BMC Neurology最新文献

{"title":"Evaluation of zonulin levels in patients with migraine.","authors":"Gözde Ülfer, Burcu Polat, Ahmet Yabalak, Çağrı Çakıcı","doi":"10.1186/s12883-025-04058-y","DOIUrl":"https://doi.org/10.1186/s12883-025-04058-y","url":null,"abstract":"<p><strong>Background: </strong>Zonulin regulates permeability in blood-brain and intestinal barriers. The pathophysiology of migraine is based on the effect of neurogenic inflammation. The aim of the current investigation was to examine the serum zonulin level in individuals suffering from migraine.</p><p><strong>Methods: </strong>The sample comprised 40 individuals who had migraine and 40 controls. Disease duration, attack duration, attack frequency, Visual Analog Scale (VAS) scores, and comorbidities were available for the migraine group. Serum zonulin levels were evaluated by using the ELISA method.</p><p><strong>Results: </strong>There were no statistically significant differences between the two groups concerning age or gender (p > 0.05). The zonulin value of patients with migraine was higher when compared to the controls, indicating a significant difference (p = 0.037; p < 0.05). The zonulin level did not correlate with disease duration, attack duration, VAS score, or attack frequency (p > 0.05). The receiver operating characteristic curve analysis of zonulin revealed a cut-off value of 30.58 and above, at which it had 52.50% sensitivity, 77.5% specificity, 70% positive predictive value, and 62% a negative predictive value. The area under the curve was 63.6%, and the standard error value was 6.3%. The analysis also showed a statistically significant correlation between migraine diagnosis and a zonulin level of 30.58 (p = 0.006; p < 0.01).</p><p><strong>Conclusions: </strong>Elevated zonulin levels in patients with migraine support the disruption of the intestinal barrier and neuroinflammation in these patients. The zonulin level may be a predictive biomarker of migraine. Multicenter, randomized trials are needed to evaluate treatments for intestinal permeability and zonulin levels in migraine patients.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"46"},"PeriodicalIF":2.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of multifocal visual evoked potential in detection of minimal hepatic encephalopathy in patients with compensated liver cirrhosis.","authors":"Reem M Sabry, Osama Hamad, Hossam Eldin Mohamed Khalil, Sahar Ibrahim Mohammed, Ragaey Ahmad Eid, Hanan Hosny","doi":"10.1186/s12883-025-04031-9","DOIUrl":"https://doi.org/10.1186/s12883-025-04031-9","url":null,"abstract":"<p><strong>Background: </strong>Minimal hepatic encephalopathy (MHE) is one of the most debilitating complications of hepatic cirrhosis, and visual electrophysiology, visual evoked potential (VEP) has long been used for MHE diagnosis. This technique only produces a summed response that is greatly dominated by the macular region. Multifocal visual evoked potential (mfVEP) imaging minimizes these limitations because it allows topographic recording of the optic nerve and visual cortex. The aim of this study was to detect minimal hepatic encephalopathy among cirrhotic patients using the mfVEP in comparison to the validated psychometric hepatic encephalopathy score (PHES), paired associative learning (PAL) and the Benton visual retention test (BVRT).</p><p><strong>Methods: </strong>Forty-five patients with compensated hepatic cirrhosis were enrolled in our study and compared to 45 normal controls who were matched for age, sex and educational level. Both groups underwent psychological tests (PHES, PAL, BVRT) and neurophysiological tests (mfVEP).</p><p><strong>Results: </strong>1According to the validated PHES, 14 patients were found to have MHE, 15 patients were found to have abnormal mfVEP, and abnormalities in the BVRT and PAL were found in 11 and 10 patients, respectively. 2-mfVEP showed the highest sensitivity in the detection of MHE in reference to the PHES. 3- The mfVEP test and potentially the BVRT have the advantage of detecting subtle abnormalities in non-MHE cirrhotic patients, for further research and follow-up are needed.</p><p><strong>Conclusion: </strong>mfVEP demonstates promising results for objective early detection of MHE, with a sensitivity of approximately 92.9%.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"45"},"PeriodicalIF":2.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between impaired brachial flow-mediated dilation and early neurological deterioration in acute ischemic stroke: a retrospective analysis.","authors":"Sang Hee Ha, Bo Hye Yoon, Bon Gook Koo, Dong Hoon Shin, Yeong-Bae Lee, Bum Joon Kim","doi":"10.1186/s12883-025-04048-0","DOIUrl":"https://doi.org/10.1186/s12883-025-04048-0","url":null,"abstract":"<p><strong>Background: </strong>Early neurological deterioration (END) occurs in individuals who had experienced acute ischemic stroke (AIS), impacting long-term functional outcomes. We aimed to investigate the association between endothelial function, measured via flow-mediated dilation (FMD), and END in patients with AIS.</p><p><strong>Methods: </strong>We retrospectively reviewed patients who had experienced AIS within 7 days of stroke onset and underwent FMD assessments during their hospitalization (%FMD = Peak diameter - baseline diameter)/baseline diameter x 100). END was defined as ≥ 2-point increase in the National Institutes of Health Stroke Scale total score or ≥ 1-point increase in the motor score within 72 h post-stroke. Through multivariate analysis, we examined factors associated with END and explored the relationship between FMD and END with considering stroke mechanisms.</p><p><strong>Results: </strong>Among 1,262 patients diagnosed with AIS, 184 (14.6%) experienced END. Those with END were on average older (69 ± 13 vs. 67 ± 13 years; P = 0.033), had a higher prevalence of stroke history (21.2 vs. 12.9%; P = 0.003), and lower FMD (5.0 ± 1.8 vs. 5.4 ± 2.2%; P = 0.029). Multivariate analysis revealed that a history of stroke (adjusted odds ratio [aOR] = 1.728; 95% confidence interval [CI] 1.159-2.578; P = 0.007) and low % were independently associated with END. Subgroup analysis revealed that low %FMD was significantly associated with END within the small vessel disease (SVD) category (aOR = 0.789; 95% CI 0.679-0.920; P = 0.002).</p><p><strong>Conclusions: </strong>Impaired FMD may be associated with END, particularly within the context of SVD.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"47"},"PeriodicalIF":2.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of specific risk factors and predictive analytics for cardio-cerebral arterial stenosis: a comparative study utilizing framingham risk stratification insights.","authors":"Gege Zhang, Sijie Dong, Fanfan Feng, Weihao Kan, Taozhen Shi, Hongmei Ding, Ruiguo Dong","doi":"10.1186/s12883-025-04024-8","DOIUrl":"https://doi.org/10.1186/s12883-025-04024-8","url":null,"abstract":"<p><p>Atherosclerotic diseases are systemic, and stroke patients often present with both intracranial artery stenosis (ICAS) and coronary artery stenosis (COAS). This study aimed to investigate the prevalence of ICAS and COAS among ischemic stroke patients across different risk strata and to construct a predictive model for assessing atherosclerosis risk. This retrospective study included patients admitted for ischemic stroke at the Affiliated Hospital of Xuzhou Medical University from December 2020 to December 2021. All patients underwent CTA, with significant stenosis defined as exceeding 50% for both cerebral and coronary arteries.Patients were categorized into low-, moderate-, and high-risk groups on the basis of the Framingham risk scale. A total of 5,816 patients were included, with a mean age of 66.54 years. Dual arterial stenosis was found in 2,258 patients (38.8%), single ICAS in 399 (6.8%), and single COAS in 3,159 (54.3%). The moderate- and high-risk groups had significantly lower risks of single ICAS and COAS. Comparing the differences in risk factors between single arterial stenosis and dual arterial stenosis, the key risk factors included hyperlipidemia, smoking, hypertension, and diabetes, with a model accuracy of 73.61% and an AUC values of 0.8562 for dual stenosis. Significant differences in age, sex, and the risk factors were observed among risk groups. The predictive model demonstrated high accuracy, highlighting the importance of personalized medicine in clinical decision-making.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"48"},"PeriodicalIF":2.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of early supplemental parenteral nutrition on new-onset infection in adults with acute severe stroke: a single-center retrospective case-control study.","authors":"Chen Ma, Zhirong Fan, Xuan Wang, Bian Li, Jingjing Zhao, Xiaogang Kang, Wen Jiang, Fang Yang","doi":"10.1186/s12883-025-04050-6","DOIUrl":"10.1186/s12883-025-04050-6","url":null,"abstract":"<p><strong>Background: </strong>Early adequate feeding reduces mortality in patients with acute severe stroke. Supplemental parenteral nutrition (SPN) may address enteral nutrition (EN) deficiency and mitigate the risk of nosocomial infection. The benefit of the EN plus early SPN strategy over the full EN strategy is unknown in acute severe stroke patients.</p><p><strong>Methods: </strong>We retrospectively enrolled 20 patients with acute severe stroke in the SPN group who received EN plus early SPN (more than 50% of the energy target within 72 h after admission). Forty control patients in the EN group who received full EN were matched by age, sex and lesion site. The time to new-onset pneumonia or nosocomial infections was analyzed by Student's t test and the Breslow generalized Wilcoxon test.</p><p><strong>Results: </strong>The baseline characteristics did not differ significantly between the SPN group and the EN group, except for higher serum leukocyte counts, neutrophil counts, and neutrophil-to-lymphocyte ratios in the SPN group (P < 0.05). Compared with that in the EN group, the time to new-onset pneumonia was significantly delayed in the SPN group (7.6 days vs. 5.2 days; mean difference, 2.5 days; 95% CI, 0.65 to 4.31; P = 0.009), as was the time to new-onset nosocomial infections (7.1 days vs. 4.8 days; mean difference, 2.3 days; 95% CI, 0.46 to 4.07; P = 0.015). Kaplan-Meier analysis revealed similar cumulative probabilities of new-onset pneumonia and new-onset nosocomial infections in the two groups (P > 0.05). The rates of digestive intolerance events were similar between the two groups (40% in the SPN group vs. 52.5% in the EN group, P = 0.361).</p><p><strong>Conclusions: </strong>In patients with acute severe stroke, the application of EN plus early SPN could delay the onset of pneumonia and nosocomial infections especially in the early phase.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"44"},"PeriodicalIF":2.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe anti-α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor encephalitis with prolonged hyperammonemia: a case report.","authors":"Chunxia Yan, Lingling Bai, Jingwei Du, Zonglei Chong, Guangjun Xu, Xiaoqian Yang","doi":"10.1186/s12883-025-04040-8","DOIUrl":"10.1186/s12883-025-04040-8","url":null,"abstract":"<p><strong>Background: </strong>Anti-α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor encephalitis (Anti-AMPAR-E) is a very rare subtype of autoimmune encephalitis, typically presenting with memory decline, seizures, and changes in psychosis and behavior. Anti-AMPAR-E is often associated with the presence of neoplasms and generally has a poor prognosis. Currently, cases of severe anti-AMPAR-E, particularly those accompanied by hyperammonemia, are exceedingly rare.</p><p><strong>Case presentation: </strong>A 66-year-old man was admitted to the hospital, complaining of deterioration in memory and confusion for at least 10 days and worsening for 3 days. The patient's condition rapidly progressed to coma, which persisted for 2 months, manifesting as a fulminant course. At that time, his Glasgow Coma Scale (GCS) score was 6, and AMPAR antibodies were strongly positive in both serum and cerebrospinal fluid (CSF). Additionally, his serum ammonia levels consistently exceeded reference values during his hospital stay. Consequently, he was diagnosed with severe anti-AMPAR-E with prolonged hyperammonemia and treated with intravenous methylprednisolone pulse (IVMP) therapy, intravenous immunoglobulin (IVIG), and rituximab therapy until he regained consciousness. However, 10 months after discharge, he was readmitted to the hospital due to seizures and subsequently diagnosed with lung cancer. The patient eventually passed away at home.</p><p><strong>Conclusions: </strong>Even if the short-term prognosis is good, regular tumor-related screening is essential for patients with severe anti-AMPAR-E to detect potential tumors early and improve long-term outcomes. Moreover, it is necessary to perform repeated ammonia level assessments and to adequately treat hyperammonemia.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"43"},"PeriodicalIF":2.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual dysfunction and quality of life across age groups in multiple sclerosis patients: a prospective cross-sectional analysis.","authors":"Reza Dehghaniathar, Ali Faegh, Fahimeh Hajiakhoundi, Behnam Shakiba, Zeynab Najjar","doi":"10.1186/s12883-025-04054-2","DOIUrl":"10.1186/s12883-025-04054-2","url":null,"abstract":"<p><strong>Introduction: </strong>As the most frequent chronic neurological disorder in young adults, Multiple sclerosis (MS) significantly affects neurological function, particularly the autonomic nervous system. While the physical symptoms are visible, MS also causes hidden effects like sexual dysfunction. Research indicates that sexual disorders are more prevalent in MS patients compared to other neurological conditions and are approximately five times more common than in the general population. This study utilized the Sexual Intimacy and Desires in MS Patients Questionnaire (MSISQ-19) and the Quality of Life in Patients with Multiple Sclerosis Questionnaire to investigate the impact of sexual disorders on the quality of life in MS patients.</p><p><strong>Methods: </strong>This cross-sectional study was conducted on MS patients attending the MS clinic in 2022 and 2023. Eighty patients were randomly selected, and data were collected using the MSISQ-19 and MSQOL-54 questionnaires. The results were analyzed to establish the impact of sexual disorders on quality of life.</p><p><strong>Results: </strong>59 women and 21 men with MS were included. The Physical Health Scale (PHC) had a mean score of 51.6 (SD = 20.2), and the Mental Health Scale (MHC) had a mean score of 57.8 (SD = 20.5). Age appeared to influence physical health scores, with the youngest group (20-30 years) scoring highest and the oldest group (51-65 years) scoring lowest.</p><p><strong>Discussion and conclusion: </strong>The present study found that primary, secondary, and tertiary sexual disorders are common in MS patients across all age groups and genders. These findings highlight the need for increased attention, research, and treatment interventions for sexual dysfunction in MS patients.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"42"},"PeriodicalIF":2.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Vertebral artery dissection in a patient with migraine treated with calcitonin gene-related peptide monoclonal antibody: a case report and FAERS database analysis.","authors":"Daiki Tokuyasu, Shungo Imai, Shih-Pin Chen, Keiko Ihara, Narumi Watanabe, Yoshikane Izawa, Jin Nakahara, Satoko Hori, Tsubasa Takizawa","doi":"10.1186/s12883-025-04052-4","DOIUrl":"10.1186/s12883-025-04052-4","url":null,"abstract":"","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"40"},"PeriodicalIF":2.2,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyponatremia is associated with malignant brain edema after mechanical thrombectomy in acute ischemic stroke.","authors":"Ao Qian, Longyi Zheng, Jia Duan, Lun Li, Wenli Xing, Shuang Tang","doi":"10.1186/s12883-025-04051-5","DOIUrl":"10.1186/s12883-025-04051-5","url":null,"abstract":"<p><strong>Background: </strong>Hyponatremia (< 135 mmol/L) is the most common electrolyte disturbance in patients with stroke. However, few studies have reported the relationship between hyponatremia at admission and outcomes in patients with acute ischemic stroke (AIS) treated with mechanical thrombectomy (MT). This study is aimed to explore the association between hyponatremia and clinical outcomes following MT.</p><p><strong>Methods: </strong>A retrospective study was conducted at our center. The primary outcome was postoperative malignant brain edema (MBE). The secondary outcomes included mortality and adverse function at the 90-day follow-up, which were defined as modified Rankin scale scores of 6 and > 2, respectively. Patients were classified into hyponatremia and nonhyponatremia groups based on their serum sodium concentration at admission before drug use. The occurrence of MBE was evaluated via computed tomography after MT, and 90-day outcomes were obtained through in-person interviews at the clinic or via telephone. Multivariate analysis was performed to investigate the associations among postoperative MBE, 90-day mortality, adverse function and hyponatremia.</p><p><strong>Results: </strong>A total of 342 patients were enrolled into the study, of whom 52 (15.2%) had hyponatremia, 86 (25.1%) developed postoperative MBE, 93 (27.2%) died within 90 days after MT, and 201 (58.8%) had adverse functions at the 90-day follow-up. Multivariate analysis revealed that hyponatremia was significantly associated with postoperative MBE (odds ratio [OR] 3.91, 95% confidence interval [CI] 1.66 - 9.23, p = 0.002), 90-day mortality (OR 5.49, 95% CI 2.48 - 12.14, p < 0.001), and 90-day adverse function (OR 3.25, 95% CI 1.29 - 8.12, p = 0.012). In addition, mediation analysis revealed that postoperative MBE may partially account for the 90-day mortality/adverse function of patients with hyponatremia (regression coefficients changed by 18.6% and 23.9%, respectively).</p><p><strong>Conclusion: </strong>Hyponatremia is an independent predictor of postoperative MBE, 90-day mortality, and adverse function. Correction of hyponatremia may reduce the postoperative MBE to improve the prognosis of patients.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"41"},"PeriodicalIF":2.2,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Number of children and dementia risk: a causal mediation analysis using data from the HUNT study linked with national registries in Norway.","authors":"Teferi Mekonnen, Vegard Skirbekk, Ekaterina Zotcheva, Bo Engdahl, Bernt Bratsberg, Astanand Jugessur, Catherine Bowen, Geir Selbæk, Hans-Peter Kohler, Jennifer R Harris, Sarah E Tom, Steinar Krokstad, Trine Holt Edwin, Yehani Wedatilake, Katrin Wolfova, Dana Kristjansson, Yaakov Stern, Asta Kristine Håberg, Bjørn Heine Strand","doi":"10.1186/s12883-025-04044-4","DOIUrl":"10.1186/s12883-025-04044-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Childlessness, as well as having a high number of children, has been reported to be associated with an elevated risk of dementia compared to having 2-3 children. The mechanisms underlying these relationships are not well understood and may be mediated by different midlife risk factors. We examined the mediating role of various factors on the relationship between the number of children and dementia risk. These factors include socioeconomic factors (e.g., occupational complexity), psychosocial (e.g.., social activities, loneliness, life satisfaction), lifestyle (e.g., smoking, physical inactivity, alcohol intake), and chronic diseases (e.g., obesity, diabetes, depression, hearing impairment and hypertension).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Using a historic cohort design, we included 9,745 participants born between 1931-48, with a mean age of 78.2 (SD = 6.4) years at the time of cognitive testing in the HUNT4 70 + sub-study (2017-2019). Further measures were obtained through data linkage between information from Statistics Norway and the HUNT1(1984-86), and HUNT2 (1995-97) Surveys. Causal mediation analyses using an inverse odd weighting approach were conducted to decompose the total effect of the number of children (0, 1, or 4 + children vs. 2-3) on the risk of dementia at age 70 + years into direct and indirect effects with mediators assessed at a mean age of 50.7 (SD = 6.4) years. The analyses were adjusted for age, sex, marital status at age 25 years, educational status, and religion assessed during HUNT3 (2006-2008).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Overall, 15.7% were diagnosed with dementia. The proportions with dementia by the number of children were 22.3% among those with no children, 21.4% for those with one child, 13% for those with 2-3 children (specifically, 12.6% for those with 2 children and 13.4% for those with 3 children), and 19.9% for those with 4 + children. Compared to the reference group of individuals with 2-3 children, the dementia risk was higher among the groups with no children (relative risk (RR): 1.30, 95% confidence interval (CI) (1.12, 1.51)), those with one child (RR: 1.30, 95% CI (1.14, 1.47)) and those with 4 + children (RR: 1.12, 95% CI (1.01, 1.24)). The elevated risks of dementia were not mediated by the socioeconomic, psychosocial, lifestyle, or chronic diseases related factors that we tested. Sex-stratified analysis showed higher dementia risk for men without children and women with one or 4 + children compared to those with 2-3 children, with similar patterns across sexes. None of the mediators contributed to mediation in either group. None of the mediators appeared to contribute through mediation in either group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our findings suggest that the number of children-specifically being childless, having one child, or having four or more children-may influence the risk of dementia. These relationships were not mediated by psychosocial, lifestyle, an","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"39"},"PeriodicalIF":2.2,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}