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This is quite an alarming finding; for the first time, the cognitive decline rate after a mini stroke has been found to be the same as a full stroke.

Mini strokes, as you know, are events during which a brain region is temporarily deprived of oxygen, most often for only few minutes, and are without a lesion on brain MRI scans.

Researchers at the University of Alabama at Birmingham evaluated TIAs’ effect on cognitive function and found a correlation between TIAs and future cognitive decline. While TIA participants were less impaired than stroke participants, results showed the two groups have the same rate of cognitive decline after their cerebrovascular event. Results have just been published in JAMA Neurology.
Mini strokes are often viewed as relatively benign cognitive events that have minimal impact on long-term health besides an increased risk of a full stroke, This study suggests that TIAs are important medical events that affect long-term cognitive outcomes.
Previous research showed reduced cognitive function following a TIA. However, the studies did not have measurements of cognition before the TIA, and additional vascular risk factors were not adjusted or excluded. In the absence of the pre-TIA cognitive baseline, this created uncertainty about whether cognitive decline after the TIA was related to the actual TIA event.
“Clinically, TIA patients should be carefully evaluated for physical and cognitive changes at the time of the event and evaluated over time for potential cognitive decline,” Del Bene said. “Future research should also focus on the mechanisms by which a TIA and causes cognitive decline. Ultimately, it could broaden how we define stroke, which would change established clinical and research guidelines.”
Hence the real importance of knowing the signs of strokes and TIA, such as FAST. As soon as symptoms appear, even if temporary, call the emergency service. A TIA is often associated with a larger stroke within 30 days, especially the first 72 hours. Earlier intervention improves the likelihood of preserving brain function and reducing long-term disability.

Del Bene VA, Howard G, Gropen TI, et al. Cognitive Decline After First-Time Transient Ischemic Attack. JAMA Neurol. 2025;82(4):323–332. doi:10.1001/jamaneurol.2024.5082

https://jamanetwork.com/…/jama…/article-abstract/2830012

A pioneering health tracker being developed for stroke survivors will use the body to transmit data and accurately monitor progress, particularly to encourage spasticity & flaccidity decline.
A team of researchers in the United States are developing a revolutionary way of tracking body movements using Body Channel Identification sensing technology.
There are three components to this – small tags, or ‘smart stickers’, which are placed on everyday objects around the home; these are activated by a wearable wrist device; these are connected by the wearer’s body to create a closed-loop circuit.
This system can help give a comprehensive picture of a survivor’s movement post-stroke, and is currently being trialled in the world-leading Shirley Ryan AbilityLab.
“Human skin is made out of conductive material, so you can think of it as a wire,” Dr Lee explains.
“We were the first group that has demonstrated that humans can be actually used as the power transfer medium. And if the power can be transmitted, that means data can be also transmitted because the wire is the same wire.”
Through accurately monitoring mobility, it can support patient progress, he adds, especially when the survivor returns back to the community again.

A high street eye scan may help predict someone’s risk of stroke or heart attack up to 10 years in advance, new research shows. The £20 scan uses artificial intelligence to analyse images of the back of the eye and spot signs linked to cardiovascular disease.
Retinal imaging, which takes less than a minute, can detect blood vessel damage or narrowing that may indicate similar problems elsewhere in the body.
Researchers at the University of Dundee ran existing eye scans from 1,200 people with diabetes through AI software.
In 70 per cent of cases, it correctly identified early warning signs in those who went on to have a major heart problem within a decade.
Dr Ify Mordi, a cardiologist and British Heart Foundation research fellow, said: “This is a one-stop scan which is routinely performed and takes less than a minute.
If there is damage or narrowing of the blood vessels at the back of the eye, there is a good chance that that will also be seen further inside the body.
“The eyes are a window to the heart.”
The scans are widely available at high street opticians and are also offered on the NHS for some patients.
Results could be used to refer people who may not know they are at risk to a doctor for preventative treatment.
Professor Bryan Williams, chief medical officer at the British Heart Foundation, said: “The more accurately we can detect someone’s risk of a heart attack or stroke, the better the opportunities to prevent them happening.
Cutting-edge innovations like this could play a role in improving risk prediction.

Have YOU got aphasia?
Approximately 40% of stroke survivors experience this difficulty: to comprehend or produce spoken or written language caused by a cerebrovascular accident. In half of these cases the language impairment still persists one year post-stroke. Aphasia has wide-ranging effects on the ability to function and quality of life of stroke survivors and easily leads to social isolation.
If you need help, ARNI SLT Telerehab can now help YOU, right now, wherever you are in the world!
The latest evidence shows clearly that you can conquer aphasia very successfully with the help of speech and language therapy.
And it also shows that SLT Telerehab is just as effective as in-person, face to face treatment.
We have a team of highly experienced low-cost specialist SLTs (all post-grads from Universities such as UCL, the University of Cape Town etc) who are available to help you right now, in your home, via Zoom. You get a one to one hourly service, based around your diary needs, from the comfort of your own home, with a highly experienced specialist speech and language therapist. Please click to https://arni.uk.com/get-remote-speech-language-help-now/

You’ve heard of Tai Chi, yes? And the moderate to strong evidence for in assisting functional recovery from stroke?
And Ki-gong (or Qigong, qi gong, chi kung, chi ‘ung, or chi gung – same things)?

Dr Tom says: ‘In essence, for stroke survivors, I think it’s better than Tai Chi because it’s a pretty static (and v powerful) system of coordinated body-posture and movement, breathing, and energy-focus/production. I practiced it extensively in my own acute to chronic recovery. I basically bought a couple of books and taught myself how to do it – and did it – every day without fail.’
‘I used Wong Kiew Kit’s book, shown here – and he’s done lots more since – see Amazon – PLEASE INVESTIGATE IT – watch some youtube vids and then get outside or even next to an open window if it’s raining – and do it if you possibly can – it’s very good for balance, gait control and upper limb – all-round proprioception recovery, really.’
A systematic review and meta-analysis of randomized controlled trials on the effect of Qigong exercise on motor function in stroke patients has just been published in the Journal ‘Topics in Stroke Rehabilitation’
Methods: Randomized controlled trials that evaluated the effect of Qigong on motor function of stroke patients were obtained from PubMed and Chinese National Knowledge Infrastructure through May 2022. Mean values and standard deviations of the post-intervention score in both experimental group and control group were collected to calculate the mean difference (MD) and corresponding 95% confidence interval (95% CI) of each study, which were quantificationally summarized using the Review Manager 5.3 software.
Results: Nineteen randomized controlled trials enrolling 1487 stroke patients were included. Pooled results indicated that Qigong exercise had beneficial effect on balance function (Berg Balance Scale), limb motor function (Fugl-Meyer Assessment); upper limb, lower limb and walking function (6-min walking test) of stroke patients. It was also found to be associated with an improvement in trunk function as indicated by the Trunk Impairment Scale.
Conclusions: Available evidence supported potential benefits of Qigong exercise for improving motor functions of stroke patients. As a safe and widely applicable exercise, Qigong is worthy of further promotion in the rehabilitation of stroke patients.

Home-based stroke rehabilitation involves continuing physiotherapy and occupational therapy exercises at home to promote neuroplasticity, the brain’s ability to adapt and change
Many stroke survivors can be assisted to retrain by advising them to have one place and a set amount of times per week in which they devote time to their retraining. I tend to promote the importance of setting up a small matted ‘training area’ in your house, which needs only to be a few square metres wide. You also need a chair and a small table with a task-board, more advanced challenge board and other small items on it.
You need to finding your own task specifics, according to your goals. You also need to work on ‘close-simulations’. Even though simulations are probably not as effective for motor learning as performing the actual task, and remember, we are after significant performance improvement via task practice, you can see that this approach gives you some great advantages.
It keeps you in the training area, keeps you working on-task and keeps you safe. And then outside of the training area, you need to make an effort to practice the tasks (or the components of them that you can manage), as part of your ADLs (activities of daily living), noting changes when you can.

An update of ‘where we are’ as far as stem cell therapy for stroke survivors is concerned. So, stem cell therapy is, as you probably know very well, not currently recommended as a standard treatment for ischemic stroke patients due to insufficient evidence of clinical efficacy, despite promising preclinical results.
Despite the limitations of current standard treatments, stem cell therapy remains investigational. No mention of stem cell therapy appears in any of the major stroke treatment guidelines.
Multiple stem cell types have been investigated in preclinical and clinical studies:
  • Mesenchymal stem cells
  • Neural stem cells
  • Bone marrow mononuclear cells
  • Embryonic stem cells
  • Induced pluripotent stem cell-derived neural stem cells
Proposed mechanisms of action include:
  • Cell differentiation and replacement
  • Immunomodulation
  • Neural circuit reconstruction
  • Release of protective factors
The most recent and highest quality evidence comes from a 2021 systematic review and meta-analysis of randomized controlled trials. An analysis of 8 RCTs involving 459 subjects (217 intervention, 242 controls) shows:
  • No significant reduction in neurological deficit (NIHSS score) in acute or subacute stroke
  • Some benefit observed in chronic stroke patients, but clinical significance unclear
  • No statistically significant reduction in mortality rates
Overall conclusion: No clinically important evidence for efficacy of stem cells in reducing neurological deficit compared to control group.
Challenges and Limitations
Several issues remain unresolved regarding stem cell therapy for stroke:
  • Cell type selection
  • Dosing regimens
  • Delivery routes (IV vs. intra-arterial)
  • Timing of administration
  • Translation challenges from bench to bedside:
  • Conflicting results between preclinical and clinical studies
  • Mechanisms of action not fully understood
  • Limited therapeutic window in most clinical trials
So, patients reading the ARNI News page who are  interested in stem cell therapy should be referred to centers conducting approved clinical trials, avoiding unproven commercial stem cell treatments outside of regulated research settings. While stem cell therapy shows theoretical promise for ischemic stroke treatment, current evidence does not support its use in routine clinical practice. Established treatments like thrombolysis and endovascular therapy remain the standard of care for improving outcomes in ischemic stroke patients.

The 3 day annual Hungarian Specialist ARNI Stroke Rehabilitation Course for 18 physiotherapists and Rehab Training for stroke survivors which took place last weekend in Budapest! A huge well done and thank you to all involved, particularly Mrs. Gabi Pasztor, our Senior ARNI Associate Instructor and International Development Officer. Dr Tom delivered the course virtually this time: this was our 6th 3-day course in as many years.

A new UK study is investigating whether a brain-controlled computer game can help stroke survivors recover movement in their more-affected upper limb.
Participants will wear a wireless headset that records brain activity as they imagine moving their affected arm, with those signals used to control a computer game.
The research, led by Queen’s University Belfast (QUB), is recruiting around 50 people who have had a stroke. It aims to harness neuroplasticity – the brain’s ability to reorganise and allow other regions to take over lost functions.
Many stroke survivors find everyday tasks such as dressing, cooking or writing extremely difficult. Different types of rehabilitation, including game-based approaches, can offer support.
Dr Kathy Ruddy, a neuroscientist leading the research, said: “The brain signals are picked up and used to control a computer game.
“This form of ‘motor imagery’ activates the same brain areas as real movement and it may help keep these body parts healthy and active after a stroke, even when actual movement isn’t yet possible.”
The team at QUB said the research is giving hope to people whose movement or speech remains affected after stroke.

This superb graph created by ARNI supporter Professor Peter Langhorne for his excellent journal article in The Lancet (also shown in Dr Balchin’ ‘Had a Stroke’, Now What’) shows that a fixed therapeutic time window of 3/6 months doesn’t necessarily exist – this is proof that you can show all the naysayers.

This is ‘hope in a graph’ as far as I’m concerned – it means that there is no real “end” to recovery and that you CAN continue to recover and do better in terms of action control after many years have passed as long as you continue to stretch to keep muscles long/pliable, do as many ADLs as possible and do at least one ‘Rehabby Hobby’ as Dr Tom calls it.

His main intensive ‘rehabby hobby’ was DJing. You can read about exactly how he used this in ‘Had a Stroke’, Now What’ and can get ideas about other hobbies which challenge the paretic upper limb to the max 😉



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