Neurosciences最新文献

Objectives: To explore the risk factors of unexplained early neurological dererioration (END) after IVT, and explore the underlying mechanisms by which these factors contribute to END onset and progression.

Methods: We performed a systematic literature search in accordance with PRISMA guidelines, utilizing PubMed, WOS, and EMBASE databases to identify all relevant studies investigating END in AIS patients who received IVT within 4.5 hours of symptom onset.

Results: Out of 2,613 reviewed records, 16 were included in this meta-analysis. The quantitative synthesis of data regarding the incidence of END in acute ischemic stroke (AIS) patients with IVT was 12% (95% confidence interval [CI], 10%-15%). Several factors were identified as significantly associated with post-IVT END, including demographic characteristics (age, male sex), comorbidities (hypertension, diabetes mellitus, atrial fibrillation), medications (antihypertensives, antiplatelets), admission parameters (hyperglycemia, elevated white blood cell count, cholesterol levels, blood pressure readings), timing of treatment, and the presence of large artery atherosclerosis (LAA).

Conclusion: Understanding and monitoring multiple factors associated with END, including other comorbidities, may achieve satisfactory results. The investigation of white blood cells' involvement in END following AIS merits particular attention, as it may guide the development of targeted preventive medications.

Objectives: To assess how facet medial branch radiofrequency thermocoagulation (FMB-RFT) outcomes are affected by severe facet joint osteoarthritis (FJO).

Methods: This retrospective study involved 91 individuals with lumbar facet joint disease-related chronic lower back pain (CLBP), all of whom underwent FMB-RFT. The patients were assigned to 3 groups using the Weishaupt facet grading system (WFGS). Pain scores were assessed prior to treatment, as well as at the 1-, 6-, and 12-month marks.

Results: Based on the WFGS, 38 of the 91 patients were assigned a grade 1 FJO, 28 a grade 2 FJO, and 25 a grade 3 FJO. The percentage of patients in each group who saw a 50% or greater improvement in their pain scores at 1, 6, and 12 months did not differ significantly.

Conclusion: For patients with CLBP, FMB-RFT has been shown to be safe and effective in both the short and long terms. The results from FMB-RFT do not seem to be affected by the severity of FJO.

Objective: To develop clinical practice guidelines based on evidence based medicine on the use of abortive and preventive therapies for managing migraine headaches. We formulated these guidelines to offer evidence-based recommendations to improve the knowledge of physicians, healthcare professionals, and policymakers in migraine headache management.

Method: A panel of 11 experts from different sectors in Saudi Arabia approved 26 questions on abortive and preventive therapies for migraines. To develop each question, we searched "PubMed" and "Cochrane Library" databases for recent relevant systematic reviews published between 2013 and 2024. We employed the Grading Recommendations, Assessment, Development, and Evaluation methodological approach to ensure the certainty of the collated evidence and to formulate the recommendations. The expert panel voted electronically on each recommendation, and a consensus was defined as >70% agreement.

Results: We formulated a total of 26 recommendations. Of these, 14 are focused on abortive therapy for acute migraine attacks, whereas 12 are focused on the prevention of episodic or chronic migraines. These guidelines strongly recommend the use of paracetamol and ibuprofen as the first-line treatment for mild to moderate migraine. Furthermore, we concluded that propranolol should be considered as the first-line preventive intervention for migraine.

Conclusion: The Saudi clinical practice guidelines offer systematically validated recommendations of migraine headaches in adults. The recommendations are potentially beneficial for all healthcare professionals managing patients with migraine headaches.

Objectives: To investigate the risk factors, clinical characteristics, and neurodevelopmental outcomes associated with perinatal stroke, as well as to assess the risk of epilepsy, seizure control, and cognitive function in children with perinatal stroke.

Methods: Data from 32 patients diagnosed with perinatal stroke between October 2007 and October 2020 were retrospectively reviewed.

Results: Of 32 patients, 27 were born after normal pregnancies, and 20 (62.5%) had consanguineous parents. Family histories of stroke, haematological disease, and epilepsy were noted in 3.13%, 3.13%, and 21.88%, respectively. Initial symptoms included hemiparesis (56.25%), seizures (37.5%), respiratory distress (3.13%), and tiptoe walking (3.13%). Epilepsy was diagnosed in 22 patients, with 72.72% achieving seizure control. Among 12 patients who underwent IQ testing, 15.63% had borderline impairment, 9.37% average IQ, 3.13% below-average IQ, and 6.26% moderate-to-severe impairment.

Conclusion: Hemiparesis was the most frequent presenting symptom, followed by seizures. Many patients developed epilepsy, with most achieving satisfactory seizure control. IQ testing revealed varying degrees of cognitive impairment, highlighting the complex neurodevelopmental effects of perinatal stroke.

Objectives: To examine the association between sleep deprivation and cigarette smoking among adolescents in the "Gulf Cooperation Council (GCC)" countries, accounting for relevant sociodemographic and behavioral factors.

Methods: The present study was conducted between June and August 2024 using data from the most recent "Global School-based Student Health Survey (GSHS)" conducted in 5 GCC countries. The study included 21,105 adolescents aged 11-18 years. Multiple logistic regression models were used to examine the association in each country. A random-effects meta-analysis was conducted to synthesize results across countries.

Results: Overall, 17.9% of adolescents reported sleep deprivation. The pooled adjusted odds ratio for the association between cigarette smoking and sleep deprivation was 1.75 (95% CI: 1.56-1.96), indicating that adolescents who smoked cigarettes had 75% higher odds of experiencing sleep deprivation compared to non-smokers. This association was consistent across all 5 GCC countries, with low heterogeneity (I² = 18.1%).

Conclusion: This study provides evidence of a significant positive association between sleep deprivation and cigarette smoking among adolescents in GCC countries. These findings emphasize the need for comprehensive public health interventions promoting both smoking prevention and sleep health among adolescents in the region.