Frontiers in stroke最新文献

{"title":"Case Report: Flossing intervention for chronic upper limb spasticity after childhood-onset stroke.","authors":"Shuichi Sasaki, Naonobu Takahira, Yuzo Ono, Keiichiro Aoki, Sora Kurosaki, Marina Moteki, Risa Fujita, Tomonori Kenmoku","doi":"10.3389/fstro.2026.1952839","DOIUrl":"10.3389/fstro.2026.1952839","url":null,"abstract":"<p><strong>Background: </strong>Upper limb spastic paralysis after stroke often limits functional use of the affected hand and restricts activities of daily living, particularly in cases with long-standing impairment following childhood-onset stroke. Although various interventions for spasticity have been reported, many require specialized equipment or invasive procedures, which may limit long-term and home-based use. Flossing intervention, which involves compressive wrapping with an elastic band combined with movement, has recently been introduced in musculoskeletal practice; however, its application for post-stroke spasticity remains unclear.</p><p><strong>Case presentation: </strong>An adolescent girl in her teens (female, Asian) presented with long-standing right upper limb spastic paralysis following childhood-onset cerebral infarction associated with moyamoya disease. At baseline, she demonstrated marked distal spasticity, limited active wrist extension, and restricted functional use of the affected hand. A flossing intervention was applied to the distal forearm and elbow region, consisting of compressive wrapping followed by passive twisting and active movements. The intervention was performed both in outpatient therapy and as a home-based program. After 6 months of continuous intervention, Modified Ashworth Scale scores decreased, upper limb motor function assessed using the Fugl-Meyer Assessment improved, and real-world use of the affected hand assessed using the Motor Activity Log increased. Active wrist extension range of motion improved from -20° to 40°, and functional bilateral hand use, including button fastening, became possible. The patient reported improved ease of hand movement and high satisfaction, and functional gains were maintained during follow-up.</p><p><strong>Conclusions: </strong>This case suggests that flossing intervention may be a feasible, non-invasive, and home-based treatment option for improving upper limb function in patients with long-standing post-stroke spastic paralysis following childhood-onset stroke. Further studies are required to clarify its efficacy and appropriate indications.</p>","PeriodicalId":73108,"journal":{"name":"Frontiers in stroke","volume":"5 ","pages":"1952839"},"PeriodicalIF":1.2,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electrophysiological signature of stroke recovery: investigating EEG biomarkers for prognostic insights.","authors":"Majid Khalili-Ardali, Vivek Sharma, Tarandeep Singh Mandahar, Francisco Páscoa Dos Santos, Paul Tiesinga, Nick Ramsey","doi":"10.3389/fstro.2026.1894659","DOIUrl":"10.3389/fstro.2026.1894659","url":null,"abstract":"<p><strong>Introduction: </strong>Stroke is a leading cause of long-term disability, often resulting in persistent motor impairments that reflect disruptions in large-scale brain networks. An integrated framework capturing spatiotemporal EEG dynamics would help clarify how these networks change during recovery.</p><p><strong>Methods: </strong>We analysed resting-state EEG from stroke patients at 1 week (Session 1) and three months (Session 2) post-stroke to investigate electrophysiological biomarkers of motor recovery, indexed by change in the Fugl-Meyer scale (Δ<i>FM</i>). We quantified relative alpha-band power, microstate metrics (mean duration, complexity, and transition probabilities), and measures of metastability and synchrony derived from the Kuramoto Order Parameter.</p><p><strong>Resultss: </strong>Change in relative alpha power emerged as the strongest single correlate of motor improvement, accounting for the largest proportion of variance among the EEG measures examined. Metastability and synchrony did not individually reach statistical significance but showed moderate positive correlations with Δ<i>FM</i>, particularly in the alpha and theta bands, and added 26% explained variance in Δ<i>FM</i> when combined with alpha power. Microstate parameters did not explain additional variance once alpha power and network-level dynamics were accounted for. A hierarchical model combining alpha power, metastability/synchrony, and microstates explained over 78% of the variance in Δ<i>FM</i>.</p><p><strong>Discussion: </strong>These findings indicate that stroke recovery involves restoring balanced alpha oscillations and flexible large-scale brain coordination. Larger samples and more frequent longitudinal assessments are required to confirm the prognostic utility of integrated EEG biomarkers for guiding personalised stroke rehabilitation strategies.</p>","PeriodicalId":73108,"journal":{"name":"Frontiers in stroke","volume":"5 ","pages":"1894659"},"PeriodicalIF":1.2,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A prospective study evaluating clopidogrel resistance among patients with ischemic cerebrovascular events across different ethnic groups in Israel.","authors":"Fadi Shbat, Karine Beiruti Wiegler, Najib Dally, Elias Saad, Saher Srour, Elizabeth Eshel, Adi Sharabi Nov, Radi Shahien, Ronen Leker, Naaem Simaan","doi":"10.3389/fstro.2026.1908099","DOIUrl":"10.3389/fstro.2026.1908099","url":null,"abstract":"<p><strong>Introduction: </strong>Clopidogrel is commonly used for secondary prevention after ischemic cerebrovascular events, but substantial interindividual variability in pharmacodynamics response has been reported. Individuals demonstrating resistance to clopidogrel face a higher likelihood of recurrent ischemic events. This study evaluated clopidogrel responsiveness among Jewish and Arab patients treated within the same regional healthcare setting.</p><p><strong>Methods: </strong>This prospective cohort included 102 patients with ischemic cerebrovascular events (acute ischemic stroke or transient ischemic attack) receiving clopidogrel for secondary prevention. Patients received either a loading dose (300 in 62 patients, 600 mg in 1 patient) followed by maintenance therapy or at least 7 days of 75 mg daily maintenance dosing (<i>n</i> = 39) prior to blood sampling. Platelet responsiveness was measured using the vasodilator-stimulated phosphoprotein (VASP) phosphorylation assay (PLT VASP/P2Y12, BioCytex, France). Patients were categorized according to VASP platelet reactivity index (PRI) as adequate responders (PRI <50%), intermediate responders (PRI 50%-69%), or patients with high residual platelet reactivity, operationally defined in this study as PRI ≥70%.</p><p><strong>Results: </strong>The study included 102 enrolled patients, of whom 57 (55.9%) were Jewish and 45 (44.1%) were Arab. A valid VASP-PRI measurement was available for 101 patients (57 Jewish and 44 Arab); one Arab patient had no evaluable PRI measurement. Therefore, analyses of platelet reactivity were based on 101 patients The median PRI for all patients was 65.5 (49.1-80.3), with no statistically significant differences between Jewish and Arab (<i>p</i> = 0.251). Overall, 42.6% were classified as non-responders, 29.7% as partial responders, and only 27.7% demonstrated adequate platelet inhibition. Jewish patients were significantly older than Arab patients (<i>p</i> = 0.008), whereas Arab patients had a significantly higher BMI (<i>p</i> = 0.019). Other demographic and clinical features were similar across groups.</p><p><strong>Conclusions: </strong>A high proportion of patients demonstrated elevated residual platelet reactivity according to the operational PRI threshold used in this study. No statistically significant ethnic difference in PRI was detected; however, the ethnic comparison was exploratory and the study was not powered to exclude modest between-group differences. Larger prospective studies incorporating CYP2C19 genotyping and longitudinal clinical outcomes are warranted.</p>","PeriodicalId":73108,"journal":{"name":"Frontiers in stroke","volume":"5 ","pages":"1908099"},"PeriodicalIF":1.2,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outpatient occupational therapy access for rural stroke survivors: barriers as perceived by therapists.","authors":"Emily A Stevens, Lexie J Pfeifer, Matt P Malcolm","doi":"10.3389/fstro.2026.1850977","DOIUrl":"10.3389/fstro.2026.1850977","url":null,"abstract":"<p><strong>Aim: </strong>Identify occupational therapist (OTs) perceived barriers to occupational therapy (OT) access for rural stroke survivors as well as barriers in stroke specific training of therapists.</p><p><strong>Methods: </strong>An electronic gap analysis survey was developed and distributed <i>via</i> email.</p><p><strong>Results: </strong>Twenty-six OTs responded. Responses were analyzed utilizing descriptive statistics and summarization of comments. Therapist-perceived barriers included: family/caregiver support, distance to clinic, insurance coverage, health literacy, roles and responsibilities, financial, and transportation. The primary barrier in treating rural stroke survivors identified by OTs was lack of appropriate clinic equipment for neuro-specific interventions.</p><p><strong>Conclusions: </strong>Further research is needed in a larger sample size to explore the extent to which therapist-perceived barriers agree with the stroke survivor's perspective and facilitate solutions to overcome them.</p>","PeriodicalId":73108,"journal":{"name":"Frontiers in stroke","volume":"5 ","pages":"1850977"},"PeriodicalIF":1.2,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex differences in risk factors, stroke etiology, treatment characteristics, and outcomes after endovascular treatment for anterior circulation ischemic stroke.","authors":"Marieta Peycheva, Charlotte Berger, Marino Costa, Lee Siegenthaler, Fiona Huber, Ismaël Rizzo, Marina Krasteva, Morin Beyeler, Tatiana Bremova-Ertl, Nedelina Slavova, Pasquale Mordasini, Roza M Umarova, Philipp Bücke, Kateryna Antonenko, Angelika Hoffmann, Sara Pilgram-Pastor, Mirjam R Heldner","doi":"10.3389/fstro.2026.1946990","DOIUrl":"10.3389/fstro.2026.1946990","url":null,"abstract":"<p><strong>Background and aims: </strong>Sex-specific differences in vascular risk factors, stroke etiology, and outcomes after endovascular treatment (EVT) remain uncertain. We investigated these differences in a contemporary single-center cohort.</p><p><strong>Methods: </strong>Consecutive patients with acute anterior circulation ischemic stroke undergoing EVT (with-/out intravenous thrombolysis) between February 2015 and March 2023 were included. Sex differences in risk factors, treatment, successful reperfusion, and 3-month outcomes (mRS ≤ 1, ≤ 2, and mortality) were examined; multivariable models included interactions with age, stroke etiology, and bridging therapy.</p><p><strong>Results: </strong>Among 1,764 patients (median age 76 years, 48% women), women were older (79.4 vs. 73.3 years, <i>p</i> < 0.001) and more often had atrial fibrillation and chronic kidney disease, while men more frequently had coronary heart disease, diabetes, and smoking history. Cardioembolic stroke was more common in women, whereas large artery atherosclerosis was more frequent in men. Successful reperfusion rates did not differ by sex (overall: 86.2%, <i>p</i> = 0.084). At 3 months, men were more likely to achieve favorable functional outcome (mRS ≤ 2: 47.6% vs. 37.5%, <i>p</i> < 0.001) and excellent functional outcome (mRS ≤ 1: 31.4% vs. 25.6%, <i>p</i> = 0.008), while mortality was higher in women (31.9 vs. 24.9%, <i>p</i> = 0.001). Female sex was not independently associated with successful reperfusion (aOR: 0.79; 95%CI: 0.60-1.06), favorable outcome (0.88; 0.69-1.11), excellent outcome (0.93; 0.73-1.19), or mortality (1.06; 0.83-1.35). A sex-by-age interaction was observed for favorable outcome (<i>p</i> interaction = 0.006), with no evidence of interaction by stroke etiology or bridging therapy.</p><p><strong>Conclusion: </strong>Women and men differ in risk profiles, stroke mechanisms, and unadjusted outcomes after EVT. However, sex was not independently associated with outcomes overall, although age may modify its association with favorable functional outcome.</p>","PeriodicalId":73108,"journal":{"name":"Frontiers in stroke","volume":"5 ","pages":"1946990"},"PeriodicalIF":1.2,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Stroke research in the elderly: addressing ageism and prognostication.","authors":"Hipólito Nzwalo, Miguel Barboza, Nicola Logallo","doi":"10.3389/fstro.2026.1978900","DOIUrl":"10.3389/fstro.2026.1978900","url":null,"abstract":"","PeriodicalId":73108,"journal":{"name":"Frontiers in stroke","volume":"5 ","pages":"1978900"},"PeriodicalIF":1.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reframing moyamoya vasculopathy within steno-occlusive disease of the circle of Willis.","authors":"Takahiro Ota","doi":"10.3389/fstro.2026.1890618","DOIUrl":"https://doi.org/10.3389/fstro.2026.1890618","url":null,"abstract":"<p><p>Moyamoya disease (MMD) is classically defined by progressive steno-occlusion of the terminal internal carotid artery (ICA) with associated basal collateral networks. Historically, however, this condition was conceptualized in Japan as part of a broader anatomical category-steno-occlusive disease of the circle of Willis (SOCW)-which preceded disease-specific nomenclature. Increasing genetic, developmental, and clinical evidence now challenges the strict separation between MMD and moyamoya syndrome (MMS). In this narrative review, we re-examine moyamoya-related conditions within a unified, location-defined framework and propose three advances: (1) an operational definition of SOCW with explicit anatomical boundaries; (2) a spectrum-based classification distinguishing phenotype from etiologic context; and (3) a refined, location-based multi-hit model integrating developmental vulnerability, genetic susceptibility, and acquired triggers. Historical analysis indicates that SOCW was originally defined as an anatomical category, within which moyamoya vasculopathy (MMV) represents the predominant but non-exclusive angiographic phenotype. Genetic studies identify RNF213 as a major susceptibility modifier influencing phenotypic expression and population prevalence, although substantial ethnic heterogeneity and incomplete penetrance indicate that RNF213 is neither necessary nor sufficient for disease development. Additional genetic and environmental factors may further influence disease expression. Developmental factors may contribute to the characteristic localization of disease, although current evidence remains indirect. This SOCW-based framework provides a structured approach to intracranial steno-occlusive disorders, facilitates interpretation of early or atypical presentations, and supports multimodal and longitudinal assessment rather than rigid categorical labeling. By integrating anatomical, genetic, and clinical dimensions, this model offers a pragmatic and biologically grounded basis for future research and refinement of disease classification.</p>","PeriodicalId":73108,"journal":{"name":"Frontiers in stroke","volume":"5 ","pages":"1890618"},"PeriodicalIF":1.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13636218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Quindío stroke network: impact of an integrated care model on mortality and functional outcomes in a middle-income country.","authors":"Laura Sofía García-Espinosa, Ángel Basilio Corredor-Quintero, Ricardo Andrés Lineros-Franco, Adriana Hernández-Cardona, Ivett Natalia Loaiza-Giraldo, Felipe Torres-Gómez, Jorge Luis Igirio-Gamero","doi":"10.3389/fstro.2026.1916617","DOIUrl":"https://doi.org/10.3389/fstro.2026.1916617","url":null,"abstract":"<p><strong>Introduction: </strong>Stroke is a major cause of death and disability worldwide, with low- and middle-income countries bearing the highest burden of this condition. To address regional shortcomings in access to reperfusion therapies-particularly thrombolysis-the Red ACV-Quindío was established as the first integrated network for stroke management in central Colombia.</p><p><strong>Methodology: </strong>This pre-post quasi-experimental study evaluated the Red ACV-Quindío strategy. The study estimated functional outcomes and in-hospital mortality in patients diagnosed with stroke before and after the implementation of the network.</p><p><strong>Results: </strong>The study included a total of 841 cases. Although year-by-year variations in patient volume were detected, linear tests confirmed a homogeneous population across the study period. Baseline clinical characteristics remained stable throughout: most patients presented with minor stroke (47.1%) and low functional dependency at admission (89.0%). At discharge, overall functional independence reached 55.0% (95% CI: 51.6-58.4, <i>p</i> = 0.23) and was associated with favorable safety outcomes. Thrombolyzed patients demonstrated a significantly reduced risk of fatal outcomes (OR = 0.61; 95% CI: 0.38-0.96; <i>p</i> = 0.037). Complications were rare, with hemorrhagic transformation occurring in 4.5% of cases and malignant edema in 3.9%. In-hospital mortality showed minor fluctuations but remained under 10% overall (9.9%, <i>p</i> = 0.39).</p><p><strong>Discussion: </strong>These findings suggest that regionally integrated stroke care networks represent an effective public health intervention to mitigate stroke-associated disability and mortality in resource-limited settings.</p>","PeriodicalId":73108,"journal":{"name":"Frontiers in stroke","volume":"5 ","pages":"1916617"},"PeriodicalIF":1.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Distal, medium vessel occlusion stroke: epidemiology, diagnostics, treatment options, and outcome prediction.","authors":"Gabriel Broocks, Panagiotis Papanagiotou, Leonard L L Yeo, Anil Gopinathan, Eytan Raz, Lukas Meyer","doi":"10.3389/fstro.2026.1967379","DOIUrl":"10.3389/fstro.2026.1967379","url":null,"abstract":"","PeriodicalId":73108,"journal":{"name":"Frontiers in stroke","volume":"5 ","pages":"1967379"},"PeriodicalIF":1.2,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum BDNF in subacute stroke: effects of a four-week aerobic exercise intervention in the PHYS-STROKE trial.","authors":"Torsten Rackoll, Lea Doppelbauer, Konrad Neumann, Alexander Heinrich Nave","doi":"10.3389/fstro.2026.1897859","DOIUrl":"10.3389/fstro.2026.1897859","url":null,"abstract":"<p><strong>Introduction: </strong>The early phase after stroke is considered a period of heightened neuroplasticity and may be responsive to rehabilitation interventions targeting biological recovery. Brain-derived neurotrophic factor is one candidate mediator of post-stroke plasticity, but it remains unclear whether clinically feasible aerobic exercise induces sustained increases in circulating brain-derived neurotrophic factor after stroke.</p><p><strong>Methods: </strong>We performed a pre-specified secondary biomarker analysis of the multicentre, randomized, endpoint-blinded Physical Fitness Training in Patients with Subacute Stroke trial. Participants were randomized to 4 weeks of moderate-intensity treadmill-based aerobic training or relaxation therapy. Serum brain-derived neurotrophic factor was assessed from baseline to 6 months post-stroke. Models were adjusted for baseline brain-derived neurotrophic factor, age, sex, stroke severity, platelet count, depressive symptoms, smoking status, and study center.</p><p><strong>Results: </strong>Among 200 randomized participants, serum brain-derived neurotrophic factor increased modestly from baseline to 3 months and remained stable thereafter. No relevant between-group difference was observed at 6 months after aerobic training compared with relaxation therapy (training: 24.6 ng/mL; 95% CI, 20.2-29.0 vs. relaxation: 24.3 ng/mL; 95% CI, 19.8-28.8; adjusted <i>p</i> = 0.74). Findings were consistent in complete-case and change-score sensitivity analyses. Exploratory analyses showed no robust treatment effect modification by depressive symptoms or intervention dose. A nominal sex-related subgroup finding should be interpreted cautiously.</p><p><strong>Discussion: </strong>Moderate-intensity aerobic exercise in early subacute stroke rehabilitation was not associated with sustained serum brain-derived neurotrophic factor increases compared with relaxation therapy. These findings argue against a robust long-term peripheral neurotrophin response, while not excluding acute, higher-intensity, or subgroup-specific effects.</p><p><strong>Clinical trial registration: </strong>[clinicaltrials.gov/study/NCT01953549], identifier [NCT01953549].</p>","PeriodicalId":73108,"journal":{"name":"Frontiers in stroke","volume":"5 ","pages":"1897859"},"PeriodicalIF":1.2,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}