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Olsson, Jan-Edvin
Publications (10 of 19) Show all publications
Sprigg, N., Gray, L., Bath, P., Lindenstrom, E., Boysen, G., De, D. P. .., . . . Turpie, A. (2007). Early Recovery and Functional Outcome are Related with Causal Stroke Subtype: Data from the Tinzaparin in Acute Ischemic Stroke Trial. Journal of Stroke & Cerebrovascular Diseases, 16(4), 180-184
Open this publication in new window or tab >>Early Recovery and Functional Outcome are Related with Causal Stroke Subtype: Data from the Tinzaparin in Acute Ischemic Stroke Trial
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2007 (English)In: Journal of Stroke & Cerebrovascular Diseases, ISSN 1052-3057, E-ISSN 1532-8511, Vol. 16, no 4, p. 180-184Article in journal (Refereed) Published
Abstract [en]

Introduction: Baseline severity and causal subtype are predictors of outcome in ischemic stroke. We used data from the Tinzaparin in Acute Ischemic Stroke Trial (TAIST) to further assess the relationship among stroke subtype, early recovery, and outcome. Methods: Patients with ischemic stroke (<48 hours ictus) and enrolled into TAIST were included. Severity was measured prospectively as the Scandinavian Neurological Stroke Scale (SNSS) at days 0, 4, 7, and 10. Causal subtype as large artery atherosclerosis (LAA), cardioembolism (CE), or small vessel occlusion (SVO) was assigned after standard investigations. The rate of recovery was calculated as the change in SNSS at each time point. Functional outcome was assessed using the modified Rankin Scale (mRS) and Barthel Index at day 90. Results: Analyses were performed on the 1190 patients in TAIST who met criteria for LAA, CE, and SVO. The largest change in SNSS score occurred between baseline and day 4 and was greatest in SVO (median improvement 4 U), compared with LAA (median improvement 2 U) and CE (median improvement 2 U) (P < .0001). If no improvement in SNSS had occurred by day 4, irrespective of subgroup, then early recovery (median SNSS improvement by day 10: 2) and functional outcome (mRS 4) tended to be limited, patients who recovered early tended to continue to improve (median SNSS improvement by day 10: 11) and had a better outcome at day 90 (median, mRS 2). Conclusions: Recovery is related to causal subtype. In all subtypes most recovery occurred by day 4, and was predictive of longer-term functional outcome. © 2007 National Stroke Association.

Keywords
Acute stroke, functional outcome, ischemic stroke, recovery
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-49166 (URN)10.1016/j.jstrokecerebrovasdis.2007.02.003 (DOI)
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-12
Sprigg, N., Gray, L. J., Bath, P. M., Lindenström, E., Boysen, G., De Deyn, P. P., . . . Turpie, A. G. (2007). Early recovery and functional outcome are related with causal stroke subtype: Data from the tinzaparin in acute ischemic stroke trial.. Journal of Stroke & Cerebrovascular Diseases, 16(4), 180-184
Open this publication in new window or tab >>Early recovery and functional outcome are related with causal stroke subtype: Data from the tinzaparin in acute ischemic stroke trial.
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2007 (English)In: Journal of Stroke & Cerebrovascular Diseases, ISSN 1052-3057, E-ISSN 1532-8511, Vol. 16, no 4, p. 180-184Article in journal (Refereed) Published
Abstract [en]

    

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-40867 (URN)54435 (Local ID)54435 (Archive number)54435 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13
Sprigg, N., Gray, L., Bath, P., Lindenstrom, E., Boysen, G., De, D. P. .., . . . Turpie, A. (2007). Stroke severity, early recovery and outcome are each related with clinical classification of stroke: Data from the 'Tinzaparin in Acute Ischaemic Stroke Trial' (TAIST). Journal of the Neurological Sciences, 254(1-2), 54-59
Open this publication in new window or tab >>Stroke severity, early recovery and outcome are each related with clinical classification of stroke: Data from the 'Tinzaparin in Acute Ischaemic Stroke Trial' (TAIST)
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2007 (English)In: Journal of the Neurological Sciences, ISSN 0022-510X, E-ISSN 1878-5883, Vol. 254, no 1-2, p. 54-59Article in journal (Refereed) Published
Abstract [en]

Introduction: Baseline severity and clinical stroke syndrome (Oxford Community Stroke Project, OCSP) classification are predictors of outcome in stroke. We used data from the 'Tinzaparin in Acute Ischaemic Stroke Trial' (TAIST) to assess the relationship between stroke severity, early recovery, outcome and OCSP syndrome. Methods: TAIST was a randomised controlled trial assessing the safety and efficacy of tinzaparin versus aspirin in 1484 patients with acute ischaemic stroke. Severity was measured as the Scandinavian Neurological Stroke Scale (SNSS) at baseline and days 4, 7 and 10, and baseline OCSP clinical classification recorded: total anterior circulation infarct (TACI), partial anterior circulation infarct (PACI), lacunar infarct (LACI) and posterior circulation infarction (POCI). Recovery was calculated as change in SNSS from baseline at day 4 and 10. The relationship between stroke syndrome and SNSS at days 4 and 10, and outcome (modified Rankin Scale at 90 days) were assessed. Results: Stroke severity was significantly different between TACI (most severe) and LACI (mildest) at all four time points (p < 0.001), with no difference between PACI and POCI. The largest change in SNSS score occurred between baseline and day 4, improvement was least in TACI (median 2 units), compared to other groups (median 3 units) (p < 0.001). If SNSS did not improve by day 4, then early recovery and late functional outcome tended to be limited irrespective of clinical syndrome (SNSS, baseline: 31, day 10: 32, mRS, day 90: 4), patients who recovered early tended to continue to improve and had better functional outcome irrespective of syndrome (SNSS, baseline: 35, day 10: 50, mRS, day 90: 2). Conclusions: Although functional outcome is related to baseline clinical syndrome (best with LACI, worst with TACI), patients who improve early have a more favourable functional outcome, irrespective of their OCSP syndrome. Hence, patients with a TACI syndrome may still achieve a reasonable outcome if early recovery occurs. © 2007 Elsevier B.V. All rights reserved.

Keywords
Acute stroke, Clinical classification, Functional outcome, Ischaemic stroke, Recovery
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-49957 (URN)10.1016/j.jns.2006.12.016 (DOI)
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-12
Sprigg, N., Gray, L. J., Bath, P. M., Boysen, G., De Deyn, P. P., Friis, P., . . . Lindenström, E. (2006). elationship between outcome and baseline blood pressure and other haemodynamic measures in acute ischaemic stroke: Data from the TAIST trial. Journal of Hypertension, 24(7), 1413-1417
Open this publication in new window or tab >>elationship between outcome and baseline blood pressure and other haemodynamic measures in acute ischaemic stroke: Data from the TAIST trial
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2006 (English)In: Journal of Hypertension, ISSN 0263-6352, E-ISSN 1473-5598, Vol. 24, no 7, p. 1413-1417Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: A poor outcome after stroke is associated independently with high blood pressure during the acute phase, however, relationships with other haemodynamic measures [heart rate (HR), pulse pressure (PP), rate-pressure product (RPP)] remain less clear. METHODS: The Tinzaparin in Acute Ischaemic Stroke Trial is a randomised, controlled trial assessing the safety and efficacy of tinzaparin versus aspirin in 1484 patients with acute ischaemic stroke. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and HR measurements taken immediately prior to randomization were averaged, and the mid-blood pressure (MBP), PP, mean arterial pressure (MAP), pulse pressure index, and RPP were calculated. The relationship between these haemodynamic measures and functional outcome (death or dependency, modified Rankin Scale > 2) and early recurrent stroke, were studied with adjustment for baseline prognostic factors and treatment group. Odds ratios (OR) and 95% confidence intervals (CI) refer to a change in haemodynamic measure by 10 points. RESULTS: A poor functional outcome was associated with SBP (adjusted OR, 1.11, 95% CI, 1.03-1.21), HR (adjusted OR, 1.15, 95% CI, 1.00-1.31), MBP (adjusted OR, 1.15, 95% CI, 1.03-1.29), PP (adjusted OR, 1.14, 95% CI, 1.02-1.26), MAP (adjusted OR, 1.15, 95% CI, 1.02-1.31) and RPP (adjusted OR, 1.01, 95% CI, 1.00-1.02). Early recurrent stroke was associated with SBP, DBP, MBP and MAP. CONCLUSIONS: A poor outcome is independently associated with elevations in blood pressure, HR and their derived haemodynamic variables, including PP and the RPP. Agents that modify these measures may improve functional outcome after stroke. © 2006 Lippincott Williams & Wilkins.

Keywords
acute stroke; ischaemic stroke; blood pressure; heart rate; pulse pressure; functional outcome
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-36275 (URN)10.1097/01.hjh.0000234123.55895.12 (DOI)30805 (Local ID)30805 (Archive number)30805 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13
Ekbom, K., Leissner, L., Olsson, J.-E. & Widner, H. (2006). Restless legs - vanligt sjukdomstillstånd som ofta missas. Möjligheter till framgångsrik behandling finns idag. Läkartidningen, 103, 207-211
Open this publication in new window or tab >>Restless legs - vanligt sjukdomstillstånd som ofta missas. Möjligheter till framgångsrik behandling finns idag
2006 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 103, p. 207-211Article in journal (Other academic) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-35645 (URN)28046 (Local ID)28046 (Archive number)28046 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13
Gray, L. J., Sprigg, N., Bath, P. M., Sörensen, P., Lindenström, E., Boysen, G., . . . Turpie, A. G. (2006). Significant variation in mortality and functional outcome after acute ischaemic stroke between western countries: Data from the tinzaparin in acute ischaemic stroke trial (TAIST). Journal of Neurology, Neurosurgery and Psychiatry, 77(3), 327-333
Open this publication in new window or tab >>Significant variation in mortality and functional outcome after acute ischaemic stroke between western countries: Data from the tinzaparin in acute ischaemic stroke trial (TAIST)
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2006 (English)In: Journal of Neurology, Neurosurgery and Psychiatry, ISSN 0022-3050, E-ISSN 1468-330X, Vol. 77, no 3, p. 327-333Article in journal (Refereed) Published
Abstract [en]

Background: The medical care of patients with acute stroke varies considerably between countries. This could lead to measurable differences in mortality and functional outcome. Objective: To compare case mix, clinical management, and functional outcome in stroke between 11 countries. Methods: All 1484 patients from 11 countries who were enrolled into the tinzaparin in acute ischaemic stroke trial (TAIST) were included in this substudy. Information collected prospectively on demographics, risk factors, clinical features, measures of service quality (for example, admission to a stroke unit), and outcome were assessed. Outcomes were adjusted for treatment assignment, case mix, and service relative to the British Isles. Results: Differences in case mix (mostly minor) and clinical service (many of prognostic relevance) were present between the countries. Significant differences in outcome were present between the countries. When assessed by geographical region, death or dependency were lower in North America (odds ratio (OR) adjusted for treatment group only = 0.52 (95% confidence interval, 0.39 to 0.71) and north west Europe (OR = 0.54 (0.37 to 0.78)) relative to the British Isles, similar reductions were found when adjustments were made for 11 case mix variables and five service quality measures. Similarly, case fatality rates were lower in North America (OR = 0.44 (0.30 to 0.66)) and Scandinavia (OR = 0.50 (0.33 to 0.74)) relative to the British Isles, whether crude or adjusted for case mix and service quality. Conclusions: Both functional outcome and case fatality vary considerably between countries, even when adjusted for prognostic case mix variables and measures of good stroke care. Differing health care systems and the management of patients with acute stroke may contribute to these findings.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-35644 (URN)10.1136/jnnp.2005.064600 (DOI)28045 (Local ID)28045 (Archive number)28045 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13
Murray, V., von Arbin, M., Bartfai, A., Berggren, A.-L., Landtblom, A.-M., Lundmark, J., . . . Mårtensson, B. (2005). Double-blind comparison of sertraline and placebo in stroke patients with minor depression and less severe major depression. Journal of Clinical Psychiatry, 66(6), 708-716
Open this publication in new window or tab >>Double-blind comparison of sertraline and placebo in stroke patients with minor depression and less severe major depression
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2005 (English)In: Journal of Clinical Psychiatry, ISSN 0160-6689, E-ISSN 1555-2101, Vol. 66, no 6, p. 708-716Article in journal (Refereed) Published
Abstract [en]

Background: Poststroke depression is a frequent condition and important to treat. The aim of this trial was to study the efficacy and tolerability of sertraline. Method: In 4 Swedish stroke centers, 123 patients (aged 70.7 ± 9.9 years) were enrolled during the period September 1998 to January 2001 in a randomized, double-blind, placebo-controlled 26-week trial, at a mean of 128 ± 97 days (range, 3-375 days) after stroke, if they fulfilled DSM-IV criteria of major depressive episode (N = 76) or minor depressive disorder (N = 47). The primary efficacy variable was a change in depression assessed by the Montgomery-Åsberg Depression Rating Scale. The Emotional Distress Scale (EDS) was administered and the occurrence of emotionalism and quality of life (QoL) were assessed, as well as neurologic recovery. Efficacy analyses were intention-to-treat, short-term (week 6) and long-term (week 26). Results: Of the 123 patients, 62 were treated with sertraline (50-100 mg/day) and 61 with placebo. Both groups improved substantially, with no differences between the treatments, either for major depressive episode or minor depressive disorder, or for short- or long-term antidepressant effect and neurologic outcome. EDS revealed a better outcome with sertraline at week 6 (p < .05). At week 26, the improvement in QoL was better in sertraline patients (p < .05) and there was a trend for emotionalism (p = .07). No serious side effects were seen. Conclusion: Poststroke depression as measured by a conventional depression rating scale improved over time irrespective of treatment. Positive effects specific to sertraline were identified in emotional distress, emotionalism, and QoL. The study indicates that poststroke emotional reactions comprise depression and other domains susceptible to pharmacologic therapy.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-31804 (URN)17629 (Local ID)17629 (Archive number)17629 (OAI)
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2017-12-13
Paviour, D. C., Revesz, T., Holton, J. L., Evans, A., Olsson, J.-E. & Lees, A. J. (2005). Neuronal intranuclear inclusion disease: Report on a case originally diagnosed as dopa-responsive dystonia with lewy bodies. Movement Disorders, 20(10), 1345-1349
Open this publication in new window or tab >>Neuronal intranuclear inclusion disease: Report on a case originally diagnosed as dopa-responsive dystonia with lewy bodies
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2005 (English)In: Movement Disorders, ISSN 0885-3185, E-ISSN 1531-8257, Vol. 20, no 10, p. 1345-1349Article in journal (Refereed) Published
Abstract [en]

Neuronal intranuclear inclusion disease (NIID) is a rare neurodegenerative disorder with a heterogeneous clinical picture characterized by the presence of eosinophilic intranuclear inclusions in neuronal and glial cells. We describe a case, reported 12 years ago as dopa-responsive dystonia (DRD) with Lewy body pathology. Pathological re-examination has led to a revised diagnosis of neuronal intranuclear inclusion disease. This rare condition, which may be diagnosed in life with a full thickness rectal biopsy, needs to be considered in the differential diagnosis of any case presenting as progressive juvenile parkinsonism (JP) or dystonia. © 2005 Movement Disorder Society.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-31199 (URN)10.1002/mds.20559 (DOI)16946 (Local ID)16946 (Archive number)16946 (OAI)
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2017-12-13
Olsson, J.-E. (2005). Ny MAO-hämmare vid behandling av Parkinsons sjukdom. Transmittorn, 1
Open this publication in new window or tab >>Ny MAO-hämmare vid behandling av Parkinsons sjukdom
2005 (Swedish)In: Transmittorn, Vol. 1Article in journal (Other (popular science, discussion, etc.)) Published
Place, publisher, year, edition, pages
Helsingborg: , 2005
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-34021 (URN)20429 (Local ID)20429 (Archive number)20429 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2018-05-28
Olsson, J.-E., Ohrvik, J. & Palhagen, S. (2005). "The Swedish Parkinson Kohort Study" : an Interim Analysis after 7 years. In: XVIII World Congress of Neurology,2005 (pp. 45-45).
Open this publication in new window or tab >>"The Swedish Parkinson Kohort Study" : an Interim Analysis after 7 years
2005 (English)In: XVIII World Congress of Neurology,2005, 2005, p. 45-45Conference paper, Published paper (Refereed)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-33810 (URN)19879 (Local ID)19879 (Archive number)19879 (OAI)
Available from: 2009-10-09 Created: 2009-10-09
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