Journal of Stroke & Cerebrovascular Diseases最新文献

{"title":"Synergistic impacts of physical activity and sleep on risk of dementia and all-cause mortality in chinese older stroke survivors","authors":"Jiawen Wei,&nbsp;Yan Shen","doi":"10.1016/j.jstrokecerebrovasdis.2026.108547","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108547","url":null,"abstract":"<div><h3>Background</h3><div>Physical activity (PA) and sleep reduce the risk of dementia and mortality, but evidence among older stroke survivors in China is limited.</div></div><div><h3>Objective</h3><div>To investigate the impact of PA on dementia and all-cause mortality risks in this population and analyze its joint effect with sleep.</div></div><div><h3>Methods</h3><div>Utilizing data from the CLHLS, we analyzed the correlation of PA with dementia and mortality in elderly stroke survivors and explored the mediating role of dementia in the PA–mortality relationship. Joint variables of PA and sleep were constructed to assess their combined effects on dementia and mortality.</div></div><div><h3>Results</h3><div>Older stroke survivors engaging in regular PA had a 38% reduced risk of dementia (OR=0.62, 95% CI: 0.56-0.69, <em>P</em>&lt;0.001) and a 44% lower risk of mortality (HR=0.56, 95% CI: 0.52-0.59, <em>P</em>&lt;0.001). Additional protective factors against dementia included pet ownership, social activity, and reading, whereas television viewing and radio listening were linked to an increased risk of dementia. Raising domestic animals/pets, participating in outdoor activities, and performing housework were associated with a lower mortality risk (<em>P</em>&lt;0.05). Dementia mediated 5.9% of PA–mortality risk relationship. The joint analysis highlighted that coupling regular PA with sleep exceeding 9 h was associated with a 42% decrease in dementia risk, whereas pairing it with 9 h or less of sleep yielded a 60% decrease in mortality risk.</div></div><div><h3>Conclusion</h3><div>For elderly stroke survivors, PA confers protective effects against both dementia and all-cause mortality. This association is partially mediated by the reduced risk of dementia. Furthermore, the beneficial impact of regular PA on these outcomes is moderated by sleep duration, underscoring the necessity of a joint consideration of both factors in prognostic assessments.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 3","pages":"Article 108547"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021124","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":"Methodological contextualization and interpretation of early gastrostomy timing in nontraumatic intracerebral hemorrhage","authors":"Andrea Loggini MD MPH MBA ,&nbsp;Victor J. Del Brutto MD ,&nbsp;Faddi G. Saleh Velez MD ,&nbsp;Jonatan Hornik MD ,&nbsp;Awni D. Shahait MD ,&nbsp;Denise Battaglini MD PhD ,&nbsp;Shawn S. Wallery MD ,&nbsp;Alejandro Hornik MD ,&nbsp;Christos Lazaridis MD ,&nbsp;Adnan I. Qureshi MD","doi":"10.1016/j.jstrokecerebrovasdis.2026.108558","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108558","url":null,"abstract":"","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 3","pages":"Article 108558"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981132","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":"Spatial and spatiotemporal pattern of stroke relative risk in Ghana using Bayesian modelling approach","authors":"Abdul-Karim Iddrisu ,&nbsp;Sampson Appiah Takyi ,&nbsp;Joyseline Owusu Afriyie ,&nbsp;Abubakar Siddick","doi":"10.1016/j.jstrokecerebrovasdis.2026.108567","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108567","url":null,"abstract":"<div><h3>Introduction</h3><div>Stroke ranks as the second-leading cause of death and third in combined death and disability globally. In Ghana, there is a significant incidence of stroke, yet systematic reviews highlight a lack of comprehensive data on stroke in Sub-Saharan Africa, including Ghana. Additionally, information on the spatial and spatiotemporal distribution of stroke risk across Ghana's 16 regions remains limited. The objective of this study was to study the spatial and spatiotemporal distribution of stroke relative risk, identify regions with high-risk regions and associated predictors.</div></div><div><h3>Material and Methods</h3><div>Stroke risk for each region was estimated using Bayesian spatial and spatiotemporal models, and these risks were mapped to visualize areas with elevated stroke relative risk. The Random Forest and Gradient Boosting models, nonparametric ensemble machine learning algorithms, were used to investigate the effects of potential predictors on stroke risk. The study utilized annual stroke data from 2018 to 2022 obtained from the Ghana Health Service (GHS) via the District Health Information Management System version 2 (DHIMS2) and utilized parameter estimates within the Integrated Nested Laplace Approximation via R software version 4.3.2.</div></div><div><h3>Results</h3><div>Stroke relative risk decreases significantly over the study period. Some regions exhibited elevated risk, where the spatial model identified Volta, Central, Eastern, Bono, Upper East, Bono East, and Oti as high-risk regions, while the spatiotemporal model pinpointed Eastern, Ahafo, Bono East, Upper West, Savannah, Bono, and Western as high-risk regions. Clustering and variability in stroke risk were observed among regions. The study highlighted that gross national income significantly decreases the risk of stroke occurrence. While temperature and diabetes prevalence showed increased stroke risk, they were not statistically significant.</div></div><div><h3>Conclusion</h3><div>This study offers valuable insights that can inform resource allocation to regions experiencing elevated stroke risk. Identified high-risk regions can inform targeted screening strategies, referral pathway strengthening, and resource prioritization. Diagnostic capacity (including CT/MRI access), health-facility reporting quality, and surveillance system upgrades needed to reduce measurement bias and improve case ascertainment. Furthermore, we situate the findings within Ghana’s existing noncommunicable disease (NCD) policy frameworks and describe how routine updates of the model using new DHIMS2 data can support ongoing decision-making.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 3","pages":"Article 108567"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146042220","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":"Outcomes of low-dose versus standard-dose alteplase in acute ischemic stroke patients aged over 80 years: A real-world propensity score-matched study from China","authors":"Chang-sheng Li MD ,&nbsp;Hong-Qiu Gu MD ,&nbsp;Kai-xuan Yang MS ,&nbsp;Zi-mo Chen MD ,&nbsp;Xia Meng MD ,&nbsp;Chun-juan Wang MD ,&nbsp;Zi-xiao Li MD","doi":"10.1016/j.jstrokecerebrovasdis.2026.108548","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108548","url":null,"abstract":"<div><h3>Background</h3><div>Optimal alteplase dosing for intravenous thrombolysis in stroke patients aged &gt;80 years remains debated due to underrepresentation in pivotal trials. This study evaluates the relative effectiveness and safety of low-dose (0.6 mg/kg) versus standard-dose (0.9 mg/kg) alteplase in elderly patients treated within 4.5 hours of onset.</div></div><div><h3>Methods</h3><div>Utilizing the China Stroke Center Alliance registry database (2018-2022), we conducted a propensity score-matched analysis encompassing 6,522 patients over 80 years of age, ultimately generating 2,050 matched pairs. The primary outcome was functional dependence or death at discharge (mRS 2–6). Secondary measures included major disability (mRS 3–6), in-hospital mortality, and symptomatic intracranial hemorrhage (sICH).</div></div><div><h3>Results</h3><div>The primary outcome showed no statistical difference between low-dose (81.6 %) and standard-dose (81.8 %) groups (OR 0.99; 95 % CI 0.84-1.16; P=0.871). Rates of major disability (56.0 % vs. 57.7 %; OR 1.02; P=0.730), mortality (15.6 % vs. 14.4 %; OR 1.10; P=0.294), and sICH (4.4 % vs. 5.2 %; OR 0.85; P=0.274) were broadly alike. Low-dose alteplase showed a numerical decline in bleeding events. Subgroup analysis found no modifying factors.</div></div><div><h3>Conclusions</h3><div>In octogenarian stroke patients, low-dose alteplase offers parallel efficacy and safety to standard therapy, with a possible reduction in hemorrhagic complications. These results support low-dose regimens as a reasonable option for elderly patients, particularly when minimizing bleeding risk is a clinical priority.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 3","pages":"Article 108548"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914651","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":"Quality of life after decompressive surgery for severe cerebral venous thrombosis","authors":"Mayte Sanchez van Kammen MD, PhD ,&nbsp;Sanjit Aaron MD ,&nbsp;Jorge M Ferreira MD ,&nbsp;Patrícia Canhão MD, PhD ,&nbsp;Adriana B. Conforto MD ,&nbsp;Antonio Arauz ,&nbsp;Marta Carvalho MD ,&nbsp;Jaime Masjuan MD ,&nbsp;Vijay K Sharma MD ,&nbsp;Jukka Putaala MD, PhD ,&nbsp;Maarten Uyttenboogaart MD ,&nbsp;Rodrigo Bazan MD ,&nbsp;Bert A Coert MD ,&nbsp;Prabhu Kirubakaran MD ,&nbsp;Pankaj Singh MD ,&nbsp;Diana Aguiar de Sousa MD, PhD ,&nbsp;Jonathan M Coutinho MD, PhD ,&nbsp;José M Ferro MD, PhD ,&nbsp;the DECOMPRESS 2 study group","doi":"10.1016/j.jstrokecerebrovasdis.2026.108549","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108549","url":null,"abstract":"<div><h3>Background</h3><div>Decompressive surgery can be lifesaving in patients with severe cerebral venous thrombosis (CVT) and impending brain herniation. However, data on health-related quality of life (HRQoL) after surgery are limited.</div></div><div><h3>Methods</h3><div>DECOMPRESS-2 was a prospective cohort study including adult patients with CVT from 15 centers in 10 countries who underwent decompressive surgery (2011–2019). HRQoL was assessed using EQ5D-3 L utility scores, subdomains, and a visual analogue scale (VAS) at 6 and 12 months post-surgery. Complete case analysis, multiple imputation, best- and worst-case analyses were performed. Predictors of EQ5D-score (Tobit regression) and VAS (linear regression) at 12 months were analyzed.</div></div><div><h3>Results</h3><div>Of 118 patients, 112 were included (median age 38 years [IQR 27–46], 68% female). At 12-months, EQ5D-3 L and VAS were available for 89% and 90% of survivors, respectively. Median EQ5D-3L-score was 0.70 (IQR 0.52–0.85, mean 0.59 [SD 0.38]) and median VAS was 70 (IQR 56–80, mean 69 [SD 18]). Overall, 84% of patients reported problems in ≥1 subdomain of the EQ5D-3L: 68% with usual activities, 59% pain/discomfort, 58% anxiety/depression, 47% with self-care, 43% with mobility. Higher age and residence in a middle-income country (vs. high-income) predicted poorer EQ5D-3 L and VAS. Preoperative coma predicted worse EQ5D-3 L only.</div></div><div><h3>Conclusions</h3><div>Twelve months after decompressive surgery for CVT, over 4 out of 5 survivors reported problems in at least one subdomain of the EQ5D-3 L. Higher age, middle-income country status and preoperative coma were negative predictors of quality of life.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 3","pages":"Article 108549"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919276","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":"Deep learning architectures for modeling and forecasting stroke cases in Ghana","authors":"Abdul-Karim Iddrisu ,&nbsp;Morongwa Gabanakgosi ,&nbsp;Abubakar Hudu Siddick","doi":"10.1016/j.jstrokecerebrovasdis.2026.108570","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108570","url":null,"abstract":"<div><h3>Introduction</h3><div>Stroke remains a leading cause of global morbidity and mortality, ranking second in deaths and third in disability-adjusted life years (DALYs). Its burden is particularly severe in low- and middle-income countries such as Ghana, where stroke is currently the leading cause of death. However, local data and predictive modeling remain limited, hindering effective health planning and intervention. This study aimed to model and forecast stroke incidence in Ghana using advanced deep learning techniques to support data-driven public health strategies.</div></div><div><h3>Material and Methods</h3><div>Monthly stroke case data from 2018 to 2023 were obtained from Ghana Health Service. Four deep learning models; Long Short-Term Memory (LSTM), Bayesian LSTM (BLSTM), Convolutional LSTM (ConvLSTM), and Bayesian ConvLSTM (BConvLSTM), were employed to capture spatiotemporal patterns in stroke incidence. Diabetes prevalence was included as a covariate. Model performance was evaluated using mean absolute error (MAE), mean square error (MSE), root mean square error (RMSE), and mean absolute percentage error (MAPE). Data analyses were carried out using python version 3.13.7 and R version software.</div></div><div><h3>Results</h3><div>LSTM and BLSTM models showed strong forecasting performance, with LSTM yielding the lowest errors. ConvLSTM and BConvLSTM models underperformed significantly. Forecasts from 2024 to 2028 reveal initial variability in 2024, with monthly cases between 1,694 and 2,007, followed by gradual stabilization through 2028, where values converge between 1,774 and 1,781.</div></div><div><h3>Conclusion</h3><div>The study highlights a persistently high but stabilizing stroke burden in Ghana. It underscores the urgent need for targeted interventions addressing modifiable risk factors, particularly diabetes, and supports LSTM as the most effective model for forecasting in this context.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 3","pages":"Article 108570"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039076","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 monocyte to high-density lipoprotein cholesterol ratio and stroke prevalence in American adults: A cross-sectional NHANES Study","authors":"Jiahui Wang ,&nbsp;Guojiang Zheng ,&nbsp;Jianhua Xu","doi":"10.1016/j.jstrokecerebrovasdis.2026.108580","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108580","url":null,"abstract":"<div><h3>Background</h3><div>The monocyte to high-density lipoprotein ratio (MHR) is a novel biomarker reflecting systemic inflammation and lipid metabolism disturbances, providing insights into the pathophysiological mechanisms of stroke development. While prior research has established a connection between MHR and cardiovascular outcomes, its association with stroke has yet to be conclusively validated in large-scale, population-based cohorts.</div></div><div><h3>Methods</h3><div>Data from the 1999-2018 National Health and Nutrition Examination Survey (NHANES) was used for the analysis. Subgroup analyses evaluated association robustness across demographic strata.The study assessed the link between MHR and stroke prevalence using restricted cubic spline regression (RCS) methods. Adjustments were made for demographic characteristics, lifestyle factors, and clinical confounding variables.Subgroup and sensitivity analyses evaluated the robustness of observed associations.</div></div><div><h3>Results</h3><div>Among the 28,238 participants included in the study, 805 individuals (2.08%) experienced a stroke. A comprehensive logistic regression analysis demonstrated that each standard deviation (SD) increase in MHR was associated with 20% higher odds of stroke (OR = 1.20, 95% CI: 1.08-1.33, <em>P</em> &lt; 0.05). RCS analysis indicated a linear association between MHR and stroke<em>(P</em> &gt; 0.05). Subgroup and sensitivity analyses consistently demonstrated a significant positive association between MHR and stroke. This national, cross-sectional study demonstrated a linear positive correlation between the MHR and stroke, highlighting its potential utility as an indicator. However, the cross-sectional design precludes causal inference, which requires verification by prospective studies.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 3","pages":"Article 108580"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138080","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":"RKIP regulates the ERK/MAPK signaling pathway to improve neuroinflammatory injury in male rats with ischemic stroke","authors":"Rui Mao,&nbsp;Xin Tan,&nbsp;Rong Li,&nbsp;Zhiyong Yang,&nbsp;Hua Liu","doi":"10.1016/j.jstrokecerebrovasdis.2026.108560","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108560","url":null,"abstract":"<div><h3>Background</h3><div>To explore the mechanism by which RAF kinase inhibitory protein (RKIP) alleviates neuroinflammatory damage in male rats with ischemic stroke (IS).</div></div><div><h3>Methods</h3><div>Male rats were subjected to middle cerebral artery occlusion (MCAO) to establish an IS model. Two weeks before MCAO, a single tail-vein injection of lentivirus or an equivalent volume of normal saline was administered to rats. The neurological deficit scores, infarct volume fractions, and pathological changes of the ischemic penumbra were evaluated in the rats. Immunohistochemstry, double-labeled immunofluorescence, ELISA, and Western blot were performed to assess microglial polarization, neuroinflammation and ERK/MAPK-related protein expressions.</div></div><div><h3>Results</h3><div>IS rats exhibited elevated neurological deficit scores and enlarged infarct volume fractions, accompanied by aggravated histopathological damage in the ischemic penumbra. Microglial M1 polarization was enhanced, meanwhile, IL-6 and TNF-α were up-regulated, whereas the anti-inflammatory mediator IL-10 was down-regulated, indicating a pronounced neuroinflammatory response. In particular, Western blot results showed that the ischemic penumbra expression of RKIP in IS rats was markedly lower in IS group than that in Control group. After achieving RKIP overexpression via lentivirus mediation, the polarization direction of microglia in the ischemic penumbra of IS rats shifted toward the M2 phenotype. This was specifically manifested by a significant decrease in the proportion of iNOS⁺/Iba1⁺ double-positive microglia, while the proportion of Arg-1⁺/Iba1⁺ double-positive microglia was significantly increased, and the neuroinflammatory response was alleviated. Moreover, its overexpression significantly reduced the expressions of p-ERK1/2 and p-p38 MAPK in ischemic penumbra. Interestingly, rmEGF-activated ERK elevated the protein levels of p-ERK1/2 and p-p38 MAPK in ischemic penumbra without altering RKIP expression itself. Consequently, the proportion of iNOS⁺/Iba1⁺ double-positive microglia rebounded, while that of Arg-1⁺/Iba1⁺ double-positive microglia decreased . Finally, functional experiments demonstrated that ERK partially reversed the neuroinflammatory protection conferred by RKIP overexpression in IS rats.</div></div><div><h3>Conclusion</h3><div>Overexpression of RKIP may alleviate the neuroinflammatory damage in IS rats by inhibiting ERK/MAPK pathway, thereby improving neurological function.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 3","pages":"Article 108560"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145992973","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":"Comment on “Association between biological aging and stroke and all-cause mortality: A population-based cross-sectional study and Mendelian randomization analysis”","authors":"Pankaj Bansal M.D ,&nbsp;Prashant Ramdas Kokiwar M.D ,&nbsp;A. Kavya M.D ,&nbsp;Archana Dhyani M.D","doi":"10.1016/j.jstrokecerebrovasdis.2025.108534","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108534","url":null,"abstract":"","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 2","pages":"Article 108534"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145812632","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":"A comparative analysis of SCALE-CTP and RAPID in determining the affected brain volumes of patients with ischemic stroke","authors":"Jundong Hwang ,&nbsp;Hyeon Sik Yang ,&nbsp;Gi-Youn Kim ,&nbsp;Regina EY Kim ,&nbsp;Minho Lee ,&nbsp;Donghyeon Kim ,&nbsp;Jin Wook Choi ,&nbsp;Woo Sang Jung ,&nbsp;Kijeong Lee","doi":"10.1016/j.jstrokecerebrovasdis.2025.108517","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108517","url":null,"abstract":"<div><h3>Background</h3><div>Computed tomography perfusion (CTP) is widely used to treat acute strokes. The affected brain volume, measured based on the threshold value in the calculated CTP map, has helped guide treatment decisions. We proposed a new software program developed for CTP analysis, SCALE-CTP, and compared the affected brain volumes estimated using RAPID and SCALE-CTP.</div></div><div><h3>Methods</h3><div>We recruited 362 individuals from the local hospital to evaluate the concordance between SCALE-CTP and RAPID in predicting affected brain volumes, including relative cerebral blood flow (rCBF) &lt;30 % and time-to-maximum concentration (Tmax) &gt; 6 s, and the mismatch volumes. Concordance correlation coefficients (CCC) and Bland–Altman plots were used to assess agreement. Subgroup analyses and comparisons with DWI-derived infarction areas were also performed, along with an evaluation of differences in clinical decision-making.</div></div><div><h3>Results</h3><div>The calculated volumes from two different software showed excellent concordance (rCBF &lt; 30 % volume: 0.91, Tmax &gt; 6s: 0.88 volume, mismatch volume: 0.82). The concordance between the two software programs remains excellent in the subgroup analysis. In the subset of 38 cases, the differences between DWI-derived infarction area and rCBF &lt; 30 % volume from both software were similar, while SCALE-CTP showed more variability. Their differences in clinical decision making were slightly different.</div></div><div><h3>Conclusion</h3><div>SCALE-CTP demonstrated strong agreement with RAPID in predicting affected brain volumes and shows potential as a reliable tool for guiding hyperacute ischemic stroke treatment. Further validation is needed to confirm its clinical utility.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 2","pages":"Article 108517"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145703757","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}