Journal of Clinical Neuroscience最新文献

{"title":"Thoracic stenosis decompression using Bi-portal endoscopic technique","authors":"Zihan Masood ,&nbsp;Richard J. Chung ,&nbsp;Julia Kincaid ,&nbsp;Ryan Turlip ,&nbsp;Daksh Chauhan ,&nbsp;Mert M. Dagli ,&nbsp;Hasan S. Ahmad ,&nbsp;Ben J. Gu ,&nbsp;Yohannes Ghenbot ,&nbsp;Jang W. Yoon","doi":"10.1016/j.jocn.2025.111608","DOIUrl":"10.1016/j.jocn.2025.111608","url":null,"abstract":"<div><h3>Background</h3><div>Thoracic spinal stenosis is a relatively rare pathology. Surgical decompression is widely regarded as the most effective treatment. Many minimally invasive techniques exist, but there is a paucity of reports and operative videos demonstrating the bi-portal technique in the thoracic spine.</div></div><div><h3>Case description</h3><div>Herein, we demonstrate the techniques and effectiveness of bi-portal endoscopic thoracic decompression in a young patient with comorbidities.</div></div><div><h3>Conclusion</h3><div>Recent advances in endoscopic spine techniques, particularly the bi-portal approach, offers an effective minimally invasive approach, with minimal tissue dissection, reduced blood loss, shorter hospital stay, and faster recovery. These techniques can be safely and effectively applied to the thoracic spine.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"142 ","pages":"Article 111608"},"PeriodicalIF":1.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145119871","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":"Factors predicting the outcome of thoracic ossification of ligamentum flavum (OLF) surgery: A systematic review and meta-analysis","authors":"Anish Tayal ,&nbsp;Pragya Mitra ,&nbsp;Aneeket Modak ,&nbsp;Sucharu Asri ,&nbsp;Kanwaljeet Garg","doi":"10.1016/j.jocn.2025.111649","DOIUrl":"10.1016/j.jocn.2025.111649","url":null,"abstract":"<div><h3>Background</h3><div>The study aimed to determine the association between demographics, clinical presentation, radiological findings, and intraoperative characteristics of patients with thoracic ossification of ligamentum flavum (OLF) surgery and their postoperative outcomes.</div></div><div><h3>Methods</h3><div>PubMed, Ovid, Embase, and Web of Sciences databases were searched until July 2023 to include articles regarding the prognostic factors for thoracic OLF surgery. The risk of bias was assessed using the Quality In Prognosis Studies (QUIPS) tool. The outcome of surgery was evaluated by calculating the recovery rate (RR), as follows: RR = (postoperative Japanese Orthopedic Association (JOA) score − preoperative JOA score)/(11 − preoperative JOA score). Meta-analyses Of Observational Studies in Epidemiology (MOOSE) and Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. Furthermore, factors associated with outcome were assessed separately within open and minimally invasive surgery (MIS) subgroups.</div></div><div><h3>Results</h3><div>Thirty-six studies with 1,511 patients were included. RR was associated with age (p-value = 0.012), JOA score (p-value &lt; 0.001), ossified region (middle vs. lower thoracic spine: p-value = 0.042), intramedullary signal intensity change on T2-weighted magnetic resonance imaging (p-value &lt; 0.001), and occurrence of dural ossification (p-value = 0.006). On subgroup analysis, JOA score (p-value &lt; 0.001) and operation time (p-value = 0.014) were associated with outcomes for patients managed with an open surgical approach, while none for those operated with the MIS technique.</div></div><div><h3>Conclusion</h3><div>Although surgery is the cornerstone of the management of OLF, careful patient prognostication should be performed considering the aforementioned factors. Further, high-quality research is warranted to confirm the findings of this study.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"142 ","pages":"Article 111649"},"PeriodicalIF":1.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145119868","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":"Platelet function testing does not predict hemorrhage progression in mild traumatic brain injury","authors":"Tessa A. Harland ,&nbsp;Andrew Ku ,&nbsp;Gregory Topp ,&nbsp;Tarun Prabhala ,&nbsp;Sruti Bandlamuri ,&nbsp;Rachel Thiets ,&nbsp;Fernando Figueroa ,&nbsp;Samuel Ortiz ,&nbsp;Alan Boulos ,&nbsp;Pouya Entezami","doi":"10.1016/j.jocn.2025.111647","DOIUrl":"10.1016/j.jocn.2025.111647","url":null,"abstract":"<div><h3>Background</h3><div>Antiplatelet medications are frequently assumed to increase the risk of radiographic progression following traumatic intracranial hemorrhage (ICH), influencing guidelines that recommend prolonged observation and repeat imaging. However, antiplatelet use does not uniformly result in functional platelet inhibition, and the clinical relevance of therapeutic response remains unclear.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of adult patients with traumatic ICH and a Glasgow Coma Scale (GCS) score of 13–15 who were on antiplatelet therapy and underwent platelet function testing (VerifyNow PRU or PFA) on admission. Patients were classified as therapeutic or non-therapeutic based on test thresholds. All patients received follow-up CT imaging within 24 h. Clinical variables and outcomes, including radiographic progression, surgical intervention, and mortality, were compared between groups. A sensitivity analysis excluded patients with hematocrit &lt;30 % or platelet count &lt;100,000.</div></div><div><h3>Results</h3><div>A total of 239 patients were included: 190 in the non-therapeutic group and 49 in the therapeutic group. Radiographic progression occurred in 17.6 % of patients overall, with no significant difference between therapeutic and non-therapeutic groups (20.4 % vs. 16.8 %; p = 0.53). Surgical intervention (p = 0.57) and mortality (p = 0.38) rates were similarly low and comparable. Sensitivity analyses confirmed these findings (p = 0.81).</div></div><div><h3>Conclusions</h3><div>Therapeutic platelet inhibition was not associated with increased risk of radiographic or clinical worsening in patients with mild traumatic ICH. These findings challenge current assumptions regarding antiplatelet risk and suggest that platelet function testing may have limited utility in this setting. These findings support the need to reevaluate current guidelines and validate risk stratification approaches through prospective multicenter studies.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"142 ","pages":"Article 111647"},"PeriodicalIF":1.8,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145119869","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":"Does the volume of Onyx injected influence outcomes after middle meningeal artery embolization for subdural hematoma?","authors":"Joanna M. Roy ,&nbsp;Basel Musmar ,&nbsp;Spyridon Karadimas ,&nbsp;Saman Sizdahkhani ,&nbsp;Arbaz Momin ,&nbsp;Mary-Katharine Pontarelli ,&nbsp;Ajay Garg ,&nbsp;Eleni Papadopoulos ,&nbsp;Vinay Pedapati ,&nbsp;Arashleen Pannu ,&nbsp;Stavropoula I. Tjoumakaris ,&nbsp;M. Reid Gooch ,&nbsp;Robert H. Rosenwasser ,&nbsp;Pascal Jabbour","doi":"10.1016/j.jocn.2025.111651","DOIUrl":"10.1016/j.jocn.2025.111651","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Recent literature has highlighted the efficacy of liquid embolic agents like Onyx for middle meningeal artery (MMA) embolization of subdural hematoma (SDH). Our study aims to assess whether the volume of Onyx injected affects outcomes in patients undergoing MMA embolization for SDH.</div></div><div><h3>Methods</h3><div>This was a retrospective study of patients who underwent MMA embolization using Onyx for SDH at a single institution between March 2019- December 2024. Patients who underwent embolization using particles were excluded. Patients were dichotomized into two groups (≥0.7 ml or &lt;0.7 ml) based on the 75th percentile of median volume of Onyx injected. The primary outcome of interest was embolization failure, defined as increase in hematoma thickness or need for surgical evacuation. The secondary outcome of interest was extended length of stay (eLOS), defined as LOS above the 75th percentile of the median.</div></div><div><h3>Results</h3><div>A total of 123 MMA embolization procedures were included. The mean age of the cohort was 71.7 ± 13.5 years, and 26 % (n = 32) were female. 70.7 % of patients (n = 87) received a lower volume (&lt;0.7 ml) of Onyx. Volume of Onyx was not associated with embolization failure or eLOS. Female gender (OR: 0.24, 95 % CI: 0.06–0.89, P = 0.034) was associated with lower odds of eLOS, while baseline functional dependence was associated with higher odds of eLOS (OR: 6.34, 95 % CI: 2.24–17.97, P &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The volume of Onyx injected does not predict embolization failure or eLOS after MMA embolization for SDH. Future research could help validate our preliminary findings through prospective multicenter studies.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"142 ","pages":"Article 111651"},"PeriodicalIF":1.8,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145119773","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":"Understanding patient perspectives in spine care: A social media analysis of 2,513 posts reveals distinct patterns in treatment perceptions","authors":"Daniel Schneider ,&nbsp;Jacob Gluski ,&nbsp;Ethan D.L. Brown ,&nbsp;Akash Mishra ,&nbsp;Harshal A. Shah ,&nbsp;Barnabas Obeng-Gyasi ,&nbsp;Daniel M. Sciubba ,&nbsp;Sheng-Fu Larry Lo","doi":"10.1016/j.jocn.2025.111624","DOIUrl":"10.1016/j.jocn.2025.111624","url":null,"abstract":"<div><h3>Background</h3><div>As patients increasingly turn to social media for health information, understanding online patterns of social discourse around medical conditions has become increasingly crucial. This study aimed to identify patient perceptions of common symptoms and interventions in spine care using data from large online communities.</div></div><div><h3>Methods</h3><div>Posts were extracted using the Python Reddit API Wrapper (PRAW) based on 39 predefined keywords covering symptoms (n = 8), interventions (n = 25), and risk factors (n = 6). Natural language processing techniques, including sentiment analysis, were employed to assess relationships between symptoms, interventions, and patient sentiment. Clustering and temporal analyses were used to identify trends in patient discussions.</div></div><div><h3>Results</h3><div>Analysis of 2,513 posts revealed pain as the predominant symptom (74.1 %, n = 1,862), followed by numbness (11.1 %, n = 280) and sciatica (9.7 %, n = 245). Physical therapy was the most discussed intervention (10.8 %, n = 272), followed by medication (5.6 %, n = 140) and microdiscectomy (3.9 %, n = 99). Significant associations emerged between numbness and surgical interventions (microdiscectomy: X² = 14.37, p = 0.014; spinal fusion: X² = 11.94, p = 0.026). Sentiment analysis revealed modestly positive scores for most interventions, with numbness-microdiscectomy showing the highest positive sentiment (0.066 [0.008, 0.125]). The five identified clusters showed distinct characteristics: Sciatica-Medication (mean sentiment = 0.024, SD = 0.134), Pain-Medication (0.048, SD = 0.119), Numbness-Physical Therapy (0.007, SD = 0.134), Pain-Physical Therapy (0.057, SD = 0.138), and Numbness-Microdiscectomy (0.038, SD = 0.113). Age dominated risk factor discussions (97.6 % of mentions), suggesting limited emphasis on modifiable risk factors. Temporal analysis showed an increase in discussion volume after 2022, particularly around pain-related topics.</div></div><div><h3>Conclusions</h3><div>Our findings highlight how social media analysis can reveal distinct patterns in patient experiences with regards to spine care. Variable sentiment towards interventions and the notable lack of discussion around modifiable risk factors suggest opportunities to enhance preoperative counseling.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"142 ","pages":"Article 111624"},"PeriodicalIF":1.8,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145100175","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":"Effect of direct revascularization on cerebral vasodilatory reserve in the unoperated hemisphere in Moyamoya disease","authors":"Yilong Zheng ,&nbsp;Colin Kok Ann Teo ,&nbsp;Vijay Kumar Sharma ,&nbsp;Vincent Diong Weng Nga","doi":"10.1016/j.jocn.2025.111645","DOIUrl":"10.1016/j.jocn.2025.111645","url":null,"abstract":"<div><div>Moyamoya disease (MMD) is characterized by progressive intracranial carotid stenosis, increasing stroke risk. While revascularization improves cerebral vasodilatory reserve (CVR) in operated hemispheres, its impact on the contralateral hemisphere remains unclear. This study evaluates postoperative CVR changes in the unoperated hemisphere and their association with clinical outcomes was conducted. A retrospective analysis of 22 MMD patients undergoing unilateral superficial temporal artery-middle cerebral artery (STA-MCA) bypass at a single center. CVR was quantified preoperatively and eight months postoperatively using transcranial Doppler (TCD)-derived breath-holding index (BHI). Changes in BHI were categorized as improved, unchanged, or worsened. Associations between CVR changes, postoperative transient ischemic attacks (TIAs)/strokes, and clinical predictors were analyzed. Postoperatively, 31.8 % (7/22) of patients exhibited improved CVR in the unoperated hemisphere, 59.1 % (13/22) showed no change, and 9.1 % (2/22) experienced worsening. TIA/stroke incidence was highest in the worsened CVR group (50.0 %, 1/2), followed by unchanged (23.1 %, 3/13) and improved (14.3 %, 1/7) groups, though differences were not statistically significant (p = 0.582). No clinical variables significantly predicted CVR deterioration. Unilateral revascularization in MMD may improve CVR in the unoperated hemisphere in approximately one-third of patients. However, this improvement did not significantly correlate with reduced postoperative TIA/stroke risk. Larger studies with longer follow-up and standardized CVR assessment methods are needed to validate these findings and explore mechanisms underlying contralateral hemodynamic changes.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"142 ","pages":"Article 111645"},"PeriodicalIF":1.8,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145100177","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 a nomogram for predicting malnutrition risk among patients with Parkinson’s disease: A retrospective cohort study","authors":"Qiaomin Tang,&nbsp;Weiya Ma,&nbsp;Yuanyuan Sun,&nbsp;Chen Hu,&nbsp;Sumin Ma","doi":"10.1016/j.jocn.2025.111635","DOIUrl":"10.1016/j.jocn.2025.111635","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to establish a nomogram to predict malnutrition risk in patients with Parkinson’s disease (PD).</div></div><div><h3>Design</h3><div>A retrospective cohort study.</div></div><div><h3>Setting</h3><div>A Grade III, Class A hospital in Zhejiang Province.</div></div><div><h3>Participants</h3><div>Patients with primary PD meeting the inclusion criteria were retrospectively identified from the electronic medical record system (January 2023–December 2024) for study inclusion.</div></div><div><h3>Methods</h3><div>This study included 21 research variables, encompassing demographic characteristics, physiological features, physical functional status, disease type, and severity. Optimal variables were selected using least absolute shrinkage and selection operator (LASSO) regression and multivariable logistic regression analyses. Internal validation was performed via bootstrap resampling (1,000 iterations), and a nomogram was constructed to predict the risk of malnutrition in patients with PD.</div></div><div><h3>Results</h3><div>This study included 215 patients with PD for model construction, with a malnutrition prevalence of 35.6 %. The LASSO regression and logistic regression models identified seven significant predictors of malnutrition: lower body mass index, advanced H-Y stage, decreased poorer Unified Parkinson’s Disease Rating Scale Part III Maximum Improvement Rate, decreased red blood cell count, reduced total cholesterol, elevated blood urea nitrogen, and dysphagia (<em>P</em> &lt; 0.05). The model achieved an area under the curve of 0.814 (95 % CI: 0.754–0.874), with 70.1 % sensitivity, 76.1 % specificity, and a Youden’s index of 0.462, indicating robust predictive performance.</div></div><div><h3>Conclusion</h3><div>The prediction model constructed based on Mini Nutritional Assessment scores demonstrated strong predictive performance and holds significant clinical importance for identifying malnutrition in patients with PD.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"142 ","pages":"Article 111635"},"PeriodicalIF":1.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145100176","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":"Diabetes and intracranial plaques: Are we missing important confounders?","authors":"Christian Messina","doi":"10.1016/j.jocn.2025.111642","DOIUrl":"10.1016/j.jocn.2025.111642","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"142 ","pages":"Article 111642"},"PeriodicalIF":1.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145100179","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 role of sleep quality and stress in isolated sleep paralysis: Unraveling the multifactorial contributors to a common phenomenon","authors":"Suryadi,&nbsp;Rici Kardo,&nbsp;Mori Dianto,&nbsp;Rila Rahma Mulyani,&nbsp;Yasrial Chandra","doi":"10.1016/j.jocn.2025.111641","DOIUrl":"10.1016/j.jocn.2025.111641","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"142 ","pages":"Article 111641"},"PeriodicalIF":1.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145100178","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":"Aggressive Lumbar vertebral hemangioma with characteristic imaging signs and effective preoperative embolization","authors":"Mustafa Kemal Demir ,&nbsp;Deniz Konya","doi":"10.1016/j.jocn.2025.111640","DOIUrl":"10.1016/j.jocn.2025.111640","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"142 ","pages":"Article 111640"},"PeriodicalIF":1.8,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086272","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}