Journal of Clinical Neuroscience最新文献

{"title":"Mortality risk among older adults of indigenous ancestry with asymptomatic intracranial atherosclerotic stenosis. A population-based, longitudinal prospective study in rural Ecuador","authors":"Oscar H. Del Brutto ,&nbsp;Robertino M. Mera ,&nbsp;Mitchell S.V. Elkind ,&nbsp;Farid Khasiyev ,&nbsp;Denisse A. Rumbea ,&nbsp;Emilio E. Arias ,&nbsp;José Gutierrez ,&nbsp;Victor J. Del Brutto","doi":"10.1016/j.jocn.2025.111197","DOIUrl":"10.1016/j.jocn.2025.111197","url":null,"abstract":"<div><h3>Background</h3><div>Intracranial atherosclerotic stenosis (ICAS)-related mortality may vary according to race/ethnicity, but information about this association in diverse populations is limited. We aimed to assess mortality according to ICAS severity in stroke-free older adults of indigenous ancestry living in Ecuador.</div></div><div><h3>Methods</h3><div>We invited <strong>s</strong>troke-free individuals ≥60 years old enrolled in the population-based Atahualpa Project cohort to undergo time-of-flight brain MRA. Participants were followed to ascertain mortality (as the primary outcome) during the observation period. Luminal stenosis in 11 large intracranial arteries was calculated to reflect the stenosis score. We categorized prevalent ICAS as a stenosis score ≥3 points or as the presence of moderate-to-severe stenosis (≥50 %). Cox proportional hazards models were fitted to estimate mortality risk according to ICAS severity.</div></div><div><h3>Results</h3><div>Analysis included 358 participants (mean age: 67.5 ± 6.9 years; 57 % women) followed on average for 10.1 ± 2.9 years. Seventy-four (21 %) participants had a stenosis score ≥3 points, and 37 (10 %) had moderate-to-severe stenosis. In adjusted analysis, mortality risk was higher in participants with a ICAS score ≥3 points (HR: 2.38; 95 % C.I.: 1.49–3.80; <em>p</em> &lt; 0.001) and among those with moderate-to-severe stenosis (HR: 1.96; 95 % C.I.: 1.12–3.43; <em>p</em> = 0.018). Thirty-five (10 %) participants had incident strokes. Overall, 97 (27 %) participants died during the follow-up, including 11/35 who developed an incident stroke and 86/323 who did not (31 % <em>versus</em> 27 %; <em>p</em> = 0.544).</div></div><div><h3>Discussion</h3><div>The burden of asymptomatic ICAS is high in older adults of indigenous Ecuadorian ancestry and is significantly associated with mortality. Incident strokes do not influence mortality in this population.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111197"},"PeriodicalIF":1.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143686379","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":"In-Hospital mortality in Spondylodiscitis: Risk factors assessed through the National Inpatient Sample analysis","authors":"Julius Gerstmeyer ,&nbsp;August Avantaggio ,&nbsp;Clifford Pierre ,&nbsp;Neel Patel ,&nbsp;Donald David Davis ,&nbsp;Bryan Anderson ,&nbsp;Periklis Godolias ,&nbsp;Thomas A. Schildhauer ,&nbsp;Amir Abdul-Jabbar ,&nbsp;Rod J. Oskouian ,&nbsp;Jens R. Chapman","doi":"10.1016/j.jocn.2025.111183","DOIUrl":"10.1016/j.jocn.2025.111183","url":null,"abstract":"<div><h3>Objective</h3><div>Spondylodiscitis (SD) poses an increasing challenge to healthcare providers by its insidious onset and diverse clinical manifestations, concurrent with an aging population, immunocompromising conditions and various influencing comorbidities. Overall mortality remains relatively high, up to 7.3%, despite advancements in diagnostics and treatment. Past studies have struggled to differentiate leading causes for mortality. With this study we want to utilize the large data group available through the National Inpatient Sample (NIS) to assess the in-hospital mortality in patients with SD in different age-groups and to identify risk factors.</div></div><div><h3>Methods</h3><div>Utilizing the 2020 NIS, Healthcare Utilization Project (HCUP) adults (&gt;18 years) were screened using the primary diagnosis of SD by ICD-10 Code (M46.2x, M46.3x and M46.4x). Demographic information, admission details, clinical data, comorbidities, and surgical treatment were extracted using the Clinical Classifications Software Refined (CSSR) categories.</div><div>Comorbidities include pre-existing conditions and those acquired during hospitalization. Age was categorized into 3 groups (&lt;65 years; 65–79: ≥ 80). The primary outcome was in-hospital mortality, with multivariable logistic regression analysis used to identify independent risk factors.</div></div><div><h3>Results</h3><div>In total 3,975 patients met our inclusion criteria resulting with an in-hospital mortality rate of 0.9 %. The mortality group was significantly older (70.86 years to 58.74 years compared to the survival group) with elective admission being more common (p=&lt;0.001) with a similar sex distribution. Patients ages 65–79 were more common in the mortality group. Overall fourteen comorbidities differed significantly between the two groups. Chronic diseases were more common in the mortality group, whereas alcohol and substance abuse were more prevalent in the survival group. Age, especially patients &lt; 65 years, elective admission status, paralysis and pneumonia were identified as independent risk factors for mortality.</div></div><div><h3>Conclusion</h3><div>Management of SD remains complex. Our study revealed a lower rate of in-hospital mortality and length of stay than previous studies. Elective admission status was the strongest predictor of mortality, highlighting the benefits of early diagnosis and treatment. Patients &gt; 65 years, especially octogenarians, were identified to be particular at risk. Risk factors contributing to mortality in SD may differ from etiological risk factors, highlighting areas for potential further research.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111183"},"PeriodicalIF":1.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143686338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between white matter hyperintensities and physical activity: A sectional study in UK Biobank participants","authors":"Yucun Chen ,&nbsp;Mia Jiming Yang ,&nbsp;Hao Huang ,&nbsp;YuanYuan Fang ,&nbsp;Xirui Zhou ,&nbsp;Zhiyuan Yu ,&nbsp;Minghuan Wang ,&nbsp;Sabine Bohnet-Joschko ,&nbsp;Xiang Luo","doi":"10.1016/j.jocn.2025.111181","DOIUrl":"10.1016/j.jocn.2025.111181","url":null,"abstract":"<div><div>White matter hyperintensities (WMH) are key markers of cerebral small vessel disease (CSVD) linked to increased risks of stroke, dementia, and cognitive decline. Physical activity (PA) has been hypothesized to reduce WMH burden and preserve brain health, yet findings across studies remain mixed. This study examines the association between PA and WMH burden, as well as white matter integrity using diffusion tensor imaging (DTI) metrics, in a cohort of 10,868 participants from the UK Biobank.</div><div>Participants were categorized into low, intermediate, and high PA tertiles based on accelerometer data. WMH volumes, normalized for head size, were classified into quintiles. Multilevel ordered logistic regression models revealed that high PA levels were significantly associated with reduced WMH burden (OR = 0.956, p = 0.026), while low PA levels increased the likelihood of higher WMH burden (OR = 1.148, p &lt; 0.001). Subtype analyses indicated stronger associations between PA and periventricular WMH compared to deep WMH. Furthermore, DTI metrics demonstrated that higher PA levels were correlated with improved fractional anisotropy (FA) and reduced mean diffusivity (MD) in key white matter tracts, such as the corpus callosum and fornix, suggesting better white matter integrity.</div><div>Our findings emphasize the potential neuroprotective effects of PA, particularly in mitigating WMH progression and preserving cognitive and motor functions. These results underscore the importance of promoting PA, especially in older adults, as a strategy to reduce the burden of CSVD and support brain health. Future longitudinal studies are needed to confirm causality and elucidate underlying mechanisms.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111181"},"PeriodicalIF":1.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674185","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 tranexamic acid on rebleeding, mortality, and hydrocephalus in patients with aneurysmal subarachnoid hemorrhage: A systematic review and meta-analysis","authors":"Mohammed Maan Al-Salihi ,&nbsp;Ahmed Abd Elazim ,&nbsp;Maryam Sabah Al-Jebur ,&nbsp;Ram Saha ,&nbsp;Farhan Siddiq ,&nbsp;Ali Ayyad ,&nbsp;Adnan I. Qureshi","doi":"10.1016/j.jocn.2025.111189","DOIUrl":"10.1016/j.jocn.2025.111189","url":null,"abstract":"<div><h3>Background</h3><div>The therapeutic benefit of tranexamic acid (TXA) in patients with aneurysmal subarachnoid hemorrhage (aSAH) remains controversial. We evaluated the efficacy and safety of TXA in aSAH patients by performing a comprehensive <em>meta</em>-analysis of randomized controlled trials (RCTs).</div></div><div><h3>Methods</h3><div>We conducted a systematic review and <em>meta</em>-analysis of RCTs comparing TXA with either placebo or standard care in aSAH patients. A comprehensive literature search was performed across PubMed, EMBASE, Web of Science, Cochrane Library, and Scopus from inception to July 2024. Outcomes of interest included rebleeding, mortality, functional outcomes, and delayed cerebral ischemia (DCI). Subgroup analyses were performed based on publication date and TXA administration duration.</div></div><div><h3>Results</h3><div>Thirteen RCTs were included in our study. TXA significantly reduced rebleeding rates (relative risk [RR] 0.61; 95 % confidence interval [CI] 0.51–0.74, P &lt; 0.00001) but did not affect mortality (RR 0.99; 95 % CI 0.86–1.13, P = 0.84) or good clinical outcomes (RR 0.98; 95 % CI 0.93–1.05, P = 0.63). TXA use was associated with increased occurrence of hydrocephalus (RR 1.12; 95 % CI 1.01–1.23, P = 0.03) but not DCI (RR 1.00; 95 % CI 0.84–1.20, P = 0.96). Subgroup analyses suggested greater rebleeding reduction with longer TXA administration (≥1 week) and in more recent studies (post-2000).</div></div><div><h3>Conclusions</h3><div>TXA reduces rebleeding in aSAH but does not improve survival or functional outcomes. Its routine use in aSAH is not supported by current evidence.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111189"},"PeriodicalIF":1.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674187","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":"Flow diverter is valid for aneurysms with incorporated branch vessels: Adding coil embolization and incorporated branch vessel diameter are predictors of treatment efficacy","authors":"Kenichiro Suyama ,&nbsp;Ichiro Nakahara ,&nbsp;Shoji Matsumoto ,&nbsp;Jun Morioka ,&nbsp;Tetsuya Hashimoto ,&nbsp;Junpei Koge ,&nbsp;Jun Tanabe ,&nbsp;Akiko Hasebe ,&nbsp;Sadayoshi Watanabe ,&nbsp;Takeya Suzuki ,&nbsp;Yuichi Hirose","doi":"10.1016/j.jocn.2025.111192","DOIUrl":"10.1016/j.jocn.2025.111192","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to determine the efficacy of flow diverters (FDs) for small/medium (≤10 mm) aneurysms and analyzed the factors that prevent aneurysm occlusion.</div></div><div><h3>Methods</h3><div>This retrospective single-center study evaluated the angiographic and clinical data of consecutive patients between June 2020 and February 2023.</div></div><div><h3>Results</h3><div>Overall, 121 small/medium aneurysms were observed in 106 patients treated with FDs. The median dome diameter was 6.1 (5.1–7.2) mm. Symptomatic thromboembolic complications were observed in four (3.7 %) patients, and none showed a major ischemic stroke. Intracranial hemorrhage was detected using postprocedural computed tomography in one (0.9 %) patient with asymptomatic subarachnoid hemorrhage. The rate of permanent neurological deficits was 1.8 %, and the mortality rate was 0 %. No delayed ischemic or hemorrhagic complications were observed during follow-up. Angiographic follow-up revealed complete and adequate occlusion (O’Kelly–Marotta grades C and D) rates of 77.5 % and 90.8 %, respectively. On multivariate analysis, incomplete occlusion was only associated with the presence of a branch vessel from the aneurysm dome (P &lt; 0.01). In aneurysms with incorporated branch vessels, univariate analysis revealed that coil usage was a predictor of complete occlusion (P = 0.03). Moreover, even without using coils, effective occlusion was achieved when the branch vessel diameter was small (P = 0.03).</div></div><div><h3>Conclusions</h3><div>FDs are an effective and safe treatment option for small/medium aneurysms. The presence of incorporated branch vessels can predict incomplete occlusion. Even in aneurysms with incorporated branch vessels, FD can obtain therapeutic effects by adding coil embolization or treating with only FD if the branch vessel diameter is small.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111192"},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in academic writing: Enhancing or replacing human expertise?","authors":"Ria Resti Fauziah, Ari Metalin Ika Puspita, Ivo Yuliana, Fiena Saadatul Ummah, Siti Mufarochah, Erfan Ramadhani","doi":"10.1016/j.jocn.2025.111193","DOIUrl":"https://doi.org/10.1016/j.jocn.2025.111193","url":null,"abstract":"<p><p>This letter discusses findings from a recent study comparing AI-generated and humanwritten neurosurgery articles. The study reveals that AI-generated articles exhibit higher readability scores (Lix: 35 vs. 26, Flesch-Kincaid: 10 vs. 8) but may lack depth in analysis. Evaluators could correctly identify AI authorship with 61 % accuracy, and preferences were nearly even between AI-generated (47 %) and human-written (44 %) articles. While AI improves accessibility and efficiency in academic writing, its limitations in clinical experience, originality, and nuanced analysis highlight the need for human oversight. The integration of AI should be as a complementary tool rather than a replacement for human expertise. Future research should focus on refining AI's analytical capabilities and ensuring ethical use in scientific publishing.</p>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":" ","pages":"111193"},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669963","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":"From biomarkers to brain imaging: Refining early diagnosis of mild cognitive impairment.","authors":"Reswita, Sri Wahyuni, Ramtia Darma Putri, Erfan Ramadhani","doi":"10.1016/j.jocn.2025.111187","DOIUrl":"https://doi.org/10.1016/j.jocn.2025.111187","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":" ","pages":"111187"},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669965","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":"Predictors of withdrawal of life-sustaining therapies in older adults with TBI and a modified frailty index score","authors":"John J. Francis ,&nbsp;Ahmed I. Kashkoush ,&nbsp;Vanessa P. Ho ,&nbsp;Mary J. Roach ,&nbsp;Michael L. Kelly","doi":"10.1016/j.jocn.2025.111191","DOIUrl":"10.1016/j.jocn.2025.111191","url":null,"abstract":"<div><h3>Background</h3><div>Withdrawal-of-life-sustaining-therapies (WLST) in patients with traumatic brain injury (TBI) is a complex decision-making process. The clinical factors related to WLST in older adults with TBI are currently poorly understood. The present study aims to determine the clinical predictors of WLST in older patients with TBI.</div></div><div><h3>Methods</h3><div>All patients ≥ 65 years old with TBI (Head Abbreviated Injury Scale Score ≥ 3) were identified from the Geriatric TBI Database, a prospective registry of patients admitted to 45 trauma centers nationwide with TBI between 2017–2019. We collected factors related to past medical history, baseline demographic data, clinical presentation, TBI sub-type, neurosurgical interventions, and do-not-attempt-resuscitation (DNAR) orders. The primary outcome measure was WLST. Binary logistic regression was subsequently performed to determine factors independently associated with WLST.</div></div><div><h3>Results</h3><div>A total of 1600 patients were identified. The median age was 80 years old and 48.6 % of patients were male. In this cohort, 120 patients (7.5 %) underwent WLST. A logistic regression model revealed that Glasgow Coma Scale (GCS) (OR 0.82; 95 %-CI 0.77––0.87), cerebral edema (3.2; 1.5–7.0), craniotomy/craniectomy (2.5; 1.4–4.4), and DNAR (8.8; 5.5–14.3) were all independently associated with WLST. This model demonstrated excellent discrimination ability with a concordance statistic of 0.935.</div></div><div><h3>Conclusions</h3><div>This study demonstrates that patients ≥ 65 years old with poor initial GCS, cerebral edema, craniotomy/craniectomy, and DNAR were all independently associated with WLST. Pre-injury frailty was not associated with WLST. Further studies are needed to evaluate the prognostic value of frailty indices in the management of patients with TBI.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111191"},"PeriodicalIF":1.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143642800","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":"Intracranial meningioma with intratumoral hemorrhage: A systematic review of associated features and outcomes","authors":"Dillon H. Putzler ,&nbsp;Mohammad Faizan Khan ,&nbsp;Frishan O. Paulo ,&nbsp;Lauren A. Nguyen ,&nbsp;Christine Galang ,&nbsp;Erin Rauber ,&nbsp;Ryan Gensler ,&nbsp;Julian Gendreau ,&nbsp;Gina Watanabe ,&nbsp;Paolo Palmisciano","doi":"10.1016/j.jocn.2025.111188","DOIUrl":"10.1016/j.jocn.2025.111188","url":null,"abstract":"<div><div>Intratumoral hemorrhage (ITH) is a rare clinical entity associated with gliomas and rarely with meningiomas. The hemorrhage risk of ITH in meningiomas remains poorly described. Literature suggests that patient age, tumor location, and histology may play some role. In this study, we aim to address ITH risk factors by evaluating patient and tumor characteristics, symptoms, and outcomes of ITH associated with meningioma. PubMed, Web of Science, Ovid EMBASE, and Scopus databases were searched from database inception to December 2024 for cases of meningioma with ITH based on PRISMA guidelines. Patient demographics, presenting symptoms, tumor characteristics, treatments, and survival outcomes were extracted and analyzed. 107 cases from 68 studies were collected. Patients were mostly female (61 %), with an average age of 56 years. The most common comorbidity was hypertension (19 %). Patients often presented awake (47 %) with headache (22 %) or weakness (20 %), 21 % were comatose on admission. Most tumors were WHO grade 1 (85 %), located on the convexity (56 %) with meningothelial histotype (34 %). Single-stage resection with hematoma evacuation was the most common treatment modality (91 %). Embolization (2 %) was rarely performed. 59 % of patients had complete resolution of symptoms, and 88 % survived to last follow-up. Current management favors single-stage resective surgery and hematoma evacuation; pre-operative embolization has a limited role. Postoperatively, the role of anticoagulation for VTE prophylaxis is unclear. Most patients survive with complete resolution of symptoms after operative intervention.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111188"},"PeriodicalIF":1.9,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143628172","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":"Survey on the impact of WHO 2021 classification of brain tumors on adult glioma management in Africo-Asian region","authors":"Sarvesh Goyal ,&nbsp;Shweta Kedia ,&nbsp;Sonal Jain ,&nbsp;Hemlata Jangir ,&nbsp;Nenkimun Dirting Bakwa ,&nbsp;Bipin Chaurasia ,&nbsp;Claire Karekezi ,&nbsp;James A Balogun ,&nbsp;Lynne Lourdes N. Lucena ,&nbsp;Mahnaaz Sultana Azeem ,&nbsp;Mabel Banson ,&nbsp;Santanu Kumar Bora ,&nbsp;Selfy Oswari ,&nbsp;Vaishali Suri ,&nbsp;Vasundhara Rangan","doi":"10.1016/j.jocn.2025.111174","DOIUrl":"10.1016/j.jocn.2025.111174","url":null,"abstract":"<div><div>The 2021 WHO classification of central nervous system (CNS) tumors introduced significant changes based on molecular and biological tumor characteristics, aiming to improve prognostication and enable more precise treatment approaches. This study investigated the awareness, adoption, and impact of the new classification on adult glioma management among healthcare professionals in Africo-Asian region. Through a structured survey questionnaire distributed across these regions, assessment of the level of awareness, diagnostic changes, challenges faced, and future perspectives among respondents was done. The survey received responses from 56 participants. Findings revealed that while 67.85% of respondents from Asia and 32.15% from Africa reported awareness of the new classification, both groups faced significant challenges in accessing molecular diagnostics, with financial constraints limiting widespread implementation. This paper provides insights into the current state of brain glioma management in resource-limited settings and discusses the potential need for further refinements in the WHO classification of CNS tumors and adult glioma management guidelines to address these disparities.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111174"},"PeriodicalIF":1.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621178","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}