Læknablaðið : fylgirit - 01.05.2002, Blaðsíða 39

POSTERS / 3 3RD SNC & 2ND SCNN
POSTERS
P01 - Hyperhomocysteinemia. A Risk Factor of Stroke and
Recurrent Stroke
Brander T, Christensen H, Gideon R, Truelsen T, Boysen G
Department of Neurology and Department of Clinical Biochemistry, Bispebjerg
Hospital, Denmark
Objective: The levels of s-homocystein (s-hcy) were compared in
patients with transient ischemic attachs (TIA), ischemic stroke and
hemorrhagic stroke. We evaluated s-hcy measured the day after
admission as a predictor of recurrent stroke within the following
year.
Methods: 944 patients were admitted at the Department of Neuro-
logy, Bispebjerg Hospital with the diagnoses TIA (n=190), ischemic
stroke (n=634) or hemorrhagic stroke (n=120). The patients' mean
levels of s-hcy were compared in the three diagnoses, and in
patients with recurrent stroke versus patients without recurrent
stroke during the following year. Due to log normal distribution,
data was analysed after log 10 transformation. A multivariate logis-
tic regression model was set up after univariate analysis including
variables at a significance level of 0.1.
Results: Patients with an ischemic event (TIA or ischemic stroke)
(n=824) had a mean s-hcy of 11.99 (j.mol/1 (CI 95%: 11.64-12.39),
patients with hemorrhagic stroke had a mean s-hcy of 10.52 p.mol/1
(CI 95%: 9.73-11.38). The difference between the two groups was
significant, p=0.003. After one year we could document recurrent
stroke in 44 cases, these patients had mean s-hcy levels at the
primary admission of 14.29 p.mol/1 (CI 95%: 11.51-17.70) whereas
patients without recurrent stroke had mean levels of s-hcy of 11.69
p.mol/1 (CI 95%: 11.53-12.27), p=0.005. S-hcy reached significance
in multivariate logistic regression model.
S-hcy+iofmoi/i OR: 1,4(0 95% 1.2-1.7) p=0.0028
Conclusion: Elevated s-hcy was independently associated with
recurrent stroke within the first year after a cerebrovascular event.
Our findings corroborate those of other investigators indicating that
hyperhomocysteinemia was a risk factor for ischemic stroke. On-
going intervention studies will clarify whether treating hyperhomo-
cysteinemia can reduce the risk of stroke and recurrent stroke.
P02 - Correlation between early TNF-A levels and ischaemic
stroke severity
Zaremba J1, Losy Ju
'Department of Clinical Neuroimmunology.University School of Medicine, Poznan,
Poland, TSeuroimmunological Unit.Institute of Experimental and Clinical
Medicine Polish Academy of Sciences, Poznan, Poland
Objectives: The study aimed to evaluate the levels of an important
proinflammatory cytokine tumour necrosis factor-a (TNF-ot) in
cerebrospinal fluid and serum in acute stroke and to study the
relation between those and the neurological stroke severity and
functional disability.
Material and methods: The investigations comprised 23 ischaemic
stroke patients. CSF and blood samples were obtained 24h after
the onset of stroke, and stored until analysis. Patients were
examined according to Scandinavian Stroke Scale (SSS) and to
Barthel Index (BI).
Results: The patients displayed statistically significant high levels
of TNF-a in CSF and sera within the first 24h of stroke. These
correlated significantly with SSS and BI scores calculated within the
same interval, and 1 and 2 weeks later.
Conclusion: The results suggest involvement of TNF-a in mecha-
nisms of early stroke-induced inflammation and a predictive value
of the initial TNF-a levels for the outcome of stroke.
P03 - Entacapone is of benefit in patients with early Parkinson's
disease without motor fluctuations
Brooks D, Gordin A, Poewe W, Deuschl G, Leinonen M, Kultalahti E-R,
Reinikainen K
Research Centre, Orion Pharma, Espoo, Finland
Objective: It has been shown that entacapone is effective and safe
in advanced Parkinson's disease (PD). Entacapone has not earlier
been studied in non-lluctuating patients. These patients can still be
bradykinetic, and also have other symptoms of PD, irrespective of
gaining relief with small doses of dopaminergic drugs.
The aim was to study whether patients with PD without motor
fluctuations could benefit from combining entacapone with their
current levodopa treatment.
Material and methods: A multicenter, placebo controlled, double-
blind, randomised (2:1 entacapone vs. placebo) six months study
was carried out in 29 clinics in the UK and republic of Ireland. The
study included 300 PD patients, of whom 128 were classified as non-
fluctuating. Entacapone, 200 mg (or placebo) was administered
with each daily levodopa dose.
Results: The ADL score improved from 10.6 to 10.0 in the entaca-
pone compared with a reduction of 0.1 in the placebo group
(p<0.01). The scheduled levodopa dose remained practically un-
changed in the entacapone group, and increased by 47 mg in the
placebo group, the difference being stalistically significant (p<0.01).
The effect of entacapone was lost upon withdrawal. The ADL score
worsened from the last visit value of 9.9 to a post-study value of
10.6.
Conclusion: Adjunct entacapone significantly improved the ADL
score in patients without fluctuations. This demonstrates the
beneficial effect of the use of entacapone before motor complica-
tions are emerging.
P04 - Changes in heart rate variability after stroke
Kristjánsson B, Hjaltason H, Stefánsson SB
Dept. of Neurology, Landspitali University Hospital, Reykjavík, Iceland.
Introduction: Heart rate variability (HRV) reflects sympathetic
and parasympathetic modulation of the cardiac sinus node. The aim
of the present study was to assess disruption of sympathetic/para-
sympathetic balance to the heart following stroke using HRV as a
probe.
Material and methods: Twelve stroke patients admitted to Land-
spítali, University Hospital participated in the investigations. These
were compared with a control group having similar age and sex
distribution and without a history of neurological or cardiac
disease. The patients were assessed by means of the National Insti-
tute of Health Stroke Scale. The electrocardiogram (ECG) was
recorded digitally for ten minutes from all participants. The R
Læknablaðið/Fylgirit 43 2002/88 39