Journal of Clinical Neuroscience最新文献

{"title":"Evaluating single-level vs. multi-level lateral lumbar interbody fusion: Clinical outcomes and complications","authors":"Akihiko Hiyama,&nbsp;Daisuke Sakai,&nbsp;Hiroyuki Katoh,&nbsp;Masato Sato,&nbsp;Masahiko Watanabe","doi":"10.1016/j.jocn.2025.111082","DOIUrl":"10.1016/j.jocn.2025.111082","url":null,"abstract":"<div><h3>Objective</h3><div>Lateral Lumbar Interbody Fusion (LLIF) treats lumbar degenerative diseases (LDD) with spinal alignment and decompression advantages but can cause sensory and motor disturbances, especially in multilevel procedures. This study compares single-level and multi-level LLIF focusing on sensory and motor disturbances, surgical duration, and quality of life (QOL).</div></div><div><h3>Methods</h3><div>A retrospective review of 139 patients (84 males, 55 females; average age 70 years) with LDD who underwent LLIF and posterior fixation between May 2018 and January 2023 was conducted. Patients were divided into two groups: 89 patients who underwent single-level LLIF and 50 patients who underwent multi-level LLIF (two or more levels). Data on demographics, surgical details, perioperative complications, and clinical outcomes, including pain scores (Numeric Rating Scales: NRS) and QOL assessments (Japanese Orthopaedic Association Back Pain Evaluation Questionnaire: JOABPEQ), were collected preoperatively and one year postoperatively. Statistical analysis was performed to compare the outcomes between the two groups.</div></div><div><h3>Results</h3><div>Patients who underwent multi-level LLIF had significantly longer operative times (145.1 min vs. 98.9 min, <em>p</em> &lt; 0.001) and higher estimated blood loss (126.5 mL vs. 62.9 mL, <em>p</em> &lt; 0.001) compared with the single-level group. Both groups significantly improved pain intensity and QOL, including NRS and JOABPEQ score, with no significant differences in perioperative complication rates (cage subsidence, motor paralysis, thigh pain/numbness) or revision rates (4 % vs. 8 %, <em>p</em> = 0.396).</div></div><div><h3>Conclusions</h3><div>Short-term clinical outcomes suggested that both single-level and multi-level LLIF effectively improved pain and QOL outcomes in patients with LDD.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"134 ","pages":"Article 111082"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080208","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":"Is time perception Different in focal vs. Generalized Epilepsy?","authors":"Prateek Kumar Panda,&nbsp;Indar Kumar Sharawat","doi":"10.1016/j.jocn.2025.111047","DOIUrl":"10.1016/j.jocn.2025.111047","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 111047"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969809","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":"Endovascular thrombectomy for large vessel occlusion in acute ischemic stroke patients with concomitant intracranial hemorrhage","authors":"Mohamed Elfil ,&nbsp;Lilian Maria Godeiro Coelho ,&nbsp;Haneen Sabet ,&nbsp;Ahmed Bayoumi ,&nbsp;Abdallah Abbas ,&nbsp;Tiffany Eatz ,&nbsp;Mohammad Aladawi ,&nbsp;Zaid Najdawi ,&nbsp;Priya Nidamanuri ,&nbsp;Sidra Saleem ,&nbsp;Lisa Surowiec ,&nbsp;Amer Malik","doi":"10.1016/j.jocn.2025.111093","DOIUrl":"10.1016/j.jocn.2025.111093","url":null,"abstract":"<div><h3>Background</h3><div>Endovascular thrombectomy (EVT) is the gold standard for acute ischemic stroke (AIS) with large vessel occlusion (LVO). However, concomitant intracranial hemorrhage (ICH) might render AIS-LVO patients ineligible for EVT in real-life practice.</div></div><div><h3>Objective</h3><div>To provide robust evidence regarding the outcomes of EVT in AIS-LVO patients with concomitant ICH.</div></div><div><h3>Methods</h3><div>We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. Data analysis was performed using OpenMetaAnalyst software. We assessed the pooled incidence rate with a 95 % confidence interval (CI) for qualitative data and analyzed the pooled mean difference (MD) with a 95 % CI for continuous data. The pooled effect size for all outcomes was calculated using the DerSimonian and Laird random-effects model.</div></div><div><h3>Results</h3><div>Six studies were included in the <em>meta</em>-analysis. The overall incidence rate of successful revascularization was 85.3 % (95 % CI: 75.8 %-94.7 %), with rates of 76.1 % for ipsilateral hemorrhages and 66.1 % for contralateral hemorrhages. Functional independence was achieved in 20 % of patients (95 % CI: 4.8 %-36.8 %), with rates of 23 % for ipsilateral and 27.7 % for contralateral hemorrhages. Mortality was reported at 52 % (95 % CI: 34.9 %-69 %), with a higher rate of 52.6 % for ipsilateral hemorrhages compared to 36.8 % for contralateral hemorrhages.</div></div><div><h3>Conclusion</h3><div>This <em>meta</em>-analysis indicates that EVT is feasible in AIS patients with concurrent ICH, yet it is associated with poor functional outcomes and high mortality rates. Careful patient selection is essential to optimize the outcomes, and further research is needed to enhance outcomes for these high-risk patients.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"134 ","pages":"Article 111093"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080206","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":"Statins’ effect on quality of life and functioning in older stroke patients: Systematic review and meta-analysis","authors":"Susanna R. Prins ,&nbsp;Sarah E. Vermeer ,&nbsp;Birgit A. Damoiseaux-Volman ,&nbsp;Simone Priester-Vink ,&nbsp;Nathalie Van der Velde ,&nbsp;Renske M. Van den Berg-Vos","doi":"10.1016/j.jocn.2024.110989","DOIUrl":"10.1016/j.jocn.2024.110989","url":null,"abstract":"<div><h3>Background</h3><div>Limited evidence exists on the efficacy and safety of statins in older ischemic stroke or transient ischemic attack patients, particularly in frail individuals. Studies often exclude frail patients, limiting insights on optimal treatments for the entire older population. This review aims to evaluate the effect of statins for secondary prevention on quality of life and functioning in older patients following an ischemic stroke or transient ischemic attack, as these outcomes are aligned with the treatment goals of this patient population.</div></div><div><h3>Methods</h3><div>We performed a systematic review and <em>meta</em>-analysis by searching four major databases up to June 6th, 2023. Studies were included if they involved statins, assessed quality of life or functioning, focused on older patients, and addressed ischemic stroke or transient ischemic attack.</div></div><div><h3>Findings</h3><div>We included six randomized controlled trials and 16 cohort studies, totaling 66.273 patients. Mean or median age ranged from 65 to 79 years. Age ranges were not provided, and frailty status was not reported. One trial examined the effect of statins on QoL, yielding mixed results. Regarding the effect of statins on functioning, two trials reported positive effects, two found no effect, and two yielded mixed results. The <em>meta</em>-analysis of cohort studies indicated a positive association between statins and functioning (effect size: 0.43, CI 0.28–0.58). Methodological quality was poor, primarily due to confounding, participant selection and the allocation of patients into intervention groups.</div></div><div><h3>Conclusion</h3><div>We could not draw definitive conclusions regarding the effect of statins and QoL or functioning in older stroke patients. Mixed results were found in RCTs, and while a positive association between statins and functional outcome was observed in cohort studies, this should be interpreted with caution due to methodological limitations. Future research should focus on age-specific analyses and adequate representation of frail individuals to clarify this issue.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 110989"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854323","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":"The effect of temporary CSF diversion modality on shunt-dependency following aneurysmal subarachnoid hemorrhage: A nationwide assessment","authors":"Michelle Lin,&nbsp;Jonathan Dallas,&nbsp;Li Ding,&nbsp;Vincent N. Nguyen,&nbsp;Devin Bageac,&nbsp;Benjamin Hopkins,&nbsp;Frank J. Attenello,&nbsp;William J. Mack","doi":"10.1016/j.jocn.2024.111008","DOIUrl":"10.1016/j.jocn.2024.111008","url":null,"abstract":"<div><h3>Background</h3><div>Aneurysmal subarachnoid hemorrhage (aSAH) carries a high economic cost and clinical morbidity in the United States. Beyond prolonged admissions and poor post-injury functional status, there is an additional cost of chronic shunt-dependent hydrocephalus for many aSAH patients. Adjuvant lumbar drain (LD) placement has been hypothesized to promote clearance of subarachnoid blood from the cisternal space, with an ultimate effect of decreasing shunt placement rates. In this nationwide database study, we aim to evaluate outcomes associated with different forms of temporary bedside cerebrospinal fluid (CSF) diversion in the aSAH patient cohort.</div></div><div><h3>Methods</h3><div>Inpatient admissions were queried from the National Inpatient Sample (NIS; 2016–2020). Inclusion criteria included adult patients presenting with non-traumatic SAH that underwent treatment with either non-elective clip ligation or coil embolization of their underlying aneurysms <em>and</em> received either an external ventricular drain (EVD), lumbar drain (LD), or both (EVD + LD) for temporary CSF diversion during that admission. Outcome variables evaluated included inpatient mortality, bacterial meningitis, length of stay, discharge disposition, and need for shunt placement.</div></div><div><h3>Results</h3><div>A total of 5505 admissions met inclusion criteria, of which 18.42 % required permanent CSF diversion. The majority of patients received EVD alone (4842, 87.96 %). The remaining patients were split between LD alone (366, 6.65 %) or EVD + LD placement (297, 5.4 %). Patients receiving LD alone tended to be healthier, with lower rates of extreme APR-DRG subclass, Elixhauser Comorbidity Index (ECI), and NIS SAH Severity Score (NIS-SSS). Patients in the EVD + LD cohort had higher rates of shunt placement (OR 1.624, p = 0.0009) and higher rates of bacterial meningitis (OR 8.715, p &lt; 0.0001), even when controlling for APR-DRG illness severity and ECI.</div></div><div><h3>Conclusion</h3><div>Our study found higher rates of permanent CSF diversion, longer lengths of stay, and higher rates of bacterial meningitis in patients receiving both EVD and LD placement. Due to limitations inherent to nationwide database studies, these results should be interpreted cautiously. Further studies are needed to clarify whether adjuvant temporary CSF diversion with LD placement in the aSAH cohort for intent of minimizing chronic shunt-dependence is efficacious.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 111008"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894676","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":"Evolving treatment paradigms of cerebral aneurysm stasis in flow diversion","authors":"Joshua H. Weinberg ,&nbsp;Max Gruber ,&nbsp;Nathan Ritchey,&nbsp;Landon Ehlers,&nbsp;Santino Cua,&nbsp;Amanda Zakeri,&nbsp;Ciaran Powers,&nbsp;Shahid Nimjee,&nbsp;Patrick Youssef","doi":"10.1016/j.jocn.2024.110996","DOIUrl":"10.1016/j.jocn.2024.110996","url":null,"abstract":"<div><h3>Introduction</h3><div>Flow diversion is an effective first-line treatment for intracranial aneurysms; however, the rate of incomplete occlusion is not insignificant. Data in neuroendovascular literature is limited regarding the implications of persistent incomplete occlusion despite flow diversion.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of a prospectively maintained database and identified 125 consecutive patients with treatment naïve intracranial aneurysms who underwent flow diversion with the PED from April 2014 − November 2022. Patients were divided into 3 groups based on the duration of stasis: venous, capillary, and no stasis. Comparative and multivariate analyses were performed between the three groups.</div></div><div><h3>Results</h3><div>At latest follow-up, complete occlusion occurred in 69.6 % and 82.4 % showed progression of occlusion. Retreatment was required in 2.4 %. There was no significant difference in retreatment (<em>p</em> = 0.667), complete occlusion (<em>p</em> = 0.774) or progression of occlusion (<em>p</em> = 0.848) at latest follow up. No patients experienced subarachnoid hemorrhage post-treatment. On multivariate analysis, hypertension was a negative predictor for complete occlusion (p = 0.006) and progression of occlusion (p = 0.017), while duration of stasis was noncontributory. The mean latest follow up was 12.55 months.</div></div><div><h3>Conclusion</h3><div>Flow diversion is a safe and effective first line treatment for intracranial aneurysms with a relatively low complication rate. Hypertension was a negative predictor of complete occlusion and progression of occlusion, while the degree of occlusion post-flow diversion may not be predictive of future rupture risk and the Raymond Roy Occlusion classification may not apply. The degree of stasis after initial treatment was not predictive of future occlusion, retreatment, nor aneurysm rupture risk. However, stasis degree may be worth additional analysis given this studies sample size, lack of long-term follow-up, and the lack of predictive factors in current literature to guide post-flow diversion management.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 110996"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894719","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":"The “make a flower bud and push at neck” technique: A safe and versatile technique for Woven EndoBridge treatment","authors":"Jun Tanabe ,&nbsp;Ichiro Nakahara ,&nbsp;Shoji Matsumoto ,&nbsp;Jun Morioka ,&nbsp;Tetsuya Hashimoto ,&nbsp;Junpei Koge ,&nbsp;Kenichiro Suyama ,&nbsp;Takeya Suzuki ,&nbsp;Akiko Hasebe ,&nbsp;Sadayoshi Watanabe","doi":"10.1016/j.jocn.2024.110942","DOIUrl":"10.1016/j.jocn.2024.110942","url":null,"abstract":"<div><h3>Purpose</h3><div>The safety and efficacy of Woven EndoBridge (WEB) treatment has been proven. However, only a few standard techniques for safe and versatile WEB deployment have been described in the literature. In this study, we introduce the “make a flower bud and push at neck” technique to achieve safety and versatility during WEB treatment, referred to simply as the “flower bud” technique.</div></div><div><h3>Methods</h3><div>Consecutive patients who underwent WEB treatment between January 2021 and October 2023 were included. We dichotomized the techniques of WEB deployment into two: the “flower bud” technique and the ordinary unsheath technique. Patient demographics, clinical characteristics of the aneurysms, and treatment results were compared between the two techniques to evaluate the safety and versatility of the “flower bud” technique.</div></div><div><h3>Results</h3><div>Of 100 aneurysms, 96 were eligible in the study. The “flower bud” technique was applied in 79 aneurysms (82.3 %), and the ordinary unsheath technique was applied in 17 aneurysms (17.7 %). The aneurysm location significantly differed between both techniques. The degree of parent artery-aneurysm (PA) angle and the proportion of the PA angle ≥ 45° were significantly higher in the “flower bud” technique than in the ordinary unsheath technique (P = 0.024 and P = 0.009, respectively). Effective angiographical results and low morbidity/mortality rate were similar in the techniques, although intraoperative rupture was experienced in one aneurysm treated using the ordinary unsheath technique.</div></div><div><h3>Conclusion</h3><div>The “make a flower bud and push at neck” technique could be safer and more versatile in treating cerebral aneurysms by WEB compared to the ordinary unsheath technique.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 110942"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780255","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":"Vanishing Rathke’s cleft cyst","authors":"Charles Champeaux Depond ,&nbsp;Dahmane Elhairech ,&nbsp;Philippe Metellus","doi":"10.1016/j.jocn.2024.110986","DOIUrl":"10.1016/j.jocn.2024.110986","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 110986"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824268","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":"Benefits and risks of antiplatelet therapy after bypass surgery for moyamoya disease: A meta-analysis","authors":"Junchen Si ,&nbsp;Xiaokui Kang ,&nbsp;Zhongchen Li,&nbsp;Jiheng Hao,&nbsp;Liyong Zhang","doi":"10.1016/j.jocn.2024.110956","DOIUrl":"10.1016/j.jocn.2024.110956","url":null,"abstract":"<div><h3>Background</h3><div>Bypass surgery is a leading treatment strategy for moyamoya disease. Antiplatelet therapy (APT) has the potential to prevent thrombosis and possibly enhance bypass graft patency. However, the efficacy and safety of APT following bypass surgery remain debatable. This study aims to assess the clinical outcomes of APT after bypass surgery.</div></div><div><h3>Methods</h3><div>A systematic review was conducted to evaluate the impact and associated complications of APT after bypass surgery. Electronic databases, including PubMed, Embase, and the Cochrane Library, were searched from their inception to September 1, 2023. The primary outcome was bypass patency.</div></div><div><h3>Results</h3><div>This <em>meta</em>-analysis included five articles, encompassing 480 patients who underwent APT post-surgery and 423 patients who did not receive APT. Statistical analysis revealed that APT significantly increased bypass vessel patency (Odds Ratio [OR] 2.58; 95 % Confidence Interval [CI] 1.51–4.43; P = 0.0006), decreased the likelihood of transient cerebral ischemic events (OR 0.55; 95 % CI 0.32–0.95; P = 0.03), and enhanced patient functional outcomes (OR 1.88; 95 % CI 1.29–2.74; P = 0.001). However, no substantial differences were observed in postoperative stroke risk (OR 0.89; 95 % CI 0.49–1.63; P = 0.72), seizures (OR 1.43; 95 % CI 0.61–3.37; P = 0.41), or cerebral hemorrhage (OR 0.69; 95 % CI 0.28–1.71; P = 0.42) between the two groups.</div></div><div><h3>Conclusions</h3><div>The current evidence indicates that APT after bypass surgery enhances bypass vessel patency, reduces the risk of transient cerebral ischemic events, and improves functional outcomes in patients. However, it does not decrease the incidence of postoperative stroke and does not elevate the risks of cerebral hemorrhage and seizures.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 110956"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791764","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":"The doctor-patient perception mismatch: Improving approaches to assessing outcomes after ischemic stroke treated with reperfusion therapy","authors":"Jane Khalife ,&nbsp;Mary Penckofer ,&nbsp;Michael J. Dubinski ,&nbsp;Danielle C. Brown ,&nbsp;Kenyon Sprankle ,&nbsp;Taryn Hester ,&nbsp;Marta Olive Gadea ,&nbsp;Federica Rizzo ,&nbsp;Marc Ribo ,&nbsp;H.Christian Schumacher ,&nbsp;Jesse M. Thon ,&nbsp;Tudor G. Jovin ,&nbsp;Manisha Koneru ,&nbsp;Khalid A. Hanafy","doi":"10.1016/j.jocn.2024.110981","DOIUrl":"10.1016/j.jocn.2024.110981","url":null,"abstract":"<div><div>The long-term effects of ischemic stroke on cognition and mental health are not reflected in traditional outcome metrics, like the modified Rankin Scale (mRS) for functional independence. Consequently, this may lead to mismatches in perceptions of overall recovery, despite otherwise qualifying as having good functional outcomes (mRS 0–2). In our multicenter, multinational analysis, we aim to describe the prevalence of, and factors associated with, patient-reported cognitive impairment despite achieving good functional outcomes. Acute ischemic stroke patients at Cooper University Hospital (2021–2024) and Hospital Vall d’Hebron in Barcelona, Spain (2020–2021) treated with reperfusion therapy and achieved 90-day mRS 0–2 were surveyed with the previously-validated PROMIS Global-10 scale for physical health (PROMIS-PH) and mental health (PROMIS-MH). The primary outcome was the rate of fair or poor PROMIS-MH scores (<span><math><mrow><mo>≤</mo></mrow></math></span> 11). Univariable and multivariable linear regressions for PROMIS-MH scores were performed. Of 157, 90-day mRS 0–2 patients, the mean age was 68 (standard deviation 15) years, and 61 % were male. Fair or poor PROMIS-MH scores were reported in 43 % of patients. Clinical factors independently associated with PROMIS-MH scores in a multivariable linear regression include: sex, tobacco use, PROMIS-PH score, and National Institutes of Health Stroke Scale at 3-day follow-up. Despite achieving favorable post-stroke mRS, there is a high prevalence of patient-reported cognitive impairment, underscoring an important gap in post-stroke care. The emphasis in post-stroke care should extend beyond the scope of traditional metrics, and should encompass evaluations and interventions targeting additional domains significant to overall patient recovery, especially patient-reported cognitive symptoms.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"132 ","pages":"Article 110981"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807338","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}