Zhijie Jiang, Si Hu, Guoqiang Zhang, Jingwei Zheng, Fei Liu, Xudan Shi, Chenhan Ling, Jing Xu, Jun Yu, Liang Xu
Background
Frontal base mixed pial-dural arteriovenous malformations (MPD-AVMs) are rare intracranial vascular malformations with both pial and dural components. Although they share some angioarchitectural similarities with anterior cranial fossa dural arteriovenous fistulas (ACF-DAVFs), the two represent different pathological processes, as ACF-DAVFs are supplied exclusively by dural arteries. This study provides an overview of frontal base MPD-AVMs, highlighting their differences from ACF-DAVFs, and discusses the therapeutic implications of their distinct angioarchitectural features.
Methods
This is a single-center case series study conducted between January 2018 and December 2024. The data of 11 patients who underwent endovascular treatment for frontal base MPD-AVMs and 29 patients diagnosed with ACF-DAVFs were retrospectively reviewed.
Results
In patients diagnosed with MPD-AVMs, all lesions were supplied by the anterior ethmoidal artery (AEA) and orbitofrontal artery (OFA). Flow-related aneurysms in the OFA were identified in seven patients (7/11, 63.6%), with three presenting with hemorrhagic events. Treatment approaches included transarterial embolization (TAE) in eight patients, with one requiring additional transvenous embolization (TVE). Primary TVE was employed in three patients, including two hemorrhagic patients who underwent staged treatment with initial aneurysm embolization. Complete obliteration was achieved in 72.7% of cases (8/11), although one patient experienced postoperative hemorrhage. In patients presenting with ACF-DAVFs, venous aneurysm (18/29, 62.1%) might represent a risk factor for bleeding (13/29, 44.8%) (p = 0.003). In the MPD-AVM group, venous aneurysms were detected in five patients (5/11, 45.5%), but none of whom experienced hemorrhage.
Conclusion
Frontal base MPD-AVMs represent distinct vascular anomalies from ACF-DAVFs, often featuring anterior cerebral artery branch involvement. Tailored multi-arterial endovascular strategies are crucial for optimizing outcomes and minimizing complications. Further studies with larger cohorts are essential to validate these observations and refine treatment guidelines.
{"title":"Frontal Base Mixed Pial-Dural Arteriovenous Malformations: A Distinct Entity Requiring Differentiated Treatment From Anterior Cranial Fossa Dural Arteriovenous Fistulas","authors":"Zhijie Jiang, Si Hu, Guoqiang Zhang, Jingwei Zheng, Fei Liu, Xudan Shi, Chenhan Ling, Jing Xu, Jun Yu, Liang Xu","doi":"10.1002/brb3.71099","DOIUrl":"10.1002/brb3.71099","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Frontal base mixed pial-dural arteriovenous malformations (MPD-AVMs) are rare intracranial vascular malformations with both pial and dural components. Although they share some angioarchitectural similarities with anterior cranial fossa dural arteriovenous fistulas (ACF-DAVFs), the two represent different pathological processes, as ACF-DAVFs are supplied exclusively by dural arteries. This study provides an overview of frontal base MPD-AVMs, highlighting their differences from ACF-DAVFs, and discusses the therapeutic implications of their distinct angioarchitectural features.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a single-center case series study conducted between January 2018 and December 2024. The data of 11 patients who underwent endovascular treatment for frontal base MPD-AVMs and 29 patients diagnosed with ACF-DAVFs were retrospectively reviewed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In patients diagnosed with MPD-AVMs, all lesions were supplied by the anterior ethmoidal artery (AEA) and orbitofrontal artery (OFA). Flow-related aneurysms in the OFA were identified in seven patients (7/11, 63.6%), with three presenting with hemorrhagic events. Treatment approaches included transarterial embolization (TAE) in eight patients, with one requiring additional transvenous embolization (TVE). Primary TVE was employed in three patients, including two hemorrhagic patients who underwent staged treatment with initial aneurysm embolization. Complete obliteration was achieved in 72.7% of cases (8/11), although one patient experienced postoperative hemorrhage. In patients presenting with ACF-DAVFs, venous aneurysm (18/29, 62.1%) might represent a risk factor for bleeding (13/29, 44.8%) (<i>p</i> = 0.003). In the MPD-AVM group, venous aneurysms were detected in five patients (5/11, 45.5%), but none of whom experienced hemorrhage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Frontal base MPD-AVMs represent distinct vascular anomalies from ACF-DAVFs, often featuring anterior cerebral artery branch involvement. Tailored multi-arterial endovascular strategies are crucial for optimizing outcomes and minimizing complications. Further studies with larger cohorts are essential to validate these observations and refine treatment guidelines.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9081,"journal":{"name":"Brain and Behavior","volume":"15 12","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12682932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145699463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abbasi H, Khoshdooz S, Abbasi MM, Eslamian G. Dietary Antioxidant Quality Score and Epilepsy Odds in the US Adults: A Cross-Sectional NHANES Study. Brain and Behavior. 2025 Nov;15(11):e71018.
In the originally published version, the affiliation superscripts for the authors were incorrect. The superscript for “Hamid Abbasi” and “Mohammad Mehdi Abbasi” should be 1, and the superscript for “Sara Khoshdooz” should be 2. The correct order of affiliations, based on the current author order, is as follows:
Student Research Committee, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Faculty of Medicine, Guilan University of Medical Science, Rasht, Iran
Department of Cellular and Molecular Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Second, two rows were missing from Table 4 in the original article. A corrected version of Table 4 has been provided.
The authors declare that these amendments do not change the results or conclusions of the paper and apologize for any inconvenience caused by these oversights.
Abbasi H, Khoshdooz S, Abbasi MM, Eslamian G.膳食抗氧化剂质量评分与美国成年人癫痫发病率：一项横断面NHANES研究。脑与行为。2025年11月；15(11):e71018。在最初发表的版本中，作者的隶属关系上标不正确。“Hamid Abbasi”和“Mohammad Mehdi Abbasi”的上标应该是1，“Sara Khoshdooz”的上标应该是2。根据目前的作者顺序，正确的隶属关系顺序如下：德黑兰Shahid Beheshti医学科学大学营养与食品技术学院学生研究委员会，伊朗吉兰医学科学大学医学院，拉什特，伊朗细胞与分子营养系，营养与食品技术学院，德黑兰Shahid Beheshti医学科学大学国家营养与食品技术研究所，其次，原始文章中的表4缺少两行。已提供表4的更正版本。作者声明这些修改不会改变论文的结果或结论，并对这些疏忽造成的任何不便表示歉意。
{"title":"Correction to “Dietary Antioxidant Quality Score and Epilepsy Odds in the US Adults: a Cross-Sectional NHANES Study”","authors":"","doi":"10.1002/brb3.71103","DOIUrl":"10.1002/brb3.71103","url":null,"abstract":"<p>Abbasi H, Khoshdooz S, Abbasi MM, Eslamian G. Dietary Antioxidant Quality Score and Epilepsy Odds in the US Adults: A Cross-Sectional NHANES Study. Brain and Behavior. 2025 Nov;15(11):e71018.</p><p>In the originally published version, the affiliation superscripts for the authors were incorrect. The superscript for “Hamid Abbasi” and “Mohammad Mehdi Abbasi” should be 1, and the superscript for “Sara Khoshdooz” should be 2. The correct order of affiliations, based on the current author order, is as follows:</p><p>Student Research Committee, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran</p><p>Faculty of Medicine, Guilan University of Medical Science, Rasht, Iran</p><p>Department of Cellular and Molecular Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran</p><p>Second, two rows were missing from Table 4 in the original article. A corrected version of Table 4 has been provided.</p><p>The authors declare that these amendments do not change the results or conclusions of the paper and apologize for any inconvenience caused by these oversights.</p>","PeriodicalId":9081,"journal":{"name":"Brain and Behavior","volume":"15 12","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12672915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145660162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Being obese considerably elevates the risk of both obstructive sleep apnea syndrome (OSAS) and mortality. Although body mass index (BMI) is a common measure, it neglects visceral adiposity, a critical factor in the development of cardiometabolic and respiratory dysfunction. By integrating waist circumference and height, the body roundness index (BRI) delivers a more accurate evaluation of central fat distribution, potentially improving the prediction of OSAS and mortality.
Methods
We analyzed data from 13,854 US adults aged ≥20 years from the NHANES 2005–2008 and 2015–2018 cycles. Using multivariable logistic and Cox regression models, along with restricted cubic spline and subgroup analyses, the connections of BRI and BMI with OSAS and all-cause mortality were examined, and ROC curves were employed to compare predictive performance.
Results
Both BRI and BMI were significantly associated with increased OSAS risk, with stronger associations observed for BRI (adjusted odds ratio [OR] = 3.060, 95% confidence interval [CI]: 2.880–3.251, p < 0.001) than for BMI (adjusted OR = 1.573, 95% CI: 1.535–1.612, p < 0.001). In OSAS patients, BRI was positively associated with all-cause mortality (adjusted hazard ratio [HR] = 1.087, 95% CI: 1.036–1.141, p < 0.001; Q4 vs. Q1: HR = 1.423, 95% CI: 1.073–1.887, p = 0.014), while BMI showed an inverse crude association that became marginally positive after adjustment (adjusted HR = 1.021, 95% CI: 1.001–1.040, p = 0.038; Q4 vs. Q1: HR = 1.378, 95% CI: 0.966–1.964, p = 0.037). BRI demonstrated superior predictive value for mortality (area under the curve [AUC] = 0.610) compared to BMI (AUC = 0.521; p < 0.001), despite comparable performance for OSAS prediction (BRI AUC = 0.793 vs. BMI AUC = 0.790; p = 0.236).
Conclusion
BRI and BMI showed comparable ability to predict OSAS risk; however, BRI demonstrated superior value in mortality stratification, emphasizing its clinical significance for assessing visceral fat-related prognosis. Because OSAS was identified using a validated questionnaire rather than polysomnography, minor classification errors may exist, warranting cautious interpretation of the findings.
{"title":"Body Roundness Index Versus Body Mass Index: Differential Associations With Obstructive Sleep Apnea Syndrome and All-Cause Mortality in US Adults Aged 20 Years and Older","authors":"Xiaodong Chen, Xianglian Chen, Hongwei Liu, Minheng Zhang","doi":"10.1002/brb3.71109","DOIUrl":"10.1002/brb3.71109","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Being obese considerably elevates the risk of both obstructive sleep apnea syndrome (OSAS) and mortality. Although body mass index (BMI) is a common measure, it neglects visceral adiposity, a critical factor in the development of cardiometabolic and respiratory dysfunction. By integrating waist circumference and height, the body roundness index (BRI) delivers a more accurate evaluation of central fat distribution, potentially improving the prediction of OSAS and mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed data from 13,854 US adults aged ≥20 years from the NHANES 2005–2008 and 2015–2018 cycles. Using multivariable logistic and Cox regression models, along with restricted cubic spline and subgroup analyses, the connections of BRI and BMI with OSAS and all-cause mortality were examined, and ROC curves were employed to compare predictive performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Both BRI and BMI were significantly associated with increased OSAS risk, with stronger associations observed for BRI (adjusted odds ratio [OR] = 3.060, 95% confidence interval [CI]: 2.880–3.251, <i>p</i> < 0.001) than for BMI (adjusted OR = 1.573, 95% CI: 1.535–1.612, <i>p</i> < 0.001). In OSAS patients, BRI was positively associated with all-cause mortality (adjusted hazard ratio [HR] = 1.087, 95% CI: 1.036–1.141, <i>p</i> < 0.001; Q4 vs. Q1: HR = 1.423, 95% CI: 1.073–1.887, <i>p</i> = 0.014), while BMI showed an inverse crude association that became marginally positive after adjustment (adjusted HR = 1.021, 95% CI: 1.001–1.040, <i>p</i> = 0.038; Q4 vs. Q1: HR = 1.378, 95% CI: 0.966–1.964, <i>p</i> = 0.037). BRI demonstrated superior predictive value for mortality (area under the curve [AUC] = 0.610) compared to BMI (AUC = 0.521; <i>p</i> < 0.001), despite comparable performance for OSAS prediction (BRI AUC = 0.793 vs. BMI AUC = 0.790; <i>p</i> = 0.236).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>BRI and BMI showed comparable ability to predict OSAS risk; however, BRI demonstrated superior value in mortality stratification, emphasizing its clinical significance for assessing visceral fat-related prognosis. Because OSAS was identified using a validated questionnaire rather than polysomnography, minor classification errors may exist, warranting cautious interpretation of the findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9081,"journal":{"name":"Brain and Behavior","volume":"15 12","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12672924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145660190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Han Tang, Yi Gou, Xiao-yi Hu, Zhen Luo, Wei-juan Gang, Hong Zhao
<div> <section> <h3> Objective</h3> <p>Acupuncture is considered an effective complementary therapy for major depressive disorder (MDD), yet current findings remain inconsistent, and its overall quality is uncertain. Therefore, this study summarizes the existing evidence on acupuncture for MDD, providing an overview of the current research, identifying gaps and limitations in the literature, and offering guidance for future research.</p> </section> <section> <h3> Methods</h3> <p>We systematically searched eight electronic databases (PubMed, EMBASE, CDSR, CENTRAL, CNKI, Wanfang, VIP, and SinoMed) and seven guideline repositories (Trip, AHRQ, NICE, NZGG, GIN, CMACPG, and NHMRC) from inception to November 15, 2024, for RCTs, systematic reviews, and clinical practice guidelines on acupuncture for major depressive disorder. Eligibility criteria were defined according to the PICOS framework. Two reviewers independently screened studies, extracted data, and assessed quality using the Cochrane Risk of Bias tool for randomized controlled trials (RCTs) and AMSTAR-2 for systematic reviews (SRs). Key evidence and recommendations were synthesized and presented in tables and figures.</p> </section> <section> <h3> Results</h3> <p>A total of 374 studies were identified, including 330 RCTs, 35 SRs, and 9 clinical guidelines. The RCTs generally involved small sample sizes (50 to 100 participants). The primary intervention was acupuncture combined with antidepressant medication (50%), while 79.39% of studies used antidepressants as the main control. Nearly all studies (97.88%) used changes in depression severity as the primary outcome, although the risk of bias was unclear in 80.3% of cases. Of the SRs, 97.14% reported positive findings favoring acupuncture's potential benefits, but 74.29% were rated as very low in methodological quality, lacking thorough bias assessments. Among the two acupuncture-specific guidelines and seven broader guidelines, recommendations for acupuncture in managing MDD varied considerably.</p> </section> <section> <h3> Conclusion</h3> <p>Evidence from RCTs, SRs, and clinical guidelines suggests that acupuncture may reduce depressive symptom severity and provide additional benefits for patients with comorbid anxiety, sleep disturbances, or somatic symptoms, particularly when used as an adjunctive therapy. However, these findings are mainly based on small-scale trials with methodological limitations, and most guidelines recommend acupuncture only as a third-line complementary option. Further large, high-quality RCTs are needed to strengthen th
{"title":"Acupuncture for Patients With Major Depressive Disorder: An Evidence Map of Randomized Controlled Trials, Systematic Reviews, and Clinical Guidelines","authors":"Han Tang, Yi Gou, Xiao-yi Hu, Zhen Luo, Wei-juan Gang, Hong Zhao","doi":"10.1002/brb3.71075","DOIUrl":"10.1002/brb3.71075","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Acupuncture is considered an effective complementary therapy for major depressive disorder (MDD), yet current findings remain inconsistent, and its overall quality is uncertain. Therefore, this study summarizes the existing evidence on acupuncture for MDD, providing an overview of the current research, identifying gaps and limitations in the literature, and offering guidance for future research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We systematically searched eight electronic databases (PubMed, EMBASE, CDSR, CENTRAL, CNKI, Wanfang, VIP, and SinoMed) and seven guideline repositories (Trip, AHRQ, NICE, NZGG, GIN, CMACPG, and NHMRC) from inception to November 15, 2024, for RCTs, systematic reviews, and clinical practice guidelines on acupuncture for major depressive disorder. Eligibility criteria were defined according to the PICOS framework. Two reviewers independently screened studies, extracted data, and assessed quality using the Cochrane Risk of Bias tool for randomized controlled trials (RCTs) and AMSTAR-2 for systematic reviews (SRs). Key evidence and recommendations were synthesized and presented in tables and figures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 374 studies were identified, including 330 RCTs, 35 SRs, and 9 clinical guidelines. The RCTs generally involved small sample sizes (50 to 100 participants). The primary intervention was acupuncture combined with antidepressant medication (50%), while 79.39% of studies used antidepressants as the main control. Nearly all studies (97.88%) used changes in depression severity as the primary outcome, although the risk of bias was unclear in 80.3% of cases. Of the SRs, 97.14% reported positive findings favoring acupuncture's potential benefits, but 74.29% were rated as very low in methodological quality, lacking thorough bias assessments. Among the two acupuncture-specific guidelines and seven broader guidelines, recommendations for acupuncture in managing MDD varied considerably.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Evidence from RCTs, SRs, and clinical guidelines suggests that acupuncture may reduce depressive symptom severity and provide additional benefits for patients with comorbid anxiety, sleep disturbances, or somatic symptoms, particularly when used as an adjunctive therapy. However, these findings are mainly based on small-scale trials with methodological limitations, and most guidelines recommend acupuncture only as a third-line complementary option. Further large, high-quality RCTs are needed to strengthen th","PeriodicalId":9081,"journal":{"name":"Brain and Behavior","volume":"15 12","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12665193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145629611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stuart C. Innes, Dorothy K. Joe, Katia Cikurel, José P. Lavrador, Francesco Vergani, Ranj Bhangoo, Keyoumars Ashkan, Gerald T. Finnerty
Introduction
New neurological symptoms in neuro-oncology patients are usually attributed to the tumor or its treatment. A diagnosis of functional neurological disorder (FND) is often only considered when investigations do not reveal a cause and medical management fails. The consequences to neuro-oncology patients of comorbid FND have not been elaborated.
Methods
We performed a single-center retrospective case study of adult neuro-oncology patients with an intracranial tumor who presented acutely with FND and required expedited investigations. Data recorded were tumor type, investigations, adverse life events, medical interventions, and outcomes. This was combined with a systematic literature review.
Results
Ten patients met our study criteria. Six had functional seizures, two had functional hemiparesis, and two had functional speech disorders. FND symptoms started prior to tumor diagnosis in three patients; between diagnosis and tumor treatment in three patients; and after treatment commenced in four patients. Two patients were thrombolyzed for a presumed stroke. Three patients had either their tumor surgery or chemoradiotherapy delayed. Diagnosis and management of FND enabled tumor treatment to restart. The systematic review identified 43 patients. Thirty-nine had functional seizures, and four had motor FND. All FNDs except one started after tumor treatment commenced.
Conclusion
Acute FND can occur at any stage of a brain tumor illness. The FND may lead to unnecessary medical interventions and can disrupt tumor treatment. Although acute FND improved with diagnosis and explanation, many neuro-oncology patients require a multidisciplinary tumor–FND pathway to manage acute FND and avoid delays to tumor treatment.
{"title":"Consequences of Acute Presentations of Functional Neurological Disorders in Neuro-Oncology Patients: Case Series and Systematic Review","authors":"Stuart C. Innes, Dorothy K. Joe, Katia Cikurel, José P. Lavrador, Francesco Vergani, Ranj Bhangoo, Keyoumars Ashkan, Gerald T. Finnerty","doi":"10.1002/brb3.71107","DOIUrl":"10.1002/brb3.71107","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>New neurological symptoms in neuro-oncology patients are usually attributed to the tumor or its treatment. A diagnosis of functional neurological disorder (FND) is often only considered when investigations do not reveal a cause and medical management fails. The consequences to neuro-oncology patients of comorbid FND have not been elaborated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a single-center retrospective case study of adult neuro-oncology patients with an intracranial tumor who presented acutely with FND and required expedited investigations. Data recorded were tumor type, investigations, adverse life events, medical interventions, and outcomes. This was combined with a systematic literature review.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ten patients met our study criteria. Six had functional seizures, two had functional hemiparesis, and two had functional speech disorders. FND symptoms started prior to tumor diagnosis in three patients; between diagnosis and tumor treatment in three patients; and after treatment commenced in four patients. Two patients were thrombolyzed for a presumed stroke. Three patients had either their tumor surgery or chemoradiotherapy delayed. Diagnosis and management of FND enabled tumor treatment to restart. The systematic review identified 43 patients. Thirty-nine had functional seizures, and four had motor FND. All FNDs except one started after tumor treatment commenced.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Acute FND can occur at any stage of a brain tumor illness. The FND may lead to unnecessary medical interventions and can disrupt tumor treatment. Although acute FND improved with diagnosis and explanation, many neuro-oncology patients require a multidisciplinary tumor–FND pathway to manage acute FND and avoid delays to tumor treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9081,"journal":{"name":"Brain and Behavior","volume":"15 12","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12665190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145629675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ramazan Paşahan, Funda Kavak Budak, Serdar Saritaş, Mustafa Kavak, Fatma Melike Erkan, Sabır Akar
Aim
This study was conducted to investigate the effects of positive psychotherapy-based education on pain, psychological resilience, and mental well-being after lumbar canal stenosis surgery.
Materials and Methods
A randomized controlled experimental study was conducted with 66 participants (33 control, 33 experimental) at the Brain and Neurosurgery Department of Medical Center X between March 2025 and July 2025. The control group received no intervention, while the experimental group received 8 weeks of psychoeducation based on positive psychotherapy. Pretests were administered to the control and experimental groups in March 2025. The training of the experimental group was administered between April 2025 and May 2025. Data collection tools included the Descriptive Characteristics Form, Pain Scale, Brief Resilience Scale, and Mental Well-Being Scale. It was determined that the data showed normal distribution, and parametric tests were used in the analyses. Chi-square and Fisher's exact tests were used to compare the descriptive characteristics of the patients in the experimental and control groups. A t-test was applied to the dependent and independent groups to determine the effect of the training.
Findings
In the study, no statistically significant difference was found in the comparison of the pretest pain, psychological resilience, and mental well-being scales of the control and experimental groups (p = 0.259, p = 0.177, p = 0.428). In the study, a statistically significant difference was found in the comparison of the posttest pain, psychological resilience, and mental well-being scales of the control and experimental groups (p = 0.001). In the study, a statistically significant difference was found in the pretest–posttest pain, psychological resilience and mental well-being scale total score averages of the experimental group (p = 0.001).
Conclusion and Recommendations
Positive psychotherapy-based education was effective in reducing pain and increasing psychological resilience, and mental well-being in patients after lumbar spinal stenosis surgery. Based on these findings, positive psychotherapy-based education can be recommended as an adjunct to pharmacological treatment for not only physical but also psychological recovery.
目的：本研究旨在探讨积极心理治疗教育对腰椎管狭窄手术后疼痛、心理弹性和心理健康的影响。材料与方法：于2025年3月至2025年7月在X医学中心脑神经外科进行了66例随机对照实验研究，其中对照组33例，实验组33例。对照组不进行干预，实验组在积极心理治疗基础上进行8周的心理教育。对照组和实验组于2025年3月进行预试。实验组的训练时间为2025年4月至2025年5月。数据收集工具包括描述性特征表、疼痛量表、简短恢复力量表和心理健康量表。确定数据呈正态分布，并采用参数检验进行分析。采用卡方检验和Fisher精确检验比较实验组和对照组患者的描述性特征。对独立组和依赖组进行t检验，以确定训练的效果。研究结果：在本研究中，对照组与实验组的测前疼痛、心理弹性、心理幸福感量表比较，差异无统计学意义（p = 0.259, p = 0.177, p = 0.428）。在本研究中，对照组和实验组在测试后疼痛、心理弹性和心理健康量表上的差异有统计学意义（p = 0.001）。在本研究中，实验组的前测后疼痛、心理弹性和心理健康量表总得分平均值差异有统计学意义（p = 0.001）。结论与建议：以积极心理治疗为基础的教育能有效减轻腰椎管狭窄术后患者的疼痛，提高患者的心理弹性和心理幸福感。基于这些发现，积极心理治疗为基础的教育可以作为药物治疗的辅助手段，不仅用于身体康复，也用于心理康复。
{"title":"Effects of Positive Psychotherapy-Based Education on Pain, Psychological Resilience, and Mental Well-Being After Lumbar Canal Stenosis Surgery: A Randomized Controlled Trial","authors":"Ramazan Paşahan, Funda Kavak Budak, Serdar Saritaş, Mustafa Kavak, Fatma Melike Erkan, Sabır Akar","doi":"10.1002/brb3.70873","DOIUrl":"10.1002/brb3.70873","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study was conducted to investigate the effects of positive psychotherapy-based education on pain, psychological resilience, and mental well-being after lumbar canal stenosis surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A randomized controlled experimental study was conducted with 66 participants (33 control, 33 experimental) at the Brain and Neurosurgery Department of Medical Center X between March 2025 and July 2025. The control group received no intervention, while the experimental group received 8 weeks of psychoeducation based on positive psychotherapy. Pretests were administered to the control and experimental groups in March 2025. The training of the experimental group was administered between April 2025 and May 2025. Data collection tools included the Descriptive Characteristics Form, Pain Scale, Brief Resilience Scale, and Mental Well-Being Scale. It was determined that the data showed normal distribution, and parametric tests were used in the analyses. Chi-square and Fisher's exact tests were used to compare the descriptive characteristics of the patients in the experimental and control groups. A <i>t</i>-test was applied to the dependent and independent groups to determine the effect of the training.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>In the study, no statistically significant difference was found in the comparison of the pretest pain, psychological resilience, and mental well-being scales of the control and experimental groups (<i>p</i> = 0.259, <i>p</i> = 0.177, <i>p</i> = 0.428). In the study, a statistically significant difference was found in the comparison of the posttest pain, psychological resilience, and mental well-being scales of the control and experimental groups (<i>p</i> = 0.001). In the study, a statistically significant difference was found in the pretest–posttest pain, psychological resilience and mental well-being scale total score averages of the experimental group (<i>p</i> = 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion and Recommendations</h3>\u0000 \u0000 <p>Positive psychotherapy-based education was effective in reducing pain and increasing psychological resilience, and mental well-being in patients after lumbar spinal stenosis surgery. Based on these findings, positive psychotherapy-based education can be recommended as an adjunct to pharmacological treatment for not only physical but also psychological recovery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9081,"journal":{"name":"Brain and Behavior","volume":"15 12","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12665189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145629599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lang Yu, Bin Gao, Lingling Sun, Jing Mu, Piaopiao Zhang, Qin Zhang, Huanzhong He, He Liu
<div> <section> <h3> Introduction</h3> <p>Surgery can induce insulin resistance (IR) in diabetic patients, and severe IR compromises the body's ability to combat infection and shock, impairs the provision of high metabolic energy required post-surgery, and delays wound healing. Local infiltration anesthesia is commonly employed for postoperative pain management due to its simplicity, cost-effectiveness, and efficacy. However, research on optimal anesthetic formulations for incisional subcutaneous infiltration anesthesia that promote wound healing in diabetic patients remains limited. This study aims to investigate the effect of dezocine and dexmedetomidine as adjuvants in ropivacaine incision subcutaneous infiltration anesthesia on incision healing in diabetic rats.</p> </section> <section> <h3> Methods</h3> <p>Six groups, each comprising 18 diabetic rats, were randomly assigned. Following wound suturing, 1 mL of liquid was administered as subcutaneous infiltration anesthesia at the incision site. The compositions of the liquids were as follows: Group A received 0.375% ropivacaine, Group B received 0.375% ropivacaine plus 0.05 mg dezocine, Group C received 0.375% ropivacaine plus 0.005 mg dexmedetomidine, Group D received 0.375% ropivacaine plus 0.05 mg dezocine and 0.005 mg dexmedetomidine, Group E received normal saline plus 0.05 mg dezocine and 0.005 mg dexmedetomidine, and Group M received normal saline. The incision healing process was evaluated on Days 3, 7, and 14 post-suturing. CD31 and CD68 expression levels in the incision tissues were quantified using mean optical density (MOD), and collagen volume fraction (CVF) was determined via Masson staining.</p> </section> <section> <h3> Results</h3> <p>The findings indicated that on Days 3, 7, and 14, Group D exhibited markedly superior incision healing compared to the other five groups. Conversely, Group M demonstrated inferior incision healing relative to the other groups. Microscopic examination revealed that Group D's enhanced function was attributed to improved tissue structure of incision neovascularization, characterized by larger vascular lumen diameters and more densely packed vascular endothelial cells. On Day 3, Group D showed significantly higher CD31 expression levels compared to the other five groups, while Group M exhibited notably lower CD31 expression. This trend persisted on Days 7 and 14, with Group D maintaining substantially higher CD31 expression. Similarly, on Day 3, Group D displayed significantly higher CD68 expression compared to the other groups, whereas Group M had significantly lower CD68 expression. This pattern was consistent on Days 7 and 14 as well. Additionally,
{"title":"Effect of Dezocine and Dexmedetomidine as Adjuvants in Ropivacaine for Incision Subcutaneous Infiltration Anesthesia on Incision Healing in Diabetic Rats","authors":"Lang Yu, Bin Gao, Lingling Sun, Jing Mu, Piaopiao Zhang, Qin Zhang, Huanzhong He, He Liu","doi":"10.1002/brb3.71111","DOIUrl":"10.1002/brb3.71111","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Surgery can induce insulin resistance (IR) in diabetic patients, and severe IR compromises the body's ability to combat infection and shock, impairs the provision of high metabolic energy required post-surgery, and delays wound healing. Local infiltration anesthesia is commonly employed for postoperative pain management due to its simplicity, cost-effectiveness, and efficacy. However, research on optimal anesthetic formulations for incisional subcutaneous infiltration anesthesia that promote wound healing in diabetic patients remains limited. This study aims to investigate the effect of dezocine and dexmedetomidine as adjuvants in ropivacaine incision subcutaneous infiltration anesthesia on incision healing in diabetic rats.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Six groups, each comprising 18 diabetic rats, were randomly assigned. Following wound suturing, 1 mL of liquid was administered as subcutaneous infiltration anesthesia at the incision site. The compositions of the liquids were as follows: Group A received 0.375% ropivacaine, Group B received 0.375% ropivacaine plus 0.05 mg dezocine, Group C received 0.375% ropivacaine plus 0.005 mg dexmedetomidine, Group D received 0.375% ropivacaine plus 0.05 mg dezocine and 0.005 mg dexmedetomidine, Group E received normal saline plus 0.05 mg dezocine and 0.005 mg dexmedetomidine, and Group M received normal saline. The incision healing process was evaluated on Days 3, 7, and 14 post-suturing. CD31 and CD68 expression levels in the incision tissues were quantified using mean optical density (MOD), and collagen volume fraction (CVF) was determined via Masson staining.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The findings indicated that on Days 3, 7, and 14, Group D exhibited markedly superior incision healing compared to the other five groups. Conversely, Group M demonstrated inferior incision healing relative to the other groups. Microscopic examination revealed that Group D's enhanced function was attributed to improved tissue structure of incision neovascularization, characterized by larger vascular lumen diameters and more densely packed vascular endothelial cells. On Day 3, Group D showed significantly higher CD31 expression levels compared to the other five groups, while Group M exhibited notably lower CD31 expression. This trend persisted on Days 7 and 14, with Group D maintaining substantially higher CD31 expression. Similarly, on Day 3, Group D displayed significantly higher CD68 expression compared to the other groups, whereas Group M had significantly lower CD68 expression. This pattern was consistent on Days 7 and 14 as well. Additionally, ","PeriodicalId":9081,"journal":{"name":"Brain and Behavior","volume":"15 12","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12665211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145629664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jia Fu, Jing Zhao, Na Mi, Chao Zhang, Yali Zhang, Lifen Yao
Background
The pathogenesis of Parkinson's disease (PD) is closely linked to ferroptosis, yet the mechanism by which ferroptosis-related proteins modulate PD risk through genetic variations remains unclear.
Methods
We performed two-sample Mendelian randomization (MR) analyses using protein quantitative trait loci (pQTLs) from the UKB-PPP and deCODE studies as instrumental variables, combined with PD genome-wide association study (GWAS) data. The inverse variance weighting (IVW) method served as the primary analytical approach to identify PD-associated proteins. To assess the role of ferroptosis-related proteins in PD, a two-step MR mediation analysis was conducted, followed by multiple sensitivity analyses. Transcriptomic datasets were analyzed to confirm the differential expression of genes encoding prioritized proteins. Publicly available single-cell RNA sequencing data were utilized to investigate cell-type-specific expression patterns and functional pathways of key proteins.
Results
A total of 210 proteins significantly associated with PD were identified (p<0.05). Mediation analysis demonstrated that CCNE1 mediated 44.17% of the neuroprotective effect (β = −0.503, p = 5.8 × 10−4) through upregulating PARP16 expression (β = 0.318, p = 2.36 × 10−18), with CCNE1's differential expression further validated in transcriptomic datasets. Single-cell analysis demonstrated that CCNE1 and PARP16 are specifically highly expressed in neurons (p < 0.05), with neurons being significantly enriched in neural survival and synaptic plasticity pathways. The cell interaction network revealed that neurons specifically communicate with astrocytes via the NRG3-ERBB4 pathway.
Conclusion
This study provides the first molecular insight into how CCNE1 exerts neuroprotective effects through the regulation of the ferroptosis key protein PARP16, offering a novel perspective for PD mechanism research.
背景：帕金森病（PD）的发病机制与铁下垂密切相关，但铁下垂相关蛋白通过遗传变异调节PD风险的机制尚不清楚。方法：我们使用UKB-PPP和deCODE研究中的蛋白质数量性状位点（pqtl）作为工具变量，结合PD全基因组关联研究（GWAS）数据，进行了两样本孟德尔随机化（MR）分析。逆方差加权（IVW）方法是鉴定pd相关蛋白的主要分析方法。为了评估铁枯相关蛋白在PD中的作用，进行了两步MR中介分析，然后进行了多重敏感性分析。对转录组学数据集进行分析，以确认编码优先蛋白的基因的差异表达。利用公开可用的单细胞RNA测序数据来研究细胞类型特异性表达模式和关键蛋白的功能途径。结果：通过上调PARP16表达，共鉴定出210个与PD显著相关的蛋白（p-4） （β = 0.318, p = 2.36 × 10-18）， CCNE1的差异表达在转录组学数据中得到进一步验证。单细胞分析表明，CCNE1和PARP16在神经元中特异性高表达(p)。结论：本研究首次从分子角度揭示了CCNE1如何通过调控铁凋亡关键蛋白PARP16发挥神经保护作用，为PD机制研究提供了新的视角。
{"title":"CCNE1 Exerts a Protective Effect on Parkinson's Disease by Regulating Ferroptosis-Related Proteins","authors":"Jia Fu, Jing Zhao, Na Mi, Chao Zhang, Yali Zhang, Lifen Yao","doi":"10.1002/brb3.71110","DOIUrl":"10.1002/brb3.71110","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The pathogenesis of Parkinson's disease (PD) is closely linked to ferroptosis, yet the mechanism by which ferroptosis-related proteins modulate PD risk through genetic variations remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed two-sample Mendelian randomization (MR) analyses using protein quantitative trait loci (pQTLs) from the UKB-PPP and deCODE studies as instrumental variables, combined with PD genome-wide association study (GWAS) data. The inverse variance weighting (IVW) method served as the primary analytical approach to identify PD-associated proteins. To assess the role of ferroptosis-related proteins in PD, a two-step MR mediation analysis was conducted, followed by multiple sensitivity analyses. Transcriptomic datasets were analyzed to confirm the differential expression of genes encoding prioritized proteins. Publicly available single-cell RNA sequencing data were utilized to investigate cell-type-specific expression patterns and functional pathways of key proteins.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 210 proteins significantly associated with PD were identified (<i>p</i><0.05). Mediation analysis demonstrated that CCNE1 mediated 44.17% of the neuroprotective effect (<i>β</i> = −0.503, <i>p</i> = 5.8 × 10<sup>−4</sup>) through upregulating PARP16 expression (<i>β</i> = 0.318, <i>p</i> = 2.36 × 10<sup>−18</sup>), with CCNE1's differential expression further validated in transcriptomic datasets. Single-cell analysis demonstrated that CCNE1 and PARP16 are specifically highly expressed in neurons (<i>p</i> < 0.05), with neurons being significantly enriched in neural survival and synaptic plasticity pathways. The cell interaction network revealed that neurons specifically communicate with astrocytes via the NRG3-ERBB4 pathway.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study provides the first molecular insight into how CCNE1 exerts neuroprotective effects through the regulation of the ferroptosis key protein PARP16, offering a novel perspective for PD mechanism research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9081,"journal":{"name":"Brain and Behavior","volume":"15 12","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12664902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145629651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lanzhen Chen, Obai Yousef, Amr Elrosasy, Khalid Sarhan, Moaz Elsayed Abouelmagd, Munzer Naima, Alshaimaa Galal, Linda Alkassas, Ahmed A. Abo Elnaga, Ibrahim Serag
<div> <section> <h3> Background</h3> <p>Stroke is a leading cause of morbidity and mortality worldwide, and patients admitted to intensive care units (ICUs) who require mechanical ventilation face an even higher risk of adverse outcomes, including increased mortality. Effective management in ICUs is crucial to improve patient outcomes.</p> </section> <section> <h3> Aim</h3> <p>This systematic review and meta-analysis aimed to synthesize existing evidence on the risk factors associated with mortality in stroke patients admitted to any form of critical care units.</p> </section> <section> <h3> Methods</h3> <p>A comprehensive search was conducted across four databases: PubMed, Web of Science, Scopus, and Embase, up to July 9, 2024. Studies were included if they evaluated mortality risk factors in adult stroke patients admitted to critical care units. Data were extracted and analyzed using a random-effects model to account for heterogeneity. Odds ratios (OR) and 95% confidence intervals (CI) were calculated for various risk factors.</p> </section> <section> <h3> Results</h3> <p>Eighteen studies involving 20,442 patients were included in the meta-analysis. Age was significantly associated with increased mortality (OR = 1.02; 95% CI: 1.01, 1.04). Lower Glasgow coma scale (GCS) scores were linked to higher mortality (OR = 0.93; 95% CI: 0.86, 1.01), though not statistically significant (<i>P</i> = 0.08). Higher National Institutes of Health Stroke Scale (NIHSS) scores showed a significant association with increased mortality (OR = 1.06; 95% CI: 1.03, 1.09), (<i>p</i> < 0.0001). Mechanical ventilation and higher body temperature (≥37.5°C) were associated with a higher risk of death (OR = 1.9; 95% CI: 1.65, 2.18) and (OR = 2.03; 95% CI: 1.56, 2.66) respectively. Atrial fibrillation (OR = 1.19; 95% CI: 1.06, 1.34) significantly contributed to mortality risk, while a higher body mass index (BMI) was not associated with a reduced risk of mortality (OR = 0.97; 95% CI: 0.92, 1.02).</p> </section> <section> <h3> Conclusion</h3> <p>This study highlights the critical importance of early identification and targeted management of high-risk stroke patients in critical care settings. Age, neurological status, respiratory support needs, and specific comorbidities are key factors that clinicians should consider improving survival outcomes. Further research is needed to refine these findings and optimize care strategies for critically ill stroke patients.</p>
{"title":"Risk Factors for Mortality in Stroke Patients Admitted to Critical Care Units: A Systematic Review and Meta-Analysis","authors":"Lanzhen Chen, Obai Yousef, Amr Elrosasy, Khalid Sarhan, Moaz Elsayed Abouelmagd, Munzer Naima, Alshaimaa Galal, Linda Alkassas, Ahmed A. Abo Elnaga, Ibrahim Serag","doi":"10.1002/brb3.71082","DOIUrl":"10.1002/brb3.71082","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Stroke is a leading cause of morbidity and mortality worldwide, and patients admitted to intensive care units (ICUs) who require mechanical ventilation face an even higher risk of adverse outcomes, including increased mortality. Effective management in ICUs is crucial to improve patient outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This systematic review and meta-analysis aimed to synthesize existing evidence on the risk factors associated with mortality in stroke patients admitted to any form of critical care units.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive search was conducted across four databases: PubMed, Web of Science, Scopus, and Embase, up to July 9, 2024. Studies were included if they evaluated mortality risk factors in adult stroke patients admitted to critical care units. Data were extracted and analyzed using a random-effects model to account for heterogeneity. Odds ratios (OR) and 95% confidence intervals (CI) were calculated for various risk factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighteen studies involving 20,442 patients were included in the meta-analysis. Age was significantly associated with increased mortality (OR = 1.02; 95% CI: 1.01, 1.04). Lower Glasgow coma scale (GCS) scores were linked to higher mortality (OR = 0.93; 95% CI: 0.86, 1.01), though not statistically significant (<i>P</i> = 0.08). Higher National Institutes of Health Stroke Scale (NIHSS) scores showed a significant association with increased mortality (OR = 1.06; 95% CI: 1.03, 1.09), (<i>p</i> < 0.0001). Mechanical ventilation and higher body temperature (≥37.5°C) were associated with a higher risk of death (OR = 1.9; 95% CI: 1.65, 2.18) and (OR = 2.03; 95% CI: 1.56, 2.66) respectively. Atrial fibrillation (OR = 1.19; 95% CI: 1.06, 1.34) significantly contributed to mortality risk, while a higher body mass index (BMI) was not associated with a reduced risk of mortality (OR = 0.97; 95% CI: 0.92, 1.02).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study highlights the critical importance of early identification and targeted management of high-risk stroke patients in critical care settings. Age, neurological status, respiratory support needs, and specific comorbidities are key factors that clinicians should consider improving survival outcomes. Further research is needed to refine these findings and optimize care strategies for critically ill stroke patients.</p>\u0000 ","PeriodicalId":9081,"journal":{"name":"Brain and Behavior","volume":"15 12","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12664908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145629662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To investigate the correlation between serum 25-hydroxyvitamin D3 (25-(OH)D3) levels and anxiety disorders in adolescents, and to assess the potential impact of vitamin D status on pediatric anxiety disorders, thereby providing clinical evidence for diagnosis and treatment.
Methods
This study included 124 adolescents with anxiety disorders who visited the pediatric outpatient department of Jingzhou First People's Hospital from January 2020 to December 2022 as the experimental group and 131 healthy adolescents who underwent physical examinations during the same period as the control group. Serum 25-(OH)D3 levels were compared between the two groups. Simple linear regression analysis was conducted to evaluate the predictive capacity of 25-(OH)D3 levels on anxiety scores in the experimental group. Additionally, 86 adolescents with anxiety disorders and 25-(OH)D deficiency or insufficiency in the experimental group received vitamin D supplementation for 12 weeks, and changes in anxiety scores before and after supplementation were analyzed to assess the effect of 25-(OH)D3 levels on anxiety disorders.
Results
The mean serum 25-(OH)D3 level in the experimental group [(16.48 ± 6.53) ng/ml] was significantly lower than that in the control group [(22.95 ± 7.25) ng/ml], with a statistically significant difference (p < 0.05). The prevalence of vitamin D deficiency and insufficiency was higher in the experimental group (69.35%) than in the control group (36.64%), with a statistically significant difference (p < 0.05). Furthermore, in the experimental group, anxiety scores were negatively correlated with serum 25-(OH)D3 levels, indicating that lower 25-(OH)D3 levels were associated with higher anxiety scores. After vitamin D supplementation, adolescents with anxiety disorders and 25-(OH)D deficiency or insufficiency exhibited reduced anxiety scores.
Conclusion
Vitamin D deficiency may represent a potential risk factor for anxiety disorders in adolescents and demonstrate some predictive value for these conditions. Vitamin D supplementation could potentially alleviate anxiety symptoms in adolescents.
{"title":"Serum 25-Hydroxyvitamin D3 Status in Adolescents With Anxiety Disorders: A Case-Control and Vitamin D Supplementation Substudy","authors":"Wan Linfang, Liu Yang","doi":"10.1002/brb3.71095","DOIUrl":"10.1002/brb3.71095","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the correlation between serum 25-hydroxyvitamin D3 (25-(OH)D3) levels and anxiety disorders in adolescents, and to assess the potential impact of vitamin D status on pediatric anxiety disorders, thereby providing clinical evidence for diagnosis and treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 124 adolescents with anxiety disorders who visited the pediatric outpatient department of Jingzhou First People's Hospital from January 2020 to December 2022 as the experimental group and 131 healthy adolescents who underwent physical examinations during the same period as the control group. Serum 25-(OH)D3 levels were compared between the two groups. Simple linear regression analysis was conducted to evaluate the predictive capacity of 25-(OH)D3 levels on anxiety scores in the experimental group. Additionally, 86 adolescents with anxiety disorders and 25-(OH)D deficiency or insufficiency in the experimental group received vitamin D supplementation for 12 weeks, and changes in anxiety scores before and after supplementation were analyzed to assess the effect of 25-(OH)D3 levels on anxiety disorders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean serum 25-(OH)D3 level in the experimental group [(16.48 ± 6.53) ng/ml] was significantly lower than that in the control group [(22.95 ± 7.25) ng/ml], with a statistically significant difference (<i>p</i> < 0.05). The prevalence of vitamin D deficiency and insufficiency was higher in the experimental group (69.35%) than in the control group (36.64%), with a statistically significant difference (<i>p</i> < 0.05). Furthermore, in the experimental group, anxiety scores were negatively correlated with serum 25-(OH)D<sub>3</sub> levels, indicating that lower 25-(OH)D<sub>3</sub> levels were associated with higher anxiety scores. After vitamin D supplementation, adolescents with anxiety disorders and 25-(OH)D deficiency or insufficiency exhibited reduced anxiety scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Vitamin D deficiency may represent a potential risk factor for anxiety disorders in adolescents and demonstrate some predictive value for these conditions. Vitamin D supplementation could potentially alleviate anxiety symptoms in adolescents.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9081,"journal":{"name":"Brain and Behavior","volume":"15 12","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12665044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145629680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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