Journal of Clinical Neuroscience最新文献

{"title":"Minimizing financial toxicity of neurological care in low and middle income countries","authors":"Gaurav Nepal ,&nbsp;Rajeev Ojha","doi":"10.1016/j.jocn.2025.111446","DOIUrl":"10.1016/j.jocn.2025.111446","url":null,"abstract":"<div><div>Neurological diseases in low- and middle-income countries (LMICs) are increasingly associated with financial toxicity (FT), where the high costs of diagnosis and treatment create severe economic burdens for patients and their families. Unlike high-income countries (HICs), where publicly funded or insurance-based systems mitigate these costs, LMICs often lack such financial safety nets, leading to FT. As a result, only wealthier individuals can afford treatment, deepening health inequities. This paper discusses potential solutions to alleviate FT.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"139 ","pages":"Article 111446"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522524","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":"Structural and functional connectomic analysis of high-grade gliomas: A systematic review","authors":"Logan R. Burrington ,&nbsp;Alexander D. Smith ,&nbsp;Alexa R. Lauinger ,&nbsp;Wael Hassaneen","doi":"10.1016/j.jocn.2025.111415","DOIUrl":"10.1016/j.jocn.2025.111415","url":null,"abstract":"<div><h3>Introduction</h3><div>High-grade glioma (HGG) is a highly aggressive and proliferative brain cancer. Treatment most often involves maximum safe resection, followed by adjuvant chemotherapy and radiation. However, an incomplete understanding of HGG’s impact on brain connectivity limits the prediction of post-HGG resection complications and extent-of-resection protocols. Previous work has primarily focused on analyzing clinical and structural data to understand and predict post-surgical outcomes. These models overlook connectomics – an emerging field focused on the functional mapping of brain neural networks. In this systematic review, the authors 1) summarize the current understanding of major neural networks impacted by HGG resection through both a functional and structural viewpoint, and 2) discuss associated advancements in connectomics-based machine-learning models and application towards predicting post-surgical outcomes.</div></div><div><h3>Methods</h3><div>A systematic search was performed of peer-reviewed articles before 10/19/2023 according to PRISMA guidelines. No restrictions on publication date were utilized. Search terms included, “connectomics,” and “glioma.” Articles were included in the review if DTI structural data and/or rs-fMRI functional data involving white matter tracts impacted by HGG were analyzed. Articles were excluded if results did not apply to HGGs, tumor location was not included, or a full-text copy was unavailable.</div></div><div><h3>Results</h3><div>We reviewed 41 studies which analyzed the impact of HGGs on the brain connectome. HGGs tend to increase structural connectivity (SC) among rich-club nodes and reduce SC among peripheral nodes, though effects on functional connectivity (FC) tend to vary by tumor location. Frontal HGGs elicit bilateral FC changes, including decreased global efficiency (GE), local efficiency (LE), degree centrality, and increased average path length. Similarly, temporal HGGs often result in altered bilateral FC, including decreased LE with preserved GE and small-world properties. Parietal HGGs have mainly local effects and preserved small world organization, apart from observed bilateral FC changes of the default-mode network (DMN) and with precuneus HGGs. Insular HGGs also primarily affect local FC. In application, connectomic metrics including FC, LE, and GE have improved the predictive capabilities of post-HGG resection complications when combined with clinical and structural metrics.</div></div><div><h3>Conclusions</h3><div>HGG has distinct impacts on the functional connectome based on tumor location. In general, HGGs tend to decrease long-distance, interhemispheric FC and LE while GE and clustering coefficient are preserved. In application, these metrics have been used in connectomic-based models to predict post-HGG resection complications more accurately than previous clinical- or structural-based models.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"139 ","pages":"Article 111415"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518222","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 impact of robotic hand rehabilitation on hand function and fatigue in patients with stroke (RoHa-S)","authors":"Letizia Castelli ,&nbsp;Davide Giannuzzi ,&nbsp;Claudia Loreti ,&nbsp;Irene Falcolini ,&nbsp;Erika Tamburro ,&nbsp;Anna Maria Malizia ,&nbsp;Chiara Iacovelli ,&nbsp;Lorenzo Biscotti ,&nbsp;Luca Padua ,&nbsp;Silvia Giovannini","doi":"10.1016/j.jocn.2025.111445","DOIUrl":"10.1016/j.jocn.2025.111445","url":null,"abstract":"<div><h3>Objective</h3><div>Considering the wide use of technology and robotics in rehabilitation, this study investigates the potential impact of robotic rehabilitation with the robot end-effector Amadeo® on hand function and its possible effects on fatigue in patients with stroke outcomes.</div></div><div><h3>Methods</h3><div>This is a single blind, randomized-controlled pilot study. Twenty-four patients were randomly assigned to the experimental group (G-AMA) for robotic rehabilitation with Amadeo® and conventional rehabilitation, or the control group (G-CON) for conventional rehabilitation. All patients received 45-minute rehabilitation thrice a week for four weeks. Clinical measures for motor function, spasticity, autonomy, quality of life, and fatigue were used to assess all patients at baseline and end of treatment. Instrumental assessment included Amadeo® force and range of motion (ROM) measurements.</div></div><div><h3>Results</h3><div>Considering clinical evaluations, all patients indifferent to the group showed statistically significant improvement at the end of treatment. Comparison between groups showed a statistically significant difference in motor function (p &lt; 0.001), autonomy (p &lt; 0.001) and fatigue (p &lt; 0.001). Regarding instrumental assessment, only G-AMA patients showed statistically significant differences in several parameters, especially considering the percent ROM of individual fingers and hand; inter-group comparison showed a significant difference in hand extension strength (p = 0.042) and percent ROM of individual fingers (p &lt; 0.001) and hand (p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>This study suggests that robotic hand treatment with Amadeo®, combined with traditional methods, reduces fatigue in stroke patients with hand impairments. Therapeutic combinations of new technologies and conventional approaches can improve rehabilitation outcomes and patients’ quality of life, transforming post-stroke rehabilitation and other disorders.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"139 ","pages":"Article 111445"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518226","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":"Between sleep and wakefulness: how sleep quality and stress affect isolated sleep paralysis – a cross-sectional survey","authors":"Ahmed Ali Khan ,&nbsp;Ammara Abid ,&nbsp;Maheen Nawaz ,&nbsp;Muhammad Shaheer Bin Faheem ,&nbsp;Zahra Ali Haque ,&nbsp;Rayyan Mohammad Makki Bakhsh ,&nbsp;Areeba Ashfaq ,&nbsp;Fnu Raja","doi":"10.1016/j.jocn.2025.111435","DOIUrl":"10.1016/j.jocn.2025.111435","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Sleep paralysis (SP) is a rapid-eye movement (REM) parasomnia in which a person is alert but temporarily unable to move or speak during the transition between wakefulness and sleep. It is a cardinal feature of narcolepsy; however, it may also occur independently as isolated sleep paralysis (ISP). This study examines ISP’s prevalence, sociodemographic variations, and contributing factors, particularly the impact of poor sleep quality and stress.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted among shopping mall visitors using the Unusual Sleep Experiences Questionnaire (USEQ) to assess ISP episodes. Participants also provided data on sleep quality and stress levels to identify potential ISP predictors.</div></div><div><h3>Results</h3><div>Data from 336 participants was analyzed (mean age: 25.6 ± 9.45; 54.8 % females). 123 (36.6 %) participants reported experiencing ISP episodes at least once in their lifetime with the average age of episode onset being 17.9 ± 5.22 years. Poor sleep quality significantly influenced ISP frequency (p &lt; 0.0001). Moderate stress levels were found to be significantly associated with the prevalence of ISP (p = 0.028). Logistic regression models showed that sleep quality and stress accounted for 11.6 % and 5.70 % of the variance in ISP prevalence.</div></div><div><h3>Conclusion</h3><div>ISP is common among the non-narcoleptic population. Poor sleep quality and stress are significantly associated with increased ISP frequency; however, their limited predictive value suggests the involvement of other contributing factors. Longitudinal research is needed to confirm the causal relationship between these factors and ISP, and to develop effective interventions aimed at lowering frequency of ISP episodes.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"139 ","pages":"Article 111435"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518223","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":"Radiographic analysis of C2 pedicle screw placement guided by the transverse foramen in patients with a high-riding vertebral artery","authors":"Chun-Pi Chang ,&nbsp;Ting-Hsien Kao ,&nbsp;Hsu-Tung Lee ,&nbsp;Chiung-Chyi Shen ,&nbsp;Chi-Ruei Li ,&nbsp;Chien-Lun Tang","doi":"10.1016/j.jocn.2025.111424","DOIUrl":"10.1016/j.jocn.2025.111424","url":null,"abstract":"<div><h3>Background</h3><div>C2 pedicle screws (C2 PS) offer superior fixation but pose vertebral artery injury risks, accentuated by a high-riding vertebral artery (HRVA) and narrow C2 pedicle, prompting alternative approaches for safety. This study evaluated the safety and feasibility of an alternative technique.</div></div><div><h3>Methods</h3><div>This retrospective analysis focused on C2 PS placement for atlantoaxial instability and was conducted at Taichung Veterans General Hospital from April 2020 to December 2022. The alternative technique involved a high-speed burr that determined the C2 PS entry point. Tactile palpation-guided screw placement was confirmed using intraoperative fluoroscopy. Preoperative and postoperative computed tomography scans were used to assess pedicle dimensions, screw angles, and breaches. A HRVA and narrow pedicle classification were established. Postoperative scans were used to identify breaches by using a grading system. Radiographic data were assessed independently.</div></div><div><h3>Results</h3><div>A HRVA was present in 18 out of 39 patients in whom C2 PS placement was performed. Significant differences in the pedicle dimensions and screw angles were observed between the HRVA and non-HRVA groups. The overall breach rate was 15.4 %, with higher rates in the HRVA cases than in the non-HRVA cases (27.8 %). Lateral-inferior breaches were predominant, and all breaches were on the right side. No symptomatic complications were noted.</div></div><div><h3>Conclusions</h3><div>This alternative technique appears safe and feasible, especially in patients with a HRVA. Shorter pedicle screws may be considered for HRVAs with narrow pedicles. An alternative technique for C2 PS placement appears to be beneficial for reducing breach rates, especially in challenging cases.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"139 ","pages":"Article 111424"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513744","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 GAHR score for prediction of in-hospital mortality patients with aneurysmal subarachnoid hemorrhage","authors":"Beny Rilianto ,&nbsp;Bambang Tri Prasetyo ,&nbsp;Ricky Gusanto Kurniawan ,&nbsp;Nurfadilah M. Rajab ,&nbsp;Sardiana Salam ,&nbsp;Ita Muharram Sari ,&nbsp;Muhammad Kusdiansah ,&nbsp;Abrar Arham ,&nbsp;Eka Musridharta ,&nbsp;Mursyid Bustami","doi":"10.1016/j.jocn.2025.111438","DOIUrl":"10.1016/j.jocn.2025.111438","url":null,"abstract":"<div><h3>Background</h3><div>Aneurysmal subarachnoid hemorrhage (aSAH) remains a prominent cause of mortality. There are several factors associated with the overall outcome. This study aimed to develop a simple scoring model of the 30-day mortality in aSAH.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed the total number of aSAH patients hospitalized at the advanced stroke center between January 2019 and June 2022. Multivariable logistic regression generated the odds ratio of age- and sex-adjusted mortality for aSAH. Scoring predictors were derived from regression β-coefficients and converted into a point score system. The diagnostic performance and probability of in-hospital mortality were assessed.</div></div><div><h3>Results</h3><div>We included 318 aSAH patients, and 61 (19.18%) patients died during hospitalization. The aSAH mortality prediction (GAHR) score with a range of 0–12 points was assigned the following point values: <strong>g</strong>rade of aSAH (4 points), <strong>a</strong>neurysmal treatment (3 points), <strong>h</strong>eart comorbidities (2 points), and <strong>r</strong>espiratory failure (3 points). The GAHR score displayed an area under the receiving operating characteristics curve (AUC) of 0.8294 (SE 0.0277) and a <em>p</em>-value for the Hosmer–Lemeshow (HL) goodness-of-fit of 0.4133. The probability of in-hospital mortality was assessed based on the total score of each patient.</div></div><div><h3>Conclusions</h3><div>The GAHR score is a simple, convenient, and reliable scoring system with four clinical predictors containing grade, aneurysmal treatment, heart comorbidities, and respiratory failure to predict in-hospital mortality of aSAH. This scoring system has good accuracy and may aid clinicians in decision-making and determining the prognosis of patients.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"139 ","pages":"Article 111438"},"PeriodicalIF":1.9,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144501206","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":"Serum creatinine-to-albumin ratio as a predictor of 28-day mortality in critically ill patients with ischemic stroke: A retrospective cohort study","authors":"Shuwen Sun,&nbsp;Xin Huang,&nbsp;Xiaobin Fei,&nbsp;Kai Gong","doi":"10.1016/j.jocn.2025.111439","DOIUrl":"10.1016/j.jocn.2025.111439","url":null,"abstract":"<div><div>The creatinine-to-albumin ratio (CAR) has emerged as a promising prognostic marker in critical illnesses, yet its role in ischemic stroke (IS) remains underexplored. This study aimed to evaluate the association between CAR and 28-day mortality in IS patients admitted to the intensive care unit (ICU). We conducted a retrospective cohort study using data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. A total of 1,596 IS patients admitted to the ICU between 2008 and 2019 were included. CAR was calculated as the ratio of serum creatinine to albumin levels at ICU admission, and patients were stratified into quartiles based on CAR values. The primary outcome was 28-day all-cause mortality. Multivariate Cox regression models, Kaplan-Meier survival analysis, restricted cubic spline (RCS) analysis, and receiver operating characteristic (ROC) curves were used to assess the predictive value of CAR. Our results showed that higher CAR index was significantly associated with increased 28-day mortality. In multivariate Cox regression analysis, CAR remained an independent predictor of mortality after adjusting for age, gender, race, and comorbidities (HR: 1.33, 95 % CI: 1.12–1.59, p = 0.001). Patients in the highest CAR quartile (Q4) had a 2.76-fold increased risk of mortality compared to those in the lowest quartile (Q1) (HR: 2.76, 95 % CI: 1.93–3.94, p &lt; 0.001). Subgroup analysis revealed that the association was stronger in patients without diabetes or renal disease. RCS analysis demonstrated a non-linear dose–response relationship, with a steeper increase in mortality risk at CAR levels above 0.288. CAR showed moderate predictive performance (AUC: 0.645, 95 % CI: 0.614–0.676), outperforming individual markers such as creatinine and albumin. CAR is an independent predictor of 28-day mortality in IS patients admitted to the ICU. By integrating renal dysfunction and systemic inflammation or malnutrition, CAR provides a comprehensive risk assessment, making it a valuable tool for risk stratification and clinical decision-making.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"139 ","pages":"Article 111439"},"PeriodicalIF":1.9,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144501207","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":"Safety profile of trans-radial approach (TRA) in patients with radial artery loop in neurointervention: retrospective analysis of a TRA-dedicated neurovascular center experience over 4 years","authors":"Wei Cao ,&nbsp;Rongguo Hu ,&nbsp;Si Zhao Tang ,&nbsp;Dandan Jia ,&nbsp;Deyuan Zhu ,&nbsp;Dayong Qi ,&nbsp;Kangqing Zhang ,&nbsp;Tonghui Song ,&nbsp;Yibin Fang","doi":"10.1016/j.jocn.2025.111400","DOIUrl":"10.1016/j.jocn.2025.111400","url":null,"abstract":"<div><h3>Introduction</h3><div>The presence of radial artery loops − complete 360° loop along the radial artery, can complicate transradial approach (TRA) in neurointerventional surgeries. Our study aims to evaluate the safety profile of TRA in patients with radial artery loops and proposes strategies for managing radial artery loops to improve the success rate of TRA.</div></div><div><h3>Methods</h3><div>This is a single-center retrospective study, which included all patients with radial artery loops who underwent neurointerventional procedures via TRA over 4 years (2021–2024). Data on baseline patient characteristics, relevant TRA anatomical data, periprocedural complications (e.g. vessel wall injury e.g. perforation), conversion to femoral access, radial artery patency at 3 months follow-up were collected.</div></div><div><h3>Results</h3><div>Radial artery loops were present in 29 patients from TRA database (total of 945 patients). The average age of patients was 75.5 years old (13 males, 16 females). TRA was successful in 27 out of 29 patients (93.1 %). Radial artery perforation occurred in 2 patients (6.9 %), both managed conservatively with manual compression. At the 3-month follow-up, radial artery patency was preserved in all cases.</div></div><div><h3>Conclusions</h3><div>TRA in patients with radial artery loops is feasible with a favorable safety profile when appropriate techniques are employed. However, the observed 7% rate of radial artery perforation highlights the need for careful case selection and emphasizes that loop navigation should be reserved for centers with sufficient expertise and clinical justification. Reinforcing the role of preliminary ultrasound screening, particularly when extended proximally, may help identify anatomical variants such as radial loops in advance, thereby reducing procedural complexity and improving planning.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"139 ","pages":"Article 111400"},"PeriodicalIF":1.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144501388","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":"Comparative analysis of facial nerve outcomes in petroclival versus posterior petrous meningioma surgery: A systematic review and meta-analysis of 2884 patients","authors":"Mehdi Khaleghi ,&nbsp;Matthew Tao ,&nbsp;Garrett Dyess ,&nbsp;Danner W. Buttler ,&nbsp;Adnan H. Shahid ,&nbsp;Sudhir Suggala ,&nbsp;Ursula Noelle Hummel ,&nbsp;Maxon Bassett ,&nbsp;Jeffrey Sosnowski ,&nbsp;Jai Deep Thakur","doi":"10.1016/j.jocn.2025.111426","DOIUrl":"10.1016/j.jocn.2025.111426","url":null,"abstract":"<div><h3>Background</h3><div>Even conservative resection of petroclival (PC) and posterior petrous (PP) meningiomas may cause facial nerve (FN) morbidities. While inconsistent classifications by tumor’s dural origin circulate among different cohorts, a comprehensive assessment of postoperative FN outcomes is lacking. We systematically evaluate early and long-term FN outcomes related to surgical extirpation of PC and PP meningiomas.</div></div><div><h3>Methods</h3><div>A PRISMA-tailored survey of PubMed, Embase, Ovid/Medline, and Scopus was used to assess pooled perioperative FN deficit rates in PC and PP meningiomas. Outcomes were dichotomized by tumor’s dural origin (PC vs. PP group), age (≥50 vs. &lt; 50 years), and tumor size (≥ 3.5 vs. &lt; 3.5 cm), and analyzed using random-effect <em>meta</em>-analysis.</div></div><div><h3>Results</h3><div>Forty-one studies involving 2884 patients with an average tumor size of 3.5 cm met the eligibility criteria. Pooled gross total resection rates were 48 % for PC and 69.6 % for PP groups. FN deficits rates (HB grade &gt; II) at presentation, early postoperative (new-onset during admission), and long-term (≥6-month follow-up) were respectively 12 % (CI:7.7–16.3 %; p &lt; 0.001; I² = 89.7 %), 18.6 % (CI:14–23.2 %; p &lt; 0.001; I² = 89.9 %), and 8.3 % (CI:5–11.7 %; p &lt; 0.001; I² = 87.3 %) in “PC group”, and 6.4 % (CI 3.8–9 %; p &lt; 0.001; I² = 79.4 %), 16.2 % (CI:10.3–22.2 %; p &lt; 0.001; I² = 89.4 %), and 9.2 % (CI:3.9–14.5 %; p &lt; 0.001; I² = 91.2 %) in “PP group.” The mixed-effect model revealed significantly higher FN deficit rates at presentation for larger PP meningiomas (15.9 % in size ≥ 3.5 cm vs. 5.8 % for &lt; 3.5 cm, p = 0.003), while larger PC meningiomas had higher early postoperative rates (18.1 % vs. 3.9 %, respectively, p &lt; 0.001). Tumor size, age, or dural origin did not impact overall long-term outcomes.</div></div><div><h3>Conclusions</h3><div>No significant difference was observed in long-term FN outcomes between PC and PP meningiomas. Anatomic preservation of the nerve should be prioritized regardless of tumor size, approach, or dural origin, as many deficits improve in the long-term. Although challenging, in meningiomas ≥ 3.5 cm, preoperative detailing of the dural origin is of value in patient consultation, as larger sizes worsen “early” FN outcomes only in true PC meningiomas.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"139 ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144489620","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":"Rare cause of dynamic limb pain: Symptomatic myofascial hernia","authors":"Siddharth Chand ,&nbsp;Padma Youron ,&nbsp;Nikita Verma ,&nbsp;Riya Sharma ,&nbsp;Ritu Shree ,&nbsp;Mahesh Prakash ,&nbsp;Manoj K. Goyal","doi":"10.1016/j.jocn.2025.111417","DOIUrl":"10.1016/j.jocn.2025.111417","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"139 ","pages":"Article 111417"},"PeriodicalIF":1.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490761","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}