International Journal of Neuroscience最新文献

Background: Differentiating between Alzheimer's disease (AD) and frontotemporal dementia (FTD) based on clinical symptoms alone can be challenging. This study investigates the utility of resting-state EEG spectral power as a tool to distinguish between these two neurodegenerative conditions.

Methods: We analyzed a publicly available dataset containing EEG recordings from 36 AD patients, 23 FTD patients, and 29 age-matched healthy controls (HC). Spectral power across delta, theta, alpha, and beta frequency bands was computed for both eyes-closed and eyes-open conditions. Rigorous statistical analysis with FDR correction was employed to identify group differences. To further investigate the relationship between EEG spectral alterations and clinical cognitive status, a correlation analysis was conducted.

Results: Both patient groups showed significant deviations from HC, but with distinct patterns. AD was characterized by a classic pattern of posterior alpha power decrease and frontal theta power increase. In contrast, FTD showed a more focused reduction of alpha power at frontal and central sites. These patterns were robust across both eyes-closed and eyes-open states, suggesting their potential as stable biomarkers. The spectral features showed limited correlation with MMSE scores, indicating they may capture unique aspects of neuropathology not reflected in standard cognitive screening.

Conclusion: Resting-state EEG reveals distinct spectral signatures for AD and FTD, supporting its potential as a low-cost, non-invasive adjunctive tool for differential diagnosis. The replication of these findings in an independent, open-access dataset underscores their reliability and provides a foundation for developing automated diagnostic algorithms.

Background: We aimed to evaluate the association between elevated cardiac troponin I (cTnI) and clinical outcomes in AIS patients receiving reperfusion therapy.

Methods: We conducted a multicenter retrospective cohort study of AIS patients treated with thrombolytics at Southern Illinois Healthcare and the University of Oklahoma (2017-2024). Demographic, clinical, laboratory, and radiographic data were collected. Elevation of cTnI was defined as levels above 0.028 ng/mL. For high sensitivity troponins, the cutoff was 15 ng/L for women and 20 ng/L for men. Outcomes included symptomatic intracranial hemorrhage (sICH), in-hospital mortality, and functional status at 30 days (good outcome defined as mRS ≤2). Overlap-weighted multivariable logistic regression was performed, adjusting for demographics, comorbidities, and stroke severity.

Results: Among 496 patients, 143 (29%) had elevated cTnI. Compared with patients with normal cTnI, those with elevated levels were older, had more vascular risk factors, and higher baseline NIHSS. Elevated cTnI was not significantly associated with sICH (OR:3.75, 95%CI 0.52-27.21, p = 0.19), but was independently associated with increased in-hospital mortality (OR:1.96, 95%CI 1.62-6.20, p = 0.025) and decreased odds of good functional outcome at 30 days (OR:0.40, 95%CI 0.19-0.84, p = 0.016). Subgroup analyses showed these associations were most pronounced in older patients and in those with moderate (NIHSS 6-15) to severe (NIHSS 16-20 and > 20) strokes, whereas no significant relationships were observed in younger patients or mild strokes. Normalization of cTnI during hospitalization did not improve survival (p > 0.05).

Conclusions: In our study, elevated cTnI on admission is an independent predictor of poor short-term outcomes in AIS patients treated with reperfusion therapy. Troponin measurement may provide important prognostic information, particularly in older patients and those with more severe strokes.

Background: Diabetes insipidus (DI) is a common complication following pituitary adenoma surgery, which can adversely affect patients' quality of life. This study aimed to clarify the types and frequency of DI in patients undergoing surgery for pituitary adenomas.

Methods: This retrospective cross-sectional analytical study examined a cohort of patients (n = 532) with pituitary adenomas who underwent endoscopic transsphenoidal surgery (ETSS) at Loghman Hakim Hospital between 2017 and 2023. Comprehensive data collection included demographics, hormonal profiles, magnetic resonance imaging (MRI) findings and pathology results, enabling an in-depth analysis of DI incidence and associated risk factors post-surgery. Chi-square tests and logistic regression were employed to identify factors associated with DI.

Results: Transient DI was most prevalent in patients with Cushing's disease (77.8%), while permanent DI was more commonly observed in non-functional adenomas (7%). However, no significant differences in DI prevalence were identified between adenoma types (p = .57 for transient DI, p = .89 for permanent DI). Tumor size and higher preoperative sodium levels were associated with transient and permanent DI in non-functional adenomas (p = .02, p = .026) and acromegaly (p = .012). Suprasellar extension correlated with transient DI in acromegaly (p = .01), while postoperative meningitis was significantly associated with transient DI in non-functional adenomas (p = .001).

Conclusion: In the present study, tumor size, suprasellar extension and postoperative meningitis were linked to transient DI. In contrast, younger age, higher tumor volume and elevated mean 24-h postoperative sodium levels were associated with an increased risk of permanent DI.

Objective: To investigate the predictive value of the Systemic Immune-Inflammation Index (SII) and the neutrophil to high-density lipoprotein cholesterol ratio (NHR) for adverse cardiovascular and cerebrovascular events in patients with acute stroke.

Methods: A retrospective analysis was conducted on 260 acute stroke patients. Based on the occurrence of adverse events, patients were divided into a no-event group (Group A, n = 195) and an event group (Group B, n = 65). Risk factors were identified using logistic regression, and the predictive performance of SII and NHR was assessed by receiver operating characteristic (ROC) curve analysis.

Results: Compared with Group B, Group A had a higher proportion of male patients, older age, smoking history, and elevated levels of white blood cell count, neutrophil percentage, lymphocyte percentage, platelet count, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and SII (p < 0.05). Univariate and multivariate logistic regression analyses demonstrated that, after adjusting for confounding factors such as sex and age, SII and NHR were independent risk factors for postoperative adverse cardiovascular events in acute stroke patients. ROC curve analysis revealed that the area under the curve (AUC) values for SII, NHR, and their combined detection in predicting adverse cardiovascular events were 0.729, 0.626, and 0.916, respectively, with significant differences (p < 0.05).

Conclusion: SII and NHR are independent predictors of recurrent cardiovascular and cerebrovascular events in acute stroke patients. Combined detection of SII and NHR offers superior predictive performance.

Background: Glioma is a common type of cancer of the central nervous system. Sirtuin 6 (SIRT6) has been reported to be a tumor suppressor in gliomas. The relationship between SIRT6 and glioma susceptibility is unknown. We aimed to investigate the association between single nucleotide polymorphisms (SNPs) of SIRT6 and the risk of glioma.

Methods: 205 glioma patients and 225 healthy controls were included in this study. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was performed. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was used to detect the transcription level of SIRT6 in the plasma of patients and healthy individuals.

Results: The distribution of the A allele of rs350843 and the C allele of rs352493 in SIRT6 was significantly lower in glioma patients (All P < 0.001). The distribution of the T allele of rs11878868 was significantly higher in glioma patients (P < 0.001). The distribution of the genotypes of the rs352493 and rs11878868 polymorphisms were independent risk predictor factors (All P < 0.01). Furthermore, we found that the expression of SIRT6 in glioma patients was lower compared with control group (P < 0.001). The expression level of SIRT6 was lower in glioma patients with the TT genotype at rs11878868 (All P < 0.01). There was no significant difference in the rs352493 and rs11878868 genotypes among the different subtypes (All P > 0.05).

Conclusions: These results indicate that SIRT6 polymorphism is associated with the risk of glioma and has the potential to be used as a marker for predicting glioma.

Objective: To assess the diagnostic value of cervical vascular ultrasound in identifying large arterial lesions in patients with transient ischemic attack (TIA).

Methods: The current study matched 84 TIA patients (disease group) with 66 healthy controls (control group). The baseline patient profiles and biochemical indices of the patients were analyzed. All patients received color Doppler ultrasonography, and outcome measures of its diagnostic efficiency included plaque status, plaque properties, and the degree of carotid stenosis. The patients in the disease group were assigned to group A (TIA of the internal carotid artery system, n = 40) and group B (TIA of the vertebrobasilar artery system, n = 44), and the plaque distribution of the patients was analyzed.

Results: TIA patients had higher rates of diabetes, hypertension, hyperlipidemia, obesity, and smoking compared to controls (p < 0.05). Their serum TC, LDL-C, and FBG levels were significantly elevated, while HDL-C levels were decreased (p < 0.05). TIA patients had more plaques, especially soft plaques, than controls (p < 0.05). They also showed higher rates of moderate to severe carotid stenosis (p < 0.05). TIA involving the internal carotid artery system was associated with a higher risk of plaques at the entrance of the subclavian artery compared to TIA involving the vertebrobasilar artery system (p < 0.05).

Conclusion: The diagnostic value of cervical vascular ultrasound in patients with TIA is remarkable, and it provides a reliable monitoring approach as well as an essential screening modality for TIA. The rational use of this technique will markedly benefit the diagnosis, treatment, and prevention of TIA.

Objective: To explore the effect of nursing intervention and quality feedback guided by stress system theory on neurological function recovery and post-traumatic growth in patients with cerebral hemorrhage.

Methods: 120 patients with cerebral hemorrhage admitted to our hospital from October 2022 to November 2023 were selected, 47 patients in the control group received routine medical care, and 73 patients in the observation group were added nursing intervention measures under the guidance of stress system theory on this basis. The effects of the intervention were evaluated by Posttraumatic Growth Inventory (PTGI), self-rating Anxiety Scale (SAS), self-rating Depression Scale (SDS), Barthel index (BI) and Chinese scale of clinical neurological impairment in stroke patients (CSS).

Results: After intervention, the PTGI score in the observation group was significantly higher than that in the control group (p < 0.05). The SAS and SDS scores were significantly lower than those of the control group (p < 0.001), indicating that the nursing intervention effectively alleviated the anxiety and depression of patients. At the same time, the BI index of the observation group was significantly increased, and the CSS score was significantly decreased (p < 0.001), indicating that the patients' self-care ability of daily life and the recovery level of neurological function were significantly improved.

Conclusion: Nursing intervention and quality feedback strategy under the guidance of stress system theory can effectively improve the neurological recovery ability and post-traumatic growth level of patients with cerebral hemorrhage, and has a significant effect on improving the psychological state and quality of life of patients.

Purpose: Tension pneumocephalus (TP) represents a rare pathology characterized by constant accumulation of air in the intracranial space, being associated with increased risk of herniation, neurologic deterioration and death. Regarding neurosurgical trauma cases, TP is majorly encountered after chronic subdural hematoma evacuation. In this case report, we present a rare case of fatal postoperative TP encountered after craniotomy for evacuation of acute subdural hematoma (aSDH).

Case presentation: An 83-year old gentleman was presented to the emergency department of our hospital with impaired level of consciousness. Initial examination revealed Glascow Coma Scale (GCS) 3/15, with pupils of 3 mm bilaterally and impaired pupillary light reflex. CT scan demonstrated a large left aSDH, with significant pressure phenomena and midline shift. Patient was subjected to an uneventful evacuation of hematoma via craniotomy and a closed subgaleal drain to gravity was placed. The following day and immediately after his transfer to the CT scanner, he presented with rapid neurologic deterioration with acute onset anisocoria and finally mydriasis with fixed and dilated pupils. Postoperative CT scan showed massive TP, and the patient was transferred to the operating room for urgent left decompressive craniectomy, with no intraoperative signs of entrapped air intracranially. Finally, he remained in severe clinical status, passing away on the eighth postoperative day.

Conclusion: TP represents a rare but severe neurosurgical emergency that may be also encountered after craniotomy in the acute trauma setting. Involved practitioners should be aware of this potentially fatal complication, so that early detection and proper management are conducted.

Background/introduction: Optociliary shunt vessels develop as a result of chronic retinal venous obstruction. Optic neuritis has never been reported as a causative influence.

Objective: To determine whether optic neuritis predisposes to the development of optociliary shunts in patients with multiple sclerosis.

Cases: This case series follows two patients with multiple sclerosis from August 1^st, 2019 to April 24^th, 2024, who developed optociliary shunt vessels after attacks of optic neuritis. A 43-year-old female presented with left visual loss and bilateral superior optociliary shunt vessels. Perimetry showed bilateral peripheral visual field loss. Optical coherence tomography showed bilateral retinal thinning and ganglion cell complex loss. Optical coherence tomography angiography showed reduced capillary density bilaterally. We investigated her and eventually diagnosed her with multiple sclerosis. The second, a 49-year-old female, developed right-sided optociliary shunt vessels after an episode of neuroretinitis. Perimetry revealed bilateral central scotomata; optical coherence tomography showed disc and retinal nerve fiber layer edema, and serous retinal detachment; later, ganglion cell complex loss; and reduced capillary density on optical coherence tomography angiography. Neuroimaging revealed demyelination in both, leading to a diagnosis of multiple sclerosis, and therapy was instituted.

Conclusions: We hypothesize, that demyelinating optic neuritis due to multiple sclerosis causes chronic retinal hypoperfusion, leading to subsequent optociliary shunt development in affected eyes. Our case series reveals that eyes with optic neuritis, both previous episodes and fresh cases, can contribute to sufficient retinal vein hypoperfusion to cause the development of optociliary shunts, which should be reported in the literature.

Objectives: This clinical, analytical, retro-prospective, auto-controlled, not randomized, and not blinded study, aimed to investigate the association of changes in the serum glucose levels with the pre-and-post changes in the size tumor in mm³ in the Non-Functional pituitary adenomas.

Methods: Pre-and post-surgical MRI, as well as the measurements in the serum glucose levels and immunohistochemical techniques were performed in all the patients in the study, with a mean followed-up until 208.57 days. A comparison was made between the reductions in tumor size of hormonally active pituitary adenomas (HSPAs) vs NFPAs.

Results: Seventy-four patients were included in this study, of whom, 46 were NFPAs. The decrease in the NFPAs tumor size after surgery was statistically significant (P ≤ 0.0001). The Mean of the differences of both type of tumors in mm³ were -9552 ± 10287. Pre-surgery, the mean of the HSPAs were 8.923 ± 2.078; and the NFPAs were 14.161 ± 1.912. The differences in the tumor size were statistically significant (p = 0.039). Post-surgical, the mean of the HSPAs were 2.079 ± 971, with a (p = 0.14): and the NFPAs were 4.609 ± 1.205. After surgery of the NFPAs, most of the patients-maintained serum levels ≤ 100 mg/dL, with a statistical significance (P ≤ 0.0003).

Conclusion: This study demonstrates for the first time the correlation between the presence of pre-and post- surgical changes in the NFPAs, with modifications in the levels of serum glucose, and the comparison, pre- and post-surgical between the tumor size of HSPAs and NFPAs.