Clinical Neurology and Neurosurgery最新文献

{"title":"Development and validation of a predictive machine learning model for postoperative long-term diabetes insipidus following transsphenoidal surgery for sellar lesions","authors":"Simon G. Ammanuel,&nbsp;Manasa H. Kalluri,&nbsp;Jesse D. Montoure,&nbsp;Benjamin Lee,&nbsp;Garret P. Greeneway,&nbsp;Paul S. Page,&nbsp;Azam S. Ahmed,&nbsp;Mustafa K. Baskaya","doi":"10.1016/j.clineuro.2025.108899","DOIUrl":"10.1016/j.clineuro.2025.108899","url":null,"abstract":"<div><h3>Objective</h3><div>Diabetes Insipidus (DI) is a common complication that occurs following transsphenoidal surgery for sellar lesions. DI is usually transient but can be permanent in select patients. Prior studies have described preoperative risk factors for developing postoperative DI. However, no predictive risk score has been created to risk stratify these patients.</div></div><div><h3>Methods</h3><div>A single-center retrospective review from 2017 – 2022 was performed, reviewing all patients who underwent transsphenoidal surgery for resection of a sellar lesion. Longterm DI was defined as a patient who met DI criteria for at least six months and required desmopressin therapy. Baseline patient, operative, and radiographic characteristics were obtained. A machine learning method (Risk-SLIM) was utilized to create a risk stratification score to identify patients at high risk for DI.</div></div><div><h3>Results</h3><div>In total, 252 patients were identified to have sellar lesions treated with transsphenoidal surgery. Of these, 27 (10.7 %) patients developed long-term DI and required desmopressin therapy. The DI after Transsphenoidal Surgery score (DITSS) was created with an area under the curve of 0.81 and a calibration error (CAL) error of 7.3 %. Predicative factors were tumor pathology, Tumor size, patient age, and endoscopic approach. The probability of developing DI requiring long-term desmopressin therapy ranged from &lt; 1 % for a score of 0 and &gt; 95 % for a score of 10</div></div><div><h3>Conclusions</h3><div>The DITSS model is a concise and accurate tool to assist in clinical decision-making for risk stratifying which patients undergoing transsphenoidal surgery for sellar lesions may go on to develop DI.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"253 ","pages":"Article 108899"},"PeriodicalIF":1.8,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848390","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":"Surgical outcomes in high-grade adult type diffuse gliomas (ATDG) with a previous diagnosis of anaplastic astrocytoma without adjuvant therapy","authors":"Daniel A. Brenner ,&nbsp;Nicholas B. Dadario ,&nbsp;Ashraf Zaman ,&nbsp;Daniel J. Valdivia ,&nbsp;Madhavi Pandya ,&nbsp;Jacky Yeung ,&nbsp;Michael Sughrue ,&nbsp;Charlie Teo","doi":"10.1016/j.clineuro.2025.108879","DOIUrl":"10.1016/j.clineuro.2025.108879","url":null,"abstract":"<div><h3>Introduction</h3><div>Gliomas pose a significant treatment challenge due to their varied genetic makeup and clinical presentations. This study examines a unique cohort of high-grade adult type diffuse gliomas (ATDG) previously diagnosed as anaplastic astrocytoma prior to the WHO 2021 tumor classification changes. This cohort chose to undergo only surgical resection without adjuvant therapies. We provide a rare dataset of patients allowing for new insight into the natural progression of this disease with surgical treatment alone.</div></div><div><h3>Methods</h3><div>A retrospective review was conducted of patients who were operated on by a single surgeon from the years 2002–2022 and who were diagnosed as having a Grade III Anaplastic Astrocytoma before the WHO 2021 guidelines were published. Correcting for the criteria in the 2021 Guidelines resulted in a mixture of adult-type diffuse malignant gliomas (ATDG), including IDH-Mutant astrocytomas (Grade 3 and 4) and IDH-WT Glioblastoma. All patients included underwent surgical resection alone after declining any adjuvant therapy for various reasons.</div></div><div><h3>Results</h3><div>A total of 20 patients met the inclusion criteria with an average age of 38 years. Among them, 15 had IDH-mutant (IDH-mt) Grade 3 astrocytomas (75 %), 1 had an IDH-mt Grade 4 astrocytoma (5 %), and 4 had IDH-wildtype (IDH-WT) glioblastomas (20 %). The 5-year survival rate for the entire cohort was 74.0 %. Grade 3 astrocytomas had a 5-year survival of 86.7 %, while Grade 4 astrocytomas and IDH-WT GBM patients exhibited a 5-year survival rate of 40 %. 5-year progression-free survival (PFS) rates were derived from the surgery date up until the recurrence or censorship. The collective cohort had a PFS rate of 34.3 %. Grade 3 astrocytomas achieved a 5-year PFS of 32.0 %, whereas Grade 4 astrocytomas and IDH-WT GBM reached a PFS of 40.0 %.</div></div><div><h3>Conclusion</h3><div>In our cohort study, we demonstrate that patients with ATDG can potentially achieve relative long-term survival through surgical resection alone. This unique cohort highlights the natural progression of this disease with surgery alone and provides the foundation for future more rigorous studies to evaluate the additive benefit of different adjuvant therapies. With evolving tumor classifications and variable responses to standard therapeutics, it becomes imperative to revisit and understand the additive benefits of different chemotherapeutic protocols in addition to surgical resection.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"253 ","pages":"Article 108879"},"PeriodicalIF":1.8,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143850797","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":"A 7-year retrospective single-center study on treatment strategy and clinical outcome of giant intracranial aneurysm","authors":"Jin Lee ,&nbsp;Sung-Tae Kim ,&nbsp;Ju Whan Lee ,&nbsp;Se Young Pyo ,&nbsp;Hae Woong Jeong ,&nbsp;Young Gyun Jeong","doi":"10.1016/j.clineuro.2025.108895","DOIUrl":"10.1016/j.clineuro.2025.108895","url":null,"abstract":"<div><h3>Background</h3><div>A giant intracranial aneurysm (GIA) measures ≥ 25 mm and is a rare, challenging condition to treat with a poor prognosis. Selecting the appropriate treatment approach, whether surgical, endovascular, or a combination of both, is crucial for achieving favorable outcomes. However, the unique characteristics of each GIA imply that no single treatment option can be considered optimal universally. This study aimed to evaluate the treatment strategies and clinical outcomes at our center.</div></div><div><h3>Methods</h3><div>This retrospective, single-center study conducted between 2012 and 2018, included 20 patients with GIA. We comprehensively reviewed demography, aneurysm characteristics, clinical and radiography data, treatment strategies, and angiography and clinical outcomes.</div></div><div><h3>Results</h3><div>The average maximum GIA was 29.4 mm (excluding serpentine). Twelve aneurysms were located in the internal carotid artery (ICA); three, anterior cerebral artery; and five, middle cerebral artery. Morphologically, 18 saccular and 2 serpentine aneurysms were observed. Among them, 14 were symptomatic, with 8 presenting with subarachnoid hemorrhage, of which, 5 (62.5 %) were accompanied by intracerebral hemorrhage. Cranial nerve–related symptoms were observed in five ICA aneurysms, and two involved a carotid cavernous fistula. Five patients had multiple aneurysms accompanied by GIA. The treatment modalities varied; eight patients initially underwent surgical treatment. Regarding the number of treatment steps, 14 patients required one step, 4 required two steps, and 2 required three steps. In eight patients, parent artery occlusion (with or without bypass surgery) was the final treatment approach. After 1 year, 70 % of patients achieved a favorable outcome, as indicated by a modified Rankin Scale score ≤ 2.</div></div><div><h3>Conclusions</h3><div>Patient-specific treatments are crucial for improving clinical outcomes. Advancements in endovascular treatment have been made owing to the development of new devices. Parent artery occlusion with vascular bypass was a reliable treatment option.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"254 ","pages":"Article 108895"},"PeriodicalIF":1.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143881872","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":"Relationship between patients with atopic dermatitis and the incidence of stroke: A systematic review with meta-analysis","authors":"Luiz Carlos Figueiredo Filho ,&nbsp;Ricardo Ormanes Massoud ,&nbsp;Rafael Augusto Silva Cabeça ,&nbsp;Ingrid Jade Muniz Wanderley ,&nbsp;Alexandre Marques da Rocha ,&nbsp;Maria Fernanda de Almeida Cavalcante Aranha ,&nbsp;Isadora Rocha Rosa ,&nbsp;Lucas Silva Cabeça ,&nbsp;Rita de Cássia Silva de Oliveira ,&nbsp;Andrew Moraes Monteiro","doi":"10.1016/j.clineuro.2025.108888","DOIUrl":"10.1016/j.clineuro.2025.108888","url":null,"abstract":"<div><h3>Background</h3><div>Atopic dermatitis (AD) is a chronic inflammatory skin condition associated with a variety of comorbidities, including cardiovascular and mental health issues. Recent studies have suggested a potential link between AD and an increased risk of stroke, particularly ischemic stroke. However, the association remains unclear, warranting further investigation.</div></div><div><h3>Methods</h3><div>This study conducted a systematic review and meta-analysis to explore the relationship between AD and stroke risk. PRISMA guidelines were followed, and a comprehensive search was carried out in multiple databases, including PubMed/MEDLINE, <em>Biblioteca Virtual em Saúde</em> (BVS), Embase, Cochrane, Web of Science, and Scopus. Observational studies reporting on the incidence of stroke in patients with AD were included. A meta-analysis was performed to assess the odds ratio (OR), hazard ratio (HR), and relative risk (RR) for stroke incidence. Heterogeneity and publication bias were evaluated using Cochran's Q test, I² statistic, and funnel plots.</div></div><div><h3>Results</h3><div>A total of 11 studies were included, with the majority being cohort studies. The meta-analysis revealed a significant association between AD and an increased risk of ischemic stroke, with an HR of 1.19 (95 % CI 1.13–1.26, p &lt; 0.00001) and moderate heterogeneity (I² = 57 %). However, no statistically significant increase in hemorrhagic stroke risk was observed (HR = 1.13, 95 % CI 1–1.29, p = 0.06). Patients with severe AD exhibited a higher stroke risk compared to those with mild AD, with ORs of 1.29 (95 % CI 1.07–1.56) and 1.06 (95 % CI 0.88–1.27), respectively.</div></div><div><h3>Conclusions</h3><div>This meta-analysis confirms a significant association between AD and ischemic stroke, particularly in patients with severe AD. Further research is needed to understand this relationship better and explore potential preventative strategies, including the role of AD treatment in reducing stroke risk.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"253 ","pages":"Article 108888"},"PeriodicalIF":1.8,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848273","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":"Antimicrobial management of unresectable embolisation agent infection: A case report","authors":"Timothy D. Shaw ,&nbsp;Suhani Bansal ,&nbsp;Jun Lau ,&nbsp;Carly Culbert ,&nbsp;Ashraf Abouharb ,&nbsp;Ian Rennie ,&nbsp;Louise McCorry","doi":"10.1016/j.clineuro.2025.108894","DOIUrl":"10.1016/j.clineuro.2025.108894","url":null,"abstract":"<div><div>Liquid embolisation agents represent an uncommon but serious site of intracranial infection. Surgical excision of the infected material is typically required to eradicate infection and outcomes are poor in inoperable cases due to recurrent, treatment-refractory ventriculitis. We present our case in whom retained E. coli-infected embolisation glue was managed with antimicrobial therapy only. Following multiple failed courses of antibiotics, we found an aggressive induction phase (12 weeks intravenous therapy) followed by lifelong suppressive oral therapy resulted in sustained clinical recovery at one year’s follow-up.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"253 ","pages":"Article 108894"},"PeriodicalIF":1.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143850798","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":"Predicting hospital outcomes in concussion and TBI: A mixed-effects analysis utilizing the nationwide readmissions database","authors":"Anubhav Chandla ,&nbsp;Shane Shahrestani ,&nbsp;Gabrielle E.A. Hovis ,&nbsp;Mahlet Mekonnen ,&nbsp;Andre E. Boyke ,&nbsp;Anna Furton ,&nbsp;Diya Dhawan ,&nbsp;Chirag Patil ,&nbsp;Isaac Yang","doi":"10.1016/j.clineuro.2025.108893","DOIUrl":"10.1016/j.clineuro.2025.108893","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>Traumatic brain injury (TBI) is characterized by a wide range in severity. This variation presents a challenge for predicting outcomes and making management decisions, particularly for patients sustaining less severe injury. We present a novel statistical model for the prediction of hospital outcomes in two propensity-matched cohorts to optimize TBI patient management and counseling.</div></div><div><h3>Methods</h3><div>Hospitalized patients diagnosed with TBI were selected from the Nationwide Readmissions Database (NRD) from 2010 to 2019 using ICD-9 and ICD-10 codes. Using propensity score matching for baseline characteristics, patients were sorted by GCS score into two cohorts: 1188 patients with mild to moderate TBI (mTBI, GCS &gt; 8) and 1219 patients with severe TBI (sTBI, GCS ≤ 8). Mixed-effects modeling was implemented, and model performance was evaluated using the Area Under the Curve (AUC). Any variance in ROC model prediction between cohorts was compared using DeLong’s test.</div></div><div><h3>Results</h3><div>After bivariate analysis, the mean length of stay (LOS), hospital cost, and mortality were significantly lower in the mTBI cohort relative to sTBI. GCS scores within the range of 9–15 were predictive of LOS (p &lt; 0.01), with a trend towards significance in the prediction of non-routine discharge (p = 0.06).</div></div><div><h3>Conclusion</h3><div>Using an advanced mixed-effects model, our study found that GCS is an accurate predictor of hospital outcomes after a TBI diagnosis. These results provide insight that may aid in the development of preventative strategies, management decisions, and patient counseling to ensure a safe return to daily life for patients diagnosed with concussion.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"253 ","pages":"Article 108893"},"PeriodicalIF":1.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864479","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":"Cerebral blood flow velocities measured by transcranial doppler are associated with magnetic resonance imaging biomarkers in moyamoya arteriopathy","authors":"Lisa R. Sun ,&nbsp;Melike Guryildirim ,&nbsp;John R. Gatti ,&nbsp;Syed Ameen Ahmad ,&nbsp;Wendy Ziai ,&nbsp;Rebecca F. Gottesman ,&nbsp;Lori C. Jordan ,&nbsp;Risheng Xu ,&nbsp;Aylin Tekes ,&nbsp;Vivek Yedavalli","doi":"10.1016/j.clineuro.2025.108889","DOIUrl":"10.1016/j.clineuro.2025.108889","url":null,"abstract":"<div><h3>Purpose</h3><div>In individuals with moyamoya arteriopathy, transcranial Doppler (TCD) may be a useful complement to MRI because of its safety, cost effectiveness, and ability to be performed without anesthesia in children. We evaluated associations between various MR-based moyamoya biomarkers and cerebral blood flow velocity (CBFV) as measured by TCD in individuals with moyamoya.</div></div><div><h3>Methods</h3><div>Participants ≤ 26-years-old with moyamoya who had not had surgical revascularization underwent TCDs within 14 days of surveillance brain MRIs. Associations between MRI parameters (Suzuki scores, cerebrovascular stenosis score, ivy sign, brush sign) and CBFV of the MCA and ICA were assessed.</div></div><div><h3>Results</h3><div>Twenty-six TCD-MRI pairs from 16 participants were analyzed. Median participant age was 7.3 (IQR 5.9–8.9) years. No associations between CBFV and Suzuki score or cerebrovascular stenosis score were identified. There was a significant positive association between MCA CBFV and degree of MCA stenosis between 0 % and 99 % stenosis (p = 0.02). Hemispheres without ivy sign had higher MCA CBFV compared with hemispheres with ivy sign (144 cm/s v. 105 cm/s, p = 0.02). Hemispheres with brush sign had higher CBFV compared with hemispheres without brush sign in both the MCA (232 cm/s v. 122 cm/s, p = 0.009) and ICA (213 cm/s v. 131 cm/s, p = 0.03).</div></div><div><h3>Conclusion</h3><div>In this cohort of children and young adults with moyamoya, higher MCA CBFV were associated with higher degrees of stenosis (but not complete occlusion), the presence of a brush sign, and the absence of the ivy sign. TCD may have an important role as an adjunct to traditional neuroimaging in moyamoya arteriopathy.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"253 ","pages":"Article 108889"},"PeriodicalIF":1.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828934","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":"Intraoperative indocyanine green videoangiography versus postoperative catheter angiography to confirm microsurgical occlusion of cranial dural arteriovenous fistulas","authors":"Katherine Karahalios ,&nbsp;Lea Scherschinski ,&nbsp;Visish M. Srinivasan ,&nbsp;Joseph H. Garcia ,&nbsp;Rohin Singh ,&nbsp;Adam T. Eberle ,&nbsp;Joelle N. Hartke ,&nbsp;Joshua S. Catapano ,&nbsp;Redi Rahmani ,&nbsp;Christopher S. Graffeo ,&nbsp;Michael T. Lawton","doi":"10.1016/j.clineuro.2025.108896","DOIUrl":"10.1016/j.clineuro.2025.108896","url":null,"abstract":"<div><h3>Objective</h3><div>Intracranial dural arteriovenous fistulas (DAVFs) are diagnosed with catheter digital subtraction angiography (DSA) and confirmed intraoperatively with indocyanine green videoangiography (ICG-VA). Stand-alone ICG-VA has been demonstrated to successfully predict complete obliteration of spinal DAVFs with an associated cost reduction. The predictive value of standalone ICG-VA has not been assessed; this study sought to assess the diagnostic value of intraoperative ICG-VA versus postoperative DSA for obliteration of cranial DAVFs.</div></div><div><h3>Methods</h3><div>A multi-institutional cerebrovascular database was queried for all surgically managed DAVFs. Patients who underwent both intraoperative ICG-VA and postoperative DSA were included. Demographic and radiologic data, intraoperative findings, and surgical outcome data were analyzed retrospectively.</div></div><div><h3>Results</h3><div>Thirty-five patients with 39 DAVFs were identified (mean [SD] age: 60.3 [10.4] years; 26 [74 %] men, 9 [26 %] women). All DAVFs were treated with interruption of the fistula with clip occlusion of the draining vein. Intraoperative ICG-VA showed complete obliteration in all patients. Postoperative DSA was performed after 28 procedures and confirmed complete obliteration in all cases. The negative predictive value of ICG-VA confirming complete occlusion of cranial DAVFs was 100 %.</div></div><div><h3>Conclusion</h3><div>Complete microsurgical occlusion of DAVFs can be confirmed using intraoperative ICG-VA. The diagnostic power of ICG-VA is underscored by its direct correlation with postoperative DSA results. The 100 % negative predictive value of ICG-VA suggests that postoperative DSA may not be necessary when intraoperative ICG-VA confirms complete occlusion of the DAVF. Forgoing postoperative DSA has the potential to save patients the procedural risk and cost associated with an additional procedure.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"253 ","pages":"Article 108896"},"PeriodicalIF":1.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143858853","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":"Association of type 2 diabetes mellitus and cognitive function with the resumption of oral intake during stroke rehabilitation","authors":"Shinya Fukuda ,&nbsp;Hitoshi Fukuda ,&nbsp;Yusuke Ueba ,&nbsp;Norio Yamamoto ,&nbsp;Isami Kumakura ,&nbsp;Suguru Shirakawa ,&nbsp;Kei Kawada ,&nbsp;Tetsuya Ueba","doi":"10.1016/j.clineuro.2025.108891","DOIUrl":"10.1016/j.clineuro.2025.108891","url":null,"abstract":"<div><h3>Background</h3><div>Physical factors including motor and balance functions are associated with resumption of oral intake of the stroke patients receiving nasogastric tube feeding. However, association of non-physical factors remains unclear. The aims of this study are to explore non-physical factors associated with resumption of oral intake after stroke and to clarify how they affect the time course of the resumption.</div></div><div><h3>Methods</h3><div>A total of 116 patients receiving nasogastric tube feeding after stroke were retrospectively analyzed from a single center observational cohort database. Associations of physical and non-physical factors with resumption of oral intake at discharge from the stroke rehabilitation facility were investigated. We also evaluated how the specific combination of non-physical prognostic factors affected the time course of resumption using survival analyses.</div></div><div><h3>Results</h3><div>Among 116 patients, 59 (50.4 %) resumed oral intake. History of diabetes mellitus (DM) (P &lt; 0.001) and higher cognitive functional independence scores (C-FIM) (P = 0.03) were significantly associated with the resumption of oral intake at discharge. These non-physical factors had an additive value on conventional risk factors to predict resumption of oral intake. Patients with a history of DM were significantly associated with improved resumption of oral intake than with non-DM patients with lower C-FIM scores (&lt; 18) by survival analysis (P = 0.001), and this difference became prominent after 90 days post-stroke.</div></div><div><h3>Conclusion</h3><div>A history of DM and better cognitive function as non-physical factors were significantly associated with the resumption of oral intake in patients receiving nasogastric tube feeding after stroke.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"253 ","pages":"Article 108891"},"PeriodicalIF":1.8,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143825616","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":"Association between the triglyceride-glucose index and cognitive function in stroke free patients with atrial fibrillation: A cross-sectional study","authors":"Juncun Wu ,&nbsp;Zhetao Wang ,&nbsp;Chen Ye ,&nbsp;Junfeng Liu ,&nbsp;Shi Chen ,&nbsp;Wendan Tao ,&nbsp;Fabao Gao ,&nbsp;Zilong Hao","doi":"10.1016/j.clineuro.2025.108890","DOIUrl":"10.1016/j.clineuro.2025.108890","url":null,"abstract":"<div><h3>Objectives</h3><div>No existing research has documented the correlation between the triglyceride-glucose (TyG) index and cognitive function in patients suffering from atrial fibrillation (AF). The objective of this study is to examine this potential association.</div></div><div><h3>Methods</h3><div>Patients diagnosed with AF were enrolled in this study from March 2021 to May 2022 at the cardiology department of West China Hospital, Sichuan University. TyG index was calculated. Cognitive function was evaluated using the Mini-Mental State Examination (MMSE) scale and Montreal Cognitive Assessment (MoCA), Verbal Fluency Test (VFT), Shape Trail Test (STT), Digit Symbol Substitution Test (DSST), and Stroop C scores and seconds. Logistic regression analyses were conducted to examine the association between the TyG index (continuous and quartiles) and cognitive function.</div></div><div><h3>Results</h3><div>A total of 142 patients were included. The median value of the TyG index was 1.28 (1.01, 1.71). After adjusted potential confounding factors, participants in the 4th quartile of the TyG index were not found to be associated with cognitive function (all P &gt; 0.05). The findings for TyG as a continuous variable were consistent with these results.</div></div><div><h3>Conclusion</h3><div>In patients with AF, the TyG index was found to be unrelated to low cognitive function as assessed by a comprehensive battery of tests. These findings should be validated in further studies.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"253 ","pages":"Article 108890"},"PeriodicalIF":1.8,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143835074","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}