IMR Press / JIN / Volume 18 / Issue 4 / DOI: 10.31083/j.jin.2019.04.1192
Open Access Original Research
Efficacy of remote limb ischemic conditioning on poststroke cognitive impairment
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1 Department of Neurology, the First Affiliated Hospital of Soochow University, Jiangsu Province, 215006, P. R. China
2 Department of Neurology, Zhabei Central Hospital, Jing'an District, Shanghai 200070, P. R. China
3 Department of Neurology, Tianyou Hospital, Tongji University, Shanghai 200331, P. R. China
J. Integr. Neurosci. 2019, 18(4), 377–385; https://doi.org/10.31083/j.jin.2019.04.1192
Submitted: 10 October 2019 | Accepted: 28 November 2019 | Published: 30 December 2019
Abstract

The impact of remote limb ischemic conditioning on poststroke cognitive impairment was evaluated with 104 first-time patients of noncardiac ischemic stroke. During the acute phase the patients were randomized into control and remote limb ischemic conditioning groups. Both groups received standard treatment, while the remote limb ischemic conditioning group received additional remote limb ischemic conditioning treatment for 6 months. All participants underwent neuropsychological evaluation, transcranial Doppler detection, P300 event-related potential and brachial-ankle pulse wave velocity measurements, and determination of serum intercellular adhesion molecule-1 and endothelin-1 levels both at admission and 6 months poststroke. The number of cases with poststroke cognitive impairment in each group was evaluated 6 months poststroke. No statistically significant difference was found in demographic data or baseline detection indices at admission between the two groups. However, at 6 months poststroke, the remote limb ischemic conditioning group had significantly higher total Montreal Cognitive Assessment score and its domains of visuospatial and executive functioning and attention scores, significantly lower activity of daily living scale score, shorter P300 latency, and higher amplitude compared with the control group. Moreover, the middle cerebral artery, average blood flow velocity was significantly higher, while the middle cerebral artery-pulsation index, basilar artery pulsation index, and the levels of brachial-ankle pulse wave velocity, intercellular adhesion molecule-1, and endothelin-1were significantly lower in the remote limb ischemic conditioning group compared with the control group. These results demonstrate that remote limb ischemic conditioning causes a significant improvement in cognitive domains, such as visuospatial and executive functioning and attention, and is therefore linked with reduced incidence of poststroke cognitive impairment.

Keywords
Event-related potential P300
stroke
cognitive impairment
ischemic conditioning
remote limb
vascular neurology
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