BMC Neurology最新文献

{"title":"Association of circle of willis variants with stroke and aneurysm: insights from a tertiary hospital in Ethiopia.","authors":"Hashime Meketa Negatie, Molla Asnake Kebede, Alemayehu Dagne Abate, Solyana Haileselassie Admassie, Adugnaw Bogale Worku, Hanan Tofiek Ahmed, Yohanes Yoseph Mesfine, Melkamu Mitikie Melak","doi":"10.1186/s12883-025-04082-y","DOIUrl":"10.1186/s12883-025-04082-y","url":null,"abstract":"<p><strong>Background: </strong>The Circle of Willis (CoW) is a crucial cerebral arterial structure that facilitates collateral blood flow to the brain. Anatomical variations within the CoW are prevalent and can have significant clinical implications, particularly concerning strokes, aneurysms and other cerebrovascular disorders. This study aimed to assess the anatomical variations of the CoW in the Ethiopian population presenting with neurological symptoms and to explore the factors associated with these variations. By investigating these relationships, the research seeks to enhance understanding of the CoW's anatomical diversity and its potential impact on cerebrovascular health.</p><p><strong>Methods: </strong>A facility-based cross-sectional study was conducted among adult patients undergone brain CT angiography at St. Paul's Hospital Millennium Medical College. A simple random sampling technique was employed to select participants. Multivariate binary logistic regression analyses were performed to determine relationships between dependent and independent variables. Statistical significance was assessed with a p-value < 0.05.</p><p><strong>Results: </strong>This study of 86 participants (mean age 48.3 years) found that 56 (65.12%) had a complete CoW. Incomplete CoW was more common in females (OR = 3.5, p = 0.007) and was significantly associated with stroke (OR = 15.4, p < 0.001). Aneurysms had a higher but non-significant association with incomplete CoW (OR = 3.2, p = 0.14). Hypoplastic arteries were present in 30% of participants.</p><p><strong>Conclusions: </strong>Hypoplastic arteries are more frequently observed in the posterior portion of the CoW than in the anterior portion. Most importantly, the incompleteness of the CoW is significantly associated with female sex and stroke.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"73"},"PeriodicalIF":2.2,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476261","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 burden of ischemic stroke in Eastern Europe from 1990 to 2021.","authors":"Jingyao Xu, Shuai Hou, Zimeng Chen, Yong Liu, Xia Deng, Chunping Wang, Shijie Liu, Yanqiang Wang","doi":"10.1186/s12883-025-04081-z","DOIUrl":"10.1186/s12883-025-04081-z","url":null,"abstract":"<p><strong>Background and purpose: </strong>Ischemic stroke is a significant public health concern, particularly in Eastern Europe, where the burden remains high. This study aims to evaluate the trends and burden of ischemic stroke in Eastern Europe from 1990 to 2021, providing insights into epidemiological changes and informing public health strategies.</p><p><strong>Methods: </strong>We used data from the Global Burden of Disease 2021 database to comprehensively assess regional and national ischemic stroke indicators in Eastern Europe. These indicators included the number of cases, incidence, number of deaths, mortality, disability-adjusted life years (DALYs), DALY rates, and estimated annual percentage change (EAPC). Joinpoint analysis was employed to examine sex-specific time trends in the burden of ischemic stroke across Eastern European countries. These estimates incorporated the Socio-Demographic Index (SDI).</p><p><strong>Results: </strong>In 2021, Eastern Europe reported 490,197 cases of ischemic stroke, with an age-standardized incidence rate (ASIR) of 142.57 (95% UI: 122.12 to 164.67), exceeding the global level. The region recorded 329,291 deaths, with an age-standardized mortality rate (ASMR) of 90.99 (95% UI: 82.79 to 98.48), significantly higher than the global rate. Disability-adjusted life years (DALYs) totaled 5,713,718, with an age-standardized DALYs rate (ASDR) of 1601.20 (95% UI: 1483.51 to 1723.12). Our joinpoint regression analysis indicates that the disease burden remains notably high in Eastern Europe, despite an overall declining trend from 1990 to 2021 in ASIR and ASMR across most countries, with estimated annual percentage changes (EAPC) of -1.13 (95% CI: -1.24 to -1.02) and - 2.78 (95% CI: -3.24 to -2.32), respectively. Lithuania reported the highest incidence rate, while the Russian Federation had the highest mortality and DALY rate. Conversely, Estonia showed significant improvements in stroke indicators. Key risk factors included low temperature and smoking, contributing notably to environmental and behavioral risks.</p><p><strong>Conclusion: </strong>Ischemic stroke continues to be a significant global health issue. Our temporal trends study results indicate that the disease burden remains notably high in Eastern Europe, particularly in Lithuania and the Russian Federation.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"74"},"PeriodicalIF":2.2,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476263","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 hydrocarbon exposure and risk of stroke: a systematic literature review.","authors":"Muhammed Shabil, Abhay M Gaidhane, Nasir Vadia, Soumya V Menon, Kattela Chennakesavulu, Rajashree Panigrahi, Ganesh Bushi, Diptismita Jena, Anju Rani, Sanjit Sah, Mahendra Singh, Prakasini Satapathy, Khang Wen Goh, Nosaibah Razaqi","doi":"10.1186/s12883-025-04083-x","DOIUrl":"10.1186/s12883-025-04083-x","url":null,"abstract":"<p><strong>Background: </strong>Hydrocarbon exposure, including polycyclic aromatic hydrocarbons (PAHs) and volatile organic compounds (VOCs), is increasingly linked to vascular dysfunction and stroke, a leading cause of morbidity and mortality globally. Common in occupational and environmental contexts, hydrocarbons induce oxidative stress, systemic inflammation, and endothelial dysfunction, disrupting vascular health. This systematic review examines the association between hydrocarbon exposure and stroke, emphasizing specific metabolites and their cerebrovascular effects.</p><p><strong>Methods: </strong>A comprehensive search across PubMed, Embase, and Web of Science was conducted through December 10 2024, identifying observational studies exploring hydrocarbon exposure and stroke risk. Studies meeting predefined inclusion criteria, excluding those with major methodological flaws, were synthesized narratively. Variations in hydrocarbon types, population demographics, and stroke outcomes were considered.</p><p><strong>Results: </strong>Six studies, including five cross-sectional and one retrospective cohort, with sample sizes ranging from 5,537 to 283,666 participants, demonstrated significant associations between hydrocarbon exposure and stroke risk. Key findings revealed strong associations for metabolites like 1-hydroxynaphthalene (OR: 1.89; 95% CI: 1.62-2.20) and 2-hydroxyfluorene (OR: 1.94; 95% CI: 1.66-2.26). However, variability in findings was noted, attributed to differences in study design, exposure levels, and populations studied.</p><p><strong>Conclusion: </strong>This review highlights a complex relationship between hydrocarbon exposure and stroke risk, with some studies indicating significant associations and others reporting inconsistencies. Standardized, large-scale research is essential to clarify this relationship, identify high-risk populations, and guide public health strategies to mitigate exposure and prevent stroke.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"71"},"PeriodicalIF":2.2,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472102","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 characteristics of Guillain-Barré syndrome in Shenzhen: a retrospective study.","authors":"Feng Guo, Qin-Yuan Yao, Xiao-Hong Wu, Hui-Xia Guo, Xiao-Lin Su, Jin-Fang Zhou, Li-Jie Ren, Yan-Xia Zhou","doi":"10.1186/s12883-025-04061-3","DOIUrl":"10.1186/s12883-025-04061-3","url":null,"abstract":"<p><strong>Background: </strong>Guillain-Barré syndrome (GBS) is a group of immune-mediated peripheral neuropathies that causes acute flaccid paralysis. The global incidence of GBS was 0.6-4/100 000, and the incidence in China was 0.698/100 000. Although the diagnosis and treatment of GBS has made rapid progress, approximately 20% of patients with GBS are still unable to walk alone within 6 months after the onset of GBS, and 40% of patients have sequelae, such as weakened strength, limb pain, and numbness, seriously affecting their life and work. We aimed to retrospectively analyze the clinical characteristics of patients with GBS in Shenzhen, China and analyze the factors affecting disease severity to provide a reference for the precise treatment of GBS.</p><p><strong>Methods: </strong>Clinical data of inpatients diagnosed with GBS in several hospitals in Shenzhen from April 2010 to October 2021 were obtained from an electronic medical record system (HIS system). The clinical characteristics of patients with GBS and the factors affecting disease severity were analyzed.</p><p><strong>Results: </strong>A total of 146 patients were identified for this study, and 13 were lost during follow-up. During the follow-up period, three patients had acute-onset chronic inflammatory demyelinating polyneuropathy (A-CIDP). One hundred and thirty patients with complete data, comprising 90 males (69.23%) and 40 females (30.77%) with a median age of 39.50 ± 23.75 years, were included in the statistical analyses. Acute inflammatory demyelinating polyneuropathy (AIDP) was the most common electrophysiological variant (106 cases [81.54%]). Miller-Fisher syndrome (MFS), acute motor axonal neuropathy (AMAN), and acute motor-sensory axonal neuropathy (AMSAN) were noted in 21 (16.15%), 2 (1.54%), and 1 (0.77%) patients, respectively. The clinical course of the disease was mainly mild in 95 cases (73.08%), while 35 patients (26.92%) experienced severe disease. Logistic multivariate regression analysis showed that age ≥ 60 years old and having pneumonia may be associated with the severity of the disease.</p><p><strong>Conclusions: </strong>AIDP is the most common electrophysiological variant of GBS in Shenzhen. Most cases of GBS in our setting are mild, and the long-term prognosis is favorable. Old age (≥ 60 years) and having pneumonia are independent risk factors for severe GBS.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"72"},"PeriodicalIF":2.2,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472148","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":"Diagnosis and management of a giant retroperitoneal hematoma compressing the femoral nerve, following an ultrasound-guided lumbar sympathetic block: a case report.","authors":"Yan Bai, Xinqiao Zhou, Lingqing Zeng, Xiaokai Zhou, Zhuqing Rao, Cunming Liu, Yinbing Pan, Xiaodi Sun","doi":"10.1186/s12883-024-03808-8","DOIUrl":"10.1186/s12883-024-03808-8","url":null,"abstract":"<p><strong>Background: </strong>The lumbar sympathetic nerve block stands as a pivotal approach in managing complex regional pain syndrome (CRPS) in the lower limbs. Retroperitoneal hemorrhage is an extremely rare and severe complication of lumbar sympathetic nerve block. Here, we report for the first time a case of retroperitoneal hemorrhage that initially presented with symptoms of femoral nerve compression.</p><p><strong>Case presentation: </strong>An 81-year-old elderly female was diagnosed with CRPS. After undergoing an ultrasound-guided lumbar sympathetic nerve block at our hospital, discomfort in her right lower back was experienced, followed by stabbing pain, numbness in the anterior thigh, and significant lower limb movement impairment. We considered that the femoral nerve might be compressed by a hematoma or abscess. An emergency percutaneous drainage was performed, resulting in partial symptom relief. However, two days later, signs of hemorrhagic shock were observed in the patient. An emergency lumbar arterial embolization was performed, effectively stabilizing her vital signs. One week later, lower limb pain and numbness disappeared, and right lower limb motor function fully recovered.</p><p><strong>Conclusions: </strong>When retroperitoneal hemorrhage is suspected, prompt computed tomography (CT) or bedside ultrasound should be conducted. Once imaging supports the diagnosis, immediate digital subtraction angiography (DSA) could be utilized to identify the bleeding source and conduct embolization.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"70"},"PeriodicalIF":2.2,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466993","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":"GPT meets PubMed: a novel approach to literature review using a large language model to crowdsource migraine medication reviews.","authors":"Elyse Mackenzie, Roger Cheng, Pengfei Zhang","doi":"10.1186/s12883-025-04071-1","DOIUrl":"10.1186/s12883-025-04071-1","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the potential of two large language models (LLMs), GPT-4 (OpenAI) and PaLM2 (Google), in automating migraine literature analysis by conducting sentiment analysis of migraine medications in clinical trial abstracts.</p><p><strong>Background: </strong>Migraine affects over one billion individuals worldwide, significantly impacting their quality of life. A vast amount of scientific literature on novel migraine therapeutics continues to emerge, but an efficient method by which to perform ongoing analysis and integration of this information poses a challenge.</p><p><strong>Methods: </strong>\"Sentiment analysis\" is a data science technique used to ascertain whether a text has positive, negative, or neutral emotional tone. Migraine medication names were extracted from lists of licensed biological products from the FDA, and relevant abstracts were identified using the MeSH term \"migraine disorders\" on PubMed and filtered for clinical trials. Standardized prompts were provided to the APIs of both GPT-4 and PaLM2 to request an article sentiment as to the efficacy of each medication found in the abstract text. The resulting sentiment outputs were classified using both a binary and a distribution-based model to determine the efficacy of a given medication.</p><p><strong>Results: </strong>In both the binary and distribution-based models, the most favorable migraine medications identified by GPT-4 and PaLM2 aligned with evidence-based guidelines for migraine treatment.</p><p><strong>Conclusions: </strong>LLMs have potential as complementary tools in migraine literature analysis. Despite some inconsistencies in output and methodological limitations, the results highlight the utility of LLMs in enhancing the efficiency of literature review through sentiment analysis.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"69"},"PeriodicalIF":2.2,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456974","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":"Leukemia and risk of stroke: a Mendelian randomization analysis.","authors":"Xiaoyao Yi, Jingrui Zhu, Xiang Zhang, Ning Huang, Yuan Cheng","doi":"10.1186/s12883-025-04079-7","DOIUrl":"10.1186/s12883-025-04079-7","url":null,"abstract":"<p><strong>Background: </strong>Observational studies suggest an association between leukemia and stroke, but causality remains unclear. Certain leukemia types may increase stroke risk, but variations exist in stroke and mortality rates across leukemia subtypes. This study employed Mendelian randomization (MR) to investigate links between leukemia subtypes and stroke.</p><p><strong>Methods: </strong>We conducted a two-sample Mendelian randomization (TSMR) study utilizing genetic variants linked to various subtypes of leukemia as instruments to investigate their causal effects on stroke, specifically ischemic stroke (IS) and intracerebral hemorrhage (ICH). The leukemia dataset comprised 456,276 subjects from the UK Biobank, while the stroke dataset was sourced from the FINNGEN consortium, encompassing 212,774 participants.</p><p><strong>Results: </strong>In the present study, there was suggestive evidence that genetically predicted chronic lymphocytic leukemia (CLL) is associated with ischemic stroke (odds ratio, 1.02; 95% confidence intervals, 1.01-1.05; P = 0.024), but no significant association was observed with intracerebral hemorrhage (ICH) (0.74; 0.99-1.03; P = 0.237). Additionally, chronic myeloid leukemia (CML), acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) was no significant associations between with stroke according to genetical prediction even if heterogeneity test and pleiotropic test was performed.</p><p><strong>Conclusions: </strong>Our Mendelian randomization analysis revealed that chronic lymphocytic leukemia (CLL) was associated with an increased risk of ischemic stroke (IS) but not intracerebral hemorrhage (ICH). Conversely, there was no evidence supporting causal associations of chronic myeloid leukemia (CML), acute lymphoblastic leukemia (ALL), or acute myeloid leukemia (AML) with either type of stroke. These findings enhance our comprehension of the intricate interplay between various leukemia subtypes and the risk of stroke. Further research is essential to delve into the underlying mechanisms and potential clinical implications of these observed associations.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"68"},"PeriodicalIF":2.2,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456975","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":"Somatosensory modulation of affective pictures' processing in adults with cerebral palsy and healthy controls: a case-control study.","authors":"Inmaculada Riquelme, Álvaro Sabater-Gárriz, Samar M Hatem, Elisabeth Martín-Jiménez, Pedro Montoya","doi":"10.1186/s12883-025-04072-0","DOIUrl":"10.1186/s12883-025-04072-0","url":null,"abstract":"<p><strong>Background: </strong>Brain processing of both somatosensation and emotion is altered in individuals with cerebral palsy. This paper aims at further exploring the interaction between the somatosensory system and affective processing in individuals with cerebral palsy.</p><p><strong>Methods: </strong>Somatosensory thresholds and emotion knowledge were assessed in 18 adults with cerebral palsy and compared with 15 age and sex-matched controls. EEG event-related potentials elicited by viewing affective pictures were recorded. During event-related potentials acquisition, a continuous cutaneous electrical stimulus was applied either at supra- or sub-threshold intensity.</p><p><strong>Results: </strong>Adults with CP had higher pain sensitivity and increased emotion difficulties, as well as lower event related potential amplitudes than controls. Moreover, the modulatory effects of the somatosensory stimuli on the brain processing of affective pictures differed between adults with CP and controls. Sex was an important factor affecting somatosensory modulation in affective picture brain processing.</p><p><strong>Conclusions: </strong>In adults with CP the interaction of abnormal processing of somatosensory and emotional inputs may give rise to a more basic interpretation of emotional cues in complex contexts. Pain sensitivity and sex appear as relevant factors that influence the processing of emotions in CP and should be taken into account in research and clinical settings.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"67"},"PeriodicalIF":2.2,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439931","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 imaging risk factors for early neurological deterioration and long-term neurological disability in patients with single subcortical small infarction.","authors":"Xiao Feng, Meiherinisa Taiwakuli, Junyong Du, Wenhao Zhu, Shabei Xu","doi":"10.1186/s12883-025-04067-x","DOIUrl":"10.1186/s12883-025-04067-x","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to evaluate the clinical and imaging risk factors for early neurological deterioration (END) and long-term neurological disability in patients with Single subcortical small infarction (SSSI).</p><p><strong>Methods: </strong>We retrospectively included SSSI patients hospitalized. Outcomes were defined as modified Rankin Scale (mRS) score > 2 at follow-up and the occurrence of END during hospitalization. Multivariate logistic regression identified independent predictors of END and long-term outcomes. Stepwise regression analysis was used to develop a predictive model for poor outcomes. The predictive performance of risk factors and the model was assessed using receiver operating characteristic (ROC) curves.</p><p><strong>Results: </strong>A total of 289 SSSI patients were included. During hospitalization, 18 patients (6.2%) experienced END, and 29 patients (10%) had neurological disability at a median follow-up of 21.4 (16.7-25.2) months. Multivariate analysis showed the National Institutes of Health Stroke Scale (NIHSS) score(OR 1.43, 95% CI 1.19-1.73, P < 0.001), and neutrophil to high-density lipoprotein cholesterol ratio (NHR) (OR 1.28, 95% CI 1.02-1.60, P = 0.034) were independently associated with END. Age (OR 1.08, 95% CI 1.01-1.15, P = 0.028), NIHSS (OR 1.60, 95% CI 1.29-1.98, P < 0.001), symptomatic intracranial artery stenosis (OR 5.26, 95% CI 1.56-17.71, P = 0.007), lacune number (OR 1.51, 95% CI 1.13-2.04, P = 0.006), the degree of brain atrophy (OR 2.03, 95% CI 1.19-3.46, P = 0.01), and mean hemoglobin concentration (MCHC) (OR 0.96, 95% CI 0.92-0.99, P = 0.04) were independently associated with neurological disability. The predictive model for END (included NIHSS score and NHR level) and long-term neurological disability (included age, NIHSS score, symptomatic intracranial artery stenosis, number of lacunes, and brain atrophy) showed areas under the ROC curve of 0.836 and 0.926, respectively.</p><p><strong>Conclusion: </strong>High NIHSS and NHR are independent risk factors for END. Age, NIHSS, symptomatic intracranial artery stenosis, the number of lacunes, and brain atrophy are predictors of neurological disability in SSSI patients.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"66"},"PeriodicalIF":2.2,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424939","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":"Comprehensive predictors of drug-resistant epilepsy in MELAS: clinical, EEG, imaging, and biochemical factors.","authors":"Rui Gao, Lihua Gu, Wenchao Zuo, Pan Wang","doi":"10.1186/s12883-025-04046-2","DOIUrl":"10.1186/s12883-025-04046-2","url":null,"abstract":"<p><strong>Background: </strong>Seizures are a common but often overlooked manifestation of MELAS. This study aimed to describe the characteristics of seizures in MELAS and to analyze the clinical, electroencephalographic, imaging, and biochemical factors associated with drug-resistant epilepsy.</p><p><strong>Methods: </strong>A single-center retrospective study was conducted to investigate the clinical characteristics of seizures in MELAS patients. The study collected data on clinical features, muscle biopsy results, genetic testing, seizure symptoms, electroencephalography (EEG), neuroimaging findings, cerebrospinal fluid and blood biochemistry, and the modified Rankin Scale (mRS). We also investigated the correlation between seizure frequency and mRS scores. In addition, we analyzed the risk factors for drug-resistant epilepsy in MELAS.</p><p><strong>Results: </strong>A total of 37 patients with confirmed MELAS (24 males and 13 females) were included in the study. All patients experienced seizures, with an onset age ranging from 14 to 53 years and a mean of 32 years. These MELAS patients experienced a variety of seizure types, with generalized seizures being the most common. EEG findings revealed background rhythm abnormalities in all patients, and epileptiform discharges were observed in 37.8% of patients during the interictal phase. Status epilepticus (OR 16.499; 95% CI, 1.615-168.557; P = 0.018) and elevated resting serum lactate levels (OR 8.594; 95% CI, 1.342-59.733; P = 0.024) were identified as independent risk factors for drug-resistant epilepsy. In addition, changes in the seizure frequency at the last follow-up compared to baseline were positively correlated with the mRS score. (r = 0.533, p < 0.001).</p><p><strong>Conclusion: </strong>Status epilepticus and elevated resting serum lactate levels were predictive of the development of drug-resistant epilepsy in MELAS. Poor seizure control was significantly associated with increased clinical disability. Early identification of high-risk patients for drug-resistant epilepsy could facilitate the development of more effective treatment plans.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"64"},"PeriodicalIF":2.2,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424949","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}