Frontiers in Neurology最新文献

{"title":"Bilateral lower limb symmetry during sit-to-stand and stand-to-sit tasks in stroke patients with hemiplegia.","authors":"Meijin Hou, Jian He, Dongwei Liu, Chenyi Guo, Ye Ma, Xiaobo Luo","doi":"10.3389/fneur.2025.1494133","DOIUrl":"10.3389/fneur.2025.1494133","url":null,"abstract":"<p><strong>Introduction: </strong>Stroke patients with hemiplegia are at an increased risk of falling during sit-to-stand (Si-St) and stand-to-sit (St-Si) tasks, partly due to impaired bilateral lower limb symmetry. Maintaining symmetrical movement between the limbs in these tasks can help reduce fall incidence.</p><p><strong>Method: </strong>This study aimed to investigate bilateral lower limb symmetry during Si-St and St-Si tasks in stroke patients with hemiplegia to compare their performance with healthy controls. Thirteen stroke patients and 13 healthy controls participated in the study. Participants were instructed to perform the 30-s chair stand test at their self-selected pace. Kinematic and kinetic parameters were calculated using OpenSim's inverse kinematics and inverse dynamics tools. Bilateral symmetry was quantified using the symmetry index (SI), with an asymmetry threshold set at 10%.</p><p><strong>Results: </strong>The stroke group exhibited significantly greater lower limb asymmetry in both kinematic and kinetic parameters during Si-St and St-Si tasks compared to the healthy controls, with the kinetic parameters being more pronounced. In the stroke group, notable bilateral asymmetry (SI > 10%) was observed in the ankle joint angle (<i>P</i> < 0.05) during both tasks. Furthermore, severe asymmetry (SI > 30%) was identified joint moments across all lower limb joints, vertical ground reaction forces, and medial-lateral center of pressure.</p><p><strong>Discussion: </strong>These findings highlight the need for targeted rehabilitation programs focusing on improving strength, coordination, and balance. Close monitoring of SI values, particularly for kinetic parameters, is recommended to guide and evaluate the effectiveness of these interventions.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1494133"},"PeriodicalIF":2.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406967","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":"Lifetime history of concussion among children and adolescents with attention-deficit/hyperactivity disorder: examining differences stratified by age, medication status, and parent-reported severity.","authors":"Julia E Maietta, Grant L Iverson, Nathan E Cook","doi":"10.3389/fneur.2024.1487909","DOIUrl":"10.3389/fneur.2024.1487909","url":null,"abstract":"<p><strong>Introduction: </strong>Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) are more likely to report a lifetime history of concussion compared to those without ADHD. Prior studies have predominantly relied on surveys of youth who self-reported their ADHD status (as opposed to parent report), examined samples with relatively narrow age ranges, and focused on youth athletes. It is unclear if ADHD severity or ADHD medication influences the association between ADHD and greater lifetime history of concussion. We investigated the association between parent-reported ADHD, ADHD severity, and medication status with parent-reported lifetime concussion history in children and adolescents ranging in age from 5 to 17, sampled from the United States general population.</p><p><strong>Methods: </strong>Parent reported health data from 33,914 children and adolescents were selected from the 2021 National Survey of Children's Health. Lifetime history of concussion, current ADHD diagnosed by a healthcare provider, and, for those with current ADHD, ADHD severity (mild or moderate/severe), and current ADHD medication status (yes/no) were reported by parents. A Mantel-Haenszel analysis was used to assess the associations between ADHD and lifetime concussion history across five age groups (ages 5-7, 8-10, 11-13, 14-15, and 16-17). Additional Mantel-Haenszel analyses were used to assess the associations between lifetime history of concussion and ADHD severity as well as medication status across five age groups.</p><p><strong>Results: </strong>Overall, 6.2% of youth had a parent-reported history of concussion and 12.3% had parent-reported current ADHD. Twice as many youth with ADHD (10.6%) had a parent-reported history of concussion compared to youth without ADHD (5.6%). There were no differences in lifetime concussion history for those with mild (10.9%) versus moderate/severe ADHD (10.3%). Similarly, among those with ADHD, there were no differences in lifetime concussion history for those taking medication (9.9%) versus those not taking medication (11.6%).</p><p><strong>Discussion: </strong>Consistent with previous literature, youth with ADHD had greater lifetime concussion history than youth without ADHD (approximately twice the prevalence in those with ADHD). Contrary to our hypotheses among youth with ADHD, parent-reported ADHD severity and current medication status were not associated with lifetime concussion history.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"15 ","pages":"1487909"},"PeriodicalIF":2.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11816110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406965","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":"Decoding HIV-associated neurocognitive disorders: a new perspective from multimodal connectomics.","authors":"Zhongkai Zhou, Wei Wang, Hui Li, Ying Shi, Lingling Zhao, Yibo Lu, Xingchen Wei, Hongjun Li","doi":"10.3389/fneur.2025.1467175","DOIUrl":"10.3389/fneur.2025.1467175","url":null,"abstract":"<p><p>Currently, HIV-associated neurocognitive disorders (HAND) remains one of the major challenges faced by people living with HIV (PLWH). HAND involves the vulnerability of neural circuits caused by synaptic degeneration and abnormal synaptic pruning. In recent years, connectomics has been gradually applied to HAND research as a cutting-edge method for describing the structural and functional connectivity patterns of the brain, to further elucidate the specific mechanisms underlying these neural circuit vulnerabilities. Using multimodal neuroimaging techniques such as diffusion tensor imaging (DTI), structural magnetic resonance imaging (sMRI), and resting-state functional magnetic resonance imaging (rs-fMRI), researchers can detail the connectome network changes in the brains of PLWH. These technologies offer potential biomarkers for the early diagnosis, prognosis, and treatment monitoring of HAND, while also providing new avenues for personalized prediction of cognitive status. Here, we start with the pathogenesis and risk factors of HAND, providing a comprehensive review of the basic concepts of unimodal and multimodal macro connectomics and related graph theory methods, and we review the latest progress in HAND connectomics research. We emphasize the use of connectomics to identify specific disease patterns of HIV-associated neurodegeneration and discuss the potential research directions and challenges in understanding these diseases from a connectomics perspective.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1467175"},"PeriodicalIF":2.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406968","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":"Optical coherence tomography angiography in patients with focal epilepsy.","authors":"Flora Rider, Alla Guekht, Alexander Shpak","doi":"10.3389/fneur.2025.1529409","DOIUrl":"10.3389/fneur.2025.1529409","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to compare optical coherence tomography angiography (OCTA) data in individuals with focal epilepsy and healthy individuals and to investigate the effect of antiseizure medications (ASM) on OCTA data.</p><p><strong>Methods: </strong>We examined 48 consecutive patients with focal epilepsy and 46 healthy controls. Area and skeleton density of superficial and deep capillary plexuses in the macular area and peripapillary radial capillary plexus were measured.</p><p><strong>Results: </strong>In general, no differences in OCTA parameters were found between groups of individuals with epilepsy and healthy individuals. A comparison of individuals with epilepsy with and without comorbid major depressive disorder revealed no differences in OCTA data. However, the area and skeleton densities of the perfused capillary retinal vascular bed in the macular region showed a negative association with the use of valproates and modifiers of the presynaptic release machinery, whereas only the skeleton density of the deep capillary plexus showed a positive association with the use of modulators of voltage-gated sodium channels.</p><p><strong>Conclusion: </strong>OCTA revealed different effects of various ASM groups on the perfused macular capillary bed. These findings suggest that OCTA parameters could serve as potential biomarkers for assessing ASM effects on small vessels and capillaries in the brain.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1529409"},"PeriodicalIF":2.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11816351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406990","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":"Evaluation of compliance and accuracy in Parkinson's disease motor symptom tracking: a comparative study of digital and traditional paper diaries using a smartphone application (MyParkinson's).","authors":"Nazli Durmaz Celik, Asli Yaman Kula, Naci Murat, Müge Kuzu Kumcu, Aydan Topal, Serhat Özkan","doi":"10.3389/fneur.2025.1522721","DOIUrl":"10.3389/fneur.2025.1522721","url":null,"abstract":"<p><strong>Background/objectives: </strong>This study aimed to evaluate compliance and accuracy in comparison with traditional PD diaries for tracking motor symptoms using a new smartphone application (MyParkinson's) and paper diary strategies. Parkinson's disease (PD) is a neurodegenerative disorder with progressive motor symptoms. Treatment becomes more challenging as PD progresses, motor complications in the form of wearing-off phenomenon and levodopa-induced dyskinesia develop. Traditional paper diaries and clinical scales used to evaluate patients may be inadequate in assessing whether the patient is \"on\" or \"off,\" resulting in less-than-ideal treatment changes.</p><p><strong>Methods: </strong>A randomized crossover design was utilized to examine 22 advanced PD patients who underwent symptomatic assessment with both diaries during two separate 24-h periods seven days apart. The compliance and accuracy of data were assessed by comparing diary entries with the clinical examination notes and WhatsApp queries. LaOerly, patients' diary preferences were also evaluated.</p><p><strong>Results: </strong>The digital diary had significantly beOer compliance and accuracy than the paper diaries, with substantial/almost perfect levels of agreement (<i>κ</i> = 0.615 to 0.818) between logged symptoms and clinical examination notes. 65% of patients preferred the digital diary for follow-ups, and there was no significant difference in ease of use compared to paper diaries.</p><p><strong>Conclusion: </strong>Digital diaries are helpful in the clinical management of PD patients as they minimize recall bias and reduce data errors in appropriately selected patients. Our study suggests a broader adoption of digital health technologies in PD management. Still, additional research is necessary to improve the tools and assess long-term patient outcomes.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1522721"},"PeriodicalIF":2.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11814194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406971","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":"Innovative epilepsy management: a combined figure of EEG categorization and medication mechanisms.","authors":"Mohamed Taha, Douglas R Nordli, Carol Park, Douglas R Nordli","doi":"10.3389/fneur.2025.1534913","DOIUrl":"10.3389/fneur.2025.1534913","url":null,"abstract":"<p><strong>Introduction: </strong>Epilepsy management requires precision in diagnosis and treatment, particularly when selecting antiseizure medications based on specific epilepsy syndromes. We present an innovative educational tool that integrates EEG categorization with antiseizure medication mechanisms, designed to enhance clinical decision-making in epilepsy management.</p><p><strong>Methods: </strong>This study evaluated a cohort of neurology trainees through a pre-test and post-test design. Participants were assessed on their ability to diagnose epilepsy syndromes and select appropriate treatments based on EEG findings before and after exposure to the teaching figure. The figure aligns key EEG patterns with specific epilepsy syndromes and outlines the corresponding mechanisms of action of antiseizure medications.</p><p><strong>Results: </strong>Post-test results demonstrated a statistically significant improvement in trainees' ability to analyze clinical cases and make informed treatment decisions (mean pre-test score: 52.8; post-test score: 66.5; <i>p</i> = 0.0019). The figure facilitated a deeper understanding of the relationship between EEG findings and medication selection, particularly in complex cases.</p><p><strong>Discussion: </strong>The integration of EEG patterns with antiseizure medication mechanisms allows for more precise epilepsy syndrome diagnosis and enhances the selection of rational polypharmacy approaches. This approach not only improves educational outcomes but also offers potential applications in clinical practice for personalized epilepsy treatment strategies.</p><p><strong>Conclusion: </strong>This innovative figure bridges the gap between EEG categorization and treatment strategies, providing a valuable tool for improving epilepsy management education and clinical outcomes.</p><p><strong>Plain language summary: </strong>This manuscript introduces a teaching tool that helps providers better understand how brainwave patterns (EEGs) relate to epilepsy types and guides them in choosing the most effective seizure medications.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1534913"},"PeriodicalIF":2.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11816356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406987","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":"Influence of nutritional status on rehabilitation efficacy of patients after stroke-a scoping review.","authors":"Huan Chen, Caihong Fu, Weihao Fang, Zhenyao Wang, Dawei Zhang, Hu Zhang","doi":"10.3389/fneur.2025.1502772","DOIUrl":"10.3389/fneur.2025.1502772","url":null,"abstract":"<p><p>Stroke patients are susceptible to malnutrition as a result of dysphagia, neurological impairments, and altered levels of consciousness. The nutritional status of individuals post-stroke is a critical determinant influencing the efficacy of rehabilitation outcomes. Therefore, there is great interest in the possible role of nutrients in promoting recovery after stroke. This article examines the enhancement of rehabilitation outcomes through the improvement of nutritional status. A comprehensive literature search was conducted using the PubMed, Cochrane, Web of Science, and Embase databases. Articles relevant to this topic, published from the inception of each database until November 2024, were identified. The selection was restricted to randomized controlled clinical trials, irrespective of language or publication date. The search specifically targeted studies involving stroke patients, encompassing both hemorrhagic and ischemic types, and interventions that combined nutritional supplementation with rehabilitation therapy. Studies with a focus on stroke prevention were excluded. Full-text articles that met the inclusion criteria were retrieved from the aforementioned sources. In instances where both a full report and a conference abstract were available for the same study, only the full report was considered. A total of 751 studies were considered for inclusion in this scoping review. Following a rigorous screening process, 13 studies were selected for detailed analysis. All selected studies were randomized controlled clinical trials. The findings indicate that supplementation with nutrients such as proteins, vitamins, essential amino acids, and antioxidants can enhance activities of daily living, improve balance function, and reduce neurological deficits in post-stroke patients. This review aims to synthesize current evidence regarding the effects of various nutrients and dietary regimens on limb rehabilitation in post-stroke patients, with the goal of providing new insights to facilitate the accelerated recovery of this population.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1502772"},"PeriodicalIF":2.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406986","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":"Instrumental balance assessment in Parkinson's disease and parkinsonism. A systematic review with critical appraisal of clinical applications and quality of reporting.","authors":"Andrea Merlo, Lorenzo Cavazzuti, Maria Chiara Bò, Francesco Cavallieri, Maria Chiara Bassi, Benedetta Damiano, Sara Scaltriti, Valentina Fioravanti, Giulia Di Rauso, Giacomo Portaro, Franco Valzania, Mirco Lusuardi, Isabella Campanini","doi":"10.3389/fneur.2025.1528191","DOIUrl":"10.3389/fneur.2025.1528191","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with Parkinson's disease (pwPD) and atypical parkinsonism usually complain of impaired balance. Instrumental posturography is widely used to quantitatively assess static balance in pwPD but many posturographic parameters and protocols have been suggested. We aimed to appraise the use of static posturography in pwPD and atypical parkinsonism, and identify gaps hindering its translation into clinical routine.</p><p><strong>Methods: </strong>A systematic review on four databases. Study methodology, clinical aspects, assessment protocol, technical aspects, and transferability to clinical practice were critically appraised by a set of quality questions, scored on three levels (0, 0.5, 1). Total scores were used to assess overall studies' quality.</p><p><strong>Results: </strong>132 studies were included. The majority (105/132) was rated medium-quality. The domains \"transferability to clinical practice\" and \"assessment protocol\" received the lowest scores. The main flaw hindering portability to clinical settings was the lack of a stated rationale behind the choice of a specific protocol and the selection of the posturographic parameters. Missing reporting about the technical aspects employed to manage posturographic data and comprehensive instructions given to the patients further contributed to lower quality.</p><p><strong>Discussion: </strong>We provided recommendations for enhancing the clinical transferability of studies on static posturography to assess pwPD, including (1) discussing the rationale for choosing the assessment protocols and posturographic parameters, (2) detailing the inclusion criteria and select appropriate samples, and (3) reporting all the technical information to replicate the procedures and computations.</p><p><strong>Systematic review registration: </strong>International Prospective Register of Systematic Reviews (PROSPERO) on 6th February 2024 (ID CRD42024500777), https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024500777.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1528191"},"PeriodicalIF":2.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11814473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406988","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":"Magnetic resonance imaging-based deep learning for predicting subtypes of glioma.","authors":"Zhen Yang, Peng Zhang, Yi Ding, Liyi Deng, Tong Zhang, Yong Liu","doi":"10.3389/fneur.2025.1518815","DOIUrl":"10.3389/fneur.2025.1518815","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the value of deep learning based on magnetic resonance imaging (MRI) in the classification of glioma subtypes.</p><p><strong>Methods: </strong>This study retrospectively included 747 adult patients with surgically pathologically confirmed gliomas from a public database and 64 patients from our hospital. Patients were classified into IDH-wildtype (IDHwt) (490 cases), IDH-mutant/1p19q-noncodeleted (IDHmut-intact) (105 cases), and IDH-mutant/1p19q-codeleted (IDHmut-codel) (216 cases) based on their pathological findings, with the public database of patients were divided into training and validation sets, and patients from our hospital were used as an independent test set. The models were developed based on five categories of preoperative T1-weighted, T1-weighted gadolinium contrast-enhanced, T2-weighted and T2-weighted fluid-attenuated inversion recovery (T1w, T1c, T2w and FLAIR) magnetic resonance imaging (MRI) of four sequences and mixed imaging of the four sequences, respectively. The receiver operating characteristic curve (ROC), area under the curve (AUC) of the ROC were generated in the jupyter notebook tool using python language to evaluate the accuracy of the models in classification and comparing the predictive value of different MRI sequences.</p><p><strong>Results: </strong>IDHwt, IDHmut-intact and IDHmut-codel were the best classified in the model containing only FLAIR sequences, with test set AUCs of 0.790, 0.737 and 0.820, respectively; and the worst classified in the model containing only T1w sequences, with test set AUCs of 0.621, 0.537 and 0.760, respectively.</p><p><strong>Conclusion: </strong>We have developed a set of models that can effectively classify glioma subtypes and that work best when only the FLAIR sequence model is included.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1518815"},"PeriodicalIF":2.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406989","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":"Psychosocial factors are associated with community mobility and participation in persons with dizziness.","authors":"Pamela M Dunlap, Jeffrey P Staab, Patrick J Sparto, Joseph M Furman, Susan L Whitney","doi":"10.3389/fneur.2025.1531204","DOIUrl":"10.3389/fneur.2025.1531204","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Among individuals with dizziness, there is an increased prevalence of psychosocial comorbidity compared to the general population. Increased psychosocial comorbidity among people with dizziness is associated with disability and poorer outcomes in vestibular rehabilitation. However, there is less knowledge regarding the association between psychosocial factors and mobility outcomes in people with dizziness. Therefore, the purpose of this study was to assess the association between psychosocial factors and future activity, participation, and community mobility among people with dizziness. The secondary aim of this study was to explore the constructs measured using patient-reported outcomes associated with psychosocial factors in this population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;We conducted a prospective cohort study with an in-person baseline assessment and a follow-up assessment completed at 3-months via computerized questionnaires. We measured psychosocial factors at baseline using the Hospital Anxiety and Depression Scale (HADS), the Patient Health Questionnaire 4-item (PHQ-4), the Vestibular Activities Avoidance Instrument (VAAI), and the Dizziness Catastrophizing Scale (DCS). We measured community mobility and participation at baseline and 3-month follow-up using the Life Space Assessment (LSA) and Vestibular Activities and Participation Measure (VAP). To determine the associations between baseline anxiety and depression symptoms, fear avoidance, catastrophizing beliefs and mobility and disability measures, we used simple linear regression and repeated measures ANOVA. We used exploratory factor analysis to identify constructs measured using patient-reported outcomes of psychosocial factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;There were 100 participants who completed the baseline assessment [mean age (SD) = 49.2 (15.7) years; 73% female] and 68 participants completed the questionnaire at the 3-month follow-up. In bivariate analyses, baseline VAAI, HADS-A, HADS-D, PHQ-4 depression, and VAP were associated with LSA, and baseline VAAI, HADS-D, PHQ-4 depression, and LSA were associated with VAP at 3-month follow-up (all &lt;i&gt;p&lt;/i&gt; &lt; 0.05). In adjusted multivariate analyses, baseline VAP had a large effect (&lt;i&gt;F&lt;/i&gt; = 11.65, &lt;i&gt;p&lt;/i&gt; = 0.001, &lt;i&gt;η&lt;/i&gt; &lt;sup&gt;2&lt;/sup&gt; = 0.18) and HADS-D had a moderately large effect (&lt;i&gt;F&lt;/i&gt; = 4.09, &lt;i&gt;p&lt;/i&gt; = 0.048, &lt;i&gt;η&lt;/i&gt; &lt;sup&gt;2&lt;/sup&gt; = 0.07) on LSA score at 3-month follow-up. Baseline VAAI had a large effect (&lt;i&gt;F&lt;/i&gt; = 23.35, &lt;i&gt;p&lt;/i&gt; &lt; 0.001, &lt;i&gt;η&lt;/i&gt; &lt;sup&gt;2&lt;/sup&gt; = 0.3) on VAP at 3-month follow-up. The exploratory factor analysis of the VAAI, HADS, PHQ-4, and DCS resulted in 4 factors measuring constructs of fear avoidance, anxiety, depression, and catastrophization.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;We found that baseline psychosocial factors were related to future measures of activity and participation as well as community mobility in people with dizziness. Specific","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1531204"},"PeriodicalIF":2.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406991","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}