Frontiers in Neurology最新文献

Background: Sudden hearing loss (SHL) is a prevalent emergency in otolaryngology. Despite its frequency, there is a lack of econometric analysis and visualisation of the most significant SHL research literature. This study aims to provide a comprehensive overview and explore the characteristics of the 100 most cited articles in SHL through bibliometric analysis.

Materials and methods: The Web of Science Core Collection (WOSCC) was used to identify the 100 most cited SHL articles from 1999 to 2024. Tools such as CiteSpace and VOSviewer were employed to visualise data on countries, institutions, authors, co-cited authors, journals, co-cited journals, co-cited references, and keywords.

Results: The citations of the 100 most cited articles ranged from 59 to 760, with publications spanning from 1999 to 2021 and peaking in 2005. The most cited article was authored by Schwartz SR. The majority of these articles originated from the United States. Key themes identified include treatment options for SHL, with prominent keywords such as deafness, therapy, and dexamethasone.

Conclusion: This study identified the highly cited literature in SHL research, revealing a primary focus on treatment options. These findings provide crucial insights into the research hotspots and frontiers in the field of SHL.

Background: Etiological classification of ischemic stroke is fundamental for secondary prevention, but frequently results in undetermined cause. We aimed to develop a Deep Learning (DL)-based model for automatic etiological classification of ischemic stroke using digital images of thrombi retrieved by mechanical thrombectomy.

Methods: Patients with large vessel occlusion stroke subjected to mechanical thrombectomy between April 2016 and January 2023 at La Fe University and Polytechnic Hospital in Valencia were included. Thrombus digital images were obtained and clinical characteristics, including TOAST etiological classification as reference standard, were retrieved. Statistical analysis was performed to compare clinical characteristics between atherothrombotic and cardioembolic strokes. A DL method was designed based on two deep neural networks for: (1) image segmentation and (2) image classification including clinical characteristics. The metrics used were DICE coefficient for the segmentation network, and accuracy, precision, sensitivity, specificity and area under the curve (AUC) for the predictions of the classification network.

Results: A total of 166 patients (mean age 69 [SD, 13], 67 female) were included. TOAST classification was: 31 atherothrombotic, 87 cardioembolic, and 48 cryptogenic. The segmentation network achieved an average DICE coefficient of 0.96 [SD, 0.13]. The optimal fused imaging and clinical classification network had a 0.968 accuracy [95% CI, 0.935-0.994], and AUC of 0.947 [95% CI, 0.870-1]. Cryptogenic thrombi were classified as cardioembolic (96%) or atherothrombotic (4%).

Conclusion: Two convolutional neural networks perform the automatic segmentation of thrombus images and, combined with selected clinical characteristics, their accurate and precise classification into atherothrombotic or cardioembolic etiology in patients with acute ischemic stroke.

Introduction: According to people with Parkinson's disease (PD), gait impairments are the most disabling motor symptoms of PD. Recently, motor imagery (MI) has gained notoriety as a gait training technique due to the flexibility of its use, however, it has not been demonstrated that causes a superior effect when included in physiotherapy. This study aims to determine if gait training combined with MI has a greater effect on the gait of people with PD than just gait training.

Methods: The GAITimagery is designed as a double-blind, randomized control trial, including a convenience sample in 2 parallel groups (1:1) with two interventions of 2 sessions per week during 6-week and 8-week follow-up. The initial recruitment will be 88 participants with idiopathic PD and unimpaired cognition state, who will be randomly divided into two groups: GAITimagery (GiG) or the active control Gait group (GaG). Both will perform the same gait exercises but only GiG will include MI training. Gait speed is the primary outcome, while Maximum gait speed (m/s) and Gait speed variability are the secondary results. The tertiary outcomes are related to Quality of life, Daily life activities, Freezing of gait, Balance, Mobility, and Gait performance measures to psychometrics and biomechanics instruments. All results will be measured at baseline (t0), post-training (t1), and follow-up assessment (t2) 8 weeks after finished physiotherapy programs.

Discussion: The GAITimagery program standardizes the application of MI exercises related to the improvement of parkinsonian gait at the same time that monitoring the vividness referred by the participants session by session. The effectiveness of this MI-exclusive program includes subjective and objective measurement tools to detect minimal changes after training. This still-to-be-finish study will support the therapeutic decisions on whether or not to allocate session time to imagery exercises depending on the effect size achieved and the comparison with a control gait training.

Objective: Acupoint-related interventions are the widely utilized modalities in traditional Chinese medicine for the alleviation of pain. This study aims to identify research hotspots and trends by conducting a bibliometric analysis of the relevant literature on acupoint and pain, thereby elucidating future research directions in this field.

Method: A comprehensive search was conducted on PubMed for literature pertaining to acupoint and pain from January 2010 to August 2024. Subsequent bibliometric analyses, encompassing statistical evaluation of bibliographic data, keyword cluster analysis, and co-occurrence analysis, were conducted utilizing the Medpulse database and the Bibliometrix R-package.

Results: A total of 742 articles from 179 journals were included in the analysis, with the majority focusing on complementary and alternative medicine or comprehensive research. The number of publications in this field has shown a consistent annual increase, involving contributions from 19 different countries of corresponding authors. China had the greatest contribution with 407 articles followed by Korea with 25 articles. The leading institutions in terms of publication volume are Chengdu University of Traditional Chinese Medicine, China Medical University, and Kyung Hee University. The topics covered in these articles include acupuncture, transcutaneous electrical acupoint stimulation (TEAS), randomized controlled trials, analgesia, zusanli (st36), systematic review, and anxiety, among others. The main cluster themes are intervention methods for various acupoints and the assessment of their efficacy.

Conclusion: The bibliometric analysis has identified the intervention methods of acupoints and the evaluation of their efficacy in pain management as emerging research focal points. Additionally, anxiety is anticipated to emerge as a future research direction within this domain.

Purpose: To explore the frequency of orthostatic hypotension (OH) in a large sample of amyotrophic lateral sclerosis patients (ALS).

Methods: From the PRO-ACT database, data of 1,240 ALS patients were analyzed, focusing on blood pressure and heart rate before and after standing. OH was defined as a drop in systolic/diastolic blood pressure > 20/10 mm Hg within 3 min of standing. Neurogenic OH was diagnosed when the heart rate increase was below 15 bpm in patients not taking medications that could affect this response.

Results: At baseline, 138 (11.1%) patients showed OH, 76.1% of whom had neurogenic OH. At follow-up, 163 patients (13.1%) had OH, 71.2% with neurogenic OH. Only 22.5% of the patients with OH at baseline had OH at follow-up.

Conclusion: In a large sample of ALS patients, OH occurred in 11-13%, pointing to a subgroup that might require special care to avoid related complications.

Objective: To compare the magnetic resonance imaging (MRI) features of the olfactory cleft (OC) and olfactory bulbs (OBs) in patients with long COVID-19-related (LCOD) and non-COVID-19 postviral olfactory dysfunction (NCPVOD) to explore mechanisms underlying persistent olfactory dysfunction.

Methods: This retrospective analysis included patients diagnosed with LCOD or NCPVOD at the China-Japan Friendship Hospital between February 2023 and July 2024. All patients underwent olfactory psychophysical testing (Sniffin' Sticks), a visual analogue scale (VAS) for olfactory function, and high-resolution MRI scans of the olfactory pathway. MRI features, including OC opacity, OB morphology, OB volume, and olfactory sulcus depth, were compared between groups. Correlations between MRI findings and olfactory test scores were assessed.

Results: Seventy patients were included (35 LCOD, 35 NCPVOD). LCOD patients had significantly higher OC opacity scores than NCPVOD patients (p < 0.001). No significant differences were found in OB morphology, abnormal OB signals, OB volume reduction, or distances between OBs and surrounding structures (p > 0.05). LCOD patients had significantly greater right olfactory sulcus depth than NCPVOD patients (p = 0.026), with negative correlation to age (r = -0.25, p = 0.04). OB volumes positively correlated with TDI and VAS scores.

Conclusion: LCOD patients exhibited greater OC opacity than NCPVOD patients, suggesting OC inflammation may contribute to persistent olfactory dysfunction. Treating inflammation in the OC could improve long-term olfactory outcomes. OB volume reduction was common in both groups.

Background: Alzheimer's disease (AD) is characterized by cognitive impairment and behavioral impairment. The gait of AD patients is attracting the increasing attention. The aim of this randomized controlled trial (RCT) is to explore the effect of acupuncture on the cognitive function, gait performance, and hemodynamic changes in the prefrontal cortices.

Methods: In this RCT, a total of 108 AD patients will be randomly assigned into acupuncture group or control group for 8 weeks. The primary outcome will be three-dimensional gait analysis and cerebral hemodynamics using functional near-infrared spectroscopy (fNIRS). Secondary outcomes will include Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Barthel Index (BI).

Discussion: This trial is expected to explore the effect of acupuncture on cognitive function, gait performance, and hemodynamic changes in the prefrontal cortices for AD patients.

Perinatal depression (PD) is a highly prevalent psychological disorder that has a detrimental effect on infant and maternal physical and mental health, but effective and objective assessment of PD is still insufficient. In recent years, the functional near-infrared spectroscopy (fNIRS) has been acknowledged as an effective non-invasive tool for clinical assessment of depression. This study proposed a free association semantic task (FAST) paradigm for fNIRS-based assessment of PD. To better address the emotion characteristics of PD, the participants are required to generate a dynamic concept chain based on positive, negative or neutral seed words, while 48-channel fNIRS recordings over frontal and bilateral temporal regions. Results from twenty-two late-pregnant women revealed that, the oxyhemoglobin (oxy-Hb) changes during the FAST with the positive and negative seed words over the frontal region were correlated with PD severity, which was different from the correlation patterns in the FAST with neutral seed word and the classical verbal fluency test (VFT). Furthermore, distinct correlation patterns were also observed in the FAST with the positive and negative seed words, manifested in fNIRS channels corresponding to the right dorsolateral prefrontal cortex (DLPFC) and right inferior frontal gyrus (IFG), respectively. Moreover, regression analyses showed that the FAST with positive and negative seed words can well explain the severity of PD. Our findings suggest the proposed FAST paradigm as a promising approach for PD assessment.

Background: Globally, in ~50% of epilepsy cases, the underlying cause remains unknown, despite the fact that various disease pathways may contribute to the condition. Nearly 80% of people with epilepsy live in low- and middle-income countries and the risk of premature death in people with epilepsy is up to three times higher than that for the general population. Identifying the determinants of epilepsy is important for applying evidence-based interventions to achieve a better outcome. However, this information is scarce in a country with limited resources like Ethiopia.

Objective: This study aimed to assess the determinant of epilepsy among outpatients in Dawo public health institutions, from 29 February to 15 April 2023.

Method: An institution-based unmatched case-control study design was used, involving 61 cases and 122 control study subjects, who were selected using a consecutive sampling technique from public health institutions in Dawo. Data were collected using a pre-tested structured questionnaire. The data were coded, entered into EpiDATA version 3.1, and exported to SPSS version 20, for further analysis. Descriptive analysis was used to determine the percentages and frequency distributions. Logistic regression analysis was used to identify the determinants of epilepsy, and a variable with p < 0.05 was considered statistically significant.

Results: A total of 61 cases and 120 controls were included in the study, with an overall response rate of 98.90%. The majority of participants, 38 (62.3) of the cases and 63 (52.5) of the controls, were farmers by occupation. A family history of epilepsy (AOR = 13.71 95% CI 3.030-22.006), history of febrile seizure (AOR = 14.57 95% CI 2.930-24.522), history of head injury (AOR = 6.853 95% CI 1.780-16.402), and non-use of latrine were found to be determinants of epilepsy (AOR = 0.028 95% CI 0.008-0.040).

Conclusion and recommendations: The current study identified a family history of epilepsy, a history of febrile seizures, head injury, and unavailability of latrines as independent predictors of epilepsy in the study area. The information that adverse febrile seizures increase the risk of epilepsy suggests that a significant proportion of epilepsy cases in Dawo district could be prevented through improved maternal, neonatal, and child care. It is recommended that the Dawo Health Office, along with relevant stakeholders, focus on addressing this issue at various levels.