Journal of Stroke & Cerebrovascular Diseases最新文献_第5页

Nattokinase supplementation for cognitive enhancement in asymptomatic intracranial/carotid stenosis: A randomized controlled trial 纳豆激酶补充对无症状颅内/颈动脉狭窄的认知增强：一项随机对照试验。

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases

Pub Date : 2025-11-29 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108511

Kemeng Zhang MD , Xuting Zhang MD , Anni Wang MD , Wansi Zhong MD , Yingjian Pei MD , Haidi Jin MS , Ziyu Zhou MD , Cong Chen MD , Shuyue Wang PhD , Min Lou MD, PhD

Objectives

The Improving Cerebral Blood Flow and Cognitive Function in Patients with Asymptomatic Intracranial/Carotid Stenosis with Nattokinase (ICC-PACS) trial was a single-center, double-blind, placebo-controlled study, aiming to evaluate the effects of 6-month nattokinase (NK) supplementation on cognitive function in patients with asymptomatic intracranial/carotid artery stenosis.

Methods

A total of 120 participants were randomized 1:1 to receive oral NK (8000 FU/day) or placebo for six months. Cognitive assessments and multimodal brain magnetic resonance imaging (MRI) were performed at baseline and 6-month follow-up.

Results

A total of 120 subjects were ultimately included (60 in the NK group and 60 in the placebo group), with balanced baseline characteristics between the two groups (average age 58.3 years, female 40.9 %). A total of 88 patients took the medication as required for 6 months and completed follow-up (45 in the NK group and 43 in the placebo group). Per-protocol analysis results found no significant between-group differences in the Montreal Cognitive Assessment (MoCA) score changes (mean difference: 0.038; 95 % CI: -1.109, 1.163; P = 0.948). However, exploratory analysis revealed significant difference in the changes of visuospatial function scores between the NK group and the placebo group (intergroup difference: 0.350; 95 % CI: 0.056, 0.649; P = 0.024), with reduced risk of visuospatial function decline in the NK group (OR: 0.35; 95 % CI: 0.127, 0.966). Besides, results were consistent in intention-to-treat analyses.

Conclusion

Six-month NK supplementation did not improve global cognition in asymptomatic intracranial/carotid stenosis patients. However, domain-specific enhancement in visuospatial function suggests potential selective neuroprotective effects.

目的：纳豆激酶改善无症状颅内/颈动脉狭窄患者脑血流量和认知功能（ICC-PACS）试验是一项单中心、双盲、安慰剂对照研究，旨在评估补充6个月纳豆激酶（NK）对无症状颅内/颈动脉狭窄患者认知功能的影响。方法：共有120名参与者按1:1的比例随机分配，接受口服NK （8000 FU/天）或安慰剂治疗，为期6个月。在基线和6个月随访时进行认知评估和多模态脑磁共振成像（MRI）。结果：最终共纳入120名受试者（NK组60名，安慰剂组60名），两组基线特征平衡（平均年龄58.3岁，女性40.9%）。88例患者按要求服药6个月并完成随访（NK组45例，安慰剂组43例）。按方案分析结果发现蒙特利尔认知评估（MoCA）评分变化在组间无显著差异（平均差异：0.038;95% CI: -1.109, 1.163; P = 0.948）。然而，探索性分析显示NK组与安慰剂组的视觉空间功能评分变化具有显著性差异（组间差异：0.350;95% CI: 0.056, 0.649; P = 0.024），NK组的视觉空间功能下降风险降低（OR: 0.35; 95% CI: 0.127, 0.966）。此外，意向治疗分析的结果是一致的。结论：六个月NK补充不能改善无症状颅内/颈动脉狭窄患者的整体认知。然而，视觉空间功能的区域特异性增强提示潜在的选择性神经保护作用。

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引用次数: 0

Artificial intelligence to predict modified rankin score after acute stroke symptoms using wrist-worn triaxial accelerometry data 使用腕带三轴加速度计数据预测急性中风症状后的改良Rankin评分。

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases

Pub Date : 2025-11-27 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108508

Benjamin R Kummer MD , Alexander Gerlach BA , Shaun Kohli BS , Joshua Z Willey MD MS , Ari Shechter PhD , David S Liebeskind MD MBA , Girish Nadkarni MD PhD

Background

The modified Rankin Scale (mRS) is the most common measure of post-stroke functional outcome. However, its impact on post-stroke care is limited by its subjectivity, impracticality in vulnerable populations, and susceptibility to cultural and language barriers. Artificial intelligence (AI) applied to triaxial wrist-worn accelerometry data may offer an objective way to characterize post-stroke functional status and related changes.

Methods

We analyzed data from the REACH Stroke-Sleep study at Columbia University Irving Medical Center. Using single-day epochs averaged over the first 30 days of recording, we trained logistic repression (LR), random forest (RF) and long short-term memory (LSTM) models to predict 1-month and 6-month mRS scores, as well as 1- to-6 month mRS changes. 5-fold cross validation was used, and model performance was evaluated using area under receiver-operating curve (AUROC) for binary exact-match predictions.

Results

We identified 362 patients, of whom 302 (83.4 %) had 1-month and 251 (69.3 %) had 6-month mRS scores. RF models (1-month AUROC 0.65, 95 %CI 0.57-0.73; 6-month 0.59, 95 %CI 0.51-0.66; ΔmRS 0.62, 95 %CI 0.53-0.71) outperformed LSTM (0.55, 95 %CI 0.48-0.63; 0.53, 95 %CI 0.45-0.60, 0.49; 95 %CI 0.39-0.59) and LR (0.54, 95 %CI 0.47-0.61; 0.58, 95 %CI 0.50-0.66; 0.50, 95 %CI 0.40- 0.61) models.

Conclusions

AI applied to wearable accelerometry predicted short-term mRS score and functional change after stroke with accuracy above chance. Although predictive performance was modest, these results provide proof-of-concept that AI applied to passive wearable data can capture meaningful post-stroke functional variation and could inform future real-time monitoring frameworks. Integrating multimodal wearable and clinical data may further improve prediction of post-stroke functional outcomes.

背景：改良Rankin量表（mRS）是脑卒中后功能结局最常用的测量方法。然而，它对中风后护理的影响受到其主观性、在弱势人群中的不实用性以及对文化和语言障碍的敏感性的限制。人工智能（AI）应用于三轴腕带加速度测量数据可以提供一种客观的方法来表征中风后的功能状态和相关变化。方法：我们分析了哥伦比亚大学欧文医学中心REACH中风-睡眠研究的数据。使用记录前30天的单日平均时间，我们训练了逻辑抑制（LR）、随机森林（RF）和长短期记忆（LSTM）模型来预测1个月和6个月的mRS评分，以及1至6个月的mRS变化。使用5倍交叉验证，并使用接收者操作曲线下面积（AUROC）评估模型性能，以进行二元精确匹配预测。结果：我们确定了362例患者，其中302例（83.4%）有1个月的mRS评分，251例（69.3%）有6个月的mRS评分。RF模型（1个月AUROC 0.65, 95%CI 0.57-0.73； 6个月0.59,95%CI 0.51-0.66； ΔmRS 0.62, 95%CI 0.53- 0.63）优于LSTM （0.55, 95%CI 0.45-0.60, 0.49; 95%CI 0.39-0.59）和LR （0.54, 95%CI 0.47-0.61; 0.58, 95%CI 0.50-0.66; 0.50, 95%CI 0.40- 0.61）模型。结论：人工智能应用于可穿戴加速度计预测脑卒中后短期mRS评分和功能变化，准确率高于随机。尽管预测性能一般，但这些结果提供了概念验证，即人工智能应用于被动可穿戴数据可以捕获有意义的中风后功能变化，并可以为未来的实时监测框架提供信息。整合多模式可穿戴和临床数据可以进一步改善脑卒中后功能结局的预测。

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引用次数: 0

Feasibility of sidestream darkfield imaging of the sublingual and conjunctival microcirculation in aneurysmal subarachnoid haemorrhage patients: A technical report 动脉瘤性蛛网膜下腔出血患者舌下和结膜微循环侧流暗场成像的可行性：一份技术报告。

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases

Pub Date : 2025-11-19 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108498

Hanna Schenck M.D., M.sc. , Sander M.J. van Kuijk Ph.D. , Hans Vink Ph.D. , Erik Gommer Ph.D. , Werner Mess Ph.D. , Inger R. de Ridder Ph.D. , Govert Hoogland Ph.D. , Onno Teernstra Ph.D. , Jim Dings Ph.D. , Marcel Aries Ph.D. , Yasin Temel Ph.D. , Roel Haeren Ph.D.

Objective

Microcirculatory changes contribute to delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH), but bedside assessment remains challenging. Sidestream darkfield imaging (SDF) enables direct visualization but may be difficult in critically ill patients. The objective was to evaluate the feasibility of repeated sublingual and conjunctival SDF imaging in aSAH patients and to compare microcirculatory changes at both sites.

Methods

SDF imaging was performed sublingually and conjunctivally at six timepoints after aSAH. Feasibility was assessed by completion rate, patient experience, and acquisition time. Logistic mixed models identified factors influencing completion and microvascular outcomes. Agreement between sites was assessed with Bland-Altman plot and Spearman correlation.

Results

Thirty patients were included. Sublingual and conjunctival imaging completion rates were 89% and 70% respectively, with the latter declining over time. Positive patient experience increased success (OR 16, 95% 3.46-74.17), while longer acquisition time reduced success (OR 0.89, 95% CI 0.80-0.98). Discomfort was the main cause of conjunctival imaging failure. Sublingual and conjunctival parameters showed distinct trajectories during follow-up.

Conclusion

Sublingual SDF imaging is a feasible, well-tolerated method for serial microcirculatory assessment in aSAH patients. Conjunctival imaging is less tolerated and may be less suitable for repeated measurements. Microcirculatory changes differ between sites and cannot be used interchangeably.

目的：微循环改变有助于动脉瘤性蛛网膜下腔出血（aSAH）后延迟性脑缺血（DCI），但床边评估仍然具有挑战性。侧流暗场成像（SDF）可以实现直接可视化，但在危重患者中可能比较困难。目的是评估aSAH患者重复舌下和结膜SDF成像的可行性，并比较两个部位的微循环变化。方法：在aSAH后的6个时间点进行舌下和结膜SDF成像。可行性通过完成率、患者经验和获取时间进行评估。Logistic混合模型确定了影响完井和微血管预后的因素。用Bland-Altman图和Spearman相关评价各站点间的一致性。结果：纳入30例患者。舌下和结膜成像完成率分别为89%和70%，后者随着时间的推移而下降。积极的患者体验增加了成功率（OR 16, 95% 3.46-74.17），而较长的获取时间降低了成功率（OR 0.89, 95% CI 0.80-0.98）。不适是结膜成像失败的主要原因。舌下和结膜参数在随访中表现出明显的变化轨迹。结论：舌下SDF成像是一种可行且耐受性良好的aSAH患者系列微循环评估方法。结膜成像的耐受性较差，可能不太适合重复测量。不同部位的微循环变化不同，不能互换使用。

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引用次数: 0

Preoperative and intraoperative risk factor assessment and model for predicting stroke risk in patients diagnosed with cancer after surgery 术前及术中危险因素评估及预测癌症患者术后卒中风险的模型

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases

Pub Date : 2025-11-19 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108495

Shangqi Chen , Yuxuan Mo , Xiangman Zeng , Ping Chen , Feng Wu , Xiaoyu Li , Hua Ye , Yuan Yuan , Qi Zheng

Background

Perioperative stroke is a devastating surgical complication associated with high mortality rates. The goals of our study were to identify the predictors of postoperative stroke and to explore the possible role of intraoperative hypotension (IOH).

Methods

Medical records of patients undergoing non-cardiovascular, non-neurological surgery at Ningbo No.2 Hospital (January 1st, 2012—December 31st, 2023) were retrospectively analyzed. Logistic regression was used to screen for independent risk factors. The nomogram is used for the visualization of the model.

Results

This retrospective cohort study included 574,102 patients. Among 419,358 patients from 2012 to 2019, 848 (0.2 %) experienced postoperative stroke; cancer-related surgeries increased this incidence by 67 % (P < 0.001). In the cancer subgroup (multivariate analysis), significant predictors included age, history of stroke, atrial fibrillation, renal failure, elevated preoperative D-Dimer, and sustained IOH (>40 % decrease in mean arterial pressure [MAP] from baseline for >15 min) (all P < 0.05). Furthermore, the nomogram model developed based on the above variables demonstrated effective performance in predicting the occurrence of postoperative stroke in both the training set (January 1st, 2012—December 31st, 2019; n = 65,312) and the validation set (January 1st, 2020—December 31st, 2023; n = 28,326), with areas under the curve (AUCs) of 0.843 and 0.852, respectively.

Conclusion

This study confirms that cancer-related surgeries significantly increase postoperative stroke risk and demonstrates IOH's independent association in this subgroup. A validated nomogram provides an effective tool for prediction.

背景：围手术期卒中是一种毁灭性的手术并发症，死亡率高。本研究的目的是确定术后卒中的预测因素，并探讨术中低血压（IOH）的可能作用。方法：回顾性分析宁波市第二医院2012年1月1日至2023年12月31日行非心血管、非神经外科手术患者的病历。采用Logistic回归筛选独立危险因素。模态图用于模型的可视化。结果：该回顾性队列研究纳入了574,102例患者。在2012-2019年的419,358例患者中，848例（0.2%）发生了术后卒中；癌症相关手术使该发生率增加67% （P < 0.001）。在癌症亚组（多因素分析）中，显著的预测因素包括年龄、卒中史、心房颤动、肾衰竭、术前d -二聚体升高和持续IOH（平均动脉压[MAP]较基线下降40%，持续>15分钟）（均P < 0.05）。在训练集（2012年1月1日- 2019年12月31日，n=65,312）和验证集（2020年1月1日- 2023年12月31日，n=28,326）中，基于上述变量建立的nomogram模型均能有效预测术后卒中的发生，曲线下面积（auc）分别为0.843和0.852。结论：本研究证实癌症相关手术显著增加术后卒中风险，并证实IOH在该亚组中具有独立相关性。经过验证的模态图为预测提供了有效的工具。

{"title":"Preoperative and intraoperative risk factor assessment and model for predicting stroke risk in patients diagnosed with cancer after surgery","authors":"Shangqi Chen , Yuxuan Mo , Xiangman Zeng , Ping Chen , Feng Wu , Xiaoyu Li , Hua Ye , Yuan Yuan , Qi Zheng","doi":"10.1016/j.jstrokecerebrovasdis.2025.108495","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108495","url":null,"abstract":"<div><h3>Background</h3><div>Perioperative stroke is a devastating surgical complication associated with high mortality rates. The goals of our study were to identify the predictors of postoperative stroke and to explore the possible role of intraoperative hypotension (IOH).</div></div><div><h3>Methods</h3><div>Medical records of patients undergoing non-cardiovascular, non-neurological surgery at Ningbo No.2 Hospital (January 1st, 2012—December 31st, 2023) were retrospectively analyzed. Logistic regression was used to screen for independent risk factors. The nomogram is used for the visualization of the model.</div></div><div><h3>Results</h3><div>This retrospective cohort study included 574,102 patients. Among 419,358 patients from 2012 to 2019, 848 (0.2 %) experienced postoperative stroke; cancer-related surgeries increased this incidence by 67 % (<em>P</em> < 0.001). In the cancer subgroup (multivariate analysis), significant predictors included age, history of stroke, atrial fibrillation, renal failure, elevated preoperative D-Dimer, and sustained IOH (>40 % decrease in mean arterial pressure [MAP] from baseline for >15 min) (all <em>P</em> < 0.05). Furthermore, the nomogram model developed based on the above variables demonstrated effective performance in predicting the occurrence of postoperative stroke in both the training set (January 1st, 2012—December 31st, 2019; <em>n</em> = 65,312) and the validation set (January 1st, 2020—December 31st, 2023; <em>n</em> = 28,326), with areas under the curve (AUCs) of 0.843 and 0.852, respectively.</div></div><div><h3>Conclusion</h3><div>This study confirms that cancer-related surgeries significantly increase postoperative stroke risk and demonstrates IOH's independent association in this subgroup. A validated nomogram provides an effective tool for prediction.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 12","pages":"Article 108495"},"PeriodicalIF":1.8,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566958","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}

引用次数: 0

Dynamic waist circumference change: A superior predictor of incident stroke compared to novel and traditional obesity indices 动态腰围变化：与新型和传统肥胖指标相比，一个更好的预测中风事件的指标。

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases

Pub Date : 2025-11-19 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108496

Huizhen Liu , Ting Wang , Xiaoqin Zhou , Deying Kang

Background

While obesity is a recognized stroke risk factor, traditional measures like body mass index (BMI) have limitations in assessing body fat distribution. Novel central obesity indices—including waist-to-height ratio (WHtR), body roundness index (BRI), conicity index (CI), a body shape index (ABSI), and weight-adjusted waist index (WWI)—offer accessible alternatives reflecting visceral fat. However, previous studies have often focused on single-time obesity measurements, neglecting how changes over time and their cumulative effects influence stroke risk.

Methods

This prospective cohort study utilized longitudinal data (2011-2018) from the China Health and Retirement Longitudinal Study (CHARLS). We analyzed 5,896 adults aged ≥45 years without baseline stroke. Seven obesity indices (waist circumference [WC], BMI, WHtR, BRI, CI, ABSI, WWI) were measured at baseline (Wave1, 2011-2012), Wave2 (2013), and Wave 3 (2015). Their longitudinal trajectories from 2012 to 2013 and then to 2015 were modeled using K-means clustering. Their relative change was calculated from 2012 to 2015. Multivariable logistic regression evaluated associations between these obesity measures and incident stroke, adjusting for demographics, lifestyle, and comorbidities.

Results

As of the 2018 survey, 426 participants (7.23 %) experienced incident strokes. Baseline WC was significantly associated with stroke risk: each 1 cm increase corresponded to a 1 % higher risk (OR =1.01, 95 % CI: 1.001-1.02), and participants in the highest WC quartile had a 37 % greater risk compared to those in the lowest quartile (OR = 1.37; 95 % CI: 1.01–1.87). Other baseline obesity measures did not show significant associations. Regarding recent measurements in 2015, only the second quartile of ABSI was significantly associated with stroke risk (OR = 1.36; 95 % CI: 1.01–1.83 versus the first quartile). Crucially, individuals with a consistently high WC trajectory had a 27 % higher risk of stroke compared to those with a low trajectory (OR = 1.27, 95 % CI: 1.02–1.58). In contrast, relative changes in all indices were not associated with stroke risk.

Conclusion

Baseline WC and a sustained high WC trajectory are significant predictors of stroke, outperforming other obesity indices. This underscores the critical importance of long-term waist circumference monitoring and management in stroke prevention strategies for middle-aged and older adults.

背景：虽然肥胖是公认的中风危险因素，但传统的测量方法如身体质量指数（BMI）在评估身体脂肪分布方面存在局限性。新型中心肥胖指数——包括腰高比（WHtR）、体圆度指数（BRI）、圆度指数（CI）、体型指数（ABSI）和体重调整腰围指数（WWI）——为反映内脏脂肪提供了可获得的替代指标。然而，以前的研究往往集中在单次肥胖测量上，忽视了随时间的变化及其累积效应如何影响中风风险。方法：本前瞻性队列研究利用中国健康与退休纵向研究（CHARLS）的纵向数据（2011-2018）。我们分析了5896名年龄≥45岁、无基线卒中的成年人。在基线（Wave1, 2011-2012）、Wave2（2013）和wave3（2015）测量7项肥胖指标（腰围[WC]、BMI、WHtR、BRI、CI、ABSI、WWI）。利用K-means聚类对2012 - 2013年至2015年的纵向轨迹进行建模。从2012年到2015年，计算了它们的相对变化。多变量逻辑回归评估了这些肥胖测量与卒中发生率之间的关联，调整了人口统计学、生活方式和合并症。结果：截至2018年的调查，426名参与者（7.23%）经历过意外中风。基线腰围与卒中风险显著相关：每增加1厘米，风险增加1% (OR =1.01, 95% CI: 1.001-1.02)，与最低四分位数的参与者相比，最高腰围四分位数的参与者风险增加37% （OR = 1.37;95% CI: 1.01-1.87）。其他基线肥胖测量没有显示出显著的关联。根据2015年的最新测量，只有第二个四分位数的ABSI与卒中风险显著相关（OR = 1.36;95% CI: 1.01-1.83与第一个四分位数相比）。至关重要的是，与低WC轨迹的个体相比，持续高WC轨迹的个体卒中风险高出27% （OR = 1.27,95% CI: 1.02-1.58）。相比之下，所有指标的相对变化与卒中风险无关。结论：基线WC和持续高WC是脑卒中的重要预测指标，优于其他肥胖指标。这强调了长期腰围监测和管理在中老年中风预防策略中的重要性。

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引用次数: 0

The efficiency of robotic hand exoskeleton system in stroke patients: A pilot randomized controlled single blind trial 机械手外骨骼系统在脑卒中患者中的有效性：一项随机对照单盲试验。

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases

Pub Date : 2025-11-14 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108494

Fatma Öztürk (Lect) , Gönül Acar (Prof) , Ulvi Başpınar , Özge Keniş Coşkun , Barkın Bakır , Ipek Midi

Objective

This study aims to investigate the effects of the Robotic Hand Exoskeleton system on spasticity, motor control skills, activities of daily living, quality of life, and functional independence in stroke patients.

Design

A randomized controlled trial was conducted with 36 stroke patients aged 35-85, divided into two groups: conventional physiotherapy (n = 18) and robotic rehabilitation (n = 18). Evaluations included the Modified Ashworth Scale (MAS) for spasticity, Motor Activity Log 28 (MAL28) for daily activities, Frenchay Arm Test for motor control, and Stroke Impact Scale 3.0 (SIS 3.0) for quality of life and functional independence. Both groups received 15 treatment sessions over five weeks, with the robotic rehabilitation group additionally using a Robotic Hand Exoskeleton for 10 minutes per session.

Results

A significant improvement was observed in MAS (ES=0.092), MAL28, Frenchay Arm Test (ES=0.093), and SIS 3.0 (ES=0.01) scores after treatment (p < 0.05). However, no statistically significant differences were found between the groups (p > 0.05).

Conclusion

Robotic hand rehabilitation improved motor function, daily activities, quality of life, and reduced spasticity, but showed no superiority over conventional physiotherapy. Both treatments demonstrated similar effectiveness, with robotic rehabilitation offering potential financial and time-saving benefits for healthcare providers.

目的：本研究旨在探讨机械手外骨骼系统对脑卒中患者痉挛、运动控制技能、日常生活活动、生活质量和功能独立性的影响。设计：随机对照试验36例35-85岁脑卒中患者，分为常规物理治疗组（n=18）和机器人康复组（n=18）。评估包括用于痉挛的改良Ashworth量表（MAS），用于日常活动的运动活动日志28 (MAL28)，用于运动控制的Frenchay手臂测试，以及用于生活质量和功能独立性的中风影响量表3.0 （SIS 3.0）。两组在五周内接受了15次治疗，机器人康复组每次额外使用机器人手外骨骼10分钟。结果：治疗后患者的MAS （ES=0.092）、MAL28、Frenchay Arm Test （ES=0.093）、SIS 3.0 （ES=0.01）评分均有显著改善（p0.05）。结论：机械手康复改善了运动功能、日常活动、生活质量，减少了痉挛，但与常规物理治疗相比没有优势。两种治疗方法都显示出相似的效果，机器人康复为医疗保健提供者提供了潜在的经济和节省时间的好处。

{"title":"The efficiency of robotic hand exoskeleton system in stroke patients: A pilot randomized controlled single blind trial","authors":"Fatma Öztürk (Lect) , Gönül Acar (Prof) , Ulvi Başpınar , Özge Keniş Coşkun , Barkın Bakır , Ipek Midi","doi":"10.1016/j.jstrokecerebrovasdis.2025.108494","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108494","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to investigate the effects of the Robotic Hand Exoskeleton system on spasticity, motor control skills, activities of daily living, quality of life, and functional independence in stroke patients.</div></div><div><h3>Design</h3><div>A randomized controlled trial was conducted with 36 stroke patients aged 35-85, divided into two groups: conventional physiotherapy (<em>n</em> = 18) and robotic rehabilitation (<em>n</em> = 18). Evaluations included the Modified Ashworth Scale (MAS) for spasticity, Motor Activity Log 28 (MAL28) for daily activities, Frenchay Arm Test for motor control, and Stroke Impact Scale 3.0 (SIS 3.0) for quality of life and functional independence. Both groups received 15 treatment sessions over five weeks, with the robotic rehabilitation group additionally using a Robotic Hand Exoskeleton for 10 minutes per session.</div></div><div><h3>Results</h3><div>A significant improvement was observed in MAS (ES=0.092), MAL28, Frenchay Arm Test (ES=0.093), and SIS 3.0 (ES=0.01) scores after treatment (<em>p</em> < 0.05). However, no statistically significant differences were found between the groups (<em>p</em> > 0.05).</div></div><div><h3>Conclusion</h3><div>Robotic hand rehabilitation improved motor function, daily activities, quality of life, and reduced spasticity, but showed no superiority over conventional physiotherapy. Both treatments demonstrated similar effectiveness, with robotic rehabilitation offering potential financial and time-saving benefits for healthcare providers.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 12","pages":"Article 108494"},"PeriodicalIF":1.8,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534163","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}

引用次数: 0

Transcending traditional prognostic assessments: Predictive efficacy of MRA-based BATMAN and PCCS scores in basilar artery occlusive stroke 超越传统的预后评估：基于mri的BATMAN和PCCS评分在基底动脉闭塞性卒中中的预测作用。

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases

Pub Date : 2025-11-11 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108492

Lichao Hong , Lina Geng , Shuyan Jing , Zhai Liu , Yong Wang , Qian Wang

Aim

This study evaluated the application of Magnetic Resonance Angiography (MRA)-based BATMAN and PCCS scoring systems to predict individual neurological functional prognosis in patients with Basilar Artery Occlusive (BAO) stroke.

Materials and methods

Forty patients with BAO were enrolled, with prognosis assessed at 3 months post-stroke using the modified Rankin Scale (mRS). Prognostic scores were classified as good (mRS ≤ 3) or poor (mRS > 3). MRA-based BATMAN and PCCS scores were used to predict outcomes, and their predictive efficacy was assessed via Receiver Operating Characteristic (ROC) curve analysis.

Results

Among the 40 BAO patients, 24 (60%) had a good prognosis and 16 (40%) had a poor prognosis. Both BATMAN-MRA and PCCS-MRA scores were significantly negatively correlated with the 3-month mRS score (BATMAN-MRA: r = -0.487, P < 0.001; PCCS-MRA: r = -0.503, P < 0.001). ROC analysis showed that the BATMAN-MRA score had slightly higher predictive efficacy (AUC = 0.849) than the PCCS-MRA score (AUC = 0.807), with an optimal cutoff value of 6.5 for both scoring systems.

Conclusion

MRA-based BATMAN and PCCS scores are effective tools for predicting neurological outcomes in BAO patients, with BATMAN-MRA demonstrating superior predictive accuracy in this study.

目的：本研究评估基于磁共振血管造影（MRA）的BATMAN和PCCS评分系统在预测基底动脉闭塞性（BAO）脑卒中患者个体神经功能预后中的应用。材料与方法：入选40例BAO患者，卒中后3个月采用改良Rankin量表（mRS）评估预后。预后评分分为好（mRS≤3）和差（mRS bb0.3）。基于mra的BATMAN和PCCS评分用于预测预后，并通过受试者工作特征（ROC）曲线分析评估其预测效果。结果：40例BAO患者中，预后良好24例（60%），预后不良16例（40%）。BATMAN-MRA和PCCS-MRA评分与3个月mRS评分均呈显著负相关（BATMAN-MRA: r = -0.487,P < 0.001; PCCS-MRA: r = -0.503,P < 0.001）。ROC分析显示，BATMAN-MRA评分的预测效能（AUC = 0.849）略高于PCCS-MRA评分（AUC = 0.807），两种评分系统的最佳截止值均为6.5。结论：基于mra的BATMAN和PCCS评分是预测BAO患者神经预后的有效工具，BATMAN- mra在本研究中显示出更高的预测准确性。

{"title":"Transcending traditional prognostic assessments: Predictive efficacy of MRA-based BATMAN and PCCS scores in basilar artery occlusive stroke","authors":"Lichao Hong , Lina Geng , Shuyan Jing , Zhai Liu , Yong Wang , Qian Wang","doi":"10.1016/j.jstrokecerebrovasdis.2025.108492","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108492","url":null,"abstract":"<div><h3>Aim</h3><div>This study evaluated the application of Magnetic Resonance Angiography (MRA)-based BATMAN and PCCS scoring systems to predict individual neurological functional prognosis in patients with Basilar Artery Occlusive (BAO) stroke.</div></div><div><h3>Materials and methods</h3><div>Forty patients with BAO were enrolled, with prognosis assessed at 3 months post-stroke using the modified Rankin Scale (mRS). Prognostic scores were classified as good (mRS ≤ 3) or poor (mRS > 3). MRA-based BATMAN and PCCS scores were used to predict outcomes, and their predictive efficacy was assessed via Receiver Operating Characteristic (ROC) curve analysis.</div></div><div><h3>Results</h3><div>Among the 40 BAO patients, 24 (60%) had a good prognosis and 16 (40%) had a poor prognosis. Both BATMAN-MRA and PCCS-MRA scores were significantly negatively correlated with the 3-month mRS score (BATMAN-MRA: r = -0.487, P < 0.001; PCCS-MRA: r = -0.503, P < 0.001). ROC analysis showed that the BATMAN-MRA score had slightly higher predictive efficacy (AUC = 0.849) than the PCCS-MRA score (AUC = 0.807), with an optimal cutoff value of 6.5 for both scoring systems.</div></div><div><h3>Conclusion</h3><div>MRA-based BATMAN and PCCS scores are effective tools for predicting neurological outcomes in BAO patients, with BATMAN-MRA demonstrating superior predictive accuracy in this study.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 12","pages":"Article 108492"},"PeriodicalIF":1.8,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145515301","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}

引用次数: 0

Serum Cardiotrophin-1 as a novel biomarker for intracranial aneurysm 血清心肌营养因子-1作为颅内动脉瘤的新生物标志物。

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases

Pub Date : 2025-11-11 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108493

Weidong Men , Xuehao Zhang , Lijian Zhang , Shuo Sun , Yatong Wang , Pengfei Zhao , Jia Zuo , Chunhui Li , Xiaosong Shan

Background

Intracranial aneurysms (IAs) carry a high risk of rupture leading to subarachnoid hemorrhage, yet current diagnostic methods are invasive and costly. This study aimed to evaluate the potential of serum inflammatory markers and cardiotrophin-1 (CT-1) as non-invasive biomarkers for IA presence and rupture risk.

Methods

A total of 131 IA patients (33 unruptured, 98 ruptured) and 21 healthy controls were enrolled. Serum levels of IL-6, IL-10, IL-33, S100B, E-selectin, and CT-1 were measured by ELISA. Statistical analyses included Kruskal-Wallis tests, ROC curve evaluation, and logistic regression for risk factors.

Results

Serum CT-1 levels were significantly elevated in IA patients versus controls (p = 0.0002), with the highest levels in ruptured IAs (p = 0.0001 vs controls). ROC analysis demonstrated CT-1’s diagnostic potential for IA (AUC = 0.7801, sensitivity 75.57%) and ruptured IA (AUC = 0.7911, sensitivity 79.59%). No significant differences were observed for IL-6, IL-10, IL-33, S100B, or E-selectin. Older age (OR = 1.072) and smoking (OR = 9.659) were significant IA risk factors.

Conclusions

CT-1 is a promising serum biomarker for IA detection and rupture risk stratification. Its elevation, particularly in ruptured cases, suggests potential clinical utility for non-invasive screening. Further validation in larger cohorts is warranted.

背景：颅内动脉瘤（IAs）具有很高的破裂风险，导致蛛网膜下腔出血，但目前的诊断方法是侵入性的和昂贵的。本研究旨在评估血清炎症标志物和心肌营养因子-1 （CT-1）作为IA存在和破裂风险的非侵入性生物标志物的潜力。方法：131例IA患者（未破裂33例，破裂98例）和21例健康对照。ELISA法检测血清IL-6、IL-10、IL-33、S100B、e -选择素、CT-1水平。统计分析包括Kruskal-Wallis检验、ROC曲线评价和危险因素的logistic回归。结果：与对照组相比，IA患者血清CT-1水平显著升高（p = 0.0002），破裂IAs患者血清CT-1水平最高（p = 0.0001）。ROC分析显示，CT-1对IA （AUC = 0.7801，敏感性75.57%）和IA破裂（AUC = 0.7911，敏感性79.59%）具有诊断潜力。IL-6、IL-10、IL-33、S100B或E-selectin均无显著差异。年龄（OR = 1.072）和吸烟（OR = 9.659）是IA的显著危险因素。结论：CT-1是一种很有前途的用于IA检测和破裂风险分层的血清生物标志物。它的升高，特别是在破裂病例中，表明非侵入性筛查的潜在临床应用。需要在更大的队列中进一步验证。

{"title":"Serum Cardiotrophin-1 as a novel biomarker for intracranial aneurysm","authors":"Weidong Men , Xuehao Zhang , Lijian Zhang , Shuo Sun , Yatong Wang , Pengfei Zhao , Jia Zuo , Chunhui Li , Xiaosong Shan","doi":"10.1016/j.jstrokecerebrovasdis.2025.108493","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108493","url":null,"abstract":"<div><h3>Background</h3><div>Intracranial aneurysms (IAs) carry a high risk of rupture leading to subarachnoid hemorrhage, yet current diagnostic methods are invasive and costly. This study aimed to evaluate the potential of serum inflammatory markers and cardiotrophin-1 (CT-1) as non-invasive biomarkers for IA presence and rupture risk.</div></div><div><h3>Methods</h3><div>A total of 131 IA patients (33 unruptured, 98 ruptured) and 21 healthy controls were enrolled. Serum levels of IL-6, IL-10, IL-33, S100B, E-selectin, and CT-1 were measured by ELISA. Statistical analyses included Kruskal-Wallis tests, ROC curve evaluation, and logistic regression for risk factors.</div></div><div><h3>Results</h3><div>Serum CT-1 levels were significantly elevated in IA patients versus controls (<em>p</em> = 0.0002), with the highest levels in ruptured IAs (<em>p</em> = 0.0001 vs controls). ROC analysis demonstrated CT-1’s diagnostic potential for IA (AUC = 0.7801, sensitivity 75.57%) and ruptured IA (AUC = 0.7911, sensitivity 79.59%). No significant differences were observed for IL-6, IL-10, IL-33, S100B, or E-selectin. Older age (OR = 1.072) and smoking (OR = 9.659) were significant IA risk factors.</div></div><div><h3>Conclusions</h3><div>CT-1 is a promising serum biomarker for IA detection and rupture risk stratification. Its elevation, particularly in ruptured cases, suggests potential clinical utility for non-invasive screening. Further validation in larger cohorts is warranted.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 12","pages":"Article 108493"},"PeriodicalIF":1.8,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145515324","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}

引用次数: 0

Prognostic significance of the hemoglobin, albumin, lymphocyte, and platelet score in stroke survivors: A population-based study 脑卒中幸存者血红蛋白、白蛋白、淋巴细胞和血小板评分的预后意义：一项基于人群的研究。

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases

Pub Date : 2025-11-07 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108490

Haizhen Qin , Rongrong Zhao

Background

Systemic inflammation and malnutrition have been associated with unfavorable outcomes in patients with acute stroke. The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score is a novel composite biomarker of inflammatory and nutritional status. The current study aimed to examine the prognostic significance of the HALP score in long-term outcomes in stroke survivors.

Methods

We analyzed data from 1,427 US adult stroke survivors from US National Health and Nutrition Examination Survey. The primary outcomes were all-cause and cardiovascular disease (CVD) mortality. The HALP score was calculated from hemoglobin, serum albumin, and platelet and lymphocyte count. Multivariable Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs).

Results

Over a median follow-up of 81 months, 630 death (37.84 %) occurred, including 276 CVD-related deaths. Compared with the lowest HALP quartile group, the HRs (95 % CIs) in the second, third and fourth quartile were 0.83 (0.63-1.10), 0.65 (0.47-0.90), and 0.61 (0.45-0.82) for all-cause mortality, and 0.84 (0.51-1.37), 0.63 (0.39-1.00), and 0.56 (0.36-0.89) for CVD mortality, respectively. Restricted cubic spline curves revealed a non-linear L-shaped association between HALP score and all-cause and CVD mortality, with inflection points at HALP = 43 and 45, respectively. Interaction analysis indicated that the association between HALP score and mortality risk was consistent among different subgroups.

Conclusion

The HALP score exhibits an L-shaped association with both all-cause and CVD mortality in US stroke survivors, suggesting its utility as a prognostic biomarker in this population.

背景：全身性炎症和营养不良与急性脑卒中患者的不良结局有关。血红蛋白、白蛋白、淋巴细胞和血小板（HALP）评分是一种新的炎症和营养状况的复合生物标志物。目前的研究旨在检查HALP评分在卒中幸存者长期预后中的预后意义。方法：我们分析了来自美国国家健康和营养检查调查的1427名成年中风幸存者的数据。主要结局是全因和心血管疾病（CVD）死亡率。根据血红蛋白、血清白蛋白、血小板和淋巴细胞计数计算HALP评分。采用多变量Cox比例风险回归模型估计风险比（hr）和95%置信区间（ci）。结果：在81个月的中位随访中，发生630例死亡（37.84%），其中276例与心血管疾病相关。与HALP最低四分位数组相比，第二、第三和第四四分位数全因死亡率的hr （95% ci）分别为0.83（0.63-1.10）、0.65（0.47-0.90）和0.61 (0.45-0.82)，CVD死亡率的hr （95% ci）分别为0.84（0.51-1.37）、0.63（0.39-1.00）和0.56（0.36-0.89）。受限三次样条曲线显示，HALP评分与全因死亡率和CVD死亡率呈非线性l型关系，拐点分别为HALP = 43和45。相互作用分析表明，不同亚组间HALP评分与死亡风险的相关性是一致的。结论：HALP评分与美国中风幸存者的全因死亡率和心血管疾病死亡率呈l型相关性，提示其作为该人群预后生物标志物的实用性。

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引用次数: 0

Effectiveness of perception–interaction-enhanced rehabilitation in post-stroke recovery: A real-world propensity-matched cohort study 感知-相互作用增强康复在脑卒中后康复中的有效性：一项真实世界倾向匹配的队列研究。

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases

Pub Date : 2025-11-07 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108491

Yan Zhang MM , Jiumei Zhao MM , Jun Dong MM , Shaomin Li MM

Background

Technology-assisted rehabilitation is increasingly used after stroke, but the real-world contribution of perception–interaction modalities remains unclear. This study evaluated their effectiveness and predictive factors in post-stroke motor recovery.

Methods

We conducted a retrospective, single-center, propensity score–matched cohort study of adults (40–85 years) with mild to moderate upper-limb impairment admitted for inpatient rehabilitation (2020–2023). Patients received either conventional therapy alone or therapy supplemented with at least one perception–interaction modality—functional electrical stimulation (FES), virtual reality (VR), or electromyographic (EMG) biofeedback. Motor and functional outcomes were assessed at admission and discharge using the Fugl-Meyer Assessment (FMA) and Modified Barthel Index (MBI). Clinically meaningful improvement was defined as ΔFMA ≥8. Multivariable logistic regression identified independent predictors.

Results

A total of 160 patients were analyzed (80 per group). The intervention group showed greater motor gains (median ΔFMA: 12.0 vs 7.0; P < 0.001) and functional independence (ΔMBI: 18.0 vs 11.0; P < 0.001). Responders were more frequent in the intervention group (70.0 % vs 45.0 %; P = 0.002). Multivariable analysis confirmed perception–interaction therapy as an independent predictor of motor recovery (OR = 2.21, 95 % CI: 1.15–4.24), along with adherence ≥80 % (OR = 1.84) and longer session duration (OR = 1.22 per 10 minutes). Subgroup analyses indicated superior outcomes with multimodal use and high adherence.

Conclusion

Perception–interaction–enhanced rehabilitation was independently associated with improved motor and functional outcomes after stroke. These findings support individualized, technology-integrated rehabilitation strategies, warranting further prospective validation.

背景：技术辅助康复越来越多地用于中风后，但感知-相互作用模式的现实贡献尚不清楚。本研究评估了它们在脑卒中后运动恢复中的有效性和预测因素。方法：我们对2020-2023年住院康复的轻中度上肢损伤成人（40-85岁）进行了一项回顾性、单中心、倾向评分匹配的队列研究。患者要么接受常规治疗，要么接受至少一种感知-相互作用模式——功能电刺激（FES）、虚拟现实（VR）或肌电图（EMG）生物反馈的辅助治疗。使用Fugl-Meyer评估（FMA）和改良Barthel指数（MBI）评估入院和出院时的运动和功能结果。临床上有意义的改善定义为ΔFMA≥8。多变量逻辑回归确定了独立的预测因子。结果：共分析160例患者（每组80例）。干预组表现出更大的运动增益（中位数ΔFMA: 12.0 vs 7.0; P < 0.001）和功能独立性（ΔMBI: 18.0 vs 11.0; P < 0.001）。干预组应答者发生率更高（70.0% vs 45.0%; P = 0.002）。多变量分析证实，感知-相互作用疗法是运动恢复的独立预测因子（OR = 2.21,95% CI: 1.15-4.24），以及依从性≥80% （OR = 1.84）和更长的疗程（OR = 1.22 / 10分钟）。亚组分析表明，多模式使用和高依从性的结果更好。结论：感知-相互作用增强康复与脑卒中后运动和功能预后的改善独立相关。这些发现支持个性化、技术整合的康复策略，需要进一步的前瞻性验证。

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引用次数: 0