Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism最新文献_第2页

EXPRESS: Chronic Intermittent Hypoxia Induces Persistent Venous Narrowing of Downstream Parenchymal Microvessels and Pial Veins in the Male Mouse Cortex. 表达：慢性间歇性缺氧诱导雄性小鼠皮层下游实质微血管和脑脊液静脉持续狭窄。

IF 4.5

Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism Pub Date : 2026-10-14 DOI: 10.1177/0271678X261499048

Ako Miura, Hiroki Suzuki, Shuko Fujiki, Miyuki Unekawa, Yutaka Tomita, Iwao Kanno, Yoshikana Izawa, Jin Nakahara, Kazuto Masamoto

{"title":"EXPRESS: Chronic Intermittent Hypoxia Induces Persistent Venous Narrowing of Downstream Parenchymal Microvessels and Pial Veins in the Male Mouse Cortex.","authors":"Ako Miura, Hiroki Suzuki, Shuko Fujiki, Miyuki Unekawa, Yutaka Tomita, Iwao Kanno, Yoshikana Izawa, Jin Nakahara, Kazuto Masamoto","doi":"10.1177/0271678X261499048","DOIUrl":"https://doi.org/10.1177/0271678X261499048","url":null,"abstract":"Chronic intermittent hypoxia (IH), a hallmark of sleep apnea, can lead to cerebral hypoperfusion and cognitive decline, though its precise impact on cerebral microcirculation remains unclear. This study investigated the longitudinal effects of 2-week chronic IH (8% O2, 6.5-min cycle for 6 hours/day) on brain microcirculation in the male mouse cortex. We observed a significant reduction in the diameters of pial veins (from 55 to 46 μm) and parenchymal venules (from 9.9 to 8.2 μm) after chronic IH relative to pre-IH conditions, while upstream arteries (47 to 44 μm) and arterioles (12.4 to 12.0 μm) were unaffected. This selective reduction in downstream venule diameter led to a significant increase in arterio-venous transit time, indicating reduced cerebral blood perfusion. Furthermore, neurovascular coupling (NVC) responses showed a substantial decrease, pointing to impaired microvascular function. Crucially, these neurovascular impairments were reversed by daily administration of an endothelin receptor antagonist during IH exposure, with the exception of pial vein constriction. In conclusion, reduced cerebral perfusion after chronic IH is associated with persistent narrowing of parenchymal venules and pial veins. These findings provide new insights into the cerebral microvascular complications of chronic IH and suggest the potential utility of neurovascular protective agents.","PeriodicalId":520660,"journal":{"name":"Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism","volume":" ","pages":"271678X261499048"},"PeriodicalIF":4.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

EXPRESS: Diagnostic and prognostic value of on-site CT-derived fractional flow reserve in intracranial atherosclerotic stenosis. EXPRESS：现场ct提取的血流储备分数对颅内动脉粥样硬化性狭窄的诊断和预后价值。

IF 4.5

Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism Pub Date : 2026-10-14 DOI: 10.1177/0271678X261499068

Xinran Wang, Xuan Zeng, Jian Guo, Zhao Shi, Bin Hu, Li Lu, Bangjun Guo, Xiaoqing Cheng, Long Jiang Zhang

{"title":"EXPRESS: Diagnostic and prognostic value of on-site CT-derived fractional flow reserve in intracranial atherosclerotic stenosis.","authors":"Xinran Wang, Xuan Zeng, Jian Guo, Zhao Shi, Bin Hu, Li Lu, Bangjun Guo, Xiaoqing Cheng, Long Jiang Zhang","doi":"10.1177/0271678X261499068","DOIUrl":"https://doi.org/10.1177/0271678X261499068","url":null,"abstract":"Background: The role of CT-derived fractional flow reserve (CT-FFR) in cerebrovascular disease remains undefined. This study validated the diagnostic and prognostic value of an on-site CT-FFR in symptomatic intracranial atherosclerotic stenosis (sICAS) patients.Methods: This retrospective study enrolled sICAS patients with 30 - 99% stenosis confirmed by CTA, divided into two substudies. The diagnostic performance study included 259 patients undergoing CTA and CT perfusion (CTP) or four-dimensional CTA (CTP as reference standard). In prognosis study, 452 patients with at least 1-year follow-up were included. Computational fluid dynamics (CFD) model was used to measure CT-FFR. Diagnostic performance was assessed by receiver-operating characteristic (ROC) curves, and predictive value by Cox regression analysis.Results: The diagnostic performance of CT-FFR was significantly higher than diameter stenosis (DS) on both per-patient (P = 0.009) and per-lesion (P = 0.004) basis. And the cut-off value of CT-FFR diagnosing cerebral hypoperfusion was 0.80. 15.0% (68 / 452) patients experienced recurrent ischemic events during the median 24 (17-33) months follow-up. CT-FFR provided incremental prognostic value beyond traditional cardiovascular risks plus DS (AUC = 0.797 vs 0.716, P < 0.001).Conclusion: This on-site CT-FFR can serve as a valuable tool for diagnosis and risk stratification in sICAS patients.","PeriodicalId":520660,"journal":{"name":"Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism","volume":" ","pages":"271678X261499068"},"PeriodicalIF":4.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

EXPRESS: Programmed Oscillatory Oxygen Therapy: Reframing Oxygen as a Dynamic Signal for Restoring Cerebrovascular Regulation After Ischemic Stroke. 程序性振荡氧治疗：重新构建氧作为缺血性脑卒中后脑血管调节恢复的动态信号。

IF 4.5

Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism Pub Date : 2026-10-14 DOI: 10.1177/0271678X261498564

Feiyang Jin, Zhengming Tian, Xunming Ji, Jia Liu

{"title":"EXPRESS: Programmed Oscillatory Oxygen Therapy: Reframing Oxygen as a Dynamic Signal for Restoring Cerebrovascular Regulation After Ischemic Stroke.","authors":"Feiyang Jin, Zhengming Tian, Xunming Ji, Jia Liu","doi":"10.1177/0271678X261498564","DOIUrl":"https://doi.org/10.1177/0271678X261498564","url":null,"abstract":"Successful recanalization after ischemic stroke does not always restore adequate microvascular perfusion within previously ischemic tissue, partly because persistent microcirculatory dysfunction, impaired neurovascular coupling, and perfusion-metabolism mismatch continue to disrupt cerebral blood flow regulation. Conventional continuous oxygen therapy primarily increases systemic oxygen availability, but may be insufficient to restore impaired cerebrovascular responsiveness, while excessive or prolonged oxygen exposure may increase oxidative stress and attenuate adaptive oxygen-sensitive pathways. In this Review, we propose programmed oscillatory oxygen therapy (POOT) as a treatment-design framework for dynamic oxygen modulation after ischemic stroke. Rather than treating oxygen solely as a metabolic substrate, POOT reframes oxygen as a dynamic biological signal that may engage hypoxia-inducible factor, reactive oxygen species, nitric oxide, and related oxygen-sensitive pathways to support cerebral blood flow regulation and neurovascular coupling. Unlike fixed intermittent hypoxia, intermittent hyperoxia, or hypoxia-hyperoxia training protocols, POOT is proposed as a parameter-explicit and potentially feedback-informed framework targeting post-recanalization microvascular dysfunction. This framework integrates response window, oxygen intensity, cycle structure, treatment frequency and duration, and physiological feedback, providing a conceptual basis for advancing oxygen therapy toward more individualized and precision-oriented modulation after ischemic stroke.","PeriodicalId":520660,"journal":{"name":"Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism","volume":" ","pages":"271678X261498564"},"PeriodicalIF":4.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

EXPRESS: Longitudinal Quantitative MRI of Blood-Brain Barrier Leakage in Chronic Cerebral Hypoperfusion Rat model. EXPRESS：慢性脑灌注不足大鼠模型血脑屏障渗漏的纵向定量MRI。

IF 4.5

Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism Pub Date : 2026-10-14 DOI: 10.1177/0271678X261498684

Ana Sampedro-Viana, Sabela Fernández-Rodicio, José Castillo, Pablo Hervella, Maria Luz Alonso-Alonso, Ramón Iglesias Rey

{"title":"EXPRESS: Longitudinal Quantitative MRI of Blood-Brain Barrier Leakage in Chronic Cerebral Hypoperfusion Rat model.","authors":"Ana Sampedro-Viana, Sabela Fernández-Rodicio, José Castillo, Pablo Hervella, Maria Luz Alonso-Alonso, Ramón Iglesias Rey","doi":"10.1177/0271678X261498684","DOIUrl":"https://doi.org/10.1177/0271678X261498684","url":null,"abstract":"Objective-Methods:Chronic cerebral-hypoperfusion is a key contributor to vascular cognitive impairment, with blood-brain barrier (BBB) dysfunction proposed as an early driver of white matter injury. The temporal-evolution and regional-heterogeneity of BBB-leakage remain poorly characterized in vivo. We longitudinally assessed BBB permeability in Sprague-Dawley rats subjected to bilateral-common carotid artery occlusion (2VO) versus sham controls using contrast-enhanced T1-weighted MRI 9.4T over 12-weeks. Gadolinium-leakage maps were generated and analyzed in predefined regions (cortex, hippocampus, striatum, corpus callosum). Exploratory histological observations included GFAP immunostaining, and circulating biochemical biomarkers (sTWEAK, MMP-9, GOT, cytokines) were quantified.Results:Localized BBB disruption was observed at weeks 3, 6 post-2VO and progressed heterogeneously, with pronounced leakage strictly targeted toward corpus callosum, hippocampus and striatum. Despite descriptive trends showing increased astroglial activation, systemic biochemical biomarkers did not correlate with imaging-derived central BBB-leakage. Volumetric analysis revealed subtle but significant brain atrophy (18% whole-brain reduction) preceding overt T2-signal abnormalities. In the 2VO model studied, BBB dysfunction in chronic-hypoperfusion appears to be a dynamic, region-specific process.Conclusion:Longitudinal contrast-enhanced MRI detected changes that were not mirrored by the circulating biomarkers studied, suggesting its potential utility as a surrogate endpoint in preclinical studies, which should be confirmed in larger cohorts and complementary models.","PeriodicalId":520660,"journal":{"name":"Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism","volume":" ","pages":"271678X261498684"},"PeriodicalIF":4.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

EXPRESS: Perfusion Extent and Hypoperfusion Severity Determine Diaschisis Patterns in Acute Ischemic Stroke: A CT Perfusion Study. EXPRESS：灌注程度和灌注不足严重程度决定急性缺血性卒中的脑缺血模式：一项CT灌注研究。

IF 4.5

Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism Pub Date : 2026-10-14 DOI: 10.1177/0271678X261499044

Q I Jia, Nan Nan Sheng, Noemie Ligot, Anissa Abderrakib, Niloufar Sadeghi Maybodi, Gilles Naeije

{"title":"EXPRESS: Perfusion Extent and Hypoperfusion Severity Determine Diaschisis Patterns in Acute Ischemic Stroke: A CT Perfusion Study.","authors":"Q I Jia, Nan Nan Sheng, Noemie Ligot, Anissa Abderrakib, Niloufar Sadeghi Maybodi, Gilles Naeije","doi":"10.1177/0271678X261499044","DOIUrl":"https://doi.org/10.1177/0271678X261499044","url":null,"abstract":"Background: Diaschisis reflects remote functional suppression following focal ischemia and large-scale network disruption. We investigate the prevalence, overlap, and determinants of multiple diaschisis subtypes using acute CTP.Methods: We retrospectively analyzed 659 patients with hyperacute large-vessel occlusion stroke. Diaschisis was primarily assessed on CBV maps and classified into Crossed Cerebellar (CCD), Ipsilateral Thalamic (ITD), Ipsilateral Hippocampal (IHD), and CCD+ITD. Tmax-based assessment was exploratory. Multivariable logistic regression evaluated severe hypoperfusion extent (Tmax>6s), hypoperfusion intensity ratio (HIR), and ischemic core volume (CBF<30%).Results: CCD was the most common subtype, followed by ITD and CCD+ITD, whereas IHD was rare. Greater severe hypoperfusion extent was independently associated with CCD, ITD, and CCD+ITD, while higher HIR was additionally associated with ITD, and CCD+ITD. Ischemic core volume was not independently associated with diaschisis. CCD was independently associated with left hemispheric stroke, while combined CCD+ITD was associated with female sex. Exploratory Tmax-based analyses showed broadly similar associations. Subtype overlap suggested involvement of multiple interconnected network nodes.Conclusion: Hyperacute diaschisis reflects ischemia-driven network dysfunction primarily related to severe hypoperfusion extent, with hypoperfusion severity contributing to specific subtypes. These findings support CBV-based CTP assessment for investigating large-scale network vulnerability, while Tmax-based may provide complementary information for future diaschisis research.","PeriodicalId":520660,"journal":{"name":"Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism","volume":" ","pages":"271678X261499044"},"PeriodicalIF":4.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

EXPRESS: Measuring solute clearance across brain states: methods and the sleep-brain-drain debate. 测量大脑状态的溶质清除率：方法和睡眠-人才流失的争论。

IF 4.5

Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism Pub Date : 2026-10-14 DOI: 10.1177/0271678X261498576

Gawon Cho, Burhan Ozturk, Marah Alian, Kaiming Xu, Joaquin Caceres Melgarejo, Brienne Miner, Nora D Volkow, Helene Benveniste

{"title":"EXPRESS: Measuring solute clearance across brain states: methods and the sleep-brain-drain debate.","authors":"Gawon Cho, Burhan Ozturk, Marah Alian, Kaiming Xu, Joaquin Caceres Melgarejo, Brienne Miner, Nora D Volkow, Helene Benveniste","doi":"10.1177/0271678X261498576","DOIUrl":"https://doi.org/10.1177/0271678X261498576","url":null,"abstract":"Background: The glymphatic hypothesis posits that cerebrospinal fluid and interstitial fluid bulk-flow clears brain waste, with increased waste transport during sleep. Recent studies reporting the opposite have generated substantial controversy. Three issues underlie the controversy surrounding this hypothesis and are the subject of this reviewMethods:We critically reviewed these three issues. First, we identified heterogeneity in the methods used to quantify brain \"clearance\" and evaluated their validity, recalculating rate constants from published data where these were not originally reported. Second, we examined uncertainty regarding the physical forces driving fluid and solute movement, and how assumptions about advection influence model specification. Third, we critiqued the dichotomization of brain state into \"sleep\" and \"wakefulness\".Results: Clearance rates reported by competing groups fall within a similar range, yet the conclusions drawn about the influence of sleep are diametrically opposed. No gold-standard approach exists either for measuring clearance or for defining and inducing brain states.Conclusion: These conflicting results cannot be adjudicated: the debate persists not because the rates differ but because no shared standard exists to determine whether the opposing state-associations are real. Methodological standardization is a precondition for a reproducible account of how brain solute clearance is regulated.","PeriodicalId":520660,"journal":{"name":"Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism","volume":" ","pages":"271678X261498576"},"PeriodicalIF":4.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

EXPRESS: Neutral lipids in Thrombectomy-retrieved clots: Histological link to Stroke Severity, Etiology and 3-Months Functional Outcome. EXPRESS：取栓后血块中的中性脂：与中风严重程度、病因和3个月功能结局的组织学联系。

IF 4.5

Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism Pub Date : 2026-10-14 DOI: 10.1177/0271678X261498578

Fabian Essig, Christoph Vollmuth, Vivian Vogt, Benedikt Trauth, Christian Hametner, Karl Georg Häusler, Marius Vogt, Konstanze Guggenberger, Mirko Pham, Alexander Marco Kollikowski, Michael K Schuhmann

{"title":"EXPRESS: Neutral lipids in Thrombectomy-retrieved clots: Histological link to Stroke Severity, Etiology and 3-Months Functional Outcome.","authors":"Fabian Essig, Christoph Vollmuth, Vivian Vogt, Benedikt Trauth, Christian Hametner, Karl Georg Häusler, Marius Vogt, Konstanze Guggenberger, Mirko Pham, Alexander Marco Kollikowski, Michael K Schuhmann","doi":"10.1177/0271678X261498578","DOIUrl":"https://doi.org/10.1177/0271678X261498578","url":null,"abstract":"Background/hypothesis: Analysis of stroke thrombi collected during catheter-based recanalization offers a promising approach to refine etiological classification and guide treatment, as it provides pathophysiological insights through clot structure and composition. Despite the established role of lipids in large artery atherosclerotic stroke, their presence in stroke thrombi has not yet been studied histologically.Methods: In a prospective single-center cohort, neutral lipids were analysed by Oil Red O staining in 145 consecutively collected clots between 07/2020 and 08/2022, and lipid content was subsequently quantified using Orbit Image analysis. Clinical, laboratory and neuroradiological data were recorded. Functional outcome was assessed by modified Rankin Scale at 3 months.Results: Of 135 evaluable clots, 25 (19%) contained neutral lipids, present as lipid droplets, scattered deposits or foam-cell like configurations. Lipid-positive thrombi contained more fibrin, and patients with lipid-positive thrombi had greater stroke severity and worse functional outcome. Lipid positivity was independently associated with undetermined rather than cardioembolic stroke etiology after adjustment for fibrin content.Conclusions: This is the first study to histologically identify neutral lipids within clots retrieved from acute ischemic stroke patients. Thrombus lipid content was associated with worse functional outcomes and may provide additional information on the underlying etiology of otherwise undetermined stroke.","PeriodicalId":520660,"journal":{"name":"Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism","volume":" ","pages":"271678X261498578"},"PeriodicalIF":4.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

EXPRESS: Association between Neurovascular Network Dysfunction and Poor Sleep Quality in Patients with Cerebral Small Vessel Disease. EXPRESS：脑血管病患者神经血管网络功能障碍与睡眠质量差的关系

IF 4.5

Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism Pub Date : 2026-10-02 DOI: 10.1177/0271678X261496208

Tong Guo, Ziyi Gao, Qianqian Yang, Yao Lu, Mengxi Zhao, Guoliang Hu, Xiaodong Li, Tingting Wang, David Wang, Yilong Wang, Jean-Paul Collet, Ling Guan

{"title":"EXPRESS: Association between Neurovascular Network Dysfunction and Poor Sleep Quality in Patients with Cerebral Small Vessel Disease.","authors":"Tong Guo, Ziyi Gao, Qianqian Yang, Yao Lu, Mengxi Zhao, Guoliang Hu, Xiaodong Li, Tingting Wang, David Wang, Yilong Wang, Jean-Paul Collet, Ling Guan","doi":"10.1177/0271678X261496208","DOIUrl":"https://doi.org/10.1177/0271678X261496208","url":null,"abstract":"Background/hypothesis: Poor sleep quality is frequently reported among patients with cerebral small vessel disease (CSVD), but its neurovascular correlates remain unclear. We examined exploratory associations between multidomain neurovascular network (NVN) measures and poor sleep quality in patients with CSVD.Methods: In this cross-sectional analysis nested within a prospective CSVD registry, 102 patients with CSVD underwent heart rate variability, cerebral haemodynamic and resting-state electroencephalography assessments. Poor sleep quality was defined as a Pittsburgh Sleep Quality Index (PSQI) global score >5. Analyses were primarily adjusted for age and sex, with false discovery rate (FDR) correction applied across all evaluated NVN variables.Results: Fifty-three participants had poor sleep quality. Among 108 evaluated NVN variables, 12 showed nominal unadjusted between-group differences and 13 showed nominal age- and sex-adjusted associations with poor sleep quality. Neither crude nor adjusted associations survived FDR correction. In secondary exploratory model analyses, the multidomain NVN model showed an apparent area under the curve (AUC) of 0.795 and a bootstrap optimism-corrected AUC of 0.758.Conclusion/interpretation: PSQI-defined poor sleep quality in CSVD was accompanied by exploratory differences across autonomic, haemodynamic and neuroelectrical NVN domains. Longitudinal studies with non-CSVD controls and objective sleep assessments are needed.","PeriodicalId":520660,"journal":{"name":"Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism","volume":" ","pages":"271678X261496208"},"PeriodicalIF":4.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

EXPRESS: Practical efficiency of coupling targeted temperature management to cerebral temperature versus systemic temperature in febrile brain-injured patients. The Brain-TTM study: a randomized controlled pathophysiology trial. 针对性温度管理与热性脑损伤患者脑温度与全身温度耦合的实际效果。脑- ttm研究：随机对照病理生理学试验。

IF 4.5

Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism Pub Date : 2026-10-02 DOI: 10.1177/0271678X261496659

Thomas Schmitt, Chloe LE Cossec, Marine DE Mesmay, Pierre Trouiller, Eleonore Bouchereau, Nicolas Engrand

{"title":"EXPRESS: Practical efficiency of coupling targeted temperature management to cerebral temperature versus systemic temperature in febrile brain-injured patients. The Brain-TTM study: a randomized controlled pathophysiology trial.","authors":"Thomas Schmitt, Chloe LE Cossec, Marine DE Mesmay, Pierre Trouiller, Eleonore Bouchereau, Nicolas Engrand","doi":"10.1177/0271678X261496659","DOIUrl":"https://doi.org/10.1177/0271678X261496659","url":null,"abstract":"BackgroundTargeted temperature management (TTM) is widely used to prevent secondary brain injury in febrile brain-injured patients, and it almost always targets systemic temperature (ST). However, because the therapeutic target is the brain, brain temperature (BT) may represent a more relevant target. We investigated whether BT-targeted TTM improved BT control compared with conventional ST-targeted TTM.MethodsBrain-TTM was a single-center, prospective, randomized controlled pathophysiology study including brain-injured patients monitored with an intracerebral pressure probe incorporating a thermal sensor. Patients with BT ≥38.5°C requiring TTM were randomized to BT-targeted or ST-targeted (bladder temperature) TTM. BT and ST were recorded every minute for 12 hours.ResultsThirty-four patients were included (17 per group). Median age was 46 years (IQR 42-53), and 68% were men. During the maintenance phase (H3-H12), the median proportion of time with BT within the target range (36.0-37.0°C) was 84% (IQR 53-99) in the BT-targeted group and 89% (IQR 63-92) in the ST-targeted group (primary outcome, p=0.89). Target attainment at H3 was similar (p=0.49). The BT-ST gradient increased from 0.11±0.07°C during induction to 0.30±0.06°C during maintenance. Per-protocol analyses were consistent.ConclusionBT-targeted TTM did not improve BT control compared with ST-targeted TTM.","PeriodicalId":520660,"journal":{"name":"Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism","volume":" ","pages":"271678X261496659"},"PeriodicalIF":4.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bayesian networks to estimate prognosis in vascular cognitive impairment and small vessel disease: Integrated analyses of interdependent contributors to multiple outcomes. EXPRESS：估计血管性认知障碍和小血管疾病预后的贝叶斯网络：多种结果相互依赖的综合分析。

IF 4.5

Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism Pub Date : 2026-10-02 DOI: 10.1177/0271678X261496217

Malin Overmars, Cor Allaart, Esther E Bron, Hans-Peter Brunner La Rocca, Jeroen de Bresser, Majon Muller, Matthias Jp van Osch, Charlotte Teunissen, Betty M Tijms, Frank J Wolters, Geert Jan Biessels

{"title":"Bayesian networks to estimate prognosis in vascular cognitive impairment and small vessel disease: Integrated analyses of interdependent contributors to multiple outcomes.","authors":"Malin Overmars, Cor Allaart, Esther E Bron, Hans-Peter Brunner La Rocca, Jeroen de Bresser, Majon Muller, Matthias Jp van Osch, Charlotte Teunissen, Betty M Tijms, Frank J Wolters, Geert Jan Biessels","doi":"10.1177/0271678X261496217","DOIUrl":"10.1177/0271678X261496217","url":null,"abstract":"Background: Vascular cognitive impairment (VCI) and small vessel disease (SVD) involve interconnected factors influencing multiple outcomes, also beyond cognitive decline. Bayesian networks (BNs) can help unravel these complex interrelations, which we demonstrate in this proof-of-concept study in the Heart-Brain Connection cohort, including memory-clinic patients with SVD, patients with heart failure, carotid occlusive disease, and reference participants.Methods: We trained BNs and jointly modelled cognitive decline (Clinical Dementia Rating (CDR) increase) and major adverse cardiovascular events (MACE) over 5 years as outcomes in relation to multiple demographic and disease factors and emerging imaging and plasma biomarkers, also considering non-random study discontinuation.Results: Of 566 individuals (median age 68, 64% men), 80 had MACE and 112 experienced CDR increase. Diagnostic group and baseline cognition were key determinants of both outcomes. The BN identified baseline clinical severity as a non-random study discontinuation source. Plasma biomarkers formed an interconnected subnetwork, linked to demographic and vascular factors, but without direct dependencies with outcomes. The trained BN provides individualized inference under partial evidence, informing on outcome probabilities.Conclusion: This proof-of-concept study demonstrates how BNs quantify and visualize the dependency structure underlying prognostic heterogeneity in VCI and SVD, including non-random study discontinuation and positioning of emerging biomarkers.","PeriodicalId":520660,"journal":{"name":"Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism","volume":" ","pages":"271678X261496217"},"PeriodicalIF":4.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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