Frontiers in Neurology最新文献

{"title":"Development and validation of a nomogram for predicting intracranial infection after intracranial aneurysm surgery.","authors":"Yongqiang Yang, Yanli Tang, Youwen Gong","doi":"10.3389/fneur.2025.1563848","DOIUrl":"10.3389/fneur.2025.1563848","url":null,"abstract":"<p><strong>Background: </strong>Intracranial infection is a severe complication following intracranial aneurysm surgery, associated with higher rates of morbidity and mortality. This study aimed to develop and validate a nomogram to predict the risk for intracranial infection after intracranial aneurysm surgery. This nomogram was designed to assist clinicians in identifying high-risk patients and implementing targeted preventive measures, ultimately improving postoperative outcomes.</p><p><strong>Methods: </strong>This retrospective cohort study included patients who underwent intracranial aneurysm surgery at a single center. Data regarding potential predictors, including clinical characteristics, surgical details, and laboratory test results, were collected. Independent risk factors for intracranial infection were identified using univariate and multivariate logistic regression analyses. A nomogram was constructed on the basis of these predictors. Nomogram performance was evaluated using the area under the receiver operating characteristic curve (AUC) for discrimination, calibration plots for predictive accuracy, and decision curve analysis (DCA) for clinical utility.</p><p><strong>Results: </strong>Data from 612 patients who underwent intracranial aneurysm surgery were analyzed, with 428 and 184 patients in the training and validation cohorts, respectively. Multivariate logistic regression analysis identified pneumonia, external ventricular drainage, tracheotomy, procalcitonin, C-reactive protein, and albumin levels as independent risk factors for intracranial infections (<i>p</i> < 0.05). A nomogram, constructed on the basis of these predictors, exhibited excellent discrimination, with an AUC of 0.91 (95% confidence interval [CI] 0.88-0.93) in the training cohort and 0.89 (95% CI 0.84-0.93) in the validation cohort. DCA demonstrated that the nomogram provided a significant net clinical benefit across a range of risk thresholds, supporting its utility in clinical decision making.</p><p><strong>Conclusion: </strong>The nomogram developed was a robust and practical tool for predicting the risk for intracranial infection after intracranial aneurysm surgery. It demonstrated strong predictive accuracy and calibration, with potential applications in identifying high-risk patients and guiding individualized preventive strategies. However, validation using a broader and more diverse population is recommended to enhance the generalizability of the model.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1563848"},"PeriodicalIF":2.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316568","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":"Is acupuncture combined with repeated transcranial magnetic stimulation more effective in improving upper limb motor dysfunction after stroke? A systematic review and meta-analysis of randomized controlled trials.","authors":"Minghui Yan, Ying Luo, Yanling Hou, Zhiying Wang, Qiguang Yang","doi":"10.3389/fneur.2025.1575879","DOIUrl":"10.3389/fneur.2025.1575879","url":null,"abstract":"<p><strong>Background: </strong>Upper limb motor dysfunction is a common sequela of stroke, which adversely affects patients' quality of life and ability of daily living. Although acupuncture and repeated transcranial magnetic stimulation (rTMS) can improve this symptom, it is uncertain whether the combined application of the two treatments can enhance the therapeutic effect.</p><p><strong>Objective: </strong>Through systematic review and meta-analysis, this study discusses the improvement effect of acupuncture combined with rTMS on upper limb motor dysfunction after stroke.</p><p><strong>Methods: </strong>We searched PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (VIP), Wanfang Database, and Chinese Biomedical Literature Service (CBM) for randomized controlled trials of acupuncture combined with rTMS for the treatment of upper limb motor dysfunction after stroke, and performed a screening process according to the inclusion and exclusion criteria. The data were screened, extracted, and analyzed using RevMan (version 5.4) software for Meta-analysis.</p><p><strong>Results: </strong>A total of 21 papers involving 1,550 patients were included. The results of the Meta-analysis showed that the combination therapy was superior to acupuncture alone and rTMS alone in improving FMA-UE (acupuncture: MD = 7.55, 95%CI: 4.18 ~ 10.92, I² = 97%, <i>p</i> < 0.00001; rTMS: MD = 9.74, 95%CI: 6.41 ~ 13.07, I² = 98%, p < 0.00001); combination therapy was superior to acupuncture alone and rTMS alone in improving MBI (acupuncture: MD = 6.43, 95%CI: 4.07 ~ 8.78, I² = 61%, <i>p</i> = 0.01; rTMS: MD = 9.49, 95%CI: 7.52 ~ 11.47, I² = 39%, <i>p</i> = 0.12); combination therapy was more effective in improving MAS compared to acupuncture (MD = -0.55, 95% CI: -0.69 to -0.41, I² = 0%, <i>p</i> = 0.61); combination therapy was more effective in improving NIHSS compared to rTMS (MD = -3. 14, 95%CI: -4.79 to -1.5, I² = 74%, <i>p</i> = 0.02).</p><p><strong>Conclusion: </strong>Acupuncture combined with rTMS is more effective than acupuncture or rTMS intervention alone in improving upper extremity motor function and daily living ability and improving neurological damage after stroke.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1575879"},"PeriodicalIF":2.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316575","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":"Chronic unilateral vestibular hypofunction: a qualitative study exploring the full spectrum of symptoms and impacts through the ICF framework.","authors":"Mustafa Karabulut, Hamide Avci, Eda Yalçınkaya, Merel Kimman, Wolfgang Viechtbauer, Alfarghal Mohamad, Vincent Van Rompaey, Nils Guinand, Angélica Perez Fornos, Levent Özlüoğlu, Osman Nuri Özgirgin, Raymond van de Berg","doi":"10.3389/fneur.2025.1589404","DOIUrl":"10.3389/fneur.2025.1589404","url":null,"abstract":"<p><strong>Aim: </strong>To explore the full spectrum of symptoms and impacts associated with chronic unilateral vestibular hypofunction (UVH), and to assess whether these symptoms and impacts are fully covered by patient-reported outcome measures (PROMs) within the International Classification of Functioning, Disability and Health (ICF) framework.</p><p><strong>Methods: </strong>A qualitative study was conducted using semi-structured interviews, which were recorded, transcribed, and analyzed by two independent reviewers through a consensus approach. Data collection continued until thematic saturation was reached. Domains were then identified from interviews and PROMs (Dizziness Handicap Inventory, Hospital Anxiety and Depression Scale, EQ-5D-5L) using the ICF linking process. The analysis comprised three stages: (1), documenting the full spectrum of UVH symptoms and impacts from interviews, (2) reporting domains and constructs based on interviews, (3) comparing domains identified from interviews with those from PROMs (DHI, HADS, EQ-5D-5L, analyzed separately).</p><p><strong>Results: </strong>Fifteen patients with chronic UVH were interviewed. Reported symptoms revealed 16 physical symptoms, four cognitive symptoms, and five emotions. Key challenges included driving difficulties, darkness, sleep problems, fear of falling, and discomfort in crowded environments. Patients adapted certain behaviors, such as moving slowly, using supports, and avoiding sudden movements. Regarding the ICF framework, the most frequently reported construct was Body functions, with key domains including emotional, vestibular, and hearing-related functions. Activities and participation focused on maintaining body position and family relationships, while environmental factors highlighted the impact of light and sound. Interviews identified key domains related to vision, memory, multitasking, and activities impacting quality of life that were often overlooked by the PROMs.</p><p><strong>Conclusion: </strong>Patients with chronic UVH experience a wide spectrum of physical, cognitive, and emotional symptoms, resulting in significant limitations in daily life. The frequently used PROMs (DHI, HADS, and EQ-5D-5L) do not fully cover these symptoms and their impacts, which leave many aspects underrepresented. A tailored PROM for UVH may be needed, to better reflect the specific symptoms, behaviors and functional limitations related to chronic UVH.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1589404"},"PeriodicalIF":2.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316566","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":"Safinamide as an adjunct to levodopa monotherapy in Asian patients with Parkinson's disease experiencing early wearing-off: a pooled analysis of the J-SILVER and KEEP studies.","authors":"Noriko Nishikawa, Do-Young Kwon, Yuki Kogo, Taku Hatano, Jin Whan Cho, Chizuru Kobayashi, Hiroyuki Shiiba, JiEun Kim, Takayuki Ishida, Jong Sam Baik, Nobutaka Hattori","doi":"10.3389/fneur.2025.1591664","DOIUrl":"10.3389/fneur.2025.1591664","url":null,"abstract":"<p><strong>Background: </strong>Limited trials are evaluating the efficacy of monoamine oxidase B inhibitors as an adjunct to levodopa monotherapy for early wearing-off in Parkinson's disease (PD). We evaluated the efficacy and safety of safinamide in patients with fluctuating PD treated with levodopa monotherapy.</p><p><strong>Methods: </strong>This pooled analysis used data from the J-SILVER and KEEP studies and targeted patients with PD experiencing wearing-off who received safinamide as adjunct to levodopa monotherapy. Efficacy endpoints were mean changes in 39-item Parkinson's Disease Questionnaire (PDQ-39), Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Parts III and IV, and daily OFF time at 18 weeks of treatment.</p><p><strong>Results: </strong>Of 54 patients (J-SILVER, <i>N</i> = 24; KEEP, <i>N</i> = 30), 41 completed the studies. Although not statistically significant, the change in PDQ-39 Summary Index exceeded the minimal clinical important difference (mean [standard deviation (SD)]: -2.2 [7.5], <i>p</i> = 0.094) at Week 18. Significant improvements in MDS-UPDRS Parts III and IV scores and daily OFF time were observed at Week 18 from baseline (mean [SD]: -2.8 [8.5]; <i>p</i> = 0.043, -1.3 [2.7]; <i>p</i> = 0.004, and -1.2 [3.5] hours; <i>p</i> = 0.041, respectively). Adverse events occurred in 24 patients (43.6%) and adverse drug reactions (ADRs) occurred in 12 patients (21.8%). ADRs with an incidence ≥5% were dyskinesia (3 events, 5.5%). In subgroup analyses, improvements in PDQ-39 Summary Index and MDS-UPDRS Parts III and IV were significant in patients aged ≥75 years (<i>p</i> = 0.039, <i>p</i> = 0.029, and <i>p</i> = 0.025, respectively).</p><p><strong>Conclusion: </strong>Safinamide as an adjunct to levodopa monotherapy was effective for early wearing-off without any new tolerability concerns. Safinamide was particularly beneficial in elderly patients.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1591664"},"PeriodicalIF":2.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316580","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":"Bowel disorders in patients with severe acquired brain injury receiving neurorehabilitation: results from a national survey in Italy.","authors":"Domenico Intiso, Andrea Montis, Federico Scarponi, Bahia Hakiki, Anna Cassio, Rossella Lopes, Susanna Lavezzi","doi":"10.3389/fneur.2025.1474360","DOIUrl":"10.3389/fneur.2025.1474360","url":null,"abstract":"","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1474360"},"PeriodicalIF":2.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316565","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":"Increased uric acid to high-density lipoprotein ratio positively correlated with stroke risk.","authors":"Tieshi Zhu, Yong He, Erxinxian Bei","doi":"10.3389/fneur.2025.1577077","DOIUrl":"10.3389/fneur.2025.1577077","url":null,"abstract":"<p><strong>Background: </strong>The Uric Acid-to-HDL Ratio (UHR), a novel index derived from serum uric acid and high-density lipoprotein, has been linked to hypertension and poor diabetes control. It has also been shown to predict ischemic heart disease and is strongly associated with collateral circulation and coronary artery flow reserve. However, fewer studies have focused on the relationship between UHR and stroke, highlighting the need for further research in this area.</p><p><strong>Methods: </strong>The study included 33,192 individuals from the NHANES 1999-2023, of whom 1,363 had a history of stroke. The nonlinear relationship between UHR and stroke risk was assessed using restricted cubic spline (RCS) analysis, and the robustness of the findings was further tested through stratified analysis. Logistic regression was employed to analyze the relationship between UHR and stroke risk, considering both UHR as a continuous variable and its categorization into quartiles (Q1-Q4).</p><p><strong>Results: </strong>UHR was not nonlinearly associated with stroke (<i>p</i> for overall <0.01; <i>p</i> for nonlinearity = 0.65), and the RCS graph approximated a straight line with a positive slope. UHR was significantly associated with an increased risk of stroke, both when analyzed as a continuous variable (Model 4: OR = 1.02, 95% CI 1.01-1.03, <i>p</i> < 0.01) and when categorized into quartiles (Q4, OR = 1.31, 95% CI 1.11-1.55, <i>p</i> < 0.01).</p><p><strong>Conclusion: </strong>There was a significant positive correlation between UHR and stroke risk.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1577077"},"PeriodicalIF":2.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316572","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":"Research progress in predicting the conversion from mild cognitive impairment to Alzheimer's disease via multimodal MRI and artificial intelligence.","authors":"Min Ai, Yu Liu, Dan Liu, Chengxi Yan, Xia Wang, Xun Chen","doi":"10.3389/fneur.2025.1596632","DOIUrl":"10.3389/fneur.2025.1596632","url":null,"abstract":"<p><p>Predicting the transition from mild cognitive impairment (MCI) to Alzheimer's disease (AD) has important clinical significance for dementia prevention and improving patient prognosis. Multimodal magnetic resonance imaging (MRI) techniques (including structural MRI, functional MRI, and cerebral perfusion MRI) can yield information on the morphology, structure, and function of the brain from multiple dimensions, providing a key basis for revealing the pathophysiological mechanisms during the conversion from MCI to AD. Artificial intelligence (AI) methods based on deep learning and machine learning, with their powerful data processing and pattern recognition capabilities, have shown great potential in mining the features of multimodal MRI data and constructing prediction models for MCI conversion. Therefore, this paper systematically reviews the research progress of multimodal MRI techniques in capturing brain changes related to MCI conversion, as well as the practical experience of AI algorithms in constructing efficient prediction models, analyses the current technical challenges faced by the research, and discusses future directions, with the goal of providing a scientific reference for the early and accurate prediction of MCI conversion and the formulation of intervention strategies.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1596632"},"PeriodicalIF":2.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316578","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":"Risk factors for postoperative thrombotic complications after meningioma resection: a retrospective single-center study in China.","authors":"Yingying Kong, Beibei Jin, Yijie Zhang, Jianhai Long","doi":"10.3389/fneur.2025.1579384","DOIUrl":"10.3389/fneur.2025.1579384","url":null,"abstract":"<p><strong>Objective: </strong>To explore the incidence and risk factors for deep vein thrombosis (DVT) and pulmonary embolism (PE) following surgical intervention for meningioma.</p><p><strong>Methods: </strong>In this retrospective, observational study, we enrolled 9,067 patients with histologically confirmed meningiomas who underwent surgical resection at our institution between January 2019 and June 2024. Demographic data (including gender, age, and geographic region) and information on comorbidity, and postoperative complications were documented and analyzed. The incidences of postoperative DVT and PE were also recorded. Risk factors for DVT and PE were identified using univariate and multivariate logistic regression analyses and restricted cubic splines.</p><p><strong>Results: </strong>Among the 9,067 patients who underwent meningioma surgery, 766 (8.4%) developed deep venous thrombosis (DVT) and 32 (0.35%) developed pulmonary embolism (PE). The mean age for patients with DVT was 59.39 ± 9.85 years, and for those with PE, it was 62.22 ± 9.86 years, both significantly higher than the overall patient population (<i>p</i> < 0.001). Geographically, the highest incidences of DVT and PE were found in Northeast, North, and East China, with provinces such as Hebei, Shandong, and Inner Mongolia reporting the highest rates. Associated risk factors for DVT included advanced age, asthma, heart failure, hypertension, and pneumonia. The associated risk factors for PE were age, DVT, pneumonia, and renal insufficiency. Multivariate analysis identified age, intracerebral hemorrhage (ICH), atrial fibrillation, heart failure, hyperlipidemia, varicose veins, hypothyroidism, hypoproteinemia, pneumonia, anemia, central nervous system infection as significant predictors for DVT, and age (OR: 1.05; 95% CI: 1.01-1.09), pneumonia (OR: 3.60; 95% CI: 1.65-7.85), and SDVT (OR: 15.88; 95% CI: 6.94-36.35) for PE. Nomogram models demonstrated strong predictive performance, with ROC values of 0.754 for DVT and 0.886 for PE.</p><p><strong>Conclusion: </strong>The incidences of DVT and PE following meningioma surgery were 8.4 and 0.35%, respectively. Age, comorbidities, and postoperative complications significantly influence the risk of these thromboembolic events. The study highlights the need for early identification and tailored prevention strategies, and the developed predictive models offer useful tools for clinical decision-making. However, the models' overestimation of risk warrants further refinement to enhance their clinical applicability.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1579384"},"PeriodicalIF":2.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316579","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 novel risk factor for dementia: chronic microplastic exposure.","authors":"Elif Gecegelen, Mete Ucdal, Burcu Balam Dogu","doi":"10.3389/fneur.2025.1581109","DOIUrl":"10.3389/fneur.2025.1581109","url":null,"abstract":"<p><p>Recent advances in dementia research have expanded our understanding of modifiable risk factors, with air pollution being a well-established contributor. However, microplastics-plastic particles smaller than 5 mm-represent an understudied component of environmental pollution that may significantly impact neurological health. This review examines emerging evidence linking chronic microplastic exposure to increased dementia risk. Microplastics enter the human body through multiple routes, including ingestion of contaminated food and water, inhalation, and dermal absorption, with demonstrated ability to cross the blood-brain barrier and initiate several pathogenic pathways. Four primary mechanisms appear to mediate microplastic-induced neurodegeneration: increased oxidative stress through reactive oxygen species (ROS) production; neuroinflammation via microglial activation and chronic inflammatory responses; neurotoxicity from transported persistent organic pollutants (POPs) and heavy metals; and accelerated amyloid-beta pathology through enhanced Aβ40 and Aβ42 nucleation. Recent bioaccumulation studies have revealed significantly elevated microplastic concentrations in the brains of dementia patients compared to non-dementia controls, supporting a potential dose-dependent relationship. Sources of environmental microplastics include industrial waste, synthetic textiles, plastic degradation products, and tire wear particles, creating a ubiquitous exposure risk through contaminated air, food, and water. While preliminary evidence supports a mechanistic link between microplastics and neurodegeneration, comprehensive epidemiological studies with larger datasets are needed to quantify this relationship and establish dose-response patterns. Future research should focus on identifying which microplastic types pose the greatest neurological risks, determining threshold exposure levels, and developing interventions to mitigate exposure.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1581109"},"PeriodicalIF":2.7,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12162254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301780","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 effectiveness of low-frequency electrical stimulation in treating hemiplegic shoulder pain: a systematic review and meta-analysis.","authors":"Tao Qin, Tiantian Hu, Yuzhuo Dan, Cheng Qiu, Mei Chen, Fanjing Kong, Sha Huang, Zhenwei Zhai, Ying Xu, Tao Sun","doi":"10.3389/fneur.2025.1574338","DOIUrl":"10.3389/fneur.2025.1574338","url":null,"abstract":"<p><strong>Objective: </strong>To clarify the effectiveness of Low-frequency electrical stimulation (LFES) in treating Hemiplegic shoulder pain (HSP), identify the therapeutic effects of different treatment parameters, and provide evidence-based recommendations.</p><p><strong>Methods: </strong>We searched PubMed, EMBASE, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, and China Science and Technology Journal Database up to October 2023. Randomized controlled trials (RCTs) comparing LFES with comparable single rehabilitation interventions, placebo/sham treatments, or conventional rehabilitation were included. The included outcomes were pain intensity and motor function in the upper extremities. The systematic review protocol is available on the International Prospective Register of Systematic Reviews (PROSPERO) (registration number: CRD42023493979).</p><p><strong>Results: </strong>A total of eight studies (341 participants) were included. LFES showed significant therapeutic effects on shoulder pain scores (SMD = -0.68; 95% CI: [-1.18, -0.18], <i>Z</i> = 2.69, <i>p</i> = 0.006, <i>I</i> ² = 76%). However, the improvement in upper limb motor function (MD = 8.50; 95% CI: [5.12, 11.88], <i>Z</i> = 4.93, <i>p</i> < 0.001, <i>I</i> ² = 16%) was influenced by a single study with lower methodological quality. Subgroup analyses examined factors such as control group type, stimulation type, duration, frequency, pulse width, and stimulation area. The variations in therapeutic effects of LFES across different treatment parameters, different hemiplegic sides, and different stimulation areas were further explored by subgroup analysis.</p><p><strong>Conclusion: </strong>The meta-analysis results indicate that LFES has significant positive effects on alleviating HSP, but its effect on improving motor function requires cautious interpretation due to potential bias.</p><p><strong>Systematic review registration: </strong>International Prospective Register of Systematic Reviews (PROSPERO), identifier: CRD42023493979.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1574338"},"PeriodicalIF":2.7,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12162256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301756","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}