Journal of Clinical Neuroscience最新文献

{"title":"Seizure risk prediction using machine learning following glioma resection surgery in seizure-naïve patients","authors":"Hua Yang ,&nbsp;Hao Wen ,&nbsp;Jiadan Ye ,&nbsp;Li Yang ,&nbsp;Zhigang Zhao","doi":"10.1016/j.jocn.2026.111869","DOIUrl":"10.1016/j.jocn.2026.111869","url":null,"abstract":"<div><h3>Background:</h3><div>Despite the ongoing controversy around the prophylactic use of antiseizure medications (ASMs) in seizure-naïve patients undergoing brain tumor surgery, this practice has persisted for years. This study aims to develop and validate a machine-learning framework for stratifying postoperative seizure risk.</div></div><div><h3>Methods:</h3><div>Demographic, tumor topographic, surgery-related details, and biomarkers were collected from a retrospective study involving patients undergoing glioma resection. The dataset was split in a stratified manner into an 80/20 ratio for training and testing purposes. Machine learning (ML) models, including random forest (RF), XGBoost, gradient boosting decision tree (GBDT), multi-layer perceptron (MLP), bootstrap-aggregation ensemble classifier with decision tree classifier (Bagging), and logistic regression (LR), were developed and evaluated. The SHAP method was applied to interpret the attribution values of the top features.</div></div><div><h3>Results:</h3><div>Among the 786 eligible patients, with a median age of 42.0 years (interquartile range [IQR] = 25.3-54.0), 154 (19.6%) experienced postoperative seizures. The multi-layer perceptron model demonstrated the best predictive performance, incorporating demographic, topographic, surgery-related, and biomarker variables (Test: AUC: 0.74, Accuracy: 0.70, Sensitivity: 0.56, Specificity: 0.73). Notably, a simpler model relying solely on demographic and topographic features also yielded comparable performance.</div></div><div><h3>Conclusions:</h3><div>This study underscores the effectiveness of the multi-layer perceptron model, which integrates demographic, topographic, surgery-related, and biomarker variables. This integration successfully developed a personalized prediction model for postoperative seizure risk. Such a model holds the potential to aid physicians in optimizing postoperative management, particularly in guiding decisions regarding the duration and discontinuation of prophylactic antiseizure medications.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"146 ","pages":"Article 111869"},"PeriodicalIF":1.8,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076232","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":"Longitudinal effects of dimethyl fumarate on patient-reported outcome measures in multiple sclerosis: treatment satisfaction, quality of life, depressive symptoms, sleep, and work productivity","authors":"Roya Abolfazli ,&nbsp;Mohammad Ali Sahraian ,&nbsp;Vahid Shaygannejad ,&nbsp;Fereshteh Ashtari ,&nbsp;Sareh Shahmohammadi ,&nbsp;Maryam Poursadeghfard ,&nbsp;Seyed Mohammad Baghbanian ,&nbsp;Nastaran Majdinasab ,&nbsp;Mohammad Ali Nahayati ,&nbsp;Samaneh Hosseini ,&nbsp;Javad Yousefi Azarfam ,&nbsp;Samira Navardi ,&nbsp;Hamid Reza Torabi ,&nbsp;Hormoz Ayromlou ,&nbsp;Morteza Saeidi ,&nbsp;Mahnaz Talebi ,&nbsp;Alireza Nikseresht ,&nbsp;Zahra Niknam ,&nbsp;Amirreza Azimi ,&nbsp;Behnaz Sedighi ,&nbsp;Sara Samadzadeh","doi":"10.1016/j.jocn.2026.111877","DOIUrl":"10.1016/j.jocn.2026.111877","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Oral therapies for relapsing–remitting multiple sclerosis (RRMS) may enhance treatment satisfaction and quality of life. Patient-reported outcome measures (PROMs) provide structured insight into treatment effectiveness and disease impact beyond clinician-reported scales.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To assess treatment satisfaction and other PROMs in RRMS patients initiating dimethyl fumarate (DMF), either treatment-naïve or switching from injectable therapies.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;PROFIT was a 12-month, multicenter, phase 4, open-label, single-arm observational study conducted in Iran. Patients received DMF with a slow-dose titration regimen to mitigate gastrointestinal adverse effects. The primary endpoint was the change in treatment satisfaction, assessed by the Treatment Satisfaction Questionnaire for Medication (TSQM-14), from baseline to month 12 among previously treated patients. Key secondary endpoints included changes in additional PROMs, including health-related quality of life (HRQoL), depressive symptoms, sleep quality, and work productivity. Patient-reported outcomes were assessed using the EuroQol-5D-3L (EQ-5D-3L), Beck Depression Inventory–Fast Screen (BDI-7), Pittsburgh Sleep Quality Index (PSQI), and Work Productivity and Activity Impairment–Multiple Sclerosis (WPAI-MS) at baseline, 6 months, and 12 months. Adverse events were monitored monthly, with safety evaluated as a secondary outcome.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Of 645 patients (72.3 % female; mean age 34.0 years), 473 (73.3 %) completed the 12-month follow-up, while 172 (26.7 %) discontinued treatment. The primary endpoint, change in treatment satisfaction (TSQM-14) among previously treated patients, showed significant improvement across all domains: effectiveness (+13.01), side effects (+7.76), convenience (+35.21), and global satisfaction (+15.75) (all p &lt; 0.001). Secondary endpoints also demonstrated favorable changes, including EQ-5D-3L utility (+0.07), EQ-5D Visual Analogue Scale (VAS) (+3.86), PSQI (–1.62), WPAI absenteeism (–7.55 %), and BDI-7 (–0.11) (all p &lt; 0.001). Treatment discontinuations (26.7 %) were primarily due to gastrointestinal adverse events (n = 45, 26.0 %), followed by physician decision (n = 34, 20.0 %), disease progression (n = 26, 15.0 %), patient preference (n = 19, 11.0 %), pregnancy (n = 14, 8.0 %), elevated liver enzymes (n = 13, 7.0 %), and other causes (n = 21, 12.0 %). Adverse events declined over time, confirming a favorable and manageable safety profile.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;DMF was associated with improvements in treatment satisfaction, quality of life, sleep quality, work productivity, and depressive symptoms in both treatment-naïve and previously treated RRMS patients, with high adherence and manageable side effects. These findings provide real-world evidence from an Iranian RRMS cohort, supporting DMF as a well-tolerated, patient-centered option ","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"146 ","pages":"Article 111877"},"PeriodicalIF":1.8,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076186","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":"Comparative safety and health service utilization for gabapentin versus non-steroidal anti-inflammatory drugs for cervical radiculopathy: A retrospective cohort study of academic centers","authors":"Anthony N. Baumann ,&nbsp;Robert J. Trager ,&nbsp;Dalton McGlamery ,&nbsp;Shahabeddin Yazdanpanah ,&nbsp;Keegan T. Conry ,&nbsp;Gordon Preston ,&nbsp;Jacob C. Hoffmann","doi":"10.1016/j.jocn.2026.111896","DOIUrl":"10.1016/j.jocn.2026.111896","url":null,"abstract":"<div><h3>Background</h3><div>Off-label use of gabapentin for neuropathic pain conditions such as cervical radiculopathy (CR) remains controversial due to limited evidence of benefit and safety concerns (e.g., opioid co-prescription, adverse drug events [ADEs], dizziness, and hospitalization risk), necessitating further research. This study explores safety risks and health service utilization in adults with newly diagnosed CR, comparing gabapentin to nonsteroidal anti-inflammatory drugs (NSAIDs) to inform clinical practice.</div></div><div><h3>Methods</h3><div>This retrospective propensity-matched cohort study using the TriNetX database included opioid-naïve adults (≥18 years) with newly-diagnosed CR without history of spinal surgery, spinal neoplasms, myelopathy, opioid-use disorder or cervical injection. Patients were divided into gabapentin or NSAID cohorts based on prescription at CR diagnosis, and matched for demographics, prescriptions, and comorbidities. Outcomes included incidence and risk ratios (RRs) of safety and health service utilization markers assessed through one year. Significance was evaluated at P &lt; 0.0036 (Bonferroni-corrected).</div></div><div><h3>Results</h3><div>After matching, there were 23,379 patients (mean age: 53 years; 57% female) per cohort. About 14% of patients per cohort were co-prescribed opioids at CR diagnosis. Compared to the NSAID cohort, the gabapentin cohort had a statistically significant (P &lt; 0.0036) increased risk of posterior cervical fusion (RR: 3.23), opioid-related disorder (RR: 2.87), cervical corticosteroid injection (RR: 2.52), opioid-related ADEs (RR: 2.32), anterior cervical discectomy and fusion (RR: 2.10), acute respiratory failure (RR: 1.80), cervical spine magnetic resonance imaging (RR: 1.43), inpatient visits (RR: 1.38), oral opioid prescription (RR: 1.34), and cervical spine radiographic imaging (RR: 1.21). Risk of dizziness, falls, somnolence, and emergency department visits was not significantly increased (P &gt; 0.0036).</div></div><div><h3>Conclusion</h3><div>Gabapentin prescription for newly-diagnosed CR in adults was associated with increases in opioid prescription, adverse safety events, and health service utilization compared to NSAIDs, corroborating its lack of guideline recommendation for CR. No outcome favored gabapentin over NSAIDs. Gabapentin was occasionally co-prescribed with opioids at CR diagnosis, raising concerns.</div><div><em>Level of Evidence:</em> Level IV.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"146 ","pages":"Article 111896"},"PeriodicalIF":1.8,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076234","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":"Neurophysiological insights into iNPH: ABR and CAEP responses to lumbar puncture and shunt surgery","authors":"Lucas Pinto Mielle ,&nbsp;Nayara Pereira Santos ,&nbsp;Liliane Aparecida Fagundes Silva ,&nbsp;Sandro Luíz de Andrade Matas ,&nbsp;Carla Gentile Matas","doi":"10.1016/j.jocn.2026.111884","DOIUrl":"10.1016/j.jocn.2026.111884","url":null,"abstract":"<div><h3>Background</h3><div>Idiopathic normal pressure hydrocephalus (iNPH) is a neurological syndrome resulting from increased cerebrospinal fluid volume without significant increase in intracranial pressure. The diagnosis is difficult and investigating other tools that can assist in this process is essential. Auditory Evoked Potentials (AEPs) can be used to assess the auditory pathway integrity and monitor cognitive auditory functions. The objective of this study was to investigate the applicability of the AEPs as a potential monitoring tool for detecting clinical improvements associated with cerebrospinal fluid removal by lumbar puncture and VPS placement in patients with iNPH.</div></div><div><h3>Methods</h3><div>This longitudinal study, evaluated 17 individuals with iNPH, aged over 60 years who underwent the ventriculoperitoneal shunt, by Auditory Brainstem Response (ABR) and Cortical Auditory Evoked Potentials (CAEP) at three different times: before the lumbar puncture during the Tap test, two to four hours after the lumbar puncture, and after the ventriculoperitoneal shunt.</div></div><div><h3>Results</h3><div>A decrease in P3 latency was observed after lumbar puncture during Tap test. No statistically significant differences were observed between assessments for P1, N1 P2, N2 latencies or P1-N1, P2-N2 and N2-P3 amplitudes of the CAEP, as well as for the absolute and interpeaks latencies of the ABR.</div></div><div><h3>Conclusions</h3><div>After the removal of significant volumes of cerebrospinal fluid in patients with iNPH, lower P3 latency values were found, suggesting an increase in the speed of acoustic information processing, during the Tap test. This result brings an insight on the applicability of this procedure as an auxiliary method for monitoring clinical improvements associated with cerebrospinal fluid removal in iNPH.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"146 ","pages":"Article 111884"},"PeriodicalIF":1.8,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076236","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":"Development and temporal validation of an odds ratio-weighted prognostic score (NPH-RKP) for idiopathic normal pressure hydrocephalus shunt surgery: a retrospective cohort study","authors":"Usame Rakip ,&nbsp;Serhat Yildizhan ,&nbsp;İhsan Canbek ,&nbsp;Mehmet Gazi Boyacı ,&nbsp;Serhat Korkmaz ,&nbsp;Omer Kimsesiz ,&nbsp;Abdullah Guzel ,&nbsp;Anas Abdallah ,&nbsp;Adem Aslan","doi":"10.1016/j.jocn.2026.111883","DOIUrl":"10.1016/j.jocn.2026.111883","url":null,"abstract":"<div><h3>Background</h3><div>Idiopathic normal pressure hydrocephalus (iNPH) is a major cause of reversible gait and cognitive impairment in older adults, yet postoperative outcomes remain difficult to predict. Existing prognostic tools are limited by methodological shortcomings, including lack of temporal validation, dependence on subjective radiological markers, insufficient events-per-variable ratios, and absence of transparent graded risk stratification. To address these gaps, we developed the first temporally validated, odds ratio–weighted prognostic scoring system specifically designed for iNPH surgical outcomes.</div></div><div><h3>Methods</h3><div>This single-center retrospective study included 114 consecutive patients treated with ventriculoperitoneal shunting between 2015 and 2024. Candidate predictors were systematically assessed, and the Normal Pressure Hydrocephalus Risk-Prediction Score (NPH-RKP) was constructed using five objective clinical variables routinely available in standard practice: age, iNPH Grading Scale score, Mini-Mental State Examination (MMSE), Fazekas score, and diagnostic delay. Four competing scoring frameworks were compared, and the odds ratio-weighted graded model was selected based on performance and interpretability. The dataset was temporally divided into development (2015–2020, n = 59) and validation (2021–2024, n = 55) cohorts. The primary endpoint was global clinical improvement at 12 months, incorporating gait, cognitive, and urinary metrics.</div></div><div><h3>Results</h3><div>Multivariable modeling identified five independent predictors (OR range: 2.00–4.14, 95% CI: 1.82–9.42). The resulting 0–12-point NPH-RKP score demonstrated excellent discrimination in the development cohort (AUC = 0.939, 95% CI: 0.881–0.985) with strong calibration (Hosmer–Lemeshow p = 0.511; Brier score = 0.113). Temporal validation revealed retained prognostic accuracy (AUC = 0.824, 95% CI: 0.715–0.933), with expected performance attenuation attributable to evolving clinical practice and improved surgical outcomes. Distinct risk strata yielded sharply separated success rates: low-risk (0–4 points, 91.4%), intermediate-risk (5–7 points, 62.5%), and high-risk (8–12 points, 8.3%). The model achieved a robust EPV of 7.8, outperforming prior iNPH tools while maintaining ease of calculation.</div></div><div><h3>Conclusions</h3><div>The NPH-RKP provides a transparent, clinically accessible, and methodologically rigorous prognostic framework for predicting iNPH shunt outcomes. Its objective parameters, grading structure, and temporal validation enhance its clinical applicability in routine decision-making and patient counseling. Prospective multicenter validation is warranted to confirm its generalizability across diverse healthcare settings.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"146 ","pages":"Article 111883"},"PeriodicalIF":1.8,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146063802","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":"Excessive daytime sleepiness in patients with idiopathic normal pressure hydrocephalus: A controlled cross-sectional study","authors":"Halil Onder ,&nbsp;Nursu Erdogan ,&nbsp;Ahmet Gunaydin ,&nbsp;Selcuk Comoglu","doi":"10.1016/j.jocn.2026.111885","DOIUrl":"10.1016/j.jocn.2026.111885","url":null,"abstract":"<div><h3>Background</h3><div>Idiopathic normal pressure hydrocephalus (iNPH) is characterized by gait disturbance, cognitive impairment, and urinary incontinence, yet non-motor symptoms such as sleep disturbances remain underexplored.</div></div><div><h3>Objective</h3><div>To investigate subjective daytime sleepiness and sleep apnea in patients with iNPH compared with healthy controls, and to assess their association with disease severity.</div></div><div><h3>Methods</h3><div>In this cross-sectional study, 46 iNPH patients and 74 age- and sex-matched controls were evaluated with the Epworth Sleepiness Scale (ESS). Apnea was assessed using a semi-structured frequency interview. Disease severity was rated with the NPH grading scale and MDS-UPDRS-3. Group comparisons and correlation analyses were performed.</div></div><div><h3>Results</h3><div>ESS scores were significantly higher in iNPH patients (10.3 ± 7.1) than in controls (6.8 ± 5.6, p = 0.008), and this difference remained after adjusting for age and BMI. No significant associations were observed between ESS scores and motor or cognitive severity measures. Apnea frequency did not differ significantly between groups and showed no relationship with disease severity.</div></div><div><h3>Conclusions</h3><div>Excessive daytime sleepiness is common in iNPH and appears independently of motor or cognitive burden, suggesting it may be an underrecognized non-motor feature. Further studies incorporating objective sleep assessments and advanced neuroimaging are warranted to clarify underlying mechanisms and explore potential therapeutic implications, including the role of sleep-focused interventions.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"146 ","pages":"Article 111885"},"PeriodicalIF":1.8,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037284","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":"Clinical and surgical significance of the jugular foramen anatomy: systematic review with meta-analysis","authors":"Nikolaos Taprantzis,&nbsp;Dimosthenis Chrysikos,&nbsp;Amir Shihada,&nbsp;Maria Piagkou,&nbsp;Theodore Troupis","doi":"10.1016/j.jocn.2026.111881","DOIUrl":"10.1016/j.jocn.2026.111881","url":null,"abstract":"<div><h3>Background</h3><div>The jugular foramen, at the junction of the temporal and occipital bones, contains critical neurovascular structures. Variations such as high-riding bulbs, bony domes, and septations can influence clinical syndromes and complicate surgery. While some reviews address individual features, no <em>meta</em>-analysis has comprehensively evaluated jugular foramen morphology and its clinical and surgical significance.</div></div><div><h3>Methods</h3><div>We systematically searched PubMed, Embase, Web of Science, and Scopus for studies reporting jugular foramen morphometry, including dome presence, septations, fossa depth, and high jugular bulbs. Pooled prevalence estimates were calculated using R programming software, with heterogeneity and risk of bias assessed via AQUA, Peter’s, and Egger’s tests.</div></div><div><h3>Results</h3><div>Our <em>meta</em>-analysis revealed significant intercontinental and sex-related variations in jugular foramen morphology. African populations had fewer bilateral domes (20% vs. ∼54–55%), higher dome absence (53.7% vs. &lt;13%), and larger AP diameters, while high-riding bulbs were more common in Asia (16.52%). Magnetic Resonance Imaging was associated with a significantly lower high jugular bulb prevalence, compared to osteological assessments and Computed Tomography-based techniques. Males showed slightly larger mediolateral dimensions, whereas females had a modestly higher incidence of high-riding bulbs (ratio 1.33). Bony septum analysis showed left partial septation as the most common pattern, with complete septations in 15.05% (right) and 12.11% (left) of individuals, indicating additional clinically relevant anatomical variation.</div></div><div><h3>Conclusion</h3><div>Anatomical variations of the jugular foramen—including asymmetry, dome morphology, high-riding bulbs, and septations—have direct clinical implications. They influence neurovascular compression, risk of hearing disturbances, tumor extension, and surgical planning for middle ear and skull base procedures. Recognition of these patterns is essential for safe operative navigation, minimizing intraoperative complications, and optimizing patient outcomes.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"146 ","pages":"Article 111881"},"PeriodicalIF":1.8,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037286","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":"Trends and disparities in cerebral edema-related mortality in the United States: A nationwide analysis using CDC WONDER data, 1999–2023","authors":"Hadiya Javed ,&nbsp;Shahtaj Tariq ,&nbsp;Wania Ahmer ,&nbsp;Muhammad Khalid Afridi ,&nbsp;Raheel Ahmed","doi":"10.1016/j.jocn.2026.111871","DOIUrl":"10.1016/j.jocn.2026.111871","url":null,"abstract":"<div><div>Cerebral edema (CE) refers to excess accumulation of fluid in the brain parenchyma, which can result from trauma, stroke, infections, or metabolic insults. Despite its clinical importance, national trends and disparities in CE-related mortality remain understudied. We analyzed mortality data from 1999 to 2023 using the CDC WONDER database. Deaths listing CE, defined by the International Classification of Diseases, 10th Revision, as a contributing cause were included. The trends were stratified by age, sex, race/ethnicity, region, and urbanization level. We calculated crude and age-adjusted mortality rates (AAMRs) and assessed trends using the Joinpoint Regression Program with results considered statistically significant if the two-sided <em>t</em>-test yielded p-values &lt; 0.05. A total of 77,278 CE-related deaths occurred from 1999 to 2023. National AAMRs rose from 0.94 per 100,000 population in 1999 to 1.3 per 100,000 population in 2023, with a significant overall increase (AAPC: +1.41 %, 95 % CI: 1.2–1.6; p &lt; 0.001). Adults aged 25–44 exhibited the sharpest rise (AAPC: 1.56 %; 95 % CI: 1.33 to 1.81). Black individuals experienced the highest mortality (peak AAMR: 0.43, AAPC: +2.08 %, 95 % CI: 1.67–2.51). The South showed the highest regional burden (AAMR: 0.32, AAPC: +1.59 %, 95 % CI: 1.38–1.79), while non-metropolitan areas reported disproportionately high mortality rates (AAPC: +2.4 %, 95 % CI: 1.5–3.2; p &lt; 0.001). CE-related mortality has increased significantly in the U.S., with marked disparities by age, race, and geography. These findings highlight the need for targeted prevention, early detection, and equity-focused intervention strategies.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"146 ","pages":"Article 111871"},"PeriodicalIF":1.8,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037283","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":"AICA aneurysm–related subarachnoid hemorrhage in a dural AVF","authors":"Ujjwal Agarwal ,&nbsp;Rajsrinivas Parthasarathy ,&nbsp;Radhey Shyam Singla ,&nbsp;Pallav Bhatter","doi":"10.1016/j.jocn.2026.111880","DOIUrl":"10.1016/j.jocn.2026.111880","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"146 ","pages":"Article 111880"},"PeriodicalIF":1.8,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037280","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":"Utilizing internal analytics and physician-director collaborations to enhance neurological health communication on YouTube","authors":"Benjamin K.P. Woo ,&nbsp;Jamie O.P. Chung","doi":"10.1016/j.jocn.2026.111878","DOIUrl":"10.1016/j.jocn.2026.111878","url":null,"abstract":"<div><div>The dissemination of health information on YouTube presents a paradox where expert-generated content, despite high clinical accuracy, often lacks the engagement seen in non-expert patient narratives. Recent evaluations of Guillain-Barré Syndrome (GBS) videos confirm that while physician-produced content achieves superior objective quality scores, it frequently suffers from low visibility and fails to correlate popularity with scientific validity. This manuscript proposes a shift toward utilizing internal analytics, specifically Average View Duration (AVD) and Click-Through Rate (CTR), alongside a collaborative physician-director production model to bridge the gap between clinical precision and public engagement. We suggest that adopting this hybrid creative model and prioritizing internal engagement metrics over aggregate view counts will better support patients and caregivers, particularly in complex neurological conditions.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"146 ","pages":"Article 111878"},"PeriodicalIF":1.8,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037287","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}