Frontiers in Neurology最新文献

{"title":"Cryptogenic strokes and neurological symptoms of Fabry disease.","authors":"Maria Luisa Ruiz-Franco, Beatriz Vélez-Gómez, Patricia Martínez-Sánchez, Remedios Garófano-López, Carlos Gómez-Navarro, Antonio Arjona-Padillo","doi":"10.3389/fneur.2025.1529267","DOIUrl":"10.3389/fneur.2025.1529267","url":null,"abstract":"<p><strong>Introduction: </strong>Fabry disease (FD) is the second most common lysosomal storage disorder. It mainly affects young people. FD can be characterized by neurological symptoms that can occur in both the central and peripheral nervous systems. Cerebrovascular involvement is common in FD and is considered an important cause of cryptogenic strokes. This study aimed to describe the neurological symptoms in patients with FD in general and, specifically, to determine the frequency of association between this disease and cerebrovascular manifestations in our environment.</p><p><strong>Materials and methods: </strong>This retrospective, observational, cross-sectional study included all patients in the FD registry of the nephrology and cardiology Departments of our center. A descriptive analysis of demographic, neurological, clinical, and neuroimaging variables was performed, with a particular focus on their association with stroke or other cerebrovascular events prior to diagnosis.</p><p><strong>Results: </strong>A total of 25 patients were included, with 14 (68%) of them being women. The median age of the patients was 52 years (relative intensity of collaboration [RIC] = 24.5). The patients belonged to five families with specific galactosidase alpha gene (GLA) mutations. Neuroimaging was performed in 13 (52%) patients, most of whom did not have neurological symptoms but had normal imaging results. Only 2 (8%) patients had nonspecific white matter hyperintensities. Among the 11 (44%) patients with neurological involvement, the most common symptom was pain in the extremities (32%). Stroke was identified in only one patient (4%), which occurred prior to the diagnosis of FD and was determined to be of cardioembolic etiology.</p><p><strong>Discussion: </strong>FD is found to be associated with several neurological symptoms. In our study, the most common neurological symptom was limb pain, which had varied characteristics. On the other hand, the incidence of stroke was significantly lower than that expected.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1529267"},"PeriodicalIF":2.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662742","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 Canadian collaborative project on genetic susceptibility to multiple sclerosis cohort population structure and disease etiology.","authors":"Alison M Pagalilauan, Elif Everest, Suzanna Rachimi, Daniel S Reich, Alex D Waldman, A Dessa Sadovnick, Carles Vilarino-Guell, Michael J Lenardo","doi":"10.3389/fneur.2025.1509371","DOIUrl":"10.3389/fneur.2025.1509371","url":null,"abstract":"<p><strong>Background: </strong>Previous genetic and epidemiological studies have examined subpopulations from the Canadian Collaborative Project on Genetic Susceptibility to Multiple Sclerosis (CCPGSMS) patient cohort, but an encompassing analysis of the study population has not yet been carried out.</p><p><strong>Objective: </strong>This retrospective study examines patterns of multiple sclerosis (MS) prevalence in 13,663 cohort members, including 4,821 persons with MS or suspected MS and 8,842 family members.</p><p><strong>Methods: </strong>We grouped participants into epidemiologic subgroups based on age of MS onset, clinical stage at diagnosis, symptom type at disease onset, sex, proband status, disability as measured by the EDSS, and ancestry based on reported ethnicity.</p><p><strong>Results: </strong>We observed a 2.7:1 MS prevalence ratio of women to men, though disease severity was greater for male patients. Variation in the age of disease onset between patients was only slightly associated with sex and strongly associated with disease type. Specific types of clinical symptoms at disease onset were associated with the prognosis. Regional residence did not correlate with disease onset, type, or severity.</p><p><strong>Conclusion: </strong>Population trends, as presented here, are not explained by environmental factors alone, highlighting the need for a comprehensive genetic analysis to understand disease variance across families.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1509371"},"PeriodicalIF":2.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11919664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663165","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":"First prospective, single-arm, multicenter study to evaluate safety and efficacy of the overall thrombectomy system -iNedit, iNdeep, and iNtercept- for acute ischemic stroke. Rationale beyond the study.","authors":"Luís San Román, Laura Ludovica Gramegna, Sara Pich, Laura Domingo-Rodriguez, Marta Duran, Lluís Duocastella, Juan Macho","doi":"10.3389/fneur.2025.1537008","DOIUrl":"10.3389/fneur.2025.1537008","url":null,"abstract":"<p><strong>Rationale: </strong>The clinical impact of a novel mechanical thrombectomy strategy, which integrates distal access with flow reversal and flow arrest via a distal balloon, all within a single procedure [Safety and Efficacy of the overall throMbectomy system for sTroke (SEMTiC) strategy], has not been tested.</p><p><strong>Aim: </strong>The SEMTiC-01 study is the first prospective, multicenter <i>in vivo</i> study evaluating the safety and efficacy of the combined thrombectomy system-iNedit, iNdeep, and iNtercept-in patients with acute ischemic stroke.</p><p><strong>Sample size estimates: </strong>The study was designed with a sequential structure based on the efficacy endpoint (eTICI ≥2b) reported in the literature [71.1% with a 95% confidence interval of (68.5%, 73.8%)]. An interim analysis was set for 115 patients and a final analysis for 225 patients, ensuring 98% power at a one-sided 0.025 significance level, with a 2.6% non-inferiority margin and a 15% assumed withdrawal rate.</p><p><strong>Design: </strong>SEMTiC-01 is a prospective, multicenter, single-arm, open-label clinical safety and efficacy investigation.</p><p><strong>Outcome: </strong>Primary efficacy endpoint: expanded treatment in cerebral infarction score (eTICI) ≥2b revascularization within ≤ 3 stent retriever passes. Primary safety endpoint: monitoring serious adverse events within 24 h post-intervention and all-cause mortality at 90 days.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1537008"},"PeriodicalIF":2.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709523","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":"Comparison of safety and efficacy of different endovascular treatments for symptomatic intracranial atherosclerotic stenosis: results from a single center.","authors":"Qiao Lin, Kaiyi Zhong, Xiyue Pan, Congfang Li, Xiaozhen Lu, Naidong Wang","doi":"10.3389/fneur.2025.1539127","DOIUrl":"10.3389/fneur.2025.1539127","url":null,"abstract":"<p><strong>Background: </strong>Symptomatic intracranial atherosclerotic stenosis (sICAS) is one of the common causes of ischemic stroke. However, the treatment of sICAS has remained a challenge in the past with unfavorable findings. This study aimed to evaluate the effectiveness and safety of different endovascular treatment methods for sICAS.</p><p><strong>Methods: </strong>The study involved 154 patients with sICAS who received endovascular treatment at Qingdao University Hospital between January 2021 and October 2023. Based on the characteristics of the lesions, three different types of treatments were performed: bare metal stent group (BMS group), drug-coated balloon group (DCB group), and drug-eluting stent group (DES group). The primary endpoints included the incidence of in-stent restenosis (ISR) in the 6-month, periprocedural complications, the rate of stroke recurrence in the area of the stented artery during the follow-up period, and modified Rankin score (mRS) at discharge, at 1-month, at 3-month, at 6-month of patients after stenting.</p><p><strong>Results: </strong>The incidence of perioperative complications did not differ significantly between groups (11.3% in the BMS group, 8.0% in the DCB group, and 6.1% in the DES group, <i>p</i> = 0.776). All patients (154/154) had successful reperfusion after endovascular treatment. The incidence of stroke during follow-up was 4.5% (7/154), with 5 (7.0%) patients in the BMS group, 1 (2.0%) patient in the DCB group, and 1 (3.0%) patient in the DES group. The restenosis rate in the BMS group [35.2% (25/71)] tended to be higher than that in the DCB group [6.0% (3/50)] and DES group [9.1% (3/33)]. In multivariate logistic regression analysis, endovascular treatment strategy and vessel distribution were significant independent risk factors for ISR within 6 months (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Adverse events and success rates following stent implantation are comparable across therapy groups in individuals with sICAS. When compared to BMS, DES, and DCB reduce the risk of ISR, with the advantages of the DCB appearing to be greater for some high-risk patients with ICAS.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1539127"},"PeriodicalIF":2.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11919668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662725","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":"Health-related quality of life and associated factors among epilepsy patients in sub-Saharan Africa: a systematic review and meta-analysis.","authors":"Dessale Abate Beyene, Desalegn Getnet Demsie, Chernet Tafere, Taklo Simeneh Yazie, Destaw Endeshaw, Tamrat Assefa Tadesse, Zenaw Debasu Addisu","doi":"10.3389/fneur.2025.1546911","DOIUrl":"10.3389/fneur.2025.1546911","url":null,"abstract":"<p><strong>Background: </strong>Epilepsy is a major public health issue worldwide, often leading to physical and cognitive impairments that limit employment, independence, and social interaction. Health-related quality of life (HRQoL) is a crucial outcome in the treatment of chronic epilepsy as it is linked to reduced independence, treatment challenges, and lower life expectancy. HRQoL serves as an important health indicator for assessing the impact of the disease on daily living activities.</p><p><strong>Objective: </strong>This study aimed to estimate the mean score of health-related quality of life (HRQoL) and factors associated with lower HRQoL in people living with epilepsy (PLWE) in sub-Saharan African (SSA) countries.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted using PubMed, Cochrane Library, Scopus, and Google Scholar databases. This review has been registered with PROSPERO (CRD42024620363). The eligibility criteria were established, and this review included cross-sectional and observational studies assessing HRQOL in PLWE in SSA countries, published in English from the inception of databases through November 2024. The pooled HRQoL was reported as the mean score with accompanying 95% confidence intervals. Finally, publication bias was evaluated using a funnel plot and Egger's regression test.</p><p><strong>Results: </strong>The pooled mean score of HRQoL among PLWE in SSA was 63.79 (95% CI: 59.75-67.84%). Owing to significant heterogeneity across the studies, a random-effects model was utilized for the meta-analysis (I² = 98.96%, <i>p</i> < 0.001). This meta-analysis indicated that anxiety (<i>β</i> = -4.762, <i>p</i> = 0.0029), depression (<i>β</i> = -4.591, <i>p</i> < 0.0001), uncontrolled seizures (<i>β</i> = -4.321, <i>p</i> < 0.0001), and a family history of epilepsy (<i>β</i> = -5.093, <i>p</i> = 0.0013) had statistically significant negative impacts on HRQoL in PLWE. Despite some asymmetry in the funnel plot, Egger's test showed no significant publication bias, with a <i>p</i>-value of 0.321.</p><p><strong>Conclusion: </strong>This review found a moderate pooled mean score of HRQoL among PLWE in SSA countries. Factors that negatively affect HRQoL in these regions include anxiety, depression, uncontrolled seizures, comorbidities, and a family history of epilepsy.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/search, identifier CRD42024620363.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1546911"},"PeriodicalIF":2.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662842","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":"Methylphenidate for the cognitive and neurobehavioural sequelae of traumatic brain injury in adults: a systematic review and meta-analysis.","authors":"Jemima L C Rees, Rachel Saunders, Carl R Krynicki, Antonio Belli, Zubair Ahmed, Valentina Di Pietro, Andrew R Stevens","doi":"10.3389/fneur.2025.1546080","DOIUrl":"10.3389/fneur.2025.1546080","url":null,"abstract":"<p><strong>Introduction: </strong>Traumatic brain injury (TBI) is a leading cause of death and disability globally and is associated with long-term cognitive and neurobehavioural deficits. Methylphenidate has been proposed to address these lasting symptoms, however comprehensive evidence is lacking.</p><p><strong>Methods: </strong>This systematic review aimed to assess the effects of methylphenidate on multiple cognitive and neurobehavioural domains in adults with TBI. The search conducted across five databases yielded 1,019 results, of which 25 were relevant to this review. Meta-analyses were conducted where homogenous data was available.</p><p><strong>Results: </strong>Significant results favouring methylphenidate were recorded by meta-analyses for one of five cognition outcome measures (Trail Making Test A) (<i>p</i> = 0.005, CI [-5.19, -0.91]), as well as the depression domain (<i>p</i> < 0.00001, CI [-0.78, -0.39]) and the fatigue domain (<i>p</i> < 0.00001, CI [-0.98, -0.67]). Insufficient data was available in the aggression, apathy, agitation, memory, motor function, post-concussion syndrome and sleep domains for inclusion in meta-analysis. Qualitative review of evidence in these domains found limited and mixed evidence on the efficacy of methylphenidate, though significant benefits have been demonstrated in these various domains in small, randomised studies. Eleven of the 25 studies were judged as containing some to high risk of bias. However, this review identified supportive evidence for the beneficial effects of methylphenidate to improve depression and fatigue in adults with TBI, with some possible benefits for cognition and other symptoms. Heterogeneity was high and risk of bias was variable across studies, somewhat limiting credibility of results.</p><p><strong>Discussion: </strong>Methylphenidate may enhance the ongoing care of TBI patients, by addressing neurobehavioural and cognitive symptoms simultaneously. Further large-scale and high-quality clinical trials evaluating a comprehensive range of possible benefits to symptoms should be conducted to more conclusively elucidate the potential of methylphenidate for clinical efficacy in TBI.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1546080"},"PeriodicalIF":2.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11919662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662843","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: Artificial intelligence for neuroimaging in the clinic - how compelling is the evidence?","authors":"Jennifer E Soun, Brent D Weinberg","doi":"10.3389/fneur.2025.1576364","DOIUrl":"https://doi.org/10.3389/fneur.2025.1576364","url":null,"abstract":"","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1576364"},"PeriodicalIF":2.7,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657024","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":"Gene mutations linked to drug-resistant epilepsy in astrocytoma.","authors":"Kanitpong Phabphal, Anukoon Kaewborisutsakul, Kittinun Leetanaporn, Pongsakorn Choochuen, Thara Tunthanathip, Raphatphorn Navakanitworakul, Surasak Sangkhathat","doi":"10.3389/fneur.2025.1523468","DOIUrl":"10.3389/fneur.2025.1523468","url":null,"abstract":"<p><strong>Introduction: </strong>Epilepsy is common in gliomas, particularly astrocytomas, even in patients who have undergone total tumor resection. Resistance to antiseizure drugs presents a significant challenge in managing epilepsy. Seizure outcomes after brain surgery for drug-resistant epilepsy (DRE) are heterogeneous and difficult to predict using models that evaluate current clinical, imaging, and electrophysiological variables. This study aimed to investigate possible correlations between genetic mutations and antiseizure resistance using whole-exome sequencing.</p><p><strong>Methods: </strong>Tumor samples from a medical biobank were subjected to whole-exome sequencing, and the contribution of 64 genes from a previous report was analyzed.</p><p><strong>Results: </strong>Fifteen patients had DRE. Compared to the patients who showed drug responsiveness, patients in the DRE group exhibited mutations in glutamate receptor genes (<i>GRIA1</i>, <i>GRIK5</i>, <i>GRIN2B</i>, or <i>GRIN2C</i>), <i>ATRX</i>, and the glutamate-S-transferase gene. No significant differences were found between the groups in terms of mutations in <i>BRAF</i>, <i>Olig2</i>, Ki-67, IDH, PIK3CA, p<i>53</i>, <i>GRM</i>, or <i>BCL2A</i>.</p><p><strong>Discussion: </strong>These findings suggest that somatic gene mutations are closely linked to DRE. Identifying the molecular basis of antiseizure drug resistance is crucial for improving the management of DRE.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1523468"},"PeriodicalIF":2.7,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657029","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":"Assessment of commercially available artificial intelligence software for differentiating hemorrhage from contrast on head CT following thrombolysis for ischemic stroke.","authors":"Ayden L Olsen, Daniel Thomas Ginat","doi":"10.3389/fneur.2025.1458142","DOIUrl":"10.3389/fneur.2025.1458142","url":null,"abstract":"<p><strong>Background: </strong>In patients who have undergone ischemic stroke therapy, retained iodine-based contrast can resemble acute intracranial hemorrhage (ICH) on standard computed tomography (CT). The purpose of this study is to determine the accuracy of commercially available artificial intelligence software for differentiating hemorrhage from contrast in such cases.</p><p><strong>Methods: </strong>A total of 45 CT scans analyzed by Aidoc software that also included dual-energy iodine subtraction maps from dual energy CT from 23 unique patients (12 male, 11 female, age range 30-99 years, mean age 67.6 years, standard deviation 18.5 years) following recent ischemic stroke therapy were retrospectively reviewed for the presence of hemorrhage versus retained contrast material.</p><p><strong>Results: </strong>The sensitivity and specificity of the model in detecting acute intracranial hemorrhage as opposed to contrast were 51.7 and 50.0%, respectively. The positive and negative predictive values were 65.2 and 36.4%, respectively.</p><p><strong>Conclusion: </strong>The current Aidoc software is not optimized for differentiating between acute hemorrhage and retained contrast on CT. This justifies the development of a more robust artificial intelligence model trained to differentiate between ICH and iodine contrast based on both DECT and standard CT images.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1458142"},"PeriodicalIF":2.7,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656970","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":"Interpretable prediction of stroke prognosis: SHAP for SVM and nomogram for logistic regression.","authors":"Kun Guo, Bo Zhu, Lei Zha, Yuan Shao, Zhiqin Liu, Naibing Gu, Kongbo Chen","doi":"10.3389/fneur.2025.1522868","DOIUrl":"10.3389/fneur.2025.1522868","url":null,"abstract":"<p><strong>Background: </strong>Ischemic Stroke (IS) stands as a leading cause of mortality and disability globally, with an anticipated increase in IS-related fatalities by 2030. Despite therapeutic advancements, many patients still lack effective interventions, underscoring the need for improved prognostic assessment tools. Machine Learning (ML) models have emerged as promising tools for predicting stroke prognosis, surpassing traditional methods in accuracy and speed.</p><p><strong>Objective: </strong>The aim of this study was to develop and validate ML algorithms for predicting the 6-month prognosis of patients with Acute Cerebral Infarction, using clinical data from two medical centers in China, and to assess the feasibility of implementing Explainable ML in clinical settings.</p><p><strong>Methods: </strong>A retrospective observational cohort study was conducted involving 398 patients diagnosed with Acute Cerebral Infarction from January 2023 to February 2024. The dataset included demographic information, medical histories, clinical evaluations, and laboratory results. Six ML models were constructed: Logistic Regression, Naive Bayes, Support Vector Machine (SVM), Random Forest, XGBoost, and AdaBoost. Model performance was evaluated using the Area Under the Receiver Operating Characteristic curve (AUC), sensitivity, specificity, predictive values, and F1 score, with five-fold cross-validation to ensure robustness.</p><p><strong>Results: </strong>The training set, identified key variables associated with stroke prognosis, including hypertension, diabetes, and smoking history. The SVM model demonstrated exceptional performance, with an AUC of 0.9453 on the training set and 0.9213 on the validation set. A Nomogram based on Logistic Regression was developed for visualizing prognostic risk, incorporating factors such as the National Institutes of Health Stroke Scale (NIHSS) score, Barthel Index (BI), Watanabe Drinking Test (KWST) score, Platelet Distribution Width (PDW), and others. Our models showed high predictive accuracy and stability across both datasets.</p><p><strong>Conclusion: </strong>This study presents a robust ML approach for predicting stroke prognosis, with the SVM model and Nomogram providing valuable tools for clinical decision-making. By incorporating advanced ML techniques, we enhance the precision of prognostic assessments and offer a theoretical and practical framework for clinical application.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1522868"},"PeriodicalIF":2.7,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656958","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}