Frontiers in Neurology最新文献

{"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}

{"title":"Radiomics prediction of MGMT promoter methylation in adult diffuse gliomas: a combination of structural MRI, DCE, and DTI.","authors":"Yuying Liu, Zhengyang Zhu, Jianan Zhou, Han Wang, Huiquan Yang, Jinfeng Yin, Yitong Wang, Xin Li, Futao Chen, Qian Li, Zhuoru Jiang, Xi Wu, Danni Ge, Yi Zhang, Xin Zhang, Bing Zhang","doi":"10.3389/fneur.2025.1493666","DOIUrl":"10.3389/fneur.2025.1493666","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the predictive value of radiomics features extracted from structural MRI, dynamic contrast enhanced (DCE), and diffusion tensor imaging (DTI) in detecting O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation in patients with diffuse gliomas.</p><p><strong>Methods: </strong>Retrospective MRI data of 110 patients were enrolled in this study. The training dataset included 88 patients (mean age 52.84 ± 14.71, 47 females). The test dataset included 22 patients (mean age 50.64 ± 12.58, 12 females). A total of 2,782 radiomic features were extracted from structural MRI, DCE, and DTI within two region of interests (ROIs). Feature section was conducted using Pearson correlation and least absolute shrinkage and selection operator. Principal component analysis was utilized for dimensionality reduction. Support vector machine was employed for model construction. Two radiologists with 1 year and 5 years of experience evaluated the MGMT status in the test dataset as a comparison with the models. The chi-square test and independent samples <i>t</i>-test were used for assessing the statistical differences in patients' clinical characteristics.</p><p><strong>Results: </strong>On the training dataset, the model structural MRI + DCE achieved the highest AUC of 0.906. On the test dataset, the model structural MRI + DCE + DTI achieved the highest AUC of 0.868, outperforming two radiologists.</p><p><strong>Conclusion: </strong>The radiomics models have obtained promising performance in predicting MGMT promoter methylation status. Adding DCE and DTI features can provide extra information to structural MRI in detecting MGMT promoter methylation.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1493666"},"PeriodicalIF":2.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406992","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":"Tailoring robot-assisted arm training to individuals with stroke: bridging neuroscience principles and clinical practice.","authors":"Giovanni Morone, Marco Tramontano, Stefano Paolucci, Antonio Cerasa, Irene Ciancarelli, Alex Martino Cinnera, Marco Iosa, Rocco Salvatore Calabrò","doi":"10.3389/fneur.2025.1506889","DOIUrl":"10.3389/fneur.2025.1506889","url":null,"abstract":"<p><p>Robot-assisted arm training (RAAT) has demonstrated promising potential in improving rehabilitation outcomes for individuals with neurological conditions, particularly stroke. Despite 20 years of their use in clinical and research settings, there are still significant needs to be made concerning clinical indications. In the present perspective manuscript, we provide some hypotheses of the suitability of different RAAT according to the features of the available devices and clinical characteristics, showing their limitations and strengths. Several factors were considered in the optimization of RAAT intervention, including the technological characteristics of the devices (e.g., support and constriction), the residual upper limb motor function, and the clinical phase of stroke. Finally, we outline key areas for improvement to advance the field in the near future and provide neuroscientific bases for hypotheses of tailored RAAT training to improve the outcome of robotic rehabilitation.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1506889"},"PeriodicalIF":2.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143407003","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":"From pixels to prognosis: radiomics and AI in Alzheimer's disease management.","authors":"Danting Peng, Weiju Huang, Ren Liu, Wenlong Zhong","doi":"10.3389/fneur.2025.1536463","DOIUrl":"10.3389/fneur.2025.1536463","url":null,"abstract":"<p><p>Alzheimer's disease (AD), the leading cause of dementia, poses a growing global health challenge due to an aging population. Early and accurate diagnosis is essential for optimizing treatment and management, yet traditional diagnostic methods often fall short in addressing the complexity of AD pathology. Recent advancements in radiomics and artificial intelligence (AI) offer novel solutions by integrating quantitative imaging features and machine learning algorithms to enhance diagnostic and prognostic precision. This review explores the application of radiomics and AI in AD, focusing on key imaging modalities such as PET and MRI, as well as multimodal approaches combining structural and functional data. We discuss the potential of these technologies to identify disease-specific biomarkers, predict disease progression, and guide personalized interventions. Additionally, the review addresses critical challenges, including data standardization, model interpretability, and the integration of AI into clinical workflows. By highlighting current achievements and identifying future directions, this article underscores the transformative potential of AI-driven radiomics in reshaping AD diagnostics and care.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1536463"},"PeriodicalIF":2.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11816362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406985","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":"Development and external validation of a dynamic nomogram for predicting the risk of functional outcome after 90 days in patients with acute intracerebral hemorrhage.","authors":"Shaojie Li, Hongjian Li, Jiani Chen, Baofang Wu, Jiayin Wang, Chaocan Hong, Changhu Yan, Weizhi Qiu, Yasong Li, Hongzhi Gao","doi":"10.3389/fneur.2025.1519091","DOIUrl":"10.3389/fneur.2025.1519091","url":null,"abstract":"<p><strong>Background and purpose: </strong>Intracerebral hemorrhage remains a significant cause of death and disability worldwide, highlighting the urgent need for accurate prognostic assessments to optimize patient management. This study aimed to develop a practical nomogram for risk prediction of poor prognosis after 90 days in patients with intracerebral hemorrhage.</p><p><strong>Methods: </strong>A retrospective study was conducted on 638 patients with intracerebral hemorrhage in the Second Hospital of Fujian Medical University, China, who were divided into a training set (<i>n</i> = 446) and a test set (<i>n</i> = 192) by random splitting. Then the data on demographics, clinical symptoms, imaging characteristics, and laboratory findings were collected. In this study, adverse outcomes were defined as a Modified Rankin Scale (mRS) score of 3-6 at 90 days post-ICH onset, as assessed during follow-up. Later, least absolute shrinkage and selection operator (LASSO) regression and multifactorial logistic regression were used to screen the variables and construct a nomogram. Next, the evaluation was performed using the Receiver Operating Characteristic (ROC) curve, calibration curve, and decision curve analysis. Finally, the external validation was completed using the data of 496 patients with intracerebral hemorrhage from the Jinjiang Hospital of Traditional Chinese Medicine.</p><p><strong>Results: </strong>In the training and test sets of intracerebral hemorrhage, the incidence of poor prognosis was 60.53 and 61.46%, respectively. Through variable screening, this study identified age, Glasgow Coma Scale (GCS), blood glucose, uric acid, hemoglobin, and hematoma location as independent predictors of poor prognosis in intracerebral hemorrhage. The developed dynamic nomogram was easy to use and demonstrated strong predictive performance (training set AUC: 0.87; test set AUC: 0.839; external validation set AUC: 0.774), excellent calibration, and clinical applicability.</p><p><strong>Conclusion: </strong>The dynamic nomogram we developed using five independent risk factors serves as a practical tool for real-time risk assessment and can help facilitate early intervention and personalized patient management, thereby improving clinical outcomes in high-risk patients.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1519091"},"PeriodicalIF":2.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11816111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406969","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":"Electroacupuncture combined with cognitive rehabilitation outperforms cognitive rehabilitation alone in treating post-stroke cognitive impairment: a randomized controlled trial.","authors":"Yisha Guo, Tingting Sun, Fengxi Qiu, Xueyi Li, Weiwei Cui, Zhenhua Liao, Jiajia Yao","doi":"10.3389/fneur.2025.1507475","DOIUrl":"10.3389/fneur.2025.1507475","url":null,"abstract":"<p><p>This study aimed to evaluate the effects of a 12-week intervention combining electroacupuncture (EA) with conventional cognitive rehabilitation (CR) on cognitive recovery and brain network topological properties in stroke patients. Thirty-four post-stroke cognitive impairment (PSCI) patients were randomly assigned to either an EA + CR group or a CR-only group, with both undergoing five weekly interventions for 12 weeks. Cognitive assessments and Diffusion Tensor Imaging tests were performed pre- and post-intervention. Primary outcomes included the Montreal Cognitive Assessment (MoCA), Digit Span Test (DST), Auditory Verbal Learning Test (AVLT-H), and Aphasia Screening Scale. Secondary outcomes measured brain network global and nodal properties. The EA + CR group showed significant improvements in MoCA (<i>p</i> < 0.001), AVLT-H (<i>p</i> = 0.004), and in areas like naming (<i>p</i> = 0.022), attention (<i>p</i> < 0.001), and delayed recall (<i>p</i> < 0.001). Local brain network metrics, such as clustering coefficients (Cp) and local efficiency (Eloc), were significantly higher (<i>p</i> < 0.05) in the EA + CR group, though global efficiency (Eglob) was unchanged. Improvements in Eloc were positively correlated with MoCA scores (<i>r</i> = 0.0716, <i>p</i> = 0.018). Specific brain regions, including the medial and paracentral cingulate gyrus, inferior temporal gyrus, and left supramarginal gyrus, exhibited significant nodal property differences, suggesting that EA may enhance cognitive recovery by targeting cognitively relevant regions. These findings indicate that EA, combined with CR, is a safe and effective treatment for cognitive impairment following stroke, potentially via structural brain network improvements.</p><p><strong>Clinical trial registration: </strong>https://clinicaltrials.gov/, ChiCTR2200066160.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1507475"},"PeriodicalIF":2.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11814160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406970","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}