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IntroductionDue to the anti-inflammatory and antioxidant properties of cynaroside (Cyn), it may be useful in the treatment of cerebral ischemia/reperfusion injury (I/R). This study aims to evaluate the effect of Cyn on cerebral ischemia/reperfusion injury.MethodsTransient middle cerebral artery occlusion model (tMCAO) and oxygen and glucose deprivation/reperfusion (OGD/R) microglia models were used to evaluate the effect of Cyn. The direct interaction between Cyn and Alox15 was investigated through bioinformatics, molecular docking and biolayer interferometry.ResultstMCAO mice treated with Cyn show improved neurological deficits, reduced infarct volume and edema, and inhibition of microglial activation. In addition, Cyn inhibited tMCAO-induced Alox15 expression. Cyn significantly reduced the overproduction of the M1 microglia-regulated pro-inflammatory cytokines NLRP3, ASC, and cleaved caspase-1, as well as the overproduction of IL-1β and IL-18, induced by tMCAO or OGD/R. Cyn also inhibits the expression of Tfrc, COX2, and Acsl4 in tMCAO and OGD/R-treated mice and BV-2 cells.DiscussionThese results suggest that Cyn may attenuate cerebral ischemia/reperfusion injury by inhibiting Alox15 to reduce inflammation and reduce ferroptosis. This study reveals the underlying molecular mechanism of Cyn in the treatment of ischemic stroke.

ObjectiveThe aim of this study was to investigate the correlation between sleep chronotype and metabolic markers to further reveal the influence of sleep chronotype on human health.MethodsThe Morningness-Eveningness Questionnaire was administered to 442 volunteers aged 23–70 years old. The sleep chronotype was divided into morning type (167 cases), neither type (224 cases), and evening type (51 cases). Blood pressure was recorded, and fasting venous blood samples were collected to assess liver function, renal function, blood glucose levels, blood lipid profile, and other biochemical parameters.Results1. There was a statistically significant difference in the age of the morning type, neither type, and evening type (p 0.05). 2. After controlling for the influence of age-related factors, significant differences were seen between morning type, neither type, and evening type groups in creatinine and aspartate aminotransferase (p

Background and purposeGuillain-Barré syndrome (GBS) is an autoimmune neurological disorder characterized by muscle weakness. In clinical trials, treatment benefit and disease severity are typically measured using clinician-reported outcome measures like the Hughes Functional Grading Scale (HFGS). However, patient-reported outcome measures, such as the Rasch-built Overall Disability Scale (R-ODS) may provide additional insight into the patient experience during treatment. In this study, exploratory analyses of clinical trial data were performed to investigate how existing clinician-reported outcomes and patient-reported outcomes can help to assess disease progression by providing an accurate measurement of functional status.MethodsData were collected as part of a phase 3 study to assess the safety and efficacy of eculizumab in patients in Japan with severe GBS. The association between HFGS score and R-ODS total centile score (linear measure of limitations; 0, most severe activity and social participation limitations and 100, no limitations) was assessed using the Spearman rank-order correlation coefficient. Threshold values of R-ODS total centile score that could differentiate between patients with an HFGS score of ≤ 1 and > 1 were determined using receiver-operating characteristic curve analyses and mapping (Rasch measurement theory). A triangulation approach was used to establish a proposed value for R-ODS total centile score equivalent to an HFGS score of ≤ 1 or > 1.ResultsOverall, 57 patients were included in this analysis. These exploratory analyses revealed good correlation between R-ODS total centile and HFGS scores. Using the Rasch model, mapping of HFGS to R-ODS scores showed a good fit. Evaluation of the R-ODS threshold that could approximate the functional motor symptom categories based on HFGS (score of 0 or 1) revealed a range of values from 60 to 80. Based on a trial sample, a threshold of 60 was found to have 100% sensitivity and 87% specificity at week 4, and 93.8% sensitivity and 77.8% specificity at week 24.ConclusionThis study established thresholds for the R-ODS total centile score that could approximate classification of functional impairment in GBS based on the HFGS score. Given that the R-ODS reflects the patient perspective, it may be used to capture a more complete picture of GBS severity.

IntroductionMild cognitive impairment (MCI) is an early stage of Alzheimer’s disease (AD), crucial for early diagnosis. BIN1, a key AD susceptibility gene after APOE, has higher brain expression in AD and interacts with tau, affecting its pathology. Specific BIN1 SNPs are linked to AD and MCI, but mechanisms are unclear. This study will explore how BIN1 polymorphisms might influence MCI development and correlate with hippocampal integrity in MCI patients using MRI.MethodsThis study enrolled a total of 52 elderly individuals with MCI and 55 cognitively CN individuals from five communities in Zhongshan Torch Development Zone. Blood samples were collected for analysis of BIN1 rs10200967, rs1060743, and rs4663093 gene polymorphisms, and MRI scans were conducted to assess the volume of hippocampal subregions. The study also seeks to examine the distribution of BIN1 genotypes in both MCI and healthy control populations, as well as to investigate the potential association between BIN1 rs10200967, rs1060743, and rs4663093 genotypes and hippocampal subregion structure in individuals with MCI.ResultsSignificant structural atrophy was observed in multiple hippocampal subregions, including left cornu ammonis (lCA), left dentate gyrus (lDG), left hippocampal-amygdaloid transition area (lHATA), left subiculum (lSubc), right ornu ammonis (rCA), right dentate gyrus (rDG), right subiculum (rSubc), left entire hippocampus complex (lHIP), and right entire hippocampus complex (rHIP) in seniors with MCI compared to those in the CN (p 0.05). Notably, there were no significant differences in the distribution of BIN1 rs10200967, rs1060743, and rs4663093 genotypes among elderly individuals (p > 0.05). Furthermore, the association between the BIN1 rs10200967 genotype and lHATA atrophy significant in the MCI after adjusting for age, gender, education level, APOEε4 status, and TIV (p

BackgroundRight-to-left shunt (RLS) associated with patent foramen ovale (PFO) is common among cryptogenic strokes. Current diagnostic tools have limitations. Transesophageal echocardiography (TEE) is not as sensitive as transthoracic echocardiography (TTE), TEE is invasive, and manual transcranial Doppler (TCD) requires trained staff to operate. Robotic automated TCD (raTCD) may be feasible and comparable to manual TCD. The study's purpose was to determine the rate of RLS detection using raTCD and combine the Spencer Logarithmic Scale (SLS) with the Risk of Paradoxical Embolism (RoPE) to identify patients at risk of PFO associated stroke or TIA.MethodsThis single-center retrospective cohort study included adult patients (≥18 y/o) admitted from December 2021 to December 2022 with a stroke or transient ischemic attack. Those with no bone window or stroke mimics were excluded. Patients with an RLS on raTCD received a second scan at the physician's discretion. The SLS combined with the RoPE score was used to generate a modified screening PFO-Associated Stroke Causal Likelihood (msPASCAL) classification.ResultsOf 212 patients who received raTCD, the mean age was 56, 14% were >65 years old, most were white (72%), predominantly male (59%), 52% had cryptogenic strokes, and 59% had an RLS. Most patients were able to perform Valsalva (89%) during raTCD. Of those with an RLS, 56% had an SLS of 1–2, while 44% had an SLS of 3–5. There were no significant differences in characteristics by SLS. Most patients with SLS grades 1–2 were classified using msPASCAL as unlikely to have PFO as stroke etiology (n = 55, 44%). A small number of large SLS grades 3–5 were considered probable for having a PFO-associated stroke while the rest were classified as possible (n = 38, 30.4%). Eight patients with positive RLS on raTCD had a negative TTE with bubbles; most of those had small RLS on raTCD (n = 5, 63%) or could not Valsalva due to sedation ((n = 6, 75%).DiscussionThis study supports the feasibility of utilizing raTCD for RLS detection. The modified screening PASCAL classification can be generated for RLS patients and may be used to guide subsequent evaluation and management.

IntroductionSpecial operations forces (SOF) are at particular risk of suffering from Posttraumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI), and often these two conditions are comorbid, with the inciting event causing both conditions. These conditions present with broad-band electroencephalogram (EEG) abnormalities that may be amenable to neuromodulation.MethodsThis retrospective chart review reports on preliminary safety and clinical response data of individualized neuromodulation in a cohort of SOF veterans suffering from symptoms of PTSD and TBI. 33 male SOF veterans with TBI and PTSD symptoms received α-guided repetitive transcranial magnetic stimulation (α-rTMS) 5 days per week, with the magnetic pulse frequency set to their individual alpha frequency (IAF). Data on clinical scale scores at baseline and conclusion of treatment were extracted, including Rivermead Post-Concussion Questionnaire (RPQ), PTSD Checklist for DSM-5 (PCL-5) and side-effects.ResultsThirty-three (33) charts containing pre-post scales for at least one of the clinical measures collected were reviewed. TBI symptom severity decreased an average of 54% on the RPQ (p

Background and aimsRecent studies reported that non-invasive imaging techniques for measuring optic nerve sheath diameter (ONSD) offer a novel diagnostic approach for intracranial pressure (ICP) elevation. However, whether ultrasound-measured ONSD sensitively evaluate the real-time ICP is unknown. This study explores the ability of different measurement modalities to predict ICP elevation, aiming to provide a superior non-invasive ICP monitoring technique for clinical practice.MethodsOptic nerve sheath (ONS) measurement using three modalities and ICP of 104 patients collected from January 2018 to May 2021 were analysis by correlation analysis and receiver operating characteristic curve analysis.ResultsSignificant correlations were observed between ICP and ONS measurement using three modalities (p 5.55 mm, ONS vertical diameter > 5.75 mm, left ONS area > 25.05 mm2 or right ONS area > 25.73 mm2, the patient was considered to have elevated ICP.ConclusionUltrasonic transverse scanning, longitudinal scanning, and area-based measurement of the retrobulbar ONS are excellent screening tools for the diagnosis of ICP. These three methods exhibited nearly identical levels of correlation, sensitivity, and specificity. All three measurement approaches demonstrated capabilities in diagnosing elevated ICP.

Although combination antiretroviral therapy (cART) has been widely applied and effectively extends the lifespan of patients infected with human immunodeficiency virus (HIV), these patients remain at a substantially increased risk of developing neurocognitive impairment, commonly referred to as HIV-associated neurocognitive disorders (HAND). Magnetic resonance imaging (MRI) has emerged as an indispensable tool for characterizing the brain function and structure. In this review, we focus on the applications of various MRI-based neuroimaging techniques in individuals infected with HIV. Functional MRI, structural MRI, diffusion MRI, and quantitative MRI have all contributed to advancing our comprehension of the neurological alterations caused by HIV. It is hoped that more reliable evidence can be achieved to fully determine the driving factors of cognitive impairment in HIV through the combination of multi-modal MRI and the utilization of more advanced neuroimaging analysis methods.

Background/ObjectivesPrimary progressive aphasia (PPA) is managed with speech-language therapy (SLT) to slow language decline. Pairing transcranial direct current stimulation (tDCS) with SLT can enhance its effects. However, further research is needed to confirm these findings and guide its clinical use. We evaluated the feasibility of providing an intervention combining tDCS with SLT as a home-based and remotely supervised intervention.MethodsParticipants with confirmed PPA who had word-finding difficulties were recruited for an open-label observational study. The intervention consisted of 20 daily sessions over 1 month, each with 45-min of personalized word retrieval training. During the first 30-min, participants received tDCS over the left inferior frontal gyrus (anode F7, cathode O1) at 2.0 mA. Language measures were remotely administered at baseline and intervention end.ResultsWe enrolled 10 patients (age: 70 ± 7 years; 60% male) with confirmed logopenic variant (n = 2), semantic variant (n = 2), or unspecified (n = 6) PPA. The intervention was well-tolerated with no treatment-limiting adverse events. All participants completed all sessions, confirming the feasibility of the home-based treatment. There were no declines in language functioning measures, with improved naming for trained vs. untrained items (p = 0.003) and a significant improvement in confrontation naming (p = 0.016) from baseline to intervention end.ConclusionsOur case series demonstrates that home-based tDCS added to SLT is feasible for patients with PPA. However, larger controlled studies are required to confirm its effectiveness in slowing language decline and to fully determine the benefits of this approach. This approach not only facilitates broader access to participation but also enables the extended treatment necessary to evaluate its clinical benefits, moving this treatment closer to clinical availability as a telehealth treatment.

BackgroundSome studies have shown a strong link between the central nervous system and peripheral immune system, but the prognostic implications of dynamic peripheral immune-inflammatory responses in patients with traumatic brain injury (TBI) remain unclear. This study aimed to determine the dynamic trajectory patterns of the Systemic Immune Inflammation Index (SII) in patients with TBI and assess its association with all-cause hospital mortality.MethodsThis retrospective cohort study utilized a large public database of patients with TBI sourced from the eICU Collaborative Research Database (eICU-CRD). Group-Based Trajectory Modeling (GBTM) was used to analyze daily SII trajectories during the initial 0–7 days of hospitalization. Logistic regression was employed to assess the relationship between different SII trajectory groups and hospital mortality. Receiver Operating Characteristic (ROC) curves were generated based on the logistic regression model.ResultsA total of 312 patients were included in this study, 52 of whom died during hospitalization. Using GBTM, three distinct SII trajectories were identified: Group 1 (low-level, rapid decline; 18.90%), Group 2 (moderate-level, slow decline; 60.20%), and Group 3 (sustained high-level; 20.80%). Compared to patients in Group 1, those in Groups 2 and 3 had a higher risk of all-cause hospital mortality (odds ratio [OR] 4.09; 95% confidence interval [CI] 1.21, 19.75) and (OR 5.84; 95% CI 1.52, 30.67), respectively. ROC analysis revealed an area under the curve (AUC) of 0.838, sensitivity: 75.0%, and specificity: 83.8% for mortality in this cohort.ConclusionThis study identified three distinct SII trajectories, suggesting that post-TBI SII trajectories are heterogeneous patterns associated with mortality. The sustained high-level SII trajectory may serve as a marker of disease deterioration, highlighting the need for targeted interventions. Describing the evolution of SII through GBTM and its correlation with clinical outcomes can enhance our understanding of the link between neuroinflammation and the peripheral immune system.

Cerebral small vessel disease (CSVD) is a complex clinical-imaging pathological syndrome caused by small vessel lesions in the brain, which is characterized by aging-related, insidious onset and slow progression. Apathy is a key component of the common neuropsychiatric symptoms among CSVD patients, severely affecting their daily lives and social functioning. Moreover, there are fewer studies on CSVD-related apathy, and greater attention should be paid to this condition in clinical practice. This article describes the latest research advances in the concept, epidemiological features, pathogenesis, assessment and diagnosis, imaging and biomarkers, and treatment of CSVD-related apathy, aiming to serve as a reference for the clinical diagnosis and prevention of CSVD-related apathy.

ObjectiveTo explore the value of delta radiomics from cerebral CT perfusion (CTP) in predicting hemorrhagic transformation after intravenous thrombolysis for acute cerebral infarction (HT-ACI).MethodsClinical and imaging data of 419 patients with acute cerebral infarction who underwent CTP after treatment between November 2016 and August 2024 were retrospectively collected. Based on post-thrombolysis cranial CT or MRI results, patients were divided into the HT-ACI group (114 cases) and the non-HT-ACI group (305 cases). The dataset was split into a training set and a test set in a 7:3 ratio based on time nodes. In the training set, regions of interest (ROI) within the cerebral infarction area on CTP images were delineated using 3D slicer software, and delta radiomic features were extracted. Hemodynamic parameters such as cerebral blood volume (CBV), cerebral blood flow (CBF), and time to peak (TTP) were obtained using CTP techniques. These were combined with baseline patient data (e.g., age, sex, NIHSS score, medical history) to establish various models for predicting HT-ACI through multivariable logistic regression analysis. The predictive performance of the models was compared using DeLong curves, clinical net benefit was assessed using decision curves, and model predictions were validated using the XGboost algorithm. These results were then validated in the test set, and a nomogram and calibration curve were constructed for clinical application.ResultsIn the training set, significant differences were observed between the two groups in NIHSS score, pre-illness usually use of anticoagulants, age, infarction size, ADC difference, CBF, and Delta radscore (P

IntroductionMigraine is a chronic, debilitating neurological disorder affecting billions worldwide. While not life-threatening, migraine patients experience significant unmet needs in diagnosis and management. Addressing these challenges could result in improvement of patient outcomes and reduction of the socioeconomic burden migraine imposes on individuals, healthcare system and the society.ObjectiveThis survey aimed to capture in Greece the perspective of medical experts (neurologists) specializing in migraine management regarding the socioeconomic burden of migraine and the unmet needs in diagnosis and treatment.MethodsAn online Delphi-based survey was conducted with 13 neurologists, experts in migraine. The survey consisted of 55 statements derived from literature research, regarding the burden of disease, diagnosis, treatment and unmet needs. Participants’ level of agreement for each statement was measured through a 5-point Likert scale (“Strongly Agree,” “Agree,” “Neither Agree nor Disagree,” “Disagree” and “Strongly Disagree”). Three rounds of voting were conducted to achieve consensus. The consensus threshold was set at 70% of responses, focusing on “Strongly Agree”/ “Agree” or “Disagree”/ “Strongly Disagree.”ResultsMost experts agreed on statements emphasizing on financial and social impact of the disease and its epidemiology. However, consensus was not reached on statements concerning patient preferences for treatment administration, treatment adherence, opioid use, and frequency of visits to neurologists. Consensus was reached on the need for better healthcare professional training and the development of effective, safe treatments.ConclusionThis survey highlighted the challenges of prompt diagnosis and effective management of migraine. Addressing these needs requires patient-centered approaches, enhanced healthcare-provider training, tailored therapeutic interventions, and advanced communication platforms.

BackgroundIschemic stroke is a major cause of death and morbidity, and risk classification is essential for predicting therapeutic outcomes. MicroRNAs may be useful indicators for risk stratification, as they control gene expression and influence physiological and pathological processes.MethodologyA systematic strategy was developed to search relevant material using databases like PubMed, Scopus, and Web of Science. Selection criteria included human research, a certain date, or categories of studies. Data extraction, synthesis, and analysis were carried out to find trends, similarities, and differences among the chosen studies. The study’s design, sample size, methodology, statistical analysis, and any potential biases or restrictions from the selected reference papers were also taken into account.Results and findingsMicroRNA is an important biomarker for risk stratification in Ischemic Strokes. It can be used to identify Stroke-Specific microRNA Signatures, identify diagnostic and prognostic values, and regulate Vascular Inflammation, Endothelial Dysfunction, and Thrombus Formation and Resolution. It also has potential therapeutic applications.ConclusionMicroRNAs have emerged as promising biomarkers for predicting stroke risk, severity of strokes, and clinical outcomes. They can be used to predict the severity of a stroke and aid clinicians in making treatment decisions.

BackgroundIntracerebral hemorrhage (ICH) is associated with high mortality and morbidity rates. Although some studies have indicated a correlation between serum bilirubin levels and ICH severity, evidence of the relationship between serum total bilirubin (TBIL) and ICH outcomes remains lacking.MethodsA total of 914 patients from the Medical Information Mart for Intensive Care IV database met the eligibility criteria and were included in the study. The patients were categorized into two groups based on whether they survived for 28 days following admission to hospital. The association between serum TBIL levels and 28-day survival in patients with ICH was investigated using Spearman’s correlation analysis and restricted cubic splines. The effect of serum TBIL levels on survival time and rate in the 28-day period was analyzed using Kaplan–Meier curves and restricted mean survival times. Univariate Cox regression, least absolute shrinkage and selection operator regression, and multivariate Cox regression were used to identify risk factors associated with 28-day all-cause mortality. Finally, subgroup analysis was performed to verify the stability of the association between serum TBIL levels and 28-day all-cause mortality in patients with ICH.ResultsA negative relationship was revealed between TBIL levels and survival (p

BackgroundDelirium is a common manifestation of acute brain dysfunction among patients in the Intensive Care Unit (ICU), afflicting an estimated 30–35% of this vulnerable population. The prevalence of delirium in ICU settings has catalyzed a surge in academic interest, as evidenced by a growing body of literature on the subject. This study seeks to synthesize the progress in understanding ICU delirium through a bibliometric analysis.MethodsWe conducted a comprehensive search of the Web of Science Core (WOS) Collection database for literature on ICU delirium, focusing on studies published between 2013 and 2023. Our analysis utilized two bibliometric software tools, Citespace and VOSviewer, to scrutinize the data across various dimensions, including country contributions, authorship patterns, publishing journals, key thematic terms, and other pertinent metrics, with the aim of identifying emerging trends in the field.ResultsOur search yielded a total of 1,178 publications on ICU delirium within the WOS database from January 2013 to June 2023. The United States emerged as the leading contributor in terms of published articles, with Ely, E. Wesley being the most prolific author, having published 85 articles, and “Critical Care Medicine” as the journal with the highest number of publications, totaling 105. The application of literature clustering and keyword analysis revealed that future research is poised to delve deeper into areas such as pediatric delirium, risk factors, and the development of preventive and therapeutic strategies.ConclusionThis study employs bibliometric analysis to provide a multifaceted overview of the ICU delirium research landscape over the past decade. By examining the topic from various perspectives, we have not only mapped the current state of ICU delirium research but also illuminated potential avenues for future inquiry and areas of emphasis.

Amyotrophic Lateral Sclerosis (ALS) is a neurodegenerative disorder leading to upper and lower motoneurons degeneration. Although several mechanisms potentially involved in disease development have been identified, its pathogenesis is not fully understood. From the patient side, ALS diagnosis, still based on clinical criteria, can be difficult and may take up to 1 year. More than 30 genes have been associated to genetically inherited ALS, among which four (C9ORF72, SOD1, TARDBP and FUS) would explain around 60–70% of cases. However, familial ALS represents only 5–10% of ALS cases while the remaining are sporadic, with genetics explaining 6–10% of such cases only. In this context, short tandem repeats (STRs) expansions, have recently been found in clinically diagnosed ALS patients. In this review, we discuss the recent discoveries on ALS associated STRs and their potential as biomarkers as well as prognosis and therapy targets.

IntroductionComputed tomography angiography (CTA) was used to explore the correlation between the calcification types of carotid plaques and ipsilateral acute ischemic stroke. This could provide new insights into the clinical evaluation and treatment of ischemic stroke.MethodsThis study obtained information on patients undergoing head and neck CTA examinations at the First People's Hospital of Lianyungang between September 2022 and August 2023 to investigate the clinical differences in baseline data between the acute ischemic stroke and control groups. Patients meeting the inclusion and exclusion criteria were classified into 1 to 6 groups according to their plaque calcification characteristics. The correlation between calcified plaque type and ipsilateral acute ischemic anterior circulation stroke was analyzed using paired sample chi-square and Spearman correlation tests.ResultsBased on the inclusion and exclusion criteria, this study included 589 patients with plaques at the bifurcation of the carotid arteries. In both the acute ischemic stroke and control groups, sex, smoking, alcohol consumption, systolic blood pressure, blood sugar, cholesterol, high-density lipoprotein, and homocysteine levels were statistically significant (p < 0.05). During the Spearman correlation analysis between calcification type and acute stroke (1,178 carotid arteries), different calcification types of plaques were linked with ipsilateral acute anterior circulation stroke with statistically significant differences (p < 0.001). Finally, the chi-squared test of the paired samples showed that the grade of plaque calcification is often higher on the side of acute infarction than on the side without acute infarction, and the difference is statistically significant (p < 0.001).DiscussionCarotid plaque calcification is associated with acute ischemic stroke. Our findings provide novel insights into the study of calcification in carotid atherosclerotic plaques and additional radiological evidence to clinically assess the risk of ischemic stroke.

IntroductionAlthough medical imaging plays a crucial role in stroke management, machine learning (ML) has been increasingly used in this field, particularly in lesion segmentation. Despite advances in acquisition technologies and segmentation architectures, one of the main challenges of subacute stroke lesion segmentation in computed tomography (CT) imaging is image contrast.MethodsTo address this issue, we propose a method to assess the contrast quality of an image dataset with a ML trained model for segmentation. This method identifies the critical contrast level below which the medical-imaging model fails to learn meaningful content from images. Contrast measurement relies on the Fisher's ratio, estimating how well the stroke lesion is contrasted from the background. The critical contrast is found-thanks to the following three methods: Performance, graphical, and clustering analysis. Defining this threshold improves dataset design and accelerates training by excluding low-contrast images.ResultsApplication of this method to brain lesion segmentation in CT imaging highlights a Fisher's ratio threshold value of 0.05, and training validation of a new model without these images confirms this with similar results with only 60% of the training data, resulting in an almost 30% reduction in initial training time. Moreover, the model trained without the low-contrast images performed equally well with all images when tested on another database.DiscussionThis study opens discussion with clinicians concerning the limitations, areas for improvement, and strategies for enhancing datasets and training models. While the methodology was only applied to stroke lesion segmentation in CT images, it has the potential to be adapted to other tasks.

IntroductionThis bibliometric study systematically analyzes the research landscape of electroacupuncture (EA), focusing on its applications in pain relief and emotional regulation from 2014 to 2024. EA, a contemporary adaptation of traditional acupuncture, has gained significant attention for its potential therapeutic benefits in managing chronic pain and mood disorders.MethodsUsing the Web of Science Core Collection as the primary data source, we identified 537 articles related to EA’s therapeutic effects. The analysis was conducted using bibliometric tools such as VOSviewer and CiteSpace to visualize publication trends, research hotspots, and collaborative networks.ResultsThe study highlights a significant upward trend in research output, with a marked increase in publications from 2019 onwards. China emerged as the leading contributor, accounting for over 60% of the total research output, followed by the United States and South Korea. Key institutions, such as Zhejiang Chinese Medical University and Shanghai University of Traditional Chinese Medicine, have made substantial contributions, emphasizing the importance of traditional Chinese medicine in this research area. Major research themes include the modulation of neurotransmitter systems, the role of endogenous opioids, and the impact of EA on chronic pain and mood disorders. Collaborative networks between countries and institutions are mapped, revealing the centrality of Chinese and American research partnerships.DiscussionThis comprehensive analysis outlines the current state of EA research and identifies gaps and opportunities for future studies, particularly in understanding the mechanistic pathways of EA and its integration into mainstream medical practices. The findings provide a roadmap for enhancing the therapeutic applications of EA and underscore its potential in managing complex conditions involving both physical and emotional components.

BackgroundIn recent years, we have witnessed a continuous, evidence-based expansion of indications for endovascular therapy (EVT) in the treatment of ischaemic stroke, driven by advancements in extended time windows and target vessel occlusion. Our study aimed to evaluate the temporal changes in patients’ characteristics, treatment, and outcomes in clinical practice.MethodsWe used data from the German Stroke Registry, a large national multicentre prospective registry, which includes all patients receiving EVT for ischaemic stroke at its participating centers. We analysed baseline factors, treatment details, and clinical outcomes [Modified Rankin Scale (mRS) at 3 months] over a 5-year period (2017–2021).ResultsWe included 6,251 patients from eight centres. Over time, the characteristics of patients undergoing EVT changed in several aspects (2017 vs. 2021). Patients became older (median age from 76 [IQR: 65–82] to 77 [65–84 years]; ptrend = 0.02), and less severely affected (NIHSS from 15 [11–19] to 13 [8–18]; ptrend

BackgroundCytokines are powerful immune response factors that operate at inflammation sites and are also found in the blood. Nevertheless, research on encephalitis and these circulating inflammatory proteins is quite limited.MethodsThis study investigated the potential causal effects of 91 circulating inflammatory proteins on three different types of encephalitis using a two-sample Mendelian randomisation analysis. The data source for encephalitis was the latest Finngen_R12 dataset, released in 2024. The study investigated causal effects mainly using Steiger, MR-Egger, weighted median and inverse variance weighting (IVW) methods. In addition, sensitivity analyses were performed, including heterogeneity assessment, horizontal pleiotropy and leave-one-out techniques.ResultsIn this study, 91 circulating inflammatory proteins were subjected to MR analysis of causality with each of the three types of encephalitis. The results suggest that the inflammatory factors with a potential causal relationship with viral encephalitis are artemin, C-C motif chemokine 28, C-X-C motif chemokine 1, interleukin-10 and neurotrophin-3. Inflammatory factors potentially causally associated with acute disseminated encephalomyelitis are monocyte chemoattractant protein 2, interleukin-10 receptor subunit beta and matrix metalloproteinase-1. Inflammatory factors potentially causally associated with autoimmune encephalitis are C-C motif chemokine 28 levels and Macrophage inflammatory protein 1a levels.ConclusionThis study identifies potential causal effects of certain circulating inflammatory factors on susceptibility to three types of encephalitis. Although the exact mechanisms by which inflammatory proteins contribute to the pathogenesis of different encephalitis subtypes remain unclear, our findings provide new perspectives on these potential causal relationships.

BackgroundPeak width of skeletonized mean diffusivity (PSMD) is a novel marker of small vessel disease. This study aimed to investigate the presence of small vessel disease in patients with occipital lobe epilepsy (OLE) using PSMD.MethodsWe enrolled 27 patients newly diagnosed with OLE and included 29 healthy controls. The age and sex of the patients and controls were comparable. Diffusion tensor imaging (DTI) was performed using a 3 T MRI scanner. We measured the PSMD based on DTI in several steps, including preprocessing, skeletonization, application of a custom mask, and histogram analysis, using the FSL program. We compared PSMD between patients with OLE and healthy controls. Additionally, we performed a correlation analysis between PSMD and clinical factors in patients with OLE.ResultsOur findings revealed that the patients with OLE exhibited higher PSMD compared to healthy controls (2.459 vs. 2.079 × 10−4 mm2/s, p

BackgroundThe effects of the menstrual cycle on neuropsychiatric and physical symptoms have been examined in multiple psychiatric illnesses, but research on Tourette syndrome (TS) and menstruation is limited and inconclusive. One study published in 1992 reported that 34% of female respondents experienced tic fluctuations with their menstrual cycles; however, a subsequent 2001 study found no significant relationship between menstrual cycle-related hormonal changes and tic symptoms across participants. There has been no further published exploration of this topic in the intervening 20+ years, and thus these discrepant results have not been reconciled. The current study aimed to assess tic changes across the menstrual cycle and to explore clinical predictors of tic fluctuations in adult females with TS.MethodsAn online survey was completed by 112 of 315 eligible female adults with TS. Respondents were asked to share their age of TS symptom onset, history of OCD and ADHD diagnoses, and current tic symptoms and severity. Participants also retrospectively reported their experiences with fluctuations in tics and other physical and psychiatric symptoms over the course of the menstrual cycle.Results26% of the 112 respondents endorsed tic changes in relation to their menstrual cycles. Univariable and multivariable logistic regression demonstrated that higher current tic severity and impairment as well as co-occurring cycle-related mood and anxiety changes significantly predicted the presence of self-reported tic fluctuations during the menstrual cycle.DiscussionResults suggest that some females with TS experience changes in tic symptoms during their menstrual cycles, although future research is required to clarify the complex relationships between the menstrual cycle, tics, and other psychiatric symptoms. The low response rate, retrospective recall of symptoms, and lack of information about hormonal influences such as contraceptives and menopause are notable study limitations.

PurposeThis study aims to develop hippocampal texture model for predicting cognitive impairment in middle-aged patients with cerebral small vessel disease (CSVD).MethodsThe dataset included 145 CSVD patients (Age, 52.662 ± 5.151) and 99 control subjects (Age, 52.576±4.885). An Unet-based deep learning neural network model was developed to automate the segmentation of the hippocampus. Features were extracted for each subject, and the least absolute shrinkage and selection operator (LASSO) method was used to select radiomic features. This study also included the extraction of total intracranial volume, gray matter, white matter, cerebrospinal fluid, white matter hypertensit, and hippocampus volume. The performance of the models was assessed using the areas under the receiver operating characteristic curves (AUCs). Additionally, decision curve analysis (DCA) was conducted to justify the clinical relevance of the study, and the DeLong test was utilized to compare the areas under two correlated receiver operating characteristic (ROC) curves.ResultsNine texture features of the hippocampus were selected to construct radiomics model. The AUC values of the brain volume, radiomics, and combined models in the test set were 0.593, 0.843, and 0.817, respectively. The combination model of imaging markers and hippocampal texture did not yield improved a better diagnosis compared to the individual model (p > 0.05).ConclusionThe hippocampal texture model is a surrogate imaging marker for predicting cognitive impairment in middle-aged CSVD patients.

IntroductionThe brain’s spontaneous neural activity can be recorded during rest using resting state functional magnetic resonance imaging (rs-fMRI), and intricate brain functional networks and interaction patterns can be discovered through correlation analysis. As a crucial component of rs-fMRI analysis, effective connectivity analysis (EC) may provide a detailed description of the causal relationship and information flow between different brain areas. It has been very helpful in identifying anomalies in the brain activity of depressed teenagers.MethodsThis study explored connectivity abnormalities in brain networks and their impact on clinical symptoms in patients with depression through resting state functional magnetic resonance imaging (rs-fMRI) and effective connectivity (EC) analysis. We first introduce some common EC analysis methods, discuss their application background and specific characteristics.ResultsEC analysis reveals information flow problems between different brain regions, such as the default mode network, the central executive network, and the salience network, which are closely related to symptoms of depression, such as low mood and cognitive impairment. This review discusses the limitations of existing studies while summarizing the current applications of EC analysis methods. Most of the early studies focused on the static connection mode, ignoring the causal relationship between brain regions. However, effective connection can reflect the upper and lower relationship of brain region interaction, and provide help for us to explore the mechanism of neurological diseases. Existing studies focus on the analysis of a single brain network, but rarely explore the interaction between multiple key networks.DiscussionTo do so, we can address these issues by integrating multiple technologies. The discussion of these issues is reflected in the text. Through reviewing various methods and applications of EC analysis, this paper aims to explore the abnormal connectivity patterns of brain networks in patients with depression, and further analyze the relationship between these abnormalities and clinical symptoms, so as to provide more accurate theoretical support for early diagnosis and personalized treatment of depression.

BackgroundAkinetopsia, or visual motion blindness, is a perceptual distortion characteristic of Alice in Wonderland syndrome in which people see moving objects as disjointed ‘jumps’ or ‘freeze frames.’ Despite its profound impact, the condition remains poorly understood beyond the established centrality of cortical area V5/MT in visual motion perception.MethodsWe carried out a systematic review of case descriptions on motion blindness, including those where additional symptoms were described.ResultsOur search yielded data on 25 clinical and 27 experimental cases, the latter induced by cortical stimulation. Of the clinical cases, 12% showed hemiakinetopsia, 50% continuous or progressive symptoms, and 52% a chronic course. Pathophysiologically, in right-handed individuals, the left area V5/MT was found to be particularly susceptible to acute interference, as evidenced by the experimental studies. In contrast to earlier studies, we found a greater prevalence of right-hemispheric afflictions in clinical cases, suggesting that the right area V5/MT plays a more dominant role in motion perception. Bilateral lesions to V5/MT most often coincided with global akinetopsia and chronicity, although we found that the severity of the condition also depends on surviving components of the visual motion network as a whole, and—in line with the dynamic parallellism theory—the speed of moving objects. Aetiologically, most cases were associated with structural neurological conditions such as stroke and neurodegenerative disease, and fewer with intoxications or paroxysmal neurological disorders such as epilepsy. Treatments were mostly successful when they were aimed at the underlying condition, while cases due to organic lesions tended to be therapy-resistant. Although individual reports confirm that akinetopsia may have detrimental effects on people’s lives, data were insufficient for a proper analysis of such experiential aspects.ConclusionPhenomenologically, pathophysiologically, and etiologically, akinetopsia is more heterogeneous than previously thought. We provide recommendations for clinical practice and further scientific research.

BackgroundInsomnia is a prevalent symptom among cancer patients. Electroacupuncture (EA) has been widely applied in managing sleep disorders, particularly in cancer patients or those experiencing insomnia.ObjectivesThis meta-analysis aims to evaluate the efficacy and safety of electroacupuncture for treating cancer-related insomnia.MethodsTwo independent reviewers conducted comprehensive searches across multiple databases, including EMBASE, Web of Science, PubMed, the Cochrane Library, Wanfang Digital Journals, China National Knowledge Infrastructure (CNKI), and the VIP Database for Chinese Technical Periodicals. The search was completed on April 28, 2024. The reviewers independently performed literature screening, data extraction, and risk of bias (ROB) assessment using the revised Cochrane ROB tool. Data were analyzed using RevMan 5.4 and Stata 15.0 software.ResultsEight randomized controlled trials (RCTs) involving 550 patients (305 in the experimental group and 245 in the control group) were included. EA significantly reduced Pittsburgh Sleep Quality Index (PSQI) scores (SMD = −0.86, 95% CI [−1.24, −0.49], p

IntroductionBenign paroxysmal positional vertigo is the most frequent peripheral vestibular disorder, characterized by brief but intense vertigo crises related to changes in position. The Liberatory maneuver is considered the gold-standard treatment, with a short-term resolution of the vertigo in over 70% of cases, and achieving a 90% success rate after four maneuvers. An immediate reaction to the subsequent repositioning maneuver is often an orthotropic nystagmus (Ny) occurring in the same direction as the Ny observed after returning to the primary position. This reaction, occurring seconds to minutes after reaching the second position, is considered a positive predictor of the maneuver’s effectiveness. To improve the success rate after the maneuver, many authors have suggested postural restrictions.MethodsTo determine the best predictors of outcome between the immediate behavior after the Semont maneuver and postural restriction, we analyzed 102 patients with posterior semicircular canalithiasis who underwent the Semont maneuver. In each case, we assessed the immediate reaction to the maneuver. Postural restrictions were recommended to 55 participants, while the remaining 40 were instructed to engage in normal head movements, even immediately following the maneuver.ResultsThe resolution rate was almost the same (69% versus 62%), regardless of postural behavior, while a significantly high success rate was obtained in the presence of Ny in position 2 of the Semont maneuver.ConclusionOur results support the hypothesis that postural restriction is not necessary after the Semont maneuver and that the occurrence of Ny during position 2 is the main outcome indicator.

BackgroundUnderstanding all factors that affect a patient’s acute migraine treatment care is crucial. We sought to determine the impact of headache specialist density and the introduction of the gepants and lasmiditan on the prescription of acute treatments for migraine.MethodsWe analyzed three scenarios: first, we performed linear regression analysis with the percentage of patients with migraine prescribed an acute medication in 2023, obtained via Epic Cosmos, and the density of headache specialists at the state level. Second, we conducted interrupted time-series analysis examining the change in patients prescribed the triptans before (2016–2019) and after (2020–2023) the introduction of the gepants and lasmiditan. Finally, we used regression analysis to look at the association of one pharmaceutical company, Pfizer, payments to physicians with prescriptions for that company’s gepant, rimegepant.ResultsWe included 6,559,854 patients with migraine and found that increased headache specialist density was associated with increased eletriptan, almotriptan, and naratriptan; there was no association with the other queried acute medications. In our interrupted time-series analysis, the introduction of the gepants and lasmiditan was linked to decreases in triptan utilization, except for eletriptan which remained stable, and rizatriptan which rose at a slower rate. Finally, increased Pfizer payments to physicians were associated with a higher percentage of patients prescribed rimegepant.ConclusionOur study suggests increased headache provider availability is associated with more prescriptions for naratriptan, eletriptan, and almotriptan. Additionally, the introduction of the gepants and lasmiditan broadly decreased the utilization of triptans. Critically, there was a strong association between a pharmaceutical company’s, Pfizer, payments to physicians and utilization of their medication, rimegepant.

BackgroundStroke-associated pneumonia (SAP) remains a neglected area despite its high morbidity and mortality. We aimed to establish an easy-to-use model for predicting SAP.MethodsTwo hundred seventy-five acute ischemic stroke (AIS) patients were enrolled, and 73 (26.55%) patients were diagnosed with SAP. T-test, Chi-square test and Fisher’s exact test were used to investigate the associations of patient characteristics with pneumonia and its severity, and multivariable logistic regression models were used to construct a prediction scale.ResultsThree variables with the most significant associations, including age, NGT placement, and right cerebral hemisphere lesions combined with gender, were used to construct a stroke-associated pneumonia prediction scale with high accuracy (AUC = 0.93). Youden index of our SAP prediction model was 0.77. The sensitivity and specificity of our SAP prediction model were 0.89 and 0.88, respectively.ConclusionWe identified the best predictive model for SAP in AIS patients. Our study aimed to be as clinically relevant as possible, focusing on features that are routinely available. The contribution of selected variables is visually displayed through SHapley Additive exPlanations (SHAP). Our model can help to distinguish AIS patients of high-risk, provide specific management, reduce healthcare costs and prevent life-threatening complications and even death.

BackgroundThe retina is a simple window to reflect the changes of brain nerves. The aim of this study was to investigate the association between retinal status and white matter lesions (WMLs) in 143 patients aged 50–80 years, utilizing Optical Coherence Tomography Angiography (OCTA) and the Fazekas Visual Scale for assessment.MethodsA total of 143 subjects underwent MRI scanning to assess the degree of WMLs using the Fazekas scale. Retinal imaging was conducted utilizing OCTA. Multivariate logistic regression analysis was employed to determine the odds ratios and 95% confidence intervals associated with the Fazekas score for each factor. The relationship between cognitive function and various OCTA parameters was assessed using quadratic and cubic simulation curve models. Data following a normal distribution are presented as means, while non-normally distributed data are reported as medians. Qualitative data are expressed as percentages.ResultsAs Fazekas grades increased, ILM-IPL thickness (OR = 3.267, OR = 8.436), vessel density in the parafoveal region of the macula, retinal vessel densities (OR = 2.058, OR = 2.363), and RNFL thickness significantly reduced (p

IntroductionTo explore the advantages and disadvantages of different vestibular function training to improve Motion sickness (MS) can be associated with significant symptoms, including fatigue, dizziness, headaches, nausea, and vomiting. Vestibular function training has increasingly replaced MS medications over the past few years and has almost no side effects.MethodsWe selected 109 students with MS from a university in Tangshan, China, and randomly assigned them to either an electric rotating chair group or a visual-motion cage rotating chair group. Both training groups underwent vestibular function training for 90 seconds a day for seven consecutive days.ResultsAfter training, both groups’ Graybiel scores, blood pressure, high-frequency power (HF), and root mean square of successive differences (rMSSD) between adjacent normal heartbeats significantly decreased. In the visual-motion cage rotating chair group, in addition to a reduction in the percentage of adjacent normal-to-normal intervals which differed by more than 50 ms (pNN50), as well as decreases in low-frequency power (LF), an increase in LF/HF was observed. Between-group comparisons showed that the Graybiel scores in the electric rotating chair group were better than those in the visual-motion cage rotating chair group. When the two groups were stratified into high and low-susceptibility subgroups, the low-susceptibility subgroup of the electric rotating chair group had lower Graybiel scores and diastolic blood pressures than the low-susceptibility visual-motion cage rotating chair subgroup, whereas in the high susceptibility subgroup, LF, rMSSD, and pNN50 were significantly higher in the visual-motion cage rotating chair group than in the electric rotating chair group.DiscussionThis study compared the effects of two types of vestibular function training on Graybiel scores and heart rate variability (HRV). we found that seven days of training with both the electric rotating chair and the visual-motion cage rotating chair relieved MS symptoms and enhanced sympathetic regulation. In terms of improving the subjective degree of MS, the electric rotating chair was superior to the visual-motion cage rotating chair. Subgroup analysis results showed that low-susceptibility MS patients’ symptoms were better relieved with electric rotating chair training, while high-susceptibility patients’ symptoms were better relieved with visual-motion cage rotating chair training.

BackgroundAlthough the circadian rhythm is known to influence several neurological diseases and response to treatments, its potential impact on brain injury following cardiac arrest and cardiopulmonary resuscitation (CA/CPR) remains unclear.MethodsWe performed a retrospective observational study on out-of-hospital cardiac arrest (OHCA) cases that presented to the emergency department of our hospital between September 2022 and August 2024. Based on the CA/CPR onset time, all patients were divided into two cohorts: daytime and nighttime groups. The gray-to white-matter signal intensity ratio (GWR) was analyzed using brain computed tomography (CT) images. We used the Cerebral Performance Category (CPC) to estimate the neurological outcomes. C-reactive protein (CRP), white blood cell (WBC) count, and monocyte (MONO) count levels in the plasma were also analyzed.ResultsOur study included 138 patients, of whom 68 were subjected to CA/CPR during daytime (8:00 to 20:00) and the remaining 70 were subjected to CA/CPR during nighttime (20:00 to 8:00). The imaging data showed that GWR values were significantly lower among patients subjected to CA/CPR during nighttime compared to those who were subjected to CA/CPR during daytime. Consistently, lower survival rates were observed among nighttime CA/CPR survivors. The CPC results indicated that a greater number of patients who underwent CA/CPR during daytime were rated as class 1–2 on day 3, day 5, and day 7 after achieving return of spontaneous circulation (ROSC). In contrast, a larger proportion of CA/CPR survivors in the nighttime group were rated as class 5 at the same time points. Elevated levels of C-reactive protein, white blood cell count, and monocyte count were observed in the plasma of survivors who underwent nighttime CA/CPR.ConclusionWe found that patients subjected to CA/CPR during nighttime (20:00–8:00) had worse neurological outcomes compared to those treated during daytime (8:00–20:00).

One lingering effect of the COVID-19 pandemic created by SARS-CoV-2 is the emergence of Long COVID (LC), characterized by enduring neurological sequelae affecting a significant portion of survivors. This review provides a thorough analysis of these neurological disruptions with respect to cognitive dysfunction, which broadly manifest as chronic insomnia, fatigue, mood dysregulation, and cognitive impairments with respect to cognitive dysfunction. Furthermore, we characterize how diagnostic tools such as PET, MRI, EEG, and ultrasonography provide critical insight into subtle neurological anomalies that may mechanistically explain the Long COVID disease phenotype. In this review, we explore the mechanistic hypotheses of these neurological changes, which describe CNS invasion, neuroinflammation, blood-brain barrier disruption, and gut-brain axis dysregulation, along with the novel vascular disruption hypothesis that highlights endothelial dysfunction and hypoperfusion as a core underlying mechanism. We lastly evaluate the clinical treatment landscape, scrutinizing the efficacy of various therapeutic strategies ranging from antivirals to anti-inflammatory agents in mitigating the multifaceted symptoms of LC.

Neuropathic pain is a chronic pathological pain caused by nervous system damage, characterized by complex mechanisms and limited treatment efficacy. Glial cells play a pivotal role in the initiation and maintenance of neuropathic pain. This study employs bibliometric analysis to explore trends and emerging hotspots in research on the relationship between glial cells and neuropathic pain. Based on literature data from the Web of Science Core Collection spanning 2003 to 2022, the study identifies key contributors in the field, including leading countries such as China, the United States, and Japan, as well as influential institutions and journals, such as the University of California system and Pain. Keyword analysis highlights research hotspots focusing on glial cell activation, spinal cord injury, satellite glial cells, oxidative stress, and neuroinflammation. The findings suggest that these themes may shape future directions in the field. This study provides researchers with a comprehensive overview of trends and hotspot analysis, offering valuable insights for further investigation into the role of glial cells in neuropathic pain.

BackgroundTo determine the influencing factors of sleep disorders in perimenopausal women by Meta-analysis.MethodsA comprehensive literature search was conducted by PubMed, Embase, CINAHL, and Web of Science(from inception to December 1,2023). Two researchers independently performed literature screening, quality evaluation and data extraction, and Stata16.0 software were used for Meta-analysis.ResultsA total of 12 studies involving 11,928 perimenopausal women with sleep disorders were included. The results of Meta-analysis showed that depression(OR = 2.73, 95%CI 1.65 ~ 4.52), hot flashes (OR = 2.70, 95%CI 1.81 ~ 4.02), chronic disease (OR = 1.39, 95%CI 1.24 ~ 1.56) and psychotropic drug use(OR = 3.19, 95%CI 1.31 ~ 7.77) were risk factors for sleep disorders in perimenopausal women (p

ObjectivesThis study aims to evaluate the clinical effectiveness of using coil embolization via radial artery access, combined with drilling and drainage, as a minimally invasive treatment for acute epidural hematoma compared to traditional craniotomy.Materials and methodsA retrospective analysis was conducted on 134 patients with acute epidural hematoma treated at the Department of Neurosurgery, Binzhou Medical University Hospital, between January 2020 and April 2023. Among these patients, 37 underwent embolization of the middle meningeal artery through radial artery access combined with burr hole drainage, while 97 patients underwent craniotomy for hematoma removal. The 37 patients treated with embolization were designated as the experimental group, while the remaining 97 patients formed the control group. General patient characteristics, operation duration, intraoperative blood loss, postoperative complications, and Glasgow Coma Scale (GCS) scores upon admission and discharge were recorded and compared between the two groups.ResultsIn comparison to the control group, the experimental group exhibited higher rates of postoperative hematoma residuals and longer average postoperative drainage times. Nevertheless, the experimental group demonstrated several advantages including shorter operation durations, reduced intraoperative bleeding, lower rates of postoperative rebleeding and complications, as well as decreased requirements for postoperative blood transfusions and transfusion volumes.ConclusionThe surgical approach involving coil embolization via radial artery access combined with minimally invasive burr hole drainage yields favorable clinical outcomes. This technique presents as a viable treatment option for acute epidural hematoma resulting from middle meningeal artery hemorrhage.

BackgroundThe main carrier protein of vitamin D and its metabolites in plasma is vitamin D binding protein (VDBP) or group-specific component (Gc). Two single nucleotide polymorphisms, rs7041, and rs4588 in the GC gene result in three major VDBP/Gc genotypes, GC1F (c.1296T, c.1307C), GC1S (c.1296G, c.1307C), GC2 (c.1296T, c.1307A), and phenotypes, Gc1F (p.432Asp, p.436Thr), Gc1S (p.432Glu, p.436Thr), and Gc2 (p.432Asp, p.436Lys). This study investigated frequencies of GC genotypes and phenotypes in Kuwaiti multiple sclerosis (MS) patients and healthy controls, and their associations with serum levels of 25 hydroxyvitamin D [25(OH)vitamin D] and VDBP.MethodsThe genomic DNA was isolated from blood samples of drug-naïve MS patients (N = 151) and controls (N = 127). DNA regions covering the targeted mutations were amplified by PCR, sequenced by the Sanger method, and analyzed to determine GC genotypes and phenotypes. Serum 25(OH)vitamin D and VDBP levels were measured by enzyme immunoassay. SPSS used for statistical analyses. Differences between independent and related groups tested by Mann–Whitney U and Wilcoxon signed-rank tests respectively, Genotype and phenotype frequencies were calculated; p

Vascular cognitive impairment (VCI) is increasingly recognized as the second most prevalent cause of dementia, primarily attributed to vascular risk factors and cerebrovascular disease. Numerous studies suggest that blood biomarkers may play a crucial role in the detection and prognosis of VCI. This study conducted a meta-analysis to evaluate the potential of various blood biomarkers associated with neuronal function as indicators of VCI. We searched four major databases—PubMed, Embase, Web of Science, and the Cochrane Library—up to December 31, 2023, for research on blood biomarkers for VCI. Of the 4,043 studies identified, 30 met the inclusion criteria for this review. The nine peripheral biomarkers analyzed for their association with neuronal function include amyloid beta 42 (Aβ42), amyloid beta 40 (Aβ40), Aβ42/Aβ40 ratio, total Tau (t-Tau), phosphorylated tau 181 (p-tau 181), neurofilament light (NfL), brain-derived neurotrophic factor (BDNF), S100B, and soluble receptor for advanced glycation end products (sRAGE). Our findings reveal that peripheral Aβ42, Aβ42/Aβ40 ratio, NfL, and S100B significantly differ between VCI and non-VCI groups, indicating their potential as blood biomarkers for VCI.

ObjectiveThe study aimed to explore the effects of virtual reality (VR) technology on motor function rehabilitation in critically ill patients.MethodsAdhering to the PRISMA systematic evaluation method for developing the literature ranking criteria and search strategy, the following databases were systematically searched: PubMed, Embase, Web of Science, the Cochrane Library, CNKI, Wanfang Data, Chinese Medical Journal Full-Text Database, and SINOMED. The search focused on the impact of virtual reality technology on limb function rehabilitation in critically ill patients, covering the period from the database’s inception to 6 December 2024. To evaluate the quality of the included studies, the risk of bias was assessed using the RevMan 5.4 tool.ResultsA total of 11 randomized controlled trials (RCTs) published over 10 years were included, involving 880 critically ill adult patients: 435 in the experimental group and 445 in the control group. The meta-analysis showed that, compared to the control group, virtual reality technology significantly improved the Berg Balance Scale (BBS) score (MD = 3.95, 95% CI: 3.19, 4.70, p 0.05), the Functional Ambulation Category (FAC) score (MD = 0.72, 95% CI: 0.49, 0.94, p

Identifying individuals at-risk for dementia is one of the critical objectives of current research efforts, highlighting the need for simple, cost-effective, and minimally invasive biomarkers. Mild behavioral impairment (MBI), characterized by the emergence of persistent neuropsychiatric manifestations in older adults, has attracted increasing attention as a potential early indicator of cognitive decline and dementia. A growing number of studies have recently begun to explore the relationship between MBI and several blood-based biomarkers associated with Alzheimer’s disease (AD) pathology, neurodegeneration, as well as systemic metabolic and inflammatory dysregulation. In this context, MBI has been associated with lower plasma Aβ42/Αβ40 ratio, higher plasma phosphorylated tau at threonine 181 (p-tau181), increased neurofilament light chain (NfL) levels, as well as disturbances in metabolic markers, including homocysteine, insulin and ferritin, suggesting a multifaceted neurobiological basis for this syndrome. These findings offer insights into the underlying pathophysiology of MBI, and connection between neuropsychiatric symptoms and progression of AD. In this narrative review, we aim to summarize and critically discuss the emerging literature evidence linking MBI to blood-based biomarkers, hoping to shed more light on MBI’s pathophysiology, its connection to AD-related neurobiology, as well as its potential practical utility for predicting cognitive impairment, guiding early interventions and managing the risk for dementia.