Pub Date : 2025-02-18DOI: 10.1016/j.jocn.2025.111126
Mickey E. Abraham , Moshe Shalom , Taylor Reardon , Julian Gendreau , Justin Gold , Garret Pierzchajlo , Melanie Alfonzo Horowitz , Mohammad Faizan Khan , Sharona Ben-Haim , Alexander A. Khalessi
Neuromodulation is a rapidly growing field in neurosurgery and has shown promise in the treatment of stroke. The aim of this study is to review current clinical trials assessing the role of neuromodulation in the treatment of stroke and post-stroke impairments. Clinical trials were found using the search terms “stroke” and “stimulation.” A total of 996 clinical trials were included in this study with 386 excluded before analysis. Overall, the number of published clinical trials significantly increased over time (p < 0.001; r = 0.927). Of these, 452 (63.7 %) clinical trials were completed, 242 (34.1 %) were in the recruitment stage, and 16 (2.3 %) in the active and not recruiting stage. Of these trials, 77 were completed with published results. By treatment modality, 35 of the published trials evaluated the use of tDCS or TMS. An additional 28 of the published trials evaluated neuromuscular stimulation. Finally, three evaluated VNS, two evaluated medication treatment and nine were found evaluating a wide variety of other modalities. Other interventions included electrical stimulation of various peripheral nerves or muscles, vagal nerve stimulation, deep brain stimulation, and thermoneuromodulation. A majority of trials studied the effects of stroke on motor function (47). The remaining studies assessed outcomes including aphasia (10), pain (6), coordination and gait (5), imaging outcomes (5), swallowing (2), sensation (1) and cognition (1). There has been strong interest in studying the effect of neuromodulation on recovery after stroke with majority of the current clinical trials studying the use of tDCS or TMS to improve motor function.
{"title":"Current and future clinical trials for the use of neuromodulation in the treatment of stroke: A review of the clinical Trials.gov database","authors":"Mickey E. Abraham , Moshe Shalom , Taylor Reardon , Julian Gendreau , Justin Gold , Garret Pierzchajlo , Melanie Alfonzo Horowitz , Mohammad Faizan Khan , Sharona Ben-Haim , Alexander A. Khalessi","doi":"10.1016/j.jocn.2025.111126","DOIUrl":"10.1016/j.jocn.2025.111126","url":null,"abstract":"<div><div>Neuromodulation is a rapidly growing field in neurosurgery and has shown promise in the treatment of stroke. The aim of this study is to review current clinical trials assessing the role of neuromodulation in the treatment of stroke and post-stroke impairments. Clinical trials were found using the search terms “stroke” and “stimulation.” A total of 996 clinical trials were included in this study with 386 excluded before analysis. Overall, the number of published clinical trials significantly increased over time (p < 0.001; r = 0.927). Of these, 452 (63.7 %) clinical trials were completed, 242 (34.1 %) were in the recruitment stage, and 16 (2.3 %) in the active and not recruiting stage. Of these trials, 77 were completed with published results. By treatment modality, 35 of the published trials evaluated the use of tDCS or TMS. An additional 28 of the published trials evaluated neuromuscular stimulation. Finally, three evaluated VNS, two evaluated medication treatment and nine were found evaluating a wide variety of other modalities. Other interventions included electrical stimulation of various peripheral nerves or muscles, vagal nerve stimulation, deep brain stimulation, and thermoneuromodulation. A majority of trials studied the effects of stroke on motor function (47). The remaining studies assessed outcomes including aphasia (10), pain (6), coordination and gait (5), imaging outcomes (5), swallowing (2), sensation (1) and cognition (1). There has been strong interest in studying the effect of neuromodulation on recovery after stroke with majority of the current clinical trials studying the use of tDCS or TMS to improve motor function.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111126"},"PeriodicalIF":1.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437106","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}
Pub Date : 2025-02-17DOI: 10.1016/j.jocn.2025.111114
Guanhua Yan , De-Cai Tian , Xinghu Zhang , Huabing Wang
Background
To investigate the clinical, imaging features, immunotherapy of anti-N-methyl-D-aspartate receptor encephalitis (NMDARE) combined with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD).
Methods
A total of 124 patients with NMDARE and 86 patients with MOGAD were screened from an ongoing prospective cohort study (Clinical and Imaging Patterns of Neuroinflammation Diseases in China, CLUE). Ten NMDARE combined with MOGAD patients, were finally enrolled in this study. Clinical and imaging data and follow-up results characteristics were collected and analyzed.
Results
In these 10 patients with NMDARE combined with MOGAD, 7 patients (70 %) showed recurrent courses. In all 26 episodes, 14 episodes (53.8 %) showed encephalitis-related symptoms, 6 episodes (23.1 %) showed demyelination-related symptoms, 6 episodes (23.1 %) showed both. The median CSF leukocytes were 13/μL (range 1–413) and the median protein was 0.43 g/L (range 0.22–0.70). MRI lesions were found involving the optic nerve (2/10), spinal cord (3/10), deep gray matter (3/10), cortex (6/10), subcortex (7/10), brainstem (5/10) and cerebellum (4/10). Leptomeningeal enhancement was found in 3 patients. All patients received high-dose intravenous methylprednisolone and immunoglobulin therapy during attacks. Seven patients received rituximab (RTX). The median annualized recurrence rate (ARR) reduced significantly following RTX treatments (z = −2.201, p = 0.028), and achieved good outcomes at the last follow-up visit (modified Rankin scale score ≤ 2).
Conclusion
NMDARE combined with MOGAD represents a unique characteristic of autoantibody-mediated encephalitis. Coexistence of NMDAR and MOG antibody may indicate high recurrence risk. RTX may be a relatively efficient therapeutic option.
{"title":"Clinical and imaging features and treatment response of anti-NMDAR encephalitis combined with MOGAD","authors":"Guanhua Yan , De-Cai Tian , Xinghu Zhang , Huabing Wang","doi":"10.1016/j.jocn.2025.111114","DOIUrl":"10.1016/j.jocn.2025.111114","url":null,"abstract":"<div><h3>Background</h3><div>To investigate the clinical, imaging features, immunotherapy of anti-N-methyl-D-aspartate receptor encephalitis (NMDARE) combined with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD).</div></div><div><h3>Methods</h3><div>A total of 124 patients with NMDARE and 86 patients with MOGAD were screened from an ongoing prospective cohort study (Clinical and Imaging Patterns of Neuroinflammation Diseases in China, CLUE). Ten NMDARE combined with MOGAD patients, were finally enrolled in this study. Clinical and imaging data and follow-up results characteristics were collected and analyzed.</div></div><div><h3>Results</h3><div>In these 10 patients with NMDARE combined with MOGAD, 7 patients (70 %) showed recurrent courses. In all 26 episodes, 14 episodes (53.8 %) showed encephalitis-related symptoms, 6 episodes (23.1 %) showed demyelination-related symptoms, 6 episodes (23.1 %) showed both. The median CSF leukocytes were 13/μL (range 1–413) and the median protein was 0.43 g/L (range 0.22–0.70). MRI lesions were found involving the optic nerve (2/10), spinal cord (3/10), deep gray matter (3/10), cortex (6/10), subcortex (7/10), brainstem (5/10) and cerebellum (4/10). Leptomeningeal enhancement was found in 3 patients. All patients received high-dose intravenous methylprednisolone and immunoglobulin therapy during attacks. Seven patients received rituximab (RTX). The median annualized recurrence rate (ARR) reduced significantly following RTX treatments (z = −2.201, <em>p</em> = 0.028), and achieved good outcomes at the last follow-up visit (modified Rankin scale score ≤ 2).</div></div><div><h3>Conclusion</h3><div>NMDARE combined with MOGAD represents a unique characteristic of autoantibody-mediated encephalitis. Coexistence of NMDAR and MOG antibody may indicate high recurrence risk. RTX may be a relatively efficient therapeutic option.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111114"},"PeriodicalIF":1.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429181","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}
Pub Date : 2025-02-17DOI: 10.1016/j.jocn.2025.111076
Jun Yan , Bo Yao , Ya-ya Gao , Pei Chen , Nan Ye , Zhuo-qiong Bian , Jie Li , Ya-feng Shi
Objective
This study aims to investigate the factors influencing RD in elderly patients with BPPV following successful manual reduction.
Methods
A total of 112 elderly patients diagnosed with benign paroxysmal positional vertigo (BPPV) were selected. The patients’ general information, comorbidities, and scores on the Dizziness Handicap Inventory (DHI) were recorded. Following a successful canalith repositioning procedure (CRP), bone mineral density (BMD) was assessed using dual-energy X-ray absorptiometry and evaluated with the T-score. The mean blood flow velocity (Vm) and pulse index (PI) of the bilateral middle cerebral arteries (MCA) and basilar artery (BA) were measured using transcranial Doppler (TCD). Cerebrovascular reactivity (CVR) was evaluated through the Breath Holding Index (BHI). White matter lesions are assessed using cranial Magnetic Resonance Imaging (MRI) and evaluated with the Leukoaraiosis score (LA-score). The patients were divided into residual dizziness (RD) and non-RD groups based on the presence of RD one week after the reduction. The effects of bone mineral density, cerebral blood flow, and cerebral white matter on short-term RD in elderly BPPV patients were subsequently evaluated.
Results
In the RD group, the DHI and LA-score were significantly higher than those in the non-RD group, while the T-score and BHI were lower, with statistically significant differences between the two groups (P < 0.05). The decreases in BHI and T-score, along with the increases in DHI and LA-score, were identified as risk factors for short-term RD following reduction in elderly patients with BPPV. Multivariate logistic regression analysis indicated that BHI, T-score, and LA-score were independent risk factors for RD. T-score and BHI exhibited a negative correlation with RD, while LA-score demonstrated a positive correlation. The diagnostic performance of each indicator was evaluated using ROC curve analysis. The results showed that the AUC for BHI was 0.715, T-score was 0.730, and LA-score was 0.732. Notably, when the three indicators were combined, the AUC significantly increased to 0.842, demonstrating high diagnostic efficiency, with a sensitivity of 70.73 % and a specificity of 90.14 %.
Conclusion
The decreases in the BHI and T-score, along with the increases in the DHI and LA-score, are all identified as risk factors for short-term RD following reduction in elderly patients with BPPV. BHI, T-score, and LA-score serve as independent risk factors for RD and can effectively predict its occurrence, with their combined predictive value being superior. BMD, CVR, and LA were utilized to predict short-term RD after successful manual reduction of BPPV.
{"title":"Risk factors for residual dizziness after successful repositioning in elderly patients with benign paroxysmal positional vertigo","authors":"Jun Yan , Bo Yao , Ya-ya Gao , Pei Chen , Nan Ye , Zhuo-qiong Bian , Jie Li , Ya-feng Shi","doi":"10.1016/j.jocn.2025.111076","DOIUrl":"10.1016/j.jocn.2025.111076","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to investigate the factors influencing RD in elderly patients with BPPV following successful manual reduction.</div></div><div><h3>Methods</h3><div>A total of 112 elderly patients diagnosed with benign paroxysmal positional vertigo (BPPV) were selected. The patients’ general information, comorbidities, and scores on the Dizziness Handicap Inventory (DHI) were recorded. Following a successful canalith repositioning procedure (CRP), bone mineral density (BMD) was assessed using dual-energy X-ray absorptiometry and evaluated with the T-score. The mean blood flow velocity (Vm) and pulse index (PI) of the bilateral middle cerebral arteries (MCA) and basilar artery (BA) were measured using transcranial Doppler (TCD). Cerebrovascular reactivity (CVR) was evaluated through the Breath Holding Index (BHI). White matter lesions are assessed using cranial Magnetic Resonance Imaging (MRI) and evaluated with the Leukoaraiosis score (LA-score). The patients were divided into residual dizziness (RD) and non-RD groups based on the presence of RD one week after the reduction. The effects of bone mineral density, cerebral blood flow, and cerebral white matter on short-term RD in elderly BPPV patients were subsequently evaluated.</div></div><div><h3>Results</h3><div>In the RD group, the DHI and LA-score were significantly higher than those in the non-RD group, while the T-score and BHI were lower, with statistically significant differences between the two groups (P < 0.05). The decreases in BHI and T-score, along with the increases in DHI and LA-score, were identified as risk factors for short-term RD following reduction in elderly patients with BPPV. Multivariate logistic regression analysis indicated that BHI, T-score, and LA-score were independent risk factors for RD. T-score and BHI exhibited a negative correlation with RD, while LA-score demonstrated a positive correlation. The diagnostic performance of each indicator was evaluated using ROC curve analysis. The results showed that the AUC for BHI was 0.715, T-score was 0.730, and LA-score was 0.732. Notably, when the three indicators were combined, the AUC significantly increased to 0.842, demonstrating high diagnostic efficiency, with a sensitivity of 70.73 % and a specificity of 90.14 %.</div></div><div><h3>Conclusion</h3><div>The decreases in the BHI and T-score, along with the increases in the DHI and LA-score, are all identified as risk factors for short-term RD following reduction in elderly patients with BPPV. BHI, T-score, and LA-score serve as independent risk factors for RD and can effectively predict its occurrence, with their combined predictive value being superior. BMD, CVR, and LA were utilized to predict short-term RD after successful manual reduction of BPPV.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111076"},"PeriodicalIF":1.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419361","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}
Pub Date : 2025-02-17DOI: 10.1016/j.jocn.2025.111119
Jae Yoon Jeong , Tae Sik Goh , Kihun Kim, Yoon Jae Cho, Jung Sub Lee
This study aimed to evaluate the validity and reliability of the newly adapted Korean version of the Bad Sobernheim Stress Questionnaire-Brace (K-BSSQ-Brace). The original German BSSQ-Brace was translated, back-translated, and underwent a comprehensive cross-cultural adaptation process. The K-BSSQ-Brace and the previously validated Korean version of the Scoliosis Research Society-22 Outcomes Questionnaire (K-SRS-22) were then administered to 120 adolescents with idiopathic scoliosis (AIS). Reliability was assessed using kappa statistics for item agreement, the intraclass correlation coefficient (ICC), and Cronbach’s α for internal consistency. The K-BSSQ-Brace demonstrated strong reliability, with all items showing kappa values above 0.6 and an excellent test–retest ICC of 0.921. Internal consistency was high, with a Cronbach’s α of 0.882. Convergent validity was confirmed through a moderate correlation between the K-BSSQ-Brace and K-SRS-22. Discriminant validity was supported by a significant association between K-BSSQ-Brace scores and major curve magnitude. These findings suggest that the K-BSSQ-Brace is a reliable and valid tool for assessing the quality of life in Korean AIS patients undergoing brace treatment.
{"title":"Validation of the Korean version of the Bad Sobernheim stress Questionnaire-Brace in adolescent idiopathic scoliosis","authors":"Jae Yoon Jeong , Tae Sik Goh , Kihun Kim, Yoon Jae Cho, Jung Sub Lee","doi":"10.1016/j.jocn.2025.111119","DOIUrl":"10.1016/j.jocn.2025.111119","url":null,"abstract":"<div><div>This study aimed to evaluate the validity and reliability of the newly adapted Korean version of the Bad Sobernheim Stress Questionnaire-Brace (K-BSSQ-Brace). The original German BSSQ-Brace was translated, back-translated, and underwent a comprehensive cross-cultural adaptation process. The K-BSSQ-Brace and the previously validated Korean version of the Scoliosis Research Society-22 Outcomes Questionnaire (K-SRS-22) were then administered to 120 adolescents with idiopathic scoliosis (AIS). Reliability was assessed using kappa statistics for item agreement, the intraclass correlation coefficient (ICC), and Cronbach’s α for internal consistency. The K-BSSQ-Brace demonstrated strong reliability, with all items showing kappa values above 0.6 and an excellent test–retest ICC of 0.921. Internal consistency was high, with a Cronbach’s α of 0.882. Convergent validity was confirmed through a moderate correlation between the K-BSSQ-Brace and K-SRS-22. Discriminant validity was supported by a significant association between K-BSSQ-Brace scores and major curve magnitude. These findings suggest that the K-BSSQ-Brace is a reliable and valid tool for assessing the quality of life in Korean AIS patients undergoing brace treatment.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111119"},"PeriodicalIF":1.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429182","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}
Pub Date : 2025-02-15DOI: 10.1016/j.jocn.2025.111100
Hon-Man Liu , Yen-Heng Lin , Wei-Lung Tseng
Background and aims
Traditionally, computed tomography (CT) has been more sensitive in detecting calcification compared to conventional magnetic resonance (MR) imaging. This study aims to compare the efficacy of susceptibility-weighted imaging (SWI), an advanced MR technique, with CT in detecting calcification in the intracranial vertebral artery.
Methods
This retrospective study reviewed brain SWI imaging of patients from January 2021 to March 2022. Inclusion criteria encompassed patients who underwent both SWI and brain CT within a 3-month interval. Exclusion criteria included poor imaging quality, insufficient or incomplete studies, and lack of MRA data. Vessel wall calcification was defined as hypointensity on SWI and hyper-attenuation (≥130 HU) on CT. We compared the incidence of calcification detected by CT with hypointensity on SWI at corresponding anatomical locations.
Results
A total of 817 patients (age range: 25–90 years, mean age: 62.1 ± 15.1 years) were included in the study. Of these, 393 (48.1 %) were females, 329 (40.3 %) had hypertension, and 242 (29.6 %) had diabetes. CT detected calcification in 613 intracranial vertebral arteries. SWI depicted hypointensity in 604 (98.5 %) of the CT positive cases. 21 subjects showed calcification on CT but no hypointensity on SWI, while 12 subjects had SWI hypointensity but no evidence of calcification on CT.
Conclusion
This study demonstrates that SWI is not inferior to CT in detecting intracranial vertebral artery wall calcification. SWI is possibly better than CT in detecting non-stenotic atherosclerosis, mural hematoma or dissection. The high concordance between SWI and CT, coupled with SWI’s ability to potentially detect additional vascular pathologies, shows promise as a radiation-free, comprehensive imaging modality.
{"title":"Comparative evaluation of intracranial vertebral artery calcification detection: CT vs. susceptibility-weighted imaging","authors":"Hon-Man Liu , Yen-Heng Lin , Wei-Lung Tseng","doi":"10.1016/j.jocn.2025.111100","DOIUrl":"10.1016/j.jocn.2025.111100","url":null,"abstract":"<div><h3>Background and aims</h3><div>Traditionally, computed tomography (CT) has been more sensitive in detecting calcification compared to conventional magnetic resonance (MR) imaging. This study aims to compare the efficacy of susceptibility-weighted imaging (SWI), an advanced MR technique, with CT in detecting calcification in the intracranial vertebral artery.</div></div><div><h3>Methods</h3><div>This retrospective study reviewed brain SWI imaging of patients from January 2021 to March 2022. Inclusion criteria encompassed patients who underwent both SWI and brain CT within a 3-month interval. Exclusion criteria included poor imaging quality, insufficient or incomplete studies, and lack of MRA data. Vessel wall calcification was defined as hypointensity on SWI and hyper-attenuation (≥130 HU) on CT. We compared the incidence of calcification detected by CT with hypointensity on SWI at corresponding anatomical locations.</div></div><div><h3>Results</h3><div>A total of 817 patients (age range: 25–90 years, mean age: 62.1 ± 15.1 years) were included in the study. Of these, 393 (48.1 %) were females, 329 (40.3 %) had hypertension, and 242 (29.6 %) had diabetes. CT detected calcification in 613 intracranial vertebral arteries. SWI depicted hypointensity in 604 (98.5 %) of the CT positive cases. 21 subjects showed calcification on CT but no hypointensity on SWI, while 12 subjects had SWI hypointensity but no evidence of calcification on CT.</div></div><div><h3>Conclusion</h3><div>This study demonstrates that SWI is not inferior to CT in detecting intracranial vertebral artery wall calcification. SWI is possibly better than CT in detecting non-stenotic atherosclerosis, mural hematoma or dissection. The high concordance between SWI and CT, coupled with SWI’s ability to potentially detect additional vascular pathologies, shows promise as a radiation-free, comprehensive imaging modality.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"134 ","pages":"Article 111100"},"PeriodicalIF":1.9,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419779","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}
This letter to the editor responds to a study on the role of felt stigma in determining the health-related quality of life of stroke survivors in China. The findings demonstrate that felt stigma significantly impacts both physical and mental health outcomes, whereas enacted stigma does not show a significant effect. We argue that cultural factors, such as self-sufficiency values and filial piety, should be further explored as contributing elements to stigma perception. Additionally, we propose several areas for future research, including longitudinal studies, intervention-based approaches, cross-cultural comparisons, and caregiver perspectives. We also emphasize the need for integrating mental health support into post-stroke rehabilitation programs to address stigma more effectively. This commentary aims to stimulate further discussion on the psychosocial dimensions of stroke recovery and encourage a more holistic, patient-centered approach to rehabilitation.
{"title":"Addressing felt stigma in stroke survivors: Implications for quality of life and future research.","authors":"Ali Fakhrudin, Dony Darma Sagita, Sumianto, Iis Aprinawati, Muchamad Arif Kurniawan, Erfan Ramadhani, Aldora Pratama, Ramtia Darma Putri, Safta Hastini, Erfan Ramadhani","doi":"10.1016/j.jocn.2025.111123","DOIUrl":"https://doi.org/10.1016/j.jocn.2025.111123","url":null,"abstract":"<p><p>This letter to the editor responds to a study on the role of felt stigma in determining the health-related quality of life of stroke survivors in China. The findings demonstrate that felt stigma significantly impacts both physical and mental health outcomes, whereas enacted stigma does not show a significant effect. We argue that cultural factors, such as self-sufficiency values and filial piety, should be further explored as contributing elements to stigma perception. Additionally, we propose several areas for future research, including longitudinal studies, intervention-based approaches, cross-cultural comparisons, and caregiver perspectives. We also emphasize the need for integrating mental health support into post-stroke rehabilitation programs to address stigma more effectively. This commentary aims to stimulate further discussion on the psychosocial dimensions of stroke recovery and encourage a more holistic, patient-centered approach to rehabilitation.</p>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":" ","pages":"111123"},"PeriodicalIF":1.9,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425491","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}
Pub Date : 2025-02-15DOI: 10.1016/j.jocn.2025.111115
Bandar Aljafen , Naif Almutairi , Hisham Almousa , Sarah Alshamrani , Ruwa Alneseyan
Background
Epilepsy is a chronic neurological disorder. Stigma significantly contributes to the disease burden and delays in medical management. Enacted stigma involves discrimination against people with epilepsy, while felt stigma, or internalized stigma, is the shame associated with epilepsy. In Saudi Arabia, enacted stigma has been extensively studied, revealing misconceptions about epilepsy. This study aims to determine the severity of felt stigma, its association with sociodemographic characteristics, and its relation to epilepsy features.
Methods
This cross-sectional study was conducted among people with epilepsy at a tertiary university hospital. The Internalized Stigma of Mental Illness (ISMI) scale, adapted for epilepsy, was used. The validated and translated questionnaire was self-administered electronically in Arabic. It consists of three sections: sociodemographic data, 29 items assessing internalized stigma using a 4-point Likert scale, and 6 items assessing epilepsy features. An average score of > 2 indicates stigma: ≥2, mild; ≥2.5, moderate; and ≥ 3, severe.
Results
Of 112 participants, 19.6 % had mild internalized stigma, and 5.4 % had moderate internalized stigma, totalling 25 % with internalized stigma. No participant was found to have severe internalized stigma. Higher levels of internalized stigma were found among those who are single, have only school-level education, and low income. Epilepsy features associated with high internalized stigma include a history of status epilepticus and the use of ≥ 2 antiseizure medications.
Conclusions
Felt stigma is prevalent in Saudi Arabia in mild to moderate severity. Controlling seizures and educating patients and their families about stigma can help reduce its prevalence.
{"title":"Evaluating felt stigma among people with epilepsy: Insights from Saudi Arabia","authors":"Bandar Aljafen , Naif Almutairi , Hisham Almousa , Sarah Alshamrani , Ruwa Alneseyan","doi":"10.1016/j.jocn.2025.111115","DOIUrl":"10.1016/j.jocn.2025.111115","url":null,"abstract":"<div><h3>Background</h3><div>Epilepsy is a chronic neurological disorder. Stigma significantly contributes to the disease burden and delays in medical management. Enacted stigma involves discrimination against people with epilepsy, while felt stigma, or internalized stigma, is the shame associated with epilepsy. In Saudi Arabia, enacted stigma has been extensively studied, revealing misconceptions about epilepsy. This study aims to determine the severity of felt stigma, its association with sociodemographic characteristics, and its relation to epilepsy features.</div></div><div><h3>Methods</h3><div>This cross-sectional study was conducted among people with epilepsy at a tertiary university hospital. The Internalized Stigma of Mental Illness (ISMI) scale, adapted for epilepsy, was used. The validated and translated questionnaire was self-administered electronically in Arabic. It consists of three sections: sociodemographic data, 29 items assessing internalized stigma using a 4-point Likert scale, and 6 items assessing epilepsy features. An average score of > 2 indicates stigma: ≥2, mild; ≥2.5, moderate; and ≥ 3, severe.</div></div><div><h3>Results</h3><div>Of 112 participants, 19.6 % had mild internalized stigma, and 5.4 % had moderate internalized stigma, totalling 25 % with internalized stigma. No participant was found to have severe internalized stigma. Higher levels of internalized stigma were found among those who are single, have only school-level education, and low income. Epilepsy features associated with high internalized stigma include a history of status epilepticus and the use of ≥ 2 antiseizure medications.</div></div><div><h3>Conclusions</h3><div>Felt stigma is prevalent in Saudi Arabia in mild to moderate severity. Controlling seizures and educating patients and their families about stigma can help reduce its prevalence.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111115"},"PeriodicalIF":1.9,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419365","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}
Pub Date : 2025-02-15DOI: 10.1016/j.jocn.2025.111121
Pin Chen , Tao Xie , Qiaoqiao Yang , Chaolong Yan , Tengfei Liu , Zeyang Li , Shuang Liu , Qiang Xie , Jinglong Huang , Cunzu Wang , Xiaobiao Zhang
Background
Jugular foramen (JF) tumors are uncommon, often requiring surgical resection due to their complex anatomical location and varied growth patterns, particularly when intraosseous.
Objective
We propose the pure endoscopic presigmoid infralabyrinthine approach (EPSIL) as a minimally invasive technique for lateral JF access during tumor resection, circumventing the need for extensive exposure of vital structures and jugular vein sacrifice.
Methods
A retrospective analysis was conducted on six patients who underwent EPSIL for JF tumor resection since 2020. The focus was on operative techniques, extent of tumor removal, neurological outcomes, and approach-related morbidity.
Results
The cohort included six patients (three male, three female) with an average age of 46.9 years and a follow-up of 21.6 months. Tumor types were four schwannomas, one paraganglioma, and one chondrosarcoma (WHO grade 2), with average dimensions of 41.2 × 18.8 × 34.5 mm. All were successfully removed via EPSIL, aided by neuro-navigation and monitoring. Four achieved gross-total resections, two subtotal (>90 %), with the latter treated with Gamma Knife for remnants. No tumor recurrence or growth was noted. Preoperative symptoms improved postoperatively, with temporary hoarseness and slight hearing impairment resolving within 8 weeks. One patient had a cerebrospinal fluid leak, managed with a lumbar drain, without long-term deficits.
Conclusion
The EPSIL approach is a highly effective method for the removal of JF tumors, particularly those with intraosseous growth. It stands out as a minimally invasive procedure that harmoniously integrates radical tumor resection with the preservation of cranial nerves.
{"title":"Pure endoscopic presigmoid infralabyrinthine approach for jugular foramen tumors: Operative technique and early results","authors":"Pin Chen , Tao Xie , Qiaoqiao Yang , Chaolong Yan , Tengfei Liu , Zeyang Li , Shuang Liu , Qiang Xie , Jinglong Huang , Cunzu Wang , Xiaobiao Zhang","doi":"10.1016/j.jocn.2025.111121","DOIUrl":"10.1016/j.jocn.2025.111121","url":null,"abstract":"<div><h3>Background</h3><div>Jugular foramen (JF) tumors are uncommon, often requiring surgical resection due to their complex anatomical location and varied growth patterns, particularly when intraosseous.</div></div><div><h3>Objective</h3><div>We propose the pure endoscopic presigmoid infralabyrinthine approach (EPSIL) as a minimally invasive technique for lateral JF access during tumor resection, circumventing the need for extensive exposure of vital structures and jugular vein sacrifice.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on six patients who underwent EPSIL for JF tumor resection since 2020. The focus was on operative techniques, extent of tumor removal, neurological outcomes, and approach-related morbidity.</div></div><div><h3>Results</h3><div>The cohort included six patients (three male, three female) with an average age of 46.9 years and a follow-up of 21.6 months. Tumor types were four schwannomas, one paraganglioma, and one chondrosarcoma (WHO grade 2), with average dimensions of 41.2 × 18.8 × 34.5 mm. All were successfully removed via EPSIL, aided by neuro-navigation and monitoring. Four achieved gross-total resections, two subtotal (>90 %), with the latter treated with Gamma Knife for remnants. No tumor recurrence or growth was noted. Preoperative symptoms improved postoperatively, with temporary hoarseness and slight hearing impairment resolving within 8 weeks. One patient had a cerebrospinal fluid leak, managed with a lumbar drain, without long-term deficits.</div></div><div><h3>Conclusion</h3><div>The EPSIL approach is a highly effective method for the removal of JF tumors, particularly those with intraosseous growth. It stands out as a minimally invasive procedure that harmoniously integrates radical tumor resection with the preservation of cranial nerves.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111121"},"PeriodicalIF":1.9,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419362","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}
{"title":"Identifying key predictors of cognitive impairment in hypertensive older adults: A call for digital health integration.","authors":"Siska Mardes, Monica Widyaswari, Ali Fakhrudin, Ramtia Darma Putri, Safta Hastini, Erfan Ramadhani","doi":"10.1016/j.jocn.2025.111117","DOIUrl":"https://doi.org/10.1016/j.jocn.2025.111117","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":" ","pages":"111117"},"PeriodicalIF":1.9,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425493","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}
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