Clinical Neurology and Neurosurgery最新文献

{"title":"Assessing Glibenclamide’s efficacy on functional recovery in aneurysmal subarachnoid hemorrhage: A meta-analysis of randomized controlled trials","authors":"Luciano Falcão ,&nbsp;Pedro Antonio Lopes Gomes ,&nbsp;Rafael Andrade Sampaio Silva ,&nbsp;Kenzo Ogasawara ,&nbsp;João Victor Pereira Gonzalez ,&nbsp;André Nishizima ,&nbsp;Victor Arthur Ohannesian ,&nbsp;Lara Souza Magalhães ,&nbsp;Davi J. Fontoura Solla","doi":"10.1016/j.clineuro.2025.108847","DOIUrl":"10.1016/j.clineuro.2025.108847","url":null,"abstract":"<div><h3>Introduction</h3><div>Glibenclamide, a sulfonylurea receptor 1 (SUR1) inhibitor initially developed for diabetes, has shown potential in reducing cerebral edema and neuroinflammation. This study evaluates its efficacy in improving functional outcomes and reducing complications in aSAH.</div></div><div><h3>Methods</h3><div>Databases including PubMed, EMBASE, and Web of Science were searched for RCTs assessing Glibenclamide's effects in aSAH. Outcomes included modified Rankin Scale (mRS), mortality, rebleeding risk, hydrocephalus incidence, and hospital stay duration. Risk Ratio (RR) and Mean Differences (MD) were calculated using random- or fixed-effects models based on heterogeneity (I² statistic).</div></div><div><h3>Results</h3><div>Four RCTs (290 participants) met inclusion criteria. No significant differences were found in mRS scores at 90 days (MD: 0.06, 95 % CI: −0.59–0.71, p = 0.86) or 180 days (MD: −0.43, 95 % CI: −1.09–0.23, p = 0.20). Similarly, mortality (RR: 0.87, 95 % CI: 0.49–1.54, p = 0.665), rebleeding risk (RR: 0.78, 95 % CI: 0.23–2.60, p = 0.639), hydrocephalus incidence (RR: 1.64, 95 % CI: 0.96–2.79, p = 0.064), and hospital stay (MD: 0.09 days, 95 % CI: −2.15–2.32, p = 0.94) showed no significant differences. The meta-regression analysis showed that Glibenclamide dosage (p = 0.0007) and modified Fisher Scale (p = 0.0312) were significantly associated with mRS outcomes, while age (p = 0.1506), WFNS grade (p = 0.1956), and Hunt-Hess Scale (p = 0.1464) had no significant impact.</div></div><div><h3>Conclusion</h3><div>Current evidence indicates that Glibenclamide does not significantly improve outcomes or reduce complications in aSAH. While promising for cerebral edema, larger multicenter RCTs with standardized protocols and extended follow-ups are needed to clarify its role.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"252 ","pages":"Article 108847"},"PeriodicalIF":1.8,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143643616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The medial antebrachial cutaneous nerve in thoracic outlet syndrome: A systematic review and meta-analysis","authors":"Andrea Shehaj ,&nbsp;Shareef Shaheen ,&nbsp;Kimberly Kray ,&nbsp;Junjia Zhu ,&nbsp;Elias Rizk","doi":"10.1016/j.clineuro.2025.108842","DOIUrl":"10.1016/j.clineuro.2025.108842","url":null,"abstract":"<div><h3>Objective</h3><div>This systematic review aims to evaluate the existing literature to ascertain the utility of MABC in diagnosing TOS and the prognosis of TOS patients who have undergone surgical intervention. By synthesizing the available evidence regarding MABC's role in this patient population, this review seeks to enhance risk stratification and inform treatment decisions.</div></div><div><h3>Methods</h3><div>A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement for Reporting Systematic Reviews. Medline/Pubmed, Embase/Scopus, and Web of Science databases were queried for potential studies using the terms (\"Medial antebrachial cutaneous nerve\" AND \"Thoracic Outlet Syndrome\"). Inclusion criteria were studies published in peer-reviewed journals discussing the utilization of medial antebrachial cutaneous nerve conduction studies in the diagnosis and/or prognosis of Thoracic Outlet Syndrome.</div></div><div><h3>Results</h3><div>A systematic literature review yielded 10 manuscripts, which were included after a full-text review. We determined 137 symptomatic TOS limbs. Overall, 93 % and 84 % of TOS patients presented with sensory abnormalities and weakness, respectively. Overall, 92 % of patients had an abnormal MABC nerve amplitude prior to surgery. The overall effect size (Hedges g) for the meta-analysis of four studies was 1.80 with a 95 % confidence interval of (0.63; 2.97). Analyzing surgical outcomes, the compiled data indicate an overall improvement rate of 87 % in some sensory and/or motor functions.</div></div><div><h3>Conclusions</h3><div>Our review demonstrates the utility of MABC as a diagnostic tool. Furthermore, we emphasize the positive response expected from surgical intervention, highlighting that more studies are needed to determine the utility of MABC as a surgical outcomes prognostic tool.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"252 ","pages":"Article 108842"},"PeriodicalIF":1.8,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroinflammatory response after subarachnoid hemorrhage: A review of possible treatment targets","authors":"Xiao-Man Fu ,&nbsp;Chen-Lu Li ,&nbsp;Hong-Ru Jiang ,&nbsp;Jia-yun Zhang ,&nbsp;Tao Sun ,&nbsp;Feng Zhou","doi":"10.1016/j.clineuro.2025.108843","DOIUrl":"10.1016/j.clineuro.2025.108843","url":null,"abstract":"<div><div>A serious neurosurgical emergency, subarachnoid hemorrhage (SAH) is characterized by vascular and neuropathy, as well as complex pathological mechanisms like vascular lesions, inflammatory responses, and nerve cell damage. The inflammatory response is an essential aspect of SAH's pathophysiology, causing the release of a number of inflammatory mediators and oxidative stress products like TNF-α, MCP-1, MMPs, and so on, which either directly or indirectly contribute to the development of SAH.It has recently been discovered that some antibodies against inflammatory mediators, antioxidant stress, botanicals, and traditional Chinese medicine decrease the inflammatory response of SAH. Additionally, certain biomarkers linked to inflammation may serve as a foundation for clinical diagnosis.Although these mechanisms are still not completely understood, we can explore potential therapeutic targets by studying the role of inflammatory responses and bioactive molecules in the formation of SAH.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"252 ","pages":"Article 108843"},"PeriodicalIF":1.8,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of acute intraprocedural thromboembolism risk factors in endovascular treatment of unruptured intracranial aneurysms","authors":"Yunus Emre Senturk ,&nbsp;Anil Arat","doi":"10.1016/j.clineuro.2025.108837","DOIUrl":"10.1016/j.clineuro.2025.108837","url":null,"abstract":"<div><h3>Background</h3><div>Acute intraprocedural thromboembolism (AIT) is not a rare complication that usually occurs immediately after stent deployment during endovascular aneurysm treatment (EVAT).</div></div><div><h3>Methods</h3><div>We retrospectively analyzed the 386 EVAT of 320 patients for the AIT occurrence between 2014 and 2018. The patient's comorbidities, aneurysm location, antiplatelet type, and thrombocyte reactivity to P2Y12 inhibitors were assessed. AIT severity was categorized as severe (hyperacute thrombus filling &gt;50 % stent lumen) or mild (in-stent thrombus &lt;50 %, side/integrated branch occlusion, or distal cortical branch occlusion<strong>).</strong> The EVAT was categorized on a location basis (proximal or distal), accounting for the terminal edges of the deployed stent.</div></div><div><h3>Results</h3><div>30 (7.8 %) of 386 EVAT procedures were complicated with AIT. There were 9 (30 %) severe AIT and 21 (70 %) mild AIT, consisting of 12 (40 %) partial in-stent thrombi and 9 (30 %) distal cortical or side branch emboli. Patient comorbidities and type of antiplatelet regimen were not different between the AIT group and uncomplicated cases. Mild AIT was higher in the flow diversion (FD) versus stent-assisted coiling (SAC), (8.1 %, and 2.3 %, respectively, p = 0.012). Deployment of braided SAC (OR: 8.5, p = 0.04) or FD (OR: 18.8, p &lt; 0.01) resulted in significantly higher AIT rates compared to laser-cut SAC. Additionally, stent placement in distal EVAT (beyond the ICA bifurcation or basilar apex) was associated with a significantly higher AIT risk (OR: 8.5, p &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>Patient comorbidities and type of antiplatelet regimen had no association with AIT when sufficient anti-aggregation was achieved. However, AIT risk surged with braid-SAC or FD, especially in the treatment of distal complex aneurysms.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"252 ","pages":"Article 108837"},"PeriodicalIF":1.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143643626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical predictors of freezing of gait in patients with Parkinson's disease: A systematic review","authors":"Sohaila Alshimemeri,&nbsp;Abdulrahman alhayssoni,&nbsp;Reema Hazazi","doi":"10.1016/j.clineuro.2025.108848","DOIUrl":"10.1016/j.clineuro.2025.108848","url":null,"abstract":"<div><h3>Background</h3><div>Freezing of gait (FOG) is a debilitating motor symptom of Parkinson’s disease (PD) that markedly impacts patients’ quality of life. This review aims to identify clinical predictors of FOG to facilitate early prediction and future interventions.</div></div><div><h3>Methods</h3><div>A systematic review adhering to PRISMA guidelines was conducted. Comprehensive searches in PubMed, EBSCO, and Web of Science yielded 1761 records. After removing duplicates, 1558 records were screened by title and abstract, and 92 full-text articles were assessed. Nine studies met the inclusion criteria and were qualitatively synthesized.</div></div><div><h3>Results</h3><div>Our systematic review indicates that higher baseline MDS-UPDRS scores, which reflect greater disease severity, alongside elevated doses and early use of levodopa, are predictive of FOG in patients with PD. Additionally, higher Postural Instability and Gait Disorder (PIGD) scores, motor fluctuations, and lower limb disease onset further increase the risk of FOG. Other factors associated with an increased risk of FOG include older age, longer disease duration, anxiety, hyposmia, cognitive deficits, and sleep disorders. Furthermore, decreased step initiation duration when using visual cues serves as a predictor for the development of FOG. Early treatment with amantadine, selegiline, and dopamine agonists may help reduce the risk of developing FOG.</div></div><div><h3>Conclusion</h3><div>A combination of motor and non-motor factors predicts the development of FOG. Understanding FOG predictors is crucial for developing future therapeutics and personalized management plans, enabling targeted interventions and improved outcomes.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"252 ","pages":"Article 108848"},"PeriodicalIF":1.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143637386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative perioperative narcotic use in tlif patients: Spinal versus general anesthesia in a retrospective cohort study of 180 cases in hospital and ambulatory settings","authors":"Colin Gold ,&nbsp;Kai-Uwe Lewandrowski ,&nbsp;Holley Spears ,&nbsp;Ernest E. Braxton","doi":"10.1016/j.clineuro.2025.108840","DOIUrl":"10.1016/j.clineuro.2025.108840","url":null,"abstract":"<div><h3>Objectives</h3><div>To implement an integrated anesthesia and surgery protocol of improved postoperative pain control to facilitate transitioning of minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) from a hospital to an ambulatory surgery center setting by lowering postoperative (in-facility) narcotic consumption and length of stay (LOS) transitioning from general to awake spinal anesthesia.</div></div><div><h3>Methods</h3><div>A retrospective cohort study of 180 patients who received awake or general anesthesia (GA) MI-TLIF from 2017 to 2023.</div></div><div><h3>Results</h3><div>Among 180 MI-TLIF patients, 101 (56 %) received awake protocol and 79 (44 %) received general anesthesia. Baseline characteristics (age, sex, Charlson comorbidity index (CCI), smoking status) were similar between groups except for body mass index (BMI) and height which was higher in the GA group. ASC patients had a significantly lower CCI (3.25 ± 1.55 vs. 1.33 ± 0.96; p &lt; 0.001). Awake patients had shorter facility LOS and total LOS compared to GA group (Hospital LOS: 25.67 ± 1.77 hours vs 33.91 ± 2.7 hours, p &lt; 0.05; p = 0.009). PACU LOS was shorter in a hospital setting (1.19 ± 0.04 hrs.) than in the ASC (6.68 ± 0.90 hrs.; p &lt; 0.001) since patients could be transferred to a step-down unit after immediate postoperative recovery. The total facility LOS was also significantly extended in inpatients (33.81 ± 1.68 hrs.) versus ASC patients (6.68 ± 0.9045; p &lt; 0.001). Awake patients required less narcotics during their entire post-operative stay compared to GA patients (155.83 ± 15.87 MME vs 258.27 ± 21.18 MME, p &lt; 0.001). Additionally, the awake group had a shorter operative time compared to the GA group (2.43 ± 0.10 hours vs. 2.93 ± 0.05 hours, p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Awake MI-TLIF procedure with spinal anesthesia is associated with shorter post-operative LOS, less post-operative narcotic use, and shorter operative time compared to MI-TLIF under GA. Awake spinal anesthesia facilitates performing MI-TLIF in an ASC due to lower narcotic requirements.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"251 ","pages":"Article 108840"},"PeriodicalIF":1.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blend sign as a prognostic factor for spontaneous intracerebral hemorrhage: A systematic review and meta-analysis","authors":"Davi Chaves Rocha de Souza ,&nbsp;Marcos Paulo Rodrigues de Oliveira ,&nbsp;Gabriel Teles de Oliveira Piñeiro ,&nbsp;Pedro Henrique Ferreira Sandes ,&nbsp;Gabriel Souza Medrado-Nunes ,&nbsp;Gabriel Araújo Cerqueira ,&nbsp;Filipe Pereira Veloso ,&nbsp;Fernanda Oliveira Gonçalves de Deus","doi":"10.1016/j.clineuro.2025.108845","DOIUrl":"10.1016/j.clineuro.2025.108845","url":null,"abstract":"<div><h3>Background and objectives</h3><div>The blend sign (BS) is a known predictor of hemorrhage expansion. However, its prognostic value remains unclear. Therefore, we aimed to compare functional and mortality outcomes between intracerebral hemorrhage (ICH) patients with and without BS.</div></div><div><h3>Methods</h3><div>We searched PubMed, EMBASE, Web of Science, and Cochrane Library for studies comparing patients with and without BS who underwent either conservative treatment or surgical evacuation for spontaneous ICH. Outcomes were functional status, hemorrhage expansion, mortality, and initial hematoma volume. Statistical analysis was performed using R software (version 4.4.0), and heterogeneity was assessed with I² statistics.</div></div><div><h3>Results</h3><div>We included 13 studies with a total of 8685 patients, of whom 5131 (59.08 %) were male. The mean age was 64.64 ± 4.92 years, and the follow-up period ranged from 30 to 360 days. Poor neurological outcomes (OR 1.71, 95 % CI: 1.23─2.37, p &lt; 0.01, I² = 84.2 %) and hemorrhage expansion (OR 2.11, 95 % CI: 1.36─3.26, p &lt; 0.01, I² = 42 %) were significantly higher in patients with BS. However, the overall mortality rate (OR 1.56, 95 % CI: 0.95─2.58, p = 0.08, I² = 0 %) was not statistically different between groups. Furthermore, no significant differences were found in initial hematoma volume (MD 1.26 mL, 95 % CI: −9.94–12.46, p = 0.83, I² = 92 %).</div></div><div><h3>Conclusion</h3><div>Patients with blend sign are associated with higher rates of poor neurological outcomes and hemorrhage expansion. Therefore, BS is a clear and easily identifiable finding that, based on our results, can improve patient management and treatment selection.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"251 ","pages":"Article 108845"},"PeriodicalIF":1.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and influencing factors of post-stroke seizure after endovascular treatment of ischemic stroke – A systematic review and meta-analysis","authors":"Faruq Muhammad Isah ,&nbsp;Shaoshuai Wang ,&nbsp;Wesley Harrisson Bouche Djatche ,&nbsp;Maomei Song ,&nbsp;Chang-xin Li","doi":"10.1016/j.clineuro.2025.108846","DOIUrl":"10.1016/j.clineuro.2025.108846","url":null,"abstract":"<div><h3>Background</h3><div>Endovascular therapies (EVTs), including mechanical thrombectomy (MT) and intra-arterial thrombolysis (IAT) are becoming the standard of care for acute ischemic stroke management. However, little is known about the epidemiology of Post-stroke seizure (PSS) incidence in patients receiving EVT.</div></div><div><h3>Aim</h3><div>The aim of this study was to evaluate the incidence of PSS, including early symptomatic seizure (ES) and late seizure or post-stroke epilepsy (PSE) in patients treated with EVT for acute ischemic stroke. Also, to identify the factors that may influence the incidence of PSS in these patients.</div></div><div><h3>Method</h3><div>We conducted a systematic review and meta-analysis of published studies indexed in PubMed, Web of Science, and Google Scholar, from inception to September 2023. A Meta-analysis was conducted using IBM SPSS 29</div></div><div><h3>Results</h3><div>18 articles were finally included in our review, with a pooled total of 41,056 participants. The cumulative incidence of PSS was 9.0 % (CI: [8.2 %-9.9 %]). The incidence of ES was 3.8 % [3.4 %–4.2 %], and late seizures (PSE) was 6.8 % [6.0 %-7.6 %]. Hemorrhagic transformation (OR: 2.04 CI: [1.59–2.62]), cortical involvement (OR: 1.71 [1.21–2.41]), and infarct size&gt; 1/3 of the affected territories (OR: 4.15 [3.02–5.73]) were associated with an increased risk of PSS. Female sex (OR: 0.89[0.81–0.98]) and a 3 months mRS 0–2 (OR: 0.36 [0.22–0.60]) were both associated with a reduced PSS incidence.</div></div><div><h3>Conclusion</h3><div>This study suggests that PSS incidence is not higher in patients receiving EVT, and the associated risk factors are similar to those in patients treated by other therapeutic options.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"252 ","pages":"Article 108846"},"PeriodicalIF":1.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143643617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abnormal resting-state neural activities of language and non-language cognitive function impairments in stroke patients with aphasia: A cross-sectional study","authors":"Siqi Li ,&nbsp;Zinan Yuan ,&nbsp;Yuexiu Li ,&nbsp;Yang Liu ,&nbsp;Yumei Zhang","doi":"10.1016/j.clineuro.2025.108849","DOIUrl":"10.1016/j.clineuro.2025.108849","url":null,"abstract":"<div><h3>Objective</h3><div>Language impairments may mask non-language cognitive deficits in post-stroke aphasia (PSA) patients. Moreover, the underlying neural mechanisms of both language and non-language cognitive impairment remain unclear. This study aimed to investigate the activities and functional abnormalities of local and remote brain regions and their relationship with cognitive function in PSA patients, to provide more effective tips in future clinical therapy.</div></div><div><h3>Methods</h3><div>This cross-sectional study included 46 PSA patients and 40 controls, who underwent language and non-language cognitive assessments, and resting-state functional magnetic resonance imaging (rs-fMRI). We then examined the fractional amplitude of low-frequency fluctuations (fALFF), regional homogeneity (ReHo), and functional connectivity (FC) based on a modest sample size (46 PSA patients and 40 normal controls (NCs)). Independent two-sample t-tests were used to identify differences in these measures between PSA patients and NCs. Moreover, partial correlation analyses were performed to determine the correlation between FC from the affected brain regions and language, and non-language cognitive performance in PSA patients.</div></div><div><h3>Results</h3><div>This study revealed that both fALFF and ReHo in PSA patients presented significantly lower in the right superior cerebellum, left thalamus, and left middle frontal gyrus, along with increased values in the right superior frontal gyrus (dorsolateral part) (p &lt; 0.05). Notably, decreased FC between the left middle frontal gyrus and orbital part of the left inferior frontal gyrus was significantly associated with both language and non-language cognitive performance (p &lt; 0.05). In addition, PSA patients were further divided into fluent and non-fluent groups. The results revealed that non-fluent patients demonstrated worse overall cognitive functioning, accompanied by reduced FC between the left thalamus and the left supplementary motor area (p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>This study provides new evidence that abnormal neural activities and functional connectivities within specific brain regions may play crucial roles in language and non-language cognitive function. The underlying mechanisms of non-language cognitive decline accompanied by impaired language function in PSA patients may be a partial overlap between language and cognitive networks. In the future, combining language and non-language functions and designing a comprehensive treatment plan will be the focus of rehabilitation.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"251 ","pages":"Article 108849"},"PeriodicalIF":1.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143601410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of carotid ultrasound using microvascular flow imaging for detecting in-stent plaque protrusion after carotid artery stenting","authors":"Yuta Hagiwara ,&nbsp;Hidemichi Ito ,&nbsp;Takayuki Fukano ,&nbsp;Takahiro Shimizu ,&nbsp;Masashi Uchida ,&nbsp;Yoshihisa Yamano","doi":"10.1016/j.clineuro.2025.108844","DOIUrl":"10.1016/j.clineuro.2025.108844","url":null,"abstract":"<div><h3>Background</h3><div>In-stent plaque protrusion (ISP) refers to the extrusion of unstable plaque material through the stent struts, potentially leading to ischemic complications. It often occurs after carotid artery stenting (CAS) and requires additional treatment. However, ISP is difficult to evaluate by conventional imaging modalities. Microvascular flow imaging (MVFI) is a novel Doppler ultrasound technique for assessing vessels with low-velocity flow. MVFI markedly increases the echogenicity of vessels, and clear contrast between the ISP and the in-stent vessels can be obtained. In this study, whether MVFI is useful for detecting ISP compared with computed tomography angiography (CTA) was investigated.</div></div><div><h3>Methods</h3><div>This study investigated 26 patients (22 men; mean age, 72.4 years). Preoperative plaque evaluation was performed by magnetic resonance imaging, ultrasonography, and carotid angiography. The mean stenosis rate according to North American Symptomatic Carotid Endarterectomy Trial methods was 76.2 %. Follow-up ultrasonography and CTA were performed in all patients 4–7 days after CAS. Whether MVFI was useful for detecting ISP compared with results of CTA was investigated.</div></div><div><h3>Results</h3><div>ISP was observed in 4 patients (15.4 %) on MVFI and in 3 patients (11.5 %) on CTA. Compared with the results of CTA for detecting ISP, MVFI offered sensitivity of 100.0 % and specificity of 95.7 %.</div></div><div><h3>Conclusions</h3><div>For detecting ISP, carotid ultrasound using MVFI may deliver a comparable result to CTA.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"251 ","pages":"Article 108844"},"PeriodicalIF":1.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143601413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}