BMC Neurology最新文献

{"title":"Myasthenia gravis complicated by intestinal pseudo-obstruction: a case report and literature review.","authors":"Yangtao Lin, Chaoyue Zhang, Zhishan Zhong, Yufei Deng, Haocheng Luo, Xiaojun Yang, Qilong Jiang","doi":"10.1186/s12883-025-04407-x","DOIUrl":"10.1186/s12883-025-04407-x","url":null,"abstract":"","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"421"},"PeriodicalIF":2.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291196","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":"Delayed emergence of parkinson's disease after reversible manganese-induced parkinsonism: a case report.","authors":"Hae-Won Shin","doi":"10.1186/s12883-025-04448-2","DOIUrl":"10.1186/s12883-025-04448-2","url":null,"abstract":"<p><strong>Background: </strong>Chronic manganese (Mn) exposure, particularly in occupational settings such as welding, can lead to Mn-induced parkinsonism, a condition typically considered reversible and distinct from idiopathic Parkinson's disease (PD). However, the neurotoxic effects of Mn may contribute to or accelerate dopaminergic degeneration in susceptible individuals.</p><p><strong>Case presentation: </strong>We report the case of a 53-year-old male welder who initially presented with symmetrical parkinsonism and characteristic T1 hyperintensities in the globus pallidus in Brain MRI, consistent with Mn-induced parkinsonism. Symptoms and Brain MRI abnormalities fully resolved one year after cessation of Mn exposure. Three years later, the patient developed new, progressive, and asymmetric parkinsonian symptoms, including a unilateral resting tremor and bradykinesia. 18- fluoropropyl-2β-carbomethoxy-3β-4-iodophenyl nortropane positron emission tomography imaging demonstrated a marked reduction in striatal dopamine transporter uptake, and the patient responded well to levodopa, confirming the diagnosis of idiopathic PD.</p><p><strong>Conclusions: </strong>This case illustrates a rare longitudinal transition from reversible Mn-induced parkinsonism to idiopathic PD, suggesting that prior Mn exposure may act as a precipitating or accelerating factor for PD pathogenesis. Functional neuroimaging is critical for differentiating between these two syndromes. This report underscores the importance of long-term neurological follow-up in patients with occupational Mn exposure and supports the hypothesis that environmental toxins can contribute to neurodegenerative processes.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"423"},"PeriodicalIF":2.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291017","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 of triglyceride-glucose index and its related parameters with the risk of stroke: a meta-analysis.","authors":"YaNan Yang, BingChen Li, YiRan Cheng, Ruxia Bai, LiPing Wang, LingZhi Sun, MiaoMiao Meng","doi":"10.1186/s12883-025-04349-4","DOIUrl":"10.1186/s12883-025-04349-4","url":null,"abstract":"<p><strong>Objective: </strong>The triglyceride-glucose (TyG) index and its related parameters are biomarkers of insulin resistance (IR) and maybe of great significance for predicting the occurrence of stroke. This systematic review and meta-analysis aimed to summarize the relationship between TyG and its related parameters with the risks of stroke.</p><p><strong>Methods: </strong>By searching the Cochrane Library, Embase, and PubMed databases, we obtained prospective cohort studies that reported the hazard ratios (HRs) and their 95% confidence intervals (CIs) for the association between the TyG index and its related parameters (TyG-BMI, TyG-WC, TyG-WHtR) and stroke incidence. The results were combined using a random-effects model.</p><p><strong>Results: </strong>This meta-analysis included 21 prospective cohort studies with a total of 6,511,326 participants. The results showed that, compared to the lowest group for TyG or its related parameters, the highest group had an increased risk of stroke (TyG-BMI: HR: 1.55, 95% CI: 1.22-1.99, I² = 84.69%; TyG-WC: HR: 1.63, 95% CI:1.17-2.28, I² = 89.51%; TyG-WHtR: HR: 1.79, 95%CI:1.17-2.72, I² = 93.91%). Subgroup analyses revealed that the relationship between TyG and its related parameters and stroke was not significantly affected by gender, region, sample size, and follow-up duration.</p><p><strong>Conclusions: </strong>Higher levels of TyG, TyG-BMI, TyG-WC, and TyG-WHtR may indicate a higher risk of stroke occurrence.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"416"},"PeriodicalIF":2.2,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12509345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257427","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":"Global burden trends of idiopathic epilepsy in young adults from 1990 to 2035: based on the global burden of disease study 2021.","authors":"Yan Zhao, Yi Li, Mei Li, Yun Xu, Jiahui Zhang, Shuwei Qiu","doi":"10.1186/s12883-025-04431-x","DOIUrl":"10.1186/s12883-025-04431-x","url":null,"abstract":"<p><strong>Background: </strong>Epilepsy is a prevalent neurological condition that greatly affects the quality of life of those affected, with increasing rates of incidence and prevalence. This study aims to evaluate the global, regional, and national burdens of idiopathic epilepsy (IE) in individuals aged 15 to 49 from 1990 to 2021 via data from the Global Burden of Disease (GBD) Study and to project trends through 2035.</p><p><strong>Methods: </strong>Using the GBD database 2021, we assessed the burden of IE through metrics involving incidence, prevalence, mortality, and disability-adjusted life years (DALYs). Statistical methods included joinpoint regression for annual percent change (APC), estimated annual percentage change (EAPC), and Bayesian age-period-cohort (BAPC) modeling for projections.</p><p><strong>Results: </strong>In 2021, there were 11.48 million (95% UI, 8.35-14.75) young adults with IE, with global incidence, prevalence, mortality and DALY rates of 37.57 (95% UI, 26.28-50.70), 290.83 (211.42-373.58), 1.64 (1.38-1.83) and 185.09 (144.06-230.00) per 100,000 people, respectively. From 1990 to 2021, incidence and prevalence rates increased by 8.51% and 5.7%, respectively, but these increases were not statistically significant. In contrast, mortality and DALY rates significantly decreased by 15.42% and 12.67%, respectively. The 15-19 age group consistently had the highest incidence and prevalence rates, which declined with age. Regionally, high sociodemographic index (SDI) areas consistently presented the highest incidence and prevalence rates, whereas low-SDI regions always exhibited the highest mortality and DALY rates. Besides, males presented higher mortality rates than females. Forecasts for 2035 suggested that the global incidence and prevalence rates of IE would keep rising, whereas mortality and DALY rates were projected to decline.</p><p><strong>Conclusion: </strong>The global burden of IE among young adults remains substantial. To effectively address the evolving global impact of this neurological disorder, it is crucial to prioritize policies and allocate resources accordingly. This will enable the implementation of targeted interventions aimed at improving healthcare access, promoting early diagnosis, and providing treatment in low-resource areas, ultimately reducing future burdens.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"415"},"PeriodicalIF":2.2,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145249829","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":"How can we reduce psychological burden for patients of amyotrophic lateral sclerosis and their family caregivers? - Insights from the participatory multi-method study \"potentiALS\".","authors":"Svenja Heyne, Adelina Kuzmanova, Peter Esser, Katharina Linse, René Günther, Anja Mehnert-Theuerkauf, Moritz Metelmann","doi":"10.1186/s12883-025-04440-w","DOIUrl":"10.1186/s12883-025-04440-w","url":null,"abstract":"<p><strong>Background: </strong>Amyotrophic lateral sclerosis (ALS) is a progressive, fatal motor neuron disease that severely impacts patients' physical and emotional well-being, while also imposing significant burdens on family caregivers. Despite the high psychosocial demands as part of the multidimensional burden, evidence for effective interventions remains limited. This study employed a participatory approach to assess the support needs of ALS patients and caregivers and to evaluate their preferences for psychosocial therapies to derive a therapeutic framework.</p><p><strong>Methods: </strong>In this observational multi-method study, ALS patients, their family caregivers, and healthcare professionals (HCPs) were actively involved throughout the research process. Quantitative Data were collected through structured questionnaires assessing quality of life (e.g., MQoL, SEIQoL-Q), depression and anxiety (ADI-12, HADS), and caregiver burden (BSFC-s). Feedback was obtained through structured group sessions that combined brief introductions, practical exercises, and subsequent evaluations of four therapy approaches - cognitive behavioral therapy (CBT), psychodynamic therapy (PT), acceptance and commitment therapy (ACT), and meaning-centered therapy (MCT).</p><p><strong>Results: </strong>14 patients, 17 caregivers and nine HCPs participated in the study. Among patients, ACT was the most frequently selected (37.5%), followed by CBT (31.3%), MCT (18.8%), and PT (12.5%) with similar distribution in caregiver attendance. Across all therapy approaches, both patients and caregivers rated the beneficial aspects highly (mean scores of 4.18, and 4.12, respectively, on a scale from 1 to 5) and identified relatively few limitations (mean scores of 2.18 and 2.09, respectively, on a scale from 1 to 5). HCPs corroborated these findings, noting that while the therapies were effective in offering emotional support and facilitating open dialogue, challenges such as time constraints and adapting interventions for speech limitations remain. Notably, caregivers showed a strong preference for individualized therapy, while patients favored a mix of individual and group formats.</p><p><strong>Conclusions: </strong>Our study highlights the distinct yet interconnected psychosocial needs of ALS patients and their caregivers. Tailored interventions should blend emotional support, open dialogue, and a structured therapeutic framework, while also emphasizing the need for adaptable delivery models in clinical practice. These findings support the development of scalable, patient-centered psychosocial support approaches as part of the multidimensional care in ALS.</p><p><strong>Trial registration: </strong>The trial is registered at ClinicalTrials.gov (number: NCT06441448, registration date: May 28, 2024).</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"414"},"PeriodicalIF":2.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243735","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":"Clazosentan for cerebral vasospasm prevention in aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis.","authors":"Saaed Abunada, Taimoor Ashraf, Dinesh Kumar, Hasnain Ali Moryani, Partab Rai, Sumiya Abbasi, Nisha Devi, Muskan Turesh, Shah Dev, Salman Hyder, Muhammad Aizazuddin, Sateesh Kumar, Laksh Kumar, Sidra Khan, Salih Abdella Yusuf","doi":"10.1186/s12883-025-04429-5","DOIUrl":"10.1186/s12883-025-04429-5","url":null,"abstract":"<p><strong>Background: </strong>Aneurysmal subarachnoid hemorrhage (aSAH) remains a devastating neurological emergency, with cerebral vasospasm contributing significantly to poor outcomes. Clazosentan, a selective endothelin-A receptor antagonist, has shown potential in preventing vasospasm, though its overall efficacy and safety profile require comprehensive assessment.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis following PRISMA guidelines, searching multiple databases through March 2025. We included randomized controlled trials and observational studies comparing clazosentan with placebo or active controls in aSAH patients. Outcomes included vasospasm incidence, its complications, and adverse events.</p><p><strong>Results: </strong>Analysis of 13 reports (n = 5,728) were included. Compared to placebo, clazosentan significantly reduced vasospasm-related cerebral infarcts (RR: 0.56, p = 0.0002), delayed ischemic neurological deficits (DIND) (RR: 0.67, p < 0.0001), and the incidence of vasospasm (RR: 0.54, p < 0.00001). Compared to fasudil, clazosentan was associated with a lower incidence of vasospasm (RR: 0.44, p = 0.0004) and vasospasm-related cerebral infarcts (RR: 0.27, p = 0.002), but no significant difference was observed in DIND (p = 0.89). The drug showed particular benefit at higher doses (10-15 mg/h) and in surgical clipping patients. Clazosentan use was linked to a higher risk of adverse events, including pulmonary complications and hypotension (p < 0.05).</p><p><strong>Conclusion: </strong>While clazosentan effectively prevents cerebral vasospasm following aSAH, particularly at higher doses in surgically treated patients, its clinical utility must be weighed against significant systemic adverse effects. These findings support selective use in high-risk patients while highlighting the need for careful monitoring and individualized treatment approaches.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"413"},"PeriodicalIF":2.2,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238171","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":"Support vector machine-based preoperative identification of IDH-Mutant low-grade gliomas in adult gliomas using clinical features.","authors":"Wei Chen, Guo-Hao Huang, Peng Ren, Fei Li, Sheng-Qing Lv","doi":"10.1186/s12883-025-04435-7","DOIUrl":"10.1186/s12883-025-04435-7","url":null,"abstract":"<p><strong>Background: </strong>The preoperative identification of (isocitrate dehydrogenase) IDH-mutant low-grade gliomas (LGGs) is critical for personalized treatment planning. We aimed to develop a streamlined machine-learning model using key clinical features for rapid and accurate preoperative prediction.</p><p><strong>Methods: </strong>A retrospective cohort of 418 adult glioma patients was partitioned into training (70%) and internal validation (30%) sets. (Support Vector Machine) SVM was selected as the optimal model after comparing 9 machine learning models. Six clinically significant features, ranked by predictive importance, were incorporated into the final SVM model. The model's generalizability was further validated using an independent external cohort (n = 206).</p><p><strong>Results: </strong>The SVM model demonstrated high discriminative performance, achieving an (area under the receiver operating characteristic curve) AUC-ROC of 0.860 (internal validation) and 0.869 (external validation). SHAP (SHapley Additive exPlanations) analysis confirmed age as the most influential predictor, followed by edema and enhanced features, aligning with known biological associations in IDH-mutant LGGs.</p><p><strong>Conclusions: </strong>This SVM-based model provides a clinically practical tool for the preoperative identification of IDH-mutant LGGs, combining diagnostic reliability, interpretability, and minimal feature requirements. Its robust external validation underscores its potential utility in diverse clinical settings.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"412"},"PeriodicalIF":2.2,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238155","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":"Disease characteristics and treatment status of genetically confirmed spinal muscular atrophy patients: a cross-sectional survey in China.","authors":"Dingding Zhang, Fengxia Yao, Chao Ling, Shan Jiang, Xunzhe Yang, Yi Dai","doi":"10.1186/s12883-025-04441-9","DOIUrl":"10.1186/s12883-025-04441-9","url":null,"abstract":"<p><strong>Background: </strong>This cross-sectional study aimed to investigate the disease status, motor function, and medication treatment choices of genetically confirmed SMA patients.</p><p><strong>Methods: </strong>A single-center, cross-sectional survey was conducted using web-based questionnaires and telephone interviews. Data were collected from genetically diagnosed SMA patients, including general information, SMA complications, motor function and medication treatment regimens.</p><p><strong>Results: </strong>Among the 106 patients finally included in analysis, the median age was 18.5 years (IQR, 14.00-25.75), with SMA types distributed as 10.4% type 1, 40.6% type 2, and 49.0% type 3. Despite the high prevalence of spinal deformities (84.0%) and joint deformities (82.1%), motor function was Generally well-maintained, with 51.9% of patients able to sit independently. The willingness of parents of patients who did not receive DMT treatment to have another child was lower than the willingness of parents of patients who had received DMT treatment (OR: 0.195; 95% CI: 0.068-0.562; P = 0.002). Notably, 66.0% had used nusinersen and 24.5% had used risdiplam. When selecting medications, the primary considerations among all patients included drug efficacy, safety, and cost. However, 48.8% of the patients who received treatment reported treatment dissatisfaction due to perceived poor efficacy and high costs. The efficacy outcomes most commonly recognized by patients included delaying disease progression, improving symptoms, and enhancing quality of Life. Additionally, 70.8% of SMA patients preferred solely oral medication therapy.</p><p><strong>Conclusions: </strong>Patients with different subtypes of SMA are currently experiencing various complications while maintaining good motor function. In the future, there is a significant need for enhanced patient education about DMTs knowledge.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"411"},"PeriodicalIF":2.2,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238221","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":"Factors facilitating pre-hospital delays in stroke patients' presentation to hospital by their caretakers in Uganda and suggested interventions.","authors":"Salvatore Ssemmanda","doi":"10.1186/s12883-025-04360-9","DOIUrl":"10.1186/s12883-025-04360-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Benefit from stroke therapy for eligible stroke patients is time dependent, it is recommended to be timeously administered. The median time to hospital arrival after stroke in Africa has been documented to be around 31 h which is a stark contrast to the 33-365 min range in the global north. Therefore, poor outcomes after stroke in African countries like Uganda, may be contributed to by patients not receiving acute stroke interventions due to ineligibility by time criteria, that sometimes is solely due to late hospital arrival following pre-hospital delays. This brief article is an extension of a prior knowledge gap analysis of knowledge levels of acute stroke alarm signs by first contact healthcare providers (HCPs) and stroke patients' caretakers (PCs) in Uganda's two largest stroke referral hospitals, and further explores the factors that contribute to pre-hospital delays in stroke patients' presentation to hospital by their caretakers in Uganda, with suggestions of how they can be addressed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The precedent study to this extension article used a cross-sectional survey design at two study site hospitals that are Uganda's largest stroke referral public hospitals. Data gathered over eight weeks between December 2024 and January 2025 using structured, in-depth interviews of 120 consented adult respondents (60 first contact HCPs and 60 PCs), of whom 10 PCs not at least educated to a primary seven level were excluded to leave 110 respondent entries, were analyzed using the IBM SPSS statistics package. Descriptive variables were compared using Fisher's exact tests and correlations were analyzed using Kendall's tau-b or tau-c. Ethics approval for the study was obtained from the Mulago Hospital Research Ethics Committee (MHREC-2024-147, September 25, 2024), administrative clearance from KNRH (November 15, 2024), and a research permit from the Uganda National Council of Science and Technology (HS5181ES, December 2, 2024).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The details of the results were reported in a precedent study to this extension article. 20 (33.3%) HCPs were knowledgeable in acute stroke algorithms and none of the PCs were. These PCs had a median age of 31.5 years (IQR 25.0-41.3), most of them (41, (82%)) were next of kin relatives to their stroke patients and most (44, (88%)) were first-time stroke patient caretakers. Only 9 (18%) of the PCs had had university education and 26 (52%) had had a secondary school education. Half of the PCs brought their stroke patients to the hospital beyond 24 h after their time last well.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Pre-hospital delays in stroke patients' presentation to hospital by their caretakers in Uganda, that were recently observed by a local knowledge gap analysis study, are multifactorial. Targeted stroke literacy programs in Uganda should be developed with the local cultural context in mind and should be extended to not only the general publi","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"409"},"PeriodicalIF":2.2,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145224970","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":"Prediction of late seizures after ischemic stroke using cognitive scores.","authors":"Hiroya Ohara, Hironori Shimizu, Masami Yamanaka, Nanami Yamada, Naoya Kikutsuji, Ryuhei Miyoshi, Hiromi Kanesaki, Takahiro Kanda, Keisuke Honda, Masako Kinoshita, Kazuma Sugie","doi":"10.1186/s12883-025-04436-6","DOIUrl":"10.1186/s12883-025-04436-6","url":null,"abstract":"<p><strong>Background: </strong>Late seizures are well-known sequelae after stroke. Previous history of stroke and dementia is common etiology of epilepsy, however, the effect of cognitive impairment on late seizures has not been fully investigated. We investigated the clinical significance of cognitive scores in predicting the occurrence of post-stroke late seizures.</p><p><strong>Methods: </strong>Adult patients with acute cerebral infarction were analyzed. Their cognitive function was evaluated using the Addenbrooke's Cognitive Examination (ACE)-III and the Japanese version of Montreal Cognitive Assessment (MoCA-J) within two weeks after stroke. Factors associated with late seizures and accuracy of cognitive scores to predict late seizures were analyzed.</p><p><strong>Results: </strong>Of 45 patients enrolled (28 males, age 77.2 ± 8.5 years, mean ± SD), eight patients had late seizures within 123.8 ± 126.5 days after cerebral infarction. Cognitive evaluation was performed at 8.0 ± 3.9 days. ACE-III and MoCA-J scores were significantly lower in patients with late seizures than in those without late seizures (ACE-III: 27.5 ± 17.3 vs. 59.1 ± 27.2, MoCA-J: 7.6 ± 5.9 vs. 15.4 ± 8.6, p < 0.05, unpaired t-test). Receiver operating characteristic curve analysis revealed that area under curve of ACE-III was larger than that of MoCA-J and size of cerebral infarction. The optimum cut-off scores of ACE-III were ≤ 58.5 (Sensitivity: 1.00, specificity: 0.62) and ≤ 45.0 (0.88, 0.73). Kaplan-Meier estimates showed that each cut-off score significantly associated with late seizures. Sizes of infarcts and of cortical lesion were not significantly different between patients with and without late seizures. ROC curve and Kaplan-Meier survival analyses showed a significant association between size of infarct and late seizures, however, ACE-III scores more strongly associated with late seizures than the size of infarct did.</p><p><strong>Conclusion: </strong>Cognitive scores, especially ACE-III, within two weeks after cerebral infarction can be useful for predicting post-stroke late seizures.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"410"},"PeriodicalIF":2.2,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225007","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}