Journal of Stroke & Cerebrovascular Diseases最新文献

{"title":"Trends in cerebrovascular disease-related mortality among older adults in the United States from 1999 to 2020: An analysis of gender, race/ethnicity, and geographical disparities","authors":"Muhammad Saad MBBS ,&nbsp;Maria Saleem MBBS ,&nbsp;Umar Maqbool MBBS ,&nbsp;Fareeha Khan MBBS ,&nbsp;Maleeha Saleem MBBS ,&nbsp;Eman Alamgir MBBS ,&nbsp;Salvia Qazi MBBS ,&nbsp;Haram Rehman MBBS ,&nbsp;Aleena Arshad Ali BDS ,&nbsp;Arfa Ahmed Assad MBBS ,&nbsp;Aasma Javed MBBS ,&nbsp;Qais Bin Abdul Ghaffar MBBS ,&nbsp;Ammad Adeel MBBS ,&nbsp;Faheemullah Khan MD ,&nbsp;Adarsh Raja MBBS","doi":"10.1016/j.jstrokecerebrovasdis.2024.108043","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108043","url":null,"abstract":"<div><h3>Background</h3><div>One of the most prevalent causes of morbidity and death is cerebrovascular disease in the US. The manifestations and pathophysiology of cerebrovascular disease are significantly impacted by ageing and determine the quality of one's late life. However, contemporary mortality trends in cerebrovascular disease and comparison to older adults of different gender, race, and geographic disparities have not been fully examined. A thorough comprehension of these correlations and current cerebrovascular disease death patterns can impact medical treatment and strategies.</div></div><div><h3>Objective</h3><div>We examined the mortality trends according to gender, race, and geographical disparities in cerebrovascular disease among older adults, using mortality data (1999 - 2020) from the Centers for Disease Control and Prevention WONDER database</div></div><div><h3>Methods</h3><div>This research study aims to analyze disparities in cerebrovascular disease among senior citizens in the United States. The analysis has considered factors such as gender, race, and geographical variations over 21 years from 1999 to 2020. Mortality data obtained from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database has been utilized for this retrospective cohort analysis, focusing on individuals aged 75 and above.</div></div><div><h3>Results</h3><div>From 1999 to 2020, there were 3,813,729 deaths related to Cerebrovascular disease in older adults, demonstrating a declining trend (AAPC=). Males (880.6) had slightly higher AAMRs than females (866.7). Non-Hispanic (NH) Black (1050) had higher AAMRs than NH whites (880.8) followed by NH American Indians (699.7), Hispanic (673.2), and NH Asians (669.3). AAMRs also varied by region with the Midwest (922) having the highest AAMRs followed by the South (918.2), West (884.3), and Northeast (744). Among states, Tennessee had the highest AAMRs (1076.3), whereas New York had the lowest (609.7).</div></div><div><h3>Conclusion</h3><div>These results indicate a significant decline in cerebrovascular disease-related mortality among older adults from 1999 to 2020, highlighting improvements in healthcare and preventive measures over the two decades. Despite the overall decrease, elderly females had more deaths, elderly males had a higher AAMR, non-Hispanic blacks had the highest AAMR, and the Midwest and non-metropolitan areas had higher mortality burdens. The recent uptick in mortality rates from 2018 to 2020 underscores the need for ongoing public health efforts to address cerebrovascular diseases, particularly targeting vulnerable populations and high-risk regions.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 1","pages":"Article 108043"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332406","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":"Corrigendum to “Spontaneous Neuronal Plasticity in the Contralateral Motor Cortex and Corticospinal Tract after Focal Cortical Infarction in Hypertensive Rats” [J Stroke Cerebrovasc Dis,2020 Dec;29(12):105235/Manuscript NO:JSCVD-D-20-00162]","authors":"Xiaoqin Huang,&nbsp;Li Chen","doi":"10.1016/j.jstrokecerebrovasdis.2024.108117","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108117","url":null,"abstract":"","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 1","pages":"Article 108117"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693974","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":"Feasibility, usability and engagement of a tangible interface for upper limb rehabilitation after stroke","authors":"Fábio Pereira ,&nbsp;Sergi Bermúdez i Badia ,&nbsp;Rúben Ornelas ,&nbsp;Mónica S. Cameirão","doi":"10.1016/j.jstrokecerebrovasdis.2024.108164","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108164","url":null,"abstract":"<div><div>Here we present a study that explores the feasibility, user engagement, and usability of an interactive system that involves the use of tangible objects with various shapes and properties to interact with virtual tasks designed for upper limb rehabilitation following a stroke. We evaluated five different types of interaction modalities, including three grasps modalities (power grasp, lateral grasp and tripod grasp) and two strength modalities. These were tested using five basic game-like tasks with a total of 20 stroke patients. High levels of enjoyment were reported, and the system overall was considered feasible. The usability mean score (63.3) was acceptable for a system still in development. Enabling the use of tangibles during serious games in rehabilitation settings can enhance the transfer of learning to real-world situations.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 1","pages":"Article 108164"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792850","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":"Thalamic hemorrhage due to ruptured aneurysm at the feeder of a tentorial dural arteriovenous fistula in the Galen region mimicking a hypertensive hemorrhage","authors":"Tomoya Okamoto MD ,&nbsp;Masashi Kotsugi MD, Ph.D. ,&nbsp;Yoshiaki Kakehi MD ,&nbsp;Hiromitsu Sasaki MD ,&nbsp;Yudai Morisaki MD, Ph.D. ,&nbsp;Ryosuke Maeoka MD ,&nbsp;Shohei Yokoyama MD, Ph.D. ,&nbsp;Ichiro Nakagawa MD, Ph.D.","doi":"10.1016/j.jstrokecerebrovasdis.2024.108166","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108166","url":null,"abstract":"<div><h3>Introduction</h3><div>Thalamic hemorrhage caused by cerebrovascular disease is unusual. We describe a rare case of thalamic hemorrhage due to rupture of an aneurysm at the feeder of a tentorial dural arteriovenous fistula in the Galen region mimicking a hypertensive hemorrhage.</div></div><div><h3>Case presentation</h3><div>A 78-year-old woman with sudden-onset right hemiparesis was diagnosed with left thalamic hemorrhage. Cerebral angiography revealed hemorrhage caused by rupture of an aneurysm at the feeder artery of a dural arteriovenous fistula at tentorial edge near the vein of Galen. The aneurysm was located at the distal site of a long circumflex branch from the left posterior cerebral artery. Trans-arterial embolization of the aneurysm was performed using N-butyl cyanoacrylate. The procedure was successful and the patient experienced no complications or re-bleeding.</div></div><div><h3>Conclusions</h3><div>Dural arteriovenous fistula sometimes shows aneurysm at a feeder artery. We need to consider the possibility of vascular diseases involvement even if parenchymal hemorrhage appears to be typical hypertensive case.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 1","pages":"Article 108166"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774713","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":"Fusobacterium nucleatum in the oral cavity is associated with cerebral small vessel disease in patients with ischemic stroke","authors":"Shiro Aoki MD, PhD ,&nbsp;Hiromi Nishi DDS, PhD ,&nbsp;Yuji Shiga MD, PhD ,&nbsp;Tomohisa Nezu MD, PhD ,&nbsp;Futoshi Eto MD ,&nbsp;Eiji Imamura MD ,&nbsp;Ryo Shimomura MD, PhD ,&nbsp;Miki Kawada-Matsuo DDS, PhD ,&nbsp;Hitoshi Komatsuzawa DDS, PhD ,&nbsp;Hiroyuki Kawaguchi DDS, PhD ,&nbsp;Hirofumi Maruyama MD, PhD","doi":"10.1016/j.jstrokecerebrovasdis.2024.108183","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108183","url":null,"abstract":"<div><h3>Objectives</h3><div>Periodontal disease is reportedly associated with an increased risk of stroke. Recent evidence suggests that periodontal disease aggravates cerebral small vessel disease (CSVD), including lacunar stroke. However, the periodontal pathogens associated with CSVD remain unclear. Thus, we examined the relationship between the relative rates of periodontal pathogens in the oral cavity and CSVD, to elucidate the effects of different types of periodontal pathogens on small cerebral vessels.</div></div><div><h3>Materials and Methods</h3><div>Consecutive patients with acute ischemic stroke were prospectively enrolled. The associations between the relative rates of periodontal pathogens on tongue coating, background factors, and CSVD imaging findings were statistically analyzed. The relative rates of periodontal pathogens were calculated using quantitative polymerase chain reaction for six species of periodontal pathogens. Positivity for each periodontal pathogen was defined as the presence of more than the third quartile of the amount of each periodontal pathogen relative to the total amount of tongue-coating bacteria.</div></div><div><h3>Results</h3><div>A total of 347 patients with acute ischemic stroke (149 [42.9%] females, mean age 75.2±13.1 y) were registered. Positivity for <em>Fusobacterium nucleatum</em> was independently associated with high-grade white matter hyperintensities (odds ratio, 1.84; 95% confidence interval [CI], 1.10–3.08; p=0.021) and high-grade total CSVD score (odds ratio, 1.76; 95% CI, 1.04–2.96; p=0.035); however, the other five species did not show any association.</div></div><div><h3>Conclusions</h3><div>The qualitative positivity for <em>Fusobacterium nucleatum</em> in the oral cavity was independently associated with high-grade white matter hyperintensities and high-grade total CSVD score in patients with ischemic stroke. Thus, oral care targeting <em>Fusobacterium nucleatum</em> may aid in impeding CSVD progression.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 1","pages":"Article 108183"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796551","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":"Possible misdiagnosis of pregnancy-associated stroke in the emergency department","authors":"Setareh Salehi Omran MD ,&nbsp;Cenai Zhang MS ,&nbsp;Alison Seitz MD ,&nbsp;Samuel S. Bruce MD ,&nbsp;Vanessa Liao BS ,&nbsp;Anokhi Pawar BS ,&nbsp;Babak B. Navi MD, MS ,&nbsp;Hooman Kamel MD, MS ,&nbsp;Ava L. Liberman MD","doi":"10.1016/j.jstrokecerebrovasdis.2024.108139","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108139","url":null,"abstract":"<div><h3>Objectives</h3><div>Pregnancy and the postpartum period are associated with an increased risk of ischemic and hemorrhagic stroke. The incidence of missed or delayed diagnosis of pregnancy-associated stroke (PAS) in the emergency setting is unknown.</div></div><div><h3>Materials and methods</h3><div>We conducted a retrospective cohort study of women hospitalized for labor and delivery identified through administrative claims data from all nonfederal EDs and hospitals in 11 states (New York 2006-2017, Florida 2005-2019, 3 states from 2016-2020, 6 states from 2016-2019). We then identified women hospitalized for stroke (ischemic or hemorrhagic) using validated <em>ICD-9-CM</em> or <em>ICD-10-CM</em> codes during a 270-day period extending from 6 months before through 3 months after delivery. The primary study outcome was possible ED misdiagnosis of PAS, defined as an ED treat-and-release visit for a neurological complaint within the 30 days preceding PAS hospitalization. Standard tests of comparison were used to compare differences in characteristics between PAS patients with a possible ED stroke misdiagnosis versus those without.</div></div><div><h3>Results</h3><div>Among 5,308,962 women hospitalized for labor and delivery, 1,656 (0.03%) were hospitalized for a stroke during the study period. Of the pregnant or postpartum women hospitalized for stroke, 79 (4.8%; median age, 30 years) had at least one preceding ED visit for a neurological symptom (possible misdiagnosis). Demographics and vascular comorbidities were similar between those with versus without possible misdiagnosis. There were also no differences in the average length of stay (7.5 versus 9.6 days, p=0.43) or discharge to home (63.3% versus 56.6%, p=0.24) after stroke.</div></div><div><h3>Conclusions</h3><div>Possible ED misdiagnosis occurred in nearly 1 of 20 cases of pregnancy-associated strokes in this multistate cohort though there were few of these strokes overall.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 1","pages":"Article 108139"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751948","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":"Prevalence of neurogenic stress cardiomyopathy in acute ischemic stroke and relationship with leukocytosis","authors":"Laura Naydovich ,&nbsp;Darshil Shah ,&nbsp;Tyrone Coleman ,&nbsp;Michael T. Mullen ,&nbsp;John Furey ,&nbsp;Lauren Koffman","doi":"10.1016/j.jstrokecerebrovasdis.2024.108169","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108169","url":null,"abstract":"<div><h3>Objective</h3><div>Describe the prevalence and features of neurogenic stress cardiomyopathy in acute ischemic stroke. Describe leukocytosis as an inflammatory marker in neurogenic stress cardiomyopathy.</div></div><div><h3>Materials/Methods</h3><div>Retrospective review of 688 adult ischemic stroke patients at a tertiary care center (1/2018 – 12/2021). Neurogenic stress cardiomyopathy was identified by one of: low left ventricular ejection fraction, ventricular wall motion abnormalities, elevated Troponin-I, or elevated brain natriuretic peptide. Leukocytosis defined as white blood cell count ≥12.0 × 10^9/L. Clinical and demographic data were collected.</div></div><div><h3>Results</h3><div>Neurogenic stress cardiomyopathy was observed in 147 (21 %) patients. In this group, mean age was 68, 44 % were female, mean National Institutes of Health Stroke Scale was 10 and mean hospital stay was 8 days. Low left ventricular ejection fraction (median 40 %) was observed in 64 % of these patients, elevated Troponin-I (median 0.252 ng/mL) in 40 %, and ventricular wall motion abnormalities in 55 %. Stroke mechanisms were cryptogenic (43 %), cardioembolic (24 %), small vessel disease (13 %), large artery atherosclerosis (12 %), and other (8 %). Mean white blood cell count was 8.63 × 10^9/L. Leukocytosis occurred in 12 % of patients with cardiomyopathy and 8 % without, with no significant difference (<em>p</em>=0.9).</div></div><div><h3>Conclusion</h3><div>We propose defining neurogenic stress cardiomyopathy by one of four cardiac biomarkers. The prevalence aligns with prior reports, most frequently identified by low left ventricular ejection fraction or ventricular wall motion abnormalities. Unlike Takotsubo Cardiomyopathy, abnormal wall motion patterns were predominantly diffuse. No significant difference in leukocytosis was found between groups. Further research is needed to identify neurogenic stress cardiomyopathy risk factors.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 1","pages":"Article 108169"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774583","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":"Circulating inflammatory cytokines and the risk of cerebral small vessel disease: a bidirectional Mendelian randomization analysis","authors":"Shasha Han ,&nbsp;Qiong Chen ,&nbsp;Qiang Zhu ,&nbsp;Wenxiu Han","doi":"10.1016/j.jstrokecerebrovasdis.2024.108163","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108163","url":null,"abstract":"<div><h3>Background</h3><div>A correlation between inflammation and cerebral small vessel disease (CSVD) has been hypothesized by earlier observational research, while this correlation has not been well established. Considering the significant clinical value of this causality determination, Mendelian randomization (MR) was implemented to investigate the causality between inflammatory cytokines and CSVD radiological lesions.</div></div><div><h3>Methods</h3><div>Using the publicly available Genome-Wide Association Study (GWAS) datasets, a bidirectional two-sample MR analysis was employed to infer causality between 91 inflammatory cytokines and CSVD phenotypes [white matter hyperintensity (WHM), fractional anisotropy (FA), mean diffusivity (MD), cerebral microbleeds (CMBs), and lacunar stroke]. A set of methods was used for sensitivity analysis, including Cochran's Q test, MR-Egger intercept method, and MR pleiotropy residual sum and outlier (MR-PRESSO) global test. Furthermore, the strength of causality was assessed using the Bonferroni correction.</div></div><div><h3>Results</h3><div>Our research discovered a mutually predictive bidirectional link between CSVD phenotypes and inflammatory cytokines. Following the application of the Bonferroni correction, fibroblast growth factor 21 (FGF-21) was significantly inversely correlated with an increased risk of CMBs (OR = 0.579, 95 % CI = 0.425-0.789, <em>P</em> = 0.00055). Using sensitivity analysis, heterogeneity, and horizontal pleiotropy were not detected.</div></div><div><h3>Conclusion</h3><div>In this investigation, we established the causality between CSVD and inflammatory cytokines, with FGF-21 in particular significantly reducing the risk of CMBs. With further validation, these findings may provide new targets for the prevention, detection, and intervention of CSVD.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 1","pages":"Article 108163"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787639","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":"Presentation, treatment and outcomes of acute basilar artery occlusion: A retrospective analysis","authors":"Nikita Chhabra DO ,&nbsp;Cumara B. O'Carroll MD, MPH ,&nbsp;Han Wang MD, MPH ,&nbsp;Adnan Shahid MBBS, MCh ,&nbsp;Amir A. Mbonde MB ChB MMED ,&nbsp;Rachel E. Carlin MD ,&nbsp;Oana M. Dumitrascu MD, MSc ,&nbsp;Gyanendra Kumar MD ,&nbsp;Josephine F. Huang MD ,&nbsp;Eugene L. Scharf MD ,&nbsp;Chia-Chun Chiang MD","doi":"10.1016/j.jstrokecerebrovasdis.2024.108153","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108153","url":null,"abstract":"<div><h3>Introduction</h3><div>We aim to assess the clinical presentation, treatment, and outcomes in patients with acute basilar artery occlusion (BAO) after receiving medical management (MM) (including IV thrombolysis, antiplatelet, anticoagulation) and endovascular therapy (EVT) (including intra-arterial thrombolysis, stent placement, mechanical thrombectomy).</div></div><div><h3>Methods</h3><div>This is a retrospective cohort study including all adult patients treated at three Mayo Clinic stroke centers with acute BAO from 2008 to 2021. Chart review was conducted to extract details of presentation, treatment, and outcome. Comparisons of treatment outcomes between patients treated with MM and EVT were analyzed and include changes of modified Rankin Scale (mRS) and NIHSS score change from admission to discharge.</div></div><div><h3>Results</h3><div>A total of 182 patients were included in our final analysis: 95 in the MM group and 87 in the EVT group. There was a statistically significant difference in favorable functional outcome at discharge (mRS 0-3) favoring the MM group compared to EVT group (56.0 % vs 34.9 %; OR 0.42, <em>p</em> = 0.005) and the difference remained significant in multivariate analysis (OR 0.38, <em>p</em> = 0.048). There were significantly increased odds of having NIHSS improvement of &gt;5 points (OR 3.94 <em>p</em> &lt; 0.001), and 10 points (OR 3.92 <em>p</em> &lt; 0.001) in patients treated with EVT compared to MM.</div></div><div><h3>Conclusion</h3><div>Our data demonstrates that although in general patients who received EVT had lower odds of having favorable outcomes at discharge, they were also more likely to have NIHSS score improvement of &gt;5 and 10 points from presentation to discharge compared to MM, suggesting EVT could be beneficial in some patients.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 1","pages":"Article 108153"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774147","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":"High plasma thrombomodulin level is associated with a decreased risk of cognitive impairment after ischemic stroke","authors":"Yu He MD ,&nbsp;Xinyue Chang MD ,&nbsp;Yi Liu MD ,&nbsp;Jiawen Fei MD ,&nbsp;Xiaoli Qin MD ,&nbsp;Beiping Song MD ,&nbsp;Quan Yu MD ,&nbsp;Mengyao Shi MD, PhD ,&nbsp;Daoxia Guo MD, PhD ,&nbsp;Jing Chen MD, MS ,&nbsp;Aili Wang MD, PhD ,&nbsp;Tan Xu MD, PhD ,&nbsp;Jiang He MD, PhD ,&nbsp;Yonghong Zhang MD, PhD ,&nbsp;Zhengbao Zhu MD, PhD","doi":"10.1016/j.jstrokecerebrovasdis.2024.108172","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108172","url":null,"abstract":"<div><h3>Background</h3><div>Thrombomodulin, a thrombin receptor with anticoagulant, anti-inflammatory, and cytoprotective properties, has been suggested to play a pivotal role in ischemic stroke. However, the association of plasma thrombomodulin with post-stroke cognitive impairment (PSCI) remains unclear. We aimed to prospectively investigate the associations of plasma thrombomodulin with PSCI among ischemic stroke patients in a multicenter cohort study.</div></div><div><h3>Methods</h3><div>We measured plasma thrombomodulin levels at baseline among 615 ischemic stroke patients from a preplanned ancillary study of the CATIS (China Antihypertensive Trial in Acute Ischemic Stroke). We used Montreal Cognitive Assessment (MoCA) to evaluate cognitive function at 3-month follow-up after ischemic stroke, and PSCI was defined as MoCA score &lt;23.</div></div><div><h3>Results</h3><div>Plasma thrombomodulin was inversely associated with PSCI, and the adjusted odds ratio of PSCI for the highest versus lowest quartile of thrombomodulin was 0.50 (95 % CI: 0.28-0.92, <em>P</em>_trend=0.026). Each standard deviation increment of log-transformed thrombomodulin was associated with a 23 % (odds ratio: 0.77, 95 % CI: 0.62-0.97, <em>P</em>=0.029) decreased risk of PSCI. In addition, plasma thrombomodulin could significantly improve the risk reclassification of PSCI beyond established risk factors (net reclassification index: 25.04 %, 95 % CI: 7.20 %-42.87 %, <em>P=</em>0.007; integrated discrimination improvement: 1.13 %, 95 % CI: 0.18 %-2.09 %, <em>P</em>=0.020).</div></div><div><h3>Conclusions</h3><div>High plasma thrombomodulin levels were associated with a decreased risk of PSCI among ischemic stroke patients. Our findings suggest that plasma thrombomodulin might be a predictive biomarker and potential therapeutic target for PSCI.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 1","pages":"Article 108172"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781346","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}