Journal of Clinical Neuroscience最新文献

{"title":"Beyond chronological age: The role of biological age in neurosurgical decision-making in long-lived individuals","authors":"Johana Patricia Galván-Barrios , Jessica Manosalva-Sandoval","doi":"10.1016/j.jocn.2025.111142","DOIUrl":"10.1016/j.jocn.2025.111142","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"134 ","pages":"Article 111142"},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501467","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":"Impact of cement cranioplasty on cerebrospinal fluid leaks after retrosigmoid craniotomy − A systematic review and meta-analysis","authors":"Alberto Benato ,&nbsp;Gianluca Trevisi ,&nbsp;Davide Palombi ,&nbsp;Fabio Zeoli ,&nbsp;Carmelo Lucio Sturiale","doi":"10.1016/j.jocn.2025.111109","DOIUrl":"10.1016/j.jocn.2025.111109","url":null,"abstract":"<div><h3>Background</h3><div>Cerebrospinal fluid (CSF) leaks and related complications (CLRC) are common after retrosigmoid approaches for cerebellopontine angle (CPA) surgeries. Bone cement cranioplasty (CCP) may provide additional sealing benefits over reconstruction without cement (RWC) in reducing these complications. This study aimed to compare the outcomes of CCP versus RWC in CPA surgery.</div></div><div><h3>Methods</h3><div>A systematic review and <em>meta</em>-analysis following PRISMA guidelines was conducted using three databases (PubMed, Scopus, Web of Science). Studies were included comparing CCP and RWC in retrosigmoid craniotomies/craniectomies for CPA pathologies. Primary outcomes were pseudo meningocele, external CSF leaks, and CLRC, while secondary outcomes included wound infection rates and rates of reoperation for wound problems. <strong>Results:</strong> Five retrospective studies were analyzed with 1,838 patients (931 CCP, 907 RWC). CCP significantly reduced the rates of pseudo meningocele (OR 0.264, CI 0.150–0.463), wound CSF leaks (OR 0.105, CI 0.028–0.399) and CLRC (OR 0.248, CI 0.078–0.794). In the CCP group, there were fewer wound infections (OR 0.310, CI 0.114–0.790) and lower reoperation rates (OR 0.189, CI 0.050–0.708).</div></div><div><h3>Conclusions</h3><div>Cement cranioplasty is associated with a lower incidence of CSF leaks and related complications compared to RWC following retrosigmoid approaches for CPA pathology. CCP also reduces reoperations and wound infections. These findings support using CCP as an effective technique for lowering postoperative complications of retrosigmoid approaches.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111109"},"PeriodicalIF":1.9,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464762","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}

{"title":"Epilepsy surgery candidate identification with artificial intelligence: An implementation study","authors":"Sheryn Tan ,&nbsp;Rudy Goh ,&nbsp;Alexander Wright ,&nbsp;Jeng Swen Ng ,&nbsp;Lewis Hains ,&nbsp;Joshua Kovoor ,&nbsp;Brandon Stretton ,&nbsp;Andrew E.C. Booth ,&nbsp;Shrirajh Satheakeerthy ,&nbsp;Sarah Howson ,&nbsp;Shaun Evans ,&nbsp;Aashray Gupta ,&nbsp;Christopher Ovenden ,&nbsp;James Triplett ,&nbsp;Ishith Seth ,&nbsp;Erin Kelly ,&nbsp;Michelle Kiley ,&nbsp;Amal Abou-Hamden ,&nbsp;Toby Gilbert ,&nbsp;John Maddison ,&nbsp;Stephen Bacchi","doi":"10.1016/j.jocn.2025.111144","DOIUrl":"10.1016/j.jocn.2025.111144","url":null,"abstract":"<div><h3>Background</h3><div>To (a) evaluate the effect of a machine learning algorithm in the identification of patients suitable for epilepsy surgery evaluation, and (b) examine the performance of a large language model (LLM) in the collation of key pieces of information pertaining to epilepsy surgery evaluation referral.</div></div><div><h3>Methods</h3><div>Artificial intelligence analyses were performed for all patients seen in the epilepsy or first seizure clinic at a tertiary hospital over a 12-month period. This study design was intended to emulate a case review that could subsequently be conducted periodically (e.g., quarterly). The previously derived random forest model was used to stratify all patients by their likelihood of being a candidate for epilepsy surgery evaluation, and the top 5% of cases underwent manual case note review. An open source LLM was utilised to answer 7 prompts summarising and extracting pieces of information from the most recent clinic note, which would be relevant to epilepsy surgery evaluation referral.</div></div><div><h3>Results</h3><div>310 patients were included in the study, with 15 undergoing manual review. Of these patients 8/15 (53.3 %) met the prespecified criteria for epilepsy surgery evaluation. 3/15 (20.0 %) of these patients were subsequently referred for further evaluation within 1 month of the study. The LLM had an accuracy ranging between 80 % to 100 % on the different prompts. Errors occurred most often when summarising the management plan. Errors included hallucinations, omissions, and copying erroneous information.</div></div><div><h3>Conclusions</h3><div>Artificial intelligence may be able to assist with the identification of patients suitable for epilepsy surgery evaluation.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111144"},"PeriodicalIF":1.9,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143471179","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":"Association between admission serum hemoglobin concentration and the Black Hole Sign on cranial CT in ICH patients: A cross-sectional study","authors":"Weiduo Zhou ,&nbsp;Yidan Liang ,&nbsp;Peng Chen ,&nbsp;Yongbing Deng ,&nbsp;Wenyi Tang ,&nbsp;Yanglingxi Wang","doi":"10.1016/j.jocn.2025.111140","DOIUrl":"10.1016/j.jocn.2025.111140","url":null,"abstract":"<div><h3>Objective</h3><div>This study explores the correlation between admission hemoglobin (HGB) concentration and the Black Hole Sign (BHS) presence on cranial CT scans in spontaneous intracerebral hemorrhage (ICH) patients. Given the prognostic value of BHS in predicting early hematoma expansion and the potential role of HGB levels in influencing outcomes in cerebrovascular conditions, this study seeks to explore the correlation between these two factors. By analyzing clinical and imaging data from the past five years, we aim to provide new insights into the relationship between HGB concentrations and BHS in ICH patients.</div></div><div><h3>Methods</h3><div>A single-center cross-sectional study gathered data from 330 ICH patients admitted to Chongqing Emergency Medical Center’s neurosurgery department between June 2018 and November 2023. Logistic regression and subgroup analysis analyzed the association between admission HGB concentration and BHS occurrence. Curve fitting evaluated any linear relationship.</div></div><div><h3>Results</h3><div>Among 330 patients (mean age: 58.4 ± 13.1 years, 72.1 % males), 40.0 % exhibited BHS on initial CT scans. Multifactorial adjustments revealed a negative correlation between admission HGB concentration and BHS. In subgroup analyses of age, sex, volume of cerebral hemorrhage, insular leaf damage, cerebral hernia, thalamic hemorrhage, and ventricular hemorrhage, No significant interactions were observed between subgroups. For every 1 g/L rise in HGB upon admission, there was a 3 % reduction in BHS likelihood (OR: 0.97, 95 % CI: 0.95–0.99).</div></div><div><h3>Conclusions</h3><div>Lower admission HGB concentrations in spontaneous cerebral hemorrhage patients correlated with increased BHS incidence on cranial CT scans. These findings underscore the importance of balanced HGB levels in ICH patients, potentially serving as a protective measure against stroke risk. Given the possible negative impact of low hemoglobin levels on coagulation and outcomes after a hemorrhage, we advise that middle-aged and elderly individuals with hypertension and other stroke risk factors receive regular medical evaluations. However, given the cross-sectional design of this study, the causal relationship between HGB levels and the BHS should be further validated through prospective cohort studies and large-scale, multicenter trials.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111140"},"PeriodicalIF":1.9,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464763","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":"Cervical extensor muscles involution in patients with symptomatic degenerative conditions: Comparative analysis and impact on alignment parameters","authors":"Brando Guarrera ,&nbsp;Cristina Cuppone ,&nbsp;Rossella Rispoli ,&nbsp;Changik Lee ,&nbsp;Giuseppe Canova ,&nbsp;Enrico Giordan","doi":"10.1016/j.jocn.2025.111112","DOIUrl":"10.1016/j.jocn.2025.111112","url":null,"abstract":"<div><h3>Introduction</h3><div>In recent years, researchers have studied the impact of lumbar paraspinal muscles’ fatty infiltration (FI) on instability and pain. FI is also commonly found in patients with cervical spine conditions such as degenerative myelopathy and spondylosis. Increased FI in the cervical flexor and extensor muscles has been linked to higher pain and disability. This study aims to analyze the composition of extensor muscles in preoperative imaging for patients undergoing cervical spine surgery, correlating them with cervical alignment and demographic parameters.</div></div><div><h3>Materials and Methods</h3><div>This retrospective study examined adults aged 18 and older who had surgery for cervical myelopathy due to spondylosis in the past five years. We recorded the type of surgery performed—either anterior cervical discectomy and fusion (ACDF) or posterior laminectomy—and categorized patients into two groups: anterior (AT) for disc spondylosis and posterior (PT) for degeneration of facet joints. We evaluated preoperative T2-weighted MRI scans for fat infiltration (FI) and cervical spine X-rays for alignment. Specifically, we assessed the FI to muscle tissue (MA) ratio in the paraspinal extensor muscles from C2 to C7. Univariate and multivariate logistic regression models were used to compare cervical alignment, %FI, and demographic factors.</div></div><div><h3>Results</h3><div>We identified 143 patients; 78 were included in the AT and 65 in the PT group. A significantly higher %FI was found in PT patients than in AT (1.8 % ± 2.6 % vs. 5.0 % ± 7.6 %, p-value: 0.015, respectively). Multivariate analysis showed a correlation with lower odds of spondylosis for lower values of T1S (OR 0.94, 95 % CI 0.89–0.98, p-value: 0.017) as well as lower odds of spondylosis for lower values of FI (OR 0.83, 95 % CI 0.71–0.98, p-value: 0.029).</div></div><div><h3>Conclusions</h3><div>We found that patients with single or multilevel stenosis had a much higher degree of %FI in the extensor muscles. Additionally, we observed significant differences in cervical lordosis and T1S values between the two groups, with patients with anterior compression showing significantly lower values of CL and T1S.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111112"},"PeriodicalIF":1.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464765","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 characteristics of late-onset neuromyelitis optica spectrum disorder in China","authors":"Qingli Sun,&nbsp;Jian Li,&nbsp;Danyang Tian","doi":"10.1016/j.jocn.2025.111137","DOIUrl":"10.1016/j.jocn.2025.111137","url":null,"abstract":"<div><h3>Background</h3><div>Neuromyelitis optica spectrum disorders (NMOSD) are central nervous system demyelinating diseases that are distinct from multiple sclerosis. According to epidemiological studies, the incidence of NMSOD peaks in individuals aged 30–40 years. Therefore, whether the clinical manifestations and prognoses of NMOSD differ on the basis of age at onset is worthy of further investigation.</div></div><div><h3>Methods</h3><div>The clinical, laboratory, and imaging data of NMOSD patients admitted to Peking University Third Hospital were retrospectively analyzed. EO-NMOSD was defined early onset NMOSD (age at onset &lt; 50 years), and LO-NMOSD was defined as late onset NMOSD (age at onset &gt; 50 years). Differences in clinical and imaging data were compared between the two groups.</div></div><div><h3>Results</h3><div>A total of 75 patients with NMOSD were enrolled. Among them, 45 patients were age &lt;50 years (EO-NMOSD), and 30 patients were age ≥ 50 years (LO-NMOSD). There was no significant difference in the EDSS score between the two groups at the time of onset (p = 0.071). The median EDSS scores at the last follow-up were 2 points and 3.5 points in the EO-NMOSD and LO-NMOSD groups, respectively, and the difference was statistically significant (p = 0.001). The proportions of patients with EDSS scores ≤ 3 points and 3 &lt; EDSS scores ≤ 6 points were significantly different between the two groups (p = 0.023, p = 0.014), and there was no significant difference in the proportion of patients with EDSS scores greater than 6 points between the two groups (p = 1.000). Spearman correlation analysis revealed that age at onset was positively correlated with EDSS scores at onset (r = 0.284, p = 0.013) and EDSS scores at the last follow-up (r = 0.425, p = 0.000) and negatively correlated with the number of attacks (r = -0.280, p = 0.015). The proportion of AQP4-ab(+) patients with EDSS scores &lt; 3 at onset was lower in the LO-NMOSD group than in the EO-NMOSD group (27.2 % vs. 59.5 %, p = 0.017), and the proportion of AQP4-ab(+) patients with 3 &lt; EDSS scores ≤ 6 was greater in the LO-NMOSD group than in the EO-NMOSD group, both at onset (72.7 % vs. 32.4 %, p = 0.003) and at the last follow-up (54.5 % vs. 24.3 %, p = 0.019). In addition, the proportion of patients with hypertension in the AQP4-ab(+) group of patients with LO-NMOSD was significantly greater than that in the AQP4-ab(+) group of patients with EO-NMOSD (5.4 % vs. 27.3 %, p = 0.043).</div></div><div><h3>Conclusion</h3><div>LO-NMOSD patients, particularly those who were AQP4-ab positive, had more severe functional impairments and poorer prognoses. The number of attacks in AQP4-ab(+) patients with EO-NMOSD was greater than that in AQP4-ab(+) patients with LO-NMOSD.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111137"},"PeriodicalIF":1.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453675","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}

{"title":"Differences in neuroradiological impacts of hematoma volume and midline shift on clinical symptoms and recurrence rate in patients with unilateral chronic subdural hematoma","authors":"Jun Takei ,&nbsp;Takayuki Inomata ,&nbsp;Takuya Aoki ,&nbsp;Shohei Nawate ,&nbsp;Tatsuya Hirotsu ,&nbsp;Keisuke Hatano ,&nbsp;Mitsuyoshi Watanabe ,&nbsp;Yasuto Noda ,&nbsp;Masato Matsushima ,&nbsp;Toshihiro Ishibashi ,&nbsp;Toshihide Tanaka ,&nbsp;Yuichi Murayama","doi":"10.1016/j.jocn.2025.111136","DOIUrl":"10.1016/j.jocn.2025.111136","url":null,"abstract":"<div><h3>Objective</h3><div>Chronic subdural hematoma (CSDH) is a prevalent neurosurgical condition, particularly among the elderly. Hematoma volume (HV) and midline shift (MLS) on CT imaging are critical for assessing CSDH severity and recurrence risk. Brain atrophy has also been linked to recurrence. This study investigates the impact of HV and MLS on clinical symptoms and recurrence, considering brain atrophy.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on patients with unilateral CSDH who underwent burr hole surgery for symptoms such as headache, disturbances of consciousness, hemiparesis, and gait disturbance. HV, MLS, and relative cortical atrophy index (RCAI) were measured using preoperative (pre-) and postoperative (post-) CT images. The rate of change in RCAI (RCAI-CR) between pre- and post-CT images was calculated to assess contralateral brain compression. Associations between HV, MLS, RCAI, RCAI-CR, symptoms, and recurrence were analyzed.</div></div><div><h3>Results</h3><div>The study included 293 patients (mean age 79.4 ± 12.1 years), with a recurrence rate of 15.0 % (44/293). Pre-HV (per 10 mL) was significantly associated with hemiparesis and gait disturbance (odds ratio [OR] 1.12, 95 % confidence interval [CI] 1.03–1.21, p = 0.011; OR 1.14, 95 % CI 1.05–1.24, p = 0.003). Pre-MLS was significantly correlated with disturbances of consciousness (OR 1.26, 95 % CI 1.14–1.39, p &lt; 0.001) and was elevated in patients with high RCAI-CR. Significant predictors of recurrence included Pre-HV (per 10 mL) (OR 1.16, 95 % CI 1.03–1.31, p = 0.014), postoperative subdural cavity volume (per 10 mL) (OR 1.18, 95 % CI 1.02–1.36, p = 0.026), antiplatelet drug use (OR 0.23, 95 % CI 0.06–0.89, p = 0.032), and CT classification (OR 2.35, 95 % CI 1.15–4.82, p = 0.020).</div></div><div><h3>Conclusions</h3><div>HV and MLS have distinct clinical implications in CSDH. Pre-HV is linked to motor disturbances, while Pre-MLS correlates with disturbances of consciousness, with high RCAI-CR indicating significant brain compression. HV is a key predictor of recurrence, while MLS and RCAI are not. These findings may improve outcome prediction and management strategies.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111136"},"PeriodicalIF":1.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453676","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":"Combined endoscopic endonasal and trans-oral approach for excision of lower clival chordoma and stabilization","authors":"Archana Kamble,&nbsp;Vikram Karmarkar,&nbsp;Chandan B. Mohanty,&nbsp;Nishit Shah,&nbsp;Chandrashekhar E. Deopujari","doi":"10.1016/j.jocn.2025.111125","DOIUrl":"10.1016/j.jocn.2025.111125","url":null,"abstract":"<div><div>Clival chordoma surgery is a challenging surgery for skull-base surgeons. Access to the tumour site is the most challenging factor <span><span>[1]</span></span> for gross total resection of tumor which is recommended for this kind of tumor and frequently results in incomplete removal and recurrence. Another dimension is added by direct anterior access by the endoscopic expanded endonasal approach in the literature <span><span>[2]</span></span>, <span><span>[3]</span></span> for maximum tumour resection with minimum complications and morbidity. The endonasal endoscopic panoramic view can expose the surgically classified <span><span>[4]</span></span> upper, middle and lower clivus and with the assistance of the <em>endo</em>-oral corridor it can reach till craniovertebral junction and upper cervical vertebrae <span><span>[3]</span></span>. We present a case of a 31-year-old female patient with clival chordoma involving the middle and lower clivus, reaching up to the upper border of the C-3 vertebral body and laterally extending to occipital condyles. This patient underwent combined endoscopic endonasal and transoral excision of tumor followed by stabilization of the craniovertebral joint. The operative video highlights the techniques of elevation of various pedicled mucoperiosteal flaps (reverse rotation flap <span><span>[2]</span></span>, Hadad- Bassagasteguy nasoseptal flap <span><span>[5]</span></span> and posterior nasopharyngeal mucosal flap <span><span>[3]</span></span>), inferior turbinectomy to widen the exposure, maxillary antrostomy for parking of flaps, use of red rubber catheter for the intermittent soft palate and uvula retraction <span><span>[3]</span></span> away from the field which will prevent velopharyngeal insufficiency due to palatal split, posterior pharyngeal wall incision technique, angled endoscopes to resect tumor from difficult access areas and reconstruction for the large skull base defect. The patient underwent stabilization of the craniovertebral junction by occipital-cervical fusion in the same setting. The patient had no new onset deficit and an uneventful course postoperatively. The use of combined endoscopic endonasal and <em>endo</em>-oral approaches for large lower clival chordomas, spending time more patiently in harvesting mucosal flaps and adequate exposure, makes the resection of tumors more feasible and to the maximal extent.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111125"},"PeriodicalIF":1.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453677","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":"Acute Progressive Frozen Eye in a Young Male","authors":"Guive Sharifi ,&nbsp;Esmaeil Mohammadi ,&nbsp;Seyed Amir Ali Safavi Naini ,&nbsp;Melika Javani","doi":"10.1016/j.jocn.2025.111135","DOIUrl":"10.1016/j.jocn.2025.111135","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"135 ","pages":"Article 111135"},"PeriodicalIF":1.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143445538","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":"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 ,&nbsp;Moshe Shalom ,&nbsp;Taylor Reardon ,&nbsp;Julian Gendreau ,&nbsp;Justin Gold ,&nbsp;Garret Pierzchajlo ,&nbsp;Melanie Alfonzo Horowitz ,&nbsp;Mohammad Faizan Khan ,&nbsp;Sharona Ben-Haim ,&nbsp;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 &lt; 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}