Journal of Stroke & Cerebrovascular Diseases最新文献

{"title":"Development and validation of clinical prediction model for functional independence measure following stroke rehabilitation","authors":"Shinya Fukuda PT ,&nbsp;Norio Yamamoto MD, PhD ,&nbsp;Yosuke Tomita PT ,&nbsp;Takeshi Matsumoto PT ,&nbsp;Tomoya Shinohara OT ,&nbsp;Tatsuro Ohno PT ,&nbsp;Hitoshi Fukuda MD, PhD ,&nbsp;Tetsuya Ueba PhD, MD","doi":"10.1016/j.jstrokecerebrovasdis.2024.108185","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108185","url":null,"abstract":"<div><h3>Objectives</h3><div>To develop and internally validate a clinical prediction model that includes balance ability and nutritional indices for the motor-functional independence measure (M-FIM) at 90 days post-stroke stroke.</div></div><div><h3>Materials and Methods</h3><div>This retrospective, single-center study included 566 patients with stroke undergoing rehabilitation at our rehabilitation hospital. The primary outcome was the M-FIM score of &gt;61 at 3 months post-strokes onset. Stepwise conditional forward selection was first used to identify predictors for the achievement of M-FIM&gt;61 at 90 days post-stroke, from 25 potential predictors at admission. The selected predictors were dichotomized with cut-off values to establish scoring systems, resulting in the B-ADL model, which includes postural balance (B), albumin level, age, arm function (A), days since stroke onset (D), and level of activities of daily living (ADL) (L). For internal validation, we corrected the optimism of the area under the curve of receiver operating characteristic curve (AUROC) induced by overfitting the original data using the bootstrap validation method. Calibration capacity was assessed using a calibration plot.</div></div><div><h3>Results</h3><div>We developed a clinical model to predict the M-FIM at 90 days post-stroke onset. The AUROC of the B-ADL model was 0.92 (sensitivity, 93.7%; specificity, 89.7%). The B-ADL model showed high accuracy with an AUROC of 0.970 in the internal validation. The scoring system in the validation cohort had a cut-off value of 5.5/12 points to predict the achievement of M-FIM&gt;61 (AUROC: 0.950; 95% CI 0.930–0.970).</div></div><div><h3>Conclusions</h3><div>The B-ADL model accurately predicted M-FIM &gt;61 at 90 days post-stroke on the day of admission to the recovery rehabilitation ward. The B-ADL model is useful for optimizing rehabilitation programs and resource allocation, allowing for targeted interventions after stroke.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 2","pages":"Article 108185"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tetramethylpyrazine attenuates cerebral ischemia-reperfusion injury by inhibiting ferroptosis via the AMPK / Nrf2 pathways","authors":"Ke-xin Zhong ,&nbsp;Qi Zeng ,&nbsp;Hao Tang ,&nbsp;Biao Tang Ph.D. (Professor) ,&nbsp;Hao Wang","doi":"10.1016/j.jstrokecerebrovasdis.2024.108196","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108196","url":null,"abstract":"<div><h3>Objectives</h3><div>Ferroptosis is involved in the development and exacerbation of cerebral ischemia-reperfusion injury (CIRI), and its inhibition can alleviate CIRI. Tetramethylpyrazine (TMP) is used for the treatment of ischemic stroke. However, the mechanism by which TMP regulates ferroptosis in CIRI is yet to be explored. This study demonstrated the effects of TMP on ferroptosis and CIRI, including the roles of the adenosine 5′-monophosphate-activated protein kinase (AMPK)/nuclear factor erythroid-2-related factor 2 (Nrf2) signaling pathway.</div></div><div><h3>Materials and methods</h3><div>A Sprague–Dawley rat middle cerebral artery occlusion/reperfusion (MCAO/R) model was generated. The extent of neuronal injury was measured using 2,3,5-triphenyl tetrazolium chloride staining and Garcia neurological scoring and behavior was evaluated using open-field tests. Ferroptosis-related indexes were examined and ferroptosis-related proteins were detected using western blotting. The binding modes of TMP and AMPK were evaluated using molecular docking and molecular dynamics simulations.</div></div><div><h3>Results</h3><div>MCAO/R rats showed a reduced cerebral infarct area and improved neurological function after TMP intervention. TMP reduced levels of Fe²⁺, 4-hydroxynonenal, malonaldehyde, and acyl-coenzyme synthetase long-chain family member 4 and increased levels of glutathione and glutathione peroxidase 4. Increased AMPK phosphorylation and Nrf2 expression were also detected. TMP bound tightly to the AMPKα subunit in silico, and the LEU157, VAL41, LEU33, VAL107, and TYR106 residues were important for binding.</div></div><div><h3>Conclusions</h3><div>Our results indicate that TMP can alleviate CIRI by inhibiting ferroptosis via the activation of the AMPK/Nrf2 pathway, providing a theoretical basis for the clinical use of TMP in treating CIRI.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 2","pages":"Article 108196"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with social isolation in stroke patients: a systematic review and meta-analysis","authors":"Yue Li ,&nbsp;Huiqiong Xu ,&nbsp;Ting Zhang ,&nbsp;Xianying Lu ,&nbsp;Xuemei Xie ,&nbsp;Jing Gao","doi":"10.1016/j.jstrokecerebrovasdis.2024.108201","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108201","url":null,"abstract":"<div><h3>Objective</h3><div>Systematic evaluation of factors influencing social isolation in stroke patients for further intervention studies.</div></div><div><h3>Methods</h3><div>We searched for observational studies in 7 databases from inception to January 2024. Two researchers performed literature screening, quality assessment, and data extraction independently according to inclusion and exclusion criteria, and meta-analysis was performed using R4.3.1 software.</div></div><div><h3>Results</h3><div>A total of 10 studies with a total sample size of 4162 cases were included. Meta-analysis showed that social isolation in stroke patients was associated with economic status (<em>β’</em>=-0.21, <em>95%CI:</em>0.39, -0.02; <em>P</em>=0.0261), degree of education (<em>β’</em>=-0.16, 95%<em>CI</em>:0.29, -0.03; <em>P</em>=0.0171), marital status (<em>β’</em>=0.13, 95%<em>CI:</em>0.04, 0.23; <em>P</em>=0.0069), social support (<em>β’</em>=-0.37, 95%<em>CI</em>;-0.50, -0.25; <em>P</em>&lt;0.0001), stigma(<em>β’</em>=0.48, 95%<em>CI</em>:0.25, 0.72; <em>P</em>&lt;0.0001), symptom burden (<em>β’</em>=0.25, 95%<em>CI</em>:0.18, 0.31; <em>P</em>&lt;0.0001), course of disease (<em>β’</em>=0.23, 95%<em>CI</em>:0.08, 0.37; <em>P</em>=0.0021), combined chronic diseases (<em>β’</em>=0.14, 95%<em>CI</em>:0.04, 0.24; <em>P</em>=0.0057), and limb function (<em>β’</em>=0.33, 95%<em>CI</em>:0.23, 0.43; <em>P</em>&lt;0.0001) were associated. Meta-regression and subgroup analyses showed that disease stage and sample source were sources of heterogeneity.</div></div><div><h3>Conclusion</h3><div>There are many factors influencing the social isolation of stroke patients, and healthcare professionals should take timely and targeted measures to prevent and intervene effectively, with a view to improving the social participation of stroke patients and reducing their social isolation.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 2","pages":"Article 108201"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute stroke care coordination in the United States: Variation in state laws for Emergency Medical Services and hospitals","authors":"Zhiqiu Ye PhD ,&nbsp;Siobhan Gilchrist JD, MPH ,&nbsp;Nina Omeaku PhD, JD, MPH ,&nbsp;Sharada Shantharam MPH ,&nbsp;Matthew Ritchey PT, DPT, MPH ,&nbsp;Sallyann M. Coleman King MD, MSc ,&nbsp;Laurence Sperling MD ,&nbsp;Jane L. Holl MD, MPH","doi":"10.1016/j.jstrokecerebrovasdis.2024.108174","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108174","url":null,"abstract":"<div><h3>Background</h3><div>Lack of care coordination between Emergency Medical Services (EMS) and hospitals contributes to delay of acute stroke (AS) treatment. In the United States, states have adopted laws to improve the quality of EMS and hospital care; the degree to which these laws create regulatory incentives to promote care coordination between them is less well known. We examined state variation in attributes of laws that may influence AS care coordination between EMS and hospitals.</div></div><div><h3>Materials and Methods</h3><div>We selected ten law “dyads” across seven domains of EMS and hospital AS care informed by published risk assessments of critical steps for improved door-to-needle time and door-in-door-out time. We assessed concordance in prescriptiveness (degree to which levels were similar) and in adoption (degree to which laws were adopted concurrently) of the laws in effect between January 2002 and January 2018 in the United States.</div></div><div><h3>Results</h3><div>The proportion of states with prescriptiveness concordance ranged from 47 % (e.g., inter-facility transfer agreements, comprehensive, primary stroke center certification) to 75 % (e.g., Continuous Quality Improvement (CQI) for EMS and hospitals). Adoption concordance ranged from 31 % (e.g., inter-facility transfer agreements, Acute Stroke Ready Hospital certification) to 86 % (e.g., CQI for EMS and hospitals). Laws for EMS triage were less prescriptive than laws for stroke center certification in 22 %–35 % of states adopting both laws, depending on stroke center type.</div></div><div><h3>Conclusions</h3><div>Subsequent policy implementation and impact studies may benefit from assessing concordance and prescriptiveness in policy intervention adoption, particularly as a foundation for evaluating delays in AS treatment due to inefficient care coordination.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 2","pages":"Article 108174"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Topography of ischemic strokes in cancer-associated non-bacterial thrombotic endocarditis: A single-institution descriptive case series","authors":"Carlee I. Oakley ,&nbsp;Ewa M. Wysokinska ,&nbsp;Alicja Kaminska ,&nbsp;Marwa A. Mohammed ,&nbsp;Patryk Patrzalek ,&nbsp;Damon Houghton ,&nbsp;David Hodge ,&nbsp;Waleed Brinjikji ,&nbsp;James P. Klaas ,&nbsp;Waldemar E. Wysokinski","doi":"10.1016/j.jstrokecerebrovasdis.2024.108171","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108171","url":null,"abstract":"<div><h3>Background</h3><div>Very limited data indicate that patients with stroke from cancer-associated NBTE (Ca-NBTE) exhibit a characteristic pattern of widely distributed ischemic lesions of varying sizes.</div></div><div><h3>Methods</h3><div>An electronic search of Mayo Clinic records (03/31/2002-06/30/2022) with ensuing manual review of brain magnetic resonance imaging (MRI) was performed to identify topographic characteristics of stroke from Ca-NBTE.</div></div><div><h3>Results</h3><div>In 112 patients with Ca-NBTE, 92 (82.1 %) had a stroke and 84 (76.5 %) had an MRI available for analysis (mean age 62.7±9.2, 57 women). 64 (76.2 %) patients had ischemic strokes in both cerebral hemispheres, 10 (11.9 %) had isolated left hemispheric infarcts, and 7 (8.3 %) had isolated right hemispheric infarcts. Strokes involving both the anterior and posterior circulation were seen in 66 (78.6 %) patients. Disseminated small, medium, and large ischemic strokes (Type IV) were seen in 57 (67.8 %), multiple punctate disseminated strokes (Type III) in 14 (16.7 %), multiple strokes in a single vascular territory (Type II) in 7 (8.3 %), and a single ischemic stroke (Type I) in 6 (7.1 %) patients. Strokes were most commonly observed in the middle cerebral artery territories – on the right in 65 (77.4 %) and on the left in 68 (81.0 %) patients. Strokes within the right posterior cerebral artery territory were observed in 54 (64.3 %) and the left posterior cerebral artery territory in 54 (64.3 %) patients. 46 (54.8 %) patients had strokes in the right cerebellum and 50 (59.5 %) had strokes in the left cerebellum. Only 5 patients had strokes in the right brainstem and 3 in the left brainstem.</div></div><div><h3>Discussion</h3><div>Ca-NBTE is most commonly associated with multifocal bihemispheric ischemic strokes of varying sizes involving both the anterior and posterior circulation, but solitary infarcts or infarcts confined to a single vascular territory can also be seen.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 2","pages":"Article 108171"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The stroke meta-metric, Defect-Free Care, was maintained year-over-year within the Florida stroke registry during the COVID-19 pandemic","authors":"David Z. Rose M.D. ,&nbsp;Lili Zhou M.S. ,&nbsp;Karlon H. Johnson MPH ,&nbsp;Charles Schutt M.D. ,&nbsp;Daniel M. Reyes de Jesus M.D. ,&nbsp;Hannah Gardener Sc.D. ,&nbsp;Carolina M. Gutierrez Ph.D. ,&nbsp;Dianne Foster BSN MBA ,&nbsp;Angus Jameson M.D. MPH ,&nbsp;Sebastian Koch M.D. ,&nbsp;Hao Ying MSc ,&nbsp;Ayham Alkhachroum M.D. MSc ,&nbsp;Jose G. Romano M.D. ,&nbsp;Tatjana Rundek M.D., Ph.D. ,&nbsp;Negar Asdaghi M.D., FRCPC","doi":"10.1016/j.jstrokecerebrovasdis.2024.108179","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108179","url":null,"abstract":"<div><h3>Background</h3><div>Resource allocation for stroke care was impacted worldwide by the Coronavirus 2019 (COVID19) pandemic. Regionally, worsened stroke outcomes varied, however comparative year-over-year in-hospital performance metrics from the pandemic are unreported. Therefore, within the large Florida Stroke Registry (FSR), we assessed the pandemic's effects upon the American Heart Association (AHA) Get With The Guidelines (GWTG) ischemic stroke metrics and the meta-metric, Defect-Free Care (DFC).</div></div><div><h3>Methods</h3><div>From March 2017 to February 2021, FSR collected 146,593 patients with a diagnosis of ischemic stroke or TIA (31,940 between 2017-2018; 35,086 between 2018-2019; 39,722 between 2019-2020; 39,845 between 2020-2021). FSR evaluated DFC, intravenous thrombolytic (IVT) use, endovascular therapy (EVT) use, and Door-To-Needle (DTN), Door-To-Computed Tomography (DTCT), and Door-To-Puncture (DTP) times.</div></div><div><h3>Results</h3><div>Pre-pandemic versus pandemic stroke patients’ demographics were similar (49.0 % vs. 48.6 % female, age 70.7±14.3 vs. 70.5±14.1 years, 64.0 % vs. 65.3 % white, 18.6 % vs. 18.8 % black, 17.4 % vs. 16.0 % Hispanic). Pandemic strokes, versus the immediate year pre-pandemic, were significantly more severe (median NIHSS 4 [IQR 8] vs. 3 [7]), utilized emergency medical services more (59.2 % vs. 57.6 %) and were more likely to receive EVT (8.0 % vs. 7.0 %). IVT use, and DTCT and DTP times were unchanged. The meta-metric DFC improved year-over-year, albeit slower during the pandemic [2017/18-2018/19: 70.7 % to 74.9 % (+4.2 %); 2018/19-2019/20: 74.9 % to 82.1 % (+7.2 %); 2019/20-2020/21: 82.1 % to 85.2 % (+3.1 %)].</div></div><div><h3>Conclusions</h3><div>Despite pandemic challenges, the stroke meta-metric DFC improved, albeit more slowly than pre-pandemic years. In this large statewide registry, pandemic patients received EVT more, potentially due to more severe stroke presentations. Stroke care infrastructure preparedness for future pandemics is warranted.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 2","pages":"Article 108179"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11781959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smartphone pupillometry with machine learning differentiates ischemic from hemorrhagic stroke: A pilot study","authors":"Anthony J. Maxin BS ,&nbsp;Bernice G. Gulek PhD ,&nbsp;Do H. Lim BA ,&nbsp;Samuel Kim BS ,&nbsp;Rami Shaibani BS ,&nbsp;Graham M. Winston MD ,&nbsp;Lynn B. McGrath MD ,&nbsp;Alex Mariakakis PhD ,&nbsp;Isaac J. Abecassis MD ,&nbsp;Michael R. Levitt MD","doi":"10.1016/j.jstrokecerebrovasdis.2024.108198","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108198","url":null,"abstract":"<div><h3>Objectives</h3><div>Similarities between acute ischemic and hemorrhagic stroke make diagnosis and triage challenging. We studied a smartphone-based quantitative pupillometer for differentiation of acute ischemic and hemorrhagic stroke.</div></div><div><h3>Materials and methods</h3><div>Stroke patients were recruited prior to surgical or interventional treatment. Smartphone pupillometry was used to quantify components of the pupillary light reflex (PLR). A synthetic minority oversampling technique (SMOTE) was applied to correct sample size imbalance. Four binary classification model types were trained using all possible combinations of the PLR components with 10-fold cross validation stratified by cohort. Models were evaluated for accuracy, sensitivity, specificity, area under the curve (AUC), and F1 score. The three best-performing models were selected based on AUC. Shapley additive explanation plots were produced to explain PLR parameter impacts on model predictions.</div></div><div><h3>Results</h3><div>Eleven subjects with intraparenchymal hemorrhage and 22 subjects with acute ischemic stroke were enrolled. One way ANOVA demonstrated significant differences between healthy control data, AIS, and IPH in five out of seven PLR parameters. After SMOTE, each class had n=22 PLR recordings for model training. The best-performing model was random forest using a combination of latency, mean and maximum constriction velocity, and mean dilation velocity to discriminate between stroke types with 91.5% (95% confidence interval: 84.1-98.9) accuracy, 90% (82.9-97.1) sensitivity, 93.3% (83-100) specificity, 0.917 (0.847-0.987) AUC, and 90.7% (84.1-97.3) F1 score.</div></div><div><h3>Conclusions</h3><div>Smartphone-based quantitative pupillometry could be useful in differentiating between acute ischemic and hemorrhagic stroke.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 2","pages":"Article 108198"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relevance of peripheral inflammation indexes in different collateral circulation for intracranial hemorrhage in acute anterior circulation ischemic stroke patients undergoing endovascular treatment","authors":"Jinrui Li MD ,&nbsp;Kailin Cheng MD ,&nbsp;Jianxia Ke MD ,&nbsp;Jintao Li MD ,&nbsp;Jia Wen MD ,&nbsp;Junting Chen MD ,&nbsp;Xue Jia ,&nbsp;Xiaoli Fu MD ,&nbsp;Kefeng Lv MD ,&nbsp;Zhu Shi MDPhD","doi":"10.1016/j.jstrokecerebrovasdis.2024.108175","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108175","url":null,"abstract":"<div><h3>Background</h3><div>Asymptomatic intracranial hemorrhage (aICH) is common after endovascular thrombectomy (EVT). Collateral circulation could modify the association between aICH with functional outcome and we aimed to investigate the impact of systemic inflammation index on 3-month outcome under different collateral circulation.</div></div><div><h3>Method</h3><div>Consecutive patients undertaken EVT were enrolled and classified into non-intracranial hemorrhage (non-ICH), aICH and symptomatic intracranial hemorrhage (sICH) groups according to the neurological status and National Institutes of Health Stroke Scale (NIHSS) changes within 72 hours after EVT. Preoperative collateral status was scored using the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) scale. Clinical data were collected and analyzed according to the stratification of collateral stratification. Multivariate regression models were constructed to evaluate the influence of systemic inflammation indexes and collateral status on functional outcome.</div></div><div><h3>Results</h3><div>Of 302 patients, 86 (28.5%) developed aICH with 36(11.9%) sICH. Compared to non-ICH patients, there was a significant trend towards higher proportion of poor collateral circulation in patients with aICH, sICH (47.8% vs. 67.2% vs. 94.4%, p &lt;0.001). Spearman's correlation analysis revealed a significant negative correlation of peripheral neutrophil counts, NLR, and SIRI with collateral circulation score. Under poor collateral circulation, neutrophil counts showed a significant positive association with sICH (OR 1.20, 95%CI: 1.07-1.35, p=0.002), but not with aICH. Under good collateral circulation, the inflammation indexes did not show a significant correlation with either ICH.</div></div><div><h3>Conclusion</h3><div>aICH patients with good collateral circulation have good functional outcome comparable to no-ICH patients. Under poor collateral circulation, elevated neutrophil counts may contribute to the conversion from aICH to sICH. Tailored anti-inflammatory therapy has potential to improve the efficacy and safety of EVT.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 2","pages":"Article 108175"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between non-verbal cognitive assessment and stroke recovery via screening test for aphasia and dysarthria","authors":"Kentaro Araki PhD, SLT,&nbsp;Yoshiyuki Hirano PhD,&nbsp;Kohei Kurita MS,&nbsp;Eiji Shimizu PhD, MD","doi":"10.1016/j.jstrokecerebrovasdis.2024.108217","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108217","url":null,"abstract":"<div><h3>Objective</h3><div>Non-verbal Screening Test for Aphasia and Dysarthria scores correlate with post-stroke cognitive function; however, their correlations with activities of daily living dependency and home discharge (cognitive function-associated outcomes) remain unclear. We investigated the correlation of these scores with activities of daily living dependency and home discharge outcomes.</div></div><div><h3>Materials and Methods</h3><div>Disability levels and functional outcomes of 278 inpatients with brain injury (age: 72.8 ± 13.0 years) were evaluated using the modified Rankin Scale. Patients were grouped according to activities of daily living dependency (independent [<em>n</em> = 96; modified Rankin Scale score≤2]) and non-home discharge (<em>n</em> = 126) status. Factors predicting home discharge were analyzed using univariate and multivariate logistic regression analyses.</div></div><div><h3>Results</h3><div>Cognitive impairment was more prevalent in the activities of daily living-dependent group than in the independent group (odds ratio: 6.34 [95 % confidence interval: 3.57–11.52]; <em>p</em> &lt; 0.001) and in the non-home discharge than in the home discharge group (2.78 [1.65–4.73]; <em>p</em> &lt; 0.001). Non-verbal test scores correlated moderately with activities of daily living independence and home discharge. Age, modified Rankin Scale score, cognitive impairment, and the Screening Test for Aphasia and Dysarthria scores were significantly associated with home discharge in univariate analyses. Only modified Rankin Scale and non-verbal test scores were significantly associated with home discharge in multivariate analysis (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Non-verbal test scores were significantly associated with activities of daily living independence and home discharge in patients with stroke. The non-verbal test, being less influenced by communicative disorders, offers a novel tool for estimating cognitive function.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 2","pages":"Article 108217"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of early antihypertensive treatment on cognitive function in patients with acute ischemic stroke with different neurofilament light chain levels","authors":"Hong Li MD ,&nbsp;Deyu Yang MD, PhD ,&nbsp;Shudong Liu MD ,&nbsp;Zhengbao Zhu MD, PhD ,&nbsp;Mengyao Shi MD, PhD ,&nbsp;Tan Xu MD, PhD ,&nbsp;Jing Chen MD, MS ,&nbsp;Yonghong Zhang MD, PhD ,&nbsp;Jiang He MD, PhD ,&nbsp;Chongke Zhong MD, PhD ,&nbsp;Xiaoqing Bu MD, PhD","doi":"10.1016/j.jstrokecerebrovasdis.2024.108206","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108206","url":null,"abstract":"<div><h3>Background</h3><div>It is unclear whether the extent of neuroaxonal damage, as measured by circulating levels of neurofilament light chain (NfL), would modify the effects of early antihypertensive therapy on cognitive performance following stroke. This study aimed to investigate the effects of early blood pressure reduction on the risk of post-stroke cognitive impairment (PSCI) among patients with different plasma NfL levels.</div></div><div><h3>Methods</h3><div>A total of 622 eligible patients from a pre-planned ancillary study of CATIS (China Antihypertensive Trial in Acute Ischemic Stroke) were included in this study. The electrochemiluminescence immunoassay technique was used to evaluate Plasma NfL levels at baseline, and the Mini-Mental State Examination (MMSE) in Chinese was used to assess cognition at the 3-month follow-up. An MMSE score of less than 27 was considered as PSCI.</div></div><div><h3>Results</h3><div>The effect of antihypertensive therapy on PSCI differed according to NfL levels at the 3-month follow-up. In the low NfL group, compared with the control group, antihypertensive treatment reduced the risk of PSCI [adjusted odds ratio (OR), 95 % confidence interval (CI): 0.50 (0.31-0.81)]. However, in the high NfL group, antihypertensive treatment increased the risk of PSCI compared with the control group [adjusted OR, 95 % CI: 1.93 (1.16-3.20)].</div></div><div><h3>Conclusions</h3><div>Antihypertensive therapy in the acute phase reduced the risk of PSCI in patients with low plasma NfL levels, but increased the risk in patients with high NfL levels.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 2","pages":"Article 108206"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}