Journal of Clinical Neuroscience最新文献

{"title":"Preventing postoperative delirium: Advancements in cognitive protection strategies","authors":"Ali Fakhrudin , Aziziyah Munawaroh , Donal , Ramtia Darma Putri , Rizky Andana Pohan , Erfan Ramadhani , Safta Hastini","doi":"10.1016/j.jocn.2025.111102","DOIUrl":"10.1016/j.jocn.2025.111102","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"133 ","pages":"Article 111102"},"PeriodicalIF":1.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254754","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":"Clinical trials targeting tau should be halted","authors":"Andi Olluri","doi":"10.1016/j.jocn.2025.111101","DOIUrl":"10.1016/j.jocn.2025.111101","url":null,"abstract":"<div><div>Experimental drugs lowering brain tau are heralded as improvements in the treatment of Alzheimer’s disease. However, the outcomes in clinical trials testing these agents have consistently failed to improve patient outcomes, i.e. slow down disease or improving cognition. Furthermore, the scientific rationale behind such drugs is rather poor in the first place and has been questioned. Therefore, I argue that trials of anti-tau drugs should be halted.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"134 ","pages":"Article 111101"},"PeriodicalIF":1.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143135694","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":"Response to Letter to The Editor: Hyponatremia is associated with cognitive decline in hospitalized patients after stroke","authors":"Yoshihiro Yoshimura","doi":"10.1016/j.jocn.2025.111103","DOIUrl":"10.1016/j.jocn.2025.111103","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"134 ","pages":"Article 111103"},"PeriodicalIF":1.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143096437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new paradigm for neurodegenerative diseases classification: A clinical perspective","authors":"Alexandros Giannakis,&nbsp;Spiridon Konitsiotis","doi":"10.1016/j.jocn.2025.111099","DOIUrl":"10.1016/j.jocn.2025.111099","url":null,"abstract":"<div><div>A vast progress has been made in the understanding of neurodegenerative diseases during the past few years. However, clinical diagnostic accuracy continues to be very low, despite the introduction of various diagnostic tools and repeated revisions of diagnostic criteria. For instance, patients with Alzheimer’s disease (AD) may present with symptoms that overlap with other neurodegenerative conditions like dementia with Lewy bodies (DLB), making accurate diagnosis challenging. This diagnostic uncertainty can lead to delayed or incorrect treatment, significantly impacting patients’ quality of life and prognosis. Thus, the definite diagnosis still relies on post-mortem pathological findings, placing a significant burden on both clinicians and researchers. As a growing body of evidence indicates, co-pathology seems to be the rule among neurodegenerative diseases. Additionally, a single pathological diagnosis, such as AD, can manifest in various clinical presentations, ranging from predominantly cognitive impairment to significant motor symptoms. Each of these presentations currently requires its own set of complicated diagnostic criteria. Perhaps, the time has come for a much-needed radical revision of existing clinical diagnostic criteria. Inclusion of patients do not neatly fit into existing diagnostic categories for neurodegenerative diseases, in future large-scale, longitudinal studies and/or clinical trials, and systematic assessment of their clinical features and disease progression using machine learning could generate valuable data on patients with mixed pathologies and improve our understanding of how to effectively treat these complex cases.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"134 ","pages":"Article 111099"},"PeriodicalIF":1.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143096434","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":"Addressing cognitive impairment in hypertensive patients: Risk factors and clinical implications","authors":"Yetty Morelent ,&nbsp;Santi Tri Meilina ,&nbsp;Hidayati Azkiya ,&nbsp;Elvima Nofrianni ,&nbsp;Sumianto ,&nbsp;Willa Putri ,&nbsp;Dhini Mufti ,&nbsp;Aldora Pratama ,&nbsp;Ramtia Darma Putri ,&nbsp;Erfan Ramadhani","doi":"10.1016/j.jocn.2025.111105","DOIUrl":"10.1016/j.jocn.2025.111105","url":null,"abstract":"<div><div>Cognitive impairment is a major public health challenge, particularly among aging populations with hypertension. The study by Zuo and Yang provides valuable insights into the predictive risk factors for cognitive decline in hypertensive patients, utilizing a model with strong discriminative ability (AUC ROC: 0.802 in training set, 0.756 in test set). This letter highlights seven key risk factors identified in the study: gender, age, education level, poverty income ratio (PIR), depression, vigorous physical activity, and creatinine levels. Men exhibited a higher risk of cognitive impairment than women, likely due to estrogen’s neuroprotective effects. Advancing age and lower education levels were also strong predictors of cognitive decline. Additionally, socioeconomic disparities and depression significantly influenced cognitive health, underscoring the need for integrated mental health and policy interventions. Protective factors, such as vigorous physical activity and lower creatinine levels, emphasize the importance of lifestyle-based strategies. Implementing this predictive model in routine clinical assessments can aid in early detection and personalized intervention. Future research should refine these findings, incorporating genetic predisposition and dietary influences to enhance cognitive health management in hypertensive patients.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"133 ","pages":"Article 111105"},"PeriodicalIF":1.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of serum levels of inflammation and oxidative stress markers with cognitive outcomes in multiple sclerosis; a systematic review","authors":"Sara Daneshvar ,&nbsp;Farinush Moradi ,&nbsp;Mehrab Rahmani ,&nbsp;Pouya Golshaniniya ,&nbsp;Negin Frounchi ,&nbsp;Sina Seifimansour ,&nbsp;Mahnaz Talebi ,&nbsp;Sarvin Sanaie ,&nbsp;Amirreza Naseri","doi":"10.1016/j.jocn.2024.110990","DOIUrl":"10.1016/j.jocn.2024.110990","url":null,"abstract":"<div><h3>Background</h3><div>Multiple sclerosis (MS) is an immune-mediated disease with cognitive impairment being a crucial manifestation. Oxidative stress and inflammation play significant roles in the disease’s pathogenesis. This systematic review explores the association between inflammation and oxidative stress markers, with cognitive outcomes in MS patients.</div></div><div><h3>Methods</h3><div>This study adhered to the Joanna Briggs Institute (JBI) and PRISMA 2020 methods. Eligibility criteria included studies with MS patients, evaluating serum inflammation and/or oxidative stress markers, assessing cognitive function, and examining the relationship between these factors. PubMed, Scopus, Embase, and Web of Science, were searched and the risk of bias was assessed using the JBI checklists.</div></div><div><h3>Results</h3><div>Out of 1609 identified records, 10 studies were included in this systematic review. The studies were published between 2006 and 2023 and involved 629 MS patients. Current evidence suggests a negative correlation between TNF-α, and cognitive outcomes in MS (reported in three out of five studies). Associations between the decreased native and total thiol levels, as well as interleukin (IL)-17A with cognitive impairment, and the correlation between IL-6 and C-reactive protein (CRP) with cognitive scores in MS are also reported (one study for each). IL-10 (four studies), glutathione peroxidase (GPX), reduced glutathione (GSH), catalase activity (CAT), ischemia-modified albumin (IMA), IL-8, IL-18, and IL-2 (one study for each) did not found to be associated with cognition in MS and evidence regarding the possible role of interferon-gamma (IFN-γ), total antioxidant capacity (TAC), and malondialdehyde (MDA) is not definitive.</div></div><div><h3>Discussion</h3><div>The review findings suggest a complex association between oxidative stress and inflammation with cognitive outcomes in MS. Diversity in study designs, participant characteristics, and assessment methods makes the findings of this study inconclusive and highlights the need for future research.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 110990"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854317","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":"Endoscopic paramaxillary ligation of the internal maxillary artery","authors":"Alejandro Vargas-Moreno,&nbsp;Maria Luna De La Ossa,&nbsp;Roger Velazco Hernandez","doi":"10.1016/j.jocn.2024.110969","DOIUrl":"10.1016/j.jocn.2024.110969","url":null,"abstract":"<div><div>Endoscopic skull base surgery is increasingly utilized for managing skull base tumors. Complex techniques for resecting multicompartmental lesions can lead to higher intraoperative bleeding rates. While embolization can reduce blood flow, it may not always be feasible and can introduce additional risks. Endoscopic techniques allow for direct visualization and coagulation of parent arteries. This study discusses a subperiosteal transoral medial dissection technique, endoscopic paramaxillary corridor, to enable early vascular control prior to resection.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 110969"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828852","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":"Evaluating the safety and efficacy of proton radiotherapy for intracranial pediatric ependymomas: A single-arm meta-analysis","authors":"Lucca B. Palavani ,&nbsp;Gabriel Semione ,&nbsp;Gustavo de Oliveira Almeida ,&nbsp;Henrique L. Lepine ,&nbsp;Pedro Borges ,&nbsp;Bernardo Vieira Nogueira ,&nbsp;Gisele Lúcia ,&nbsp;Márcio Yuri Ferreira ,&nbsp;Anna Pereira ,&nbsp;David Abraham Batista da Hora ,&nbsp;Matheus de Jesus Leone Pereira ,&nbsp;Fabio Torregrossa ,&nbsp;Fernando De Nigris Vasconcellos ,&nbsp;Raphael Bertani ,&nbsp;Raphael Bastianon ,&nbsp;Carolina Benjamin ,&nbsp;Cleiton Formentin","doi":"10.1016/j.jocn.2024.110977","DOIUrl":"10.1016/j.jocn.2024.110977","url":null,"abstract":"<div><h3>Background</h3><div>Ependymomas account for 6% to 10% of childhood central nervous system tumors. This study aimed to evaluate the safety and efficacy of proton radiotherapy in intracranial ependymoma patients.</div></div><div><h3>Methods</h3><div>We performed a systematic review and single-arm <em>meta</em>-analysis. We searched Medline, Embase, Cochrane, and Web of Science for eligible trials. Random-effects model was used to calculate the risk ratios (RRs), with 95% confidence intervals (CIs). Statistical analyses were performed using RStudio version 4.2.3.</div></div><div><h3>Results</h3><div>Ten cohorts comprising 908 patients with ependymoma were included. The patient population had an average age of 3.5 years, and 53.4 % were male. In terms of proportion, nine outcomes were analyzed: 3-year Progression-Free Survival (PFS; Proportion = 0.63; 95 % CI [0.40–0.87]; I2 = 95 %), 5-year Local Control (LC; Proportion = 0.79; 95 % CI [0.69–0.90]; I2 = 85 %), 5-year Event-Free Survival (EFS; Proportion = 0.65; 95 % CI [0.52–0.78]; I2 = 95 %), 5-year Overall Survival (OS; Proportion = 0.83; 95 % CI [0.77–0.90]; I2 = 82 %), 2-year OS (Proportion = 0.91; 95 % CI [0.88–0.94]; I2 = 0 %), 3-year OS (Proportion = 0.92; 95 % CI [0.89;0.95]; I2 = 43 %). Additionally, neurological (Proportion = 0.17; 95 % CI [0.07–0.27]; I2 = 97 %), dermatological (Proportion = 0.20; 95 % CI [0.00–0.44]; I2 = 82 %), and brainstem complications (Proportion = 0.03; 95 % CI [0.01–0.04]; I2 = 31 %) were investigated.</div></div><div><h3>Conclusion</h3><div>While proton radiotherapy appears safe and effective based on current data, these results should be approached cautiously, as broad confidence intervals in some adverse event rates suggest variability in outcomes.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 110977"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813072","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":"Massive pneumocephalus after Valsalva maneuver in sphenoidal meningocele","authors":"Letizia Neri ,&nbsp;Giulia Monti ,&nbsp;Alberto Daniele Arosio ,&nbsp;Maurizio Bignami","doi":"10.1016/j.jocn.2024.110973","DOIUrl":"10.1016/j.jocn.2024.110973","url":null,"abstract":"<div><div>Pneumocephalus, defined as the presence of gas within the intracranial space, typically results from head trauma, surgery, or diagnostic/therapeutic procedures that disrupt the dura. However, spontaneous or non-traumatic pneumocephalus is rare. This video article presents a case report of a 64-year-old woman referred to the Department of Otolaryngology with a severe frontal headache and clear nasal discharge (rhinorrhea) after performing the Valsalva maneuver to relieve ear fullness. The patient had previously been diagnosed with sphenoidal meningocele and was awaiting skull base reconstruction surgery. A computed tomography (CT) scan of the brain and paranasal sinuses revealed significant pneumocephalus, with a defect in the sellar floor and cerebrospinal fluid (CSF) pooling in the sphenoid sinus. An endoscopic <em>trans</em>-sphenoidal repair of the CSF leak was promptly performed, and a post-operative CT scan showed complete resolution of the pneumocephalus. At the 2-month follow-up, the defect had healed optimally, with no intracranial complications observed. Pneumocephalus is a rare clinical condition, and prompt, accurate diagnosis, along with early intervention, is crucial to prevent neurological complications.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 110973"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818280","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 frailty on patient selection and outcomes for open versus endovascular treatment of unruptured intracranial aneurysms: A propensity-score matched analysis","authors":"Joanna M. Roy ,&nbsp;Basel Musmar ,&nbsp;Shiv Patil ,&nbsp;Shyam Majmundar ,&nbsp;Shray Patel ,&nbsp;Stavropoula I. Tjoumakaris ,&nbsp;Michael R. Gooch ,&nbsp;Robert H. Rosenwasser ,&nbsp;Christian Bowers ,&nbsp;Pascal M. Jabbour","doi":"10.1016/j.jocn.2024.110988","DOIUrl":"10.1016/j.jocn.2024.110988","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>Endovascular treatment (EVT) has been demonstrated to have improved post-operative outcomes and fewer complications compared to open microsurgical clipping of unruptured intracranial aneurysms (UIAs). Our study analyzes patient selection and outcomes for open versus EVT stratified by frailty measured using the Risk Analysis Index (RAI).</div></div><div><h3>Methods</h3><div>This was a retrospective study of patients who underwent open or EVT for an UIA at our institution between March 2017 and June 2022. Propensity-score matching (PSM) was performed using the 1:1 nearest neighbour method to create two groups (open and EVT) matched by demographics and treatment modality. RAI-measured frailty was used to categorize patients into 4 tiers: robust (0–10), pre-frail (11–20), frail (21–30) and severely frail (≥31). Outcomes of interest were length of stay (LOS), functional dependence at discharge and 30-day readmission.</div></div><div><h3>Results</h3><div>After PSM, 209 patients were stratified into two groups, open and EVT, respectively. Patients who received EVT were older compared to open surgery (mean ± SD: 62.6 ± 11.4 vs. 60.8 ± 10.6, P &lt; 0.05), however, RAI-measured frailty did not differ significantly between the two groups (median (IQR) open: 3 (2–7), vs. EVT: 3 (2–9)), P = 0.090. Among robust and pre-frail patients, EVT was associated with significantly shorter LOS compared to open surgery, median (IQR): 1 (1–2) vs. 3 (2–4) and 1 (1–2), vs. 3 (2–6); P &lt; 0.001, respectively). Neither functional dependence at discharge nor 30-day readmission rates were different after stratification by frailty.</div></div><div><h3>Conclusion</h3><div>Patients in the robust and pre-frail tiers experienced significantly shorter LOS after EVT compared to open surgery. We would like to encourage the use of frailty assessment as a pre-operative risk stratification tool patients undergoing treatment of UIAs.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 110988"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854327","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}