Frontiers in Neurology最新文献

{"title":"Distinguishing stroke from transient ischemic attack using plaque characteristics and arterial transit artifacts.","authors":"Ling Li, Peichun Pan, Na Zhang, Yu Wen, Min Tang, Kai Ai, Xiaoling Zhang, Xiaoyan Lei, Xuejiao Yan","doi":"10.3389/fneur.2025.1514679","DOIUrl":"10.3389/fneur.2025.1514679","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to investigate the differences in plaque characteristics and hemodynamics in patients with ischemic stroke and transient ischemic attack (TIA), comparing the diagnostic abilities of high-resolution magnetic resonance imaging (HRMRI) and arterial spin labeling (ASL) for ischemic stroke.</p><p><strong>Methods: </strong>This retrospective analysis included patients who underwent HRMRI and ASL between October 2020 and December 2023. We compared clinical risk factors, vascular plaque characteristics, and the presence of arterial transit artifacts (ATAs) at post-labeling delays (PLDs) of 1.5-s and 2.5-s between stroke and TIA groups. Multivariate logistic regression analysis was used to evaluate the diagnostic performance of different prediction models combining clinical factors, differential plaque characteristics, and the presence of ^PLD ATAs.</p><p><strong>Results: </strong>A total of 147 patients (mean age, 57.12 ± 13.08 years; 102 men) were initially included in this study, divided into stroke (79) and TIA (68) groups. Significant differences in vascular positive remodeling, intraplaque hemorrhage, enhancement ratio, and the presence of 1.5-s and 2.5-s ATAs (<i>p</i> < 0.05) were observed between groups. Combined HRMRI and ASL performed best in distinguishing ischemic stroke and TIA (area under the curve [AUC], 0.926; 95% confidence interval [CI], 0.885-0.967), with no significant difference in ischemic stroke diagnostic performance between HRMRI and ASL (95% CI, -0.039 to 0.087, <i>Z</i> = 0.742, <i>p</i> = 0.458).</p><p><strong>Conclusion: </strong>A model combined with plaque characteristics and ATAs showed good diagnostic performance in distinguishing between TIA and stroke in patients with intracranial atherosclerotic stenosis. ASL provides a simpler imaging evaluation method than HRMRI, and ATA evaluation may become a more widely used imaging marker in clinical practice.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1514679"},"PeriodicalIF":2.7,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795375","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":"Patient centered outcomes in stroke: utility-weighted modified Rankin Scale results in a community-based study.","authors":"Carlos Delfino, Gabriel Cavada, Lorena Hoffmeister, Pablo Lavados, Paula Muñoz Venturelli","doi":"10.3389/fneur.2025.1539107","DOIUrl":"10.3389/fneur.2025.1539107","url":null,"abstract":"","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1539107"},"PeriodicalIF":2.7,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795305","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":"Sex-related differences in the association between migraine, COVID-19, and long COVID: a population-based cohort.","authors":"Linda Al-Hassany, Antoinette MaassenVanDenBrink, Tobias Kurth","doi":"10.3389/fneur.2025.1547893","DOIUrl":"10.3389/fneur.2025.1547893","url":null,"abstract":"<p><strong>Background: </strong>Coronavirus disease 2019 (COVID-19), caused by the SARS-CoV-2 virus, placed unprecedented pressure on public health systems due to its mortality and global panic-and later due to long COVID challenges. One of these long COVID symptoms, headache, often resembles migraine-like features. Migraine shares similarities with COVID-19 and long COVID, yet the influence of sex is understudied. Our primary objective was to study the interrelationship between COVID-19 and migraine prevalence, while considering sex differences. The secondary objective was to examine how long COVID symptoms (headache, anosmia, memory, and concentration problems) affect males and females with and without COVID-19 and migraine.</p><p><strong>Methods: </strong>All analyses were conducted using Lifelines, a prospective cohort study in the northern Netherlands. Baseline characteristics (2006-2014), self-reported migraine diagnoses (until 2021), and questionnaires on COVID-19 and long COVID symptoms (2020-2022) were collected. Logistic regression analyses were conducted to study the association between lifetime migraine and current SARS-CoV-2 infections while adjusting for age, sex, diet, educational attainment, activity, and smoking. Descriptive and sex-stratified analyses were conducted on long COVID symptoms.</p><p><strong>Results: </strong>A total of 150,507 individuals were included, of which 29,680 (19.7%) reported migraine and 120,827 (80.3%) not. A total of 1,867 individuals with migraine [6.3% of individuals with migraine, 44.0 years (IQR 36.1-50.3)] and 6,797 individuals without migraine [5.6% of individuals without migraine, 44.4 years (IQR 35.3-52.2)] reported to be SARS-CoV-2 infected. The majority of individuals with migraine consisted of females (77.0% of those with migraine vs. 54.0% of those without migraine). The adjusted odds of having SARS-CoV-2 infections was 6.3% higher among those with (a history of) migraine compared with individuals without migraine in the logistic regression model (OR = 1.06, 95% CI 1.01-1.12). A slightly higher OR was observed in females (OR = 1.08, 95% CI 1.02-1.15), and the association was not apparent in males (OR = 1.00, 95% CI 0.88-1.12). Secondary analyses revealed that individuals with both migraine and COVID-19, and females in particular, were the most frequently bothered by long COVID symptoms headache, anosmia, concentration, and memory problems. Individuals with none of these diseases were the least bothered.</p><p><strong>Conclusions: </strong>Individuals with migraine, especially females, are slightly more likely to report and/or contract COVID-19. Those with both conditions report long COVID symptoms more frequently, suggesting a shared vulnerability or pathophysiology. This may indicate the need for clinical surveillance of migraine patients recovering from COVID-19.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1547893"},"PeriodicalIF":2.7,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795326","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: RT-ring: a small wearable device for tremulous Parkinson's disease diagnosis in primary care.","authors":"Jolanda Buonocore, Basilio Vescio, Marida De Maria, Marianna Crasà, Rita Nisticò, Pier P Arcuri, Giuseppe L Cascini, Anna Latorre, Aldo Quattrone, Andrea Quattrone","doi":"10.3389/fneur.2025.1588171","DOIUrl":"https://doi.org/10.3389/fneur.2025.1588171","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fneur.2025.1534205.].</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1588171"},"PeriodicalIF":2.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779717","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":"Histopathological composition of thrombus material in a large cohort of patients with acute ischemic stroke: a study of atypical clots.","authors":"Laura Rojas-Bartolomé, María Payá, Rosa Barbella-Aponte, Laura Restrepo Carvajal, Jorge García-García, Oscar Ayo-Martín, Juan David Molina-Nuevo, Gemma Serrano-Heras, Enrique Juliá-Molla, María José Pedrosa-Jiménez, Lorena López-Martínez, Ángela Fernández López, Tomás Segura, Francisco Hernández-Fernández","doi":"10.3389/fneur.2025.1563371","DOIUrl":"10.3389/fneur.2025.1563371","url":null,"abstract":"<p><strong>Introduction: </strong>Clot composition appears to be associated with outcomes in stroke recanalization therapy. This study aims to analyze thrombus composition and assess the relationship between atypical clot composition and clinical parameters, laboratory markers, and recanalization strategies in a series of patients with acute ischemic stroke (AIS) undergoing endovascular treatment (EVT).</p><p><strong>Methods: </strong>This is a prospective single-center registry conducted from December 2014 to July 2022. All retrieved clots were examined under an established protocol and classified as follows: red blood cell-rich clots (RBC), fibrin/platelet-rich clots (FPC), mixed clots (MC), septic emboli (SE), atheroma emboli (AE), fatty emboli (FE), and calcium emboli (CE). We categorized them into two groups: atypical clot composition (ACC: SE, AE, FE, and CE) and usual clot composition (UCC: RBC, FPC, and MC). A subgroup of 10 ACC (four SE, three AE, two FE, and one CE) and nine UCC (three RBC, three FPC, and three MC), matched by age and sex, was analyzed using immunohistochemistry to detect neutrophil extracellular traps (NETs).</p><p><strong>Results: </strong>A total of 606 patients were assessed for EVT, with 448 (73.92%) meeting the inclusion criteria. The clot categorization was as follows: FPC 211 (47.1%), RBC 105 (23.4%), MC 104 (23.2%), SE 16 (3.6%), AE 5 (1.1%), CE 4 (0.9%), and FE 3 (0.7%). Consequently, we classified 420 (93.75%) patients into the UCC group and 28 (6.25%) into the ACC group. Bivariate analysis revealed that the ACC group had a significantly higher number of leukocytes (11.40 leukocytes/mm³ vs. 9.49, <i>p</i> = 0.005), a greater frequency of TICA occlusion (28.6% vs. 9.8%, <i>p</i> = 0.006), and higher mortality at three months (28.6% vs. 12.4%, <i>p</i> = 0.038). Multivariate analysis indicated that atypical clot composition was significantly associated with a higher prevalence of diabetes mellitus, smoking, occlusion of the terminal internal carotid artery, and an increased number of passes. Immunohistochemical studies showed the presence of neutrophil extracellular traps (NETs) in all 19 thrombi that were analyzed.</p><p><strong>Conclusion: </strong>Diabetes and TICA occlusion were the strongest predictors of atypical clot composition. We also observed a significant association between atypical composition and an increased number of passes. Furthermore, the presence of NETs in all thrombi analyzed, regardless of their composition, indicates inflammatory mechanisms associated with clot formation and consolidation in AIS.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1563371"},"PeriodicalIF":2.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779720","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":"Association between methylenetetrahydrofolate reductase C677T polymorphism and cerebral small vessel disease: a systematic review and meta-analysis.","authors":"Hao-Tao Zheng, Wen-Wen Lai, Jian-Jun Wang, Fan-Xin Kong, Hao-Bin Cai, Song-Jun Lin, Xu Wang, Dong-Bin Cai, Min Pi, Xiu-de Qin","doi":"10.3389/fneur.2025.1556535","DOIUrl":"10.3389/fneur.2025.1556535","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review and meta-analysis aimed to evaluate the association between the methylenetetrahydrofolate reductase (5,10-methylenetetrahydrofolate reductase, MTHFR) cytosine (C)677thymine (T) polymorphism and cerebral small vessel disease (CSVD), addressing potential sources of heterogeneity and publication bias.</p><p><strong>Methods: </strong>An extensive search of databases, including PubMed, the Excerpta Medical Database, and The Cochrane Database of Systematic Reviews, was conducted to identify studies assessing the prevalence of the MTHFR C677T variant associated with CSVD subtypes in humans. Random or fixed effects models were used to accommodate heterogeneity across the study results. Odds ratios (ORs) and weighted mean differences with 95% confidence intervals (CIs) were used for pooled analyses of the relationships between the MTHFR C677T variant associated and CSVD subtypes. Subgroup analyses and assessments of publication bias were performed using Stata software.</p><p><strong>Results: </strong>Nineteen studies involving 12,441 participants were included. Significant associations were observed across all genetic models: recessive (OR = 1.33; 95%CI = 1.16, 1.52), dominant (OR = 1.25; 95%CI = 1.14, 1.37), allelic (OR = 1.24; 95%CI = 1.14, 1.35), TT vs. CC (OR = 1.42; 95%CI = 1.25, 1.61), and CT vs. CC (OR = 1.20; 95%CI = 1.09, 1.32). Subgroup analyses revealed stronger associations in CSVD-NOS. However, the trim-and-fill method indicated significant publication bias, with adjusted ORs becoming non-significant (recessive model: OR =1.10, 95% CI=0.81, 1.49). Heterogeneity was low to moderate across models (<i>I</i> ² = 14.2-32.4%).</p><p><strong>Conclusion: </strong>This study highlights the significant association between MTHFR C677T genotyping and CSVD. Early assessment of MTHFR C677T genotyping during the clinical evaluation of elderly patients may improve patient management and reduce the adverse prognostic impact of the CSVD burden. However, further validation of these findings in large-scale, high-quality prospective studies is required.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/prospero/; identifier: CRD42023339320.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1556535"},"PeriodicalIF":2.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779716","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":"Editorial: Third window syndrome, volume II.","authors":"P Ashley Wackym, Carey D Balaban, Konstantina M Stankovic, Tetsuo Ikezono, Todd M Mowery","doi":"10.3389/fneur.2025.1554737","DOIUrl":"10.3389/fneur.2025.1554737","url":null,"abstract":"","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1554737"},"PeriodicalIF":2.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A machine learning model based on emergency clinical data predicting 3-day in-hospital mortality for stroke and trauma patients.","authors":"Xu Chen, Bin Yu, Yaming Zhang, Xin Wang, Danping Huang, Shaohui Gong, Wei Hu","doi":"10.3389/fneur.2025.1512297","DOIUrl":"10.3389/fneur.2025.1512297","url":null,"abstract":"<p><strong>Background: </strong>Accurately predicting the short-term in-hospital mortality risk for patients with stroke and TBI (Traumatic Brain Injury) is crucial for improving the quality of emergency medical care.</p><p><strong>Method: </strong>This study analyzed data from 2,125 emergency admission patients with stroke and traumatic brain injury at two Grade a hospitals in China from January 2021 to March 2024. LASSO regression was used for feature selection, and the predictive performance of logistic regression was compared with six machine learning algorithms. A 70:30 ratio was applied for cross-validation, and confidence intervals were calculated using the bootstrap method. Temporal validation was performed on the best-performing model. SHAP values were employed to assess variable importance.</p><p><strong>Results: </strong>The random forest algorithm excelled in predicting in-hospital 3-day mortality, achieving an AUC of 0.978 (95% CI: 0.966-0.986). Time series validation demonstrated the model's strong generalization capability, with an AUC of 0.975 (95% CI: 0.963-0.986). Key predictive factors in the final model included metabolic syndrome, NEWS2 score, Glasgow Coma Scale (GCS), whether surgery was performed, bowel movement status, potassium level (K), aspartate transaminase (AST) level, and temporal factors. SHAP value analysis further confirmed the significant contributions of these variables to the predictive outcomes. The random forest model developed in this study demonstrates good accuracy in predicting short-term in-hospital mortality rates for stroke and traumatic brain injury patients. The model integrates emergency scores, clinical signs, and key biochemical indicators, providing a comprehensive perspective for risk assessment. This approach, which incorporates emergency data, holds promise for assisting decision-making in clinical practice, thereby improving patient outcomes.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1512297"},"PeriodicalIF":2.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779715","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":"Automatically quantified follow-up imaging biomarkers predict clinical outcomes after acute ischemic stroke.","authors":"Sonya Abraham, Davide Carone, Orell Mielke, Mark Heise, Agnieszka Swierczak, Greg Bass, Stephen Gerry, Zoe V J Woodhead, Rafael Namias, James Garrard, David Kallmes, Waleed Brinjikji, Daniel Vaclavik, Petr Mikulenka, Patrick Nicholson, John Thornton, Gary A Ford, George Harston","doi":"10.3389/fneur.2025.1483138","DOIUrl":"10.3389/fneur.2025.1483138","url":null,"abstract":"<p><strong>Background: </strong>Follow-up infarct volume (FIV) is a proposed surrogate endpoint for proof-of-concept clinical studies in acute ischemic stroke (AIS). This study aimed to provide clinical validation of an automated FIV algorithm, demonstrating the association of imaging biomarkers with clinical outcomes to support the use of these imaging endpoints in clinical trials.</p><p><strong>Methods: </strong>Data were gathered for adult AIS patients undergoing mechanical thrombectomy with follow-up imaging 12-96 h from initial assessment. Non-contrast computed tomography was used to quantify infarct volume. Image processing used the AI-powered software <i>Brainomix 360 Stroke</i> (Brainomix Ltd., Oxford, United Kingdom) and Brainomix core lab research software. Measures included total FIV and components-ischemic injury corrected FIV (cFIV), hemorrhagic transformation (HT), anatomical distortion (AD; a marker of edema) and infarct growth (IG). The primary clinical endpoint was modified Rankin Scale (mRS) at 90 days; secondary clinical endpoint was NIH Stroke Scale (NIHSS) score at 24 h.</p><p><strong>Results: </strong>Of 986 patients, 843 (85.5%; median age 72 years, 56.7% male) had complete data and were included in the study analysis. Median baseline NIHSS score was 17 (IQR: 12-21). Median imaging follow-up time was 24 h (IQR 20-28). Median 24 h NIHSS score was 11 (5-17); 34% of patients had mRS 0-2 at 90 days. Median FIV was 30.2 mL (12.5-120.8 mL). FIV was significantly associated with 90-day mRS (concordance = 0.819, <i>p</i> < 0.001) and NIHSS at 24 h (concordance = 0.722, <i>p</i> < 0.001). cFIV, HT, AD, and IG were also significantly associated with good clinical outcomes in both 90-day mRS (concordance = 0.702, <i>p</i> < 0.001; 0.660, <i>p</i> < 0.001; 0.591, <i>p</i> = 0.002; and 0.663, <i>p</i> < 0.001, respectively) and NIHSS at 24 h (0.774, <i>p</i> < 0.001; 0.652, <i>p</i> = 0.004 L; 0.694, <i>p</i> < 0.001; and 0.716, <i>p</i> < 0.001, respectively). In multivariate analysis, FIV remained strongly associated with 90-day mRS. FIV showed a bimodal distribution consistent with success/failure of recanalization during thrombectomy.</p><p><strong>Conclusion: </strong>Of the algorithm outputs assessed, FIV was most strongly associated with clinical outcomes. Ischemic injury, HT, edema and IG were also independently significantly associated with clinical outcome. This study validates the prognostic significance of automated FIV and its composites as mechanistic endpoints to improve early-stage trials of therapeutics in AIS.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1483138"},"PeriodicalIF":2.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772090","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":"Observation of risk factors for shoulder subluxation after stroke using ultrasonography to measure thickness of the supraspinatus muscle: a cross-sectional study.","authors":"Yu Qu, Xiue Shi, Yongyong Wang, Tiecheng Ji, Lei Chen, Suli Yu, Ming Huo","doi":"10.3389/fneur.2025.1532004","DOIUrl":"10.3389/fneur.2025.1532004","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The prevention of shoulder subluxation, which is mainly caused by stroke, remains a challenge in rehabilitation treatment. While shoulder subluxation is a common problem after stroke, adequate objective predictors is lacking.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;This study aimed to determine the acromion-greater tuberosity (A-GT) distance using ultrasound imaging in stroke patients, investigate the risk factors for shoulder subluxation after stroke, analyze the etiology of shoulder subluxation, and effectively prevent its occurrence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Cross-sectional study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Inpatient rehabilitation unit.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Population: &lt;/strong&gt;One hundred twenty-eight patients in our hospital between 2023 and 2024 with a confirmed diagnosis of stroke (age 59.1 ± 10.5 years; range 22-82 years; 82 males, 46 females; 100 cases of cerebral infarction and 28 of cerebral hemorrhage; 79 cases of left stroke and 49 of right; 82 patients in stage I, 19 in stage II; 11 in stage III, 9 in stage IV, and 7 in stage V).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Ultrasonographic variables (A-GT distance and supraspinatus thickness on the lesion side) were collected. The paired &lt;i&gt;t&lt;/i&gt;-test was adopted to compare the A-GT distance and supraspinatus thickness between the paralyzed and non-paralyzed sides. Data (A-GT distance, supraspinatus thickness on the lesion side) were analyzed using one-way analysis of variance (ANOVA) and multiple comparison tests. Spearman's correlation and multivariate linear regression were used to analyze the associations between the A-GT distance and specific clinical characteristics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The A-GT distance was significantly increased in the paralyzed sides compared with the non-paralyzed sides (&lt;i&gt;p&lt;/i&gt; &lt; 0.01; paired &lt;i&gt;t&lt;/i&gt;-test). The supraspinatus thickness was significantly reduced in the paralyzed compared sides with the non-paralyzed sides (&lt;i&gt;p&lt;/i&gt; &lt; 0.01; paired &lt;i&gt;t&lt;/i&gt;-test). Significant differences were observed in A-GT distance between the sex, stroke type, and Brunnstrom stage groups (&lt;i&gt;p&lt;/i&gt; &lt; 0.01). Supraspinatus thickness on the lesion side showed significant differences between the sex, type of stroke, and lesion side groups (&lt;i&gt;p&lt;/i&gt; &lt; 0.01). A correlation between A-GT distance and supraspinatus thickness was also found (&lt;i&gt;r&lt;/i&gt; = -0.474, &lt;i&gt;p&lt;/i&gt; &lt; 0.01). Based on the multivariate regression analysis, the independent risk factors for shoulder subluxation after stroke included type of stroke, supraspinatus thickness on the lesioned side, and Brunnstrom stage.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Acromio-greater tuberosity distance and reduced supraspinatus thickness on ultrasound, low Brunnstrom stage and history of cerebral hemorrhage were all found to be significant risk factors for shoulder subluxation after stroke.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical rehabilitation impact: &lt;/strong&gt;We investigated the risk factors for shoulder subluxation after","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1532004"},"PeriodicalIF":2.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772095","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}