Frontiers in stroke最新文献

{"title":"Relationships between arm and leg real-life activity and clinical assessments in individuals with disabling spasticity after stroke.","authors":"Sofi Andersson, Anna Danielsson, Katharina S Sunnerhagen, Margit Alt Murphy","doi":"10.3389/fstro.2026.1731911","DOIUrl":"10.3389/fstro.2026.1731911","url":null,"abstract":"<p><strong>Background: </strong>Accelerometer-based measures can provide valuable and objective information about arm and leg use in daily life. This information can be particularly useful in tailoring treatment and rehabilitation in people with disabling spasticity after stroke. To better understand clinical relevance of accelerometer-based measures, this study aimed to determine the strength of relationships between real-life arm and leg activity and a set of clinical assessments encompassing body function and activity domains.</p><p><strong>Methods: </strong>Thirty-five individuals with disabling spasticity in the chronic stage of stroke (mean age 56.8 ± 8.9 years; 54% female) were included. Real-life activity was measured over 4 days using wrist- and ankle-worn accelerometers. Unilateral arm and leg activity as well as arm/leg ratio were derived from vector magnitude counts per minute. Associations between accelerometer-based measures and clinical assessments of motor function, spasticity, activity capacity, and self-perceived activity performance were analyzed using Spearman's rank-order correlation.</p><p><strong>Results: </strong>Affected arm and leg real-life activity showed mostly moderate correlations with motor function and activity capacity assessments (ρ = 0.55-0.76), low correlations with spasticity assessments (ρ = -0.32 to -0.43) and high correlations with self-perceived manual and walking performance (ρ = 0.70-0.82). Arm activity ratio showed high correlations (ρ = 0.73-0.83) with motor function, activity capacity, and self-perceived performance. Real-life activity of the non-affected limbs demonstrated predominantly low correlations with clinical assessments.</p><p><strong>Conclusion: </strong>Accelerometer-based real-life activity measures of the affected arm and leg, along with activity ratios, provide clinically valid information regarding motor function and activity in people with disabling spasticity. Self-reported activity performance questionnaires can be valid tools for clinical practice when accelerometer-based measurements are not readily available.</p>","PeriodicalId":73108,"journal":{"name":"Frontiers in stroke","volume":"5 ","pages":"1731911"},"PeriodicalIF":1.2,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517209","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 APOE paradox: divergent genetic influences on hemorrhagic stroke risk-A meta-analysis.","authors":"Manabesh Nath, Astha Rai, Shubham Misra, Pradeep Kumar","doi":"10.3389/fstro.2026.1684121","DOIUrl":"10.3389/fstro.2026.1684121","url":null,"abstract":"<p><strong>Background: </strong>Apolipoprotein E (APOE) regulates lipid metabolism and neuronal repair, yet its alleles show contrasting effects on hemorrhagic stroke (HS) risk. While some variants increase susceptibility, others appear protective, leading to inconsistent findings. This meta-analysis systematically evaluates the APOE-HS association to clarify its role in stroke pathophysiology.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across multiple databases up to January 31, 2025, using the keywords: (\"Apolipoprotein E\" OR \"APOE\" OR \"APOE genotype\") AND (\"Single Nucleotide Polymorphisms\" OR \"SNP\") AND (\"Hemorrhagic stroke\" OR \"HS\" OR \"Intracerebral Hemorrhage\" OR \"ICH\"). The APOE ε3/ε3 genotype served as the reference genotype in all studies, and only those studies with ε3/ε3 genotype were included in the analysis. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated, and statistical analyses were performed using STATA version 13.0 (StataCorp LLC, College Station, Texas, United States).</p><p><strong>Results: </strong>A total of 24 studies comprising 8,269 HS patients and 26,321 controls were included. Meta-analysis revealed a significant association of APOE ε2/ε2 (OR = 1.93, 95% CI = 1.32-2.81), ε4/ε4 (OR = 1.60, 95% CI = 1.21-2.13), ε2/ε4 (OR = 1.81, 95% CI = 1.34-2.44), ε2 (OR = 1.23, 95% CI = 1.12-1.35), and ε4 (OR = 1.31, 95% CI = 1.14-1.51) with an increased risk of HS.</p><p><strong>Conclusion: </strong>Our findings suggest that APOE ε2/ε2, ε2/ε4, ε2, and ε4/ε4 genotypes and the ε4 allele are associated with an elevated risk of HS. These results highlight the potential role of APOE genotypes in HS susceptibility and warrant further investigation.</p>","PeriodicalId":73108,"journal":{"name":"Frontiers in stroke","volume":"5 ","pages":"1684121"},"PeriodicalIF":1.2,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12995800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147488745","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":"Role of C-reactive protein and fibreoptic endoscopic evaluation of swallowing as early markers of stroke-associated pneumonia.","authors":"Svetlana Politz Geleva, Ludwig D Schelosky","doi":"10.3389/fstro.2026.1742758","DOIUrl":"10.3389/fstro.2026.1742758","url":null,"abstract":"<p><strong>Introduction: </strong>Stroke may result in dysphagia, which can subsequently lead to stroke-associated pneumonia (SaP). This condition has been shown to exert a significant negative impact on patient outcome. Early diagnosis and prevention are therefore desirable.</p><p><strong>Methods: </strong>This retrospective study compared inflammatory markers during the first 4 days after stroke in 515 patients from 2015 and 2021, analyzing associations with dysphagia, year of treatment, dietary adjustments, stroke-associated pneumonia, and antibiotic use. Data entry and descriptive analyses were performed using Microsoft Excel^®. Datasets from 2015 and 2021 were analyzed in SPSS^® (IBM SPSS Statistics 27).</p><p><strong>Results: </strong>This retrospective analysis demonstrates that dysphagia significantly influences C-reactive protein (CRP) levels within the first 4 days after stroke. Dysphagia and elevated CRP are early markers of emergence of stroke-associated pneumonia, whereas leukocyte count and temperature show limited forewarning value. The combination of post-stroke inflammatory response, dysphagia (PAS > 5), and elevated CRP may serve as an early indicator of SaP and support timely FEES-based assessment.</p><p><strong>Discussion: </strong>Early elevated CRP levels in dysphagic stroke patients are indicative of aspiration-related inflammation and may serve as a sensitive early biomarker for stroke-associated pneumonia. The combined assessment of dysphagia severity and CRP supports improved early risk stratification and preventive management.</p>","PeriodicalId":73108,"journal":{"name":"Frontiers in stroke","volume":"5 ","pages":"1742758"},"PeriodicalIF":1.2,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12953130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147358032","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":"Comprehensive immunological profiling of acute ischemic stroke during mechanical thrombectomy: myeloid cell activation and molecular signatures in blood and thrombus.","authors":"Wirginia Krzyściak, Tadeusz Popiela","doi":"10.3389/fstro.2026.1731953","DOIUrl":"10.3389/fstro.2026.1731953","url":null,"abstract":"<p><strong>Background: </strong>Acute ischemic stroke (AIS) induces a complex local and systemic inflammatory response; however, most studies rely solely on peripheral blood, providing an incomplete view of immune activity at the occlusion site and within the thrombus.</p><p><strong>Objective: </strong>To characterize immune activation and transcriptomic signatures of myeloid cells across three compartments-arterial blood at the occlusion site, peripheral blood, and thrombus-and to evaluate their associations with radiological and clinical outcomes following mechanical thrombectomy.</p><p><strong>Methods: </strong>This prospective, single-center study will include AIS patients treated with mechanical thrombectomy. Matched arterial, peripheral, and thrombus samples will undergo spectral flow cytometry, cytokine profiling, cell-free DNA (cfDNA) quantification, microscopy, and RNA sequencing. Immune and molecular readouts will be correlated with clinical scores (NIHSS, mRS), imaging markers (e.g., hyperdense middle cerebral artery sign [HMCAS]), and procedural outcomes (TICI score, number of passes).</p><p><strong>Significance: </strong>Integrating local and systemic immune profiles with clinical and radiological parameters may identify biomarkers predictive of thrombectomy efficacy and functional recovery, thereby supporting precision-medicine approaches in AIS.</p><p><strong>Clinical trial registration: </strong>www.ClinicalTrials.gov.</p>","PeriodicalId":73108,"journal":{"name":"Frontiers in stroke","volume":"5 ","pages":"1731953"},"PeriodicalIF":1.2,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12935871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328307","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":"Is early thrombectomy of proximal middle cerebral artery occlusion to salvage internal capsule associated with improved clinical outcomes?","authors":"Elochukwu Ibekwe, Robert Kassinger, Nicholas Mannix, Jing Peng, Archana Hinduja","doi":"10.3389/fstro.2026.1751007","DOIUrl":"10.3389/fstro.2026.1751007","url":null,"abstract":"<p><strong>Background: </strong>Eloquence of tissue rather than infarct volume is a better predictor of outcomes following proximal middle cerebral artery (MCA) occlusion. The aim of this study was to determine the impact of white matter tract involvement, specifically the internal capsule (IC), following occlusion of non-collateralized lenticulostriate arteries (LSAs) on functional outcomes.</p><p><strong>Methods: </strong>A retrospective observational single-center study of patients with proximal MCA occlusions in the period from 2015 to 2020 who were treated with mechanical thrombectomy and had post-interventional diffusion-weighted imaging was conducted. Patients were distributed based on the presence or absence of IC infarction (IC+ vs. IC-) at the level supplied by the MCA LSAs. Multivariate logistic or linear regression analysis was used to evaluate factors associated with the development of IC infarction.</p><p><strong>Results: </strong>Of 368 patients with proximal MCA occlusion, 200 (55%) developed IC+ infarction. On univariate analysis, patients with IC+ infarction had higher baseline NIHSS (National Institute of Health Stroke Scale), lower ASPECTS (Alberta Stroke Program Early CT Score), lower collateral score, and were less likely to have partial reperfusion of LSA prior to thrombectomy. On multivariate analysis, those with higher baseline NIHSS, low ASPECTS, lack of successful reperfusion (TICI2b, 2c, 3), poor collateral circulation, and/or lack of partial perfusion of LSA prior to thrombectomy were likely to develop IC+ infarction. After adjusting for confounders, patients with IC+ infarction were less likely to experience early neurological improvement, more likely to develop hemorrhagic transformation of putamen, and had larger infarct volume. However, no significant correlation between IC+ infarction with poor 3-month functional outcome was observed.</p><p><strong>Conclusion: </strong>Delayed recovery is possible despite IC+ infarction and hemorrhagic transformation of lenticulostriate territory. Larger studies are needed to confirm these findings.</p>","PeriodicalId":73108,"journal":{"name":"Frontiers in stroke","volume":"5 ","pages":"1751007"},"PeriodicalIF":1.2,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12935990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328362","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 as a predictor and moderator of psychosocial determinants of cardiometabolic risks for Métis People in Canada.","authors":"Shara Johnson, Samantha Moore, Muqtasida Fatima, Adam McInnes, Heather Foulds","doi":"10.3389/fstro.2026.1736530","DOIUrl":"10.3389/fstro.2026.1736530","url":null,"abstract":"<p><strong>Introduction: </strong>Métis People, one Indigenous group in Canada, have distinct culture, identity, and experiences. The determinants of Métis People's health, including stroke risk, may differ from other groups. This study examined relationships between psychosocial and lifestyle factors with cardiometabolic risk, a stroke risk indicator, and the moderating role of sex among Métis adults living in Saskatchewan, Canada.</p><p><strong>Methods: </strong>A community-based cross-sectional observation study was conducted with 70 Métis adults (39 ± 16 years; 66% female). Hierarchical multiple regression, moderated by sex, assessed psychosocial and lifestyle predictors of cardiometabolic risks (blood cholesterol, fasting glucose, glycosylated hemoglobin, blood pressure, and waist circumference).</p><p><strong>Results: </strong>Psychosocial factors were significantly associated with cardiometabolic risk components. Psychological distress, adverse childhood experiences, age and sex explained 30% of the variance in average blood pressure, <i>F</i> (4, 65) = 6.997, <i>p</i> = 0.01. Well-being, discrimination experiences, age and sex significantly explained 27% of the variance in average blood pressure, <i>F</i> (4, 65) = 5.89, <i>p</i> = 0.04. Sex moderated relationships of wellbeing with glycosylated hemoglobin, <i>F</i> (6, 63) = 7.374, <i>p</i> = 0.02, <i>R</i> ² = 0.414, with age (β = -0.497, <i>p</i> < 0.01), wellbeing (β = 0.593, <i>p</i> = 0.01), and wellbeing × sex (β = -0.53, <i>p</i> = 0.01) being significant predictors. Psychological distress moderated by sex also predicted total cholesterol. Lifestyle factors did not significantly predict cardiometabolic risk.</p><p><strong>Discussion: </strong>Psychosocial determinants, particularly wellbeing, play a central role in Métis People's cardiometabolic risk, with effects differing by sex. This emphasized the need for Métis-specific, trauma, and sex-informed approaches to cardiovascular health promotion.</p>","PeriodicalId":73108,"journal":{"name":"Frontiers in stroke","volume":"5 ","pages":"1736530"},"PeriodicalIF":1.2,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12935955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328312","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":"CXCL1: a novel therapeutic target to increase aneurysm healing after coil embolization.","authors":"Devan Patel, Melanie Martinez, Supreeya A Saengchote, Kartik Motwani, William S Dodd, Zahra Hasanpour Segherlou, Haiyan Xu, Koji Hosaka, Brian L Hoh","doi":"10.3389/fstro.2026.1746652","DOIUrl":"10.3389/fstro.2026.1746652","url":null,"abstract":"<p><strong>Objective: </strong>CXCL1 is highly expressed in human aneurysms but its role in aneurysm healing is unknown. The objective of this study was to determine whether CXCL1 neutralization increases murine aneurysm healing post-coiling.</p><p><strong>Methods: </strong>Carotid artery aneurysms were created in female and male C57BL/6 mice. CXCL1 expression was compared between aneurysms and sham-operated carotid arteries. In a separate cohort, aneurysms were coiled with poly (lactic-co-glycolic acid) (PLGA)-coated coils. Mice received intraperitoneal injections of either CXCL1 neutralizing antibody or IgG control for 7, 14, or 21 days post-coiling. Coiled aneurysms were assessed for aneurysm healing, neutrophil infiltration, macrophage polarization, and total macrophage burden.</p><p><strong>Results: </strong>CXCL1 is highly expressed in murine carotid artery aneurysms. CXCL1 neutralization significantly increased aneurysm healing compared to IgG when administered for 14 days (<i>females:</i> 66.4% vs. 51.2%, <i>p</i> = 0.03; <i>males:</i> 69.8% vs. 47.0%, <i>p</i> = 0.004) and 21 days (<i>females:</i> 71.9% vs. 44.3%, <i>p</i> = 0.002; <i>males:</i> 67.8% vs. 61.6%, <i>p</i> = 0.02), but not when given for only 7 days (<i>females:</i> 48.1% vs. 49.4%; <i>males:</i> 52.3% vs. 50.4%). 14 days of CXCL1 neutralization decreased neutrophil infiltration (<i>females:</i> 0.43 vs. 5.21 cells/high power field (hpf), <i>p</i> = 0.04; <i>males:</i> 0.00 vs. 4.42 cells/hpf, <i>p</i> = 0.04) and increased reparative M2 macrophages (<i>females:</i> 2.25 vs. 0.79 cells/hpf, <i>p</i> = 0.03; <i>males:</i> 2.00 vs. 0.27 cells/hpf, <i>p</i> = 0.02).</p><p><strong>Conclusions: </strong>CXCL1 neutralization for 14 or 21 days improved aneurysm healing in female and male mice. 14 days of CXCL1 neutralization decreased neutrophil infiltration and increased M2 macrophage polarization. Systemic CXCL1 neutralization is a promising potential therapy to improve aneurysm healing by modulating the inflammatory response after coiling.</p>","PeriodicalId":73108,"journal":{"name":"Frontiers in stroke","volume":"5 ","pages":"1746652"},"PeriodicalIF":1.2,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12929126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147291974","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":"Interaction between age and atrial fibrillation on ischemic stroke severity: a cross-sectional analysis.","authors":"Daniel Zhihao Hong, Rehena Sultana, Nur Sarah Binte Ibrahim, Hui Meng Chang, Deidre Anne De Silva","doi":"10.3389/fstro.2026.1706746","DOIUrl":"10.3389/fstro.2026.1706746","url":null,"abstract":"<p><strong>Background: </strong>While atrial fibrillation (AF) and older age are established independent risk factors for greater ischemic stroke severity, their interactive effect remains poorly characterized. This study aimed to evaluate the interaction between age and AF status on stroke severity, as measured by the National Institutes of Health Stroke Scale (NIHSS).</p><p><strong>Methods: </strong>We conducted a cross-sectional study using a prospectively collected institutional stroke registry comprising 5,044 patients with acute ischemic stroke from 2019-2023. The primary exposures were AF status and age, categorized as < 65 and ≥65 years, while stroke severity at admission measured by the NIHSS served as the outcome. NIHSS was modeled using a negative binomial distribution within PROC GLIMMIX with a logarithmic link function to account for overdispersion in the NIHSS scores. Model included age, AF, and their interaction term, along with relevant co-variates such as gender, race and premorbid mRS.</p><p><strong>Results: </strong>AF was present in 17.3% of patients. Stroke severity was significantly greater in patients with AF across both age groups: IRR 1.88 (95% CI, 1.44-2.45; <i>p</i> < 0.0001) in patients < 65 years, and IRR 2.13 (95% CI, 1.89-2.39; <i>p</i> < 0.0001) in patients ≥65 years. The interaction between AF and age on stroke severity was not statistically significant (<i>p</i> for interaction = 0.40).</p><p><strong>Conclusions: </strong>AF is associated with greater stroke severity in both younger and older adults. There was no statistically significant interaction between age and AF status on NIHSS scores, indicating no evidence of effect modification by age within limits of our data. These findings underscore the need to consider stroke severity in risk stratification, especially in younger AF patients who often experience greater treatment burden.</p>","PeriodicalId":73108,"journal":{"name":"Frontiers in stroke","volume":"5 ","pages":"1706746"},"PeriodicalIF":1.2,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12907190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146215048","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":"Disconnection syndromes and injury to neural systems after ischemic stroke.","authors":"Anne Schwarz, Christina K Holl, Lorie Brinkman, Andrea J Stehman, Isabel Cardoso Ferreira, Nina Soleimani, Eden Farahmand, Maeve Settle, Shivani Sakthi, Ivy Vo, Natalie Olivares, Min-Keun Song, Steven C Cramer","doi":"10.3389/fstro.2025.1643570","DOIUrl":"10.3389/fstro.2025.1643570","url":null,"abstract":"<p><strong>Background: </strong>Stroke-related impairments present in wide-ranging combinations, including cognitive and upper extremity (UE) sensorimotor deficits, complicating an understanding of their relationship with the anatomy of injury. Here, we hypothesized that deficits in UE sensorimotor function, mood, and cognition would be associated with distinct patterns of neural injury, and we explored whether complex outcome measures that make both cognitive and motor demands are more vulnerable to injury-related disconnection after stroke.</p><p><strong>Methods: </strong>Subject testing included elementary sensorimotor behaviors (shoulder and finger strength [SAFE], Fugl-Meyer Assessment [FMUE], and wrist proprioception [WPST]), complex behaviors that require substantial motor and cognitive control (Box and Blocks Test [BBT] and Trail Making Test-A [TMT-A]), cognition (Montreal Cognitive Assessment [MoCA]), and mood (Geriatric Depression Scale). Infarcts were outlined on clinical scans and used to compute lesion volume, injury to the corticospinal tract (CST) as well as thalamocortical sensory tract, and measures of structural network disconnection. Associations between lesions and behavior were examined using three methods: [1] voxel-lesion-symptom mapping (VLSM) to identify lesioned voxels associated with behavioral deficits; [2] correlation, to identify bivariate relationships between neuroimaging and behavioral measures; and [3] LASSO regression to identify the most behaviorally relevant variables among neuroimaging and clinical measures.</p><p><strong>Results: </strong>Stroke patients (<i>n</i> = 55, mean age 69.2, 42% females) had lesion volumes ranging from 0.1 to 354.9 (mean 30.9) ml and averaged 10.4 ± 4.9 days post-stroke. Deficits in all three elementary UE sensorimotor behaviors (SAFE, WPST, FMUE) correlated with extent of injury to CST not disconnection measures, with VLSM largely consistent, while deficits in complex motor and cognitive behaviors (BBT and TMT-A) were related to widespread structural disconnection between brain networks. LASSO models that consider all neuroimaging and clinical measures revealed complex patterns of disconnections across behaviors.</p><p><strong>Conclusion: </strong>These findings indicate that elementary UE sensorimotor behaviors are related to the integrity of regional sensorimotor system structures, but that more complex motor and cognitive behaviors are more related to intact structural connectivity between multiple brain networks.</p>","PeriodicalId":73108,"journal":{"name":"Frontiers in stroke","volume":"4 ","pages":"1643570"},"PeriodicalIF":0.0,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12879346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144455","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":"Value of routine heart rate variability parameters for atrial fibrillation detection in ischaemic stroke and high-risk TIA patients.","authors":"Kurt Moelgg, Anel Karisik, Lucie Buergi, Lukas Scherer, Luisa Delazer, Benjamin Dejakum, Silvia Felicetti, Theresa Koehler, Julian Granna, Christian Boehme, Raimund Pechlaner, Theresa Prock, Thomas Toell, Axel Bauer, Michael Schreinlechner, Daniel Pavluk, Michael Knoflach, Stefan Kiechl, Lukas Mayer-Suess","doi":"10.3389/fstro.2025.1727719","DOIUrl":"10.3389/fstro.2025.1727719","url":null,"abstract":"<p><strong>Introduction: </strong>Undetected atrial fibrillation (AF) increases the risk of recurrent ischaemic stroke, but current prediction scores do not incorporate heart rate variability (HRV) measures readily available from 24-h Holter ECGs.</p><p><strong>Methods: </strong>In 697 patients with non-AF ischaemic stroke or non-AF high-risk transient ischaemic attack (TIA) from the STROKE-CARD Registry (NCT04582825), we assessed eight time-domain HRV parameters for predicting incident AF within 1 year. ROC analyses, logistic regression, and the Youden index were used to identify optimal cut-offs and compare HRV performance with Brown-ESUS AF and AS5F scores.</p><p><strong>Results: </strong>New-onset AF was detected in 28 patients (4.0%). PNN50, rMSSD, and SDSD showed the best discrimination (AUC = 0.711, 0.766, and 0.775), outperforming both clinical scores (AUC ≤ 0.612). Optimal cut-offs were 5.5% (PNN50), 48.5 ms (rMSSD), and 43.5 ms (SDSD). Dichotomized analyses confirmed strong associations with AF (ORs 5.34-7.70, all <i>p</i> < 0.001), and adding HRV parameters significantly improved prediction beyond existing scores.</p><p><strong>Conclusions: </strong>PNN50, rMSSD, and SDSD from routine Holter ECGs enhance AF risk prediction after non-cardioembolic stroke or high-risk TIA and may support targeted monitoring strategies.</p>","PeriodicalId":73108,"journal":{"name":"Frontiers in stroke","volume":"4 ","pages":"1727719"},"PeriodicalIF":0.0,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12870696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127733","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}