Journal of Clinical Neuroscience最新文献

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Assessment of comatose patients: comparative analysis of electrophysiological techniques and clinical scores 昏迷患者的评估:电生理技术与临床评分的比较分析
IF 1.8 4区 医学
Journal of Clinical Neuroscience Pub Date : 2025-07-30 DOI: 10.1016/j.jocn.2025.111528
Youfang Luo , Longxiang Huang , Wenli Li , Chunhui Che , Huapin Huang
{"title":"Assessment of comatose patients: comparative analysis of electrophysiological techniques and clinical scores","authors":"Youfang Luo ,&nbsp;Longxiang Huang ,&nbsp;Wenli Li ,&nbsp;Chunhui Che ,&nbsp;Huapin Huang","doi":"10.1016/j.jocn.2025.111528","DOIUrl":"10.1016/j.jocn.2025.111528","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the correlation between different electrophysiological indicators, clinical scores, and coma prognosis, comparing predictive efficacy across diverse etiologies and lesion sites.</div></div><div><h3>Methods</h3><div>A total of 220 coma patients from Fujian Medical University Union Hospital were enrolled. Within one week of onset, we performed EEG, SLSEP, BAEP, the FOUR score and the GCS score on all patients. Three months after onset, we took the GOS score as a prognostic indicator for the patients and analyzed the relationship between different indicators of the abovementioned examinations and prognosis.</div></div><div><h3>Results</h3><div>EEG Synek grade and SLSEP N20 demonstrated the strongest correlation with prognosis(EEG Synek, R<sup>2</sup> = 0.327, <em>P</em> &lt; 0.001; SLSEP N20, R<sup>2</sup> = 0.231, <em>P</em> &lt; 0.001), followed by the FOUR and the GCS scores (FOUR, R<sup>2</sup> = 0.165, <em>P</em> &lt; 0.001; GCS, R<sup>2</sup> = 0.189, <em>P</em> &lt; 0.001). EEG Synek grade predicted prognosis best in hypoxic-ischemic encephalopathy (R<sup>2</sup> = 0.462, <em>P</em> &lt; 0.001, AUC = 0.900), while SLSEP N20 had the highest predictive specificity (100 %) in cerebrovascular disease. EEG Synek grading excelled in diffuse cortical lesions (R<sup>2</sup> = 0.329, <em>P</em> &lt; 0.001, AUC = 0.870), with SLSEP<!--> <!-->N20 superior in subcortical lesions (specificity was 100 %). While the FOUR<!--> <!-->score<!--> <!-->had the highest specificity (100 %) in diffuse cortical lesions. Brainstem auditory evoked potentials had limited predictive value in diffuse cortical coma.</div></div><div><h3>Conclusion</h3><div>EEG demonstrated good predictive value in the prognosis of coma resulting from hypoxic-ischemic encephalopathy and diffuse cortical lesions, while SLSEP showed better specificity in predicting the prognosis of coma caused by cerebrovascular disease and subcortical lesions. BAEP has poor sensitivity to diffuse cortical lesions.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"140 ","pages":"Article 111528"},"PeriodicalIF":1.8,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144739691","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}
引用次数: 0
Blood transfusion guidelines in skull base surgery: a scoping review 颅底外科输血指南:范围回顾
IF 1.9 4区 医学
Journal of Clinical Neuroscience Pub Date : 2025-07-28 DOI: 10.1016/j.jocn.2025.111522
Carson Gundlach , Trevor A. Poulson , Mohamed Bah , Takara Newome-Cuby , Mohammad Mirahmadi Eraghi , Michelot Michel , Parsa Nilchian , Michael Farid , Faraaz Azam , Usama AlDallal , Soummitra Anand , Sean O’Leary , Umaru Barrie , Salah G. Aoun
{"title":"Blood transfusion guidelines in skull base surgery: a scoping review","authors":"Carson Gundlach ,&nbsp;Trevor A. Poulson ,&nbsp;Mohamed Bah ,&nbsp;Takara Newome-Cuby ,&nbsp;Mohammad Mirahmadi Eraghi ,&nbsp;Michelot Michel ,&nbsp;Parsa Nilchian ,&nbsp;Michael Farid ,&nbsp;Faraaz Azam ,&nbsp;Usama AlDallal ,&nbsp;Soummitra Anand ,&nbsp;Sean O’Leary ,&nbsp;Umaru Barrie ,&nbsp;Salah G. Aoun","doi":"10.1016/j.jocn.2025.111522","DOIUrl":"10.1016/j.jocn.2025.111522","url":null,"abstract":"<div><h3>Objective</h3><div>Consensus guidelines are lacking for the administration of blood product transfusions in adult skull base neurosurgery. This study aims to synthesize the current literature and provide preliminary evidence-based considerations for blood product transfusions in skull base surgery.</div></div><div><h3>Methods</h3><div>A scoping review was conducted using PubMed, Web of Science, and SCOPUS databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines.</div></div><div><h3>Results</h3><div>Eleven articles were included. Of the three studies reporting skull base surgery outcomes, greater mean age was correlated with a higher likelihood of transfusion. Pre-admission diagnoses of cardiovascular disease, diabetes, coagulopathy, anticoagulation, liver disease, stroke, and seizure were the most common comorbid diseases of transfused patients. Transfused patients had a greater range of hospital length of stay (15.5–19.9 days versus 4.9–8 days). One study comparing anemic versus non-anemic patients found a marked difference in the mean length of stay (4.6 versus 1.4 days, respectively) between their two patient groups. Additionally, this study found anemic patients to have a 3.4 % mortality rate while the non-anemic cohort had a 0.8 % mortality rate. The average volume of transfused blood in standard and transglabellar/subcranial approaches was 545 mL and 194 mL, respectively. Only one study proposed a hemoglobin threshold specific to skull base surgery for blood transfusion at 7–8 g/dL.</div></div><div><h3>Conclusion</h3><div>Based on our scoping review, a hemoglobin level of 7 g/dL (Level B, Class IIa) may represent a reasonable starting point to guide transfusions in skull base surgery, though prospective validation is warranted.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"140 ","pages":"Article 111522"},"PeriodicalIF":1.9,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144713805","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}
引用次数: 0
Intraoperative radiation therapy for glioblastoma and brain metastases: Program development and initial experience from the Philippines 术中放射治疗胶质母细胞瘤和脑转移:菲律宾的项目发展和初步经验
IF 1.8 4区 医学
Journal of Clinical Neuroscience Pub Date : 2025-07-28 DOI: 10.1016/j.jocn.2025.111524
Kathleen Joy O. Khu , Juan Silvestre G. Pascual , Johanna Patricia A. Cañal , Nonette A. Cupino , Henri Cartier S. Co , Almira O. Apor , Mary Angeline Luz U. Hernandez , Sairon Jay B. Libit , Julia Rebecca D. Posadas , Gerardo D. Legaspi
{"title":"Intraoperative radiation therapy for glioblastoma and brain metastases: Program development and initial experience from the Philippines","authors":"Kathleen Joy O. Khu ,&nbsp;Juan Silvestre G. Pascual ,&nbsp;Johanna Patricia A. Cañal ,&nbsp;Nonette A. Cupino ,&nbsp;Henri Cartier S. Co ,&nbsp;Almira O. Apor ,&nbsp;Mary Angeline Luz U. Hernandez ,&nbsp;Sairon Jay B. Libit ,&nbsp;Julia Rebecca D. Posadas ,&nbsp;Gerardo D. Legaspi","doi":"10.1016/j.jocn.2025.111524","DOIUrl":"10.1016/j.jocn.2025.111524","url":null,"abstract":"<div><h3>Background</h3><div>Intraoperative radiation therapy (IORT) is a technique that precisely delivers ionizing radiation to the tumor or tumor bed during surgery. It is currently used for glioblastoma (GBM) and brain metastases (BrM). We report our experience in establishing our Neuro IORT program and preliminary results, which represent the first brain IORT procedures performed in the country.</div></div><div><h3>Methods</h3><div>Adult patients with a single, superficial, supratentorial brain tumor and a pre-operative diagnosis of GBM or BrM were considered for IORT. The recommendation for IORT was made after discussion in a multidisciplinary conference. Intraoperative tumor specimens were submitted for frozen section, and IORT commenced once the diagnosis was confirmed. Demographic and clinical patient data, imaging findings, IORT treatment parameters, and short-term outcomes were recorded.</div></div><div><h3>Results</h3><div>Twelve patients underwent IORT: 9 BrM and 3 GBM. The mean age was 56.9 years (range 45–70), and majority were women. Most of the BrM patients had breast cancer, followed by lung, thyroid, and renal cell cancer. The mean maximum tumor diameter was 3.7 cm for BrM and 4.1 cm for GBM. The IORT dose ranged from 20–21 Gy to the surface of the resection cavity, and mean IORT duration was 13.3 min (range 6–20) for BrM and 18 min (range 14–21) for GBM. The most common morbidity was focal neurologic deficits, seen in 33 % of patients.</div></div><div><h3>Conclusion</h3><div>IORT for BrM and GBM is safe and feasible in resource-limited settings. More work needs to be done to overcome the challenges and improve the program.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"140 ","pages":"Article 111524"},"PeriodicalIF":1.8,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722376","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}
引用次数: 0
Neck posture–dependent variations in cervical central canal stenosis among ossification of the posterior longitudinal ligament patients: Follow-up neutral position magnetic resonance study 后纵韧带骨化患者颈中央管狭窄的颈部姿势依赖性变化:随访中性位磁共振研究
IF 1.9 4区 医学
Journal of Clinical Neuroscience Pub Date : 2025-07-26 DOI: 10.1016/j.jocn.2025.111515
Hyo Jin Kim, Eugene Lee, Joon Woo Lee, Youngjune Kim, Choong Guen Chee
{"title":"Neck posture–dependent variations in cervical central canal stenosis among ossification of the posterior longitudinal ligament patients: Follow-up neutral position magnetic resonance study","authors":"Hyo Jin Kim,&nbsp;Eugene Lee,&nbsp;Joon Woo Lee,&nbsp;Youngjune Kim,&nbsp;Choong Guen Chee","doi":"10.1016/j.jocn.2025.111515","DOIUrl":"10.1016/j.jocn.2025.111515","url":null,"abstract":"<div><div>In patients with cervical ossification of the posterior longitudinal ligament (OPLL), posture differences in neutral Magnetic Resonance Imaging (MRI) can affect central canal stenosis evaluation, but their impact on sagittal alignment parameters and central canal stenosis measurements remains unclear. This retrospective cohort study sought to evaluate neck posture-dependent variations in central canal stenosis in patients with OPLL and assess the influence of sagittal alignment parameters. Fifty-seven patients underwent two neutral-position MRI scans within six months. Occipito-C2 (O-C2) angle, C2-C7 Cobb angle, K-line-C7 angle, and C2-C7 sagittal vertical axis (SVA) were measured. Central canal stenosis was assessed using anteroposterior (A-P) diameter, Disc-OPLL thickness, ligamentum flavum thickness, and stenosis grading. The results showed that C2-C7 Cobb angle (p &lt; 0.001), K-line-C7 angle (p &lt; 0.001), and C2-C7 SVA (p &lt; 0.001) showed significant differences, whereas O-C2 angle remained unchanged (p = 0.175). Changes in C2-C7 SVA had the strongest correlation with A-P diameter (p = 0.009).</div><div>Central canal stenosis grading changed in 35.1% of cases at the level adjacent superior to the most stenotic site, 24.6% at the level adjacent inferior, and 5.3% at the most stenotic level, suggesting that posture differences influence both quantitative and qualitative assessments Variations in neck posture, particularly C2-C7 SVA, significantly influenced central canal measurements. Given its strong positive correlation with A-P diameter, C2-C7 SVA should be carefully considered during MRI acquisition for accurate assessment of cervical OPLL progression.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"140 ","pages":"Article 111515"},"PeriodicalIF":1.9,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144711599","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}
引用次数: 0
Neurosurgery surgical site infections in Cameroon: diagnosis, management and associated factors 喀麦隆神经外科手术部位感染:诊断、管理和相关因素
IF 1.9 4区 医学
Journal of Clinical Neuroscience Pub Date : 2025-07-25 DOI: 10.1016/j.jocn.2025.111520
Tina W.G. Mataa , Chinonso P. Shu , Nda J.P. Mefo’o , Martine Nida , Mathieu Motah
{"title":"Neurosurgery surgical site infections in Cameroon: diagnosis, management and associated factors","authors":"Tina W.G. Mataa ,&nbsp;Chinonso P. Shu ,&nbsp;Nda J.P. Mefo’o ,&nbsp;Martine Nida ,&nbsp;Mathieu Motah","doi":"10.1016/j.jocn.2025.111520","DOIUrl":"10.1016/j.jocn.2025.111520","url":null,"abstract":"<div><h3>Background</h3><div>Surgical site infections (SSI) are a public health issue. Most neurosurgical cases are clean; hence, surgical site infections are not as common. This subject has not been extensively studied in literature, worst of all in resource-limited settings where SSI increases health care burden.</div></div><div><h3>Objective</h3><div>To examine clinical and paraclinical presentations, therapeutic approaches, and factors associated with SSI in two neurosurgery departments.</div></div><div><h3>Materials and methods</h3><div>A retrospective observational study was conducted in the neurosurgery departments of Douala General and Laquintinie hospitals using medical records of patients who had surgery between January 1, 2018, to December 31, 2022. Patients who had surgery for infectious etiologies and those with incomplete medical records were excluded. Univariate and bivariate analyses were done for associations. A p-value less than 0.05 was considered significant.</div></div><div><h3>Results</h3><div>We included 386 patient records. SSI occurred in 7.3 %, with a mean age of occurrence of 45+/-18.6 years. The most frequently isolated germs were <em>Pseudomonas aeruginosa</em> (43.7 %) and <em>Klebsiella pneumoniae</em> (37.4 %). Amikacin and carbapenems were the most prescribed antibiotics after culture and sensitivity. Factors associated with SSI occurrence included: being HIV positive (p &lt; 0.001), long operative time (p = 0.001), NNISS score &gt; 0 (p = 0.004), having a clean surgery (p = 0.008), having multi-level spinal surgery (p = 0.002), developing pressure sores (p = 0.021) or respiratory infections (p = 0.007) postoperatively.</div></div><div><h3>Conclusion</h3><div>The most common germs isolated in our setting are gram-negative bacilli. Empirical treatment of SSI in neurosurgery needs further investigations and adjustments.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"140 ","pages":"Article 111520"},"PeriodicalIF":1.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703888","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}
引用次数: 0
The quantification of surgical flow disruptions secondary to fogging and biofouling of endoscopic lens during endoscopic skull base surgeries 内镜颅底手术中内镜透镜雾化和生物污染引起的手术血流中断的定量分析
IF 1.9 4区 医学
Journal of Clinical Neuroscience Pub Date : 2025-07-25 DOI: 10.1016/j.jocn.2025.111521
Amandeep Kumar
{"title":"The quantification of surgical flow disruptions secondary to fogging and biofouling of endoscopic lens during endoscopic skull base surgeries","authors":"Amandeep Kumar","doi":"10.1016/j.jocn.2025.111521","DOIUrl":"10.1016/j.jocn.2025.111521","url":null,"abstract":"<div><h3>Purpose</h3><div>Despite significant progress in field of endoscopy, lens contamination (LC) continues to plague endoscopic surgeries. Apart from being an ergonomic nuisance, it potentially contributes to adverse surgical outcomes. The literature on the problem of LC during endoscopic skullbase surgeries (ESBSs) is lacking. The current study was conducted to address this lacuna.</div></div><div><h3>Methods</h3><div>In this study, operative videos of ESBSs performed by the author were retrospectively analysed. The videos were edited on Apple iMovie to identify surgical flow disruptions (SFDs) due to LC. The total number and duration of SFDs were then calculated to determine proportion of total surgical time spent on lens cleaning.</div></div><div><h3>Results</h3><div>Ten operative videos of ESBSs were analysed. The average duration of surgeries was 204 min. The various pathologies included were pituitary macroadenomas (n = 6), craniopharyngiomas (n = 2) and clival chordomas (n = 2). The average number and duration of SFDs were 56 (range: 43–68) and 15.5 min (range: 150–245 min) per surgery, respectively. The average rate of SFDs was 16 events per hour. Thus, 7.5 % of surgical time was wasted due to LC. Intracavitary cleaning was done in 73 % and extracavitary in 27 % of SFDs. On an average, endoscope had to be removed out of nasal cavity 15 times per surgery for cleaning, which means scope being removed q13.6 min.</div></div><div><h3>Conclusions</h3><div>The current study is first of its kind in literature that addresses the issue of LC in ESBSs. It shows that LC is a significant cause of SFDs during ESBSs. The study also reveals that probably SFDs due to LC are more frequent in ESBSs than laparoscopic surgeries. However, more studies on LC in ESBSs are needed to corroborate the findings of this study.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"140 ","pages":"Article 111521"},"PeriodicalIF":1.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144711598","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}
引用次数: 0
Computed tomography-based symmetry in bilateral chronic subdural hematomas: Its prognostic significance 双侧慢性硬膜下血肿的计算机断层对称:其预后意义
IF 1.9 4区 医学
Journal of Clinical Neuroscience Pub Date : 2025-07-25 DOI: 10.1016/j.jocn.2025.111498
Naoaki Fujisawa , Shinsuke Yoshida , Shunya Hanakita , Soichi Oya
{"title":"Computed tomography-based symmetry in bilateral chronic subdural hematomas: Its prognostic significance","authors":"Naoaki Fujisawa ,&nbsp;Shinsuke Yoshida ,&nbsp;Shunya Hanakita ,&nbsp;Soichi Oya","doi":"10.1016/j.jocn.2025.111498","DOIUrl":"10.1016/j.jocn.2025.111498","url":null,"abstract":"<div><div>Previous studies have suggested that bilateral chronic subdural hematomas (CSDH) have higher recurrence rates and poorer postoperative prognosis than unilateral CSDH. The present study aimed to investigate the significance of bilateral symmetry in computed tomography (CT) findings in patients with bilateral CSDH to identify patients who are at high risk of poor outcomes. This study included 160 individuals who underwent burr hole surgery for symptomatic bilateral CSDH at two medical centers between January 2019 and December 2023. We collected data on demographics, preoperative blood tests, treatment outcomes, and CT scans. Hematomas were categorized into homogeneous, laminar, separate, and trabecular types according to Nakaguchi’s classification. The concordance rate between the CT classifications of bilateral hematomas was significantly higher than would be expected under the assumption that those are independent between right and left. Albumin levels were significantly lower in individuals with bilateral symmetric hematomas than those with asymmetric hematomas. Logistic regression identified hypoalbuminemia as the only independent predictor of bilateral symmetry (odds ratio 3.79, 95 % confidence interval 1.04–18.5, p = 0.04). Although recurrence rates did not significantly differ between symmetric and asymmetric cases, the proportion of patients with modified Rankin Scale 3–6 was significantly higher in those with symmetric hematomas than in those with asymmetric hematomas (49.2 % vs. 25.0 %, p = 0.008). Additionally, preoperative albumin levels were significantly lower in patients with poor outcomes (mRS 3–6) than in those with favorable outcomes (mRS 0–2) (4.1 [IQR 3.8–4.4] vs. 3.7 [3.3–4.0], p &lt; 0.0001). Multivariate analysis revealed that hypoalbuminemia was an independent risk factor for poor outcomes (odds ratio 7.14, 95 % CI 3.17–17.5, p &lt; 0.0001). Bilateral symmetric CSDH may indicate more severe systemic dysfunction and worse treatment outcome. The association between specific CT patterns, hypoalbuminemia, and adverse outcomes helps in identifying patients who are at high risk and may benefit from tailored management strategies.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"140 ","pages":"Article 111498"},"PeriodicalIF":1.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703883","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}
引用次数: 0
Biomarkers in normal pressure hydrocephalus: A mini review 常压脑积水的生物标志物:一个小回顾
IF 1.9 4区 医学
Journal of Clinical Neuroscience Pub Date : 2025-07-24 DOI: 10.1016/j.jocn.2025.111517
Anderson Silva Corin , Gabriel Semione , Leonardo B.O. Brenner , Anderson M.P. Da Silva , Romualdo de Freitas Ruiz Filho , Isabela Zampirolli Leal , João Victor de Oliveira Ramos , Maria Fernanda P. Santana , Carlos Henrique de Oliveira Ferreira , Raphael Bertani
{"title":"Biomarkers in normal pressure hydrocephalus: A mini review","authors":"Anderson Silva Corin ,&nbsp;Gabriel Semione ,&nbsp;Leonardo B.O. Brenner ,&nbsp;Anderson M.P. Da Silva ,&nbsp;Romualdo de Freitas Ruiz Filho ,&nbsp;Isabela Zampirolli Leal ,&nbsp;João Victor de Oliveira Ramos ,&nbsp;Maria Fernanda P. Santana ,&nbsp;Carlos Henrique de Oliveira Ferreira ,&nbsp;Raphael Bertani","doi":"10.1016/j.jocn.2025.111517","DOIUrl":"10.1016/j.jocn.2025.111517","url":null,"abstract":"<div><h3>Background</h3><div>Normal Pressure Hydrocephalus (NPH) is a neurological disorder characterized by the classic triad of gait disturbances, cognitive impairment, and urinary incontinence. However, despite its clinical significance and prevalence, the diagnosis of NPH remains challenging due to symptom overlap with other neurodegenerative conditions. This mini-review aims to identify biomarkers for Normal Pressure Hydrocephalus (NPH) that could address this diagnostic gap, improving diagnostic accuracy and guiding treatment strategies.</div></div><div><h3>Design/methods</h3><div>Following PRISMA guidelines, the authors systematically searched the Embase, PubMed, Scopus, Cochrane, and Web of Science databases for literature on biomarkers in NPH. The articles included were exclusively published in English and discussed biomarkers in clinical studies involving NPH patients.</div></div><div><h3>Results</h3><div>A total of 91 articles were included in the final analysis. The most common biomarkers found were Beta-amyloid, Tau protein, Neurofilament protein light, Soluble amyloid precursor protein, Leucine-rich alpha-2-glycoprotein-1; Glial fibrillary acidic protein, Interleukins, Monocyte chemoattractant protein 1.</div></div><div><h3>Conclusions</h3><div>Biomarkers related to disease severity, complications, and prognosis prediction could significantly enhance NPH management. They have shown potential relevance for diagnosis and monitoring disease progression. Although there are some gaps related to accuracy, several biomarkers demonstrate promising results and could improve patient outcomes soon.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"140 ","pages":"Article 111517"},"PeriodicalIF":1.9,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144696414","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}
引用次数: 0
Prognostic Role of Carotid Plaque MRI Features in Cerebrovascular Accidents: A Systematic Review and Meta-analysis 颈动脉斑块MRI特征在脑血管意外中的预后作用:系统回顾和荟萃分析
IF 1.9 4区 医学
Journal of Clinical Neuroscience Pub Date : 2025-07-24 DOI: 10.1016/j.jocn.2025.111478
Hossein Hemmati , Amirhossein Larijani , Amirabbas Mollaei , Mohammad Amin Ashoobi , Abolfazl Nikkhoy , Parnia Vajdi Mozzayan , Mohammad Amin Hajari , Naeim Norouzi , Saeid Anvari , Mohaya Farzin , Kimia Jazi
{"title":"Prognostic Role of Carotid Plaque MRI Features in Cerebrovascular Accidents: A Systematic Review and Meta-analysis","authors":"Hossein Hemmati ,&nbsp;Amirhossein Larijani ,&nbsp;Amirabbas Mollaei ,&nbsp;Mohammad Amin Ashoobi ,&nbsp;Abolfazl Nikkhoy ,&nbsp;Parnia Vajdi Mozzayan ,&nbsp;Mohammad Amin Hajari ,&nbsp;Naeim Norouzi ,&nbsp;Saeid Anvari ,&nbsp;Mohaya Farzin ,&nbsp;Kimia Jazi","doi":"10.1016/j.jocn.2025.111478","DOIUrl":"10.1016/j.jocn.2025.111478","url":null,"abstract":"<div><h3>Background</h3><div>Characteristics of carotid plaques reported by magnetic resonance imaging (MRI) has been recently used to predict cerebrovascular accidents (CVA). We conducted this systematic review and <em>meta</em>-analysis to summarize the association of MRI-reported intraplaque hemorrhage (IPH), lipid-rich necrotic core (LRNC), and thinning/rupture of the fibrous cap (TRFC) with subsequent CVAs.</div></div><div><h3>Methods</h3><div>Comprehensive search was performed in PubMed, Scopus, and Web of Science databases from inception to September 19, 2024. We included cohort studies evaluating IPH, LRNC, and TRFC carotid plaques with the mean follow-up of ≥1 month, and outcome of the first stroke or transient ischemic attack. A random effect model with assessment of study heterogeneity and publication bias was applied.</div></div><div><h3>Results</h3><div>Of 5342 studies screened, 13 articles with a total subject of 2729 met the eligibility for systematic review. The hazard ratios (HR) for IPH, LRNC, and TRFC as predictors of CVA were 4.64 (95 % confidence interval (CI), 3.31–6.5), 2.89 (95 % CI, 1.5–5.57), 5.02 (95 % CI, 2.8–8.99), respectively. This demonstrates a significant association between these MRI features and an increased risk of CVA. The subgroup analysis showed no significant difference between the asymptomatic and the symptomatic groups. No significant heterogeneity was found in the <em>meta</em>-analyses.</div></div><div><h3>Conclusions</h3><div>The presence of IPH, LRNC, and TRFC on MRI reports of carotid plaques are significant predictors of cerebral ischemic events beyond measurement of luminal stenosis. MRI could identify at risk patients who might benefit from revascularization.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"140 ","pages":"Article 111478"},"PeriodicalIF":1.9,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144696413","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}
引用次数: 0
Diabetes is associated with a decreased risk of meningiomas: a mendelian randomization study 糖尿病与脑膜瘤风险降低相关:孟德尔随机研究
IF 1.9 4区 医学
Journal of Clinical Neuroscience Pub Date : 2025-07-24 DOI: 10.1016/j.jocn.2025.111519
Ruikang Wang , Tiit Mathiesen , Christian Mirian , Andrea Daniela Maier , Anders Broechner
{"title":"Diabetes is associated with a decreased risk of meningiomas: a mendelian randomization study","authors":"Ruikang Wang ,&nbsp;Tiit Mathiesen ,&nbsp;Christian Mirian ,&nbsp;Andrea Daniela Maier ,&nbsp;Anders Broechner","doi":"10.1016/j.jocn.2025.111519","DOIUrl":"10.1016/j.jocn.2025.111519","url":null,"abstract":"<div><h3>Background</h3><div>Meningiomas are the commonest primary intracranial tumors, but the risk factors are complex and not fully understood. Type 1 and 2 diabetes mellitus (T1DM and T2DM) are frequently occurring endocrine diseases, but their relationship with meningiomas is debated. Obesity and elevated body mass index (BMI) are known risk factors for meningiomas but often confound with diabetes. We aim to address this controversy using mendelian randomization a method inherently robust to confounding.</div></div><div><h3>Methods</h3><div>We used mendelian randomization on genetic instruments for T1DM and T2DM to assess the risks of three outcomes: benign neoplasm of cerebral meninges (D32.0), benign neoplasm of spinal meninges (D32.1), and malignant neoplasm of meninges (C70.0). All T2DM SNPs underwent additional testing for concurrent associations with BMI and other obesity traits.</div></div><div><h3>Results</h3><div>We found an inverse association between T1DM and the risk of benign cerebral and malignant meningiomas. Similarly, T2DM was inversely associated with benign and malignant cerebral meningiomas after adjusting for obesity and increased BMI. No significant associations were observed for benign spinal meningioma. Further, pleiotropic SNPs linked to higher BMI and T2DM tend to increase meningioma risk.</div></div><div><h3>Conclusions</h3><div>Our results suggest that T1DM and T2DM correlate with a lower risk of benign cerebral and malignant meningiomas. We also identify BMI as a risk factor of meningiomas and as a confounder. These insights into the interplay between T2DM, obesity and meningiomas provide a better foundation to understand the complex underlying biology and pathophysiology of meningiomas.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"140 ","pages":"Article 111519"},"PeriodicalIF":1.9,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703884","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}
引用次数: 0
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