Frontiers in Neurology最新文献

{"title":"Prognostic value of temporalis muscle thickness as a marker of sarcopenia in intracerebral hemorrhage.","authors":"Waldemar Gubarev, Jan Klinke, Ulrike Voßmann, Daniel Cantré, Bijan Zendeh Zartoshti, Artem Rafaelian, Milos Arsenovic, Daniel Dubinski, Sae-Yeon Won, Florian Gessler, Thomas Freiman, Alexander Storch, Matthias Wittstock","doi":"10.3389/fneur.2025.1564550","DOIUrl":"10.3389/fneur.2025.1564550","url":null,"abstract":"<p><strong>Introduction: </strong>Estimating the prognosis of spontaneous intracerebral hemorrhage (ICH) is of great importance. It has not been conclusively clarified whether sarcopenia is predictive for the functional outcome in ICH. Determining the temporalis muscle thickness (TMT) may be helpful for estimating sarcopenia. An association of TMT with outcome (mRS) has been shown in cerebellar ischemia and traumatic brain injury.</p><p><strong>Methods: </strong>The present retrospective study of 488 consecutive patients with ICH aimed to investigate the association of sarcopenia as assessed by TMT with mRS. In addition to biometric data, ICH subtype and severity [modified ICH score (mICH)], occurrence of complications and mRS at discharge and after 90 days were recorded. The influence of sarcopenia assessed by TMT as the surrogate marker using head imaging (cCT, cMRT) on mRS was analyzed by ordinal regression analysis. Dichotomization into sarcopenic and non-sarcopenic patients was carried out using standard threshold values.</p><p><strong>Results: </strong>Finally, 322 patients were analyzed [median (IQR) age: 77 (66-83) years; 57.5% male]. Sarcopenic patients were older (<i>P</i> < 0.001), had lower BMI (<i>P</i> = 0.025) and higher mICH scores (<i>P</i> < 0.001) compared to non-sarcopenic patients. There was no significant difference in the overall distribution of mRS scores between sarcopenic and non-sarcopenic patients at discharge (unadjusted common OR: 1.28; 95% CI: 0.85-1.92; <i>P</i> = 0.236), but at 90 days favoring the non-sarcopenic over the sarcopenic group (unadjusted common OR: 1.41; 95% CI: 1.07-2.12; <i>P</i> = 0.049). The results did not subsist statistical adjustment to candidate covariates by multivariate ordinal regression.</p><p><strong>Discussion: </strong>In conclusion, sarcopenia as assessed by TMT seems to have limited prognostic value in ICH.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1564550"},"PeriodicalIF":2.7,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12122341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198841","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":"Comparative safety and efficacy of manual therapy interventions for cervicogenic headache: a systematic review and network meta-analysis.","authors":"Xueliang Xu, Yan Ling","doi":"10.3389/fneur.2025.1566764","DOIUrl":"10.3389/fneur.2025.1566764","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate and compare the safety and efficacy of spinal manipulation, mobilization, and massage for the management of cervicogenic headache (CGH) using meta-analytic techniques.</p><p><strong>Methods: </strong>Comprehensive searches were conducted in Cochrane, Embase, PubMed, and ClinicalTrials.gov to identify studies investigating the effects of manipulation, mobilization, and massage on pain, disability, and physical function in patients with CGH. Key outcomes included pain severity (visual analog scale, VAS), Neck Disability Index (NDI), Flexion-Rotation Test (FRT), and Headache Disability Inventory (HDI) at various follow-up timepoints.</p><p><strong>Results: </strong>Fourteen studies totaling 1,297 CGH patients were included. Standard pairwise meta-analysis revealed that sustained natural apophyseal glides (SNAG) mobilization produced significantly greater improvements compared to non-SNAG interventions in VAS (MD = 1.73, 95%CI: 1.05, 2.40), NDI (MD = 8.55, 95%CI: 2.73, 14.37), FRT (MD = -7.22, 95%CI: -9.38, -5.07), and HDI (MD = 9.29, 95%CI: 3.64, 14.95), with benefits maintained over time. Network meta-analysis showed that for VAS improvement, the surface under the cumulative ranking curve (SUCRA) probabilities were: cervical spine manipulation (CSM, 98.9%), mobilization (67.3%), exercise (21.0%), and massage (12.8%). For NDI, the SUCRA scores were: CSM (82.2%), mobilization (57.2%), exercise (6.7%), and massage (53.9%). CSM exhibited significantly greater VAS reductions compared to exercise, massage, and mobilization, while mobilization was superior to exercise and massage for VAS. For NDI, CSM was significantly better than exercise, but no other between-group differences were observed.</p><p><strong>Conclusion: </strong>In patients with CGH, SNAG mobilization can significantly improve pain and function, with benefits maintained in the long-term. Additionally, CSM may be the most effective short-term intervention for reducing pain and disability compared to mobilization, massage, and exercise, although clinician expertise appears to be an important factor.</p><p><strong>Systematic review registration: </strong>DOI: 10.37766/inplasy2025.3.0079.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1566764"},"PeriodicalIF":2.7,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198827","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":"Corrigendum: Task demands influence search strategy selection in otoconia-deficient mice.","authors":"Ryan M Yoder, Lucas C Carstensen, Keshav Jagannathan","doi":"10.3389/fneur.2025.1621211","DOIUrl":"https://doi.org/10.3389/fneur.2025.1621211","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fneur.2025.1531705.].</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1621211"},"PeriodicalIF":2.7,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12122321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198828","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":"Exploring the correlation between corrective glucose treatment and long-term patient outcomes: a SHINE secondary analysis.","authors":"Paul Horton, Vishal Patel, C L Hall, Karen C Johnston, Yajun Mei, Ofer Sadan","doi":"10.3389/fneur.2025.1567766","DOIUrl":"10.3389/fneur.2025.1567766","url":null,"abstract":"<p><strong>Introduction: </strong>Glucose control is an important aspect of acute ischemic stroke management. Although absolute glucose concentration remains the focus in clinical stroke care, glucose variability is increasingly recognized as a viable treatment target. To assess the relationship between acute post-stroke glycemic control parameters and patient outcomes, we reanalyzed the data from the first 8 h of treatment for patients in the Stroke Hyperglycemia Insulin Network Effort (SHINE) clinical trial, when glycemic variability is highest.</p><p><strong>Methods: </strong>In this secondary analysis of the SHINE dataset, the rate of glucose change during the first 8 h was evaluated for its association with patient outcomes, dichotomized as modified Rankin scale (mRS) 0-2 versus 3-6, using logistic regression and a linear mixed-effects model.</p><p><strong>Results: </strong>Unadjusted analysis of the glucose correction period during the first 8 h suggested that patients with mRS 3-6 had a faster glucose correction compared to those with mRS 0-2 (-8.9 and -6.7 mg/dL/h, <i>p</i> < 0.001). This finding remained statistically significant in both the intensive intervention group and the poorly controlled diabetic sub-group (glycosylated hemoglobin [HbA1c] ≥ 6.4). Mixed-effects models also indicated a significant difference in the rate of glucose change (1.9 mg/dL/h, <i>p</i> < 0.001) between outcome groups (mRS 0-2 versus 3-6) across both treatment and HbA1c sub-groups.</p><p><strong>Conclusion: </strong>Analysis of the first 8 h of the SHINE data suggests that early, rapid correction of glucose is associated with poor outcomes, particularly in the sub-group of patients with HbA1c ≥ 6.4. Further research is warranted to assess early glycemic correction as a possible personalized glucose management goal.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1567766"},"PeriodicalIF":2.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12119312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182011","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":"Corrigendum: Selective intraarterial hypothermia combined with mechanical thrombectomy for acute cerebral infarction based on microcatheter technology: a single-center, randomized, single-blind controlled study.","authors":"Yue Wan, Hao Tian, Hui Wang, DaPeng Wang, HaiWei Jiang, Qi Fang","doi":"10.3389/fneur.2025.1620774","DOIUrl":"https://doi.org/10.3389/fneur.2025.1620774","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fneur.2023.1039816.].</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1620774"},"PeriodicalIF":2.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181707","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":"Altered cerebral perfusion in Parkinson's disease patients with anxiety: an arterial spin labeling MRI study.","authors":"Lu Li, Shiyuan Song, Yingying Hu, Yuan Luo, Lu Wang, Peiyao Zhang","doi":"10.3389/fneur.2025.1583451","DOIUrl":"10.3389/fneur.2025.1583451","url":null,"abstract":"<p><strong>Purpose: </strong>In this study, we used arterial spin labeling (ASL) to explore altered cerebral blood flow perfusion in Parkinson's disease (PD) patients with anxiety and assessed the relationship between anxiety and perfusion in various brain regions to determine the pathophysiologic basis for the occurrence of anxiety in patients with PD.</p><p><strong>Materials and methods: </strong>Seventy-three patients with PD who were treated at China-Japan Friendship Hospital from September 2023 to November 2024 were enrolled: 36 PD patients with anxiety (PD-A) and 37 PD patients without anxiety (PD-NA); in addition, 37 healthy volunteers were recruited as healthy controls (HCs). All the subjects underwent three-dimensional T1-weighted imaging (3D-T1WI) and pseudo-continuous arterial spin labeling (pCASL) sequential scans via 3.0-T MRI, and cerebral blood flow (CBF) values were obtained from the whole brain. Independent samples <i>t</i> tests and non-parametric Mann-Whitney U tests were applied to test the differences in the CBF values of each brain region between the PD and HC groups, and between the PD-A and PD-NA groups. The relationships between CBF values and anxiety scores in the PD group were also investigated.</p><p><strong>Results: </strong>CBF values in the bilateral frontal lobes, parietal lobes, temporal lobes, occipital lobes, substantia nigra, striatum, caudate nuclei, left pallidum, and bilateral cerebellum were lower in the PD group than in the HC group (<i>P</i> < 0.05). Compared with those in the PD-NA group, the CBF values of the bilateral frontal lobes, temporal lobes, left putamen and left pallidum were lower in the PD-A group (<i>P</i> < 0.05). CBF values in the left frontal lobe (r = -0.265, <i>P</i> = 0.024), right frontal lobe (r = -0.283, <i>P</i> = 0.015), left temporal lobe (r = -0.287, <i>P</i> = 0.014), and right temporal lobe (r = -0.275, <i>P</i> = 0.019) were negatively correlated with Hamilton Anxiety Scale (HAMA) scores in PD patients.</p><p><strong>Conclusion: </strong>The development of PD-A may be associated with dysfunctional brain perfusion in multiple brain regions, notably the bilateral frontal lobes, temporal lobes, left putamen, and left pallidum. Abnormal CBF in these brain regions may serve as a neuroimaging marker for early PD-A diagnosis. Using ASL to identify perfusion changes in core regions may advance our understanding of the pathophysiological mechanisms underlying PD-A.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1583451"},"PeriodicalIF":2.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12119255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144179982","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 role of a combined model for futile recanalization in acute ischemic stroke: a retrospective cohort study.","authors":"Yangbin Zhou, Yitao Zhou, Huijie Yang, Xiaoyan Wang, Xiping Zhang, Ganying Huang","doi":"10.3389/fneur.2025.1566842","DOIUrl":"10.3389/fneur.2025.1566842","url":null,"abstract":"<p><strong>Objective: </strong>There is a lack of data regarding patients with acute ischemic stroke caused by large vessel occlusions (LVOs) undergoing mechanical thrombectomy (MT) and their predictors of futile recanalization (FR). We sought to investigate the predictors of FR in patients with AIS-LVO undergoing mechanical thrombectomy.</p><p><strong>Method: </strong>A retrospective analysis was conducted on 229 acute AIS patients who received MT, after eliminating the 31 patients not meet the requirements. The patients were categorized into the FR group and the useful recanalization (UR) group. Multivariate logistic regression analysis was used to explore the factors that influence FR after mechanical thrombectomy. ROC curve was used to plot the ability to predict FR after MT, and then the combined model was constructed and evaluate the predictive ability of this model to FR.</p><p><strong>Results: </strong>198 patients who achieved successful recanalization were included in the analysis, of whom 124 experienced UR and 74 experienced FR. Patients with FR had higher Baseline NIHSS; they were more frequently on hypertension history and had longer door-to-puncture time (DPT) and door-to-recanalization time (DRT). Multivariable regression analysis showed that the hypertension history, Admission NIHSS, Admission DBP, Admission blood glucose, ischemic core, and DPT were associated with an increased probability of FR. The combined model was better than the models alone in predicting the risk of FR.</p><p><strong>Conclusion: </strong>Admission blood pressure, admission NIHSS scores, admission DBP, ischemic core and DPT are independent risk factors for FR after MT in patients with AIS, and the combined model established by them has high predictive efficacy for FR risk after MT.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1566842"},"PeriodicalIF":2.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180032","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 efficacy of controlled stepped intracranial decompression surgery in patients with craniocerebral injury.","authors":"Xiaobin Huang, Cheng Yu, Xiaoyue Liao, Baizhuo Dong, Jun Zheng, Shanchi Zhang","doi":"10.3389/fneur.2025.1574036","DOIUrl":"10.3389/fneur.2025.1574036","url":null,"abstract":"<p><strong>Background: </strong>Head injuries are frequently the result of high-energy trauma, which is often severe and has a high mortality rate.</p><p><strong>Methods: </strong>This retrospective study included 78 patients with severe traumatic brain injury treated from January 2021 to January 2023. Patients were divided into two groups: a control group (<i>n</i> = 33) treated with standard large bone flap decompression, and a research group (<i>n</i> = 45) treated with controlled stepwise intracranial decompression. Surgical parameters, treatment efficacy, complications, neurological function, and serum biomarkers (IL-6, CRP, NSE) were compared. Multivariate logistic regression was adjusted for confounders received.</p><p><strong>Results: </strong>The research group had significantly shorter decompression initiation times, reduced operation durations, and less intraoperative blood loss (<i>p</i> < 0.05). The effective treatment rate was higher in the research group (80.0% vs. 57.6%, <i>p</i> < 0.05). After treatment, both groups showed improvements in NFD and GCS scores, with more significant improvement in the research group (<i>p</i> < 0.01). Inflammatory markers (IL-6, CRP, NSE) decreased post-treatment in both groups, with significantly lower levels in the research group (<i>p</i> < 0.01). The complication rate was markedly lower in the research group (8.9% vs. 30.3%, <i>p</i> < 0.05). Multivariate analysis confirmed that stepwise decompression was associated with higher clinical efficacy (aOR = 3.20, 95% CI: 1.24-8.28, <i>p</i> = 0.016) and fewer complications (aOR = 0.24, 95% CI: 0.07-0.82, <i>p</i> = 0.022). treatment, and NSE levels of the two groups were less than those after therapy (<i>p</i> < 0.05); and the blood IL-6, CRP, and NSE levels of the research group after treatment were greater than those of the control group.</p><p><strong>Conclusion: </strong>Controlled stepped intracranial decompression surgery could effectively shorten the operation time of sufferers with severe craniocerebral injury, reduce intraoperative blood loss, improve clinical treatment effects, improve patient prognosis, and promote neurological recovery.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1574036"},"PeriodicalIF":2.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181344","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":"Low intensity gamma-frequency TMS safely modulates gamma oscillations in probable mild Alzheimer's dementia: a randomized 2 × 2 crossover pilot study.","authors":"A J Mimenza-Alvarado, S G Aguilar-Navarro, I E Abarca-Jiménez, I Vázquez-Villaseñor, Diana I Luna-Umanzor, C Dorard, G Villafuerte","doi":"10.3389/fneur.2025.1566476","DOIUrl":"10.3389/fneur.2025.1566476","url":null,"abstract":"<p><strong>Introduction: </strong>AD is a progressive neurodegenerative disorder characterized by cognitive decline and memory loss. While traditional treatments targeting beta-amyloid accumulation have shown limited success, there is a pressing need for novel therapeutic approaches. Recent studies have highlighted the role of disrupted gamma oscillations in AD pathology, leading to the exploration of gamma neuromodulation as a potential therapeutic strategy to modify disease progression in individuals with AD dementia. This pilot clinical trial aimed to investigate the electrophysiological effects of low intensity gamma transcranial magnetic stimulation (gTMS) on gamma oscillations in patients with a diagnosis of probable mild AD dementia.</p><p><strong>Methods: </strong>Employing a randomized, double-blind, sham-controlled, 2 × 2 crossover design, participants underwent a single session of both real low intensity gTMS and sham stimulation. EEG recordings and cognitive assessments were conducted before and after stimulation to assess changes in brain activity and their impact on episodic memory.</p><p><strong>Results: </strong>We observed statistically significant changes in EEG activity (<i>n</i> = 14), indicating transient modulation of gamma oscillations immediately after low intensity gTMS. There was no significant improvement in cognition compared to baseline scores, but we evidenced a positive correlation between electrophysiological changes and cognitive outcome. Importantly, the intervention was well-tolerated, with no significant adverse effects reported.</p><p><strong>Discussion: </strong>Low intensity gTMS has shown the capability to induce significant changes in brain activity, particularly in gamma oscillations. These findings suggest that low intensity gTMS holds promise as a safe and non-invasive therapeutic approach, challenging the conventional belief that high intensity magnetic pulses are necessary for effective brain modulation. To corroborate these initial findings, further research with extended intervention durations and larger, well-defined cohorts of patients with mild AD dementia is essential. This will validate the potential benefits of low intensity gTMS on cognitive performance in this population.</p><p><strong>Clinical trial registration: </strong>https://clinicaltrials.gov/study/NCT05784298?term=NCT05784298&rank=1, NCT05784298.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1566476"},"PeriodicalIF":2.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181868","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":"Cerebral hemodynamics evaluation of FLAIR vascular hyperintensity in TIA patients with large artery severe stenosis or occlusion.","authors":"Lichuan Zeng, Jiamei Wang, Qu Wang, Yaodan Zhang, Huaqiang Liao, Wenbin Wu","doi":"10.3389/fneur.2025.1589198","DOIUrl":"10.3389/fneur.2025.1589198","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the practicality and utility of employing dual post-label delay (PLD) arterial spin labeling (ASL) in transient ischemic attack (TIA) individuals exhibiting Fluid-attenuated inversion recovery (FLAIR) vascular hyperintensity (FVH).</p><p><strong>Materials and methods: </strong>We conducted a retrospective review of clinical data from TIA patients presenting with unilateral severe atherosclerotic stenosis or obstruction of either the intracranial internal carotid artery or the middle cerebral artery. Participants were categorized into two groups based on the presence or absence of FVH: FVH positive and FVH negative. All individuals underwent pseudo-continuous ASL perfusion imaging, utilizing distinct PLD durations (1,525 and 2,525 ms) alongside qualitative visual assessments of ASL perfusion irregularities. Standardized TIA evaluations, which included medical history reviews, neuropsychological assessments, and ABCD2 scoring, were performed on all subjects. We explored the correlations between FVHs, clinical manifestations, vascular risk factors, and perfusion metrics.</p><p><strong>Results: </strong>A total of 50 patients were included in this investigation, with FVH detected in 16 subjects (32.0%). The ABCD2 score was notably elevated within the FVH positive cohort compared to the FVH negative group. At a PLD of 1,525 ms, cerebral blood flow (CBF) values for the affected and healthy hemispheres in the FVH positive group were recorded at 19.55 ± 6.67 and 40.32 ± 6.83, respectively; corresponding values in the FVH negative group were 23.74 ± 5.03 and 46.43 ± 7.91. For a PLD of 2,525 ms, the CBF values for the affected and healthy sides in the FVH positive group were 34.11 ± 5.87 and 50.27 ± 8.57, while the FVH negative group recorded values of 42.79 ± 7.03 and 52.07 ± 7.29, respectively. The differential CBF (ΔCBF) for the affected side in the FVH positive and negative groups was 14.57 ± 4.34 and 19.05 ± 6.10, respectively. A significant negative correlation was established between ΔCBF and ABCD2 scores (Kendall's tau-b = -0.578, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>The findings of this study indicate a strong association between the presence of FVH signs and a marked reduction in cerebral blood flow, as well as diminished blood flow reserve. This underscores the potential role of FVH as a biomarker for hemodynamic impairment in TIA patients.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1589198"},"PeriodicalIF":2.7,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173442","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}