Journal of Clinical Neuroscience最新文献

{"title":"Comparison of microdiscectomy and fragmentectomy on clinical outcomes for single level lumbar disc herniation: a systematic review and meta-analysis of comparative studies","authors":"James Kelbert ,&nbsp;Nikhil Dholaria ,&nbsp;Giovanni Barbagli ,&nbsp;Diego T. Soto Rubio ,&nbsp;Annie Pico ,&nbsp;Courtney Deaver ,&nbsp;Amna Hussein ,&nbsp;Michael Prim ,&nbsp;Ali Baaj","doi":"10.1016/j.jocn.2025.111416","DOIUrl":"10.1016/j.jocn.2025.111416","url":null,"abstract":"<div><h3>Background</h3><div>Lumbar disc herniation can lead to radiculopathy, pain, and weakness. Surgery is indicated if patients remain symptomatic despite medical management, or if they develop significant neurological deficits like footdrop or cauda equina syndrome. There is no consensus on whether fragmentectomy alone or aggressive discectomy leads to improved resolution of radicular pain and leads to lower reherniation rates. To the best of our knowledge, this systematic review presents the most comprehensive and up-to-date evaluation of comparative studies comparing microdiscectomy and fragmentectomy within the last ten years.</div></div><div><h3>Methods</h3><div>A systematic review was conducted according to PRISMA guidelines. A search was conducted on March 19th, 2024, of PubMed, EMBASE, Scopus and Web of Science databases. The systematic review software Rayyan was used to include or exclude studies with additional filters. After full text analysis for final inclusion, demographic data as well as those regarding reherniation rates and changes in axial and radicular pain were collected. Continuous meta-analysis and meta-analysis of proportions were conducted using R versions 4.3.3. Radiographic changes were described qualitatively, as there was not enough quantitative evidence to metaanalyze.</div></div><div><h3>Results</h3><div>A total of 9 comparative studies with 574 microdiscectomy and 449 fragmentectomy only patients were ultimately included after screening through a total of 183 unique papers. A random effects model meta-analysis of axial pain found a standardized mean difference of 0.09 [−0.33, 0.51] (p = 0.67) with an I2 of 91%. A random effects model meta-analysis of radicular pain demonstrated an overall standardized mean difference of 0.01 [−0.14, 0.17] (p = 0.87) with an I2 of 0%. Metaanalysis of proportions for reherniation showed a relative risk of 0.96 [0.54, 1.71] (p = 0.88) with an I2 of 0%. Reoperation rates between groups showed a relative risk of 0.86 [0.47, 1.55] (p = 0.61) with an I2 of 0%. The relative risk of complication rates was 0.96 [0.35, 2.66] (p = 0.93) with an I2 of 0 %.</div></div><div><h3>Conclusions</h3><div>There is no statistically significant difference between VAS axial and radicular pain relief after fragmentectomy alone or aggressive microdiscectomy based on this meta-analysis. The reherniation rate was 5 % for both groups and similarly there was no difference between reoperation and complication rates. Despite advances in technique, technology, and our understanding of lumbar disc herniation, this current and comprehensive review demonstrates that both fragmentectomy and aggressive microdiscectomy are equally effective.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"139 ","pages":"Article 111416"},"PeriodicalIF":1.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481117","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":"Endovascular coiling vs microsurgical clipping for unruptured aneurysms of the anterior circulation: A systematic review and meta-analysis","authors":"Anderson Matheus Pereira da Silva ,&nbsp;Mariana Leticia de Bastos Maximiano ,&nbsp;Lucas Silva Cabeça ,&nbsp;Anderson Silva Corin ,&nbsp;Ocilio de Deus ,&nbsp;Ariane Barros Mesquita Cunha ,&nbsp;Gabrielle Silva Vieira ,&nbsp;Julia Oliveira Franco ,&nbsp;Eberval Gadelha Figueiredo ,&nbsp;Gustavo Sousa Noleto","doi":"10.1016/j.jocn.2025.111419","DOIUrl":"10.1016/j.jocn.2025.111419","url":null,"abstract":"<div><h3>Background</h3><div>Despite extensive research, the optimal approach for treating unruptured anterior circulation aneurysms (UACs) remains uncertain because of heterogeneous findings and limited robust data. To compare the outcomes of microsurgical clipping (MSC) with endovascular treatment (EVT) for UACs.</div></div><div><h3>Methods</h3><div>A systematic search was conducted in PubMed, Embase, Cochrane Library, Web of Science, and Scopus up to December 2024. Eligible studies included patients with UCAs treated with MSC or EVT. The primary outcomes were functional outcomes (mRS 0–2), recurrence rates, procedural complications, and mortality. Odds Ratios (OR) with 95% Confidence Intervals (CI) were calculated using a random-effects model. The Mantel-Haenszel method with a random-effects model was employed for the <em>meta</em>-analyses. All statistical analyses were conducted using R version 4.4.2.</div></div><div><h3>Results</h3><div>The analysis included data from 17 studies with 7,176 patients, of whom 3,810 (53.1 %) underwent EVT and 3,366 (46.9 %) received MSC. Complete occlusion rates were higher with MSC (OR 0.29; 95 % CI 0.15–0.56; p &lt; 0.01), while procedural success also favored MSC (OR 0.42; 95 % CI 0.23–0.78; p &lt; 0.01). Complications were less frequent with EVT, including serious adverse events (OR 0.53; 95 % CI 0.33–0.84; p &lt; 0.01), vasospasm (OR 0.63; 95 % CI 0.44–0.89; p = 0.04), and thrombotic events (OR 2.23; 95 % CI 0.84–5.96; p = 0.12). However, EVT was associated with higher rates of residual aneurysms (OR 4.57; 95 % CI 1.75–11.97; p = 0.95), residual neck (OR 5.31; 95 % CI 2.81–10.02; p = 0.22), and need for retreatment (OR 5.65; 95 % CI 2.35–13.54; p = 0.99).</div></div><div><h3>Conclusion</h3><div>EVT offers advantages in reducing perioperative complications, while MSC provides greater long-term durability. Considering comparable functional outcomes and mortality, individualized treatment decisions should be based on patient profiles, aneurysm characteristics.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"139 ","pages":"Article 111419"},"PeriodicalIF":1.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144471826","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":"Types of stent retrievers used in mechanical thrombectomy for acute ischaemic stroke: A scoping review","authors":"Jane Song ,&nbsp;Kevin Z. Zhou ,&nbsp;Davor Pavlin-Premrl ,&nbsp;Ashu Jhamb ,&nbsp;Calvin Gan ,&nbsp;Ali Khabaza ,&nbsp;Julian Maingard ,&nbsp;Andrew Gauden ,&nbsp;Lee-Anne Slater ,&nbsp;Justin Moore ,&nbsp;Numan Kutaiba ,&nbsp;Ronil V. Chandra ,&nbsp;Anousha Yazdabadi ,&nbsp;Mark D. Brooks ,&nbsp;Hong Kuan Kok ,&nbsp;Christen Barras ,&nbsp;Hamed Asadi","doi":"10.1016/j.jocn.2025.111412","DOIUrl":"10.1016/j.jocn.2025.111412","url":null,"abstract":"<div><div>Mechanical thrombectomy using stent retrievers is the standard endovascular treatment for acute ischaemic stroke due to large vessel occlusion. With the rapid evolution in device design, this scoping review aims to map the current landscape of stent retriever types used in clinical practice, as well as their application across different sites of vessel occlusion. A comprehensive literature search was conducted using MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials to identify primary studies reporting on the safety and efficacy of stent retrievers in mechanical thrombectomy for acute stroke. After screening and data extraction by two independent reviewers, 133 studies were included, encompassing 22 distinct stent retriever devices. Frequencies of thrombectomy procedures were analysed according to device type and occlusion location. The Solitaire and Trevo devices accounted for the majority of cases (57 %), with the most commonly treated occlusion sites being the M1 segment of the middle cerebral artery and the internal carotid artery (51 % and 19 %, respectively). In contrast, anterior cerebral artery and M3 or more distal occlusions were underrepresented, each comprising only 1 % of the data. This review highlights a strong evidence base for conventional stent retrievers in large vessel occlusions, particularly M1, while also revealing a significant gap in knowledge regarding newer generation stent retrievers and their use in distal medium vessel occlusions. Further research is needed to evaluate device safety and effectiveness in these smaller, more challenging vessels.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"138 ","pages":"Article 111412"},"PeriodicalIF":1.9,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144364887","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":"Symptom measurement of post‐stroke depression at rehabilitation stage: Development and validation of a new short form","authors":"Junya Chen ,&nbsp;Chong Mei Chan ,&nbsp;Nant Thin Thin ,&nbsp;Fen Xu ,&nbsp;Wen Ding ,&nbsp;Biji Xu ,&nbsp;Andong Liang","doi":"10.1016/j.jocn.2025.111422","DOIUrl":"10.1016/j.jocn.2025.111422","url":null,"abstract":"<div><h3>Background</h3><div>The Symptom Measurement of Post-Stroke Depression in the Rehabilitation Stage (SMPSD-RS) is a specialized measurement tool designed to detect early depressive symptoms in acute stroke patients, but it is too lengthy for use in busy clinical settings. This study aims to develop a shortened test version through statistical methods to reduce the assessment burden and validate its effectiveness.</div></div><div><h3>Methods</h3><div>During the three months from March 2024 to May 2024, 445 post-stroke patients completed two questionnaires: a demographic survey and the SMPSD-RS questionnaire. The item reduction process primarily involves item response theory (IRT), item analysis, exploratory factor analysis, and confirmatory factor analysis.</div></div><div><h3>Result</h3><div>The item reduction process results in a shortened 12-item questionnaire, demonstrating acceptable structural validity and internal reliability. Three factors are extracted, accounting for most of the total variance: “Cognition,” “Sleep,” and “Emotion.” All estimates of the confirmatory model fit indices meet the standard criteria. The standardized factor loadings for the 12 items meet the standard criteria, and the variance explained by the items is acceptable. Additionally, the internal reliability estimates for the 12-item questionnaire are acceptable, with corrected item-total correlations and item-subscale correlations questionnaire supporting the short-form questionnaire’s reliability.</div></div><div><h3>Conclusion</h3><div>The Symptom Measurement of Post-Stroke Depression in the Rehabilitation Stage Short Form (SMPSD-RSSF) demonstrates acceptable reliability and validity for screening depressive symptoms in post-stroke rehabilitation patients Which is useful to be used in a busy clinical setting.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"139 ","pages":"Article 111422"},"PeriodicalIF":1.9,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365127","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 stroke fatigue: Analysis of subtypes and associated factors","authors":"Mohammad Etoom ,&nbsp;Manal Al Battat ,&nbsp;Ibrahem Hanafi ,&nbsp;Nicola Manocchio ,&nbsp;Calogero Foti ,&nbsp;Alia Alghwiri","doi":"10.1016/j.jocn.2025.111418","DOIUrl":"10.1016/j.jocn.2025.111418","url":null,"abstract":"<div><h3>Background</h3><div>Post stroke fatigue (PSF) is a disabling complaint endorses stroke recovery. PSF is highly varied, while most of previous studies did not consider physical and cognitive subtypes. The current study aimed to investigate PSF prevalence and associated factors with consideration of fatigue subtypes.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted. Demographics, medical history, stroke characteristics, depression, anxiety, sleep quality, and stroke recovery were evaluated. The Modified Fatigue Impact Scale (MFIS) has been adopted to assess PSF and its subtypes (physical and cognitive). Descriptive statistics, t-tests for MFIS subscales comparisons, and regression analyses were performed.</div></div><div><h3>Results</h3><div>A total of 92 participants were included; 45 % were female, age ranged between 27 and 85 years. The PSF prevalence rate was 71.7 %. The MFIS physical subscale demonstrated a significantly higher prevalence and severity than cognitive subscale (t = 11.1, p &lt; 0.001). Perceived stroke recovery, depression, anxiety, and sleep quality were related with the MFIS total score as well as its two subscales (B = 0.21–3.32). Diabetes mellitus (B = 0.05, p = 0.02), hypercholesterolemia (B = 0.06, p = 0.018), and left hemisphere stroke (B = -0.04, p = 0.027) were associated with the MFIS cognitive subscale, while recurrent stroke was related to the MFIS physical subscales (B = 0.08, p = 0.04). Anxiety and perceived stroke recovery represented the common significant predictors for MFIS total score and all its subscales (B = 0.13–1.16). Depression and left hemisphere stroke were significant predictors for MFIS total score and cognitive subscale (B = 0.87–7.51). Sleep quality (B = 0.64, p = 0.026) and being male (B = 3.32, p = 0.049) were additional significant predictors for MFIS cognitive fatigue.</div></div><div><h3>Conclusion</h3><div>PSF is highly prevalent. PSF subtypes were markedly varied in prevalence, severity and associated factors. Future research and clinical protocols should consider different PSF subtypes rather than conceptualizing PSF as one entity.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"139 ","pages":"Article 111418"},"PeriodicalIF":1.9,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365128","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":"Endovascular carotid artery revascularization utilizing multiple distal embolic protection strategies: active and passive flow reversal in combination with balloon assisted reperfusion","authors":"Jason H. Boulter ,&nbsp;Jeffrey D. Shapiro ,&nbsp;Amber M. Pratt ,&nbsp;Kristin Viaggio ,&nbsp;Albert J. Schuette ,&nbsp;Michael F. Stiefel","doi":"10.1016/j.jocn.2025.111413","DOIUrl":"10.1016/j.jocn.2025.111413","url":null,"abstract":"<div><h3>Background</h3><div>Carotid artery stenosis is a common cause of stroke. Carotid artery stenting (CAS) includes multiple approaches to endovascular carotid revascularization, including transfemoral/transradial CAS (TF-CAS/TR-CAS) and transcarotid artery revascularization (TCAR). Although CAS has declined in frequency since the development of TCAR, distal embolic protection (DEP) strategies differ between the two procedures, with studies reporting a lower risk of stroke with TCAR. TCAR uses open surgical common carotid artery clamping combined with passive flow reversal (PFR), whereas traditional TF-CAS/TR-CAS often employs a DEP device. Modifications to TF-CAS/TR-CAS include balloon guide catheter (BGC) carotid occlusion and PFR for additional DEP, mirroring aspects of TCAR.</div></div><div><h3>Methods</h3><div>Patients underwent endovascular carotid artery revascularization (ECAR) using either transfemoral or transradial approaches (i.e., TF-CAS/TR-CAS) with the implementation of multiple DEP strategies: proximal flow arrest with a BGC, active flow reversal (AFR) and PFR, DEP device, and balloon-assisted reperfusion (BAR).</div></div><div><h3>Results</h3><div>Two patients underwent successful TF-CAS/TR-CAS utilizing a DEP device in combination with novel adjuvant endovascular techniques. BGC occlusion of the common carotid artery provided anterograde flow arrest. AFR was employed during scenarios where PFR was not feasible or insufficient. BAR was performed with transient balloon occlusion of the proximal internal carotid artery during common carotid artery reperfusion and restoration of anterograde blood flow.</div></div><div><h3>Conclusion</h3><div>Adjuvant endovascular techniques can be employed during TF-CAS/TR-CAS that provide similar, if not more, DEP strategies to those used during TCAR. A purely endovascular approach lends itself to a multitude of specialists and eliminates wound care post-procedure, contributing to higher patient satisfaction and fewer complications.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"139 ","pages":"Article 111413"},"PeriodicalIF":1.9,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365129","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":"‘Father of neonatal neurology’: the life of Joseph J. Volpe","authors":"Juliette Nutovits ,&nbsp;Brendan Huang","doi":"10.1016/j.jocn.2025.111423","DOIUrl":"10.1016/j.jocn.2025.111423","url":null,"abstract":"<div><div>Dr. Joseph J. Volpe, a prominent figure in neonatal neurology, has made many important contributions to the understanding and treatment of brain injuries in newborns, particularly premature infants. Over his 60-year career, Volpe conducted pioneering research in the basic and clinical aspects of neonatal brain development and pathology. He played a key role in advancing neonatal care, improving outcomes for premature infants, and shaping the field of neonatal neurology. Volpe’s early neurology career at Harvard Medical School and later work at Massachusetts General Hospital and Washington University led him to specialize in neonatal neurology, where he identified critical gaps in clinical practice. His research in neonatal brain injuries such as intraventricular hemorrhage, periventricular leukomalacia, and encephalopathy of prematurity has been instrumental in the development of modern diagnostic and treatment approaches. Volpe’s influential textbook <em>Neurology of the Newborn</em> has served as a definitive guide for clinicians worldwide, currently now in its seventh edition. Throughout his career, Volpe mentored a generation of neonatologists and pediatric neurologists, leaving a legacy as both a researcher and educator. His ongoing contributions continue to shape neonatal care, improving survival and developmental outcomes for newborns.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"139 ","pages":"Article 111423"},"PeriodicalIF":1.9,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare tandem anomalies of the vertebral artery at the craniovertebral junction – What the mind does not know the eyes do not see!!","authors":"K. Sridhar","doi":"10.1016/j.jocn.2025.111405","DOIUrl":"10.1016/j.jocn.2025.111405","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"138 ","pages":"Article 111405"},"PeriodicalIF":1.9,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144329953","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":"Prognostic value of regional cerebral oxygen saturation pre and post decompressive craniectomy in patients with malignant anterior circulation ischemic stroke − a prospective observational study","authors":"Rohini M. Surve ,&nbsp;Gayatri Sakrikar ,&nbsp;Pramod Kalgudi ,&nbsp;G. Parthiban ,&nbsp;Dhritiman Chakrabarti","doi":"10.1016/j.jocn.2025.111414","DOIUrl":"10.1016/j.jocn.2025.111414","url":null,"abstract":"<div><h3>Background</h3><div>Malignant ischemic stroke (MIS) is a life-threatening emergency requiring decompressive craniectomy (DC). Regional cerebral oxygenation (rScO₂) may provide valuable insights during the perioperative period of MIS. Primary objective of this study was to observe the correlation between baseline bilateral rScO₂ (ipsilateral side (rScO₂I) and contralateral side (rScO₂C) with severity of the stroke assessed by National Institutes of Health Stroke Scale score (NIHSS) and Glasgow Coma Scale (GCS), and with discharge and 30 days functional outcome. Secondary objectives were to study the effect of DC on bilateral rScO₂ changes and its correlation with the outcome.</div></div><div><h3>Methods</h3><div>This prospective observational study was conducted over a period of one year, and included adult patients of MIS requiring DC. NIHSS and GCS were assessed at admission, before and immediately after surgery. In operation theatre, baseline, during induction and at the end of the surgery, bifrontal rScO₂ were recorded. Patient’s outcome was assessed using Glasgow outcome scale extended (GOSE) and modified Rankin Score (mRS) at discharge and 30 days. Data analysed using R version 4.3.2.</div></div><div><h3>Results</h3><div>A total of 35 patients were recruited. Baseline rScO₂I values, but not the rScO₂C, significantly correlated with admission GCS (r = 0.457, p = 0.007), and preoperative NIHSS (r = -0.384, p = 0.025). Baseline rScO₂ did not correlate with the outcome. Following DC, significant improvement was observed in rScO₂I (p = 0.03) and rScO₂C (p = 0.02) with changes in rScO₂C, but not rScO₂I, showed a strong positive correlation with discharge GOSE (r = 0.734, p = 0.000) and 30-day GOSE (r = 0.455, p = 0.02), and a negative correlation with discharge (r = -0.641, p = 0.000) and 30-day mRS (r = -0.485, p = 0.01).</div></div><div><h3>Conclusion</h3><div>Non-invasive cerebral oxygenation correlates with the severity of stroke, helps to monitor the changes following DC and also to predict the short-term functional outcome, suggesting its utility during the perioperative course in MIS patients.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"138 ","pages":"Article 111414"},"PeriodicalIF":1.9,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144329952","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":"Online and ChatGPT-generated patient education materials regarding brain tumor prognosis fail to meet readability standards","authors":"Ishav Y. Shukla,&nbsp;Matthew Z. Sun","doi":"10.1016/j.jocn.2025.111410","DOIUrl":"10.1016/j.jocn.2025.111410","url":null,"abstract":"<div><h3>Objective</h3><div>Online healthcare literature often exceeds the general population’s literacy level. Our study assesses the readability of online and ChatGPT-generated materials on glioblastomas, meningiomas, and pituitary adenomas, comparing readability by tumor type, institutional affiliation, authorship, and source (websites vs. ChatGPT).</div></div><div><h3>Methods</h3><div>This cross-sectional study involved a Google Chrome search (November 2024) using ‘prognosis of [tumor type],’ with the first 100 English-language, patient-directed results per tumor included. Websites were categorized by tumor, institutional affiliation (university vs. non-affiliated), and authorship (medical-professional reviewed vs. non-reviewed). ChatGPT 4.0 was queried with three standardized questions per tumor, based on the most prevalent content found in patient-facing websites. Five metrics were assessed: Flesch Reading Ease, Flesch-Kincaid Grade Level, Gunning Fog Index, Coleman-Liau Index, and SMOG Index. Comparisons were conducted using Mann-Whitney U tests and t-tests.</div></div><div><h3>Results</h3><div>Zero websites and ChatGPT responses met the readability benchmarks of 6th grade or below (AMA guideline) or 8th grade or below (NIH guideline). Of the websites, 50.4 % were at a 9th–12th grade level, 47.9 % at an undergraduate level, and 1.7 % at a graduate level. Websites reviewed by medical professionals had higher FRE (p = 0.03) and lower CLI (p = 0.009) compared to non-reviewed websites. Among ChatGPT responses, 93.3 % were graduate level. ChatGPT responses had lower readability than websites across all metrics (p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Online and ChatGPT-generated neuro-oncology materials exceed recommended readability standards, potentially hindering patients’ ability to make informed decisions. Future efforts should focus on standardizing readability guidelines, refining AI-generated content, incorporating professional oversight consistently, and improving the accessibility of online neuro-oncology materials.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"138 ","pages":"Article 111410"},"PeriodicalIF":1.9,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144329951","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}