Journal of Stroke & Cerebrovascular Diseases最新文献

{"title":"Letter to the editor regarding “Causal association of inflammation with ischemic stroke and its subtypes: a bidirectional Mendelian randomization study”","authors":"Aidong Li","doi":"10.1016/j.jstrokecerebrovasdis.2025.108309","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108309","url":null,"abstract":"","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 6","pages":"Article 108309"},"PeriodicalIF":2.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820515","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":"High mimic rate among recipients of intravenous thrombolysis for acute minor ischemic stroke presenting with disabling symptoms","authors":"Saira Afzal,&nbsp;Pramit Mukherjee,&nbsp;Metin Bicen,&nbsp;Mark Orlando,&nbsp;Chetna Dengri,&nbsp;Dixie Reinoso,&nbsp;Ahmed Koriesh,&nbsp;Amre Nouh","doi":"10.1016/j.jstrokecerebrovasdis.2025.108298","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108298","url":null,"abstract":"<div><h3>Background</h3><div>Patients with minor acute ischemic stroke, defined as having an NIHSS score of ≤5, and presenting with disabling symptoms are routinely administered intravenous (IV) thrombolytics. Our study aimed to assess the prevalence of stroke mimics among these patients and compare the characteristics between stroke mimics and true strokes in those who received thrombolytic therapy. Additionally, we evaluated the safety of thrombolytic therapy in stroke mimic patients.</div></div><div><h3>Observation</h3><div>This single-center, retrospective study reviewed patients with NIHSS scores of ≤5 and disabling symptoms who received IV thrombolytics for suspected acute ischemic stroke from March 2018 to March 2023. Univariate analysis compared demographics and characteristics between stroke and stroke mimic groups using Chi-square or Fisher's exact test for categorical variables and Wilcoxon's rank-sum test for continuous variables. Among 61 patients identified, 29 % (n = 18) were classified as stroke mimics. There were no significant differences in age, gender, presenting symptoms. Hypertension, hyperlipidemia and diabetes mellitus was more predominant among stroke patients. Although not statistically significant, the rate of adverse events was higher among stroke patients compared to stroke mimics (9 % vs 0 %, p = 0.30). One patient developed symptomatic intracerebral hemorrhage, two patients experienced asymptomatic intracerebral hemorrhage and one patient had gross hematuria while no adverse events were observed in the stroke mimic group. Stroke mimics were more likely to achieve a good functional outcome at discharge (mRS &lt;1) compared to stroke patients (89 % vs 37 %, p = 0.008). The final discharge diagnoses for stroke mimics included migraine(50 %), toxic-metabolic encephalopathy (27 %), seizures (17 %) and somatoform disorders (5 %). None of the stroke mimic patients experienced adverse events post-IV thrombolysis. In contrast, 1 stroke patient (2 %) developed symptomatic intracranial hemorrhage, two patients (4.6 %) had asymptomatic intracranial hemorrhage and one patient(2 %) had minor extracranial bleeding (gross hematuria)</div></div><div><h3>Conclusions</h3><div>The high percentage of stroke mimics among patients with NIHSS ≤5 despite disabling features suggests a need for improved diagnostic tools to distinguish true strokes from mimics. Importantly, thrombolytic therapy was not associated with significant adverse events in stroke mimic patients, who had a better functional outcome at discharge.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 6","pages":"Article 108298"},"PeriodicalIF":2.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797028","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":"Quantification of patent foramen ovale shunt severity by transesophageal echocardiogram and transcranial doppler in routine clinical practice","authors":"Philip Y. Sun ,&nbsp;Jonathan M. Tobis ,&nbsp;Samuel A. Daneshvar ,&nbsp;Rodel C. Alfonso ,&nbsp;David S. Liebeskind ,&nbsp;Jeffrey L. Saver","doi":"10.1016/j.jstrokecerebrovasdis.2025.108306","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108306","url":null,"abstract":"<div><h3>Background</h3><div>The presence of a large physiologic shunt, defined as &gt;20 left atrial microbubbles within 3 cardiac cycles on transesophageal echocardiography (TEE), is a randomized trial-validated indication for patent foramen ovale (PFO) closure in patients with otherwise cryptogenic ischemic stroke. The frequency with which this information is available to treating physicians from clinical TEE reports has not been well-delineated.</div></div><div><h3>Methods</h3><div>Among consecutive ischemic stroke patients, clinical TEE report shunt size characterizations were abstracted and compared to transcranial Doppler (TCD) formal shunt grades in the same patients and to central Core Lab TEE quantified assessments.</div></div><div><h3>Results</h3><div>Among 77 patients, median age was 64 (IQR 56-73), and 33 (43 %) female. On TEE, shunt presence was assessed by bubble study in 60 (78 %), direct Doppler alone in 5 (7 %), and neither in 12 (16 %). Among bubble study patient, a right-to-left shunt (RLS) potentially due to PFO was present in 25 (42 %). RLS severity was quantified on the clinical report in 4 (16 %) patients and only with informal descriptive terms in 21 (84 %) - “small/mild/trace” (13 cases), “moderate/medium” (6), and “large” (1). In the 19 patients also undergoing TCD, RLS severity was quantified in all clinical reports. Shunt severity agreement between clinical TEE reports and TCD quantification was 100 % (3/3) for formally quantified TEE shunts but poor (3/15, 20 %) for the15 TEE reports using informal descriptions. For presence of a large shunt, an indication for PFO closure, clinical TEE with informal descriptions and TCD were incongruent in 5/15 (33 %) of patients.</div></div><div><h3>Conclusions</h3><div>Quantified, evidence-based ratings of PFO shunt severity were present in &lt;1 of every 6 TEE reports, and unquantified, informal size estimates correlated poorly with TCD quantification of shunt severity. Patient management would be aided by inclusion of formal PFO shunt size quantification in all clinical stroke patient TEE reports.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 6","pages":"Article 108306"},"PeriodicalIF":2.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788967","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":"Risk factors for clazosentan-induced fluid retention in subarachnoid hemorrhage from the Japanese adverse event database","authors":"Rie Ando-Matsuoka ,&nbsp;Kei Kawada ,&nbsp;Takahiro Niimura ,&nbsp;Hitoshi Fukuda ,&nbsp;Tomoaki Ishida ,&nbsp;Toshihiko Yoshioka ,&nbsp;Yu Kawanishi ,&nbsp;Tomohito Kadota ,&nbsp;Shinji Abe ,&nbsp;Fuka Aizawa ,&nbsp;Kenta Yagi ,&nbsp;Yuki Izawa-Ishizawa ,&nbsp;Mitsuhiro Goda ,&nbsp;Tetsuya Ueba ,&nbsp;Keisuke Ishizawa","doi":"10.1016/j.jstrokecerebrovasdis.2025.108296","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108296","url":null,"abstract":"<div><h3>Background</h3><div>Clazosentan, a selective endothelin receptor antagonist, is used to prevent cerebral vasospasm. We investigated patient characteristics and concomitant medications associated with an increased risk of clazosentan-induced fluid retention, the risk factors of which remain unknown.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed cases of clazosentan-induced adverse drug reactions from the Japanese Adverse Drug Event Report (JADER) database, published by the Pharmaceuticals and Medical Devices Agency. We investigated the time course of fluid retention onset following clazosentan administration before analyzing whether specific patient characteristics and concomitant medications were associated with an increased risk of clazosentan-induced fluid retention.</div></div><div><h3>Results</h3><div>Among 241 cases of clazosentan use identified, fluid retention occurred in 114 (47.3 %). The median time interval from clazosentan initiation to onset of fluid retention was 3 days, and 88.7 % of fluid retention cases were reported within 1 week of initiation. Patients with fluid retention were older than those without; patients &gt;70 years old accounted for 63.16 % of the cohort with fluid retention vs 44.1 % of the cohort without fluid retention. Fluid retention occurred more frequently in patients with concomitant use of fasudil hydrochloride, a conventional vasospasm drug in Japan, than in those without. Multivariate logistic regression analysis revealed that older age (&gt;70 years) and concomitant use of fasudil hydrochloride remained independent risk factors for fluid retention.</div></div><div><h3>Conclusions</h3><div>Clazosentan-induced fluid retention occurred more frequently in older adult patients. Clazosentan combined with fasudil hydrochloride increased the incidence of fluid retention. These findings can guide pharmacological treatment of cerebral vasospasm in patients with subarachnoid hemorrhage.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 6","pages":"Article 108296"},"PeriodicalIF":2.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143760014","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 changes in inflammation-related proteins in the cerebrospinal fluid and plasma of patients with aneurysmal subarachnoid hemorrhage","authors":"David J. Braun PhD ,&nbsp;Kevin W. Hatton MD, PhD, FCCM ,&nbsp;Justin F. Fraser MD ,&nbsp;Robert M. Flight PhD ,&nbsp;Hunter N.B. Moseley PhD ,&nbsp;Caleb S. Bailey PhD ,&nbsp;Josh M. Morganti PhD ,&nbsp;Bingqing Zhang PhD ,&nbsp;Ishara S. Ariyapala PhD ,&nbsp;Tae K. Kim PhD ,&nbsp;Linda J. Van Eldik PhD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108304","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108304","url":null,"abstract":"<div><h3>Background</h3><div>Aneurysmal subarachnoid hemorrhage (aSAH) is a relatively uncommon but high mortality form of stroke that can result in long-lasting disability. A better understanding of key neuroinflammatory changes during the early phase (&lt;72 h) may provide potential avenues of treatment.</div></div><div><h3>Methods</h3><div>In an attempt to understand these early changes, we recruited 7 aSAH patients for profiling of longitudinal plasma and cerebrospinal fluid (CSF) proteins at up to 72 h post injury. We additionally compared this to control plasma obtained previously from healthy elderly volunteers. Using the Alamar Biosciences NULISAseq platform, we obtained a comprehensive picture of early peripheral and central inflammatory changes after injury.</div></div><div><h3>Results</h3><div>This study demonstrated very early plasma changes across 107 inflammatory proteins, 22 of which showed significant correlations between plasma and CSF. Of these, CXCL12, IL-15, and SAA1 are detectably elevated &lt;24 h in plasma, significantly correlated with CSF levels, and altered as a function of aSAH progression over time during this early phase.</div></div><div><h3>Conclusion</h3><div>This study demonstrates the feasibility of measuring a large number of inflammatory proteins in CSF and plasma from aSAH patients soon after injury. Despite the small sample size and limitations of the control group, we identified several previously reported “hits” that may offer prognostic utility and/or therapeutic potential for aSAH patients: CXCL12, IL-15, and SAA1.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 6","pages":"Article 108304"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781938","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":"Neuroimaging biomarkers on routine Computed Tomography (CT) after acute stroke and their association with post-stroke delirium: A cohort study","authors":"Amanda Barugh MBChB PhD ,&nbsp;Andrew Farrall PhD ,&nbsp;Karen Ferguson BSc PhD ,&nbsp;Susan Shenkin MBChB MD ,&nbsp;Alasdair MacLullich MBChB PhD ,&nbsp;Gillian Mead MB BChir MA FRCP FRSE FMedSci","doi":"10.1016/j.jstrokecerebrovasdis.2025.108302","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108302","url":null,"abstract":"<div><h3>Background</h3><div>Delirium affects a quarter of patients after acute stroke and predicts poorer outcomes. The aim of this pragmatic study was to determine whether either qualitative assessment or quantitative assessments of the regional atrophy obtained from routinely performed computed tomography (CT) brain imaging could identify patients most at risk of developing delirium.</div></div><div><h3>Methods</h3><div>We recruited 95 patients with acute stroke (age ≥60) (ischaemic or intracerebral haemorrhage) over one year. Follow-up for delirium and cognition was performed at 1, 3, 5, 7, 14, 21, 28 days, 4 months and 12 months. All participants underwent routine CT brain (Toshiba 64-slice or 128-slice scanner) (within 24 h of stroke onset). White matter lesions and atrophy were rated qualitatively (mild, moderate, severe). Atrophy in multiple specific areas was measured quantitatively.</div></div><div><h3>Results</h3><div>Twenty-six (27 %) developed delirium during the 12 months of follow-up. On univariable analysis, delirium was associated with increasing age, being female, less independent in pre-stroke activities of daily living, pre-existing cognitive impairment, increasing stroke severity, having had a total anterior circulation stroke and global cerebral atrophy on brain CT. Multivariable analysis demonstrated that only global cerebral atrophy, being female and having a more severe stroke predicted delirium. This model accounted for between 38 % and 55 % of the variance in delirium.</div><div>For quantitative CT analysis, on univariable analysis, delirium was associated with atrophy in several specific brain areas. On multivariable analysis, only NIHSS (for every one point increase OR 1.23, 95 % CI 1.06–1.43; <em>p</em> = 0.006)) and cistern ambiens ratio (OR 1.41, 95 % CI 1.48–4.96; <em>p</em> = 0.028) were significantly associated. This model accounted for between 35.1 % and 51.2 % of delirium variance.</div></div><div><h3>Conclusion</h3><div>Clinical variables together with either qualitative atrophy assessment or cistern ambiens ratio on routine CT brain could identify stroke patients most at risk of delirium and to stratify patients in clinical trials of delirium prevention and treatment.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 6","pages":"Article 108302"},"PeriodicalIF":2.0,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765902","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":"Analysis and comparison of trends in the burden of subarachnoid hemorrhage in china and globally, 1990–2021","authors":"Zhihua Cheng ,&nbsp;Liang Wang ,&nbsp;Xiang Wang,&nbsp;Jialong Xuan,&nbsp;Bin Xu,&nbsp;Longfei You","doi":"10.1016/j.jstrokecerebrovasdis.2025.108303","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108303","url":null,"abstract":"<div><h3>Background</h3><div>Subarachnoid hemorrhage (SAH), the rarest form of hemorrhagic stroke, is associated with high mortality and disability rates. Therefore, it is a major public health concern.</div></div><div><h3>Methods</h3><div>This study reviewed the epidemiological characteristics of SAH in China and worldwide, focusing on the 2021 Global Burden of Disease (GBD) database. Researchers, using the GBD database, conducted epidemiological studies that included joinpoint regression analyses covering the incidence, mortality, prevalence, and disability-adjusted life years of SAH in the years 1990-2021. This analysis revealed the trends and effects of SAH in China and globally.</div></div><div><h3>Results</h3><div>From 1990 to 2021, the age-standardized incidence rate (ASIR) in China decreased from 17.96 to 7.81 per 100,000 people. The age-standardized mortality rate (ASMR) decreased from 27.29 to 4.72 per 100,000 people. This resulted in a 51.58 % reduction in mortality. In contrast, both the ASIR and ASMR showed a slower decline at the global level. China has reported that women aged 70 years and older are at a high risk for SAH. Furthermore, middle-aged men have high prevalence and mortality rates.</div></div><div><h3>Conclusions</h3><div>The current observations warrant the design of focused interventions for both the elderly and female patients with oblique stroke. They can be useful for addressing the SAH burden globally. This study provides valuable information regarding the effectiveness of existing healthcare interventions. This information can also inform future strategies for the prevention and management of SAH.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 6","pages":"Article 108303"},"PeriodicalIF":2.0,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143740058","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":"Melatonin attenuates brain edema via the PI3K/Akt/Nrf2 pathway in rats with cerebral ischemia-reperfusion injury","authors":"Yang Liu ,&nbsp;Xin Wang ,&nbsp;Zhen Li ,&nbsp;Xiaotian Gao ,&nbsp;Xiaoli Wu ,&nbsp;Jiayang Pi ,&nbsp;Xizhen Wang ,&nbsp;Qi Wang ,&nbsp;Fenghua Zhou ,&nbsp;Xiaoli Wang","doi":"10.1016/j.jstrokecerebrovasdis.2025.108299","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108299","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to explore the neuroprotective effects of Melatonin (Mel) administration on cerebral ischemia-reperfusion injury (CIRI) and elucidate its underlying mechanism <em>in vivo</em> to provide a theoretical foundation for the clinical application of Mel.</div></div><div><h3>Materials and methods</h3><div>CIRI models were established in male adult Sprague Dawley rats by middle cerebral artery occlusion (MCAO) for 2 h. Water content of brain tissue was assessed using both dry/wet weight method and T2-weighted Imaging (T2WI). The infarct volume of the brain was measured by 2,3,5-triphenyltetrazolium chloride (TTC) staining. Cell morphology changes and brain damage were detected through hematoxylin &amp; eosin (H&amp;E) staining and NeuN immunofluorescence staining. The integrity of blood-brain barrier (BBB) was examined using transmission electron microscopy (TEM). The expression of aquaporin 4 (AQP4) protein was quantified through western blots analysis and immunofluorescence staining. The expression of p-PI3K, p-AKT and Nrf2 proteins were detected by immunohistochemistry staining and western blots analysis.</div></div><div><h3>Results</h3><div>Compared with the CIRI group, Mel administration significantly reduced the infarct volume and ameliorated the morphology alterations, accompanied by an increase in the number of neurons. The water content of brain tissue decreased significantly, and the value of relative average diffusion coefficient (rADC) of injured brain increased in the CIRI + Mel group as compared with the CIRI group. Compared with the CIRI group, Mel administration improved the damage to the tight junctions of endothelial cells in the cerebral cortex. The expression of AQP4 protein decreased, and that of p-PI3K, p-AKT and Nrf2 proteins increased in the CIRI + Mel group compared with the CIRI group. After administration of p-PI3K inhibitor LY294002, the expression of AQP4 was upregulated, and that of the p-PI3K, p-AKT and Nrf2 proteins decreased compared with the CIRI + Mel group.</div></div><div><h3>Conclusions</h3><div>Mel administration exerts neuroprotective effects against CIRI by mitigating brain edema through upregulating the PI3K/AKT/Nrf2 signaling pathway, and then attenuating brain damage in CIRI rats.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 6","pages":"Article 108299"},"PeriodicalIF":2.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755712","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":"Changes in fatigue after first-ever ischemic stroke and their associations with changes in physical fitness, body composition, and physical activity","authors":"Petra Larsson MSc ,&nbsp;Elisabeth Edvardsen PhD ,&nbsp;Caryl L Gay PhD ,&nbsp;Marie Ursin PhD ,&nbsp;Hege Ihle-Hansen PhD ,&nbsp;Prof. Milada Hagen ,&nbsp;Prof. Anners Lerdal","doi":"10.1016/j.jstrokecerebrovasdis.2025.108297","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108297","url":null,"abstract":"<div><h3>Objectives</h3><div>The objectives of the present study were 1) to describe changes in fatigue from 3 to 12 months post-stroke and compare different patterns of fatigue changes with respect to concurrent changes in physical fitness, body composition, and activity levels, and 2) to explore whether changes in fatigue are associated with changes in physical fitness, body composition, and physical activity levels in patients recovering from first-ever ischemic stroke.</div></div><div><h3>Materials and methods</h3><div>In this longitudinal observational study, we assessed 72 patients (mean age 62 years, 36 % females) at 3 and 12 months after first-ever ischemic stroke. Fatigue was measured with the 7-item Fatigue Severity Scale. Physical fitness, body composition and physical activity were assessed using cardiopulmonary exercise testing, physical function tests, Dual-energy X-ray Absorptiometry, and accelerometers.</div></div><div><h3>Results</h3><div>Fatigue levels was stable between 3 and 12 months post-stroke in 44 (61 %) patients, decreased in 14 (19 %), and increased in another 14 (19 %). Patients with increased fatigue levels showed a greater decrease in cardiorespiratory fitness, as measured directly by peak oxygen uptake, compared to those with decreased fatigue. Robust regression analysis, adjusted for age and sex, indicated that each kilogram of lean body mass gained from 3 to 12 months post-stroke was significantly associated with a 0.3-point reduction in fatigue during the same timeframe (<em>B</em>= -0.32; 95 %CI [-0.51, -0.12]).</div></div><div><h3>Conclusion</h3><div>There was considerable individual variation in changes to fatigue, physical fitness, body composition, and physical activity levels between 3 and 12 months following a first-ever ischemic stroke. Increased fatigue was linked to a greater concurrent decline in cardiorespiratory fitness, while lean body mass was associated with decreases in fatigue.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 6","pages":"Article 108297"},"PeriodicalIF":2.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755940","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":"Circulating Mucosal-associated Invariant T Cells Predict Early Neurological Deterioration in Acute Ischemic Stroke","authors":"Ruihua Liu ,&nbsp;Lulu Pei ,&nbsp;Jiacheng Liu ,&nbsp;Liang Peng ,&nbsp;Cairu Guo ,&nbsp;Yan Li ,&nbsp;Zhihui Duan ,&nbsp;Yanjiao Du ,&nbsp;Dandan Shang ,&nbsp;Shao Li ,&nbsp;Yunting Zhang ,&nbsp;Bo Song","doi":"10.1016/j.jstrokecerebrovasdis.2025.108301","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108301","url":null,"abstract":"<div><h3>Background</h3><div>Mucosal-associated invariant T (MAIT) cells are innate-like T cells that rapidly produce cytokines such as tumor necrosis factor-α (TNF-α) and interleukin-17 (IL-17) upon activation. The immune response is crucial in stroke-related injury. However, few studies have investigated the role of MAIT cells in ischemic brain injury. This study assessed the predictive value of circulating MAIT cells in acute ischemic stroke (AIS) and early neurological deterioration (END).</div></div><div><h3>Methods</h3><div>We prospectively and continuously enrolled AIS patients within 72 h of stroke onset and included controls. END was defined as a ≥2-point increase in the National Institutes of Health Stroke Scale score within the first 72 h. Receiver operating characteristic curves were used to evaluate the predictive value of MAIT cells for END.</div></div><div><h3>Results</h3><div>This study included 188 AIS patients and 135 controls, with 50 (26.6%) AIS patients experiencing END. After adjusting for all potential confounders, circulating MAIT cell frequencies were lower in AIS patients than in controls (odds ratio [OR]: 0.83, 95% confidence interval [CI]: 0.70–0.97, P = 0.02). IL-17 and TNF-α levels were significantly higher in AIS patients and negatively correlated with MAIT cell frequencies (R = −0.26, P &lt; 0.05; R = −0.19, P &lt; 0.05). Multivariate logistic regression analysis revealed that MAIT cell frequencies were lower in patients with END compared to those without END (OR: 0.74, 95% CI: 0.55–0.96, P = 0.03). The area under the curve for MAIT cells in END prediction was 0.641 (95% CI: 0.548–0.725, P &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>MAIT cell frequency was reduced in AIS patients and may serve as a predictive marker for END. Modulating these cells could be a novel AIS treatment strategy.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 6","pages":"Article 108301"},"PeriodicalIF":2.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744437","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}