Frontiers in Neurology最新文献

{"title":"Efficacy and safety of levetiracetam in preventing postoperative seizures in adult patients with brain tumors: a meta-analysis.","authors":"Yongyi Zhang, Haoming Li, Bin Zhang, Junchen Zhang, Chengde Li","doi":"10.3389/fneur.2025.1543905","DOIUrl":"10.3389/fneur.2025.1543905","url":null,"abstract":"<p><strong>Objective: </strong>Seizures are one of the most common symptoms in patients with brain tumor. The efficacy of prophylactic antiepileptic agents in reducing postoperative seizures in patients with brain tumor remains disputed. We conducted this meta-analysis to evaluate the efficacy and safety of levetiracetam in preventing seizures in adult patients with brain tumor.</p><p><strong>Review methods: </strong>We gathered studies comparing the effectiveness of levetiracetam with other antiepileptic drugs in preventing postoperative seizures in individuals with brain tumor from 2008 to 2023. We used the search terms levetiracetam, brain tumor, prevention, and seizures to retrieve relevant studies from the Pubmed, Medline, EMBASE, China National Knowledge Infrastructure, and Wanfang databases. The meta-analysis was conducted using RevMav 5.3 software.</p><p><strong>Results: </strong>After the literature search and screening, nine English-language studies involving a total of 2,433 patients were analyzed. The meta-analysis revealed that levetiracetam had higher efficacy for preventing overall seizures than the control intervention (odds ratio [OR] 0.56, 95% confidence interval [CI] 0.44-0.71, <i>p</i> < 0.00001). Subgroup analyses revealed that the efficacy of levetiracetam was superior to that of sodium valproate (OR 0.53, 95% CI 0.39-0.72, <i>p</i> < 0.0001) and phenytoin sodium (OR 0.35, 95% CI 0.19-0.62, <i>p</i> = 0.0004). No statistically significant difference in the efficacy of early seizure prophylaxis (OR 0.55, 95% CI 0.15-2.04, <i>p</i> = 0.37) was observed. The subgroup analysis revealed that the efficacy of levetiracetam for preventing early seizures was better than that of phenytion sodium (OR 0.13, 95% CI 0.03-0.56, <i>p</i> = 0.006). No statistically significant difference was noted in the preventive efficacy against late seizures (OR 0.75, 95% CI 0.27-2.03, <i>p</i> = 0.57). The incidence of adverse drug reactions was lower in the levetiracetam group than in the control group (OR 0.18, 95% CI 0.05-0.64, <i>p</i> = 0.008). Further subgroup analyses revealed that the incidence of adverse drug reactions in the levetiracetam group was lower than that in the phenytion sodium group (OR 0.06, 95% CI 0.02-0.21, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Prophylactic levetiracetam decreases the frequency of postoperative seizures, particularly early postoperative seizures, in individuals with brain tumor, with superior effectiveness to phenytion sodium and sodium valproate. In addition, levetiracetam induced only minor adverse effects, with a lower occurrence rate of adverse reactions than phenytion sodium and valproate. Nevertheless, a potential for bias exists. Due to the limited number of high-quality randomized controlled trials included in this meta-analysis, prospective, multicenter, ethnically diverse, high-quality studies on levetiracetam are essential to determine the efficacy of preventive levetiracetam in managin","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1543905"},"PeriodicalIF":2.7,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691709","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":"Effect and safety of interventional recanalization in acute cerebral infarction with low NIHSS score due to anterior circulation large vessel occlusion and exploration of factors associated with futile recanalization.","authors":"Wensheng Zhang, Weifang Xing, Yangchun Wen, Xiaojing Zhong, Jinzhao He","doi":"10.3389/fneur.2025.1473306","DOIUrl":"10.3389/fneur.2025.1473306","url":null,"abstract":"<p><strong>Objective: </strong>To explore the efficacy and safety of successful interventional recanalization in patients with low NIHSS score acute cerebral infarction due to anterior circulation large vessel occlusion and influencing factors of futile recanalization.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of patients with acute cerebral infarction due to anterior circulation large vessel occlusion treated in our hospital from January 2019 to December 2023. Statistical methods such as chi square test, t-test and non parametric test for statistical analysis were used.</p><p><strong>Results: </strong>A total of 445 patients were included in the study, including 32 in the low NIHSS score group and 413 in the non low NIHSS score group. There were statistical differences in NIHSS score at onset, preoperative ASPECT score, collateral circulation score, pathogenesis, effective recanalization rate, futile recanalization rate and 3-month postoperative mRS score between the two groups. There was no statistical difference in the incidence of complications such as symptomatic cerebral hemorrhage between the two groups. There were statistically significant differences in preoperative ASPECT score and collateral circulation score in terms of factors affecting futile recanalization in patients with low NIHSS score.</p><p><strong>Conclusion: </strong>Patients with acute cerebral infarction with anterior circulation large vessel occlusion and low NIHSS score had good therapeutic effect after successful interventional recanalization, and the safety was comparable to that of patients with non low NIHSS score. The factors that affecting futile recanalization in patients with low NIHSS score included preoperative ASPECT score and collateral circulation score.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1473306"},"PeriodicalIF":2.7,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691694","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":"Efficacy of combined non-invasive brain stimulation and robot-assisted gait training on lower extremity recovery post-stroke: a systematic review and meta-analysis of randomized controlled trials.","authors":"Jiaoyun Wang, Huihuang Zhang, Jiani Ma, Lei Gu, Xiang Li","doi":"10.3389/fneur.2025.1500020","DOIUrl":"10.3389/fneur.2025.1500020","url":null,"abstract":"<p><strong>Background: </strong>Lower extremity dysfunction post-stroke significantly impedes patient independence and quality of life. Non-invasive brain stimulation (NIBS) and robot-assisted gait training (RAGT) have individually shown promising outcomes in gait recovery. However, the synergistic efficacy of non-invasive brain stimulation combined with robot-assisted gait training remains uncertain. This systematic review and meta-analysis aim to evaluate the combined therapy's effectiveness on gait improvement and related motor functions in stroke patients.</p><p><strong>Methods: </strong>Following PRISMA guidelines, a comprehensive search was conducted to identify randomized controlled trials (RCTs) published up to September 2024. The primary outcome was assessed using the 6-min walk test (6MWT), with secondary outcomes examining assessed using the Functional Ambulation Category (FAC); the Motion Index (MI) to analyze exercise intensity; the Modified Ashworth Scale (MAS) to assess spasticity; and spatiotemporal gait parameters (SPG).</p><p><strong>Results: </strong>Six randomized controlled trials involving 191 stroke patients were included. Meta-analysis revealed that combined non-invasive brain stimulation and robot-assisted gait training significantly improved the 6-min walk test scores (mean difference [MD] = 21.81, 95% CI = 0.03-43.59), though effects on strength, activity participation, spasticity, and coordination were non-significant.</p><p><strong>Conclusion: </strong>Non-invasive brain stimulation combined with robot-assisted gait training shows potential in enhancing gait function but provides limited additional benefits for other motor functions. This combined approach may serve as an effective rehabilitation strategy for post-stroke gait recovery, warranting further large-scale studies to refine intervention protocols.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD42021283890.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1500020"},"PeriodicalIF":2.7,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691713","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 and prognostic values of serum C1q/tumor necrosis factor-related protein 9 for first-ever ischemic stroke.","authors":"Yan-Qing Zhang, Hai-Feng Zhang, Xiao-Gang Liu, Rong Li","doi":"10.3389/fneur.2025.1526853","DOIUrl":"10.3389/fneur.2025.1526853","url":null,"abstract":"<p><strong>Background: </strong>The C1q/Tumor Necrosis Factor-related Protein 9 (CTRP9) is a relatively novel adipokine having showed protection on cerebrovascular system. However, its clinical values have not been well established. This work is to evaluate CTRP9 as predictors of onset risk and outcome of ischemic stroke.</p><p><strong>Methods: </strong>One thousand one hundred and twenty-three patients undergoing first-ever ischemic stroke and 835 controls were enrolled. Serum CTRP9 was determined within 24 h after the onset. One thousand and twenty-six patients were successfully followed up for all-cause and cardiovascular deaths. Stepwise regression was conducted to screen the independent factors of stroke onset in the whole sample and mortality in the patient subgroup. Survival curves were plotted to evaluate the effect of baseline serum CTRP9 on 3-year all-cause and cardiovascular mortalities of stroke patients.</p><p><strong>Results: </strong>At baseline, prevalence of first-ever onset of ischemic stroke in high CTRP9 group was significantly lower than that in low CTRP9 group (<i>p</i> < 0.05) in non-hyperlipidemic subjects. Accumulative all-cause and cardiovascular mortality of patients with high baseline CTRP9 was significantly lower for the first year post stroke onset (<i>p</i> < 0.05). Baseline low CTRP9 was one of the independent risk factors of 3-year all-cause mortality (<i>p</i> < 0.05) of ischemic stroke patients.</p><p><strong>Conclusion: </strong>High serum CTRP9 exerted protection against first-ever onset of ischemic stroke in non-hyperlipidemic subjects, and also protected general stroke patients against all-cause and cardiovascular mortality at least 1 year post stroke onset. Our findings in this study may pinpoint both the predictive and prognostic values of CTRP9 as a promising biomarker.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1526853"},"PeriodicalIF":2.7,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691767","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":"Brain glucose metabolism in patients with traumatic brain injury undergoing rehabilitation: a longitudinal 18F-FDG PET study.","authors":"Valeria Pingue, Irene Bossert, Daniela D'Ambrosio, Antonio Nardone, Giuseppe Trifirò, Nicola Canessa, Diego Franciotta","doi":"10.3389/fneur.2025.1556427","DOIUrl":"10.3389/fneur.2025.1556427","url":null,"abstract":"<p><strong>Background: </strong>Measuring 18F-FDG PET-detected brain glucose uptake provides reliable information on metabolic tissue abnormalities, cells dysfunction, and neurovascular changes after traumatic brain injury (TBI).</p><p><strong>Objectives: </strong>We aimed to study the relationship between post-traumatic brain glucose metabolism and functional outcomes in the so far unexplored field of longitudinally 18F-FDG PET-monitored patients undergoing rehabilitation after moderate-to-severe TBI.</p><p><strong>Methods: </strong>Fourteen patients consecutively admitted to our unit in the post-acute phase after TBI underwent 18F-FDG-PET scans performed before and 6 months after inpatient rehabilitation program. The Glasgow Coma Scale (GCS) for neurological status, and the Functional Independence Measure (FIM) plus the Glasgow Outcome Scale-Extended (GOSE) scales for the rehabilitation outcome, were applied on admission and discharge. Voxel-wise analyses were performed, with the Statistical Parametric Mapping (SPM12) software, to investigate pre- vs. post-rehabilitation changes of brain metabolism, and their relationships with clinical indices.</p><p><strong>Results: </strong>In the whole sample, 18F-FDG uptake significantly increased in the following five regions that were hypometabolic before rehabilitation: inferior frontal gyrus bilaterally, alongside right precentral gyrus, inferior parietal lobule, and cerebellum. However, only for the right precentral gyrus the median voxel peak-value at baseline resulted a significant predictor of both cognitive (FIM cognitive subscale, <i>p</i> = 0.012), and functional (GOS-E, <i>p</i> = 0.02; post- vs. pre-treatment GOS-E difference, <i>p</i> = 0.009) improvements. ROC curve analysis showed that a peak voxel-value of 1.7998 was the optimal cut-off for favorable rehabilitation outcome. Unfavorable functional outcomes were predicted by increased 18F-FDG uptake in the inferior frontal gyrus (GOS-E, <i>p</i> = 0.032) and precentral gyrus (FIM cognitive subscale, <i>p</i> = 0.017; GOS-E, <i>p</i> = 0.015).</p><p><strong>Conclusion: </strong>This proof-of-principle study enlightens the metabolic changes occurring in moderate-to-severe TBI course. Notably, such changes preferentially involve definite frontal brain areas regardless of TBI localization and entity. These findings pave the way for further studies with translational purposes.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1556427"},"PeriodicalIF":2.7,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669241","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":"Mechanisms and clinical significance of Tumarkin-like phenomenon during the final step of the Epley and Semont maneuver: insights from virtual simulation and literature review.","authors":"Ruihu Yang, Xiaokai Yang","doi":"10.3389/fneur.2025.1547798","DOIUrl":"10.3389/fneur.2025.1547798","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to investigate the mechanisms underlying the Tumarkin-like phenomenon during the final step of the Epley and Semont maneuvers for benign paroxysmal positional vertigo (BPPV) through virtual simulation and a comprehensive literature review. We also provide clinical recommendations to improve treatment outcomes and optimize repositioning protocols.</p><p><strong>Methods: </strong>A three-dimensional virtual simulation model was developed to accurately represent the semicircular canals, otoliths, and associated vestibular structures. Key parameters governing otolith movement were defined based on physiological data. Virtual experiments were conducted to simulate the final steps of the Epley and Semont maneuvers, allowing detailed observation of otolith movement. The study followed ethical guidelines throughout.</p><p><strong>Results: </strong>Virtual simulations revealed distinct otolith movement patterns during the Epley and Semont maneuvers. In the standard Epley maneuver, otoliths should enter the utricle before the final sitting up step, resulting in no further movement or symptoms. Conversely, in the Semont maneuver, otoliths may enter the utricle through the common crus when sitting up, potentially causing vertigo, nystagmus, and unsteadiness. Improper execution of either maneuver can lead to unexpected otolith movements and symptoms. The clinical significance of symptoms during the final step varies between the two maneuvers and is closely linked to proper execution. The study also highlights the importance of head positioning during the maneuvers, with specific angles influencing otolith movement and symptom manifestation.</p><p><strong>Conclusions: </strong>The findings provide a detailed understanding of otolith movement dynamics during the final steps of the Epley and Semont maneuvers. The results challenge existing views on the correlation between dizziness and successful repositioning, emphasizing the need for personalized treatment approaches and accurate maneuver execution. This study contributes to refining repositioning protocols, optimizing outcomes, and advancing our comprehension of BPPV dynamics. Future clinical studies are needed to verify these simulation results and develop more precise and personalized BPPV diagnosis and treatment methods.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1547798"},"PeriodicalIF":2.7,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669272","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 effect of Kinesio Taping on motor function in children with cerebral palsy: a systematic review and meta-analysis of randomized controlled trials.","authors":"Xiaoguang Lin, Jiongliang Zhang, Minmin Wu, Jinting Li, Wenjing Song, Luwen Zhu","doi":"10.3389/fneur.2025.1527308","DOIUrl":"10.3389/fneur.2025.1527308","url":null,"abstract":"<p><strong>Introduction: </strong>Kinesio taping (KT) is a well-known rehabilitation therapy technique used for treating children with cerebral palsy. However, no meta-analysis of kinesio taping has been conducted specifically for this purpose. This systematic review and meta-analysis aim to explore the effectiveness of kinesio taping in enhancing gross motor function, balance ability, and gait in children with cerebral palsy.</p><p><strong>Methods: </strong>A comprehensive database search was conducted using PubMed, Embase, the Cochrane Library, Web of Science, Cnki, Wan Fang, VIP, and the Physiotherapy Evidence Database (PEDro) to identify randomized controlled trials (RCTs) investigating the impact of kinesio taping (KT) on cerebral palsy. RCTs published until May 31, 2024, that met our predetermined inclusion and exclusion criteria were included. Data extraction, literature review, and assessment of the methodological quality of the trials were performed. The meta-analysis was conducted using StataSE version 16.</p><p><strong>Results: </strong>The primary outcome was Gross Motor Function Measure, Berg Balance Scale, Muscle Tension-Heel-Ear Test. The secondary outcomes were step frequency, step speed, step length. Our meta-analysis includes 378 children from 10 RCTs incorporated. Main result the Gross Motor Function Measure (GMFM D) (SMD = 1.00, 95%CI = 0.24-1.77, <i>p</i> = 0.01, <i>I</i> ² = 87.3), the Gross Motor Function Measure (GMFM E) (SMD = 0.84, 95%CI = 0.22-1.46, <i>p</i> = 0.008, <i>I</i> ² = 81.5%), the Berg Balance Scale (BBS) (SMD = 0.81, 95%CI = 0.20-1.42, <i>p</i> = 0.009, <i>I</i> ² = 76.3%). Muscle Tension-Heel-Ear Test (SMD = 1.57, 95%CI = 0.59-2.55, <i>p</i> = 0.002, <i>I</i> ² = 79.8%). The children showed significant improvements in gross motor function, balance and muscle tension compared to the results of the control group. The secondary step length (SMD = 0.46, 95% CI = 0.18-0.76, <i>I</i> ² = 47.3%, <i>p</i> = 0.002) had an improvement effect, but no significant effect on step frequency and step speed.</p><p><strong>Conclusion: </strong>To some extent, compared to the control group, the addition of kinesio taping improved motor dysfunction in children with cerebral palsy during rehabilitation.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/search, identifier: CRD42024528254.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1527308"},"PeriodicalIF":2.7,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691771","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":"Measuring electrophysiological changes induced by sub-concussive impacts due to soccer ball heading.","authors":"Geoffrey Brookshire, Angelo Pennati, Keith J Yoder, MacKenzie Tweardy, Colin Quirk, Marilyn Perkins, Spencer Gerrol, Steven Raethel, Devin Nikjou, Simona Nikolova, Michael Leonard, Amy Crepeau, David W Dodick, Todd J Schwedt, Ché Lucero","doi":"10.3389/fneur.2025.1500796","DOIUrl":"10.3389/fneur.2025.1500796","url":null,"abstract":"<p><p>A growing body of research suggests that impacts to the head, including sub-concussive impacts, carry risks for long-term detrimental effects on cognition and brain health. Despite the potential for negative health consequences associated with sub-concussive impacts, there is currently no reliable and objective method used in clinical practice to assess whether a particular sub-concussive impact affected the brain. In this preliminary study, we developed a machine-learning classifier to detect changes in brain electrophysiological activity following sub-concussive impacts that occur during soccer ball heading. We recorded EEG from soccer players before and after they repeatedly headed a soccer ball, and trained classifiers to distinguish between an individual's EEG patterns before and after these sub-concussive impacts. The classifiers were able to identify post-impact EEG recordings with significantly higher accuracy than would be expected by chance, both 1 h and 24 h after the impacts occurred. After controlling for electrophysiological changes attributed to exercise, changes to brain activity attributable to soccer heading were detectable at 24 h post-heading, but not at 1-h post-heading. The observed time-course of EEG changes mirrors a similar pattern seen in traumatic brain injury, in which an inflammatory cascade is manifest 24 to 48-h post-injury; we suggest that EEG changes following sub-concussive impacts may stem from inflammation or some other physiological process that unfolds on a similar timescale. These results are an important step toward developing an EEG-based tool that can assess whether electrophysiological consequences are present following sub-concussive head impacts.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1500796"},"PeriodicalIF":2.7,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669257","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":"Safety and efficacy of tirofiban after intravenous thrombolysis with urokinase in patients with acute ischemic stroke.","authors":"Dian Qu, Huanhuan Liu, Zhongming Wei, Yao Cheng, Yutong Fei, Jinghan Xu, Xiuyu Lv, Wendi Li","doi":"10.3389/fneur.2025.1529331","DOIUrl":"10.3389/fneur.2025.1529331","url":null,"abstract":"<p><strong>Introduction: </strong>Tirofiban combined with alteplase thrombolysis or endovascular therapy has been proven to improve the prognosis of patients with acute ischemic stroke (AIS). Some patients, due to the extended time window beyond 4 h and economic considerations, opt for urokinase thrombolysis instead of alteplase thrombolysis in China. However, there is currently limited research on the use of urokinase thrombolysis bridged with tirofiban.</p><p><strong>Methods: </strong>We employed propensity score match to pair 80 sets of patients from a total of 196 individuals who underwent urokinase thrombolysis for acute ischemic stroke. The study analyzed the 14-day National Institutes of Health Stroke Scale (NIHSS), 90-day modified Rankin Scale (mRS), bleeding events, and compared the odds ratio (OR) of patients with mRS scores of 0-2 within the subgroups.</p><p><strong>Results: </strong>The results show that the NIHSS at 14 days of the tirofiban group was significantly lower than that of the dual antiplatelet group. No significant difference was found in the proportion of patients with mRS score 0-2. The odds ratios were slightly different in subgroups classified with or without previous stroke and hypertension.</p><p><strong>Discussion: </strong>It was confirmed that the tirofiban might be safe in AIS patients received tirofiban after urokinase thrombolysis and could improve short-term neurological function.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1529331"},"PeriodicalIF":2.7,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669572","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":"Healthy dietary intake diminishes the effect of cerebral small vessel disease on cognitive performance in older adults.","authors":"Christopher E Bauer, Valentinos Zachariou, Colleen Pappas, Pauline Maillard, Charles DeCarli, Arvind Caprihan, Brian T Gold","doi":"10.3389/fneur.2025.1508148","DOIUrl":"10.3389/fneur.2025.1508148","url":null,"abstract":"<p><strong>Introduction: </strong>We evaluated whether regular dietary intake of nutrients commonly found in fish, unsaturated oils, and nuts would moderate the associations between neuroimaging biomarkers of cerebral small vessel disease (cSVD) and cognitive function in older adults.</p><p><strong>Methods: </strong>Dietary information, Montreal Cognitive Assessment (MoCA) scores, and magnetic resonance imaging (MRI) scans were collected from 71 older adults without dementia (60-86 years). MRI biomarkers of cSVD were calculated for each participant. Multivariate linear regression models were computed using dietary intake as the moderating variable. Covariates included age, sex, and estimated intracranial volume.</p><p><strong>Results: </strong>Dietary intake moderated the association between several cSVD biomarkers and MoCA scores such that the expected negative association between cSVD biomarkers and cognition was seen at low levels of healthy dietary intake, but not at medium or high levels. A dietary intake by age moderation was not observed.</p><p><strong>Discussion: </strong>Our findings indicate that healthy dietary intake may confer cognitive reserve against cSVD in older adults.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1508148"},"PeriodicalIF":2.7,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669246","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}