Journal of Stroke & Cerebrovascular Diseases最新文献

{"title":"Longitudinal characterization of carotid siphon calcifications: A CT-based population study","authors":"Oscar H. Del Brutto MD ,&nbsp;Robertino M. Mera MD, PhD ,&nbsp;Aldo F. Costa MD ,&nbsp;Denisse A. Rumbea MHA ,&nbsp;Emilio E. Arias MD ,&nbsp;Víctor J. Del Brutto MD, MS","doi":"10.1016/j.jstrokecerebrovasdis.2025.108523","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108523","url":null,"abstract":"<div><h3>Background and aims</h3><div>Carotid siphon calcifications (CSC) are recognized markers of cerebrovascular aging and vascular injury. Despite their relevance, longitudinal data on CSC progression is limited. In this study, we evaluated factors associated with CSC progression in middle-aged and older adults.</div></div><div><h3>Methods</h3><div>We conducted a prospective cohort study in a rural Ecuadorian population, assessing CSC progression using non-enhanced CT scans carried out an average of 7.4 years apart. CSC were graded using Woodcock’s scale (absent, mild, moderate, and severe), with progression defined as an increase of ≥1 grade in the follow-up CT. Poisson and multinomial logistic regression models assessed associations between CSC progression and baseline demographics and cardiovascular risk factors.</div></div><div><h3>Results</h3><div>The study included 396 individuals aged ≥40 years (mean age: 57.5±11.2 years; 45% women). At baseline, 236 (60%) participants had absent; 87 (22%) mild; and 73 (18%) moderate CSC. Follow-up CTs revealed CSC progression in 17 (4.3%) participants, with an overall rate of 0.78 events per 100 person-years. Smoking (IRR: 3.83; 95% C.I.: 1.3–11.3) and arterial hypertension (IRR: 3.67; 95% CI: 1.5–8.63) emerged as the strongest modifiable predictors of CSC progression. Participants with a poor smoking status showed a progression of 2.61 events per 100 person-years <em>versus</em> 0.68 in non-smokers. Hypertensives had a progression rate of 1.51 events <em>versus</em> 0.41 in normotensives.</div></div><div><h3>Conclusions</h3><div>CSC may progress over time – albeit slowly – in individuals with advancing age, smoking history, and hypertension. The low rate of progression suggests that routine CT-based monitoring is unlikely to be justified in clinical practice. Instead, our findings highlight the importance of controlling modifiable risk factors to mitigate vascular injury.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 1","pages":"Article 108523"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145746562","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":"Cerebral small vessel disease characteristics associate with domain-specific impairments during Intracerebral Hemorrhage: A retrospective cohort study","authors":"Karim Borei MD ,&nbsp;Abdulaziz T. Bako PhD MPH MBBS ,&nbsp;Alan P. Pan MS ,&nbsp;Osman Khan BS ,&nbsp;Gavin W. Britz MD MPH MBA ,&nbsp;Farhaan S. Vahidy PhD MBBS MPH ,&nbsp;Thomas B.H. Potter PhD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108522","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108522","url":null,"abstract":"<div><h3>Introduction</h3><div>Cerebral Small Vessel Disease (CSVD) is associated with cognitive disruptions after intracerebral hemorrhage (ICH), however evidence connecting CSVD to admission National Institutes of Health Stroke Scale (NIHSS) scores is limited.</div></div><div><h3>Methods</h3><div>Electronic medical record data were retrieved for adult patients (&gt;18 years) with admission for primary ICH and available NIHSS and CSVD assessment. CSVD burden was graded from 0 to 4 based on magnetic resonance imaging, with 1 point assessed for: 1) deep Fazekas score of 2-3 or periventricular (PV) Fazekas score of 3; 2) cerebral microbleed presence; 3) lacune presence; 4) &gt; 20 basal ganglia perivascular spaces. Severe CSVD was defined as a summary score ≥ 3, and individual marker severity was assessed using the same criteria. The primary outcome was moderate-severe stroke (total NIHSS score ≥5). Secondary outcomes were severe motor deficit (motor score &gt;12), complete aphasia (language score = 3), and cortical deficit (any impairment in language, extinction, and gaze). Associations between CSVD and NIHSS were determined using multivariable logistic regression, adjusting for major clinical and demographic factors. Adjusted odds ratios (aOR) and 95 % confidence interval (CI) are reported.</div></div><div><h3>Results</h3><div>The cohort included 1024 patients (median age [interquartile range]: 71 [61-79], 53 % male). Patients were 43 % White, 23 % Black, 21 % Hispanic, 8 % Asian, 5 % other; 477 (47 %) showed moderate-severe NIHSS scores and 262 (26 %) showed severe CSVD. Periventricular white matter hyperintensity (WMH) burden was independently associated with moderate-severe NIHSS score (aOR, 95 % CI: 1.54, [1.02-2.33]). Deep WMH burden was independently associated with aphasia (2.02, [1.03-3.91]), and motor deficit (3.64, [1.15-12.19]).</div></div><div><h3>Conclusion</h3><div>Severe WMH burdens independently increase odds of neurological deficit among patients with primary ICH.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 1","pages":"Article 108522"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145746575","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":"Worse visibility of deep medullary veins is associated with larger lateral ventricles but not with cortical thickness","authors":"Sushruth Manchineella BS ,&nbsp;Henry Rusinek PhD ,&nbsp;Yuan Ma PhD ,&nbsp;Xiuyuan Hugh Wang PhD ,&nbsp;Surendra Maharjan PhD ,&nbsp;Liangdong Zhou PhD ,&nbsp;Tracy Butler MD ,&nbsp;Yi Li MD ,&nbsp;Alexus Jones BS ,&nbsp;Emily Tanzi MA ,&nbsp;Gloria C Chiang MD ,&nbsp;Silky Pahlajani MD ,&nbsp;Katarzyna Olejniczak-Gniadek MD PhD ,&nbsp;Seyed Hani Hojjati PhD ,&nbsp;Thomas Maloney PhD ,&nbsp;Mony J. de Leon EdD ,&nbsp;Lidia Glodzik MD PhD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108510","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108510","url":null,"abstract":"<div><h3>Background</h3><div>Deep medullary veins (DMVs) play important roles within the cerebrovascular network related to brain drainage and clearance. Although they have been previously correlated with brain volume, it is unknown whether their count is specifically correlated with subcortical or cortical volume changes.</div></div><div><h3>Purpose</h3><div>This study aims to better understand the relationship between DMVs, subcortical (lateral ventricle to intracranial volume ratio (ICV)) and cortical atrophy (cortical thickness) to identify whether DMVs can be a predictor of volume changes in these regions.</div></div><div><h3>Methods</h3><div>We performed a retrospective analysis of 332 cognitively healthy subjects previously followed between 2010 and 2019. Imaging and patient charts were analyzed for baseline demographic and clinical characteristics. Patients underwent a standardized cognitive interview and received a magnetic resonance imaging scan to assess DMVs, cortical thickness, lateral ventricle and global gray matter (GM) volumes, white matter lesions (WMLs) and microbleeds.</div></div><div><h3>Results</h3><div>Among 332 patients (62% female, median age 70), lateral ventricle/ICV was significantly related to DMV count (p&lt;0.001). Similarly, sex stratified analyses confirmed that a larger lateral ventricle/ICV ratio, but not cortical thickness or global GM volumes, was associated with fewer DMVs. In the entire group, subcortical atrophy remained a significant predictor of DMVs even after accounting for baseline characteristics, WMLs, microbleeds and total gray matter volume.</div></div><div><h3>Conclusions</h3><div>In a large cohort of cognitively unaffected people, subcortical, but not cortical, atrophy was significantly correlated with venous health as measured by DMVs. Reduced DMVs are a strong predictor of ventricular enlargement.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 1","pages":"Article 108510"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145656813","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":"Artificial intelligence to predict modified rankin score after acute stroke symptoms using wrist-worn triaxial accelerometry data","authors":"Benjamin R Kummer MD ,&nbsp;Alexander Gerlach BA ,&nbsp;Shaun Kohli BS ,&nbsp;Joshua Z Willey MD MS ,&nbsp;Ari Shechter PhD ,&nbsp;David S Liebeskind MD MBA ,&nbsp;Girish Nadkarni MD PhD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108508","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108508","url":null,"abstract":"<div><h3>Background</h3><div>The modified Rankin Scale (mRS) is the most common measure of post-stroke functional outcome. However, its impact on post-stroke care is limited by its subjectivity, impracticality in vulnerable populations, and susceptibility to cultural and language barriers. Artificial intelligence (AI) applied to triaxial wrist-worn accelerometry data may offer an objective way to characterize post-stroke functional status and related changes.</div></div><div><h3>Methods</h3><div>We analyzed data from the REACH Stroke-Sleep study at Columbia University Irving Medical Center. Using single-day epochs averaged over the first 30 days of recording, we trained logistic repression (LR), random forest (RF) and long short-term memory (LSTM) models to predict 1-month and 6-month mRS scores, as well as 1- to-6 month mRS changes. 5-fold cross validation was used, and model performance was evaluated using area under receiver-operating curve (AUROC) for binary exact-match predictions.</div></div><div><h3>Results</h3><div>We identified 362 patients, of whom 302 (83.4 %) had 1-month and 251 (69.3 %) had 6-month mRS scores. RF models (1-month AUROC 0.65, 95 %CI 0.57-0.73; 6-month 0.59, 95 %CI 0.51-0.66; ΔmRS 0.62, 95 %CI 0.53-0.71) outperformed LSTM (0.55, 95 %CI 0.48-0.63; 0.53, 95 %CI 0.45-0.60, 0.49; 95 %CI 0.39-0.59) and LR (0.54, 95 %CI 0.47-0.61; 0.58, 95 %CI 0.50-0.66; 0.50, 95 %CI 0.40- 0.61) models.</div></div><div><h3>Conclusions</h3><div>AI applied to wearable accelerometry predicted short-term mRS score and functional change after stroke with accuracy above chance. Although predictive performance was modest, these results provide proof-of-concept that AI applied to passive wearable data can capture meaningful post-stroke functional variation and could inform future real-time monitoring frameworks. Integrating multimodal wearable and clinical data may further improve prediction of post-stroke functional outcomes.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 1","pages":"Article 108508"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145644496","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":"Efficacy and safety of acupuncture or moxibustion combined with rehabilitation therapy for post-stroke shoulder-hand syndrome: a systematic review and meta-analysis of randomized controlled trials","authors":"Xinle Wang ,&nbsp;Lujia Xiao ,&nbsp;Xingxing Lin ,&nbsp;Feng Zhang ,&nbsp;Kaixuan Zhang ,&nbsp;Baoqiang Dong","doi":"10.1016/j.jstrokecerebrovasdis.2025.108509","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108509","url":null,"abstract":"<div><h3>Background</h3><div>This study evaluated the efficacy and safety of acupuncture or moxibustion combined with rehabilitation therapy for post-stroke shoulder-hand syndrome (SHS).</div></div><div><h3>Methods</h3><div>PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang, Chinese Scientific Journals Database (VIP), and SinoMed were searched from inception to March 5, 2025 for randomized controlled trials (RCTs). Cochrane Risk of Bias 2.0 (RoB2) tool was used to assess study quality, RevMan 5.4 software was employed for meta-analysis, GRADE criteria were applied to evaluate evidence quality.</div></div><div><h3>Results</h3><div>46 RCTs involving 3730 participants were included. Compared to rehabilitation alone, acupuncture or moxibustion combined with rehabilitation significantly improved efficacy rate (RR = 1.24, 95 % CI: 1.20 to 1.28), motor function (FMA: MD = 8.35, 95 % CI: 6.96 to 9.74), reduced pain (VAS: MD = -1.43, 95 % CI:1.65 to -1.21), and reduced SHS severity (SHSS: MD = -1.60, 95 % CI:1.99 to -1.22). Combination therapy also significantly reduced biomarkers (SP, BK, ET-1), increased CGRP (SMD = 1.27, 95 % CI: 0.53 to 2.02), decreased swelling volume (MD = -5.88, 95 % CI:9.25 to -2.50), and improved activities of daily living (MBI: MD = 13.31, 95 % CI: 9.10 to 17.53). However, the GRADE indicated low or very low certainty for most outcomes. Only six studies explicitly documented adverse events (none severe), warranting cautious interpretation.</div></div><div><h3>Conclusions</h3><div>Acupuncture or moxibustion combined with rehabilitation improves outcomes for post-stroke SHS. Nevertheless, conclusions require further validation through multicenter, large-sample RCTs due to evidence limitations.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 1","pages":"Article 108509"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145656822","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 blood pressure and outcome in patients with acute ischemic stroke treated with alteplase","authors":"Ole Morten Rønning MD, PhD ,&nbsp;Linn Nordby MD ,&nbsp;Nicola Logallo MD, PhD ,&nbsp;Christopher E Kvistad MD, PhD ,&nbsp;Espen Saxhaug Kristoffersen MD, PhD ,&nbsp;Håkon Ihle-Hansen MD, PhD ,&nbsp;Hege Ihle-Hansen MD, PhD ,&nbsp;Vojtech Novotny MD PhD ,&nbsp;Ulrike Waje-Andreassen MD, PhD ,&nbsp;Halvor Næss MD, PhD ,&nbsp;Lars Thomassen MD, PhD ,&nbsp;Bente Thommessen MD, PhD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108518","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108518","url":null,"abstract":"<div><h3>Background</h3><div>The role of blood pressure (BP) in acute stroke remains unclear. We investigated the impact of BP trajectories during the first 24 hours (h) after hospital admission on outcomes in acute ischemic stroke patients treated with intravenous alteplase.</div></div><div><h3>Methods</h3><div>In 424 ischemic stroke patients from the NOR-TEST I trial treated with alteplase, we assessed systolic BP (sBP) at baseline, change in sBP between 0 h and 24 h, and increase in sBP over the same period. Outcomes included modified Rankin Scale (mRS) at 3 months, NIHSS at 24 h, and symptomatic intracerebral haemorrhage (sICH) within 48 h.</div><div>Logistic and linear regression analyses were used to explore the association of blood pressure trajectories and outcome adjusted for age, sex, time from onset of symptoms to intravenous thrombolysis (IVT) and NIHSS at admittance (NIHSSadm).</div></div><div><h3>Results</h3><div>Mean sBP at baseline (admittance), 2 h and 24 h were 155, 147 and 142 mmHg, respectively. An increase in sBP from baseline to 24 h was seen in 115 patients (27 %), while 409 showed an overall change. In unadjusted analyses, sBP increase (but not baseline sBP or change in sBP) was associated with worse mRS at 3 months. This remained significant after adjustment (OR 0.933, 95 %CI 0.876 – 0.993). Higher baseline sBP and sBP increase predicted worse NIHSS at 24 h. sBP increase and baseline sBP were also associated with sICH within 48 h, but only baseline sBP remained significant after adjustment (OR 1.022, 95 % CI 1.003–1.042).</div></div><div><h3>Conclusions</h3><div>An increase in sBP within the first 24 h was associated with worse neurological and functional outcomes at 3 months, while higher baseline sBP was linked to worse neurological outcomes and sICH in acute ischemic stroke patients treated with alteplase.</div></div><div><h3>Clinical trial registration</h3><div>NCT01949948.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 1","pages":"Article 108518"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710658","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":"Lipoprotein(a) testing trends in young ischemic stroke patients from 2015-2024: An analysis of 188,000 individuals","authors":"Mustafa Naguib BS ,&nbsp;Brett C. Meyer MD ,&nbsp;Francesca Felipe ,&nbsp;Raphael E. Cuomo PhD ,&nbsp;Michael Wilkinson MD ,&nbsp;Ehtisham Mahmud MD ,&nbsp;Pam Taub MD ,&nbsp;Harpreet S. Bhatia MD, MAS ,&nbsp;Mattheus Ramsis MD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108513","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108513","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Lipoprotein(a) [Lp(a)] is a genetically determined risk factor for myocardial infarction and stroke. Elevated Lp(a) &gt;50 mg/dL (&gt;125 nmol/L) is common and present in about 1 in 5 individuals. Although Lp(a) may be a cause of young ischemic stroke (age ≤60), limited data on national testing trends in this population are available, testing in the general population remains low overall, and different organizations have varying guidelines for testing. By determining the degree to which this population is tested, information on national testing trends of Lp(a) in young ischemic stroke patients may influence future guideline recommendations to increase Lp(a) testing. This study aims to use a large, real-world dataset to assess trends of Lp(a) testing in young ischemic stroke patients in the United States from 2015-2024.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We performed a retrospective analysis of Lp(a) testing in young ischemic stroke patients across the United States from January 1, 2015 to December 31, 2024 using Epic Cosmos, a nationwide, de-identified electronic health record (EHR) dataset comprising over 300 million patient records from over 1,715 hospitals and 41,000 clinics, including from all 50 states, Washington D.C., Lebanon, and Saudi Arabia. The current count values for patients, hospitals, and clinics are available on the Epic Cosmos website. Although the Epic Cosmos data dictionary includes Lebanon and Saudi Arabia as standardized site locations, no patients from these countries were present in our analytic cohort; thus, all analyses were restricted to individuals within the United States. We evaluated the number of young ischemic stroke patients, defined as age ≤60 with history of an ischemic cerebrovascular accident (CVA), who had ever undergone Lp(a) testing, the testing rate per annual young ischemic stroke patients, geographical variation, and percentages of patients tested stratified by age, sex, ethnicity, race, and diagnosis of coronary artery disease (CAD). Testing rates were calculated as the number of distinct patients tested per year and as the testing rate per annual patient population. For each stratum we calculated the proportion tested with Wilson 95 % confidence intervals and assessed between-group differences using chi square or Fisher exact tests as appropriate. Annual trends in the testing proportion were modeled using a binomial generalized linear model with a logit link, treating the annual number tested as the numerator and the annual young ischemic stroke population as the denominator, and we report the odds ratio per calendar year with robust standard errors. Geographical variation was visualized using a heat map of testing by state. All analyses were descriptive and intended to characterize population-level patterns of ischemic stroke within the Cosmos network rather than infer causal associations. Given the exploratory design, no additional model-based adjustment for confoundin","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 1","pages":"Article 108513"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673380","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":"Cerebroprotection in acute ischemic stroke: Perspectives on combining cerebrolysin with recanalization therapy","authors":"Marc Ribó ,&nbsp;Jacek Staszewski ,&nbsp;Steven R. Zeiler ,&nbsp;Sławomir Michalak ,&nbsp;Ahmed El Bassiouny ,&nbsp;Fernando Gongora-Rivera ,&nbsp;Zdravka Poljakovic ,&nbsp;Dina R Khasanova ,&nbsp;Mikhail N Kalinin ,&nbsp;Aurauma Chutinet ,&nbsp;Roni Eichel ,&nbsp;Klaudyna Kojder ,&nbsp;Marissa Ong ,&nbsp;Marina Roje Bedeković ,&nbsp;Chien-Hung Chang ,&nbsp;Minwoo Lee ,&nbsp;Peter Quitasol ,&nbsp;Alexander Tsiskaridse ,&nbsp;Natan M Bornstein","doi":"10.1016/j.jstrokecerebrovasdis.2025.108515","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108515","url":null,"abstract":"<div><div>This article provides perspectives on the use of Cerebrolysin as an adjunct treatment to reperfusion therapy in acute ischemic stroke (AIS). In the evolving landscape of AIS reperfusion therapy, we hypothesize that adjunctive cerebroprotective therapy, such as Cerebrolysin, is likely to further improve patient outcomes. Beyond its established neurorecovery benefits, recent data indicate that Cerebrolysin also offers protection to the neurovascular unit and the blood-brain barrier. This paper introduces the CErebrolysin in RECanalization And Perfusion (CERECAP) program, a collaborative initiative of independent academic investigations exploring the favorable trends of Cerebrolysin in reperfusion. The CERECAP program has generated compelling data demonstrating Cerebrolysin’s alignment with current AIS reperfusion therapy concepts, particularly its role in early intervention targeting multiple pathways. We review these studies and discuss the critical need to clearly define the patient population that benefit most from adjunctive Cerebrolysin therapy in AIS.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 1","pages":"Article 108515"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688917","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":"Combined healthy lifestyle and post-stroke depression: a cross-sectional study in US adults","authors":"Chanchan Miao,&nbsp;Fu rong Zhang,&nbsp;Xuejun Gao,&nbsp;Yingying Liu","doi":"10.1016/j.jstrokecerebrovasdis.2025.108512","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108512","url":null,"abstract":"<div><h3>Background</h3><div>Post-stroke depression (PSD) is a serious complication affecting the survival and functional recovery of stroke patients, with a prevalence of approximately 30 %. It predominantly occurs within the first year after stroke, particularly within the first three months. Although individual lifestyle factors are associated with PSD, the combined impact of composite lifestyle factors (smoking, alcohol consumption, physical activity, diet, sleep, and obesity) on PSD remains unclear. This study aims to examine the association between composite healthy lifestyle behaviors and PSD among stroke survivors in the United States.</div></div><div><h3>Method</h3><div>By analyzing data from the 2005–2020 National Health and Nutrition Examination Survey (NHANES) in the United States, a total of 708 stroke survivors were included. The Healthy Lifestyle Score was used to assess the association between a composite healthy lifestyle and PSD. This score encompasses six factors: non-smoking, moderate alcohol consumption, regular physical activity, a nutritious diet, an ideal waist circumference, and sufficient sleep. Scores range from 0 to 6, with higher scores indicating a healthier lifestyle. Depression was diagnosed using the Patient Health Questionnaire-9 (PHQ-9) with a cutoff score of ≥9.</div></div><div><h3>Results</h3><div>The weighted prevalence of PSD among stroke survivors was 20.54 %. Multivariate logistic regression analysis indicated a significant negative correlation between healthy lifestyle scores and PSD risk. Compared to stroke survivors with 0-1 healthy lifestyle behaviors, those with 4-6 healthy lifestyle behaviors had an 80 % reduced risk of PSD (OR=0.20, 95 % CI: 0.08-0.45). Furthermore, each additional healthy lifestyle behavior was associated with a 45 % reduction in PSD risk (OR = 0.55, 95 % CI: 0.44-0.68). Subgroup analyses revealed that this inverse association persisted across all subgroups and was more pronounced among individuals with a household poverty-income ratio (PIR) of 3.5 or higher (P for interaction = 0.01). Sensitivity analyses supported the robustness of these findings.</div></div><div><h3>Conclusion</h3><div>This study demonstrates that adopting a composite healthy lifestyle is significantly associated with reduced risk of PSD among stroke survivors in the United States, underscoring the importance of healthy lifestyles in preventing PSD.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 1","pages":"Article 108512"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145656818","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":"Integrated TyG index and eGDR measure enhances stroke risk stratification in early cardiovascular-kidney-metabolic syndrome: A prospective national cohort analysis","authors":"Xiaolei Wang,&nbsp;Hongfeng Sun,&nbsp;Taojing Zhang,&nbsp;Hui Zhou","doi":"10.1016/j.jstrokecerebrovasdis.2025.108516","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108516","url":null,"abstract":"<div><h3>Background</h3><div>The triglyceride-glucose (TyG) index and estimated glucose disposal rate (eGDR) are established markers of insulin resistance (IR), yet their combined role in predicting stroke among individuals with early-stage cardiovascular-kidney-metabolic (CKM) syndrome remains unclear.</div></div><div><h3>Methods</h3><div>We included 4,414 participants from the China Health and Retirement Longitudinal Study (CHARLS) with baseline (2011) and follow-up (2015) data. TyG-eGDR was calculated at both timepoints, and cumulative exposure was derived. K-means clustering categorized participants into three dynamic trajectory groups. Cox proportional hazards models evaluated stroke risk, restricted cubic splines (RCS) tested nonlinearity, and receiver operating characteristic (ROC) curves assessed predictive performance.</div></div><div><h3>Results</h3><div>Over the follow-up period, 219 stroke events occurred. Compared to the low TyG-eGDR trajectory group, the high-trajectory group had a 2.84-fold increased stroke risk (HR = 2.84, 95 % CI: 1.67–4.81). Participants with the highest cumulative TyG-eGDR exposure exhibited a 4.28-fold increased stroke risk (HR = 4.28, 95 % CI: 2.66–6.89), while those with high baseline levels had a 3.46-fold elevated risk (HR = 3.46, 95 % CI: 1.82–6.58). RCS analyses revealed significant nonlinear relationships between TyG-eGDR indices and stroke (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>Sustained high TyG-eGDR levels predict stroke risk in early CKM syndrome, supporting its integration into routine metabolic cerebrovascular risk assessment.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 1","pages":"Article 108516"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145703744","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}