Journal of Stroke & Cerebrovascular Diseases最新文献

{"title":"Comment on “synergistic impacts of physical activity and sleep on risk of dementia and all-cause mortality in Chinese older stroke survivors”","authors":"Bhumesh Tyagi MD , Leelabati Toppo MD , Aishwarya Biradar MD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108526","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108526","url":null,"abstract":"","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 2","pages":"Article 108526"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145784126","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":"Knockdown of programmed cell death 4 inhibits endoplasmic reticulum stress in male mice with intracerebral hemorrhage through the phosphoinositide 3-kinase/protein kinase B pathway","authors":"Jianfeng Qi ,&nbsp;Zhimin Zhang ,&nbsp;Jixiang Yin ,&nbsp;Xuhui Yuan ,&nbsp;Xu Wang ,&nbsp;Zexiang Liu ,&nbsp;Yuhang Liu ,&nbsp;Jianjun Wang","doi":"10.1016/j.jstrokecerebrovasdis.2026.108554","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108554","url":null,"abstract":"<div><h3>Background</h3><div>Pdcd4 is a potential target for intracerebral hemorrhage (ICH) treatment. This research intended to elucidate the mechanism by which Pdcd4 regulates ICH progression.</div></div><div><h3>Methods</h3><div>Male mice were infected with sh-<em>Pdcd4</em> lentivirus, followed by injection of bacterial collagenase to establish an ICH model. Subsequent experiments, including brain water content assessment, neurological injury scoring, brain hematoma volume measurement, ELISA, HE staining, immunohistochemistry, Evans blue extravasation assay, and Western blot, were conducted to analyze the role of Pdcd4 in ICH. PI3K inhibitor LY294002 was employed to further investigate the potential mechanisms <em>in vivo</em>. bEnd.3 cells were infected with sh-<em>Pdcd4</em> in the presence or absence of tunicamycin (an ER stress inducer), followed by hemoglobin treatment to mimic ICH <em>in vitro</em>. The effects of Pdcd4 on endoplasmic reticulum (ER) stress in ICH were evaluated through CCK-8, ELISA, and Western blot assays.</div></div><div><h3>Results</h3><div>Pdcd4 was upregulated in ICH mice, with the highest levels observed at 24 h. <em>Pdcd4</em> knockdown markedly alleviated brain injury and neuroinflammation, inhibited ER stress, and upregulated PI3K/AKT pathway in ICH mice. These changes were partially reversed by LY294002. In bEnd.3 cells, Pdcd4 levels were significantly increased after hemoglobin treatment. Additionally, <em>Pdcd4</em> knockdown significantly increased cell viability and inhibited inflammatory factor secretion and ER stress in the ICH group. This phenomenon was partially counteracted by tunicamycin. Furthermore, <em>Pdcd4</em> knockdown markedly activated the PI3K/AKT pathway in the ICH group.</div></div><div><h3>Conclusion</h3><div><em>Pdcd4</em> knockdown alleviates ICH through PI3K/AKT pathway-mediated ER stress.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 2","pages":"Article 108554"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145947141","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":"Global and regional burden of ischemic stroke attributable to smoking and high alcohol use from 1990 to 2021, with projections to 2050","authors":"Sijia Guo ,&nbsp;Bo Qu ,&nbsp;Qiqi Wang ,&nbsp;Yan Sun","doi":"10.1016/j.jstrokecerebrovasdis.2026.108543","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108543","url":null,"abstract":"<div><h3>Objective</h3><div>This study employs data from the Global Burden of Disease Study (GBD) 2021 to analyze the age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) of ischemic stroke (IS) attributable to smoking and high alcohol use from 1990 to 2021 across 204 countries and territories, stratified by Socio-demographic Index (SDI), region, sex, and age. Trends are assessed using estimated annual percentage change (EAPC), and future burdens are projected to 2050 using an autoregressive integrated moving average (ARIMA) model.</div></div><div><h3>Results</h3><div>Globally, the burden of IS attributable to both risk factors declined, with smoking consistently associated with higher ASMR and ASDR than high alcohol use. High-SDI regions showed the most substantial reductions, whereas low-SDI regions experienced stagnant or slightly increasing burdens. Southeast Asia was the only region with a rising trend in smoking-related IS, while Tropical Latin America achieved remarkable success in alcohol control. The burden was higher among males and older age groups for smoking, and more prominent in young and middle-aged adults for alcohol use. Projections suggested a continuing decline in high-SDI regions but limited improvement in low-SDI areas by 2050.</div></div><div><h3>Conclusion</h3><div>Significant geographic and demographic disparities persist in the IS burden attributable to smoking and high alcohol use. Targeted policy interventions—especially enhanced tobacco and alcohol control in low- and middle-SDI regions, along with focused strategies for males and high-risk age groups—are urgently needed to reduce the global burden of ischemic stroke.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 2","pages":"Article 108543"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145902075","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 biological aging and stroke and all-cause mortality: A population-based cross-sectional study and Mendelian randomization analysis","authors":"Zijie Wang ,&nbsp;Xinwei Zhao ,&nbsp;Yan Ma","doi":"10.1016/j.jstrokecerebrovasdis.2025.108525","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108525","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Stroke is a major acute cerebrovascular disorder and a leading cause of disability and death, for which ageing is a key risk factor. However, individuals of the same chronological age differ markedly in cerebrovascular vulnerability. This study aimed to investigate the association between biological aging and stroke risk and prognosis using several validated aging metrics.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;In NHANES 1999–2018, we derived the frailty index (FI), Klemera–Doubal age (KDMAge) and phenotypic age (PhenoAge) as alternative measures of biological aging. Logistic regression, tests for trend, restricted cubic splines and subgroup analyses were used to assess associations with stroke prevalence. Kaplan–Meier curves and Cox regression were applied to evaluate all-cause mortality among stroke survivors. In parallel, we conducted bidirectional two-sample Mendelian randomization (MR) using large genome-wide association studies to examine the potential causal effects of multiple biological aging indicators (four epigenetic age acceleration measures, telomere length, facial aging and FI) on stroke and its ischaemic subtypes, and the reverse effects of stroke on aging acceleration.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Among 34,856 participants, higher FI, KDMAge and PhenoAge, as well as biological age acceleration, were associated with increased stroke risk; these associations remained significant in fully adjusted models. Dose–response analyses revealed non-linear relationships between biological aging metrics and stroke, with FI and PhenoAge showing J-shaped and KDMAge S-shaped patterns. In survival analyses of 1,167 stroke patients, PhenoAge acceleration and frailty status were significantly associated with reduced survival probability and higher all-cause mortality, whereas KDMAge acceleration showed weaker prognostic value. In MR analyses meta-analysing GIGASTROKE and MEGASTROKE, genetically predicted FI was associated with higher risk of stroke overall (OR = 1.57, 95 % CI: 1.36–1.83, &lt;em&gt;p&lt;/em&gt; &lt; 0.001) and with major ischaemic subtypes, while other aging clocks showed weaker or subtype-specific associations. Reverse MR indicated that stroke liability was associated with higher PhenoAge acceleration (OR = 1.54, 95 % CI: 1.12–2.12, &lt;em&gt;p&lt;/em&gt; = 0.008), higher FI (OR = 1.11, 95 % CI: 1.05–1.17, &lt;em&gt;p&lt;/em&gt; &lt; 0.001) and accelerated facial aging (OR = 1.02, 95 % CI: 1.01–1.03, &lt;em&gt;p&lt;/em&gt; = 0.001).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;In a nationally representative sample, multiple biological aging indicators were associated with stroke and post-stroke all-cause mortality, and bidirectional MR supported a potential two-way relationship between biological aging and stroke. Among the evaluated metrics, FI showed the most robust and consistent associations with stroke risk and survival and provided the clearest and most stable genetic evidence compatible with a causal effect on stroke and its ischaemic subty","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 2","pages":"Article 108525"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145771990","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":"Integration of genetic risk, cardiometabolic diseases, and cognitive impairment among African American adults","authors":"Chaitali Dagli ,&nbsp;Nicole D. Armstrong ,&nbsp;Daeeun Kim ,&nbsp;Laura M. Raffield ,&nbsp;Hemant K. Tiwari ,&nbsp;Mary Cushman ,&nbsp;Suzanne E. Judd ,&nbsp;Michael Crowe ,&nbsp;Virginia J. Howard ,&nbsp;Marguerite R. Irvin","doi":"10.1016/j.jstrokecerebrovasdis.2025.108535","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108535","url":null,"abstract":"<div><h3>Background</h3><div>African American (AA) adults have a high burden of late-life cognitive impairment (CI) and dementia but remain underrepresented in genetic epidemiology studies. Genetic risk and cardiometabolic diseases (CMDs) contribute to dementia risk. This study investigated whether genetic susceptibility and CMDs were associated with a composite CI outcome and whether CMDs modified these associations.</div></div><div><h3>Methods</h3><div>In AA participants within the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, we assessed the association of a dementia polygenic risk score (PRS), <em>APOE</em> ε4 carrier status, and three prevalent CMDs: stroke, coronary artery disease (CAD), and type 2 diabetes (T2D) with a composite outcome of CI and dementia as a contributing cause of death (DCCD).</div><div>We used logistic regression adjusted for age, sex, education, income, body mass index, smoking status, alcohol intake, physical activity, hypertension, low-density lipoprotein, and C-reactive protein. Interaction terms were included to assess whether CMDs modified the associations between genetic risk and the composite outcome.</div></div><div><h3>Results</h3><div>Of 8,838 participants, 516 (5.84 %) developed CI or had DCCD. In fully adjusted models, high polygenic risk (highest vs lowest PRS tertile) was associated with increased odds of the composite outcome [odds ratio (OR): 1.42; 95 % confidence interval (CI): 1.12-1.78], as was <em>APOE</em> ε4 carrier status (OR: 1.46; 95% CI: 1.21-1.78). Among CMDs, stroke (OR: 1.45; 95% CI: 1.04-2.02) and T2D (OR: 1.31; 95% CI: 1.06-1.61) were significantly associated with increased odds of the composite outcome. However, the association between genetic risk and the composite outcome did not significantly differ by CMD status.</div></div><div><h3>Conclusion</h3><div>Genetic risk and CMDs independently contributed to dementia-related outcomes, indicating their relevance in understanding dementia risk among AA adults.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 2","pages":"Article 108535"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145822637","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":"Access to neighborhood destinations that offer opportunities for physical activity and socialization is associated with favorable post-stroke outcomes","authors":"Leanna M Delhey PhD ,&nbsp;Jon Zelner PhD ,&nbsp;Xu Shi PhD ,&nbsp;Lewis B Morgenstern MD ,&nbsp;Devin L Brown MD ,&nbsp;Melinda A Smith DrPH ,&nbsp;Erin C Case BA ,&nbsp;Lynda D Lisabeth PhD","doi":"10.1016/j.jstrokecerebrovasdis.2026.108545","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108545","url":null,"abstract":"<div><h3>Objective</h3><div><strong>:</strong> Assess associations between destinations near stroke survivor's residence – places like restaurants, recreation centers, and stores that offer opportunities for physical activity and socialization outside of the home and work – and their poststroke outcomes.</div></div><div><h3>Methods</h3><div><strong>:</strong> We included non-Hispanic white and Mexican American incident stroke survivors enrolled in the Brain Attack Surveillance in Corpus Christi project (2009-19), a population-based cohort in Texas. Exposure: count of destinations within 0.5-miles around survivors’ residences. Outcomes assessed at approximately 3-, 6-, and 12-months poststroke: cognition (Modified Mini-Mental State Examination), functioning (activities of daily living (ADL)/instrumental ADL), health-related quality of life (abbreviated Stroke-Specific Quality of Life scale), and depression (Patient Health Questionnaire-8). We fit adjusted linear mixed models and considered interactions with follow-up time and stroke severity (NIH stroke scale - mild (&lt;5), moderate-severe (≥5)).</div></div><div><h3>Results</h3><div><strong>:</strong> We included 1,786 survivors who completed 3 (<em>N</em> = 1,321), 6 (<em>N</em> = 677), or 12-month interviews (<em>N</em> = 652). Median age was 64 years, 55% male, and 74% mild stroke. Stroke severity modified associations with functioning (<em>p</em> = 0.09) and quality of life (<em>p</em> = 0.05), follow-up time did not (<em>p</em> &gt; 0.25). Among moderate-severe stroke survivors, more destinations were associated with more favorable functioning (mean difference=-0.12, 95% CI=-0.22, -0.01) and quality of life (mean difference=0.16, 95% CI=0.03, 0.30). No associations were observed among mild stroke survivors or with cognition or depression (<em>p</em> &gt; 0.05).</div></div><div><h3>Interpretation</h3><div><strong>:</strong> Among moderate-severe stroke survivors, more nearby destinations were associated with more favorable functioning and quality of life in the first year. Future research is needed to explore if specific types of destinations may support more favorable outcomes.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 2","pages":"Article 108545"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145902082","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 cumulative changes of the triglyceride glucose index and incidence of Cardio-cerebral vascular diseases in a population with cardiovascular-kidney-metabolic syndrome stage 0–3: a nationwide prospective cohort study","authors":"Li Hou ,&nbsp;Jing Tang ,&nbsp;Lei Zhang ,&nbsp;Yanhong Li ,&nbsp;Yao Niu","doi":"10.1016/j.jstrokecerebrovasdis.2026.108540","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108540","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the relationship between the longitudinal changes of the triglyceride-glucose (TyG) index and the incidence of cardio-cerebral vascular diseases (CCVD) among individuals with CKM syndrome stages 0-3.</div></div><div><h3>Methods</h3><div>Utilizing data from the China Health and Retirement Longitudinal Study (CHARLS), this longitudinal study included 3,416 participants aged 45 and above. Participants were categorized into different TyG trajectory groups using k-means clustering analysis. Logistic regression and restricted cubic spline (RCS) models were employed to assess the associations between cumTyG and TyG changes with CCVD incidence.</div></div><div><h3>Results</h3><div>Over a median follow-up of 5 years, 698 participants developed CCVD. The relationship between cumTyG and CCVD risk was linear in RCS regression. After adjusting for potential confounders, the risk of CCVD was found to be significantly higher for participants in Class 2, Class 4, and Class 5 compared to those in Class 1. Specifically, Class 2 had an odds ratio (OR) of 1.45 (95% confidence interval [CI]: 1.14, 1.84), Class 4 had an OR of 1.42 (95% CI: 1.09, 1.86), and Class 5 had an OR of 1.64 (95% CI: 1.14, 2.34). Additionally, an elevated cumTyG index was associated with an increased risk of CCVD, with an OR of 1.13 (95% CI: 1.05, 1.22, P=0.002).</div></div><div><h3>Conclusion</h3><div>CumTyG and its longitudinal trend are independent and potent predictors of CCVD in patients with stage 1–3 CKM syndrome. Dynamic monitoring of the TyG trajectory can enable the early identification of high-risk individuals, providing reliable evidence for individualized and cost-effective prevention.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 2","pages":"Article 108540"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145906797","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":"Dl-3-n-butylphthalide protects against ischemic stroke by enhancing mitochondrial function via MT-CO1 upregulation","authors":"Yangfang An ,&nbsp;Biao Wang ,&nbsp;Jiali Zhao ,&nbsp;Hui Zhou ,&nbsp;Qiong Zhou","doi":"10.1016/j.jstrokecerebrovasdis.2025.108529","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108529","url":null,"abstract":"<div><h3>Objective</h3><div>Mitochondrial dysfunction is a key determinant of neuronal death and a promising therapeutic target in ischemic stroke. Dl-3-n-butylphthalide (NBP), an approved neuroprotective agent in China, has been shown to improve mitochondrial integrity, yet its precise molecular mechanisms remain unclear. This study aimed to determine whether NBP exerts neuroprotection by upregulating mitochondrial cytochrome c oxidase subunit 1 (MT-CO1) and to clarify the contribution of MT-CO1 to mitochondrial function recovery.</div></div><div><h3>Methods</h3><div>MT-CO1 expression was measured in the circulation from acute ischemic stroke participants before and following NBP therapy. In SH-SY5Y cells under OGD/R treatment, the action of NBP on mitochondrial bioenergetics, oxidative stress, and apoptosis were assessed. MT-CO1 knockdown was used to determine mechanistic involvement.</div></div><div><h3>Results</h3><div>NBP significantly increased MT-CO1 expression both <em>in vivo</em> and <em>in vitro</em>, improved mitochondrial membrane voltage and ATP production, reduced ROS generation, and decreased apoptosis. MT-CO1 silencing markedly attenuated these protective effects.</div></div><div><h3>Conclusion</h3><div>NBP protects against ischemia-induced mitochondrial dysfunction partly through MT-CO1 upregulation, supporting MT-CO1 as a potential therapeutic target for mitochondrial function protection in ischemic stroke.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 2","pages":"Article 108529"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145795979","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":"Post-stroke epilepsy in revascularized versus not revascularized stroke patients: A prospective cohort study","authors":"Stefania Lazzari ,&nbsp;Carlotta Mutti ,&nbsp;Francesca Bozzetti ,&nbsp;Antonio Genovese ,&nbsp;Maddalena Frapporti ,&nbsp;Francesca Badini ,&nbsp;Carmine Siniscalchi ,&nbsp;Andrea Becciolini ,&nbsp;Valentina Tontini ,&nbsp;Elisa Mannini ,&nbsp;Irene Florindo ,&nbsp;Francesco Misirocchi ,&nbsp;Francesca Iuculano ,&nbsp;Liborio Parrino ,&nbsp;Lucia Zinno","doi":"10.1016/j.jstrokecerebrovasdis.2026.108544","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108544","url":null,"abstract":"<div><h3>Objective</h3><div>The association between post stroke epilepsy (PSE) and revascularization therapy in stroke patients remains controversial. The prognostic significance of other supportive techniques such as Computed Tomography (CT) brain data and electroencephalograph (EEG) in PSE prediction is poorly understood.</div></div><div><h3>Methods</h3><div>We performed a single-center prospective observational study to evaluate the incidence of acute symptomatic seizures (ASS) and PSE in adult patients affected by acute ischaemic stroke undergoing reperfusional approaches compared to non-revascularized patients, with a 30-months follow-up.</div></div><div><h3>Results</h3><div>We enrolled 258 patients with stroke: 155 cases (treated with intravenous tissue plasminogen activator (IV-tPA)) and/or endovascular thrombectomy (ET) and 103 controls (non-revascularized). The global incidence of ASS was 3.4%, while PSE was diagnosed in 5% of patients. Reperfusion treatments were not associated with increased risk of ASS or PSE. Hemorrhagic infarction was found as the only independent risk factor for PSE development (HR 5.33, (95% CI, 1.69 – 16.82), p=0.004). In parallel, we analyzed the relationship between ASS and hemorrhagic infarction using the chi-square test (OR 8.59 (95% CI, 2.19 - 33.7), p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Reperfusion therapies for acute ischemic stroke do not increase the risk of epilepsy during the first 30 months after stroke. Hemorrhagic infarction was the main risk for epilepsy after stroke.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 2","pages":"Article 108544"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145902055","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":"Cervicocerebral atherosclerosis and atrial fibrillation increase long-term mortality in patients with ischemic stroke","authors":"Kati Lainelehto MD ,&nbsp;Juha-Pekka Pienimäki MD, PhD ,&nbsp;Sirpa Savilahti MD, PhD ,&nbsp;Heini Huhtala MSc ,&nbsp;Tomi Sarkanen MD, PhD ,&nbsp;Heikki Numminen MD, PhD ,&nbsp;Jukka Putaala MD, PhD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108532","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108532","url":null,"abstract":"<div><h3>Background and aims</h3><div>Atrial fibrillation (AF) and atherosclerosis in the arteries supplying the brain are both strong risk factors of ischemic cerebrovascular events. However, the effect of their concurrent presence on long-term mortality in patients with acute ischemic stroke or transient ischemic attack (TIA) has gone little studied.</div></div><div><h3>Methods</h3><div>A total of 406 patients with acute ischemic stroke or TIA were enrolled in a tertiary university center and their cervicocerebral arteries imaged with computed tomography angiography (CTA). The extent of atherosclerosis in the carotid, vertebral and intracranial arteries were rated as Cervicocerebral Atherosclerotic Burden (CAB) score. Furthermore, we assessed the combined effect of atherosclerosis and AF with a variable including AF status and CAB score in quartiles.</div></div><div><h3>Results</h3><div>After a median follow-up of 7.3 years (interquartile range 5.7-7.6), 62 of the 121 patients with AF had died, compared to 74 of 285 patients without AF (cumulative mortality rate 52.0 %, 95 % CI 47.1-56.9 % vs. 27.0 %, 24.7-29.3 %, respectively). In adjusted Cox regression, the two highest CAB score quartiles were associated with mortality in AF patients with hazard ratios of 12.7 (1.6-99.7) and 15.8 (2.0-126.4), respectively. Furthermore, with combined variable of AF and CAB score the risk of death was 3-fold in AF patients with two highest quartiles of CAB score compared to those without AF in the two lowest CAB score quartiles.</div></div><div><h3>Conclusions</h3><div>The total atherosclerotic burden in arteries supplying the brain appears as a strong independent factor increasing long-term mortality in patients with acute ischemic stroke or TIA and concurrent AF.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 2","pages":"Article 108532"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145807294","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}