Journal of Clinical Neuroscience最新文献

{"title":"Comparison of sodium fluorescein and sodium fluorescein with intraoperative ultrasonography Efficacy in glioblastoma resection","authors":"Aykut Gokbel ,&nbsp;Ayse Uzuner ,&nbsp;Eren Yilmaz ,&nbsp;Atakan Emengen ,&nbsp;Sibel Balci ,&nbsp;Ihsan Anik ,&nbsp;Savas Ceylan","doi":"10.1016/j.jocn.2025.111404","DOIUrl":"10.1016/j.jocn.2025.111404","url":null,"abstract":"<div><h3>Background</h3><div>This study investigated the effectiveness of intraoperative ultrasonography (IOUS) combined with sodium fluorescein (SF) in evaluating tumor resection completeness in patients with glioblastoma IDH1-wildtype. By comparing SF with IOUS with postoperative magnetic resonance imaging (MRI) for detecting residual tumors, we aimed to evaluate its potential in improving surgical precision and neurosurgical outcomes.</div></div><div><h3>Methods</h3><div>Adult patients with supratentorial IDH-wildtype grade 4 glioblastoma who underwent resection using SF or SF with IOUS during 2015–2024 were included.</div></div><div><h3>Results</h3><div>A total of 97 patients met the inclusion criteria (49 SF group and 48 SF with IOUS group). The gross total resection (GTR) rate was higher in the SF with IOUS group (83.3 %) than in the SF group (67.3 %), although the difference was not statistically significant (p = 0.112). For residual tumors according to postoperative MRI findings as a result of subtotal resection due to tumor invasion of eloquent anatomical locations, 6/49 (12.2 %) patients in the SF group showed a positive result (ϰ: 0.447, p = 0.001), and 4/48 (8.3 %) patients in the SF with IOUS group showed a positive result (ϰ: 0.625, p &lt; 0.001). The sensitivity, specificity, negative predictive value, and positive predictive value for predicting residual tumors peroperatively compared with postoperative MRI results were calculated for the SF and SF with IOUS groups. Comparison between the SF and SF with IOUS groups revealed a statistically significant difference in the estimated mean survival time, with 14 months (standard error: 1.236) for the SF group and 24 months (standard error: 4.103) for the SF with IOUS group (p &lt; 0.001). In total, 11/49 (22.4 %) patients in the SF group, and 10/48 (20.8 %) patients in the SF with IOUS group experienced newly developed neurological deficits postoperatively (p &gt; 0.05). In the SF with IOUS group, 26/48 (54.2 %) patients, 14/48 (29.2 %) patients, and 8/48 (16.7 %) patients had Karnofsky Performance Status scores of 90–100, 70–80, and &lt; 70, respectively (p = 0.525), and 12 patients experienced deterioration, 24 patients were stable, and 12 patients had improved at 1 month.</div></div><div><h3>Conclusions</h3><div>SF with IOUS provides a reliable imaging modality for achieving successful GTR and improving surgical outcomes. Nevertheless, further research is necessary to overcome its limitations and better define its intraoperative role.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"138 ","pages":"Article 111404"},"PeriodicalIF":1.9,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144306732","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":"Disparities in epilepsy-associated mortality trends in the United States of America over two decades","authors":"Umar Maqbool ,&nbsp;Maleeha Saleem ,&nbsp;Fareeha Khan ,&nbsp;Arfa Ahmed Assad ,&nbsp;Haram Rehman ,&nbsp;Qais Bin Abdul Ghaffar ,&nbsp;Unsa Alamgir ,&nbsp;Iqra Alamgir ,&nbsp;Maria Saleem ,&nbsp;Eman Alamgir ,&nbsp;Ammad Adeel ,&nbsp;Muhammad Rayan Syed ,&nbsp;Muhammad Saad","doi":"10.1016/j.jocn.2025.111396","DOIUrl":"10.1016/j.jocn.2025.111396","url":null,"abstract":"<div><h3>Introduction</h3><div>Epilepsy affects millions of people in the US annually, leading to disability and death. This study aims to comprehensively delve into the epidemiological framework of epilepsy-related mortality by stratification of data through gender, ethnicity, and geographical regions over two decades, as these have not been done previously to this extent, with a view to addressing the target population precisely.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed epilepsy-related mortality data in the United States from the CDC (Centers for Disease Control and Prevention) database of all age groups using ICD-10 codes of G40.0 to G40.9 from 1999 to 2020. Age-adjusted Mortality rates (AAMRs) per 100,000 persons were calculated and categorized by year, sex, race/ethnicity, place of death, and geographic location. The Joinpoint regression analyzed these AAMRs to produce annual percent changes (APCs) to assess mortality trend changes.</div></div><div><h3>Results</h3><div>A total of 57,304 Epilepsy related deaths occurred between 1999 and 2020 in the United States. The overall AAMR for epilepsy in 1999 was 0.6 (95 % CI, 0.5 to 0.6) and increased to 1.64 (95 % CI, 1.59 to 1.68) in 2020. Men exhibited a higher AAMR than females throughout the study period from 1999 (0.7 vs. 0.47) to 202O (1.84 vs. 1.46); a significant rise was seen in APC for both genders in the second decade, i.e., 2010 to 2020. The highest mortality was noted in Non-Hispanic (NH) black or African Americans (AAMR:1.38), followed by NH American Indian or Alaskan Natives (AAMR:1.07), NH White (AAMR:0.76), Hispanics or Latinos (AAMR:0.76), and NH Asian or Pacific Islanders (AAMR:0.32). Regional analysis showed disparities in AAMR, the West being most prominent with an AAMR reported to be 1.04, followed by the Midwest regions (AAMR: 0.88), the South regions (AAMR: 0.77), and the Northeast regions (AAMR: 0.53). The states with AAMRs in the top 90th percentile included Iowa, Mississippi, Colorado, South Dakota, and Michigan, with non-metropolitan regions having higher AAMRs (0.92) than metropolitan counterparts (0.76).</div></div><div><h3>Conclusion</h3><div>The findings of our study emphasize the critical importance of addressing the rise in mortality, especially in the second decade, by devising strategies and policies targeting at-risk populations and improving the management framework for such patients, with more widespread public awareness regarding the disease and its risk factors.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"138 ","pages":"Article 111396"},"PeriodicalIF":1.9,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144298990","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 body mass index and intracranial procedural complications in patients undergoing endovascular treatment for unruptured aneurysms","authors":"Hidetoshi Matsukawa ,&nbsp;Kiyoshi Kazekawa ,&nbsp;Masahiro Yasaka ,&nbsp;Yoshimasa Fukui ,&nbsp;Kosei Maruyama ,&nbsp;Takashi Fujii ,&nbsp;Kosuke Takigawa ,&nbsp;Noriaki Tashiro ,&nbsp;Yoshiya Hashiguchi ,&nbsp;Hiroshi Aikawa ,&nbsp;Yoshinori Go","doi":"10.1016/j.jocn.2025.111402","DOIUrl":"10.1016/j.jocn.2025.111402","url":null,"abstract":"<div><h3>Background</h3><div>The association between body mass index (BMI) and procedural intracranial complications in the endovascular treatment (EVT) of unruptured intracranial aneurysms (UIAs) remains inadequately understood. While BMI is a well-established risk factor in cardiovascular and cerebrovascular disease, its specific role in the context of EVT for UIAs has not been clearly defined. Given the rising prevalence of obesity and the increased detection of UIAs through routine imaging, it is important to clarify whether BMI influences procedural safety or short-term outcomes following EVT.</div></div><div><h3>Methods</h3><div>This retrospective single-center study included consecutive patients with UIAs treated with EVT between April 2017 and April 2022. Patients were stratified into four BMI categories based on WHO classification: underweight (&lt;18.5 kg/m²), normal (18.5–24.9), overweight (25.0–29.9), and obese (≥30.0). The primary outcome was any intracranial procedural complication (ischemic or hemorrhagic) occurring within 30 days of treatment. Secondary outcomes included symptomatic complications, complications requiring treatment, 30-day modified Rankin Scale (mRS) score of 0–2, and mortality. Multivariate logistic regression was performed adjusting for potential confounders, including sex, dyslipidemia, diabetes mellitus, wide neck, aneurysm location, and EVT technique. Subgroup analyses further evaluated BMI’s role in key risk strata.</div></div><div><h3>Results</h3><div>A total of 756 patients were included: 70 underweight (9.3 %), 481 normal weight (63.6 %), 163 overweight (21.6 %), and 42 obese (5.5 %). Procedural complications occurred in 46 cases (6.1 %), with ischemic events in 43 and hemorrhagic events in 3. There were no statistically significant differences in complication rates across BMI categories. Similarly, the 30-day favorable outcome rate (mRS 0–2) was high (96.0 %) and did not differ significantly by BMI. Subgroup analyses confirmed that BMI did not significantly impact complication rates when stratified by sex, aneurysm morphology, comorbidities, or treatment type. In multivariate analysis, only aneurysm neck size was independently associated with procedural complications (adjusted OR 1.21, 95 % CI 1.04–1.40; P = 0.02).</div></div><div><h3>Conclusion</h3><div>BMI was not significantly associated with procedural intracranial complications or short-term functional outcomes following EVT for UIAs. These findings suggest that EVT can be performed safely across BMI categories and that BMI alone should not influence patient selection or procedural planning. Future studies with larger, diverse populations and longer follow-up may provide further insight into the long-term implications of BMI in neuroendovascular procedures.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"138 ","pages":"Article 111402"},"PeriodicalIF":1.9,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144306731","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":"Socioeconomic correlates of decompressive craniectomy outcomes for pediatric traumatic brain injury: a meta-epidemiological study","authors":"Cesar Ramirez ,&nbsp;Ankitha Iyer ,&nbsp;Brandon Hoglund ,&nbsp;Anant Naik ,&nbsp;Umaru Barrie ,&nbsp;Queeneth Onwujiogu ,&nbsp;Happiness Rabiel ,&nbsp;Carolina Sandoval Garcia ,&nbsp;Daniel Guillaume ,&nbsp;Paul M. Arnold","doi":"10.1016/j.jocn.2025.111366","DOIUrl":"10.1016/j.jocn.2025.111366","url":null,"abstract":"<div><h3>Introduction</h3><div>Low- and middle-income countries experience high pediatric traumatic brain injury rates. A decompressive craniectomy (DC) is a viable option for patients who are unresponsive to medical management. In 2019, the AANS Joint Section for Neurotrauma developed guidelines for pediatric TBI; however, the literature regarding socioeconomic factors that influence the success rate of DC in resource-poor environments remains sparse. Identification of these barriers is important to modify appropriate guidelines for these communities.</div></div><div><h3>Methods</h3><div>A PRISMA-adherent systematic review of four databases was performed to identify all primary articles investigating outcomes following DC in pediatric patients. Data were extracted for study features and primary outcomes including mortality and postoperative functional status. Socioeconomic epidemiological metrics, including poverty, population density, and health outcomes, were obtained from the United Nations and World Bank. A multivariable <em>meta</em>-regression analysis was performed to evaluate epidemiological factors influencing the pooled mortality and GOS estimates.</div></div><div><h3>Results</h3><div>Data from 39 studies, spanning 17 unique countries were abstracted. The mean age of patients in LMIC undergoing DC was younger, mean 4.74 (sD = 2.76) vs. mean 9.37 (sD = 3.52). Factors correlated with mortality rate included Human Development Index (HDI) (B (SE) = −2.33 (1.02), p = 0.022), population density (0.798 (0.188), p &lt; 0.001), percent of urban population (−0.02 (0.007), p = 0.006), percent of underweight population under 5 years of age (0.028 (0.011), p = 0.010), school enrollment (−0.018 (0.006), p = 0.006), LMIC status (0.83 (0.323), p = 0.010), and the number of hospital beds (−0.12 (0.039), p = 0.002). Post-operative GOS was not associated with any epidemiological covariates.</div></div><div><h3>Conclusion</h3><div>Socioeconomic determinants predict the success rate of DC in pediatric traumatic brain injury. Population density and the number of hospital beds having the strongest correlation to mortality rate indicate that low-resource, high-volume communities suffer from worse outcomes post-DC.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"138 ","pages":"Article 111366"},"PeriodicalIF":1.9,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144306729","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":"Tumor treating fields utilization and efficacy for glioblastoma at a large multicenter academic practice","authors":"David J. Crompton ,&nbsp;Shelby Kern ,&nbsp;Aaron Bogan ,&nbsp;Bobby Do ,&nbsp;Sujay Vora ,&nbsp;Alfredo Quinones-Hinojosa ,&nbsp;Terry Burns ,&nbsp;Wendy Sherman ,&nbsp;Ugur T. Sener ,&nbsp;Alyx B. Porter ,&nbsp;Paul Brown ,&nbsp;Nadia Laack ,&nbsp;Michael D Story ,&nbsp;Jennifer Peterson ,&nbsp;William G. Breen ,&nbsp;Daniel M. Trifiletti","doi":"10.1016/j.jocn.2025.111395","DOIUrl":"10.1016/j.jocn.2025.111395","url":null,"abstract":"<div><h3>Purpose</h3><div>Despite Tumor Treating Fields (TTF) being included in NCCN guidelines as standard treatment for GBM after improving overall survival in a prospective randomized trial, adoption has been limited. We sought to describe utilization, validate the efficacy, and compare patterns of failure after TTF for GBM patients in a real-world dataset.</div></div><div><h3>Methods</h3><div>We identified patients with newly diagnosed GBM between 2014–2023 who received standard fractionation external beam radiotherapy (EBRT). Data collected included extent of resection, radiotherapy dose fractionation and modality, utilization of tumor treating fields, and presence and location of progression based on radiographic findings. Kaplan-Meier (KM) curves were generated for progression-free and overall survival. Patient/disease characteristics in relation to TTF utilization were evaluated between the two groups.</div></div><div><h3>Results</h3><div>Three-hundred and ninety-three (393) patients were included in this study. 74 patients were treated with TTF (18.8 %). The adoption of TTF utilization increased in 2019 by 10 %. The rate of TTF utilization was approximately 20 % from 2019 to 2023. 2-year OS was improved with the addition of TTF after EBRT (58 % versus 41 %, p &lt; 0.006). On multivariable adjustment, TTF use remained associated with improved OS (p = 0.038). There was a trend towards increased marginal failures and decreased in-field failures with the addition of TTF (p = 0.099).</div></div><div><h3>Conclusion</h3><div>Widespread adoption of TTF in the treatment of GBM has been generally met with hesitation with less than one-fourth of modern patients receiving TTF. TTF was associated with improved OS, consistent with previously published prospective clinical trial results. Our results also suggest there may be an interplay between TTF and EBRT, affecting pattern of failure, with decreased rates of in-field failure among the TTF group.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"138 ","pages":"Article 111395"},"PeriodicalIF":1.9,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144298991","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":"Impact of promoting physical exercise on migraine – A video-based randomized clinical trial","authors":"Mariana Gomes ,&nbsp;Beatriz Barreto ,&nbsp;Bárbara Martins ,&nbsp;Daniela Ferreira-Santos ,&nbsp;Andreia Costa","doi":"10.1016/j.jocn.2025.111394","DOIUrl":"10.1016/j.jocn.2025.111394","url":null,"abstract":"<div><h3>Introduction</h3><div>Migraine significantly impacts quality of life, and a substantial proportion of subjects experience refractory migraine. Non-pharmacological strategies, such as physical exercise, have shown potential benefits in headache control. This study aims to evaluate the effectiveness of a video-based educational intervention in promoting physical activity and improving migraine-related outcomes.</div></div><div><h3>Methods</h3><div>A single-centre, single-blinded randomized clinical trial included 65 migraine subjects from a tertiary hospital in Porto, Portugal. Participants were stratified by age and randomized into an intervention group, receiving seven educational videos on exercise benefits over three months, or a control group, receiving usual care. Assessments were conducted at baseline (<em>T0</em>) and six months later (<em>T6</em>; three months after intervention). Primary outcome included the Headache Impact Test – 6 item (HIT-6) score; secondary outcomes included migraine frequency, acute medication use, and three Physical Activity Indices. Preventive treatments followed standard clinical practice, with physicians blinded to group allocation. Statistical analyses included between-group and within-group comparisons (p ≤ 0.05).</div></div><div><h3>Results</h3><div>Among 105 randomized subjects, 65 completed the study (61.9 %; 32 out of 53 in the intervention group <em>vs.</em> 33 out of 52 in the control group). Baseline sociodemographic and headache characteristics were comparable between groups, including the number and the type of preventive medication used. A negative correlation between leisure-time physical activity and HIT-6 score was observed at baseline. The intervention group showed significant reductions in monthly headache frequency (p = 0.003) and acute medication intake (p = 0.005), but no significant improvements in HIT-6 score or physical activity indices.</div></div><div><h3>Conclusions</h3><div>This study shows that a low-cost, accessible video-based educational intervention can reduce migraine frequency and acute medication use, even without significantly changing physical activity levels. By increasing awareness and promoting self-management, such tools may complement conventional care. Future studies should explore personalized, multimodal strategies combining education, behavioural support, and pharmacological treatments to optimize migraine outcomes.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"138 ","pages":"Article 111394"},"PeriodicalIF":1.9,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144298989","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":"Telerehabilitation for acute ischemic stroke patients post-discharge: A critical Appraisal","authors":"Jie Hao","doi":"10.1016/j.jocn.2025.111398","DOIUrl":"10.1016/j.jocn.2025.111398","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"138 ","pages":"Article 111398"},"PeriodicalIF":1.9,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144279118","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":"Pituitary surgery in New Zealand: A single neurosurgeon case series of 1,224 operations","authors":"Hector A. Law ,&nbsp;Andrew J.J. Law ,&nbsp;Timothy G. Short ,&nbsp;Carl L. Eagleton ,&nbsp;Jason A. Correia ,&nbsp;Esther M. Ewart ,&nbsp;Ayushi C.S. Sharma ,&nbsp;Pattranun Sangkaew","doi":"10.1016/j.jocn.2025.111388","DOIUrl":"10.1016/j.jocn.2025.111388","url":null,"abstract":"<div><div>Pituitary neuroendocrine tumours (PitNETs) are among the most common tumours of the central nervous system, yet data regarding surgical outcomes is limited for New Zealand (NZ). This study presents a 23-year single-surgeon case series of pituitary surgery. A retrospective analysis of 1,224 pituitary operations performed between August 1999 and July 2023 was conducted. Patient demographics, tumour characteristics, complications, and long-term outcomes were analysed. Statistical analyses included univariate and multivariate models. Pituitary neuroendocrine tumours (PitNETs) accounted for 88 % of cases (n = 1,087), including 612 non-functioning, 175 GH-producing, and 112 ACTH-producing tumours. The complications of transsphenoidal surgery for PitNETs included postoperative cerebrospinal fluid (CSF) leaks (7.3 %), permanent diabetes insipidus (3.4 %), meningitis (2.4 %), and visual deterioration (1.2 %). Carotid injury, stroke, and death within 30 days each occurred in less than 1 % of cases. Among 554 non-functioning PitNETs with surveillance imaging, 20 % recurred after a median follow-up of 3.7 years (IQR 1.6–7.7), with 10 % requiring reoperation. Recurrence was detected in 60 % of cases by five years and 90 % by ten years, of those who recurred. Age was protective, with each additional year reducing risk (HR = 0.98, p = 0.005). Cavernous invasion strongly predicted recurrence (HR = 2.9, p &lt; 0.001). No significant association between ethnicity and recurrence was observed, including among Māori and Pasifika patients. Surgical remission in acromegaly was achieved in 76 % of microadenomas (median follow-up: 4.8 years; IQR: 1.0–6.8) and 75 % of macroadenomas (median follow-up: 4.3 years; IQR: 1.5–8.5). In Cushing’s disease, remission was achieved in 82 % of microadenomas (median follow-up: 3.1 years; IQR: 0.8–9.2) and 75 % of macroadenomas (median follow-up: 4.0 years; IQR: 0.6–8.7). These findings demonstrate postoperative outcomes, complication rates, hormonal improvement, and tumour control, comparable to international standards.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"138 ","pages":"Article 111388"},"PeriodicalIF":1.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144270944","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":"Risk factors contributing to polyneuropathy in chronic hepatitis B: a cross-sectional perspective","authors":"Nurbanu Sezak ,&nbsp;Ozge Eren Korkmaz ,&nbsp;Alper Doner ,&nbsp;Murat Gursoy","doi":"10.1016/j.jocn.2025.111397","DOIUrl":"10.1016/j.jocn.2025.111397","url":null,"abstract":"<div><h3>Objective</h3><div>During the course of chronic hepatitis B (CHB), polyneuropathy (PNP) may occur. The purpose of this study is to investigate risk factors and determine the frequency of PNP in CHB patients who have complaints such as pain, paresthesia, and numbness.</div></div><div><h3>Method</h3><div>The data of 350 CHB patients who presented to the neurology outpatient clinic with symptoms suggestive of PNP were retrospectively analyzed. Sociodemographic and disease-related data and nerve conduction studies (NCS) results were obtained from hospital records.</div></div><div><h3>Results</h3><div>PNP was found in 59 out of 350 patients. Out of these individuals, 72.9 % had axonal PNP and 27.1 % had demyelinating PNP. High hepatic activity index (HAI) score (OR = 2.74, 95 % CI: [1.63;4.72], p &lt; 0.001), HBeAg-negative CHB (OR = 5.46, 95 % CI: [1.78;16.87], p = 0.003), male gender (OR = 7.53, 95 % CI: [3.71;15.91], p &lt; 0.001), and advanced age (OR = 1.07, 95 % CI: [1.03;1.10], p &lt; 0.001) were identified as independent risk factors linked to PNP. Male participants were significantly more common in the axonal PNP group (p = 0.003), while female participants predominated in the demyelinating PNP group. Disease duration was significantly longer in the demyelinating PNP group (p = 0.025). The Ishak Fibrosis Score (IFS), which reflects the severity of fibrosis, was significantly higher in the axonal group (p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Our results reveal that male gender, high HAI score, advanced age and HBeAg positivity are risk factors for PNP in CHB. Male patients who have severe liver fibrosis face a higher likelihood of developing PNP, characterized by substantial axonal damage. Conversely, female individuals with a prolonged history of CHB are susceptible to demyelinating injury. Consequently, it is advantageous to inquire about PNP problems in CHB patients during their routine examinations and, if warranted, to arrange a NCS and provide guidance for diagnosis and therapy.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"138 ","pages":"Article 111397"},"PeriodicalIF":1.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144279117","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":"Traumatic atlantoaxial rotatory fixation","authors":"Mehmet H. Atalar","doi":"10.1016/j.jocn.2025.111364","DOIUrl":"10.1016/j.jocn.2025.111364","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"138 ","pages":"Article 111364"},"PeriodicalIF":1.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144270927","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}