{"title":"Nomogram Models for Predicting Poor Prognosis in Lobar Intracerebral Hemorrhage: A Multicenter Study.","authors":"Yijun Lin, Anxin Wang, Xiaoli Zhang, Mengyao Li, Yi Ju, Wenjuan Wang, Xingquan Zhao","doi":"10.2174/0115672026365579241220073506","DOIUrl":"10.2174/0115672026365579241220073506","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to investigate the prognostic factors associated with lobar intracerebral hemorrhage (ICH) and to construct convenient models to predict 3-month unfavorable functional outcomes or all-cause death.</p><p><strong>Methods: </strong>Our study included 322 patients with spontaneous lobar ICH from 13 hospitals in Beijing as a derivation cohort. The clinical outcomes were unfavorable functional prognosis, defined as a modified Rankin Scale (mRS) score of 4-6, or all-cause death. Variable selection was performed using the Least Absolute Shrinkage and Selection Operator (LASSO) analysis, and two nomogram models were constructed. Additionally, multivariable logistic regression analysis was conducted to identify the factors associated with unfavorable prognosis. Finally, the Area Under The Receiver Operating Characteristic Curve (AUROC), calibration curve, and decision curve analyses (DCA) were performed to evaluate the models in both the derivation and external validation cohorts.</p><p><strong>Results: </strong>Predictive factors for unfavorable functional outcomes in lobar ICH included age, dyslipidemia, ICH volume, NIHSS score, Stroke-Associated Pneumonia (SAP), and lipidlowering therapy. The model included age, GCS score, NIHSS score, antihypertensive therapy, in-hospital rehabilitation training, and ICH volume to predict all-cause mortality. Our models exhibited good discriminative ability, with an AUC of 0.897 (95% CI: 0.862-0.933) for unfavorable functional outcomes and 0.894 (95% CI: 0.870-0.918) for death. DCA and calibration curves confirmed the models' excellent clinical decision-making and calibration capabilities.</p><p><strong>Conclusion: </strong>Nomogram models for predicting 3-month unfavorable outcomes or death in patients with lobar ICH were developed and independently validated in this study, providing valuable prognostic information for clinical decision-making.</p>","PeriodicalId":93965,"journal":{"name":"Current neurovascular research","volume":" ","pages":"595-605"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142934107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Wnt Signaling, Musculoskeletal Disease, and the Onset of Dementia and Alzheimer's Disease.","authors":"Kenneth Maiese","doi":"10.2174/1567202622999241211154331","DOIUrl":"10.2174/1567202622999241211154331","url":null,"abstract":"","PeriodicalId":93965,"journal":{"name":"Current neurovascular research","volume":" ","pages":"523-528"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Plasma Osteoprotegerin and Cognitive Impairment after Ischemic Stroke.","authors":"Xinyue Chang, Pinni Yang, Yi Liu, Yu He, Xiaoli Qin, Beiping Song, Quan Yu, Jiawen Fei, Mengyao Shi, Daoxia Guo, Yanbo Peng, Jing Chen, Aili Wang, Tan Xu, Jiang He, Yonghong Zhang, Zhengbao Zhu","doi":"10.2174/0115672026368528250113080256","DOIUrl":"10.2174/0115672026368528250113080256","url":null,"abstract":"<p><strong>Background: </strong>Plasma osteoprotegerin (OPG) has been linked to poor prognosis following stroke, but its impact on post-stroke cognitive impairment (PSCI) is unknown. The purpose of our work was to analyze the relationship of OPG with PSCI.</p><p><strong>Methods: </strong>Our study included 613 ischemic stroke subjects with plasma OPG levels. We used the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) to assess PSCI. PSCI was defined as MMSE score <25 or MoCA score <23.</p><p><strong>Results: </strong>As assessed by the MMSE score, the adjusted odds ratio for PSCI in the highest OPG tertile was 1.77, with a 95% confidence interval of 1.09 to 2.89 (P<sub>trend</sub>=0.021), compared to that in the lowest tertile. We observed a positive linear relationship of plasma OPG levels with 3- month PSCI (P for linearity=0.046). Incorporating plasma OPG into conventional risk factors enhanced PSCI risk reclassification (all P <0.05). Consistent results were discovered when PSCI was evaluated using the MoCA score.</p><p><strong>Conclusion: </strong>High plasma OPG levels were related to an elevated risk of 3-month PSCI, indicating that OPG might be an effective biomarker for predicting PSCI.</p>","PeriodicalId":93965,"journal":{"name":"Current neurovascular research","volume":" ","pages":"545-553"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Nanotechnology in Drug Delivery: An Overview of Developing the Blood Brain Barrier.","authors":"Rasmita Dash, Subhankar Samanta, Bikash Ranjan Jena, Soumyaranjan Pradhan","doi":"10.2174/0115672026346307240919112023","DOIUrl":"10.2174/0115672026346307240919112023","url":null,"abstract":"<p><p>The close connection between the brain microvascular endothelial cells (BMECs) that are enclosed within this barrier is the result of an intracellular junction, which is responsible for the constricted connection. The regulation and control of drug delivery systems both require nanoparticles, which are extremely small particles made up of a variety of materials, including polymers, metals, and other chemicals. Nanoparticles are a crucial component of the regulation and control of drug delivery systems. There is a possibility that nanomaterials composed of inorganic chemicals, such as gold nanoparticles, could be utilized in the treatment of neurodegenerative illnesses like Parkinson's disease. In addition to this, they are used as nano-carriers for the aim of distributing drugs to the region of the brain that is being targeted. There are a number of advantages that are easily apparent when compared to other methods of administering drugs for neurological diseases. The current review demonstrates both the advantages and disadvantages of utilizing a wide variety of nanomaterials for brain delivery, as well as the potential impact that this will have in the future on the safety and effectiveness of patient care.</p>","PeriodicalId":93965,"journal":{"name":"Current neurovascular research","volume":" ","pages":"347-358"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xie Wang, Hong Chen, Nan Shao, Xiaoyan Zhang, Chenye Huang, Xiangjun Li, Juan Zhang, Ze Chang, Le Tang, Daojun Xie
{"title":"Protective Effect of Aloe-emodin on Cognitive Function in Copper-loaded Rats Based on The Inhibition of Hippocampal Neuron Ferroptosis.","authors":"Xie Wang, Hong Chen, Nan Shao, Xiaoyan Zhang, Chenye Huang, Xiangjun Li, Juan Zhang, Ze Chang, Le Tang, Daojun Xie","doi":"10.2174/0115672026348862241003042336","DOIUrl":"10.2174/0115672026348862241003042336","url":null,"abstract":"<p><strong>Background: </strong>Aloe-emodin (AE), a monomer derived from traditional Chinese medicine, has demonstrated remarkable efficacy in the clinical management of cognitive disorders. Ferroptosis (FPT), a specialized form of programmed cell death, plays a critical role in the pathological progression of various cognitive diseases.</p><p><strong>Methods: </strong>This study explored the therapeutic potential of AE in a rat model of Wilson's disease cognitive impairments (WDCI) and examined whether these effects are mediated through the silencing information regulator 1 (SIRT1)-regulated FPT signaling pathway. Employing techniques, such as the Morris water maze (MWM), Hematoxylin & eosin (H&E) staining, Transmission electron microscopy (TEM), Immunofluorescence (IF), assessments of oxidative stress markers, and measurements of FPT-related protein levels, we evaluated the extent of SIRT1-mediated FPT and the therapeutic efficacy of AE.</p><p><strong>Results: </strong>The findings from the WD copper-loaded rat model experiments revealed that MWM, H&E, TEM, and IF outcomes indicated AE's potential to promote the restoration of learning and memory functions, ameliorate hippocampal neuronal morphological damage, and preserve cell membrane integrity. Results from western blot (WB) and ELISA analyses demonstrated that AE markedly upregulated the expression of SIRT1, nuclear factor erythroid-2-related factor 2 (Nrf2), solute carrier family 7 member 11 (SCL7A11), and glutathione peroxidase 4 (GPX4) proteins while simultaneously reversing the expression of oxidative stress markers such as malondialdehyde (MDA), glutathione (GSH), and superoxide dismutase (SOD), and reactive oxygen species (ROS). Consequently, we posit that AE may attenuate WD copper-loaded rat model hippocampal neuronal FPT by activating the SIRT1-mediated signaling pathway.</p><p><strong>Conclusion: </strong>These findings suggested that AE mitigates WD copper-loaded rat model hippocampal neuronal damage through the activation of SIRT1-mediated FPT, thereby presenting a valuable candidate Chinese herbal monomer for the clinical treatment of WDCI.</p>","PeriodicalId":93965,"journal":{"name":"Current neurovascular research","volume":" ","pages":"458-471"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jie Li, Wendan Tao, Deren Wang, Junfeng Liu, Ming Liu
{"title":"Malignant Brain Edema and Associated Factors in Large Hemispheric Infarction Following Reperfusion Therapy.","authors":"Jie Li, Wendan Tao, Deren Wang, Junfeng Liu, Ming Liu","doi":"10.2174/0115672026363146241216075333","DOIUrl":"10.2174/0115672026363146241216075333","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore Malignant Brain Edema (MBE) and associated factors in patients with Large Hemispheric Infarction (LHI) following early reperfusion therapy.</p><p><strong>Methods: </strong>We consecutively and retrospectively enrolled a cohort of 114 LHI patients who had received early reperfusion therapy, including Intravenous Thrombolysis (IVT) or Endovascular Therapy (EVT) at the hyperacute stage of stroke between January 2009 and December 2018. MBE was defined as a midline shift ≥5 mm, accompanied by signs of herniation. Multivariate logistic analyses were conducted to identify independent factors associated with MBE in LHI patients following early reperfusion therapy.</p><p><strong>Results: </strong>Among the enrolled patients, 69 (60.53%) were treated with IVT alone and 45 (39.47%) with EVT. Successful recanalization was achieved in 56 (49.12%) patients, while complete recanalization was achieved in 38 (33.33%) patients. After early reperfusion therapy, 50 (43.86%) developed MBE in LHI patients. The MBE group showed higher rates of in-hospital death (54% vs. 4.69%), 3-month mortality (64% vs. 10.94%), and 3-month unfavorable outcomes (90% vs. 64.06%) (all p<0.01). Neither different reperfusion therapy (EVT vs. IVT alone) nor different recanalization status (complete recanalization or not) was independently associated with the development of MBE in LHI patients following reperfusion therapy in multivariate analyses. MBE was independently associated with age [Odds Ratio (OR) 0.953, 95% confidence interval (CI) 0.910-0.999, p =0.044], right hemisphere stroke (OR 4.051, 95% CI 1.035-15.860, p =0.045), previous ischemic stroke or TIA (OR 0.090, 95% CI 0.014-0.571, p =0.011), and hypodensity >1/3 MCA territory (OR 8.071, 95% CI 1.878-34.693, p =0.005). Meanwhile, patients with lower baseline Alberta Stroke Program Early CT Score (ASPECTS) had a trend of higher incidence of MBE following reperfusion therapy (OR 0.710, 95% CI 0.483-1.043, p =0.081).</p><p><strong>Conclusion: </strong>MBE occurred in nearly one-half of LHI patients following early reperfusion therapy and was related to poor outcomes. An increased risk of MBE was found to be associated with younger age, right hemisphere stroke, absence of a history of ischemic stroke or TIA, and hypodensity >1/3 MCA region on baseline CT images.</p>","PeriodicalId":93965,"journal":{"name":"Current neurovascular research","volume":" ","pages":"511-521"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142934097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mengke Zhang, Xian Wang, Xi Chen, Jiali Xu, Wenting Guo, Changhong Ren, Sijie Li, Wenbo Zhao, Chuanjie Wu, Xunming Ji
{"title":"Role of Circadian Rhythm Changes on Functional Dependence Despite Successful Repercussion in Patients with Endovascular Treatment.","authors":"Mengke Zhang, Xian Wang, Xi Chen, Jiali Xu, Wenting Guo, Changhong Ren, Sijie Li, Wenbo Zhao, Chuanjie Wu, Xunming Ji","doi":"10.2174/0115672026346635240816095721","DOIUrl":"10.2174/0115672026346635240816095721","url":null,"abstract":"<p><strong>Background: </strong>Increasing evidence of circadian biology may influence the physiopathologic mechanism, progression, and recovery of stroke. However, few data have shown about circadian rhythm on futile recanalization (FR) in patients treated with endovascular treatment (EVT).</p><p><strong>Methods: </strong>From 2017 to 2021, an observational cohort of acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) underwent EVT was conducted. FR was defined as the failure to achieve functional independence in patients at 90 days after EVT, although the occluded vessels reached a recanalization. The effect of circadian rhythm on FR was investigated using the logistic regression model.</p><p><strong>Results: </strong>Of 783 patients, there were 149 patients who had stroke onset between 23:00-6:59, 318 patients between 7:00-14:59, and 316 patients between 15:00-22:59. Patients suffered from stroke during 15:00-22:59 had shorter OTP (p =0.001) time, shorter OTR (p<0.001) time, higher rate of intravenous thrombolysis (p =0.001) than groups of other time intervals. The rate of FR post-EVT in patients who had a stroke between 15:00-22:59 was significantly higher than in those with stroke onset between 23:00-6:59 (p =0.017). After adjusting for confounding factors, the time of stroke occurring during 15:00-22:59 (adjusted OR [aOR], 1.652; 95%CI, 1.024-2.666, p =0.04) was an independent predictor of FR.</p><p><strong>Conclusion: </strong>Circadian rhythm can directly or indirectly affect the occurrence, development, and prognosis of AIS. More studies may be needed in the future to validate the results of our study and to explore the potential mechanisms behind the effects of circadian rhythms on FR.</p>","PeriodicalId":93965,"journal":{"name":"Current neurovascular research","volume":" ","pages":"427-433"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142304520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Late Endovascular Treatment for Ischemic Stroke with Moderate to Large Infarct Volume is Associated with a better Clinical Prognosis.","authors":"Peng Jiang, Sheng Zhang, Weitao Yu, Zongjie Shi, Xinzhao Jiang, Xu Wang, Longting Lin, Mark Parsons, Wenting Guo","doi":"10.2174/0115672026370829250108051837","DOIUrl":"10.2174/0115672026370829250108051837","url":null,"abstract":"<p><strong>Objective: </strong>The concept of \"time is brain\" is crucial for the reperfusion therapy of ischemic stroke. However, the Infarct Growth Rate (IGR) varies among individuals, which is regarded as a more powerful factor than the time when determining infarct volume and its association with clinical outcomes. For stroke patients with a similar infarct volume, a longer time from stroke Onset to Imaging (OTI) correlates with a lower IGR, which may indicate a better prognosis. This study aimed to compare the prognoses of patients with anterior circulation stroke who received Endovascular Treatment (EVT), specifically comparing early EVT vs. late EVT.</p><p><strong>Methods: </strong>We analyzed 255 patients with acute anterior circulation stroke due to large vessel occlusion and who have successfully undergone recanalization after EVT. All patients were divided into the late (OTI≥6 hours) and early (<6 hours) time window groups and compared. The primary outcome was moderate functional prognosis, defined as a modified Rankin Scale (mRS) ≤3 at 90 days. The secondary outcome was No Significant Infarct Expansion (NSIE), defined as a reduction of less than 2 points on the Alberta Stroke Program Early CT Score (ASPECTS).</p><p><strong>Results: </strong>In the moderate to large infarct subgroup, the late time window EVT was independently associated with a higher rate of moderate functional outcome (P =0.007) and NSIE (P =0.001); mediation analysis showed that NSIE partially mediated the effects of the late time window EVT on moderate functional outcome (coefficient: 0.112, 95% CI: 0.051 to 0.239, P =0.011); however, these associations were not consistent in the small infarct group.</p><p><strong>Conclusion: </strong>For anterior circulation stroke patients who received EVT according to current guidelines, those with moderate to large infarct volume and having a longer OTI had better clinical outcomes than those who had a shorter OTI and were more suitable for EVT.</p>","PeriodicalId":93965,"journal":{"name":"Current neurovascular research","volume":" ","pages":"564-573"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yuan Kan, Lu Yang, Changhong Ren, Chuanhui Li, Jiali Xu, Wenting Guo, Wenbo Zhao, Xunming Ji
{"title":"The Effect of Systemic Inflammatory Response on Mechanical Thrombectomy is Partly Mediated by Pre-thrombectomy Cerebral Edema in Acute Stroke Patients.","authors":"Yuan Kan, Lu Yang, Changhong Ren, Chuanhui Li, Jiali Xu, Wenting Guo, Wenbo Zhao, Xunming Ji","doi":"10.2174/0115672026348875241011100717","DOIUrl":"10.2174/0115672026348875241011100717","url":null,"abstract":"<p><strong>Objective: </strong>To explore the effect of baseline Systemic Inflammatory Response reflected by platelet-to-lymphocyte ratio (PLR) and pre-thrombectomy cerebral edema reflected by Net Water Uptake (NWU) on futile recanalization in patients with Acute Ischemic Stroke (AIS) after successful thrombectomy, and to investigate the potential mediating role of baseline cerebral edema.</p><p><strong>Methods: </strong>134 Patients with anterior circulation ischemic stroke receiving successful thrombectomy were retrospectively studied. Their demographic and clinical characteristics were collected at admission, and the NWU was quantitatively calculated based on baseline computed tomography (CT). The predictive value of PLR for futile recanalization and the relationship between PLR, NWU, and futile recanalization using mediation analysis were explored. Patients were followed up for 90 days and were divided into a futile recanalization group and a favorable prognosis group [90-day modified Rankin Scale score of 0-2].</p><p><strong>Results: </strong>High baseline PLR, NWU, no first-pass reperfusion, and large baseline ischemic core volume were independent predictors of futile recanalization after successful thrombectomy in patients with AIS. Mediation analysis results indicate that PLR may partially mediate the occurrence of futile recanalization through NWU.</p><p><strong>Conclusion: </strong>Baseline PLR and NWU were independent predictors of futile recanalization, and higher PLR and NWU values were associated with a higher likelihood of futile recanalization. The findings suggest that early cerebral edema reflected by a high NWU value may be a mediator of PLR-affecting prognosis.</p>","PeriodicalId":93965,"journal":{"name":"Current neurovascular research","volume":" ","pages":"447-457"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}