Neuroepidemiology最新文献

Introduction The study uniquely focuses on the global incidence, mortality, and temporal trends of brain and central nervous system (CNS) cancer from 1992 to 2021. It explores the association between the disease burden and factors such as age, period, and birth cohorts, and provides forecasts for future incidence and mortality. Methods Leveraging the Global Burden of Disease 2021 data from 1992 to 2021, we calculated incidence, and deaths and their age-standardized rates (ASR) and assessed temporal trends using the average annual percent change derived from joinpoint regression analysis. To explore the impacts of age, period, and birth cohort in greater depth, we applied an age-period-cohort model. Additionally, a Nordpred age-period-cohort analysis was conducted to forecast the global epidemiological trends from 2022 to 2031. Results The global incidence of brain and CNS cancer has increased from 2,831,075 in 1992 to 3,420,786 in 2021, and the number of mortalities has risen by 80.62%. The incidence ASR was highest in high sociodemographic index (SDI) regions, and showed an increasing trend. Conversely, the mortality ASR displayed downward trends in high-middle and high SDI regions. Notably, the age-period-cohort model suggests a recent increase in incidence risk, and a decline in mortality. From 2022 to 2031, the global mortality ASR was predicted to decrease whereas the incidence ASR increases slowly. Conclusion The global trends in brain and CNS cancer incidence and mortality generally showed an increasing trend with considerable heterogeneity. Furtherly, high SDI regions where health care systems could conduct earlier and better medical interventions with better outcome for brain and CNS cancer.

Introduction: People with epilepsy present an excess risk of mortality, but questions remain regarding the underlying causes and risk distribution. Here, we estimated the excess mortality by age and sex among adults and adolescents with epilepsy in France and identified their main causes.

Methods: A national cohort study was conducted between 2009 and 2019, with adults and adolescents aged between 12 and 60 years and having at least one hospitalization, assurance record, or delivery of anti-seizure medication linked to epilepsy on the French National Health Data System (SNDS). Mortality rates and standardized mortality ratios (SMR) were estimated according to age and sex. Specific causes of death from death certificates were also explored.

Results: Between 2009 and 2019, 619,753 patients were included, of whom 60,033 (9.7%) died during follow-up, corresponding to a mortality rate of 9.55 [9.30; 9.79] per 1000 person-years. Compared with the general population, people with epilepsy had a 3.33-fold higher risk of death [3.24; 3.41], with a higher risk in women than in men, with SMRs of 4.11 [3.94; 4.29] and 2.99 [2.90; 3.09], respectively. Excess mortality was found for all causes of death, particularly neurological causes. Women with epilepsy presented a higher excess risk of death than men, especially between 20-40 years old.

Conclusion: Our findings provide further evidence of increased mortality in patients with epilepsy. Remarkably, we found major differences according to sex, which have been largely overlooked so far. The fact that young women with epilepsy are at risk poses additional clinical and societal challenges.

Introduction: Migraine and other types of primary headache are widely prevalent and are thought to have substantial economic implications on a global scale. Nevertheless, the precise prevalence rates in China exhibited discrepancies across various studies. The present study aimed to ascertain the prevalence of migraine and other primary headache disorders in China.

Methods: A systematic search of peer-reviewed literature was conducted in the Chinese Wanfang, CNKI, PubMed, and Medline databases from January 1988 to December 2023 to identify prevalence data on migraine and other primary headache disorders among the Chinese population, published in either English or Chinese language. The study utilized a random effects model to summarize pooled prevalence estimates, with subgroup analyses conducted based on sex, age, publication year, and geographical region.

Results: A total of 18 studies were included for detailed review and meta-analysis. The pooled prevalence of migraine and tension-type headache (TTH) in China was found to be 6.1% (95% CI: 4.1-8.6%) and 13.4% (95% CI: 7.2-21.2%), respectively. The prevalence of migraine in the years 1988-1999 was 1.3% (95% CI: 1.1-1.5%), while the prevalence of TTH was 5.0% (95% CI: 4.5-5.4%). In contrast, the prevalence of migraine in the years 2000-2023 increased to 7.0% (95% CI: 4.9-9.4%), with TTH prevalence at 13.2% (95% CI: 7.1-20.8%). The weighted-pooled prevalence of both migraine and TTH were higher in females than in males. Subgroup analyses suggested that factors such as geographical region, age, sex, and publication year may be associated with the prevalence of these headache disorders. A single study encompassing 3,457,170 participants revealed a prevalence rate of 0.0068% for cluster headache.

Conclusion: Our research suggested an increasing trend in the prevalence of migraine and TTH in China over time, with females being more susceptible to primary headaches than males. This underscores the significance of not disregarding these conditions, especially in females. Future epidemiological studies of high quality are warranted to further investigate the prevalence of migraine and other primary headaches in China.

Background and purpose: Acute ischemic stroke (AIS) is the most prevalent type of stroke, associated with a significant burden of functional impairments. About 94.2% of AIS patients present with multiple comorbidities, but how they affect AIS prognosis remains largely unknown. This study aims to comprehensively assess the associations of a wide range of AIS-related comorbidities, their patterns, with functional impairments in AIS patients.

Method: This study utilized data from the China National Stroke Registry 3 (CNSR3), a prospective registry encompassing 201 Chinese hospitals from August 2015 to March 2018. A total of 10,508 AIS patients were included, with a median age of 62.0 years (IQR: 54.0-70.0), and 65% were female. Eighteen AIS-related comorbidities were considered in the analysis and frequent pattern mining was employed to identify potential comorbidity patterns among AIS patients. Functional outcomes at one year after an AIS event were assessed using the Modified Rankin Scale (mRS). Logistic regression models were utilized to evaluate associations of comorbidities, their patterns with AIS prognosis. Furthermore, association rule mining was applied to explore the hidden comorbidity combinations, and their relationship with functional outcomes based on the identified patterns.

Results: Comorbidity was observed in 88.9% of AIS patients. The majority of AIS patients exhibited one to three comorbidities. Eight patterns of main comorbidities among AIS patients were identified. The pattern of common metabolic disorders, coronary heart disease, and atrial fibrillation demonstrated the strongest association (OR = 2.49, 1.59 to 3.89) with the development of poor functional outcomes. The further combination of heart failure, and arthritis significantly increases the probability of poor functional outcomes, with lifts of 3.11 and 5.52, respectively.

Conclusions: Our study revealed that comorbidity is highly prevalent among AIS patients in China, encompassing diverse patterns. Specific comorbidities and comorbidity patterns are closely associated with poor functional outcomes. Our findings emphasized the importance of prioritizing comprehensive management of AIS and AIS-related comorbidities to reduce the risk of disability among AIS patients.

Background: Tea is widely consumed around the world, with green tea showing potential protective effects against cognitive decline, as indicated by multiple studies. These effects are thought to stem from its polyphenols and neuroprotective properties. This study aims to systematically review and meta-analyze recent observational research on the link between green tea consumption and the risk of cognitive impairment.

Methods: A systematic search was performed in PubMed, Embase, Web of Science, and the Cochrane Library for observational studies published between September 2004 and September 2024. The relationship between green tea consumption and cognitive impairment was summarized using odds ratios with 95% confidence intervals. Additionally, the study conducted subgroup analyses, assessed heterogeneity, evaluated publication bias, and performed sensitivity analyses.

Results: Eighteen studies were included, comprising a total of 58,929 participants. The quality of these studies was evaluated using the Newcastle-Ottawa Scale, and overall, the quality was found to be high. The random-effects meta-analysis indicated that green tea consumption was inversely associated with cognitive impairment OR 0.63 (95% CI: 0.54-0.73), with the greatest benefit observed in individuals aged 50-69 years. Subgroup analysis showed protective effects for dementia OR 0.75 (95% CI: 0.60-0.92) and mild cognitive impairment OR 0.64 (95% CI: 0.43-0.96). Additionally, a significant reduction in the risk of cognitive impairment was observed in Asian populations, whereas no such association was found in European populations. Both women OR 0.51 (95% CI: 0.28-0.95) and men OR 0.47 (95% CI: 0.28-0.80) showed significant associations. High consumption groups had reduced cognitive impairment risk OR 0.63 (95% CI: 0.50-0.82).

Conclusions: Green tea consumption is associated with a reduced risk of cognitive impairment, suggesting potential cognitive benefits. However, large-scale longitudinal studies are needed to confirm dose-response relationships and long-term effects. Future studies should also investigate the long-term effects of green tea and its role in personalized nutrition based on genetic predispositions.

Background: Management of ruptured intracranial aneurysms (RIAs) in elderly patients remains a major challenge in the treatment of cerebrovascular diseases. This study aims to provide a comprehensive analysis of the impact of microsurgical treatment (MST) and endovascular treatment (EVT) on the outcomes of elderly patients with RIAs in northern China.

Methods: We consecutively enrolled elderly patients with RIAs who underwent surgery in the Chinese Multicenter Cerebral Aneurysm Database (CMAD) from January 2017 to December 2020. In this study, in-hospital complications, survival, and functional outcomes were compared between MST and EVT after 1:1 propensity score matching (PSM). Kaplan-Meier survival analyses and Cox proportional hazards modeling identified factors associated with mortality in both groups. Logistic regression analyses identified 2-year survival-dependent risk factors, and subgroup analyses were conducted for key strata.

Results: 744 elderly patients with RIAs were enrolled in the study. 219 patients with MST after PSM were matched with 219 patients with EVT. Compared to EVT, MST had a higher 2-year mortality rate (32.8% vs. 20.5%, p=0.002), higher incidence of adverse discharge outcomes (48.4% vs. 32.4%, p=0.001), longer length of stay (LOS) (16 (12-24) vs. 15 (10-23), p=0.049), pneumonia (MST: 31.1%; EVT: 21.9%, p=0.030), and intracranial infection (9.6% vs. 2.7%, p=0.005). However, there was no difference in the 2-year survival-dependent outcome (22.7% vs 23.2%, p=0.924). Differences in risk factors for mortality and 2-year survival-dependent outcomes were observed between the MST and EVT groups in the elderly population. The negative association of EVT with risk of mortality was consistent across specific subgroups.

Conclusion: Elderly patients with RIAs who underwent EVT were significantly better than the MST group in terms of short-term functional outcomes, in-hospital complications, long-term survival, and LOS. However, there were no differences in the 2-year survival-dependent outcomes.

Background: Encephalitis can lead to significant disability among survivors. Up-to-date estimates of encephalitis incidence and the risk of postencephalitic epilepsy (PE) are crucial for informing health policy.

Methods: We used the National Taiwan Insurance Research Database to estimate the standardized incidence of encephalitis for each year from 2003 to 2017. We analyzed PE among these cases.

Results: From 2003 to 2017, the age- and sex-standardized incidence of encephalitis increased from 5.95 (95% confidence interval [CI]: 5.61-6.28) to 10.46 (95% CI: 10.04-10.87) per 100,000 person-years, with an annual percentage change of 1.6% (1.1-2.2, p < 0.05). However, yearly variation was observed. The incidence was consistently higher in patients under 18 years than in those aged ≥ 18 years throughout the study period. In 2017, the highest annual incidence was seen in adults aged ≥ 70 years and in children aged 1-4 years. Approximately 20% of the survivors developed PE within 5 years, with the highest risk observed in infants under 1 year of age.

Conclusions: The overall incidence of encephalitis in Taiwan increased from 2003 to 2017. Pediatric patients, particularly those under 1 year of age, are more vulnerable to encephalitis and its long-term complications, including PE, compared to adults, except for those aged ≥ 70 years.

Background: Prospective data show an increased risk of mortality in essential tremor (ET). Understanding the contributors to this increased mortality is of value.

Methods: A total of 347 cases were enrolled in a prospective study of cognition in elders with ET (M baseline age = 79.6 years, M follow-up length = 2.7 years). At each visit, cases completed clinical assessments, a cognitive test battery, and were assigned a Clinical Dementia Rating (CDR). Cox proportional hazards regression equations identified predictors of cases' relative risk of mortality.

Results: 41 (11.8%) of 347 cases died during follow-up. Deceased cases were older at baseline, had fewer years of education, used more medication, had more severe tremor, had more gait impairment, and reported more falls, less physical activity, and more depressive symptoms than did living cases. In univariate analyses, a CDR score of 1 or 2 (dementia) was associated with a six-fold increased risk of mortality (hazard ratio [HR] = 6.33). Moderate rather than milder levels of dementia (CDR 2 rather than 1) were driving this effect, with multivariate models demonstrating HRs in excess of 7.5 (p < 0.001). Gait impairment and falls were also associated with significant increased risk of mortality in multivariate models.

Conclusion: We identified several factors that may be used to risk-stratify ET patients with respect to mortality. The information from these analyses can be of value in identifying subgroups of ET patients who demonstrate risk for early death; such subgroups can then be targeted for interventions as well as preventive measures.

Background: Intracerebral hemorrhage represents a critical subtype of stroke, imposing substantial social and economic challenges. Considering the considerable impact of intracerebral hemorrhage in Asia and the absence of studies detailing its epidemiological features, the aim of this study was to elucidate the temporal trends and distribution characteristics of intracerebral hemorrhage in Asia from 1990 to 2021, as well as to forecast the future burden.

Methods: The data derived from Global Disease Burden Study 2021 were used to investigate the age-standardized rates and absolute numbers of incident intracerebral hemorrhage cases and related deaths in Asia across genders, age groups, and geographical locations. An estimated annual percentage change was estimated to represent temporal trends, and an autoregressive integrated moving average model was used to forecast the future burden.

Results: In Asia, the age-standardized incidence and mortality rates of intracerebral hemorrhage per 100,000 population have declined from 1990 to 2021, despite a continuous increase in the absolute numbers, which exhibit significant heterogeneity across different geographical locations. In terms of gender, males experience a greater burden of intracerebral hemorrhage compared to females, and the impact of risk factors on disability-adjusted life years of intracerebral hemorrhage varies. In comparison to the figures observed in 2021, our forecasts indicate a rise in the burden of intracerebral hemorrhage in Asia.

Conclusions: The study offers an extensive depiction of the epidemiological features of intracerebral hemorrhage in Asia spanning from 1990 to 2021 while also outlining the diverse trajectories of the impending burden of this condition in the region. Comprehending the expected increase in disease burden can aid in formulating tailored strategies to tackle upcoming challenges.