Neurologia medico-chirurgica最新文献

{"title":"Postoperative Magnetic Resonance Imaging Signal Patterns Predict the Shrinkage of Aneurysms in Large and Giant Intracranial Aneurysms.","authors":"Hiroki Akiyama, Takeshi Mikami, Shouhei Noshiro, Katsuya Komatsu, Nobuhiro Mikuni","doi":"10.2176/jns-nmc.2025-0122","DOIUrl":"10.2176/jns-nmc.2025-0122","url":null,"abstract":"<p><p>This study aimed to evaluate whether postoperative T2-weighted magnetic resonance imaging signal patterns can predict aneurysm shrinkage after surgery for large and giant intracranial aneurysms. We retrospectively analyzed 17 patients with large (10-24 mm) or giant (≥25 mm) cerebral aneurysms treated by clipping, trapping, or proximal ligation between 2009 and 2023. Postoperative aneurysmal signal intensity on T2-weighted magnetic resonance imaging was classified as homogeneous or heterogeneous. Aneurysm shrinkage was defined as a ≥50% reduction in maximum diameter at 2 years compared with the preoperative size. Changes in aneurysm diameter and signal patterns were assessed at 6 months, 1 year, and 2 years postoperatively. Statistical analyses included the Mann-Whitney U test for shrinkage rate and Fisher's exact test for categorical variables. In total, 13 aneurysms (76.5%) showed shrinkage, and 4 (23.5%) did not. The homogeneous group demonstrated a significantly greater reduction in aneurysm diameter than the heterogeneous group at 6 months (p = 0.002) and 1 year (p = 0.006), with a similar trend at 2 years (p = 0.051). Some aneurysms initially showing heterogeneous intensity later became homogeneous and subsequently decreased in size. In contrast, persistent heterogeneous signals were associated with poor shrinkage and, in 1 case, regrowth. Postoperative homogeneous signal intensity on T2-weighted magnetic resonance imaging was associated with aneurysm shrinkage, whereas heterogeneous intensity indicated incomplete thrombus organization and limited reduction. Postoperative magnetic resonance imaging signal patterns may serve as a simple imaging biomarker for evaluating thrombus stability and treatment efficacy after surgery for large and giant cerebral aneurysms.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"162-169"},"PeriodicalIF":1.6,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of First-pass Effect for M2 Segment of Middle Cerebral Artery Occlusion.","authors":"Shuichi Tanada, Kazutaka Uchida, Manabu Shirakawa, Koichiro Shindou, Daichi Baba, Shoichiro Tsuji, Taishi Nigami, Soichiro Abe, Yoji Kuramoto, Masato Kiriki, Kazuma Matsumoto, Shinichi Yoshimura","doi":"10.2176/jns-nmc.2025-0251","DOIUrl":"10.2176/jns-nmc.2025-0251","url":null,"abstract":"<p><p>Although the efficacy of endovascular therapy for large-vessel occlusion is well-established, its effectiveness in the M2 segment of middle cerebral artery occlusion remains uncertain. This study aimed to identify which M2 segment of middle cerebral artery occlusion cases may benefit from endovascular therapy by focusing on the first-pass effect, which refers to patients who underwent endovascular therapy and achieved complete reperfusion after 1 pass. The study analyzed computed tomography perfusion imaging using the Rapid Processing of Perfusion and Diffusion software. In this retrospective study, we analyzed 71 patients with M2 segment of middle cerebral artery occlusion who underwent endovascular therapy after computed tomography perfusion imaging using the Rapid Processing of Perfusion and Diffusion software. The patients were divided into 2 groups: the first-pass effect group (n = 15) and the No first-pass effect group (n = 56). The first-pass effect group showed a significantly higher proportion of patients with a modified Rankin Scale score of 0-2 at 90 days than the No first-pass effect group (80.0% vs. 39.3%; adjusted odds ratio: 12.6, 95% confidence interval: 1.27-125.5). Among Rapid Processing of Perfusion and Diffusion-derived parameters, a median Hypoperfusion Intensity Ratio, an index of collateral status, was significantly lower in the first-pass effect group, with a suggested threshold of <0.22. In patients with M2 segment of middle cerebral artery occlusion, achieving first-pass effect was associated with better neurological outcomes. First-pass effect was more likely when Hypoperfusion Intensity Ratio was ≤ 0.22, suggesting this parameter may guide treatment decisions.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"75-81"},"PeriodicalIF":1.6,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12973193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Experiences with Robotic-assisted Implantation of Deep Brain Stimulation Electrodes in Awake or Asleep Patients in Japan.","authors":"Masafumi Fukuda, Yosuke Ito, Tomoyoshi Ota, Hiroshi Masuda, Makoto Oishi","doi":"10.2176/jns-nmc.2025-0207","DOIUrl":"10.2176/jns-nmc.2025-0207","url":null,"abstract":"<p><p>This study evaluated 14 patients who underwent robot-assisted deep brain stimulation electrode implantation and described our early experiences and workflows in both awake and asleep states. The deep brain stimulation targets included the subthalamic nucleus (n = 6), anterior thalamic nucleus (n = 5), and globus pallidus internus (n = 3). The patient was placed in the supine position, and the ROSA system was affixed diagonally onto the Leksell head frame to align with the X-ray system. Registration was performed at the center of each Leksell pin opening. In some patients with globus pallidus internus-deep brain stimulation, we performed semi-microelectrode recording to confirm the inferior border of the globus pallidus internus even under general anesthesia. In all patients with subthalamic nucleus-deep brain stimulation, semi-microelectrode recording was used to confirm the subthalamic nucleus location under local and intravenous anesthesia. In patients with anterior thalamic nucleus-deep brain stimulation, we used several methods for burr holes to avoid cerebrospinal fluid leakage as much as possible because of the trajectories running through the lateral ventricles. Deep brain electroencephalography was performed after the electrodes were inserted into the anterior thalamic nucleus. Deep brain stimulation implantation using the ROSA system was performed smoothly without any trouble in all patients. No intraoperative complications or major complications were reported immediately after deep brain stimulation. This study represents the first reported experience with ROSA-assisted deep brain stimulation in Japan and supports its broader application in awake or asleep state, and with or without semi-microelectrode recording.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"99-105"},"PeriodicalIF":1.6,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12973190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced Age and Hypoalbuminemia as Complication-related Mortality after 30 Days in Older Patients with Intracerebral Hemorrhage.","authors":"Takahiro Tsuchiya, Tsukasa Koike, Yudai Hirano, Yasuaki Karasawa, Atsumi Takenobu, Satoru Miyawaki, Akio Morita, Nobuhito Saito, Akira Teraoka","doi":"10.2176/jns-nmc.2025-0238","DOIUrl":"10.2176/jns-nmc.2025-0238","url":null,"abstract":"<p><p>In Japan, which has become a super-aging society, the incidence of spontaneous intracerebral hemorrhage among older adults is increasing. Managing these patients is often complicated by frailty and systemic comorbidities. Although these issues pose unique challenges, there is limited research on spontaneous intracerebral hemorrhage in this population, leaving their clinical characteristics and prognoses unclear. This retrospective study reviewed spontaneous intracerebral hemorrhage patients aged ≥75 years who were admitted to our institution from April 2004 to March 2024. Demographics, clinical presentation, imaging findings, and in-hospital outcomes were analyzed to identify risk factors for both 30-day and complication-related mortality. A total of 501 patients were included in the study, with 213 (42.5%) categorized as the oldest-old (age ≥85 years). Over the 2-decade study period, the proportion of oldest-old spontaneous intracerebral hemorrhage patients increased, and this age group exhibited a high risk of complication-related mortality (16.9%). Multivariate analysis identified age ≥85 years (odds ratio: 4.25, 95% confidence interval: 2.12-8.51, p < 0.001), Glasgow Coma Scale score ≤8 at admission (odds ratio: 2.27, 95% confidence interval: 1.19-4.34, p = 0.013), and serum albumin ≤3.5 g/dL at admission (odds ratio: 2.12, 95% confidence interval: 1.07-4.19, p = 0.031) as independent risk factors for complication-related mortality. The prognosis of spontaneous intracerebral hemorrhage in older adults is significantly worse in individuals aged ≥85 years. Older patients with spontaneous intracerebral hemorrhage are at a heightened risk of complication-related mortality, which is primarily associated with advanced age, neurological severity, and hypoalbuminemia.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"82-89"},"PeriodicalIF":1.6,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12973201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Middle Cerebral Artery Branching Patterns on Mechanical Thrombectomy Outcomes for M1 Occlusion.","authors":"Ryohei Tsuchie, Yukishige Hashimoto, Masaru Abiko, Reo Kawano, Nobutaka Horie","doi":"10.2176/jns-nmc.2025-0182","DOIUrl":"10.2176/jns-nmc.2025-0182","url":null,"abstract":"<p><p>Anatomical variations in the middle cerebral artery affect outcomes of mechanical thrombectomy in M1 occlusion cases. However, the relationship between middle cerebral artery branching patterns-specifically trifurcation and bifurcation-and mechanical thrombectomy outcomes remains unclear. This study investigated that relationship and attempted to identify optimal mechanical thrombectomy strategies for trifurcation patterns. We retrospectively analyzed patients treated with mechanical thrombectomy for M1 occlusion at our institution between 2019 and 2024. Patients were categorized into bifurcation and trifurcation groups based on middle cerebral artery branching patterns, and differences in outcomes between the groups were analyzed. In the trifurcation group, further analysis compared characteristics between patients with and without successful recanalization, defined as a modified Thrombolysis in Cerebral Infarction score of 2b-3. Among 98 patients (trifurcation, n = 21; bifurcation, n = 77), the trifurcation group showed lower successful recanalization rates (57% vs. 91%, p = 0.001) and higher procedural complication rates, including distal thrombus migration (62% vs. 36%, p = 0.047) and symptomatic intracerebral hemorrhage (38% vs. 14%, p = 0.027), compared with the bifurcation group. A multivariate modified Poisson regression demonstrated that the trifurcation pattern was independently associated with reduced successful recanalization (relative risk = 0.22; 95% confidence interval, 0.09-0.53; p = 0.001). In trifurcation cases, contact aspiration achieved higher successful recanalization rates than the combined technique (100% vs. 44%, p = 0.009). Moreover, in combined technique cases, direct contact between the aspiration catheter and thrombus significantly improved recanalization rates (77% vs. 0%, p < 0.001) without increasing complications. Trifurcation anatomy hindered effective clot engagement by the aspiration catheter because of narrow M2 diameters and large branching angles, resulting in lower successful recanalization rates compared with bifurcation.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"59-67"},"PeriodicalIF":1.6,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12973191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clazosentan Affects Temporal Profile of Endothelin-A Expression in Macro- and Microcirculation after Subarachnoid Hemorrhage.","authors":"Yuyuan Zheng, Masahito Kawabori, Yoichiro Fujioka, Shuho Gotoh, Ryota Tatezawa, Takuma Ikeda, Taishi Honda, Yo Nakahara, Erika Yoshie, Zheng Li, Yusuke Ohba, Miki Fujimura","doi":"10.2176/jns-nmc.2025-0185","DOIUrl":"10.2176/jns-nmc.2025-0185","url":null,"abstract":"<p><p>Subarachnoid hemorrhage is a life-threatening cerebrovascular event, and cerebral vasospasm remains a major cause of poor neurological outcomes. Clazosentan, an endothelin-A receptor antagonist, has been recently approved in Japan to reduce post-subarachnoid hemorrhage vasospasm; however, recurrent vasospasm after cessation of therapy has occasionally been reported, which underlying mechanisms remain unclear. Moreover, endothelin-A receptor is also expressed on pericytes; however, the effects of clazosentan on microvascular endothelin-A receptor remain unexplored. In this study, we employed a rat subarachnoid hemorrhage model to investigate the temporal dynamics of vasospasm and endothelin-A receptor expression in both large arteries and microvessels, and to evaluate the effects of clazosentan administration. Sprague-Dawley rats were assigned to naïve controls, subarachnoid hemorrhage with saline, or subarachnoid hemorrhage with continuous clazosentan administration for 7 days via osmotic pumps. Vasospasm was assessed by arterial wall thickness, and endothelin-A receptor expression was quantified using immunohistochemistry and immunofluorescence, including staining with α-SMA, CD31, and PDGF-β. Clazosentan significantly attenuated vasospasm in the middle and anterior cerebral arteries, and recurrent vasospasm was observed 3 days after cessation of clazosentan, coinciding with sustained upregulation of endothelin-A receptor in these vessels. In microvessels, pericyte density transiently decreased, peaking at a nadir on day 3 post-subarachnoid hemorrhage, while endothelin-A receptor expression on pericytes was highest at the same time point, and further elevated by clazosentan treatment. These findings indicate that clazosentan induces endothelin-A receptor upregulation in both macro- and microcirculation, potentially contributing to recurrent vasospasm after treatment, and highlight the critical role of pericytes in post-subarachnoid hemorrhage vascular regulation.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"90-98"},"PeriodicalIF":1.6,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12975303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluid Dynamics Simulation Analysis for Identifying Optimal Anastomosis Sites in Superficial Temporal Artery to Middle Cerebral Artery Bypass Surgery in Cerebrovascular Occlusive Disease.","authors":"Riki Tanaka, Liew Boon Seng, Fuminari Komatsu, Kotato Kihara, Kento Sasaki, Akiko Hasebe, Jun Tanabe, Kenichi Haraguchi, Yasuhiro Yamada, Tomoka Katayama, Chisato Fuseya, Yoko Kato","doi":"10.2176/jns-nmc.2025-0256","DOIUrl":"10.2176/jns-nmc.2025-0256","url":null,"abstract":"<p><p>This study investigated the hemodynamic effects of anastomosis site selection in superficial temporal artery to middle cerebral artery bypass surgery using computational fluid dynamics based on three-dimensional cerebral vascular models. By noninvasively reproducing blood flow changes that are difficult to evaluate in clinical settings, we visualized and quantified the effects of different bypass locations under both normal and stenotic conditions. To our knowledge, this is the first study to noninvasively evaluate the validity of anastomosis site selection in superficial temporal artery to middle cerebral artery bypass surgery using computational fluid dynamics simulation. The results demonstrated that factors, such as the distance from the anastomosis site to the target territory, flow direction, recipient vessel diameter, and pressure gradient, significantly influenced cerebral perfusion. In particular, bypass configurations that ensured antegrade flow, minimized the distance to the target region, and involved a larger recipient vessel diameter showed greater improvement in blood flow. These findings offer practical guidance for preoperative planning and are expected to contribute to the safer and more effective selection of bypass sites.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"68-74"},"PeriodicalIF":1.6,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12973192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Method for Optimal Woven EndoBridge Device Sizing by Inscribing a Rectangle in Aneurysm Projections on 2-Dimensional Angiograms.","authors":"Shu Kimura, Shota Yamashita, Yasuo Nishijima, Naoto Kimura, Hidenori Endo","doi":"10.2176/jns-nmc.2025-0179","DOIUrl":"10.2176/jns-nmc.2025-0179","url":null,"abstract":"<p><p>The Woven EndoBridge device is used for endovascular treatment of wide-neck bifurcation cerebral aneurysms. Conventional sizing methods often result in oversizing and require subsequent resizing. Although recent studies demonstrated the accuracy of volumetric methods for sizing, they are often complex. We aimed to develop a simplified method for estimating the appropriate Woven EndoBridge size using two-dimensional angiographic images by inscribing rectangles in aneurysms modeled as ellipsoids, which we named the Inscribed Rectangle Method. This retrospective, single-center study included 12 patients with wide-neck bifurcation cerebral aneurysms treated with the Woven EndoBridge device between May 2023 and July 2024. Aneurysm projections were approximated as ellipses, with the horizontal and vertical axes corresponding to the aneurysm's mean width and minimum height, respectively. The largest inscribed rectangle dimensions (D_rec, H_rec) were calculated. We then developed a predictive formula for Woven EndoBridge sizing based on D_rec and H_rec and compared its performance with conventional sizing methods. Adequate perioperative occlusion was achieved in 83% of cases, and no significant procedural complications were observed. Analysis of these cases revealed that the implanted Woven EndoBridge width and height were approximately D_rec × 1.5 and H_rec, respectively. The Inscribed Rectangle Method, which uses D_rec × 1.5 and H_rec, more closely predicted the implanted Woven EndoBridge size than conventional methods (p < 0.01). The Inscribed Rectangle Method provides a simplified, two-dimensional angiography-based approach for Woven EndoBridge sizing that may reduce the need for device resizing while preserving procedural efficiency.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"32-39"},"PeriodicalIF":2.3,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12877436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145701255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiological Factors Affecting Cage Subsidence after Single-level Anterior Cervical Discectomy and Fusion with Double Titanium Cylindrical Cages.","authors":"Toshiyuki Okazaki, Kazuma Doi, Kazunori Shibamoto, Satoshi Tani, Junichi Mizuno","doi":"10.2176/jns-nmc.2024-0345","DOIUrl":"10.2176/jns-nmc.2024-0345","url":null,"abstract":"<p><p>Anterior cervical discectomy and fusion has become established as a standard surgical method for degenerative cervical disease. Various materials have been used, and we currently usually use double titanium cylindrical cages. Many investigators have reported on the incidence of subsidence after anterior cervical discectomy and fusion. This study focused on the radiological position of the inserted cages and radiological factors influencing the surgical method and examined their relationship with subsidence. Participants in this retrospective study comprised 112 patients diagnosed with cervical myelopathy and radiculopathy caused by disc herniation and spondylosis who underwent one-level anterior cervical discectomy and fusion at a single institution between September 2012 and December 2022. Subsidence was defined as a ≥3-mm decrease in segmental disc height on lateral X-ray at the 1-year follow-up compared to that on postoperative day 1. Subsidence was identified in 53 patients (47.3%). At the view of radiological cage position, our univariate analysis demonstrated that the only deviation of the inserted cages from the anatomical center on the anterior-posterior view was significantly associated with subsidence. Inserting cages in a central position thus appears important to prevent radiological subsidence after anterior cervical discectomy and fusion. Despite high subsidence rates, no patients required additional procedures at the same level by the end of the minimum 2-year follow-up period.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"7-15"},"PeriodicalIF":2.3,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12877434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145701296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal Dynamics of Microlesion Effects in Subthalamic Local Field Potentials.","authors":"Naoki Tani, Takuto Emura, Yuki Kimoto, Takahiro Matsuhashi, Takuto Yamamoto, Koichi Hosomi, Takafumi Omori, Satoru Oshino, Hui Ming Khoo, Yuya Fujita, Ryohei Fukuma, Takufumi Yanagisawa, Haruhiko Kishima","doi":"10.2176/jns-nmc.2025-0102","DOIUrl":"10.2176/jns-nmc.2025-0102","url":null,"abstract":"<p><p>We investigated how subthalamic local field potentials evolve as the microlesion effect emerges and wanes after electrode implantation in Parkinson's disease. Thirteen patients underwent repeated resting recordings that were analyzed across six predefined postoperative periods (days 0-6, 7-30, 31-90, 91-180, 181-365, and ≥366). Power spectral density (1-50 Hz) was decomposed into periodic and aperiodic components. Period-wise changes were tested with nonparametric within-subject analyses, and spatial differences across sensing-electrode pairs were evaluated with population-averaged regression under multiplicity control. Total local field potential power and aperiodic parameters (offset and exponent) followed an inverted-U trajectory, peaking at 31-90 days and declining by ≥12 months. In contrast, periodic beta power (13-30 Hz) increased from approximately 1-3 months onward and remained elevated at 6-12 months, resulting in a higher periodic-to-total beta ratio in late windows. Spatially, periodic beta was maximal over more dorsal, putative sensorimotor territories, whereas the aperiodic exponent was relatively larger ventrally, indicating distinct topographies of oscillatory versus aperiodic activity. Clinically, Movement Disorder Society-Unified Parkinson's Disease Rating Scale Part III improved at 6 months with partial attenuation by 12 months; time-matched correlations with electrophysiological metrics did not survive multiple-comparison adjustment. These findings suggest that the microlesion initially suppresses oscillatory beta more than broadband activity, with a later relative prominence of the periodic component, and that spatial dissociation between periodic and aperiodic features may inform biomarker selection and contact targeting for adaptive stimulation.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"40-48"},"PeriodicalIF":2.3,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12877435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145701409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}