Rick Swartz

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This update outlines new guidelines for helping people recover and participate in their communities after having a stroke. It highlights the importance of regular follow-ups, managing mood and cognitive issues, and addressing personal goals like returning to work or driving. These recommendations aim to support long-term recovery and ensure that stroke survivors can lead independent and active lives. Who this helps: This helps stroke patients and their families, as well as healthcare providers involved in their care.

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This study looked at the relationship between certain fatty acids in the blood and brain changes in people with Alzheimer’s disease and those without it, focusing on a type of small vessel disease in the brain. It found that higher levels of docosahexaenoic acid (DHA), an omega-3 fatty acid, were linked to larger hippocampal volumes in people with both Alzheimer’s and small vessel disease, while higher levels of linoleic acid (LA), an omega-6 fatty acid, were linked to fewer brain issues in healthy individuals. These findings highlight how specific types of fatty acids may influence brain health differently depending on the presence of Alzheimer's and vascular conditions. Who this helps: This helps patients with Alzheimer's disease and cerebrovascular conditions.

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This study looked at patients who had strokes and a certain kind of carotid artery disease where the narrowing is less than 50%. Researchers analyzed images from 1,407 patients and found that 27.4% of those with nonstenotic disease experienced strokes specifically in the territory supplied by the affected artery. They discovered that certain features, like blood clots and unusual artery structures, greatly increased the risk of having a stroke, with some factors raising the odds by over eight times. Who this helps: Patients with nonstenotic carotid disease and their doctors.

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This study looked at how cognitive abilities change after coronary artery bypass graft (CABG) surgery by reviewing trials conducted between 2005 and 2025. Out of nearly 3,500 studies reviewed, only 71 trials involved checking patients' cognitive skills, which included nearly 16,000 patients, mostly men around 64 years old. The findings showed that the common cognitive tests used didn’t identify any significant changes before and after the surgery, highlighting that many studies fail to adequately assess cognitive impacts, which is important for understanding how these surgeries affect patients' mental health. Who this helps: This helps patients undergoing CABG surgery and their doctors.

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This study looked at a specific blood test for tracking brain injury in patients who had an acute ischemic stroke. Researchers found that higher levels of a protein called brain-derived tau (BD-tau) in the blood were linked to more severe brain damage, with higher concentrations predicting larger areas of injury and worse recovery outcomes. Notably, BD-tau outperformed traditional imaging methods in predicting patients' functional capabilities three months after the stroke. Who this helps: This research benefits patients who have experienced a stroke and their doctors by providing a clearer way to assess brain damage and recovery potential.

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This study examined how certain brain imaging markers related to cerebral amyloid angiopathy (CAA) affect the risk of bleeding and recovery outcomes after a specific stroke treatment known as thrombolysis. It found that among 1,600 patients, an increase in cortical superficial siderosis (a brain imaging indicator) significantly raised the risk of having a brain bleed (especially a 4-fold increase for symptomatic bleeds), as well as higher chances of disability and even death. Understanding these risks is crucial for doctors deciding whether to use thrombolysis in patients with strokes. Who this helps: This research benefits doctors making treatment decisions for stroke patients.

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This study focused on creating and testing a new tool called segcsvd, which uses artificial intelligence to automatically identify and measure enlarged perivascular spaces (PVS) in brain images. The results showed that segcsvd accurately identified PVS in areas of the brain, achieving a considerable accuracy of 78% for the basal ganglia region, and significantly improved the understanding of how PVS relate to age. This is important because it helps researchers and doctors better assess brain health and diseases related to small blood vessels. Who this helps: Patients with cerebral small vessel disease and doctors involved in their care.

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This study focused on how differences in computed tomography perfusion (CTP) blood flow maps from various sites can lead to errors in measuring brain injury during strokes. By analyzing 741 CTP cases, researchers found that their new method reduced errors in estimating the size of brain injuries by 39% (from 12.7 ml to 7.7 ml) and improved accuracy in identifying larger injuries. This is important because it ensures that stroke assessments are more reliable, which can lead to better treatment decisions. Who this helps: This benefits patients by ensuring they receive the most accurate stroke evaluations possible.

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The study looked at how well brain imaging from CT scans lines up with MRI scans in assessing brain shrinkage and changes in white matter in stroke patients. Out of 1,577 participants, 491 had data that could be compared, showing a strong agreement between CT and MRI results for assessing brain health (with scores for some measures being as high as 0.97, where 1.0 is perfect agreement). This finding is important because it demonstrates that CT scans can effectively evaluate brain damage and predict recovery outcomes just like MRIs do, which could make stroke assessments quicker and more accessible. Who this helps: Patients and doctors making treatment decisions after a stroke.

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This study looked at how effective and safe the treatment tenecteplase is for young adults (aged 45 and under) who have suffered a stroke, comparing it to another treatment called alteplase. Out of 1,577 patients, only 68 were young adults, and among them, 84.72% who received tenecteplase had a good recovery at 90 days compared to 45% who received alteplase. This is important because it suggests that tenecteplase may lead to better recovery outcomes for young adults with strokes, even though more research is needed to confirm these findings. Who this helps: Patients who are young adults experiencing a stroke.

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This study looked at how different groups of neuropsychiatric symptoms in people with Alzheimer’s disease are related to changes in brain structure and daily functioning. Researchers found four main symptom groups: hyperactivity, psychosis, neurovegetative symptoms, and affective symptoms, which together explained 62% of the differences in symptoms. Notably, more severe symptoms were linked to lower functioning in daily activities, especially for those showing hyperactivity and affective symptoms, with specific brain regions associated with these issues. Who this helps: Patients with Alzheimer’s and their caregivers will benefit from this understanding of symptoms and their impact on brain health and daily life.

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This study looked at how safe and effective a treatment called intravenous thrombolysis is for patients with acute ischemic stroke that doesn't show a blockage in brain scans. Out of 1,577 patients, 456 had no visible blockage, and among these, those with lacunar infarcts (small strokes from tiny vessel blockages) had better safety outcomes, with only 2.3% developing serious complications. This is important because knowing which types of strokes respond better to treatment can help doctors make better decisions for their patients. Who this helps: This helps patients with acute ischemic stroke and their doctors by guiding treatment choices.

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This study investigated whether a combination of the blood thinner rivaroxaban and aspirin could prevent recurring strokes in patients with a specific type of blockage in the brain's blood vessels called intracranial atherosclerotic disease. The results showed that the combination therapy led to a lower rate of stroke-related complications (15.7% compared to 24% with aspirin alone) without increasing the risk of serious bleeding. This is important because it suggests that using this combination could help reduce the chances of repeat strokes for affected patients. Who this helps: Patients at risk of recurring strokes due to intracranial atherosclerotic disease.

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This study updated guidelines for diagnosing and managing vascular cognitive impairment (VCI), a condition affecting thinking and memory that can occur after a stroke or other vascular issues. Experts, along with people who have firsthand experience with VCI, created recommendations covering everything from recognizing symptoms to treatment and end-of-life care. A key part of the guidelines is a journey map illustrating the experiences of those living with VCI, which aims to improve care and awareness in healthcare settings. Who this helps: This benefits patients with vascular cognitive impairment and their families, as well as healthcare providers.

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This study examined the link between periodic limb movements during sleep (PLMs) and a type of brain damage known as cerebral small vessel disease (CSVD) in patients who recently had a stroke or a mini-stroke (TIA). Out of 86 patients, 42% had a high level of PLMs, and researchers found that those with more significant PLMs had worse scores on brain imaging tests indicating CSVD. These findings highlight the potential importance of monitoring sleep patterns in stroke patients, as PLMs may signal higher risks of brain damage. Who this helps: This helps patients recovering from strokes and their doctors in managing and understanding their condition.

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This study looked at whether a treatment called endovascular thrombectomy (EVT) helps stroke patients who have blockages in medium-sized blood vessels. A total of 530 patients were involved, and it was found that after 90 days, 41.6% of those treated with EVT were doing well (scores of 0 or 1 on a quality of life scale) compared to 43.1% of those who received standard care. However, EVT did not result in better outcomes and had a higher death rate (13.3% vs. 8.4%), suggesting that it may not be beneficial for this group of stroke patients. Who this helps: This helps doctors decide on the best treatment for stroke patients with medium-vessel occlusions.

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In the ESCAPE-NA1 trial, researchers studied the effects of a drug called nerinetide on stroke patients who did not receive another treatment, alteplase. They found that 59.4% of patients treated with nerinetide achieved better outcomes (independence) compared to 49.8% of those who received a placebo. The results were particularly promising for patients with higher ASPECTS scores, indicating that nerinetide could be more effective for certain types of strokes. Who this helps: This benefits stroke patients who are not candidates for alteplase treatment.

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This study tested a drug called nerinetide in patients who experienced an acute ischemic stroke and underwent a specific procedure called endovascular thrombectomy. The researchers found that 45% of those given nerinetide had a favorable recovery 90 days later, compared to 46% in the placebo group, which shows nerinetide did not improve outcomes. However, the drug was safe and did not lead to more serious side effects than the placebo group, indicating it is not harmful. Who this helps: This benefits researchers and doctors looking for effective treatments for stroke patients.

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This study looked at the drug nerinetide, which is intended to protect the brain during severe strokes, and tested whether it is effective and safe when given by paramedics before patients reach the hospital. Out of 532 participants, 57% in the nerinetide group and 58% in the placebo group had good recovery after 90 days, showing no significant difference overall. However, nerinetide may help those with certain types of strokes who receive additional treatments shortly after the stroke, which is important for improving outcomes for these patients. Who this helps: This benefits patients experiencing acute ischemic strokes who receive timely medical intervention.

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This study looked at the drug nerinetide to see if it helps patients with acute ischemic stroke when given within 3 hours of the stroke. Researchers gathered data from three trials involving 690 participants, finding that 56% of patients who received nerinetide had a positive outcome after 90 days compared to 48% who received a placebo. This matters because it shows that nerinetide could be a beneficial treatment for stroke patients if administered quickly, specifically for those eligible for certain procedures to restore blood flow. Who this helps: Patients who suffer from acute ischemic strokes.

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This study examined how a new measurement called the Odds Ratio Product (ORP), which tracks sleep depth, can help predict breathing problems and wakefulness in patients who have had a stroke. Researchers analyzed data from 113 stroke patients and found that ORP was closely linked to important measures of sleep disturbances: specifically, it showed strong predictions for breathing difficulties in patients with sleep apnea (OSA) but was less effective in those without it. Understanding and using ORP could lead to better diagnoses and treatments, ultimately improving recovery for stroke survivors. Who this helps: This helps stroke patients, especially those with sleep apnea, by improving their diagnosis and treatment options.

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This study looked at how well patients who have had a stroke can complete cognitive tests over the phone or on a computer. Out of 791 eligible patients, only 401 (51%) finished the phone test and just 242 (31%) completed the computer test. The findings show that older patients and those with more severe impairment were less likely to complete these tests, suggesting that remote testing methods may not work well for everyone after a stroke. Who this helps: This helps researchers and healthcare providers understand the challenges stroke patients face in cognitive testing, guiding better support and methods for evaluation.

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This study looked at how people living with dementia in urban and rural areas of Ontario accessed virtual doctor visits during the COVID-19 pandemic. It found that only 9.2% of the 122,751 people studied lived in rural areas, and those in rural settings had significantly lower rates of virtual visits compared to those in urban areas: 29% fewer visits to family doctors, 21% fewer visits to neurologists, and 28% fewer visits to psychiatrists or geriatricians. This is important because it highlights a gap in healthcare access for people with dementia in rural communities, which needs to be addressed to ensure they receive proper medical care. Who this helps: This helps patients living with dementia, especially those in rural areas, as well as their caregivers.

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This research study looked at how people aged 80 and older compared to those under 80 fared after having an acute ischemic stroke, and whether the treatments they received (tenecteplase or alteplase) made a difference. Out of 1,577 patients, those aged 80 and older had worse outcomes, with only 30% achieving excellent recovery compared to 42% of younger patients. The study found similar rates of bleeding and safety issues for both age groups and both treatments, but older patients experienced higher death rates and lower quality of life. Who this helps: This research benefits elderly stroke patients and their healthcare providers by highlighting the challenges faced by older individuals after a stroke.

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This research looked at the long-term risk of having a stroke after experiencing a transient ischemic attack (TIA) or a minor stroke. They found that during the first year after such an event, nearly 6 out of every 100 people will have a stroke, and by 10 years, about 20% will experience a stroke. This information is important because it highlights the ongoing risk for these patients, showing the need for better ways to prevent strokes in the future. Who this helps: Patients who have had a TIA or minor stroke.

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The study looked at how the speed of treatment for stroke patients has changed over five years, comparing two groups of patients from different trials. Researchers found that the time from when a patient arrives at the hospital to the beginning of important treatment has decreased significantly, from an average of 110 minutes in the earlier trial to 91 minutes in the newer trial, which is a big improvement. This rapid treatment is crucial because faster care leads to better outcomes for stroke patients. Who this helps: Patients experiencing strokes and the doctors treating them.

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This study looked at how the health of white matter in the brain relates to how well people with cerebrovascular disease can speak. Researchers found that better speaking skills were linked to the integrity of certain white matter pathways in the brain, particularly one called the left superior longitudinal fasciculus. For example, a stronger connection was found between language performance and the condition of the white matter, with relationships showing fractional anisotropy scores of 0.51 and mean diffusivity scores of 0.56. Who this helps: This helps patients with cerebrovascular disease by providing a better way to assess their cognitive abilities.

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This research reviewed whether training and certification for two stroke assessment tools, the NIHSS and the mRS, improve how accurately healthcare providers rate stroke conditions. Out of 23 studies analyzed, only two showed a slight increase in accuracy after NIHSS training, while the majority found no real benefits, indicating that recertification requirements for these assessments might not be necessary. This matters because it could reduce the burden on medical professionals without compromising patient care. Who this helps: Patients and healthcare professionals involved in stroke care.

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This study looked at how risk factors for heart and blood vessel problems, like high blood pressure and cholesterol, affect the brain's white matter in people with different types of brain diseases and cognitive issues. Researchers examined 520 participants, finding that those with conditions like Alzheimer's and Frontotemporal Dementia had significantly higher vascular risk factors compared to healthy individuals. Specifically, those with Alzheimer's had a 50% higher risk, Frontotemporal Dementia had a 70% higher risk, and those with Cerebrovascular Disease had more than double the risk of having these vascular issues, which also correlated with poorer brain white matter condition. Who this helps: This study benefits patients with neurodegenerative diseases and their doctors by highlighting the importance of managing vascular health to potentially improve brain function.

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This study looked at the effects of local anesthesia versus conscious sedation on recovery in patients undergoing a procedure called endovascular thrombectomy for acute ischemic stroke. The researchers found that 57.5% of patients who received local anesthesia had a good recovery three months later, compared to 55.6% of those who were sedated. This is important because it suggests that using local anesthesia may lead to better outcomes for stroke patients. Who this helps: This helps patients undergoing endovascular thrombectomy for strokes.

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The study focused on a new tool called the Canadian Outcome Scale for Minor Stroke (COSMOS) designed to provide a better assessment of outcomes for patients with minor strokes. It found that COSMOS showed a high level of agreement among different doctors and when the same doctors assessed the same cases at different times, with about 80.5% agreement for different raters and 87.1% for the same raters over time. This is important because it means that COSMOS can reliably measure recovery and challenges faced by minor stroke patients beyond just basic daily activities. Who this helps: This helps patients and doctors understand recovery from minor strokes more accurately.

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This study examined the relationship between free-water diffusion (FWD) in the brain and two processes: neuroinflammation and neurodegeneration in patients with different neurodegenerative diseases. Researchers analyzed data from 367 patients and found that FWD was more closely linked to neuroinflammation, as indicated by levels of a protein called GFAP, rather than neurodegeneration, indicated by another protein, NfL. This matters because effective ways to measure neuroinflammation non-invasively could help in the early detection and treatment of neurodegenerative diseases. Who this helps: This benefits patients with neurodegenerative diseases and the doctors treating them.

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This study looked at how quickly patients with acute ischemic stroke received treatment and how that affected their cognitive abilities three to six months later. Researchers found that reducing the time from when symptoms started to when treatment was given improved cognitive scores; specifically, each 15-minute decrease in this time lowered the chance of cognitive impairment by 7.3%. This is important because better cognitive outcomes can lead to improved overall recovery and quality of life after a stroke. Who this helps: Patients who suffer from acute ischemic strokes.

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This study examined whether giving patients a drug called tenecteplase before a procedure to remove blood clots (endovascular thrombectomy) helps achieve better blood flow in the brain on the first attempt compared to another drug, alteplase. The research included 445 patients and found that first-pass blood flow restoration occurred in 38% of patients overall, with 35% in the tenecteplase group and 41% in the alteplase group. Ultimately, the type of drug given before the procedure did not significantly affect the chances of restoring blood flow or the time taken for the procedure. Who this helps: This research benefits doctors by providing clarity on treatment options for stroke patients.

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This study looked at the health care costs for people with dementia in Ontario over five years, focusing on different stages of the disease. Researchers found that the total costs were substantial, highlighting the growing financial burden on the health system. Understanding these costs is important for planning and ensuring that resources are available to support patients and their families as dementia progresses. Who this helps: This helps patients with dementia and their families, as well as health care planners and providers.

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This study looked at how often cognitive abilities are tested in clinical trials for stroke treatments conducted between 2011 and 2024. Out of nearly 13,000 studies reviewed, only 406 involved cognitive tests, and among those, only 43 focused on treatments directly after a stroke or for prevention. The researchers found that common tests used included the Mini-Mental State Examination and the Montreal Cognitive Assessment, but there was a significant issue with missing data, averaging 22.2% across these trials. Who this helps: This research benefits patients recovering from strokes by highlighting the need for better cognitive assessments in clinical trials.

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This study looked at how two different medications, tenecteplase and alteplase, affect movement of blood clots (thrombus) in patients preparing for treatment of acute strokes. Out of 496 patients studied, those treated with tenecteplase experienced more blood clot migration—19.4% compared to 11.5% for alteplase—yet this movement was linked to better recovery after 90 days. Understanding these differences is important for choosing the best treatment for stroke patients. Who this helps: This helps patients experiencing acute ischemic strokes.

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This study looked at different tests to check brain function in adults who survived a cardiac arrest outside of a hospital. Researchers reviewed 27 studies on 13 different tests, finding that the MoCA test was reliable and valid for measuring cognitive function, with a strong accuracy rate of about 80%. However, overall, the evidence for using these tests is limited, which makes it challenging to choose the best tools for screening this patient group. Who this helps: This benefits healthcare providers and patients recovering from cardiac arrest by improving cognitive assessment methods.

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Researchers studied how likely patients who had a stroke or a transient ischemic attack (TIA) are to experience another stroke or die within a year after their initial event, particularly those who were stable enough to follow up as outpatients. They analyzed data from nearly 27,000 patients and found that 2.71% of stroke patients and 3.44% of TIA patients had a recurrent stroke within one year. They noted that older age and previous strokes or TIAs increased this risk, but overall, the ability to predict who would have a second stroke or die was quite limited. Who this helps: This helps doctors identify high-risk patients to provide better follow-up care and prevention strategies.

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This study examined how certain signs of "brain frailty," like brain shrinkage and damage to white matter, impacted recovery in patients who had a stroke and received a clot-dissolving treatment called thrombolysis. Researchers found that among 1,568 patients, those with more severe brain frailty (measured by a score of 3 to 6) were less likely to have a good recovery (only 40% were expected to have a good outcome compared to those with no frailty). Understanding these brain changes can help doctors set better expectations for patients regarding their recovery after treatment for stroke. Who this helps: Patients who have suffered an acute ischemic stroke and their doctors.

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This study looked at how the size of brain damage from a stroke (measured as infarct volume) affects recovery outcomes for patients receiving a specific treatment called intravenous thrombolysis. They found that even small increases in infarct volume could significantly impact recovery: an increase of about 1.5 mL in brain damage correlates with a 1% greater chance of a good recovery, while increases of 7.3 mL and 14.6 mL relate to 5% and 10% increases, respectively. This is important because it helps guide future treatment decisions and research on improving recovery after strokes. Who this helps: Patients recovering from acute ischemic strokes.

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This research examined the rates of major adverse cardiovascular events (MACE), like heart attacks and strokes, in separate studies of patients receiving antithrombotic treatments for either stroke prevention or general cardiovascular health. Out of 57 studies involving nearly 404,000 participants, stroke rates were significantly higher in stroke trials (7.4% per year) compared to cardiovascular trials (1.2% per year), while heart attack rates were higher in cardiovascular trials (1.5% per year vs 0.1% per year for stroke trials). Understanding these differences is important because it indicates that prevention strategies should be tailored to the specific diseases being treated, and using standardized definitions can help compare results across studies. Who this helps: This research benefits doctors and healthcare providers by informing treatment strategies for patients at risk of cardiovascular events.

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This study looked at how problems with eye movements could predict freezing of gait, a serious walking issue in people with Parkinson's disease. Over two years, researchers found that certain eye movement tests and arm stiffness could help identify patients at risk of experiencing freezing of gait. Specifically, they discovered that abnormalities in eye movement and upper limb rigidity were strong indicators that freezing would occur within two years. Who this helps: This information benefits patients with Parkinson's disease and their doctors by helping identify those at risk for serious mobility issues.

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This study looked at how changes in the retina (the light-sensitive layer at the back of the eye) can help in spotting Alzheimer's disease early. Researchers found that abnormalities in the retina related to Alzheimer’s, such as deposits of certain proteins and changes in blood vessels, may indicate what's happening in the brain. They suggested that using advanced imaging techniques could improve early detection of Alzheimer’s by revealing these retinal changes. Who this helps: This benefits patients at risk for Alzheimer’s and their doctors by providing new ways to identify the disease earlier.

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This study looked at how patients with cancer responded to a treatment called thrombolysis after experiencing a type of stroke called acute ischemic stroke (AIS). Out of 1,577 patients analyzed, only 37 had a history of cancer, and those patients were found to be significantly less likely to recover well (only about 33% achieving good functional outcomes) and had a higher chance of dying (almost four times more likely) compared to stroke patients without cancer. This matters because it highlights that cancer patients who suffer a stroke face worse outcomes, indicating a need for tailored care strategies for this group. Who this helps: This helps patients with cancer and their doctors in understanding the risks and managing treatments for strokes.

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This study examined how well the Creyos Cognitive Assessment Tool works for evaluating thinking skills in patients with heart failure. Out of 40 patients who completed all 12 tests, 73% showed significant cognitive impairment, while 93% had some level of cognitive decline compared to healthy peers. This matters because effective cognitive testing can help understand the brain health of heart failure patients and improve their care. Who this helps: Patients with heart failure and their healthcare providers.

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This study looked at two treatments, tenecteplase and alteplase, for patients suffering from acute ischemic stroke, which occurs when a blood vessel in the brain gets blocked. The researchers found that tenecteplase was just as effective as alteplase, with similar safety profiles, meaning that patients experienced similar outcomes without increased risks. This finding is important because it supports the use of tenecteplase in Europe, where it was approved for stroke treatment in January 2024. Who this helps: This helps patients experiencing acute ischemic strokes by providing them with effective treatment options.

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This study introduced a new tool called segcsvd that uses advanced technology to measure white matter hyperintensities (WMH), which are brain changes linked to cognitive decline and increased risks of stroke and dementia. Tested on over 700 MRI scans from different patient groups, segcsvd outperformed existing tools by being 44% more accurate in identifying WMH. This is important because it can lead to better understanding and tracking of brain health in various patients. Who this helps: This helps doctors and researchers working with patients at risk for cognitive issues or strokes.