Clinical Neurology and Neurosurgery最新文献

{"title":"Comparison of quality, empathy and readability of physician responses versus chatbot responses to common cerebrovascular neurosurgical questions on a social media platform","authors":"Joanna M. Roy,&nbsp;Elias Atallah,&nbsp;Keenan Piper,&nbsp;Shyam Majmundar,&nbsp;Nikolaos Mouchtouris,&nbsp;D. Mitchell Self,&nbsp;Anand Kaul,&nbsp;Saman Sizdahkhani,&nbsp;Basel Musmar,&nbsp;Stavropoula I. Tjoumakaris,&nbsp;Michael R. Gooch,&nbsp;Robert H. Rosenwasser,&nbsp;Pascal M. Jabbour","doi":"10.1016/j.clineuro.2025.108986","DOIUrl":"10.1016/j.clineuro.2025.108986","url":null,"abstract":"<div><h3>Background</h3><div>Social media platforms are utilized by patients prior to scheduling formal consultations and also serve as a means of pursuing second opinions. Cerebrovascular pathologies require regular surveillance and specialized care. In recent years, chatbots have been trained to provide information on neurosurgical conditions. However, their ability to answer questions in vascular neurosurgery have not been evaluated in comparison to physician responses. Our study is a pilot study evaluating the accuracy, completeness, empathy, and readability of responses provided by ChatGPT 3.5 (Open AI, San Francisco) to standard specialist physician responses on social media.</div></div><div><h3>Methods</h3><div>We identified the top 50 cerebrovascular questions and their verified physician responses from Reddit. These questions were inputted into ChatGPT. Responses were anonymized and ranked on a Likert scale for accuracy regarding neurosurgical guidelines, completeness and empathy by four independent reviewers. Readability was assessed using standardized indexes (Flesch Reading Ease, Flesch Kincaid Grade, Gunning Fox Index, Simple Measure of “Gobbledygook” (SMOG) Index, Automated Readability Index and Coleman Liau Index).</div></div><div><h3>Results</h3><div>Responses provided by ChatGPT had significantly higher ratings of completeness (median (IQR) 3 (2−3) vs. 2 (1−3) and empathy 4 (3−5) vs. 2 (1−3) compared to physician responses, respectively (p &lt; 0.001). Accuracy of healthcare information did not differ significantly (4 (3−4) vs. (4 (3−4), p = 0.752). Physician responses had significantly higher ease of readability and lower grade-level readability compared to ChatGPT (p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Our results suggest higher empathy and completeness of information provided by ChatGPT compared to physicians. However, these responses are at readability levels higher than the literacy of the average American population. Future research could emphasize incorporating chatbot responses while drafting physician responses to provide more balanced information to healthcare questions.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"255 ","pages":"Article 108986"},"PeriodicalIF":1.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185709","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":"Comparing clinical outcomes in patients with M2 middle cerebral artery segment occlusions of different stroke etiologies who undergo endovascular treatment: A retrospective study","authors":"Yaning Xu ,&nbsp;Wangsheng Jin ,&nbsp;Chengchun Liu ,&nbsp;Qiuju Zhao ,&nbsp;Wei Li ,&nbsp;Meng Zhang","doi":"10.1016/j.clineuro.2025.108990","DOIUrl":"10.1016/j.clineuro.2025.108990","url":null,"abstract":"<div><h3>Background</h3><div>Distal medium vessel occlusion may lead to severe neurological deficits. The aim of this study was to investigate the differences in endovascular treatment (EVT) procedure and their impact on clinical outcomes in patients with different etiologies of the M2 segment of the middle cerebral artery (M2-MCA) occlusion.</div></div><div><h3>Methods</h3><div>This study was a single center, retrospective analysis of patients with M2-MCA occlusion treated with EVT. Patients were divided into atherosclerosis group and embolization group, and we determined the etiology of stroke based on the imaging features during EVT. Procedure-related outcomes included treatment modalities, degree of recanalization, and procedural complications. Clinical outcomes included the good outcome (modified Rankin Scale score 0–2) at 90 days, incidence of symptomatic intracranial hemorrhage (sICH) and any intracranial hemorrhage within 24 h, and mortality at 90 days.</div></div><div><h3>Results</h3><div>A total of 81 patients were included, and the numbers of patients in the atherosclerosis and embolization groups were 20 and 61, respectively. In the embolization group, patients were treated with a higher number of mechanical thrombectomies (2 [1–3] vs 1 [1,2], P = 0.028). However, the proportion of patients treated with rescue therapy (50.0 % vs 1.6 %, P＜0.001) were significantly greater in the atherosclerosis group. The degree of recanalization and incidence of procedural complications were not significantly different between the two groups. There was also no statistical difference in the four clinical outcomes between the two groups.</div></div><div><h3>Conclusion</h3><div>Specific approaches to EVT differ for patients with M2-MCA occlusion of different etiologies. However, there were no significant differences in recanalization rates, procedural complications, or clinical outcomes.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"255 ","pages":"Article 108990"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185710","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":"Langerhans cell histiocytosis of the spine in adults: A rare and controversial disorder: A systematic review","authors":"Ebtesam Abdulla,&nbsp;Monis Khan,&nbsp;Amna Hussain,&nbsp;Esteban Quiceno,&nbsp;Alexandros Moniakis,&nbsp;Michael Prim,&nbsp;Isabel Bauer,&nbsp;Annie Pico,&nbsp;Kristin Nosova,&nbsp;Ali A. Baaj","doi":"10.1016/j.clineuro.2025.108991","DOIUrl":"10.1016/j.clineuro.2025.108991","url":null,"abstract":"<div><h3>Introduction</h3><div>Langerhans cell histiocytosis (LCH) involving the spine in adults is rare. If left untreated, LCH lesions can results in progressive neurological deficits and structural instability. While much has been reported on LCH in children, the pathology, treatment and outcomes in adults is less well understood. We present a comprehensive literature review of all cases of adult-onset spinal LCH reported to date.</div></div><div><h3>Objective</h3><div>To present the outcomes and clinical experience in the management of spinal LCH in the adult population.</div></div><div><h3>Methods</h3><div>A systematic review was performed by searching online databases to analyze all reported cases of adult-onset spinal LCH.</div></div><div><h3>Results</h3><div>Forty-seven patients were identified and analyzed. The male ratio was 63.82 %. The mean age at presentation was 34.70 (range; 20–69) years. Local pain, radiating pain, and restricted movement were the most frequent symptoms. The lumbar vertebrae were the most frequently involved. The vertebral body was involved in 53.19 % of the patients, and only three had vertebral plana morphology. Spinal lesions involved a single vertebra in 42 patients (89.36 %), whereas 5 patients (10.63 %) had multiple vertebral involvement. Lytic destruction of the vertebra is the most notable radiologic feature. Twenty-nine patients underwent surgery, including anterior, posterior, combined decompression, and other approahces. The mean follow-up duration was 22 months (range; 1–120 months). The outcome was good to excellent in all except seven, which reported recurrence or progression.</div></div><div><h3>Conclusion</h3><div>Surgical intervention seemed to help adult patients showing neurological problems or spinal instability. Non-operative treatment, though common in children, was linked to disease progression/recurrence, underscoring the need for customized treatment plans.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"255 ","pages":"Article 108991"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178793","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":"Optimal timing for early cranioplasty following craniectomy: A propensity-matched national database study of 3241 patients","authors":"Georgios S. Sioutas,&nbsp;Alan Napole,&nbsp;Bhargavi Budihal,&nbsp;Pierce Davis,&nbsp;Saarang Patel,&nbsp;Oleg Shekhtman,&nbsp;Mohamed M. Salem,&nbsp;Visish M. Srinivasan,&nbsp;Jan Karl Burkhardt","doi":"10.1016/j.clineuro.2025.108989","DOIUrl":"10.1016/j.clineuro.2025.108989","url":null,"abstract":"<div><h3>Introduction</h3><div>Nearly 30 % of patients experience complications following cranioplasty after decompressive craniectomy. However, the optimal timing for this procedure is not well established.</div></div><div><h3>Objective</h3><div>To compare complication rates for cranioplasty performed at different early monthly intervals after craniectomy.</div></div><div><h3>Methods</h3><div>Using the TriNetX Research Network, we included patients who underwent either late cranioplasty (91 days-1 year), or cranioplasty in the first, second, or third month after craniectomy. Propensity score matching was used to match the late cranioplasty group separately with the other three cranioplasty groups based on baseline characteristics in the whole cohort and in a TBI-specific subgroup. Postoperative outcomes were assessed at 6 months after cranioplasty.</div></div><div><h3>Results</h3><div>We analyzed 3241 patients. After matching, 375 patients remained in the first-month, 365 in the second month, and 434 in the third-month group. Compared to late cranioplasty, ICH as a post-operative outcome was significantly more common in the first-month cranioplasty (p = 0.037) and second-month cranioplasty (p = 0.042) groups, while SDH as a post-operative outcome was more frequent in all early cranioplasty groups (p &lt; 0.01). The need for repeat cranioplasty was higher in the first month (p = 0.002) and second month (p = 0.031) groups. Repeat Craniectomy/Craniotomy and CSF leak were more common in the first-month group (p = 0.006 and 0.001, respectively). Mortality was higher in the first month (RR=2.9, 95 %CI:1.5–5.5, p = 0.001) cranioplasty group.</div></div><div><h3>Conclusion</h3><div>Cranioplasty within 2 months after craniectomy was associated with increased postoperative morbidity and mortality, especially for patients without TBI. Prospective studies are needed to establish the best timing for cranioplasty.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"255 ","pages":"Article 108989"},"PeriodicalIF":1.8,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144168194","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":"Procedure-related cerebral air embolism: Systematic review and individual participant data meta-analysis","authors":"Kaho Adachi ,&nbsp;Youssef Soliman ,&nbsp;Allison Raymundo ,&nbsp;Jason Fernando ,&nbsp;Anthony Sanchez ,&nbsp;Mohammed Abdul Muqsith ,&nbsp;Rime Ezzeldin ,&nbsp;Brian Nguyen ,&nbsp;Uzma Ali ,&nbsp;Dina Zamil ,&nbsp;Ibrahim Yazji ,&nbsp;Siva T. Sarva ,&nbsp;Zuhair Ali ,&nbsp;Mohamad Ezzeldin","doi":"10.1016/j.clineuro.2025.108982","DOIUrl":"10.1016/j.clineuro.2025.108982","url":null,"abstract":"<div><h3>Introduction</h3><div>Cerebral air embolism (CAE) is a rare, life-threatening condition often caused by iatrogenic procedures. Despite numerous case reports, there are limited systematic reviews, with insufficient data integration for clinical application. This study aims to analyze procedure-related CAEs, focusing on clinical characteristics, diagnostic methods, and outcomes.</div></div><div><h3>Methods</h3><div>A systematic review and single-patient analysis were conducted using PubMed, Embase, and Cochrane (2015–2024), supplemented by one institutional case. Descriptive statistics examined demographics, presentation, diagnostics, and outcomes. Kruskal-Wallis and Fisher’s exact tests compared clinical differences across procedures, while univariable logistic regression identified mortality risk factors.</div></div><div><h3>Results</h3><div>The study analysed 132 patients (65.2 % male, median age 68), with minimally invasive pulmonary interventions being the most common procedure (24.2 %). Motor dysfunction (78 %) and altered consciousness (42.4 %) were the most frequent symptoms. Post-treatment, 63.1 % of motor and sensory symptoms resolved, with high recovery rates for visual (93 %) and language impairments (69 %). The mortality rate was 30.5 %. In logistic regression, cranial nerve symptoms, coma, cardiac angiography, and intervention were associated with increased mortality, while motor deficit and hyperbaric oxygen therapy were protective factors (p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Our study synthesized smaller studies to establish a clinically relevant CAE profile, emphasizing neurological patterns, diagnostic methods, and outcomes across procedures. Motor deficits and altered consciousness were the most common presentations, while cranial nerve dysfunction, coma, and cardiac angiography and interventions were significant mortality predictors. These findings offer valuable insights for early CAE identification and management, improving overall patient outcomes.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"255 ","pages":"Article 108982"},"PeriodicalIF":1.8,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190399","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":"Reassessing predictors of non-functioning pituitary macroadenoma growth: Beyond tumor volume","authors":"Brijesh Sathian,&nbsp;Hanadi Al Hamad,&nbsp;Javed Iqbal","doi":"10.1016/j.clineuro.2025.108979","DOIUrl":"10.1016/j.clineuro.2025.108979","url":null,"abstract":"<div><div>Kim et al.’s study (Clinical Neurology and Neurosurgery, 2025;254:108920) investigates the natural history of 232 conservatively managed non-functioning pituitary macroadenomas (NFPMAs), identifying female sex and initial tumor volume (≥2.5 cm³) as predictors of growth. While offering valuable insights, the study’s reliance on static tumor volume is questioned by recent evidence emphasizing dynamic features (e.g., growth velocity) and molecular markers (e.g., Ki-67, USP8 mutations) as stronger predictors. The reported 47.4 % growth rate may underestimate risks, with other studies noting higher progression (up to 60 %) and visual/hormonal deficits. Furthermore, dismissing age as a predictor contradicts findings linking younger age (&lt;50 years) to increased progression risk. These limitations highlight the need for a more comprehensive approach to NFPMA risk stratification.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"256 ","pages":"Article 108979"},"PeriodicalIF":1.8,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144204726","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":"Real-world data on the effect of long-term treatment with nusinersen over > 4 years in a cohort of Swiss patients with spinal muscular atrophy","authors":"Anne Tscherter ,&nbsp;Leonie Steiner ,&nbsp;Philip Julian Broser ,&nbsp;Cornelia Enzmann ,&nbsp;Elea Galiart ,&nbsp;Bettina Cornelia Henzi ,&nbsp;David Jacquier ,&nbsp;Andrea Maria Mathis ,&nbsp;Christoph Neuwirth ,&nbsp;Gian Paolo Ramelli ,&nbsp;Paolo Ripellino ,&nbsp;Olivier Scheidegger ,&nbsp;Bettina Schreiner ,&nbsp;Esther Irene Schwarz ,&nbsp;Georg Martin Stettner ,&nbsp;Andrea Klein ,&nbsp;on behalf of the Swiss-Reg-NMD Group","doi":"10.1016/j.clineuro.2025.108983","DOIUrl":"10.1016/j.clineuro.2025.108983","url":null,"abstract":"<div><h3>Introduction</h3><div>Current disease-modifying treatments for spinal muscular atrophy (SMA) have been shown to significantly improve the course of the disease, but data on long-term real-world outcomes remain scarce.</div></div><div><h3>Methods</h3><div>This prospective multicentre, observational study investigated 28 patients treated with nusinersen for 4.1–6.2 years. Motor function was assessed with the Children’s Hospital of Philadelphia Infant Test of Neuromuscular Disorders (CHOP-INTEND), Hammersmith Functional Motor Scale (Expanded) (HFMS/E) and the Revised Upper Limb Module (RULM). Patient global impression of improvement scale, respiratory and nutritional support were assessed.</div></div><div><h3>Results</h3><div>Eight patients were 0–2.5 years old at treatment start and median gain of motor scores was 31.5 points in the CHOP-INTEND and 10 points in the HFMS/E. Three patients started part-time non-invasive ventilation and/or nutritional support during observation period. Fourteen patients were 3.5–16 years old and showed a median gain of 1 point in the HFMS/E. Four patients required non-invasive ventilation and/or nutritional support at treatment start, and three started support during observation period. Six patients were aged 16–45 years old and showed a median gain of 3.5 points in the HFMS/E. None needed chronic respiratory or nutritional support. After one year, 84 %, and after 4 years of treatment, 54 % of patients felt their condition had improved in the last 6 months.</div></div><div><h3>Conclusion</h3><div>Our data confirm sustained gains of motor function in early-treated patients and disease stabilisation in patients in the chronic phase under nusinersen treatment.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"255 ","pages":"Article 108983"},"PeriodicalIF":1.8,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185363","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":"Progression of intracranial hemorrhages in neurotrauma patients: A clinical and radiological comparison of isolated versus multiple areas of hemorrhage and associated transfusion treatment strategies","authors":"Cody J. Orton ,&nbsp;Samuel A. Tenhoeve ,&nbsp;Matthew C. Findlay ,&nbsp;Sarah Nguyen ,&nbsp;Sarah T. Menacho","doi":"10.1016/j.clineuro.2025.108984","DOIUrl":"10.1016/j.clineuro.2025.108984","url":null,"abstract":"<div><h3>Purpose</h3><div>The similar presentation of patients with multiple simultaneous (mICHs) or isolated (iICH) intracranial hemorrhages prompted investigation of clinical and radiological ICH progression during hospitalization in these cohorts. We also examined the role of aggressive transfusion and acute interventions on patient morbidity and mortality.</div></div><div><h3>Methods</h3><div>Adult (&gt;18 years) neurotrauma patients treated at our Level 1 trauma center between January 1, 2002, and December 31, 2022, with an iICH or mICH were included based on meeting 5 criteria: isolated neurotrauma; ICH injury beyond subarachnoid hemorrhage; repeat head CT available; no anticoagulant usage; and survivable injuries. Data collected retrospectively included demographics, potential risk factors for ICH, injury type, management details, transfusion characteristics, and outcomes. The primary outcome was the clinical and radiological progression of ICH during hospitalization, and the secondary outcome was the role of aggressive transfusion and acute interventions on patient morbidity and mortality.</div></div><div><h3>Results</h3><div>Among the 596 patients, 242 had iICH and 354 had mICH. Other than age (p = .01) and Glasgow Coma Scale score (p &lt; .001), most presentation characteristics, including comorbidities, were similar in the two groups. Although patients with iICH were less likely to have subarachnoid hemorrhage (p &lt; .001), epidural hematoma (p = .03), intraparenchymal hematoma (p &lt; .001), and hemorrhagic contusions (p &lt; .001), subdural hematomas were equally likely to occur in both groups (p = .52). There were no significant differences in neurosurgical treatment by ICH type. There were no significant differences in progression on imaging or transfusions received between the two groups.</div></div><div><h3>Conclusion</h3><div>Although our data are limited as a single-center retrospective analysis, these results highlight the similarities between patients with iICH and mICH and indicate that treatment may be independent of the number of bleeds.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"255 ","pages":"Article 108984"},"PeriodicalIF":1.8,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144168195","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":"Identifying associated comorbidities in the development of trigeminal neuralgia: A propensity-matched analysis of the National Inpatient Sample","authors":"Megan Tang,&nbsp;Alex Devarajan,&nbsp;Lily Huo,&nbsp;Tony Chung,&nbsp;Vikram Vasan,&nbsp;Jack Y. Zhang,&nbsp;Rui Feng,&nbsp;Emily Chapman,&nbsp;Joshua Bederson,&nbsp;Raj K. Shrivastava","doi":"10.1016/j.clineuro.2025.108985","DOIUrl":"10.1016/j.clineuro.2025.108985","url":null,"abstract":"<div><h3>Introduction</h3><div>Trigeminal neuralgia (TN) is an uncommon disorder that leads to debilitating pain and interference with daily life. While often attributed to neurovascular compression, limited research has explored the underlying etiology and risk factors for TN. This study uses the National Inpatient Sample (NIS), the largest publicly-available administrative inpatient database in the United States, to examine demographics and comorbidities associated with TN, aiming to identify potential risk factors and vulnerable inpatient populations.</div></div><div><h3>Methods</h3><div>NIS data from 2016 to 2019 was searched for patients with a primary diagnosis of TN (ICD-10 G50.0). Demographics and comorbidities were identified. A 1:1 propensity match was performed between TN and non-TN patients based on demographics, hospital characteristics, and Charlson Comorbidity Index scores. Multivariable regression was performed to identify factors associated with TN and calculate adjusted odds ratios (OR).</div></div><div><h3>Results</h3><div>The final cohort included 38,300 patients, of whom 19,150 (50.0%) had TN. After matching, TN was significantly associated with multiple sclerosis (p &lt; 0.001), other neurovascular compression disorders (NCD) including glossopharyngeal neuralgia and hemifacial spasm (p &lt; 0.001), stroke (p &lt; 0.001), systemic lupus erythematosus (p = 0.003), hyperlipidemia (p = 0.006), and complex diabetes (p &lt; 0.001). Risk factors with the highest ORs included other NCDs (OR: 60.60, p &lt; 0.001), multiple sclerosis (OR: 8.92, p &lt; 0.001), and lupus (OR: 2.84, p = 0.003).</div></div><div><h3>Conclusion</h3><div>TN requiring hospitalization was independently associated with several comorbidities, including multiple sclerosis, lupus, stroke, hyperlipidemia, diabetes, and other NCDs. Notably, this is the first population-level study to identify an association between lupus and TN, highlighting a potential inflammatory component in TN pathophysiology. Prospective studies are warranted to further elucidate these associations.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"255 ","pages":"Article 108985"},"PeriodicalIF":1.8,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185708","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":"Altered default mode network connectivity in basal ganglia intracerebral hemorrhage: A resting-state fMRI study","authors":"Lichao Wei ,&nbsp;Jun Zhang ,&nbsp;Fengyuan Zhou ,&nbsp;Dewen Ru ,&nbsp;Caihua Xi ,&nbsp;Zhuoyin Du ,&nbsp;Biwu Wu ,&nbsp;Gang Wu ,&nbsp;Qiang Yuan ,&nbsp;Jin Hu","doi":"10.1016/j.clineuro.2025.108987","DOIUrl":"10.1016/j.clineuro.2025.108987","url":null,"abstract":"<div><h3>Objective</h3><div>This study investigates the impact of basal ganglia intracerebral hemorrhage (ICH) on default mode network (DMN) connectivity and its relationship with cognitive impairment using resting-state functional magnetic resonance imaging (rs-fMRI).</div></div><div><h3>Method</h3><div>DMN differences between left/right basal ganglia ICH patients and healthy controls were analyzed respectively. Co-altered brain region were obtained by overlapping the differential brain regions of bilateral basal ganglia ICH. Gene and functional decoding analyses validated the role of co-altered brain regions in cognition. Whole-brain functional connectivity (FC) analysis was conducted using the co-altered brain region as a seed, and correlation analysis was performed with the Mini-Mental State Examination (MMSE) to obtain the cognitive representation brain network of patients in basal ganglia ICH. Finally, it was nested with the DMN of basal ganglia ICH patients to obtain the important brain regions regulating cognitive function in the DMN of basal ganglia ICH patients.</div></div><div><h3>Result</h3><div>A total of 89 basal ganglia ICH patients were enrolled. Compared to healthy controls, bilateral basal ganglia ICH patients showed significant alterations in DMN connectivity. The co-altered brain region mainly involved the medial prefrontal cortex (mPFC). Additionally, gene and functional decoding analyses revealed strong association with chemical synaptic transmission, synaptic signaling, cognition, and intelligence. The left parahippocampal gyrus, the left superior temporal gyrus, right temporal regions, the cerebellar, and posterior cingulate cortex exhibited significant correlation with MMSE. Furthermore, the left parahippocampal gyrus emerged as a key node in the DMN of basal ganglia ICH patients involved in cognitive regulation.</div></div><div><h3>Conclusion</h3><div>The mPFC-left parahippocampal circuit in the DMN plays a crucial role in cognitive regulation following basal ganglia ICH. These findings provide new insights into neural mechanisms underlying cognitive changes after basal ganglia ICH and suggest potential therapeutic targets for cognitive rehabilitation.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"255 ","pages":"Article 108987"},"PeriodicalIF":1.8,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138517","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}