Pub Date : 2025-01-21DOI: 10.1016/j.jocn.2025.111055
Guoxu Lv , Yu Zhang , Shuang Liu , Jinyi Zhu , Xianyi Chen , Haiyan Wu , Chuming Liu , Wang Chai , Jian Lv , Ruoyu Wang
Cognitive decline is an increasingly serious global health challenge. In recent years, an increasing number of non-traditional cognitive rehabilitation training (N-TCRT) interventions have been applied to improve cognitive function, however, Tthe existing evidence is restricted. The meta-analysis of this randomized controlled trial evaluated the efficacy of leisure activity interventions compared to TCRT control on cognitive function in older adults. A literature search was conducted on PubMed, Embase, Cochrane Central Register of Controlled Trials, and related databases through June 31, 2024. The risk of bias was assessed using the PEDro scale. A total of 23 included RCTs (n = 1,293) utilized mahjong, poker, VR, and other games. Results show that leisure activities interventions improve global cognition function (MOCA, P < 0.00001; MMSE, P < 0.0001), memory function (DSB, P = 0.002; DSF, P = 0.03), executive function (TMT-A, P = 0.0009; TMT-B, P = 0.005) and quality of life (ADL, P < 0.000001; WHOQOL-OLD, P < 0.00001). In summary, leisure activities can improve some cognitive domains in older adults. (PROSPERO registration: CRD42024563951).
{"title":"Effect of leisure activities on cognitive and memory function in older adults: A systematic review and meta-analysis of randomized controlled trials","authors":"Guoxu Lv , Yu Zhang , Shuang Liu , Jinyi Zhu , Xianyi Chen , Haiyan Wu , Chuming Liu , Wang Chai , Jian Lv , Ruoyu Wang","doi":"10.1016/j.jocn.2025.111055","DOIUrl":"10.1016/j.jocn.2025.111055","url":null,"abstract":"<div><div>Cognitive decline is an increasingly serious global health challenge. In recent years, an increasing number of non-traditional cognitive rehabilitation training (N-TCRT) interventions have been applied to improve cognitive function, however, Tthe existing evidence is restricted. The <em>meta</em>-analysis of this randomized controlled trial evaluated the efficacy of leisure activity interventions compared to TCRT control on cognitive function in older adults. A literature search was conducted on PubMed, Embase, Cochrane Central Register of Controlled Trials, and related databases through June 31, 2024. The risk of bias was assessed using the PEDro scale. A total of 23 included RCTs (n = 1,293) utilized mahjong, poker, VR, and other games. Results show that leisure activities interventions improve global cognition function (MOCA, <em>P</em> < 0.00001; MMSE, <em>P</em> < 0.0001), memory function (DSB, <em>P</em> = 0.002; DSF, <em>P</em> = 0.03), executive function (TMT-A, <em>P</em> = 0.0009; TMT-B, <em>P</em> = 0.005) and quality of life (ADL, <em>P</em> < 0.000001; WHOQOL-OLD, <em>P</em> < 0.00001). In summary, leisure activities can improve some cognitive domains in older adults. (PROSPERO registration: CRD42024563951).</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"133 ","pages":"Article 111055"},"PeriodicalIF":1.9,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023026","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 : 2025-01-18DOI: 10.1016/j.jocn.2025.111052
Nicolás Rincón-Arias , Paula A. Pulido , Yamila Micaela Zampini , Nicolás Llanos Orozco , Martín Pinzón , Giovanni Barbagli , Fernando Hakim , Diego F. Gómez-Amarillo , Edgar G. Ordoñez-Rubiano
Background
The Endoscopic Endonasal Approach (EEA) has revolutionized the treatment landscape for optic pathway–hypothalamic gliomas (OPHGs) by providing precise visualization of the lesion neuroanatomic and minimizing brain manipulation. Despite the variable clinical trajectories of OPHGs, the optimal management neurosurgical strategy continues to be a subject of debate.
Methods
We present a case of an 8-year-old female with an OPHG who underwent EEA and performed a systematic review search in English and Spanish case reports from January 2007 (date of first reported case) to June 2024, focusing on OPHG treated with EEA. Databases such as PubMed, Lilacs, and Embase.
Search results
Our systematic review encompassed 30 cases of OPHGs treated with EEA. Most patients (86.6%) presented with visual disturbance, 43.3% with headaches, and 30% with endocrine disturbances. Gross-total resection (GTR) was achieved in 20%, subtotal in 40%, and near-total in 20%. Histologically, pilocytic astrocytoma predominated (73.3%), with varied clinical presentations highlighting the need for tailored management approaches.
Conclusions
The EEA offers safe access to the optic pathway and hypothalamic region. Despite limitations in achieving GTR compared to other approaches, EEA’s benefits in clinical improvement and neuroanatomical preservation make it a valuable option for select cases of OPHGs.
{"title":"Endoscopic endonasal approach for optic Pathway–Hypothalamic Glioma: A pediatric case Report and a Systematic review","authors":"Nicolás Rincón-Arias , Paula A. Pulido , Yamila Micaela Zampini , Nicolás Llanos Orozco , Martín Pinzón , Giovanni Barbagli , Fernando Hakim , Diego F. Gómez-Amarillo , Edgar G. Ordoñez-Rubiano","doi":"10.1016/j.jocn.2025.111052","DOIUrl":"10.1016/j.jocn.2025.111052","url":null,"abstract":"<div><h3>Background</h3><div>The Endoscopic Endonasal Approach (EEA) has revolutionized the treatment landscape for optic pathway–hypothalamic gliomas (OPHGs) by providing precise visualization of the lesion neuroanatomic and minimizing brain manipulation. Despite the variable clinical trajectories of OPHGs, the optimal management neurosurgical strategy continues to be a subject of debate.</div></div><div><h3>Methods</h3><div>We present a case of an 8-year-old female with an OPHG who underwent EEA and performed a systematic review search in English and Spanish case reports from January 2007 (date of first reported case) to June 2024, focusing on OPHG treated with EEA. Databases such as PubMed, Lilacs, and Embase.</div></div><div><h3>Search results</h3><div>Our systematic review encompassed 30 cases of OPHGs treated with EEA. Most patients (86.6%) presented with visual disturbance, 43.3% with headaches, and 30% with endocrine disturbances. Gross-total resection (GTR) was achieved in 20%, subtotal in 40%, and near-total in 20%. Histologically, pilocytic astrocytoma predominated (73.3%), with varied clinical presentations highlighting the need for tailored management approaches.</div></div><div><h3>Conclusions</h3><div>The EEA offers safe access to the optic pathway and hypothalamic region. Despite limitations in achieving GTR compared to other approaches, EEA’s benefits in clinical improvement and neuroanatomical preservation make it a valuable option for select cases of OPHGs.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"133 ","pages":"Article 111052"},"PeriodicalIF":1.9,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006318","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 : 2025-01-18DOI: 10.1016/j.jocn.2025.111048
Rehman Ali Baig , Esteban Quiceno , Mohamed A.R. Soliman , Alexander O. Aguirre , Bernard K. Okai , Cathleen C. Kuo , Hendrick B. Francois , Isabelle Stockman , Shashwat Shah , Hannon W. Levy , Asham Khan , Kyungduk Rho , John Pollina , Jeffrey P. Mullin
Background
Although cage subsidence is one of the most common phenomenona associated with interbody fusions and was characterized more than 70 years ago, a standardized method for its measurement, detection, and reporting among different lumbar fusion procedures does not exist. Here, we review previously published literature on cage subsidence to present the most common methods for defining subsidence in the posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) techniques.
Methods
A search was completed in PubMed and Embase with inclusion criteria focused on identifying any study that provided descriptions of the method, imaging modality, and subsidence threshold used to define the presence of cage subsidence in study articles published between January 1, 2001 and December 31, 2022.
Results
A total of 54 studies were included in the final analysis. Among them, 32 (59.2 %) reported on TLIF, 20 (37.1 %) reported on PLIF, and 2 studies (3.7 %) reported on both approaches. For TLIF and PLIF procedures, the preferred method to determine subsidence was cage migration into the vertebral bodies rather than changes in disc height. In the TLIF group, the predominant criteria for defining subsidence were thresholds of ≥ 2 mm and > 2 mm utilized in each of 10 of the 34 studies (58.8 %). Similarly, in the PLIF group, the common criterion for defining subsidence was also ≥ 2 mm, observed in 5 of 22 studies (22.7 %), with > 2 mm observed in 4 studies (18.2 %). The methods for assessing cage migration or disc height change varied substantially among studies, with none of the measurements being consistently applied in more than 50 % of the studies.
Conclusions
Inconsistency persists in the methods used to determine, report, or measure the degree of subsidence. Surgeons and researchers should standardize these methods to ensure consistency and generalizability in reporting and studying subsidence.
{"title":"Definition of cage subsidence in transforaminal lumbar interbody fusion (TLIF) approach and posterior lumbar interbody fusion (PLIF) approach – A systematic review","authors":"Rehman Ali Baig , Esteban Quiceno , Mohamed A.R. Soliman , Alexander O. Aguirre , Bernard K. Okai , Cathleen C. Kuo , Hendrick B. Francois , Isabelle Stockman , Shashwat Shah , Hannon W. Levy , Asham Khan , Kyungduk Rho , John Pollina , Jeffrey P. Mullin","doi":"10.1016/j.jocn.2025.111048","DOIUrl":"10.1016/j.jocn.2025.111048","url":null,"abstract":"<div><h3>Background</h3><div>Although cage subsidence is one of the most common phenomenona associated with interbody fusions and was characterized more than 70 years ago, a standardized method for its measurement, detection, and reporting among different lumbar fusion procedures does not exist. Here, we review previously published literature on cage subsidence to present the most common methods for defining subsidence in the posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) techniques.</div></div><div><h3>Methods</h3><div>A search was completed in PubMed and Embase with inclusion criteria focused on identifying any study that provided descriptions of the method, imaging modality, and subsidence threshold used to define the presence of cage subsidence in study articles published between January 1, 2001 and December 31, 2022.</div></div><div><h3>Results</h3><div>A total of 54 studies were included in the final analysis. Among them, 32 (59.2 %) reported on TLIF, 20 (37.1 %) reported on PLIF, and 2 studies (3.7 %) reported on both approaches. For TLIF and PLIF procedures, the preferred method to determine subsidence was cage migration into the vertebral bodies rather than changes in disc height. In the TLIF group, the predominant criteria for defining subsidence were thresholds of ≥ 2 mm and > 2 mm utilized in each of 10 of the 34 studies (58.8 %). Similarly, in the PLIF group, the common criterion for defining subsidence was also ≥ 2 mm, observed in 5 of 22 studies (22.7 %), with > 2 mm observed in 4 studies (18.2 %). The methods for assessing cage migration or disc height change varied substantially among studies, with none of the measurements being consistently applied in more than 50 % of the studies.</div></div><div><h3>Conclusions</h3><div>Inconsistency persists in the methods used to determine, report, or measure the degree of subsidence. Surgeons and researchers should standardize these methods to ensure consistency and generalizability in reporting and studying subsidence.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"133 ","pages":"Article 111048"},"PeriodicalIF":1.9,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006288","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 : 2025-01-17DOI: 10.1016/j.jocn.2025.111038
Yusuf A. Mehkri , Grace Hey , Cathleen C. Kuo , Melanie Alfonzo Horowitz , Julian L. Gendreau , Pate J. Duddleston , Joseph R. Keen
Background
Patients with nontraumatic subdural hemorrhage often require immediate surgical intervention that may not be available at community hospitals and are therefore transferred to tertiary care centers. This study aims to evaluate the effects of interhospital transfer (IHT) on postoperative complications and outcomes following ntSDH.
Methods
The National Surgical Quality Improvement Program (NSQIP) database was queried for patients treated for ntSDH from January 2014 to January 2020. Baseline demographics, clinical characteristics, postoperative complications, and postoperative outcomes compared based on IHT status. Univariate and multivariate logistic regression analyses were performed. Effect sizes in the final model were presented as odds ratio (OR) with associated 95% confidence interval (CI).
Results
Of the 715 included patients, 295 (41.3 %) were in the IHT cohort. Non-IHT patients demonstrated significantly increased progressive renal insufficiency (1.90 % vs 0.00 %, p = 0.043) and 30-day readmission rates (11.9 % vs 6.10 %, p = 0.003) when compared with IHT patients. IHT was associated with significantly increased odds of postoperative sepsis (OR = 1.37, p = 0.009), 30-day mortality (OR = 1.20, p = 0.011), and non-home disposition (OR = 1.14, p = 0.003).
Conclusions
Despite similar baseline characteristics, patients transferred for ntSDH treatment are associated with worse postoperative outcomes. Future studies should be conducted to identifying specific factors associated with IHT and poor outcomes.
背景：非外伤性硬膜下出血患者通常需要立即手术治疗，而社区医院可能无法提供这种治疗，因此他们被转移到三级护理中心。本研究旨在评估医院间转院（IHT）对ntSDH术后并发症和预后的影响。方法：查询国家外科质量改进计划（NSQIP）数据库中2014年1月至2020年1月收治的ntSDH患者。基线人口统计学、临床特征、术后并发症和基于IHT状态的术后结果的比较。进行单因素和多因素logistic回归分析。最终模型中的效应量以比值比（OR）和相关的95%置信区间（CI）表示。结果：在纳入的715例患者中，295例（41.3%）属于IHT队列。与IHT患者相比，非IHT患者表现出明显增加的进行性肾功能不全（1.90%对0.00 %,p = 0.043）和30天再入院率（11.9%对6.10%,p = 0.003）。IHT与术后脓毒症（OR = 1.37, p = 0.009）、30天死亡率（OR = 1.20, p = 0.011）和非居家倾向（OR = 1.14, p = 0.003）的发生率显著增加相关。结论：尽管基线特征相似，但转行ntSDH治疗的患者术后预后较差。未来的研究应确定与IHT和不良预后相关的具体因素。
{"title":"Association between interhospital transfer status and outcomes following nontraumatic subdural hemorrhage","authors":"Yusuf A. Mehkri , Grace Hey , Cathleen C. Kuo , Melanie Alfonzo Horowitz , Julian L. Gendreau , Pate J. Duddleston , Joseph R. Keen","doi":"10.1016/j.jocn.2025.111038","DOIUrl":"10.1016/j.jocn.2025.111038","url":null,"abstract":"<div><h3>Background</h3><div>Patients with nontraumatic subdural hemorrhage often require immediate surgical intervention that may not be available at community hospitals and are therefore transferred to tertiary care centers. This study aims to evaluate the effects of interhospital transfer (IHT) on postoperative complications and outcomes following ntSDH.</div></div><div><h3>Methods</h3><div>The National Surgical Quality Improvement Program (NSQIP) database was queried for patients treated for ntSDH from January 2014 to January 2020. Baseline demographics, clinical characteristics, postoperative complications, and postoperative outcomes compared based on IHT status. Univariate and multivariate logistic regression analyses were performed. Effect sizes in the final model were presented as odds ratio (OR) with associated 95% confidence interval (CI).</div></div><div><h3>Results</h3><div>Of the 715 included patients, 295 (41.3 %) were in the IHT cohort. Non-IHT patients demonstrated significantly increased progressive renal insufficiency (1.90 % vs 0.00 %, p = 0.043) and 30-day readmission rates (11.9 % vs 6.10 %, p = 0.003) when compared with IHT patients. IHT was associated with significantly increased odds of postoperative sepsis (OR = 1.37, p = 0.009), 30-day mortality (OR = 1.20, p = 0.011), and non-home disposition (OR = 1.14, p = 0.003).</div></div><div><h3>Conclusions</h3><div>Despite similar baseline characteristics, patients transferred for ntSDH treatment are associated with worse postoperative outcomes. Future studies should be conducted to identifying specific factors associated with IHT and poor outcomes.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"133 ","pages":"Article 111038"},"PeriodicalIF":1.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006267","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}
Gliomas are the most common primary tumor in the central nervous system (CNS), with low-grade gliomas (LGG) comprising more than 5 percent of all adult primary CNS tumors. While glioblastoma, the most malignant glioma subtype, is known to present with hemorrhage, LGGs rarely present with hemorrhage. This systematic review investigates LGGs that present as hemorrhage and provides an illustrative case presentation in order to evaluate trends and outcomes for this pathology.
Methods
A systematic review of the literature was performed to evaluate presentation, treatment, and outcomes for patients with LGG that present as intracranial hemorrhage. Articles included were case series describing surgical approach; literature reviews were excluded. Variables evaluated included presenting symptoms, imaging results, and postoperative outcomes.
Results
The initial screen yielded 1373 articles. Fourteen articles, published between 1977 and 2023, met inclusion criteria. Sixteen (16) patients were identified with LGG that presented initially as hemorrhage. The most common tumors were pilocytic astrocytoma (6/16), subependymoma (4/16), and ependymoma (2/16). The most common presenting symptoms were headaches (9/11) and impaired consciousness (9/11). Eleven patients underwent gross total resection of the tumor, while four patients received partial resection. Outcomes included two mortalities and one recurrence after six months; the thirteen remaining patients had no recurrence at final reported follow-up.
Conclusion
LGGs presenting with hemorrhage are associated with more severe initial symptoms. Though very uncommon, it is imperative to recognize the possibility of an underlying low-grade neoplasm in the setting of hemorrhage. Such early identification can lead to expeditious surgical intervention which can alleviate symptoms, lead to diagnosis, and ultimately trigger adjuvant treatment that has the potential to prolong survival. Continued research on the underlying pathophysiology of these hemorrhagic low-grade tumors is needed to further stratify risk in these populations.
{"title":"Low-grade gliomas presenting with hemorrhage: Are intratumoral blood products associated with malignant transformation?","authors":"Aarti Kishore Jain , Sima Vazquez , Sabrina Zeller , Eris Spirollari , Simon J Hanft","doi":"10.1016/j.jocn.2025.111041","DOIUrl":"10.1016/j.jocn.2025.111041","url":null,"abstract":"<div><h3>Objective</h3><div>Gliomas are the most common primary tumor in the central nervous system (CNS), with low-grade gliomas (LGG) comprising more than 5 percent of all adult primary CNS tumors. While glioblastoma, the most malignant glioma subtype, is known to present with hemorrhage, LGGs rarely present with hemorrhage. This systematic review investigates LGGs that present as hemorrhage and provides an illustrative case presentation in order to evaluate trends and outcomes for this pathology.</div></div><div><h3>Methods</h3><div>A systematic review of the literature was performed to evaluate presentation, treatment, and outcomes for patients with LGG that present as intracranial hemorrhage. Articles included were case series describing surgical approach; literature reviews were excluded. Variables evaluated included presenting symptoms, imaging results, and postoperative outcomes.</div></div><div><h3>Results</h3><div>The initial screen yielded 1373 articles. Fourteen articles, published between 1977 and 2023, met inclusion criteria. Sixteen (16) patients were identified with LGG that presented initially as hemorrhage. The most common tumors were pilocytic astrocytoma (6/16), subependymoma (4/16), and ependymoma (2/16). The most common presenting symptoms were headaches (9/11) and impaired consciousness (9/11). Eleven patients underwent gross total resection of the tumor, while four patients received partial resection. Outcomes included two mortalities and one recurrence after six months; the thirteen remaining patients had no recurrence at final reported follow-up.</div></div><div><h3>Conclusion</h3><div>LGGs presenting with hemorrhage are associated with more severe initial symptoms. Though very uncommon, it is imperative to recognize the possibility of an underlying low-grade neoplasm in the setting of hemorrhage. Such early identification can lead to expeditious surgical intervention which can alleviate symptoms, lead to diagnosis, and ultimately trigger adjuvant treatment that has the potential to prolong survival. Continued research on the underlying pathophysiology of these hemorrhagic low-grade tumors is needed to further stratify risk in these populations.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"133 ","pages":"Article 111041"},"PeriodicalIF":1.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006326","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 : 2025-01-17DOI: 10.1016/j.jocn.2025.111054
Kwadwo Darko , Grace Simmons , W. Elorm Yevudza Jr. , Pearl Tenkorang , Bernice Limann , Chibueze Agwu , Simon Sackitey , Ruth Agyekum , Peace Odiase , Nana K. Darko , Mina Guirguis , Umaru Barrie , Salah G. Aoun , Mabel Banson , Teddy Totimeh
Background
Approximately two percent of the world’s population are affected by intracranial aneurysms (IAs). This study aimed to evaluate literature regarding presentation, treatment and outcomes of ruptured IAs in Africa.
Methods
A systematic review of the literature using PubMed/MEDLINE, SCOPUS, Web of Science and Google Scholar databases was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
Results
Twenty-one retrospective studies with 1,109 patients and 11 case reports (10 countries) were included. The mean Methodological Index for Nonrandomized Studies (MINORS) for included articles was 9.1 ± 2.5. The mean age was 43.3 years (95 %CI: 37.8–48.8), with 58.4 % (342/586) female patients. WFNS/H&H grade 1 was reported in 41.2 % (98/238) of cases and Fischer grade 2 was reported in 30.4 % (98/322) of cases. CT angiography was utilized in 94.6 % (560/592, 12 articles). The ICA was reported in 24.5 % of cases (CI: 12.9 %-36.1 %). AComA and MCA were affected in 21.2 % (95 %CI: 15.2–27.2 %) and 21.3 % (95 %CI: 15.2–27.2 %) of cases, respectively. The odds of ruptured aneurysms in the anterior circulation were 14.3 (CI: 6.3–32.2). Surgical clipping was reported in 75.0 % (448/597) and coiling in 20.4 % (122/597) across 13 studies. 66.8 % (95 %CI: 57.4–76.3 %) of patients experienced neurological improvement with a mortality rate of 12.3 % (95 %CI: 7.5–17.1 %) at last follow-up.
Conclusion
Ruptured IAs are small and located in the anterior circulation. The lack of detailed aneurysm size reporting hampers the identification of a critical rupture size for management. More research is needed to understand aneurysm characteristics and predictors of rupture in Africa.
{"title":"Presentation, management and outcomes of ruptured intracranial aneurysms in Africa: A systematic review and meta-analysis","authors":"Kwadwo Darko , Grace Simmons , W. Elorm Yevudza Jr. , Pearl Tenkorang , Bernice Limann , Chibueze Agwu , Simon Sackitey , Ruth Agyekum , Peace Odiase , Nana K. Darko , Mina Guirguis , Umaru Barrie , Salah G. Aoun , Mabel Banson , Teddy Totimeh","doi":"10.1016/j.jocn.2025.111054","DOIUrl":"10.1016/j.jocn.2025.111054","url":null,"abstract":"<div><h3>Background</h3><div>Approximately two percent of the world’s population are affected by intracranial aneurysms (IAs). This study aimed to evaluate literature regarding presentation, treatment and outcomes of ruptured IAs in Africa.</div></div><div><h3>Methods</h3><div>A systematic review of the literature using PubMed/MEDLINE, SCOPUS, Web of Science and Google Scholar databases was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.</div></div><div><h3>Results</h3><div>Twenty-one retrospective studies with 1,109 patients and 11 case reports (10 countries) were included. The mean Methodological Index for Nonrandomized Studies (MINORS) for included articles was 9.1 ± 2.5. The mean age was 43.3 years (95 %CI: 37.8–48.8), with 58.4 % (342/586) female patients. WFNS/H&H grade 1 was reported in 41.2 % (98/238) of cases and Fischer grade 2 was reported in 30.4 % (98/322) of cases. CT angiography was utilized in 94.6 % (560/592, 12 articles). The ICA was reported in 24.5 % of cases (CI: 12.9 %-36.1 %). AComA and MCA were affected in 21.2 % (95 %CI: 15.2–27.2 %) and 21.3 % (95 %CI: 15.2–27.2 %) of cases, respectively. The odds of ruptured aneurysms in the anterior circulation were 14.3 (CI: 6.3–32.2). Surgical clipping was reported in 75.0 % (448/597) and coiling in 20.4 % (122/597) across 13 studies. 66.8 % (95 %CI: 57.4–76.3 %) of patients experienced neurological improvement with a mortality rate of 12.3 % (95 %CI: 7.5–17.1 %) at last follow-up.</div></div><div><h3>Conclusion</h3><div>Ruptured IAs are small and located in the anterior circulation. The lack of detailed aneurysm size reporting hampers the identification of a critical rupture size for management. More research is needed to understand aneurysm characteristics and predictors of rupture in Africa.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"133 ","pages":"Article 111054"},"PeriodicalIF":1.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006339","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 : 2025-01-16DOI: 10.1016/j.jocn.2025.111053
Jiyuan Yao , Bingyong Xie , Haoyu Ni , Zhibin Xu , Haoxiang Wang , Sicheng Bian , Kun Zhu , Peiwen Song , Yuanyuan Wu , Yongqiang Yu , Fulong Dong
Background
Cervical spondylotic myelopathy (CSM) is a debilitating condition that affects the cervical spine, leading to neurological impairments. While the neural mechanisms underlying CSM remain poorly understood, changes in brain network connectivity, particularly within the context of static and dynamic functional network connectivity (sFNC and dFNC), may provide valuable insights into disease pathophysiology. This study investigates brain-wide connectivity alterations in CSM patients using both sFNC and dFNC, combined with machine learning approaches, to explore their potential as biomarkers for disease classification and progression.
Methods
A total of 191 participants were included in this study, comprising 108 CSM patients and 83 healthy controls (HCs). Resting-state fMRI data were used to derive functional connectivity networks (FCNs), which were further analyzed to obtain sFNC and dFNC features. K-means clustering was applied to identify distinct dFNC states, and machine learning models, including support vector machine (SVM), decision tree (DT), linear discriminant analysis (LDA), logistic regression (LR), and random forests (RF), were constructed to classify CSM patients and HCs based on FNC features.
Results
The sFNC analysis revealed significant alterations in brain network connectivity in CSM patients, including enhanced connectivity between the posterior default mode network (pDMN) and ventral attention network (vAN), and between the right and left frontoparietal networks (rFPN and lFPN), alongside weakened connectivity in multiple other network pairs. K-means clustering of dFNC identified four distinct functional states, with CSM patients exhibiting altered connectivity in State 1 and State 3. Machine learning models based on sFNC demonstrated excellent classification performance, with the SVM model achieving an AUC of 0.92, accuracy of 85.86%, and sensitivity and specificity both exceeding 0.80. Models based on dFNC also performed well, with the State 3-based model yielding an AUC of 0.91 and accuracy of 84.97%.
Conclusions
Our findings highlight significant alterations in both sFNC and dFNC in CSM patients, suggesting that these connectivity changes may reflect underlying neural mechanisms of the disease. Machine learning models based on FNC features, particularly SVM, exhibit strong potential for classifying CSM patients and may serve as valuable neuroimaging biomarkers for diagnosis and monitoring disease progression. Future research should explore longitudinal studies and multimodal neuroimaging approaches to further validate these findings.
{"title":"Characterizing brain network alterations in cervical spondylotic myelopathy using static and dynamic functional network connectivity and machine learning","authors":"Jiyuan Yao , Bingyong Xie , Haoyu Ni , Zhibin Xu , Haoxiang Wang , Sicheng Bian , Kun Zhu , Peiwen Song , Yuanyuan Wu , Yongqiang Yu , Fulong Dong","doi":"10.1016/j.jocn.2025.111053","DOIUrl":"10.1016/j.jocn.2025.111053","url":null,"abstract":"<div><h3>Background</h3><div>Cervical spondylotic myelopathy (CSM) is a debilitating condition that affects the cervical spine, leading to neurological impairments. While the neural mechanisms underlying CSM remain poorly understood, changes in brain network connectivity, particularly within the context of static and dynamic functional network connectivity (sFNC and dFNC), may provide valuable insights into disease pathophysiology. This study investigates brain-wide connectivity alterations in CSM patients using both sFNC and dFNC, combined with machine learning approaches, to explore their potential as biomarkers for disease classification and progression.</div></div><div><h3>Methods</h3><div>A total of 191 participants were included in this study, comprising 108 CSM patients and 83 healthy controls (HCs). Resting-state fMRI data were used to derive functional connectivity networks (FCNs), which were further analyzed to obtain sFNC and dFNC features. K-means clustering was applied to identify distinct dFNC states, and machine learning models, including support vector machine (SVM), decision tree (DT), linear discriminant analysis (LDA), logistic regression (LR), and random forests (RF), were constructed to classify CSM patients and HCs based on FNC features.</div></div><div><h3>Results</h3><div>The sFNC analysis revealed significant alterations in brain network connectivity in CSM patients, including enhanced connectivity between the posterior default mode network (pDMN) and ventral attention network (vAN), and between the right and left frontoparietal networks (rFPN and lFPN), alongside weakened connectivity in multiple other network pairs. K-means clustering of dFNC identified four distinct functional states, with CSM patients exhibiting altered connectivity in State 1 and State 3. Machine learning models based on sFNC demonstrated excellent classification performance, with the SVM model achieving an AUC of 0.92, accuracy of 85.86%, and sensitivity and specificity both exceeding 0.80. Models based on dFNC also performed well, with the State 3-based model yielding an AUC of 0.91 and accuracy of 84.97%.</div></div><div><h3>Conclusions</h3><div>Our findings highlight significant alterations in both sFNC and dFNC in CSM patients, suggesting that these connectivity changes may reflect underlying neural mechanisms of the disease. Machine learning models based on FNC features, particularly SVM, exhibit strong potential for classifying CSM patients and may serve as valuable neuroimaging biomarkers for diagnosis and monitoring disease progression. Future research should explore longitudinal studies and multimodal neuroimaging approaches to further validate these findings.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"133 ","pages":"Article 111053"},"PeriodicalIF":1.9,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006283","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 : 2025-01-16DOI: 10.1016/j.jocn.2025.111030
Asmaa Mohammed AboElela , Soso Shawky Mohamed , Safar A Alsaleem , Rahil Abdulaziz M Aboareef , Ghaida Mohammed Al Hunaif , Yara Ahmed S Alshehri , Taif Ali A Almazni , Layan Saeed Alshmrani , Razan Mubarak Alqahtani , Lama Mohammed A Alshehri , Layan Dulaym Dashnan , Salem Ahmed S Alshehri , Dalia Mohammed Al manea , Ghala Saeed alahmari , Ramy Mohamed Ghazy
Background
Migraine is a common primary headache disorder that significantly affects academic life and is often associated with stress, depression, anxiety, and irregular sleep patterns among university students. This study aimed to assess the prevalence of migraine among King Khalid University (KKU) students, identify its determinants, and evaluate the impact of migraine and other headaches on academic life and performance.
Methods
An analytical cross-sectional study was conducted among 732 students from Colleges of Medicine, Pharmacy, Engineering, and Computer science. We used a self-administered questionnaire, including the ID Migraine™ screening tool, which was administered either through an online survey or face-to-face. Convenience and snowball sampling methods were adopted to recruit participants between June 1 and August 31, 2024.
Results
The median [interquartile range (IQR)] age was 21(2.0) years, 58.2 % were female, 97.5 % were Saudi, and 93.0 % were non-smokers. The prevalence of migraine was 44.1%. The key predictors of migraine were female gender (adjusted odds ratio (AOR) = 1.78 (1.29 – 2.46), P < 0.001), family history AOR = 2.39 (1.75– 3.27), P < 0.001], working alongside education (AOR = 1.95 (1.19 – 3.18), P = 0.007), family debt (AOR = 1.86 (1.06 – 3.29), P = 0.03), and having chronic diseases like bronchial asthma (AOR = 2.16 (1.11 – 4.20), P = 0.02) and hypertension AOR = 6.23 (1.34 – 28.84), P = 0.01). Over 90 % reported migraines affected concentration, sleep, and exam preparation, and 65 % indicated an impact on university attendance.
Conclusions
Migraines are highly prevalent among KKU students, affecting academic daily life. Early detection and lifestyle changes are essential, and universities should plan and implement coping strategies to support affected students.
{"title":"Migraine among King Khaled University students; prevalence, determinants, and impact on academic life","authors":"Asmaa Mohammed AboElela , Soso Shawky Mohamed , Safar A Alsaleem , Rahil Abdulaziz M Aboareef , Ghaida Mohammed Al Hunaif , Yara Ahmed S Alshehri , Taif Ali A Almazni , Layan Saeed Alshmrani , Razan Mubarak Alqahtani , Lama Mohammed A Alshehri , Layan Dulaym Dashnan , Salem Ahmed S Alshehri , Dalia Mohammed Al manea , Ghala Saeed alahmari , Ramy Mohamed Ghazy","doi":"10.1016/j.jocn.2025.111030","DOIUrl":"10.1016/j.jocn.2025.111030","url":null,"abstract":"<div><h3>Background</h3><div>Migraine is a common primary headache disorder that significantly affects academic life and is often associated with stress, depression, anxiety, and irregular sleep patterns among university students. This study aimed to assess the prevalence of migraine among King Khalid University (KKU) students, identify its determinants, and evaluate the impact of migraine and other headaches on academic life and performance.</div></div><div><h3>Methods</h3><div>An analytical cross-sectional study was conducted among 732 students from Colleges of Medicine, Pharmacy, Engineering, and Computer science. We used a self-administered questionnaire, including the ID Migraine™ screening tool, which was administered either through an online survey or face-to-face. Convenience and snowball sampling methods were adopted to recruit participants between June 1 and August 31, 2024.</div></div><div><h3>Results</h3><div>The median [interquartile range (IQR)] age was 21(2.0) years, 58.2 % were female, 97.5 % were Saudi, and 93.0 % were non-smokers. The prevalence of migraine was 44.1%. The key predictors of migraine were female gender (adjusted odds ratio (AOR) = 1.78 (1.29 – 2.46), P < 0.001), family history AOR = 2.39 (1.75– 3.27), P < 0.001], working alongside education (AOR = 1.95 (1.19 – 3.18), P = 0.007), family debt (AOR = 1.86 (1.06 – 3.29), P = 0.03), and having chronic diseases like bronchial asthma (AOR = 2.16 (1.11 – 4.20), P = 0.02) and hypertension AOR = 6.23 (1.34 – 28.84), P = 0.01). Over 90 % reported migraines affected concentration, sleep, and exam preparation, and 65 % indicated an impact on university attendance.</div></div><div><h3>Conclusions</h3><div>Migraines are highly prevalent among KKU students, affecting academic daily life. Early detection and lifestyle changes are essential, and universities should plan and implement coping strategies to support affected students.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"133 ","pages":"Article 111030"},"PeriodicalIF":1.9,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006331","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 : 2025-01-16DOI: 10.1016/j.jocn.2025.111049
Hang Li , Xue-Yun Wang , Ling-Yan Bao , Jia-Lei Zheng , Jing Li
Objective
The objective of this study was to develop a scale to assess the self-management capability of patients with spinal cord injuries and provide an evaluation tool for implementing targeted interventions.
Methods
Drawing upon the Integrated Theory of Health Behavior Change (ITHBC) and the International Classification of Functioning, Disability, and Health (ICF) framework, an initial version of the Spinal Cord Injury Patient Self-Management Capability Assessment Scale was developed through literature analysis, semi-structured interviews, and expert inquiry using the Delphi method. Subsequently, two rounds of inquiries were conducted with a panel of 20 experts to refine items in the scale based on the feedback obtained.
Results
The two rounds of expert inquiry questionnaires yielded an effective recovery rate of 100%, with expert authority coefficients for the two rounds of inquiries being 0.925 and 0.940, respectively. Kendall’s coefficient of concordance for the two rounds was 0.200 and 0.317, respectively. The finalized 54-item Spinal Cord Injury Patient Self-Management Capability Assessment Scale developed in this study comprises five dimensions: disease knowledge management, daily behavior management, social-psychological management, information and resource management, and rehabilitation exercise.
Conclusion
A Spinal Cord Injury Patient Self-Management Capability Assessment Scale was developed based on the Delphi method. It may be used to evaluate the level of self-management capability of patients with spinal cord injuries but warrants further empirical verification.
{"title":"Development and psychometric evaluation of a self-management ability assessment scale for individuals with spinal cord injury","authors":"Hang Li , Xue-Yun Wang , Ling-Yan Bao , Jia-Lei Zheng , Jing Li","doi":"10.1016/j.jocn.2025.111049","DOIUrl":"10.1016/j.jocn.2025.111049","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this study was to develop a scale to assess the self-management capability of patients with spinal cord injuries and provide an evaluation tool for implementing targeted interventions.</div></div><div><h3>Methods</h3><div>Drawing upon the Integrated Theory of Health Behavior Change (ITHBC) and the <em>International Classification of Functioning, Disability, and Health</em> (ICF) framework, an initial version of the Spinal Cord Injury Patient Self-Management Capability Assessment Scale was developed through literature analysis, semi-structured interviews, and expert inquiry using the Delphi method. Subsequently, two rounds of inquiries were conducted with a panel of 20 experts to refine items in the scale based on the feedback obtained.</div></div><div><h3>Results</h3><div>The two rounds of expert inquiry questionnaires yielded an effective recovery rate of 100%, with expert authority coefficients for the two rounds of inquiries being 0.925 and 0.940, respectively. Kendall’s coefficient of concordance for the two rounds was 0.200 and 0.317, respectively. The finalized 54-item Spinal Cord Injury Patient Self-Management Capability Assessment Scale developed in this study comprises five dimensions: disease knowledge management, daily behavior management, social-psychological management, information and resource management, and rehabilitation exercise.</div></div><div><h3>Conclusion</h3><div>A Spinal Cord Injury Patient Self-Management Capability Assessment Scale was developed based on the Delphi method. It may be used to evaluate the level of self-management capability of patients with spinal cord injuries but warrants further empirical verification.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"133 ","pages":"Article 111049"},"PeriodicalIF":1.9,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006302","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 : 2025-01-16DOI: 10.1016/j.jocn.2025.111050
Renuka Chintapalli , Stephano Chang , Tania Kaprealian , Ricky Savjani , Stephen Tenn , Ausaf Bari
Background
Tremor, either in patients with Essential Tremor (ET) or Parkinson’s disease (PD), constitutes the most common movement disorder. Stereotactic radiosurgery using Gamma Knife (GK) and linear accelerator (LINAC) systems, is an effective, incisionless treatment modality for ET and PD. Although these technologies have been used clinically since the 1990′s, most studies have focused on GK, and efficacy, safety and time to treatment effect (latency) of GK and LINAC have not been compared.
Objective
We therefore aimed to conduct a systematic review with network meta-analysis examining efficacy, adverse events (AEs) and latency of GK and LINAC for treating tremor in ET and PD.
Methods
We conducted a systematic review with network meta-analysis in accordance with PRISMA guidelines, using the Embase and PubMed databases. We included all primary GK/LINAC thalamotomy studies in ET/PD patients with at least 6 months of follow-up, reporting unilateral Fahn-Tolosa-Marin Tremor Scale (FTM-TRS) or Unified Parkinson’s disease rating scale (UPDRS) scores pre-treatment/post-treatment and/or AEs and/or latency. The primary efficacy outcome was FTM-TRS Scale A or UPDRS Item 16 score reduction. AEs were presented as an estimated incidence, and latency as average time to first recorded clinical improvement in tremor.
Results
Six studies of 311 patients and 2 studies of 60 patients met inclusion criteria for GK/LINAC efficacy comparison, respectively. Network meta-analysis showed similar tremor reduction between modalities (standardized mean difference between pre- and post-treatment scores: GK: −2.18 (95 % CI: −2.79, −1.57); LINAC: −2.13 (95 % CI: −5.13, 0.87). GK also had a higher absolute AE rate, while LINAC was associated with a greater latency period. There was no correlation between GK efficacy and AE rate.
Conclusions
Despite the relatively small sample sizes, these results demonstrate similar efficacy between GK and LINAC for ET and PD, with a trend toward higher efficacy but greater AE incidence and slower onset of tremor improvement in GK compared to LINAC.
{"title":"Gamma knife versus linear accelerator thalamotomy for essential tremor and Parkinson’s disease: A systematic review and meta-analysis","authors":"Renuka Chintapalli , Stephano Chang , Tania Kaprealian , Ricky Savjani , Stephen Tenn , Ausaf Bari","doi":"10.1016/j.jocn.2025.111050","DOIUrl":"10.1016/j.jocn.2025.111050","url":null,"abstract":"<div><h3>Background</h3><div>Tremor, either in patients with Essential Tremor (ET) or Parkinson’s disease (PD), constitutes the most common movement disorder. Stereotactic radiosurgery using Gamma Knife (GK) and linear accelerator (LINAC) systems, is an effective, incisionless treatment modality for ET and PD. Although these technologies have been used clinically since the 1990′s, most studies have focused on GK, and efficacy, safety and time to treatment effect (latency) of GK and LINAC have not been compared.</div></div><div><h3>Objective</h3><div>We therefore aimed to conduct a systematic review with network <em>meta</em>-analysis examining efficacy, adverse events (AEs) and latency of GK and LINAC for treating tremor in ET and PD.</div></div><div><h3>Methods</h3><div>We conducted a systematic review with network <em>meta</em>-analysis in accordance with PRISMA guidelines, using the Embase and PubMed databases. We included all primary GK/LINAC thalamotomy studies in ET/PD patients with at least 6 months of follow-up, reporting unilateral Fahn-Tolosa-Marin Tremor Scale (FTM-TRS) or Unified Parkinson’s disease rating scale (UPDRS) scores pre-treatment/post-treatment and/or AEs and/or latency. The primary efficacy outcome was FTM-TRS Scale A or UPDRS Item 16 score reduction. AEs were presented as an estimated incidence, and latency as average time to first recorded clinical improvement in tremor.</div></div><div><h3>Results</h3><div>Six studies of 311 patients and 2 studies of 60 patients met inclusion criteria for GK/LINAC efficacy comparison, respectively. Network <em>meta</em>-analysis showed similar tremor reduction between modalities (standardized mean difference between pre- and post-treatment scores: GK: −2.18 (95 % CI: −2.79, −1.57); LINAC: −2.13 (95 % CI: −5.13, 0.87). GK also had a higher absolute AE rate, while LINAC was associated with a greater latency period. There was no correlation between GK efficacy and AE rate.</div></div><div><h3>Conclusions</h3><div>Despite the relatively small sample sizes, these results demonstrate similar efficacy between GK and LINAC for ET and PD, with a trend toward higher efficacy but greater AE incidence and slower onset of tremor improvement in GK compared to LINAC.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"133 ","pages":"Article 111050"},"PeriodicalIF":1.9,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006321","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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