Frontiers in Neurology最新文献

{"title":"Tenecteplase for ischemic stroke at 4.5 to 24 hours without thrombectomy: a cost-utility analysis from the perspective of Chinese healthcare system.","authors":"Maolin Chen, Ying Yu, Baozhong Yu, Yudan Cao, Yake Lou, Yudong Ma","doi":"10.3389/fneur.2025.1551332","DOIUrl":"10.3389/fneur.2025.1551332","url":null,"abstract":"<p><strong>Background: </strong>Tenecteplase improves functional outcomes in acute ischemic stroke (AIS) patients treated 4.5 to 24 h after symptom onset who do not undergo thrombectomy. However, its cost-utility remains unexamined.</p><p><strong>Methods: </strong>A hybrid model combining a short-term decision tree and a long-term Markov model was developed to simulate the costs and quality-adjusted life years (QALYs) for Chinese patients with AIS at 4.5 to 24 h, who did not undergo thrombectomy. Clinical data were sourced from the TRACE-III trial, while cost data were obtained from the China National Stroke Registry and the Thrombolysis Implementation and Monitor of Acute Ischemic Stroke in China database. The primary outcome was the incremental cost-effectiveness ratio (ICER). Secondary outcomes included total costs, total QALYs and remaining life expectancy, as well as the incremental cost, incremental QALYs, and incremental remaining life expectancy. One-way sensitivity analysis, probabilistic sensitivity analysis (PSA), and scenario analysis were conducted to test the robustness of the results.</p><p><strong>Results: </strong>For a Chinese patient with AIS treated within 4.5 to 24 h after symptom onset without thrombectomy, adding tenecteplase to standard care resulted in an incremental cost of 2,536 Chinese Yuan (CNY) and an increase of 0.40 QALYs, yielding an ICER of 6,386 CNY per QALY. One-way sensitivity analysis revealed that the most significant factors influencing the ICER were the efficacy and cost of tenecteplase. PSA and scenario analyses confirmed the robustness of these results.</p><p><strong>Conclusion: </strong>Compared to standard medical treatment alone, administering intravenous tenecteplase between 4.5 and 24 h after onset for Chinese patients with AIS who did not undergo thrombectomy, is highly cost-effective.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1551332"},"PeriodicalIF":2.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700213","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":"Ischemic stroke in young Asians caused by spontaneous cervical artery dissection may be due to slightly increased homocysteine.","authors":"Zijun Lin, Shuhan Huang, Wei Li","doi":"10.3389/fneur.2025.1527896","DOIUrl":"10.3389/fneur.2025.1527896","url":null,"abstract":"<p><strong>Background: </strong>Spontaneous cervical artery dissection (sCAD) is a non-atherosclerotic vascular disease among young and middle-aged individuals of unknown etiology that is recognized as a cause of ischemic stroke. Total plasma homocysteine (tHcy) is associated with an increased risk of sCAD, but the precise mechanism and level of tHcy remain unclear.</p><p><strong>Methods: </strong>Fasting tHcy levels were determined in 296 patients with a first ischemic stroke due to sCAD (<i>n</i> = 159) and in age-/gender-matched hospital-based controls (<i>n</i> = 137) within 24 h after the onset of symptoms.</p><p><strong>Results: </strong>The mean age of sCAD patients with ischemic stroke and controls was 45.6 years; 61.0% of the cases and controls were male. The prevalence rates of hypertension, diabetes mellitus, and hyperlipidemia in sCAD patients were significantly increased. Fasting tHcy levels in sCAD patients were significantly higher (12.81 ± 5.24 μmol/L, 95% CI: 11.79-13.89) than those in controls (10.21 ± 3.33 μmol/L, 95% CI: 9.92-11.89, <i>p</i> < 0.001). Compared with the lowest homocysteine quartile, the quartile between 12.1 and 14.54 μmol/L was significantly associated with sCAD, with an adjusted odds ratio of 4.7. The adjusted odds ratio was 5.02 (95% CI: 1.91-13.39, <i>p</i> = 0.001) for every 1 μmol/L increase in log homocysteine according to the logistic regression model. Although sCAD occurred more often in winter than in other seasons (<i>p</i> = 0.02), tHcy levels in sCAD were not significantly different in terms of seasonal variation (<i>p</i> > 0.05).</p><p><strong>Conclusion: </strong>Our results suggest that mildly increased tHcy may be a predisposing risk factor for ischemic stroke in young Asians caused by sCAD and that the relationship between them is significant; however, the precise mechanism requires further study. This result also supports the screening of fasting tHcy in young Asian adults for early intervention and control of tHcy levels, which plays an important role in early clinical prediction and intervention of sCAD.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1527896"},"PeriodicalIF":2.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700219","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":"Long-term functional outcomes in patients with isolated cerebellar infarction: the KOSCO study.","authors":"Ho Seok Lee, Min Kyun Sohn, Jongmin Lee, Deog Young Kim, Yong-Il Shin, Gyung-Jae Oh, Yang-Soo Lee, Min Cheol Joo, So Young Lee, Min-Keun Song, Junhee Han, Jeonghoon Ahn, Young-Hoon Lee, Dae Hyun Kim, Young-Taek Kim, Yun-Hee Kim, Won Hyuk Chang","doi":"10.3389/fneur.2025.1541245","DOIUrl":"10.3389/fneur.2025.1541245","url":null,"abstract":"<p><strong>Background: </strong>There are relatively few reports on the long-term sequential functional recovery and prognosis in patients with cerebellar infarction. The aim of this study was to investigate the long-term recovery of multifaceted functional outcomes up to 36 months after onset and the functional prognosis of isolated cerebellar infarction.</p><p><strong>Methods: </strong>This study was a retrospective analysis of the Korean Stroke Cohort for Functioning and Rehabilitation (KOSCO) data up to 36 months after onset. Isolated cerebellar infarction was defined as the presence of lesions in the cerebellum without lesions in other brain parenchyma. We assessed multifaceted functional domains, including motor (Fugl-Meyer Assessment, FMA), ambulatory (Functional Ambulation Category, FAC), cognitive (Korean Mini-Mental State Examination, K-MMSE), swallowing (American Speech-Language-Hearing Association National Outcome Measurement System Swallowing Scale, ASHA-NOMS), and language functions (Short version of the Korean Frenchay Aphasia Screening Test, Short K-FAST), using serial measurements. In addition, functional outcome was assessed with the Functional Independence Measure (FIM) up to 36 months after onset.</p><p><strong>Results: </strong>Among 390 screened isolated cerebellar infarction patients, a total of 183 patients were included in this study. Cognitive (mean[SD] of K-MMSE 27.6 ± 3.6) and swallowing (ASHA-NOMS 6.8 ± 0.7) functions showed significant improvement up to 3 months (<i>p</i> < 0.05). Motor (FMA 98.8 ± 3.8) and language (ASHA-NOMS 6.9 ± 0.4) functions improved significantly up to 6 months (<i>p</i> < 0.05). Furthermore, ambulatory function (FAC 4.7 ± 0.9) and functional independency (FIM 122.2 ± 12.0) continued to improve up to 12 months (<i>p</i> < 0.05). Vascular territory involving superior cerebellar artery, older age, female sex, and greater initial severity were identified as negative independent prognostic factors predicting functional outcome measured by FIM at 12 months after stroke.</p><p><strong>Conclusion: </strong>The plateau of recovery in multifaceted functional outcomes varied among patients with cerebellar infarction. Functional independence plateaued at 12 months and showed a relatively favorable prognosis up to 36 months after stroke.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1541245"},"PeriodicalIF":2.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700221","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 \"brain-gut\" mechanism of postherpetic neuralgia: a mini-review.","authors":"Peijun Zhang, Cuomaoji Zhang, Bixin Zheng, Yuntao Liu, Dingkun Zhang, Hong Xiao","doi":"10.3389/fneur.2025.1535136","DOIUrl":"10.3389/fneur.2025.1535136","url":null,"abstract":"<p><p>Postherpetic neuralgia (PHN), a representative type of neuropathic pain, has attracted much research on its diagnosis and therapy at the molecular level. Interestingly, this study based on the brain-gut axis provided a novel point of view to interpret the mechanism of PHN. Past neuroanatomical and neuroimaging studies of pain suggest that the prefrontal cortex, anterior cingulate cortex, amygdala, and other regions of the brain may play crucial roles in the descending inhibition of PHN. Dominant bacterial species in patients with PHN, such as Lactobacillus, generate short-chain fatty acids, including butyrate. Evidence indicates that disturbance of some metabolites (such as butyrate) is closely related to the development of hyperalgesia. In addition, tryptophan and 5-HT in the intestinal tract act as neurotransmitters that regulate the descending transmission of neuropathic pain signals. Concurrently, the enteric nervous system establishes close connections with the central nervous system through the vagus nerve and other pathways. This review aims to investigate and elucidate the molecular mechanisms associated with PHN, focusing on the interplay among PHN, the gut microbiota, and relevant metabolites while scrutinizing its pathogenesis.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1535136"},"PeriodicalIF":2.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700242","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":"Correlation of atorvastatin with subjective memory deficits: a study from the NHANES and FAERS databases.","authors":"Hao Zhang, Hua Huang, Panli Zhao","doi":"10.3389/fneur.2025.1526959","DOIUrl":"10.3389/fneur.2025.1526959","url":null,"abstract":"<p><strong>Background: </strong>Post-marketing regulatory data suggest a potential association between atorvastatin use and memory protection; however, findings from observational studies have been inconsistent and remain a subject of controversy.</p><p><strong>Objective: </strong>This study aims to investigate the correlation between atorvastatin exposure and subjective memory deficits, with the objective of providing more precise safety and efficacy information for its clinical use.</p><p><strong>Methods: </strong>We utilized two primary data sources: the National Health and Nutrition Examination Survey (NHANES) covering the years 2001 to 2018, and the Food and Drug Administration Adverse Event Reporting System (FAERS) spanning 2011 to 2018. We systematically analyzed the correlation between atorvastatin exposure and memory function using a range of statistical methods, including descriptive statistics, multivariate logistic regression, and receiver operating characteristic (ROC) curves.</p><p><strong>Results: </strong>In the analysis of the NHANES database, multivariate logistic regression modeling, after controlling for various factors such as demographic characteristics and lifestyle, revealed a significant association between atorvastatin use and a reduced risk of memory loss (OR = 0.47; 95% CI, 0.15-0.79; <i>p</i> = 0.004). This suggests that atorvastatin may offer a protective effect on memory. Conversely, our analysis of the FAERS database identified 15,277 reports of adverse reactions associated with atorvastatin, of which 401 were related to psychiatric adverse events, including memory loss. This finding indicates that while atorvastatin may not generally increase the risk of memory loss, some patients may still experience these side effects.</p><p><strong>Conclusion: </strong>This study integrated data from NHANES and FAERS to provide a comprehensive analysis of the relationship between atorvastatin and memory function. On one hand, the NHANES findings support the potential benefits of atorvastatin in reducing the risk of memory loss. On the other hand, the FAERS data highlight specific cognitive side effects associated with the drug. Consequently, clinicians and patients should carefully consider both the potential benefits and risks of atorvastatin, taking into account individual patient differences and implementing appropriate monitoring strategies.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1526959"},"PeriodicalIF":2.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700215","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":"Future applications of fluorescence lifetime imaging ophthalmoscopy in neuro-ophthalmology, neurology, and neurodegenerative conditions.","authors":"Daniel M Markowitz, Elizabeth Affel, György Hajnóczky, Robert C Sergott","doi":"10.3389/fneur.2025.1493876","DOIUrl":"10.3389/fneur.2025.1493876","url":null,"abstract":"<p><p>Fluorescence lifetime imaging ophthalmoscopy (FLIO) has emerged as an innovative advancement in retinal imaging, with the potential to provide <i>in vivo</i> non-invasive insights into the mitochondrial metabolism of the retina. Traditional retinal imaging, such as optical coherence tomography (OCT) and fundus autofluorescence (FAF) intensity imaging, focus solely on structural changes to the retina. In contrast, FLIO provides data that may reflect retinal fluorophore activity, some of which may indicate mitochondrial metabolism. This review builds upon the existing literature to describe the principles of FLIO and established uses in retinal diseases while introducing the potential for FLIO in neurodegenerative conditions.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1493876"},"PeriodicalIF":2.7,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691729","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":"Personality traits, pain perception, and patient attitudes toward orthodontic treatment with fixed appliances.","authors":"Monika Lorek, Anna Jarząbek, Magdalena Sycińska-Dziarnowska, Sylwia Gołąb, Ewa Cichocka, Gianrico Spagnuolo, Krzysztof Woźniak, Liliana Szyszka-Sommerfeld","doi":"10.3389/fneur.2025.1547095","DOIUrl":"10.3389/fneur.2025.1547095","url":null,"abstract":"<p><strong>Background: </strong>Orthodontic pain is defined as orofacial pain induced by orthodontic tooth movement. The application of orthodontic forces activates periodontal sensory receptors, resulting in a cascade of nociceptive pain processing and transduction in both the central and peripheral nervous systems, which is eventually felt by patients. The purpose of this study was to evaluate the association between pain perception, pressure pain threshold (PPT), attitude toward orthodontic treatment, and personality traits in adolescents treated with fixed orthodontic appliances.</p><p><strong>Methods: </strong>The study involved 60 subjects aged 16 to 18 year-olds divided into 2 groups: group 1 consisted of 30 patients undergoing orthodontic treatment with fixed orthodontic appliances, and group 2 consisted of 30 untreated subjects. The tool for data collection was a questionnaire that assessed pain experience for treated subjects, pain expectation for untreated subjects, and attitude toward treatment using a visual analog scale (VAS) marked at 10-mm intervals. The assessment of patients' personality profiles was carried out using the NEO Five-Factor Inventory (NEO-FFI). PPT was measured using a digital force algometer. The results were subjected to statistical analysis. The significance threshold was established at <i>p</i> < 0.05.</p><p><strong>Results: </strong>The multivariate analysis showed that treatment status was the only variable affecting patients' average attitude scores and average pain experience/expectation scores measured using a VAS, and average PPT scores (<i>p</i> < 0.0001). Gender and personality traits did not affect PPT scores, pain intensity, and attitude toward treatment (<i>p</i> > 0.05). The results of the follow-up univariate analysis demonstrated a significant difference in the patients' average attitude toward treatment (<i>p</i> = 0.017) and PPT scores (<i>p</i> < 0.0001) between the treated and untreated groups.</p><p><strong>Conclusion: </strong>Orthodontic treatment may impact the pressure pain thresholds measured using algometry and patient attitudes toward treatment. This knowledge is essential for orthodontists and patients, as the success of orthodontic treatment largely depends on the patient's cooperation and motivation, which may be affected by patient's attitude toward treatment and pain perception. This, in turn, encourages the search for effective methods of pain reduction during orthodontic treatment and attention to communication between orthodontists and patients for a good understanding of the procedures used.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1547095"},"PeriodicalIF":2.7,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691737","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":"Feedforward control in children with cerebral palsy and association with white matter integrity.","authors":"Ophélie Martinie, Philippe Karan, Martin Simoneau, Maxime Descoteaux, Catherine Mercier, Maxime T Robert","doi":"10.3389/fneur.2025.1515432","DOIUrl":"10.3389/fneur.2025.1515432","url":null,"abstract":"<p><strong>Background: </strong>Precise upper limb movements required for daily activities rely on feedback and feedforward control mechanisms. In children with cerebral palsy (CP), damage to white matter tracts impairs motor execution and sensorimotor control. Most studies in CP have focused on motor execution deficits, whereas the relationship between feedforward control alterations and white matter microstructure features has received less attention.</p><p><strong>Method: </strong>This study compared feedforward control during a grasp and lift task in 9 children with CP (diagnosis of hemiplegic CP with mild to moderate upper limb deficits) to 40 typically developing (TD) children aged 8 to 17 years. A secondary objective was to examine associations between feedforward control and the microstructural measures of corticocerebellar and other motor-planning related tracts. All participants completed 13 trials of the grasp and lift task. The CP group also underwent diffusion magnetic resonance imaging (MRI) using a 3-Tesla system to acquire anatomical and diffusion MRI.</p><p><strong>Results: </strong>Results showed feedforward control deficits in the non-dominant hand of children with CP, reflected by reduced peak force rates before sensory feedback was available and a lack of adaptation across trials. Strong correlations were observed between feedforward control and microstructural measures of the corticospinal tract and superior longitudinal fasciculus, but not with the corticocerebellar tracts.</p><p><strong>Conclusion: </strong>These findings suggest that broader sensorimotor processes, beyond feedforward control alone, contribute to force control deficits observed in children with CP.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1515432"},"PeriodicalIF":2.7,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691722","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":"Sliding balloon-assisted thrombectomy combined with aspiration and intrasinus urokinase thrombolysis for the treatment of hemorrhagic cerebral venous sinus thrombosis: experience of 10 patients.","authors":"Mingsi Zhang, Feixin Jiang, Qingyan Wen, Yiman Chen, Zhiquan Zhang, Min Zhang, Jianxin Zhong","doi":"10.3389/fneur.2025.1519308","DOIUrl":"10.3389/fneur.2025.1519308","url":null,"abstract":"<p><strong>Background: </strong>Cerebral venous sinus thrombosis (CVST) is an unusual cause of stroke. Currently, standard anticoagulant therapy does not have satisfactory efficacy for treating some cases of hemorrhagic CVST. Therefore, we explored the efficacy and safety of the combination of sliding balloon-assisted thrombectomy with aspiration and intrasinus urokinase thrombolysis for the treatment of CVST patients with intracranial hemorrhage (ICH).</p><p><strong>Methods: </strong>We retrospectively analyzed the clinical, imaging and follow-up data of 10 CVST patients with ICH who underwent sliding balloon-assisted thrombectomy combined with aspiration and intrasinus thrombolysis with urokinase from February 2022 to June 2023. Complete recanalization and partial recanalization in the cerebral venous sinus were defined as imaging outcomes, and the modified Rankin score (mRS) at the 3-month and 6-month follow-ups was used to evaluate clinical efficacy.</p><p><strong>Results: </strong>A total of 10 CVST patients aged 18-68 years were enrolled, including 5 males. All of the patients was diagnosed with ICH by noncontrast CT and with thrombosis at 3 or more venous sinuses by digital subtraction angiography (DSA). After treatment, complete recanalization was achieved in 6 patients, and partial recanalization was achieved in 4 patients. At the 3- and 6-month follow-up, all 10 patients showed neurological independence (mRS score ≤ 2), without any signs of symptom aggravation, cerebral hematoma enlargement, pulmonary embolism or other complications after treatment.</p><p><strong>Conclusion: </strong>These results indicated that the combination of sliding balloon-assisted thrombectomy, aspiration and intrasinus urokinase thrombolysis may be safe and effective for the treatment of CVST patients with intracranial hemorrhage.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1519308"},"PeriodicalIF":2.7,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691769","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":"Cognitive impairment after intravenous thrombolysis in mild stroke: assessment of cerebral blood flow covariance network.","authors":"Kefu Mei, Feng Li, Zhiming Kang, Dong Sun, Xuefei Luo, Shiyuan Tian, Lei Zhang, Junjian Zhang","doi":"10.3389/fneur.2025.1513182","DOIUrl":"10.3389/fneur.2025.1513182","url":null,"abstract":"<p><strong>Background: </strong>Mild stroke may lead to cognitive impairment, and it remains unclear whether intravenous thrombolysis (IVT) can mitigate cognitive deficits. This study investigates whether IVT can help alleviate cognitive function impairment in patients and further explores changes in the topological properties of cerebral blood flow (CBF) networks.</p><p><strong>Methods: </strong>This observational study prospectively enrolled 94 patients with acute mild ischemic stroke (44 IVT vs. 50 non-IVT) from two hospitals. A battery of neuropsychological tests and arterial spin labeling were performed to evaluate their cognitive functioning and CBF in 116 brain regions. Voxel-wise CBF was compared between patients and health controls. The CBF covariance network of patients was constructed by calculating across-subject CBF covariance among 116 brain regions. Network properties were calculated and compared between IVT and no-IVT groups.</p><p><strong>Results: </strong>The mild stroke group demonstrated significantly lower Montreal Cognitive Assessment (MoCA) scores compared to healthy controls (<i>p</i> < 0.001). Patients receiving IVT showed superior performance on the Trail Making Test-B (<i>p</i> = 0.043), Clock Drawing Test (<i>p</i> = 0.001), and Verbal Fluency Test (<i>p</i> = 0.033). Multivariate regression analysis adjusted for covariates demonstrated significant associations between IVT and cognitive outcomes: Montreal Cognitive Assessment (<i>β</i> = 2.85; 95% CI, 0.64-5.13), Trail Making Test-A (<i>β</i> = -16.90; 95% CI, -32.89--0.90), Trail Making Test-B (<i>β</i> = -43.27; 95% CI, -78.78--7.76), Hopkins Verbal Learning Test-Revised total recall (<i>β</i> = 3.57; 95% CI, 1.36-5.78), HVLT-R delayed recall (<i>β</i> = 1.53; 95% CI, 0.43-2.63), Clock Drawing Test (β = 7.09; 95% CI, 2.40-11.79), and Verbal Fluency Test (<i>β</i> = 3.00; 95% CI, 1.33-4.68). IVT patients exhibited higher small-worldness, clustering coefficient, and global efficiency of the network compared to non-IVT patients.</p><p><strong>Conclusion: </strong>Intravenous thrombolysis demonstrated early cognitive benefits across multiple domains in patients with mild stroke. Improvement in the brain CBF covariance network properties may be the underlying mechanism.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1513182"},"PeriodicalIF":2.7,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691690","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}