Neurological Research最新文献

{"title":"Transradial versus transfemoral access for diagnostic cerebral angiography: a systematic review and meta-analysis of 32 studies.","authors":"Aleena Amir Malik, Goodluck Oparaugo, Sajjad Khan, Gaaitri Lohano, Renat Garifullin, Yashfa Asad, Madyana Abdul Rehman, Tooba Ikram Qazi, Faiz Un Nisa, Rehmat Maheen, Rozeen, Adnan Memon, Aroona Devi, Iqra Murtaza, Misbah Parwaiz, Muhammad Huzaifa Khattak, Bilal Wazir Khan","doi":"10.1080/01616412.2026.2733683","DOIUrl":"10.1080/01616412.2026.2733683","url":null,"abstract":"<p><strong>Objective: </strong>To compare the safety, efficacy, and patient-centered outcomes of transradial access (TRA) versus transfemoral access (TFA) in patients undergoing diagnostic cerebral angiography.</p><p><strong>Methods: </strong>PubMed, Embase, and Scopus were searched from inception through April 2026. RCTs and observational studies comparing TRA with TFA for diagnostic cerebral angiography were included. Random-effects meta-analyses were performed using risk ratios (RRs) for dichotomous outcomes and standardized mean differences (SMDs) for continuous outcomes with 95% confidence intervals.</p><p><strong>Results: </strong>Thirty-two studies (18,953 patients) were included. TRA showed significantly lower total complications (RR 0.63,95% CI 0.43-0.93; <i>p</i> = 0.02), fewer minor complications (RR 0.39,95% CI 0.22-0.68;<i>p</i> = 0.0009), shorter hospital stay (SMD -0.78,95% CI - 1.50 to -0.07;<i>p</i> = 0.03), and reduced immobilization time (SMD -5.81,95% CI - 7.66 to -3.96; <i>p</i> < 0.01); major complications were comparable between groups (RR 0.27; <i>p</i> = 0.24). Overall diagnostic success was similar (RR 0.98,95% CI 0.96-1.00; <i>p</i> = 0.11), though RCTs alone showed significantly lower diagnostic success with TRA (RR 0.96,95% CI 0.93-0.99; <i>p</i> = 0.008). Crossover rates were significantly higher with TRA (RR 3.19,95% CI 1.62-6.28; <i>p</i> = 0.0008). Procedural duration, fluoroscopy time, contrast utilization, and radiation exposure did not differ significantly between groups (<i>p</i> = 0.20-0.89). Radial artery occlusion did not differ significantly between groups (RR 10.93,95% CI 0.50-236.74; <i>p</i> = 0.13).</p><p><strong>Discussion: </strong>TRA was associated with fewer complications and faster post-procedural recovery while maintaining broadly comparable overall procedural outcomes. However, the higher crossover rate and modestly lower diagnostic success observed in randomized studies highlight important technical limitations. TRA should therefore be considered a reasonable alternative to TFA, with patient selection, operator experience, and institutional expertise influencing procedural success.</p>","PeriodicalId":19131,"journal":{"name":"Neurological Research","volume":" ","pages":"1-27"},"PeriodicalIF":1.9,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008788","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 abnormalities in gray matter, white matter, and cerebrospinal fluid in parkinson's disease: a voxel-based morphometry study.","authors":"Yetong Shi, Yan Zhang, Yunhe Zhang, Yuzhang Wu, Xin Liu, Keke Feng, Yifeng Cheng, Shaoya Yin","doi":"10.1080/01616412.2026.2733676","DOIUrl":"https://doi.org/10.1080/01616412.2026.2733676","url":null,"abstract":"<p><strong>Objective: </strong>Parkinson's disease (PD) is a neurodegenerative disorder affecting multiple brain systems, yet whole-brain structural changes remain incompletely characterized. We used voxel-based morphometry (VBM) to systematically quantify gray matter (GM), white matter (WM), and cerebrospinal fluid (CSF) volume alterations in PD and explore their potential clinical significance for deep brain stimulation (DBS).</p><p><strong>Methods: </strong>High-resolution T1-weighted MRI scans were acquired from 200 PD patients and 176 age- and sex-matched healthy controls. VBM analysis was performed using SPM12/CAT12, with age, sex, and total intracranial volume as covariates. Statistical threshold was set at voxel-level <i>p</i> < 0.001, cluster-level family-wise error-corrected <i>p</i> < 0.05, with a cluster extent ≥ 100 voxels.</p><p><strong>Results: </strong>Compared with controls, PD patients showed significant GM and WM volume reductions (both <i>p</i> < 0.001) and CSF volume increase (<i>p</i> < 0.001). GM atrophy was observed in the olfactory cortex, caudate nucleus, precentral gyrus, and supplementary motor area, while bilateral putamen and ventral posterolateral thalamus showed GM volume increase. WM atrophy was distributed in brain regions anatomically corresponding to key tracts of the sensorimotor network, default mode network, and dorsal attention network.</p><p><strong>Conclusion: </strong>PD patients demonstrate global GM and WM atrophy with increased CSF volume, a bidirectional pattern of coexisting GM reduction and increase, and widespread WM atrophy across multiple functional networks, providing macrostructural imaging evidence for understanding PD clinical heterogeneity. The potential utility of these structural features for preoperative DBS assessment remains purely theoretical and requires prospective validation.</p>","PeriodicalId":19131,"journal":{"name":"Neurological Research","volume":" ","pages":"1-14"},"PeriodicalIF":1.9,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148969839","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":"Neuroendoscopic surgery versus external ventricular drainage for spontaneous intraventricular hemorrhage: a systematic review and meta-analysis.","authors":"Buyun Shao, Jiajun Pan, Kaiping Deng, Huitao Dan","doi":"10.1080/01616412.2026.2713657","DOIUrl":"https://doi.org/10.1080/01616412.2026.2713657","url":null,"abstract":"<p><strong>Objective: </strong>To compare the efficacy and safety of neuroendoscopic surgery (NES) versus external ventricular drainage (EVD) in treating spontaneous intraventricular hemorrhage (IVH).</p><p><strong>Methods: </strong>A systematic search of PubMed, Embase, Cochrane Library, and Web of Science was conducted for studies published up to March 1, 2025. Randomized controlled trials and observational studies comparing NES with EVD for spontaneous IVH were included. Primary outcomes were good functional outcome (GOS 4-5 or mRS 0-2) and mortality. Secondary outcomes included length of hospital/ICU stay and ventriculoperitoneal shunt (VPS) rate. Pooled odds ratios (OR) or weighted mean differences (WMD) with 95% confidence intervals (CI) were calculated using random- or fixed-effects models.</p><p><strong>Results: </strong>Sixteen studies involving 992 patients (487 NES, 505 EVD) were included. NES was associated with significantly higher rates of good functional outcome (OR 2.46, 95% CI 1.79-3.39; I²=28%), lower mortality (OR 0.46, 95% CI 0.28-0.77; I²=25%), reduced VPS dependence (OR 0.20, 95% CI 0.13-0.30; I²=0%), and shorter hospital/ICU stays (WMD -4.82 days, 95% CI -7.98 to -1.66; I²=97%) compared to EVD.</p><p><strong>Conclusion: </strong>Neuroendoscopic surgery demonstrates superior clinical outcomes over EVD for spontaneous IVH, including better functional recovery, lower mortality, reduced shunt dependency, and shorter hospitalization. However, given the limited number of randomized trials and regional heterogeneity, further high-quality multicenter RCTs are warranted to confirm these findings.</p>","PeriodicalId":19131,"journal":{"name":"Neurological Research","volume":" ","pages":"1-8"},"PeriodicalIF":1.9,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148970507","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":"Loading-dose dual antiplatelet therapy for early motor deterioration in minor stroke: a randomized controlled trial.","authors":"Takashi Mizowaki, Yasukazu Hijikata, Ryosuke Ikeo, Takayuki Nakasho, Te-Jin Lee, Satoshi Inoue, Ryuichi Kuroda, Hiroshi Kudo, Tetsuro Kawaguchi, Naoya Takeda, Eiji Kurihara","doi":"10.1080/01616412.2026.2733685","DOIUrl":"https://doi.org/10.1080/01616412.2026.2733685","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether loading-dose dual antiplatelet therapy (DAPT) reduces early motor deterioration in supratentorial non-cardioembolic ischemic stroke with motor deficits.</p><p><strong>Method: </strong>This single-center, parallel-group randomized controlled trial was conducted in Japan from 1 July 2023, to 30 June 2025. Patients aged 20-85 years presenting within 48 hours of onset with supratentorial non-cardioembolic ischemic stroke, unilateral motor deficit, and no ≥ 50% stenosis or proximal large artery occlusion were randomized 1:1 to loading-dose DAPT or non-loading antiplatelet therapy. The primary outcome was motor deterioration within 7 days, defined as an increase of ≥1 point in the affected-side National Institutes of Health Stroke Scale limb motor subscore. Risk ratios (RRs) and 95% confidence intervals (CIs) were estimated using modified Poisson regression.</p><p><strong>Results: </strong>Of 189 randomized patients, 188 were included in the primary analysis. Motor deterioration occurred in 15/98 patients (15%) in the loading-dose DAPT group and 32/90 (36%) in the non-loading group (RR 0.43; 95% CI, 0.25-0.74). Favorable functional outcomes were more frequent with loading-dose DAPT at day 21 (76% vs 61%; RR 1.24; 95% CI, 1.01-1.51) and day 90 (90% vs 73%; RR 1.23; 95% CI, 1.06-1.42). One intracerebral hemorrhage requiring surgery and one fatal pulmonary hemorrhage occurred in the loading-dose group.</p><p><strong>Conclusion: </strong>Loading-dose DAPT initiated within 48 hours was associated with reduced early motor deterioration and better functional outcomes, but larger multicenter trials are needed to confirm efficacy and safety. Trial registration: UMIN000058468; retrospectively registered.</p>","PeriodicalId":19131,"journal":{"name":"Neurological Research","volume":" ","pages":"1-12"},"PeriodicalIF":1.9,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148970502","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":"Robot-assisted gait training in cerebral palsy: a GRADE-assessed systematic review and meta-analysis with trial sequential analysis.","authors":"Alzahra'a Al Matairi, Omar Abuhashem, Bara M Hammadeh, Bana Al Najjar, Mohamad Ezzeldin","doi":"10.1080/01616412.2026.2697005","DOIUrl":"https://doi.org/10.1080/01616412.2026.2697005","url":null,"abstract":"<p><strong>Background: </strong>Cerebral palsy (CP) causes gait impairments, limiting functional independence. Robot-assisted gait training (RAGT) may improve walking, but its effectiveness is unclear.</p><p><strong>Methods: </strong>A systematic review and meta-analysis of RCTs comparing RAGT with conventional therapy (CT) in children was conducted. Primary outcomes were gait, balance, and gross motor function. Study quality was assessed using the ROB 2 and GRADE frameworks. Meta-analyses were performed in R using fixed- or random-effects models, with effects expressed as mean differences or, where trials reported an outcome on different scales, as standardised mean differences, together with sensitivity analyses, publication bias assessment, and Trial Sequential Analysis (TSA).</p><p><strong>Results: </strong>Fifteen RCTs, including 542 patients, met the inclusion criteria, and fourteen contributed to the meta-analyses. No significant differences were observed for hip flexion/extension, GMFM-66, total GMFM, GMFM-88 Dimension D, stride length, walking speed, step width, or balance (all p > 0.05). RAGT showed modest benefits over conventional physiotherapy in the 6MWT (MD 17.52 m, 95% CI 7.70 to 27.34), the 10MWT (MD 0.11 m/s, 95% CI 0.05 to 0.17) and GMFM-88 Dimension E (SMD 0.30, 95% CI 0.05 to 0.54). TSA confirmed robust evidence for the 6MWT and for Dimension E; Dimension D remained inconclusive, the required information size not having been reached.</p><p><strong>Conclusion: </strong>RAGT yields similar improvements to CT in most motor, gait, and balance outcomes in children with CP, whereas RAGT offers modest additional benefit in walking endurance, walking speed, and the walking/running/jumping dimension of the GMFM-88.</p>","PeriodicalId":19131,"journal":{"name":"Neurological Research","volume":" ","pages":"1-21"},"PeriodicalIF":1.9,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148969818","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":"Single versus double burr-hole drainage for chronic subdural hematoma: a systematic review and meta-analysis of 2,359 patients.","authors":"Atef F Hulliel, Dana Saleh, Adam Abdallah","doi":"10.1080/01616412.2026.2733669","DOIUrl":"https://doi.org/10.1080/01616412.2026.2733669","url":null,"abstract":"<p><strong>Background: </strong>CSDH is one of the most common neurosurgical conditions in older adults. Burr-hole craniostomy remains the standard surgical treatment; however, the optimal number of burr holes remains controversial. This systematic review and meta-analysis aimed to compare recurrence rates following SBHC versus DBHC in patients with CSDH.</p><p><strong>Method: </strong>A systematic search of PubMed/MEDLINE and Scopus was conducted. Comparative studies evaluating SBHC versus DBHC for adult CSDH were included. The primary outcome was recurrence requiring reoperation. Random-effects meta-analyses were performed. Heterogeneity, sensitivity analyses, subgroup analyses, meta-regression, and publication bias assessments were conducted.</p><p><strong>Results: </strong>Nineteen studies involving 2,359 patients were included, comprising 1,249 patients treated with SBHC and 1,110 with DBHC. Overall recurrence occurred in 10.1% of patients, including 11.5% in the SBHC group and 8.6% in the DBHC group. Pooled analysis demonstrated no statistically significant difference in recurrence between techniques (OR 1.29, 95% CI 0.84-1.99; <i>p</i> = 0.234). Similar findings were observed using RR (1.24, 95% CI 0.86-1.79) and RD (1.46%, 95% CI - 2.31% to 5.22%). Moderate heterogeneity was present (I² = 33%). Excluding studies with recurrence-modifying co-interventions strengthened the effect estimate toward DBHC (OR 1.44, 95% CI 0.99-2.08; <i>p</i> = 0.061) while reducing heterogeneity (I² = 16%).</p><p><strong>Conclusion: </strong>Single and double burr-hole craniostomy provide comparable recurrence outcomes in the surgical management of chronic subdural haematoma. Although a non-significant trend favored DBHC, current evidence supports individualized surgical decision-making. Adequately powered randomized trials controlling for adjunctive interventions are needed to clarify any potential advantage of DBHC.</p>","PeriodicalId":19131,"journal":{"name":"Neurological Research","volume":" ","pages":"1-18"},"PeriodicalIF":1.9,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963136","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":"Severe COVID-19 outcomes in patients with epilepsy: evidence from a nationwide, population-based study in Poland.","authors":"Aleksandra Pawlicka, Marcin Kruk, Beata Koń, Agnieszka Słowik, Katarzyna Bosak, Magdalena Bosak","doi":"10.1080/01616412.2026.2717712","DOIUrl":"https://doi.org/10.1080/01616412.2026.2717712","url":null,"abstract":"<p><strong>Objective: </strong>The course of COVID-19 and its mortality rate largely depend on the presence of comorbidities. The aim of the study was to evaluate the association between epilepsy and severe COVID-19 outcomes in a nationwide cohort of hospitalized patients in Poland.</p><p><strong>Methods: </strong>This retrospective, nationwide, population-based cohort study used National Health Fund data to identify adults hospitalized due to COVID-19 between 1 March 2021 and 31 December 2023. Patients with epilepsy were identified based on neurologist-confirmed diagnosis and antiseizure medication use. Exact matching was applied to ensure comparability between people with epilepsy (PWE) and patients without epilepsy (PWOE). Outcomes included 60-day mortality, intensive care unit (ICU) admission, mechanical ventilation, and length of hospital stay (LOS).</p><p><strong>Results: </strong>A total of 404,639 COVID-19 hospitalizations were analyzed, including 3,362 PWE in the unmatched cohort. After matching, epilepsy was associated with a significantly higher risk of death within 60 days of admission, with odds of death 26.4% higher among PWE compared with PWOE. LOS was also significantly longer in PWE, by approximately 14.6%. Epilepsy was not independently associated with an increased risk of mechanical ventilation or ICU admission.</p><p><strong>Conclusions: </strong>In this large nationwide cohort, epilepsy was associated with increased mortality and prolonged hospitalization among patients hospitalized with COVID-19 in Poland, although it did not independently increase the likelihood of ICU admission or mechanical ventilation. These findings suggest that PWE - particularly those with substantial comorbidity burden - represent a clinically vulnerable population in the context of COVID-19 and may require heightened clinical attention and preventive strategies.</p>","PeriodicalId":19131,"journal":{"name":"Neurological Research","volume":" ","pages":"1-9"},"PeriodicalIF":1.9,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930730","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":"Treatment strategy, stroke severity, and functional outcomes in acute ischemic stroke: evidence of effect modification in a real-world cohort.","authors":"Karlygash Shinalieva, Arystan Zhakupbekov, Aigul Kaisarbekova, Murat Talasbayev, Aliya Omarbek, Adelya Beisenbekova, Aigerima Turebekova","doi":"10.1080/01616412.2026.2730579","DOIUrl":"https://doi.org/10.1080/01616412.2026.2730579","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the association between treatment strategy and functional outcomes in acute ischemic stroke (AIS) and assess whether this association is modified by stroke severity and imaging findings.</p><p><strong>Methods: </strong>We conducted a retrospective single-center cohort study of adults with AIS treated between March 2023 and September 2025 at a tertiary stroke center in Central Asia. Patients were categorized into intravenous thrombolysis, selective intra-arterial thrombolysis, or angiography without thrombolysis. The primary outcome was poor functional outcome, defined as modified Rankin Scale (mRS) score ≥ 3 at discharge. Multivariable logistic regression and interaction analyses were performed.</p><p><strong>Results: </strong>A total of 247 patients were included, of whom 60.3% had poor functional outcomes. Outcomes differed significantly between treatment groups (<i>p</i> = 0.024), with favorable outcomes more common after intravenous thrombolysis than after selective intra-arterial thrombolysis or angiography without thrombolysis. In multivariable analysis, both selective intra-arterial thrombolysis (OR 2.23, 95% CI 1.04-4.78) and angiography without thrombolysis (OR 2.70, 95% CI 1.23-5.92) were associated with higher odds of poor outcome than intravenous thrombolysis. A significant interaction was observed between treatment strategy and admission NIHSS (Pinteraction < 0.001), whereas the interaction with MRI-confirmed ischemia was not significant (Pinteraction = 0.066). Admission NIHSS demonstrated modest predictive performance (AUC 0.65, 95% CI 0.56-0.74).</p><p><strong>Discussion: </strong>In this exploratory observational cohort, treatment strategy was associated with functional outcome at discharge, and this association varied according to baseline stroke severity. Because treatment allocation was non-random and residual confounding cannot be excluded, these findings should be considered hypothesis-generating rather than causal evidence of treatment effectiveness.</p>","PeriodicalId":19131,"journal":{"name":"Neurological Research","volume":" ","pages":"1-13"},"PeriodicalIF":1.9,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930746","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":"Inflammation-related proteins in the superficial temporal arteries and Chlamydia trachomatis in the middle cerebral arteries in moyamoya disease.","authors":"Xin Xiang, Xiaoling Ruan, Xiang'en Shi, Zaitao Yu, Ting Lei, Fangjun Liu, Yuning Sun, Mengqing Hu","doi":"10.1080/01616412.2026.2729697","DOIUrl":"https://doi.org/10.1080/01616412.2026.2729697","url":null,"abstract":"<p><strong>Objective: </strong>The role of Chlamydia trachomatis (CT) infection with inflammation of the superficial temporal artery (STA) and middle cerebral artery (MCA) in the development of moyamoya disease (MMD) is still under investigation.</p><p><strong>Methods: </strong>We conducted a comparative analysis of the histopathological features and ultrastructures of STAs obtained from patients with MMD and control patients. Immunohistochemical staining for IL-1β, IL-10, CTLA-4, TNF-α, and CD15 was performed. A goat polyclonal antibody that targets a specific antigen associated with CT-related major outer membrane protein (MOMP) was used. The presence of CT was observed using laser scanning confocal microscopy (LSCM). Transmission electron microscopy (TEM) was used to detect CT-generated elementary bodies in the arterial wall tissues from four STA samples and three MCA samples using immunogold labeling.</p><p><strong>Results: </strong>Immunostaining revealed higher expression of TNF-α and CTLA-4 in the STAs of MMD patients than in the STAs of control patients. Through LSCM, CT-related MOMP was observed in the intima and smooth muscle fibers under the elastic lamina of the STA. CT elementary bodies were detected in the arterial wall tissues of four STA samples and three MCA samples.</p><p><strong>Conclusion: </strong>The existing literature, together with our experimental findings, suggests that complex interactions among the immune system, inflammation, and angiogenesis occur during the pathogenesis of MMD. CT species appear to be present throughout the progression of MMD. Further investigation of these processes is crucial to understanding the cause of MMD.</p>","PeriodicalId":19131,"journal":{"name":"Neurological Research","volume":" ","pages":"1-11"},"PeriodicalIF":1.9,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930733","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":"An integrative clinical-molecular model as an auxiliary predictive tool for glioma malignancy grade.","authors":"Wei Wen, Xiaoli Zhang, Lin Yue","doi":"10.1080/01616412.2026.2730581","DOIUrl":"https://doi.org/10.1080/01616412.2026.2730581","url":null,"abstract":"<p><strong>Objective: </strong>An integrative auxiliary predictive model incorporating clinical parameters, serum biomarkers, and molecular pathological markers was developed to assess glioma malignancy grade.</p><p><strong>Methods: </strong>This single-center retrospective observational study consecutively enrolled 400 glioma patients. A total of 26 variables, including demographic characteristics, clinical parameters, laboratory indicators, and serum biomarkers, were analyzed. Predictors were selected using univariate analysis, followed by Least Absolute Shrinkage and Selection Operator (LASSO) regression and machine learning models to construct the model. Model interpretability was assessed via SHapley Additive exPlanations (SHAP) analysis. Performance was evaluated using the area under the receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis (DCA).</p><p><strong>Results: </strong>Independent predictors for high-grade glioma (WHO grades III-IV) included age (OR = 1.085, 95%CI: 1.035-1.138), KPS score (OR = 0.928, 95%CI: 0.886-0.972), maximum tumor diameter (OR = 1.649, 95%CI: 1.233-2.205), neutrophil-to-lymphocyte ratio (OR = 2.310, 95%CI: 1.487-3.589), albumin-to-globulin ratio (OR = 0.163, 95%CI: 0.031-0.847), IDH mutation status (wild-type vs. mutant, OR = 4.502, 95%CI: 1.694-11.966), and Ki-67 proliferation index (OR = 1.176, 95%CI: 1.106-1.250). The Random Forest achieved an AUC of 0.864 (95%CI: 0.815-0.914) in the training set and 0.820 (95%CI: 0.732-0.909) in the validation set. Calibration was excellent (Hosmer-Lemeshow test, <i>p</i> > 0.05), and DCA demonstrated clinical net benefit within a 0.2-0.8 threshold probability range.</p><p><strong>Conclusion: </strong>A novel hybrid clinical-molecular predictive model integrating serum biomarkers and clinical parameters was developed via internal validation for glioma grading. This exploratory auxiliary tool can assist preoperative assessment and guide individualized treatment strategies; however, it cannot replace pathological and molecular diagnosis, as it incorporates tissue-derived markers such as IDH mutation status and Ki-67 index.</p>","PeriodicalId":19131,"journal":{"name":"Neurological Research","volume":" ","pages":"1-14"},"PeriodicalIF":1.9,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906886","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}