Neurologia medico-chirurgica最新文献

{"title":"Contralateral Progression after Unilateral Surgery for Bilateral Chronic Subdural Hematoma: A Prospective Observational Study.","authors":"Kenji Yagi, Yasukazu Hijikata, Yoshifumi Tao, Yoshihiro Sunada, Ryunosuke Haruta, Masato Maruno, Yukari Minami, Hisanori Edaki, Satoshi Hirai, Satoshi Inoue, Tomohito Hishikawa, Masaaki Uno","doi":"10.2176/jns-nmc.2024-0308","DOIUrl":"https://doi.org/10.2176/jns-nmc.2024-0308","url":null,"abstract":"<p><p>Bilateral chronic subdural hematoma is treated by burr-hole surgery. Patients may undergo simultaneous bilateral surgery, or unilateral surgery which occasionally necessitates subsequent contralateral surgery due to the contralateral chronic subdural hematoma progression. Contralateral chronic subdural hematoma progression is not well understood, and an optimal surgical strategy for bilateral chronic subdural hematoma remains undefined. This study aimed to identify predictors for contralateral chronic subdural hematoma progression following unilateral surgery in patients with bilateral chronic subdural hematoma, specifically examining contralateral chronic subdural hematoma presented as membranous (indicating an older hematoma) and the contralateral hematoma volume. In this prospective observational study, 39 patients with bilateral chronic subdural hematoma requiring surgery were included between February 2020 and July 2024. All patients initially underwent unilateral burr-hole surgery. Additional surgery was performed if contralateral chronic subdural hematoma progression occurred. The preoperative predictors of contralateral chronic subdural hematoma progression were investigated. Among the 39 patients, 16 (41%) experienced contralateral chronic subdural hematoma progression, necessitating contralateral surgery. Of the 12 patients with membranous-type chronic subdural hematoma on the contralateral side, contralateral chronic subdural hematoma progression developed in one patient (8%), whereas 15 (56%) of the 27 patients with non-membranous type had contralateral chronic subdural hematoma progression. Logistic regression analyses revealed that membranous-type hematoma was negatively associated with the risk of contralateral chronic subdural hematoma progression, with an odds ratio of 0.07 (95% confidence interval: 0.01-0.65). Additionally, preoperative hematoma volume on the contralateral side was identified as a risk factor for contralateral chronic subdural hematoma progression, with an odds ratio of 1.58 (95% confidence interval: 1.04-2.40) per 10 mL increase. The membranous type and small volume of contralateral chronic subdural hematoma were associated with a lower risk of contralateral chronic subdural hematoma progression after unilateral surgery in bilateral chronic subdural hematoma. We suggest applying unilateral surgery selectively to bilateral chronic subdural hematoma with these characteristics.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700832","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":"Questionnaire Survey on the Current Use of Brain Docks and Their Compliance with Guidelines in Japan.","authors":"Hiroshi Kondo, Fusao Ikawa, Takeshi Hara, Masashi Kuwabara, Daizo Ishii, Hidekazu Tomimoto, Nobutaka Horie","doi":"10.2176/jns-nmc.2024-0235","DOIUrl":"https://doi.org/10.2176/jns-nmc.2024-0235","url":null,"abstract":"<p><p>Brain dock is used for the early diagnosis of intracranial lesions, prevention of cerebrovascular disorders, and early detection of cognitive decline. However, its application varies per facility. This study evaluated the use of brain dock and compliance with its guidelines via a questionnaire survey on the members of the Japan Society of Ningen Dock and Preventive Medical Care and the Japan Brain Dock Society. The questionnaire included information on the respondents, facility characteristics, and brain dock implementation. The number of responses was 288 (response rate: 10.3%). Brain dock was predominantly used in combination with other diagnostic methods. In addition to magnetic resonance imaging, the other examinations performed included the assessment of stroke risk factors and dementia. Radiographic image interpretation was frequently performed by more than one person, often by a neurosurgeon or radiologist. Artificial intelligence was used less frequently. In several facilities, the results were explained to all patients in person and to those who requested the findings in other facilities. Meanwhile, 10% of centers sent the results to the patients. Neurosurgeons were the most common professionals who provided explanations to the patients, followed by outpatient physicians who used the interpretation result as a reference. Only 24% of professionals were aware of the brain dock certification program. By solving the related problems, brain docks can play a greater role in improving medical issues in Japan, where the aging society is projected to increase.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Tigertriever and Self-expanding Stent Retrievers for Mechanical Thrombectomy of Acute Ischemic Stroke: A Single-center Experience.","authors":"Koichiro Shindo, Kazutaka Uchida, Manabu Shirakawa, Shoichiro Tsuji, Shuntaro Kuwahara, Yoji Kuramoto, Shinichi Yoshimura","doi":"10.2176/jns-nmc.2024-0297","DOIUrl":"https://doi.org/10.2176/jns-nmc.2024-0297","url":null,"abstract":"<p><p>Stent retrievers, including the novel Tigertriever, are important in mechanical thrombectomy for acute ischemic stroke due to a proximal large-vessel occlusion within the anterior circulation. We aimed to assess the efficacy and safety of the Tigertriever compared to self-expanding stent retrievers like EmboTrap, Solitaire, Trevo, or Tron. Patients treated at a stroke center for intracranial vessel occlusion in the anterior circulation between August 2022 and August 2024 were evaluated. The primary outcome was a modified first-pass effect, defined as a modified thrombolysis in cerebral infarction grade of 2b-3 after the first pass. Secondary outcomes included the first-pass effect, device-related serious adverse events, embolization in new territory, and hemorrhagic complications within 24 hours post-procedure. Data from 104 hemispheres in 103 patients were analyzed (24 in the Tigertriever group and 80 in the stent-retriever group). The Tigertriever group demonstrated a higher modified first-pass effect (70.8% vs. 52.5%; adjusted odds ratio 3.17; 95% confidence interval 1.06-9.47; p = 0.02). Although not statistically significant, vessel dissection (0% vs. 3.8%), subarachnoid hemorrhage (20.8% vs. 32.5%), and symptomatic intracranial hemorrhage (4.2% vs. 12.5%) within 24 hours post-procedure were lower in the Tigertriever group. No significant differences were observed in the first-pass effect or embolization in the new territory between the 2 groups. The Tigertriever might be effective for anterior circulation intracranial vessel occlusion, achieving a higher rate of modified first-pass effect. It might also be associated with minimal serious procedural complications, indicating its safety profile.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Surgical Outcomes in Microscopic and Fully Endoscopic Microvascular Decompression for Hemifacial Spasm.","authors":"Kyosuke Matsunaga, Norio Ichimasu, Nobuyuki Nakajima, Michihiro Kohno","doi":"10.2176/jns-nmc.2024-0245","DOIUrl":"https://doi.org/10.2176/jns-nmc.2024-0245","url":null,"abstract":"<p><p>Fully endoscopic microvascular decompression is increasingly being used to treat hemifacial spasm; however, its efficacy must be validated by comparing it with conventional microscopic microvascular decompression. In this study, we aimed to compare the surgical outcomes of microsurgical and endoscopic microvascular decompression for hemifacial spasm and discuss the usefulness and risks of endoscopic treatment. A total of 40 patients with hemifacial spasm were retrospectively evaluated at a single institution between 2016 and 2022, including 33 patients who underwent microscopic microvascular decompression (microvascular decompression group) and 7 patients who underwent fully endoscopic microvascular decompression group, which was chosen for patients with sufficient space in the cerebellopontine cistern for endoscopic manipulation. Statistical analyses of the microvascular decompression group and the endoscopic microvascular decompression group were performed to compare patient background and surgical outcomes. No significant differences in age, sex, or affected side were observed between the 2 groups. At the 6-month follow-up, substantial improvement was observed in more than 85% of the patients in each group. Delayed facial palsy and mild lower cranial nerve palsy, such as hoarseness, were more common in the endoscopic microvascular decompression group than in the microvascular decompression group, although there were no significant differences in the rate of complications between the 2 groups. All complications were alleviated within 3 months after surgery. During endoscopic microvascular decompression, interference between the endoscope and instruments can cause neural damage owing to the limited space along the petrosal surface of the cerebellum. Our results suggest that endoscopic procedures cannot always be used as a substitute for conventional microscopic microvascular decompression.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700637","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":"Prospects of BRAF/MEK Inhibitor Therapy in Papillary Craniopharyngiomas with the BRAF V600E Mutation: A Scoping Review.","authors":"Shingo Fujio, Rafi Ilmansyah, Ryutaro Makino, Tareq A Juratli, Jun Sugata, Yuriz Bakhtiar, Ryosuke Hanaya","doi":"10.2176/jns-nmc.2024-0246","DOIUrl":"https://doi.org/10.2176/jns-nmc.2024-0246","url":null,"abstract":"<p><p>Craniopharyngiomas are locally aggressive, rare tumors that pose significant treatment challenges and often result in permanent neurological deficits. Since the discovery of the BRAF V600E driver mutation in papillary craniopharyngioma, several case reports have reported on the efficacy of BRAF inhibitors or the combination of BRAF and MEK inhibitors in treating papillary craniopharyngiomas with this mutation. However, the efficacy, safety, and optimal utilization of this emerging therapy for craniopharyngiomas remain unclear. We conducted a systematic review of published articles in PubMed, Scopus, and the Cochrane Library-CENTRAL, focusing on the efficacy and safety of BRAF/MEK inhibitor therapy in papillary craniopharyngiomas with the BRAF V600E mutation, covering publications from inception through June 2024. A total of 20 case reports and series involving 22 patients were included in the analysis. Combination therapy with BRAF/MEK inhibitors was employed in 81.8% of cases. Significant tumor reduction (≥80%) was observed in 18 of 21 cases, regardless of radiation therapy history, pretargeted therapy tumor volume, and tumor composition. The duration of tumor minimization ranged from 1 to 24 months (median: 5 months). Fever was the most commonly reported adverse event (28.6%), followed by dermatological symptoms (19%). Tumor recurrence was noted in 4 of 6 patients who did not receive additional treatment following the completion of targeted therapy; however, targeted therapy was effective in the cases in which it was resumed. This study provides critical insights into optimizing treatment strategies for papillary craniopharyngiomas and underscores the potential role of targeted therapies in enhancing patient outcomes.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700760","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":"Surgical Outcomes of Carotid Endarterectomy in Patients with Twisted Carotid Bifurcation: Focus on Postoperative Nerve Complications.","authors":"Yuma Hiratsuka, Takeo Murahashi, Yusuke Nakagaki, Yoichi Nakagaki, Hirohiko Nakamura","doi":"10.2176/jns-nmc.2024-0291","DOIUrl":"https://doi.org/10.2176/jns-nmc.2024-0291","url":null,"abstract":"<p><p>Twisted carotid bifurcation, a condition in which the internal carotid artery is positioned medially to the external carotid artery at the carotid bifurcation, is one of the anatomical variations encountered during carotid endarterectomy. Although previous studies have suggested that carotid endarterectomy can be performed safely in twisted carotid bifurcation cases, few have focused on postoperative neurological complications. Therefore, this study aimed to evaluate postoperative neurological complications in carotid endarterectomy cases with twisted carotid bifurcation. This study included patients who underwent carotid endarterectomy at Takikawa Neurosurgical Hospital between January 2012 and July 2024. Twisted carotid bifurcation was diagnosed using preoperative computed tomography angiography images. In twisted carotid bifurcation cases, the internal carotid artery was rotated laterally toward the external carotid artery before endarterectomy. Postoperative complications were compared between the twisted carotid bifurcation group and the normal anatomy group. Of the 143 patients who underwent carotid endarterectomy procedures, 31 cases (20.3%) were diagnosed with twisted carotid bifurcation. The incidence of postoperative hoarseness was significantly higher in the twisted carotid bifurcation group (25.8%) compared with the normal anatomy group (8.2%) (p = 0.012). All cases of hoarseness were transient and resolved by the first outpatient follow-up visit after discharge. There were no differences between the 2 groups in the incidence of other postoperative complications. Patients with twisted carotid bifurcation undergoing carotid endarterectomy have a higher risk of postoperative hoarseness compared with those with normal anatomy. However, the hoarseness was transient, and there were no differences in other postoperative complications. With detailed preoperative planning and careful surgical technique, carotid endarterectomy can be performed safely in patients with twisted carotid bifurcation.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700946","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":"Development of a Clinically Applicable Deep Learning System Based on Sparse Training Data to Accurately Detect Acute Intracranial Hemorrhage from Non-enhanced Head Computed Tomography.","authors":"Huan-Chih Wang, Shao-Chung Wang, Furen Xiao, Ue-Cheung Ho, Chiao-Hua Lee, Jiun-Lin Yan, Ya-Fang Chen, Li-Wei Ko","doi":"10.2176/jns-nmc.2024-0163","DOIUrl":"10.2176/jns-nmc.2024-0163","url":null,"abstract":"<p><p>Non-enhanced head computed tomography is widely used for patients presenting with head trauma or stroke, given acute intracranial hemorrhage significantly influences clinical decision-making. This study aimed to develop a deep learning algorithm, referred to as DeepCT, to detect acute intracranial hemorrhage on non-enhanced head computed tomography images and evaluate its clinical applicability. We retrospectively collected 1,815 computed tomography image sets from a single center for model training. Additional computed tomography sets from 3 centers were used to construct an independent validation dataset (VAL) and 2 test datasets (GPS-C and DICH). A third test dataset (US-TW) comprised 150 cases, each from 1 hospital in Taiwan and 1 hospital in the United States of America. Our deep learning model, based on U-Net and ResNet architectures, was implemented using PyTorch. The deep learning algorithm exhibited high accuracy across the validation and test datasets, with overall accuracy ranging from 0.9343 to 0.9820. Our findings show that the deep learning algorithm effectively identifies acute intracranial hemorrhage in non-enhanced head computed tomography studies. Clinically, this algorithm can be used for hyperacute triage, reducing reporting times, and enhancing the accuracy of radiologist interpretations. The evaluation of the algorithm on both United States and Taiwan datasets further supports its universal reliability for detecting acute intracranial hemorrhage.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"103-112"},"PeriodicalIF":2.4,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047345","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":"Randomized Clinical Trial of Extending the Time Window of Endovascular Therapy in the Triage of Late Presenting Stroke Beyond 24 h (SKIP-EXTEND): Rationale and Study Protocol.","authors":"Kentaro Suzuki, Yuji Matsumaru, Masataka Takeuchi, Masafumi Morimoto, Junya Kaneko, Keigo Shigeta, Tomoji Takigawa, Takehiro Katano, Junya Aoki, Mikito Hayakawa, Toshiaki Otsuka, Shigeru Fujimoto, Koji Iihara, Kazumi Kimura","doi":"10.2176/jns-nmc.2024-0196","DOIUrl":"10.2176/jns-nmc.2024-0196","url":null,"abstract":"<p><p>The therapeutic time window for endovascular therapy in acute stroke patients with large-vessel occlusion was extended to 24 hours from onset. Although a retrospective study showed the efficacy of endovascular therapy beyond 24 hours from the last known well, it remains unclear whether endovascular therapy is effective. Extending the time window of Endovascular therapy in the Triage of Late Presenting Strokes beyond 24 h (SKIP-EXTEND trial) aimed to clarify the efficacy of endovascular therapy compared to the best medical management. This is an investigator-initiated, multicenter, prospective, randomized, open-label, blinded end-point clinical trial. Eligibility criteria included adults and pre-stroke modified Rankin scale score ≤2 with internal carotid artery or M1 (horizontal or sphenoidal segment) occlusion beyond 24 to 72 hours of the last known well. The target enrollment is 260 patients, with 130 reeiving endovascular therapy and 130 receiving the best medical treatment. The primary outcome is the rate of favorable outcome defined as a modified Rankin scale score ≤2 at 90 days. The secondary outcomes are the ordinal logistic regression analysis of the modified Rankin scale score and the rate of recanalization at 48 hours. As safety outcomes, the rate of any and symptomatic intracranial hemorrhage at 24 hours and the rate of mortality at 90 days are assessed. This is the first randomized controlled trial to focus on the efficacy of endovascular therapy beyond 24 hours. Our results will not only benefit patients but also reduce healthcare costs. We believe that this novel study will be useful in clinical practice.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"155-159"},"PeriodicalIF":2.4,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047348","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":"Outcome after Endovascular Treatment of Patients with Ruptured Cerebral Aneurysm over 90 Years of Age.","authors":"Fuminori Shimizu, Kazutaka Uchida, Jiro Takeuchi, Hiroto Kakita, Sou Sawamura, Akihiro Kanbara, Yuji Kitada, Yoshinori Akiyama, Takashi Yoshida, Kiyoshi Asada, Satoru Fujiwara, Hirotoshi Imamura, Chiaki Sakai, Manabu Shirakawa, Shinichi Yoshimura, Nobuyuki Sakai, Masato Kasahara","doi":"10.2176/jns-nmc.2024-0212","DOIUrl":"10.2176/jns-nmc.2024-0212","url":null,"abstract":"<p><p>For ruptured cerebral aneurysms over 90 years of age, the outcome and the safety after endovascular treatment are not well-known. This multicenter retrospective registry enrolled patients with ruptured cerebral aneurysms after endovascular treatment from January 2015 to December 2019 in Japan. We investigated differences between the patients over 90 years (age ≥ 90) and those under 90 years of age (age <90). The primary outcome was defined as a modified Rankin scale 0-2 at 30 days. Secondary outcomes were all-cause death and returned to premorbid modified Rankin scale at 30 days. Safety outcomes were the incidence of ischemic stroke and technical complications. Among 8,024 patients with aneurysm, 204 were aged ≥ 90 years and 7,820 were <90 years, those of median age were 92 and 65 years. The proportion of females and premorbid modified Rankin scale was higher in the age ≥ 90 group (n [%]; 191 [93.6] vs. 5,395 [69.0], median [interquartile range]; 1 [0-2] vs. 0 [0-0]). The modified Rankin scale 0-2 at 30 days was lower in age ≥ 90 patients than in age <90 patients (13.2% vs. 56.2%, adjusted odds ratio [95% confidence intervals]; 0.13 [0.08-0.21]). In age ≥ 90 patients, all-cause death was significantly higher (adjusted odds ratio [95% confidence intervals]; 1.85 [1.19-2.86]) and returned to premorbid modified Rankin scale was significantly lower (adjusted odds ratio [95% confidence intervals]; 0.26 [0.17-0.39]). However, safety outcomes were not significantly different between both groups. In this population undergoing endovascular treatment for ruptured cerebral aneurysms, patients older than 90 years had a poor prognosis but no difference in having perioperative complications.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"148-154"},"PeriodicalIF":2.4,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256363","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":"Gender Difference in Outcome of Subthalamic Nucleus-deep Brain Stimulation in Japan.","authors":"Fumi Mori, Chikashi Fukaya, Mitsuru Watanabe, Koichiro Sumi, Toshikatsu Ikeda, Hideki Oshima, Atsuo Yoshino","doi":"10.2176/jns-nmc.2024-0108","DOIUrl":"10.2176/jns-nmc.2024-0108","url":null,"abstract":"<p><p>Some studies showed a gender difference with the predominance of men in the prevalence of Parkinson's disease, and such a trend in Asia, particularly in Japan, is opposite to that in Western countries. Hence, the gender difference in the outcome of subthalamic nucleus-deep brain stimulation has stimulated the interest. The aim of this study was to clarify the gender difference in the outcome of Parkinson's disease in Japanese patients. The subjects were 57 patients with Parkinson's disease. The gender difference in outcome was studied retrospectively on the basis of the Unified Parkinson's Disease Rating Scale score and score improvement rate in the short- (1 month) and long-term (5 years). In the postoperative state, statistically significant gender differences were noted in the improvement rates of Unified Parkinson's Disease Rating Scale total and part III scores during the off-period in the short term. There was no significant gender difference in the long term. This study is the first on the gender difference in the outcome of Parkinson's disease in Japan. Some significant gender differences were noted in the short term with a higher improvement rate in women.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"126-132"},"PeriodicalIF":2.4,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256361","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}