BMC Neurology最新文献

{"title":"Factors influencing short-term and long-term survival rates in stroke patients receiving enteral nutrition: a machine learning approach using MIMIC-IV database.","authors":"Xuehui Fan, Chenyiyi He, Jing Xu, Ruixue Ye, Jingpu Zhao, Yulong Wang","doi":"10.1186/s12883-025-04201-9","DOIUrl":"https://doi.org/10.1186/s12883-025-04201-9","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to evaluate the survival and mortality rates of stroke patients after receiving enteral nutrition, and to explore factors influencing long-term survival. With an aging society, nutritional management of stroke patients has become a focus of clinical attention.</p><p><strong>Methods: </strong>This study is based on the MIMIC-IV database, which contains patient data from healthcare institutions in the United States. We included 81 stroke patients who received enteral nutrition, encompassing various subtypes of stroke, specifically subarachnoid hemorrhage, cerebral infarction, and intracerebral hemorrhage. The exposure variable was the type of enteral nutrition, while the outcome variables were survival rates at 30 days, 1 year, and 3 years. Covariates included age, sex, Charlson Comorbidity Index, and minimum blood glucose levels. We employed Kaplan-Meier survival analysis and machine learning models to assess survival rates and their influencing factors.</p><p><strong>Results: </strong>Results showed a 30-day survival rate of 66.67%, indicating 27 patient deaths within the initial 30 days. The 1-year survival rate decreased to 45.68%, with a cumulative death count of 44 during the follow-up period. The 3-year survival rate was 43.21%, with a total of 46 deaths. Kaplan-Meier survival analysis indicated that low-risk group patients had significantly higher survival rates than the high-risk group (p = 0.0229), with higher survival probability in the first 600 days, while the high-risk group showed a significant decline at 400 days. Machine learning model evaluation showed that the XGBoost model had a C-index of 0.80 in predicting survival time, with the Charlson Comorbidity Index being the most important predictor (F score = 12.0). Additionally, factors such as lowest blood glucose, age, and hospital mortality flag significantly influenced survival time.</p><p><strong>Conclusion: </strong>This study highlights the role of early intervention and nutritional management in improving stroke patient outcomes. Our findings suggest that the Charlson Comorbidity Index, age, and in-hospital mortality markers are major predictors of post-stroke survival. These findings underscore the necessity for personalised nutritional strategies, and they call for validation through prospective multicentre studies.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"190"},"PeriodicalIF":2.2,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961343","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":"Knowledge of alarm signs of stroke among caretakers of stroke patients and first contact healthcare providers at two tertiary referral hospitals in Uganda.","authors":"Salvatore Ssemmanda, Abdu Kisekka Musubire","doi":"10.1186/s12883-025-04202-8","DOIUrl":"https://doi.org/10.1186/s12883-025-04202-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Stroke is a leading cause of disability and mortality worldwide and existing global literature suggests that public knowledge of stroke symptoms is generally poor. Algorithms that encompass stroke alarm signs and partly address this knowledge gap of stroke symptoms in the public like FAST (Face, Arm, Speech, Time) and BE- FAST (Balance, Eyes, Face, Arm, Speech, Time) have been developed. However, the diagnostic value of BE-FAST in acute ischemic stroke has been found higher than in FAST. Although acute stroke recognition algorithms like BE-FAST are widely accepted, applied and generally easy to administer, their utility in Uganda is unknown. This study therefore intended to describe how well the alarm signs and symptoms of stroke summarized in the BE-FAST algorithm are known by acute stroke patients' caretakers (PCs) and first contact stroke healthcare providers (HCPs) at the two major stroke referral hospitals in Uganda and how this knowledge by the PCs affects time of arrival of their stroke patients for rapid stroke intervention services.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a cross-sectional survey study design using data collected over ten weeks by structured questionnaire based in-depth interviews of autonomously consented adult study participants. Data analysis was performed using the IBM SPSS statistics package, version 27.0.1.0. Descriptive variables were compared using Fisher's exact tests and statistical analyses for correlation were performed using Kendall's tau-b or tau-c as appropriate. Of the total 120 respondents interviewed (60 first contact HCPs and 60 PCs), 10 caretakers were excluded because they achieved less than Uganda's primary seven level of education leaving 110 respondent entries to eventual statistical analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Females comprised the majority of the first contact HCPs (55%) and PCs (68%). Majority of the first contact HCPs were medical interns (38.3%) allocated to either the neurology ward or the emergency ward of a study site hospital. The PCs had a median age of 31.5 years (IQR 25.0-41.3) and only 9% had been through university level education, the majority having made it only to secondary school (52.0%). Of the 60 healthcare worker respondents, only 20 (33.3%) were familiar with the BE-FAST algorithm and none of the PCs knew or had heard about it. Half (50%) of the caretakers had their patients arrive to hospital beyond 24 h from their patient's time last known well for stroke treatment (between 2 and 5 days). Because caretakers had no knowledge of the BE-FAST algorithm, its correlation to their acute stroke patients' hospital intervention arrival time could not be tested.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Knowledge of acute stroke recognition aids like BE-FAST was poor amongst first contact HCPs and was non-existent amongst caretakers of acute stroke patients at the two largest stroke referral hospitals in Uganda. This calls for focused integratio","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"188"},"PeriodicalIF":2.2,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980670","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":"Comparative study of brain functional imaging of brain in patients with mild to moderate Alzheimer's disease based on functional near infrared spectroscopy.","authors":"Zhen Yang, Li Liu, Tao You, Lingling Wang, Fang Yi, Yu Jiang, Ying Zhou","doi":"10.1186/s12883-024-03989-2","DOIUrl":"https://doi.org/10.1186/s12883-024-03989-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Based on the near-infrared functional brain imaging system, this research studied the hemoglobin concentration signal in resting state and task state. The purpose of this research was to analyze the activated brain regions and functional connections by exploring the changes in hemoglobin concentration and the differences in brain network functional connections between healthy people and mild to moderate AD patients. So as to identify the cognitive dysfunction of patients at an early stage. By accurately locating the area of cognitive impairment in patients, it provides a basis for precise neural regulation of physical therapy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients who came to our hospital from January 2022 to December 2022 were recruited and selected according to the exclusion criteria. After receiving their informed consent, MMSE scale examination and near-infrared brain function imaging examination were performed in a relatively quiet environment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Result: &lt;/strong&gt;A total of 24 subjects were included in this study, including 7 in the control group (age: 72.57 ± 7.19) and 17 (age: 76.88 ± 9.29) in the AD group. The average cognitive scores were (28.00 ± 1.16), (19.24 ± 4.89), respectively. There were no statistically significant differences in gender, years of education, age, and past medical history between the AD group and the control group (P &gt; 0.05). In the verbal fluency test (VFT) task, there was a significant difference in the activation values of the two groups in channels 01, 06, 07, 09, 13, 14, 15, 16, 19, 21, 22, 23, 27, 29, 31, 35, 38, 40, 43, 44, 45, 51, and 52II (p &lt; 0.05), and the activation values of the normal group were greater than those of the AD group. There was a significant difference in the mean oxygenated hemoglobin concentration in channels 01, 07, 15, 16, 21, 22, 23, 31, 35, 40, 41, 44, and 48 (p &lt; 0.05), and the average oxygenated hemoglobin concentration in the AD group was lower than that in the normal group. There was no significant difference in activation speed between the two groups. In the resting state, the number of total network edges, DLPFC-L to PreM and SMC-L, DLPFC-L to FEF-L, DLPFC-L to DLPFC-L, FPA-L to PreM and SMC-L, FPA-L to FPA-L, FPA-R to FPA-L, DLPFC-L to DLPFC-R, FEF-R to PreM and There was a statistically significant difference in the number of network edges in SMC-L (p &lt; 0.05). Among the different groups, the number of network edges in the AD group was smaller than that in the normal group. Correlation analysis showed that T14, T31, T16, T23, T27, M16, M22, M41 (T: represents activation value, M: represents mean hemoglobin concentration, and number represents channel number). There was a positive correlation between the total number of network edges, DLPFC-L to PreM and SMC-L, DLPFC-L to DLPFC-L, FPA-L to PreM and SMC-L, FPA-L to FPA-L, DLPFC-L to DLPFC-R, FEF-R to PreM and SMC-L, and MMSE scores (p &lt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;In t","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"186"},"PeriodicalIF":2.2,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978373","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":"Neurologic symptoms as a hallmark of glymphatic alteration in recovered patients with COVID-19.","authors":"Minhoe Kim, Kyung Hoon Lee, Ji Su Ko, Myung Sub Kim, Kyu Sung Choi, Jiwon Seo, Minchul Kim","doi":"10.1186/s12883-025-04198-1","DOIUrl":"https://doi.org/10.1186/s12883-025-04198-1","url":null,"abstract":"<p><strong>Background: </strong>The glymphatic system is a glial-based perivascular network that facilitates the clearance of metabolic waste from the brain. Dysfunction of the glymphatic system, along with neurological symptoms such as cognitive deficits and olfactory dysfunction, has been reported in patients with coronavirus disease (COVID-19). However, the link between these neurological symptoms and alterations in the glymphatic system remains unclear. In this study, we aimed to evaluate magnetic resonance imaging (MRI)-based measures of the glymphatic system in patients recovered from COVID-19 with and without neurological symptoms.</p><p><strong>Methods: </strong>This study included 89 patients who recovered from respiratory infections, of whom 71 had confirmed COVID-19 (20 experienced anosmia and 41 had cognitive symptoms). Three MRI-based measures were quantified and compared: the dilated perivascular spaces (dPVS), free water (FW) fraction, and diffusion tensor image analysis along the perivascular spaces (DTI-ALPS). A partial correlation network was used to assess the relationships between COVID-19 infection, neurological symptoms, and glymphatic measures.</p><p><strong>Results: </strong>COVID-19 patients with anosmia had increased FW in the left orbitofrontal area compared to those without anosmia (mean difference: 0.01, p = 0.48), while patients with cognitive symptoms showed decreased left-sided DTI-ALPS (mean difference: 0.06, p = 0.40). Neurological symptoms mediate the relationship between COVID-19 and glymphatic system measures.</p><p><strong>Conclusions: </strong>Our findings imply that neurological symptoms accompanied by COVID-19 are linked to distinct alterations in the glymphatic system, suggesting a potential association between neuroinvasion and neuroinflammatory processes related to COVID-19.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"187"},"PeriodicalIF":2.2,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973014","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":"Characteristics of chronic subdural haematomas related to DOACs vs warfarin.","authors":"Gokul Raj Krishna, Aleksandra Sobieraj, Sayan Biswas, Anand Pandit, Kate Sheridan, Anas Patel, Richa Job, Alishba Rizvi, Hannah Cheng, Maya Holt, Lameesa Kaysor, Aaliya Ashik, Joshua MacArthur, Ella Snowdon, Ved Sarkar, Callum Tetlow, K Joshi George","doi":"10.1186/s12883-025-04134-3","DOIUrl":"https://doi.org/10.1186/s12883-025-04134-3","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to investigate the effects of anticoagulation with DOACs and warfarin on the characteristics of chronic subdural hematomas (CSDHs), specifically, the size of the hematomas, the presence of midline shift and the effect on consciousness levels, measured via the Glasgow Coma Scale (GCS).</p><p><strong>Methods: </strong>A multi-centre retrospective case series analysis from January 2015 to May 2020 was conducted. Patients who were anticoagulated with DOACs and warfarin were of primary interest. The CSDH characteristics that were focussed on included the size of the CSDH, midline shift and GCS. Chi-squared analysis and independent t-tests were conducted for inter-variable analysis. Relative risk was also calculated.</p><p><strong>Results: </strong>Two thousand, six hundred seventy-five patients across two tertiary neurosurgical units referred with CSDHs were included in the analysis. 1799 patients were male (67.3%), with a mean age of 78.5 years. 905 patients (33.8%) were on antithrombotic therapy, with 298 patients (11.1%) on warfarin and 203 patients (7.6%) on DOACs. There were statistically significant associations between the type of antithrombotic medication and both midline shift and size of the CSDH (p < 0.0001), but not GCS (p = 0.1956). No significant difference in relative risk (RR) for impaired GCS was found between DOACs and warfarin (1.158 vs 1.174 respectively). Relative risk analysis revealed a safer profile for DOACs, with a lower risk of developing a larger sized hematoma (RR 0.887 v 1.021) and a reduced likelihood of midline shift (RR 0.858 VS 0.938), which was supported by effect size analysis using odd's ratios. Comparative risk analysis between DOACs and warfarin further demonstrated a higher risk of midline shift for patients on warfarin (RR 1.431), that trended towards statistical significance (p = 0.0511, 95% confidence interval 0.998-2.05).</p><p><strong>Conclusions: </strong>For CSDH patients, DOACs may potentially be a safer method of anticoagulation as opposed to warfarin as they appear to be linked to the development of smaller sized hematomas and reduced midline shift, although there was no significant difference in GCS between the groups. These features are known to reduce the risk of needing neurosurgical intervention for CSDH. This is important in influencing the management of an increasingly ageing, multi-morbid population on increasing amounts of anticoagulation medication.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"184"},"PeriodicalIF":2.2,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980734","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":"Comparing face-to-face and online LSVT®LOUD speech training using LSVT®Coach in patients with Parkinson's disease: a pilot randomised controlled trial.","authors":"Elisabeth Kratz, Judith Scheffer, Dieter Volc, Barbara Seebacher","doi":"10.1186/s12883-025-04161-0","DOIUrl":"https://doi.org/10.1186/s12883-025-04161-0","url":null,"abstract":"<p><strong>Background: </strong>LSVT®LOUD is an intensive speech therapy targeting voice amplitude, incorporating proprioceptive feedback and auditory-vocal self-monitoring, delivered through 16 one-hour sessions over a month with a high-effort approach. This study aimed to investigate preliminary effects of LSVT®LOUD teletherapy (LSVT®LOUD-tele) in comparison to traditional face-to-face LSVT®LOUD therapy (LSVT®LOUD-FTF) in people with PD and hypokinetic dysarthria, and to assess the usability of the LSVT®LOUD-tele software and the feasibility of a full-scale randomised controlled trial (RCT).</p><p><strong>Methods: </strong>Using a pilot RCT, 20 people with PD and hypokinetic dysarthria were assigned to either LSVT®LOUD-tele or LSVT®LOUD-FTF, receiving 60-min sessions 4x/week for 4 weeks, along with home-based practice maintaining the same intensity and frequency in both conditions. Primary outcome was voice loudness (sound pressure levels [SPL]). Secondary outcomes included voice handicap, dysarthria-related QoL, HRQoL, and depression, assessed at baseline and post-intervention. The feasibility of conducting a full-scale RCT based on predetermined criteria (33% recruitment rate, 85% retention rate, 75% adherence rate, and high intervention safety) and the usability of the LSVT®LOUD-tele software were assessed post-intervention.</p><p><strong>Results: </strong>Nineteen participants completed the study (10 women). The LSVT®LOUD-FTF group showed improvements in vowel 'Ah' and 'high-pitched A' SPLs (Hedge's g = 1.416 and 0.826), while both groups showed increases in 'low-pitched A' and good quality loud voice SPLs (g = 0.148; g = 0.211). No changes were observed in everyday phrases SPL (g = 0.167) for either intervention, and both groups showed improvements in text reading (g = 0.436) and conversation SPLs (g = 0.345). Subjective voice handicap improved in both groups (eta squared [η²] = 0.259), while only LSVT®LOUD brought improvement to total dysarthria-related QoL (η² = 0.747). HRQoL improvements were noted in activities of daily living, cognition, and bodily discomfort domains after LSVT®LOUD-FTF, and in communication after LSVT®LOUD-tele (η² = 0.054-0.386). LSVT®LOUD-FTF led to small improvements in depression, with no significant differences noted between groups. Good-to-excellent usability of LSVT®LOUD-tele was observed, and the feasibility of a full-scale RCT was supported by high overall recruitment, retention, and adherence rates, with no adverse events reported.</p><p><strong>Conclusions: </strong>Both LSVT®LOUD-tele and LSVT®LOUD-FTF appear effective for people with PD and hypokinetic dysarthria, and the feasibility of a full-scale RCT was confirmed. Larger studies are needed to validate these findings.</p><p><strong>Trial registration: </strong>German Clinical Trials Register, DRKS00027825 . Registered on 13.01.2022.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"183"},"PeriodicalIF":2.2,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958773","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":"Dengue fever with bilateral thalamic diffusion restriction lesions: a case report.","authors":"Husna Yoosuf, Josef A Alawneh, Zafar Hashim, Umama B Fatima, Saqib I Dara","doi":"10.1186/s12883-025-04197-2","DOIUrl":"https://doi.org/10.1186/s12883-025-04197-2","url":null,"abstract":"<p><strong>Background: </strong>Dengue encephalitis is a rare complication of dengue and can manifest as ischemic stroke, making the diagnosis challenging. This case highlights the need of recognizing unusual presentation of dengue and the use of neuroradiology in its diagnosis.</p><p><strong>Case presentation: </strong>A previously healthy 38-years-old man presented to the emergency department with weakness of the left upper limb and bilateral lower limbs, aphasia and confusion. He had flu-like symptoms along with fever for the past 3 days. Magnetic Resonance Imaging (MRI) of the brain showed hyperintensities in the bilateral thalamic and parafalcine regions. The patient was started on aspirin for the suspicion of ischemic stroke. But the patient's condition deteriorated. Lumbar puncture did not reveal any evidence of meningitis. The blood Reverse Transcription Polymerase Chain Reaction (RT-PCR) confirmed the diagnosis of dengue hemorrhagic fever.</p><p><strong>Conclusions: </strong>This article emphasizes the importance of including the complications and manifestations of dengue fever in the differential diagnosis of ischemic stroke in a relevant context. Unique radiological finding of bilateral thalamic lesions can serve as important diagnostic clues in such atypical cases. Early diagnosis can help guide therapy.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"185"},"PeriodicalIF":2.2,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977183","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":"Analysis of the glymphatic system function in high-grade glioma patients using diffusion tensor imaging along perivascular spaces.","authors":"Bin Tian, Xili Jiang, Xin Luo, Wei Zhang","doi":"10.1186/s12883-025-04166-9","DOIUrl":"https://doi.org/10.1186/s12883-025-04166-9","url":null,"abstract":"<p><strong>Objectives: </strong>This study seeks to determine if patients with high-grade glioma (HGG) demonstrate glymphatic system (GS) impairments using Diffusion Tensor Imaging Along Perivascular Spaces (DTI-ALPS). Additionally, it aims to examine the factors affecting GS performance and their implications for HGG prognosis.</p><p><strong>Methods: </strong>The study enrolled fifty HGG patients alongside fifty age- and sex-matched healthy individuals. Each participant underwent diffusion tensor imaging with a Philips 3.0T MRI scanner to assess and compute the ALPS index within perivascular spaces. Variables such as gender, grade, location, volume, peritumoral edema volume, mass-edema index (peritumoral edema volume/tumor volume) and ALPS index were recorded. The Student's t-test and rank sum test compared the ALPS indices between HGG patients and healthy controls to evaluate hemispheric differences. Linear and multivariate Cox regression analyses were utilized to discern factors influencing the ALPS index and to establish independent prognostic markers for HGG, respectively.</p><p><strong>Results: </strong>The ALPS indices in both hemispheres were significantly lower in HGG patients, with the ipsilateral hemisphere exhibiting further reduced levels than the contralateral (P < 0.001). In comparisons involving tumor and edema volumes, no significant variations were observed between the hemispheres within HGG patients harboring larger tumors (P = 0.079) or lesser edema volumes (P = 0.24). A decrease in postoperative ALPS indices compared to preoperative figures was noted (P < 0.001). Univariate linear regression indicated a negative relationship between the ipsilateral ALPS index and peritumoral edema volume (P = 0.0392). Kaplan-Meier analysis demonstrated shorter survival times in patients with lower ALPS indices. Moreover, multivariate Cox regression highlighted tumor grade (HR = 1.548, P = 0.023) and ipsilateral ALPS index (HR = 0.040, P = 0.003) as crucial prognostic indicators.</p><p><strong>Conclusion: </strong>In patients with HGG, there is impaired GS function in both hemispheres of the brain. Additionally, the impaired GS function in the tumor-side hemisphere is associated with tumor-associated edema. Following surgery, further damage to GS function is observed in both hemispheres of the brain in HGG patients. Poor GS function in the tumor-side hemisphere is correlated with a worse prognosis in HGG patients.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"181"},"PeriodicalIF":2.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973010","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":"Abnormalities of regional brain activity in patients with asymptomatic internal carotid artery occlusion: a resting-state fMRI study.","authors":"Renjie Ji, Chunlan Deng, Jianxin Zhang, Hanfeng Chen, Ziqi Xu, Zeqi Hao, Benyan Luo","doi":"10.1186/s12883-025-04156-x","DOIUrl":"https://doi.org/10.1186/s12883-025-04156-x","url":null,"abstract":"<p><strong>Background: </strong>Asymptomatic internal carotid artery occlusion (aICAO) disrupts cerebral blood flow and can impair brain function. While previous research has primarily focused on abnormal functional connectivity between brain networks or regions in aICAO patients, less is known about specific regional brain activity alterations. This study investigated changes in local brain activity and their associations with cognitive function in patients with aICAO.</p><p><strong>Methods: </strong>A total of 26 unilateral patients with aICAO without MRI lesions and 25 matched healthy controls (HCs) underwent resting-state functional magnetic resonance imaging and neuropsychological assessment. Local brain activity in patients with aICAO was investigated using percentage amplitude of fluctuation (PerAF) and degree centrality (DC). The association between the abnormal regional brain activity in patients with aICAO and cognitive function was also explored.</p><p><strong>Results: </strong>Compared with HCs, patients with aICAO showed decreased PerAF in the ipsilateral (occlusion side, right) superior temporal gyrus (temporal pole), ipsilateral inferior frontal gyrus (triangular part). In addition, decreased DC was detected in the ipsilateral cuneus of patients with aICAO, while increased DC was observed in the contralateral (opposite to occlusion side, left) precuneus and contralateral inferior frontal gyrus (triangular part) among patients with aICAO. Furthermore, the DC value of contralateral precuneus in aICAO group was negatively correlated with Montreal Cognitive Assessment (MoCA) (r = -0.612, p = 0.002), Forward Digit Span Test (FDST) (r = -0.677, p = 0.001), and Backward Digit Span Test (BDST) (r = -0.531, p = 0.011) scores.</p><p><strong>Conclusions: </strong>Our findings revealed abnormal local spontaneous brain activity within brain regions associated with cognitive functions in patients with unilateral aICAO. Notably, some of these abnormalities correlated with their cognitive impairments. This study contributes to the understanding of potential neural mechanisms underlying cognitive dysfunction in unilateral aICAO patients.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"182"},"PeriodicalIF":2.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976720","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":"Isolated Uhthoff phenomenon as first manifestation of multiple sclerosis: a case report.","authors":"Annabelle Löffler, Charlotte Bereuter, Murat Delikaya, Judith Bellmann-Strobl, Frederike Cosima Oertel","doi":"10.1186/s12883-025-04193-6","DOIUrl":"https://doi.org/10.1186/s12883-025-04193-6","url":null,"abstract":"<p><strong>Background: </strong>The Uhthoff phenomenon (UP) is a temporary worsening of neurological symptoms due to an increase in body temperature, commonly observed in demyelinating diseases, especially multiple sclerosis (MS).</p><p><strong>Case presentation: </strong>A 37-year-old female presented with a four-year history of transient vision impairment in the right eye, particularly during dancing. Visual evoked potentials (VEP) revealed prolonged P100 latency and reduced amplitude of the right eye. Optical coherence tomography (OCT) confirmed thinning of the macular ganglion cell and inner plexiform layer (GCIPL) and peripapillary retinal nerve fiber layer (pRNFL) in the right eye with significant inter-eye differences, consistent with a unilateral optic nerve lesion. Magnetic resonance imaging (MRI) findings of periventricular, pons and spinal cord lesions, along with positive oligoclonal bands in cerebrospinal fluid, confirmed MS diagnosis.</p><p><strong>Conclusions: </strong>This case underscores the importance of recognizing UP as a potential early indicator of MS. Specific diagnostic tools, such as OCT, VEP, and MRI, can be used to objectify optic nerve involvement and should be considered to identify underlying demyelinating conditions. Early diagnosis of MS can facilitate a timely initiation of therapies and improve patient outcomes. It is essential for clinicians to consider UP for better clinical management of MS.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"180"},"PeriodicalIF":2.2,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972755","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}