Journal of Clinical Neuroscience最新文献

{"title":"Corrigendum to “Development and temporal validation of an odds ratio-weighted prognostic score (NPH-RKP) for idiopathic normal pressure hydrocephalus shunt surgery: a retrospective cohort study” [J. Clin. Neurosci. 146 (2026) 111883]","authors":"Usame Rakip , Serhat Yıldızhan , İhsan Canbek , Mehmet Gazi Boyacı , Serhat Korkmaz , Ömer Kimsesiz , Abdullah Guzel , Anas Abdallah , Adem Aslan","doi":"10.1016/j.jocn.2026.111901","DOIUrl":"10.1016/j.jocn.2026.111901","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"147 ","pages":"Article 111901"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142637","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":"Outcomes of Gamma Knife radiosurgery for meningiomas overlying the motor cortex","authors":"Neil D. Almeida ,&nbsp;Shefalika Prasad ,&nbsp;Venkatesh Madhugiri ,&nbsp;Assaf Berger ,&nbsp;Sarthak Sinha ,&nbsp;Mengyu Fang ,&nbsp;Babar Gulzar ,&nbsp;Harshini K. Cheruvu ,&nbsp;Tyler V. Schrand ,&nbsp;Victor Goulenko ,&nbsp;Matthew Podgorsak ,&nbsp;Kenneth V. Snyder ,&nbsp;Lindsay Lipinski ,&nbsp;Andrew J. Fabiano ,&nbsp;Robert A. Fenstermaker ,&nbsp;Dheerendra Prasad","doi":"10.1016/j.jocn.2026.111909","DOIUrl":"10.1016/j.jocn.2026.111909","url":null,"abstract":"<div><h3>Background</h3><div>Meningiomas involving the motor cortex pose a therapeutic challenge due to the risk of treatment-related neurological morbidity. This study evaluates the clinical, imaging, and survival outcomes of patients with motor cortex meningiomas treated with Gamma Knife radiosurgery (GKRS).</div></div><div><h3>Methods</h3><div>Clinical, imaging, and survival data were retrospectively obtained from an institutional radiosurgery registry. Serial magnetic resonance imaging was reviewed to assess treatment volumes and longitudinal tumor response. Progression-free survival and tumor control were analyzed using standard survival methods.</div></div><div><h3>Results</h3><div>Between 2008 and 2024, 47 patients with 58 meningiomas involving the motor cortex underwent either upfront definitive GKRS or adjuvant GKRS following surgical resection. Prescribed margin doses ranged from 12 to 17 Gy, normalized to the 50–80% isodose line. Patients with WHO Grade 1 meningiomas demonstrated significantly longer progression-free survival compared with those harboring Grade 2–3 tumors (p = 0.0014). Lesions with treatment volumes &lt;5 cc were associated with superior progression-free survival relative to larger tumors (p = 0.0008). On univariate analysis, meningioma grade (p = 0.0014) and treatment volume (p = 0.0015) were significantly associated with tumor control. While GKRS Dmax showed only a marginal association with tumor control across the full cohort (p = 0.0882), a significant positive correlation between Dmax and percentage tumor volume reduction was observed in Grade 1 meningiomas (r = 0.53, p = 0.0287).</div></div><div><h3>Conclusions</h3><div>GKRS provides effective tumor control for meningiomas involving the motor cortex, particularly in patients with small-volume, WHO Grade 1 lesions. These findings support GKRS as a safe and efficacious treatment option in this eloquent location when careful patient selection and dose planning are applied.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"147 ","pages":"Article 111909"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146157279","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":"The Bone Microenvironment and Therapeutic Resistance in Spinal Metastases: Mechanisms and Clinical Implications","authors":"Laura Mittelman ,&nbsp;Luis O. Vargas ,&nbsp;Matthew Abikenari ,&nbsp;Samuel Latzman ,&nbsp;John Chen ,&nbsp;Karthik Rangavajhula ,&nbsp;Shoaib Syed ,&nbsp;Brandon A. Santhumayor ,&nbsp;James Duehr ,&nbsp;Nicholas Cassimatis ,&nbsp;John Caridi ,&nbsp;Sheng-Fu Larry Lo ,&nbsp;Daniel M. Sciubba ,&nbsp;Randy S. D’Amico","doi":"10.1016/j.jocn.2026.111928","DOIUrl":"10.1016/j.jocn.2026.111928","url":null,"abstract":"<div><h3>Background</h3><div>Spinal metastases represent a biologically distinct manifestation of systemic cancer, frequently progressing despite durable visceral response. The vertebral niche is defined by hypoxia, immune suppression, osteoclast–osteoblast coupling, and stromal signaling. These features create a therapeutic sanctuary that fosters tumor dormancy, clonal evolution, and resistance to systemic therapy.</div></div><div><h3>Objective</h3><div>We aim to synthesize current knowledge of the bone niche in spinal metastases, explain how microenvironmental factors and tumor-intrinsic changes converge to drive therapeutic resistance, and provide translational implications for prognosis and treatment design.</div></div><div><h3>Methods</h3><div>A narrative review of English-language studies (1990–2024) from PubMed and Scopus was conducted, examining pathophysiology, bone-tumor crosstalk, dormancy, immune evasion, and resistance genetics. Foundational pre-1990 works were included when biologically essential. When available, bone-specific outcomes (skeletal progression, skeletal-related events, spine-PFS) were prioritized.</div></div><div><h3>Results</h3><div>Spinal metastases are driven by unique interactions between tumor cells and the bone microenvironment, including RANK/RANKL signaling, hypoxia-induced HIF activation, immune sequestration, and dormancy niches. Specific molecular alterations include <em>EGFR</em> and <em>ALK</em> mutations in NSCLC, BRCA and PI3K/AKT pathway dysregulation in prostate and breast cancers, and VHL/HIF pathway alterations in RCC. Resistance patterns such as <em>EGFR T790M</em> and <em>BRCA</em> reversion mutations emerge disproportionately in bone, reflecting site-specific selective pressure. Conventional systemic therapies achieve lower efficacy in the spine, underscoring the need for site-specific biomarkers, advanced imaging, and tailored therapeutic strategies.</div></div><div><h3>Conclusion</h3><div>The vertebral niche constitutes a treatment-resistant microenvironment where dormant tumor cells persist, immune surveillance is impaired, and resistant clones evolve. Integrating bone-microenvironment biology with molecular profiling, liquid biopsy, and advanced imaging is essential for refining prognostic models, guiding intervention timing, and designing spine-specific clinical trials. By reframing spinal metastases as a biologically and therapeutically distinct disease entity, this review establishes a framework for developing bone-directed treatment strategies and advancing precision oncology in metastatic spine care.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"147 ","pages":"Article 111928"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146172488","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":"Timing of adjuvant radiotherapy impacts overall survival for atypical intracranial meningiomas: a National Cancer Database (NCDB) analysis","authors":"Linda Tang,&nbsp;Raj Patel,&nbsp;Sachiv Chakravarti,&nbsp;Arjit Singh,&nbsp;Jacob Gould,&nbsp;Yuncong Mao,&nbsp;A.Karim Ahmed,&nbsp;Debraj Mukherjee","doi":"10.1016/j.jocn.2026.111935","DOIUrl":"10.1016/j.jocn.2026.111935","url":null,"abstract":"<div><h3>Introduction</h3><div>Atypical intracranial meningiomas are characterized by brain invasion and faster growth than lower grade counterparts. Adjuvant radiotherapy (aRT) improves survival for patients with atypical meningiomas (AMs). This study assesses the association between timing of initiating radiotherapy following surgery upon survival.</div></div><div><h3>Methods</h3><div>Patients &gt; 18 years old with intracranial AMs surgically resected (2004–2019) within the National Cancer Database were included. Kaplan-Meier survival curves for each variable were generated. Cox proportional hazards models were developed to assess the association between timing of initiating radiotherapy with overall survival, while controlling for age, sex, race, ethnicity, facility type, tumor size, comorbidities, resection type, and systemic therapy.</div></div><div><h3>Results</h3><div>5,452 patients were included; 28.28% received aRT. Median time to initiation of radiation post-surgery was 9 weeks. On multivariate analysis, starting radiotherapy within 6 weeks post-surgery (HR 0.73, p &lt; 0.01), between 6–12 weeks (HR 0.73, p &lt; 0.01), and between 12 weeks-6 months (HR 0.69, p &lt; 0.01) all showed survival benefits compared to not receiving radiotherapy, whereas initiating radiotherapy &gt; 6 months post-surgery did not offer survival benefits (HR 0.49, p = 0.22). Pairwise Wald tests showed no significant differences among the &lt; 6 weeks, 6–12 weeks, and 12 weeks–6 months groups (p = 0.97, 0.78, 0.71). On subgroup analysis, following gross total resection, initiating radiotherapy &lt; 6 weeks (HR 0.53, p = 0.01) or between 6–12 weeks (HR 0.59, p &lt; 0.01) offered survival benefits, whereas initiating radiotherapy later did not. Following subtotal resection, initiating radiotherapy between 12 weeks-6 months (HR 0.60, p = 0.01) offered survival benefits whereas initiating radiotherapy earlier or later did not.</div></div><div><h3>Conclusion</h3><div>For AMs overall, radiotherapy is associated with improved survival if initiated &lt; 6 months post-surgery. Starting radiotherapy &lt; 12 weeks after surgery is associated with improved survival following gross total resection and initiating radiotherapy between 12 weeks-6 months is associated with improved survival following subtotal resection.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"147 ","pages":"Article 111935"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146172539","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":"The effect of physical therapy in spine surgery: a systematic review","authors":"Minjun Park,&nbsp;Nathan D. McLaughlin,&nbsp;Mayur S. Patel,&nbsp;Jorge F. Urquiaga,&nbsp;Mauricio J. Avila","doi":"10.1016/j.jocn.2026.111900","DOIUrl":"10.1016/j.jocn.2026.111900","url":null,"abstract":"<div><div>While physical therapy is a well-established preoperative intervention to manage pain and improve function for patients undergoing spinal surgery, its postoperative utility, particularly following fusion procedures, remains less well defined. We aim to systematically review the current literature on the efficacy of physical therapy following spine surgery. A systematic review in accordance with PRISMA guidelines was performed with a comprehensive search in PubMed, EBSCO, and CINAHL database. The database was searched up to March 2025 with the following MESH terms using AND or OR boolean operators: (“Spine/surgery” “Spinal Fusion” “Laminectomy” “Discectomy”), (“Physical Therapy Modalities” “Exercise Therapy” “Rehabilitation”), and (“Treatment Outcome” “Outcome Assessment (Health Care)” “Recovery of Function”). Thirty-one studies involving 4,335 patients were included: 22 RCTs, 8 retrospective analyses and 1 prospective cohort. Studies focused on lumbar surgeries (n = 25) and cervical surgeries (n = 6). In lumbar fusion studies (n = 7), 43% (3/7) demonstrated significant pain improvement and 17% (1/6) showed reduced disability with postoperative rehabilitation. Among non-instrumented lumbar procedures (n = 18), 63% (10/16) of studies found greater pain relief and 59% (10/17) observed reduced disability with physical therapy. Cervical studies revealed pain benefits in 40% (2/5) of trials and disability improvement in 33% (1/3) associated with postoperative physical therapy. Evidence supporting postoperative physical therapy following lumbar fusion is mixed with respect to pain, disability, and functional outcomes. In contrast, non-instrumented lumbar procedures show more consistent benefit, particularly in pain outcomes. Additional high-quality randomized controlled trials are warranted to better define the role of rehabilitation in post-operative spinal surgery care.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"147 ","pages":"Article 111900"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146116344","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":"Gamma knife radiosurgery for cystic vestibular schwannomas: Morphological and dosimetric correlation in a single-institution retrospective study","authors":"Shweta Kedia ,&nbsp;Pitchaikannu Venkatraman ,&nbsp;Sundarakrishnan Dharanipathy ,&nbsp;Rajinder Kumar ,&nbsp;Manoj Phalak ,&nbsp;Satish Kumar Verma ,&nbsp;Dattaraj P. Sawarkar ,&nbsp;Deepak Agarwal","doi":"10.1016/j.jocn.2026.111902","DOIUrl":"10.1016/j.jocn.2026.111902","url":null,"abstract":"<div><h3>Background</h3><div>Cystic vestibular schwannomas (CyVS) have unique biological and morphological characteristics which presents the development of specialized Stereotactic Radiosurgery (SRS) treatment protocols. This retrospective study addresses the relationship between linear and volumetric parameters of CyVS treated with Gamma Knife (GKRS) radiosurgery and evaluates the long-term tumor control predictive ability of the cyst-to-tumor volume ratio (CVR).</div></div><div><h3>Methods</h3><div>Thirty-eight patients treated from 2012 to 2019 were included in the study. A Pearson analysis was performed to correlate the tumor diameter/volume with cyst diameter/volume. The CVR was evaluated as the ratio of the cyst volume to total tumor volume and classified as solid-dominant (&lt;10 % cyst volume), mixed (10–50 % cyst volume), or cyst-dominant (&gt;50 % cyst volume). Dosimetric analysis included conformity index (CI), gradient index (GI), target coverage and selectivity, as well as hearing outcomes assessed using the AAO-HNS and Gardner-Robertson scales. Local tumor control was evaluated using Kaplan-Meier survival analysis.</div></div><div><h3>Results</h3><div>The mean tumor diameter and volume was 20.0 +/- 6.2 mm and 5.25 +/- 3.51 cc, respectively. The mean cyst diameter and volume were 10.9 +/- 4.7 mm and 0.97 +/- 1.21 cc, respectively. There was strong correlation between tumor diameter and volume (r = 0.86, p &lt; 0.0001) as well as between cyst diameter and volume (r = 0.85, p &lt; 0.0001), indicating linear measures are appropriate substitutes for volumetric measurements in evaluating treatment response. Actuarial local control following GKRS was 84.8 %, with over 20 % of patients achieving a ≥ 20 % volume reduction at last follow-up.</div></div><div><h3>Conclusion</h3><div>These findings demonstrate that CVR serves as a useful imaging biomarker, supporting individualized radiosurgical planning and enabling reliable long-term management of patients with CyVS.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"147 ","pages":"Article 111902"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137609","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":"GLP-1 receptor agonists and aneurysm rupture risk in type 2 diabetes: a multicenter retrospective study","authors":"Sean Y. Li ,&nbsp;Anisha Sonti ,&nbsp;David C. Kaelber ,&nbsp;David Ben-Israel ,&nbsp;Alfred Bowles Jr. ,&nbsp;Deven Reddy ,&nbsp;Michael L. Kelly","doi":"10.1016/j.jocn.2026.111905","DOIUrl":"10.1016/j.jocn.2026.111905","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Intracranial aneurysms (IAs) occur in up to 3% of the population, with rupture leading to substantial morbidity and mortality. Preclinical evidence suggests glucagon-like peptide-1 receptor agonists (GLP-1RAs) may provide vascular protection. Their role in IA rupture prevention has not been readily assessed in large human cohorts.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study using the TriNetX Research Network to identify adults with type 2 diabetes mellitus (T2DM) and unruptured IAs between 2008 and 2025. Patients were classified as GLP-1RA users or non-users. Propensity score matching (PSM) was applied to balance demographics, comorbidities, laboratory values, and medication use. The primary outcome was nontraumatic subarachnoid hemorrhage (SAH) at 3- and 5-year follow-up.</div></div><div><h3>Results</h3><div>A total of 24,776 T2DM patients with unruptured IA(s) were identified: 3119 of those with GLP-1RA prescriptions and 8063 without GLP-1RA prescriptions. After 1:1 PSM, 2651 patients remained in each cohort. GLP-1RA prescriptions were associated with significantly lower risk of SAH diagnoses at 3 years (HR 0.62, 95% CI 0.44–0.88) with a decreased effect at 5 years (HR 0.65, 95% CI 0.47–0.92). Follow-up laboratory values showed no significant differences between groups.</div></div><div><h3>Conclusions</h3><div>GLP-1RA prescriptions in patients with T2DM and unruptured IAs were associated with reduced risk of aneurysmal rupture. These results suggest a possible stabilizing effect of GLP-1RAs on IAs, although future prospective, imaging-based studies will be required to further investigate this association.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"147 ","pages":"Article 111905"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165688","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 and validation of interpretable machine learning models for predicting long-term functional outcomes in elderly patients with aneurysmal subarachnoid hemorrhage","authors":"Xianggan Wang ,&nbsp;Wei Tu ,&nbsp;Xiuli Li ,&nbsp;Gang Wu","doi":"10.1016/j.jocn.2026.111899","DOIUrl":"10.1016/j.jocn.2026.111899","url":null,"abstract":"<div><h3>Background</h3><div>Accurate prognostication in elderly patients with aneurysmal subarachnoid hemorrhage (aSAH) remains challenging due to high morbidity and mortality. This study aimed to develop and externally validate interpretable machine learning (ML) models for predicting 12-month functional outcomes.</div></div><div><h3>Methods</h3><div>Data from 426 consecutive elderly aSAH patients at the primary center were randomly split into a training cohort (n = 298, 70%) and an internal test cohort (n = 128, 30%). An independent external validation cohort (n = 41) was obtained from a collaborating tertiary medical center. Features with multicollinearity (|Spearman ρ| &gt; 0.8) were excluded. Predictive variables were identified using univariate/multivariate logistic regression and the Boruta algorithm. Eight ML models were trained using 5-fold cross-validation. Model performance was assessed on both internal and external validation cohorts using receiver operating characteristic (ROC) and precision-recall (PR) curves, along with calibration plots. Model interpretability was evaluated using SHapley Additive exPlanations (SHAP).</div></div><div><h3>Results</h3><div>The Multilayer Perceptron (MLP) model demonstrated superior performance, achieving ROC-AUCs of 0.913 (internal testing) and 0.912 (external validation), with favorable calibration in both cohorts. SHAP analysis identified the Hunt-Hess scale, age, total bleeding volume, delayed cerebral ischemia (DCI), modified Fisher scale, rebleeding, hydrocephalus, aneurysm multiplicity, and aneurysm length as key predictors. SHAP dependency plots facilitated individualized risk interpretation.Conclusion: This study successfully developed and externally validated interpretable ML models that reliably predict long-term functional outcomes in elderly aSAH patients. These tools demonstrate robust generalizability across clinical settings and hold potential to support personalized clinical decision-making and optimize resource allocation in neurocritical care.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"147 ","pages":"Article 111899"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137535","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":"Investigation of psychological and sleep states in patients with Intracerebral hemorrhage and analysis of influencing Factors: A Single-Center Case-Control study","authors":"Yan He ,&nbsp;Chengling Xia ,&nbsp;Xiaolei Zhao ,&nbsp;Ling Xiao ,&nbsp;Qinglian Luo","doi":"10.1016/j.jocn.2026.111870","DOIUrl":"10.1016/j.jocn.2026.111870","url":null,"abstract":"<div><div>Introduction: This study explores the prevalence of anxiety and depression at various time points during the rehabilitation of intracerebral hemorrhage (ICH) patients, ascertains their sleep quality, and analyzes influencing factors regarding psychological conditions, family and society.</div><div>Methods: Multiple questionnaires were employed to assess the disease and psychological status of ICH patients at different time points following onset. Assessments were conducted upon hospital admission, as well as at 1, 3, 6, and 12 months (s) after onset. Simultaneously, data regarding the rehabilitation support provided by caregivers or family members were collected. The prevalence and correlation of psychological disorders in patients during rehabilitation were analyzed. A comprehensive discussion was made on the factors influencing psychological disorders in ICH patients. Our study accounted for patient-specific, family, and psychological factors at different time points.</div><div>Results: 524 ICH patients were ultimately enrolled in this study. Results showed that the prevalence of moderate-to-severe anxiety and depression gradually declined over one year post-discharge, while the sleep quality fluctuated, peaking at 1 and 6 months. Multivariate analysis identified several risk factors, encompassing male gender, low muscle strength, lack of exercise, unemployment (OR &lt; 1), hypertension, lower family income (OR &gt; 1), prolonged daily caregiving hours (OR &gt; 1), caregivers’ limited disease knowledge, and low caregiver enthusiasm (OR &lt; 1). Psychological scores exhibited intercorrelations. For instance, anxiety and depression were strongly correlated at 1 month post-discharge (r = 0.730). Admission SSS (Somatic Symptom Scale) scores significantly predicted anxiety, while depression was linked to PSQI (Pittsburgh Sleep Quality Index), SSS, and Barthel Index scores. The sleep quality was influenced by HAMD (Hamilton Depression Scale) and Barthel scores. These findings highlighted that psychological issues in ICH patients, though prevalent, declined over time, affected by patient characteristics (physical function, socioeconomic status), caregiver dynamics, and multidimensional psychological interactions.</div><div>Conclusion: Following the onset of ICH, patients commonly exhibit varying degrees of anxiety, depression, and sleep quality. The prevalence of these conditions declines progressively throughout the rehabilitation period. Psychological and sleep-related outcomes are influenced by a combination of individual characteristics, familial circumstances, and multiple psychosocial factors, underscoring the need for comprehensive nursing care and multidimensional support.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"147 ","pages":"Article 111870"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146131985","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":"Anterior spinal artery aneurysm: a rare cause of subarachnoid hemorrhage","authors":"Ujjwal Agarwal ,&nbsp;Rajsrinivas Parthasarathy ,&nbsp;Vipul Gupta","doi":"10.1016/j.jocn.2026.111897","DOIUrl":"10.1016/j.jocn.2026.111897","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"147 ","pages":"Article 111897"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142607","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}