{"title":"Clinical and radiological characteristics of adult-onset X-linked adrenoleukodystrophy: a Chinese cohort study and review of the literature.","authors":"Han Xiao, Hui Huang, Ying Chen, Yingying Luo, Zhenchu Tang, Xuling Tan, Xiaoliu Shi, Chunyu Wang, Hainan Zhang, Jia Fang, Jianguang Tang","doi":"10.1186/s12883-025-04449-1","DOIUrl":"10.1186/s12883-025-04449-1","url":null,"abstract":"<p><strong>Background: </strong>Adrenoleukodystrophy (ALD) is a rare X-linked genetic metabolic disorder characterized by the accumulation of very long chain fatty acids (VLCFA) within the adrenal glands, as well as the central and peripheral nervous systems. Adult-onset ALD is particularly uncommon and easily misdiagnosed. The objective of this study is to facilitate the early diagnosis and treatment of adult-onset ALD.</p><p><strong>Case presentation: </strong>Seven adult-onset ALD patients of Chinese descent were enrolled in the study. Detailed clinical characteristics, laboratory results, imaging findings and genetic testing of the patients were collected and analyzed. All seven patients diagnosed with adult-onset ALD were male, including two with adult cerebral ALD (ACALD), one with adrenomyeloneuropathy (AMN), and four presenting with the spinocerebellar variant. The primary clinical manifestations of the two ACALD patients were progressive cognitive dysfunction and psychiatric symptoms. The AMN patient showed chronic progressive spastic paraplegia and displayed non-specific thoracic spinal cord atrophy on MRI. Symptoms observed in the four patients with spinocerebellar variant included cerebellar ataxia, dysarthria, spastic paraplegia, peripheral neuropathy, sphincter dysfunction, and alopecia. These four patients all demonstrated symmetrical white matter hyperintensity (WMH) in the cerebellum on brain magnetic resonance imaging (MRI). Additionally, two of these patients exhibited abnormal MRI signals in the pyramidal tract. All the patients had an elevation of VLCFAs, which is diagnostic for ALD. One patient exhibited elevated adrenocorticotropic hormone (ACTH) and decreased cortisol levels, while six patients displayed slightly elevated ACTH levels and normal cortisol levels without any clinical signs of adrenal insufficiency. Genetic testing identified four known ABCD1 pathogenic variants as well as two novel pathogenic variants.</p><p><strong>Conclusions: </strong>Progressive cognitive impairment and behavioral abnormalities are common clinical manifestations of ACALD. AMN and the spinocerebellar variant are prevalent phenotypes of adult-onset ALD. Patients with adult-onset ALD may present with isolated WMH in the cerebellum on brain MRI. Routine screening for ALD should be conducted in male patients diagnosed with Addison's disease. Subclinical adrenal cortex insufficiency is a common finding in adult-onset ALD. Elevated levels of VLCFA function as a reliable clinical biomarker for ALD. The identification of novel pathogenic variants in ABCD1 broadens the genetic spectrum of ALD.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"428"},"PeriodicalIF":2.2,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12523032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298490","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}
BMC NeurologyPub Date : 2025-10-15DOI: 10.1186/s12883-025-04405-z
Mohamed Abdelaziz Emam, Salma Ragab, András Attila Horváth, Olfat Ibrahim Ali, Zizi M Ibrahim, Magda Ramadan
{"title":"Effect of gaze direction recognition task on pain, rom and functional activities in cervicogenic headache patients.","authors":"Mohamed Abdelaziz Emam, Salma Ragab, András Attila Horváth, Olfat Ibrahim Ali, Zizi M Ibrahim, Magda Ramadan","doi":"10.1186/s12883-025-04405-z","DOIUrl":"10.1186/s12883-025-04405-z","url":null,"abstract":"<p><strong>Background: </strong>Cervicogenic headache is characterized by unilateral headache potentially stemming from cervical spine mechanical dysfunction. Research indicates that proprioceptive exercises, specifically gaze direction recognition (GDR), are found to be effective in reducing cervical joint position error and enhancing the quality of cervical afferent signals to the central nervous system.</p><p><strong>Purpose: </strong>This study aimed to evaluate proprioceptive training's impact on headache pain intensity, functional limitation, and neck motion range in individuals experiencing cervicogenic headache.</p><p><strong>Subjects and methods: </strong>This study employed a randomized controlled design involving 40 participants with cervicogenic headache between 35 and 49 years of age, divided equally into two groups. CONT (control) received only conventional physical therapy interventions, while EXPR (Experimental) underwent both proprioceptive training and standard physical therapy. Both programs consisted of 24, 60-70 min long sessions over 8 weeks. Assessment tools included the Numeric Rating Scale for headache pain, the Neck Disability Index for functional limitation evaluation, and a cervical range of motion (CROM) device for mobility assessment.</p><p><strong>Results: </strong>Statistical analysis showed that headache pain and disability level significantly decreased (P = 0.0001) post-intervention in both groups, with superior outcomes in EXPR. Similarly, cervical mobility significantly improved (p = 0.0001) in both groups following treatment, with EXPR demonstrating greater enhancements.</p><p><strong>Conclusions: </strong>Gaze direction recognition exercise (GDR) is effective in reducing headache pain severity, and disability level, and increasing cervical ROM in subjects with Cervicogenic headache.</p><p><strong>Trial registration: </strong>Approval was granted on 29 February 2024. (PACTR202402489039282), available at https://pactr.samrc.ac.za/ .</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"427"},"PeriodicalIF":2.2,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298542","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}
BMC NeurologyPub Date : 2025-10-14DOI: 10.1186/s12883-025-04433-9
Bushra Batool Zahra, Muhammad Amir Hamza, Rehana Sarwat, Sharon Floric, Maria Tanveer, Anam Fatima, Muhammad Tariq Khan, Mudassar Iqbal Arain, Ali Ahmed
{"title":"Barriers and facilitators of antiseizure medication adherence: a qualitative study among persons with epilepsy in Pakistan.","authors":"Bushra Batool Zahra, Muhammad Amir Hamza, Rehana Sarwat, Sharon Floric, Maria Tanveer, Anam Fatima, Muhammad Tariq Khan, Mudassar Iqbal Arain, Ali Ahmed","doi":"10.1186/s12883-025-04433-9","DOIUrl":"10.1186/s12883-025-04433-9","url":null,"abstract":"","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"419"},"PeriodicalIF":2.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291064","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}
BMC NeurologyPub Date : 2025-10-14DOI: 10.1186/s12883-025-04384-1
Laura Cardona-Roca, Carlos Seguí-Solanes, Manuel Cano-Alonso, Alba Sosa-Pons, Nuria Almendros-Abad, Nuria Rudi Sola
{"title":"Impact of anti-CGRP monoclonal antibodies on treatment satisfaction and quality of life in patients with resistant migraine: a retrospective real-world study.","authors":"Laura Cardona-Roca, Carlos Seguí-Solanes, Manuel Cano-Alonso, Alba Sosa-Pons, Nuria Almendros-Abad, Nuria Rudi Sola","doi":"10.1186/s12883-025-04384-1","DOIUrl":"10.1186/s12883-025-04384-1","url":null,"abstract":"<p><strong>Background: </strong>Several studies have demonstrated that calcitonin gene-related peptide receptor antagonist monoclonal antibodies (anti-CGRP mAbs) are a safe and effective treatment for migraine prevention. Patients' perceptions, however, do not always match clinical findings. Numerous studies have evaluated the effects of anti-CGRP mAbs on quality of life, but few have studied treatment satisfaction. This study collected data on patient-reported satisfaction and quality of life after 1 year of anti-CGRP mAb therapy and analyzed effectiveness, safety, and adherence in routine practice.</p><p><strong>Methods: </strong>Single-center retrospective study of patients with high-frequency episodic migraine (HFEM) and chronic migraine (CM) treated for at least 1 year with the same anti-CGRP mAb. Patients were assessed using the Treatment Satisfaction Questionnaire for Medication (TSQM) at week 52 and the EuroQol 5-Dimension, 5-Level questionnaire (EQ-5D-5 L) and 6-Item Headache Impact Test (HIT-6) at weeks 0, 12, 24, and 52. Effectiveness was assessed through monthly migraine days (MMDs) and HIT-6 results, safety through reports of adverse events (AEs) and reasons for treatment discontinuation, and treatment adherence through the Medication Possession Ratio.</p><p><strong>Results: </strong>Eighty patients (95% women, mean ± SD age, 50 ± 9.9 years) with migraine (70% CM, 30% HFEM) treated with fremanezumab (88.8%), erenumab (6.2%), or galcanezumab (5%) were included. Mean global satisfaction on the TSQM was 77.2 ± 20.8 points. Treatment satisfaction was correlated with a reduction in HIT-6 score (r = 0.372, p < 0.001). At 1 year, significant improvements were observed in the EQ-5D-5L index score and visual analog scale. MMDs decreased significantly by 8.7 ± 7.4 days from baseline to week 52; 52 patients (65%) achieved a ≥ 50% reduction in MMDs. Fifty-three patients (66%) achieved a ≥ 6-point reduction on the HIT-6 (mean reduction, 12.1 ± 9.8 points); the improvement was significant (p < 0.0001) from week 12 onwards. Eighteen patients (22.5%) reported mild AEs and treatment adherence was 100%.</p><p><strong>Conclusions: </strong>Patient satisfaction with anti-CGRP mAb therapy was high in this real-world study and correlated with effectiveness measured by the HIT-6 and significantly improved quality of life. Anti-CGRP mAbs are effective and safe for resistant migraine; they have a quick onset of action and provide lasting relief.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"418"},"PeriodicalIF":2.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291169","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}
BMC NeurologyPub Date : 2025-10-14DOI: 10.1186/s12883-025-04450-8
Arshia Ghalamkari, Yousef Mokary, Saba Naghavi, Iman Adibi, Ahmad Pourmohammadi, Mohammad Yazdan Panah, Fereshteh Ashtari
{"title":"Sleep disorders and associated factors in multiple sclerosis patients: a cross-sectional study in Iran.","authors":"Arshia Ghalamkari, Yousef Mokary, Saba Naghavi, Iman Adibi, Ahmad Pourmohammadi, Mohammad Yazdan Panah, Fereshteh Ashtari","doi":"10.1186/s12883-025-04450-8","DOIUrl":"10.1186/s12883-025-04450-8","url":null,"abstract":"<p><strong>Background: </strong>Sleep disorders are commonly noted in people with multiple sclerosis (PwMS). These disorders are often underestimated due to the tendency of individuals to focus on their more noticeable physical symptoms. This study aimed to survey factors affecting the sleep disorders of PwMS in Iran.</p><p><strong>Methods: </strong>This cross-sectional study recruited PwMS from the Isfahan Province of Iran. The International Restless Legs Syndrome Study Group, STOP-Bang, Berlin, and the Insomnia Severity Index questionnaires were employed to evaluate the severity of sleep disorders.</p><p><strong>Results: </strong>Seven hundred ninety-six PwMS (693 patients with relapsing-remitting MS and 103 patients with secondary-progressive MS) were included in the current study. 12.69% and 11.56% of patients were at high risk of obstructive sleep apnea (OSA) based on STOP-Bang and Berlin questionnaires, respectively. Also, 49.5% and 48.87% of participants experienced insomnia and severe restless legs syndrome (RLS), respectively. According to multivariable logistic regression, age (OR = 1.042, p = 0.001; OR = 1.041, p = 0.002) and gender (OR = 2.906, p < 0.001; OR = 2.491, p = 0.001) were associated with the STOP-Bang and Berlin scores, respectively. Also, the Expanded Disability Status Scale (EDSS) was associated with RLS (OR = 1.253, p < 0.001).</p><p><strong>Conclusion: </strong>Sleep disorders, such as RLS, insomnia, and OSA, are highly prevalent among PwMS in Iran. Physicians should consider additional clinical characteristics, such as EDSS, when managing RLS. Moreover, demographic features, such as age and gender, significantly impact the risk of developing OSA.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"424"},"PeriodicalIF":2.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291182","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}
BMC NeurologyPub Date : 2025-10-14DOI: 10.1186/s12883-025-04455-3
Denise Mellace, Francesca Mameli, Fabiana Ruggiero, Filippo Cogiamanian, Linda Borellini, Angelica De Sandi, Angelica Marfoli, Eleonora Zirone, Enrico Mailland, Elena Pirola, Antonella M Ampollini, Luigi G Remore, Marco Locatelli, Alberto Priori, Sergio Barbieri, Roberta Ferrucci
{"title":"Triple perspective: assessing deep brain stimulation outcomes in Parkinson's disease.","authors":"Denise Mellace, Francesca Mameli, Fabiana Ruggiero, Filippo Cogiamanian, Linda Borellini, Angelica De Sandi, Angelica Marfoli, Eleonora Zirone, Enrico Mailland, Elena Pirola, Antonella M Ampollini, Luigi G Remore, Marco Locatelli, Alberto Priori, Sergio Barbieri, Roberta Ferrucci","doi":"10.1186/s12883-025-04455-3","DOIUrl":"10.1186/s12883-025-04455-3","url":null,"abstract":"","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"426"},"PeriodicalIF":2.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291127","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}
BMC NeurologyPub Date : 2025-10-14DOI: 10.1186/s12883-025-04443-7
Kai Wang, Hong Liu
{"title":"Analysis of factors influencing short-term outcomes after early interventional therapy for acute ischaemic stroke.","authors":"Kai Wang, Hong Liu","doi":"10.1186/s12883-025-04443-7","DOIUrl":"10.1186/s12883-025-04443-7","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the potential factors influencing the early efficacy outcomes of patients with acute ischaemic stroke (AIS) after endovascular interventional therapy.</p><p><strong>Methods: </strong>A retrospective analysis was conducted involving 326 patients with AIS. The early efficacy outcomes and complications among patients after emergency cerebrovascular intervention were evaluated. Univariate analysis was performed to compare the baseline data between good outcome and poor outcome groups. Binary logistic regression analysis was used to determine the independent risk factors for poor outcomes at discharge.</p><p><strong>Results: </strong>Among the 326 patients, 174 (53.4%) had poor outcomes at discharge. Univariate analysis showed that a poor prognosis was associated with age, history of atrial fibrillation and stroke, a high preoperative National Institutes of Health Stroke Scale (NIHSS) score, a low thrombolysis in cerebral infarction (TICI) grade after thrombectomy, and a high incidence of postoperative symptomatic intracranial haemorrhage and cerebral oedema/hernia (P < 0.05). Binary logistic regression analysis showed that age (P = 0.010), NIHSS score before surgery (P < 0.001), the Alberta Stroke Program Early CT Score (ASPECTS) before surgery (P < 0.001), TICI grade after thrombectomy (P < 0.001), symptomatic intracranial haemorrhage after surgery (P = 0.001) and cerebral oedema/hernia after surgery (P = 0.004) were independent risk factors for a poor outcome at discharge.</p><p><strong>Conclusion: </strong>Age, NIHSS score before surgery, ASPECTS before surgery, TICI grade after thrombectomy, symptomatic intracranial haemorrhage, and cerebral oedema/hernia after surgery were independent risk factors for poor short-term outcomes after endovascular interventional therapy for AIS.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"425"},"PeriodicalIF":2.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291097","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}
BMC NeurologyPub Date : 2025-10-14DOI: 10.1186/s12883-025-04410-2
Chong Li, Mengmeng Liu, Ying Ji, Shushu Pang, Jin Tian, Xiaowen Li, Meng Zhang, Yaqin Gu, Hao Chen, Lin He, Yihan Wu
{"title":"Clinical characteristics and prognostic indicators in Listeria monocytogenes meningoencephalitis: A retrospective case series and literature review.","authors":"Chong Li, Mengmeng Liu, Ying Ji, Shushu Pang, Jin Tian, Xiaowen Li, Meng Zhang, Yaqin Gu, Hao Chen, Lin He, Yihan Wu","doi":"10.1186/s12883-025-04410-2","DOIUrl":"10.1186/s12883-025-04410-2","url":null,"abstract":"<p><strong>Background: </strong>Listeria monocytogenes meningoencephalitis (LMM) is a rare but severe central nervous system (CNS) infection. This study aimed to characterize the clinical manifestations, diagnostic findings, treatment responses, and prognostic factors associated with LMM.</p><p><strong>Methods: </strong>We retrospectively analyzed the clinical data of 13 patients diagnosed with LMM at Xuzhou Medical University Affiliated Hospital between 2018 and 2023. An additional five cases were identified through a literature search in the China National Knowledge Infrastructure (CNKI) and Wanfang databases from 2019 to 2022. Clinical features, cerebrospinal fluid (CSF) and blood test results, imaging findings, treatments, and outcomes were summarized.</p><p><strong>Results: </strong>Among 18 patients (11 males, 7 females; mean age 51.6 ± 17.2 years), all had acute onset with fever (100%), headache (83.3%), and altered consciousness (77.8%). CSF analysis showed elevated pressure in 83.3%, increased leukocytes and protein in all cases, and variable glucose levels. LM was cultured from CSF in 10 patients and detected via metagenomic next-generation sequencing (mNGS) in 12. Imaging findings included hydrocephalus in 4 cases and meningeal enhancement in 2 cases. Full recovery was observed in 2 cases, improvement in 9, palliative care in 3, and death in 4. Early seizures and hydrocephalus were linked to worse outcomes.</p><p><strong>Conclusion: </strong>Listeria monocytogenes meningoencephalitis is a rapidly progressive CNS infection with variable presentations and significant risk of poor outcomes. Early recognition, appropriate antimicrobial coverage, and timely diagnostic testing are essential to improving prognosis.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"420"},"PeriodicalIF":2.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291058","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}
BMC NeurologyPub Date : 2025-10-14DOI: 10.1186/s12883-025-04445-5
Tianjin Zhong, Xiaodan Chen, Ye Li, Yizhu Chen, Yichao Zhang, Hui Zheng, Danjie Lin, Sihui Liu, Peirong Jiang, Yang Song, Yunjing Xue, Lin Lin
{"title":"Preoperative prediction of brain invasion in meningiomas: a comparison of diffusion kurtosis imaging and diffusion tensor imaging.","authors":"Tianjin Zhong, Xiaodan Chen, Ye Li, Yizhu Chen, Yichao Zhang, Hui Zheng, Danjie Lin, Sihui Liu, Peirong Jiang, Yang Song, Yunjing Xue, Lin Lin","doi":"10.1186/s12883-025-04445-5","DOIUrl":"10.1186/s12883-025-04445-5","url":null,"abstract":"<p><strong>Objective: </strong>Identifying brain invasion particularly important for meningioma patients, but there is still a lack of valuable early biomarkers. The authors aimed to investigate the value of histogram analysis of diffusion kurtosis imaging (DKI) and diffusion tensor imaging (DTI) in predicting the brain invasion of meningioma.</p><p><strong>Methods: </strong>A total of 132 meningioma patients were prospectively included and underwent magnetic resonance diffusion imaging. The whole-tumour histogram parameters were extracted from diffusion maps including Mean kurtosis (MK), fractional anisotropy (FA), and mean diffusivity (MD). The Mann-Whitney U test was used to compare the parameters of brain invasive and non-invasive meningiomas. The receiver operating characteristic (ROC) curve and multiple logistic regression analyes were performed to identify the diagnostic performance. Spearman's partial correlation was used to evaluate correlations between histogram parameters and the Ki-67 index.</p><p><strong>Results: </strong>DKI-MK (10th, 50th, 90th percentile, maximum, mean and kurtosis), DKI-FA (minimum, maximum), DKI-MD (minimum, maximum, kurtosis and skewness), DTI-FA (maximum), DTI-MD (10th percentile, kurtosis and skewness) showed statistically significant differences between brain invasive and non-invasive meningiomas (p < 0.05). For all histogram parameters, the highest individual predictor was DKI-MK 90th percentile with an AUC of 0.837 and an accuracy of 75.0%. The DKI combined model can further improve the diagnostic efficiency, with an AUC of 0.914 and an accuracy of 85.6%. Significant correlations were found between various diffusion histogram parameters and the Ki-67 index (rho = -0.244-0.504, p < 0.05).</p><p><strong>Conclusions: </strong>The whole-tumour DKI and DTI histogram analysis is a promising approach for predicting brain invasion in meningiomas, and the multi-parameter combined model can further improve diagnostic efficiency.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"422"},"PeriodicalIF":2.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291114","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}