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Efficacy and Safety of Bilateral Deep Brain Stimulation (DBS) for Severe Alzheimer's Disease: A Comparative Analysis of Fornix Versus Basal Ganglia of Meynert
IF 4.8 1区 医学 Q1 NEUROSCIENCES Pub Date : 2025-04-17 DOI: 10.1111/cns.70285
Junpeng Xu, Bin Liu, Guosong Shang, Zhebin Feng, Haonan Yang, Yuhan Chen, Xinguang Yu, Zhiqi Mao
<div> <section> <h3> Background</h3> <p>Deep brain stimulation (DBS) is a novel therapy for severe Alzheimer's disease (AD). However, there is an ongoing debate regarding the optimal target for DBS, particularly the fornix and the basal ganglia of Meynert (NBM).</p> </section> <section> <h3> Objective</h3> <p>This study aimed to investigate the safety and efficacy of DBS for severe AD and to compare the fornix and the NBM as potential targets.</p> </section> <section> <h3> Methods</h3> <p>We conducted a prospective, nonrandomized clinical study involving 20 patients with severe AD (MMSE score 0 to 10, CDR level 3) from January 2015 to August 2022, comprising 12 males and eight females, with a mean age of 59.05 ± 6.45 years. All patients underwent DBS treatment, among which 14 received bilateral fornix implantation, while six received bilateral implantation in the NBM. Electrical stimulation commenced 1 month postoperatively. We assessed the patients before surgery, followed by evaluations at 1 month, 3 months, 6 months, and 12 months poststimulation. Primary outcome measures focused on changes in cognitive function, assessed using the MMSE, MoCA, ADAS-Cog, and CDR scales. Secondary measures encompassed quality of life, caregiver burden, neuropsychiatric symptoms, and sleep disturbances, evaluated through the BI, FAQ, FIM, ZBI, NPI, HAMA, HAMD, and PSQI scales.</p> </section> <section> <h3> Results</h3> <p>All patients tolerated DBS well, with no serious adverse effects reported. Early on, DBS significantly improved cognitive function and quality of life. Long-term benefits include the improvement of neuropsychiatric symptoms and sleep disorders and the alleviation of caregiver burden. Comparison between DBS targeting the NBM and fornix revealed no significant differences in overall scale scores. However, upon deeper analysis, NBM-DBS exhibited a more pronounced improvement in neuropsychiatric symptoms, particularly in NPI scores.</p> </section> <section> <h3> Conclusion</h3> <p>DBS is a potential therapeutic approach for severe AD, capable of improving patients' cognitive function, quality of life, and neuropsychiatric symptoms. Notably, NBM-DBS showed distinct advantages in ameliorating neuropsychiatric symptoms, providing valuable insights for clinically selecting the optimal DBS target.</p> </section> <section> <h3> Trial Registration</h3> <p>Cl
背景 大脑深部刺激(DBS)是一种治疗严重阿尔茨海默病(AD)的新型疗法。然而,关于 DBS 的最佳靶点,尤其是穹窿和梅内特基底节(NBM),一直存在争议。 目的 本研究旨在探讨 DBS 治疗重度 AD 的安全性和有效性,并比较作为潜在靶点的穹窿和 NBM。 方法 我们在 2015 年 1 月至 2022 年 8 月期间进行了一项前瞻性、非随机临床研究,涉及 20 例重度 AD 患者(MMSE 评分 0 至 10 分,CDR 3 级),其中男性 12 例,女性 8 例,平均年龄(59.05±6.45)岁。所有患者均接受了 DBS 治疗,其中 14 人接受了双侧穹窿植入,6 人接受了双侧 NBM 植入。术后一个月开始电刺激。我们在手术前对患者进行评估,然后在刺激后 1 个月、3 个月、6 个月和 12 个月进行评估。主要结果测量侧重于认知功能的变化,使用 MMSE、MoCA、ADAS-Cog 和 CDR 量表进行评估。次要指标包括生活质量、护理负担、神经精神症状和睡眠障碍,通过 BI、FAQ、FIM、ZBI、NPI、HAMA、HAMD 和 PSQI 量表进行评估。 结果 所有患者对 DBS 耐受良好,无严重不良反应报告。在早期,DBS 明显改善了认知功能和生活质量。长期疗效包括改善神经精神症状和睡眠障碍,减轻护理人员的负担。对针对 NBM 和穹窿的 DBS 进行比较后发现,两者在总体量表评分上没有明显差异。然而,经过深入分析,NBM-DBS 对神经精神症状的改善更为明显,尤其是在 NPI 评分方面。 结论 DBS 是一种治疗严重注意力缺失症的潜在方法,能够改善患者的认知功能、生活质量和神经精神症状。值得注意的是,NBM-DBS在改善神经精神症状方面表现出明显优势,为临床选择最佳DBS靶点提供了宝贵的启示。 试验注册 ClinicalTrials.gov identifier:NCT03115814
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引用次数: 0
Cannabinoid Receptors Reduced Early Brain Damage by Regulating NOX-2 and the NLRP3 Inflammasome in an Animal Model of Intracerebral Hemorrhage
IF 4.8 1区 医学 Q1 NEUROSCIENCES Pub Date : 2025-04-17 DOI: 10.1111/cns.70385
Ari Misael Martínez-Torres, Crisalde Ramírez-Celis, Julio Morán

Background

Intracerebral hemorrhage (ICH) is a leading cause of death and disability worldwide. Following the initial mechanical injury caused by hematoma expansion, a secondary injury occurs, characterized by the production of reactive oxygen species (ROS) generated by NOX-2 and neuroinflammation, which is exacerbated by the upregulation of the NLRP3 inflammasome. These conditions collectively aggravate brain damage. The endocannabinoid system (ECS), through the activation of the cannabinoid receptors, has demonstrated neuroprotective properties in various models of brain injury. However, the role of the ECS during ICH remains poorly understood, particularly regarding the action of the CB1 receptor in the activation of NOX-2 and the inflammasome. The present study investigates the neuroprotective effects of the cannabinoid receptor agonist WIN55,212-2 in an ICH animal model, specifically examining the roles of NLRP3 and NOX-2.

Methods

Male C57BL/6 mice were subjected to ICH through an intracerebral injection of collagenase, followed by intraperitoneal administration of WIN55,212-2 and/or MCC950, a selective NLRP3 inhibitor. Various outcome measures were employed, including assessments of motor activity, hematoma volume, brain water content, and blood–brain barrier (BBB) permeability, which was evaluated using Evans blue assay. Additionally, the activity of NOX and the protein levels of crucial markers such as CB1, gp91phox, NLRP3, AQP4, and caspase-1 were measured via western blot analysis.

Result

The findings demonstrate that ICH induced a significant brain lesion characterized by hematoma formation, edema, BBB disruption, and subsequent motor impairments in the affected mice. Notably, these detrimental effects were markedly reduced in animals treated with WIN55,212-2. The study also revealed an activation of both NOX-2 and NLRP3 in response to ICH, which was reduced by cannabinoid receptor activation. Furthermore, the pharmacological inhibition of NLRP3 using MCC950 also led to a reduction in hematoma size, edema, and motor impairment secondary to ICH.

Conclusions

These results support a neuroprotective role of the cannabinoid receptor activation during ICH and suggest the involvement of NOX-2 and NLRP3.

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引用次数: 0
Biological Effects of Dietary Restriction on Alzheimer's Disease: Experimental and Clinical Investigations
IF 4.8 1区 医学 Q1 NEUROSCIENCES Pub Date : 2025-04-17 DOI: 10.1111/cns.70392
Zijiao Liu, Jun Zhang, Fei Jiang, Cong Liu, Yaping Shao, Weidong Le

Backgrounds

Dementia can impose a heavy economic burden on both society and families. Alzheimer's disease (AD), the most prevalent form of dementia, is a complex neurodegenerative disease characterized by the abnormal deposition of extracellular amyloid β-protein (Aβ) and the aggregation of intracellular Tau protein to form neurofibrillary tangles (NFTs). Given the limited efficacy of pharmacological treatment, scientists have already paid more attention to non-pharmacological strategies, including dietary restriction (DR). DR refers to a nutritional paradigm aimed at promoting overall health by modifying the balance between energy consumption and expenditure. Studies have demonstrated that DR effectively extends the healthy lifespan, delays the aging process, and achieves promising results in the prevention and treatment of AD in preclinical studies.

Methods

In this review we collected related studies and viewpoints by searching on PubMed database using the keywords. Most of the citations were published between 2015 and 2025. A few older literatures were also included due to their relevance and significance in this field.

Results

We first provide a concise overview of the current therapeutic and preventive strategies for AD. Then, we introduce several specific DR protocols and their favorable effects on AD. Furthermore, the potential mechanisms underlying the benefits of DR on AD are discussed. Finally, we briefly highlight the role of DR in maintaining brain health.

Conclusion

This review may offer valuable insights into the development of innovative non-pharmacological strategies for AD treatment.

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引用次数: 0
Prefrontal Internal Event-Driven Analysis of Dynamical Electroencephalographic Biomarkers in Depression During Emotional Auditory Task
IF 4.8 1区 医学 Q1 NEUROSCIENCES Pub Date : 2025-04-16 DOI: 10.1111/cns.70382
Qinglin Zhao, Kunbo Cui, Hua Jiang, Zhongqing Wu, Lixin Zhang, Mingqi Zhao, Bin Hu

Aims

This study for the first time proposed a novel prefrontal internal event-driven analytic framework for electroencepalography (EEG) data, which aim to dynamically resolve neural processes during natural emotional auditory tasks.

Methods

The framework employed a novel unsupervised time-series clustering model for internal prefrontal event extraction, which supports event-related analyses with the absence of external event labeling. The framework was validated using a 64-channel EEG data obtained from 110 (55 depressed) subjects in a three-polar (positive, neutral, and negative) emotional-auditory task.

Results

Our results suggest that anhedonia in depressed patients are associated with high activation levels in multiple brain regions during specific internal events, and we found that cross-frequency modulation of the bilateral prefrontal lobe with other relevant regions revealed completely different unidirectional patterns for the positive and negative tasks.

Conclusion

Our study confirmed the effectiveness of the framework in resolving fine-grained internal event-driven neural processes without relying on traditional precise event-related data acquisision paradigms that often require high attention on the task events and causes high cognitive load. Our study present new insights for identifying dynamical electroencephalographic biomarkers in depression, which potentially provide EEG signal decoding solutions for EEG feedback-based closed-loop intervention of depression.

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引用次数: 0
Animal Models of Traumatic Brain Injury and Their Relevance in Clinical Settings
IF 4.8 1区 医学 Q1 NEUROSCIENCES Pub Date : 2025-04-16 DOI: 10.1111/cns.70362
Payal Chauhan, Nikita Yadav, Karan Wadhwa, Subbulakshmi Ganesan, Chakshu Walia, Gulshan Rathore, Govind Singh, Mosleh Mohammad Abomughaid, Abhilasha Ahlawat, Athanasios Alexiou, Marios Papadakis, Niraj Kumar Jha

Background

Traumatic brain injury (TBI) is a significant concern that often goes overlooked, resulting from various factors such as traffic accidents, violence, military services, and medical conditions. It is a major health issue affecting people of all age groups across the world, causing significant morbidity and mortality. TBI is a highly intricate disease process that causes both structural damage and functional deficits. These effects result from a combination of primary and secondary injury mechanisms. It is responsible for causing a range of negative effects, such as impairments in cognitive function, changes in social and behavioural patterns, difficulties with motor skills, feelings of anxiety, and symptoms of depression.

Methods

TBI associated various animal models were reviewed in databases including PubMed, Web of Science, and Google scholar etc. The current study provides a comprehensive overview of commonly utilized animal models for TBI and examines their potential usefulness in a clinical context.

Results

Despite the notable advancements in TBI outcomes over the past two decades, there remain challenges in evaluating, treating, and addressing the long-term effects and prevention of this condition. Utilizing experimental animal models is crucial for gaining insight into the development and progression of TBI, as it allows us to examine the biochemical impacts of TBI on brain mechanisms.

Conclusion

This exploration can assist scientists in unraveling the intricate mechanisms involved in TBI and ultimately contribute to the advancement of successful treatments and interventions aimed at enhancing outcomes for TBI patients.

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引用次数: 0
LncRNA ENSSSCG00000035331 Alleviates Hippocampal Neuronal Ferroptosis and Brain Injury Following Porcine Cardiopulmonary Resuscitation by Regulating the miR-let7a/GPX4 Axis
IF 4.8 1区 医学 Q1 NEUROSCIENCES Pub Date : 2025-04-16 DOI: 10.1111/cns.70377
Mao Zhang, Wenbin Zhang, Ziwei Chen, Lu He, Qijiang Chen, Pin Lan, Lulu Li, Xianlong Wu, Xingui Wu, Jiefeng Xu

Background

Following successful cardiopulmonary resuscitation, those survivors of cardiac arrest (CA) often suffer from severe brain injury, and the latter can result in significant mortality and morbidity. Emerging evidence implicates that ferroptosis is involved in the pathogenesis of post-resuscitation brain injury, and its regulatory mechanisms remain to be investigated. Recently, some studies manifested that long noncoding RNAs could be critical regulators of cell ferroptosis in diverse ischemia–reperfusion injuries of vital organs. This study was designed to explore the role and mechanism of a newly screened long noncoding RNA ENSSSCG00000035331 in alleviating post-resuscitation hippocampal neuronal ferroptosis and further investigate its potential regulation by a novel antioxidant sulforaphane.

Methods and Results

Healthy male pigs and mice were used to establish the models of CA and resuscitation in vivo. A hypoxia/reoxygenation (H/R) model using primary porcine hippocampal neurons was constructed to replicate post-resuscitation brain injury in vitro. We found that the expression of ENSSSCG00000035331 was significantly decreased in the post-resuscitation impaired hippocampus using RNA sequencing analysis and verification. Subsequently, ENSSSCG00000035331 overexpression significantly reduced ferroptosis-related ferrous iron and reactive oxygen species production while markedly increased glutathione and further alleviated post-resuscitation brain injury. Mechanistically, ENSSSCG00000035331 interacted with miR-let7a, then inhibited its binding with glutathione peroxidase 4 (GPX4) mRNA and finally promoted the recovery of the latter's translation after H/R stimulation. In addition, sulforaphane treatment significantly increased ENSSSCG00000035331 and GPX4 expression while markedly decreased miR-let7a expression and hippocampal neuronal ferroptosis and finally alleviated post-resuscitation brain injury.

Conclusions

Our findings highlighted that ENSSSCG00000035331 was a critical regulator of hippocampal neuronal ferroptosis after CA and resuscitation by targeting the miR-let7a/GPX4 axis, and additionally, sulforaphane might be a promising therapeutic agent for alleviating post-resuscitation brain injury by regulating the signaling axis mentioned above.

{"title":"LncRNA ENSSSCG00000035331 Alleviates Hippocampal Neuronal Ferroptosis and Brain Injury Following Porcine Cardiopulmonary Resuscitation by Regulating the miR-let7a/GPX4 Axis","authors":"Mao Zhang,&nbsp;Wenbin Zhang,&nbsp;Ziwei Chen,&nbsp;Lu He,&nbsp;Qijiang Chen,&nbsp;Pin Lan,&nbsp;Lulu Li,&nbsp;Xianlong Wu,&nbsp;Xingui Wu,&nbsp;Jiefeng Xu","doi":"10.1111/cns.70377","DOIUrl":"https://doi.org/10.1111/cns.70377","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Following successful cardiopulmonary resuscitation, those survivors of cardiac arrest (CA) often suffer from severe brain injury, and the latter can result in significant mortality and morbidity. Emerging evidence implicates that ferroptosis is involved in the pathogenesis of post-resuscitation brain injury, and its regulatory mechanisms remain to be investigated. Recently, some studies manifested that long noncoding RNAs could be critical regulators of cell ferroptosis in diverse ischemia–reperfusion injuries of vital organs. This study was designed to explore the role and mechanism of a newly screened long noncoding RNA ENSSSCG00000035331 in alleviating post-resuscitation hippocampal neuronal ferroptosis and further investigate its potential regulation by a novel antioxidant sulforaphane.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>Healthy male pigs and mice were used to establish the models of CA and resuscitation in vivo. A hypoxia/reoxygenation (H/R) model using primary porcine hippocampal neurons was constructed to replicate post-resuscitation brain injury in vitro. We found that the expression of ENSSSCG00000035331 was significantly decreased in the post-resuscitation impaired hippocampus using RNA sequencing analysis and verification. Subsequently, ENSSSCG00000035331 overexpression significantly reduced ferroptosis-related ferrous iron and reactive oxygen species production while markedly increased glutathione and further alleviated post-resuscitation brain injury. Mechanistically, ENSSSCG00000035331 interacted with miR-let7a, then inhibited its binding with glutathione peroxidase 4 (GPX4) mRNA and finally promoted the recovery of the latter's translation after H/R stimulation. In addition, sulforaphane treatment significantly increased ENSSSCG00000035331 and GPX4 expression while markedly decreased miR-let7a expression and hippocampal neuronal ferroptosis and finally alleviated post-resuscitation brain injury.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings highlighted that ENSSSCG00000035331 was a critical regulator of hippocampal neuronal ferroptosis after CA and resuscitation by targeting the miR-let7a/GPX4 axis, and additionally, sulforaphane might be a promising therapeutic agent for alleviating post-resuscitation brain injury by regulating the signaling axis mentioned above.</p>\u0000 </section>\u0000 </div>","PeriodicalId":154,"journal":{"name":"CNS Neuroscience & Therapeutics","volume":"31 4","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cns.70377","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143836282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
MK5 Regulates Microglial Activation and Neuroinflammation in Experimental Stroke Models
IF 4.8 1区 医学 Q1 NEUROSCIENCES Pub Date : 2025-04-16 DOI: 10.1111/cns.70395
Xingzhi Wang, Wenqi Mao, Li Du, Fei Wang, Ye Pang, Yangdanyu Li, Guangci Xu, Guiyun Cui

Objective

Microglial activation plays a crucial role in neuroinflammation following ischemic stroke. This study was conducted to investigate the role and potential mechanisms of MK5 within microglial cells in the inflammatory response following ischemic stroke in mice in vivo and in vitro.

Methods

Microglia-specific conditional MK5 knockout (MK5 cKO) mice and their control mice (MK5f/f) were subjected to middle cerebral artery occlusion (MCAO). BV2 cells (a mouse microglial cell line) were transfected with small interfering RNA (siRNA) to knock down MK5 levels and subsequently exposed to oxygen–glucose deprivation/reperfusion (OGD/R) to simulate ischemic conditions in vitro. Following MCAO, behavioral tests and infarct volume measurements were conducted. Levels of cytokines and microglial markers were evaluated using qPCR and Western blotting, while immunofluorescence was employed to observe microglial activation. Additionally, Western blotting was performed to assess the phosphorylation of HSP27 and NF-κB.

Results

Compared to the control group, the knockout of the MK5 gene in microglia significantly exacerbated neurological deficits and increased infarct volume in MCAO mice. The loss of the MK5 promoted inflammation by upregulating pro-inflammatory factors and downregulating anti-inflammatory factors, while also enhancing microglial activation in both MCAO mice and BV2 microglial cells subjected to OGD/R. Furthermore, the knockout of the MK5 gene in microglia reduced the phosphorylation levels of HSP27 and increased the phosphorylation levels of NF-κB in the aforementioned models.

Conclusion

Microglial MK5 plays a critical role in the ischemic neuroinflammatory response by regulating the phosphorylation of HSP27 and NF-κB, positioning it as a potential target for stroke treatment.

{"title":"MK5 Regulates Microglial Activation and Neuroinflammation in Experimental Stroke Models","authors":"Xingzhi Wang,&nbsp;Wenqi Mao,&nbsp;Li Du,&nbsp;Fei Wang,&nbsp;Ye Pang,&nbsp;Yangdanyu Li,&nbsp;Guangci Xu,&nbsp;Guiyun Cui","doi":"10.1111/cns.70395","DOIUrl":"https://doi.org/10.1111/cns.70395","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Microglial activation plays a crucial role in neuroinflammation following ischemic stroke. This study was conducted to investigate the role and potential mechanisms of MK5 within microglial cells in the inflammatory response following ischemic stroke in mice in vivo and in vitro.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Microglia-specific conditional MK5 knockout (MK5 cKO) mice and their control mice (MK5<sup>f/f</sup>) were subjected to middle cerebral artery occlusion (MCAO). BV2 cells (a mouse microglial cell line) were transfected with small interfering RNA (siRNA) to knock down MK5 levels and subsequently exposed to oxygen–glucose deprivation/reperfusion (OGD/R) to simulate ischemic conditions in vitro. Following MCAO, behavioral tests and infarct volume measurements were conducted. Levels of cytokines and microglial markers were evaluated using qPCR and Western blotting, while immunofluorescence was employed to observe microglial activation. Additionally, Western blotting was performed to assess the phosphorylation of HSP27 and NF-κB.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared to the control group, the knockout of the MK5 gene in microglia significantly exacerbated neurological deficits and increased infarct volume in MCAO mice. The loss of the MK5 promoted inflammation by upregulating pro-inflammatory factors and downregulating anti-inflammatory factors, while also enhancing microglial activation in both MCAO mice and BV2 microglial cells subjected to OGD/R. Furthermore, the knockout of the MK5 gene in microglia reduced the phosphorylation levels of HSP27 and increased the phosphorylation levels of NF-κB in the aforementioned models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Microglial MK5 plays a critical role in the ischemic neuroinflammatory response by regulating the phosphorylation of HSP27 and NF-κB, positioning it as a potential target for stroke treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":154,"journal":{"name":"CNS Neuroscience & Therapeutics","volume":"31 4","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cns.70395","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143836283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prediction and SHAP Analysis Integrating Morphological and Hemodynamic Parameters for Unruptured Intracranial Aneurysm Occlusion After Flow Diverter Treatment
IF 4.8 1区 医学 Q1 NEUROSCIENCES Pub Date : 2025-04-16 DOI: 10.1111/cns.70386
Hongchen Zhang, Chuanhao Lu, Zhen Hu, Deyu Sun, Liang Li, Hongxing Wu, Hua Lu, Bin Lv, Jun Wang, Shuhui Dai, Xia Li

Background

Although most unruptured intracranial aneurysms (UIAs) have good prognosis after flow diverter (FD) treatment, some remain unoccluded for extended periods, posing a persistent rupture risk. This study aims to develop a predictive model for UIA occlusion after FD treatment through integrating morphological and hemodynamic parameters, which may be critical for personalized postoperative management.

Methods

Data from patients with single UIAs treated with stand-alone FD were collected from June 2018 to December 2022 in four cerebrovascular disease centers. Morphological parameters were obtained from 3D reconstructed aneurysm models, and hemodynamic parameters were derived by computational fluid dynamics (CFD) analysis. A predictive model for aneurysm occlusion was constructed using various machine learning algorithms, including logistic regression, Random Forest, XGBoost, and K-Nearest Neighbors. Model performances were evaluated through repeated cross-validation, 0.632 bootstrap, and 0.632+ bootstrap. Shapley additive explanation (SHAP) analysis was employed to assess the contribution of each parameter to UIA occlusion.

Results

Seventy-nine patients were reviewed; a total of 51 cases met the criteria, with an average age of 53.9 ± 9.9 years. The average aneurysm diameter was 3.72 ± 2.72 mm, comprising 29 occlusions and 22 non-occlusions. Five variables were selected for further modeling, including follow-up time > 6 months, aneurysm rupture ratio (ArR), occlusion ratio (OsR), parent artery wall shear stress (WSS), and the change of parent artery WSS. Logistic regression outperformed other algorithms, achieving an area under the curve (AUC) above 0.75, indicating good predictive performance. SHAP analysis revealed that the change of parent artery WSS contributed most significantly to accurate and early prediction. Additionally, a web application software was developed to assist clinicians in real-time aneurysm occlusion prediction.

Conclusions

This study developed a robust predictive model for UIA occlusion following FD treatment by integrating morphological and hemodynamic parameters, which may provide potentially valuable decision-making support for optimizing treatment strategies.

{"title":"Prediction and SHAP Analysis Integrating Morphological and Hemodynamic Parameters for Unruptured Intracranial Aneurysm Occlusion After Flow Diverter Treatment","authors":"Hongchen Zhang,&nbsp;Chuanhao Lu,&nbsp;Zhen Hu,&nbsp;Deyu Sun,&nbsp;Liang Li,&nbsp;Hongxing Wu,&nbsp;Hua Lu,&nbsp;Bin Lv,&nbsp;Jun Wang,&nbsp;Shuhui Dai,&nbsp;Xia Li","doi":"10.1111/cns.70386","DOIUrl":"https://doi.org/10.1111/cns.70386","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although most unruptured intracranial aneurysms (UIAs) have good prognosis after flow diverter (FD) treatment, some remain unoccluded for extended periods, posing a persistent rupture risk. This study aims to develop a predictive model for UIA occlusion after FD treatment through integrating morphological and hemodynamic parameters, which may be critical for personalized postoperative management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from patients with single UIAs treated with stand-alone FD were collected from June 2018 to December 2022 in four cerebrovascular disease centers. Morphological parameters were obtained from 3D reconstructed aneurysm models, and hemodynamic parameters were derived by computational fluid dynamics (CFD) analysis. A predictive model for aneurysm occlusion was constructed using various machine learning algorithms, including logistic regression, Random Forest, XGBoost, and K-Nearest Neighbors. Model performances were evaluated through repeated cross-validation, 0.632 bootstrap, and 0.632+ bootstrap. Shapley additive explanation (SHAP) analysis was employed to assess the contribution of each parameter to UIA occlusion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy-nine patients were reviewed; a total of 51 cases met the criteria, with an average age of 53.9 ± 9.9 years. The average aneurysm diameter was 3.72 ± 2.72 mm, comprising 29 occlusions and 22 non-occlusions. Five variables were selected for further modeling, including follow-up time &gt; 6 months, aneurysm rupture ratio (ArR), occlusion ratio (OsR), parent artery wall shear stress (WSS), and the change of parent artery WSS. Logistic regression outperformed other algorithms, achieving an area under the curve (AUC) above 0.75, indicating good predictive performance. SHAP analysis revealed that the change of parent artery WSS contributed most significantly to accurate and early prediction. Additionally, a web application software was developed to assist clinicians in real-time aneurysm occlusion prediction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study developed a robust predictive model for UIA occlusion following FD treatment by integrating morphological and hemodynamic parameters, which may provide potentially valuable decision-making support for optimizing treatment strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":154,"journal":{"name":"CNS Neuroscience & Therapeutics","volume":"31 4","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cns.70386","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143836316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correction to “Inhibition of ADORA3 Promotes Microglial Phagocytosis and Alleviates Chronic Ischemic White Matter Injury”
IF 4.8 1区 医学 Q1 NEUROSCIENCES Pub Date : 2025-04-16 DOI: 10.1111/cns.70326

In Figure 6, the LFB-stained image in panel M was inadvertently replaced with an incorrect version during figure assembly; the correct version has been provided and does not affect the experimental findings.

We apologize for this error.

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引用次数: 0
Alleviation of Microglia Mediating Hippocampal Neuron Impairments and Depression-Related Behaviors by Urolithin B via the SIRT1-FOXO1 Pathway
IF 4.8 1区 医学 Q1 NEUROSCIENCES Pub Date : 2025-04-16 DOI: 10.1111/cns.70379
Cuilan Liu, Di Zhao, Guoxing Yu, HengWei Du, Lihong Xu, Yifan Cao, Minghu Cui, Wentao Wang, Dan Wang, Jing Liu, Fantao Meng, Fengai Hu, Wei Li, Jing Du, Chen Li

Aims

Conventional antidepressants exhibit limited efficacy and delayed onset. This study aimed to elucidate the antidepressant effects of urolithin B (UB) and its regulatory role in microglia-mediated hippocampal neuronal dysfunction.

Methods

The mouse model of depression was established using both chronic unpredicted stress (CUS) and lipopolysaccharide (LPS) injection. The therapeutic efficacy of UB was assessed through behavioral paradigms. The microglia activation, cellular cytotoxicity and apoptosis levels, and underlying molecular mechanisms were delineated utilizing proteomics analysis, immunofluorescence staining, real-time PCR and Western blotting.

Results

UB efficiently alleviated depression-related behaviors, accompanied by suppressed microglia activation, neuroinflammation, changes of classic activation (M1)/alternative activation (M2) polarization and recovered sirtuin-1 (SIRT1) and forkhead box protein O1 (FOXO1) expression in the hippocampus. Additionally, UB reduced the cytotoxicity and apoptosis of HT22 cells and depression-related phenotypes treated by the cellular supernatant from LPS-incubated BV2 cells, which was mediated by the SIRT1-FOXO1 pathway. The proteomics analysis of the cellular supernatant content revealed abundant secreting proteins among the LPS/UB application.

Conclusion

This study confirmed that microglial SIRT1 mediates UB's antidepressant effects, positioning UB as a promising therapeutic candidate for depression by targeting neuroinflammatory pathways.

{"title":"Alleviation of Microglia Mediating Hippocampal Neuron Impairments and Depression-Related Behaviors by Urolithin B via the SIRT1-FOXO1 Pathway","authors":"Cuilan Liu,&nbsp;Di Zhao,&nbsp;Guoxing Yu,&nbsp;HengWei Du,&nbsp;Lihong Xu,&nbsp;Yifan Cao,&nbsp;Minghu Cui,&nbsp;Wentao Wang,&nbsp;Dan Wang,&nbsp;Jing Liu,&nbsp;Fantao Meng,&nbsp;Fengai Hu,&nbsp;Wei Li,&nbsp;Jing Du,&nbsp;Chen Li","doi":"10.1111/cns.70379","DOIUrl":"https://doi.org/10.1111/cns.70379","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Conventional antidepressants exhibit limited efficacy and delayed onset. This study aimed to elucidate the antidepressant effects of urolithin B (UB) and its regulatory role in microglia-mediated hippocampal neuronal dysfunction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The mouse model of depression was established using both chronic unpredicted stress (CUS) and lipopolysaccharide (LPS) injection. The therapeutic efficacy of UB was assessed through behavioral paradigms. The microglia activation, cellular cytotoxicity and apoptosis levels, and underlying molecular mechanisms were delineated utilizing proteomics analysis, immunofluorescence staining, real-time PCR and Western blotting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>UB efficiently alleviated depression-related behaviors, accompanied by suppressed microglia activation, neuroinflammation, changes of classic activation (M1)/alternative activation (M2) polarization and recovered sirtuin-1 (SIRT1) and forkhead box protein O1 (FOXO1) expression in the hippocampus. Additionally, UB reduced the cytotoxicity and apoptosis of HT22 cells and depression-related phenotypes treated by the cellular supernatant from LPS-incubated BV2 cells, which was mediated by the SIRT1-FOXO1 pathway. The proteomics analysis of the cellular supernatant content revealed abundant secreting proteins among the LPS/UB application.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study confirmed that microglial SIRT1 mediates UB's antidepressant effects, positioning UB as a promising therapeutic candidate for depression by targeting neuroinflammatory pathways.</p>\u0000 </section>\u0000 </div>","PeriodicalId":154,"journal":{"name":"CNS Neuroscience & Therapeutics","volume":"31 4","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cns.70379","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143836176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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CNS Neuroscience & Therapeutics
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