Journal of Clinical Neuroscience最新文献

{"title":"Same-day mask-based gamma-knife stereotactic radiosurgery: workflow analysis and impact","authors":"Mark Mizrachi ,&nbsp;Iñigo L. Sistiaga ,&nbsp;Benjamin Hartley ,&nbsp;Eric Hintz ,&nbsp;Jessica S. Jung ,&nbsp;Emel Calugaru ,&nbsp;Anuj Goenka ,&nbsp;Michael Schulder","doi":"10.1016/j.jocn.2025.111277","DOIUrl":"10.1016/j.jocn.2025.111277","url":null,"abstract":"<div><h3>Objective</h3><div>Over the last 30 years, there has been a steady move towards the use of mask immobilization in SRS. Benefits of masks include the ability to hypofractionate SRS and improved patient comfort. However, there has been criticism that it eliminates the possibility of same-day, “wheels in to wheels out” treatments, as mask fixation is traditionally done on a separate day. This study evaluates the feasibility of doing mask fabrication and SRS treatment on the same day.</div></div><div><h3>Methods</h3><div>Patients who underwent SRS from September 2020 to June 2021 were reviewed. Leksell Gamma Knife (LGK) console data were processed, and operator reports were analyzed for treatment time, number of pauses, alarms, and pause durations.</div></div><div><h3>Results</h3><div>A total of 100 patients met the inclusion criteria. 52 patients underwent same-day fabrication and treatment, and 48 patients were treated at least one day following mask fabrication. Same-day patients had more frequent pauses and longer average pause durations than different-day patients. However, there were no significant differences in predicted vs. actual treatment times or the number of treatment alarms between groups.</div></div><div><h3>Conclusion</h3><div>Mask-based SRS can be done safely and efficiently in a single day, mirroring the approach of frame-based treatments. There is an increased number of pauses in the same-day group; however, it does not result in a significant prolongation of treatment time. The reduction in the number of visits to a GK facility for SRS may impact the overall subjective experience, increasing patient satisfaction.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"136 ","pages":"Article 111277"},"PeriodicalIF":1.9,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874216","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":"Real-world performance evaluation of a telemonitoring system for Parkinson’s disease symptom assessment","authors":"Eleni Kosmidi ,&nbsp;Foivos S. Kanellos ,&nbsp;Georgia A. Xiromerisiou ,&nbsp;Maria Chondrogiorgi ,&nbsp;Georgios Rigas ,&nbsp;Andreas P. Katsenos ,&nbsp;Yannis V. Simos ,&nbsp;Dimitrios Peschos ,&nbsp;Spyridon Konitsiotis ,&nbsp;Konstantinos I. Tsamis","doi":"10.1016/j.jocn.2025.111285","DOIUrl":"10.1016/j.jocn.2025.111285","url":null,"abstract":"<div><h3>Background</h3><div>Parkinson’s disease (PD) nurses constitute a reliable modality for appraising the motor status of patients, second only to expert neurologists. Consequently, employing PD nurses for the assessment of medical device performance is appreciated to be a fundamental benchmark in the field.</div></div><div><h3>Objective</h3><div>To evaluate the precision of a telemonitoring device in measuring motor symptoms when utilized at patient’s home during everyday life conditions.</div></div><div><h3>Methods</h3><div>To ascertain the extent of correlation between device-reported outcomes and PD nurse assessments and the precision with which the device detects symptoms such as gait impairment, rest tremor, bradykinesia, and the presence of OFF, a total of 34 evaluations were conducted by a PD nurse at the patients’ home, each lasting 3 h.</div></div><div><h3>Results</h3><div>A robust correlation was noted for all three symptoms when analyzed at both 30-minute intervals and cumulatively over the entire 3-hour duration with Pearson’s <em>r</em> range 0.68–0.76 and 0.83–0.90 respectively. Furthermore, substantial agreement was observed for the identification of the presence of all three symptoms with Cohen’s kappa range from 0.61 to 0.71 across all 30-minute evaluations. Finally, the device demonstrates high accuracy in detecting rest tremor (90%), bradykinesia (89%), gait impairment (95%) and OFF state (94%).</div></div><div><h3>Conclusion</h3><div>This study evaluates for the first time the performance of a remote monitoring device, unobtrusively, at patients familiar environment, with a PD nurse present in non-scripted scenarios. The device exhibited commendable efficacy in the accurate detection of PD symptoms and state.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"136 ","pages":"Article 111285"},"PeriodicalIF":1.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874289","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":"Revision LITT for Epilepsy: How likely are patients to get a second treatment if the first fails?","authors":"Nolan Winslow,&nbsp;Alexander Himstead,&nbsp;Sumeet Vadera","doi":"10.1016/j.jocn.2025.111235","DOIUrl":"10.1016/j.jocn.2025.111235","url":null,"abstract":"<div><h3>Aims</h3><div>Medically-refractory epilepsy is a serious neurological problem. Surgical resection may offer the greatest chance of seizure freedom, but is underutilized. Laser interstitial thermal therapy (LITT) has minimal incision size and variable efficacy by pathology. LITT can be repeated to provide seizure freedom, however, the number of patients who receive subsequent LITT treatments after a failed first attempt is unknown. We aimed to review the literature on this potential patient population who might benefit most from multiple surgical treatments.</div></div><div><h3>Methods</h3><div>We performed a record review of multiple medical databases for studies treating 5 or more epilepsy patients with LITT utilizing the PRISMA guidelines. From the search, we reviewed 55 articles with a total of 1734 patients with at least six months of follow up. We recorded clinical variables, rates of seizure control after LITT, and details of follow up treatments.</div></div><div><h3>Results</h3><div>Of 1734 total epilepsy patients treated with LITT, 46.4 % were listed as seizure free at last follow up. Out of 850 patients with data on additional procedural treatment, 40.5 % were seizure free and 59.5 % had persistent seizures. Of these, 29.1 % received subsequent intervention for continued seizures. These included additional LITT (55.4 %), surgical resections (41.9 %), and neurostimulator placement (2.0 %). Seizure freedom was achieved in 51.20 % of patients undergoing additional LITT, 62.9 % of patients undergoing subsequent surgical resection, and no patient undergoing neurostimulation. Lesions more likely to achieve seizure freedom with LITT were cavernous malformations (66.7 %) and hypothalamic hamartoma (66.4 %). Lesions less likely to achieve seizure freedom with LITT were temporal lobe epilepsy (43.6 %), focal cortical dysplasia (45.5 %), and periventricular nodular heterotopia (35 %).</div></div><div><h3>Conclusion</h3><div>Though LITT has respectable efficacy in epilepsy, not all patients may be participating in subsequent procedures after a failed first treatment. Patients should be advised that repeat LITT or subsequent surgical resection may be necessary for best chance of seizure freedom.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"136 ","pages":"Article 111235"},"PeriodicalIF":1.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868055","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":"Development of a deep neural network model for ultra-early neurological deterioration in ischemic stroke and analysis of associated risk factors","authors":"Lihong Zhang ,&nbsp;Zhanjun Wu ,&nbsp;Ce Zhang ,&nbsp;Hong Qu ,&nbsp;Jianping Xu ,&nbsp;Jitong Ma ,&nbsp;Jinggong Jiang ,&nbsp;Di Li","doi":"10.1016/j.jocn.2025.111246","DOIUrl":"10.1016/j.jocn.2025.111246","url":null,"abstract":"<div><h3>Background</h3><div>In this study, we established a deep neural network (DNN)-based predictive model, aiming to provide a basis for improving the treatment prognosis of early neurological deterioration (END) in patients with ultra-early ischemic stroke after intravenous thrombolysis with Alteplase.</div></div><div><h3>Methods</h3><div>A total of 1747 patients with ultra-early ischemic stroke who received intravenous thrombolysis with Alteplase were retrospectively included into the Yidu cloud database. These patients were assigned into the END group (234 cases) and the (No-END) group (1513 cases) based on whether END occurred within 48 h of admission. Tensorflow module in Python software platform was utilized to establish a DNN-based predictive model. Based on the training set (1397 cases) and a testing set (350 cases), the final DNN-based predictive model was generated for the prediction of END-associated factors. The discriminant performance of the model was evaluated by calculating the area under the receiver operating characteristic (ROC) curve (AUC).</div></div><div><h3>Results</h3><div>The incidence of END in the participants was 13.39 % after intravenous thrombolysis with alteplase. The END group exhibited higher incidences of hemorrhage, all-cause deaths during hospitalization, and poor prognosis versus the No-END group (all p &lt; 0.001). The AUC of DNN model prediction was 0.853, with a sensitivity of 70.53 % and specificity of 100.00 %. The DNN-based predictive model could effectively predict the END-associated factors.</div></div><div><h3>Conclusion</h3><div>The DNN-based predictive model in this study has a high predicative accuracy, good generalization ability, and robustness, without overfitting. This model is available for the prediction of END in ultra-early ischemic stroke.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"136 ","pages":"Article 111246"},"PeriodicalIF":1.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874288","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":"Sensory integration dysfunction in adolescent idiopathic scoliosis: Insights from a clinical balance assessment using the m-CTSIB","authors":"Dan Wang ,&nbsp;Raymond Tsang ,&nbsp;Qing Li ,&nbsp;Feng Chen ,&nbsp;Rajkumar Krishnan Vasanthi ,&nbsp;Vinosh Kumar Purushothaman ,&nbsp;Song Wang","doi":"10.1016/j.jocn.2025.111267","DOIUrl":"10.1016/j.jocn.2025.111267","url":null,"abstract":"<div><div>Sensory integration dysfunction contributes to postural instability, particularly in conditions challenging vestibular and proprioceptive processing. This study evaluated balance function in adolescent idiopathic scoliosis (AIS) using the modified Clinical Test of Sensory Interaction on Balance (m-CTSIB).A cross-sectional study was conducted with 80 participants (40 AIS, 40 controls), assessing postural stability under various sensory conditions, including a novel foam-surface, eyes-closed, head-movement condition designed to challenge vestibular function. AIS patients exhibited significantly greater center of pressure (COP) deviations, movement velocity, and elliptical area than controls (P &lt; 0.05), suggesting deficits in vestibular recalibration and sensory reweighting.Subgroup analysis revealed that lumbar scoliosis patients had greater postural instability than those with thoracic curves, suggesting differences in proprioceptive feedback. These findings may reflect that AIS-related balance deficits stem from sensory integration dysfunction rather than spinal deformity severity alone. This study highlights the need for targeted neurorehabilitation, including vestibular therapy and proprioceptive training, to improve postural control in AIS. Future research should explore neurophysiological mechanisms and rehabilitation efficacy.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"136 ","pages":"Article 111267"},"PeriodicalIF":1.9,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863642","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":"Genetic associations of sex hormones with cerebral aneurysm formation and subarachnoid hemorrhage: A two-sample Mendelian randomization analysis","authors":"Guanping Tan ,&nbsp;Jing Wang ,&nbsp;Jia Duan ,&nbsp;Wenli Xing","doi":"10.1016/j.jocn.2025.111244","DOIUrl":"10.1016/j.jocn.2025.111244","url":null,"abstract":"<div><h3>Background and aim</h3><div>Women are more likely than men to develop aneurysmal subarachnoid hemorrhage, and this difference is more pronounced in women after menopause, suggesting a possible correlation between sex hormone levels and cerebral aneurysm formation and rupture.</div></div><div><h3>Methods and results</h3><div>We selected genetic variants closely related to estrogen (estradiol), bioavailable testosterone (Bio T), and sex hormone-binding globulin (SHBG) as instrumental variables from the pooled data of the IEU Open GWAS project and cerebral aneurysm (CA) and subarachnoid hemorrhage (SAH) data from two independent datasets from the same study. Two-sample Mendelian randomization was subsequently performed to determine whether the relevant sex hormones and SHBG are causally associated with the formation and rupture of CA. We identified 14 causal associations of related sex hormones and their binding proteins with cerebral aneurysm formation and rupture. Inverse-variance weighting revealed that genetically predicted increased BioT levels reduced the risk of SAH development and genetically predicted increased levels of SHBG in females influenced reduced the risk of cerebral aneurysm formation. After excluding sex differences, weighted mode revealed opposite results, but there was no difference in the IVW, MR-Egger regression, weighted median, or simple mode analyses. No significant effects of the concentrations of other relevant sex hormones or SHBG on the risk of cerebral aneurysm formation or rupture were found.</div></div><div><h3>Conclusions</h3><div>Our study may explain the mechanisms underlying the increased incidence of cerebral aneurysms in menopausal women and provide new directions for intervention in cerebral aneurysm formation and rupture, but further studies are needed.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"136 ","pages":"Article 111244"},"PeriodicalIF":1.9,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143867859","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 population based survival analysis of skull base and sacral-coccygeal chordomas in an elderly population: 2000–2021","authors":"Taylor Furst,&nbsp;Muhammad I. Jalal,&nbsp;Suyash Sau,&nbsp;Prasanth Romiyo,&nbsp;Jonathan Stone,&nbsp;Tyler Schmidt","doi":"10.1016/j.jocn.2025.111278","DOIUrl":"10.1016/j.jocn.2025.111278","url":null,"abstract":"<div><div>Chordoma is an aggressive primary osseous tumor that most often arises from the sacral-coccygeal region and the skull base. Treatment typically requires en bloc gross total resection necessitating significant iatrogenic tissue disruption and physiological stress making management in a vulnerable elderly cohort challenging. The Surveillance, Epidemiology, and End Results (SEER) database was employed to isolate cases of chordoma in patients 65+ years of age between the years 2000–2021. Kaplan Meier survival analyses were used to identify survival trends. Multivariate cox regression analysis controlled for confounding variables. A subgroup analysis comparing geriatric survival to an adult cohort was performed. A total of 380 cases (128 skull base, 252 sacral-coccygeal) were included. Surgery not performed improved cumulative tumor-specific survival in both univariate and multivariate analyses (HR = 0.49, 95 % CI [0.27–0.88], p = 0.016), but surgery did not impact cumulative all-cause survival nor primary site-specific all-cause survival. Geriatric survival (89.2 ± 4.6 months) was significantly shorter than adult survival (187.6 ± 4.9 months) in subgroup analysis (p &lt; 0.001). Year of diagnosis did not significantly impact survival. Minimal improvements in geriatric chordoma survival have been made over the last two decades. Worsened tumor-specific survival with surgery likely results from the need for resection of advanced disease that inherently carries high risk within this population and surgery being deferred in the event of less advanced disease. Further study is needed to improve medical and surgical therapies within this cohort to improve survival.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"136 ","pages":"Article 111278"},"PeriodicalIF":1.9,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143867860","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":"Is the FIB-4 score a prognostic factor in acute ischemic stroke patients receiving intravenous thrombolytic therapy?","authors":"Ege Çadırci ,&nbsp;Mine Hayriye Sorgun ,&nbsp;Kurtuluş Umut Bozkurt ,&nbsp;Seyda Erdoğan ,&nbsp;Zerin Özaydın Aksun ,&nbsp;Eray Ergül ,&nbsp;Burak Çoban ,&nbsp;Büşra Begüm Yaşıtlı ,&nbsp;Elif İpek Gencer ,&nbsp;Dicle Seray Muratoğlu ,&nbsp;Buse Elitaş Özmutlu ,&nbsp;Derya Gökmen ,&nbsp;Canan Togay Işıkay","doi":"10.1016/j.jocn.2025.111251","DOIUrl":"10.1016/j.jocn.2025.111251","url":null,"abstract":"<div><h3>Background</h3><div>Liver dysfunction is recognized as a risk factor for poor outcome after.</div><div>stroke. The FIB-4 index, a laboratory test for predicting liver fibrosis, has been shown to be.</div><div>associated with poor prognosis in cardiovascular and cerebrovascular diseases. The aim of.</div><div>this study was to explore the relationship between FIB-4 score and hemorrhagic.</div><div>transformation, mortality, and prognosis in patients with acute ischemic stroke who received.</div><div>intravenous thrombolytic therapy (IV tPA).</div></div><div><h3>Methods</h3><div>The records of 255 consecutive patients who received IV tPA for acute.</div><div>ischemic stroke were retrospectively reviewed. Patients were divided into two groups.</div><div>according to their FIB-4 scores: group 1 (FIB-4 ≤ 2.67) and group 2 (FIB-4 &gt; 2.67). The.</div><div>demographic data, NIHSS scores at admission, THRIVE scores, intracranial bleeding rates,</div><div>(using the Heidelberg Bleeding Classification, NINDS and ECASS criteria for symptomatic.</div><div>intracranial hemorrhage), stroke etiology subtypes (using the automated Causative.</div><div>Classification System), and mRS scores at the third month were recorded.</div></div><div><h3>Results</h3><div>On logistic regression analysis, group 2 patients were older, had higher mRS.</div><div>scores at the third month and had increased mortality within 3 months when compared with.</div><div>group 1 (p ≤ 0.05). Although group 2 patients had a higher rate of intracranial hemorrhage,</div><div>the difference was not statistically significant.</div></div><div><h3>Conclusions</h3><div>The FIB-4 index may serve as a a useful predictor of poor prognosis in patients with acute ischemic stroke who received IV tPA. Large-scale prospective studies are needed to confirm this relationship and provide valuable insights for clinical practice.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"136 ","pages":"Article 111251"},"PeriodicalIF":1.9,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863641","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":"Association between thyroid hormone levels and early neurological deterioration in acute ischemic stroke","authors":"Zichen Rao,&nbsp;Yiming Zhang,&nbsp;Chunyan Zhu","doi":"10.1016/j.jocn.2025.111253","DOIUrl":"10.1016/j.jocn.2025.111253","url":null,"abstract":"<div><h3>Background</h3><div>Acute ischemic stroke (AIS) prognosis is significantly influenced by early neurological deterioration (END). Emerging evidence suggests that thyroid function, particularly free triiodothyronine (FT3) levels and the FT3/FT4 ratio, may play a crucial role in END occurrence. This study aimed to investigate the association between thyroid function parameters and END.</div></div><div><h3>Methods</h3><div>This study included a total of 1767 AIS patients. Multivariable regression analysis was conducted to assess the associations between FT3, the FT3/FT4 ratio, and other thyroid function parameters with END. Subgroup analyses were performed to explore the potential moderating effects of age, smoking status, and sex on these relationships. The predictive performance of the models was evaluated using receiver operating characteristic (ROC) curves.</div></div><div><h3>Results</h3><div>The FT3 levels (3.66 vs. 4.03 pmol/L, P &lt; 0.001) and the FT3/FT4 ratio (0.28 vs. 0.30, P &lt; 0.001) were significantly lower in the END group compared to the non-END group. Multivariable regression analysis identified a higher FT3/FT4 ratio as an independent protective factor against END (OR = 1.20, 95 % CI: 1.07–1.35, P = 0.0014). Subgroup analyses demonstrated that this protective effect was more pronounced inpatients older than 70 years, and non-smokers. Furthermore, the predictive model incorporating thyroid function parameters demonstrated certain predictive advantages over the CRP-based model (AUC = 0.688 vs. 0.624, P = 0.0036), suggesting its potential utility in predicting early neurological deterioration in AIS patients.</div></div><div><h3>Conclusions</h3><div>Lower FT3 levels and a reduced FT3/FT4 ratio are significantly associated with a higher risk of END. The FT3/FT4 ratio may serve as a valuable biomarker for risk stratification in AIS patients, underscoring the potential role of thyroid function in stroke management.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"136 ","pages":"Article 111253"},"PeriodicalIF":1.9,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859384","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":"Critical appraisal of: “expression of SARS-CoV-2 spike protein in cerebral arteries: implications for hemorrhagic stroke post-mRNA vaccination”","authors":"Ahmed Mueed ,&nbsp;Abia Shariq ,&nbsp;Manaal Ashar","doi":"10.1016/j.jocn.2025.111270","DOIUrl":"10.1016/j.jocn.2025.111270","url":null,"abstract":"<div><div>This correspondence offers a critical appraisal of the study by Ota et al. on the expression of SARS-CoV-2 spike protein in cerebral arteries following mRNA vaccination. While the original study contributes to understanding potential neurological sequelae post-vaccination, we identify several methodological limitations. Chief concerns include the absence of a control group, reliance on negative nucleocapsid staining to exclude prior infection, a small and unbalanced sample size, lack of lesionspecific tissue analysis, and unconfirmed RNA detection techniques. These issues collectively undermine causal inferences regarding vaccine-related spike protein persistence. We recommend methodological refinements for future studies, including matched controls, serial serological testing, tissue validation protocols, and robust subgroup stratification.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"136 ","pages":"Article 111270"},"PeriodicalIF":1.9,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143855435","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}