Dramatic Recovery Research Articles

Abstract TP63: Hypoperfusion Volume Immediately After Endovascular Reperfusion Therapies: A Highly Accurate Early Predictor of Clinical Outcome After Recanalization

Despite successful recanalization after endovascular treatment (EVT), a proportion of patients will not experience favorable outcome. We hypothesize that an early computed tomography perfusion (CTP-AFT) immediately after EVT may improve clinical outcome prediction. Methods: Consecutive patients with large vessel occlusion (LVO) who achieved partial (TICI 2a) or complete (TICI 2b/3) recanalization after EVT underwent CTP-AFT within 30 minutes. Different CTP parameters were measured with the Rapid software. Clinical data were recorded including dramatic recovery (DR: ≥8 points decrease from baseline NIHSS or NIHSS 0-2 at 24 hours) Results: Forty-six LVO were included, median baseline NIHSS was 18 (P25-75 13-22). Final recanalization grades were: TICI 2a, 5 patients (10.8%); TICI 2b, 19 (41.6%); and TICI 3, 22 (47.8%). Median 24h infarct volume was 7.5 cc (0-19). Median NIHSS decrease after 24h was 8 (1-16). Twenty-seven (58%) patients experienced DR. The volume with Tmax>6 seconds was the only CTP parameter that correlated with degree of recanalization: TICI 2a: 102cc (60-138); TICI 2b: 15cc (0-37); and TICI 3: 0cc (0-5), p<0.005. Lower Tmax>6s volume was associated with lower 24h-infarct volume (p<0.01), lower 24h NIHSS (p<0.01) and higher probability of DR (p<0.01). A ROC curve identified a Tmax>6s volume <5.5cc as the best cut-off point to predict DR (sens 73.7%, specif 70.4%, AUC 0.74). A logistic regression analysis adjusted by age, baseline NIHSS, ASPECTS, occlusion location and time and degree of recanalization showed that the only predictor of DR was a Tmax>6s volume <5.5cc (OR 21.6, CI 2.7-173.2, p<0.01). Conclusion: CTP maps performed immediately after EVT correlated with degree of recanalization. However, a low Tmax>6s volume predicted clinical outcome better than post-procedural TICI scores.

Conditional BDNF Delivery from Astrocytes Rescues Memory Deficits, Spine Density, and Synaptic Properties in the 5xFAD Mouse Model of Alzheimer Disease.

It has been well documented that neurotrophins, including brain-derived neurotrophic factor (BDNF), are severely affected in Alzheimer's disease (AD), but their administration faces a myriad of technical challenges. Here we took advantage of the early astrogliosis observed in an amyloid mouse model of AD (5xFAD) and used it as an internal sensor to administer BDNF conditionally and locally. We first demonstrate the relevance of BDNF release from astrocytes by evaluating the effects of coculturing WT neurons and BDNF-deficient astrocytes. Next, we crossed 5xFAD mice with pGFAP:BDNF mice (only males were used) to create 5xFAD mice that overexpress BDNF when and where astrogliosis is initiated (5xF:pGB mice). We evaluated the behavioral phenotype of these mice. We first found that BDNF from astrocytes is crucial for dendrite outgrowth and spine number in cultured WT neurons. Double-mutant 5xF:pGB mice displayed improvements in cognitive tasks compared with 5xFAD littermates. In these mice, there was a rescue of BDNF/TrkB downstream signaling activity associated with an improvement of dendritic spine density and morphology. Clusters of synaptic markers, PSD-95 and synaptophysin, were also recovered in 5xF:pGB compared with 5xFAD mice as well as the number of presynaptic vesicles at excitatory synapses. Additionally, experimentally evoked LTP in vivo was increased in 5xF:pGB mice. The beneficial effects of conditional BDNF production and local delivery at the location of active neuropathology highlight the potential to use endogenous biomarkers with early onset, such as astrogliosis, as regulators of neurotrophic therapy in AD.SIGNIFICANCE STATEMENT Recent evidence places astrocytes as pivotal players during synaptic plasticity and memory processes. In the present work, we first provide evidence that astrocytes are essential for neuronal morphology via BDNF release. We then crossed transgenic mice (5xFAD mice) with the transgenic pGFAP-BDNF mice, which express BDNF under the GFAP promoter. The resultant double-mutant mice 5xF:pGB mice displayed a full rescue of hippocampal BDNF loss and related signaling compared with 5xFAD mice and a significant and specific improvement in all the evaluated cognitive tasks. These improvements did not correlate with amelioration of β amyloid load or hippocampal adult neurogenesis rate but were accompanied by a dramatic recovery of structural and functional synaptic plasticity.

Shoshin syndrome: report of a treatable disaster

Shoshin syndrome is a rare fulminating heart failure caused by thiamine deficiency. In Japanese “sho” means acute damage and “shin” means heart. It consists of a rare and hyperacute manifestation of beriberi that was first described in polished white rice-eating communities in various locations across Asia including China, Japan and Indonesia. In a totally different context, ‘Shoshin’ is a word from Zen Buddhism meaning “beginner’s mind”, which is considered the necessary attitude to approach the Zen practice. This case report is a prime example of clinical manifestations of thiamine deficiency for the presence of both cardiological and neurological disorders, for hyperacute onset of cardiac failure (shoshin syndrome), for the simultaneous involvement of peripheral and central nervous system, and for the dramatic global recovery after thiamine replacement therapy. We therefore explain why the physician should adopt a beginner’s mind in clinical practice.

Guillain–barre syndrome as a presenting feature of systemic lupus erythematosus in a child and it's complete resolution with rituximab treatment

Systemic lupus erythematosus (SLE) can present with varied neurological manifestations in children. Guillain–Barre syndrome (GBS) as a presenting feature of SLE is quite rare in children. We report a 9-year-old girl who presented with acute motor axonal polyradiculoneuropathy and noticed to have features of SLE. She was initially treated with intravenous immunoglobulins and corticosteroids with partial response. After starting rituximab, she showed dramatic recovery, proving the role of rituximab in GBS refractory to first-line medications in SLE. She remained in remission after 12 months of follow-up.

Polyethylene glycol (PEG) and other bioactive solutions with neurorrhaphy for rapid and dramatic repair of peripheral nerve lesions by PEG-fusion

BackgroundNervous system injuries in mammals often involve transection or segmental loss of peripheral nerves. Such injuries result in functional (behavioral) deficits poorly restored by naturally occurring 1–2 mm/d axonal outgrowths aided by primary repair or reconstruction. “Neurorrhaphy” or nerve repair joins severed connective tissues, but not severed cytoplasmic/plasmalemmal extensions (axons) within the tissue. New methodPEG-fusion consists of neurorrhaphy combined with a well-defined sequence of four pharmaceutical agents in solution, one containing polyethylene glycol (PEG), applied directly to closely apposed viable ends of severed axons. ResultsPEG-fusion of rat sciatic nerves: (1) restores axonal continuity across coaptation site(s) within minutes, (2) prevents Wallerian degeneration of many distal severed axons, (3) preserves neuromuscular junctions, (4) prevents target muscle atrophy, (5) produces rapid and improved recovery of voluntary behaviors compared with neurorrhaphy alone, and (6) PEG-fused allografts are not rejected, despite no tissue-matching nor immunosuppression. Comparison with existing methodsIf PEG-fusion protocols are not correctly executed, the results are similar to that of neurorrhaphy alone: (1) axonal continuity across coaptation site(s) is not re-established, (2) Wallerian degeneration of all distal severed axons rapidly occurs, (3) neuromuscular junctions are non-functional, (4) target muscle atrophy begins within weeks, (5) recovery of voluntary behavior occurs, if ever, after months to levels well-below that observed in unoperated animals, and (6) allografts are either rejected or not well-accepted. ConclusionPEG-fusion produces rapid and dramatic recovery of function following rat peripheral nerve injuries.

Enhanced electrochemical performance by size-dependent SEI layer reactivation of NiCo2O4 anodes for lithium ion batteries

Under over-increasing demand of advanced lithium-ion batteries (LIBs) for long-range electric vehicles (EVs), high-capacity transition metal oxide (TMO) negative electrodes for LIBs are thought as potential substitutes of traditional graphite anodes. A major barrier for TMO anodes is volumetric expansion during lithiation processes, leading to active material pulverization and falling off current collectors, which seriously deteriorates capacity retention. Herein, apart from conventional mechanical degradation, another capacity fading mechanism is revealed. Furthermore, the understanding is supported by an interesting cycling property. Firstly, NiCo2O4 with designed morphologies of nanoplates and microspheres are studied for the initial (de)lithiation and prolonged cycles. The morphology changes indicate solid electrolyte interphase (SEI) layer accumulating on the surface of electrodes and impeding the contact and reactions between lithium and active materials with a result of severe capacity loss. It can be understood as SEI layer insulating NiCo2O4, and if SEI film appropriately changes, high capacities can recovery. This conjecture is confirmed by following research of NiCo2O4 nanoparticles with amazing cycling performance prepared by a facile water-bath method. As LIB anodes, NiCo2O4 nanoparticles exhibit capacities of 1144 mAh g−1 at the initial discharging, 230 mAh g−1 at the 100th cycle and 661 mAh g−1 at the 500th cycle. The corresponding coulombic efficiency is of 73.1%, 98.4% and 99.5%, respectively. By TEM characterization in combination with electrochemical analysis, size-dependent SEI layer reactivation (from thick and unstable to thin and stable) is a key role on the dramatic capacity recovery.

Encephalitis Associated to Metabotropic Glutamate Receptor 5 (mGluR5) Antibodies in Cerebrospinal Fluid

A 68-years-old Hispanic man, complained of night sweats, low grade fewer, unexplained weight loss, and memory problems over 3 months. Abdominal tomography showed multiple intra-abdominal adenopathy and biopsy confirmed classic Hodgkin's lymphoma. He commenced treatment with chemotherapy. Three months later, he had acute onset of inattention, auditory hallucinations and alterations of anterograde memory. The patient developed psychomotor agitation, unresponsive to a combination of neuroleptics and benzodiazepines. Brain MRI showed a small established cerebellar infarction. Electroencephalogram was normal. Tests for toxic metabolic encephalopathy were negative. One oligoclonal IgG bands was found in the Cerebrospinal fluid (CSF), which was not observed in corresponding serum, but cell count and protein were normal. Extensive testing for infectious encephalitis was unremarkable. CSF testing for commercially available neural and non-neural autoantibodies was negative. The patient fulfilled the Gultekin diagnostic criteria for paraneoplastic limbic encephalitis and methylprednisolone IV 1g/d for 5 days was given. He recovered rapidly, with progressive improvement in memory and psychomotor agitation. After treatment commenced, results for antibodies to mGluR5 in CSF taken prior to treatment were returned as positive. mGluR5 is found on post-synaptic terminals of neurons and microglia and is expressed primarily in the hippocampus and amygdala. This case highlights the difficulties in diagnosing this type of encephalitis: the CSF did not show pleocytosis, the MRI showed only chronic change and the electroencephalogram was normal. The dramatic recovery after methylprednisolone help to better characterized the clinical spectrum of auto-immune encephalitis. Diagnosing anti mGlutR5 encephalitis may lead to potentially highly effective treatment option and may anticipate the diagnostic of a cancer. A high index of suspicion is needed to avoid missed diagnosis. In patients with unexplained encephalitis, testing for antibodies to mGluR5 in CSF and serum should be considered. When there is a reasonable index of suspicion of auto-immune encephalitis, treatment should not be delayed for the antibody results.

Endangered Père David's deer genome provides insights into population recovering.

The Milu (Père David's deer, Elaphurus davidianus) were once widely distributed in the swamps (coastal areas to inland areas) of East Asia. The dramatic recovery of the Milu population is now deemed a classic example of how highly endangered animal species can be rescued. However, the molecular mechanisms that underpinned this population recovery remain largely unknown. Here, different approaches (genome sequencing, resequencing, and salinity analysis) were utilized to elucidate the aforementioned molecular mechanisms. The comparative genomic analyses revealed that the largest recovered Milu population carries extensive genetic diversity despite an extreme population bottleneck. And the protracted inbreeding history might have facilitated the purging of deleterious recessive alleles. Seventeen genes that are putatively related to reproduction, embryonic (fatal) development, and immune response were under high selective pressure. Besides, SCNN1A, a gene involved in controlling reabsorption of sodium in the body, was positively selected. An additional 29 genes were also observed to be positively selected, which are involved in blood pressure regulation, cardiovascular development, cholesterol regulation, glycemic control, and thyroid hormone synthesis. It is possible that these genetic adaptations were required to buffer the negative effects commonly associated with a high‐salt diet. The associated genetic adaptions are likely to have enabled increased breeding success and fetal survival. The future success of Milu population management might depend on the successful reintroduction of the animal to historically important distribution regions.

Aligned Copper Zinc Tin Sulfide Nanorods as Lithium-Ion Battery Anodes with High Specific Capacities

Highly aligned copper zinc tin sulfide nanorods electrophoretically deposited directly on the current collector are tested for suitability as Li-ion battery anodes in both half-cell (HC) and full-cell (FC) configurations. This facile fabrication process offers several advantages for high-performance nanostructured battery electrodes, notably the formation of a dense, conductive carbon and binder-free film maximizing active material content. High initial capacities of 1611 and 1369 mA h g–1 are achieved for the HC and FC, respectively. The capacity trends and degradation mechanisms for this combined alloying and conversion material are analyzed in detail using differential capacity plots and electrochemical impedance spectroscopy, and it is determined that an evolution in the electrode resistance (instead of typical material pulverization/delamination) is the major driver of an initial capacity fade followed by a dramatic capacity recovery. Differences in capacity retention trends between HCs and FCs are h...

Enhancement of the adaptability of anammox granules to zinc shock by appropriate organic carbon treatment

Heavy metals, which are commonly present in high ammonia-containing wastewater, can cause inhibitory effects to anammox reaction. This study proposes a novel approach to enhance the adaptability of anammox granules to heavy metal [Zn(II)] shock by organic carbon (sodium acetate, NaAc) treatment, paying special attention to optimization of the treatment dosage and duration. For granules treated with 200 mg chemical oxygen demand (COD)/L NaAc for 2 d, the activity recovery (six cycles) efficiency after Zn(II) (40 mg/L) shock reached 127.4%. The extracellular polymeric substance (EPS) production increased by 168% and heterotrophic bacteria mildly proliferated (increased by 14%) in such granules compared with the control. The dramatic recovery capacity was likely due to the entrapment and barrier function of EPS and the outer-layer proliferated heterotrophic bacteria. This finding offers a useful process to enable maximum adaptability of anammox granules from heavy metals shocks, allowing anammox technology to be more widely applied.

P.108 Case report: listeria rhombencephalitis in a healthy 64 year old woman

Background: Listeria rhombencephalitis is a rare and serious complication of Listeria monocytogenes infection. We present a case of presumed Listeria rhombencephalitis with dramatic recovery from a highly morbid state. Methods: A previously healthy 64 year old woman with a remote and stable history of a major depressive episode and no history to suggest immune compromise presented with nausea and vomiting followed by the acute onset of diplopia and gait disturbance 28 days after exposure to an identified infectious source of spring rolls and 21 days after a severe diarrheal illness from that exposure. Our patient was evaluated by emergency physicians and general internists over a period of 1 week after the onset of diplopia and gait disturbance and given a diagnosis of serotonin syndrome before receiving a consultation from Neurology. Her presentation featured a deep encephalopathy and an unusual hyperkinetic movement disorder with startle myoclonus, palatal myoclonus and diffuse tremor. Results: Her MRI scan showed FLAIR hyperintensities in the bilateral cerebellum and pons with adjacent pial enhancement, characteristic of Listeria rhombencephalitis. Her CSF showed a lymphocytic pleocytosis with normal chemistry. Conclusions: She recovered dramatically to treatment with IV ampicillin. This case report illustrates the importance of considering Listeria rhombencephalitis in immunocompetent patients with brainstem symptoms following a diarrheal illness.

Delayed Hypoxic Reversible Leukoencephalopathy Syndrome

We report a case of postanoxic leukoencephalopathy in a patient who started to have cognitive and behavioral changes weeks after the anoxic insult along with white matter lesions on neuroimaging and demyelination on brain biopsy. His disease course followed a steady decline initially both clinically and radiologically and assumed a steady plateau. Months after his decline, the patient was seen to be completely functional with substantially improved mental status examination and resolution of white matter changes on imaging. The course of this disease entity usually assumes a plateau after clinical worsening with little improvement subsequently. However, our patient showed a dramatic recovery to his baseline after a few months. In this article, we review mechanisms, presentation and the sequelae of hypoxic injury to the brain.

Polyethylene glycol solutions rapidly restore and maintain axonal continuity, neuromuscular structures, and behaviors lost after sciatic nerve transections in female rats.

Complete severance of major peripheral mixed sensory-motor nerve proximally in a mammalian limb produces immediate loss of action potential conduction and voluntary behaviors mediated by the severed distal axonal segments. These severed distal segments undergo Wallerian degeneration within days. Denervated muscles atrophy within weeks. Slowly regenerating (∼1 mm/day) outgrowths from surviving proximal stumps that often nonspecifically reinnervate denervated targets produce poor, if any, restoration of lost voluntary behaviors. In contrast, in this study using completely transected female rat sciatic axons as a model system, we provide extensive morphometric, immunohistochemical, electrophysiological, and behavioral data to show that these adverse outcomes are avoided by microsuturing closely apposed axonal cut ends (neurorrhaphy) and applying a sequence of well-specified solutions, one of which contains polyethylene glycol (PEG). This "PEG-fusion" procedure within minutes reestablishes axoplasmic and axolemmal continuity and signaling by nonspecifically fusing (connecting) closely apposed open ends of severed motor and/or sensory axons at the lesion site. These PEG-fused axons continue to conduct action potentials and generate muscle action potentials and muscle twitches for months and do not undergo Wallerian degeneration. Continuously innervated muscle fibers undergo much less atrophy compared with denervated muscle fibers. Dramatic behavioral recovery to near-unoperated levels occurs within days to weeks, almost certainly by activating many central nervous system and peripheral nervous system synaptic and other plasticities, some perhaps to a greater extent than most neuroscientists would expect. Negative control transections in which neurorrhaphy and all solutions except the PEG-containing solution are applied produce none of these remarkably fortuitous outcomes observed for PEG-fusion.

Dilemmas in Current Management of Complicated Chronic Otitis Media.

To evaluate the distribution of complications of chronic otitis media, dilemma of how soon to operate a seriously ill patient with CSOM and treatment outcomes. A retrospective study was done in a tertiary care centre. Clinical data from 2013 to 2015 was compiled, surgical management with outcome was analysed. A total of 425 patients with chronic otitis media were evaluated. Single/multiple complications were seen in 147 (34.5%) patients. Majority of the complications were seen in active squamosal type of chronic otitis media i.e. 137 (59.5%) cases out of the 147. Meningitis (3.3%) was the most common intracranial complication. Patients with intracranial complications were referred from other departments and did not primarily present to ENT, indicating a major fact that treatment was sort for the complication and not for chronic otitis media. Headache with or without ear discharge was the most common presenting complaint. Fever and pain were not prominent indicators of complications, posing a diagnostic dilemma as patients were already receiving antibiotics and analgesics before reaching tertiary care centre. The patients with severe intracranial complications were promptly taken up (within 3-5days) for canal wall down mastoidectomy with intravenous broad spectrum antibiotic (vancomycin) and mannitol with high risk consent. However ill the patients were, especially children with very poor general conditions, there was dramatic recovery as soon as the mastoidectomy was done. There were no deaths due to the complications of chronic otitis media in our 3years study period. Delay in resorting to surgical management of chronic otitis media was the main reason for patients going into complications. Timely mastoidectomy in patients with poor general condition with high risk of mortality, the surgery actually had a major role in reducing the morbidity and mortality. Lack of awareness that chronic otitis media is a condition that can lead to life threatening complications resulted in procrastination of surgery. Chronic otitis media requires speedy surgical management i.e. as soon as patient is fit to tolerate anaesthesia: Tympanoplasty and Canal wall up or down Mastoidectomy to prevent complications from arising or to resolve the present complication.

Rapid Expansion of Banded Killifish Fundulus diaphanus across Northern Illinois: Dramatic Recovery or Invasive Species?

The distribution of the Illinois state-threatened Banded Killifish Fundulus diaphanus has remained largely unchanged in Illinois from 1880 to 2000, being restricted mainly to the northeastern corner of the state. One population identified as Western Banded Killifish F. d. menona has remained stable in the glacial lakes region along the southeastern Wisconsin–northeastern Illinois border. Starting in 2001 a second population began to spread and become more common along the Lake Michigan shoreline. From there the population expanded through the Chicago Area Waterway System into the Des Plaines River and eventually the Illinois River. Historical museum specimens from this region are identified as F. d. menona, but recent specimens are identified as hybrids between F. d. menona and Eastern Banded Killifish F. d. diaphanus. Subsequently, a third population appeared in the Mississippi River near the mouth of the Rock River in 2009 and has spread from there. These individuals are also identified as F. d. menona. The rapid expansion of Banded Killifish from Lake Michigan to the Illinois River appears to be an invasion of the Eastern subspecies F. d. diaphanus and the subsequent hybridization with the native Western subspecies. It is unknown where the Banded Killifish in the Mississippi River originated, possibly from populations 160 kilometers upstream or human introductions. As the Illinois River and Mississippi River populations continue to expand their ranges, their ecological impacts are unknown at this time.

Closed-loop neuromodulation restores network connectivity and motor control after spinal cord injury.

Recovery from serious neurological injury requires substantial rewiring of neural circuits. Precisely-timed electrical stimulation could be used to restore corrective feedback mechanisms and promote adaptive plasticity after neurological insult, such as spinal cord injury (SCI) or stroke. This study provides the first evidence that closed-loop vagus nerve stimulation (CLV) based on the synaptic eligibility trace leads to dramatic recovery from the most common forms of SCI. The addition of CLV to rehabilitation promoted substantially more recovery of forelimb function compared to rehabilitation alone following chronic unilateral or bilateral cervical SCI in a rat model. Triggering stimulation on the most successful movements is critical to maximize recovery. CLV enhances recovery by strengthening synaptic connectivity from remaining motor networks to the grasping muscles in the forelimb. The benefits of CLV persist long after the end of stimulation because connectivity in critical neural circuits has been restored.

Rapid Reversal of Complete Binocular Blindness With High-Dose Corticosteroids and Lumbar Drain in a Solid Organ Transplant Recipient With Cryptococcal Meningitis and Immune Reconstitution Syndrome: First Case Study and Literature Review.

Blindness is a rare, devastating, usually permanent complication of cryptococcal meningitis (CM). We present the first case of complete vision loss in a solid organ transplant recipient with CM treated with placement of a lumbar drain who had a dramatic visual recovery that started after 3 doses of high-dose steroids.

Thyroid Storm Presenting as Psychosis.

Thyroid storm is a life-threatening endocrine emergency with an incidence rate of 1% to 2%. It is a systemic condition of excessive thyroid hormone production and release leading to thermoregulatory, adrenergic, neuropsychiatric, cardiovascular, and abdominal manifestations. Although it is a rare condition, it carries a significant mortality rate. Hence, knowing the common and uncommon presentations of thyroid storm is important for its prompt diagnosis and treatment. In this article, we present an unusual case of a young woman who presented with psychosis as the manifesting symptom of thyroid storm. She did not respond adequately to conventional medical treatment, requiring plasmapheresis and a definitive thyroidectomy, which ultimately led to the return of patient’s baseline mental status and a dramatic recovery.

A case of dramatic recovery from septic shock by ESBL-producing E.coli

A case of dramatic recovery from septic shock by ESBL-producing E.coli

Ecosystem vs. community recovery 25 years after grass invasions and fire in a subtropical woodland

Summary Despite a large body of research documenting invasive plant impacts, few studies have followed individual invaded sites over decades to observe how they change, and none have contrasted how compositional impacts from invasion compare to ecosystem‐process impacts over a multi‐decadal time‐scale. Using direct measurements of plant density and composition and of ecosystems processes, we evaluate how ecosystem structure, above‐ground net primary production (ANPP), and above‐ground and soil nutrient pools compare over 25 years since fire and C4 grass invasions disrupted seasonally dry Hawaiian woodlands. We compare structure and function between primary woodland that has never burned and is largely native species‐dominated, with sites that had been the same woodland type but burned in alien‐grass‐fuelled fires in the 1970s and 1980s. The sites have not experienced fires since 1987. We report here that woody plant composition and structure continue to be dramatically changed by the initial invasions and fires that occurred 25 years ago and invaders continue to dominate in burned sites. This is reflected in continued low plant carbon pools in burned compared to unburned sites. Yet ANPP and N storage, which were dramatically lower in the initial decade after invasive‐grass fuelled fires, have increased and are now indistinguishable from values measured in intact woodlands. Soil carbon pools were resilient to both invasion and fire initially and over time. Above‐ground net primary production has recovered because of invasion of burned sites by a non‐native N‐fixing tree rather than because of recovery of native species. This invasive N‐fixing tree is unlikely to return C storage of the invaded sites to those of unburned woodland because of its tissue and growth characteristics and its interactions with invasive grasses. It does not facilitate native species but rather promotes a persistent invasive grass/N‐fixer savanna. Synthesis. We conclude that fire, an unusual disturbance in this system, has perpetuated the dominance of these sites by invasive species and that despite the dramatic recovery of above‐ground net primary production and N pools, the ecosystem continues to be in a distinctly different state than the pre‐fire, pre‐Melinis community. Thus, despite the absence of further disturbance (fire), there is no evidence that succession towards the original ecosystem is occurring. The fact that N pools and above‐ground net primary production recover because of a new invader (Morella faya), highlights the unpredictability of ecosystem trajectories in the face of altered regional species pools.