Journal of Clinical Neuroscience最新文献

{"title":"Acute subdural hematomas in nonagenarians and centenarians","authors":"Richard Cook,&nbsp;Laura Zima,&nbsp;Ryan Kitagawa","doi":"10.1016/j.jocn.2024.110997","DOIUrl":"10.1016/j.jocn.2024.110997","url":null,"abstract":"<div><h3>Background</h3><div>There is minimal literature on the outcomes of acute traumatic subdural hematoma (SDH) in patients 90 years of age or older. This study aims to characterize the presentation and acute outcomes of patients in this population, particularly for surgical candidates.</div></div><div><h3>Methods</h3><div>Patients 90 years of age or older with acute SDH between 2013–2023 were analyzed (n = 117). Multivariable binomial logistic regression assessed associations with favorable outcome, defined as a discharge to a non-hospice facility with a Glasgow Coma Scale (GCS) of 14 or greater. Nominal data was analyzed via Wilcoxon rank-sum test and categorical data was analyzed via Chi-squared test.</div></div><div><h3>Results</h3><div>For this patient population mortality was 7.7%. 86.3% of all patients had favorable outcome.<!--> <!-->Eight patients underwent surgery, with two resulting in mortality.. However, 62.5% of patients who underwent surgery had a favorable outcome. Patients undergoing surgery had longer average length of stay (P = 0.002), greater in-hospital mortality (P = 0.013), and younger age (P = 0.008) compared to non-surgical patients. Prior independence (OR 7.07, 95% CI 1.33–37.45, P = 0.022) and higher GCS at arrival (OR 1.67, 95% CI 1.11–2.49, P = 0.013) were associated with favorable outcomes.</div></div><div><h3>Conclusion</h3><div>86.3% of patients 90 years of age or older with acute subdural hematomas had a favorable outcome in our series. Prior independence and higher GCS at arrival were associated with favorable discharge. Several patients had good outcomes after craniotomy for acute SDH, indicating there are some patients in this age group who should be considered for surgery.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 110997"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894656","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 triglycerides and glucose index and critically ill stroke in non-obese population: An observational study on eICU database","authors":"Jie Shu ,&nbsp;Rui Zheng","doi":"10.1016/j.jocn.2024.110980","DOIUrl":"10.1016/j.jocn.2024.110980","url":null,"abstract":"<div><h3>Background</h3><div>Both the triglyceride glucose (TyG) index and stroke are associated with insulin resistance (IR). Studies have shown that TyG is associated with stroke. However, the relationship between TyG index and stroke in non-obese population remains unclear. This study investigated the association between TyG and the prognosis of severe stroke in non-obese individuals.</div></div><div><h3>Methods</h3><div>This was a retrospective observational study. TyG was determined at baseline and stroke mortality was assessed at follow-up. All data were extracted from the eICU Collaborative Research Database. Hospital and intensive care unit (ICU) mortality rates were determined as endpoints. Smoothing curves were performed to estimate the relationship between TyG and stroke mortality. Multivariate logistic regression analysis and restricted cubic spline regression were used to evaluate the independent effect of TyG on stroke mortality.</div></div><div><h3>Results</h3><div>A total of 1946 eligible subjects were included. The hospital and ICU mortality rates were 10.6 % and 5.3 %, respectively. In univariate analysis, for per unit increase in TyG, the odds ratio (OR) for in-hospital mortality and ICU mortality of stroke were 1.85 (95 %CI 1.50–2.28) and 2.08 (95 %CI 1.58–2.75), respectively. After fully adjusting for confounding factors, the OR for in-hospital mortality and ICU mortality of stroke were 8.64 (95 %CI 4.25–17.55) and 9.30 (95 %CI 3.73–23.20), respectively. The restricted cubic spline regression model indicated a linear increase in hospital and ICU mortality with rising TyG index. Subgroup analysis showed consistent effect sizes and directions across different subgroups, demonstrating the stability of the findings.</div></div><div><h3>Conclusion</h3><div>In the non-obese population, an increase in TyG was related to higher stroke mortality. TyG may have clinical significance in identifying poor prognosis of stroke patients.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 110980"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824244","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":"Characteristics of reported industry payments to neurosurgeons from 2019 to 2022: The impact of COVID-19","authors":"Aladine A. Elsamadicy ,&nbsp;James Cross ,&nbsp;Benjamin C. Reeves ,&nbsp;Annabelle Shaffer ,&nbsp;Laura S. McGuire ,&nbsp;William C. Welch ,&nbsp;Paul M. Arnold ,&nbsp;Joshua M. Rosenow ,&nbsp;on behalf of the AANS/CNS Drugs Device Committee","doi":"10.1016/j.jocn.2025.111089","DOIUrl":"10.1016/j.jocn.2025.111089","url":null,"abstract":"<div><h3>Objective</h3><div>Neurosurgeons have long held financial relationships with pharmaceutical and surgical device companies. While industry partnerships drive innovation, there is concern that these collaborations may negatively influence patient care. In response, stakeholders have called for increased monitoring of these relationships. This study aims to provide an up-to-date review of the industry payments to neurosurgeons and how COVID-19 has impacted these payments.</div></div><div><h3>Methods</h3><div>A retrospective study was performed using data from the Center of Medicare and Medicaid Services Open Payments Database (1/1/19–12/31/23). Neurosurgeons were identified using the taxonomy code, 207T00000X. Data collected included the number of payments, purpose, total value, and mean value per year.</div></div><div><h3>Results</h3><div>From 2019 to 2023, 362,270 industry payments were made to 7,846 unique neurosurgeons for a total of $479,072,106. The most common types of payments were for food and beverage (72.7 %), travel and lodging (15.2 %), consulting fees (5.85 %), royalties and licensing (3.02 %), and services other than consulting (1.86 %), while the largest contributors to total payment value were payments for royalties and licensing (57.6 %), consulting fees (14.5 %), acquisitions (12.8 %), services other than consulting (5.00 %), and travel and lodging (3.89 %). Overall, the total amount paid to neurosurgeons decreased during the COVID-19 years (2020–2021) compared to 2019 but rose again in 2022.</div></div><div><h3>Conclusion</h3><div>Neurosurgeons maintain an active financial partnership with industry. Similar to prior reports, payments related to product development comprised the majority of payment value, while payments for food and beverage were the most common. The years of COVID-19, particularly 2020, had a substantial impact on the number, value amount, and subcategory distribution of industry payments made to neurosurgeons. Future investigations of these financial ties on practice, research, and innovation are warranted.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"134 ","pages":"Article 111089"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080204","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":"Transradial versus transfemoral access in middle meningeal artery embolization for chronic subdural hematoma: A systematic review and meta-analysis","authors":"Mohamed Elfil ,&nbsp;Hazem S. Ghaith ,&nbsp;Ahmed Elmashad ,&nbsp;Zaid Najdawi ,&nbsp;Mohammad Aladawi ,&nbsp;Islam Ashor ,&nbsp;Pankajavalli Ramakrishnan ,&nbsp;Elie Dancour ,&nbsp;Gurmeen Kaur ,&nbsp;Chirag D. Gandhi ,&nbsp;Fawaz Al-Mufti","doi":"10.1016/j.jocn.2025.111094","DOIUrl":"10.1016/j.jocn.2025.111094","url":null,"abstract":"<div><h3>Background</h3><div>Chronic subdural hematoma (cSDH) is increasingly prevalent in the elderly and traditionally treated with surgical interventions. Middle meningeal artery embolization (MMAE) has emerged as an adjunctive therapy to reduce recurrence rates. Transfemoral access (TFA) is the conventional route for neuroendovascular procedures, but transradial access (TRA) offers potential advantages, including reduced access-site complications, earlier ambulation, and shorter hospital stays.</div></div><div><h3>Objective</h3><div>The aim of this systematic review and <em>meta</em>-analysis was to compare the safety and efficacy of TRA versus TFA for MMAE in cSDH patients.</div></div><div><h3>Methods</h3><div>This study followed Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and involved a comprehensive search of four databases to identify studies comparing TRA and TFA in MMAE. Outcomes included hematoma recurrence, hospital length of stay, procedural duration, access-site complications, and overall complications.</div></div><div><h3>Results</h3><div>Four studies met the inclusion criteria. There were no significant differences between TRA and TFA in hematoma recurrence (Relative Risk (RR) 0.65, 95 % Confidence Interval [CI] 0.09–4.85), hospital length of stay (Mean Difference [MD] 0.10 days, 95 % CI −0.11–0.31), procedural duration (MD 0.04 h, 95 % CI −0.49–0.56), access-site complications (RR 0.24, 95 % CI 0.04–1.40), or overall complications (RR 0.76, 95 % CI 0.33–1.75).</div></div><div><h3>Conclusion</h3><div>TRA demonstrates comparable safety and efficacy to TFA for MMAE in cSDH patients. Although current evidence is limited to observational studies, these findings support the feasibility of TRA as an access route. Future large-scale studies are necessary to validate these results and optimize procedural strategies.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"134 ","pages":"Article 111094"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074349","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":"Arteriovenous malformations treated by stereotactic radiosurgery – Review of an Australian single centre’s experience","authors":"Daniel Morris ,&nbsp;Janet R. Williams ,&nbsp;Belinda Vangelov ,&nbsp;Robert I. Smee","doi":"10.1016/j.jocn.2024.110961","DOIUrl":"10.1016/j.jocn.2024.110961","url":null,"abstract":"<div><div>Linear accelerator (LINAC) stereotactic radiosurgery (SRS) is a specialised treatment used for various brain conditions, including arteriovenous malformations (AVMs). This paper investigates the obliteration rate of AVMs treated by the LINAC-based facility at Prince of Wales Hospital, defines factors influencing obliteration rate, time to obliteration and complications post-SRS. A retrospective audit review of patient notes sourced from electronic medical records was conducted. During the study period 219 patients received treatment, of which the final status of 136 AVMs was known. Overall obliteration rate was 75.7 %, with obliteration rates of 5 %, 30 % and 46 % at one, three and four years, respectively. Post analysis, a radiosurgery dose of <span><math><mo>≥</mo></math></span> 18 Gray (Gy) was predictive of achieving obliteration (Odds Ratio (OR) 4.2, 95 % Confidence Interval (CI) 1.61–10.83, p = 0.003) whilst a nidus size of 3–6 cm was less likely of achieving obliteration (OR 0.2, CI 0.10–0.57, p = 0.001). Multivariate analysis showed a radiosurgery dose of <span><math><mo>≥</mo></math></span> 18 Gy remained predictive (OR 4.7, CI 1.69–13.25, p = 0.003) and a nidus size of 3–6 cm remained less likely to achieve obliteration (OR 0.2, CI 0.10–0.57, p = 0.001). Females were predictive of developing temporary complications post-SRS in multivariate analysis (OR 2.8, CI 1.24–6.13, p = 0.013), and having &gt; 1 SRS session was predictive of developing permanent complications post-SRS (OR 7.1, CI 2.44–20.53, p &lt; 0.001). The obliteration rate achieved from our study and the predictive nature to achieve obliteration with a radiosurgery dose of <span><math><mo>≥</mo></math></span> 18 Gy is comparable to existing literature including that using the Gamma-Knife system.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 110961"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801039","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":"T-shaped myofascial incision for Chiari I malformation surgery without dural closure in children: Technical note","authors":"Arthur R. Kurzbuch,&nbsp;Jayaratnam Jayamohan,&nbsp;Shailendra Magdum","doi":"10.1016/j.jocn.2024.110970","DOIUrl":"10.1016/j.jocn.2024.110970","url":null,"abstract":"<div><h3>Background</h3><div>Like in all posterior fossa surgeries the avoidance of cerebrospinal fluid (CSF) leaks is of paramount importance for foramen magnum decompression in Chiari I malformation in children. The present technical note decribes the experience with the creation of a T-shaped myofascial cuff to reduce the risk of postoperative CSF leaks.</div></div><div><h3>Methods</h3><div>The medical records of 98 children were evaluated. They underwent foramen magnum decompression without dural closure using a T-shaped myofascial cuff whose incision lines run completely within the fascia and the muscles not extending beyond their attachment line to the bone.</div></div><div><h3>Results</h3><div>There were 2 CSF leaks and no infections in 98 operated patients. The follow-up was between 4 and 48 months.</div></div><div><h3>Conclusions</h3><div>The placement of a T-shaped myofascial cuff allows for watertight closure of the muscles and the fascia which is likely to reduce the rate of CSF leaks in pediatric Chiari I patients operated on without closure of the dura.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 110970"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791716","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":"Subthalamic nucleus versus globus pallidus internus deep brain stimulation in the treatment of dystonia: A systematic review and meta-analysis of safety and efficacy","authors":"Obai Yousef ,&nbsp;Abdallah Abbas ,&nbsp;Maickel Abdelmeseh ,&nbsp;Ruaa Mustafa Qafesha ,&nbsp;Yehia Nabil ,&nbsp;Amr Elrosasy ,&nbsp;Ahmed Negida ,&nbsp;Brian D Berman","doi":"10.1016/j.jocn.2024.110958","DOIUrl":"10.1016/j.jocn.2024.110958","url":null,"abstract":"<div><h3>Objective</h3><div>This systematic review and <em>meta</em>-analysis aimed to compare the efficacy and safety of deep brain stimulation (DBS) targeting subthalamic nucleus (STN) versus the globus pallidus internus (GPI) in the treatment of dystonia.</div></div><div><h3>Methods</h3><div>A comprehensive search strategy was implemented up to July 2024, across five databases, identifying studies relevant to STN-DBS and GPI-DBS in dystonia. Eligibility criteria included randomized controlled trials (RCTs) and observational studies comparing the two interventions. Two independent reviewers conducted the screening and data extraction. The risk of bias was assessed using RoB-2 for RCTs and the Newcastle-Ottawa Scale for cohort studies. Statistical analysis involved <em>meta</em>-analysis using Review Manager, with heterogeneity assessed by I² and Chi-square tests. Subgroup and sensitivity analyses were performed.</div></div><div><h3>Results</h3><div>Five studies, involving 154 patients, were included. No significant difference was found between STN-DBS and GPI-DBS in Burke-Fahn-Marsden Dystonia Rating Scale motor and disability (BFMDRS-M and BFMDRS-D) scores at 1 months, 6 and 12 months. STN-DBS showed significant improvement in mental health (SMD = 0.43, 95 % CI: [0.05, 0.8], P = 0.03). STN-DBS also showed significant improvement in Hamilton Anxiety Rating Scale (HAMA) (SMD = −2.7, 95 % CI: [-5.38, −0.02], P = 0.05). No significant difference was found in Hamilton Depression Rating Scale (HAMD) scores.</div></div><div><h3>Conclusions</h3><div>Both STN-DBS and GPI-DBS can improve motor symptoms in dystonia, with STN-DBS potentially resulting in more superior mental health benefits. Future research should address long-term outcomes, and regional effectiveness, and include diverse populations to enhance generalizability.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 110958"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794505","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":"Low Middle Income Countries and Academic Productivity of Neurosurgery: A Quantitative Analysis From Pakistan","authors":"Kaleem Ullah Ranjha ,&nbsp;Syeda Fatima Abid ,&nbsp;Muhammad Hammad Khan ,&nbsp;Muhammad Shayan Waheed ,&nbsp;Laiba Sarfraz ,&nbsp;Muhammad Kashif ,&nbsp;Ahmed Muthana ,&nbsp;Samer S. Hoz ,&nbsp;Minaam Farooq","doi":"10.1016/j.jocn.2024.110992","DOIUrl":"10.1016/j.jocn.2024.110992","url":null,"abstract":"<div><div>Neurosurgical training and practice rely heavily on research, which is a pivotal marker of academic productivity. This study investigates the current landscape of neurosurgery publications originating from Pakistan, encompassing overall research output, prevalent topics, and disparities across institutions and regions. Electronic databases, including PubMed, Scopus, Web of Science, and ScienceDirect, were systematically searched up to November 1, 2023, using specified keywords. Data pertaining to authors, publication years, affiliations, article types, citations, journals, impact factors, and topics were extracted from eligible articles. From inception till Nov 1, 2023, a total of 825 articles relating to Neurosurgery were published from Pakistan. A significant upsurge in publications occurred from 2017 onwards, reaching its peak in 2021 with 115 studies published. A total of 12 articles had 100 or more citations. The majority of publications were original articles (n = 592, 71.7 %) followed by reviews (n = 144, 17.5 %), predominantly focusing on brain-related topics (n = 203, 24.6 %), neuro-oncology (n = 164, 19.8 %), spine (n = 145, 17.5 %), and trauma (n = 143. 17.3 %). Vascular neurosurgery contributed 88 studies, general neurosurgery 40, neuroradiology 28, functional neurosurgery 14, and pediatric neurosurgery 17. Shamim MS was the top author with the most number of publications (n = 89), followed by Enam SA (n = 51). JPMA (n = 93) and Surgical Neurology International (n = 71) emerged as the top publishing journals. Aga Khan University and Hospital emerged as the most prolific contributor with 236 original studies conducted. There exists notable regional disparities and a lack of experimental studies. While there has been a substantial increase in neurosurgical publications from Pakistan in recent years, significant regional disparities and challenges persist. Addressing these issues is crucial to fostering a more robust research environment in neurosurgery within the country.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 110992"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854320","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":"Biomechanical study between two varieties of axial screw fixation techniques: Analysed by finite elements","authors":"Zhao Li ,&nbsp;Fanchao Meng ,&nbsp;Yushi Fang ,&nbsp;Ruiyu Qin ,&nbsp;Xun Zhang ,&nbsp;Wei Zhao","doi":"10.1016/j.jocn.2024.110978","DOIUrl":"10.1016/j.jocn.2024.110978","url":null,"abstract":"<div><h3>Background</h3><div>The atlantoaxial vertebral model was established in order to compare the biomechanical properties of C2 pedicle and translaminar screws from the perspective of the screws themselves.</div></div><div><h3>Methods</h3><div>A finite element model of the screw-vertebrae was developed. The screw load–displacement ratios were analysed under up/down and left/right load conditions; the vertebral load–displacement ratios under flexion/posterior extension (FLX/EXT), left/right lateral bending (LLB/RLB), and left/right rotation (LAR/RAR) load conditions; the bone-screw interface stress values and screw load–displacement ratios under physiological load conditions; and the structural stress values of the screw-rod structure under front/back and left/right load conditions.</div></div><div><h3>Results</h3><div>The C2 pedicle screw group (C2PG) exhibited significantly greater load–displacement ratios than did the C2 translaminar screw group (C2TG). The vertebral load–displacement ratios were significantly greater in the C2PG than in the C2TG. Under physiological loading, the maximum stress of the cortical bone in the C2TG exceeded the threshold significantly, and the anteriormost part of the vertebrae exhibited much greater displacement in the C2TG than in the C2PG. In screw-rod stability studies, C2TG exhibited greater peak stress in the screw-rod structure under anterior-posterior loading.</div></div><div><h3>Conclusions</h3><div>This study is the first to analyse the biomechanical properties of two types of axial screws from the perspective of the screws themselves. In this study, C2 pedicle screws exhibited greater biomechanical stability from the perspective of the two screws themselves. From the perspective of a single screw-vertebrae model, this may account for the higher postoperative revision rate of axial translaminar screws than pedicle screws in atlantoaxial internal fixation.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 110978"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872257","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":"Circulating plasma protein identified as a therapeutic target for intracranial aneurysm through Mendelian Randomization analysis","authors":"Songquan Wang ,&nbsp;Jiali Mu ,&nbsp;Quansheng Wu ,&nbsp;Laizhao Chen ,&nbsp;Xiaofeng Yin","doi":"10.1016/j.jocn.2024.110998","DOIUrl":"10.1016/j.jocn.2024.110998","url":null,"abstract":"<div><h3>Background</h3><div>Intracranial aneurysms are the main cause of subarachnoid hemorrhage (SAH), a severe stroke with devastating effects. However, there are no existing medications for intracranial aneurysms (IAs) and novel therapeutic targets are required. Methods: We performed a summary data-based Mendelian Randomization (MR) analysis to explore the causal association between circulating plasma proteins and the risk of IAs and SAH. Colocalization analysis was conducted to identify shared causal variants between circulating plasma proteins and IAs, as well as SAH. Finally, mediation MR analyses were conducted to clarify the role of potential plasma proteins in aneurysm formation. Results: Proteome-wide MR analysis showed that FGF5 (fibroblast growth factor 5) had a causal effect on IA and SAH risk (Pfdr &lt; 0.05). Moreover, genetic variants affecting FGF5 expression levels showed strong evidence of colocalization with IA risk (PPH4 = 0.993) and SAH risk (PPH = 0.988), suggesting that this protein represents a potential direct target for IA intervention. Mediation analysis using two-step MR showed that systolic blood pressure and diastolic blood pressure mediate the effects of FGF5 on IA and SAH. Conclusion: Our investigation identified a causal connection between FGF5 and IAs.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 110998"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894694","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}