European Neurology最新文献

{"title":"Aging of the Patients with Neuromyelitis Optica Spectrum Disorder in the Noto Peninsula, Japan.","authors":"Tsuyoshi Hamaguchi, Michiyo Fujita-Nakata, Yuri Mizuno-Shojima, Nobuaki Uchida, Megumi Nakanishi, Makoto Matsui, Masato Asahina","doi":"10.1159/ene/acsag002","DOIUrl":"10.1159/ene/acsag002","url":null,"abstract":"<p><strong>Introduction: </strong>Reports of late-onset neuromyelitis optica spectrum disorder (NMOSD) cases have been accumulating. The Noto Peninsula areas exhibit a considerably higher aging rate compared to urban centers, potentially serving as an early example of aging-related challenges in NMOSD care in Japan. This study aimed to elucidate the demographic and clinical characteristics associated with aging in NMOSD patients in the Noto Peninsula areas.</p><p><strong>Methods: </strong>A retrospective, single-center analysis was conducted on patients diagnosed with NMOSD and treated at Kanazawa Medical University Hospital between January 2009 and December 2024.</p><p><strong>Results: </strong>The mean age at onset among patients residing in the Noto Peninsula areas (n = 10) was 63.0 years, significantly higher than the 41.9 years observed in patients from the Kanazawa City and surrounding areas (n = 8, p = 0.034). Moreover, age at onset showed a significant upward trend over the years (ρ = 0.636, p = 0.005). At the final observation, vascular risk factors were identified in 11.1-38.9% of patients, with hypertension notably prevalent among those with onset at age 70 years or older (75%, p = 0.028). The mean number of medications at the last follow-up was 7.9 (4-11), with no significant difference across age-at-onset groups.</p><p><strong>Conclusions: </strong>The age at NMOSD onset has exhibited a progressive increase over recent years, most markedly within the Noto Peninsula areas, likely reflecting demographic shifts such as declining birthrates and population aging. Advances in immunotherapeutic regimens have extended patient longevity, thereby contributing to an aging NMOSD cohort. Consequently, age-associated complications, including vascular risk factors and polypharmacy, are becoming increasingly prevalent.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"1"},"PeriodicalIF":2.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864332","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":"Downregulation of miR-33a-5p Regulates TNF-α/NF-κB signaling and is Associated with Reduced Diabetic Neuropathic Pain through Targeting SIRT6.","authors":"Wenju Li, Yimei Li, Yongxin Wang","doi":"10.1159/000552973","DOIUrl":"10.1159/000552973","url":null,"abstract":"<p><strong>Introduction: </strong>The pathogenesis of diabetic neuropathic pain (DNP) remains unclear, with neuroinflammation mediated by abnormal tumor necrosis factor-α/nuclear factor-kappa B (TNF-α/NF-κB) pathway activation being a key factor. This study aims to elucidate how this pathway contributes to DNP.</p><p><strong>Methods: </strong>miR-33a-5p levels were measured via qPCR in the serum of diabetic patients and in cell models. Its diagnostic value for DNP was assessed using ROC and logistic regression. A high-glucose HMC3 microglia model was established. TNF-α and NF-κB levels were quantified by ELISA. Cell proliferation and oxidative stress were evaluated. The targeting relationship between miR-33a-5p and SIRT6 was confirmed by dual-luciferase assay, and their regulatory effects on TNF-α and NF-κB expression were examined.</p><p><strong>Results: </strong>miR-33a-5p was significantly elevated in DNP patients (p < 0.001) and correlated positively with HbA1c (p < 0.001), demonstrating strong diagnostic value (AUC = 0.906, p < 0.001). DNP was associated with higher miR-33a-5p expression, in addition to its association with HbA1c levels. In vitro, high glucose upregulated miR-33a-5p (p < 0.01), NF-κB (p < 0.001), and TNF-α (p < 0.001) in microglia. Mechanistically, miR-33a-5p targets SIRT6, activating the NF-κB/TNF-α/p38MAPK pathway and worsening oxidative stress (p < 0.001). Inhibiting miR-33a-5p or overexpressing SIRT6 alleviated microglial activation and inflammation (p < 0.01).</p><p><strong>Conclusion: </strong>miR-33a-5p aggravates DNP by regulating SIRT6 and enhancing TNF-α/NF-κB signaling; its inhibition may reduce neuroinflammation and pain.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"1-11"},"PeriodicalIF":2.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850123","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":"Plasma Desmoplakin as a Novel Biomarker for Early-Onset Susceptibility and Prognostic Stratification in Young Intracerebral Hemorrhage.","authors":"Hongli Zhang, Qiuyi Jiang, Chunyang Liu, Shouyue Wu, Cheng Jiang, Jinyi Guo, Huan Xiang, Chao Yuan, Jian Zhang, Boxian Zhao, Lu Wang, Guang Yang","doi":"10.1159/000553007","DOIUrl":"10.1159/000553007","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to identify plasma protein biomarkers associated with the presence and prognosis of intracerebral hemorrhage (ICH) in young adults.</p><p><strong>Methods: </strong>We conducted a plasma proteomic analysis to identify differential proteins (DEPs) in an exploratory cohort consisting of young spontaneous intracerebral hemorrhage (YSICH, N = 24) patients and a control group (N = 26: cranial trauma patients, CT-Ctrl [n = 15]; brain tumor patients, BT-Ctrl [n = 11]). A potential biomarker was then selected from these differential proteins based on fold change (FC), machine learning algorithms, and previous studies. The level of this biomarker was validated using ELISA kits in an independent validation cohort, consisting of YSICH patients (N = 144) and geriatric spontaneous intracerebral hemorrhage (GEICH, N = 144) patients.</p><p><strong>Results: </strong>Within the exploratory cohort, 112 DEPs were significantly associated with YSICH and desmoplakin (DSP) emerged as a key biomarker (p = 0.007, FC = 0.434). In the validation cohort, plasma DSP levels in young patients were significantly lower than in elderly patients (p < 0.001), demonstrating good discriminative ability for early-onset ICH susceptibility (area under the receiver operating characteristic curve [AUC] = 0.805, 95% CI: 0.750-0.861). Moreover, combining DSP with the ICH score improved prognostic accuracy, with the AUC value increasing from 0.795 to 0.828 (ΔAUC = 0.034), compared to using the ICH score alone. Notably, subgroup analysis revealed that this prognostic utility was highly specific to young patients presenting with mild-to-moderate clinical severity.</p><p><strong>Conclusion: </strong>Reduced plasma DSP levels reflect a susceptibility to early-onset ICH. Furthermore, DSP represents a promising adjunctive biomarker for prognostic risk stratification, particularly in young patients with mild-to-moderate disease severity.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"1-13"},"PeriodicalIF":2.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850083","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":"Validation of Orthostatic Hypotension in MDS Diagnostic Criteria for Multiple System Atrophy.","authors":"Satoko Yoshizaki, Yoshitaka Yamanaka, Tatsuya Yamamoto, Nobuyuki Araki, Atsuhiko Sugiyama, Shigeki Hirano, Satoshi Kuwabara","doi":"10.1159/000553181","DOIUrl":"10.1159/000553181","url":null,"abstract":"<p><strong>Introduction: </strong>In 2022, the Movement Disorder Society (MDS) proposed revised diagnostic criteria for multiple system atrophy (MSA), defining neurogenic orthostatic hypotension (OH) as a reduction in systolic/diastolic blood pressure exceeding 20/10 mm Hg. This study aimed to validate the sensitivity of the MDS OH criteria and to compare the extent and pattern of OH across synucleinopathies, including Parkinson's disease (PD), dementia with Lewy bodies (DLB), and pure autonomic failure (PAF).</p><p><strong>Methods: </strong>The medical records of 451 patients were retrospectively reviewed, including those with clinically probable MSA (n = 107), PD (n = 223), DLB (n = 89), and PAF (n = 32). OH was assessed using both the MDS and Gilman criteria for probable MSA. Systolic blood pressure overshoot following head-up tilting was also evaluated.</p><p><strong>Results: </strong>Among patients with MSA, neurogenic OH was identified in 39.3% using the Gilman criteria and in 64.5% using the MDS criteria (p < 0.001). OH based on the MDS criteria was also detected in PD (39.0%), DLB (67.4%), and PAF (87.5%). Systolic blood pressure overshoot was observed in patients with MSA (6.5%), PD (12.6%; p = 0.097 vs. MSA), DLB (21.3%; p = 0.002), and PAF (28.1%; p < 0.001).</p><p><strong>Conclusion: </strong>The MDS criteria more sensitively detect neurogenic OH in MSA compared with the Gilman criteria. Although OH is common across synucleinopathies, the lower frequency of systolic blood pressure overshoot in MSA may assist in its differentiation, potentially reflecting less prominent postganglionic autonomic impairment.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"1-9"},"PeriodicalIF":2.0,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618940","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":"Emerging Trends from the 30 Most-Cited Papers on Iatrogenic Cerebral Amyloid Angiopathy: A Bibliometric Review.","authors":"Jacob A Alderete, Jamie E Clarke, Anshul Ratnaparkhi, Snehin Rajkumar, Antony Alvarado, Stuart D Harper, Jay Acharya","doi":"10.1159/000551920","DOIUrl":"10.1159/000551920","url":null,"abstract":"<p><strong>Introduction: </strong>Iatrogenic cerebral amyloid angiopathy (ICAA) is a newly understood clinical phenomenon that has been increasingly described in the past 10 years. The objective of this study was to identify trends and clinical recommendations based on a bibliometric analysis on the 30 most-cited papers on ICAA.</p><p><strong>Methods: </strong>On October 30, 2024, we queried the web database Web of Science for publications on ICAA using the Boolean string (\"iatrogenic cerebral amyloid angiopathy\" OR \"iatrogenic CAA\" OR iatrogenic amyloidosis OR cerebral amyloid angiopathy OR CAA OR vascular amyloidosis) AND (neurosurgery OR medical procedures OR iatrogenic). Using defined inclusion criteria, we compiled the 30 most-cited articles and performed a review with quantitative and qualitative analyses.</p><p><strong>Results: </strong>From 2016 to 2024, publications on ICAA have steadily increased, with the sharpest growth seen between 2022 and 2024. The 30 most-cited papers accumulated 948 citations in total. Observational studies were the most common category, while public health and transmissibility papers had the highest average citations per article. Categories such as treatment/management and diagnostic criteria were underrepresented.</p><p><strong>Conclusion: </strong>This bibliometric review highlights the growing academic interest in ICAA and identifies key areas for future investigation. Despite increased recognition, the literature remains limited in mechanistic, diagnostic, and therapeutic studies. Targeted research in these areas is essential to advancing understanding and clinical care of ICAA.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"1-10"},"PeriodicalIF":2.0,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577534","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":"Validation of the DIAS³ Score in Cerebral Venous Thrombosis Patients Treated by Decompressive Surgery.","authors":"Mariana C Taveira, Mayte Sanchez van Kammen, Sanjith Aaron, Jorge M Ferreira, Jonathan M Coutinho, Patrícia Canhão, Adriana B Conforto, Antonio Arauz, Marta Carvalho, Jaime Masjuan, Vijay K Sharma, Jukka Putaala, Maarten Uyttenboogaart, David J Werring, Rodrigo Bazan, Sandeep Mohindra, Jochen Weber, Bert A Coert, Prabhu Kirubakaran, Pankaj Singh, Diana Aguiar de Sousa, José M Ferro","doi":"10.1159/ene/acsag001","DOIUrl":"10.1159/ene/acsag001","url":null,"abstract":"<p><strong>Introduction: </strong>Cerebral venous thrombosis (CVT) is associated with a risk of late seizures, particularly in patients with severe disease requiring decompressive surgery. The DIAS3 score was developed to predict late seizures after CVT, but its performance in surgically treated patients is unknown. We aimed to validate the DIAS3 score in a high-risk cohort of CVT patients treated by decompressive surgery.</p><p><strong>Methods: </strong>This was a substudy of the DECOMPRESS2 - a prospective, multicenter cohort, including patients with CVT treated with decompressive surgery. Patients with available data on the occurrence and timing of seizures following CVT were included. Late seizures were defined as those occurring more than 7 days after CVT diagnosis, up to 1-year follow-up. We calculated DIAS3 score for all included patients. Predictive performance was assessed only for the 1-year risk of late seizures. Discrimination was evaluated using receiver operating characteristic analysis, and calibration by comparing predicted and observed seizure risks. Diagnostic performance was assessed across multiple probability thresholds.</p><p><strong>Results: </strong>In total, 89 patients were included (median age 38 years; 69.7% female). Late seizures occurred in 22 (24.7%) patients. The mean predicted 1-year seizure risk according to the DIAS3 score was 28.4%. The DIAS3 score showed poor discrimination (area under the curve 0.44, 95% confidence interval 0.30-0.59) and poor calibration. Across all tested thresholds, sensitivity and specificity showed an expected trade-off, but overall predictive accuracy was limited.</p><p><strong>Conclusion: </strong>The DIAS3 score demonstrated poor discrimination and calibration in CVT patients treated by decompressive surgery. These findings suggest that the DIAS3 score should not be used to predict late seizures in this high-risk surgical subgroup.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"1"},"PeriodicalIF":2.0,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577520","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":"Social Networks and Longitudinal Neuropsychiatric Symptom Trajectories across the Cognitive Continuum.","authors":"Hyo-Jeong Lee, Moon-Ho Park","doi":"10.1159/000553583","DOIUrl":"10.1159/000553583","url":null,"abstract":"<p><strong>Introduction: </strong>Neuropsychiatric symptoms (NPSs) significantly contribute to caregiver burden and the risk of institutionalization in patients with cognitive dysfunction. Although social isolation is linked to cognitive decline, its associations with longitudinal NPS trajectories are poorly understood. This study explores the association between social network characteristics and longitudinal NPS trajectories across the cognitive continuum.</p><p><strong>Methods: </strong>We conducted a retrospective observational study of 618 adults (aged ≥ 50) evaluated at a memory clinic between 2017 and 2024. Social networks were assessed, and NPS were measured using the Neuropsychiatric Inventory (NPI). Linear mixed-effects models examined associations between social networks and NPI trajectories, adjusting for demographics, comorbidities, medications, and cognitive status.</p><p><strong>Results: </strong>At baseline, 485 (78.5%) participants had an adequate social network. A cross-sectional multivariable analysis showed that an adequate social network was independently associated with lower NPI scores (β = -1.716, p = 0.029). Longitudinally, adequate social networks were associated with lower NPI scores (β = -2.156, p = 0.008), though the time × social network interaction was not significant overall (p > 0.05). However, a subgroup analysis revealed a significant interaction (β = -0.124, p < 0.001) in participants without baseline NPS. No significant interactions were observed by cognitive status (p > 0.05).</p><p><strong>Conclusion: </strong>Social networks are associated with the cross-sectional NPS burden and predict longitudinal symptom trajectories. These findings suggest that social network characteristics could be a modifiable target for attenuating the risk of NPS emergence.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"1-9"},"PeriodicalIF":2.0,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148455026","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":"Falls Prevalence and Fear of Falling in Multiple Sclerosis: A Systematic Review and Meta-Analysis.","authors":"Vasileios Giannopapas, Vassiliki Smyrni, Dimitrios K Kitsos, Sophia Stasi, Athanasios K Chasiotis, Konstantina Stavrogianni, Alexandra Akrivaki, Evangelia-Makrina Dimitriadou, Dimitrios Tzanetakos, Daphne Bakalidou, John S Tzartos, Georgios Tsivgoulis, Sotirios Giannopoulos","doi":"10.1159/000549066","DOIUrl":"10.1159/000549066","url":null,"abstract":"<p><strong>Introduction: </strong>Approximately 50-70% of people with multiple sclerosis (MS) experience at least one fall event during their lifetime. These events can have debilitating consequences in the quality of life of the individuals' experiencing them, as they can often result in injury, extending beyond physical harm, which may negatively impact the rehabilitation process as well as their psychological well-being.</p><p><strong>Methods: </strong>This systematic review and meta-analysis aimed to determine the proportion of one-time and repeated falls among patients with MS within a year and investigate any potential associations with demographic and disease-specific characteristics. Adhering to PRISMA guidelines, a systematic search of the MEDLINE, PubMed, Scopus, and Google Scholar databases was conducted.</p><p><strong>Results: </strong>Results from 4,342 patients were included. The pooled proportion of one fall within a year was estimated at 28.03% (95% CI [20.21, 36.57]), and for repeated falls, 31.74% (95% CI [23.73, 40.31]). Subgroup analyses revealed significant heterogeneity, while meta-regression showed no significant associations between fall prevalence and age, EDSS, or disease duration.</p><p><strong>Conclusion: </strong>42.5% of patients experienced a one-time fall, while 44.7% reported repeated falls. These findings, demonstrate the significant prevalence of falls among individuals with MS, underlying the need for targeted interventions to mitigate fall risk.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"1-12"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145457653","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":"When Neurology Meets Art History: Tetanus (or Rabies) in a 19th-Century Painting (Neurology and Art).","authors":"Alexis Demas","doi":"10.1159/000551292","DOIUrl":"10.1159/000551292","url":null,"abstract":"","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"150-152"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343469","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":"Developing a Predictive Model for Ischemic Stroke Onset Time Using Transfer Learning.","authors":"Yang Du, Shuai Wang, Weidong Wang, Wenming Zhang, Xiang Chen, Yuan Li, Jie Li, Lili Zhang, Xin Ding","doi":"10.1159/000549892","DOIUrl":"10.1159/000549892","url":null,"abstract":"<p><strong>Introduction: </strong>Identification of acute ischemic stroke (AIS) patients within the 4.5-h therapeutic window is critical for therapy. Diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR) sequences are an approach to determine whether the time since stroke (TSS) is within 4.5 h. However, interobserver variability and limited accuracy are observed in visual assessments. We aimed to develop a transfer learning model for predicting AIS onset within 4.5 h.</p><p><strong>Materials and methods: </strong>A total of 266 AIS patients with known TSS who underwent imaging scans before treatment were retrospectively analyzed, divided into a training set (n = 211) and a validation set (n = 55). The model was built using DWI and FLAIR sequences. After image preprocessing and data augmentation, a 3D ResNet-18 pretrained on the Kinetics dataset was selected and adapted via transfer learning with DWI-FLAIR input. The model performance was compared with human visual assessment, which was based on the DWI-FLAIR mismatch principle. Partial mismatch was defined as hyperintense infarct on DWI with a smaller corresponding hyperintense area on FLAIR.</p><p><strong>Results: </strong>Baseline characteristics did not differ between the training and validation sets. On the validation set, the model achieved sensitivity of 0.833 (0.703-0.941), specificity of 0.880 (0.737-1.000), and AUC of 0.929 (0.758-0.935), outperforming human visual assessment (sensitivity 0.767 [0.613-0.903]; specificity 0.360 [0.185-0.560]; AUC 0.563 [0.451-0.693]). For partial DWI-FLAIR mismatch cases, the model correctly classified all 15 cases, whereas humans classified 4.</p><p><strong>Conclusion: </strong>The 3D ResNet-18 model shows promise in identifying AIS within 4.5 h, including partial DWI-FLAIR mismatch, but requires multicenter validation before use.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"33-44"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145707871","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}