首页 > 最新文献

Journal of Stroke & Cerebrovascular Diseases最新文献

英文 中文
A comparative analysis of SCALE-CTP and RAPID in determining the affected brain volumes of patients with ischemic stroke SCALE-CTP与RAPID测定缺血性脑卒中患者脑容量的比较分析。
IF 1.8 4区 医学 Q3 NEUROSCIENCES Pub Date : 2026-02-01 Epub Date: 2025-12-05 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108517
Jundong Hwang , Hyeon Sik Yang , Gi-Youn Kim , Regina EY Kim , Minho Lee , Donghyeon Kim , Jin Wook Choi , Woo Sang Jung , Kijeong Lee

Background

Computed tomography perfusion (CTP) is widely used to treat acute strokes. The affected brain volume, measured based on the threshold value in the calculated CTP map, has helped guide treatment decisions. We proposed a new software program developed for CTP analysis, SCALE-CTP, and compared the affected brain volumes estimated using RAPID and SCALE-CTP.

Methods

We recruited 362 individuals from the local hospital to evaluate the concordance between SCALE-CTP and RAPID in predicting affected brain volumes, including relative cerebral blood flow (rCBF) <30 % and time-to-maximum concentration (Tmax) > 6 s, and the mismatch volumes. Concordance correlation coefficients (CCC) and Bland–Altman plots were used to assess agreement. Subgroup analyses and comparisons with DWI-derived infarction areas were also performed, along with an evaluation of differences in clinical decision-making.

Results

The calculated volumes from two different software showed excellent concordance (rCBF < 30 % volume: 0.91, Tmax > 6s: 0.88 volume, mismatch volume: 0.82). The concordance between the two software programs remains excellent in the subgroup analysis. In the subset of 38 cases, the differences between DWI-derived infarction area and rCBF < 30 % volume from both software were similar, while SCALE-CTP showed more variability. Their differences in clinical decision making were slightly different.

Conclusion

SCALE-CTP demonstrated strong agreement with RAPID in predicting affected brain volumes and shows potential as a reliable tool for guiding hyperacute ischemic stroke treatment. Further validation is needed to confirm its clinical utility.
背景:计算机断层扫描灌注(CTP)被广泛应用于急性脑卒中的治疗。根据计算的CTP图中的阈值来测量受影响的脑容量,有助于指导治疗决策。我们提出了一种新的CTP分析软件,SCALE-CTP,并比较了使用RAPID和SCALE-CTP估计的受影响的脑容量。方法:我们从当地医院招募了362名患者,评估SCALE-CTP和RAPID在预测影响脑容量(包括相对脑血流量(rCBF) 6s和不匹配容量)方面的一致性。一致性相关系数(CCC)和Bland-Altman图用于评估一致性。还进行了亚组分析和与dwi衍生梗死区域的比较,并评估了临床决策的差异。结果:两种不同软件计算的体积具有良好的一致性(rCBF < 30%体积:0.91,Tmax bbb6s体积:0.88,错配体积:0.82)。在亚群分析中,两个软件程序之间的一致性仍然很好。在38例的子集中,两种软件得出的dwi衍生的梗死面积和rCBF < 30%体积之间的差异相似,而SCALE-CTP显示出更多的可变性。他们在临床决策方面的差异略有不同。结论:SCALE-CTP与RAPID在预测受影响脑容量方面表现出强烈的一致性,并显示出作为指导超急性缺血性脑卒中治疗的可靠工具的潜力。需要进一步验证以确认其临床应用。
{"title":"A comparative analysis of SCALE-CTP and RAPID in determining the affected brain volumes of patients with ischemic stroke","authors":"Jundong Hwang ,&nbsp;Hyeon Sik Yang ,&nbsp;Gi-Youn Kim ,&nbsp;Regina EY Kim ,&nbsp;Minho Lee ,&nbsp;Donghyeon Kim ,&nbsp;Jin Wook Choi ,&nbsp;Woo Sang Jung ,&nbsp;Kijeong Lee","doi":"10.1016/j.jstrokecerebrovasdis.2025.108517","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108517","url":null,"abstract":"<div><h3>Background</h3><div>Computed tomography perfusion (CTP) is widely used to treat acute strokes. The affected brain volume, measured based on the threshold value in the calculated CTP map, has helped guide treatment decisions. We proposed a new software program developed for CTP analysis, SCALE-CTP, and compared the affected brain volumes estimated using RAPID and SCALE-CTP.</div></div><div><h3>Methods</h3><div>We recruited 362 individuals from the local hospital to evaluate the concordance between SCALE-CTP and RAPID in predicting affected brain volumes, including relative cerebral blood flow (rCBF) &lt;30 % and time-to-maximum concentration (Tmax) &gt; 6 s, and the mismatch volumes. Concordance correlation coefficients (CCC) and Bland–Altman plots were used to assess agreement. Subgroup analyses and comparisons with DWI-derived infarction areas were also performed, along with an evaluation of differences in clinical decision-making.</div></div><div><h3>Results</h3><div>The calculated volumes from two different software showed excellent concordance (rCBF &lt; 30 % volume: 0.91, Tmax &gt; 6s: 0.88 volume, mismatch volume: 0.82). The concordance between the two software programs remains excellent in the subgroup analysis. In the subset of 38 cases, the differences between DWI-derived infarction area and rCBF &lt; 30 % volume from both software were similar, while SCALE-CTP showed more variability. Their differences in clinical decision making were slightly different.</div></div><div><h3>Conclusion</h3><div>SCALE-CTP demonstrated strong agreement with RAPID in predicting affected brain volumes and shows potential as a reliable tool for guiding hyperacute ischemic stroke treatment. Further validation is needed to confirm its clinical utility.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 2","pages":"Article 108517"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145703757","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
Knockdown of programmed cell death 4 inhibits endoplasmic reticulum stress in male mice with intracerebral hemorrhage through the phosphoinositide 3-kinase/protein kinase B pathway 敲低程序性细胞死亡4通过磷酸肌肽3-激酶/蛋白激酶B途径抑制脑出血雄性小鼠内质网应激。
IF 1.8 4区 医学 Q3 NEUROSCIENCES Pub Date : 2026-02-01 Epub Date: 2026-01-07 DOI: 10.1016/j.jstrokecerebrovasdis.2026.108554
Jianfeng Qi , Zhimin Zhang , Jixiang Yin , Xuhui Yuan , Xu Wang , Zexiang Liu , Yuhang Liu , Jianjun Wang

Background

Pdcd4 is a potential target for intracerebral hemorrhage (ICH) treatment. This research intended to elucidate the mechanism by which Pdcd4 regulates ICH progression.

Methods

Male mice were infected with sh-Pdcd4 lentivirus, followed by injection of bacterial collagenase to establish an ICH model. Subsequent experiments, including brain water content assessment, neurological injury scoring, brain hematoma volume measurement, ELISA, HE staining, immunohistochemistry, Evans blue extravasation assay, and Western blot, were conducted to analyze the role of Pdcd4 in ICH. PI3K inhibitor LY294002 was employed to further investigate the potential mechanisms in vivo. bEnd.3 cells were infected with sh-Pdcd4 in the presence or absence of tunicamycin (an ER stress inducer), followed by hemoglobin treatment to mimic ICH in vitro. The effects of Pdcd4 on endoplasmic reticulum (ER) stress in ICH were evaluated through CCK-8, ELISA, and Western blot assays.

Results

Pdcd4 was upregulated in ICH mice, with the highest levels observed at 24 h. Pdcd4 knockdown markedly alleviated brain injury and neuroinflammation, inhibited ER stress, and upregulated PI3K/AKT pathway in ICH mice. These changes were partially reversed by LY294002. In bEnd.3 cells, Pdcd4 levels were significantly increased after hemoglobin treatment. Additionally, Pdcd4 knockdown significantly increased cell viability and inhibited inflammatory factor secretion and ER stress in the ICH group. This phenomenon was partially counteracted by tunicamycin. Furthermore, Pdcd4 knockdown markedly activated the PI3K/AKT pathway in the ICH group.

Conclusion

Pdcd4 knockdown alleviates ICH through PI3K/AKT pathway-mediated ER stress.
背景:Pdcd4是脑出血(ICH)治疗的潜在靶点。本研究旨在阐明Pdcd4调控脑出血进展的机制。方法:用sh-Pdcd4慢病毒感染雄性小鼠,注射细菌胶原酶建立脑出血模型。随后的实验包括脑含水量评估、神经损伤评分、脑血肿体积测量、ELISA、HE染色、免疫组织化学、Evans蓝色外渗试验和Western blot分析Pdcd4在脑出血中的作用。使用PI3K抑制剂LY294002进一步研究其体内潜在机制。弯曲。3个细胞在tunicamycin(一种内质酰胺应激诱导剂)存在或不存在的情况下用sh-Pdcd4感染,然后用血红蛋白处理以模拟体外ICH。通过CCK-8、ELISA和Western blot检测评估Pdcd4对脑出血内质网应激的影响。结果:脑出血小鼠的Pdcd4表达上调,在24 h时达到最高水平。Pdcd4敲低可显著减轻脑出血小鼠的脑损伤和神经炎症,抑制内质网应激,上调PI3K/AKT通路。LY294002部分逆转了这些变化。在弯曲。3细胞,血红蛋白处理后Pdcd4水平明显升高。此外,在ICH组中,Pdcd4敲低可显著提高细胞活力,抑制炎症因子分泌和内质网应激。tunicamycin部分地抵消了这种现象。此外,在ICH组中,Pdcd4敲低显著激活PI3K/AKT通路。结论:Pdcd4敲低可通过PI3K/AKT通路介导内质网应激减轻ICH。
{"title":"Knockdown of programmed cell death 4 inhibits endoplasmic reticulum stress in male mice with intracerebral hemorrhage through the phosphoinositide 3-kinase/protein kinase B pathway","authors":"Jianfeng Qi ,&nbsp;Zhimin Zhang ,&nbsp;Jixiang Yin ,&nbsp;Xuhui Yuan ,&nbsp;Xu Wang ,&nbsp;Zexiang Liu ,&nbsp;Yuhang Liu ,&nbsp;Jianjun Wang","doi":"10.1016/j.jstrokecerebrovasdis.2026.108554","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108554","url":null,"abstract":"<div><h3>Background</h3><div>Pdcd4 is a potential target for intracerebral hemorrhage (ICH) treatment. This research intended to elucidate the mechanism by which Pdcd4 regulates ICH progression.</div></div><div><h3>Methods</h3><div>Male mice were infected with sh-<em>Pdcd4</em> lentivirus, followed by injection of bacterial collagenase to establish an ICH model. Subsequent experiments, including brain water content assessment, neurological injury scoring, brain hematoma volume measurement, ELISA, HE staining, immunohistochemistry, Evans blue extravasation assay, and Western blot, were conducted to analyze the role of Pdcd4 in ICH. PI3K inhibitor LY294002 was employed to further investigate the potential mechanisms <em>in vivo</em>. bEnd.3 cells were infected with sh-<em>Pdcd4</em> in the presence or absence of tunicamycin (an ER stress inducer), followed by hemoglobin treatment to mimic ICH <em>in vitro</em>. The effects of Pdcd4 on endoplasmic reticulum (ER) stress in ICH were evaluated through CCK-8, ELISA, and Western blot assays.</div></div><div><h3>Results</h3><div>Pdcd4 was upregulated in ICH mice, with the highest levels observed at 24 h. <em>Pdcd4</em> knockdown markedly alleviated brain injury and neuroinflammation, inhibited ER stress, and upregulated PI3K/AKT pathway in ICH mice. These changes were partially reversed by LY294002. In bEnd.3 cells, Pdcd4 levels were significantly increased after hemoglobin treatment. Additionally, <em>Pdcd4</em> knockdown significantly increased cell viability and inhibited inflammatory factor secretion and ER stress in the ICH group. This phenomenon was partially counteracted by tunicamycin. Furthermore, <em>Pdcd4</em> knockdown markedly activated the PI3K/AKT pathway in the ICH group.</div></div><div><h3>Conclusion</h3><div><em>Pdcd4</em> knockdown alleviates ICH through PI3K/AKT pathway-mediated ER stress.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 2","pages":"Article 108554"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145947141","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
Global and regional burden of ischemic stroke attributable to smoking and high alcohol use from 1990 to 2021, with projections to 2050 1990年至2021年吸烟和高酒精使用导致的全球和区域缺血性卒中负担,并预测到2050年。
IF 1.8 4区 医学 Q3 NEUROSCIENCES Pub Date : 2026-02-01 Epub Date: 2026-01-02 DOI: 10.1016/j.jstrokecerebrovasdis.2026.108543
Sijia Guo , Bo Qu , Qiqi Wang , Yan Sun

Objective

This study employs data from the Global Burden of Disease Study (GBD) 2021 to analyze the age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) of ischemic stroke (IS) attributable to smoking and high alcohol use from 1990 to 2021 across 204 countries and territories, stratified by Socio-demographic Index (SDI), region, sex, and age. Trends are assessed using estimated annual percentage change (EAPC), and future burdens are projected to 2050 using an autoregressive integrated moving average (ARIMA) model.

Results

Globally, the burden of IS attributable to both risk factors declined, with smoking consistently associated with higher ASMR and ASDR than high alcohol use. High-SDI regions showed the most substantial reductions, whereas low-SDI regions experienced stagnant or slightly increasing burdens. Southeast Asia was the only region with a rising trend in smoking-related IS, while Tropical Latin America achieved remarkable success in alcohol control. The burden was higher among males and older age groups for smoking, and more prominent in young and middle-aged adults for alcohol use. Projections suggested a continuing decline in high-SDI regions but limited improvement in low-SDI areas by 2050.

Conclusion

Significant geographic and demographic disparities persist in the IS burden attributable to smoking and high alcohol use. Targeted policy interventions—especially enhanced tobacco and alcohol control in low- and middle-SDI regions, along with focused strategies for males and high-risk age groups—are urgently needed to reduce the global burden of ischemic stroke.
目的:本研究采用2021年全球疾病负担研究(GBD)的数据,分析1990年至2021年204个国家和地区因吸烟和高酒精使用导致的缺血性卒中(IS)的年龄标准化死亡率(ASMR)和年龄标准化DALY率(ASDR),并按社会人口指数(SDI)、地区、性别和年龄分层。使用估计的年百分比变化(EAPC)评估趋势,并使用自回归综合移动平均(ARIMA)模型预测到2050年的未来负担。结果:在全球范围内,可归因于这两种风险因素的IS负担下降,吸烟始终与较高的ASMR和ASDR相关。高sdi地区的负担减少幅度最大,而低sdi地区的负担停滞不前或略有增加。东南亚是唯一一个与吸烟有关的IS呈上升趋势的地区,而热带拉丁美洲在控制酒精方面取得了显著成功。男性和老年人吸烟的负担更高,而年轻人和中年人饮酒的负担更突出。预测表明,到2050年,高sdi地区将继续下降,而低sdi地区的改善有限。结论:吸烟和酗酒导致的IS负担存在显著的地理和人口差异。迫切需要有针对性的政策干预,特别是在低和中等sdi地区加强烟草和酒精控制,以及针对男性和高危年龄组的重点战略,以减轻缺血性卒中的全球负担。
{"title":"Global and regional burden of ischemic stroke attributable to smoking and high alcohol use from 1990 to 2021, with projections to 2050","authors":"Sijia Guo ,&nbsp;Bo Qu ,&nbsp;Qiqi Wang ,&nbsp;Yan Sun","doi":"10.1016/j.jstrokecerebrovasdis.2026.108543","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108543","url":null,"abstract":"<div><h3>Objective</h3><div>This study employs data from the Global Burden of Disease Study (GBD) 2021 to analyze the age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) of ischemic stroke (IS) attributable to smoking and high alcohol use from 1990 to 2021 across 204 countries and territories, stratified by Socio-demographic Index (SDI), region, sex, and age. Trends are assessed using estimated annual percentage change (EAPC), and future burdens are projected to 2050 using an autoregressive integrated moving average (ARIMA) model.</div></div><div><h3>Results</h3><div>Globally, the burden of IS attributable to both risk factors declined, with smoking consistently associated with higher ASMR and ASDR than high alcohol use. High-SDI regions showed the most substantial reductions, whereas low-SDI regions experienced stagnant or slightly increasing burdens. Southeast Asia was the only region with a rising trend in smoking-related IS, while Tropical Latin America achieved remarkable success in alcohol control. The burden was higher among males and older age groups for smoking, and more prominent in young and middle-aged adults for alcohol use. Projections suggested a continuing decline in high-SDI regions but limited improvement in low-SDI areas by 2050.</div></div><div><h3>Conclusion</h3><div>Significant geographic and demographic disparities persist in the IS burden attributable to smoking and high alcohol use. Targeted policy interventions—especially enhanced tobacco and alcohol control in low- and middle-SDI regions, along with focused strategies for males and high-risk age groups—are urgently needed to reduce the global burden of ischemic stroke.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 2","pages":"Article 108543"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145902075","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
Association between biological aging and stroke and all-cause mortality: A population-based cross-sectional study and Mendelian randomization analysis 生物学老化与中风和全因死亡率之间的关系:一项基于人群的横断面研究和孟德尔随机化分析
IF 1.8 4区 医学 Q3 NEUROSCIENCES Pub Date : 2026-02-01 Epub Date: 2025-12-15 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108525
Zijie Wang , Xinwei Zhao , Yan Ma
<div><h3>Introduction</h3><div>Stroke is a major acute cerebrovascular disorder and a leading cause of disability and death, for which ageing is a key risk factor. However, individuals of the same chronological age differ markedly in cerebrovascular vulnerability. This study aimed to investigate the association between biological aging and stroke risk and prognosis using several validated aging metrics.</div></div><div><h3>Methods</h3><div>In NHANES 1999–2018, we derived the frailty index (FI), Klemera–Doubal age (KDMAge) and phenotypic age (PhenoAge) as alternative measures of biological aging. Logistic regression, tests for trend, restricted cubic splines and subgroup analyses were used to assess associations with stroke prevalence. Kaplan–Meier curves and Cox regression were applied to evaluate all-cause mortality among stroke survivors. In parallel, we conducted bidirectional two-sample Mendelian randomization (MR) using large genome-wide association studies to examine the potential causal effects of multiple biological aging indicators (four epigenetic age acceleration measures, telomere length, facial aging and FI) on stroke and its ischaemic subtypes, and the reverse effects of stroke on aging acceleration.</div></div><div><h3>Results</h3><div>Among 34,856 participants, higher FI, KDMAge and PhenoAge, as well as biological age acceleration, were associated with increased stroke risk; these associations remained significant in fully adjusted models. Dose–response analyses revealed non-linear relationships between biological aging metrics and stroke, with FI and PhenoAge showing J-shaped and KDMAge S-shaped patterns. In survival analyses of 1,167 stroke patients, PhenoAge acceleration and frailty status were significantly associated with reduced survival probability and higher all-cause mortality, whereas KDMAge acceleration showed weaker prognostic value. In MR analyses meta-analysing GIGASTROKE and MEGASTROKE, genetically predicted FI was associated with higher risk of stroke overall (OR = 1.57, 95 % CI: 1.36–1.83, <em>p</em> < 0.001) and with major ischaemic subtypes, while other aging clocks showed weaker or subtype-specific associations. Reverse MR indicated that stroke liability was associated with higher PhenoAge acceleration (OR = 1.54, 95 % CI: 1.12–2.12, <em>p</em> = 0.008), higher FI (OR = 1.11, 95 % CI: 1.05–1.17, <em>p</em> < 0.001) and accelerated facial aging (OR = 1.02, 95 % CI: 1.01–1.03, <em>p</em> = 0.001).</div></div><div><h3>Conclusion</h3><div>In a nationally representative sample, multiple biological aging indicators were associated with stroke and post-stroke all-cause mortality, and bidirectional MR supported a potential two-way relationship between biological aging and stroke. Among the evaluated metrics, FI showed the most robust and consistent associations with stroke risk and survival and provided the clearest and most stable genetic evidence compatible with a causal effect on stroke and its ischaemic subty
中风是一种主要的急性脑血管疾病,是致残和死亡的主要原因,其中衰老是一个关键的危险因素。然而,相同年龄的个体在脑血管易损性方面存在显著差异。本研究旨在通过几个有效的衰老指标来研究生物衰老与卒中风险和预后之间的关系。方法在NHANES 1999-2018中,我们导出了脆性指数(FI)、klemera - double年龄(KDMAge)和表型年龄(PhenoAge)作为生物衰老的替代指标。采用Logistic回归、趋势检验、受限三次样条和亚组分析来评估与卒中患病率的关系。应用Kaplan-Meier曲线和Cox回归评价脑卒中幸存者的全因死亡率。与此同时,我们利用大型全基因组关联研究进行了双向双样本孟德尔随机化(MR),以检验多种生物衰老指标(四种表观遗传年龄加速指标、端粒长度、面部衰老和FI)对中风及其缺血性亚型的潜在因果影响,以及中风对衰老加速的反向影响。结果在34,856名参与者中,较高的FI、KDMAge和PhenoAge以及生物年龄加速与卒中风险增加相关;这些关联在完全调整后的模型中仍然显著。剂量-反应分析显示生物老化指标与中风之间存在非线性关系,FI和PhenoAge呈j型,kdage呈s型。在1167例脑卒中患者的生存分析中,表型age加速和虚弱状态与生存率降低和全因死亡率升高显著相关,而KDMAge加速显示出较弱的预后价值。在对GIGASTROKE和MEGASTROKE进行的MR荟萃分析中,基因预测的FI与卒中总体风险较高(OR = 1.57, 95% CI: 1.36-1.83, p < 0.001)和主要缺血亚型相关,而其他衰老时钟显示较弱或亚型特异性关联。反向MR显示卒中易感性与较高的表型加速(OR = 1.54, 95% CI: 1.12-2.12, p = 0.008)、较高的FI (OR = 1.11, 95% CI: 1.05-1.17, p < 0.001)和面部加速老化(OR = 1.02, 95% CI: 1.01-1.03, p = 0.001)相关。结论:在一个具有全国代表性的样本中,多种生物衰老指标与脑卒中和脑卒中后全因死亡率相关,双向磁共振支持生物衰老与脑卒中之间潜在的双向关系。在评估的指标中,FI显示出与卒中风险和生存最强大和一致的关联,并提供了最清晰和最稳定的遗传证据,与卒中及其缺血性亚型的因果效应相一致。这些发现支持FI作为在卒中风险分层和二级预防中捕获生物衰老的实用工具,这一主张值得在前瞻性和介入性研究中进行测试。
{"title":"Association between biological aging and stroke and all-cause mortality: A population-based cross-sectional study and Mendelian randomization analysis","authors":"Zijie Wang ,&nbsp;Xinwei Zhao ,&nbsp;Yan Ma","doi":"10.1016/j.jstrokecerebrovasdis.2025.108525","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108525","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Stroke is a major acute cerebrovascular disorder and a leading cause of disability and death, for which ageing is a key risk factor. However, individuals of the same chronological age differ markedly in cerebrovascular vulnerability. This study aimed to investigate the association between biological aging and stroke risk and prognosis using several validated aging metrics.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;In NHANES 1999–2018, we derived the frailty index (FI), Klemera–Doubal age (KDMAge) and phenotypic age (PhenoAge) as alternative measures of biological aging. Logistic regression, tests for trend, restricted cubic splines and subgroup analyses were used to assess associations with stroke prevalence. Kaplan–Meier curves and Cox regression were applied to evaluate all-cause mortality among stroke survivors. In parallel, we conducted bidirectional two-sample Mendelian randomization (MR) using large genome-wide association studies to examine the potential causal effects of multiple biological aging indicators (four epigenetic age acceleration measures, telomere length, facial aging and FI) on stroke and its ischaemic subtypes, and the reverse effects of stroke on aging acceleration.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Among 34,856 participants, higher FI, KDMAge and PhenoAge, as well as biological age acceleration, were associated with increased stroke risk; these associations remained significant in fully adjusted models. Dose–response analyses revealed non-linear relationships between biological aging metrics and stroke, with FI and PhenoAge showing J-shaped and KDMAge S-shaped patterns. In survival analyses of 1,167 stroke patients, PhenoAge acceleration and frailty status were significantly associated with reduced survival probability and higher all-cause mortality, whereas KDMAge acceleration showed weaker prognostic value. In MR analyses meta-analysing GIGASTROKE and MEGASTROKE, genetically predicted FI was associated with higher risk of stroke overall (OR = 1.57, 95 % CI: 1.36–1.83, &lt;em&gt;p&lt;/em&gt; &lt; 0.001) and with major ischaemic subtypes, while other aging clocks showed weaker or subtype-specific associations. Reverse MR indicated that stroke liability was associated with higher PhenoAge acceleration (OR = 1.54, 95 % CI: 1.12–2.12, &lt;em&gt;p&lt;/em&gt; = 0.008), higher FI (OR = 1.11, 95 % CI: 1.05–1.17, &lt;em&gt;p&lt;/em&gt; &lt; 0.001) and accelerated facial aging (OR = 1.02, 95 % CI: 1.01–1.03, &lt;em&gt;p&lt;/em&gt; = 0.001).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;In a nationally representative sample, multiple biological aging indicators were associated with stroke and post-stroke all-cause mortality, and bidirectional MR supported a potential two-way relationship between biological aging and stroke. Among the evaluated metrics, FI showed the most robust and consistent associations with stroke risk and survival and provided the clearest and most stable genetic evidence compatible with a causal effect on stroke and its ischaemic subty","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 2","pages":"Article 108525"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145771990","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
Integration of genetic risk, cardiometabolic diseases, and cognitive impairment among African American adults 非裔美国成年人的遗传风险、心脏代谢疾病和认知障碍的整合
IF 1.8 4区 医学 Q3 NEUROSCIENCES Pub Date : 2026-02-01 Epub Date: 2025-12-21 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108535
Chaitali Dagli , Nicole D. Armstrong , Daeeun Kim , Laura M. Raffield , Hemant K. Tiwari , Mary Cushman , Suzanne E. Judd , Michael Crowe , Virginia J. Howard , Marguerite R. Irvin

Background

African American (AA) adults have a high burden of late-life cognitive impairment (CI) and dementia but remain underrepresented in genetic epidemiology studies. Genetic risk and cardiometabolic diseases (CMDs) contribute to dementia risk. This study investigated whether genetic susceptibility and CMDs were associated with a composite CI outcome and whether CMDs modified these associations.

Methods

In AA participants within the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, we assessed the association of a dementia polygenic risk score (PRS), APOE ε4 carrier status, and three prevalent CMDs: stroke, coronary artery disease (CAD), and type 2 diabetes (T2D) with a composite outcome of CI and dementia as a contributing cause of death (DCCD).
We used logistic regression adjusted for age, sex, education, income, body mass index, smoking status, alcohol intake, physical activity, hypertension, low-density lipoprotein, and C-reactive protein. Interaction terms were included to assess whether CMDs modified the associations between genetic risk and the composite outcome.

Results

Of 8,838 participants, 516 (5.84 %) developed CI or had DCCD. In fully adjusted models, high polygenic risk (highest vs lowest PRS tertile) was associated with increased odds of the composite outcome [odds ratio (OR): 1.42; 95 % confidence interval (CI): 1.12-1.78], as was APOE ε4 carrier status (OR: 1.46; 95% CI: 1.21-1.78). Among CMDs, stroke (OR: 1.45; 95% CI: 1.04-2.02) and T2D (OR: 1.31; 95% CI: 1.06-1.61) were significantly associated with increased odds of the composite outcome. However, the association between genetic risk and the composite outcome did not significantly differ by CMD status.

Conclusion

Genetic risk and CMDs independently contributed to dementia-related outcomes, indicating their relevance in understanding dementia risk among AA adults.
背景:非裔美国成年人有很高的晚年认知障碍(CI)和痴呆负担,但在遗传流行病学研究中仍未得到充分代表。遗传风险和心脏代谢疾病(cmd)会导致痴呆风险。本研究调查了遗传易感性和cmd是否与复合CI结果相关,以及cmd是否改变了这些关联。方法:在卒中地理和种族差异(REGARDS)研究中的AA参与者中,我们评估了痴呆多基因风险评分(PRS), APOE ε4携带者状态和三种流行的CMDs:卒中,冠状动脉疾病(CAD)和2型糖尿病(T2D)与CI和痴呆作为死亡原因(DCCD)的复合结局的关系。我们使用logistic回归校正了年龄、性别、教育程度、收入、体重指数、吸烟状况、酒精摄入量、体育活动、高血压、低密度脂蛋白和c反应蛋白。纳入相互作用项以评估cmd是否改变了遗传风险与复合结局之间的关联。结果:8838名参与者中,516名(5.84%)发生CI或DCCD。在完全调整的模型中,高多基因风险(最高/最低PRS分位数)与复合结局的几率增加相关[优势比(OR): 1.42;95%置信区间(CI): 1.12-1.78], APOE ε4载体状态为1.46;1.21-1.78。在慢性阻塞性肺病患者中,卒中(1.45;1.04-2.02)和T2D(1.31; 1.06-1.61)与复合结局的几率增加显著相关。然而,遗传风险与综合结果之间的关联并没有因CMD状态而显着差异。结论:遗传风险和CMDs独立影响痴呆相关结果,表明它们与了解AA成人痴呆风险相关。
{"title":"Integration of genetic risk, cardiometabolic diseases, and cognitive impairment among African American adults","authors":"Chaitali Dagli ,&nbsp;Nicole D. Armstrong ,&nbsp;Daeeun Kim ,&nbsp;Laura M. Raffield ,&nbsp;Hemant K. Tiwari ,&nbsp;Mary Cushman ,&nbsp;Suzanne E. Judd ,&nbsp;Michael Crowe ,&nbsp;Virginia J. Howard ,&nbsp;Marguerite R. Irvin","doi":"10.1016/j.jstrokecerebrovasdis.2025.108535","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108535","url":null,"abstract":"<div><h3>Background</h3><div>African American (AA) adults have a high burden of late-life cognitive impairment (CI) and dementia but remain underrepresented in genetic epidemiology studies. Genetic risk and cardiometabolic diseases (CMDs) contribute to dementia risk. This study investigated whether genetic susceptibility and CMDs were associated with a composite CI outcome and whether CMDs modified these associations.</div></div><div><h3>Methods</h3><div>In AA participants within the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, we assessed the association of a dementia polygenic risk score (PRS), <em>APOE</em> ε4 carrier status, and three prevalent CMDs: stroke, coronary artery disease (CAD), and type 2 diabetes (T2D) with a composite outcome of CI and dementia as a contributing cause of death (DCCD).</div><div>We used logistic regression adjusted for age, sex, education, income, body mass index, smoking status, alcohol intake, physical activity, hypertension, low-density lipoprotein, and C-reactive protein. Interaction terms were included to assess whether CMDs modified the associations between genetic risk and the composite outcome.</div></div><div><h3>Results</h3><div>Of 8,838 participants, 516 (5.84 %) developed CI or had DCCD. In fully adjusted models, high polygenic risk (highest vs lowest PRS tertile) was associated with increased odds of the composite outcome [odds ratio (OR): 1.42; 95 % confidence interval (CI): 1.12-1.78], as was <em>APOE</em> ε4 carrier status (OR: 1.46; 95% CI: 1.21-1.78). Among CMDs, stroke (OR: 1.45; 95% CI: 1.04-2.02) and T2D (OR: 1.31; 95% CI: 1.06-1.61) were significantly associated with increased odds of the composite outcome. However, the association between genetic risk and the composite outcome did not significantly differ by CMD status.</div></div><div><h3>Conclusion</h3><div>Genetic risk and CMDs independently contributed to dementia-related outcomes, indicating their relevance in understanding dementia risk among AA adults.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 2","pages":"Article 108535"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145822637","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
Access to neighborhood destinations that offer opportunities for physical activity and socialization is associated with favorable post-stroke outcomes 能够前往提供体育活动和社交机会的社区目的地与卒中后的良好预后相关。
IF 1.8 4区 医学 Q3 NEUROSCIENCES Pub Date : 2026-02-01 Epub Date: 2026-01-02 DOI: 10.1016/j.jstrokecerebrovasdis.2026.108545
Leanna M Delhey PhD , Jon Zelner PhD , Xu Shi PhD , Lewis B Morgenstern MD , Devin L Brown MD , Melinda A Smith DrPH , Erin C Case BA , Lynda D Lisabeth PhD

Objective

: Assess associations between destinations near stroke survivor's residence – places like restaurants, recreation centers, and stores that offer opportunities for physical activity and socialization outside of the home and work – and their poststroke outcomes.

Methods

: We included non-Hispanic white and Mexican American incident stroke survivors enrolled in the Brain Attack Surveillance in Corpus Christi project (2009-19), a population-based cohort in Texas. Exposure: count of destinations within 0.5-miles around survivors’ residences. Outcomes assessed at approximately 3-, 6-, and 12-months poststroke: cognition (Modified Mini-Mental State Examination), functioning (activities of daily living (ADL)/instrumental ADL), health-related quality of life (abbreviated Stroke-Specific Quality of Life scale), and depression (Patient Health Questionnaire-8). We fit adjusted linear mixed models and considered interactions with follow-up time and stroke severity (NIH stroke scale - mild (<5), moderate-severe (≥5)).

Results

: We included 1,786 survivors who completed 3 (N = 1,321), 6 (N = 677), or 12-month interviews (N = 652). Median age was 64 years, 55% male, and 74% mild stroke. Stroke severity modified associations with functioning (p = 0.09) and quality of life (p = 0.05), follow-up time did not (p > 0.25). Among moderate-severe stroke survivors, more destinations were associated with more favorable functioning (mean difference=-0.12, 95% CI=-0.22, -0.01) and quality of life (mean difference=0.16, 95% CI=0.03, 0.30). No associations were observed among mild stroke survivors or with cognition or depression (p > 0.05).

Interpretation

: Among moderate-severe stroke survivors, more nearby destinations were associated with more favorable functioning and quality of life in the first year. Future research is needed to explore if specific types of destinations may support more favorable outcomes.
目的:评估中风幸存者住所附近的目的地(如餐馆、娱乐中心和商店等提供家庭和工作之外的体育活动和社交机会的地方)与他们中风后的结果之间的联系。方法:我们纳入了非西班牙裔白人和墨西哥裔美国人突发中风幸存者,他们参加了科珀斯克里斯蒂脑梗死监测项目(2009-19),这是一个基于德克萨斯州人群的队列。暴露:幸存者住所周围0.5英里范围内的目的地数量。卒中后大约3、6和12个月评估的结果:认知(修改后的迷你精神状态检查)、功能(日常生活活动(ADL)/工具性ADL)、健康相关生活质量(卒中特异性生活质量量表)和抑郁(患者健康问卷-8)。我们拟合调整后的线性混合模型,并考虑随访时间和中风严重程度(NIH中风量表-轻度)之间的相互作用(结果:我们纳入了1786名幸存者,他们完成了3个月(N= 1321)、6个月(N=677)或12个月的访谈(N=652)。中位年龄为64岁,55%为男性,74%为轻度中风。脑卒中严重程度与功能(p=0.09)和生活质量(p=0.05)相关,随访时间无相关性(p < 0.05)。在中重度中风幸存者中,更多的目的地与更有利的功能(平均差异=-0.12,95% CI=-0.22, -0.01)和生活质量(平均差异=0.16,95% CI=0.03, 0.30)相关。轻度脑卒中幸存者或与认知或抑郁无关联(p < 0.05)。解释:在中重度中风幸存者中,更近的目的地与第一年更有利的功能和生活质量相关。未来的研究需要探索特定类型的目的地是否可能支持更有利的结果。
{"title":"Access to neighborhood destinations that offer opportunities for physical activity and socialization is associated with favorable post-stroke outcomes","authors":"Leanna M Delhey PhD ,&nbsp;Jon Zelner PhD ,&nbsp;Xu Shi PhD ,&nbsp;Lewis B Morgenstern MD ,&nbsp;Devin L Brown MD ,&nbsp;Melinda A Smith DrPH ,&nbsp;Erin C Case BA ,&nbsp;Lynda D Lisabeth PhD","doi":"10.1016/j.jstrokecerebrovasdis.2026.108545","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108545","url":null,"abstract":"<div><h3>Objective</h3><div><strong>:</strong> Assess associations between destinations near stroke survivor's residence – places like restaurants, recreation centers, and stores that offer opportunities for physical activity and socialization outside of the home and work – and their poststroke outcomes.</div></div><div><h3>Methods</h3><div><strong>:</strong> We included non-Hispanic white and Mexican American incident stroke survivors enrolled in the Brain Attack Surveillance in Corpus Christi project (2009-19), a population-based cohort in Texas. Exposure: count of destinations within 0.5-miles around survivors’ residences. Outcomes assessed at approximately 3-, 6-, and 12-months poststroke: cognition (Modified Mini-Mental State Examination), functioning (activities of daily living (ADL)/instrumental ADL), health-related quality of life (abbreviated Stroke-Specific Quality of Life scale), and depression (Patient Health Questionnaire-8). We fit adjusted linear mixed models and considered interactions with follow-up time and stroke severity (NIH stroke scale - mild (&lt;5), moderate-severe (≥5)).</div></div><div><h3>Results</h3><div><strong>:</strong> We included 1,786 survivors who completed 3 (<em>N</em> = 1,321), 6 (<em>N</em> = 677), or 12-month interviews (<em>N</em> = 652). Median age was 64 years, 55% male, and 74% mild stroke. Stroke severity modified associations with functioning (<em>p</em> = 0.09) and quality of life (<em>p</em> = 0.05), follow-up time did not (<em>p</em> &gt; 0.25). Among moderate-severe stroke survivors, more destinations were associated with more favorable functioning (mean difference=-0.12, 95% CI=-0.22, -0.01) and quality of life (mean difference=0.16, 95% CI=0.03, 0.30). No associations were observed among mild stroke survivors or with cognition or depression (<em>p</em> &gt; 0.05).</div></div><div><h3>Interpretation</h3><div><strong>:</strong> Among moderate-severe stroke survivors, more nearby destinations were associated with more favorable functioning and quality of life in the first year. Future research is needed to explore if specific types of destinations may support more favorable outcomes.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 2","pages":"Article 108545"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145902082","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
Association between cumulative changes of the triglyceride glucose index and incidence of Cardio-cerebral vascular diseases in a population with cardiovascular-kidney-metabolic syndrome stage 0–3: a nationwide prospective cohort study 心血管-肾-代谢综合征0-3期人群中甘油三酯葡萄糖指数累积变化与心脑血管疾病发病率的关系:一项全国前瞻性队列研究
IF 1.8 4区 医学 Q3 NEUROSCIENCES Pub Date : 2026-02-01 Epub Date: 2026-01-03 DOI: 10.1016/j.jstrokecerebrovasdis.2026.108540
Li Hou , Jing Tang , Lei Zhang , Yanhong Li , Yao Niu

Objective

To evaluate the relationship between the longitudinal changes of the triglyceride-glucose (TyG) index and the incidence of cardio-cerebral vascular diseases (CCVD) among individuals with CKM syndrome stages 0-3.

Methods

Utilizing data from the China Health and Retirement Longitudinal Study (CHARLS), this longitudinal study included 3,416 participants aged 45 and above. Participants were categorized into different TyG trajectory groups using k-means clustering analysis. Logistic regression and restricted cubic spline (RCS) models were employed to assess the associations between cumTyG and TyG changes with CCVD incidence.

Results

Over a median follow-up of 5 years, 698 participants developed CCVD. The relationship between cumTyG and CCVD risk was linear in RCS regression. After adjusting for potential confounders, the risk of CCVD was found to be significantly higher for participants in Class 2, Class 4, and Class 5 compared to those in Class 1. Specifically, Class 2 had an odds ratio (OR) of 1.45 (95% confidence interval [CI]: 1.14, 1.84), Class 4 had an OR of 1.42 (95% CI: 1.09, 1.86), and Class 5 had an OR of 1.64 (95% CI: 1.14, 2.34). Additionally, an elevated cumTyG index was associated with an increased risk of CCVD, with an OR of 1.13 (95% CI: 1.05, 1.22, P=0.002).

Conclusion

CumTyG and its longitudinal trend are independent and potent predictors of CCVD in patients with stage 1–3 CKM syndrome. Dynamic monitoring of the TyG trajectory can enable the early identification of high-risk individuals, providing reliable evidence for individualized and cost-effective prevention.
目的:探讨CKM综合征0 ~ 3期患者甘油三酯-葡萄糖(TyG)指数纵向变化与心脑血管病(CCVD)发病率的关系。方法:利用中国健康与退休纵向研究(CHARLS)的数据,对3416名年龄在45岁及以上的参与者进行纵向研究。使用k-均值聚类分析将参与者分为不同的TyG轨迹组。采用Logistic回归和限制性三次样条(RCS)模型来评估cumTyG和TyG变化与CCVD发病率之间的关系。结果:在中位5年的随访中,698名参与者发展为CCVD。在RCS回归中,cumTyG与CCVD风险呈线性关系。在对潜在混杂因素进行调整后,发现2类、4类和5类受试者的CCVD风险明显高于1类受试者。具体来说,2级的比值比(OR)为1.45(95%可信区间[CI]: 1.14, 1.84), 4级的OR为1.42 (95% CI: 1.09, 1.86), 5级的OR为1.64 (95% CI: 1.14, 2.34)。此外,cumTyG指数升高与CCVD风险增加相关,OR为1.13 (95% CI: 1.05, 1.22, P=0.002)。结论:CumTyG及其纵向趋势是1-3期CKM综合征患者CCVD的独立且有效的预测因子。动态监测TyG轨迹可以早期识别高危个体,为个性化和高性价比的预防提供可靠证据。
{"title":"Association between cumulative changes of the triglyceride glucose index and incidence of Cardio-cerebral vascular diseases in a population with cardiovascular-kidney-metabolic syndrome stage 0–3: a nationwide prospective cohort study","authors":"Li Hou ,&nbsp;Jing Tang ,&nbsp;Lei Zhang ,&nbsp;Yanhong Li ,&nbsp;Yao Niu","doi":"10.1016/j.jstrokecerebrovasdis.2026.108540","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108540","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the relationship between the longitudinal changes of the triglyceride-glucose (TyG) index and the incidence of cardio-cerebral vascular diseases (CCVD) among individuals with CKM syndrome stages 0-3.</div></div><div><h3>Methods</h3><div>Utilizing data from the China Health and Retirement Longitudinal Study (CHARLS), this longitudinal study included 3,416 participants aged 45 and above. Participants were categorized into different TyG trajectory groups using k-means clustering analysis. Logistic regression and restricted cubic spline (RCS) models were employed to assess the associations between cumTyG and TyG changes with CCVD incidence.</div></div><div><h3>Results</h3><div>Over a median follow-up of 5 years, 698 participants developed CCVD. The relationship between cumTyG and CCVD risk was linear in RCS regression. After adjusting for potential confounders, the risk of CCVD was found to be significantly higher for participants in Class 2, Class 4, and Class 5 compared to those in Class 1. Specifically, Class 2 had an odds ratio (OR) of 1.45 (95% confidence interval [CI]: 1.14, 1.84), Class 4 had an OR of 1.42 (95% CI: 1.09, 1.86), and Class 5 had an OR of 1.64 (95% CI: 1.14, 2.34). Additionally, an elevated cumTyG index was associated with an increased risk of CCVD, with an OR of 1.13 (95% CI: 1.05, 1.22, P=0.002).</div></div><div><h3>Conclusion</h3><div>CumTyG and its longitudinal trend are independent and potent predictors of CCVD in patients with stage 1–3 CKM syndrome. Dynamic monitoring of the TyG trajectory can enable the early identification of high-risk individuals, providing reliable evidence for individualized and cost-effective prevention.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 2","pages":"Article 108540"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145906797","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
Dl-3-n-butylphthalide protects against ischemic stroke by enhancing mitochondrial function via MT-CO1 upregulation dl -3-正丁苯酞通过上调MT-CO1增强线粒体功能来预防缺血性卒中。
IF 1.8 4区 医学 Q3 NEUROSCIENCES Pub Date : 2026-02-01 Epub Date: 2025-12-17 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108529
Yangfang An , Biao Wang , Jiali Zhao , Hui Zhou , Qiong Zhou

Objective

Mitochondrial dysfunction is a key determinant of neuronal death and a promising therapeutic target in ischemic stroke. Dl-3-n-butylphthalide (NBP), an approved neuroprotective agent in China, has been shown to improve mitochondrial integrity, yet its precise molecular mechanisms remain unclear. This study aimed to determine whether NBP exerts neuroprotection by upregulating mitochondrial cytochrome c oxidase subunit 1 (MT-CO1) and to clarify the contribution of MT-CO1 to mitochondrial function recovery.

Methods

MT-CO1 expression was measured in the circulation from acute ischemic stroke participants before and following NBP therapy. In SH-SY5Y cells under OGD/R treatment, the action of NBP on mitochondrial bioenergetics, oxidative stress, and apoptosis were assessed. MT-CO1 knockdown was used to determine mechanistic involvement.

Results

NBP significantly increased MT-CO1 expression both in vivo and in vitro, improved mitochondrial membrane voltage and ATP production, reduced ROS generation, and decreased apoptosis. MT-CO1 silencing markedly attenuated these protective effects.

Conclusion

NBP protects against ischemia-induced mitochondrial dysfunction partly through MT-CO1 upregulation, supporting MT-CO1 as a potential therapeutic target for mitochondrial function protection in ischemic stroke.
目的:线粒体功能障碍是缺血性脑卒中中神经元死亡的关键决定因素,是一个有希望的治疗靶点。dl -3-正丁基酞(NBP)是中国批准的一种神经保护剂,已被证明可以改善线粒体完整性,但其确切的分子机制尚不清楚。本研究旨在确定NBP是否通过上调线粒体细胞色素c氧化酶亚基1 (MT-CO1)发挥神经保护作用,并阐明MT-CO1对线粒体功能恢复的贡献。方法:测定急性缺血性卒中患者NBP治疗前后血液中MT-CO1的表达。在OGD/R处理的SH-SY5Y细胞中,评估NBP对线粒体生物能量学、氧化应激和凋亡的作用。MT-CO1敲低用于确定机制参与。结果:NBP显著提高MT-CO1在体内和体外的表达,改善线粒体膜电压和ATP的产生,减少ROS的产生,减少细胞凋亡。MT-CO1沉默显著减弱了这些保护作用。结论:NBP对缺血诱导的线粒体功能障碍的保护作用部分是通过上调MT-CO1实现的,支持MT-CO1作为缺血性卒中线粒体功能保护的潜在治疗靶点。
{"title":"Dl-3-n-butylphthalide protects against ischemic stroke by enhancing mitochondrial function via MT-CO1 upregulation","authors":"Yangfang An ,&nbsp;Biao Wang ,&nbsp;Jiali Zhao ,&nbsp;Hui Zhou ,&nbsp;Qiong Zhou","doi":"10.1016/j.jstrokecerebrovasdis.2025.108529","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108529","url":null,"abstract":"<div><h3>Objective</h3><div>Mitochondrial dysfunction is a key determinant of neuronal death and a promising therapeutic target in ischemic stroke. Dl-3-n-butylphthalide (NBP), an approved neuroprotective agent in China, has been shown to improve mitochondrial integrity, yet its precise molecular mechanisms remain unclear. This study aimed to determine whether NBP exerts neuroprotection by upregulating mitochondrial cytochrome c oxidase subunit 1 (MT-CO1) and to clarify the contribution of MT-CO1 to mitochondrial function recovery.</div></div><div><h3>Methods</h3><div>MT-CO1 expression was measured in the circulation from acute ischemic stroke participants before and following NBP therapy. In SH-SY5Y cells under OGD/R treatment, the action of NBP on mitochondrial bioenergetics, oxidative stress, and apoptosis were assessed. MT-CO1 knockdown was used to determine mechanistic involvement.</div></div><div><h3>Results</h3><div>NBP significantly increased MT-CO1 expression both <em>in vivo</em> and <em>in vitro</em>, improved mitochondrial membrane voltage and ATP production, reduced ROS generation, and decreased apoptosis. MT-CO1 silencing markedly attenuated these protective effects.</div></div><div><h3>Conclusion</h3><div>NBP protects against ischemia-induced mitochondrial dysfunction partly through MT-CO1 upregulation, supporting MT-CO1 as a potential therapeutic target for mitochondrial function protection in ischemic stroke.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 2","pages":"Article 108529"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145795979","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
Post-stroke epilepsy in revascularized versus not revascularized stroke patients: A prospective cohort study 血运重建术与非血运重建术的卒中后癫痫患者:一项前瞻性队列研究。
IF 1.8 4区 医学 Q3 NEUROSCIENCES Pub Date : 2026-02-01 Epub Date: 2026-01-02 DOI: 10.1016/j.jstrokecerebrovasdis.2026.108544
Stefania Lazzari , Carlotta Mutti , Francesca Bozzetti , Antonio Genovese , Maddalena Frapporti , Francesca Badini , Carmine Siniscalchi , Andrea Becciolini , Valentina Tontini , Elisa Mannini , Irene Florindo , Francesco Misirocchi , Francesca Iuculano , Liborio Parrino , Lucia Zinno

Objective

The association between post stroke epilepsy (PSE) and revascularization therapy in stroke patients remains controversial. The prognostic significance of other supportive techniques such as Computed Tomography (CT) brain data and electroencephalograph (EEG) in PSE prediction is poorly understood.

Methods

We performed a single-center prospective observational study to evaluate the incidence of acute symptomatic seizures (ASS) and PSE in adult patients affected by acute ischaemic stroke undergoing reperfusional approaches compared to non-revascularized patients, with a 30-months follow-up.

Results

We enrolled 258 patients with stroke: 155 cases (treated with intravenous tissue plasminogen activator (IV-tPA)) and/or endovascular thrombectomy (ET) and 103 controls (non-revascularized). The global incidence of ASS was 3.4%, while PSE was diagnosed in 5% of patients. Reperfusion treatments were not associated with increased risk of ASS or PSE. Hemorrhagic infarction was found as the only independent risk factor for PSE development (HR 5.33, (95% CI, 1.69 – 16.82), p=0.004). In parallel, we analyzed the relationship between ASS and hemorrhagic infarction using the chi-square test (OR 8.59 (95% CI, 2.19 - 33.7), p < 0.001).

Conclusion

Reperfusion therapies for acute ischemic stroke do not increase the risk of epilepsy during the first 30 months after stroke. Hemorrhagic infarction was the main risk for epilepsy after stroke.
目的:脑卒中后癫痫(PSE)与脑卒中患者血运重建治疗之间的关系仍存在争议。其他辅助技术如计算机断层扫描(CT)脑数据和脑电图(EEG)在PSE预测中的预后意义尚不清楚。方法:我们进行了一项单中心前瞻性观察性研究,以评估急性缺血性卒中成人患者接受再灌注入路与非血运重建患者相比急性症状性癫痫发作(ASS)和PSE的发生率,随访30个月。结果:我们纳入258例卒中患者:155例(静脉注射组织型纤溶酶原激活剂(IV-tPA))和/或血管内取栓(ET)治疗,103例对照(非血运重建)。ASS的全球发病率为3.4%,而PSE的诊断率为5%。再灌注治疗与ASS或PSE风险增加无关。出血性梗死是PSE发展的唯一独立危险因素(HR 5.33, (95% CI, 1.69 - 16.82), p=0.004)。同时,我们使用卡方检验分析ASS与出血性梗死之间的关系(OR 8.59 (95% CI, 2.19 - 33.7), p < 0.001)。结论:急性缺血性脑卒中再灌注治疗不会增加脑卒中后30个月内癫痫的发生风险。出血性梗死是卒中后癫痫的主要危险因素。
{"title":"Post-stroke epilepsy in revascularized versus not revascularized stroke patients: A prospective cohort study","authors":"Stefania Lazzari ,&nbsp;Carlotta Mutti ,&nbsp;Francesca Bozzetti ,&nbsp;Antonio Genovese ,&nbsp;Maddalena Frapporti ,&nbsp;Francesca Badini ,&nbsp;Carmine Siniscalchi ,&nbsp;Andrea Becciolini ,&nbsp;Valentina Tontini ,&nbsp;Elisa Mannini ,&nbsp;Irene Florindo ,&nbsp;Francesco Misirocchi ,&nbsp;Francesca Iuculano ,&nbsp;Liborio Parrino ,&nbsp;Lucia Zinno","doi":"10.1016/j.jstrokecerebrovasdis.2026.108544","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2026.108544","url":null,"abstract":"<div><h3>Objective</h3><div>The association between post stroke epilepsy (PSE) and revascularization therapy in stroke patients remains controversial. The prognostic significance of other supportive techniques such as Computed Tomography (CT) brain data and electroencephalograph (EEG) in PSE prediction is poorly understood.</div></div><div><h3>Methods</h3><div>We performed a single-center prospective observational study to evaluate the incidence of acute symptomatic seizures (ASS) and PSE in adult patients affected by acute ischaemic stroke undergoing reperfusional approaches compared to non-revascularized patients, with a 30-months follow-up.</div></div><div><h3>Results</h3><div>We enrolled 258 patients with stroke: 155 cases (treated with intravenous tissue plasminogen activator (IV-tPA)) and/or endovascular thrombectomy (ET) and 103 controls (non-revascularized). The global incidence of ASS was 3.4%, while PSE was diagnosed in 5% of patients. Reperfusion treatments were not associated with increased risk of ASS or PSE. Hemorrhagic infarction was found as the only independent risk factor for PSE development (HR 5.33, (95% CI, 1.69 – 16.82), p=0.004). In parallel, we analyzed the relationship between ASS and hemorrhagic infarction using the chi-square test (OR 8.59 (95% CI, 2.19 - 33.7), p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Reperfusion therapies for acute ischemic stroke do not increase the risk of epilepsy during the first 30 months after stroke. Hemorrhagic infarction was the main risk for epilepsy after stroke.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 2","pages":"Article 108544"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145902055","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
Cervicocerebral atherosclerosis and atrial fibrillation increase long-term mortality in patients with ischemic stroke 脑颈动脉粥样硬化和房颤增加缺血性脑卒中患者的长期死亡率。
IF 1.8 4区 医学 Q3 NEUROSCIENCES Pub Date : 2026-02-01 Epub Date: 2025-12-19 DOI: 10.1016/j.jstrokecerebrovasdis.2025.108532
Kati Lainelehto MD , Juha-Pekka Pienimäki MD, PhD , Sirpa Savilahti MD, PhD , Heini Huhtala MSc , Tomi Sarkanen MD, PhD , Heikki Numminen MD, PhD , Jukka Putaala MD, PhD

Background and aims

Atrial fibrillation (AF) and atherosclerosis in the arteries supplying the brain are both strong risk factors of ischemic cerebrovascular events. However, the effect of their concurrent presence on long-term mortality in patients with acute ischemic stroke or transient ischemic attack (TIA) has gone little studied.

Methods

A total of 406 patients with acute ischemic stroke or TIA were enrolled in a tertiary university center and their cervicocerebral arteries imaged with computed tomography angiography (CTA). The extent of atherosclerosis in the carotid, vertebral and intracranial arteries were rated as Cervicocerebral Atherosclerotic Burden (CAB) score. Furthermore, we assessed the combined effect of atherosclerosis and AF with a variable including AF status and CAB score in quartiles.

Results

After a median follow-up of 7.3 years (interquartile range 5.7-7.6), 62 of the 121 patients with AF had died, compared to 74 of 285 patients without AF (cumulative mortality rate 52.0 %, 95 % CI 47.1-56.9 % vs. 27.0 %, 24.7-29.3 %, respectively). In adjusted Cox regression, the two highest CAB score quartiles were associated with mortality in AF patients with hazard ratios of 12.7 (1.6-99.7) and 15.8 (2.0-126.4), respectively. Furthermore, with combined variable of AF and CAB score the risk of death was 3-fold in AF patients with two highest quartiles of CAB score compared to those without AF in the two lowest CAB score quartiles.

Conclusions

The total atherosclerotic burden in arteries supplying the brain appears as a strong independent factor increasing long-term mortality in patients with acute ischemic stroke or TIA and concurrent AF.
背景与目的:心房颤动(AF)和脑供血动脉粥样硬化都是缺血性脑血管事件的重要危险因素。然而,它们同时存在对急性缺血性卒中或短暂性脑缺血发作(TIA)患者长期死亡率的影响研究甚少。方法:对406例急性缺血性脑卒中或TIA患者进行ct血管造影(CTA)检查。以颈动脉、椎动脉和颅内动脉的动脉粥样硬化程度作为颅脑动脉粥样硬化负荷(CAB)评分。此外,我们评估了动脉粥样硬化和房颤的综合影响,包括房颤状态和CAB评分(四分位数)。结果:在中位随访7.3年(四分位数范围5.7-7.6)后,121例AF患者中有62例死亡,而285例非AF患者中有74例死亡(累积死亡率为52.0%,95% CI分别为47.1-56.9%和27.0%,24.7-29.3%)。在校正Cox回归中,CAB评分最高的两个四分位数与AF患者的死亡率相关,风险比分别为12.7(1.6-99.7)和15.8(2.0-126.4)。此外,结合房颤和CAB评分的联合变量,CAB评分最高的两个四分位数的房颤患者的死亡风险是CAB评分最低的两个四分位数的房颤患者的3倍。结论:供脑动脉的总动脉粥样硬化负担似乎是增加急性缺血性卒中或TIA合并AF患者长期死亡率的一个强有力的独立因素。
{"title":"Cervicocerebral atherosclerosis and atrial fibrillation increase long-term mortality in patients with ischemic stroke","authors":"Kati Lainelehto MD ,&nbsp;Juha-Pekka Pienimäki MD, PhD ,&nbsp;Sirpa Savilahti MD, PhD ,&nbsp;Heini Huhtala MSc ,&nbsp;Tomi Sarkanen MD, PhD ,&nbsp;Heikki Numminen MD, PhD ,&nbsp;Jukka Putaala MD, PhD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108532","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108532","url":null,"abstract":"<div><h3>Background and aims</h3><div>Atrial fibrillation (AF) and atherosclerosis in the arteries supplying the brain are both strong risk factors of ischemic cerebrovascular events. However, the effect of their concurrent presence on long-term mortality in patients with acute ischemic stroke or transient ischemic attack (TIA) has gone little studied.</div></div><div><h3>Methods</h3><div>A total of 406 patients with acute ischemic stroke or TIA were enrolled in a tertiary university center and their cervicocerebral arteries imaged with computed tomography angiography (CTA). The extent of atherosclerosis in the carotid, vertebral and intracranial arteries were rated as Cervicocerebral Atherosclerotic Burden (CAB) score. Furthermore, we assessed the combined effect of atherosclerosis and AF with a variable including AF status and CAB score in quartiles.</div></div><div><h3>Results</h3><div>After a median follow-up of 7.3 years (interquartile range 5.7-7.6), 62 of the 121 patients with AF had died, compared to 74 of 285 patients without AF (cumulative mortality rate 52.0 %, 95 % CI 47.1-56.9 % vs. 27.0 %, 24.7-29.3 %, respectively). In adjusted Cox regression, the two highest CAB score quartiles were associated with mortality in AF patients with hazard ratios of 12.7 (1.6-99.7) and 15.8 (2.0-126.4), respectively. Furthermore, with combined variable of AF and CAB score the risk of death was 3-fold in AF patients with two highest quartiles of CAB score compared to those without AF in the two lowest CAB score quartiles.</div></div><div><h3>Conclusions</h3><div>The total atherosclerotic burden in arteries supplying the brain appears as a strong independent factor increasing long-term mortality in patients with acute ischemic stroke or TIA and concurrent AF.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"35 2","pages":"Article 108532"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145807294","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
期刊
Journal of Stroke & Cerebrovascular Diseases
全部 Org. Geochem. Chem. Ecol. Geol. Ore Deposits EUR PHYS J-APPL PHYS "Laboratorio;" analisis clinicos, bacteriologia, inmunologia, parasitologia, hematologia, anatomia patologica, quimica clinica Ore Geol. Rev. 环境与发展 Environmental Claims Journal Laser Phys. Geochem. Perspect. 2007 IEEE Ultrasonics Symposium Proceedings P GEOLOGIST ASSOC Phys. Rev. Appl. Appl. Geochem. ACTA GEOL POL Yan Ke Xue Bao (Hong Kong) GEOCHRONOMETRIA CRIT REV ENV SCI TEC Ann. Phys. INT J MOD PHYS E GROUNDWATER Aquat. Geochem. J. Afr. Earth. Sci. Am. J. Sci. INFRARED PHYS TECHN ENG SANIT AMBIENT Prog. Oceanogr. 2010 4th International Conference on Bioinformatics and Biomedical Engineering J. Nanophotonics ARCH ACOUST Atmos. Meas. Tech. Meteorol. Atmos. Phys. Solid Earth Int. J. Geomech. 2005 Asian Conference on Sensors and the International Conference on New Techniques in Pharmaceutical and Biomedical Research ECOTOXICOLOGY Atmos. Chem. Phys. EQEC'96. 1996 European Quantum Electronic Conference BEHAV BRAIN FUNCT J. Math. Phys. 2013 International Conference on Optical MEMS and Nanophotonics (OMN) ASTRON ASTROPHYS ITAL J REMOTE SENS SCI CHINA EARTH SCI OFIOLITI CHIN OPT LETT Chin. J. Phys. MNRAS Weather Forecasting STRUCT EQU MODELING J. Adv. Model. Earth Syst. 2011 Conference on Lasers and Electro-Optics Europe and 12th European Quantum Electronics Conference (CLEO EUROPE/EQEC) Mineral. Mag. Miner. Deposita IZV-PHYS SOLID EART+ Basin Res. GEOLOGY Acta Oceanolog. Sin. Geobiology Archaeol. Anthropol. Sci. Int. J. Biometeorol. Am. Mineral. Geostand. Geoanal. Res. Ann. Glaciol. BIOGEOSCIENCES ACTA GEOL SIN-ENGL Aust. J. Earth Sci. Carbon Balance Manage. J. Hydrol. Ecol. Processes Acta Geophys. Asia-Pac. J. Atmos. Sci. Conserv. Genet. Resour. Adv. Atmos. Sci. Adv. Meteorol. Chin. Phys. Lett. Atmos. Res. Acta Geochimica ARCHAEOMETRY Astrophys. J. Suppl. Ser. ARCT ANTARCT ALP RES Int. J. Climatol. J. Atmos. Chem. Environ. Res. Lett. AAPG Bull. ATMOSPHERE-BASEL Chin. Phys. C ACTA PETROL SIN Contrib. Mineral. Petrol. Astrophys. Space Sci. Big Earth Data Geochim. Cosmochim. Acta 建设监理 Am. J. Phys. Anthropol. J APPL METEOROL CLIM ASTROBIOLOGY Appl. Clay Sci. Chin. Phys. B Clean-Soil Air Water Mon. Weather Rev.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1