BMC Neurology最新文献

{"title":"Valproic acid levels in neurodevelopmental disorders: correlation with CYP and SULT genes using LC-MS/MS.","authors":"Shada Abutaleb, Eyad Mallah, Luay Abu-Qatouseh, Ahmad Abu-Awwad, Kenza Mansoor, Sarah Khallad, Khaled W Omari, Omar Mouhtady, Tawfiq Arafat","doi":"10.1186/s12883-025-04065-z","DOIUrl":"10.1186/s12883-025-04065-z","url":null,"abstract":"<p><strong>Background: </strong>Valproic acid (VPA) is one of the most widely prescribed antiepileptic drugs worldwide, which is used to treat migraines, bipolar disorder, and anxiety. However, VPA is associated with a wide range of side effects. This study evaluates therapeutic drug monitoring (TDM) in individuals with neurodevelopmental disorders. It explores the correlation between valproic acid (VPA) plasma levels and genetic polymorphisms in cytochrome P450 (CYP) enzymes and cytosolic sulfotransferase (SULT) genes.</p><p><strong>Methods: </strong>A simple and accurate LC-MS/MS method was developed, validated, and applied in the TDM of 14 individuals on VPA therapy. Plasma VPA levels were measured, and genotyped genes SULT1A1, CYP2D64, CYP2D610, CYP3A5, and CYP2C19*2. Statistical analyses were conducted using SPSS.</p><p><strong>Results: </strong>Of the fourteen participants, two had toxic plasma VPA levels (≥ 100 µg/mL), one had a sub-therapeutic level (< 50 µg/mL), and eleven were within or slightly above the therapeutic range (50-100 µg/mL). No significant correlation was observed between VPA plasma concentrations and genotypes of SULT1A1 (p = 0.522), CYP2C192 (p = 0.288), CYP2D64 (p = 0.895), or CYP2D6*10 (p = 0.067). While no direct associations were found, genotype-guided drug therapy remains a promising strategy for optimizing drug efficacy and minimizing toxicity.</p><p><strong>Conclusions: </strong>This study highlights the complexity of valproic acid (VPA) therapy in individuals with neurodevelopmental disorders and the limited influence of common genetic polymorphisms in CYP and SULT genes on VPA plasma levels. While therapeutic drug monitoring (TDM) remains an invaluable tool for optimizing VPA therapy, the lack of significant correlations between genetic variants and VPA concentrations suggests that routine pharmacogenetic testing for these specific variants may not be warranted in clinical practice. However, the observed toxic and sub-therapeutic VPA levels emphasize the importance of regular TDM to mitigate risks associated with overdose or insufficient dosing.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"93"},"PeriodicalIF":2.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584770","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":"Imaging predictors of progressive infarction in patients with anterior circulation small subcortical infarction.","authors":"Liangbin Dong, Xiaocheng Mao, Kaiyan Jiang, Zubing Xu, Shumeng Li, Jincai Tang, Xiaobing Li, Qin Huang, Jing Lin","doi":"10.1186/s12883-025-04097-5","DOIUrl":"10.1186/s12883-025-04097-5","url":null,"abstract":"<p><strong>Background: </strong>The purpose of the present study is to investigate the association between imaging characteristics and progressive infarction (PI) in patients with anterior circulation single subcortical infarction (ACSSI).</p><p><strong>Methods: </strong>Between January 2020 and October 2022, we retrospectively enrolled 638 ACSSI patients admitted to the Stroke Unit of First Affiliated Hospital of Nanchang University within 48 h after symptom onset. Demographic characteristics, clinical information, laboratory data, and imaging features (the number of infarct slices and the maximal diameter of infarcts) were collected.</p><p><strong>Results: </strong>There were 121 patients with PI, accounting for 18.9% of the total. In univariate analysis, the infarct slice number tended to be higher in the PI group (P < 0.05). Additionally, patients with PI had a higher frequency of infarct diameter≥ 10 mm and infarct slices≥3 than patients without PI (P < 0.05). Patients diagnosed with branch atheromatous disease (BAD) were more likely to develop PI compared to lacunar infarction (LI) when BAD was defined as axial slices of infarcts ≥ 3 and the infarct diameter ≥10 mm (P < 0.05). Multivariate logistic analysis revealed that slice number ≥ 3 remained slightly significant after adjusting all variables with P < 0.05. Finally, receiver operating characteristic curves were used to compare discriminative abilities and suggested slices of infarcts ≥ 3 were superior to other imaging variables to predict PI in ACSSI patients.</p><p><strong>Conclusion: </strong>The present study suggests a lesion visible ≥3 slices is independently correlated with PI in ACSSI patients. The slice number of infarcts in ASCCI is a superior indicator to predict PI than other imaging markers.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"95"},"PeriodicalIF":2.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584753","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":"Association between SARS-CoV-2 and stroke: perspectives from a metaumbrella-review.","authors":"Andreza Maria Luzia Baldo de Souza, Enoque Fernandes de Araújo, Nelson Carvas Junior, Augusto Cesar Sousa Raimundo, Antonio Carlos Pereira, Marcelo de Castro Meneghim","doi":"10.1186/s12883-025-04041-7","DOIUrl":"10.1186/s12883-025-04041-7","url":null,"abstract":"<p><p>In the face of the global COVID-19 pandemic, the need arose to investigate potential complications associated with SARS-CoV-2, including the risk of stroke.ObjectiveThis study aimed to verify the association between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the risk of stroke on the basis of systematic reviews and meta-analyses to assess the inclusion of the virus as a new risk factor for cerebrovascular diseases.MethodsA metaumbrella study was conducted, which included 34 systematic reviews, of which 4 were selected for the final analysis on the basis of methodological quality and consistency. The analysis aggregated the results of 70 primary studies, considering different stroke subtypes and outcomes associated with COVID-19. Study heterogeneity was assessed via the I² index, and significance bias was verified via Egger's test.ResultsCOVID-19 severity was significantly associated with an increased risk of stroke (eOR = 2.48; 95% CI: 1.55-3.95), particularly ischemic stroke (eOR = 1.76; 95% CI: 1.11-2.80) and hemorrhagic stroke (eOR = 3.86; 95% CI: 1.79-8.33). Additionally, patients with cerebrovascular comorbidities had higher mortality (eOR = 2.48; 95% CI: 2.48-19.63), as did those who had previously suffered a stroke (eOR = 6.08; 95% CI: 3.73-9.91).ConclusionThe association between SARS-CoV-2 and stroke incidence was consistent and significant, suggesting that COVID-19 should be considered a new risk factor for cerebrovascular diseases. However, the high heterogeneity among the studies analyzed reinforces the need for further research to consolidate this relationship.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"97"},"PeriodicalIF":2.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584746","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":"Exploring comorbidity networks in mild traumatic brain injury subjects through graph theory: a traumatic brain injury model systems study.","authors":"Kaustav Mehta, Shyam Kumar Sudhakar","doi":"10.1186/s12883-025-04102-x","DOIUrl":"10.1186/s12883-025-04102-x","url":null,"abstract":"<p><strong>Background: </strong>Traumatic brain injuries (TBIs) are characterized by myriad comorbidities that affect the functioning of the affected individuals. The comorbidities that TBI subjects experience span a wide range, ranging from psychiatric diseases to those that affect the various systems of the body. This is compounded by the fact that the problems that TBI subjects face could span over an extended period post-primary injury. Further, no drug exists to prevent the spread of secondary injuries after a primary impact.</p><p><strong>Methods: </strong>In this study, we employed graph theory to understand the patterns of comorbidities after mild TBIs. Disease comorbidity networks were constructed for old and young subjects with mild TBIs and a novel clustering algorithm was applied to understand the comorbidity patterns.</p><p><strong>Results: </strong>Upon application of network analysis and the clustering algorithm, we discovered interesting associations between comorbidities in young and old subjects with the condition. Specifically, bipolar disorder was seen as related to cardiovascular comorbidities, a pattern that was observed only in the young subjects. Similar associations between obsessive-compulsive disorder and rheumatoid arthritis were observed in young subjects. Psychiatric comorbidities exhibited differential associations with non-psychiatric comorbidities depending on the age of the cohort.</p><p><strong>Conclusion: </strong>The study results could have implications for effective surveillance and the management of comorbidities post mild TBIs.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"94"},"PeriodicalIF":2.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584751","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":"Unmasking the hidden culprit: neurosyphilis mimicking parkinsonism in a middle-aged male.","authors":"Zhaobo Shi, Yong Sun, Xinsheng Han","doi":"10.1186/s12883-025-04101-y","DOIUrl":"10.1186/s12883-025-04101-y","url":null,"abstract":"<p><strong>Background: </strong>General paresis, a tertiary manifestation of neurosyphilis affecting the brain, is characterized by mental and behavioral disorders, such as attention disorder, cognitive impairment, and personality changes. But parkinsonism is rarely reported in patients with neurosyphilis, let alone general paresis. This study reports a case suffering from both general paresis and parkinsonism.</p><p><strong>Case presentation: </strong>A 50-year-old man was initially misdiagnosed with \"alcohol-related psychiatric and behavioral disorders\" due to the onset of psychiatric symptoms following alcohol abstinence. The excessive administration of psychotropic medications, attributed to their limited efficacy, was identified as the primary cause of his subsequent extrapyramidal symptoms, including tremor and bradykinesia. However, treatment with levodopa yielded only marginal effectiveness. Following a comprehensive diagnostic evaluation, which encompassed brain magnetic resonance imaging, syphilis screening, and cerebrospinal fluid analysis, neurosyphilis was ultimately identified as the underlying etiology. Subsequent treatment with aqueous penicillin resulted in a marked improvement in his symptoms.</p><p><strong>Conclusion: </strong>This case illustrates a rare manifestation of neurosyphilis, specifically parkinsonism. The diagnostic process was complicated by several confounding factors. As neurosyphilis is known as the \"great imitator,\" capable of mimicking various neuropsychiatric disorders, routine syphilis screening is imperative for patients presenting with mental disorders and parkinsonian symptoms to facilitate early diagnosis and enhance prognosis.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"96"},"PeriodicalIF":2.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584768","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":"Early NCCT imaging signs for prognostication in intracerebral hemorrhage: a retrospective cohort study with long follow up results.","authors":"Rong Deng, Chuyue Wu, Lina Zhang, Jing Wang, Jing Guo, Zhenjie Yang, Lei He, Shengli Chen","doi":"10.1186/s12883-025-04100-z","DOIUrl":"10.1186/s12883-025-04100-z","url":null,"abstract":"<p><strong>Objective: </strong>This study intends to investigate the connection between non-contrast computed tomography (NCCT) imaging findings and neurological function scores in patients with intracerebral hemorrhage (ICH) in a long follow up of 451 patients.</p><p><strong>Methods: </strong>Between January 2020 and October 2021, a retrospective review was undertaken on patients with ICH. The NCCT imaging results within 24 h of symptom onset, clinical information, biochemical markers and the one-year outcome post-discharge were collected and analyzed. Subsequently, a prognostic model was devised to predict poor outcomes.</p><p><strong>Results: </strong>A cohort of 451 patients diagnosed with ICH was analyzed in this study. Adverse prognostic outcomes at three months were found to be independently associated with several factors, including the presence of the swirl sign (P = 0.010), advanced age (P = 0.003), post-ICH modified Rankin Scale (mRS) score (P = 0.003,), time elapsed from symptom onset to NCCT scan (P = 0.018), and the presence of ventricular hemorrhage (P = 0.003). Unfavorable prognosis at 12 months was independently associated with the presence of the island sign (P = 0.001), older age (P = 0.003), post-ICH mRS score (P = 0.003), and HE (P = 0.014). Additionally, the integration of NCCT imaging signs into the predictive model significantly improved its accuracy in predicting adverse outcomes at both three months (AUC = 0.817 vs. 0.782 in the model without NCCT, NRI = 0.219, P = 0.033, IDI = 0.080, P = 0.006) and 12 months (AUC = 0.829 vs. 0.797 in the model without NCCT, NRI = 0.235, P = 0.028, IDI = 0.096, P = 0.003).</p><p><strong>Conclusions: </strong>The early imaging features of patients suffering from ICH can provide a more precise prognosis from the analysis of the 12-month follow up results.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"91"},"PeriodicalIF":2.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572147","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":"The predictive role of composite inflammatory ratio parameters in the conscious awareness recovery after severe acute ischemic stroke: a retrospective cohort study.","authors":"Yiyuan Xu, Yanyan Liu","doi":"10.1186/s12883-024-04016-0","DOIUrl":"10.1186/s12883-024-04016-0","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory mechanisms play a significant role in ischemic stroke. Peripheral neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), which are indicators capable of reflecting the magnitude of the inflammatory response, have been research hotspots. However, few research findings evaluate the prediction significance of these biomarkers in the recovery of conscious awareness following severe acute ischemic stroke.</p><p><strong>Methods: </strong>This was a retrospective cohort study of 142 patients with consciousness disorders after acute ischemic stroke (GCS score ≤ 8) treated from January 2022 to May 2024. The cases were divided into three groups according to the GCS score at discharge as died/ vegetative state (GCS ≤ 3),moderate/ severe coma(GCS = 4-11) and mild coma/ normal (GCS:12-15). Demographic and clinical assessment data were reviewed and abstracted. NLR, PLR, SII and SIRI were calculated based on the peripheral blood tests at admission. The study investigated the correlation between changes in GCS scores from admission to discharge (calculated as the GCS score at discharge minus the baseline GCS score, where a negative value indicates worsening and a positive value indicates improvement) and the levels of NLR, PLR, SII, and SIRI.</p><p><strong>Results: </strong>The level of NLR, PLR, SII and SIRI in died/ vegetative state group were significantly higher than those in moderate/ severe coma group (p = 0.0429, p = 0.0215, p = 0.0288, p = 0.026, respectively) and mild coma/ normal group (p = 0.0085, p = 0.0079, p = 0.0019, p = 0.0017, respectively). The area under the curve (AUC) values of NLR, PLR, SII, and SIRI to prognosis were 0.670, 0.661, 0.677, and 0.609, respectively. Spearman correlation analysis indicated NLR, PLR and SII were negatively correlated with GCS scores increase during hospitalization (r =- 0.317, p<0.0001 for NLR, r = -0.285, p = 0.001 for PLR, r = -0.3331, p < 0.0001 for SII, r= -0.199,p = 0.018 for SIRI).However, ordinal logistic regression analyses failed to indicate that NLR, PLR, SII and SIRI were independent predictors of poor consciousness response for severe acute ischemic stroke coma patients after adjusting for other confounders.</p><p><strong>Conclusion: </strong>Patients with poorer consciousness outcomes exhibited a tendency towards elevated NLR, PLR, SII, and SIRI levels which were inversely correlated with GCS scores increase during hospitalization. However, the four indexes did not exhibit sufficient promise to be the valuable predictors for the prognosis of recovery from consciousness following severe acute ischemic stroke.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"90"},"PeriodicalIF":2.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571700","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":"Effect of expressive writing on the sexual self-concept in men with multiple sclerosis: a randomized clinical controlled trial.","authors":"Malihe Mohammadzade Sabbaghi, Leila Amini, Seyed Massood Nabavi, Naiemeh Seyedfatemi, Hamid Haghani","doi":"10.1186/s12883-025-04110-x","DOIUrl":"10.1186/s12883-025-04110-x","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have examined the various outcomes of expressive writing intervention in different populations. The purpose of this study was to evaluate the effect of expressive writing on the sexual self-concept of men with multiple sclerosis.</p><p><strong>Methods: </strong>This parallel randomized controlled clinical trial conducted on 70 men attending an MS clinic in Tehran in 2022. The participants were randomly assigned to expressive writing intervention and control groups. For two weeks, participants in the intervention group disclosed their emotions and expressed their feelings in writing twice a week. Sexual self-concept was evaluated using the Multidimensional Sexual Self-Concept Questionnaire on three occasions, before, after, and 4-week follow-up. The data ware analyzed using SPSS software version 22 (IBM Corp., Armonk, N.Y., USA). The analysis employed Chi-squared test, Fisher's exact test, independent t-test, and repeated measured ANOVA. A p-value < 0.05 was considered to be statistically significant.</p><p><strong>Results: </strong>The mean of age in the intervention group was 38.6 ± 6.85 years, while in the control group it was 38.94 ± 6.07 years. There were no significant differences between the two groups, in terms of these characteristics. According to the results, the dimensions of SSC did not change over time assessments, except for sexual problem self-blame (p = 0.011) and sexual fear/apprehension (p = 0.042) in the expressive writing intervention group, and sexual motivation in the control group (p = 0.002). On the other hand, before the intervention, sexual motivation was significantly higher in the control group compared to the expressive writing intervention group (p = 0.046).</p><p><strong>Conclusions: </strong>Our findings did not support the general effectiveness of a 2-week expressive writing intervention on the sexual self-concept of the men with MS except for the sexual fear/apprehension and sexual problem self-blame dimensions. However, further research is needed to better understand the effects of expressive writing intervention on Sexual self-concept in men with multiple sclerosis, while controlling for the limitations of our study.</p><p><strong>Trial registration: </strong>The present study has been registered on the Iranian Registry of Clinical Trials (IRCT) at https://irct.behdasht.gov.ir/trial/59664 on November 17, 2021, with the code IRCT20211028052892N1.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"88"},"PeriodicalIF":2.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572149","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":"Early venous filling is associated with unfavorable outcomes in acute ischemic stroke with large vessel occlusion after mechanical thrombectomy: a real-world analysis.","authors":"Jiaxin Han, Yixuan Wu, Zihan Wang, Jianfeng Han, Guogang Luo, Kang Huo","doi":"10.1186/s12883-025-04111-w","DOIUrl":"10.1186/s12883-025-04111-w","url":null,"abstract":"<p><strong>Background: </strong>The presence of early venous filling (EVF) post-mechanical thrombectomy (MT) in acute ischemic stroke (AIS) patients has been observed, yet its prognostic value for clinical outcomes remains underexplored. This study aimed to assess the correlation between EVF and poor clinical outcomes in AIS patients who underwent MT.</p><p><strong>Materials and methods: </strong>This retrospective analysis included AIS patients with large vessel occlusions treated with MT at the First Affiliated Hospital of Xi'an Jiaotong University from January 2018 to June 2023. The primary outcome was mRS at 90 days, secondary outcomes included hemorrhagic transformation, symptomatic intracranial hemorrhage, and malignant brain edema. The study used inverse probability weighting for balancing baseline characteristics and employed univariate and multivariate logistic regression analyses to explore the association between EVF and clinical outcomes. G*Power was used to calculate the sample size.</p><p><strong>Results: </strong>Among 307 patients, 75 (24.4%) presented with EVF. Patients with EVF had significantly higher rates of unfavorable outcomes at 90 days (76.00% vs. 46.12%, P < 0.001). Multivariate analysis revealed significant associations between EVF and unfavorable outcome (odds ratio [OR] = 2.69, 95%CI [1.37-5.26], P = 0.004), hemorrhagic transformation (OR = 3.11, 95%CI [1.73-5.62], P < 0.001), symptomatic intracranial hemorrhage (OR = 3.24, 95%CI 1.42 to 7.37, P = 0.005), and malignant brain edema (OR = 3.06, 95%CI [1.56-6.01], P = 0.001). Stratified analysis showed EVF group with a baseline Alberta Stroke Program Early CT (ASPECT) score of ≤ 8 exhibited a higher risk of unfavorable outcomes compared with patients in the non-EVF group (OR = 2.64, 95%CI [1.03-6.73], P = 0.042). Mediation analysis indicated that malignant brain edema accounted for 35.42% of the correlation between EVF and unfavorable outcomes.</p><p><strong>Conclusions: </strong>This study establishes EVF as an independent risk factor for unfavorable outcomes after MT in AIS. Therefore, EVF in conjunction with a low ASPECT score provides essential insights for identifying patients at high risk for unfavorable outcomes.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"92"},"PeriodicalIF":2.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572148","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":"Clinical and electrophysiological features of pure sensory Guillain-Barré syndrome: retrospective analysis of 22 patients across 14 provinces in Southern China.","authors":"Songyan Liu, Hong Chu, Bin Peng, Yanping Zeng, Jia Liu, Zuneng Lu, Chao Weng","doi":"10.1186/s12883-025-04103-w","DOIUrl":"10.1186/s12883-025-04103-w","url":null,"abstract":"<p><strong>Objective: </strong>Currently, there are limited reports, both nationally and internationally, regarding Guillain-Barré Syndrome (GBS) that manifests solely with isolated sensory impairment. This study aims to explore the epidemiological and clinical features of GBS patients experiencing only paresthesia in southern China.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of the medical records of GBS patients admitted to 31 hospitals across 14 provinces in southern China from January 1, 2013, to September 30, 2016.</p><p><strong>Results: </strong>A total of 1,056 patients diagnosed with GBS were identified from medical records, of whom 276 had paresthesia as their first symptom. Among these 276 patients, a total of 41 patients with GBS who exhibited only paresthesia were analyzed. Among them, 19 patients served as a control group and showed abnormal compound muscle action potential (CMAP). We identified 22 cases of pure sensory disturbances in GBS patients and named them \"pure sensory GBS\", characterized by normal CMAP. Comparative analysis revealed no statistically significant differences between the two groups in terms of age at onset, gender, residence, or antecedent events; however, the pure sensory GBS group demonstrated a higher incidence of onset during the spring. Electrophysiological evaluations revealed that the pure sensory GBS group had a lower likelihood of reduced amplitude in sensory nerve action potential (SNAP) compared to the control group. However, there were no significant differences between the two groups in sensory conduction latency, velocity, H-reflex, or F-wave detection. Additionally, no significant differences were observed in cerebrospinal fluid (CSF) studies, treatment modalities, discharge Hughes scores, or peak time. Notably, patients in the pure sensory GBS group had lower Hughes scores at admission and a shorter hospital stay, with these differences reaching statistical significance.</p><p><strong>Conclusion: </strong>Among GBS patients, those presenting solely with sensory disturbances are relatively uncommon, with only 22 cases. Compared to the control group, those patients are more frequently diagnosed in the spring, demonstrate a milder degree of reduction in amplitude of SNAP, present with milder symptoms at admission, and have shorter hospital stays.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"87"},"PeriodicalIF":2.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572145","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}