Antihypertensive Medication Adherence, APOE Genotype, and Subsequent Dementia in Community-Dwelling Adults ≥50 Years

≥50岁社区居民的降压药物治疗依从性、载脂蛋白E（APOE）基因型与后续痴呆症的关系

We aim to examine prospective associations of longitudinal adherence to antihypertensive medication, APOE ε4 carrier, and subsequent dementia risk in community-dwelling middle-aged and older adults. Persistently adhering to antihypertensive medication was consistently associated with a lower subsequent dementia risk in community-dwelling middle-aged and older adults.

我们旨在研究社区中老年居民长期坚持服用降压药物、载脂蛋白E（APOE）ε4携带者与后续痴呆风险之间的前瞻性关联。在社区中老年居民中，持续坚持服用降压药物始终与较低的后续痴呆风险相关。

REF: Li Y, Li C. Antihypertensive Medication Adherence, APOE Genotype, and Subsequent Dementia in Community-Dwelling Adults ≥50 Years. Stroke. Published online December 24, 2025. doi:10.1161/STROKEAHA.125.051564 PMID: 41439317

Time-Dependent Impact of Mismatch Profiles on Outcomes Following Endovascular Thrombectomy for Large Ischemic Stroke

错配模式对大缺血性脑卒中血管内取栓术后预后的时间依赖性影响

Endovascular therapy (EVT) has demonstrated efficacy in patients with large core infarctions, yet favorable outcomes remain limited. Although mismatch profiles have long informed EVT decision-making in small-core strokes, their prognostic significance in large-core infarcts remains uncertain and may be affected by time from symptom onset. This study aims to evaluate the relationship between mismatch profiles, time distribution, and EVT efficacy in patients with large ischemic cores. Among patients with large infarct cores, the absence of mismatch was more common in the early time window and was associated with diminished benefit from EVT. These results suggest that mismatch evaluation-even in early presenting patients-may help inform treatment selection for patients with large ischemic cores. All interaction tests were nonsignificant; these findings are hypothesis‑generating and require prospective, prespecified confirmation.

血管内治疗（EVT）已被证明对大面积核心梗死患者有效，但良好预后仍较为有限。尽管不匹配特征长期以来一直为小核心梗死患者的血管内治疗决策提供参考，但它们在大面积核心梗死中的预后意义仍不确定，且可能受症状发作时间的影响。本研究旨在评估大面积缺血核心患者的不匹配特征、时间分布与血管内治疗疗效之间的关系。在大面积梗死核心患者中，早期时间窗内不匹配情况更为常见，且与血管内治疗获益减少相关。这些结果表明，即使是早期就诊的患者，进行不匹配评估也可能有助于为大面积缺血核心患者选择治疗方案。所有交互检验均无统计学意义；这些发现为提出假设，需要前瞻性、预先设定的研究予以证实。

REF: Chen J, Nie X, Wang M, et al. Time-Dependent Impact of Mismatch Profiles on Outcomes Following Endovascular Thrombectomy for Large Ischemic Stroke. Stroke. Published online December 24, 2025. doi:10.1161/STROKEAHA.125.052698 PMID: 41439308

Preservation of Septo-Hippocampal Theta Oscillations via Cholinergic Protection Underlies Cognitive Recovery After Physical Exercise Postcardiac Arrest

心脏骤停后体育锻炼通过胆碱能保护维持隔 - 海马θ振荡是认知恢复的基础

Significant cognitive impairment follows cardiac arrest, yet few interventions restore memory. We previously demonstrated that physical exercise (PE) after asphyxial cardiac arrest (ACA) mitigates memory deficits and cell loss in the septal nuclei, but not in the hippocampus in rats. Given the critical role of the septum in modulating hippocampal theta oscillations, essential for memory, we hypothesize that PE preserves memory by safeguarding septal pacemaker neurons and septo-hippocampal theta activity. This study is the first to directly implicate PE-induced cholinergic neuron preservation in the reengagement of septo-hippocampal circuitry and cognitive recovery postcardiac arrest. Rather than relying on hippocampal cell survival, the observed memory improvements appear to stem from reinstated interregional theta synchrony. These findings define a novel mechanistic pathway for promoting functional recovery via targeted circuit-level rehabilitation after ischemic brain injury.

心脏骤停后会出现严重的认知障碍，但很少有干预措施能恢复记忆。我们此前证明，窒息性心脏骤停（ACA）后进行体育锻炼（PE）可减轻大鼠中隔核的记忆缺陷和细胞丢失，但对海马体无效。鉴于中隔在调节对记忆至关重要的海马体θ波振荡中起着关键作用，我们推测体育锻炼通过保护中隔起搏器神经元和中隔 - 海马体θ波活动来保存记忆。这项研究首次直接表明，体育锻炼诱导的胆碱能神经元保存与心脏骤停后中隔 - 海马体神经回路的重新激活和认知恢复有关。观察到的记忆改善似乎并非依赖于海马体细胞的存活，而是源于区域间θ波同步性的恢复。这些发现为缺血性脑损伤后通过有针对性的神经回路层面康复促进功能恢复确定了一条新的机制途径。

REF: Ferrier FJ, Perez-Lao EJ, Lipsky R, et al. Preservation of Septo-Hippocampal Theta Oscillations via Cholinergic Protection Underlies Cognitive Recovery After Physical Exercise Postcardiac Arrest. Stroke. Published online December 24, 2025. doi:10.1161/STROKEAHA.125.053242 PMID: 41439302

Simple MRI Lesion Levels Improve Two-Year Prognostic Accuracy Beyond Clinical History in CADASIL

在伴有皮质下梗死和白质脑病的常染色体显性遗传性脑动脉病（CADASIL）中，简易磁共振成像病变分级对两年预后的预测准确性优于临床病史

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common hereditary cerebral small-vessel disease. The CADASIL MRI Inventory Tool summarizes individual MRI findings as simple, type-specific lesion levels. We assessed the predictive value of these levels beyond clinical information. CADASIL MRI Inventory Tool lesion levels are differentially associated with CADASIL manifestations and provide independent 2-year prognostic information beyond clinical covariates. These simple measures may supplement clinical evaluation to improve short-term risk stratification and support patient selection in clinical trials.

伴有皮质下梗死和白质脑病的常染色体显性遗传性脑动脉病（CADASIL）是最常见的遗传性脑小血管病。CADASIL磁共振成像（MRI）评估工具将个体的MRI表现总结为简单的、特定类型的病变分级。我们评估了这些分级在临床信息之外的预测价值。CADASIL MRI评估工具的病变分级与CADASIL的临床表现存在不同程度的关联，并能在临床协变量之外提供独立的2年预后信息。这些简单的评估指标可补充临床评估，以改善短期风险分层，并有助于在临床试验中筛选患者。

REF: Zhang R, Chen CH, Lambert L, et al. Simple MRI Lesion Levels Improve Two-Year Prognostic Accuracy Beyond Clinical History in CADASIL. Stroke. Published online December 24, 2025. doi:10.1161/STROKEAHA.125.053727 PMID: 41439314

Efficacy of Wearable Exoskeleton for Gait Recovery in Patients With Stroke: A Multicenter Randomized Controlled Trial

可穿戴式外骨骼对脑卒中患者步态恢复的疗效：一项多中心随机对照试验

Robot-assisted gait training (RAGT) with wearable exoskeletons has the potential to enhance walking in patients with stroke; however, large-scale evidence is inconclusive. The aim of this study was to determine the effect of overground gait training using a torque-assisted exoskeleton in patients with subacute stroke on the recovery of ambulatory function. Overground gait training using an exoskeleton was not superior to conventional rehabilitation for improving ambulatory function in subacute stroke patients; however, it could provide additional lower extremity motor improvement. These findings suggest that the overground gait training with an exoskeleton might be a potential intervention for patients with subacute stroke.

使用可穿戴外骨骼的机器人辅助步态训练（RAGT）有改善中风患者行走能力的潜力；然而，大规模的证据尚不明确。本研究的目的是确定使用扭矩辅助外骨骼进行地面步态训练对亚急性中风患者步行功能恢复的影响。对于改善亚急性中风患者的步行功能，使用外骨骼进行地面步态训练并不优于传统康复治疗；然而，它可以额外改善下肢运动功能。这些研究结果表明，使用外骨骼进行地面步态训练可能是亚急性中风患者的一种潜在干预措施。

REF: Chang WH, Kim TW, Kim HS, et al. Efficacy of Wearable Exoskeleton for Gait Recovery in Patients With Stroke: A Multicenter Randomized Controlled Trial. Stroke. Published online December 22, 2025. doi:10.1161/STROKEAHA.125.052763 PMID: 41424275

Progression of Neuroinflammation Is Associated With Clinical Prognosis of Patients Undergoing Intravenous Thrombolysis

神经炎症的进展与接受静脉溶栓治疗患者的临床预后相关

Recent research has shown that neuroinflammation progresses rapidly within a few hours after stroke; however, the relationship between its progression and clinical outcomes remains unclear. Therefore, this study aimed to investigate the effect of neuroinflammation, measured by serum GFAP (glial fibrillary acidic protein), on patient outcomes, as well as the influence of baseline peripheral inflammation on the progression of neuroinflammation. The increase in GFAP levels over the first 24 hours after IVT is independently associated with clinical outcomes, with higher baseline peripheral inflammation correlating with greater GFAP elevation during that period.

近期研究表明，中风后数小时内神经炎症会迅速进展；然而，其进展与临床结局之间的关系仍不清楚。因此，本研究旨在探讨以血清神经胶质纤维酸性蛋白（GFAP）衡量的神经炎症对患者预后的影响，以及基线外周炎症对神经炎症进展的影响。静脉溶栓治疗后首24小时内GFAP水平升高与临床结局独立相关，在此期间，较高的基线外周炎症与GFAP升高幅度较大相关。

REF: Qu Y, Zhou T, Li C, et al. Progression of Neuroinflammation Is Associated With Clinical Prognosis of Patients Undergoing Intravenous Thrombolysis. Stroke. Published online December 19, 2025. doi:10.1161/STROKEAHA.125.053004 PMID: 41416382

Effect of Rurality on Global Access to Mechanical Thrombectomy: A Subanalysis of the MT-GLASS Study

偏远地区特征对全球机械取栓术可及性的影响：MT - GLASS研究的亚组分析

Mechanical thrombectomy access (MTA) for large vessel occlusion stroke varies and is limited globally. While regional studies have suggested rurality as a barrier to MTA, the magnitude and variability of this effect across countries remain unknown. This study evaluates the association of country-level rural population proportion with mechanical thrombectomy (MT) access. Country-level rural population proportion is an independent negative predictor of access to MT. The unique challenges that rural populations experience within countries should be carefully studied to strategize and align global efforts to bridge thrombectomy access gaps and address rural-urban disparities.

对于大血管闭塞性卒中，机械取栓途径（MTA）存在差异，且在全球范围内应用有限。尽管区域研究表明农村地区是获取机械取栓途径的障碍，但这一影响在不同国家的程度和差异仍不清楚。本研究评估了国家级农村人口比例与机械取栓（MT）可及性之间的关联。国家级农村人口比例是获取机械取栓的一个独立负向预测因素。应仔细研究各国农村人口面临的独特挑战，以便制定战略并协调全球行动，缩小取栓可及性差距，解决城乡差异问题。

REF: Asif KS, Aroor S, Otite FO, et al. Effect of Rurality on Global Access to Mechanical Thrombectomy: A Subanalysis of the MT-GLASS Study. Stroke. Published online December 18, 2025. doi:10.1161/STROKEAHA.125.050608 PMID: 41410045

Trametinib Decreased Intracerebral Hemorrhages and Endothelial-to-Mesenchymal Transition in KRASG12V-Induced Brain Arteriovenous Malformations in Mice

曲美替尼可减少小鼠KRASG12V诱导的脑动静脉畸形中的脑出血和内皮-间充质转化

Brain arteriovenous malformations (bAVMs) are a major risk factor for intracerebral hemorrhages in young patients. Recent clinical studies have reported that the majority of human bAVMs harbor somatic KRAS mutations. In our previous study, we confirmed the causal role of endothelial KRASG12V mutation in bAVM development in mice through hyperactivation of the MEK/ERK (extracellular signal-regulated kinase) pathway. However, the treatment efficacy of targeting MEK/ERK signaling in bAVMs, regarding clinical and biological outcomes, remains unclear. Our data demonstrate that trametinib improves bAVM pathology by reducing hemorrhagic risk and normalizing endothelial-to-mesenchymal transition. These findings suggest that trametinib is a promising agent to treat patients with bAVM.

脑动静脉畸形（bAVMs）是年轻患者发生脑出血的主要危险因素。近期临床研究报道，大多数人类脑动静脉畸形存在体细胞KRAS突变。在我们之前的研究中，我们证实了内皮细胞KRAS G12V突变通过过度激活MEK/ERK（细胞外信号调节激酶）通路在小鼠脑动静脉畸形发展中起因果作用。然而，针对MEK/ERK信号通路治疗脑动静脉畸形在临床和生物学结局方面的疗效仍不清楚。我们的数据表明，曲美替尼可通过降低出血风险和使内皮-间质转化正常化来改善脑动静脉畸形病理状况。这些发现提示，曲美替尼是治疗脑动静脉畸形患者的一种有前景的药物。

REF: Myint O, Freeman B, Jeong JY, et al. Trametinib Decreased Intracerebral Hemorrhages and Endothelial-to-Mesenchymal Transition in KRASG12V-Induced Brain Arteriovenous Malformations in Mice. Stroke. Published online December 18, 2025. doi:10.1161/STROKEAHA.125.052418 PMID: 41410028 PMCID: PMC12768455

Patterns of Structural Disconnection Driving Proprioceptive Deficits in Chronic Stroke

慢性卒中中驱动本体感觉障碍的结构连接中断模式

Stroke is a leading cause of death and disability, with proprioceptive impairments affecting up to 64% of survivors. These impairments hinder sensorimotor recovery, significantly impacting poststroke quality of life. Proprioception depends on an integrated brain network but remains underexplored due to limitations in clinical assessments, hindering links between stroke-related damage and functional deficits. We combined quantitative proprioceptive measurements (arm position matching task) with connectome-based lesion-symptom mapping to identify white matter (WM) disconnection patterns underlying proprioceptive deficits in chronic sensorimotor stroke while controlling for motor impairment. We provide evidence that proprioceptive impairments in chronic stroke may arise from network-wide WM disconnection in key tracts mediating proprioceptive function. Our findings highlight the benefits of connectome-based lesion-symptom mapping for assessing stroke-related proprioceptive deficits and offer a framework for network-informed assessments of functional impairments that could guide targeted therapies poststroke.

中风是导致死亡和残疾的主要原因，多达64%的幸存者存在本体感觉障碍。这些障碍会阻碍感觉运动功能的恢复，严重影响中风后的生活质量。本体感觉依赖于一个完整的大脑网络，但由于临床评估的局限性，该领域仍未得到充分研究，这阻碍了确定中风相关损伤与功能缺陷之间的联系。我们将定量的本体感觉测量（手臂位置匹配任务）与基于连接组的病变 - 症状映射相结合，以确定慢性感觉运动性中风患者本体感觉缺陷背后的白质（WM）断开模式，同时控制运动障碍的影响。我们提供的证据表明，慢性中风患者的本体感觉障碍可能源于介导本体感觉功能的关键神经束出现全网络范围的白质断开。我们的研究结果凸显了基于连接组的病变 - 症状映射在评估中风相关本体感觉缺陷方面的优势，并为基于网络的功能障碍评估提供了一个框架，这可能有助于指导中风后的靶向治疗。

REF: Kaeja M, Gajiyeva L, Iturria-Medina Y, Villringer A, Sehm B, Steele C. Patterns of Structural Disconnection Driving Proprioceptive Deficits in Chronic Stroke. Stroke. Published online December 15, 2025. doi:10.1161/STROKEAHA.125.052266 PMID: 41392885