Frontiers in Neurology最新文献

{"title":"Ventriculomegaly without elevated intracranial pressure? Normal pressure hydrocephalus as a disorder of the cerebral windkessel.","authors":"Racheed Mani, Jade Basem, Liu Yang, Nahid Shirdel Abdolmaleki, Anand Ravishankar, Susan Fiore, Petar Djuric, Michael Egnor","doi":"10.3389/fneur.2025.1591275","DOIUrl":"https://doi.org/10.3389/fneur.2025.1591275","url":null,"abstract":"<p><strong>Objective: </strong>Normal pressure hydrocephalus (NPH) is characterized by ventriculomegaly without elevations in intracranial pressure (ICP). One way of viewing hydrocephalus is as a disorder of the cerebral windkessel. The cerebral windkessel is the system that dampens the arterial blood pressure (ABP) pulse in the cranium, transmitting this pulse from arteries to veins via the cerebrospinal fluid (CSF) path, bypassing the microvasculature to render capillary flow smooth. When the windkessel is physiologically tuned, windkessel effectiveness (<i>W</i>) is given by: <i>W</i>=<i>IE</i>/<i>R</i>, where <i>I</i> represents CSF path inertance (pulse magnitude), <i>E</i> is CSF path elastance, and <i>R</i> is resistance in the CSF path. In NPH, we posit that there is a combination of arteriosclerosis (blunting the CSF pulse in the SAS- lowering <i>I</i>), and age-related softening of brain tissue (decreasing the elastance of subarachnoid CSF pathways- lowering <i>E</i>).</p><p><strong>Methods: </strong>To model the windkessel, we utilize a tank circuit with parallel inductance and capacitance to simulate the pulsatile flow of blood and CSF as alternating current (AC), and smooth flow as direct current (DC). We model NPH as a disorder of windkessel impairment by decreasing windkessel inertance (reflecting diminished CSF pulsatility in the SAS from arteriosclerosis) and decreasing intracranial elastance (reflecting age-related brain atrophy). We simulate ventriculomegaly and shunting by lowering the resistance of this circuit.</p><p><strong>Results: </strong>In simulating NPH using this circuit, we found significant elevations in the amplitude and power of AC in the CSF and capillary paths when inertance and elastance were decreased. Conversely, this pulse power decreased with decreased resistance in the CSF path from ventriculomegaly and shunting.</p><p><strong>Conclusion: </strong>Simulations of NPH demonstrated increased amplitude and power of AC in the CSF and capillary paths due to windkessel impairment. We posit that this pulsatility is redistributed from the SAS to the ventricular CSF path, exerting pulsatile stress on the periventricular leg and bladder fibers, which may explain NPH symptomatology. Ventriculomegaly may represent an active adaptation to improve windkessel effectiveness by decreasing CSF path resistance to mitigate decreased CSF path inertance and parenchymal elastance. Shunting provides a low resistance, accessory windkessel to obviate adaptive ventriculomegaly. This has significant implications in understanding this paradoxical condition.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1591275"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077454","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":"Ferroptosis-associated pathological injury mechanisms and therapeutic strategies after intracerebral hemorrhage.","authors":"Yuhua Gong, Fumei Yang, Ying Liu, Yuping Gong","doi":"10.3389/fneur.2025.1508718","DOIUrl":"https://doi.org/10.3389/fneur.2025.1508718","url":null,"abstract":"<p><p>Intracerebral hemorrhage (ICH) is an important neurological disease caused by the rupture of blood vessels in the brain parenchyma, with a high mortality and disability rate. At present, many studies have focused on the injury mechanisms and intervention strategies after ICH. However, there is no effective clinical treatment that can significantly improve the prognosis of ICH patients. Ferroptosis, a regulated form of cell death, has been identified as a significant contributor to brain tissues damage and neurological dysfunction following ICH. The hallmark of ferroptosis is iron-dependent lipid peroxidation, which is closely related to the pathological process of iron overload and oxidative stress after ICH. Exploring the interaction between ferroptosis and pathological injury mechanisms post-ICH will contribute to our understanding the key pathways involved in the ferroptosis-related injury mechanisms and facilitating the discovery of appropriate intervention strategies. On this basis, we present a comprehensive overview of ferroptosis-related brain injury mechanisms (e.g., iron overload, oxidative stress, inflammatory response and mass effect) in the pathogenesis and development of ICH. Following ICH, the degradation of hematoma and iron metabolism provide the fundamental material basis for ferroptosis, and oxidative stress primarily participates in the lipid peroxidation process of ferroptosis via related molecular pathways (such as the GPX4). By synthesizing current evidence, this article aims to provide a theoretical foundation for future research on therapeutic strategies targeting ferroptosis and related pathways in ICH.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1508718"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077295","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":"Predictive value of the fibrinogen-to-albumin ratio for hemorrhagic transformation following intravenous thrombolysis in ischemic stroke: a retrospective propensity score-matched analysis.","authors":"Xiao-Yu Liu, Hui-Yang Jia, Gang Wang","doi":"10.3389/fneur.2025.1465508","DOIUrl":"https://doi.org/10.3389/fneur.2025.1465508","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore the factors associated with hemorrhagic transformation (HT) in acute ischemic stroke patients after intravenous thrombolysis (IVT), with a specific focus on the relationship with the post-thrombolysis fibrinogen-to-albumin ratio (FAR).</p><p><strong>Methods: </strong>The clinical records of 569 acute ischemic stroke (AIS) patients admitted to our department from 2020 to 2023 were retrospectively analyzed. All eligible patients were stratified into HT and non-HT (NHT) groups. Propensity score matching (PSM) was performed between the two groups. Receiver operating characteristic (ROC) curves were used to assess the predictive performance of the FAR, determining the optimal predictive value.</p><p><strong>Results: </strong>Ultimately, 142 patients were included, with 71 in the HT group and 71 in the NHT group. After propensity score matching, a significant association was observed between the FAR and HT (<i>OR</i> = 1.40, 95% CI, 1.187-1.645; <i>p</i> <0.001). The ROC curve analysis indicated that the FAR predicted HT after intravenous thrombolysis, with an area under the curve (AUC) value of 0.751 (95% CI, 0.669-0.831; <i>p</i> <0.001) and an optimal cutoff value of 0.0918. The corresponding sensitivity and specificity were 78.9 and 60.9%, respectively.</p><p><strong>Conclusion: </strong>In ischemic stroke patients undergoing IVT, the FAR may serve as a promising biochemical marker for predicting HT following treatment.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1465508"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077337","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":"Roles of neuroimaging markers and biomarkers in cerebral small vessel disease and their associations with cognitive function.","authors":"Xiaoqian Song, Chenyang Jin, Moxin Luan, Xueping Zheng","doi":"10.3389/fneur.2025.1483842","DOIUrl":"https://doi.org/10.3389/fneur.2025.1483842","url":null,"abstract":"<p><p>Cerebral small vessel disease (CSVD) is an intracranial vascular disorder caused by the impairment of cerebral microvessels, with various pathological backgrounds. Currently, a clear and definitive set of diagnostic criteria for CSVD continues to be elusive, and its diagnosis relies primarily on medical history, clinical presentation, brain imaging features, and genetic detection. In clinical practice, no single biomarker was identified. Previous studies have delved into various biomarkers in CSVD and their relationships with cognitive functions, yielding promising candidates. However, drawing a unified and conclusive consensus poses a challenge due to the inherent heterogeneity in research. Therefore, we reviewed the current progression of CSVD biomarkers and their relationship with cognitive functions, mainly including neuroimaging markers and biomarkers related to cerebrospinal fluid (CSF), as well as blood to assist clinicians in diagnosis.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1483842"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077411","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":"Platelet aggregation rate serves as a significant predictive indicator for thromboembolic events in the context of stent-assisted embolization for unruptured arterial aneurysms.","authors":"Xiaopeng Huang, Tingbao Zhang, Yu Feng, Xiang Li, Kui Liu, Wenyuan Zhao","doi":"10.3389/fneur.2025.1538753","DOIUrl":"https://doi.org/10.3389/fneur.2025.1538753","url":null,"abstract":"<p><strong>Background: </strong>Perioperative cerebrovascular thromboembolic events are serious complications of stent-assisted embolization (SAE) for unruptured intracranial aneurysms (UIAs). To date, there have been no definitive clinical trial results to effectively predict and prevent the occurrence of this complication. This study aims to elucidate the correlation between platelet aggregation rate (PAR) and thromboembolic events (TEs), with the goal of predicting the occurrence of cerebrovascular TEs in these patients.</p><p><strong>Methods: </strong>In this retrospective, single-center cohort study, we included 704 cases of unruptured intracranial aneurysms treated with stent-assisted intervention from 2016 to 2020. Cerebrovascular TEs were defined as cerebral ischemic events occurring within 7 days before or after the interventional procedure. Light Transmission Aggregometry (LTA) was used to detect PAR in patients. Clinical data, including patients' demographic information and perioperative PAR, were collected. Multivariate analysis was conducted to examine the correlation between these factors and the occurrence of TEs. Additionally, Lasso regression was employed to select clinical indicators associated with perioperative TEs. Receiver Operating Characteristic (ROC) curves were generated for prognostic indicators such as PAR, with the optimal cutoff value determined. A nomogram was then simulated, and predictive accuracy of the model was evaluated using Decision Curve Analysis (DCA).</p><p><strong>Results: </strong>A total of 562 patients were included in the final analysis. Significant differences were observed in the incidence of thrombosis between the control group and the experimental group (9.38% vs. 4.96%). The ROC curve of platelet aggregation index, highly correlated with prognosis and derived from Lasso regression, identified the optimal cutoff value for the maximum preoperative PAR as 19.81. A nomogram was constructed based on selected clinical baseline data, and its calibration was assessed using data from the prediction group. The net benefit of the experimental group model's DCA curve was significantly improved.</p><p><strong>Conclusion: </strong>For patients undergoing SAE for UIAs, utilizing PAR and other indicators as reference standards for treatment results in better prognosis compared to empirical treatment based on guidelines. Guiding antiplatelet therapy using PAR and other indicators is both meaningful and beneficial to clinical practice.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1538753"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077403","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":"Ameliorating motor performance and quality of life in Parkinson's disease: a comparison of deep brain stimulation and focused ultrasound surgery.","authors":"Mingqian Liang, Le Hou, Jinjun Liang, Shengyong Bao","doi":"10.3389/fneur.2025.1449973","DOIUrl":"https://doi.org/10.3389/fneur.2025.1449973","url":null,"abstract":"<p><strong>Introduction: </strong>Deep brain stimulation (DBS) and magnetic resonance-guided focused ultrasound surgery (MRgFUS) have emerged as valuable treatment options for Parkinson's disease (PD) with drug-resistant symptoms. However, comparative studies of various DBS targets and MRgFUS are still limited.</p><p><strong>Methods: </strong>We reviewed three databases for trials on the effects of DBS or MRgFUS on PD patients, focusing on motor performance and quality of life (QoL). A frequentist network meta-analysis was conducted to estimate the treatment effects.</p><p><strong>Results: </strong>There were 39 trials in this study, comprising 3,002 patients. In the off-phase, subthalamic nucleus_DBS (STN_DBS [SMD, -0.94; 95%CI, -1.40 to -0.48]) significantly improved the UPDRS-III Total score compared to medication treatment alone (MT). In the on-phase, STN_DBS (SMD, -0.83; 95%CI, -1.13 to -0.53), internal globus pallidus_DBS (GPi_DBS [SMD, -0.80; 95%CI, -1.20 to -0.40]), and STN_Focused Ultrasound (STN_FUS [SMD, -1.83; 95%CI, -2.97 to -0.68]) significantly improved the UPDRS-III Total score. Regarding QoL, STN_DBS (SMD, -0.75; 95% CI, -1.46 to -0.05) and GPi_DBS (SMD, -0.58; 95% CI, -0.96 to -0.21) demonstrated better outcomes compared to MT. The SUCRA plot indicated that the top three treatments for UPDRS-III Total score in the off-phase were STN_FUS (79.6%), STN-GPi_DBS (73.7%), and STN_DBS (69.1%). In the on-phase, the top three treatments were STN_FUS (95.7%), STN_DBS (69.6%), and GPi_DBS (66.9%). Regarding QoL, GPi_DBS (77.2%) ranks first, followed by STN_DBS (67.3%), STN_FUS (56.9%) ranks third.</p><p><strong>Conclusion: </strong>STN_DBS, GPi_DBS, and STN_FUS have exhibited efficacy in ameliorating motor performance and enhancing QoL in PD patients. Nevertheless, as a potential alternative to STN_DBS with comparable efficacy, STN-FUS may serve as another treatment option.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1449973"},"PeriodicalIF":2.7,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12074956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077522","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":"Assessment of causality association between serum adiponectin levels and the risk of Alzheimer's disease and Parkinson's disease: a Mendelian randomization study.","authors":"Jiali Lin, Langhuan Lei, Qiuyu Liang, Xiaozhi Huang, Yanping Ding, Liuxian Pan, Jianrong Yang, Wei Li","doi":"10.3389/fneur.2025.1395798","DOIUrl":"https://doi.org/10.3389/fneur.2025.1395798","url":null,"abstract":"<p><strong>Background: </strong>Until recently, the association between circulating adiponectin (ADPN) levels and the risk of Alzheimer's disease (AD) and Parkinson's disease (PD) remained unclear.</p><p><strong>Methods: </strong>We utilized public data from the IEU GWAS database to conduct a two-sample bidirectional Mendelian randomization (MR) analysis and multiple sensitivity analyses. The MR analysis was performed using the aggregated data, with the genetic risk score (GRS) serving as an instrumental variable.</p><p><strong>Results: </strong>The MR analyses revealed no significant causal association between genetically determined ADPN levels and the risk of AD (OR_IVW = 0.852, 95% confidence interval [CI]: 0.586-1.117, <i>p</i> = 0.235) or PD (OR_IVW = 0.830, 95% CI: 0.780-1.156, <i>p</i> = 0.606). Conversely, neither AD nor PD demonstrated any causal association with ADPN levels. The GRS approach yielded similar results (<i>p</i> > 0.05). However, it exhibited a negative correlation with interleukin 1β (IL1β, β_IVW = -0.31; 95% CI: -0.55 to -0.07, <i>p</i> = 0.011). The Cochrane's Q test and MR-PRESSO analysis revealed no evidence of pleiotropy.</p><p><strong>Conclusion: </strong>Our findings provide no evidence to substantiate a causal relationship between ADPN levels and the risk of AD and PD or vice versa. However, elevated levels of ADPN may correlate with lower levels of IL1β.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1395798"},"PeriodicalIF":2.7,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12075267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076949","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":"Identification immune-related hub genes in diagnosing atherosclerosis with ischemic stroke through comprehensive bioinformatics analysis and machine learning.","authors":"Ming Zhang, Li-Jun Tang, Shi-Yu Long","doi":"10.3389/fneur.2025.1507855","DOIUrl":"https://doi.org/10.3389/fneur.2025.1507855","url":null,"abstract":"<p><strong>Background: </strong>Atheroma plaques are major etiological factors in the pathogenesis of ischemic stroke (IS). Emerging evidence highlights the critical involvement of the immune microenvironment and dysregulated inflammatory responses throughout IS progression. Consequently, therapeutic strategies targeting specific immune-related markers or signaling pathways within this microenvironment hold significant promise for IS management.</p><p><strong>Methods: </strong>We integrated Weighted Gene Co-expression Network Analysis (WGCNA), CIBERSORT, and machine learning (LASSO/Random Forest) to identify disease-associated modules and hub genes. Immune infiltration analysis evaluated hub gene-immune cell correlations, while protein-protein interaction (PPI) and ROC curve analyses assessed diagnostic performance.</p><p><strong>Results: </strong>Comprehensive bioinformatics analysis identified three hub genes-OAS2, TMEM106A, and ABCB1-with high prognostic value for ischemic stroke. Immune infiltration profiling revealed significant correlations between these genes and distinct immune cell populations, underscoring their roles in modulating the immune microenvironment. The diagnostic performance of the gene panel was robust, achieving an area under the curve (AUC) was calculated as 0.9404 (<i>p</i> < 0.0001; 95% CI: 0.887-0.9939) for atherosclerotic plaques, demonstrating superior accuracy compared to conventional biomarkers.</p><p><strong>Conclusion: </strong>By integrating machine learning with multi-omics bioinformatics, we established a novel three-gene signature (OAS2, TMEM106A, ABCB1) for precise diagnosis of atherosclerosis and ischemic stroke. These genes exhibit dual diagnostic utility and may influence disease progression through immune cell modulation. Our findings provide a foundation for developing targeted therapies and biomarker-driven clinical tools.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1507855"},"PeriodicalIF":2.7,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12074939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077246","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":"Association of plasma neurofilament light protein concentration with sleep disturbance after intracerebral hemorrhage.","authors":"Peng Xu, Jinlei Yang, Xin Zhao, Fang Liu, Qiang Liu, Handong Wang","doi":"10.3389/fneur.2025.1482808","DOIUrl":"https://doi.org/10.3389/fneur.2025.1482808","url":null,"abstract":"<p><strong>Background: </strong>Intracerebral hemorrhage (ICH) represents a critical subtype of stroke characterized by substantial morbidity and mortality. Emerging research indicates that neurofilament light protein (NfL), a biomarker indicative of neuronal damage, may offer valuable prognostic information regarding outcomes and recovery trajectories post-ICH. This study seeks to elucidate the relationship between plasma NfL (pNfL) concentrations and long-term patient outcomes, with a particular focus on sleep disturbances following ICH.</p><p><strong>Methods: </strong>We conducted a cohort study comprising 26 healthy controls and 49 patients who had experienced ICH. The Glasgow Coma Scale (GCS) was assessed upon admission. Plasma samples were collected at admission and on 3, 7, and 14 days post-ICH. Then pNfL levels were quantified using Enzyme-Linked Immunosorbent Assay (ELISA). Clinical outcomes were evaluated at 6 months post-ICH using the Glasgow Outcome Scale-Extended (GOSE) and the Pittsburgh Sleep Quality Index (PSQI). Receiver operating characteristic (ROC) curves and the areas under the ROC curves (AUC) were utilized to determine the accuracy of hemorrhage volume and pNfL levels in identifying sleep disturbances.</p><p><strong>Results: </strong>pNfL levels were elevated in patients with ICH compared to healthy controls. Longitudinal analysis indicated an increasing trend in pNfL levels over the initial 7 days post-admission. pNfL levels demonstrated an AUC for distinguishing ICH patients from controls (admission for 0.92, post-ICH 3d for 0.98). In ICH patients, pNfL levels showed a positive correlation with hemorrhage volume and PSQI, and a negative correlation with GCS and GOSE. The AUCs for pNfL levels and hemorrhage volume, which were indicative of sleep disturbances, were 0.82 and 0.75, respectively. Furthermore, the combined assessment of pNfL levels and hemorrhage volume exhibited superior predictive performance compared to the evaluation of each factor individually.</p><p><strong>Conclusion: </strong>pNfL represents a promising biomarker for predicting functional outcomes and evaluating sleep disturbances in patients following ICH. Elevated levels of NfL at admission are associated with poorer prognoses and increased sleep-related issues, indicating that monitoring pNfL could be valuable for prognostication and the implementation of targeted interventions.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1482808"},"PeriodicalIF":2.7,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12077819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077261","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":"Status and influencing factors of balance in middle-aged and older adults with Parkinson's disease: a national longitudinal study.","authors":"Wu-Xiao Wei, Xin-Gui Zhuo, Hong-Qiao Chen, Ming-Li Chen","doi":"10.3389/fneur.2025.1499640","DOIUrl":"https://doi.org/10.3389/fneur.2025.1499640","url":null,"abstract":"<p><strong>Background: </strong>To examine the current status and influencing factors of balance in middle-aged and older adults with Parkinson's disease (PD) and explore the correlations of these factors with balance.</p><p><strong>Methods: </strong>The China Health and Retirement Longitudinal Study (CHARLS) Database in 2015, 2018 and 2020 were utilized as the data source, from which the missing value samples were excluded and 1,390 participants aged ≥45 years were recruited. Using the chi-square test, balance comparisons were made among middle-aged and older adults PD patients under different indicators. The influences of different factors on the patient balance were investigated through regression analysis.</p><p><strong>Results: </strong>Regression analysis revealed the correlations of age, gender, smoking, falls, hypertension, diabetes and physical activity with balance in PD patients. A significant association between aging and declined balance was found, with middle-aged and older adults PD patients aged > 65 years showing a higher probability of declined balance (OR = 0.716, <i>p</i> = 0.016). Male middle-aged and older adults PD patients exhibited better balance than female counterparts (OR = 1.829, <i>p</i> = 0.001). Previous smoking (OR = 0.580, <i>p</i> = 0.004), falls (OR = 0.769, <i>p</i> = 0.035), hypertension (OR = 0.738, <i>p</i> = 0.019) and diabetes (OR = 0.734, <i>p</i> = 0.027) were positively correlated with the declined balance in PD patients. Light physical activity could significantly improve balance in middle-aged and older adults PD patients (OR = 1.672, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Balance impairment is a major concern for middle-aged and older adults with PD. Our findings highlight that age, gender, smoking, history of falls, hypertension, diabetes, and physical activity significantly influence balance. Specifically, old age, male gender, light physical activity (such as walking), and lower risks of hypertension and diabetes are linked to better balance. Clinicians should focus on managing these risk factors and promoting light physical activity to improve balance and reduce fall risks.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1499640"},"PeriodicalIF":2.7,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12074968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077343","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}