Journal of Clinical Neuroscience最新文献

{"title":"Trends in Intervention Modality for Hospitalizations with Infectious Intracranial Aneurysms: A Nationwide Analysis","authors":"Giana Dawod,&nbsp;Alis J. Dicpinigaitis,&nbsp;Cenai Zhang,&nbsp;Hooman Kamel,&nbsp;Santosh Murthy,&nbsp;Alexander E. Merkler","doi":"10.1016/j.jocn.2026.111852","DOIUrl":"10.1016/j.jocn.2026.111852","url":null,"abstract":"<div><h3>Background/Objective</h3><div>Data regarding the optimal treatment of infectious intracranial aneurysms remains sparse. With growing utilization of endovascular therapy for cerebrovascular disease, we examined trends in endovascular versus neurosurgical treatment of infectious aneurysms and investigated the impact of treatment modality on outcomes.</div></div><div><h3>Methods</h3><div>Using data from the National Inpatient Sample from 2000 to 2019, we conducted a trends analysis on rates of treatment modalities among hospitalizations with infective endocarditis with ruptured or unruptured cerebral aneurysms. Treatment modalities were categorized as endovascular versus open neurosurgical repair based on ICD-9 and ICD-10 codes. Logistic regressions were utilized to assess the association between treatment modality and the outcomes of in-hospital mortality and discharge disposition.</div></div><div><h3>Results</h3><div>We identified 24,461 hospitalizations with an infectious intracranial aneurysm in the setting of infective endocarditis. Mean age was 56.0 years (SD, 17.8) and 61.8 % were male. The overall rate of intervention was 5.8 % (95 % CI, 5.0–6.5 %), and this did not change over time (p = 0.669). There was a significant increase in the rate of endovascular repair (APC = 3.6 %; 95 % CI, 1.2 %-8.1 %) and a significant decrease in the rate of open neurosurgical repair (APC = -5.4 %; 95 % CI, −8.1 % to −3.5 %). Treatment modality was not associated with in-hospital mortality (p = 0.698) or non-home discharge disposition (p = 0.897).</div></div><div><h3>Conclusion</h3><div>Although rates of infectious intracranial aneurysm intervention for infective endocarditis did not change, utilization of endovascular treatment increased while the use of open neurosurgical treatment decreased without adverse effects on mortality rate. Further directions include elucidating predictors of favorable outcomes for undergoing intervention and the most beneficial timing for the procedure during hospitalization.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"146 ","pages":"Article 111852"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037288","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":"Elevated baseline glucose and hemorrhagic complications in bridging vs direct EVT","authors":"Peng Lu ,&nbsp;Rundong Chen ,&nbsp;Meihua Huyan ,&nbsp;Weilong Hua ,&nbsp;Yilei Zhang ,&nbsp;Hongjian Zhang ,&nbsp;Zifu Li ,&nbsp;Yongwei Zhang ,&nbsp;Jianmin Liu ,&nbsp;Pengfei Yang ,&nbsp;Lei Zhang","doi":"10.1016/j.jocn.2026.111886","DOIUrl":"10.1016/j.jocn.2026.111886","url":null,"abstract":"<div><h3>Background</h3><div>Hyperglycemia on admission is associated with heightened hemorrhagic risk in acute ischemic stroke (AIS), but whether this risk association differs between bridging therapy (intravenous alteplase followed by endovascular thrombectomy [EVT]) and direct EVT remains unclear.</div></div><div><h3>Methods</h3><div>This post hoc analysis of the DIRECT-MT trial (2016–2019) included 627 patients with anterior circulation large-vessel occlusion AIS eligible for alteplase from multiple centers. Baseline glucose levels were assessed, and hemorrhagic outcomes followed the Heidelberg scheme: hemorrhagic transformation (HT; radiologic umbrella that includes hemorrhagic infarction [HI] and parenchymatous hematoma [PH]) and symptomatic intracranial hemorrhage (sICH). Logistic regression and restricted cubic spline models evaluated glucose-hemorrhage associations and the treatment-by-glucose interactions.</div></div><div><h3>Results</h3><div>Median age was 69 years (43 % female), with median baseline glucose of 7.8 mmol/L. Elevated glucose was associated with greater odds of<!--> <!-->hemorrhagic transformation (HT)<!--> <!-->(adjusted OR<!--> <!-->1.168<!--> <!-->per 1 mmol/L; 95 % CI,<!--> <!-->1.100–1.243). A significant interaction indicated higher hemorrhagic risk with bridging therapy versus direct EVT at glucose levels &gt; 11.1 mmol/L. In the &gt; 11.1 mmol/L subgroup (n = 71), bridging therapy was associated with increased PH risk (OR 4.84; 95 % CI 1.34–21.95, p = 0.024), whereas no excess risk was seen at ≤ 11.1 mmol/L. No significant differences were observed for HI or sICH.</div></div><div><h3>Conclusion</h3><div>Admission hyperglycemia was associated with higher odds of hemorrhagic complications in AIS patients undergoing EVT. In patients with marked admission hyperglycemia (&gt;11.1 mmol/L), bridging therapy was associated with higher odds of parenchymal hematoma than direct EVT, whereas no excess risk was observed at lower glucose levels. These exploratory findings apply only to EVT-eligible patients and primarily inform the choice between bridging therapy and direct EVT, suggesting that, when blood glucose is markedly elevated, a direct EVT strategy may warrant consideration alongside early glucose assessment and careful glycemic management.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"146 ","pages":"Article 111886"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076233","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":"AICA aneurysm–related subarachnoid hemorrhage in a dural AVF","authors":"Ujjwal Agarwal ,&nbsp;Rajsrinivas Parthasarathy ,&nbsp;Radhey Shyam Singla ,&nbsp;Pallav Bhatter","doi":"10.1016/j.jocn.2026.111880","DOIUrl":"10.1016/j.jocn.2026.111880","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"146 ","pages":"Article 111880"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037280","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":"Neurophysiological insights into iNPH: ABR and CAEP responses to lumbar puncture and shunt surgery","authors":"Lucas Pinto Mielle ,&nbsp;Nayara Pereira Santos ,&nbsp;Liliane Aparecida Fagundes Silva ,&nbsp;Sandro Luíz de Andrade Matas ,&nbsp;Carla Gentile Matas","doi":"10.1016/j.jocn.2026.111884","DOIUrl":"10.1016/j.jocn.2026.111884","url":null,"abstract":"<div><h3>Background</h3><div>Idiopathic normal pressure hydrocephalus (iNPH) is a neurological syndrome resulting from increased cerebrospinal fluid volume without significant increase in intracranial pressure. The diagnosis is difficult and investigating other tools that can assist in this process is essential. Auditory Evoked Potentials (AEPs) can be used to assess the auditory pathway integrity and monitor cognitive auditory functions. The objective of this study was to investigate the applicability of the AEPs as a potential monitoring tool for detecting clinical improvements associated with cerebrospinal fluid removal by lumbar puncture and VPS placement in patients with iNPH.</div></div><div><h3>Methods</h3><div>This longitudinal study, evaluated 17 individuals with iNPH, aged over 60 years who underwent the ventriculoperitoneal shunt, by Auditory Brainstem Response (ABR) and Cortical Auditory Evoked Potentials (CAEP) at three different times: before the lumbar puncture during the Tap test, two to four hours after the lumbar puncture, and after the ventriculoperitoneal shunt.</div></div><div><h3>Results</h3><div>A decrease in P3 latency was observed after lumbar puncture during Tap test. No statistically significant differences were observed between assessments for P1, N1 P2, N2 latencies or P1-N1, P2-N2 and N2-P3 amplitudes of the CAEP, as well as for the absolute and interpeaks latencies of the ABR.</div></div><div><h3>Conclusions</h3><div>After the removal of significant volumes of cerebrospinal fluid in patients with iNPH, lower P3 latency values were found, suggesting an increase in the speed of acoustic information processing, during the Tap test. This result brings an insight on the applicability of this procedure as an auxiliary method for monitoring clinical improvements associated with cerebrospinal fluid removal in iNPH.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"146 ","pages":"Article 111884"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076236","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":"Comparison of the efficacy of lidocaine and bupivacaine in GON blockade for prophylaxis of chronic migraine","authors":"Sıddıka Sena İnan ,&nbsp;Kübra Mehel Metin ,&nbsp;Arzu Muz ,&nbsp;İsmail Eren Durmuş ,&nbsp;Suna Akın Takmaz ,&nbsp;Levent Ertuğrul İnan","doi":"10.1016/j.jocn.2026.111872","DOIUrl":"10.1016/j.jocn.2026.111872","url":null,"abstract":"<div><h3>Background</h3><div>Numerous studies have evaluated greater occipital nerve (GON) blockade for migraine prophylaxis using various techniques and anesthetic agents, yet a standardized protocol remains lacking. Although both lidocaine and bupivacaine are effective compared with placebo, no direct comparison exists. This study aimed to compare the efficacy of lidocaine and bupivacaine in GON blockade for chronic migraine.</div></div><div><h3>Materials and methods</h3><div>Data from 79 chronic migraine patients who underwent ultrasound-guided GON blockade at the University of Health Sciences Ankara Training and Research Hospital were retrospectively analyzed. Patients received either 1.5 mL of 2% lidocaine + 1 mL saline or 1.5 mL of 0.5% bupivacaine + 1 mL saline. Multivariate path analysis was used to evaluate the factors affecting pain reduction and to adjust for baseline differences<strong>.</strong> Blocks were administered weekly during the first month and monthly for two subsequent months on the side corresponding to pain. The number of headache days, attack duration, and Visual Analog Scale (VAS) scores were recorded before and after each session.</div></div><div><h3>Results</h3><div>Both groups showed significant reductions in headache days, attack duration, and VAS scores after treatment. Baseline values were similar except for disease duration, which was significantly longer in the bupivacaine group (p = 0.028). At the first month, the bupivacaine group reported significantly more headache days than the lidocaine group (P = 0.046), but no further intergroup differences were found. Although the lidocaine group showed lower pain scores in the first month in univariate analysis, multivariate path analysis revealed that the treatment group (Lidocaine vs. Bupivacaine) did not have a statistically significant effect on the change in VAS scores (p &gt; 0.05). The baseline VAS score was the only significant predictor of pain reduction (β = -0.70, p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Lidocaine and bupivacaine were both effective for migraine prophylaxis via GON blockade. While lidocaine appeared to provide faster relief initially, regression analysis suggests that baseline pain severity, rather than the choice of agent or disease duration, is the primary determinant of treatment response.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"146 ","pages":"Article 111872"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146006772","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":"Utilizing internal analytics and physician-director collaborations to enhance neurological health communication on YouTube","authors":"Benjamin K.P. Woo ,&nbsp;Jamie O.P. Chung","doi":"10.1016/j.jocn.2026.111878","DOIUrl":"10.1016/j.jocn.2026.111878","url":null,"abstract":"<div><div>The dissemination of health information on YouTube presents a paradox where expert-generated content, despite high clinical accuracy, often lacks the engagement seen in non-expert patient narratives. Recent evaluations of Guillain-Barré Syndrome (GBS) videos confirm that while physician-produced content achieves superior objective quality scores, it frequently suffers from low visibility and fails to correlate popularity with scientific validity. This manuscript proposes a shift toward utilizing internal analytics, specifically Average View Duration (AVD) and Click-Through Rate (CTR), alongside a collaborative physician-director production model to bridge the gap between clinical precision and public engagement. We suggest that adopting this hybrid creative model and prioritizing internal engagement metrics over aggregate view counts will better support patients and caregivers, particularly in complex neurological conditions.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"146 ","pages":"Article 111878"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037287","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":"Longitudinal effects of dimethyl fumarate on patient-reported outcome measures in multiple sclerosis: treatment satisfaction, quality of life, depressive symptoms, sleep, and work productivity","authors":"Roya Abolfazli ,&nbsp;Mohammad Ali Sahraian ,&nbsp;Vahid Shaygannejad ,&nbsp;Fereshteh Ashtari ,&nbsp;Sareh Shahmohammadi ,&nbsp;Maryam Poursadeghfard ,&nbsp;Seyed Mohammad Baghbanian ,&nbsp;Nastaran Majdinasab ,&nbsp;Mohammad Ali Nahayati ,&nbsp;Samaneh Hosseini ,&nbsp;Javad Yousefi Azarfam ,&nbsp;Samira Navardi ,&nbsp;Hamid Reza Torabi ,&nbsp;Hormoz Ayromlou ,&nbsp;Morteza Saeidi ,&nbsp;Mahnaz Talebi ,&nbsp;Alireza Nikseresht ,&nbsp;Zahra Niknam ,&nbsp;Amirreza Azimi ,&nbsp;Behnaz Sedighi ,&nbsp;Sara Samadzadeh","doi":"10.1016/j.jocn.2026.111877","DOIUrl":"10.1016/j.jocn.2026.111877","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Oral therapies for relapsing–remitting multiple sclerosis (RRMS) may enhance treatment satisfaction and quality of life. Patient-reported outcome measures (PROMs) provide structured insight into treatment effectiveness and disease impact beyond clinician-reported scales.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To assess treatment satisfaction and other PROMs in RRMS patients initiating dimethyl fumarate (DMF), either treatment-naïve or switching from injectable therapies.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;PROFIT was a 12-month, multicenter, phase 4, open-label, single-arm observational study conducted in Iran. Patients received DMF with a slow-dose titration regimen to mitigate gastrointestinal adverse effects. The primary endpoint was the change in treatment satisfaction, assessed by the Treatment Satisfaction Questionnaire for Medication (TSQM-14), from baseline to month 12 among previously treated patients. Key secondary endpoints included changes in additional PROMs, including health-related quality of life (HRQoL), depressive symptoms, sleep quality, and work productivity. Patient-reported outcomes were assessed using the EuroQol-5D-3L (EQ-5D-3L), Beck Depression Inventory–Fast Screen (BDI-7), Pittsburgh Sleep Quality Index (PSQI), and Work Productivity and Activity Impairment–Multiple Sclerosis (WPAI-MS) at baseline, 6 months, and 12 months. Adverse events were monitored monthly, with safety evaluated as a secondary outcome.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Of 645 patients (72.3 % female; mean age 34.0 years), 473 (73.3 %) completed the 12-month follow-up, while 172 (26.7 %) discontinued treatment. The primary endpoint, change in treatment satisfaction (TSQM-14) among previously treated patients, showed significant improvement across all domains: effectiveness (+13.01), side effects (+7.76), convenience (+35.21), and global satisfaction (+15.75) (all p &lt; 0.001). Secondary endpoints also demonstrated favorable changes, including EQ-5D-3L utility (+0.07), EQ-5D Visual Analogue Scale (VAS) (+3.86), PSQI (–1.62), WPAI absenteeism (–7.55 %), and BDI-7 (–0.11) (all p &lt; 0.001). Treatment discontinuations (26.7 %) were primarily due to gastrointestinal adverse events (n = 45, 26.0 %), followed by physician decision (n = 34, 20.0 %), disease progression (n = 26, 15.0 %), patient preference (n = 19, 11.0 %), pregnancy (n = 14, 8.0 %), elevated liver enzymes (n = 13, 7.0 %), and other causes (n = 21, 12.0 %). Adverse events declined over time, confirming a favorable and manageable safety profile.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;DMF was associated with improvements in treatment satisfaction, quality of life, sleep quality, work productivity, and depressive symptoms in both treatment-naïve and previously treated RRMS patients, with high adherence and manageable side effects. These findings provide real-world evidence from an Iranian RRMS cohort, supporting DMF as a well-tolerated, patient-centered option ","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"146 ","pages":"Article 111877"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076186","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 between the cumulative defined daily dose of statins and ischemic stroke recurrence: a cohort study","authors":"Yue Han ,&nbsp;Zhe Bian ,&nbsp;Haochen Gu ,&nbsp;Dunzhu Guo ,&nbsp;Rui Li ,&nbsp;Liping Liu ,&nbsp;Dali Wang ,&nbsp;Yanbo Peng","doi":"10.1016/j.jocn.2026.111873","DOIUrl":"10.1016/j.jocn.2026.111873","url":null,"abstract":"<div><h3>Background</h3><div>The cumulative defined daily dose (cDDD) enables quantification of statin exposure, balancing therapeutic intensity and patient adherence. However, the relationship between statin cDDD and recurrence risk in ischemic stroke (IS) patients remains unclear.</div></div><div><h3>Objective</h3><div>The aim of this study was to investigate the impact of statin cDDD on recurrence risk in IS patients.</div></div><div><h3>Methods</h3><div>This prospective cohort study enrolled 728 patients with acute ischemic stroke (AIS). After 1 year of follow-up, participants were stratified into four groups (Q1-Q4) according to the quartiles of statin cDDD, and Kaplan-Meier curves were used to estimate the risk of stroke recurrence. The association between cDDD and recurrence risk was examined using restricted cubic spline (RCS) and Cox proportional hazards models, with sensitivity analyses employed to assess population heterogeneity and confirm the robustness of the findings.</div></div><div><h3>Results</h3><div>Kaplan-Meier survival analysis revealed statistically significant differences in recurrence rates across quartiles (<em>P</em> &lt; 0.001). RCS analysis confirmed a nonlinear negative correlation between cDDD and recurrence risk (<em>P</em> for nonlinearity &lt; 0.001). Multivariate Cox regression demonstrated that the recurrence risk in Q4 was 87.7% lower than in Q1. Sensitivity analysis further confirmed that the association between cDDD and IS recurrence risk was independent of antihypertensive or antidiabetic medication use.</div></div><div><h3>Conclusions</h3><div>Statin cDDD shows a significant nonlinear inverse correlation with stroke recurrence, and exhibits a dose-dependent threshold effect.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"146 ","pages":"Article 111873"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037282","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":"Excessive daytime sleepiness in patients with idiopathic normal pressure hydrocephalus: A controlled cross-sectional study","authors":"Halil Onder ,&nbsp;Nursu Erdogan ,&nbsp;Ahmet Gunaydin ,&nbsp;Selcuk Comoglu","doi":"10.1016/j.jocn.2026.111885","DOIUrl":"10.1016/j.jocn.2026.111885","url":null,"abstract":"<div><h3>Background</h3><div>Idiopathic normal pressure hydrocephalus (iNPH) is characterized by gait disturbance, cognitive impairment, and urinary incontinence, yet non-motor symptoms such as sleep disturbances remain underexplored.</div></div><div><h3>Objective</h3><div>To investigate subjective daytime sleepiness and sleep apnea in patients with iNPH compared with healthy controls, and to assess their association with disease severity.</div></div><div><h3>Methods</h3><div>In this cross-sectional study, 46 iNPH patients and 74 age- and sex-matched controls were evaluated with the Epworth Sleepiness Scale (ESS). Apnea was assessed using a semi-structured frequency interview. Disease severity was rated with the NPH grading scale and MDS-UPDRS-3. Group comparisons and correlation analyses were performed.</div></div><div><h3>Results</h3><div>ESS scores were significantly higher in iNPH patients (10.3 ± 7.1) than in controls (6.8 ± 5.6, p = 0.008), and this difference remained after adjusting for age and BMI. No significant associations were observed between ESS scores and motor or cognitive severity measures. Apnea frequency did not differ significantly between groups and showed no relationship with disease severity.</div></div><div><h3>Conclusions</h3><div>Excessive daytime sleepiness is common in iNPH and appears independently of motor or cognitive burden, suggesting it may be an underrecognized non-motor feature. Further studies incorporating objective sleep assessments and advanced neuroimaging are warranted to clarify underlying mechanisms and explore potential therapeutic implications, including the role of sleep-focused interventions.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"146 ","pages":"Article 111885"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037284","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 long-term influence of early rehabilitation nursing on neurological improvement and life quality in patients with severe traumatic brain injury: A prospective cohort study","authors":"Tiantian Zou ,&nbsp;Mengyi Xu ,&nbsp;Ying Liu","doi":"10.1016/j.jocn.2026.111874","DOIUrl":"10.1016/j.jocn.2026.111874","url":null,"abstract":"<div><h3>Background</h3><div>Severe traumatic brain injury (sTBI) leads to substantial neurological dysfunction and diminished quality of life. However, prospective evidence regarding the long-term effects of early rehabilitation nursing on neurological recovery in sTBI patients remains scarce.</div></div><div><h3>Methods</h3><div>This prospective cohort study enrolled 73 sTBI patients (Glasgow Coma Scale ≤ 8) between January and December 2022. Patients were allocated to receive routine nursing (control group, n = 35) or early rehabilitation nursing (research group, n = 38), which comprised psychological support, cognitive intervention, and motor rehabilitation initiated within 48 h of stabilization. Outcomes including consciousness (GCS), motor function (Fugl-Meyer Assessment), functional independence (Functional Independence Measure), neurological deficit (NIHSS), quality of life (QOL-100), and global outcome (Glasgow Outcome Scale-Extended) were assessed at baseline, 6, 12, and 18 months.</div></div><div><h3>Results</h3><div>Repeated-measures analysis revealed significant Time × Group interactions across all outcomes (p &lt; 0.001), indicating divergent recovery trajectories. At 18 months, the research group demonstrated superior GCS (14.82 ± 0.89 vs. 13.45 ± 1.12, p &lt; 0.001), FMA (87.24 ± 5.67 vs. 79.86 ± 6.34, p &lt; 0.001), FIM (95.42 ± 4.85 vs. 85.71 ± 5.92, p &lt; 0.001), and GOSE scores (7.21 ± 0.74 vs. 6.43 ± 0.95, p &lt; 0.001), alongside lower NIHSS scores (7.18 ± 2.45 vs. 13.57 ± 3.21, p &lt; 0.001). Quality of life improved significantly across all domains in the research group. Effect sizes were uniformly large (Cohen’s d: 0.92–2.24).</div></div><div><h3>Conclusions</h3><div>Early rehabilitation nursing was associated with sustained improvements in neurological function, functional independence, and quality of life over 18 months. These findings warrant confirmation through multicenter randomized controlled trials.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"146 ","pages":"Article 111874"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076237","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}