Journal of Clinical Neuroscience最新文献

{"title":"LVO TRUST EMS – Large vessel occlusion triage and routing utilized for long-distance stroke transports by emergency medical services","authors":"Rafail A. Chionatos,&nbsp;Camelia Valhuerdi Porto,&nbsp;Katelyn Skeels,&nbsp;Devin Zebelean,&nbsp;Noor Tarim Fahim,&nbsp;Lester Y. Leung","doi":"10.1016/j.jocn.2025.111440","DOIUrl":"10.1016/j.jocn.2025.111440","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Endovascular treatment (EVT) is the most effective therapy in acute ischemic stroke (AIS) with large vessel occlusion (LVO) but its practice is limited to Comprehensive Stroke Centers (CSC). Previous studies have suggested that trained Emergency Medical Services (EMS) professionals can successfully detect LVO cases using a validated screening tool. We aimed to assess the diagnostic accuracy of trained community-based EMS.</div></div><div><h3>Methods</h3><div>This is a retrospective cohort study from 01/01/2018–12/31/2022 of patients with suspected stroke transported by EMS providers from 14 community agencies in Southeastern Massachusetts. When stroke was suspected, EMS providers applied the Field Assessment Stroke Triage for Emergency Destination (FAST-ED) score to assess severity. Bypass of local community hospitals for direct transport to CSC was generally considered for patients with FAST-ED ≥ 4 and approval of the Region V EMS Medical Director.</div></div><div><h3>Results</h3><div>Among the 166 patients triaged for direct transport to the CSC, 57.2 % were diagnosed with AIS, of whom 56.8 % had LVO, and 64.8 % of those received EVT. There was a higher proportion of AIS or intracranial hemorrhage (ICH) in cases with higher FAST-ED scores. Only 23.5 % of the cases were diagnosed with stroke mimics, associated with lower FAST-ED scores. In total, 36.9 % of patients with AIS received EVT: thrombectomy with standard window tPA (21.1 %) or late-presenter window tPA (LKW ≥ 4.5 h, 1.1 %), and without tPA (14.7 %).</div></div><div><h3>Conclusions</h3><div>A diverse group of community-based EMS services in Southeastern Massachusetts using a prehospital tool can identify patients with severe stroke, i.e. AIS due to LVO or ICH, with acceptable diagnostic accuracy.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"139 ","pages":"Article 111440"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518225","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":"Microlesion and stimulation effects on motor symptom fluctuations in Parkinson’s disease following subthalamic deep brain stimulation","authors":"Bin Wu ,&nbsp;Yuting Ling ,&nbsp;Changming Zhang ,&nbsp;Simin Wang ,&nbsp;Qianqian Guo ,&nbsp;Baoshu Xie ,&nbsp;Wenbiao Xian ,&nbsp;Ling Chen ,&nbsp;Nan Jiang ,&nbsp;Jinlong Liu","doi":"10.1016/j.jocn.2025.111441","DOIUrl":"10.1016/j.jocn.2025.111441","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to investigate motor symptom fluctuations associated with microlesion effects (MLE) and stimulation in the short term following subthalamic deep brain stimulation (STN-DBS) surgery for Parkinson’s disease (PD).</div></div><div><h3>Materials and Methods</h3><div>A total of 54 PD patients who underwent bilateral STN-DBS surgery were included in this study. Total motor symptoms were evaluated preoperatively, one week postoperatively, and one month postoperatively. These scores were analyzed to evaluate motor symptom fluctuations due to microlesion and stimulation effects, along with associated factors.</div></div><div><h3>Results</h3><div>Among the participants, 48 patients (88.89%) exhibited MLE-related improvements in motor symptoms one week after surgery, with an average symptom improvement of 45.92%. At one month post-surgery, 27 patients (50.00%) demonstrated MLE-related improvements in motor symptoms, with an average improvement of 27.08%. Multivariate linear regression analysis revealed that preoperative tremor subscores were positively correlated with MLE at both one week and one month, while the preoperative Parkinson’s Disease Sleep Scale (PDSS) score was positively correlated with MLE at one week. Stimulation effects, measured one month postoperatively with the stimulator activated, resulted in an overall motor symptom improvement of 35.21%. No significant differences were observed in stimulation-induced improvements between patients with and without MLE at one week or one month.</div></div><div><h3>Conclusions</h3><div>This case series demonstrated that the efficacy of stimulation one month postoperatively was not correlated with postoperative MLE in PD patients who underwent STN-DBS surgery. However, patients with more severe preoperative tremor symptoms exhibited greater MLE at both one week and one month postoperatively.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"139 ","pages":"Article 111441"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518224","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 relationship between gait profile and spino-pelvic alignment in patients with adolescent idiopathic scoliosis of Lenke type 1 and 5","authors":"Minjun Choi,&nbsp;Tae Sik Goh,&nbsp;Jung Sub Lee","doi":"10.1016/j.jocn.2025.111444","DOIUrl":"10.1016/j.jocn.2025.111444","url":null,"abstract":"<div><div>Adolescent idiopathic scoliosis (AIS) is a complex three-dimensional structural deformity of the spine. While studies have reported gait abnormalities in AIS patients and their impact on patients’ quality of life, the interrelationship between the sagittal spino-pelvic alignment and gait kinematics has not yet been elucidated. The purpose of this study is to investigate the association between gait profile and sagittal alignment in AIS patients, especially with Lenke type 1 and 5 curve deformities.</div><div>The study group consisted of 111 AIS patients and sixty healthy controls. Standing spinal radiographs and gait analysis were performed for all participants. Gait parameters included gait speed, step length, stance phase, cadence, single leg support, double legs support, gait asymmetry (GA), and phase coordination index (PCI). Radiographic parameters included pelvic tilt (PT), sacral slope (SS), pelvic incidence (PI), thoracic kyphosis (TK), lumbar lordosis (LL), Cobb’s major curve angle, sagittal vertical axis (SVA), and coronal balance (CB).</div><div>There were statistically significant differences between the AIS group and the control in gait speed, step length, cadence, single leg support, double legs support, GA, PT, TK, SVA, and CB. However, no significant difference was observed between the groups in stance phase, PCI, SS, PI, and LL (<em>p</em> &gt; 0.05). In addition, correlation analysis revealed significant relationships between the following pairs of gait and sagittal alignment parameters in the AIS patients; step length was related with SS, PT, and LL, PCI with CB, GA with TK and CB. Multiple regression analysis of gait and sagittal profile also indicated that PT and SS are accurate predictors of step length and CB is a predictor of GA.</div><div>In conclusion, our findings demonstrated that there are significant differences in gait kinematics and sagittal spino-pelvic alignment between the AIS patients and healthy population and that these parameters are closely correlated in the AIS patients.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"139 ","pages":"Article 111444"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522525","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":"Does optic nerve sheath fenestration alleviate headaches in patients with idiopathic intracranial hypertension? A retrospective study","authors":"Hüseyin Nezih Özdemir ,&nbsp;Neşe Çelebisoy ,&nbsp;Figen Gökçay ,&nbsp;Anıl Yakut ,&nbsp;Meltem Söylev Bajin ,&nbsp;Aylin Yaman","doi":"10.1016/j.jocn.2025.111447","DOIUrl":"10.1016/j.jocn.2025.111447","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate headache course after optic nerve sheath fenestration (ONSF) in idiopathic intracranial hypertension (IIH) patients.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, IIH patients’ data who had undergone ONSF due to progressive visual field loss despite medical treatment or advanced visual field loss at onset, including age, sex, cerebrospinal fluid (CSF) opening pressure, laterality of ONSF (unilateral or bilateral), best corrected visual acuity (BCVA), visual field mean deviation (MD) preoperatively and after ONSF in the worse and fellow eyes, were noted. Headache severity assessed using the visual analog scale, and headache frequency defined as the number of headache days per month before and after surgery were considered.</div></div><div><h3>Results</h3><div>20 patients (17 females, 3 males) with a mean age of 32.4 years and a mean CSF opening pressure of 492.79 mm H2O were studied. ONSF was unilateral in 12 (60 %) and bilateral in 8 (40 %) patients. Median LogMAR BCVA and MD in the worse eye improved significantly after surgery (p = 0.04 and p = 0.02, respectively), whereas improvement in the fellow eye was not significant (p &gt; 0.05). Though headache severity and frequency decreased after surgery (p = 0.01 and p = 0.001, respectively) it was still present in 12 patients (60 %). Age, sex, CSF opening pressure, uni/bilateral ONSF, BCVA or MD in the worse or fellow eye had no effect on the course of headache severity or frequency.</div></div><div><h3>Conclusion</h3><div>Specific headache treatment is essential in IIH, since lowering intracranial pressure by ONSF is not associated with headache relief in over half of the patients.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"139 ","pages":"Article 111447"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522102","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":"Minimizing financial toxicity of neurological care in low and middle income countries","authors":"Gaurav Nepal ,&nbsp;Rajeev Ojha","doi":"10.1016/j.jocn.2025.111446","DOIUrl":"10.1016/j.jocn.2025.111446","url":null,"abstract":"<div><div>Neurological diseases in low- and middle-income countries (LMICs) are increasingly associated with financial toxicity (FT), where the high costs of diagnosis and treatment create severe economic burdens for patients and their families. Unlike high-income countries (HICs), where publicly funded or insurance-based systems mitigate these costs, LMICs often lack such financial safety nets, leading to FT. As a result, only wealthier individuals can afford treatment, deepening health inequities. This paper discusses potential solutions to alleviate FT.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"139 ","pages":"Article 111446"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522524","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":"Structural and functional connectomic analysis of high-grade gliomas: A systematic review","authors":"Logan R. Burrington ,&nbsp;Alexander D. Smith ,&nbsp;Alexa R. Lauinger ,&nbsp;Wael Hassaneen","doi":"10.1016/j.jocn.2025.111415","DOIUrl":"10.1016/j.jocn.2025.111415","url":null,"abstract":"<div><h3>Introduction</h3><div>High-grade glioma (HGG) is a highly aggressive and proliferative brain cancer. Treatment most often involves maximum safe resection, followed by adjuvant chemotherapy and radiation. However, an incomplete understanding of HGG’s impact on brain connectivity limits the prediction of post-HGG resection complications and extent-of-resection protocols. Previous work has primarily focused on analyzing clinical and structural data to understand and predict post-surgical outcomes. These models overlook connectomics – an emerging field focused on the functional mapping of brain neural networks. In this systematic review, the authors 1) summarize the current understanding of major neural networks impacted by HGG resection through both a functional and structural viewpoint, and 2) discuss associated advancements in connectomics-based machine-learning models and application towards predicting post-surgical outcomes.</div></div><div><h3>Methods</h3><div>A systematic search was performed of peer-reviewed articles before 10/19/2023 according to PRISMA guidelines. No restrictions on publication date were utilized. Search terms included, “connectomics,” and “glioma.” Articles were included in the review if DTI structural data and/or rs-fMRI functional data involving white matter tracts impacted by HGG were analyzed. Articles were excluded if results did not apply to HGGs, tumor location was not included, or a full-text copy was unavailable.</div></div><div><h3>Results</h3><div>We reviewed 41 studies which analyzed the impact of HGGs on the brain connectome. HGGs tend to increase structural connectivity (SC) among rich-club nodes and reduce SC among peripheral nodes, though effects on functional connectivity (FC) tend to vary by tumor location. Frontal HGGs elicit bilateral FC changes, including decreased global efficiency (GE), local efficiency (LE), degree centrality, and increased average path length. Similarly, temporal HGGs often result in altered bilateral FC, including decreased LE with preserved GE and small-world properties. Parietal HGGs have mainly local effects and preserved small world organization, apart from observed bilateral FC changes of the default-mode network (DMN) and with precuneus HGGs. Insular HGGs also primarily affect local FC. In application, connectomic metrics including FC, LE, and GE have improved the predictive capabilities of post-HGG resection complications when combined with clinical and structural metrics.</div></div><div><h3>Conclusions</h3><div>HGG has distinct impacts on the functional connectome based on tumor location. In general, HGGs tend to decrease long-distance, interhemispheric FC and LE while GE and clustering coefficient are preserved. In application, these metrics have been used in connectomic-based models to predict post-HGG resection complications more accurately than previous clinical- or structural-based models.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"139 ","pages":"Article 111415"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518222","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 impact of robotic hand rehabilitation on hand function and fatigue in patients with stroke (RoHa-S)","authors":"Letizia Castelli ,&nbsp;Davide Giannuzzi ,&nbsp;Claudia Loreti ,&nbsp;Irene Falcolini ,&nbsp;Erika Tamburro ,&nbsp;Anna Maria Malizia ,&nbsp;Chiara Iacovelli ,&nbsp;Lorenzo Biscotti ,&nbsp;Luca Padua ,&nbsp;Silvia Giovannini","doi":"10.1016/j.jocn.2025.111445","DOIUrl":"10.1016/j.jocn.2025.111445","url":null,"abstract":"<div><h3>Objective</h3><div>Considering the wide use of technology and robotics in rehabilitation, this study investigates the potential impact of robotic rehabilitation with the robot end-effector Amadeo® on hand function and its possible effects on fatigue in patients with stroke outcomes.</div></div><div><h3>Methods</h3><div>This is a single blind, randomized-controlled pilot study. Twenty-four patients were randomly assigned to the experimental group (G-AMA) for robotic rehabilitation with Amadeo® and conventional rehabilitation, or the control group (G-CON) for conventional rehabilitation. All patients received 45-minute rehabilitation thrice a week for four weeks. Clinical measures for motor function, spasticity, autonomy, quality of life, and fatigue were used to assess all patients at baseline and end of treatment. Instrumental assessment included Amadeo® force and range of motion (ROM) measurements.</div></div><div><h3>Results</h3><div>Considering clinical evaluations, all patients indifferent to the group showed statistically significant improvement at the end of treatment. Comparison between groups showed a statistically significant difference in motor function (p &lt; 0.001), autonomy (p &lt; 0.001) and fatigue (p &lt; 0.001). Regarding instrumental assessment, only G-AMA patients showed statistically significant differences in several parameters, especially considering the percent ROM of individual fingers and hand; inter-group comparison showed a significant difference in hand extension strength (p = 0.042) and percent ROM of individual fingers (p &lt; 0.001) and hand (p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>This study suggests that robotic hand treatment with Amadeo®, combined with traditional methods, reduces fatigue in stroke patients with hand impairments. Therapeutic combinations of new technologies and conventional approaches can improve rehabilitation outcomes and patients’ quality of life, transforming post-stroke rehabilitation and other disorders.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"139 ","pages":"Article 111445"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518226","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":"Between sleep and wakefulness: how sleep quality and stress affect isolated sleep paralysis – a cross-sectional survey","authors":"Ahmed Ali Khan ,&nbsp;Ammara Abid ,&nbsp;Maheen Nawaz ,&nbsp;Muhammad Shaheer Bin Faheem ,&nbsp;Zahra Ali Haque ,&nbsp;Rayyan Mohammad Makki Bakhsh ,&nbsp;Areeba Ashfaq ,&nbsp;Fnu Raja","doi":"10.1016/j.jocn.2025.111435","DOIUrl":"10.1016/j.jocn.2025.111435","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Sleep paralysis (SP) is a rapid-eye movement (REM) parasomnia in which a person is alert but temporarily unable to move or speak during the transition between wakefulness and sleep. It is a cardinal feature of narcolepsy; however, it may also occur independently as isolated sleep paralysis (ISP). This study examines ISP’s prevalence, sociodemographic variations, and contributing factors, particularly the impact of poor sleep quality and stress.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted among shopping mall visitors using the Unusual Sleep Experiences Questionnaire (USEQ) to assess ISP episodes. Participants also provided data on sleep quality and stress levels to identify potential ISP predictors.</div></div><div><h3>Results</h3><div>Data from 336 participants was analyzed (mean age: 25.6 ± 9.45; 54.8 % females). 123 (36.6 %) participants reported experiencing ISP episodes at least once in their lifetime with the average age of episode onset being 17.9 ± 5.22 years. Poor sleep quality significantly influenced ISP frequency (p &lt; 0.0001). Moderate stress levels were found to be significantly associated with the prevalence of ISP (p = 0.028). Logistic regression models showed that sleep quality and stress accounted for 11.6 % and 5.70 % of the variance in ISP prevalence.</div></div><div><h3>Conclusion</h3><div>ISP is common among the non-narcoleptic population. Poor sleep quality and stress are significantly associated with increased ISP frequency; however, their limited predictive value suggests the involvement of other contributing factors. Longitudinal research is needed to confirm the causal relationship between these factors and ISP, and to develop effective interventions aimed at lowering frequency of ISP episodes.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"139 ","pages":"Article 111435"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518223","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":"Radiographic analysis of C2 pedicle screw placement guided by the transverse foramen in patients with a high-riding vertebral artery","authors":"Chun-Pi Chang ,&nbsp;Ting-Hsien Kao ,&nbsp;Hsu-Tung Lee ,&nbsp;Chiung-Chyi Shen ,&nbsp;Chi-Ruei Li ,&nbsp;Chien-Lun Tang","doi":"10.1016/j.jocn.2025.111424","DOIUrl":"10.1016/j.jocn.2025.111424","url":null,"abstract":"<div><h3>Background</h3><div>C2 pedicle screws (C2 PS) offer superior fixation but pose vertebral artery injury risks, accentuated by a high-riding vertebral artery (HRVA) and narrow C2 pedicle, prompting alternative approaches for safety. This study evaluated the safety and feasibility of an alternative technique.</div></div><div><h3>Methods</h3><div>This retrospective analysis focused on C2 PS placement for atlantoaxial instability and was conducted at Taichung Veterans General Hospital from April 2020 to December 2022. The alternative technique involved a high-speed burr that determined the C2 PS entry point. Tactile palpation-guided screw placement was confirmed using intraoperative fluoroscopy. Preoperative and postoperative computed tomography scans were used to assess pedicle dimensions, screw angles, and breaches. A HRVA and narrow pedicle classification were established. Postoperative scans were used to identify breaches by using a grading system. Radiographic data were assessed independently.</div></div><div><h3>Results</h3><div>A HRVA was present in 18 out of 39 patients in whom C2 PS placement was performed. Significant differences in the pedicle dimensions and screw angles were observed between the HRVA and non-HRVA groups. The overall breach rate was 15.4 %, with higher rates in the HRVA cases than in the non-HRVA cases (27.8 %). Lateral-inferior breaches were predominant, and all breaches were on the right side. No symptomatic complications were noted.</div></div><div><h3>Conclusions</h3><div>This alternative technique appears safe and feasible, especially in patients with a HRVA. Shorter pedicle screws may be considered for HRVAs with narrow pedicles. An alternative technique for C2 PS placement appears to be beneficial for reducing breach rates, especially in challenging cases.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"139 ","pages":"Article 111424"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513744","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 GAHR score for prediction of in-hospital mortality patients with aneurysmal subarachnoid hemorrhage","authors":"Beny Rilianto ,&nbsp;Bambang Tri Prasetyo ,&nbsp;Ricky Gusanto Kurniawan ,&nbsp;Nurfadilah M. Rajab ,&nbsp;Sardiana Salam ,&nbsp;Ita Muharram Sari ,&nbsp;Muhammad Kusdiansah ,&nbsp;Abrar Arham ,&nbsp;Eka Musridharta ,&nbsp;Mursyid Bustami","doi":"10.1016/j.jocn.2025.111438","DOIUrl":"10.1016/j.jocn.2025.111438","url":null,"abstract":"<div><h3>Background</h3><div>Aneurysmal subarachnoid hemorrhage (aSAH) remains a prominent cause of mortality. There are several factors associated with the overall outcome. This study aimed to develop a simple scoring model of the 30-day mortality in aSAH.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed the total number of aSAH patients hospitalized at the advanced stroke center between January 2019 and June 2022. Multivariable logistic regression generated the odds ratio of age- and sex-adjusted mortality for aSAH. Scoring predictors were derived from regression β-coefficients and converted into a point score system. The diagnostic performance and probability of in-hospital mortality were assessed.</div></div><div><h3>Results</h3><div>We included 318 aSAH patients, and 61 (19.18%) patients died during hospitalization. The aSAH mortality prediction (GAHR) score with a range of 0–12 points was assigned the following point values: <strong>g</strong>rade of aSAH (4 points), <strong>a</strong>neurysmal treatment (3 points), <strong>h</strong>eart comorbidities (2 points), and <strong>r</strong>espiratory failure (3 points). The GAHR score displayed an area under the receiving operating characteristics curve (AUC) of 0.8294 (SE 0.0277) and a <em>p</em>-value for the Hosmer–Lemeshow (HL) goodness-of-fit of 0.4133. The probability of in-hospital mortality was assessed based on the total score of each patient.</div></div><div><h3>Conclusions</h3><div>The GAHR score is a simple, convenient, and reliable scoring system with four clinical predictors containing grade, aneurysmal treatment, heart comorbidities, and respiratory failure to predict in-hospital mortality of aSAH. This scoring system has good accuracy and may aid clinicians in decision-making and determining the prognosis of patients.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"139 ","pages":"Article 111438"},"PeriodicalIF":1.9,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144501206","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}