International Journal of Neuroscience最新文献

{"title":"Bidirectional Mendelian randomization study of causal associations between white-matter structural connectivity and multiple sclerosis.","authors":"Zhenxing Yu, Haijun Chen, Zhipeng Zhang, Yuhan Xiong, Jing Zha, Lei Deng, Xianbin Zhang","doi":"10.1080/00207454.2026.2658643","DOIUrl":"10.1080/00207454.2026.2658643","url":null,"abstract":"<p><strong>Background: </strong>Multiple sclerosis (MS) is associated with widespread network disruption, but whether specific white-matter structural connectivity (WMSC) phenotypes contribute causally to MS susceptibility remains unclear.</p><p><strong>Methods: </strong>We performed bidirectional two-sample Mendelian randomization (MR) using genome-wide association study (GWAS) summary statistics for 206 tractography-derived WMSC phenotypes (UK Biobank; <i>N</i> = 26,333) and MS susceptibility (IMSGC; <i>N</i> = 115,803 of European ancestry). Primary inference used inverse-variance weighted (IVW) MR under a multiplicative random-effects model, complemented by MR-Egger, weighted median, weighted mode, and simple mode.</p><p><strong>Results: </strong>In forward MR, 12 WMSC phenotypes remained associated with MS susceptibility after direction-concordance filtering and robustness assessment. These signals were not randomly distributed across the structural connectome: risk-increasing effects were concentrated in salience/control-related cortico-subcortical and sensorimotor couplings, particularly connections involving the amygdala, putamen, and contralateral somatomotor network, whereas inverse associations were more prominent in default-mode/limbic and cross-network connections, including limbic-accumbens, limbic-caudate, default-mode-hippocampus, and visual-default-mode links. Sensitivity analyses did not indicate directional pleiotropy, outlier-driven distortion, or single-variant dependence among the retained traits. No reverse causal effect of MS liability on the prioritized WMSC phenotypes was supported.</p><p><strong>Conclusions: </strong>These bidirectional MR results support a circuit-selective model in which genetically influenced variation in specific cortico-subcortical WMSC phenotypes is associated with MS susceptibility, with risk-increasing effects concentrated in salience/control-basal ganglia-sensorimotor circuits and inverse associations enriched in default-mode/limbic and cross-network couplings. The absence of robust reverse effects is more consistent with predisposing connectivity architectures than with MS liability causally altering WMSC.</p>","PeriodicalId":14161,"journal":{"name":"International Journal of Neuroscience","volume":" ","pages":"1-13"},"PeriodicalIF":1.5,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147673450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methylation of tenascin XB mediated by methyltransferase-like 3 can effectively suppress neural injury and cellular apoptosis induced by ischemic stroke.","authors":"Lige Ding, Xiaojie Feng, Fan Gao","doi":"10.1080/00207454.2026.2652635","DOIUrl":"10.1080/00207454.2026.2652635","url":null,"abstract":"<p><strong>Background: </strong>Ischemic stroke (IS), a cerebrovascular disorder due to brain vessel blockage, poses a direct life-threatening risk. Tenascin XB (TNXB), a glycoprotein, is key in regulating extracellular matrix structure and signal transduction. This study aims to unveil the mechanism by which TNXB alleviates IS.</p><p><strong>Methods: </strong>Differentially expressed genes (DEGs) in IS were screened from GSE58294 dataset, and GO and KEGG enrichment analyses of DEGs were conducted using the SangerBox website. Protein expression was detected by western blot; cell viability was assessed <i>via</i> CCK-8 assay; LDH release was measured with an LDH assay kit; and cell apoptosis rate was evaluated by flow cytometry. TNXB mRNA modification sites were predicted using SRAMP website; the N6-methyladenosine (m6A) level of RNA was detected using MeRIP assay; the half-life of TNXB mRNA was assessed by actinomycin D assay.</p><p><strong>Results: </strong>In IS, TNXB was underexpressed and associated with the PI3K-Akt pathway. Overexpression of TNXB reversed the OGD/R-induced decline in SK-N-SH cell viability, the increase in LDH levels, and the exacerbation of apoptosis. Methyltransferase-like 3 (METTL3) stabilized TNXB expression <i>via</i> the m6A methylation mechanism. By targeting TNXB, METTL3 mitigated OGD/R-induced cell damage. Additionally, METTL3 activated the PI3K-Akt pathway <i>via</i> targeting TNXB.</p><p><strong>Conclusions: </strong>METTL3 stabilizes TNXB expression through m6A methylation modification, thereby alleviating IS-induced cellular damage. This suggests that targeting the METTL3-TNXB axis may represent a potential therapeutic strategy for IS.</p>","PeriodicalId":14161,"journal":{"name":"International Journal of Neuroscience","volume":" ","pages":"1-13"},"PeriodicalIF":1.5,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147673361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Platelet-to-lymphocyte ratio as an inflammatory marker associated with stroke severity in acute ischemic stroke: a prospective observational study.","authors":"Sathiyanarayanan Janakiraman, Kawiraj N, C Pravin Coumar","doi":"10.1080/00207454.2026.2654040","DOIUrl":"10.1080/00207454.2026.2654040","url":null,"abstract":"<p><p>Stroke is a major cause of disability and mortality in India, occurring as ischemic or hemorrhagic. Platelets drive thrombosis and inflammation, while lymphocytes exert anti-inflammatory effects. The platelet-to-lymphocyte ratio (PLR) reflects these opposing mechanisms. This study evaluated PLR in acute ischemic stroke and its correlation with 'National Institutes of Health Stroke Scale (NIHSS)'. A prospective observational study was conducted at Sri ManakulaVinayagar Medical College, Puducherry (January-December 2023). Sixty-four acute ischemic stroke patients were evaluated. NIHSS was recorded, and PLR calculated from complete blood counts at admission and after five days. Most patients were above 45 years (87.5%) and male (60.9%). Dyslipidemia (65.6%) and diabetes mellitus (64.1%) were the commonest comorbidities. The middle cerebral artery was most frequently affected (48.4%). PLR showed a significant positive correlation with NIHSS at admission and day five. PLR is a simple, cost-effective marker for predicting stroke severity and outcomes, aiding management decisions.</p>","PeriodicalId":14161,"journal":{"name":"International Journal of Neuroscience","volume":" ","pages":"1-17"},"PeriodicalIF":1.5,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147591838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic role of miR-296-5p in hypertensive stroke through ACE2-dependent Edn1 suppression.","authors":"Jibo Li, Feng Chen, Chanchan Liu, Feng Xu","doi":"10.1080/00207454.2026.2652632","DOIUrl":"10.1080/00207454.2026.2652632","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the mechanism of miR-296-5p in hypertensive stroke.</p><p><strong>Methods: </strong>Ten patients with acute stroke and ten healthy volunteers were selected. EPCs were isolated and transfected, followed by assessment of cell activities. A mouse middle cerebral artery occlusion (tMCAO) model was established, and neural function deficits were evaluated using neural function score, forelimb placement test, and balance beam walking test. ACE2 and Mas receptor expression were assessed by TUNEL staining and immunohistochemical analysis. Serum Ang-(1-7) levels were measured using an ELISA kit. miR-296-5p, ACE2, and Mas were detected by RT-qPCR. The binding relationship between miR-296-5p and ACE2 was verified by dual luciferase assay and FISH.</p><p><strong>Results: </strong>miR-296-5p expression was elevated in the peripheral blood of stroke patients. Lower HDL-C levels were associated with higher hemorrhagic volume, increased NIHSS score, and elevated miR-296-5p expression. miR-296-5p expression was also increased in brain tissue of tMCAO mice. Knockdown of miR-296-5p increased neuron numbers, indicating enhanced survival and reduced apoptosis. The decrease in Ang-(1-7) following miR-296-5p knockdown may reflect a feedback mechanism involving ACE2 regulation. Additionally, miR-296-5p targeted ACE2 expression, which may indirectly regulate Mas transcription through signaling pathways involved in neuroinflammation and ischemic injury. Overexpression of ACE2 reduced the effect of miR-296-5p knockdown on neural repair in tMCAO mice.</p><p><strong>Conclusion: </strong>Serum miR-296-5p is a highly predictive marker for stroke prognosis. miR-296-5p alleviates hypertensive stroke by inhibiting Edn1 through ACE2.</p>","PeriodicalId":14161,"journal":{"name":"International Journal of Neuroscience","volume":" ","pages":"1-14"},"PeriodicalIF":1.5,"publicationDate":"2026-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147573904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive value of systemic immune-inflammation index and neutrophil to high-density lipoprotein ratio in acute ischemic stroke.","authors":"Lei Meng, Angui Feng, Zhou Ding","doi":"10.1080/00207454.2025.2570439","DOIUrl":"10.1080/00207454.2025.2570439","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the predictive value of the Systemic Immune-Inflammation Index (SII) and the neutrophil to high-density lipoprotein cholesterol ratio (NHR) for adverse cardiovascular and cerebrovascular events in patients with acute stroke.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 260 acute stroke patients. Based on the occurrence of adverse events, patients were divided into a no-event group (Group A, <i>n</i> = 195) and an event group (Group B, <i>n</i> = 65). Risk factors were identified using logistic regression, and the predictive performance of SII and NHR was assessed by receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>Compared with Group B, Group A had a higher proportion of male patients, older age, smoking history, and elevated levels of white blood cell count, neutrophil percentage, lymphocyte percentage, platelet count, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and SII (<i>p</i> < 0.05). Univariate and multivariate logistic regression analyses demonstrated that, after adjusting for confounding factors such as sex and age, SII and NHR were independent risk factors for postoperative adverse cardiovascular events in acute stroke patients. ROC curve analysis revealed that the area under the curve (AUC) values for SII, NHR, and their combined detection in predicting adverse cardiovascular events were 0.729, 0.626, and 0.916, respectively, with significant differences (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>SII and NHR are independent predictors of recurrent cardiovascular and cerebrovascular events in acute stroke patients. Combined detection of SII and NHR offers superior predictive performance.</p>","PeriodicalId":14161,"journal":{"name":"International Journal of Neuroscience","volume":" ","pages":"452-457"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EEG spectral power differences in Alzheimer's disease and frontotemporal dementia.","authors":"Yue Pan, Li Zhu, Zi-Liang Wang","doi":"10.1080/00207454.2025.2591129","DOIUrl":"10.1080/00207454.2025.2591129","url":null,"abstract":"<p><strong>Background: </strong>Differentiating between Alzheimer's disease (AD) and frontotemporal dementia (FTD) based on clinical symptoms alone can be challenging. This study investigates the utility of resting-state EEG spectral power as a tool to distinguish between these two neurodegenerative conditions.</p><p><strong>Methods: </strong>We analyzed a publicly available dataset containing EEG recordings from 36 AD patients, 23 FTD patients, and 29 age-matched healthy controls (HC). Spectral power across delta, theta, alpha, and beta frequency bands was computed for both eyes-closed and eyes-open conditions. Rigorous statistical analysis with FDR correction was employed to identify group differences. To further investigate the relationship between EEG spectral alterations and clinical cognitive status, a correlation analysis was conducted.</p><p><strong>Results: </strong>Both patient groups showed significant deviations from HC, but with distinct patterns. AD was characterized by a classic pattern of posterior alpha power decrease and frontal theta power increase. In contrast, FTD showed a more focused reduction of alpha power at frontal and central sites. These patterns were robust across both eyes-closed and eyes-open states, suggesting their potential as stable biomarkers. The spectral features showed limited correlation with MMSE scores, indicating they may capture unique aspects of neuropathology not reflected in standard cognitive screening.</p><p><strong>Conclusion: </strong>Resting-state EEG reveals distinct spectral signatures for AD and FTD, supporting its potential as a low-cost, non-invasive adjunctive tool for differential diagnosis. The replication of these findings in an independent, open-access dataset underscores their reliability and provides a foundation for developing automated diagnostic algorithms.</p>","PeriodicalId":14161,"journal":{"name":"International Journal of Neuroscience","volume":" ","pages":"538-546"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145540579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-improved LeNet and modified SegNet for Alzheimer's disease classification using MRI.","authors":"Rajasree R S, Gopika G S, Supriya S, Archana P, Ashok K","doi":"10.1080/00207454.2026.2644529","DOIUrl":"10.1080/00207454.2026.2644529","url":null,"abstract":"<p><p>Alzheimer's disease is the leading cause of dementia, typically affecting the elderly. It results in cognitive and memory loss with progression that can lead to death. Although the exact cause remains unclear, it is believed to involve genetics, diet and environment. One key sign of Alzheimer's disease is the shrinkage of the hippocampus and frontal lobe cortex. Magnetic resonance imaging is frequently used to diagnose Alzheimer's disease due to its ability to capture detailed images of soft tissues. This study proposes an innovative Multi-head Parallel LeNet5-based Alzheimer's Disease Classification framework. The proposed Multi-head Parallel LeNet5-based Alzheimer's Disease Classification system processes magnetic resonance imaging images through several key steps. First, the Modified Wiener Filter is applied for noise reduction during preprocessing. Next, Pyramid Convolutional Kernels-based SegNet performs segmentation to isolate relevant brain regions. In the feature extraction phase, Improved Local Gabor Binary Pattern Histogram Sequence, shape features and deep features from VGG16 and ResNet are used to capture both texture and structural details. These features are augmented and then input into a Multi-head Parallel LeNet-5 (MPL5) classifier, which produces the final classified output for accurate and early detection of Alzheimer's disease. The Multi-head Parallel LeNet5-based Alzheimer's Disease Classification model predicts a higher accuracy score of 98% to confirm that it more consistently classifies Alzheimer's disease using magnetic resonance imaging.</p>","PeriodicalId":14161,"journal":{"name":"International Journal of Neuroscience","volume":" ","pages":"1-20"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147457374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and risk factors for transient and permanent central diabetes insipidus following pituitary adenoma surgery: a single center study.","authors":"Zahra Davoudi, Saeed Shahriari, Omidvar Rezaei, Mahdi Amirdosara, Kimia Vakili, Masood Zangi, Mohammad Samadian, Maryam Haghighimorad, Kave Ebrahimzade, Seyed Ali Mousavinejad, Fatemeh Sayehmiri, Mohammad Hallajnejad, Guive Sharifi","doi":"10.1080/00207454.2025.2564646","DOIUrl":"10.1080/00207454.2025.2564646","url":null,"abstract":"<p><strong>Background: </strong>Diabetes insipidus (DI) is a common complication following pituitary adenoma surgery, which can adversely affect patients' quality of life. This study aimed to clarify the types and frequency of DI in patients undergoing surgery for pituitary adenomas.</p><p><strong>Methods: </strong>This retrospective cross-sectional analytical study examined a cohort of patients (<i>n</i> = 532) with pituitary adenomas who underwent endoscopic transsphenoidal surgery (ETSS) at Loghman Hakim Hospital between 2017 and 2023. Comprehensive data collection included demographics, hormonal profiles, magnetic resonance imaging (MRI) findings and pathology results, enabling an in-depth analysis of DI incidence and associated risk factors post-surgery. Chi-square tests and logistic regression were employed to identify factors associated with DI.</p><p><strong>Results: </strong>Transient DI was most prevalent in patients with Cushing's disease (77.8%), while permanent DI was more commonly observed in non-functional adenomas (7%). However, no significant differences in DI prevalence were identified between adenoma types (<i>p</i> = .57 for transient DI, <i>p</i> = .89 for permanent DI). Tumor size and higher preoperative sodium levels were associated with transient and permanent DI in non-functional adenomas (<i>p</i> = .02, <i>p</i> = .026) and acromegaly (<i>p</i> = .012). Suprasellar extension correlated with transient DI in acromegaly (<i>p</i> = .01), while postoperative meningitis was significantly associated with transient DI in non-functional adenomas (<i>p</i> = .001).</p><p><strong>Conclusion: </strong>In the present study, tumor size, suprasellar extension and postoperative meningitis were linked to transient DI. In contrast, younger age, higher tumor volume and elevated mean 24-h postoperative sodium levels were associated with an increased risk of permanent DI.</p>","PeriodicalId":14161,"journal":{"name":"International Journal of Neuroscience","volume":" ","pages":"417-425"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145495149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel machine learning-based method to quantify the effect of transcranial direct current stimulation on opioid users.","authors":"Fatemeh Kazemzadeh, Sepideh Jabbari, Bahram Perseh, Zakaria Eskandari, Alireza Faridi, Davoud Ahmadi","doi":"10.1080/00207454.2025.2569423","DOIUrl":"10.1080/00207454.2025.2569423","url":null,"abstract":"<p><strong>Background: </strong>Opioid addiction is a major public health concern, associated with numerous health and social problems. Conventional diagnostic methods for addiction have notable limitations, highlighting the need for alternative approaches.</p><p><strong>Methods: </strong>This study investigates the use of electroencephalography (EEG) signals in conjunction with transcranial direct current stimulation (tDCS) for the diagnosis and treatment of opioid addiction. Thirty-six male patients undergoing methadone maintenance treatment were recruited and randomly assigned to three groups: Group A received left anodal/right cathodal tDCS (<math><mi>n</mi><mo>=</mo><mn>12</mn></math>), Group B received right anodal/left cathodal tDCS (<math><mi>n</mi><mo>=</mo><mn>12</mn></math>), and Group C received sham stimulation (<math><mi>n</mi><mo>=</mo><mn>12</mn></math>). EEG recordings were obtained from all participants before and after tDCS, as well as from 24 healthy controls. Machine learning techniques were applied to develop an optimized algorithm capable of distinguishing between healthy and addicted individuals by selectively analyzing addiction-affected EEG channels, thereby reducing processing time and costs.</p><p><strong>Results: </strong>The proposed method achieved a diagnostic accuracy of 94.30%. In addition, the effects of tDCS on craving reduction were assessed using EEG signals, psychological questionnaires, and blood biomarkers. Significant reductions in craving levels were observed in Groups A and B.</p><p><strong>Conclusion: </strong>These findings suggest that tDCS can be an effective intervention for reducing craving in patients with opioid addiction.</p>","PeriodicalId":14161,"journal":{"name":"International Journal of Neuroscience","volume":" ","pages":"439-451"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concomitant trends in stroke and COPD-related mortality in the U.S.: a 25-year retrospective analysis of the CDC WONDER database.","authors":"Areej Javeid, Rayyan Nabi, Muhammad Affan, Hanzala Ahmed Farooqi, Sophia Ahmed, Javeria Javeid, Wajeeh Hassan, Tabeer Zahid, Najaf Ahmed Rajpar","doi":"10.1080/00207454.2025.2577353","DOIUrl":"10.1080/00207454.2025.2577353","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) and stroke are leading contributors to mortality and disability. We analyzed national trends in deaths attributed to co-occurring stroke and COPD in US adults from 1999-2023.</p><p><strong>Methods: </strong>Using CDC WONDER multiple cause-of-death data for adults aged ≥25 years, we identified decedents with co-existent stroke (ICD-10 I60.x, I61.x, I63.x, I64, I69.0, I69.1, I69.3, I69.4) and COPD (J40-J44). Crude and age-adjusted mortality rates (AAMRs) per 100,000 population were calculated using the 2000 US standard population. Joinpoint regression estimated annual percent changes (APCs) and identified trend inflection points. Analyses were stratified by sex, race/ethnicity, metropolitan status, and state.</p><p><strong>Results: </strong>From 1999 to 2023, 311,375 deaths involved concurrent stroke and COPD. Overall AAMRs declined from 8.04 per 100,000 in 1999 to 5.17 in 2009 (APC -4.40%), with continued decline to 2018 (APC -1.34%). Rates then increased through 2020-2021 (APC +7.33%) before a modest decline toward 2023. Males consistently exhibited higher AAMRs than females. Non-Hispanic White adults had the highest AAMRs, whereas Hispanic and Asian/Pacific Islander groups had lower rates. Non-metropolitan areas experienced consistently higher AAMRs than metropolitan areas. State-level analyses identified the highest burdens in Appalachian and Deep South regions.</p><p><strong>Conclusion: </strong>Mortality from coexisting stroke and COPD declined for two decades but rose around the COVID-19 period, revealing significant sex, racial/ethnic, and geographic disparities. These findings highlight the need for targeted prevention, improved access to care for high-risk populations, and further research into mechanisms driving recent inflection points. Data and methods are detailed in the manuscript.</p>","PeriodicalId":14161,"journal":{"name":"International Journal of Neuroscience","volume":" ","pages":"478-488"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}