily leisure sedentary time among all participants was 4.08 hours. Individuals aged 60 and younger had an average leisure sedentary time of 3.9 hours per day. Average daily leisure sedentary time was 4.4 hours for adults aged 60 to 79, and 4.3 hours for those 80 years and older.
  • Adults 60 years and younger who had low physical activity and reported eight or more hours of leisure sedentary time a day had a 4.2 times higher risk of stroke compared to those reporting less than four hours of daily leisure sedentary time.
  • The most inactive group — those reporting eight or more hours of sedentary time and low physical activity — had 7 times higher risk of stroke compared to those reporting less than four hours of sedentary time a day and higher levels of physical activity.

“Adults 60 years and younger should be aware that very high sedentary time with little time spent on physical activity can have adverse effects on health, including increased risk of stroke,” Joundi said. “Physical activity has a very important role in that it reduces the actual time spent sedentary, and it also seems to diminish the negative impact of excess sedentary time. Physician recommendations and public health policies should emphasize increased physical activity and lower sedentary time among young adults in combination with other healthy habits to lower the risks of cardiovascular events and stroke.”

A significant limitation of the study’s results was that the survey did not ask participants about occupation-related sedentary time; this could mean sedentary time is underreported among people who have desk jobs, for example.

Source: American Heart Association

Daily Half-Hour Walk Can Greatly Boost Survival After Stroke

Robert Preidt and Ernie Mundell wrote . . . . . . . . .

After a stroke, survivors can greatly increase their odds for many more years of life through activities as easy as a half-hour’s stroll each day, new research shows.

The nearly five-year-long Canadian study found that stroke survivors who walked or gardened at least three to four hours a week (about 30 minutes a day), cycled at least two to three hours per week, or got an equivalent amount of exercise had a 54% lower risk of death from any cause.

The benefits were highest among younger stroke survivors. Those younger than 75 who did at least that much physical activity had an 80% lower risk of death, according to the study published online in the journal Neurology.

“We should particularly emphasize [physical activity] to stroke survivors who are younger in age, as they may gain the greatest health benefits from walking just 30 minutes each day,” study author Dr. Raed Joundi, of the University of Calgary, said in a journal news release.

One U.S. expert in stroke care said more needs to be done to help people who survive a stroke get active.

“It is important that stroke neurologists enroll their patients in exercise programs, because encouraging exercise/physical activity may not be sufficient,” noted Dr. Andrew Rogove, who wasn’t involved in the new research. He directs stroke care at Northwell Health’s South Shore University Hospital in Bay Shore, N.Y.

The new study included nearly 900 stroke survivors, average age 72, and more than 97,800 people, average age 63, who had never had a stroke. All of the participants were followed for an average of about 4.5 years.

After accounting for other factors that could influence the risk of death (such as age and smoking), the researchers found that 25% of the stroke survivors and 6% of those who’d never had a stroke died from any cause during follow-up.

Among the stroke survivors, 15% of the people who exercised at least the equivalent of three to four hours of walking each week died, compared to 33% of those who didn’t get at least that much exercise, Joundi’s group reported.

The bottom line: “Our results suggest that getting a minimum amount of physical activity may reduce long-term mortality from any cause in stroke survivors,” Joundi said.

“Our results are exciting, because just three to four hours a week of walking was associated with big reductions in mortality, and that may be attainable for many community members with prior stroke,” he said. “In addition, we found people achieved even greater benefit with walking six to seven hours per week. These results might have implications for guidelines for stroke survivors in the future.”

One other expert noted that although the study couldn’t prove cause and effect, there was a “dose-dependent” trend in the findings: As the amount of exercise rose, the risk of dying during the study period fell.

“This study is important because it establishes a dose-dependent response between physical activity and mortality,” said Dr. Salman Azhar, who directs the stroke program at Lenox Hill Hospital in New York City.

Azhar, who wasn’t involved in the new research, stressed that stroke survivors’ ability to be mobile and exercise of course varies greatly from patient-to-patient. He noted that many patients who had “functional difficulties,” other illnesses, financial issues or a lack of family support did not provide information in the study on just how much activity they engaged in each day.

“This is the very group that would tend to have less physical activity and have a higher risk of dying,” Azhar noted.

So, he said, “the challenge remaining is how to overcome the obstacles to increase physical activity in stroke survivors in the community, especially when resources are limited, and [other illnesses] exist.”

Source: HealthDay

Why Strokes Can Affect Women, Men Differently

It is often said that stroke affects men and women differently. Now, scientists say the location of the stroke’s damage in the brain may help explain why.

Women have more strokes, and are more likely to have symptoms such as fatigue and mental confusion rather than classic indications such as paralysis. Women also tend to have more severe strokes, according to the authors of a new study.

“We frequently take care of stroke patients whose outcomes we cannot explain — and when I say outcomes, I mean disability as a result of stroke,” said study co-author Dr. Natalia Rost, chief of the stroke division at Massachusetts General Hospital.

“Many times we can’t predict which patients will do well and why, and this is further complicated by the differences in outcomes between men and women,” Rost said in a hospital news release.

To learn more about sex-specific differences in stroke, the researchers examined more than 1,000 brain imaging scans of ischemic stroke patients. An ischemic stroke is caused by blocked blood flow in the brain.

They found that stroke severity in women is associated with lesions (areas of tissue damage) in the left hemisphere of the brain, in the vicinity of blood vessels at or near the back of the brain.

“In our study we had the opportunity to link specific lesions to stroke severity in men and women, and we could actually show that lesions in the left posterior [back] part of the brain lead to higher stroke severity in women than in men,” said study co-author Dr. Anna Katharina Bonkhoff, a stroke research fellow at MGH.

Identifying gender-specific areas of brain damage that are linked with certain disabilities after ischemic stroke could lead to more “sex aware” treatments, according to the researchers.

For example, women with stroke damage that affects vulnerable areas might benefit more than men from surgery to remove a blood clot, they suggested.

“Sex-informed acute stroke care has the potential to alleviate the burden of disease on an individual patient level, as well as broader and socioeconomically relevant levels,” the researchers wrote.

The findings were published recently in the journal Nature Communications.

Source: HealthDay

Soft Skin Patch Could Provide Early Warning for Strokes, Heart Attacks

Liezel Labios wrote . . . . . . . . .

Engineers at the University of California San Diego developed a soft and stretchy ultrasound patch that can be worn on the skin to monitor blood flow through major arteries and veins deep inside a person’s body.

Knowing how fast and how much blood flows through a patient’s blood vessels is important because it can help clinicians diagnose various cardiovascular conditions, including blood clots; heart valve problems; poor circulation in the limbs; or blockages in the arteries that could lead to strokes or heart attacks.

The new ultrasound patch developed at UC San Diego can continuously monitor blood flow—as well as blood pressure and heart function—in real time. Wearing such a device could make it easier to identify cardiovascular problems early on.

A team led by Sheng Xu, a professor of nanoengineering at the UC San Diego Jacobs School of Engineering, reported the patch in a paper published in Nature Biomedical Engineering.

The patch can be worn on the neck or chest. What’s special about the patch is that it can sense and measure cardiovascular signals as deep as 14 centimeters inside the body in a non-invasive manner. And it can do so with high accuracy.

“This type of wearable device can give you a more comprehensive, more accurate picture of what’s going on in deep tissues and critical organs like the heart and the brain, all from the surface of the skin,” said Xu.

“Sensing signals at such depths is extremely challenging for wearable electronics. Yet, this is where the body’s most critical signals and the central organs are buried,” said Chonghe Wang, a former nanoengineering graduate student in Xu’s lab and co-first author of the study. “We engineered a wearable device that can penetrate such deep tissue depths and sense those vital signals far beneath the skin. This technology can provide new insights for the field of healthcare.”

Another innovative feature of the patch is that the ultrasound beam can be tilted at different angles and steered to areas in the body that are not directly underneath the patch.

This is a first in the field of wearables, explained Xu, because existing wearable sensors typically only monitor areas right below them. “If you want to sense signals at a different position, you have to move the sensor to that location. With this patch, we can probe areas that are wider than the device’s footprint. This can open up a lot of opportunities.”

How It Works

The patch is made up of a thin sheet of flexible, stretchable polymer that adheres to the skin. Embedded on the patch is an array of millimeter-sized ultrasound transducers. Each is individually controlled by a computer—this type of array is known as an ultrasound phased array. It is a key part of the technology because it gives the patch the ability to go deeper and wider.

The phased array offers two main modes of operation. In one mode, all the transducers can be synchronized to transmit ultrasound waves together, which produces a high-intensity ultrasound beam that focuses on one spot as deep as 14 centimeters in the body. In the other mode, the transducers can be programmed to transmit out of sync, which produces ultrasound beams that can be steered to different angles.

“With the phased array technology, we can manipulate the ultrasound beam in the way that we want,” said Muyang Lin, a nanoengineering Ph.D. student at UC San Diego who is also a co-first author of the study. “This gives our device multiple capabilities: monitoring central organs as well as blood flow, with high resolution. This would not be possible using just one transducer.”

The phased array consists of a 12 by 12 grid of ultrasound transducers. When electricity flows through the transducers, they vibrate and emit ultrasound waves that travel through the skin and deep into the body. When the ultrasound waves penetrate through a major blood vessel, they encounter movement from red blood cells flowing inside. This movement changes or shifts how the ultrasound waves echo back to the patch—an effect known as Doppler frequency shift. This shift in the reflected signals gets picked up by the patch and is used to create a visual recording of the blood flow. This same mechanism can also be used to create moving images of the heart’s walls.

A Potential Game Changer in the Clinic

For many people, blood flow is not something that is measured during a regular visit to the physician. It is usually assessed after a patient shows some signs of cardiovascular problems, or if a patient is at high risk.

The standard blood flow exam itself can be time consuming and labor intensive. A trained technician presses a handheld ultrasound probe against a patient’s skin and moves it from one area to another until it’s directly above a major blood vessel. This may sound straightforward, but results can vary between tests and technicians.

Since the patch is simple to use, it could solve these problems, said Sai Zhou, a materials science and engineering Ph.D. student at UC San Diego and co-author of the study. “Just stick it on the skin, then read the signals. It’s not operator dependent, and it poses no extra work or burden to the technicians, clinicians or patients,” he said. “In the future, patients could wear something like this to do point of care or continuous at-home monitoring.”

In tests, the patch performed as well as a commercial ultrasound probe used in the clinic. It accurately recorded blood flow in major blood vessels such as the carotid artery, which is an artery in the neck that supplies blood to the brain. Having the ability to monitor changes in this flow could, for example, help identify if a person is at risk for stroke well before the onset of symptoms.

The researchers point out that the patch still has a long way to go before it is ready for the clinic. Currently, it needs to be connected to a power source and benchtop machine in order to work. Xu’s team is working on integrating all the electronics on the patch to make it wireless.

Source: UC San Diego

Vocal Music Boosts the Recovery of Language Functions After Stroke

Research has shown that listening to music daily improves language recovery in patients who have experienced a stroke. However, the neural mechanisms underlying the phenomenon have so far remained unknown.

A study conducted at the University of Helsinki and the Turku University Hospital Neurocenter compared the effect of listening to vocal music, instrumental music and audiobooks on the structural and functional recovery of the language network of patients who had suffered an acute stroke. In addition, the study investigated the links between such changes and language recovery during a three-month follow-up period. The study was published in the eNeuro journal.

Based on the findings, listening to vocal music improved the recovery of the structural connectivity of the language network in the left frontal lobe compared to listening to audiobooks. These structural changes correlated with the recovery of language skills.

“For the first time, we were able to demonstrate that the positive effects of vocal music are related to the structural and functional plasticity of the language network. This expands our understanding of the mechanisms of action of music-based neurological rehabilitation methods,” says Postdoctoral Researcher Aleksi Sihvonen.

Listening to music supports other rehabilitation

Aphasia, a language impairment resulting from a stroke, causes considerable suffering to patients and their families. Current therapies help in the rehabilitation of language impairments, but the results vary and the necessary rehabilitation is often not available to a sufficient degree and early enough.

“Listening to vocal music can be considered a measure that enhances conventional forms of rehabilitation in healthcare. Such activity can be easily, safely and efficiently arranged even in the early stages of rehabilitation,” Sihvonen says.

According to Sihvonen, listening to music could be used as a cost-efficient boost to normal rehabilitation, or for rehabilitating patients with mild speech disorders when other rehabilitation options are scarce.

After a disturbance of the cerebral circulation, the brain needs stimulation to recover as well as possible. This is the goal of conventional rehabilitation methods as well.

“Unfortunately, a lot of the time spent in hospital is not stimulating. At these times, listening to music could serve as an additional and sensible rehabilitation measure that can have a positive effect on recovery, improving the prognosis,” Sihvonen adds.

Source: University of Helsinki