Frontiers in Neurology最新文献

{"title":"Prognostic performance of blood neurofilament light chain for functional outcomes in patients with ischemic stroke: a systematic review and meta-analysis.","authors":"Tong Tong He, Bo Wang, Jing Wang, Meng Li","doi":"10.3389/fneur.2026.1895703","DOIUrl":"10.3389/fneur.2026.1895703","url":null,"abstract":"<p><strong>Introduction: </strong>This meta-analysis aimed to assess the association between blood neurofilament light chain (NfL) and functional outcomes in patients with ischemic stroke.</p><p><strong>Methods: </strong>PubMed, Web of Science, Embase, Cochrane Library, and the China National Knowledge Infrastructure database were searched from inception through March 15, 2026. Odds ratios (ORs) and 95% confidence intervals (CIs) were pooled to quantify the association between blood NfL and functional outcomes in patients with ischemic stroke. We pooled the area under the curve (AUC), sensitivity, and specificity; conducted meta-regression and sensitivity analyses; and assessed publication bias.</p><p><strong>Results: </strong>A total of 18 studies involving 3,448 patients were included in this meta-analysis. The pooled results demonstrated that blood NfL was associated with poor functional outcomes after ischemic stroke (OR = 1.78, 95% CI: 1.41-2.24, <i>p</i> < 0.001, <i>I</i> ² = 87.5%, <i>p</i> < 0.01). The pooled AUC for blood NfL in predicting functional outcomes in patients with ischemic stroke was 0.79 (95% CI: 0.75-0.82), with 71% (95% CI: 62-79%) sensitivity and 74% (95% CI: 67-80%) specificity. Subgroup analyses and meta-regression revealed that participant age, sample size, study design, blood sample type, assay method, proportion of poor functional outcomes, blood sampling time, reperfusion therapy rate, National Institutes of Health Stroke Scale score, definition of poor functional outcome, and the proportion of large artery atherosclerosis were not identified as significant sources of heterogeneity. Sensitivity analysis indicated that the pooled estimate was robust. Begg's test also showed no evidence of publication bias (<i>p</i> = 0.753), although Egger's test suggested the presence of publication bias (<i>p</i> < 0.001). The trim-and-fill method showed that the overall effect of this meta-analysis was stable.</p><p><strong>Conclusion: </strong>This meta-analysis showed that elevated blood NfL levels may have prognostic value for functional outcomes in patients with ischemic stroke. However, given the substantial between-study heterogeneity and the presence of publication bias, these findings should be interpreted with caution.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD420261297284, identifier PROSPERO (CRD420261297284).</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"17 ","pages":"1895703"},"PeriodicalIF":3.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265684","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":"Depression, anxiety, and cognitive function in patients with ischemic cerebrovascular disease: a cross-sectional study based on the Montreal Cognitive Assessment.","authors":"Weiwen Chen, Yinan Zhuo","doi":"10.3389/fneur.2026.1854573","DOIUrl":"10.3389/fneur.2026.1854573","url":null,"abstract":"<p><strong>Background: </strong>Depression and anxiety are highly prevalent in patients with ischemic cerebrovascular disease and have been linked to cognitive impairment, but their differential effects across specific cognitive domains remain poorly characterized. Evidence using statistical mediation analysis to examine associations among anxiety, depression, and cognition is limited.</p><p><strong>Methods: </strong>In this hospital-based cross-sectional study, 667 patients (predominantly with ischemic cerebrovascular disease; a diagnostic review of 318 consecutive patients revealed that 90.9% had cerebrovascular pathology) completed the Montreal Cognitive Assessment (MoCA), Self-Rating Depression Scale (SDS), and Self-Rating Anxiety Scale (SAS). Cognitive impairment was defined as MoCA <26, with a 1-point education adjustment for ≤12 years of education applied in sensitivity analyses (available for 586/667 patients, 87.9%). Spearman correlations examined associations between mood symptoms and MoCA total and domain scores. Bootstrap mediation analysis (1,000 resamples) tested the statistical mediation the anxiety-cognition relationship by depression. Subgroup analyses were stratified by age (<60, 60-75, ≥75 years) and sex.</p><p><strong>Results: </strong>Among 667 participants (mean age 65.2 ± 16.2 years; 53.8% male), the prevalence of cognitive impairment was 45.3% (302/667) in the education-adjusted sensitivity analysis. MoCA total score was inversely correlated with SDS (<i>ρ</i> = -0.652, 95% CI: -0.693 to -0.607, <i>p</i> < 0.001) and SAS (<i>ρ</i> = -0.559, 95% CI: -0.608 to -0.506, <i>p</i> < 0.001). Domain-specific patterns of association showed delayed recall was most strongly associated with mood symptoms (composite vulnerability index 0.295), followed by visuospatial/executive function (0.238) and attention (0.234). Mediation analysis showed that 49.5% of the statistical association between anxiety and MoCA was accounted for by depression (indirect effect = -0.153, 95% CI: -0.201 to -0.105, <i>p</i> < 0.001). Subgroup analyses using interaction terms showed stronger mood-cognition associations in the elderly (≥75 years: age × depression interaction <i>B</i> = -0.0018, <i>p</i> = 0.089), while sex × depression interaction was not significant (<i>B</i> = 0.045, <i>p</i> = 0.31).</p><p><strong>Conclusion: </strong>Depression and anxiety are independently associated with cognitive impairment in patients with ischemic cerebrovascular disease, with delayed recall being the most vulnerable domain. The anxiety-cognition association is partially statistically accounted for by depression, but the data do not support directional inference. Elderly patients warrant particular attention.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"17 ","pages":"1854573"},"PeriodicalIF":3.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13701099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265705","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":"Perception of virus effects and vaccination among people with multiple sclerosis in Saudi Arabia.","authors":"Hind Alnajashi, Khadijah Ibraheem Basheikh, Bushra Obaidallah A Alqurayqiri, Fayzah Shaikh Albar, Shahad Ayed M Algarni, Lana Saeed Allakhmi","doi":"10.3389/fneur.2026.1816182","DOIUrl":"10.3389/fneur.2026.1816182","url":null,"abstract":"<p><strong>Background: </strong>People with multiple sclerosis (pwMS) are at increased risk of infection due to immune dysregulation and exposure to disease-modifying therapies (DMTs). Despite this risk, real-world vaccine uptake remains inconsistent. This study evaluated vaccination readiness, counseling practices, and infection-related perceptions among pwMS in Saudi Arabia.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among adults with MS (<i>n</i> = 204) recruited using non-probability (convenience) sampling from tertiary-care clinical and community-based sources. The survey assessed demographic characteristics, vaccination attitudes and uptake, counseling experiences, perceptions of infection risk related to MS and DMTs, and awareness of Epstein-Barr virus (EBV). Internal consistency of multi-item measures was acceptable (Cronbach's α = 0.72). Descriptive statistics were used to summarize outcomes.</p><p><strong>Results: </strong>The cohort was relatively young (mean age 35.7 years), with two-thirds aged 25-44 years (25-34 years: 38.2%; 35-44 years: 36.8%). Most participants held a bachelor's degree (66.7%). Attitudes toward routine vaccination were frequently non-committal: 47.6% were somewhat or very likely to vaccinate, 33.8% were neutral, and 18.6% were somewhat or very unlikely; separately, 60.8% agreed or somewhat agreed that routine vaccines might be harmful for pwMS. COVID-19 vaccination uptake was high (72.5%), whereas influenza vaccination was low (30.9%). Uptake of other adult vaccines, including hepatitis B, meningococcal, herpes zoster, and human papillomavirus vaccines, was < 10% for each. Perceived infection vulnerability was substantial, with 62.7% expressing concern about viral infections due to MS and 71.1% believing that DMTs increased susceptibility, consistent with 59.4% receiving high-efficacy DMTs. Awareness of EBV was limited: 26.5% had heard of EBV, 16.6% perceived an MS-EBV association, and 21.1% were aware of possible causality. Nearly half of participants (49.0%) were undecided about a hypothetical EBV vaccine, while approximately 44% expressed willingness to receive it. Counseling gaps were evident, as only 32.8% reported any discussion about vaccination with clinicians; counseling prior to DMT initiation and during ongoing treatment was reported by 16.2% and 19.1%, respectively.</p><p><strong>Conclusions: </strong>In a young and highly educated cohort of pwMS in Saudi Arabia, vaccine hesitancy and counseling gaps persist despite high perceived infection risk. These findings highlight the need for structured and routine vaccine counseling, particularly at MS diagnosis and before initiating high-efficacy DMTs, to improve uptake of influenza and other recommended adult vaccines in MS clinics.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"17 ","pages":"1816182"},"PeriodicalIF":3.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265616","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":"Procedural interventions for chronic migraine: an umbrella review intervention-specific evidence map.","authors":"Lijie Xia, Dianhui Yang, Yan Lu, Yunfei Gong, Chengtao Zhang","doi":"10.3389/fneur.2026.1915292","DOIUrl":"10.3389/fneur.2026.1915292","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To synthesize and map intervention-specific evidence on the efficacy, clinical relevance, and safety of procedural interventions for chronic migraine (CM).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a PROSPERO-registered umbrella review in accordance with PRISMA 2020 and methodological guidance for umbrella reviews. Eligible systematic reviews evaluated onabotulinumtoxinA, greater occipital nerve block (GONB), other peripheral nerve blocks and percutaneous procedures, acupuncture, implanted occipital nerve stimulation (ONS), or surgical interventions. Evidence concerning the addition of CGRP-targeted monoclonal antibody therapy to ongoing onabotulinumtoxinA treatment was retained separately as contextual evidence on adjunctive pharmacotherapy and was not classified as a procedural intervention. Methodological quality was assessed using A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR 2), certainty of evidence using Grading of Recommendations Assessment, Development and Evaluation (GRADE), and primary-study overlap using the corrected covered area (CCA). Evidence was synthesized separately by intervention, outcome, comparator, and follow-up period. Pooled estimates from different systematic reviews were not statistically combined, and clinically heterogeneous evidence was summarized narratively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Seventeen reviews were included, of which 12 contained at least one meta-analysis. The strength and maturity of evidence varied substantially across interventions. OnabotulinumtoxinA had the most established evidence base and the clearest role in CM prevention. For GONB, low-certainty evidence from clinically comparable randomized trials suggested a possible short-term reduction in headache day and headache severity, although sustained benefit remains uncertain. Evidence for combined onabotulinumtoxinA-CGRP monoclonal antibody therapy was derived predominantly from uncontrolled observational cohorts and should therefore be considered preliminary. Implanted ONS showed possible benefit in selected patients with refractory CM, but evidence was limited by small study numbers, imprecision, heterogeneous outcomes, and device- or procedure-related risks. Evidence for acupuncture, other peripheral nerve blocks, percutaneous procedures, and surgical interventions was limited by clinical heterogeneity, indirectness, uncontrolled study designs, or uncertain applicability specifically to CM. TRAEs profiles differed substantially among intervention categories and were therefore not pooled across procedures. Most intervention-outcome evidence was rated as low or very low certainty.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Procedural interventions for CM should not be interpreted as a homogeneous therapeutic class. OnabotulinumtoxinA is supported by the most mature evidence and established clinical positioning, whereas GONB may provide a short-term, protocol-specific benefit with low certainty. Evidence","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"17 ","pages":"1915292"},"PeriodicalIF":3.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265714","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 internal validation of a clinical prediction model for postoperative venous thromboembolism after neurosurgical intervention in patients with traumatic brain injury.","authors":"Dongping Li, Jianhui Chen, Chunfa Weng, Jianhuang Huang","doi":"10.3389/fneur.2026.1953953","DOIUrl":"10.3389/fneur.2026.1953953","url":null,"abstract":"<p><strong>Background: </strong>Venous thromboembolism (VTE) is a critical complication after traumatic brain injury (TBI) surgery. Conventional risk assessment tools were not developed for neurosurgical trauma populations, limiting their applicability.</p><p><strong>Objective: </strong>To develop and internally validate an interpretable clinical prediction model for postoperative VTE in TBI surgery patients.</p><p><strong>Methods: </strong>This retrospective cohort study enrolled 1,450 TBI patients who underwent surgery (2016-2024). Seven predictors were selected using Recursive Feature Elimination. Six machine learning algorithms were compared, with logistic regression (LR) selected as the final model. Performance was evaluated using AUC-ROC, calibration, and decision curve analysis.</p><p><strong>Results: </strong>Among 1,450 patients, 205 (14.1%) developed postoperative VTE. The LR model achieved AUC-ROC of 0.868 (95% CI: 0.815-0.920) with good calibration (Brier score: 0.085). Seven predictors were identified: age, Barthel index, ASA classification, multiple surgeries, general anesthesia, limb AIS score, and serum magnesium. Compared with Caprini score (AUC: 0.686), the model showed improved discrimination (ΔAUC = 0.182; NRI: 0.559).</p><p><strong>Conclusion: </strong>An interpretable model based on seven routinely available variables demonstrated promising performance for postoperative VTE risk stratification in TBI surgery patients. A nomogram and web-based calculator are provided for clinical use.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"17 ","pages":"1953953"},"PeriodicalIF":3.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13701100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265730","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":"Robot-assisted aspiration improves survival over conservative treatment in critical primary brainstem hemorrhage: a multicenter, volume-stratified cohort study.","authors":"Haoming Guo, Xiaoliang Wang, Jialong Li, Shuoxuan Che, Qingyang You, Shang Gao, Lifeng Wu, Juncang Zhao, Zhiqiang Wang, Tao Li, Hailong Du, Xiaosong Liu, Lei Zhao, Xianming Wang, Shan Zhang, Wei Tian, Jianliang Wu","doi":"10.3389/fneur.2026.1954969","DOIUrl":"10.3389/fneur.2026.1954969","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The optimal management of critical primary brainstem hemorrhage (PBSH, hematoma volume 5-15 mL) remains controversial. While minimally invasive surgery shows promise, multicenter evidence-particularly stratified by hematoma volume-is lacking. This study aimed to evaluate the survival benefit and safety of frameless robot-assisted aspiration compared to conservative treatment in patients with critical PBSH.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a multicenter, retrospective cohort study involving 79 consecutive patients [Glasgow Coma Scale (GCS) 3-8] admitted to three neurosurgical centers between May 2022 and October 2025. Patients were allocated to a robot-assisted aspiration group (&lt;i&gt;n&lt;/i&gt; = 38) or a conservative care group (&lt;i&gt;n&lt;/i&gt; = 41). Further stratification was performed based on initial hematoma volume (5-10 mL, &lt;i&gt;n&lt;/i&gt; = 63; &gt;10 mL, &lt;i&gt;n&lt;/i&gt; = 16). Volumetric measurements were performed by two independent neurosurgeons blinded to outcomes, demonstrating excellent inter-rater reliability (intraclass correlation coefficient = 0.96). Primary outcomes included 30-day and 90-day survival rates, analyzed using Kaplan-Meier curves and Cox proportional hazards regression. To rigorously control for potential treatment selection bias inherent in a retrospective cohort design, a 1:1 propensity score matching (PSM) sensitivity analysis was additionally performed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Baseline characteristics, including age, GCS score, and hemorrhage location, were comparable between groups. Safety profiles, including rebleeding (7.89% vs. 4.88%) and intracranial infection rates, were similar (all &lt;i&gt;p&lt;/i&gt; &gt; 0.05). In the overall cohort, the robot-assisted aspiration group exhibited a significantly higher 30-day survival rate (76.3% vs. 43.9%, &lt;i&gt;p&lt;/i&gt; = 0.006). Stratified analysis revealed that the survival benefit was confined to the 5-10 mL subgroup, where robot-assisted aspiration significantly improved 30-day (82.1% vs. 45.7%, &lt;i&gt;p&lt;/i&gt; = 0.004) and 90-day survival (71.4% vs. 42.9%, &lt;i&gt;p&lt;/i&gt; = 0.044), alongside improved discharge GCS scores. In the &gt;10 mL subgroup (&lt;i&gt;n&lt;/i&gt; = 16), 30-day survival was 60.0% (6/10) vs. 33.3% (2/6) - an absolute difference of +26.7 percentage points (95% CI: -19.9 to +59.8; Fisher's exact &lt;i&gt;p&lt;/i&gt; = 0.61; &lt;i&gt;post-hoc&lt;/i&gt; power 0.28). This subgroup was underpowered and the result is inconclusive rather than negative. Multivariable Cox regression confirmed robot-assisted aspiration as an independent protective factor (hazard ratio = 0.494, 95% CI: 0.245-0.997, &lt;i&gt;p&lt;/i&gt; = 0.049), reducing mortality risk by 50.6%. In the PSM sensitivity cohort (34 matched pairs; 68 patients in total), robot-assisted aspiration still showed a significant survival benefit, reducing the risk of 90-day death by 60.0% (adjusted HR = 0.400, 95% CI: 0.195-0.822, &lt;i&gt;p&lt;/i&gt; = 0.013). Volume stratification confirmed significant surgical benefits with respect to both survival and neurological func","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"17 ","pages":"1954969"},"PeriodicalIF":3.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265682","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":"Clinical evaluation of visual snow syndrome: a structured narrative review with proposed clinical diagnostic approach.","authors":"Nemira Žilinskaitė-Tranas, Gytis Makarevičius, Aušra Liveikienė, Kristina Ryliškienė","doi":"10.3389/fneur.2026.1961508","DOIUrl":"10.3389/fneur.2026.1961508","url":null,"abstract":"<p><p>Visual snow syndrome (VSS) is a chronic neurological condition marked by persistent, bilateral, pan-field visual static and a constellation of additional visual and non-visual symptoms. Affecting an estimate of 2% of the populations, VSS remains substantially underdiagnosed, as its symptoms overlap with migraine aura and structural ophthalmological disease, and no standardised diagnostic protocol currently exists. This structured narrative review synthesises evidence on the clinical features, pathophysiology, comorbidities, and differential diagnosis. It also proposes a stepwise diagnostic approach for routine practice, distinguished from the advanced, research-oriented evaluations used to investigate underlying mechanisms. Converging neuroimaging and electrophysiological evidence suggests cortical hyperexcitability and large-scale network dysfunction may underlie VSS, though the precise mechanisms remain incompletely understood. We recommend a multidisciplinary, patient-centred management approach and identify biomarker development, multicentre validation of the diagnostic approach, and large-scale interventional trials as research priorities.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"17 ","pages":"1961508"},"PeriodicalIF":3.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13700013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265697","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 application of square-stepping exercise in patients with stroke: a scoping review.","authors":"Yali Yan, Juan Xu, Jiaxin Yao, Yuanyuan Liu, Mengdan Li, Xinxin Geng","doi":"10.3389/fneur.2026.1952887","DOIUrl":"10.3389/fneur.2026.1952887","url":null,"abstract":"<p><strong>Background: </strong>Square-stepping exercise (SSE) is a form of dual-task training that has been used in studies involving patients with stroke. This scoping review provides an overview of the intervention protocols and outcomes reported in studies examining the use of SSE among patients with stroke.</p><p><strong>Methods: </strong>PubMed, Embase, Web of Science, The Cochrane Library, CINAHL, CNKI, SinoMed, Wanfang Data, and the VIP Database were searched for studies published from 2006, when the first study on SSE was published, to April 30, 2026. A total of 459 records were identified, of which seven met the eligibility criteria and were included in the final analysis.</p><p><strong>Results: </strong>A total of seven studies were included. The intervention types included face-to-face and hybrid interventions. The duration of a single session was generally 30 min, the frequency was mostly 3-5 times per week, and the intervention period ranged from 6 to 24 weeks. The outcome measures primarily covered two domains: motor function and cognitive function. The findings suggested that SSE may improve balance and gait function in patients with stroke and may reduce the risk of falls. In addition, SSE may improve global cognitive function, including executive function and attention.</p><p><strong>Conclusion: </strong>SSE may help improve motor and cognitive function in patients with stroke, but related research remains at an exploratory stage. Future research should include large-scale, multicenter studies with long-term follow-up to further clarify its long-term effects and optimal intervention protocol, explore remotely delivered SSE interventions, and promote the standardized implementation and dissemination of SSE in stroke rehabilitation.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"17 ","pages":"1952887"},"PeriodicalIF":3.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265727","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: Photobiomodulation therapy for brain disorders, volume II.","authors":"Qianting Deng, Ge Song, Luodan Yang","doi":"10.3389/fneur.2026.2009205","DOIUrl":"10.3389/fneur.2026.2009205","url":null,"abstract":"","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"17 ","pages":"2009205"},"PeriodicalIF":3.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265759","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":"Accuracy of CSF tap test and lumbar infusion test in predicting shunt response in idiopathic normal pressure hydrocephalus: a systematic review and meta-analysis.","authors":"Aminu Aliyar, Deepa Dash, Alfonso Fasano, Manya Prasad, Vikas Dhikav, Aparna Wagle Shukla, Ashish Datt Upadhyay, Soaham Desai, Sagar Poudel, Pramod Kumar Pal, Arunmozhimaran Elavarasi","doi":"10.3389/fneur.2026.1908328","DOIUrl":"https://doi.org/10.3389/fneur.2026.1908328","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic normal pressure hydrocephalus (iNPH) presents with gait disturbance, cognitive impairment, and urinary incontinence. The cerebrospinal fluid tap test (CSF-TT) and lumbar infusion test (LIT) are commonly used to predict postoperative improvement after shunt surgery; however, their validity remains debated.</p><p><strong>Methods: </strong>We performed a systematic review and meta-analysis to assess the sensitivity and specificity of CSF-TT and LIT. The protocol was registered in PROSPERO (CRD42023454502). Reporting followed the PRISMA-DTA guidelines, and the certainty of evidence was assessed using the GRADE approach.</p><p><strong>Results: </strong>Of 1,955 studies, 15 were included, reporting on 721 CSF-TT and 393 LIT patients, with shunt surgery as the reference standard. Nine CSF-TT studies (<i>n</i> = 700) and five LIT studies (<i>n</i> = 368) contributed to the primary meta-analysis. Considerable heterogeneity existed in test protocols, timing of assessment, and outcome measures. Several studies were retrospective with a high risk of bias. The pooled estimates were derived from a limited number of heterogeneous studies. Using a bivariate random-effects model, pooled sensitivity and specificity of CSF-TT were 64.1% (95% <i>CI</i> 49.2-76.6%, <i>I</i> ² 81.3%) and 54.8% (95% <i>CI</i> 41.8-67.2%, <i>I</i> ² 59.7%), respectively. The certainty of evidence was very low for sensitivity due to bias, inconsistency, and imprecision, and low for poor specificity due to bias and inconsistency. LIT showed a pooled sensitivity of 77.5% (95% <i>CI</i> 70.2-83.4%, <i>I</i> ² 14.7%) and a specificity of 28.3% (95% <i>CI</i> 19.0-39.9%, <i>I</i> ² 4.6%), with moderate certainty for sensitivity and moderate certainty for poor specificity.</p><p><strong>Conclusion: </strong>Both CSF-TT and LIT show poor specificity for predicting shunt responsiveness in iNPH, with low-certainty evidence for CSF-TT and moderate-certainty evidence for LIT. A positive result from either test should not be used in isolation to guide surgical decisions. Standardized prospective studies with clearly defined patient selection criteria and outcome measures are needed to establish the true diagnostic value of these tests.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD42023454502.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"17 ","pages":"1908328"},"PeriodicalIF":3.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13710815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149286319","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}