Prevalence of depression and cognitive impairment and their inter-relationship and association with quality of life among older stroke survivors: the findings of a national survey in China

老年卒中幸存者抑郁和认知障碍的患病率及其相互关系以及与生活质量的关联：中国一项全国性调查的结果

Post-stroke depression (PSD) and post-stroke cognitive impairment (PSCI) are prevalent neuropsychiatric problems that are associated with high disability burden and low quality of life (QoL). This study explored the PSD-PSCI network, along with the interaction and association with QoL among Chinese older stroke survivors. This study revealed that both PSD and PSCI were prevalent among older stroke survivors. The key central and bridge symptoms in the PSD-PSCI network, along with those symptoms that negatively impact on QoL, should be prioritised in targeted interventions to enhance treatment outcomes in this population.

卒中后抑郁（PSD）和卒中后认知障碍（PSCI）是常见的神经精神问题，与高残疾负担和低生活质量（QoL）相关。本研究探讨了中国老年卒中幸存者中PSD - PSCI网络，以及其与生活质量的相互作用和关联。本研究显示，PSD和PSCI在老年卒中幸存者中均较为普遍。PSD - PSCI网络中的关键核心症状和桥梁症状，以及那些对生活质量产生负面影响的症状，应在针对性干预中优先考虑，以提高该人群的治疗效果。

REF: Zheng MR, Chen P, Feng Y, et al. Prevalence of depression and cognitive impairment and their inter-relationship and association with quality of life among older stroke survivors: the findings of a national survey in China. Stroke Vasc Neurol. Published online July 6, 2025. doi:10.1136/svn-2024-003623 PMID: 40623732

Predictors of futile recanalisation in patients with large infarct: a post-hoc analysis of the ANGEL-ASPECT trial

大面积梗死患者血管再通失败的预测因素：ANGEL - ASPECT试验的事后分析

Studies on futile recanalisation after endovascular therapy (EVT) for anterior circulation large vessel occlusion with large infarct were scarce. The present study aimed to explore the incidence and independent predictors of futile recanalisation in patients with large infarct. Futile recanalisation occurred in approximately half of patients who had an acute stroke with large infarct after EVT in the ANGEL-ASPECT trial. Nonmodifiable factors that included old age, high baseline NIHSS score, diabetes mellitus, sICH and large FIV, and modifiable factors that included respiratory failure were independent predictors of futile recanalisation after EVT for large ischaemic strokes. Stroke-related pneumonia control may improve prognosis.

针对大面积梗死的前循环大血管闭塞患者进行血管内治疗（EVT）后出现再通无改善情况的研究较少。本研究旨在探讨大面积梗死患者再通无改善的发生率及其独立预测因素。在“天使 - ASPECT”试验中，约半数发生大面积梗死的急性脑卒中患者在接受血管内治疗后出现再通无改善情况。高龄、高基线美国国立卫生研究院卒中量表（NIHSS）评分、糖尿病、症状性颅内出血（sICH）和大面积梗死体积（FIV）等不可改变因素，以及呼吸衰竭等可改变因素，是大面积缺血性脑卒中血管内治疗后再通无改善的独立预测因素。控制卒中相关性肺炎可能改善预后。

REF: Yi T, Huo X, Lin X, et al. Predictors of futile recanalisation in patients with large infarct: a post-hoc analysis of the ANGEL-ASPECT trial. Stroke Vasc Neurol. Published online July 6, 2025. doi:10.1136/svn-2024-003382 PMID: 40623733

Vascular β-amyloid potentially colocalises with phosphorylated tau in cerebral amyloid angiopathy

在脑淀粉样血管病中，血管β-淀粉样蛋白可能与磷酸化tau蛋白共定位

Tau pathology is observed in cerebral amyloid angiopathy (CAA) and is related to cognitive impairment and neurodegeneration. However, the relationship between tau pathology and amyloid accumulation in the vasculature is unknown. We aimed to assess if regional associations exist between vascular amyloid and tau protein in sporadic CAA. In CAA, tau pathology exhibits significant regional in situ correlations with amyloid deposition in the posterior brain, which suggests a distinct pathophysiology to AD.

在脑淀粉样血管病（CAA）中可观察到tau蛋白病变，且其与认知障碍和神经退行性变有关。然而，tau蛋白病变与血管中淀粉样蛋白积聚之间的关系尚不清楚。我们旨在评估散发性CAA中血管淀粉样蛋白与tau蛋白之间是否存在区域相关性。在CAA中，tau蛋白病变与后脑的淀粉样蛋白沉积存在显著的原位区域相关性，这表明其病理生理学与阿尔茨海默病（AD）不同。

REF: Tsai HH, Lee BC, Liu CJ, et al. Vascular β-amyloid potentially colocalises with phosphorylated tau in cerebral amyloid angiopathy. Stroke Vasc Neurol. Published online July 6, 2025. doi:10.1136/svn-2024-003774 PMID: 40461155

Multiomics genetic insights into potential molecular targets for intracranial aneurysm

颅内动脉瘤潜在分子靶点的多组学遗传学见解

This study aimed to identify multiomics therapeutic targets for aneurysmal subarachnoid haemorrhage (aSAH) and unruptured intracranial aneurysm (uIA) using Mendelian randomisation (MR), summary-data-based MR (SMR) and postanalysis methods. The study identified key targets for aSAH and uIA, providing insights for developing preventive therapies and advancing research on intracranial aneurysm mechanisms.

本研究旨在运用孟德尔随机化（MR）、基于汇总数据的孟德尔随机化（SMR）及后续分析方法，确定动脉瘤性蛛网膜下腔出血（aSAH）和未破裂颅内动脉瘤（uIA）的多组学治疗靶点。该研究确定了aSAH和uIA的关键靶点，为开发预防性疗法和推进颅内动脉瘤机制研究提供了见解。

REF: Jia Y, Lin F, Li R, Yang Y, Chen X, Wang S. Multiomics genetic insights into potential molecular targets for intracranial aneurysm. Stroke Vasc Neurol. Published online July 10, 2025. doi:10.1136/svn-2025-004175 PMID: 40639910

Functional outcomes of minimally invasive surgery treatment for patients with small supratentorial spontaneous intracerebral haematoma less than 30 mL: a propensity score matching study

30 mL以下幕上小型自发性脑出血患者微创手术治疗的功能结局：一项倾向得分匹配研究

This study investigated the efficacy of frameless robot-assisted stereotactic aspiration coupled with catheter thrombolysis (SA-CT) in treating supratentorial spontaneous intracerebral haemorrhage (sICH) with small haematoma volumes (<30 mL). Frameless robot-guided SA-CT for small supratentorial haematoma with contralateral hemiplegia seems safe and potentially facilitates the recovery of independent standing ability and reduces the mortality rates.

本研究探讨了无框架机器人辅助立体定向抽吸联合导管溶栓（SA - CT）治疗血肿量较小（<30 mL）的幕上自发性脑出血（sICH）的疗效。对于伴有对侧偏瘫的幕上小血肿，采用无框架机器人引导的SA - CT治疗似乎是安全的，且可能有助于恢复独立站立能力并降低死亡率。

REF: Sun H, Luo X, Guo Z, et al. Functional outcomes of minimally invasive surgery treatment for patients with small supratentorial spontaneous intracerebral haematoma less than 30 mL: a propensity score matching study. Stroke Vasc Neurol. Published online July 17, 2025. doi:10.1136/svn-2024-003893 PMID: 40246319

Rationale and design of Low-Frequency REpetitive TRanscranial Magnetic Stimulation Combined with Endovascular Treatment in ACute Ischaemic StrokE (RETRACE II): a randomised double-blind controlled multicentre phase II pilot study

低频重复经颅磁刺激联合血管内治疗急性缺血性卒中的原理与设计（RETRACE II）：一项随机双盲对照多中心 II 期先导研究

While endovascular therapy (EVT) remains the primary treatment for acute ischaemic stroke (AIS) management, persistent functional deficits in patients with successful recanalisation underscore the necessity for complementary neuroprotective strategies. To investigate the safety and efficacy of low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) as a potential adjunctive neuroprotective intervention following EVT in AIS patients. RETRACE-II establishes methodological rigour for evaluating neuromodulation therapies during the hyperacute stroke phase, with findings expected to inform future trials and advance combination therapy paradigms in cerebrovascular neuroprotection.

尽管血管内治疗（EVT）仍然是急性缺血性卒中（AIS）管理的主要治疗方法，但成功再通患者仍存在持续性功能缺损，这凸显了采用辅助神经保护策略的必要性。旨在研究低频重复经颅磁刺激（LF - rTMS）作为AIS患者血管内治疗后潜在的辅助神经保护干预措施的安全性和有效性。“急性缺血性卒中血管内治疗后低频重复经颅磁刺激研究 - II”（RETRACE - II）为评估超急性卒中阶段的神经调节疗法制定了严谨的方法，其研究结果有望为未来试验提供参考，并推动脑血管神经保护联合治疗模式的发展。

REF: Ding L, Wang W, Yi T, et al. Rationale and design of Low-Frequency REpetitive TRanscranial Magnetic Stimulation Combined with Endovascular Treatment in ACute Ischaemic StrokE (RETRACE II): a randomised double-blind controlled multicentre phase II pilot study. Stroke Vasc Neurol. Published online July 28, 2025. doi:10.1136/svn-2025-004331 PMID: 40721316

Altered gut microbiota and short-chain fatty acid in acute ischaemic stroke with active cancer

合并活动性癌症的急性缺血性卒中患者肠道微生物群及短链脂肪酸的改变

Acute ischaemic stroke (AIS) in patients with active cancer presents unique etiological factors and correlates with worse outcomes. Although gut microbiota dysbiosis has been separately documented in stroke pathophysiology and cancer progression, gut microbial profiles in patients with concurrent conditions remain unexplored. We investigated gut microbiota composition and short-chain fatty acid (SCFA) levels in patients with AIS and active cancer. Patients with concurrent AIS and active cancer demonstrate distinct gut microbiota profiles and reduced SCFA production, associated with compromised intestinal barrier function and poor outcomes. These observations suggest perturbed gut-brain axis function and motivate exploratory research into microbiota-targeted approaches for this high-risk population.

患有活动性癌症的患者发生急性缺血性卒中（AIS）具有独特的病因因素，且与更差的预后相关。尽管在卒中病理生理学和癌症进展中分别有关于肠道微生物群失调的报道，但并发这两种疾病的患者的肠道微生物特征仍未被探索。我们研究了患有AIS和活动性癌症患者的肠道微生物群组成和短链脂肪酸（SCFA）水平。并发AIS和活动性癌症的患者表现出独特的肠道微生物群特征，且SCFA生成减少，这与肠道屏障功能受损和不良预后相关。这些观察结果提示肠道 - 脑轴功能紊乱，并促使对针对这一高危人群的微生物群靶向治疗方法开展探索性研究。

REF: Song W, Lin X, Xia G, et al. Altered gut microbiota and short-chain fatty acid in acute ischaemic stroke with active cancer. Stroke Vasc Neurol. Published online July 30, 2025. doi:10.1136/svn-2025-004217 PMID: 40738752

Association of fluid balance with 3-month outcomes in severe acute ischaemic stroke

液体平衡与严重急性缺血性脑卒中3个月预后的关联

Fluid therapy is commonly used for patients with severe stroke, for whom fluid balance is a safety endpoint for evaluating the therapy. We aimed to investigate the association of fluid balance with 3-month outcomes in patients with severe ischaemic stroke. In patients with severe ischaemic stroke, the positive fluid balance in the first 3 days was associated with a higher risk of death at 3 months.

液体疗法常用于重症卒中患者，对于这类患者，液体平衡是评估该疗法的一个安全终点。我们旨在研究重症缺血性卒中患者的液体平衡情况与3个月预后的关联。在重症缺血性卒中患者中，发病前3天的液体正平衡与3个月时较高的死亡风险相关。

REF: Liu M, Wang Y, Hua X, Huang L, Liu M, Wu S. Association of fluid balance with 3-month outcomes in severe acute ischaemic stroke. Stroke Vasc Neurol. Published online July 30, 2025. doi:10.1136/svn-2024-004001 PMID: 40738754

Where are we going for the treatment in ischaemic stroke: a comprehensive study of investigator-sponsored randomised controlled trials, 1990–2024

缺血性卒中的治疗方向何在：1990 - 2024年研究者发起的随机对照试验的综合研究

Until recently, a comprehensive understanding of the current development status and emerging trends of investigator-sponsored randomised controlled trials (RCTs) for the treatment of ischaemic stroke (IS) on a global scale remains elusive, making it unclear where the research and innovation in the field are going. Since 1990 to the present, investigator-sponsored RCTs of IS treatment have seen a significant increase worldwide. Nevertheless, a multitude of impediments in the DREP cycle still persists that necessitate resolution and enhancement. There is a pressing need for addressing issues such as retrospective registration, premature termination of enrolment and suppression of study results, to further expand the reach of research improvements to a wider patient community.

直到最近，全球范围内对研究者发起的缺血性卒中（IS）治疗随机对照试验（RCT）的当前发展状况和新兴趋势仍缺乏全面了解，这使得该领域的研究和创新方向不明。自1990年至今，全球范围内研究者发起的IS治疗RCT数量显著增加。然而，设计、实施、报告和出版（DREP）周期中仍存在诸多障碍，亟待解决和改进。迫切需要解决回顾性注册、提前终止入组以及隐瞒研究结果等问题，以便将研究改进的成果惠及更广泛的患者群体。

REF: Li X, Xia X, Gao M, et al. Where are we going for the treatment in ischaemic stroke: a comprehensive study of investigator-sponsored randomised controlled trials, 1990-2024. Stroke Vasc Neurol. Published online July 30, 2025. doi:10.1136/svn-2025-004027 PMID: 40738753