Journal of Central Nervous System Disease最新文献

{"title":"Machine Learning-Based Detection of Parkinson's Disease From Arabic Speech: A Cross-Linguistic Validation Study.","authors":"Ahmad B Hassanat, Ahmad S Tarawneh, Enas Al-Khlifeh, Alaa O Almahadin, Mansoor Alghamdi, Khalid Almohammadi, Malek Alrashidi, Lujain A Alhasanat, Ahmad H Al-Nawafleh","doi":"10.1177/11795735261448278","DOIUrl":"https://doi.org/10.1177/11795735261448278","url":null,"abstract":"<p><p>Early detection of Parkinson's disease (PD) through speech analysis offers significant clinical advantages, yet no validated tools exist for Arabic-speaking populations, representing a critical gap in global healthcare. Previous studies have relied on limited machine learning (ML) classifiers and voice attributes, which may introduce bias and hinder effective technique discovery. To address this, we developed an optimal PD prediction pipeline by testing multiple ML classifiers and feature extraction methods. We created the first Arabic PD speech dataset, comprising 40 subjects (17 with PD and 23 controls), and validated our methodology on an independent Spanish cohort of 100 subjects. Feature extraction included traditional, audio-to-text, and deep voice features from a pre-trained Whisper model. We employed feature selection and dimensionality reduction techniques to refine the dataset dimensions. Final features were assessed using twelve classifiers with leave-one-out and k-fold cross-validation for robust performance evaluation. Shapley additive explanations (SHAP) were utilized to determine feature importance as vocal biomarkers. Linear Discriminant Analysis achieved optimal performance with 90% accuracy, precision, recall, and F1-score using leave-one-out cross-validation. Linear Support Vector Classification also performed well, achieving 87.7% precision and 87.5% recall. When tested on the independent Spanish dataset, our methodology attained 83% accuracy, confirming cross-linguistic generalizability. SHAP analysis indicated that audio-to-text features provide contextual insights on fluency and coherence, while traditional features effectively capture acoustic variations. This study establishes the first validated Arabic PD speech classification system and demonstrates its universal applicability, laying the groundwork for global speech-based PD screening.</p>","PeriodicalId":15218,"journal":{"name":"Journal of Central Nervous System Disease","volume":"18 ","pages":"11795735261448278"},"PeriodicalIF":2.8,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depression, Anxiety, and Stress After Acquired Brain Injury: The Role of Cognitive Reserve in Patients and Caregivers 'Symptoms.","authors":"Debora Bertoni, Benedetta Basagni, Sara Mondini, Antonio De Tanti, Elisa Di Rosa","doi":"10.1177/11795735261443603","DOIUrl":"https://doi.org/10.1177/11795735261443603","url":null,"abstract":"<p><strong>Objectives: </strong>Severe acquired brain injury (sABI) can impact the psychological health not only in patients, but also in their caregivers. The present study was aimed at examining depression, anxiety and stress symptoms in patients with sABI and in their caregivers, exploring differences and correlations between the two, and investigating the role of cognitive reserve as potential predictor of patients and caregiver's psychological wellbeing.</p><p><strong>Methods: </strong>Fifty-four individuals (27 patients-caregiver's dyads) took part in the present study. All patients had a severe injury and data were collected approximately five years post-injury. During a telemedicine assessment, the Depression Anxiety Stress Scale (DASS-21), the Caregiver Burden Inventory (CBI) and the Cognitive Reserve Index questionnaire (CRIq) were administered.</p><p><strong>Results: </strong>Results show higher levels of anxiety and perceived stress in caregivers, when compared with patients. Significant associations emerged between patients and caregivers' symptoms of depression and anxiety. Furthermore, cognitive reserve emerged as a significant modulator of caregivers' emotional burden and depressive symptoms.</p><p><strong>Conclusion: </strong>Findings highlight the interconnection between patients' and caregivers' psychological wellbeing and suggest that cognitive reserve might be considered a predictor of caregivers' mental health.</p>","PeriodicalId":15218,"journal":{"name":"Journal of Central Nervous System Disease","volume":"18 ","pages":"11795735261443603"},"PeriodicalIF":2.8,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13087322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GLP-1 Receptor Agonists in Acute Ischemic Stroke and Secondary Stroke Prevention: A Narrative Review of Preclinical and Clinical Evidence.","authors":"Valentini Samanidou, Konstantinos Tsamis, Alexandr Ceasovschih, Theocharis Koufakis, Dimitrios Patoulias, Evangelos C Rizos, Manfreddi Rizzo, Haralampos Milionis, Fotios Barkas","doi":"10.1177/11795735261444425","DOIUrl":"https://doi.org/10.1177/11795735261444425","url":null,"abstract":"<p><strong>Background: </strong>Acute ischemic stroke (AIS) is a leading cause of death and disability. Glucagon-like peptide-1 receptor agonists (GLP-1RA) reduce atherosclerotic events in type 2 diabetes and obesity, and meta-analyses of cardiovascular outcome trials (CVOTs) suggest a modest reduction in incident stroke. Their safety and efficacy within acute AIS pathways remain uncertain.</p><p><strong>Methods: </strong>We conducted a narrative review by searching MEDLINE (PubMed), Cochrane CENTRAL, and ClinicalTrials.gov for studies through January 2026. We included in vitro and animal stroke models, observational studies, randomized controlled trials, and meta-analyses reporting AIS-related outcomes or stroke prevention endpoints with GLP-1RA.</p><p><strong>Results: </strong>Experimental models commonly show reduced infarct volume and improved neurological outcomes, with proposed mechanisms including attenuation of excitotoxicity, apoptosis, oxidative stress, neuroinflammation, and blood-brain barrier disruption, alongside signals of angiogenesis and neurogenesis. Translation is limited by heterogeneity of agents, timing, dosing, and routes, and by uncertainty over direct central nervous system versus systemic mediation. CVOTs and meta-analyses support long-term stroke risk reduction, whereas observational studies and small AIS trials mainly inform feasibility, metabolic control, and safety, with efficacy unproven. Ongoing stroke-dedicated trials should define patient selection, exposure-response relationships, and interactions with thrombolysis or thrombectomy, while prospectively incorporating imaging and biomarker endpoints to test mechanisms.</p><p><strong>Conclusions: </strong>Current evidence does not support routine GLP-1RA use as an acute neuroprotective therapy in AIS in humans. At present, GLP-1RA should be considered primarily for secondary prevention in patients with established indications, pending dedicated stroke trials clarifying acute safety, optimal timing/dosing, interactions with reperfusion therapies, and functional endpoints.</p>","PeriodicalId":15218,"journal":{"name":"Journal of Central Nervous System Disease","volume":"18 ","pages":"11795735261444425"},"PeriodicalIF":2.8,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13087331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ofatumumab Treatment Used in Pediatric MOGAD: A Retrospective Case Series.","authors":"Wenlin Wu, Haixia Zhu, Chi Hou, Yanping Ran, Wenxiao Wu, Wen-Xiong Chen, Xiaolan Mo, Kelu Zheng, Huiling Shen, Houliang Deng, Yulin Tang, Wei Liang, Yuanyuan Gao, Xiaojing Li","doi":"10.1177/11795735261436889","DOIUrl":"https://doi.org/10.1177/11795735261436889","url":null,"abstract":"<p><strong>Background: </strong>Myelin oligodendrocyte glycoprotein antibody-associated disorder (MOGAD) is a rare central nervous system demyelinating disease with a variable course, including both monophasic and relapsing phenotypes. Effective treatment options, particularly for relapsing disease, remain limited. Ofatumumab (OFA), a subcutaneous anti-CD20 monoclonal antibody approved for multiple sclerosis, has not been studied in pediatric MOGAD. This study aims to assess its safety and efficacy in this population.</p><p><strong>Objective: </strong>To describe the safety and efficacy of off-label OFA use in pediatric MOGAD patients.</p><p><strong>Patients and methods: </strong>We conducted a retrospective case series of consecutive pediatric patients with relapsing MOGAD who received OFA. Clinical data, including relapse history, annualized relapse rate (ARR), laboratory findings, and adverse events, were collected and analyzed.</p><p><strong>Results: </strong>Three pediatric (1 female, 2 males) were included. Age at onset was 2.3, 6.1, and 2.5 years; disease duration before OFA was 6.3, 2.2, and 9.1 years; and age at OFA initiation was 8.6, 8.3, and 11.6 years. Two patients started OFA due to breakthrough relapses on mycophenolate mofetil (MMF); one switched from maintenance intravenous immunoglobulin (IVIG) for administrative convenience. Treatment durations were 12, 9, and 9 months. All patients achieved rapid B-cell depletion (CD19+ < 10 cells/μL), which was sustained in two. Serum MOG-IgG titers increased in two patients and became negative in one. Two patients remained relapse-free during OFA treatment; one experienced a single relapse at 3 months. ARR decreased in all three patients post-OFA initiation. OFA was well tolerated. Only one patient developed transient fever after the first injection, which resolved with symptomatic treatment and did not recur.</p><p><strong>Conclusion: </strong>In this small case series, OFA was generally well-tolerated and associated with a reduction in ARR, suggesting a potential role in combination therapy for relapsing pediatric MOGAD. Given the use of combination treatments in some cases, including OFA+MMF and IVIG, the role of OFA alone remains unclear. Its subcutaneous route provides practical advantages in terms of convenience. Owing to the small sample size and relapse observed in one patient, these findings remain preliminary and warrant validation in larger, prospective studies.</p>","PeriodicalId":15218,"journal":{"name":"Journal of Central Nervous System Disease","volume":"18 ","pages":"11795735261436889"},"PeriodicalIF":2.8,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147673721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple Sclerosis in Charcot-Marie-Tooth Disease Type 1A - A Case Report and Literature Review.","authors":"Wen Yang, Lei Zhou, Gavin P Reynolds, Xianwen Wei","doi":"10.1177/11795735261431921","DOIUrl":"https://doi.org/10.1177/11795735261431921","url":null,"abstract":"<p><p>Central nervous system (CNS) demyelination is an uncommon observation in patients with Charcot-Marie-Tooth disease (CMT). Where it does occur, it is usually associated with X-linked CMT. We present a case of CMT type 1A with a likely de novo mutation who experienced initial symptoms, and subsequent exacerbation, of multiple sclerosis following respiratory infection. A review of the literature reveals that reports of CMT1A with CNS demyelination are rare. We propose that the mutations in the PMP22 gene result in an over-expression of PMP22 mRNA, which overcomes the normal suppression by miRNA species that occurs in the CNS. This abnormal expression of PMP22 protein may, in certain circumstances, exacerbate autoimmune responses to result eventually in CNS demyelination.</p>","PeriodicalId":15218,"journal":{"name":"Journal of Central Nervous System Disease","volume":"18 ","pages":"11795735261431921"},"PeriodicalIF":2.8,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12982849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147468155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modulation of EEG Background Rhythms in Sturge-Weber Syndrome: Impact of Surgical Timing on the Unaffected Hemisphere.","authors":"Jing Wang, Kun Lv, Zeming Wang, Xiongfei Wang, Yuguang Guan, Jian Zhou, Tianfu Li, Mengyang Wang, Yujiao Yang, Guoming Luan","doi":"10.1177/11795735261431415","DOIUrl":"10.1177/11795735261431415","url":null,"abstract":"<p><strong>Background: </strong>Epilepsy surgery improves seizure outcomes in Sturge-Weber syndrome (SWS), yet the electrophysiological patterns of postoperative recovery remain poorly characterized. Previous studies suggest that early intervention may yield distinct clinical trajectories, but the associated changes in EEG background activity have not been systematically investigated.</p><p><strong>Objective: </strong>To investigate whether age of surgery influences the postoperative modulation of EEG background rhythms in children with unilateral SWS, and to evaluate the utility of preoperative EEG asymmetry for lateralizing the epileptogenic hemisphere.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Methods: </strong>We analyzed children with unilateral SWS who underwent epilepsy surgery, stratified by age at intervention (<2 vs. ≥2 years). Pre- and postoperative scalp EEGs were visually assessed to quantify posterior dominant alpha frequency and slow-wave (delta and theta bands) activity separately in the affected and unaffected hemispheres (AH, UH). Preoperative lateralization accuracy was also evaluated for both frequency bands.</p><p><strong>Results: </strong>A total of 99 patients were included. Seizure freedom rates were comparable between age groups. However, younger patients exhibited a significantly greater postoperative increase in alpha frequency, particularly in the UH (20 ± 20% vs. 4 ± 10%, <i>P</i> < 0.001). This effect was consistent across both focal resection (17±12% vs. 1 ± 8%, <i>P</i> < 0.001) and hemispheric surgery (22 ± 22% vs. 7 ± 11%, <i>P</i> = 0.006). In contrast, slow-wave modulation did not differ by age. Preoperative alpha asymmetry correctly lateralized the surgical hemisphere in 86.9% of cases (sensitivity 85.7%, specificity 88.0%, <i>κ</i> = 0.74), outperforming slow-wave asymmetry (accuracy 66.7%, <i>κ</i> = 0.33).</p><p><strong>Conclusion: </strong>Early epilepsy surgery in SWS is associated with enhanced postoperative modulation of alpha frequency in the UH, possibly reflecting greater neuroplastic capacity during early development. Preoperative alpha asymmetry offers robust lateralizing value. These findings support the clinical utility of background EEG analysis in surgical planning and postoperative monitoring.</p>","PeriodicalId":15218,"journal":{"name":"Journal of Central Nervous System Disease","volume":"18 ","pages":"11795735261431415"},"PeriodicalIF":2.8,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12961107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147377565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-Existing Charcot-Marie-Tooth Disease Type II and Parkinson's Disease Linked to a Novel DNAjB2 Pathogenic Variant.","authors":"Alexandru N Lerint, Johanna S Canenguez Benitez, Vijaya Lakshmi Valaparla, Elena Shanina, Laura J Wu","doi":"10.1177/11795735261428314","DOIUrl":"10.1177/11795735261428314","url":null,"abstract":"<p><strong>Background: </strong>The DNAjB2 gene encodes a co-chaperone protein that interacts with the heat shock protein (HSP) family to maintain protein quality control and preserve neuronal integrity. Variants in this gene have been associated with the axonal form of Charcot-Marie-Tooth Disease (CMT2). Recent literature has also suggested an association between DNAjB2 variants and neurodegenerative disorders such as Parkinson's disease (PD).</p><p><strong>Design/methods: </strong>Case Report.</p><p><strong>Case description: </strong>We present a 36-year-old female patient initially diagnosed with CMT2 at the age of 28, who later developed symptoms of PD in her fourth decade. Genetic test revealed compound heterozygous pathogenic variants in DNAjB2 (c.352+1 G>A and c.175+2T>A).</p><p><strong>Conclusion: </strong>To our knowledge, this is the first case report describing the dual phenotype of CMT2 and young-onset PD linked to compound heterozygosity in DNAjB2. The dual dysfunction of axonal degeneration and dopaminergic neuron loss suggests that DNAjB2 plays a pivotal role in maintaining proteostasis in both the peripheral and central nervous systems.</p>","PeriodicalId":15218,"journal":{"name":"Journal of Central Nervous System Disease","volume":"18 ","pages":"11795735261428314"},"PeriodicalIF":2.8,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12961101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147377477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the Efficacy and Safety of Endovascular Therapy Versus Best Medical Treatment in Acute Ischemic Stroke Patients With Distal Medium Vessel Occlusion: A Systematic Review and Meta-Analysis.","authors":"Muhammad Hassan Waseem, Zain Ul Abideen, Eeshal Zulfiqar, Barka Sajid, Aisha Kakakhail, Haider Kashif, Muhammad Ansab, Muhammad Wajih Ansari, Rowaid Ahmad, Zara Fahim, Pawan Kumar Thada, Brandon Lucke-Wold","doi":"10.1177/11795735261428814","DOIUrl":"https://doi.org/10.1177/11795735261428814","url":null,"abstract":"<p><strong>Introduction: </strong>Distal Medium Vessel Occlusions (DMVOs) represent a significant subset of Acute Ischemic Stroke (AIS), with unique treatment challenges due to vessel size and location. While Endovascular Therapy (EVT) shows promise, its efficacy compared to Best Medical Treatment (BMT) remains unclear.</p><p><strong>Methods: </strong>PubMed, Cochrane Central, and ScienceDirect were searched from inception till May 2025. Categorical data were pooled as risk ratios (RRs) along with 95% Confidence intervals (CIs) using the Review Manager software. Quality was assessed using the Cochrane Risk of Bias tool and the Newcastle Ottawa Scale.</p><p><strong>Results: </strong>Thirty-seven studies pooling a total of 9,505 patients were included in this meta-analysis. The excellent functional outcome (modified Rankin Scale (mRS) 0-1) was comparable between both the EVT and BMT arms (RR= 1.04; 95% CI: [0.96, 1.13]; p= 0.34; I²= 59%). Similarly, the functional independence (mRS 0-2) showed no significant difference between the two groups (RR= 1.00; 95% CI: [0.94, 1.06]; p= 0.99; I²= 64%). The 90-day mortality (RR= 1.21; 95% CI: [0.97, 1.52]; p= 0.09; I²= 46%) and neurological deterioration (RR= 1.39; 95% CI: [0.65, 2.95]; p= 0.40; I²= 82%) were also comparable between the two arms. EVT showed a statistically significant increase in early neurological improvement (RR= 1.38; 95% CI: [1.05, 1.82]; p= 0.02; I²= 53%) although it was associated with a high risk of symptomatic intracranial hemorrhage (sICH) (RR= 1.56; 95% CI: [1.15, 2.13]; p= 0.005; I²= 39%).</p><p><strong>Conclusion: </strong>EVT was associated with a significant increase in the early neurological improvement, although the risk of sICH was high in it. Other safety and efficacy outcomes were comparable. Further high-powered randomized trials are needed to confirm these findings.</p>","PeriodicalId":15218,"journal":{"name":"Journal of Central Nervous System Disease","volume":"18 ","pages":"11795735261428814"},"PeriodicalIF":2.8,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12957600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147365481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Association of the Dietary Inflammatory Index With Stroke Risk and All-Cause Mortality Among Hypertension Patients: A NHANES Cross-Sectional Study (2005-2018).","authors":"Amu Jike, Shuming Wang, Erha Munai, Ping Xiong, Lvmeng Song, Yinchuan Cheng, Shun Li","doi":"10.1177/11795735261428321","DOIUrl":"https://doi.org/10.1177/11795735261428321","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between the Dietary Inflammatory Index (DII) and stroke risk among hypertensive adults, as well as all-cause mortality post-stroke, utilizing data from the National Health and Nutrition Examination Survey (NHANES).</p><p><strong>Methods: </strong>This cross-sectional analysis included 7,590 hypertensive participants (stroke group: N=609; non-stroke group: N=6,981). DII was derived from 28 dietary components. Participants were stratified into DII tertiles: Q1 (lowest), Q2 (moderate), and Q3 (highest). Weighted multivariable logistic regression assessed associations between DII (continuous and categorical) and stroke prevalence. Restricted cubic splines (RCS) evaluated non-linearity. Subgroup analyses identified effect modifiers. Cox proportional hazards regression modeled associations of DII and its components with all-cause mortality in the stroke cohort.</p><p><strong>Results: </strong>Stroke patients exhibited significantly higher DII scores than non-stroke controls (<i>P</i> <0.05). Each 1-unit increase in DII was associated with a 13% elevated stroke risk (Odds Ratio (OR)=1.13, 95%CI: 1.04-1.22, <i>P</i> =0.006). Compared to Q1, Q3 had a 68% higher stroke risk (OR=1.68, 95%CI: 1.22-2.32, <i>P</i>=0.002). RCS confirmed significant non-linearity (<i>P</i><0.001). Antihypertensive medication modified this association (<i>P</i>-interaction =0.042). Among stroke patients, DII demonstrated a U-shaped association with mortality (<i>P</i>-trend =0.048): Q2 had the lowest mortality, while Q1 and Q3 showed poorer survival. Component analysis revealed higher β-carotene scores associated with increased mortality risk (Hazard Ratio (HR)=1.44, 95%CI: 1.01-2.04), whereas higher vitamin A scores correlated with reduced risk (HR=0.68, 95%CI: 0.47-0.99).</p><p><strong>Conclusion: </strong>This cross-sectional study identifies a significant, dose-response association between elevated DII and increased stroke risk in hypertensive adults, suggesting that reducing dietary inflammatory load holds preventive potential. Moreover, β-carotene and vitamin A show opposing associations with post-stroke mortality, reflecting the complexity of nutritional inflammation and informing precision nutrition strategies for stroke.</p>","PeriodicalId":15218,"journal":{"name":"Journal of Central Nervous System Disease","volume":"18 ","pages":"11795735261428321"},"PeriodicalIF":2.8,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12957580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147365330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deriving a Simple Clinical Predictive Score for Posterior Circulation Ischemic Stroke (PCS-SCORE).","authors":"Yahia Imam, Rajvir Singh, Prem Chandra, Ishrat Hakeem, Saadat Kamran, Ahmad Muhammad, Salman Al Jerdi, Suhail Hussain, Khawaja Hassan Haroon, Jon D Perkins, Ahmed Elsotouhy, Mohamed Sayed Abdelmoneim, Zain A Bhutta, Mostafa Mahmoud, Ehab Mahmoud, Osman Koc, Dirk Deleu","doi":"10.1177/11795735261424050","DOIUrl":"10.1177/11795735261424050","url":null,"abstract":"<p><strong>Background: </strong>Posterior circulation ischemic stroke (PCS) accounts for up to 25% of all ischemic strokes but remains frequently under-recognized due to atypical symptoms and poor representation in conventional stroke scales. Early diagnosis is critical yet challenging. This study aimed to derive a pragmatic clinical scoring tool, the PCS-SCORE, to identify patients at high risk of PCS based solely on bedside features.</p><p><strong>Methods: </strong>We retrospectively analyzed 5163 patients from a prospective stroke registry, including 1571 with -confirmed PCS. Key predictors were identified through multivariable logistic regression and lasso modeling. Variables were weighted according to regression coefficients and clinical relevance. The final PCS-SCORE (0-9 points) included: diabetes (1 point), hypertension (1), male sex (1), double/blurred vision (2), vertigo with vomiting (2), and incoordination (2).</p><p><strong>Results: </strong>At a score threshold >3, the PCS-SCORE achieved an area under the curve (AUC) of 0.76, with 87.9% specificity and 43.4% sensitivity. Raising the threshold to >4 increased specificity to 94.4% (sensitivity 27.9%). Higher scores corresponded with progressively increased likelihood of PCS, enabling confident identification of high-risk patients.</p><p><strong>Conclusion: </strong>The PCS-SCORE is a simple, highly specific bedside tool for early detection of posterior circulation strokes. Its rule-in strength makes it especially useful in prehospital settings, resource-limited environments, and crowded emergency departments. Prospective validation is ongoing.</p>","PeriodicalId":15218,"journal":{"name":"Journal of Central Nervous System Disease","volume":"18 ","pages":"11795735261424050"},"PeriodicalIF":2.8,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12901941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146201724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}