Journal of the Neurological Sciences issue 448 now available

Development of a stroke risk score with MRI asymptomatic brain lesions attributes to evaluate prognostic vascular events

Iwasa et al.

Published online: April 2, 2023

The use of a combination of stroke predictors, such as clinical factors and asymptomatic lesions on brain magnetic resonance imaging (MRI), may improve the accuracy of stroke risk prediction. Therefore, we attempted to develop a stroke risk score for healthy individuals.

The following items were found to be significant risk factors for stroke: age (≥60 years), hypertension, subclinical cerebral infarction, deep white matter lesion, and microbleeds. Each item was scored with 1 point, and the hazard ratios for the risk of developing stroke based on the group with 0 points were 17.2 (95% confidence interval [CI] 2.31–128) for 3 points, 18.1 (95% CI 2.03–162) for 4 points, and 102 (95% CI 12.6–836) for 5 points.

A precise stroke prediction score biomarker can be obtained by combining MRI findings and clinical factors.

Clinical milestones as triggers for palliative care intervention in progressive Supranuclear palsy and multiple system atrophy

Bessemer et al.

Published online: March 29, 2023

• Clinical milestones may serve as triggers for initiation of neuropalliative care.
• Initiate neuropalliative care earlier if there are more milestones reached in the first 3 years.
• Red flags in PSP are admission to hospital and early cognitive impairment.
• Red flags in MSA are admission to hospital and early stridor or REM sleep behavior disorder.

Plasma growth differentiation factor − 8 / Myostatin level as prognostic biomarker of patients with ischemic stroke and acute revascularization therapy. PARADISE study

Jakubina et al.

Published online: March 16, 2023

Identifying biological markers of ischemic stroke (IS) is an important research approach to develop innovative therapeutic strategies. This study aimed to assess the association between plasma Growth Differentiation Factor-8 (GDF-8)/Myostatin levels and outcome of IS patients.

Lower plasma GDF-8 levels were associated with a poorer functional outcome in IS patients treated with acute revascularization therapy. Underlying pathophysiological mechanisms involving GDF-8 in post-stroke outcome remain to be elucidated.

Vitamin K antagonists but not non-vitamin K antagonists in addition on antiplatelet therapy should be associated with increase of hematoma volume and mortality in patients with intracerebral hemorrhage: A sub-analysis of PASTA registry study

Nomura et al.

Published online: April 1, 2023

Prior concomitant use of vitamin K antagonists (VKAs) and antiplatelet (AP) therapy increase the hematoma volume and mortality compared with VKA monotherapy in patients with intracranial hemorrhage (ICH). However, the prior concomitant use of non-vitamin K oral antagonists (NOACs) and AP has not been clarified.

We conducted a PASTA registry study, which was an observational, multicenter, registry of 1043 patients with stroke receiving oral anticoagulants (OACs) in Japan. In the present study, ICH from the PASTA registry was used to analyze the clinical characteristics including mortality among the four groups (NOAC, VKA, NOAC and AP, and VKA and AP) using univariate and multivariate analyses.

Although VKA in addition to AP therapy could increase the in-hospital mortality, NOAC and AP did not increase the hematoma volume, stroke severity, or mortality compared to NOAC monotherapy.