Diffusion Tensor Imaging Study After Intraarterial Cell Therapy in Acute Ischemic Stroke: A Substudy of the IBIS Randomized Clinical Trial

急性缺血性卒中动脉内细胞治疗后的扩散张量成像研究：IBIS 随机临床试验的一项子研究

Bone marrow mononuclear cell (BM-MNC) intraarterial transplantation has emerged as a potential stroke therapy. We aimed to determine whether BM-MNC therapy induces changes in diffusion tensor imaging metrics of major white matter tracts. Intraarterial autologous BM-MNC transplantation within 7 days after stroke onset seems to modify long-term white matter tract microstructure, suggesting that this cell therapy may mitigate acute stroke damage, through main projection fibers. Greater corticospinal tract preservation was associated with improved clinical outcomes.

骨髓单个核细胞（BM - MNC）动脉内移植已成为一种潜在的中风治疗方法。我们旨在确定BM - MNC治疗是否会引起主要白质束弥散张量成像指标的变化。中风发作后7天内进行动脉内自体BM - MNC移植似乎会改变长期白质束微观结构，这表明这种细胞疗法可能通过主要投射纤维减轻急性中风损伤。皮质脊髓束更好的保留与更好的临床结局相关。

REF: Cabezas-Rodriguez JA, Biarnes C, Martí-Navas M, et al. Diffusion Tensor Imaging Study After Intraarterial Cell Therapy in Acute Ischemic Stroke: A Substudy of the IBIS Randomized Clinical Trial. Stroke. Published online April 30, 2025. doi:10.1161/STROKEAHA.124.050261 PMID: 40304033

Proteome-Wide Genetic Study in East Asians and Europeans Identified Multiple Therapeutic Targets for Ischemic Stroke

东亚人群和欧洲人群全蛋白质组遗传研究确定了多个缺血性中风治疗靶点

Analyses of genomic and proteomics data in prospective biobank studies in diverse populations may discover novel or repurposing drug targets for stroke. Proteogenomic investigation in diverse ancestry populations identified the causal relevance of 10 proteins for IS, with several being potentially novel or repurposed targets that could be prioritized for further investigation.

对不同人群前瞻性生物样本库研究中的基因组和蛋白质组学数据进行分析，可能会发现用于治疗中风的新药物靶点或重新确定现有药物的新靶点。对不同血统人群进行的蛋白质基因组学研究确定了10种蛋白质与缺血性中风的因果关系，其中有几种可能是新的或可重新利用的靶点，可优先进行进一步研究。

REF: Yao P, Mazidi M, Pozarickij A, et al. Proteome-Wide Genetic Study in East Asians and Europeans Identified Multiple Therapeutic Targets for Ischemic Stroke. Stroke. Published online April 30, 2025. doi:10.1161/STROKEAHA.125.050982 PMID: 40304040

Association Between Dietary Fiber Intake and Stroke Among US Adults: From NHANES and Mendelian Randomization Analysis

美国成年人膳食纤维摄入量与中风之间的关联：来自美国国家健康与营养检查调查（NHANES）和孟德尔随机化分析

There is debate on the link between dietary fiber intake and stroke risk. The purpose of this study was to look at how it impacts dietary fiber intake and stroke risk, as well as mortality among stroke survivors. Two-sample Mendelian randomization was also used to investigate the causal relationship. There is a stable negative correlation between dietary fiber intake and stroke risk. High fiber intake is associated with reduced all-cause mortality among stroke survivors. Additionally, genetic prediction further demonstrates a causal relationship between dietary fiber and reduced risk of small vessel stroke.

关于膳食纤维摄入量与中风风险之间的关联存在争议。本研究的目的是探讨膳食纤维摄入量对中风风险以及中风幸存者死亡率的影响。还采用了双样本孟德尔随机化方法来研究两者之间的因果关系。膳食纤维摄入量与中风风险之间存在稳定的负相关关系。高纤维摄入与中风幸存者全因死亡率降低有关。此外，基因预测进一步证实了膳食纤维与降低小血管中风风险之间存在因果关系。

REF: Lai S, Zhou G, Li Y, et al. Association Between Dietary Fiber Intake and Stroke Among US Adults: From NHANES and Mendelian Randomization Analysis. Stroke. Published online April 29, 2025. doi:10.1161/STROKEAHA.124.049093 PMID: 40297895

Arteriolosclerosis in CNS Tissues Outside the Cerebrum and Late-Life Motor Impairment

大脑外中枢神经系统组织的小动脉硬化与晚年运动障碍

The pathological basis underlying motor impairment in older adults is partially accounted for by Alzheimer disease and related dementias pathologies. We tested the hypothesis that arteriolosclerosis, a pathological correlate of small vessel disease, outside the cerebrum is related to motor impairment in older adults above and beyond Alzheimer disease and related dementias pathologies. Arteriolosclerosis severity varies in the central nervous system tissues outside of the cerebrum and is differentially associated with varied motor performances, suggesting that the adverse motor consequences of small vessel disease in older adults may be underestimated by studies focusing only on the brain.

老年人运动障碍的病理基础部分可归因于阿尔茨海默病及相关痴呆症的病理改变。我们验证了一个假设，即大脑外的小动脉硬化（一种与小血管病相关的病理表现）与老年人的运动障碍有关，且这种关联独立于阿尔茨海默病及相关痴呆症的病理改变。大脑外中枢神经系统组织中的小动脉硬化严重程度存在差异，并且与不同的运动表现存在不同程度的关联，这表明仅关注大脑的研究可能低估了老年人小血管病对运动功能的不良影响。

REF: Oveisgharan S, Agrawal S, Yu L, et al. Arteriolosclerosis in CNS Tissues Outside the Cerebrum and Late-Life Motor Impairment. Stroke. Published online April 29, 2025. doi:10.1161/STROKEAHA.124.050002 PMID: 40297893

Cerebrovascular Pathology and Cognitive Outcomes in Older Black Decedents

老年黑人死者的脑血管病理与认知结局

Few neuropathologic studies focus on the associations of cerebrovascular pathologies with cognition in older Black adults. Cerebrovascular pathologies are common in older Black decedents, most often as a mixed cerebrovascular pathology profile. Arteriosclerosis and microinfarcts were associated with lower cognition above and beyond the presence of neurodegenerative pathologies. Burden and cognitive associations with cerebrovascular pathologies were similar across races.

很少有神经病理学研究关注老年黑人成年人脑血管病变与认知功能之间的关联。脑血管病变在老年黑人死者中很常见，最常见的表现为混合性脑血管病变特征。除了神经退行性病变外，动脉硬化和微梗死也与较低的认知功能相关。不同种族中，脑血管病变的负担及其与认知功能的关联相似。

REF: Kapasi A, Capuano AW, Mojdeganlou P, et al. Cerebrovascular Pathology and Cognitive Outcomes in Older Black Decedents. Stroke. Published online April 28, 2025. doi:10.1161/STROKEAHA.124.047954 PMID: 40289798

Association of Biomarkers With Intracerebral Hematoma Expansion and Arterial Thromboembolic Events in Patients With Acute Intracranial Hemorrhage: The ANNEXA-I Biomarker Substudy

急性颅内出血患者生物标志物与脑内血肿扩大及动脉血栓栓塞事件的关联：ANNEXA - I生物标志物亚研究

ANNEXA-I (Andexanet Alfa, a Novel Antidote to the Anticoagulation Effects of FXA Inhibitors) was a randomized trial that demonstrated that andexanet compared with usual care in patients with intracranial hemorrhage associated with FXa (factor Xa) inhibitor treatment reduces the risk of hematoma expansion and increases the risk of arterial thromboembolic events. In patients with apixaban- or rivaroxaban-associated intracranial hemorrhage, andexanet compared with usual care produces greater reduction in anti-FXa and greater increase in ETP at 1 hour. Reduction in anti-FXa from baseline to 1 hour is independently associated with reduced hematoma expansion, and increase in ETP from baseline to 1 hour is independently associated with both reduced hematoma expansion and increase of thromboembolic events.

ANNEXA - I（阿奈沙班，一种新型Xa因子抑制剂抗凝作用解毒剂）是一项随机试验，该试验表明，在使用Xa因子（凝血因子Xa）抑制剂治疗后发生颅内出血的患者中，与常规治疗相比，阿奈沙班可降低血肿扩大的风险，但会增加动脉血栓栓塞事件的风险。在服用阿哌沙班或利伐沙班后发生颅内出血的患者中，与常规治疗相比，阿奈沙班在1小时时能更大程度降低抗FXa活性，并更大程度提高内源性凝血酶生成潜能（ETP）。从基线到1小时抗FXa活性的降低与血肿扩大减少独立相关，从基线到1小时ETP的升高与血肿扩大减少和血栓栓塞事件增加均独立相关。

REF: Eikelboom JW, Sharma M, Xu L, et al. Association of Biomarkers With Intracerebral Hematoma Expansion and Arterial Thromboembolic Events in Patients With Acute Intracranial Hemorrhage: The ANNEXA-I Biomarker Substudy. Stroke. Published online April 28, 2025. doi:10.1161/STROKEAHA.124.049966 PMID: 40289797

White Matter Hyperintensity Load Independent From the Stroke Lesion Is Associated With Chronic Aphasia Severity and Treatment Outcome

与卒中病灶无关的脑白质高信号负荷与慢性失语症严重程度及治疗结局相关

Although many studies have suggested that white matter hyperintensity (WMH) severity predicts naming and aphasia severity in chronic poststroke aphasia, there are inconsistencies in the literature. WMHs are typically symmetrical in neurotypical controls, and measuring WMH in the contralateral hemisphere is likely the best option to estimate brain health independently from the stroke lesion and avoid measurement contamination from stroke-related gliosis. In this study, we aimed to clarify the discrepancies in the literature by testing whether WMH rating methods are related to clinical outcomes. Given the regional effect of the stroke lesion, whole-brain ratings can overestimate the WMH burden and thus reduce the accuracy in evaluating small vessel disease effects on stroke recovery and aphasia severity, particularly therapy-related neuroplasticity. This is an important detail that should be considered in mechanistic studies of small vessel disease, brain health, and stroke recovery.

尽管许多研究表明，白质高信号（WMH）的严重程度可预测慢性卒中后失语症患者的命名能力和失语症严重程度，但文献中存在不一致的情况。在神经典型的对照人群中，白质高信号通常是对称的，测量对侧半球的白质高信号可能是独立于卒中病灶评估大脑健康状况的最佳选择，并且可以避免因卒中相关的神经胶质增生而影响测量结果。在本研究中，我们旨在通过检验白质高信号评级方法是否与临床结局相关来澄清文献中的差异。鉴于卒中病灶存在区域效应，全脑评级可能会高估白质高信号的负担，从而降低评估小血管病对卒中恢复和失语症严重程度（尤其是与治疗相关的神经可塑性）影响的准确性。这是在小血管病、大脑健康和卒中恢复的机制研究中应考虑的一个重要细节。

REF: Busby N, Kristinsson S, Johnson L, et al. White Matter Hyperintensity Load Independent From the Stroke Lesion Is Associated With Chronic Aphasia Severity and Treatment Outcome. Stroke. Published online April 25, 2025. doi:10.1161/STROKEAHA.124.046710 PMID: 40276856

Cost-Effectiveness Analysis of Early Minimally Invasive Removal of Intracerebral Hemorrhage

早期微创清除脑出血的成本 - 效果分析

Supratentorial intracerebral hemorrhage (ICH) is common and often devastating. In a randomized controlled trial, ICH evacuation with minimally invasive trans-sulcal parafascicular surgery (MIPS) improved functional outcomes at 180 days compared with medical management (MM), primarily in patients with lobar hemorrhages. The cost-effectiveness of MIPS compared with MM is explored. In the ENRICH randomized controlled trial, MIPS cost less and was more effective compared with MM from both hospital and healthcare perspectives for patients with lobar ICH.

幕上脑出血（ICH）很常见，且往往后果严重。在一项随机对照试验中，与药物治疗（MM）相比，采用微创经脑沟束旁手术（MIPS）清除脑出血可改善患者180天时的功能结局，这主要体现在脑叶出血患者中。本文探讨了MIPS与MM相比的成本效益。在ENRICH随机对照试验中，从医院和医疗保健的角度来看，对于脑叶脑出血患者，MIPS的成本更低且效果更好。

REF: Hanmer J, Arnold J, Hall A, et al. Cost-Effectiveness Analysis of Early Minimally Invasive Removal of Intracerebral Hemorrhage. Stroke. Published online April 25, 2025. doi:10.1161/STROKEAHA.124.048493 PMID: 40276867

One-Year Outcome After Endovascular Thrombectomy for Basilar Artery Occlusion With Mild Deficits

轻度神经功能缺损的基底动脉闭塞患者血管内取栓术后1年结局

The long-term benefits of endovascular thrombectomy (EVT) for basilar artery occlusion (BAO) in patients with low National Institutes of Health Stroke Scale scores upon admission remain unclear. This study aimed to compare the 1-year clinical follow-up outcomes of best medical management (BMM) alone versus BMM plus EVT. In this long-term follow-up study among patients with BAO admitted with a National Institutes of Health Stroke Scale score of ≤10, there were no significant differences in functional outcomes and mortality at 1 year between BMM plus EVT and BMM alone.

入院时美国国立卫生研究院卒中量表（NIHSS）评分较低的基底动脉闭塞（BAO）患者接受血管内血栓切除术（EVT）的长期获益仍不明确。本研究旨在比较单纯最佳药物治疗（BMM）与BMM联合EVT的1年临床随访结局。在这项针对入院时NIHSS评分≤10分的BAO患者的长期随访研究中，BMM联合EVT与单纯BMM在1年时的功能结局和死亡率方面无显著差异。

REF: Xu Y, Xiao L, Zhang P, et al. One-Year Outcome After Endovascular Thrombectomy for Basilar Artery Occlusion With Mild Deficits. Stroke. Published online April 25, 2025. doi:10.1161/STROKEAHA.124.050389 PMID: 40276850