Development and internal validation of a nomogram for predicting cognitive impairment after mild ischemic stroke and transient ischemic attack based on cognitive trajectories: a prospective cohort study

Frontiers in Aging Neuroscience, Journal Year: 2025, Volume and Issue: 17

Published: Jan. 29, 2025

Introduction Many predictive models for cognitive impairment after mild stroke and transient ischemic attack are based on scales at a certain timepoint. We aimed to develop two easy-to-use longitudinal trajectories facilitate early identification treatment. Methods This was prospective cohort study of 556 patients, followed up every 3 months. Patients with least within 2.5 years were included in the latent class growth analysis (LCGA). The patients categorized into groups LCGA. First, difference performed, further univariate stepwise backward multifactorial logistic regression performed. results presented as nomograms, receiver operating characteristic curve analysis, calibration, decision cross-validation performed assess model performance. Results LCGA eventually 255 “22” group selected subgroup analysis. Among them, 29.8% trajectory. Model 1, which incorporated baseline Montreal Cognitive Assessment, ferritin, age, previous stroke, achieved an area under (AUC) 0.973, 2, education, AUC 0.771. Decision showed excellent clinical applicability. Discussion Here, we developed simple post-stroke LCGA, form nomograms suitable application. These provide basis detection prompt

Language: Английский

---

Pathological features of post-stroke pain: a comprehensive analysis for subtypes

Brain Communications, Journal Year: 2025, Volume and Issue: 7(3)

Published: Jan. 1, 2025

Abstract Post-stroke pain is heterogeneous and includes both nociceptive neuropathic pain. These subtypes can be comprehensively assessed using several clinical tools, such as pain-related questionnaires, quantitative somatosensory tests brain imaging. In the present study, we conducted a comprehensive assessment of patients with central post-stroke non-central analysed their features. We also performed detailed analysis relationships between lesion areas or structural disconnection white matter dysfunctions. this multicentre cross-sectional 70 were divided into 24 pain, 26 20 no-pain groups. Multiple logistic regression was used to summarize each pathological feature (for groups) factors results tests. Relationships dysfunctions voxel-based lesion–symptom mapping disconnection–symptom mapping. All pathology models indicated that associated cold hypoesthesia at 8°C (β = 2.98, odds ratio 19.6, 95% confidence interval 2.7–141.8), hyperalgesia 2.61, 13.6, 1.13–163.12) higher Neuropathic Pain Symptom Inventory scores spontaneous evoked items only; β 0.17, 1.19, 95%, 1.07–1.32), whereas joint 5.01, 149.854, 19.93–1126.52) lower −0.17, 0.8, 0.75–0.94). mapping, extracted mainly voxels significantly hyperalgesia, allodynia 22°C heat 45°C. in putamen, insular cortex, hippocampus, Rolandic operculum, retrolenticular part internal external capsules sagittal stratum. maps 8°C, 37°C patterns cingulum frontal parahippocampal tract, reticulospinal tract superior longitudinal fasciculus widespread interhemispheric corpus callosum. findings serve important indicators facilitate decision-making optimize precision treatments through data dimensionality reduction when diagnosing assessments, bedside sensory testing, factors, questionnaires

Language: Английский

---

Evaluation of stroke sequelae and rehabilitation effect on brain tumor by neuroimaging technique: A comparative study

PLoS ONE, Journal Year: 2025, Volume and Issue: 20(2), P. e0317193 - e0317193

Published: Feb. 24, 2025

This study aims at the limitations of traditional methods in evaluation stroke sequelae and rehabilitation effect monitoring, especially for accurate identification tracking brain injury areas. To overcome these challenges, we introduce an advanced neuroimaging technology based on deep learning, SWI-BITR-UNet model. model, introduced as novel Machine Learning (ML) combines SWIN Transformer’s local receptive field shift mechanism, effective feature fusion strategy U-Net architecture, aiming to improve accuracy lesion region segmentation multimodal MRI scans. Through application a 3-D CNN encoder decoder, well integration CBAM attention module jump connection, model can finely capture refine features, achieve level comparable that manual by experts. introduces 3D encoder-decoder architecture specifically designed enhance processing capabilities medical imaging data. The development utilizes ADAM optimization algorithm facilitate training process. Bra2020 dataset is utilized assess proposed learning neural network. By employing skip connections, effectively integrates high-resolution features from with up-sampling thereby increasing model’s sensitivity spatial characteristics. both testing phases, SWI-BITR-Unet trained using reliable datasets evaluated through comprehensive array statistical metrics, including Recall (Rec), Precision (Pre), F1 test score, Kappa Coefficient (KC), mean Intersection over Union (mIoU), Receiver Operating Characteristic-Area Under Curve (ROC-AUC). Furthermore, various machine models, such Random Forest (RF), Support Vector (SVM), Extreme Gradient Boosting (XGBoost), Categorical (CatBoost), Adaptive (AdaBoost), K-Nearest Neighbor (KNN), have been employed analyze tumor progression brain, performance characterized Hausdorff distance. In From ML was more than other models. Subsequently, regarding DICE coefficient values, maps (annotation distributions) generated models indicated models’s capability autonomously delineate areas core (TC) enhancing (ET). Moreover, efficacy demonstrated superiority existing research field. computational efficiency ability handle long-distance dependencies make it particularly suitable applications clinical Settings. results showed SNA-BITR-UNet not only identify monitor subtle changes area, but also provided new efficient tool process, providing scientific basis developing personalized plans.

Language: Английский

---

Unravelling the nexus of stroke and dementia: Deciphering the role of secondary neurodegeneration in orchestrating cognitive decline

Neuroprotection/Neuroprotection (Chichester, England. Print), Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 25, 2025

Abstract Stroke is the leading cause of acquired disability. The development acute ischemic stroke treatments, such as mechanical thrombectomy and tissue plasminogen activator, has resulted in more patients surviving initial insult. However, long‐term complications, post‐stroke cognitive impairment (PSCI) dementia (PSD), are at an all‐time high. Notably, 80% survivors suffer from impairment, a history doubles patient's lifetime risk developing dementia. A combination greater life expectancy, increase number strokes young individuals, improved survival have inherently increased years living post‐stroke, highlighting critical need to understand effects stroke, including how pathological changes brain might give rise functional behavioral survivors. Even with this PSCI PSD survivors, understanding itself develops into these conditions remains incomplete. Recently, secondary neurodegeneration (SND) following been linked PSD. SND degeneration regions outside original site. Degeneration sites thought arise due diaschisis infarct core; however, observation pathology multiple without direct connectivity suggests that likely complex. Moreover, hallmarks dementia, deposition neurodegenerative proteins iron, cell death, inflammation blood–brain barrier alterations, all found thalamus, hippocampus, basal ganglia, amygdala prefrontal cortex stroke. Hence, review, we present current context outline remote anatomical molecular may drive conditions.

Language: Английский

---

Longitudinal relationships between depressive symptoms and cognitive function after stroke: A cross-lagged panel design

Journal of Psychosomatic Research, Journal Year: 2023, Volume and Issue: 174, P. 111486 - 111486

Published: Sept. 9, 2023

Language: Английский

---

Targeting MAD2B as a strategy for ischemic stroke therapy

Journal of Advanced Research, Journal Year: 2024, Volume and Issue: unknown

Published: July 1, 2024

Post-stroke cognitive impairment is one of the major causes disability due to cerebral ischemia. MAD2B an inhibitor Cdh1/APC, and loss Cdh1/APC function in mature neurons increases ROCK2 activity, leading changes synaptic plasticity memory mouse neurons. Whether regulates learning capacity through ischemia not known. We investigated role mechanism ischemia-induced dysfunction. The expression its downstream related molecules was detected by immunoblotting intervened with neuroprotectants after middle artery occlusion (MCAO) oxygen-glucose deprivation/reoxygenation (OGD/R). constructed MAD2B-cKO-specific knockout mice, knocked down overexpressed hippocampus lentiviral injection brain stereotaxis, modeled using MCAO, explored post-stroke (PSCI) animal behaviors such as Y-maze Novel object recognition test. Then MAD2B/ROCK2, apoptosis-related detected. Finally, shRNA-ROCK2 lentivirus. increased MCAO OGD/R. Nonetheless, this underwent a decline post-therapy neuroprotective agents. Deletion ameliorated deficits improved motor coordination mice. Conversely, overexpression exacerbated deficits. resulted downregulation ROCK2/LIMK1/cofilin. It effectively reduced upregulation BAX cleaved caspase-3, which could be reversed overexpression. Inhibition or knockdown primary cultured led LIMK1/cofilin apoptosis-associated induced Our findings suggest that affects neuronal apoptosis via Rock2, neurological infarction.

Language: Английский

---

Vascular cognitive impairment: Advances in clinical research and management

Chinese Medical Journal, Journal Year: 2024, Volume and Issue: unknown

Published: July 24, 2024

Abstract Vascular cognitive impairment (VCI) encompasses a wide spectrum of disorders, ranging from mild to vascular dementia. Its diagnosis relies on thorough clinical evaluations and neuroimaging. VCI predominately arises risk factors (VRFs) cerebrovascular disease, either independently or in conjunction with neurodegeneration. Growing evidence underscores the prevalence VRFs, highlighting their potential for early prediction dementia later life. The precise mechanisms linking pathologies deficits remain elusive. Chronic pathology is most common neuropathological feature VCI, often interacting synergistically neurodegenerative processes. Current research efforts are focused developing validating reliable biomarkers unravel etiology brain changes VCI. collaborative integration these into practice, alongside routine incorporation assessments, presents promising strategy predicting stratifying cornerstone prevention remains control which includes multi-domain lifestyle modifications. Identifying appropriate pharmacological approaches also paramount importance. In this review, we synthesize recent advancements field including its definition, determinants risk, pathophysiology, neuroimaging fluid-correlated biomarkers, predictive methodologies, current intervention strategies. Increasingly evident notion that more rigorous complex interplay physiological events, still needed pave way better outcomes enhanced quality life affected individuals.

Language: Английский

---

Imaging, biomarkers, and vascular cognitive impairment in China: Rationale and design for the VICA study

Alzheimer s & Dementia, Journal Year: 2024, Volume and Issue: unknown

Published: Nov. 13, 2024

Abstract INTRODUCTION Vascular cognitive impairment (VCI) is highly heterogeneous, with unclear pathogenesis. Individuals vascular risk factors (VRF), cerebral small vessel disease (CSVD), and stroke are all at of developing VCI. To address the growing challenges posed by VCI, “Vascular, Imaging Cognition Association China” (VICA) was established. METHODS VICA aims to recruit 10,000 participants, including 2000 VRF, 3000 CSVD, 5000 patients, form a nationwide multicenter cohort. The study integrates clinical, neuroimaging, multi‐omics data better understand VCI heterogeneity, improve prediction, ensure timely diagnosis. RESULTS has screened 2045 eligible VRF participants from six communities in Wuhan, Shanghai, Taizhou, along 602 CSVD 1269 patients 135 hospitals nationwide. Baseline enrollment follow‐up work still ongoing. DISCUSSION Establishing high‐quality longitudinal cohort crucial for understanding pathogenesis novel markers early screening Highlights Establish large‐scale prospective comprising focusing on high‐risk population China. three‐tier medical network, make full use resources, achieve extensive patients. Utilize multimodal imaging biomarkers lay foundation constructing more‐precise models. Introduce eye movement gait analysis as new methods assessing function. Use positron emission tomography further investigate interaction between neurodegeneration.

Language: Английский

---

Specific Mode Electroacupuncture Stimulation Mediates the Delivery of NGF Across the Hippocampus Blood–Brain Barrier Through p65-VEGFA-TJs to Improve the Cognitive Function of MCAO/R Convalescent Rats

Molecular Neurobiology, Journal Year: 2024, Volume and Issue: unknown

Published: July 12, 2024

Abstract Cognitive impairment frequently presents as a prevalent consequence following stroke, imposing significant burdens on patients, families, and society. The objective of this study was to assess the effectiveness underlying mechanism nerve growth factor (NGF) in treating post-stroke cognitive dysfunction rats with cerebral ischemia–reperfusion injury (MCAO/R) through delivery into brain using specific mode electroacupuncture stimulation (SMES). From 28th day after modeling, were treated NGF mediated by SMES, function observed treatment. Learning memory ability evaluated behavioral tests. impact SMES blood–brain barrier (BBB) permeability, enhancement MCAO/R, including transmission electron microscopy, enzyme-linked immunosorbent assay, immunohistochemistry, immunofluorescence, TUNEL staining. We reported that demonstrates safe efficient open BBB during ischemia repair phase, facilitating p65-VEGFA-TJs pathway. Graphical By Figdraw

Language: Английский

---