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Goal-Directed Rehabilitation Versus Standard Care for Individuals with Hereditary Cerebellar Ataxia: A Multicenter, Single-Blind, Randomized Controlled Superiority Trial. 针对遗传性小脑共济失调患者的目标导向康复治疗与标准护理:多中心、单盲、随机对照优越性试验。
IF 8.1 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-11-09 DOI: 10.1002/ana.27130
Sarah C Milne, Melissa Roberts, Shannon Williams, Jillian Chua, Alison C Grootendorst, Genevieve Agostinelli, Anneke C Grobler, Hannah L Ross, Amy Robinson, Kristen Grove, Gabrielle Modderman, Annabel Price, Megan Thomson, Libby Massey, Christina Liang, Kishore R Kumar, Kim Dalziel, Joshua Burns, Carolyn M Sue, Pubudu N Pathirana, Malcolm Horne, Nikki Gelfard, Helen Curd, David Szmulewicz, Louise A Corben, Martin B Delatycki

Objective: Rehabilitation is thought to reduce ataxia severity in individuals with hereditary cerebellar ataxia (HCA). This multicenter, randomized controlled superiority trial aimed to examine the efficacy of a 30-week goal-directed rehabilitation program compared with 30 weeks of standard care on function, ataxia, health-related quality of life, and balance in individuals with an HCA.

Methods: Individuals with an autosomal dominant or recessive ataxia (aged ≥15 years) were enrolled at 5 sites in Australia. Participants were randomized (1:1) to receive rehabilitation (6 weeks of outpatient physiotherapy followed by a 24-week home exercise program) (n = 39) or continued their usual activity (n = 37). The primary outcome measure was the motor domain of the Functional Independence Measure (mFIM) at 7 weeks. Secondary outcomes included the Scale for the Assessment and Rating of Ataxia (SARA) and the SF-36v2, assessed at 7, 18, and 30 weeks. Outcome assessors were blinded to treatment allocation.

Results: Seventy-one participants (rehabilitation, 37; standard-care, 34) were included in the intention-to-treat analysis. At 7 weeks, mFIM (mean difference 2.26, 95% confidence interval [CI]: 0.26 to 4.26, p = 0.028) and SARA (-1.21, 95% CI: -2.32 to -0.11, p = 0.032) scores improved after rehabilitation compared with standard care. Compared with standard care, rehabilitation improved SARA scores at 30 weeks (mean difference -1.51, 95% CI: -2.76 to -0.27, p = 0.017), but not mFIM scores (1.74, 95% CI: -0.32 to 3.81, p = 0.098). Frequent adverse events in both groups were fatigue, pain, and falls.

Interpretation: Goal-directed rehabilitation improved function at 7 weeks, with improvement in ataxia and health-related quality of life maintained at 30 weeks in individuals with HCA, beyond that of standard care. ANN NEUROL 2024.

目的:康复治疗被认为可以减轻遗传性小脑共济失调(HCA)患者共济失调的严重程度。这项多中心随机对照优越性试验旨在研究为期 30 周的目标导向康复计划与为期 30 周的标准护理相比,对遗传性小脑共济失调患者的功能、共济失调、与健康相关的生活质量和平衡能力的疗效:澳大利亚的 5 个研究机构招募了常染色体显性或隐性共济失调患者(年龄≥15 岁)。参与者被随机分配(1:1)接受康复治疗(6 周门诊物理治疗,然后进行为期 24 周的家庭锻炼计划)(39 人)或继续其日常活动(37 人)。主要研究结果为7周时的功能独立性测量(mFIM)运动领域。次要结果包括共济失调评估和评级量表 (SARA) 和 SF-36v2 (分别在 7 周、18 周和 30 周进行评估)。结果评估者对治疗分配双盲:71名参与者(康复治疗37名;标准治疗34名)被纳入意向治疗分析。7周时,与标准护理相比,康复治疗后的mFIM(平均差异为2.26,95%置信区间[CI]:0.26至4.26,p = 0.028)和SARA(-1.21,95% CI:-2.32至-0.11,p = 0.032)评分有所改善。与标准护理相比,康复治疗提高了患者30周时的SARA评分(平均差-1.51,95% CI:-2.76至-0.27,p = 0.017),但未提高mFIM评分(1.74,95% CI:-0.32至3.81,p = 0.098)。两组患者经常出现的不良反应是疲劳、疼痛和跌倒:目标导向康复治疗在7周时改善了HCA患者的功能,30周时共济失调和健康相关生活质量的改善得以维持,超出了标准治疗的效果。ann neurol 2024.
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引用次数: 0
Annals of Neurology: Volume 96, Number S33, November 2024 神经病学年鉴》:第 96 卷,第 S33 号,2024 年 11 月
IF 8.1 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-11-08 DOI: 10.1002/ana.27085
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引用次数: 0
53rd Child Neurology Society Annual Meeting 第 53 届儿童神经病学学会年会。
IF 8.1 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-11-08 DOI: 10.1002/ana.27080
<p> </p><p>Abatkun, M.  199</p><p>Abdelmoity, A.  PL2-5</p><p>Abdelmoity, L.  316</p><p>Abdullahi, S.  92</p><p>Abe, K.  41</p><p>Abend, N.  PL2-3</p><p>Abera, S.  64</p><p>Abler, V.  87</p><p>Aboulsaoud, P.  79</p><p>Abreu, N.  280</p><p>Abushanab, E.  241</p><p>Acosta, M.  GAT1-2, 222</p><p>Adams, D.  222</p><p>Adams, H.  76</p><p>Adams, S.  241</p><p>Adanene, A.  199</p><p>Adeniyi-Jones, S.  85</p><p>Aduru, C.  285</p><p>Agarwal, R.  53</p><p>Agarwal, S.  156</p><p>Aggarwal, M.  170</p><p>Aghai, Z.  85</p><p>Agner, S.  187</p><p>Aguilar, S.  GAT2-1</p><p>Ahmadi, S.  23</p><p>Ahmed, A.  232</p><p>Ahmed, M.  7</p><p>Ahn, S.-H.  131</p><p>Ahsan, N.  248</p><p>Ailion, A.  98</p><p>Aimetti, A.  9, 205</p><p>Aitken, A.  235</p><p>Aiuti, A.  GAT1-1</p><p>Al Nimir, H.  89</p><p>Al Shouli, R.  329</p><p>Albazron, F.  51</p><p>Albor, L.  54, 107, 120</p><p>Alcaraz, W.  240</p><p>Aldana, P.  32</p><p>Aldinger, K.  30</p><p>Alecu, J.  PL1-3, 145</p><p>Alfano, L.  280</p><p>Algee, S.  107</p><p>Alhadid, K.  196</p><p>Ali, E.  125</p><p>Alleman, K.  8</p><p>Allen, S.  207</p><p>Allhusen, V.  185</p><p>Allison, T.  307</p><p>Almashnu, S.  GAT2-4</p><p>Alosi, S.  235</p><p>Alsayouf, H.  6</p><p>Al-Yahia, M.  128</p><p>Amin, H.  35</p><p>Amin, S.  9</p><p>Amoah, N.  20</p><p>Anand, P.  111</p><p>Ananth, A.  242</p><p>Andrade-Machado, R.  241</p><p>Andrews, A.  20, 153</p><p>Andrews, C.  214</p><p>Andringa-Seed, R.  221</p><p>Angelis, D.  121</p><p>Ankar, A.  57</p><p>Annesley, C.  117</p><p>Anwar, S.  164</p><p>Anwar, T.  17, 38, 69, 86, 254</p><p>Aquino, P.  PL3-1, 270</p><p>Aradhya, S.  GAT2-1, 209</p><p>Aras, S.  PL2-5, 279</p><p>Aravamuthan, B.  75</p><p>Arellano, J.  191, 286, 319</p><p>Arias, J.  169</p><p>Arkalgud, A.  269</p><p>Armstrong, D.  281</p><p>Aronin, N.  207</p><p>Arroyave-Wessel, M.  221</p><p>Arroyo, M.  127</p><p>Asarnow, R.  49</p><p>Aschbacher-Smith, L.  93</p><p>Asmar, Y.  26, 154</p><p>Astorga, G.  201</p><p>Atkinson, S.  81, 102</p><p>Au, J.  126</p><p>Augustine, E.  268</p><p>Austin, C.  295</p><p>Autio, K.  137</p><p>Auvin, S.  118, 219, 228</p><p>Avula, S.  292</p><p>Aykanat, A.  167</p><p>Bach, A.  PL2-7</p><p>Bacon, G.  243</p><p>Bacon, K.  168</p><p>Bacus, P.  15</p><p>Badh, R.  64</p><p>Bae, G.  8</p><p>Baiandurova, A.  298</p><p>Bailey, K.  208</p><p>Baim, A.  PL1-5</p><p>Bain, J.  183</p><p>Bajikar, S.  PL2-5</p><p>Baker, F.  PL1-7</p><p>Baker, M.  157</p><p>Bakulski, K.  16</p><p>Balamurugan, C.  42</p><p>Balasubramaniam, S.  85</p><p>Baldoli, C.  GAT1-1</p><p>Ballance, E.  3</p><p>Ballou, E.  253</p><p>Balls-Berry, J.  252</p><p>Banerjee, A.  PL2-4</p><p>Bansal, S.  84</p><p>Banwell, B.  PL2-7, PL3-4</p><p>Barber, J.  20, 66</p><p>Barisano, G.  PL1-7, 49</p><p>Barnfather, A.  GAT2-3</p><p>Baronio, D.  122</p><p>Barrett, E.  20</p><p>Barry, D.  231</p><p>Barry, M.  246, 266</p><p>Barsh, G.  312</p><p>Bartscherer, A.  48</p><p>Bass, N.  241</p><p>Bassan, H.  GAT2-4</p><p>Batschelett, M.  93</p><p>Batt
267, 271, 275Clerici, A. GAT1-1Coffey, C. 56Cohen, A. 180, 196, 260Cohen, B. 318, 320Cohen, J. 152Cole, J. 252Coleman, C. 10, 225, 256Collins, A. 3Collins-Ruff, K. 192Comaduran-Marquez, D. GAT2-3Conelea, C. PL1-5, 243, 259, 267Conley, A. 59, 60Conley, C. 25, 55, 164, 237Consing, K. 182Cook, L. 226  PL1-5, 243, 259, 261Conley, A. 59, 60Conley, C. 25, 55, 164, 237Consing, K. 182Cook, L. 226Coquery, C. 119, 161Corn, E. 221Cortina, C. 98Coryell, J. 298Cosand, L. 87Coster, D. GAT2-4Cottrell, K. GAT2-4  23Couce,M. 239Couteranis,S. 170Cox,M. 160Coyne,F. PL3-7,276Crawford,J. 181Cristancho,A. 156Crocetti,D. 101Croen,L. 16Crosiers,D. PL1-2Cross,J. PL1-1,219Cruz,C. 298Cruz Bravo,P.  23Cudkowicz,M. 56Cunniff,T. 81,102Cure,C. 221Curry,D. 67Curry,M. 223Curtin,M. 147Czarnecka,S. 167Czech,T. 160da Silva,P. PL1-2Daddo,N. 325Dahlgren,W. 315Dahmoush,H. 287,312Dahshi,H.  281Danese, S. 83, 91Dang, M. 194Dang Do, A. 268Daniel, S. 12Danieli, H. 97Danos, O. 29Darbro, B. 160Das, A. 57, 292, 301, 310Dasan, R. 20Dastgir, J. 29Datta, A. 167Davis, C. 264Davis, S. 42de Cast Cast.  42de Castro, M. 239de los Reyes, E. 280De Mattia, F. GAT1-1de Vera, A. 267, 271, 275de Vries, L. PL2-1, 112DeCarvalho, S. 125Deck, R. 211DeCuypere, M. 8Dedkov, I. 170, 178Deginet, E. 199DeKorver, N.  194del Toro, M. 239DeLa Rosa Abreu, L. 200, 206Delgado, K. 315Demmler-Harrison, G. 253Deng, S. 31Dennis, E. 49Dennis, L. 49DeRonda, A. 101Dervan, L. 231Desai, S. PL1-2Desurkar, A. PL1-1Devaraj, A. 328Devine, S. PL1-2Devaraj, A. PL1-1  328Devine, S. 278Devinsky, O. 219, 228Dhar, S. 86Dias, C. 132Diaz, A. 155Diaz, M. 255DiCarlo, S. 299Dickendesher, T. 68Diehl, E. 231DiFiglia, M. 207DiFrancesco, M. 93Dilley, R. 123DiMario Jr、F.135,216Diorio,C.117Do,L.185Dobyns,W.30,78Doherty,D.149Dolan,G.117Dolins,K.140Donkervoort,S.123,177Dougherty,L.239Douglas,G.GAT2-5Dove,K.GAT2-2,47,184Downey,R.121Drackley,A.  266Drakou,E. 70Drew,W. 180Drummond,E. 265D'Souza,D. 100D'Souza,P. GAT1-2,222Dubbs,H. 156Dujmovic Basuroski,I. 255Dumanski,S. 174,322Dunbar,M. PL3-3,174,322Dutt,M. 120Dwight,S.  211Ebrahimi-Fakhari,D. PL1-2,PL1-3,133,134,145,249Echeverria,D. 207Edmondson,E. 299,310Edwards,M. 157Ehrman,J. 101Eichler,F. PL3-5,138,200,206,265Eisengart,J. 78Elaasar,H. 175Elgallab,J.  197Elias, R. 171Eliot, L. 8El-kelany, A. 7Elliott, J. PL1-7, 49Elliott, L. 146Elsea, S. 283, 288Emrick, L. 283Encalarde, T. 54, 234, 278Eng, C. 214, 247Engelen, M. 230Epperly, R. 117Erdem, G.  121Erdogan,E. 117Erdogan,E. N. 30Erickson,T. 253Erikson,T. 109Erpelding,N. 23Errichiello,E. 30Espinoza,A. 4Esposito,E. 76Evans,B. 299Faanes,B. 10,225,256Faber,E. 279Facchini,M.  GAT1-1Facio,F. GAT2-1,209Faig,W. 3Fakih,H. 207Falabella,P. 29Falk,E. PL3-7,276Fallah,A. 129Fallin,M. 16Fan,Z. 36Farhat,N. 56Farmer,A. 103Farooq,O. PL3-3Fatemi,A. 139,230Fay,A. PL3-5,302Fay,A. PL3-5,302Fay,A.  PL3-5,302Feik,M. 126Fenstermacher,S. 231Ferdinandsen,K. 242Fergason,K. 285Fernandez,A. 181,319Fernandez,R. 313Ferrer,M. 311Feyma,T. 75Fidaan,E. 328Fiecas,M. 259Field,N. 84,86,104,254Fie
{"title":"53rd Child Neurology Society Annual Meeting","authors":"","doi":"10.1002/ana.27080","DOIUrl":"10.1002/ana.27080","url":null,"abstract":"&lt;p&gt;\u0000 \u0000 &lt;/p&gt;&lt;p&gt;Abatkun, M.  199&lt;/p&gt;&lt;p&gt;Abdelmoity, A.  PL2-5&lt;/p&gt;&lt;p&gt;Abdelmoity, L.  316&lt;/p&gt;&lt;p&gt;Abdullahi, S.  92&lt;/p&gt;&lt;p&gt;Abe, K.  41&lt;/p&gt;&lt;p&gt;Abend, N.  PL2-3&lt;/p&gt;&lt;p&gt;Abera, S.  64&lt;/p&gt;&lt;p&gt;Abler, V.  87&lt;/p&gt;&lt;p&gt;Aboulsaoud, P.  79&lt;/p&gt;&lt;p&gt;Abreu, N.  280&lt;/p&gt;&lt;p&gt;Abushanab, E.  241&lt;/p&gt;&lt;p&gt;Acosta, M.  GAT1-2, 222&lt;/p&gt;&lt;p&gt;Adams, D.  222&lt;/p&gt;&lt;p&gt;Adams, H.  76&lt;/p&gt;&lt;p&gt;Adams, S.  241&lt;/p&gt;&lt;p&gt;Adanene, A.  199&lt;/p&gt;&lt;p&gt;Adeniyi-Jones, S.  85&lt;/p&gt;&lt;p&gt;Aduru, C.  285&lt;/p&gt;&lt;p&gt;Agarwal, R.  53&lt;/p&gt;&lt;p&gt;Agarwal, S.  156&lt;/p&gt;&lt;p&gt;Aggarwal, M.  170&lt;/p&gt;&lt;p&gt;Aghai, Z.  85&lt;/p&gt;&lt;p&gt;Agner, S.  187&lt;/p&gt;&lt;p&gt;Aguilar, S.  GAT2-1&lt;/p&gt;&lt;p&gt;Ahmadi, S.  23&lt;/p&gt;&lt;p&gt;Ahmed, A.  232&lt;/p&gt;&lt;p&gt;Ahmed, M.  7&lt;/p&gt;&lt;p&gt;Ahn, S.-H.  131&lt;/p&gt;&lt;p&gt;Ahsan, N.  248&lt;/p&gt;&lt;p&gt;Ailion, A.  98&lt;/p&gt;&lt;p&gt;Aimetti, A.  9, 205&lt;/p&gt;&lt;p&gt;Aitken, A.  235&lt;/p&gt;&lt;p&gt;Aiuti, A.  GAT1-1&lt;/p&gt;&lt;p&gt;Al Nimir, H.  89&lt;/p&gt;&lt;p&gt;Al Shouli, R.  329&lt;/p&gt;&lt;p&gt;Albazron, F.  51&lt;/p&gt;&lt;p&gt;Albor, L.  54, 107, 120&lt;/p&gt;&lt;p&gt;Alcaraz, W.  240&lt;/p&gt;&lt;p&gt;Aldana, P.  32&lt;/p&gt;&lt;p&gt;Aldinger, K.  30&lt;/p&gt;&lt;p&gt;Alecu, J.  PL1-3, 145&lt;/p&gt;&lt;p&gt;Alfano, L.  280&lt;/p&gt;&lt;p&gt;Algee, S.  107&lt;/p&gt;&lt;p&gt;Alhadid, K.  196&lt;/p&gt;&lt;p&gt;Ali, E.  125&lt;/p&gt;&lt;p&gt;Alleman, K.  8&lt;/p&gt;&lt;p&gt;Allen, S.  207&lt;/p&gt;&lt;p&gt;Allhusen, V.  185&lt;/p&gt;&lt;p&gt;Allison, T.  307&lt;/p&gt;&lt;p&gt;Almashnu, S.  GAT2-4&lt;/p&gt;&lt;p&gt;Alosi, S.  235&lt;/p&gt;&lt;p&gt;Alsayouf, H.  6&lt;/p&gt;&lt;p&gt;Al-Yahia, M.  128&lt;/p&gt;&lt;p&gt;Amin, H.  35&lt;/p&gt;&lt;p&gt;Amin, S.  9&lt;/p&gt;&lt;p&gt;Amoah, N.  20&lt;/p&gt;&lt;p&gt;Anand, P.  111&lt;/p&gt;&lt;p&gt;Ananth, A.  242&lt;/p&gt;&lt;p&gt;Andrade-Machado, R.  241&lt;/p&gt;&lt;p&gt;Andrews, A.  20, 153&lt;/p&gt;&lt;p&gt;Andrews, C.  214&lt;/p&gt;&lt;p&gt;Andringa-Seed, R.  221&lt;/p&gt;&lt;p&gt;Angelis, D.  121&lt;/p&gt;&lt;p&gt;Ankar, A.  57&lt;/p&gt;&lt;p&gt;Annesley, C.  117&lt;/p&gt;&lt;p&gt;Anwar, S.  164&lt;/p&gt;&lt;p&gt;Anwar, T.  17, 38, 69, 86, 254&lt;/p&gt;&lt;p&gt;Aquino, P.  PL3-1, 270&lt;/p&gt;&lt;p&gt;Aradhya, S.  GAT2-1, 209&lt;/p&gt;&lt;p&gt;Aras, S.  PL2-5, 279&lt;/p&gt;&lt;p&gt;Aravamuthan, B.  75&lt;/p&gt;&lt;p&gt;Arellano, J.  191, 286, 319&lt;/p&gt;&lt;p&gt;Arias, J.  169&lt;/p&gt;&lt;p&gt;Arkalgud, A.  269&lt;/p&gt;&lt;p&gt;Armstrong, D.  281&lt;/p&gt;&lt;p&gt;Aronin, N.  207&lt;/p&gt;&lt;p&gt;Arroyave-Wessel, M.  221&lt;/p&gt;&lt;p&gt;Arroyo, M.  127&lt;/p&gt;&lt;p&gt;Asarnow, R.  49&lt;/p&gt;&lt;p&gt;Aschbacher-Smith, L.  93&lt;/p&gt;&lt;p&gt;Asmar, Y.  26, 154&lt;/p&gt;&lt;p&gt;Astorga, G.  201&lt;/p&gt;&lt;p&gt;Atkinson, S.  81, 102&lt;/p&gt;&lt;p&gt;Au, J.  126&lt;/p&gt;&lt;p&gt;Augustine, E.  268&lt;/p&gt;&lt;p&gt;Austin, C.  295&lt;/p&gt;&lt;p&gt;Autio, K.  137&lt;/p&gt;&lt;p&gt;Auvin, S.  118, 219, 228&lt;/p&gt;&lt;p&gt;Avula, S.  292&lt;/p&gt;&lt;p&gt;Aykanat, A.  167&lt;/p&gt;&lt;p&gt;Bach, A.  PL2-7&lt;/p&gt;&lt;p&gt;Bacon, G.  243&lt;/p&gt;&lt;p&gt;Bacon, K.  168&lt;/p&gt;&lt;p&gt;Bacus, P.  15&lt;/p&gt;&lt;p&gt;Badh, R.  64&lt;/p&gt;&lt;p&gt;Bae, G.  8&lt;/p&gt;&lt;p&gt;Baiandurova, A.  298&lt;/p&gt;&lt;p&gt;Bailey, K.  208&lt;/p&gt;&lt;p&gt;Baim, A.  PL1-5&lt;/p&gt;&lt;p&gt;Bain, J.  183&lt;/p&gt;&lt;p&gt;Bajikar, S.  PL2-5&lt;/p&gt;&lt;p&gt;Baker, F.  PL1-7&lt;/p&gt;&lt;p&gt;Baker, M.  157&lt;/p&gt;&lt;p&gt;Bakulski, K.  16&lt;/p&gt;&lt;p&gt;Balamurugan, C.  42&lt;/p&gt;&lt;p&gt;Balasubramaniam, S.  85&lt;/p&gt;&lt;p&gt;Baldoli, C.  GAT1-1&lt;/p&gt;&lt;p&gt;Ballance, E.  3&lt;/p&gt;&lt;p&gt;Ballou, E.  253&lt;/p&gt;&lt;p&gt;Balls-Berry, J.  252&lt;/p&gt;&lt;p&gt;Banerjee, A.  PL2-4&lt;/p&gt;&lt;p&gt;Bansal, S.  84&lt;/p&gt;&lt;p&gt;Banwell, B.  PL2-7, PL3-4&lt;/p&gt;&lt;p&gt;Barber, J.  20, 66&lt;/p&gt;&lt;p&gt;Barisano, G.  PL1-7, 49&lt;/p&gt;&lt;p&gt;Barnfather, A.  GAT2-3&lt;/p&gt;&lt;p&gt;Baronio, D.  122&lt;/p&gt;&lt;p&gt;Barrett, E.  20&lt;/p&gt;&lt;p&gt;Barry, D.  231&lt;/p&gt;&lt;p&gt;Barry, M.  246, 266&lt;/p&gt;&lt;p&gt;Barsh, G.  312&lt;/p&gt;&lt;p&gt;Bartscherer, A.  48&lt;/p&gt;&lt;p&gt;Bass, N.  241&lt;/p&gt;&lt;p&gt;Bassan, H.  GAT2-4&lt;/p&gt;&lt;p&gt;Batschelett, M.  93&lt;/p&gt;&lt;p&gt;Batt","PeriodicalId":127,"journal":{"name":"Annals of Neurology","volume":"96 S33","pages":"S1-S162"},"PeriodicalIF":8.1,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ana.27080","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Enhancement of Glutamate Uptake as Novel Antiseizure Approach: Preclinical Proof of Concept. 增强谷氨酸摄取作为新型抗癫痫方法:临床前概念验证。
IF 8.1 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-11-08 DOI: 10.1002/ana.27124
Krzysztof Kamiński, Katarzyna Socała, Michał Abram, Marcin Jakubiec, Katelyn L Reeb, Rhea Temmermand, Mirosław Zagaja, Maciej Maj, Magdalena Kolasa, Agata Faron-Górecka, Marta Andres-Mach, Aleksandra Szewczyk, Mustafa Q Hameed, Andréia C K Fontana, Alexander Rotenberg, Rafał M Kamiński

Objective: Excitotoxicity is a common hallmark of epilepsy and other neurological diseases associated with elevated extracellular glutamate levels. Thus, here, we studied the protective effects of (R)-AS-1, a positive allosteric modulator (PAM) of glutamate uptake in epilepsy models.

Methods: (R)-AS-1 was evaluated in a range of acute and chronic seizure models, while its adverse effect profile was assessed in a panel of standard tests in rodents. The effect of (R)-AS-1 on glutamate uptake was assessed in COS-7 cells expressing the transporter. WAY 213613, a selective competitive EAAT2 inhibitor, was used to probe the reversal of the enhanced glutamate uptake in the same transporter expression system. Confocal microscopy and Western blotting analyses were used to study a potential influence of (R)-AS-1 on GLT-1 expression in mice.

Results: (R)-AS-1 showed robust protection in a panel of animal models of seizures and epilepsy, including the maximal electroshock- and 6 Hz-induced seizures, corneal kindling, mesial temporal lobe epilepsy, lamotrigine-resistant amygdala kindling, as well as seizures induced by pilocarpine or Theiler's murine encephalomyelitis virus. Importantly, (R)-AS-1 displayed a favorable adverse effect profile in the rotarod, the minimal motor impairment, and the Irwin tests. (R)-AS-1 enhanced glutamate uptake in vitro and this effect was abolished by WAY 213613, while no influence on GLT-1 expression in vivo was observed after repeated treatment.

Interpretation: Collectively, our results show that (R)-AS-1 has favorable tolerability and provides robust preclinical efficacy against seizures. Thus, allosteric enhancement of EAAT2 function could offer a novel therapeutic strategy for treatment of epilepsy and potentially other neurological disorders associated with glutamate excitotoxicity. ANN NEUROL 2024.

目的:兴奋毒性是癫痫和其他与细胞外谷氨酸水平升高有关的神经系统疾病的常见特征。因此,我们在此研究了(R)-AS-1(一种谷氨酸摄取的正性异位调节剂 (PAM))在癫痫模型中的保护作用。方法:在一系列急性和慢性癫痫发作模型中评估了(R)-AS-1,同时在啮齿动物的一系列标准测试中评估了其不良反应特征。在表达谷氨酸转运体的 COS-7 细胞中评估了 (R)-AS-1 对谷氨酸摄取的影响。在同一转运体表达系统中,选择性竞争性 EAAT2 抑制剂 WAY 213613 被用来检测谷氨酸摄取增强的逆转情况。共聚焦显微镜和 Western 印迹分析用于研究 (R)-AS-1 对小鼠 GLT-1 表达的潜在影响。结果:(R)-AS-1 在一系列癫痫发作和癫痫动物模型中显示出强大的保护作用,包括最大电击和 6 赫兹诱导的癫痫发作、角膜点燃、中位颞叶癫痫、拉莫三嗪抗性杏仁核点燃,以及皮洛卡品或泰勒氏鼠脑脊髓炎病毒诱导的癫痫发作。重要的是,(R)-AS-1 在旋转木马、最小运动损伤和欧文试验中显示出良好的不良反应特征。(R)-AS-1能增强体外谷氨酸摄取,WAY 213613能消除这种效应,而反复处理后对体内GLT-1的表达没有影响:总之,我们的研究结果表明,(R)-AS-1 具有良好的耐受性,对癫痫发作具有强大的临床前疗效。因此,异位增强 EAAT2 功能可为治疗癫痫和可能与谷氨酸兴奋毒性相关的其他神经系统疾病提供一种新的治疗策略。ann neurol 2024.
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引用次数: 0
Issue Information – TOC 发行信息 - TOC
IF 8.1 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-11-08 DOI: 10.1002/ana.27086
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引用次数: 0
Association of Reperfusion and Procedural Characteristics with Endovascular Thrombectomy Outcomes in Large Core Stroke: Sub-Analysis from the SELECT2 Trial. 再灌注和手术特征与大面积核心卒中血管内血栓切除术结果的关系:SELECT2 试验的子分析。
IF 8.1 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-11-07 DOI: 10.1002/ana.27104
Ameer E Hassan, Michael G Abraham, Spiros Blackburn, Muhammad S Hussain, Santiago Ortega-Gutierrez, Michael Chen, Yin C Hu, Deep K Pujara, Nabeel A Herial, Jenny P Tsai, Ronald F Budzik, Nathan W Manning, Osman Kozak, Ricardo A Hanel, Amin N Aghaebrahim, Chirag D Gandhi, Fawaz Al-Mufti, Andrew Cheung, Bernard Yan, Peter Mitchell, Jordi Blasco, Luis San Román Manzanera, Nirav Vora, Daniel Gibson, Adam Wallace, Daniel Sahlein, Lucas Elijovich, Juan F Arenillas, Teddy Y Wu, Pere Cardona Portela, Natalia Pérez de la Ossa, Joanna D Schaafsma, William J Hicks, Dennis J Cordato, Navdeep Sangha, Steven Warach, Timothy J Kleinig, Faris Shaker, Hannah Johns, Wondwossen Tekle, Mark J Dannenbaum, Koji Ebersole, Gabor Toth, Michael Gooch, Abdulnasser Alhajeri, Krishna Amuluru, Abhishek Ray, Jan-Karl Burkhardt, Mohammad A Abdulrazzak, David P Rosenbaum-Halevi, Haris Kamal, Kelsey R Duncan, Clark W Sitton, Leonid Churilov, Vitor Mendes Pereira, Jeffrey Sunshine, Thanh N Nguyen, Johanna T Fifi, Edgar A Samaniego, Adam Arthur, Stavropoula Tjoumakaris, Pascal Jabbour, Stephen M Davis, Lawrence Wechsler, Nicholas Bambakidis, Scott E Kasner, James C Grotta, Michael D Hill, Bruce C Campbell, Marc Ribo, Amrou Sarraj

Endovascular thrombectomy (EVT) was shown to be safe and efficacious in patients with large core stroke in multiple randomized controlled trials. However, the impact of reperfusion and other procedural metrics on EVT outcomes in this population has not been well-characterized.

Methods: From the SELECT2 trial, we evaluated the association between reperfusion status, first-pass effect (near-complete or complete reperfusion [extended thrombolysis in cerebral infarction (eTICI) 2c-3] in 1 pass), procedure time and primary technique (aspiration vs stent-retriever) with functional outcomes in patients receiving EVT across ASPECTS (3 vs 4 vs 5) and core estimate strata (<70 vs ≥70ml, <100 vs ≥100ml, and <150 vs ≥150ml).

Results: Of 180 patients who received thrombectomy, 144 (80%) achieved successful reperfusion (eTICI 2b-3) and demonstrated better clinical outcomes (adjusted generalized odds ratios [aGenOR]: 1.48, 95% confidence interval [CI]: 1.01-2.15), compared with unsuccessful reperfusion. Results were consistent across ASPECTS and core estimate strata. Additionally, complete or near-complete reperfusion (eTICI 2c-3) was associated with better functional outcome (aGenOR: 1.99, 95% CI: 1.33-2.97) in patients achieving successful reperfusion. Functional outcome point estimates favored those with first-pass-effect (42 of 167 (25%), aGenOR: 1.46, 95% CI: 0.96-2.24). Longer procedure time was associated with worse modified Rankin scale (mRS) distribution (aGenOR: 0.92, 95% CI: 0.87-0.96, p-value = 0.001 for 10 minutes increment). Aspiration-first technique was used in 43 of 154 (25%) patients and was not associated with higher reperfusion (88% vs 78%, p = 0.18) or better functional outcome (aGenOR: 0.74, 95% CI: 0.50-1.10) as compared with stent-retriever first.

Interpretation: Successful reperfusion resulted in improved clinical outcomes in large core patients across baseline ischemic core strata. Near complete or complete reperfusion was further associated with better outcomes, whereas prolonged procedures were associated with worse outcomes. Results were consistent regardless of the technique used. ANN NEUROL 2024.

多项随机对照试验显示,血管内血栓切除术(EVT)对大面积核心卒中患者安全有效。然而,再灌注和其他程序指标对这一人群 EVT 结果的影响尚未得到很好的描述:方法:我们从 SELECT2 试验中评估了再灌注状态、首次治疗效果(1 次治疗中接近完全或完全再灌注[脑梗塞扩大溶栓(eTICI)2c-3])、手术时间和主要技术(抽吸法 vs 支架截流法)与不同 ASPECTS(3 vs 4 vs 5)和核心估计分层接受 EVT 患者的功能预后之间的关系(结果:在接受血栓切除术的 180 名患者中,144 人(80%)成功实现了再灌注(eTICI 2b-3),并获得了更好的临床疗效(调整后的广义几率比 [aGenOR]:1.48,95% 置信区间 [CI]:1.01-2.15)。不同 ASPECTS 和核心估计分层的结果一致。此外,在成功再灌注的患者中,完全或接近完全再灌注(eTICI 2c-3)与更好的功能预后相关(aGenOR:1.99,95% CI:1.33-2.97)。功能预后点估计值更偏向于首次通过效果的患者(167 例中有 42 例(25%),aGenOR:1.46,95% CI:0.96-2.24)。手术时间越长,改良兰金量表(mRS)分布越差(aGenOR:0.92,95% CI:0.87-0.96,10 分钟增量的 p 值 = 0.001)。154例患者中有43例(25%)采用了抽吸先行技术,与支架截流先行技术相比,抽吸先行技术与更高的再灌注率(88% vs 78%,P = 0.18)或更好的功能预后(aGenOR:0.74,95% CI:0.50-1.10)无关:成功的再灌注改善了基线缺血核心分层大核心患者的临床预后。接近完全或完全再灌注与更好的预后进一步相关,而延长手术时间与更差的预后相关。无论使用哪种技术,结果都是一致的。ann neurol 2024。
{"title":"Association of Reperfusion and Procedural Characteristics with Endovascular Thrombectomy Outcomes in Large Core Stroke: Sub-Analysis from the SELECT2 Trial.","authors":"Ameer E Hassan, Michael G Abraham, Spiros Blackburn, Muhammad S Hussain, Santiago Ortega-Gutierrez, Michael Chen, Yin C Hu, Deep K Pujara, Nabeel A Herial, Jenny P Tsai, Ronald F Budzik, Nathan W Manning, Osman Kozak, Ricardo A Hanel, Amin N Aghaebrahim, Chirag D Gandhi, Fawaz Al-Mufti, Andrew Cheung, Bernard Yan, Peter Mitchell, Jordi Blasco, Luis San Román Manzanera, Nirav Vora, Daniel Gibson, Adam Wallace, Daniel Sahlein, Lucas Elijovich, Juan F Arenillas, Teddy Y Wu, Pere Cardona Portela, Natalia Pérez de la Ossa, Joanna D Schaafsma, William J Hicks, Dennis J Cordato, Navdeep Sangha, Steven Warach, Timothy J Kleinig, Faris Shaker, Hannah Johns, Wondwossen Tekle, Mark J Dannenbaum, Koji Ebersole, Gabor Toth, Michael Gooch, Abdulnasser Alhajeri, Krishna Amuluru, Abhishek Ray, Jan-Karl Burkhardt, Mohammad A Abdulrazzak, David P Rosenbaum-Halevi, Haris Kamal, Kelsey R Duncan, Clark W Sitton, Leonid Churilov, Vitor Mendes Pereira, Jeffrey Sunshine, Thanh N Nguyen, Johanna T Fifi, Edgar A Samaniego, Adam Arthur, Stavropoula Tjoumakaris, Pascal Jabbour, Stephen M Davis, Lawrence Wechsler, Nicholas Bambakidis, Scott E Kasner, James C Grotta, Michael D Hill, Bruce C Campbell, Marc Ribo, Amrou Sarraj","doi":"10.1002/ana.27104","DOIUrl":"https://doi.org/10.1002/ana.27104","url":null,"abstract":"<p><p>Endovascular thrombectomy (EVT) was shown to be safe and efficacious in patients with large core stroke in multiple randomized controlled trials. However, the impact of reperfusion and other procedural metrics on EVT outcomes in this population has not been well-characterized.</p><p><strong>Methods: </strong>From the SELECT2 trial, we evaluated the association between reperfusion status, first-pass effect (near-complete or complete reperfusion [extended thrombolysis in cerebral infarction (eTICI) 2c-3] in 1 pass), procedure time and primary technique (aspiration vs stent-retriever) with functional outcomes in patients receiving EVT across ASPECTS (3 vs 4 vs 5) and core estimate strata (<70 vs ≥70ml, <100 vs ≥100ml, and <150 vs ≥150ml).</p><p><strong>Results: </strong>Of 180 patients who received thrombectomy, 144 (80%) achieved successful reperfusion (eTICI 2b-3) and demonstrated better clinical outcomes (adjusted generalized odds ratios [aGenOR]: 1.48, 95% confidence interval [CI]: 1.01-2.15), compared with unsuccessful reperfusion. Results were consistent across ASPECTS and core estimate strata. Additionally, complete or near-complete reperfusion (eTICI 2c-3) was associated with better functional outcome (aGenOR: 1.99, 95% CI: 1.33-2.97) in patients achieving successful reperfusion. Functional outcome point estimates favored those with first-pass-effect (42 of 167 (25%), aGenOR: 1.46, 95% CI: 0.96-2.24). Longer procedure time was associated with worse modified Rankin scale (mRS) distribution (aGenOR: 0.92, 95% CI: 0.87-0.96, p-value = 0.001 for 10 minutes increment). Aspiration-first technique was used in 43 of 154 (25%) patients and was not associated with higher reperfusion (88% vs 78%, p = 0.18) or better functional outcome (aGenOR: 0.74, 95% CI: 0.50-1.10) as compared with stent-retriever first.</p><p><strong>Interpretation: </strong>Successful reperfusion resulted in improved clinical outcomes in large core patients across baseline ischemic core strata. Near complete or complete reperfusion was further associated with better outcomes, whereas prolonged procedures were associated with worse outcomes. Results were consistent regardless of the technique used. ANN NEUROL 2024.</p>","PeriodicalId":127,"journal":{"name":"Annals of Neurology","volume":" ","pages":""},"PeriodicalIF":8.1,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Wine Glass Sign in Bulbar Onset Amyotrophic Lateral Sclerosis. 横纹肌萎缩性侧索硬化症的酒杯征
IF 8.1 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-11-07 DOI: 10.1002/ana.27131
Prashant Bhatele, Aparna Ramakrishna Pai
{"title":"Wine Glass Sign in Bulbar Onset Amyotrophic Lateral Sclerosis.","authors":"Prashant Bhatele, Aparna Ramakrishna Pai","doi":"10.1002/ana.27131","DOIUrl":"https://doi.org/10.1002/ana.27131","url":null,"abstract":"","PeriodicalId":127,"journal":{"name":"Annals of Neurology","volume":" ","pages":""},"PeriodicalIF":8.1,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
The Scientific and Therapeutic Rationale for Off-Label Treatments in Amyotrophic Lateral Sclerosis. 标示外治疗肌萎缩侧索硬化症的科学和治疗原理。
IF 8.1 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-11-06 DOI: 10.1002/ana.27126
Richard Bedlack, Xiaoyan Li, Baggio Angelo Evangelista, Maria E Panzetta, Justin Kwan, Lauren M Gittings, Rita Sattler

There are no dramatically effective pharmacological treatments for most patients with amyotrophic lateral sclerosis, a complex disease with multiple underlying mechanisms, such as neuroinflammation, oxidative stress, mitochondrial dysfunction, microbiome alteration, and antiretroviral activity. We sifted through 15 years of reviews by a group called ALSUntangled to identify 8 alternative and off-label treatments that target ≥1 of these mechanisms, and have ≥1 human trial suggesting meaningful benefits. Given the overlapping pathological mechanisms of the highlighted products, we suggest that combinations of these treatments targeting diverse mechanisms might be worthwhile for future amyotrophic lateral sclerosis therapy development. ANN NEUROL 2024.

肌萎缩性脊髓侧索硬化症是一种具有多种潜在机制的复杂疾病,如神经炎症、氧化应激、线粒体功能障碍、微生物组改变和抗逆转录病毒活性。我们筛选了一个名为 ALSUntangled 的小组 15 年来的综述,找出了 8 种针对其中≥1 种机制、且有≥1 项人体实验表明有显著疗效的替代疗法和标签外疗法。鉴于这些重点产品的病理机制相互重叠,我们认为这些针对不同机制的治疗方法的组合在未来肌萎缩性脊髓侧索硬化症的治疗开发中可能会很有价值。ann neurol 2024.
{"title":"The Scientific and Therapeutic Rationale for Off-Label Treatments in Amyotrophic Lateral Sclerosis.","authors":"Richard Bedlack, Xiaoyan Li, Baggio Angelo Evangelista, Maria E Panzetta, Justin Kwan, Lauren M Gittings, Rita Sattler","doi":"10.1002/ana.27126","DOIUrl":"10.1002/ana.27126","url":null,"abstract":"<p><p>There are no dramatically effective pharmacological treatments for most patients with amyotrophic lateral sclerosis, a complex disease with multiple underlying mechanisms, such as neuroinflammation, oxidative stress, mitochondrial dysfunction, microbiome alteration, and antiretroviral activity. We sifted through 15 years of reviews by a group called ALSUntangled to identify 8 alternative and off-label treatments that target ≥1 of these mechanisms, and have ≥1 human trial suggesting meaningful benefits. Given the overlapping pathological mechanisms of the highlighted products, we suggest that combinations of these treatments targeting diverse mechanisms might be worthwhile for future amyotrophic lateral sclerosis therapy development. ANN NEUROL 2024.</p>","PeriodicalId":127,"journal":{"name":"Annals of Neurology","volume":" ","pages":""},"PeriodicalIF":8.1,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Sex Modifies the Severity and Outcome of Spontaneous Intracerebral Hemorrhage. 性别改变自发性脑内出血的严重程度和预后
IF 8.1 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-11-05 DOI: 10.1002/ana.27123
Cyprien A Rivier, Daniela Renedo, Sandro Marini, Jessica R Magid-Bernstein, Adam de Havenon, Jonathan Rosand, Daniel F Hanley, Wendy C Ziai, Stephan A Mayer, Daniel Woo, Lauren H Sansing, Kevin N Sheth, Christopher D Anderson, Guido J Falcone

Objective: The limited existing evidence on sex differences in the clinical characteristics of patients with spontaneous, non-traumatic intracerebral hemorrhage (ICH) comes from small, single-center studies. Here, we performed an individual patient data meta-analysis of 3 randomized clinical trials and 1 multi-ethnic observational study of ICH to investigate the impact of sex on ICH severity and outcome.

Methods: Inclusion criteria in our study were a neuroimaging-confirmed ICH. We evaluated whether sex was associated with ICH severity (hematoma volume and expansion) and poor functional outcomes (modified Rankin Scale >3) 3 or 6 months after the ICH.

Results: A total of 4,812 ICH patients were evaluated (mean age 62, 40% female). Males with ICH were younger, more likely to be smokers and have diabetes, and less likely to be on anticoagulants (all p < 0.05). In multivariable analyses, male sex was associated with non-lobar location (odds ratio [OR]: 1.63; 95% confidence interval [CI]: [1.39-1.92]; p < 0.001), larger hemorrhages (beta: 0.16 [0.08-0.23]; p < 0.001) and a higher risk of hematoma expansion (OR: 1.43 [1.20-1.71]; p < 0.001). Despite the larger hemorrhage volume and higher risk of expansion, male sex was associated with a 24% lower risk of poor outcomes (OR: 0.76 [0.64-0.90]; p = 0.002).

Interpretation: Compared to females, males with ICH have larger bleeds and higher risk of hematoma expansion. Despite the larger bleeds and higher risk of hematoma expansion, males with ICH have lower risk of poor outcomes. Our results suggest that the biology and clinical trajectory are different in females and males with ICH, supporting sex-specific research in this condition. ANN NEUROL 2024.

目的:关于自发性非外伤性脑内出血(ICH)患者临床特征的性别差异,现有的有限证据均来自小型单中心研究。在此,我们对 3 项随机临床试验和 1 项多种族 ICH 观察性研究的单个患者数据进行了荟萃分析,以研究性别对 ICH 严重程度和预后的影响:我们研究的纳入标准是神经影像学确诊的 ICH。我们评估了性别是否与 ICH 严重程度(血肿体积和扩大)和 ICH 3 个月或 6 个月后的不良功能预后(修正的 Rankin 量表>3)相关:共评估了 4812 名 ICH 患者(平均年龄 62 岁,女性占 40%)。男性 ICH 患者更年轻,更有可能是吸烟者和糖尿病患者,服用抗凝药物的可能性较低(均为 p):与女性相比,男性 ICH 患者的出血量更大,血肿扩大的风险更高。尽管男性 ICH 患者出血量较大,血肿扩大的风险较高,但其不良预后的风险较低。我们的研究结果表明,女性和男性 ICH 患者的生物学特性和临床轨迹是不同的,这支持了针对这种疾病的性别特异性研究。ann neurol 2024.
{"title":"Sex Modifies the Severity and Outcome of Spontaneous Intracerebral Hemorrhage.","authors":"Cyprien A Rivier, Daniela Renedo, Sandro Marini, Jessica R Magid-Bernstein, Adam de Havenon, Jonathan Rosand, Daniel F Hanley, Wendy C Ziai, Stephan A Mayer, Daniel Woo, Lauren H Sansing, Kevin N Sheth, Christopher D Anderson, Guido J Falcone","doi":"10.1002/ana.27123","DOIUrl":"https://doi.org/10.1002/ana.27123","url":null,"abstract":"<p><strong>Objective: </strong>The limited existing evidence on sex differences in the clinical characteristics of patients with spontaneous, non-traumatic intracerebral hemorrhage (ICH) comes from small, single-center studies. Here, we performed an individual patient data meta-analysis of 3 randomized clinical trials and 1 multi-ethnic observational study of ICH to investigate the impact of sex on ICH severity and outcome.</p><p><strong>Methods: </strong>Inclusion criteria in our study were a neuroimaging-confirmed ICH. We evaluated whether sex was associated with ICH severity (hematoma volume and expansion) and poor functional outcomes (modified Rankin Scale >3) 3 or 6 months after the ICH.</p><p><strong>Results: </strong>A total of 4,812 ICH patients were evaluated (mean age 62, 40% female). Males with ICH were younger, more likely to be smokers and have diabetes, and less likely to be on anticoagulants (all p < 0.05). In multivariable analyses, male sex was associated with non-lobar location (odds ratio [OR]: 1.63; 95% confidence interval [CI]: [1.39-1.92]; p < 0.001), larger hemorrhages (beta: 0.16 [0.08-0.23]; p < 0.001) and a higher risk of hematoma expansion (OR: 1.43 [1.20-1.71]; p < 0.001). Despite the larger hemorrhage volume and higher risk of expansion, male sex was associated with a 24% lower risk of poor outcomes (OR: 0.76 [0.64-0.90]; p = 0.002).</p><p><strong>Interpretation: </strong>Compared to females, males with ICH have larger bleeds and higher risk of hematoma expansion. Despite the larger bleeds and higher risk of hematoma expansion, males with ICH have lower risk of poor outcomes. Our results suggest that the biology and clinical trajectory are different in females and males with ICH, supporting sex-specific research in this condition. ANN NEUROL 2024.</p>","PeriodicalId":127,"journal":{"name":"Annals of Neurology","volume":" ","pages":""},"PeriodicalIF":8.1,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Carotid Stent Fracture. 颈动脉支架骨折
IF 8.1 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-11-02 DOI: 10.1002/ana.27127
Ioana Maria Ion, Dimitri Renard
{"title":"Carotid Stent Fracture.","authors":"Ioana Maria Ion, Dimitri Renard","doi":"10.1002/ana.27127","DOIUrl":"https://doi.org/10.1002/ana.27127","url":null,"abstract":"","PeriodicalId":127,"journal":{"name":"Annals of Neurology","volume":" ","pages":""},"PeriodicalIF":8.1,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
期刊
Annals of Neurology
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