Journal of Stroke & Cerebrovascular Diseases最新文献

{"title":"Nattokinase supplementation for cognitive enhancement in asymptomatic intracranial/carotid stenosis: A randomized controlled trial","authors":"Kemeng Zhang MD ,&nbsp;Xuting Zhang MD ,&nbsp;Anni Wang MD ,&nbsp;Wansi Zhong MD ,&nbsp;Yingjian Pei MD ,&nbsp;Haidi Jin MS ,&nbsp;Ziyu Zhou MD ,&nbsp;Cong Chen MD ,&nbsp;Shuyue Wang PhD ,&nbsp;Min Lou MD, PhD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108511","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108511","url":null,"abstract":"<div><h3>Objectives</h3><div>The Improving Cerebral Blood Flow and Cognitive Function in Patients with Asymptomatic Intracranial/Carotid Stenosis with Nattokinase (ICC-PACS) trial was a single-center, double-blind, placebo-controlled study, aiming to evaluate the effects of 6-month nattokinase (NK) supplementation on cognitive function in patients with asymptomatic intracranial/carotid artery stenosis.</div></div><div><h3>Methods</h3><div>A total of 120 participants were randomized 1:1 to receive oral NK (8000 FU/day) or placebo for six months. Cognitive assessments and multimodal brain magnetic resonance imaging (MRI) were performed at baseline and 6-month follow-up.</div></div><div><h3>Results</h3><div>A total of 120 subjects were ultimately included (60 in the NK group and 60 in the placebo group), with balanced baseline characteristics between the two groups (average age 58.3 years, female 40.9 %). A total of 88 patients took the medication as required for 6 months and completed follow-up (45 in the NK group and 43 in the placebo group). Per-protocol analysis results found no significant between-group differences in the Montreal Cognitive Assessment (MoCA) score changes (mean difference: 0.038; 95 % CI: -1.109, 1.163; <em>P</em> = 0.948). However, exploratory analysis revealed significant difference in the changes of visuospatial function scores between the NK group and the placebo group (intergroup difference: 0.350; 95 % CI: 0.056, 0.649; <em>P</em> = 0.024), with reduced risk of visuospatial function decline in the NK group (OR: 0.35; 95 % CI: 0.127, 0.966). Besides, results were consistent in intention-to-treat analyses.</div></div><div><h3>Conclusion</h3><div>Six-month NK supplementation did not improve global cognition in asymptomatic intracranial/carotid stenosis patients. However, domain-specific enhancement in visuospatial function suggests potential selective neuroprotective effects.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 1","pages":"Article 108511"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145656809","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":"Based on the PINK1/Parkin signaling pathway, the protective effect of salidroside on cerebral ischemia-reperfusion injury in male rats was investigated","authors":"Ting Dong ,&nbsp;Haoyu Wang ,&nbsp;Yanwei Li ,&nbsp;Jun Tan","doi":"10.1016/j.jstrokecerebrovasdis.2025.108519","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108519","url":null,"abstract":"<div><h3>Objective</h3><div>Based on the male Sprague-Dawley rats middle cerebral artery occlusion model and SH-SY5Y hypoxia-reoxygenation model, this study systematically evaluated the neuroprotective effect of salidroside (SAL) on cerebral ischemia/reperfusion injury in rats, and explored its possible protective mechanism through PINK1/Parkin signaling axis regulating mitochondrial autophagy.</div></div><div><h3>Materials and methods</h3><div>Using the middle cerebral artery occlusion (MCAO) model in male Sprague-Dawley rats and the SH-SY5Y cell hypoxia-reoxygenation model, we assessed neurological damage severity through the modified neurological severity scores (NSS). Brain histopathological changes were evaluated using hematoxylin-eosin staining, while the infarct volume in the ischemic brain was assessed with 2,3,5-triphenyltetrazolium chloride (TTC) staining. Transmission electron microscopy was employed to observe mitochondrial ultrastructural alterations in the ischemic brain tissue. Western blotting was used for quantitative analysis of key autophagy-related molecules (PINK1, Parkin), and ROS, MDA, and ferrous ion kit were utilized to evaluate ferroptosis biomarker.</div></div><div><h3>Results</h3><div>The findings indicate that SAL effectively reduces infarction rates and ameliorates histopathological changes. SAL decreases the formation of reactive oxygen species, malondialdehyde, and ferrous ions by upregulating the expression of PINK1 and Parkin proteins, thereby mitigating apoptosis. Furthermore, SAL significantly inhibits ferroptosis in SH-SY5Y neuroblastoma cells subjected to OGD/R and reduces oxidative stress. The application of the mitochondrial autophagy inhibitor Mdivi-1 enhances the protective effect of SAL against ferroptosis in both MCAO and OGD/R models. Therefore, we draw the following conclusions: In the rat cerebral ischemia-reperfusion injury model and the SH-SY5Y cell oxygen-glucose deprivation/reoxygenation (OGD/R) model, iron death was found to be increased. Pre-treatment with salidroside was able to reduce the occurrence of iron death in both the cerebral ischemia-reperfusion injury model and the cellular OGD/R model.</div></div><div><h3>Conclusions</h3><div>Salidroside may inhibit iron death by activating the PINK 1 / Parkin signaling pathway and thereby reduce cerebral ischemia-reperfusion injury. Targeted regulation of this pathway may become an important strategy to interfere with CIRI.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 1","pages":"Article 108519"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710645","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":"Holo-Stroke-ii: Stroke care through stroke hologram teleportation- inpatient immersion","authors":"Weichen Liu ,&nbsp;Ben Shifflett ,&nbsp;Teri McQuaid ,&nbsp;Marissa D’Souza ,&nbsp;Reza Bavarsad Shahripour ,&nbsp;Kunal Agrawal ,&nbsp;Dawn M. Meyer ,&nbsp;Derek Dutt ,&nbsp;Dale Keehan ,&nbsp;Nadir Weibel ,&nbsp;Brett C. Meyer","doi":"10.1016/j.jstrokecerebrovasdis.2025.108524","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108524","url":null,"abstract":"<div><h3>Background</h3><div>Telestroke allows care irrespective of distance but has limitations in degree of immersive interaction. Augmented Reality (AR) holds promise, enabling providers and patients to interact as if in the same physical space. Prior investigations have shown immersive satisfaction for Holo-Stroke allowing 3D hologram providers to be transmitted to distant sites, and allowing for hologram assessments of Large Vessel Occlusions (LVOs).</div></div><div><h3>Methods</h3><div>We presented 2 evaluation techniques (both telestroke and Holo-Stroke) to a group of stroke service inpatients. Three optical cameras with depth sensing capability were placed around the stroke provider, with imaging streams transmitted in real-time via intranet to a HoloLens 2 Head-Mounted-Display (HMD) worn by patient at a distant site. The provider was visualized in the patient’s room as a hologram. Sample MRI, CTA, NIHSS picture card, and animation video were also visible to the patient through the HMD. Satisfaction questions were assessed via Likert scale. Wilcoxon Signed Rank, and Exact Binomial Test were used.</div></div><div><h3>Results</h3><div>Twenty inpatients with deficits consistent with acute stroke participated. Median age was 68 years, 45 % were female, 55 % white, and 20 % Hispanic. Median Likert scores favored Holo-Stroke over telestroke overall (47(93 %) vs 25.5(48 %);<em>p</em> &lt; 0.001), and for immersion (10(92 %) vs 4(37 %);<em>p</em> &lt; 0.001), beneficial technique (10(95 %) vs 5.5(55 %);<em>p</em> &lt; 0.001), and seeing images (10(97 %) vs 5(45 %);<em>p</em> &lt; 0.001). Clinical observations were overwhelmingly favorable.</div></div><div><h3>Discussion</h3><div>This Holo-Stroke telestroke, assessing acute stroke patients in the inpatient setting using wireless 3D hologram technique, resulted in robust immersion and significant increase in patient satisfaction. Although future evaluations of Holo-Stroke in acute telestroke are still warranted, Holo-Stroke has now clearly been shown to improve inpatient immersion and satisfaction.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 1","pages":"Article 108524"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145759330","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":"Improved outcome prediction in large vessel occlusion stroke: A comparison of Tmax-based hypoperfusion ratios HIR10/4 and HIR10/6","authors":"Jeewon Chon MA ,&nbsp;Ashley Treanor BS ,&nbsp;Andrew C. Pickles BS ,&nbsp;William Y. Shin BA ,&nbsp;Ronak H. Jani MD ,&nbsp;John T. Tsiang MD ,&nbsp;Amy Wozniak MS ,&nbsp;Anthony W. Kam MD, PhD ,&nbsp;David P. Pasquale MD ,&nbsp;Joseph C. Serrone MD ,&nbsp;Brandon J. Bond MD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108504","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108504","url":null,"abstract":"<div><h3>Background</h3><div>The hypoperfusion intensity ratio (HIR), derived from CT perfusion (CTP), reflects collateral flow quality, but its optimal formulation remains unsettled.</div></div><div><h3>Objective</h3><div>To compare the prognostic utility of conventional HIR_10/6 (time-to-maximum [T_max] &gt;10s / &gt;6 s) with an alternative HIR_10/4 (T_max &gt;10s / &gt;4 s) in patients undergoing endovascular thrombectomy (EVT).</div></div><div><h3>Methods</h3><div>We retrospectively analyzed consecutive large-vessel occlusion (LVO) strokes treated with EVT at our quaternary academic medical center (2015–2024). CTP was processed using RAPID software. Primary outcomes were modified Rankin Scale (mRS) at discharge and at 90 days. Secondary outcomes included National Institutes of Health Stroke Scale (NIHSS) at discharge and hemorrhagic transformation on follow-up imaging. Ordinal and linear regression models were adjusted for age, sex, vascular risk factors, intravenous thrombolysis, presentation window, and transfer status. Receiver operating characteristic (ROC) curves assessed discriminative performance.</div></div><div><h3>Results</h3><div>Among 280 patients (mean age 70 ±15 years; 49 % male), mean HIR_10/6 was 0.418 and HIR_10/4 was 0.241. Each 0.1-unit increase in HIR_10/4 translated to 31 % higher odds of worse mRS at discharge (adjusted odds ratio [aOR] 1.31, 95 % CI 1.12–1.54; <em>p</em>=0.001), 24 % higher odds of worse mRS at 90 days (aOR 1.24, 95 % CI 1.04–1.48; <em>p</em>=0.016), and higher discharge NIHSS (β=0.88, 95 % CI 0.05–1.71; <em>p</em>=0.039). HIR_10/6 showed weaker associations and was not significant for discharge NIHSS. Neither HIR metric demonstrated meaningful discrimination for hemorrhagic transformation or dichotomized outcomes (area under the curve [AUC] 0.50–0.52).</div></div><div><h3>Conclusions</h3><div>Incorporating mildly delayed tissue (T_max &gt;4 s) may enhance the physiologic sensitivity of HIR. HIR_10/4 may be a potential prognostic biomarker; however, prospective validation is needed, and its standalone ability to discriminate binary outcomes remains limited.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 12","pages":"Article 108504"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145644516","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":"Visual outcome comparison of intravenous thrombolysis after central retinal artery occlusions","authors":"Daniel X. Chen BS ,&nbsp;Bobeck S. Modjtahedi MD ,&nbsp;Alex T. Vo DO ,&nbsp;SeungYong Han PhD ,&nbsp;Navdeep Sangha MD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108472","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108472","url":null,"abstract":"<div><h3>Background</h3><div>Central retinal artery occlusions (CRAOs) are an important cause of vision loss that lacks standardized emergent treatment. While intravenous thrombolysis is effective in acute ischemic stroke, its safety and efficacy in CRAOs remain unclear. This study compares visual outcomes of patients with CRAOs treated with intravenous thrombolysis versus medical management (MM).</div></div><div><h3>Methods</h3><div>A retrospective cohort study was done of patients with acute CRAOs presenting with count fingers or worse. Patients receiving thrombolysis tenecteplase (TNK) or tissue plasminogen activator (tPA)] were matched to those who received MM without thrombolysis based on age, gender, hypertension, diabetes, and hyperlipidemia. Groups included 20 TNK, 19 tPA, and 39 MM patients. Primary outcomes were average visual acuity (logMAR) and proportion of patients with &gt;20/200 vision at initial and final visit within 6 months of CRAO diagnosis. Multivariate regression controlled for demographics, comorbidities, and non-thrombolytic treatments.</div></div><div><h3>Results</h3><div>Better than 20/200 vision was more common in those who received TNK than MM at first follow-up [OR: 6.70, 95 % CI: (1.25, 46.4), <em>p</em> = 0.04]. Similarly, patients receiving TNK had significantly better average visual acuity compared to MM on the first (-0.60 logMAR difference (95 % CI: (-1.0, -0.16), <em>p</em> = 0.008) and final (-0.60 logMAR difference 95 % CI: (-1.1, -0.12), <em>p</em> = 0.01) follow-up. No symptomatic intracranial hemorrhages or intraocular hemorrhages occurred within one week following treatment.</div></div><div><h3>Conclusions</h3><div>Patients who received TNK had better visual outcomes than those treated with MM, a difference that was not seen with tPA use. These findings demonstrate a possible role for TNK in the management of CRAOs.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 12","pages":"Article 108472"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145305088","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":"Letter to the editor regarding “Hybrid clinical-radiomics model based on fully automatic segmentation for predicting the early expansion of spontaneous intracerebral hemorrhage”","authors":"Emmanuel Pio Pastore","doi":"10.1016/j.jstrokecerebrovasdis.2025.108464","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108464","url":null,"abstract":"","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 12","pages":"Article 108464"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234630","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":"VU0360172 exerts anti-inflammatory effect on germinal matrix hemorrhage in neonatal rats via the mGluR5/PI3Kγ/PPARγ pathway","authors":"Xiaoya Wang ,&nbsp;Jianwei Xu ,&nbsp;Ying Liu ,&nbsp;Qin Chen ,&nbsp;Rongjie Liu ,&nbsp;Qing Zhang ,&nbsp;Ying Xiong ,&nbsp;Zhanhui Feng ,&nbsp;Qian Zheng ,&nbsp;Lan Ye","doi":"10.1016/j.jstrokecerebrovasdis.2025.108469","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108469","url":null,"abstract":"<div><h3>Background</h3><div>This study investigated the neuroprotective and anti-inflammatory effects of the mGluR5-specific positive allosteric modulator VU0360172 on germinal matrix hemorrhage (GMH) in neonatal rats, as well as the pharmacological mechanism pathway that may underlie this anti-inflammatory effect.</div></div><div><h3>Methods</h3><div>A GMH model was established by intracerebral injection of 0.3 U collagenase VII-S in 7-day-old Sprague-Dawley rats. Animals were randomly divided into the following seven groups: (1) Sham, (2) GMH, (3) GMH +VU0360712 (0.75 mg/kg), (4) GMH + VU0360712 (1.5 mg/kg), (5) GMH + VU0360712 (3.0 mg/kg), (6) GMH + VU0360172 (3.0 mg/kg) + MTEP (0.6 mg/kg), and (7) GMH + VU0360172 (3.0 mg/kg) + AS-605240 (1.8 mg/kg). Western blot analysis was conducted on samples collected at 0, 3, 12 and 24 h and 3 and 7 days post-surgery to observe the postoperative changes in metabotropic glutamate receptor 5 (mGluR5). The neuroprotective and anti-inflammatory effects of different doses of VU0360172 (0.75, 1.5, and 3.0 mg/kg) on GMH were evaluated through neurological behavior testing, brain water content, brain hemorrhage volume, hematoxylin and eosin staining, and ELISA. Finally, MTEP and AS-605240 as inhibitors, were administered to explore the inflammatory regulation and microglial polarization regulation of the mGluR5/PI3Kγ/PPARγ pathway.</div></div><div><h3>Results</h3><div>The results demonstrated that mGluR5 levels started to decline as early as 3 hours after GMH and reached a minimum at 24 hours. Compared with the GMH group, treatment with VU0360172 reduced improved neurological deficits, brain edema, and hemorrhage, reduced tissue loss and inflammatory cell infiltration, and alleviated the inflammatory response, with the middle and high doses showing particularly notable effects (<em>P</em> &lt; 0.05). However, both MTEP and AS-605240 reversed the regulatory effects of VU0360172 on the mGluR5/PI3Kγ/PPARγ pathway. Significant reversals in the expression of key inflammatory factors and microglial markers were observed in the MTEP and AS-605240 groups compared to the high-dose VU0360172 group (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>VU3060172 has a neuroprotective effect and anti-inflammatory properties on the GMH mouse model. Its anti-inflammatory mechanism may be achieved by activating the mGluR5/PI3Kγ/PPARγ pathway to regulate microglial polarization.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 12","pages":"Article 108469"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276932","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":"Predicting post-stroke depression in middle-aged and older adults in china using obesity-related index: A cohort study","authors":"Bo Lin ,&nbsp;Na Chen ,&nbsp;Xiao Chen ,&nbsp;Jingbo Jia ,&nbsp;Jie Xiang ,&nbsp;Tingjun Zhang ,&nbsp;Ruwen Zheng","doi":"10.1016/j.jstrokecerebrovasdis.2025.108468","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108468","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to investigate the efficacy of 13 obesity and dyslipidemia-related indicators in predicting post-stroke depression (PSD) and to determine the optimal cutoff values for these indicators in middle-aged and elderly Chinese populations.</div></div><div><h3>Method</h3><div>This study utilized data from the China Health and Retirement Longitudinal Study (CHARLS) spanning 2011 to 2020, which included 3912 participants aged 45 years and older. Body Mass Index (BMI), Waist Circumference (WC), Waist-to-Height Ratio (WHtR), Visceral Adiposity Index (VAI), Adiposity Body Shape Index (ABSI), Body Roundness Index (BRI), Lipid Accumulation Score (LAP), Cone Index (CI), Chinese Visceral Adiposity Index (CVAI), Triglyceride-Glucose (TyG) Index, and its related indices (TyG-BMI, TyG-WC, TyG-WHtR). Logistic regression analysis assessed the unadjusted and adjusted associations between these indicators and PSD. The area under the receiver operating characteristic (ROC) curve (AUC) was calculated for each indicator as a predictor of PSD capability to compare predictive performance and determine optimal cutoff values.</div></div><div><h3>Results</h3><div>After adjusting for confounding factors, 12 obesity and dyslipidemia-related indices were independently associated with PSD risk in women (p &lt; 0.05), with 11 indicators demonstrating predictive value for PSD (all AUC &gt; 0.6). Among these, the CVAI index exhibited the highest predictive efficacy (AUC = 0.693, 95% CI: 0.602–0.757, optimal cutoff = 128.031). Among men, 12 obesity and lipid-related indices were independently associated with PSD risk (p &lt; 0.05), but all indices demonstrated poor predictive value for PSD (AUC &lt; 0.6). PSD risk significantly increased with higher obesity and lipid indices.</div></div><div><h3>Conclusion</h3><div>Among the 12 obesity-related lipid parameters excluding ABSI, all were effective predictors of PSD risk in middle-aged and elderly Chinese women, with CVAI being the optimal predictor. These indices can serve as simple screening tools to identify PSD risk and facilitate early intervention. Effective predictors for male PSD require further exploration.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 12","pages":"Article 108468"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276980","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":"Age at natural menopause and stroke: A U-shaped association in the health and retirement study","authors":"QinFeng Zeng ,&nbsp;Wenjia Zhang,&nbsp;Yingzhi Liu,&nbsp;Weijun Yang,&nbsp;XiaoLing Wu,&nbsp;Jieding Li","doi":"10.1016/j.jstrokecerebrovasdis.2025.108497","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108497","url":null,"abstract":"<div><h3>Background</h3><div>The association between age at natural menopause and cerebrovascular risk is unclear. This study investigates non-linear relationships, effect modification, mediation, and long-term stroke-free survival in postmenopausal women.</div></div><div><h3>Methods</h3><div>We analyzed 9,159 postmenopausal women from the Health and Retirement Study. Menopause age was categorized (&lt;40, 40–44, 45–49, 50–55, &gt;55) and modeled continuously. Stroke outcomes were derived from self-reports and linked Medicare claims. We used multivariable logistic regression with restricted cubic splines, interaction terms among hypertension, diabetes, and hypercholesterolemia, structural equation modeling for mediation, and Kaplan-Meier/Cox models for survival analysis.</div></div><div><h3>Results</h3><div>Each additional year of later menopause was linked to lower stroke odds (OR 0.935, 95 % CI 0.922–0.948). Compared to the 50–55 age group, those with menopause &lt;45 years (OR 2.76, 95 % CI 2.09–3.47) and 45–49 years (OR 2.08, 95 % CI 1.72–2.62) had higher risks. Spline analysis indicated a U-shaped curve, with the lowest risk at ages 50–52. Stroke-free survival differed significantly across groups (log-rank <em>p</em> = 0.0017), particularly worse with premature menopause.</div></div><div><h3>Conclusions</h3><div>Age at natural menopause exhibits a U-shaped association with stroke risk, emphasizing the importance of timing in individualized prevention strategies.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 12","pages":"Article 108497"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145575177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficiency of robotic hand exoskeleton system in stroke patients: A pilot randomized controlled single blind trial","authors":"Fatma Öztürk (Lect) ,&nbsp;Gönül Acar (Prof) ,&nbsp;Ulvi Başpınar ,&nbsp;Özge Keniş Coşkun ,&nbsp;Barkın Bakır ,&nbsp;Ipek Midi","doi":"10.1016/j.jstrokecerebrovasdis.2025.108494","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108494","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to investigate the effects of the Robotic Hand Exoskeleton system on spasticity, motor control skills, activities of daily living, quality of life, and functional independence in stroke patients.</div></div><div><h3>Design</h3><div>A randomized controlled trial was conducted with 36 stroke patients aged 35-85, divided into two groups: conventional physiotherapy (<em>n</em> = 18) and robotic rehabilitation (<em>n</em> = 18). Evaluations included the Modified Ashworth Scale (MAS) for spasticity, Motor Activity Log 28 (MAL28) for daily activities, Frenchay Arm Test for motor control, and Stroke Impact Scale 3.0 (SIS 3.0) for quality of life and functional independence. Both groups received 15 treatment sessions over five weeks, with the robotic rehabilitation group additionally using a Robotic Hand Exoskeleton for 10 minutes per session.</div></div><div><h3>Results</h3><div>A significant improvement was observed in MAS (ES=0.092), MAL28, Frenchay Arm Test (ES=0.093), and SIS 3.0 (ES=0.01) scores after treatment (<em>p</em> &lt; 0.05). However, no statistically significant differences were found between the groups (<em>p</em> &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>Robotic hand rehabilitation improved motor function, daily activities, quality of life, and reduced spasticity, but showed no superiority over conventional physiotherapy. Both treatments demonstrated similar effectiveness, with robotic rehabilitation offering potential financial and time-saving benefits for healthcare providers.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 12","pages":"Article 108494"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534163","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}