Frontiers in Neurology最新文献

{"title":"Association between serum uric acid levels and white matter hyperintensities in patients with mild ischemic stroke.","authors":"Chaoxin Chai, Yuqi Cui, Meng Li, Jianing Xia, Yiming Wang, Fuyun Ren, Liping Chen","doi":"10.3389/fneur.2025.1590408","DOIUrl":"https://doi.org/10.3389/fneur.2025.1590408","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to investigate the association between uric acid (SUA) level and white matter hyperintensities (WMH) in patients with mild ischemic stroke.</p><p><strong>Methods and results: </strong>This study retrospectively analyzed 290 patients with mild ischemic Stroke who were hospitalized at the Second Hospital of Hebei Medical University from March 2021 to January 2022. General clinical information and laboratory test results were collected. WMH was interpreted on MRI, and periventricular hyperintensity (PVH) and deep white matter hyperintensities (DWMH) were scored, respectively. According to the score of Fazekas, WMH was divided into two groups. Factors influencing WMH severity were analyzed, and the relationship between SUA and WMH was further explored. The results showed that the SUA of patients with moderate to severe DWMH was higher than that of patients with no or mild DWMH (345.10 ± 97.52 μmol/L vs. 317.99 ± 91.21 μmol/L, <i>p</i> = 0.028). There was no significant difference in SUA between the moderate to severe PVH group and the no or mild PVH group (336.49 ± 99.29 μmol/L vs. 319.16 ± 89.92 μmol/L, <i>p</i> = 0.131). Spearman correlation analysis showed that SUA was positively correlated with the severity of DWMH (<i>r</i> = 0.123, <i>p</i> = 0.037), while SUA was not significantly correlated with PVH severity (<i>r</i> = 0.070, <i>p</i> = 0.234). After adjusting for confounders by multifactor logistic regression, SUA was independently correlated with DWMH severity (OR: 1.005, 95% CI: 1.002-1.009, <i>p</i> = 0.004). There was no significant correlation between SUA and PVH (OR: 1.003, 95% CI: 1.000-1.006<i>, p</i> = 0.051).</p><p><strong>Conclusion: </strong>SUA is an independent risk factor for DWMH in patients, and there is no significant correlation between SUA level and PVH.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1590408"},"PeriodicalIF":2.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brain metabolic changes associated with post-stroke pathological laughing and crying: an ¹⁸F-FDG-PET study in pontine stroke.","authors":"Soojin Choi, Dae Hyun Kim, Won Jun Kang, Yong Wook Kim","doi":"10.3389/fneur.2025.1641045","DOIUrl":"https://doi.org/10.3389/fneur.2025.1641045","url":null,"abstract":"<p><strong>Background: </strong>Pathological laughing and crying (PLC) is characterized by sudden, uncontrollable, and inappropriate episodes of laughter or crying. While previous studies have identified PLC-associated structural lesions, the underlying metabolic alterations in these patients remain unclear.</p><p><strong>Objective: </strong>We aimed to investigate cerebral metabolic alterations in patients with PLC following pontine stroke using ¹⁸F-fluorodeoxyglucose-positron emission tomography imaging.</p><p><strong>Methods: </strong>In this retrospective study, we included 49 patients with pontine stroke admitted to a tertiary inpatient rehabilitation hospital between January 2011 and December 2021. Patients were classified into PLC (<i>n</i> = 20) and non-PLC (<i>n</i> = 29) groups. ¹⁸F-fluorodeoxyglucose-positron emission tomography images obtained within 14 days of admission were analyzed using the SPM 12 software. Voxel-wise two-sample t-tests were performed to compare brain metabolism between the two groups (<i>P</i> _{family-wise error-corrected} < 0.05). Multiple regression analysis was conducted to identify brain regions significantly associated with PLC severity, adjusting for age and stroke lesion volume.</p><p><strong>Results: </strong>Compared with that of the non-PLC group, the PLC group exhibited significant hypometabolism in the right superior frontal gyrus (<i>P</i> _{family-wise error-corrected} < 0.05). Multiple regression analysis revealed that decreased metabolism in the right inferior and middle temporal gyri was significantly correlated with higher Pathological Laughter and Crying Scale scores, indicating greater PLC severity. No brain regions showed positive correlations with the Pathological Laughter and Crying Scale scores.</p><p><strong>Conclusion: </strong>Our findings reveal that PLC following pontine stroke is associated with distinct patterns of hypometabolism, particularly in the right superior frontal gyrus and the right inferior and middle temporal gyri. These regions may contribute to the regulation of emotional expression and provide insights into the neural mechanisms underlying PLC.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1641045"},"PeriodicalIF":2.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The development of functional glutamatergic and GABAergic synaptic connections between vestibulo-ocular projection neurons and oculomotor motoneurons in the chicken embryo.","authors":"Hiraku Mochida, Joel C Glover","doi":"10.3389/fneur.2025.1568926","DOIUrl":"https://doi.org/10.3389/fneur.2025.1568926","url":null,"abstract":"<p><strong>Introduction and methods: </strong>We assessed the functional development of synapses from defined vestibulo-ocular projection neurons to motoneurons (MNs) in the oculomotor nuclear complex in the chicken embryo using optical recording of postsynaptic responses with the calcium-sensitive probe Calcium Green Dextran Amine (CGDA). The vestibulo-ocular projection neuron groups were defined according to the hodological nomenclature established by Díaz et al. (1) and encompassed the ipsilateral rostral, ipsilateral caudal and contralateral caudal vestibulo-ocular (iR-VO, iC-VO and cC-VO) groups. These groups provide differential input to the inferior rectus (IR), superior oblique (SO), superior rectus (SR) and inferior oblique IO) MN pools. The cC-VO group includes abducens interneurons (abd INs) which innervate the medial rectus (MR) MN pool. Since the SO MN pool, which projects out the trochlear nerve, was not labeled, recordings were limited to the IR, SR, IO and MR MN pools.</p><p><strong>Results: </strong>Single pulse stimulation of all the presynaptic axons collectively in wholemount preparations of the brain stem elicited robust calcium responses in all four of the CGDA-labeled postsynaptic MN pools. Responses were recorded from the dorsal surface in different regions of interest (ROIs) deployed along the mediolateral axis, which allowed us to distinguish responses in IR, MR+IO and SR MNs. Responses were first detected in a fraction of preparations at d7 of development, and from d8 in all preparations. Response magnitudes increased through d9, and then diminished through d11. Pharmacological experiments showed that responses included both glutamatergic (AMPA receptor and NMDA receptor-mediated) and GABAergic (GABA_A receptor-mediated) components. All three components were present when the first responses appeared, but their proportional contribution changed during development. Covert NMDA-sensitive responses could be revealed by superfusing unresponsive d7 preparations with Mg²⁺-free Ringer, indicating that the very first responses to develop were mediated by NMDA receptors. GABAergic responses involved the activation of voltage-gated calcium channels and were therefore likely to be depolarizing, but nevertheless had an inhibitory effect on glutamatergic responses. Paired pulse and train stimulation at d9-d11 demonstrated substantial facilitation of the aggregate response.</p><p><strong>Discussion: </strong>These data provide new information about the functional development of vestibulo-ocular reflex (VOR) circuitry and set the stage for testing the role of specific receptors and downstream signaling in establishing the specific synaptic connections that characterize the VOR.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1568926"},"PeriodicalIF":2.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beneficial effects of intermittent intravenous saline infusion in dysautonomic patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: a case-series.","authors":"Per Sjögren, Helena Huhmar, Bo C Bertilson, Björn Bragée, Olli Polo","doi":"10.3389/fneur.2025.1601599","DOIUrl":"https://doi.org/10.3389/fneur.2025.1601599","url":null,"abstract":"<p><strong>Purpose: </strong>Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a debilitating condition with no single, uniformly effective pharmacologic therapy. Dysautonomic features like orthostatic intolerance and postural tachycardia syndrome are common features in ME/CFS, severely affecting the patient's quality-of-life. Intermittent saline infusion may reduce symptoms associated with dysautonomia, but this has not been tested scientifically in patients with ME/CFS.</p><p><strong>Methods: </strong>In this case-series, 22 patients with ME/CFS and signs of dysautonomia and/or hypovolemia were treated every third week over 9 weeks with intravenous saline (9 mg/mL NaCl), using standard aseptic technique. Symptoms were monitored throughout the treatment regime, and a follow-up evaluation was conducted.</p><p><strong>Results: </strong>At treatment start, patients were predominantly female (95%), at mean age 46 ± 10 years, and with a mean body hydration percentage of 48 ± 6. Self-reported health status revealed an overall symptom score of 47 ± 13 on a 0-96 scale, a median POTS score of 64 (IQR 16) on a 0-120 scale, and poor measures of quality-of-life (median 25 IQR 25, on a 0-100 scale) and ability-to-work (median 0, IQR 26, on a 0-100 scale). Following 9 weeks of intermittent saline infusion (mean volume 1,600 ± 360 mL), self-reported composite symptom score, quality-of-life and POTS-related symptoms improved significantly (all <i>p</i> < 0.001), as did ability-to-work (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Our data derived from a non-controlled case-series indicate health benefits from volume loading with intermittent infusion of saline among patients with ME/CFS, which may stimulate further studies on various forms of intravenous volume loading to patients with ME/CFS and dysautonomia.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1601599"},"PeriodicalIF":2.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurologic symptoms following COVID-19 in Lima, Peru: a prospective longitudinal observational study.","authors":"Hanalise V Huff, Carla Villanueva-Colina, Monica M Diaz, Sofia Tovar, Andrea Davila Luna, Tianxia Wu, Davidson H Hamer, Igor J Koralnik, Tom Solomon, Miguela A Caniza, Patricia J Garcia","doi":"10.3389/fneur.2025.1524613","DOIUrl":"https://doi.org/10.3389/fneur.2025.1524613","url":null,"abstract":"<p><strong>Introduction: </strong>There is limited research on long-term neurologic symptoms following SARS-CoV-2 infection in Peru. This study aimed to describe the longitudinal experience of survivors of mild to moderate COVID-19 in Lima, Peru.</p><p><strong>Methods: </strong>This prospective, longitudinal observational study included neurologic follow-up data between 3- and 12-months following SARS-CoV-2 infection. Recruitment to a parent study: \"Natural History of SARS-CoV-2 in Comparison to Influenza Virus: A Multi-site Study Focused on the Southern Hemisphere and Equatorial Regions\" (COFLU Peru), occurred between February 2021 and February 2022 in a Callao, Peru public hospital emergency department. In-person visits for this sub-study, \"Neuro COFLU,\" included neurologic history and symptom questionnaire.</p><p><strong>Results: </strong>Fifty-four patients were seen for at least one visit, two of whom required hospitalization for COVID-19. Forty-one (76%) reported at least one pre-existing neurologic diagnosis (59% headaches; 24% migraines). At follow-up visits, patients reported at least one new neurologic symptom since COVID-19: 24/29 (83%) at 90 days, 31/42 (74%) at 180 days, 41/46 (89%) at 270 days, and 20/21 (95%) at 365 days. The median number of new symptoms was 3 at 90 days, 3 at 180, 4 at 270 and 3 at 365 days. Days 90-180 frequent symptoms included: muscular pain, neck stiffness, headache, loss of appetite, numbness, insomnia, and weakness (24-31%). Days 181-365 frequent symptoms included: fatigue, weakness, memory problems, irritability, changes in hearing, muscular pain, joint pain, and insomnia (28-33%). Pre-existing anxiety was associated with post-COVID-19 hearing changes, muscular pain, numbness and weakness and pre-existing depression with neck stiffness and numbness. No significant association was found with age, sex, vaccination status, or pre-existing headaches. Full recovery was reported for 6/29 (21%) at day 90, 13/42 (31%) at day 180, 17/46 (37%) at day 270, and 9/20 (45%) at day 365. By day 365, patients reported median recovery of 85-90%.</p><p><strong>Discussion: </strong>Persistent neurological symptoms are common in COVID-19 survivors in Lima. Many new neurologic symptoms persisted and increased in prevalence over 3-12 months. Limitations include lack of control group and small sample size. Longitudinal studies of outcomes are needed to predict and mitigate the long-term physical, social and economic effects of SARS-CoV-2 infection.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1524613"},"PeriodicalIF":2.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Appendectomy and risk of Parkinson's disease: a systematic review and meta-analysis.","authors":"Hok Leong Chin, Yiu Sing Tsang, Haojun Shi","doi":"10.3389/fneur.2025.1619236","DOIUrl":"https://doi.org/10.3389/fneur.2025.1619236","url":null,"abstract":"<p><strong>Introduction: </strong>Braak's hypothesis suggests that α-synuclein may enter the central nervous system through the enteric nervous system and contribute to the pathogenesis of Parkinson's disease (PD). The appendix, enriched in α-synuclein, has been proposed as a possible entry point in PD pathogenesis. This systematic review and meta-analysis aimed to assess the association between appendectomy and PD risk using newly available data.</p><p><strong>Methods: </strong>A literature search was conducted in PubMed and Embase through September 10, 2024, to identify studies on appendectomy and PD risk. Two independent reviewers screened and assessed articles for eligibility with a third reviewer involved in cases of disagreement. Study quality was assessed using the Newcastle-Ottawa Scale. Data for meta-analysis were pooled using a random-effects model and analyzed in Review Manager 5.4. Meta-regression, subgroup, and sensitivity analyses were performed.</p><p><strong>Results: </strong>Nine studies met inclusion criteria. Meta-analysis indicated no significant association between appendectomy and PD risk (RR: 1.01, 95% CI: 0.90-1.12, <i>p</i> = 0.89). Subgroup analyses showed similar findings. Sensitivity analyses did not change the estimate.</p><p><strong>Conclusion: </strong>This analysis suggests no association between appendectomy and PD risk.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1619236"},"PeriodicalIF":2.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between remote diffusion-weighted imaging lesions and the triglyceride-glucose index and clinical outcomes in patients with intracerebral hemorrhage.","authors":"Lu Wang, Yu Gu, Guoliang Jiang, Chunyan Lei, Potao Zhang, Wen Jiang, Xinglong Yang, Ansong Jin, Qionghua Deng","doi":"10.3389/fneur.2025.1562361","DOIUrl":"https://doi.org/10.3389/fneur.2025.1562361","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to observe the relationship between the presence of distal diffusion-weighted imaging (DWI) lesions and triglyceride-glucose (TyG) index and clinical outcome after intracerebral hemorrhage (ICH), and identify the risk factors for DWI lesions in ICH patients.</p><p><strong>Methods: </strong>ICH patients at the First Affiliated Hospital of Kunming Medical University were retrospectively collected. Demographic data, laboratory examination, and imaging data of the patients were collected. The patients were divided into two groups based on the presence or absence of distal DWI lesions as determined by magnetic resonance imaging (MRI). Multivariate logistic regression analysis was used to evaluate the risk factors for DWI lesions and clinical outcomes.</p><p><strong>Results: </strong>Among 245 ICH patients included in this study, 46 (18.78%) had DWI lesions and 199 (81.22%) did not. We found that the occurrence probability of DWI lesions reached the maximum in the range Q2 of the TyG index. ICH patients with DWI lesions had a similar frequency of death or disability at 90 days compared with patients without DWI lesions. Multivariate logistic regression analysis showed that high fasting glucose (<i>p</i> = 0.039) and hematoma site (<i>p</i> = 0.048) were significant predictors of DWI lesions after ICH. The old age (<i>p</i> < 0.001), higher National Institutes of Health Stroke Scale (NIHSS) score (<i>p</i> < 0.001), and midline shift (<i>p</i> = 0.034) were independent predictors of poor functional outcome at 3 months.</p><p><strong>Conclusion: </strong>There was no definitive correlation between the TyG index and distal DWI lesions in our study. The elevated high fasting glucose levels and hematoma site were significant predictors for DWI lesions after ICH.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1562361"},"PeriodicalIF":2.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of virtual reality-based treadmill gait training on functional mobility and balance in chronic stroke patients: a randomized controlled trial.","authors":"Seung-Hyeon Han, Hyeon Ju Jang, Jong Weon Lee, Jin Woong Cheong, Young Dae Kim, Hyo Suk Nam, Deog Young Kim","doi":"10.3389/fneur.2025.1603233","DOIUrl":"https://doi.org/10.3389/fneur.2025.1603233","url":null,"abstract":"<p><strong>Introduction: </strong>Stroke is a leading cause of long-term disability worldwide. Chronic stroke survivors experience gait and balance impairments, limiting mobility and increasing fall risk. Treadmill training improves walking speed and endurance but lacks real-world adaptability. Virtual reality (VR)-based treadmill training offers immersive, task-specific practice, potentially improving functional mobility in real environments. This randomized controlled trial, using a prospective, open, blinded end-point (PROBE) design, aimed to evaluate the effects of VR-based treadmill gait training on gait performance, functional mobility, balance, and gait symmetry compared with conventional physical therapy in individuals with chronic stroke.</p><p><strong>Methods: </strong>Thirty chronic stroke patients were randomly assigned to virtual reality treadmill training (VTT) or conventional therapy (CT) groups. Both groups received 30 min of conventional therapy twice weekly for 6 weeks. The VTT group received an additional 30 min of VR-based treadmill training per session using the C-Mill VR+ system, including obstacle negotiation and velocity modulation. The 10-meter walk test (10MWT), 6-min walk test (6MWT), Timed Up and Go (TUG) test, Dynamic Gait Index (DGI), Performance-Oriented Mobility Assessment (POMA), Berg Balance Scale (BBS), asymmetry of spatiotemporal gait parameters, and center of pressure (CoP) sway velocity were assessed pre- and post-intervention.</p><p><strong>Results: </strong>Walking speed during the 10MWT and the 6MWT significantly increased in the VTT group compared to the CT group, and asymmetric index values for stance and swing duration decreased (<i>p</i> < 0.05). TUG test time, DGI values, and the POMA gait component were significantly improved in the VTT group compared to the CT group (<i>p</i> < 0.05). BBS scores and CoP sway velocity for eyes open and tandem stance conditions also significantly improved (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>This study demonstrated that VR-based treadmill gait training effectively improved gait performance, functional mobility, balance, and gait symmetry in chronic stroke patients. Thus, simulating diverse virtual walking environments in a controlled setting can improve functional benefits in individuals with chronic stroke and potentially reduce fall risk in real-world community and home environments.</p><p><strong>Clinical trial registration: </strong>https://clinicaltrials.gov/study/NCT06557681?term=NCT06557681&rank=1, Identifier: NCT06557681.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1603233"},"PeriodicalIF":2.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multitask framework based on CA-EfficientNetV2 for the prediction of glioma molecular biomarkers.","authors":"Qian Xu, Feng Ning Liang, Ya Ru Cao, Jin Duan, Teng Cui, Teng Zhao, Hong Zhu","doi":"10.3389/fneur.2025.1609594","DOIUrl":"https://doi.org/10.3389/fneur.2025.1609594","url":null,"abstract":"<p><strong>Introduction: </strong>Glioma is the most common primary malignant tumor of the central nervous system. The mutation status of isocitrate dehydrogenase (IDH) and the methylation status of the O6-methylguanine-DNA methyltransferase (MGMT) promoter are key biomarkers for glioma diagnosis and prognosis. Accurate, non-invasive prediction of these biomarkers using MRI is of significant clinical value.</p><p><strong>Materials and methods: </strong>We proposed a novel multitask deep learning framework based on Coordinate Attention-EfficientNetV2 (CA-EfficientNetV2) to simultaneously predict IDH mutation and MGMT promoter methylation status based on MRI data. Initially, unlabeled MR images were annotated using K-means clustering to generate pseudolabels, which were subsequently refined using a Vision Transformer (ViT) network to improve labeling accuracy. Then, the Fruit Fly Optimization Algorithm (FOA) was employed to assign optimal weights to the pseudolabeled data. The CA-EfficientNetV2 model, integrated with a coordinate attention mechanism, was constructed. The multitask framework comprised three independent subnetworks: T2-net (based on T2-weighted imaging), T1C-net (based on contrast-enhanced T1-weighted imaging), and TU-net (based on the fusion of T2WI and T1CWI).</p><p><strong>Results: </strong>The proposed framework demonstrated high performance in predicting both IDH mutation and MGMT promoter methylation status. Among the three subnetworks, TU-net achieved the best results, with accuracies of 0.9598 for IDH and 0.9269 for MGMT, and AUCs of 0.9930 and 0.9584, respectively. Comparative analysis showed that our proposed model outperformed other convolutional neural network (CNN) - based approaches.</p><p><strong>Conclusion: </strong>The CA-EfficientNetV2-based multitask framework offers a robust, non-invasive method for preoperative prediction of glioma molecular markers. This approach holds strong potential to support clinical decision-making and personalized treatment planning in glioma management.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1609594"},"PeriodicalIF":2.8,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12313511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical features, disease burden and impact on quality of life in participants with mitochondrial encephalomyopathy.","authors":"John Sieh Dumbuya, Chuan Tian, Lin Deng, Bashir Ahmad, Xiuling Chen, Jun Lu","doi":"10.3389/fneur.2025.1585906","DOIUrl":"https://doi.org/10.3389/fneur.2025.1585906","url":null,"abstract":"<p><strong>Background: </strong>Mitochondrial encephalomyopathy (ME) is a rare genetic disorder that significantly impacts participants' quality of life and places emotional and financial burdens on caregivers. However, the dynamics between perceived financial burden, disability, and caregiver strain are not fully understood. This study aimed to explore the differences in perceived financial burden, QoL, disability levels, and caregiver burden among participants with ME.</p><p><strong>Methods: </strong>Between January and December 2023, we conducted a cross-sectional analysis of ME participants and their caregivers at Haikou Affiliated Hospital of Xiangya Medical College, Central South University. Multiple assessment scales, including CHU-9D, PedsQL, PHQ-9, and CBI, were used to evaluate disease burden, QoL, disability, and caregiver burden. Descriptive statistics and correlation coefficients were employed to assess the relationships between these factors.</p><p><strong>Results: </strong>A total of 27 participants with ME were identified, with a mean age of 10.14 years, 88.9% of whom were children. The cohort comprised 18 (66.7%) males and 9 (33.3%) females; MELAS and Leigh syndrome were the most common subtypes. Significant correlations were found between QoL scores and caregiver burden, with CHU-9D showing negative correlations with PHQ-9 and CBI and positive correlations with PedsQL and health utility scores. Additionally, 44.4% of participants reported severe financial burdens, and 57.7% of caregivers experienced moderate to severe levels of burden.</p><p><strong>Conclusion: </strong>Our findings highlight the complex relationships between financial strain, QoL, and caregiver burden in ME. This underscores the need for comprehensive, patient-centered care and targeted policy interventions to alleviate patient and caregiver burdens. Further research is essential to develop effective support systems and improve overall outcomes.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1585906"},"PeriodicalIF":2.8,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}