Journal of Clinical Neuroscience最新文献

{"title":"Craniovertebral junction degenerative arthritis- evolving understanding","authors":"Atul Goel ,&nbsp;Nasser M.F. El–Ghandour ,&nbsp;Abhidha Shah ,&nbsp;Apurva Prasad ,&nbsp;Ravikiran Vutha ,&nbsp;Siddharth Gautam ,&nbsp;Tejas Vaja ,&nbsp;Arjun Dhar","doi":"10.1016/j.jocn.2025.111638","DOIUrl":"10.1016/j.jocn.2025.111638","url":null,"abstract":"<div><h3>Objective</h3><div>The report analyzes the outcome of atlantoaxial stabilization in patients presenting with clinical symptoms and with radiological features that were attributed to atlantoaxial instability related degenerative alterations at craniovertebral junction.</div></div><div><h3>Material and methods</h3><div>During the period January 2009 to December 2024, 95 patients presented with clinical symptoms that indicated mild to severe myelopathy and on imaging were identified to have degenerative alterations at the craniovertebral junction. Apart from validated parameters of abnormal alterations in atlantodental interval, atlantoaxial instability was diagnosed based on high level of clinical suspicion and physical alterations in the region of craniovertebral junction that included abnormal bone and osteophyte formation or soft tissue alterations in the vicinity of the odontoid process and atlantoaxial articulation, joint space reduction and alterations in alignment of facets of atlas and axis. The height of occipital condyle- atlas facet- axis facet complex was assessed and compared with a ‘normal’ cohort of individuals between ages of 30–50 years. All patients underwent atlantoaxial stabilization using the described techniques. No bone or soft tissue decompression was done. The clinical outcome was assessed on the standard parameters of VAS, Goel’s clinical grade and JOA score. Additionally, patient self-assessment questionnaire was used to evaluate the result of surgery.</div></div><div><h3>Results</h3><div>On dynamic head flexion–extension imaging, 47 patients had completely reducible and 26 patients partially reducible) atlantoaxial instability, 30 patients had fixed or irreducible atlantoaxial instability and 16 patients had no abnormal alteration in the atlantodental interval. Two patients had vertical mobile and partially reducible atlantoaxial dislocation. Twenty-four patients had varying degree of basilar invagination. Fifty-one patients had osteophytes in the paraodontoid region that included apical region (46 patients), lateral to odontoid process (14 patients), retroodontoid region (34 cases) and around the facets (57 cases). The height of occipital condyle- atlas facet- axis facet complex ranged from 20 mm to 32 mm (average 27 mm) when compared to 30 mm to 43 mm (average 39 mm) in the control group. During the average follow-up period of 26 months, all patients improved in their clinical symptoms following surgery. No patient needed any additional surgery to the craniovertebral junction or to the cervical spine.</div></div><div><h3>Conclusions</h3><div>Chronic weakness of the muscles of the nape forms the basis of atlantoaxial instability that leads to secondary degenerative ‘alterations’. Atlantoaxial stabilization can lead to gratifying clinical outcome.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"142 ","pages":"Article 111638"},"PeriodicalIF":1.8,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091500","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 associated with early seizure in patients with cerebral arteriovenous malformations","authors":"Prut Koonalintip ,&nbsp;Aurakoch Kanjana-opas ,&nbsp;Jarudetch Wichaitum ,&nbsp;Rujimas Khumtong ,&nbsp;Suwanna Setthawatcharawanich ,&nbsp;Pornchai Sathirapanya ,&nbsp;Rattana Leelawattana ,&nbsp;Pat Korathanakhun","doi":"10.1016/j.jocn.2025.111637","DOIUrl":"10.1016/j.jocn.2025.111637","url":null,"abstract":"<div><div>This retrospective cohort study aimed to identify factors associated with early seizure (ES) in patients with cerebral arteriovenous malformations (AVMs). Patients diagnosed with cerebral AVMs between 2002 and 2023 were enrolled. Clinical and seizure characteristics, radiographic findings, and clinical outcomes were compared between the ES and non-seizure groups. Factors with p-values &lt; 0.05 in univariate analyses were further analyzed using a multivariable logistic regression model to identify independent factors associated with ES. The incidence of ES was 39.81 % among 309 patients with cerebral AVMs. Focal seizure semiology was recorded in 77 patients (62.60 %), and the rest were considered motor tonic–clonic seizures with unknown onset. Long pial venous drainage (adjusted odds ratio [aOR] 12.015, 95 % confidence interval [CI] 5.325–30.018, p = 0.038) and adjacent cortical edema (aOR 3.112, 95 % CI 1.825–20.125, p = 0.014) were independent associated factors with ES, whereas the focal neurological deficit showed a reversed association (aOR 0.063, 95 % CI 0.011–0.202, p = 0.028). In conclusion, the long pial venous drainage and the adjacent cortical edema were independently associated with ES in patients with cerebral AVMs.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"142 ","pages":"Article 111637"},"PeriodicalIF":1.8,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091480","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 approaches to postictal state assessment: Insights from an international survey of epilepsy care providers","authors":"Sally Shaaban ,&nbsp;Tamer Belal ,&nbsp;Shorouk Mohsen ,&nbsp;Yasmeena Abdelall Kozaa ,&nbsp;Yasser Elsadany ,&nbsp;Ibrahim Elmenshawi","doi":"10.1016/j.jocn.2025.111636","DOIUrl":"10.1016/j.jocn.2025.111636","url":null,"abstract":"<div><h3>Purpose</h3><div>Postictal assessment is essential for seizure localization during presurgical evaluation and for identifying serious complications such as sudden unexpected death in epilepsy. This study aimed to evaluate the current clinical practices and attitudes of epilepsy care providers toward postictal state assessment in routine clinical settings.</div></div><div><h3>Methods</h3><div>A cross-sectional online survey was conducted using the Google Forms platform between May and August 2023. The questionnaire included five sections addressing participant demographics, postictal clinical and EEG assessment practices, key monitoring tools, and perspectives on incorporating postictal evaluation into routine care. Participants were stratified into higher-income and lower-income country groups based on World Bank classifications.</div></div><div><h3>Results</h3><div>A total of 155 participants from 32 countries completed the survey, of whom 79.4 % were neurologists. Only 50 % reported applying the standardized postictal test proposed by the International League Against Epilepsy in 2016. Postictal psychosis was routinely assessed by only a minority of providers, with significantly fewer in higher-income countries (24.5 %) compared to lower-income countries (41.2 %; p = 0.04). Approximately one-third of respondents in both groups did not monitor oxygen saturation postictally. Among those with access to long-term video EEG, only 57.6 % reported assessing both postictal generalized EEG suppression and polymorphic delta activity. Despite these gaps, nearly all respondents supported the integration of postictal assessment into routine epilepsy care.</div></div><div><h3>Conclusions</h3><div>The results highlight significant gaps in postictal assessment practices across countries regardless of income level or clinical experience and emphasize the need for improved training and standardized protocols to enhance patient safety and diagnostic accuracy.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"142 ","pages":"Article 111636"},"PeriodicalIF":1.8,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091898","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 of general anesthesia in patients with unruptured intracranial aneurysms undergoing non-aneurysm-related surgery: A systematic review","authors":"Qingping Joseph Feng ,&nbsp;Kah Jun Tham ,&nbsp;Chin Lik Tan","doi":"10.1016/j.jocn.2025.111646","DOIUrl":"10.1016/j.jocn.2025.111646","url":null,"abstract":"<div><h3>Objective</h3><div>The increasing utilization of neuroimaging has led to a rising number of incidental unruptured intracranial aneurysms (UIAs). Most UIAs carry a low rupture risk, but concerns remain regarding the potential impact of general anesthesia (GA) on perioperative aneurysm stability. This systematic review aims to evaluate the incidence of perioperative aneurysmal rupture in patients with UIAs undergoing GA for non-aneurysm-related procedures.</div></div><div><h3>Methods</h3><div>A search of the PubMed and EMBASE databases identified studies reporting adult patients with UIAs undergoing GA for non-aneurysm-related surgeries, detailing aneurysm characteristics and rupture incidence. The primary outcome was aneurysmal rupture during or within 48 h of surgery, and the secondary outcome was aneurysm-rupture-related mortality. Perioperative management strategies were also reviewed.</div></div><div><h3>Results</h3><div>A total of 21 studies involving 627 patients were included. The majority were case reports or small series, alongside three larger cohort studies. Across all patients, only one case of perioperative aneurysmal rupture (0.16 %) was identified, with no rupture-related mortality. Most aneurysms were small (&lt;7 mm) and located in the anterior circulation. No specific surgical procedure or anesthetic technique was associated with an increased rupture risk. Several studies highlighted the importance of meticulous intraoperative hemodynamic management, although no standardized protocols were reported.</div></div><div><h3>Conclusion</h3><div>This systematic review demonstrates that GA is generally safe for patients with UIAs undergoing non-aneurysm-related surgery, with an extremely low risk of perioperative rupture and no associated mortality. Current evidence does not support prophylactic aneurysm treatment. Individualized risk assessment and vigilant perioperative blood pressure management are key to maintaining safety in this population.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"142 ","pages":"Article 111646"},"PeriodicalIF":1.8,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091442","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":"Post-craniotomy emergence hypertension: A scoping review","authors":"Fatima Gauhar,&nbsp;Naveed Kamal,&nbsp;Patrick D. Kelly","doi":"10.1016/j.jocn.2025.111629","DOIUrl":"10.1016/j.jocn.2025.111629","url":null,"abstract":"<div><h3>Introduction</h3><div>Post-craniotomy emergence hypertension (PCEH) is a phenomenon of transient increase in blood pressure during and after emergence from anesthesia for a craniotomy. It is frequently encountered in neurosurgical and neuroanesthesia practice. Clinical definitions and reported prevalence of PCEH vary significantly, so this review aims to characterize existing literature on the diagnosis and management of this clinical entity.</div></div><div><h3>Methods</h3><div>A scoping review of the literature was conducted using six electronic databases: PubMed, Embase, CINAHL, Web of Science, Cochrane, and Scopus. Title and abstract screening and subsequent full-text screening were conducted by two reviewers, and twenty-one relevant articles were identified. The quality of all studies was assessed using the appropriate version of the Joanna Briggs Institute (JBI) Critical Appraisal Checklists.</div></div><div><h3>Results</h3><div>The definitions of PCEH were heterogeneous among the studies included. The predominant method of reporting blood pressure diagnostic criteria was mean arterial blood pressure (42.9 %), followed by systolic blood pressure alone (33.3 %), or systolic and diastolic blood pressure together (14.3 %). Management of PCEH begins with early detection, often including arterial line blood pressure monitoring. Treatment mostly includes anti-hypertensives, including beta-blockers and calcium-channel blockers, where nicardipine seems superior to beta-blocker therapy. PCEH is believed to increase the risk of postoperative bleeding, and management of PCEH may also increase ICU length of stay.</div></div><div><h3>Conclusions</h3><div>Current literature reveals widespread variability in the definition, monitoring approach, and management of PCEH. This review highlights the need to establish a consensus definition for PCEH to allow for more robust investigation of its clinical consequences.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"141 ","pages":"Article 111629"},"PeriodicalIF":1.8,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086170","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":"Microsurgical clipping of previously endovascularly treated intracranial aneurysms: A single centre case series","authors":"Edward Goacher ,&nbsp;Elias Williams ,&nbsp;Dorin Fetche ,&nbsp;Gueorgui Kounin ,&nbsp;Mihai Danciut","doi":"10.1016/j.jocn.2025.111633","DOIUrl":"10.1016/j.jocn.2025.111633","url":null,"abstract":"<div><h3>Background</h3><div>With increasing numbers of cerebral aneurysms being treated endovascularly, an increasing number of intracranial aneurysm (IA) recurrences/residuums post-endovascular treatment (EVT) are being encountered. This single centre study aims to assess the surgical technique, outcomes and complications of patients undergoing microsurgical clipping of IA following previous EVT.</div></div><div><h3>Methods</h3><div>All patients undergoing microsurgical clipping of IAs post-ETV over the last 3 years were identified and included. Ruptured and unruptured IAs were included. Patient demographics, EVT techniques, surgical technique and time to clipping were examined. The following outcomes were recorded; intra-operative complications, post-operative complications, 30-day and 12-month survival.</div></div><div><h3>Results</h3><div>In total, 23 cases were included in this study. Median age at microsurgical clipping was 57 years (range: 22 – 75 years). Median time to clipping from primary EVT was 37 months (range: 7 months – 18 years). Three cases (13 %) presented due to subarachnoid haemorrhage (SAH). The most commonly employed primary endovascular technique was simple coiling alone (n = 14, 61 %). Median time from primary treatment to surgery was 35 months (range: 7 months – 18 years). Multiple clips were required in 48 % (n=11). Five (22 %) cases required EVT device removal. Intra-operative complication rate was 4 %, with one case of intra-operative rupture. 30-day survival was 100 %. 12-month survival was 96 %.</div></div><div><h3>Conclusions</h3><div>Microsurgical clipping of previously endovascularly treated IAs is a challenging but feasible treatment with high obliteration rates. EVT device removal was not required in the majority of cases. Surgical adjuncts such as the endoscope can be particularly useful in optimising clip placement.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"142 ","pages":"Article 111633"},"PeriodicalIF":1.8,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086232","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":"Durability in symptomatic and radiographic outcomes after standalone anterolateral minimally invasive surgery for adult spinal deformity","authors":"Ayesha Akbar Waheed ,&nbsp;Alp Ozpinar ,&nbsp;Nallammai Muthiah ,&nbsp;James H. Mooney ,&nbsp;Harry M. Mushlin ,&nbsp;Daipayan Guha ,&nbsp;Thomas J. Buell ,&nbsp;Hansen Deng ,&nbsp;Nima Alan ,&nbsp;Marc Peretti BS ,&nbsp;Nitin Agarwal MD ,&nbsp;D.Kojo Hamilton ,&nbsp;Adam S. Kanter ,&nbsp;David O. Okonkwo","doi":"10.1016/j.jocn.2025.111555","DOIUrl":"10.1016/j.jocn.2025.111555","url":null,"abstract":"<div><h3>Purpose</h3><div>Adult spinal deformity (ASD) impacts patients’ quality-of-life. Minimally invasive surgery (MIS) can adequately treat carefully selected patients with ASD. Stand-alone lateral interbody fusion has been found effective in the treatment of low-grade degenerative spondylolisthesis, degenerative lumbar scoliosis as well as other degenerative spine conditions. However, the efficacy of anterolateral interbody fusion as an alternative approach to open spinal deformity correction has not been fully explored. Herein, the outcomes of patients who underwent standalone MIS anterolateral fusion were evaluated.</div></div><div><h3>Methods</h3><div>Patients with planned two-stage scoliosis correction from 2019 to 2021 were reviewed. Those whose preoperative symptoms improved after first-stage anterolateral MIS and did not undergo posterior fixation were identified. Spinopelvic parameters were measured with 36-inch-standing films. Oswestry disability index (ODI), visual analog scale (VAS) back and leg, and Scoliosis Research Society (SRS) average subdomain scores were collected.</div></div><div><h3>Results</h3><div>Eleven patients (3:8, male: female) were included. Mean age was 62.9 ± 8.0 years, BMI was 31.3 ± 4.3 kg/m², and follow-up was 18.5 ± 12.6 months. Average preoperative spinopelvic parameters were: C7-sagittal vertical axis (C7-SVA) 51 mm, C7-sagittal-center vertical line (C7-SVL) 18.7 mm, pelvic incidence (PI) 47°, lumbar lordosis (LL) 36°, PI-LL mismatch 11°, pelvic tilt (PT) 23°, and coronal Cobb angle (CCA) 34°. Average spinopelvic parameters at first radiographic follow-up were: C7-SVA 29 mm (p = 0.002), C7-SVL 8 mm (p = 0.005), PI 47° (p = 0.455), LL 57° (p = 0.001), PI-LL mismatch −9.5° (p = 0.002), PT 18° (p = 0.004), and CCA 24° (p = 0.011). Besides lower LL, smaller PI-LL mismatch, and higher PT, there were no significant differences in radiographic parameters between first and last postoperative imaging. Significant improvements in ODI, VAS back and leg, and SRS average subdomain scores were identified (p &lt; 0.05). No patients required hardware revision or second-stage fixation.</div></div><div><h3>Conclusions</h3><div>In select patients with adult spinal deformity, standalone anterolateral MIS fusion yielded enough radiographic correction and clinical improvement to defer or avoid the second stage of fusion. Longer-term follow-up and more studies are needed to establish its efficacy as a standard-of-care procedure.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"141 ","pages":"Article 111555"},"PeriodicalIF":1.8,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086094","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":"Is There a Correlation between the position of conus medullaris and the clinical presentation and surgical outcomes in primary tethered cord Syndrome?","authors":"Ahmed J. Awad ,&nbsp;Jessica Zhou ,&nbsp;Pranjal Srivastava ,&nbsp;Carisa L. Bergner ,&nbsp;Lisa Haney ,&nbsp;Dan S. Heffez","doi":"10.1016/j.jocn.2025.111627","DOIUrl":"10.1016/j.jocn.2025.111627","url":null,"abstract":"<div><div>Adult tethered-cord syndrome (TCS) is a controversial subject. Clinical presentation and radiographic diagnosis do not always corelate, resulting in the diagnosis being incorrectly dismissed. We reviewed the clinical presentation and surgical outcome with regards to the position of the conus medullaris using a prospectively maintained database of patients treated by single neurosurgeon between 9/1/2019 to 12/31/2021. The position of the conus medullaris was determined from the T-2 weighted sagittal and axial MRI images and designated as being above, at or below the L1/L2 disc space. Prevalence of signs, symptoms, intra-operative findings and outcomes were compared. In 101 patients reviewed, the conus was located above, at or below the L1/L2 disc in 32, 30 and 39 patients respectively. The male/female ratio and duration of symptoms did not differ between the groups. The groups did not differ with regards to the prevalence of low back pain, paresthesiae or pain in the lower extremities, subjective weakness in the lower extremities, urinary symptoms or bowel motility symptoms. Surgery, prescribed based on clinical signs and symptoms, consisted of sacral laminectomy and sectioning of the filum terminale interna. Near complete resolution of symptoms was achieved in 75 patients, independently of the position of the conus medullaris. The diagnosis of the TCS should be considered in the differential diagnosis of patients presenting with lower back and leg pain accompanied by urological symptoms.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"141 ","pages":"Article 111627"},"PeriodicalIF":1.8,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086135","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 cross-sectional study of associations between stroke survivors’ disability and caregiver burden dimensions","authors":"Åsa Franzén-Dahlin ,&nbsp;Minh Tuan Hoang ,&nbsp;Lena von Koch ,&nbsp;Ann Charlotte Laska","doi":"10.1016/j.jocn.2025.111599","DOIUrl":"10.1016/j.jocn.2025.111599","url":null,"abstract":"<div><h3>Objectives</h3><div>Caregivers of stroke survivors, mostly spouses, experience significant strain. This study examined the associations between stroke survivors’ disabilities and their spouses’ psychological health and caregiver reactions.</div></div><div><h3>Materials and methods</h3><div>Six months post-stroke, we recruited four groups (30 dyads each) based on the stroke survivors’ disabilities at inclusion. A total of 118 dyads were included. Survivors were assessed using the Barthel Index, Mini–mental State, and modified Rankin Score. Groups included: No disability, Physical disability (Barthel Index ≤ 90), Cognitive disability (Mini-mental state ≤ 23), and Cognitive and Physical disability. Spouses were assessed using the Comprehensive Psychopathological Rating Scale–Self-Affective and the Caregiver Reaction Assessment Scale, which includes <em>Disrupted schedule, Lack of family support, Health problems, Financial problems,</em> and <em>Self-esteem.</em></div></div><div><h3>Results</h3><div>Any disability was associated with <em>Disrupted schedule, Lack of family support,</em> and <em>Health problems.</em> There were no significant differences between groups in the <em>Self-esteem</em> dimension. Physical disability, alone or combined with cognitive disability, was associated with <em>Financial problems</em>, whereas cognitive disability alone was not. An adjusted logistic regression model showed caregiver depression was significantly associated with <em>Disrupted schedule, Lack of family support,</em> and <em>Health problems.</em></div></div><div><h3>Conclusion and implications</h3><div>Six months post-stroke, any disability and caregiveŕs possible depression are associated with <em>Disrupted schedule, Lack of family support,</em> and <em>Health problems</em> among spouses of stroke survivors<em>.</em> Early rehabilitation should be provided to maximize stroke survivors’ functioning and minimize caregiver burden. Additionally, families should receive social support to help mitigate these challenges.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"141 ","pages":"Article 111599"},"PeriodicalIF":1.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060575","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":"Exploring the role of sleep quality and psychological stress in the prevalence of isolated sleep paralysis","authors":"Erfan Ramadhani ,&nbsp;Triyono ,&nbsp;Ake Royke Calvin Langingi ,&nbsp;Angreni Beaktris Liunokas ,&nbsp;Rachmawaty M. Noer","doi":"10.1016/j.jocn.2025.111628","DOIUrl":"10.1016/j.jocn.2025.111628","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"141 ","pages":"Article 111628"},"PeriodicalIF":1.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060578","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}