Stroke最新文献

{"title":"Intracerebral Delivery of rhFGF20 via Heparin-Poloxamer Hydrogel Promotes Neurological Recovery in Ischemic Stroke.","authors":"Shasha Ye, Yeli Zhao, Yuyun Xu, Fei Liang, Rendi Wu, Yujie Zhang, Chengkun Cao, Jiana Li, Yichen Wang, Xue Wang, Keyang Chen, Li Lin","doi":"10.1161/STROKEAHA.125.050828","DOIUrl":"10.1161/STROKEAHA.125.050828","url":null,"abstract":"<p><strong>Background: </strong>Ischemic stroke poses a significant threat to human health. FGF (fibroblast growth factor) 20 is involved in the repair of central nervous system diseases, but it has the shortcomings of short half-life and inability to penetrate the blood-brain barrier. Therefore, to overcome the drawbacks of rhFGF20 (recombinant human FGF20) and explore its role in ischemic stroke, the effects of intracerebral administration of rhFGF20 by heparin-poloxamer hydrogel (HP-rhFGF20 [heparin-poloxamer hydrogel-encapsulated rhFGF20]) in a rat stroke model were the focus of this study.</p><p><strong>Methods: </strong>A rat model of middle cerebral artery occlusion/reperfusion and oxygen-glucose deprivation-reoxygenation models were established to mimic ischemic stroke in vivo and in vitro, respectively. Endogenous FGF20 levels were measured in patients, ischemic rats, and oxygen-glucose deprivation-reoxygenation-injured neurons. To assess the therapeutic potential, rhFGF20 was administered intracerebrally via heparin-poloxamer hydrogel implants (1 mg/mL, 20 μL) on day 5 poststroke. 2,3,5-Triphenyltetrazolium chloride staining, neurobehavioral tests (including the mNSS test [modified Neuro-Severity Score], the corner test, the rotarod test, the cylinder test, and the Morris water maze test), and Nissl staining were performed to evaluate neurological recovery. Immunofluorescence and Western blotting were conducted to assess the brain repair processes (neurogenesis, neuronal remodeling, and angiogenesis).</p><p><strong>Results: </strong>High expression of FGF20 was detected in the serum of patients with ischemic stroke, the cortex of ischemic rats, and oxygen-glucose deprivation-reoxygenation-injured neurons. Heparin-poloxamer increased the stability and bioavailability of rhFGF20. HP-rhFGF20 attenuated neurobehavioral deficits and infarct volume in ischemic stroke rats. HP-rhFGF20 inhibited neuronal cell death, microglial activation, and glial scar formation on day 7 post-implantation. Moreover, HP-rhFGF20 promoted the proliferation, migration, and differentiation of neural stem cells and improved neuronal plasticity and angiogenesis in ischemic stroke rats.</p><p><strong>Conclusions: </strong>HP-rhFGF20 promoted functional recovery in ischemic stroke rats by enhancing neurogenesis and angiogenesis. The combination of growth factors and biomaterials provides a promising therapeutic strategy for central nervous system diseases.</p><p><strong>Registration: </strong>URL: http://www.chictr.org.cn; Unique identifier: ChiCTR2100051104.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"2707-2719"},"PeriodicalIF":8.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in 3D Chromatin Organization Drive Topologically Determined Gene Expression in the Poststroke Mouse Cortex.","authors":"Ankit Patel, Ashutosh Dharap","doi":"10.1161/STROKEAHA.125.050915","DOIUrl":"10.1161/STROKEAHA.125.050915","url":null,"abstract":"<p><strong>Background: </strong>Recent advances in high-throughput transcriptomics have revealed extensive gene expression changes during cerebral ischemia. However, the changes in 3-dimensional chromatin architecture and long-range chromatin looping between genes and distal regulatory elements that drive these gene expression changes remain virtually unexplored. In this study, we map the landscape of the dynamic alterations in topologically associating domains and chromatin loops in the ischemic cortex and evaluate their contributions to poststroke transcriptional changes.</p><p><strong>Methods: </strong>We used high-throughput chromatin conformation capture (Hi-C) to profile genome-wide changes of the 3-dimensional chromatin architecture in the cerebral cortex of adult mice following a 1-hour middle cerebral artery occlusion and 6 hours of reperfusion or sham treatment. We conducted RNA sequencing to identify the differentially expressed genes that are concomitantly altered in association with the stroke-induced topologically associating domains and loops.</p><p><strong>Results: </strong>We identified 293 altered topologically associating domains following stroke, harboring a total of 60 upregulated differentially expressed genes and 106 downregulated differentially expressed genes. Chromatin looping analysis identified 4323 differentially altered loops in response to stroke, of which 1583 had enriched interactions and 2741 had diminished interactions. These loci included previously unknown enhancer and silencer elements, which were linked to a total of 88 upregulated and 96 downregulated genes. Upregulated genes associated with altered topologically associating domains and loops were linked to endothelial and immune cell functions, suggesting a role for dynamic chromatin remodeling in the poststroke cerebrovascular and neuroimmune response. Conversely, downregulated genes were associated with neuronal and synaptic functions, suggesting a role in poststroke neuronal fate.</p><p><strong>Conclusions: </strong>This study is the first to map changes in the 3-dimensional chromatin of the adult cerebral cortex following ischemic stroke. Our findings reveal novel regulatory elements directly associated with stroke-altered genes that may be involved in the regulation of these genes via dynamic changes in chromatin architecture and looping characteristics to fine-tune their expression.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"2720-2733"},"PeriodicalIF":8.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12354084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TET3-Interacting LncRNA TILR Is Essential for DNA Hydroxymethylation-Mediated Neuroprotection After Ischemic Stroke.","authors":"Vijay Arruri, Kahlilia C Morris-Blanco, Suresh L Mehta, Mehakpreet Kaur, Raghu Vemuganti","doi":"10.1161/STROKEAHA.125.052347","DOIUrl":"10.1161/STROKEAHA.125.052347","url":null,"abstract":"<p><strong>Background: </strong>Epigenetic modifications 5-methylcytosine and 5-hydroxymethylcytosine in DNA regulate neuronal survival under ischemic stress. We previously showed that TET3 (ten-eleven translocase 3)-mediated 5-methylcytosine to 5-hydroxymethylcytosine conversion induces neuroprotective gene transcription after stroke. As TET3 neuronal isoform lacks the DNA-binding domain, how TET3 drives 5-hydroxymethylcytosine-mediated transcriptional induction in the ischemic brain remains unclear. Long noncoding RNAs (lncRNAs) act as structural scaffolds to recruit chromatin-modifying proteins and other RNAs to specific genomic loci. However, whether TET3 requires an lncRNA to drive DNA hydroxymethylation in the ischemic brain is unknown.</p><p><strong>Methods: </strong>Adult male and female mice were subjected to transient middle cerebral artery occlusion. TET3-bound lncRNAs were immunoprecipitated from peri-infarct cortex, and TILR (TET3-interacting lncRNA; AK020504) identified was inhibited with small interfering RNA injected at 5 minutes of reperfusion. Ascorbate was administered at 30 minutes of reperfusion to induce TET3 activity. Poststroke DNA hydroxymethylation was assessed with hydroxymethylation DNA immunoprecipitation sequencing, and sensorimotor deficits, and infarct volume were evaluated between days 1 and 7 of reperfusion.</p><p><strong>Results: </strong>TILR binds to TET3 with high affinity and was significantly upregulated in the peri-infarct cortex at 12 hours of reperfusion. Knockdown of TILR increased the infarct volume and reduced the motor function recovery after transient middle cerebral artery occlusion, in a TET3-dependent manner. On contrary, TET3 activation by ascorbate decreased brain damage and improved motor function recovery after ischemia. However, ascorbate-induced postischemic protection was abrogated by TILR knockdown. Genome-wide profiling showed that ascorbate increases the number of differentially hydroxymethylated regions in the poststroke genome, a neuroprotective effect that is reversed by TILR knockdown. Moreover, TILR inhibition significantly reduced the DNA hydroxymethylation in the intergenic regions associated with enhancers, super enhancers, and the promoters of other lncRNAs, microRNAs, and PIWI-interacting RNAs.</p><p><strong>Conclusions: </strong>These findings highlight the essential role of TILR in TET3-mediated 5-hydroxymethylcytosine-dependent epigenetic reprogramming in the ischemic brain.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"2748-2760"},"PeriodicalIF":8.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Large Core Paradox.","authors":"Adrien Ter Schiphorst, Pierre Seners, Caroline Arquizan, Vivek Yedavalli, Jean-Marc Olivot, Maarten G Lansberg, Keith W Muir, Mark W Parsons, Jeffrey L Saver, Marc Fisher, Gregory W Albers, Vincent Costalat, Jean-Claude Baron","doi":"10.1161/STROKEAHA.125.050397","DOIUrl":"10.1161/STROKEAHA.125.050397","url":null,"abstract":"<p><p>Recently, 6 randomized controlled trials of endovascular treatment (EVT) versus medical management in anterior circulation large vessel occlusion with large-core documented significant benefit of EVT on functional outcome. Moreover, one trial reported the benefit of EVT in the very large-core category (Alberta Stroke Program Early CT Score, 0-2). These results are considered paradoxical by some as they contradict the prevailing view that the presence of a large core precludes the possibility of good outcomes following reperfusion. They, in turn, led some investigators to question the applicability of the core/penumbra model in the case of large-core stroke and even its overall validity, specifically regarding the notion that the core reliably predicts tissue infarction. Here, we discuss the trial results and propose alternative explanations for the large-core paradox. First, although EVT does improve outcomes as compared with medical management, overall outcomes remain poor in ≈80% of the treated population. Second, the assessment of core extent on imaging, particularly with computed tomography, is potentially inaccurate, especially in the early time window. Third, consistent with observational studies, some randomized controlled trial substudies suggest that the benefit of EVT in this population derives at least in part from the salvage of penumbra, which appears to have been present in a large percentage of enrolled patients. Fourth, the markedly reduced perfusion that prevails within large cores facilitates the early development of vasogenic edema. This heterogeneity of tissue injury may, in turn, lead to an overestimation of true core/neuronal death as estimated with computed tomography and magnetic resonance imaging. Assessing patients with apparent large core should consider these notions when discussing eligibility for EVT. Early reperfusion of large-core patients is expected to both target any residual penumbra and prevent the development of vasogenic edema within the severely hypoperfused areas. These considerations underscore the need for more reliable methods to identify irreversible neuronal injury inside the imaging-based estimated core.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"2786-2797"},"PeriodicalIF":8.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perinatal Arterial Stroke Treated With Stromal Cells Intranasally: 2-Year Safety and Neurodevelopment.","authors":"Nienke Wagenaar, Lisanne M Baak, Niek E van der Aa, Floris Groenendaal, Jeroen Dudink, Maria Luisa Tataranno, Corine Koopman, Cornelia H Verhage, Rian M J C Eijsermans, Heleen C van Teeseling, Liesbeth S Smit, Reint K Jellema, Timo R de Haan, Hendrik J Ter Horst, Willem P de Boode, Sylke J Steggerda, Susanne M Mulder-de Tollenaer, Koen P Dijkman, Colin G de Haar, Linda S de Vries, Frank van Bel, Cobi J Heijnen, Cora H Nijboer, Manon J N L Benders","doi":"10.1161/STROKEAHA.125.050786","DOIUrl":"10.1161/STROKEAHA.125.050786","url":null,"abstract":"<p><strong>Background: </strong>The PASSIoN study (Perinatal Arterial Stroke Treated With Stromal Cells Intranasally) demonstrated the feasibility and short-term safety of single-dose allogeneic mesenchymal stromal cells (MSCs) administered intranasally to neonates with perinatal arterial ischemic stroke between February 2020 and April 2021. In this study, we assessed long-term safety and neurodevelopmental outcomes and explored outcome differences with a non-MSC-treated cohort.</p><p><strong>Methods: </strong>In this post hoc analysis, we evaluated the safety of MSC administration by assessing brain tissue loss, adverse events, and neurodevelopmental outcomes of PASSIoN participants (N=10). The tissue loss ratio was calculated using semi-automatic segmentation based on neonatal and 3-month magnetic resonance imaging. At the age of 2 years, we assessed the occurrence of cerebral palsy, motor and cognitive delays (<i>Z</i> score <-1 SD), behavioral and language problems, visual field defects, and epilepsy. We selected a non-MSC-treated registry cohort (N=39) born between 1994 and 2022, who would have met PASSIoN trial inclusion criteria to compare magnetic resonance imaging and outcome characteristics.</p><p><strong>Results: </strong>At 3 months, the mean±SD tissue loss ratio of PASSIoN participants was 89±21%, indicating more preserved tissue than expected based on initial stroke volume. By the age of 2 years, no related adverse events were reported. Two children (20%) developed cerebral palsy (Gross Motor Function Classification System I) without motor developmental delays. Cognitive, behavioral, and language problems affected 10% to 20%, and none had developed epilepsy. Compared with the registry cohort, and PASSIoN participants showed less often asymmetry of the posterior limb of the internal capsule (40% versus 81%; <i>P</i>=0.02) and the cerebral peduncle (10% versus 61%; <i>P</i>=0.01) on 3-month magnetic resonance imaging and had a better motor performance at the age of 2 years (median [interquartile range] <i>Z</i> score, 0.3 [0.8] versus -0.4 [1.5]; <i>P</i>=0.003).</p><p><strong>Conclusions: </strong>This study demonstrates the long-term safety of intranasal MSC therapy in 10 infants with perinatal arterial ischemic stroke and may suggest better motor outcomes compared with the literature and a non-MSC-treated cohort. Randomized controlled trials are required to confirm MSC efficacy for children with perinatal arterial ischemic stroke.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT03356821.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"2410-2418"},"PeriodicalIF":8.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"September 2025 <i>Stroke</i> Highlights.","authors":"José Rafael Romero","doi":"10.1161/STROKEAHA.125.052658","DOIUrl":"https://doi.org/10.1161/STROKEAHA.125.052658","url":null,"abstract":"","PeriodicalId":21989,"journal":{"name":"Stroke","volume":"56 9","pages":"2385"},"PeriodicalIF":8.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Network Meta-Analysis of 4 Rehabilitation Methods With rTMS on Upper Limb Function and Daily Activities in Patients With Stroke.","authors":"Xinyu Lin, Haojie Li, Nan Chen, Xie Wu","doi":"10.1161/STROKEAHA.124.049546","DOIUrl":"10.1161/STROKEAHA.124.049546","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Stroke is one of the leading causes of disability and death worldwide, often leading to physical paralysis and cognitive dysfunction, seriously affecting patients' quality of life, and increasing economic burden. Repetitive transcranial magnetic stimulation (rTMS), a noninvasive brain stimulation technique, has been used in stroke rehabilitation, but the difference in efficacy among rehabilitation methods combined with rTMS is unclear. In this study, we compared the effects of 4 rehabilitation methods, namely, clinical routine rehabilitation therapy, smart rehabilitation therapy, behavioral rehabilitation therapy, and Chinese traditional rehabilitation therapy (CTRT) combined with rTMS on the upper limb function and activities of daily living of patients with stroke through a reticulated meta-analysis, which provided a basis for clinical optimization of rehabilitation strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Six databases, namely, PubMed, Embase, Web of Science, Cochrane, EBSCO, and China National Knowledge Infrastructure, were systematically searched, and 24 randomized controlled trials with a total of 868 patients with stroke were finally included. The primary outcome indicators were upper limb Fugl-Meyer assessment and activities of daily living (Barthel index, modified Barthel index, and functional independence measure were included). Network meta-analysis was performed using Stata 17.0 to assess the relative effect of each combined intervention and examine the consistency of direct and indirect evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In this study, a total of 24 randomized controlled trials involving 868 patients with stroke were included. CTRT combined with rTMS had the most significant upper limb Fugl-Meyer assessment improvement CTRT (standardized mean difference [SMD], 1.23 [95% CI, 0.95-1.52]; &lt;i&gt;P&lt;/i&gt;&lt;0.0001), and smart rehabilitation therapy combined with rTMS was the most effective in improving activities of daily living (SMD, 1.74 [95% CI, 1.31-2.18]; &lt;i&gt;P&lt;/i&gt;&lt;0.0001). Clinical routine rehabilitation therapy combined with rTMS had the most significant effect that improved action research arm test (SMD, 3.19 [95% CI, 1.70-4.69]; &lt;i&gt;P&lt;/i&gt;&lt;0.0001) and the combination of the 4 rehabilitation methods with rTMS improved box and block test, but none of them exerted significant effects (&lt;i&gt;P&lt;/i&gt;&gt;0.05). The combination of smart rehabilitation therapy with rTMS had the most significant improvement effect on the wolf motor function test (SMD, 0.78 [95% CI, 0.39-1.16]; &lt;i&gt;P&lt;/i&gt;&lt;0.0001), CTRT combined with rTMS had the most significant effect that improved upper limb modified Ashworth scale (SMD, -0.67 [95% CI, -0.99 to -0.36]; &lt;i&gt;P&lt;/i&gt;&lt;0.0001), and behavioral rehabilitation therapy combined with rTMS had the most significant effect that improved grip strength (SMD, 1.21 [95% CI, 0.42-2.00]; &lt;i&gt;P&lt;/i&gt;&lt;0.01).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This meta-analysis shows varied efficacy of 4 rehabilitation method","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"2644-2657"},"PeriodicalIF":8.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in Digital Health 2025.","authors":"Lee H Schwamm, Gisele Sampaio Silva","doi":"10.1161/STROKEAHA.125.049865","DOIUrl":"https://doi.org/10.1161/STROKEAHA.125.049865","url":null,"abstract":"","PeriodicalId":21989,"journal":{"name":"Stroke","volume":"56 9","pages":"2782-2785"},"PeriodicalIF":8.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"StrokeCog-15 Is an Efficient Neuropsychological Battery to Screen for Cognitive Impairment in Chronic Stroke.","authors":"Lauren L Drag, Michael Mlynash, Alperen Aslan, Muhith Musabbir, Amy Bradley, Maarten G Lansberg, Stuart M Allan, Nima Aghaeepour, Craig J Smith, Marion S Buckwalter","doi":"10.1161/STROKEAHA.124.049217","DOIUrl":"10.1161/STROKEAHA.124.049217","url":null,"abstract":"<p><strong>Background: </strong>Poststroke cognitive impairment can significantly impact functional outcomes and quality of life. While comprehensive neuropsychological evaluations are valuable in characterizing this impairment, their time-intensive nature is not always feasible. Thus, we set out to develop a brief cognitive battery that is sensitive to poststroke cognitive impairment.</p><p><strong>Methods: </strong>Neuropsychological testing was completed in a validation sample of 126 participants with chronic ischemic stroke (median days since stroke, 337 [interquartile range, 235-1057]) as part of StrokeCog, a prospective observational cohort study. This comprehensive 60-minute cognitive battery contained 9 tests covering 5 cognitive domains. A partial least square regression analysis informed the selection of a brief, 15-minute battery of 4 tests (StrokeCog-15) covering 4 cognitive domains: language, memory, working memory, and processing speed/executive functioning. We then compared StrokeCog-15 with Montreal Cognitive Assessment and an established 30-minute battery in its ability to detect cognitive impairment as identified by the comprehensive battery. Finally, we assessed the utility of StrokeCog-15 in an external validation sample of 61 participants (median days since stroke, 210 [interquartile range, 193-230]) enrolled in the parallel Stroke-IMPaCT study (Stroke-Immune Mediated Pathways and Cognitive Trajectory).</p><p><strong>Results: </strong>Cognitive impairment was common, occurring in 50% (n=61) and 66% (n=40) of the 2 cohorts. Deficits occurred most frequently in the memory and processing speed/executive functioning domains. In the derivation sample, StrokeCog-15 demonstrated high sensitivity (0.97) and adequate specificity (0.78) in detecting cognitive impairment on the comprehensive battery, outperforming both Montreal Cognitive Assessment (sensitivity, 0.77; specificity, 0.73) and the 30-minute battery (sensitivity, 0.97; specificity, 0.35). StrokeCog-15 similarly demonstrated high sensitivity (0.93) and adequate specificity (0.67) in the validation sample.</p><p><strong>Conclusions: </strong>A brief 15-minute battery of tests has high sensitivity to detect cognitive impairment as identified on a longer neuropsychological test battery. StrokeCog-15 assesses multiple cognitive domains commonly impacted by stroke and represents an efficient yet effective means to identify chronic poststroke cognitive impairment.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"2464-2473"},"PeriodicalIF":8.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glucagon-Like Peptide-1 Receptor Agonists and Risk of Nontraumatic Intracerebral Hemorrhage in Patients With Type 2 Diabetes.","authors":"Marco Pasi, Arnaud Bretonnière, Lisa Lochon, Arnaud Dosda, Arnaud Bisson, Grégoire Boulouis, Pierre Henri Ducluzeau, Laurent Fauchier","doi":"10.1161/STROKEAHA.125.050972","DOIUrl":"10.1161/STROKEAHA.125.050972","url":null,"abstract":"<p><strong>Background: </strong>GLP-1RAs (glucagon-like peptide-1 receptor agonists) have consistently demonstrated a protective effect against ischemic stroke. However, whether this benefit also extends to nontraumatic intracerebral hemorrhage (ICH) remains unknown. Given the blood pressure-lowering and anti-inflammatory properties of GLP-1RAs, we aimed to evaluate their potential impact on ICH risk in patients with type 2 diabetes.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using global health care data from the TriNetX network. Patients with type 2 diabetes who used GLP-1RAs (n=326 777) were compared with those who did not (n=643 614). Propensity score matching (1:1) was performed to balance baseline characteristics, and follow-up was conducted for up to 4 years. The primary outcomes included all-cause mortality, ischemic stroke, and ICH (overall and by location). Hazard ratios and 95% CIs were calculated to assess the mean treatment effect in the treated group.</p><p><strong>Results: </strong>After propensity score matching (resulting in 2 balanced groups of 255 460 individuals each), GLP-1RAs use was associated with a lower risk of ICH (hazard ratio, 0.743 [95% CI, 0.684-0.807]). The lower ICH risk associated with GLP-1RAs was observed across all ICH locations (all <i>P</i>≤0.01). In addition, exposure to GLP-1RAs was associated with a significantly lower rate of mortality (hazard ratio, 0.525 [95% CI, 0.512-0.538]) and ischemic stroke (hazard ratio, 0.871 [95% CI, 0.843-0.901]).</p><p><strong>Conclusions: </strong>This study highlights a novel potential association between GLP-1RAs and a lower risk of ICH in patients with type 2 diabetes. Prospective studies and future trials are needed to confirm the potential protective effect of GLP-1RAs on small vessel rupture.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"2761-2766"},"PeriodicalIF":8.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}