Journal of Stroke & Cerebrovascular Diseases最新文献

{"title":"Recombinant human pro-urokinase vs. alteplase within 4.5 hours of acute ischemic stroke: A systematic review and meta-analysis of randomized controlled trials","authors":"Tallal Mushtaq Hashmi MBBS ,&nbsp;Aimen Shafiq MBBS ,&nbsp;Rohma Zia MBBS ,&nbsp;Hadiah Ashraf MBBS ,&nbsp;Muhammad Burhan MBBS ,&nbsp;Mushood Ahmed MBBS ,&nbsp;Ahmad Mesmar MBBS ,&nbsp;Raheel Ahmed MRCP ,&nbsp;Gregg C. Fonarow MD, FACC","doi":"10.1016/j.jstrokecerebrovasdis.2025.108392","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108392","url":null,"abstract":"<div><h3>Background</h3><div>Recombinant human pro-urokinase (rhPro-UK) has emerged as a potential alternative to alteplase for patients with acute ischemic stroke (AIS) presenting within 4.5 hours of symptom onset. This meta-analysis evaluates and compares the efficacy and safety of rhPro-UK with alteplase in this patient population.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted on PubMed, Cochrane and Embase from inception to November 30, 2025, to identify eligible RCTs comparing intravenous rhPro-UK with alteplase in AIS patients treated within 4.5 hours of symptom onset. A random-effects meta-analysis was conducted using RevMan Web.</div></div><div><h3>Results</h3><div>Three RCTs encompassing 2,289 patients (rhPro-UK: 1141; alteplase: 1148) met the inclusion criteria. The pooled analysis demonstrated no significant difference between rhPro-UK and alteplase in achieving excellent functional outcome (mRS 0-1 at 90d: RR = 1.04, 95 % CI = 0.98 to 1.10; <em>P</em> = 0.17) and good functional outcome (mRS 0-2 at 90d: RR = 1.0, 95 % CI = 0.96 to 1.05; <em>P</em> = 0.86). No statistically significant difference was observed for early neurological improvement (RR 1.05, 95 % CI 0.96 to 1.15), symptomatic intracranial hemorrhage (RR = 0.52, 95 % CI = 0.19 to 1.43), all-cause mortality (RR 1.10, 95 % CI 0.64 to 1.91) and severe adverse events (RR = 0.92, 95 % CI = 0.75 to 1.13).</div></div><div><h3>Conclusion</h3><div>This meta-analysis found no statistically significant differences between rhPro-UK and alteplase in terms of functional outcomes, early neurological improvement, or safety profiles in patients with acute ischemic stroke. rhPro-UK shows promise as a cost-effective alternative, but further large-scale RCTs are required to confirm its role in AIS management.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 8","pages":"Article 108392"},"PeriodicalIF":2.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144579398","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":"Dystypia following left lenticulostriate artery cerebral infarction: A case report with MR Tractography and SPECT analysis","authors":"Ryohei Yasugi ,&nbsp;Takakuni Maki ,&nbsp;Atsushi Shima ,&nbsp;Akihiro Shimotake ,&nbsp;Kaede Tanaka ,&nbsp;Keita Ueda ,&nbsp;Toshiya Murai ,&nbsp;Nobukatsu Sawamoto ,&nbsp;Akio Ikeda ,&nbsp;Ryosuke Takahashi ,&nbsp;Riki Matsumoto","doi":"10.1016/j.jstrokecerebrovasdis.2025.108389","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108389","url":null,"abstract":"<div><h3>Objectives</h3><div>To report a rare case of dystypia—a selective typing impairment—following a subcortical infarction, and to explore its neural correlates using clinical and imaging data.</div></div><div><h3>Case Presentation</h3><div>A 65-year-old right-handed man with proficient typing ability developed sudden difficulty typing during a web conference. He showed intact language comprehension, naming, and motor function, but exhibited romanization errors and touch-typing difficulties without agraphia, apraxia, or aphasia, while the Frontal Assessment Battery revealed impaired verbal fluency.</div></div><div><h3>Imaging Findings</h3><div>MRI revealed an acute infarct in the left putamen and corona radiata. Diffusion-weighted imaging with tractography showed partial involvement of the fronto-striatal tract connecting the putamen to the supplementary motor area. SPECT demonstrated hypoperfusion in the left frontal and parietal cortices.</div></div><div><h3>Conclusion</h3><div>This case suggests that disruption of the fronto-striatal tract may impair typing ability, even in the absence of classical language deficits. Subcortical lesions can cause highly selective cognitive-motor dysfunctions, and combined clinical and imaging approaches are key to understanding such atypical post-stroke presentations.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 8","pages":"Article 108389"},"PeriodicalIF":2.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577595","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":"Closing the gap: Early experience from a new Endovascular Thrombectomy service in regional and rural North Queensland, Australia","authors":"Muhammad Usman Manzoor ,&nbsp;Abdul Shaik ,&nbsp;Awais Farid ,&nbsp;Ramon Luis Navarro Balbuena ,&nbsp;Ravindra Urkude ,&nbsp;Yasir Khattak ,&nbsp;Nerida Myers ,&nbsp;Lori Mackay ,&nbsp;Firas Alnidawi ,&nbsp;Rufus Corkill","doi":"10.1016/j.jstrokecerebrovasdis.2025.108390","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108390","url":null,"abstract":"<div><h3>Background</h3><div>Endovascular clot retrieval is the standard of care for acute ischemic stroke caused by large vessel occlusion. However, access to mechanical thrombectomy remains limited in rural and regional areas, where patients often require transfer to urban centres. These delays are directly associated with poorer clinical outcomes. To address this disparity, a mechanical thrombectomy service was established at a regional tertiary hospital in North Queensland, Australia. This study aims to evaluate the safety and clinical outcomes of mechanical thrombectomy in a regional setting.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on all consecutive patients who underwent mechanical thrombectomy at Townsville University Hospital (TUH), Queensland, Australia, between March 2022 and February 2024. Patients were categorized into two groups—local (TUH) and interhospital transfer—based on their initial presentation. Clinical outcomes, procedural success, and complications were assessed.</div></div><div><h3>Results</h3><div>A total of 120 patients (mean age: 71 years; 51 % male) underwent mechanical thrombectomy. Of these, 48 (40 %) presented locally, while 72 (60 %) were interhospital transfers. A good functional outcome (mRS 0–2 at 90 days) was achieved in 56 patients (47 %). Procedural success (mTICI score 2b–3) was observed in 106 patients (88 %), while 14 patients (12 %) experienced procedure-related complications.</div></div><div><h3>Conclusion</h3><div>The establishment of a mechanical thrombectomy service at TUH has significantly improved access to stroke intervention for regional and rural populations in North Queensland. Our early experience demonstrates clinical outcomes comparable to those reported in large multicentre thrombectomy trials, confirming the feasibility and safety of delivering this service in a regional setting.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 9","pages":"Article 108390"},"PeriodicalIF":2.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577594","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":"More than half of patients with wake-up stroke have slept through their stroke onset","authors":"Lynette Andreasyan,&nbsp;Jeffrey L. Saver","doi":"10.1016/j.jstrokecerebrovasdis.2025.108388","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108388","url":null,"abstract":"<div><h3>Background</h3><div>Conventional time-from-onset decision-making for use of reperfusion therapies in acute ischemic stroke is challenged by patients with wake-up strokes (WUS) in whom onset time is uncertain. Management of these patients, including use of advanced imaging to make “tissue-clock” rather than “time-clock” treatment decisions, and development of wearable technologies to detect stroke onset during sleep, would be aided by delineation of how often WUS patients had onset long before or shortly before awakening.</div></div><div><h3>Methods</h3><div>We performed a meta-analysis of studies comparing diffusion weighted imaging–fluid-attenuated inversion recovery (DWI-FLAIR) mismatch frequencies in patients with WUS compared with patients with clear onset time stroke (COS). Differences in FLAIR-DWI mismatch frequency between WUS and COS patients in matched time intervals from first symptom detection were analyzed in a novel manner to derive the timepoints during sleep of stroke onset in WUS patients.</div></div><div><h3>Results</h3><div>Two studies of WUS and COS patients met selection criteria, collectively enrolling 443 patients (201 WUS, 242 COS). For COS patients, mismatch frequency declined gradually as time from first symptom detection increased: &lt;2 h 60 %; 2-3 h 53 %; 3-4 h 41 %; 4-5 h 37 %; 5-6 h 11 %. In contrast, for WUS patients, &lt;2 h patients had similar mismatch rates to &lt;2 h COS patients but mismatch then declined precipitously in all later time windows: &lt;2 h 50 %; 2-3h13 %; 3-4 h 13 %; 4-5 h 6 %; 5-6 h 12 %. The lower mismatch rate indicated that 56.5 % of WUS patients had stroke onset long (2-8 h) before awakening and 43.5 % had stroke onset shortly (0-2 h) before awakening.</div></div><div><h3>Conclusions</h3><div>A majority of wake-up stroke patients stayed asleep for 2-8 hours after stroke onset, while a minority awoke at the time of or soon after onset. These findings can inform multimodal imaging strategies and wireless stroke detection technology development programs for patients with wake-up stroke.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 8","pages":"Article 108388"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562636","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":"The hidden cost of being uninsured: Stroke mortality after mechanical thrombectomy","authors":"Alexander T. Lyons BS ,&nbsp;Jordan Davis MS ,&nbsp;Anthony E. Bishay BS ,&nbsp;Akshay Bhamidipati MD ,&nbsp;Michael Longo MD ,&nbsp;Seoiyoung Ahn MD ,&nbsp;Gabriel Bendfeldt MD ,&nbsp;Lakshmi Suryateja Gangavarapu BA ,&nbsp;Emma Ye BA ,&nbsp;Nishit Mummareddy MD ,&nbsp;Naveed Kamal MD ,&nbsp;Michael T. Froehler MD, PhD ,&nbsp;Rohan V. Chitale MD ,&nbsp;Matthew R. Fusco MD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108387","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108387","url":null,"abstract":"<div><h3>Introduction</h3><div>The impact of insurance status on mortality and functional outcomes has yet to be examined in Mechanical Thrombectomy (MT) patients, despite research on socioeconomic status.</div></div><div><h3>Objective</h3><div>Herein we describe the effects of insurance status on MT outcomes while controlling for other components of socioeconomic status like race, gender, and area deprivation index (ADI).</div></div><div><h3>Methods</h3><div>We performed a retrospective cohort study of 395 patients undergoing MT at a single comprehensive stroke center between 2018 and 2022. Patients were grouped based on presence of insurance on admission. Univariate and multivariate analysis were conducted examining the following outcome variables: length of stay (LoS), readmission within 90 days, good functional outcomes measured as a modified Rankin score at 90 days&lt;3, and death.</div></div><div><h3>Results</h3><div>A total of 44/395 (11.1 %) patients were uninsured. Uninsured patients were significantly younger on average (59.5 ± 18.2 years compared to 67.1 ± 14.7 years (<em>p</em> = 0.010)) On multivariate analysis, insured status was associated with improved mortality rates (OR: 0.33; 95 % CI: 0.11-0.93; <em>p</em> = 0.035). On univariate analysis, insured status did not have a significant effect on favorable functional outcome (OR:1.15; 95 % CI:0.56-2.34; <em>p</em> = 0.70), LoS (OR:1.23; 95 % CI:0.66-2.32; <em>p</em> = 0.511) or readmission rate (OR:1.66; 95 % CI:0.38-7.31; <em>p</em> = 0.50). Discharge disposition neared significance, with 50 % of insured patients being discharged to a rehabilitation facility, while only 29.3 % of uninsured patients were discharged similarly (<em>p</em> = 0.06).</div></div><div><h3>Conclusion</h3><div>Lack of insurance is associated with increased mortality following MT after controlling for other socioeconomic variables and may be an important marker of outcomes in AIS patients.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 8","pages":"Article 108387"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562637","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":"Genetic liability to depression and cerebral small vessel disease: A mendelian randomization study","authors":"Mengmeng Wang ,&nbsp;Iyas Daghlas ,&nbsp;Ning Wei","doi":"10.1016/j.jstrokecerebrovasdis.2025.108385","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108385","url":null,"abstract":"<div><h3>Background and Purpose</h3><div>To investigate the association of genetic liability to depression with cerebral small vessel disease (cSVD).</div></div><div><h3>Methods</h3><div>Genetic instruments for liability to depression were obtained from a meta-analysis of genome-wide association studies of depression (371,184 cases and 978,703 controls). Mendelian randomization (MR) was used to examine the associations of genetic liability to depression with cSVD clinical outcomes (small vessel stroke [SVS], deep intracerebral hemorrhage [ICH]) and radiographic measures (white matter hyperintensity [WMH] volume, cerebral microbleeds [CMBs], and burden of perivascular spaces [PVS]). The primary analysis was performed using the random-effects inverse-variance weighted method. Sensitivity analyses were conducted to examine the robustness of results to violations of assumptions of MR assumptions.</div></div><div><h3>Results</h3><div>Genetic liability to depression was associated with a higher risk of SVS (odds ratio [OR], 1.36; 95 % confidence interval [CI], 1.14-1.62; <em>P</em> = 5.4 × 10^-4) and deep ICH (OR, 1.82; 95 % CI, 1.14–2.89; <em>P</em> = 0.012). Consistent with this finding, genetic liability to depression was associated with higher WMH volume (β, 0.09; 95 % CI, 0.02–0.16; <em>P</em> = 0.017), but not with CMBs or PVS (<em>P</em> &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>This study supports a potential causal effect of genetic liability to depression on cSVD. Further investigation is warranted to explore mechanisms and therapeutic implications.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 8","pages":"Article 108385"},"PeriodicalIF":2.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144489704","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":"The safety and efficacy of factor XIa inhibitors for the prevention of stroke and thromboembolism: A systematic review and meta-analysis of randomized controlled trials","authors":"Nayab Zahid ,&nbsp;Fatima Iqbal ,&nbsp;Amber Siddique ,&nbsp;Anushah Nadeem ,&nbsp;Waqar Hussain ,&nbsp;Amna Ishaq ,&nbsp;Mansoor Ahmed ,&nbsp;Nauman Lal ,&nbsp;Saad Abdullah ,&nbsp;Humyoun Yousaf ,&nbsp;Uzair Jafar ,&nbsp;Muhammad Ayyan ,&nbsp;Muzammil Farhan ,&nbsp;Muhammad Ameen Noushad ,&nbsp;Raheel Ahmed","doi":"10.1016/j.jstrokecerebrovasdis.2025.108381","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108381","url":null,"abstract":"<div><h3>Background</h3><div>Stroke and thromboembolism remain the leading causes of mortality worldwide. Factor Xia inhibitors (FXIa) might prevent thromboembolism without interfering with hemostasis, thus leading to a lower risk of bleeding than direct oral anticoagulants (DOACs).</div></div><div><h3>Methods</h3><div>We conducted a systematic search using PubMed, Embase, and Clinicaltrials.gov to retrieve randomized controlled trials comparing FXIa inhibitors to placebo or DOACs in patients at risk of stroke or thromboembolism. All statistical analyses were carried out using RevMan 5.4, using a random effects model.</div></div><div><h3>Results</h3><div>Our meta-analysis included 14 RCTs involving 30,952 patients. FXIa inhibitors significantly decreased the risk of major bleeding (RR 0.47, 95% CI: 0.33-0.66, I²= 46%) with no significant change in systemic embolism or thromboembolism (RR 0.83, 95% CI: 0.64-1.07, I²= 70%). There was no significant change between the two groups when assessing the rate of all bleeding events (RR 0.78, 95% CI: 0.55-1.11, I²= 73%), all-cause mortality (RR 0.87, 95% CI: 0.70-1.09, I²= 0%), ischemic stroke (RR 0.99, 95%CI: 0.49-1.98, I²= 86%), myocardial infarction (RR 1.30; 95% CI, 0.54 – 3.13; I² = 68%), and intracranial hemorrhage (RR 0.49, 95% CI: 0.23- 1.05, I²= 9%). The rate of all adverse events (RR 1.05, 95% CI: 0.86-1.29, I²= 79%) and serious adverse events (RR 1.16, 95% CI: 0.86-1.55, I²= 74%) remained comparable between the two groups.</div></div><div><h3>Conclusion</h3><div>In conclusion, FXIa inhibitors show promise as safer anticoagulant agents, demonstrating favorable bleeding outcomes without changing thromboembolism, mortality, or other safety outcomes. The presence of heterogeneity across various subgroups warrants data from further high-quality, large-scale RCTs to establish evidence of its clinical benefit. This is especially important in atrial fibrillation, where conflicting evidence regarding thromboembolism warrants cautious interpretation and further investigation.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 8","pages":"Article 108381"},"PeriodicalIF":2.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340797","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":"Tryptophan metabolites as biomarkers to predict the severity and prognosis of acute ischemic stroke patients","authors":"Chuzheng Pan ,&nbsp;Feng Chen ,&nbsp;Yan Yan ,&nbsp;Haiwen Li ,&nbsp;Chengfeng Qiu","doi":"10.1016/j.jstrokecerebrovasdis.2025.108382","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108382","url":null,"abstract":"<div><h3>Objective</h3><div>Ischemic stroke is among the leading causes of mortality and long-term disability worldwide. A growing body of evidence indicates alterations in metabolite levels and enzyme activities associated with the conversion of tryptophan (TRP) throughout the course of cerebral ischemia. In this study we aim to explore the potential relationship between TRP metabolism and clinical prognosis in acute ischemic stroke (AIS) patients of mainland China.</div></div><div><h3>Materials and methods</h3><div>Blood samples were obtained from a cohort of 304 patients diagnosed with AIS. The concentrations of ten TRP metabolites were quantified utilizing liquid chromatography-tandem mass spectrometry (LC-MS/MS). Stroke severity was evaluated upon admission using the National Institutes of Health Stroke Scale (NIHSS). A poor functional outcome was defined as a modified Rankin scale (mRS) &gt; 3, whereas a good functional outcome was defined by mRS ≤ 3 at 3 months post-stroke. LASSO regression and random forest algorithms were then employed to identify key TRP metabolism parameters associated with prognosis.</div></div><div><h3>Results</h3><div>Following the optimization of variable selection through Lasso regression, a prognostic risk model with 7-factors related to AIS was constructed, yielding an AUC of 0.917. Subsequently, a random forest analysis was conducted to establish an 11-factor prognostic risk model, which demonstrated an enhanced AUC of 1.000. Ultimately, three robust parameters related to TRP metabolism were identified. Multivariable logistic regression analysis, adjusted for covariates, revealed that TRP (odds ratio .[OR] = 0.46, 95 % confidence interval .[CI]: 0.26 - 0.76, <em>p</em> = 0.004), the kynurenine (KYN)/TRP ratio (OR = 2.06, 95 % CI: 1.23 - 3.60, <em>p</em> = 0.008), and the kynurenic acid (KYNA)/TRP ratio (OR = 2.15, 95 % CI: 1.23 - 4.12, <em>p</em> = 0.014) were independently associated with poor functional prognosis.</div></div><div><h3>Conclusions</h3><div>The results of this study indicate that TRP metabolism is associated with the severity and prognosis of AIS. The TRP, KYN/TRP ratio and KYNA/TRP ratio may serve as potential biomarkers for 3-month prognostic evaluation.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 8","pages":"Article 108382"},"PeriodicalIF":2.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481637","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":"Association between anti-Ro52 antibodies and cerebral small vessel disease with neurological functional outcomes in acute ischemic stroke patients","authors":"Ruojun Wang MD ,&nbsp;Kai Wang MD ,&nbsp;Xue Yang MD ,&nbsp;Shengyi Zhang MD ,&nbsp;Zeqin Ren MD ,&nbsp;Guangxia Yang MD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108383","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108383","url":null,"abstract":"<div><h3>Objective</h3><div>This study investigated the association between anti-Ro52 antibodies, cerebral small vessel disease (CSVD) burden, and neurological outcomes in acute ischemic stroke (AIS) patients.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study of 127 AIS patients admitted between June 2017 and June 2024. CSVD burden was quantified using a composite score (range: 0-3) based on three neuroimaging markers. Severe CSVD was defined as a score &gt;1. Neurological function was evaluated using the modified Rankin Scale (mRS), where a score &gt;2 at admission and 3 months post-stroke indicated poor outcomes. After propensity score matching, 38 anti-Ro52-positive patients were compared with 38 anti-Ro52-negative controls. Multivariate logistic regression analyses were performed to assess independent associations.</div></div><div><h3>Results</h3><div>Multivariate analysis revealed that anti-Ro52 positivity, advanced age, and hypertension were independently associated with severe CSVD burden (all <em>p</em> &lt; 0.05). Furthermore, anti-Ro52 positivity, higher NIHSS scores, and severe CSVD burden were independently correlated with poor neurological function at admission and 3 months post-stroke (all <em>p</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Our findings demonstrate that anti-Ro52 antibodies are independently associated with severe CSVD burden in AIS patients. Moreover, both anti-Ro52 positivity and CSVD burden are significantly associated with worse neurological outcomes. Our study suggests that anti-Ro52 antibodies may influence stroke severity through the development and progression of CSVD.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 8","pages":"Article 108383"},"PeriodicalIF":2.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144470444","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":"Association between secondhand smoke exposure, maternal smoking during pregnancy, and stroke incidence in nonsmokers","authors":"Yi-Ping Huang ,&nbsp;Wei-Dong Fan ,&nbsp;Ying Feng ,&nbsp;Daniel Nyarko Hukportie ,&nbsp;Cui-Yi Jin ,&nbsp;Fu-Rong Li","doi":"10.1016/j.jstrokecerebrovasdis.2025.108379","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108379","url":null,"abstract":"<div><h3>Background</h3><div>To evaluate the independent and combined associations of secondhand smoke (SHS) exposure and maternal smoking during pregnancy with the risk of total stroke and its subtypes, including ischemic and hemorrhagic stroke, among nonsmokers.</div></div><div><h3>Objectives</h3><div>To investigate the independent and combined associations of SHS exposure and maternal smoking during pregnancy with stroke risk in nonsmokers.</div></div><div><h3>Methods</h3><div>A prospective analysis was conducted using 336,640 nonsmoking participants from a nationwide cohort, free from pre-existing cardiovascular disease. SHS exposure was categorized based on hours per week (0, &gt;0–4, &gt;4), and maternal smoking was assessed via participant recall. Outcomes included total stroke, ischemic stroke, and hemorrhagic stroke, identified through hospital records. Cox regression models adjusted for demographic, behavioral, and clinical covariates were used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs).</div></div><div><h3>Results</h3><div>Over a median follow-up of 11.8 years, 5,051 participants experienced strokes. SHS exposure &gt;4 hours/week was associated with increased incident stroke risk (HR 1.34, 95 % CI 1.18–1.52) compared to no exposure. Maternal smoking was associated with a 7 % increase in total stroke risk (HR 1.07, 95 % CI 1.02–1.14). Combined exposure to SHS &gt;4 hours/week and maternal smoking conferred the highest stroke risk (HR 1.57, 95 % CI 1.29–1.90). Subgroup and sensitivity analyses confirmed these findings.</div></div><div><h3>Conclusions</h3><div>SHS exposure and maternal smoking was independently and jointly associated with higher stroke risk, underscoring the need for robust tobacco control policies to mitigate these exposures and their public health impact.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 8","pages":"Article 108379"},"PeriodicalIF":2.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328461","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}