Clinical Neurology and Neurosurgery最新文献_第6页

Factors associated with development of depression in adult patients with brain arteriovenous malformations

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Neurology and Neurosurgery

Pub Date : 2025-02-01 DOI: 10.1016/j.clineuro.2024.108714

Wuyang Yang , Sean Li , James Feghali , Alice Hung , Shahab Aldin Sattari , Yuxi Chen , Judy Huang

Objective

Cerebrovascular diseases are often associated with the development of depression, but few studies have assessed this association with brain arteriovenous malformations (bAVMs). We aim to explore the association of brain arteriovenous malformation(bAVM) with new onset depression at follow-up.

Methods

We performed a retrospective cohort study on adult bAVMs patients using an institutional bAVM database. Patients with hereditary hemorrhagic telangiectasia(HHT), incomplete data or a confirmed diagnosis of depression before their bAVM diagnosis were excluded. The outcome of interest was diagnosis of depression at follow-up. Self-reported depression without an established diagnosis were not counted. Patient demographics, socioeconomic status, clinical and bAVM characteristics were analyzed in a multivariable logistic regression against the outcome variable.

Results

Among 752 adult bAVM patients with complete data, 660 (87.8 %) had no depression at the time of their bAVM diagnosis and were included as the final cohort. There were 250(37.9 %) ruptured bAVMs. Mean follow-up time was 9.60 years, during which 187(28.3 %) had a new diagnosis of depression. Multivariable analysis found that white race(OR=1.75,CI=[1.21,2.57],p = 0.004), female(OR=1.49,CI=[1.04,2.14],p = 0.031), ADI quantile 2(OR=1.85,CI=[1.21,2.85],p = 0.005) and quantile 3(OR=2.05,CI=[1.22,3.42],p = 0.006), occipital lobe involvement(OR=1.66,CI=[1.05,2.60],p = 0.028), follow-up mRS≥ 2(OR=1.69,CI=[1.14,2.52],p = 0.010), bAVM obliteration (OR=1.46,CI=[1.02,2.11],p = 0.040), and follow-up seizures(OR=1.70,CI=[1.14,2.55],p = 0.009) were significant factors associated with new-onset diagnosis of depression at follow-up.

Conclusion

We characterized the probability of new-onset depression at follow-up in patients with bAVMs. More than 25 % of patients developed depression in this study. White female, suboptimal socioeconomic status, occipital lobe, poor outcome, follow-up seizures, and definitive management with bAVM obliteration was associated with depression. Identification of these features may provide guidance in early preventive measures.

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引用次数: 0

Research on predicting radiographic exposure time in imaging based on neural network prediction models

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Neurology and Neurosurgery

Pub Date : 2025-02-01 DOI: 10.1016/j.clineuro.2025.108736

Hanghui Hu , Jian Zhang , Shuyu Xie , Hui Zhou , Yanhua Fan , Jinmei Lin , Shengliang Shi , Yueling Zhang

Objective

To explore the anatomical and clinical factors that affect the radiographic exposure time in radial artery cerebral angiography and to establish a model.

Method

A total of 210 patients who underwent radial artery cerebral angiography at this center from September 2021 to May 2022 were selected, and their anatomical and clinical factors were analyzed to evaluate the correlation between these factors and the duration of radiographic exposure. A related neural network prediction model was established.

Results

(1) Hypertension (p = 0.014), the presence of a double subclavian innominate artery curve (p＜0.001) and a proximal left common carotid artery loop (p = 0.014) increased the fluoroscopy time. (2) Age (p = 0.002), diameter of the aortic arch (p < 0.001), width of the innominate artery (brachiocephalic artery) (p < 0.001), and angle between the innominate artery and aortic arch (p = 0.042) were positively correlated with the fluoroscopy time. (3) The length of the innominate artery was negatively correlated with the fluoroscopy time (p = 0.024). (4) The accuracy of the neural network model was 80.0 % with the training set and 76.9 % with the test set, indicating a relatively high prediction accuracy. The ROC curve analysis showed an area under the curve (AUC) of 0.821, indicating its good predictive performance.

Conclusion

Age, hypertension, double curvature of the subclavian and innominate arteries, proximal left common carotid artery loop, diameter of the aortic arch, width and length of the innominate artery, and angle between the innominate artery and aortic arch can affect the fluoroscopy time for cerebral angiography in TRA.

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引用次数: 0

The stent-screw assisted internal fixation (SAIF) technique: A treatment option for OF5, the three-column unstable osteoporotic vertebral fractures – A case series

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Neurology and Neurosurgery

Pub Date : 2025-02-01 DOI: 10.1016/j.clineuro.2025.108757

Christian Commodaro , Lukasz Strulak , Ivan Cabrilo , Marco Pileggi , Maurizio Isalberti , Joshua A. Hirsch , Andrea Cardia , Alessandro Cianfoni

Purpose

The OF5 type of vertebral osteoporotic fracture (AO Spine-DGOU classification) represents a three-column lesion and as such is considered as highly unstable. These lesions, however, tend to affect elderly, frail patients, in whom invasive management options are limited. The stent-screw-assisted internal fixation (SAIF) technique has previously been reported as a minimally invasive treatment for osteoporotic and neoplastic vertebral fractures. Here, we sought to assess the safety and efficacy of the SAIF technique in a retrospective series of patients with thoracic OF5-fractures.

Methods

Retrospective identification, in a prospectively maintained database, of patients with OF5-fractures treated with SAIF. Intra- and post-operative complications were reported. Clinical outcome using NRS pain scale and Patient’s Global Impression of Change (PGIC) and radiological outcome, with local kyphotic angle (LKA) and VB height (VBH) correction were analyzed.

Results

N = 22 consecutive patients were identified. All fractures were located in the thoracic spine. No intra-procedural complications occurred, although hospitalization-related complications did occur in 2 patients (9 %). There was a statistically significant pain reduction on follow-up. VBH restoration range was 0–12 mm (mean 5.5 mm). The mean postoperative LKA correction was 7.5°, which was maintained at last follow-up.

Conclusion

The SAIF technique appears to be a viable alternative in the management of OF5-fractures. Although it does not address all elements of OF5 instability, it appears that the stabilisation of the anterior and middle vertebral columns, coupled with the stabilising effect of the ribcage in the hypomobile thoracic spine, are biomechanically sufficient to treat OF5-fractures in this section of the spine.

{"title":"The stent-screw assisted internal fixation (SAIF) technique: A treatment option for OF5, the three-column unstable osteoporotic vertebral fractures – A case series","authors":"Christian Commodaro , Lukasz Strulak , Ivan Cabrilo , Marco Pileggi , Maurizio Isalberti , Joshua A. Hirsch , Andrea Cardia , Alessandro Cianfoni","doi":"10.1016/j.clineuro.2025.108757","DOIUrl":"10.1016/j.clineuro.2025.108757","url":null,"abstract":"<div><h3>Purpose</h3><div>The OF5 type of vertebral osteoporotic fracture (AO Spine-DGOU classification) represents a three-column lesion and as such is considered as highly unstable. These lesions, however, tend to affect elderly, frail patients, in whom invasive management options are limited. The stent-screw-assisted internal fixation (SAIF) technique has previously been reported as a minimally invasive treatment for osteoporotic and neoplastic vertebral fractures. Here, we sought to assess the safety and efficacy of the SAIF technique in a retrospective series of patients with thoracic OF5-fractures.</div></div><div><h3>Methods</h3><div>Retrospective identification, in a prospectively maintained database, of patients with OF5-fractures treated with SAIF. Intra- and post-operative complications were reported. Clinical outcome using NRS pain scale and Patient’s Global Impression of Change (PGIC) and radiological outcome, with local kyphotic angle (LKA) and VB height (VBH) correction were analyzed.</div></div><div><h3>Results</h3><div>N = 22 consecutive patients were identified. All fractures were located in the thoracic spine. No intra-procedural complications occurred, although hospitalization-related complications did occur in 2 patients (9 %). There was a statistically significant pain reduction on follow-up. VBH restoration range was 0–12 mm (mean 5.5 mm). The mean postoperative LKA correction was 7.5°, which was maintained at last follow-up.</div></div><div><h3>Conclusion</h3><div>The SAIF technique appears to be a viable alternative in the management of OF5-fractures. Although it does not address all elements of OF5 instability, it appears that the stabilisation of the anterior and middle vertebral columns, coupled with the stabilising effect of the ribcage in the hypomobile thoracic spine, are biomechanically sufficient to treat OF5-fractures in this section of the spine.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"249 ","pages":"Article 108757"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143180750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Epidemiology of traumatic cervical artery dissections 外伤性颈动脉夹层的流行病学研究。

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Neurology and Neurosurgery

Pub Date : 2025-02-01 DOI: 10.1016/j.clineuro.2024.108688

Helena K. Xeros , Kim J. Griffin , William S. Harmsen , Giuseppe Lanzino , Robert D. Brown Jr. , Zafer Keser

Introduction

Unlike spontaneous cervical artery dissection (CeAD), the incidence of CeAD after a major trauma is not well characterized. This population-based observational study investigates the epidemiology and natural history of traumatic cervical artery dissection (CeADs) using data from the Rochester Epidemiology Project (REP) in Olmsted County, USA.

Methods

The REP system database has a high likelihood of complete case ascertainment and comparable demographics (age, sex) to the US population. After the initial screening of the database with ICD-based codes for carotid and vertebral dissections, meticulous review was performed to select patients with CeAD due to major trauma. We used Poisson regression to assess the association of age, sex, and time-period using crude incidence rates.

Results

Analyzing cases from 2002 to 2020, we identified 21 patients with traumatic CeAD, noting a significant 3.5-fold increase in incidence from 2002 to 2011–2012–2020 (0.37–1.29 per 100,000 person-years, p = 0.005). Only 23.8 % of cases experienced traumatic CeAD-related cerebral infarction. No patients received acute reperfusion therapies. Antithrombotic treatment predominantly involved single antiplatelet therapy (47.6 %) with aspirin. However, increasing use of dual antiplatelet therapy (11.8 %) along with declining use of anticoagulation (17.6 %) was also noted over time. We observed no recurrent strokes, dissections, or de-novo pseudoaneurysms. at the final follow-up.

Conclusion

The population-based incidence of traumatic CeAD is on the rise, potentially due to an increased screening in real-life practice leading to improved identification of cases that may have otherwise gone unrecognized. Our study also shows that traumatic CeADs tend to have a favorable prognosis.

引言：与自发性颈动脉夹层（CeAD）不同，重大创伤后CeAD的发生率并没有很好的特征。这项以人群为基础的观察性研究利用美国奥姆斯特德县罗切斯特流行病学项目（REP）的数据调查了外伤性颈动脉夹层（CeADs）的流行病学和自然史。方法：REP系统数据库具有与美国人口完全确定病例和可比较的人口统计（年龄，性别）的高可能性。在对基于icd的颈动脉和椎体解剖编码的数据库进行初步筛选后，对因重大创伤导致的CeAD患者进行了细致的审查。我们使用泊松回归来评估年龄、性别和使用粗发病率的时间段之间的关系。结果：分析2002年至2020年的病例，我们确定了21例创伤性CeAD患者，发现2002年至2011-2012-2020年的发病率显著增加了3.5倍（0.37-1.29 / 100,000人年，p = 0.005）。只有23.8% %的病例发生外伤性脑梗死。无患者接受急性再灌注治疗。抗血栓治疗主要涉及阿司匹林单抗血小板治疗（47.6 %）。然而，随着时间的推移，双重抗血小板治疗的使用增加（11.8% %），抗凝治疗的使用减少（17.6% %）。我们没有观察到复发性中风、夹层或新生假性动脉瘤。在最后的随访中。结论：创伤性脑卒中在人群中的发病率正在上升，这可能是由于现实生活中筛查的增加，从而提高了对可能未被识别的病例的识别。我们的研究还表明，创伤性脑卒中往往有良好的预后。

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引用次数: 0

Quadrigeminal arachnoid cyst: Factors affecting outcomes and complications in a large series of cases 四叉系蛛网膜囊肿：影响预后和并发症的因素。

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Neurology and Neurosurgery

Pub Date : 2025-02-01 DOI: 10.1016/j.clineuro.2024.108701

Harsh Deora, Mohammed Nadeem, Himanshu YN, Joginapalli Anirudh, Abhinith Shashidhar, Subhas Kanti Konar, Vikas V, Arivazaghan A, Dhaval P. Shukla, Dwarakanath Srinivas, Malla Bhaskara Rao

Purpose

Arachnoid cysts constitute approximately 1 % of intracranial mass lesions, with quadrigeminal cistern arachnoid cysts being 5–18 % of those. This study presents a series of 31 cases of quadrigeminal cistern arachnoid cysts, constituting the most extensive series reported to date.

Methods

A retrospective analysis was conducted on 31 patients diagnosed with quadrigeminal cistern arachnoid cysts, focusing on clinical presentation, demographics, treatment approaches, and outcomes. Patient ages ranged from 6 m to 45 years, with a mean age of 29. The cysts were classified into three subtypes based on MRI findings, and all patients underwent surgical intervention.

Results

Of the 31 patients, 7 had Type 1 cysts, 12 had Type 2 cysts, and 12 had Type 3 cysts. For patients with Type 1 cysts, endoscopic third ventriculostomy with cyst fenestration was done in 6 cases, with craniotomy in 1 one case. In those with Type 2 cysts, Shunt was done in 3 cases: craniotomy with cyst wall excision in 4, ETV alone in 3, and cyst fenestration in 2. For Type 3 cysts, 11 patients underwent endoscopic fenestration to the subarachnoid space or ventricles, combined with endoscopic third ventriculostomy, and craniotomy was done in one case. All three shunts, one craniotomy, and 2 ETV with fenestration needed revision surgery due to symptoms(6/31 cases). Three cases had an intraventricular haemorrhage, with 2 cases needing external drainage. Four of the six revision cases showed no reduction in cyst size on MRI after the first surgery.

Conclusion

Quadrigeminal plate arachnoid cysts typically present with symptoms and necessitate surgical treatment. Our findings show that Type 2 and 3 cysts are the most common. Shunts are NOT indicated as the first procedure, as they have poor results. Endoscopic fenestration with ETV remains the procedure of choice, while ETV alone may suffice in most cases. Bleeding and infection reduce success rates.

目的：蛛网膜囊肿约占颅内肿块病变的1 %，其中四叉池蛛网膜囊肿占5-18 %。本研究报告了一系列的31例四分生池蛛网膜囊肿，构成迄今为止报道的最广泛的系列。方法：回顾性分析31例经诊断为四叉腹腔蛛网膜囊肿的患者的临床表现、人口学特征、治疗方法及转归。患者年龄从6岁 到45岁，平均年龄29岁。根据MRI表现将囊肿分为三种亚型，所有患者均接受手术治疗。结果：31例患者中，1型囊肿7例，2型12例，3型12例。对于1型囊肿患者，内镜下第三脑室造瘘加囊肿开窗6例，开颅1例。2型囊肿行分流术3例：开颅切除囊肿壁4例，单纯行ETV 3例，囊肿开窗2例。3型囊肿11例行腔内蛛网膜下腔或脑室开窗，联合腔内第三脑室造口术，1例开颅。所有3例分流术、1例开颅术和2例开窗ETV均因症状需要翻修手术（6/31例）。3例脑室内出血，2例需要体外引流。6例翻修病例中的4例在第一次手术后的MRI上显示囊肿大小没有缩小。结论：股四叉盘状蛛网膜囊肿具有典型的症状，需要手术治疗。我们的研究结果显示，2型和3型囊肿最常见。分流术不建议作为首选手术，因为分流术效果不佳。内镜开窗与ETV仍然是选择的程序，而ETV单独可能在大多数情况下就足够了。出血和感染降低了成功率。

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引用次数: 0

A microanatomical study of the precentral cerebral wall in human fetuses of the second trimester with ventriculomegaly and corpus callosal dysgenesis 伴有脑室肿大和胼胝体发育不良的妊娠中期胎儿中央前脑壁的显微解剖研究。

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Neurology and Neurosurgery

Pub Date : 2025-02-01 DOI: 10.1016/j.clineuro.2024.108715

Veeresh , Shalini S. Nayak , Deepak Nayak , Aamna Kausar , Mamatha Hosapatna

Background

The complex structure and function of the cerebrum make it a key focus in neuroscience research. It develops from telencephalic vesicles through processes such as cell growth, division, and migration from the neuroepithelium's ventricular matrix, forming the six-layered isocortex or neocortex. Multipotent neuroepithelial cells give rise to both neuronal and glial precursors, which populate the cerebral cortex. This study investigated the number of cerebral layers and their thickness in second-trimester human fetuses with ventriculomegaly and corpus callosal dysgenesis.

Materials and methods

This study was conducted at Kasturba Medical College, Manipal, with Institutional Ethics Committee approval. The study analyzed the cerebral wall of 10 human fetuses in the second trimester. Histological sections were stained with hematoxylin and eosin, and the cortical layers were identified and measured.

Results

The mean total cerebral wall thickness was 4079.2 μm in fetuses with ventriculomegaly and 6532.8 μm in fetuses with corpus callosal dysgenesis. The morphological findings in corpus callosal dysgenesis included disorganization of the cortical plate zone, which may impact brain development, as well as the presence of dilated blood vessels.

Conclusion

This study quantified the six transient layers of the precentral cerebral wall, which are distinct during the embryonic stage and disappear at term. These layers are generally associated with specific neurodevelopmental processes. Compared with ventriculomegaly, corpus callosal dysgenesis involves distinct morphological alterations. One sample had disorganized cells in the cortical plate, and another displayed dilated blood vessels in the subventricular zone. These findings indicate significant disruptions in cortical development in corpus callosal dysgenesis.

背景：大脑复杂的结构和功能使其成为神经科学研究的热点。它由端脑小泡发育而来，经过细胞生长、分裂和从神经上皮的心室基质迁移等过程，形成六层的等皮质或新皮质。多能性神经上皮细胞产生神经元和胶质前体，它们分布在大脑皮层。本研究对伴有脑室肥大和胼胝体发育不全的妊娠中期胎儿的大脑层数和厚度进行了研究。材料和方法：本研究在马尼帕尔Kasturba医学院进行，并获得了机构伦理委员会的批准。该研究分析了10名妊娠中期胎儿的脑壁。组织切片用苏木精和伊红染色，并对皮质层进行鉴定和测量。结果：脑室肿大胎儿的平均总脑壁厚度为4079.2 μm，胼胝体发育不良胎儿的平均总脑壁厚度为6532.8 μm。胼胝体发育不良的形态学结果包括可能影响大脑发育的皮质板带紊乱，以及血管扩张的存在。结论：本研究量化了胚胎期明显、足月消失的6层中央前脑壁瞬变层。这些层通常与特定的神经发育过程有关。与脑室肥大相比，胼胝体发育不良涉及明显的形态学改变。一个样本在皮质板中有紊乱的细胞，另一个样本在心室下区显示血管扩张。这些发现表明胼胝体发育不良导致皮质发育明显中断。

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引用次数: 0

Enhancing brain tumor surgery precision with multimodal connectome imaging: Structural and functional connectivity in language-dominant areas

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Neurology and Neurosurgery

Pub Date : 2025-02-01 DOI: 10.1016/j.clineuro.2025.108760

Harshal A. Shah , James Duehr , Arevik Abramyan , Laura Mittelman , Rosivel Galvez , Taylor Winby , Justin W. Silverstein , Randy S. D’Amico

Objectives

Language is a critical aspect of human cognition and function, and its preservation is a priority for neurosurgical interventions in the left frontal operculum. However, identification of language areas can be inconsistent, even with electrical mapping. The use of multimodal structural and functional neuroimaging in conjunction with intraoperative neuromonitoring may augment cortical language area identification to guide the resection of left frontal opercular lesions.

Methods

Structural and functional connectome scans were generated using a machine learning software to reparcellate a validated schema of the Human Connectome Project Multi-Modal Parcellation (HCP-MMP) atlas based on individual structural and functional connectivity identified through anatomic, diffusion, and resting-state functional MRI (rs-fMRI). Structural connectivity imaging was analyzed to determine at-risk parcellations and seed-based analysis of regions of interest (ROIs) was performed to identify functional relationships.

Results

Two patients with left frontal lesions were analyzed, one with a WHO Grade IV gliosarcoma, and the other with an intracerebral abscess. Individual patterns of functional connectivity were identified by functional neuroimaging revealing distinct relationships between language network parcellations. Multimodal, connectome-guided resections with intraoperative neuromonitoring were performed, with both patients demonstrating intact or improved language function relative to baseline at follow-up. Follow-up imaging demonstrated functional reorganization observed between Brodmann areas 44 and 45 and other parcellations of the language network.

Conclusion

Preoperative visualization of structural and functional connectivity of language areas can be incorporated into a multimodal operative approach with intraoperative neuromonitoring to facilitate the preservation of language areas during intracranial neurosurgery. These modalities may also be used to monitor functional recovery.

{"title":"Enhancing brain tumor surgery precision with multimodal connectome imaging: Structural and functional connectivity in language-dominant areas","authors":"Harshal A. Shah , James Duehr , Arevik Abramyan , Laura Mittelman , Rosivel Galvez , Taylor Winby , Justin W. Silverstein , Randy S. D’Amico","doi":"10.1016/j.clineuro.2025.108760","DOIUrl":"10.1016/j.clineuro.2025.108760","url":null,"abstract":"<div><h3>Objectives</h3><div>Language is a critical aspect of human cognition and function, and its preservation is a priority for neurosurgical interventions in the left frontal operculum. However, identification of language areas can be inconsistent, even with electrical mapping. The use of multimodal structural and functional neuroimaging in conjunction with intraoperative neuromonitoring may augment cortical language area identification to guide the resection of left frontal opercular lesions.</div></div><div><h3>Methods</h3><div>Structural and functional connectome scans were generated using a machine learning software to reparcellate a validated schema of the Human Connectome Project Multi-Modal Parcellation (HCP-MMP) atlas based on individual structural and functional connectivity identified through anatomic, diffusion, and resting-state functional MRI (rs-fMRI). Structural connectivity imaging was analyzed to determine at-risk parcellations and seed-based analysis of regions of interest (ROIs) was performed to identify functional relationships.</div></div><div><h3>Results</h3><div>Two patients with left frontal lesions were analyzed, one with a WHO Grade IV gliosarcoma, and the other with an intracerebral abscess. Individual patterns of functional connectivity were identified by functional neuroimaging revealing distinct relationships between language network parcellations. Multimodal, connectome-guided resections with intraoperative neuromonitoring were performed, with both patients demonstrating intact or improved language function relative to baseline at follow-up. Follow-up imaging demonstrated functional reorganization observed between Brodmann areas 44 and 45 and other parcellations of the language network.</div></div><div><h3>Conclusion</h3><div>Preoperative visualization of structural and functional connectivity of language areas can be incorporated into a multimodal operative approach with intraoperative neuromonitoring to facilitate the preservation of language areas during intracranial neurosurgery. These modalities may also be used to monitor functional recovery.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"249 ","pages":"Article 108760"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Integrating AI-driven wearable devices and biometric data into stroke risk assessment: A review of opportunities and challenges 将人工智能驱动的可穿戴设备和生物识别数据纳入中风风险评估：机遇与挑战综述。

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Neurology and Neurosurgery

Pub Date : 2025-02-01 DOI: 10.1016/j.clineuro.2024.108689

David B. Olawade , Nicholas Aderinto , Aanuoluwapo Clement David-Olawade , Eghosasere Egbon , Temitope Adereni , Mayowa Racheal Popoola , Ritika Tiwari

Stroke is a leading cause of morbidity and mortality worldwide, and early detection of risk factors is critical for prevention and improved outcomes. Traditional stroke risk assessments, relying on sporadic clinical visits, fail to capture dynamic changes in risk factors such as hypertension and atrial fibrillation (AF). Wearable technology (devices), combined with biometric data analysis, offers a transformative approach by enabling continuous monitoring of physiological parameters. This narrative review was conducted using a systematic approach to identify and analyze peer-reviewed articles, reports, and case studies from reputable scientific databases. The search strategy focused on articles published between 2010 till date using pre-determined keywords. Relevant studies were selected based on their focus on wearable devices and AI-driven technologies in stroke prevention, diagnosis, and rehabilitation. The selected literature was categorized thematically to explore applications, opportunities, challenges, and future directions. The review explores the current landscape of wearable devices in stroke risk assessment, focusing on their role in early detection, personalized care, and integration into clinical practice. The review highlights the opportunities presented by continuous monitoring and predictive analytics, where AI-driven algorithms can analyze biometric data to provide tailored interventions. Personalized stroke risk assessments, powered by machine learning, enable dynamic and individualized care plans. Furthermore, the integration of wearable technology with telemedicine facilitates remote patient monitoring and rehabilitation, particularly in underserved areas. Despite these advances, challenges remain. Issues such as data accuracy, privacy concerns, and the integration of wearables into healthcare systems must be addressed to fully realize their potential. As wearable technology evolves, its application in stroke care could revolutionize prevention, diagnosis, and rehabilitation, improving patient outcomes and reducing the global burden of stroke.

中风是世界范围内发病和死亡的主要原因，早期发现危险因素对于预防和改善结果至关重要。传统的卒中风险评估依赖于零星的临床访问，无法捕捉到高血压和心房颤动（AF）等危险因素的动态变化。可穿戴技术（设备）与生物识别数据分析相结合，通过实现对生理参数的连续监测，提供了一种变革性的方法。本叙述性综述采用系统的方法来识别和分析来自知名科学数据库的同行评议文章、报告和案例研究。搜索策略集中在2010年到目前为止发表的文章，使用预先确定的关键字。根据可穿戴设备和人工智能驱动技术在卒中预防、诊断和康复方面的研究重点，选择相关研究。所选文献按主题进行分类，以探讨应用、机遇、挑战和未来方向。该综述探讨了可穿戴设备在卒中风险评估中的现状，重点关注其在早期检测、个性化护理和临床实践中的作用。该综述强调了持续监测和预测分析带来的机会，其中人工智能驱动的算法可以分析生物特征数据，以提供量身定制的干预措施。由机器学习驱动的个性化中风风险评估可实现动态和个性化的护理计划。此外，可穿戴技术与远程医疗的结合促进了患者的远程监测和康复，特别是在服务不足的地区。尽管取得了这些进步，但挑战依然存在。必须解决诸如数据准确性、隐私问题以及将可穿戴设备集成到医疗保健系统中的问题，以充分发挥其潜力。随着可穿戴技术的发展，其在中风护理中的应用可能会彻底改变预防、诊断和康复，改善患者的治疗效果，减轻全球中风负担。

{"title":"Integrating AI-driven wearable devices and biometric data into stroke risk assessment: A review of opportunities and challenges","authors":"David B. Olawade , Nicholas Aderinto , Aanuoluwapo Clement David-Olawade , Eghosasere Egbon , Temitope Adereni , Mayowa Racheal Popoola , Ritika Tiwari","doi":"10.1016/j.clineuro.2024.108689","DOIUrl":"10.1016/j.clineuro.2024.108689","url":null,"abstract":"<div><div>Stroke is a leading cause of morbidity and mortality worldwide, and early detection of risk factors is critical for prevention and improved outcomes. Traditional stroke risk assessments, relying on sporadic clinical visits, fail to capture dynamic changes in risk factors such as hypertension and atrial fibrillation (AF). Wearable technology (devices), combined with biometric data analysis, offers a transformative approach by enabling continuous monitoring of physiological parameters. This narrative review was conducted using a systematic approach to identify and analyze peer-reviewed articles, reports, and case studies from reputable scientific databases. The search strategy focused on articles published between 2010 till date using pre-determined keywords. Relevant studies were selected based on their focus on wearable devices and AI-driven technologies in stroke prevention, diagnosis, and rehabilitation. The selected literature was categorized thematically to explore applications, opportunities, challenges, and future directions. The review explores the current landscape of wearable devices in stroke risk assessment, focusing on their role in early detection, personalized care, and integration into clinical practice. The review highlights the opportunities presented by continuous monitoring and predictive analytics, where AI-driven algorithms can analyze biometric data to provide tailored interventions. Personalized stroke risk assessments, powered by machine learning, enable dynamic and individualized care plans. Furthermore, the integration of wearable technology with telemedicine facilitates remote patient monitoring and rehabilitation, particularly in underserved areas. Despite these advances, challenges remain. Issues such as data accuracy, privacy concerns, and the integration of wearables into healthcare systems must be addressed to fully realize their potential. As wearable technology evolves, its application in stroke care could revolutionize prevention, diagnosis, and rehabilitation, improving patient outcomes and reducing the global burden of stroke.</div></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":"249 ","pages":"Article 108689"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Guillain-Barré syndrome in COVID-19 vaccinated patients: There is a lot to uncover COVID-19疫苗接种患者的格林-巴<s:1>综合征：有很多有待发现。

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Neurology and Neurosurgery

Pub Date : 2025-02-01 DOI: 10.1016/j.clineuro.2024.108712

Mohammad T. Abuawwad, Mohammad J.J. Taha, Ahmad J. Taha, Yasmeena Abdelall Kozaa, Obaida Falah, Ibrahim T. Abuawwad, Elsayed Mohamed Hammad, Ayman A. Mahmoud, Mohammad Aladawi, Hashem Abu Serhan

引用次数: 0

Response to "Anti-amyloid-beta treatments in Alzheimer’s disease: When neurologists turn into cheerleaders” 对“阿尔茨海默病的抗淀粉样蛋白治疗：当神经科医生变成啦啦队长”的回应。

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Neurology and Neurosurgery

Pub Date : 2025-02-01 DOI: 10.1016/j.clineuro.2025.108735

Robert C. Alexander, Eric M. Reiman, Jeffrey L. Cummings, Jessica B. Langbaum, Soeren Mattke

引用次数: 0