Late-Life Incident Stroke in the Atherosclerosis Risk in Communities Study: Cause and Prediction

社区动脉粥样硬化风险研究中的晚年新发中风：病因与预测

As life expectancy rises, identifying causes and risk factors for incident acute ischemic stroke (AIS) among the oldest-old (≥80 years) is increasingly important. We examined whether the effect of age at stroke on AIS subtype is mediated by embolic risk factors and whether these factors improve AIS prediction. These findings suggest that identification and control of embolic risk factors are critical to reduce stroke risk as people age, and better stroke-specific prediction tools are needed.

随着预期寿命的延长，确定高龄老人（≥80岁）新发急性缺血性卒中（AIS）的病因和危险因素变得越来越重要。我们研究了卒中发生时的年龄对AIS亚型的影响是否由栓塞性危险因素介导，以及这些因素是否能改善AIS的预测。这些研究结果表明，识别和控制栓塞性危险因素对于降低老年人的卒中风险至关重要，并且需要更好的卒中特异性预测工具。

REF: Wang J, Egle M, Jin Z, et al. Late-Life Incident Stroke in the Atherosclerosis Risk in Communities Study: Cause and Prediction. Stroke. Published online April 30, 2026. doi:10.1161/STROKEAHA.125.054194 PMID: 42059062 PMCID: PMC13143348

Mapping the mRS Scores Into the EQ-5D-5L in Patients With Ischemic Stroke

缺血性中风患者改良Rankin量表（mRS）评分映射至五维健康量表（EQ - 5D - 5L）

Mapping concerns the cross-walking of one health-related quality of life instrument to another. This study aimed to translate the modified Rankin Scale (mRS) score at 3 months after ischemic stroke into a 5-level version of the EQ-5D-based utility values, which may be used for the derivation of quality-adjusted life years for cost-effectiveness analyses. The mean utility weights provided in this study may be used for the direct estimation of quality-adjusted life years from mRS scores. Furthermore, the multinomial logit model may be used to derive utility values from new data sets with different country-specific utility tariffs. Our results are ideally suited for application in cost-effectiveness analyses.

映射涉及将一种与健康相关的生活质量测量工具与另一种进行交叉转换。本研究旨在将缺血性中风后3个月的改良Rankin量表（mRS）评分转换为基于EQ - 5D的5个等级版本的效用值，这些效用值可用于推导质量调整生命年，以进行成本效益分析。本研究中提供的平均效用权重可用于直接根据mRS评分估算质量调整生命年。此外，多项逻辑回归模型可用于从具有不同国家特定效用费率的新数据集中推导出效用值。我们的研究结果非常适合应用于成本效益分析。

REF: Pinckaers FME, Grutters JPC, Evers SMAA, et al. Mapping the mRS Scores Into the EQ-5D-5L in Patients With Ischemic Stroke. Stroke. Published online April 29, 2026. doi:10.1161/STROKEAHA.126.055741 PMID: 42052683

Brain Health Across the Life Span: A Framework for Future Studies: A Scientific Statement From the American Heart Association

全生命周期的脑健康：未来研究框架——美国心脏协会科学声明

The concepts of brain health (ie, optimal functioning of the brain across cognitive, emotional, and behavioral domains throughout life) and cognitive resilience (ie, the ability of the brain to recover after an insult) have become increasingly important as the population ages. Previous research has called attention to vascular risk factors underlying cerebrovascular disease, as well as modifiable variables that contribute to premature aging and cognitive dysfunction. In this scientific statement, we focus on the role of nonvascular physical and psychologic variables that affect brain health across the life span. We provide a broad overview of influences such as chronic medical conditions, inflammation, environmental exposures, and socioeconomic drivers that affect the developing brain, along with factors including sleep quality, the gut microbiome, and mental health that contribute to neurodegeneration. We also review the varying strength of evidence supporting biologic mechanisms and mitigating strategies that may help optimize resilience, with the goal of providing a framework for future studies.

随着人口老龄化，脑健康（即大脑在一生中的认知、情感和行为领域的最佳功能）和认知恢复力（即大脑在受到损伤后恢复的能力）的概念变得越来越重要。先前的研究已关注到脑血管疾病背后的血管危险因素，以及导致过早衰老和认知功能障碍的可改变变量。在这份科学声明中，我们聚焦于影响终身脑健康的非血管性身体和心理变量的作用。我们广泛概述了影响发育中大脑的因素，如慢性疾病、炎症、环境暴露和社会经济驱动因素，以及包括睡眠质量、肠道微生物群和心理健康等导致神经退行性变的因素。我们还回顾了支持生物机制和缓解策略的不同强度的证据，这些策略可能有助于优化恢复力，旨在为未来研究提供一个框架。

REF: Marsh EB, Lavretsky H, Kasparian NA, et al. Brain Health Across the Life Span: A Framework for Future Studies: A Scientific Statement From the American Heart Association. Stroke. Published online April 28, 2026. doi:10.1161/STR.0000000000000518 PMID: 42047038

Early Inflammatory Biomarkers Associated With Functional Outcomes in Acute Cerebral Venous Thrombosis: CLOT-VENUS Substudy

急性脑静脉血栓形成中与功能结局相关的早期炎症生物标志物：CLOT - VENUS 亚研究

Inflammatory serum biomarkers, including neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII), are associated with outcomes in acute cerebrovascular diseases. However, their prognostic role in cerebral venous thrombosis remains uncertain. We aimed to assess the prognostic value of these biomarkers in acute cerebral venous thrombosis by identifying optimal thresholds and internally validating their predictive performance. Elevated admission levels of neutrophil-to-lymphocyte ratio, PLR, monocyte-to-lymphocyte ratio, and SII are independently associated with poor discharge and 6-month outcomes in patients with acute cerebral venous thrombosis. These accessible biomarkers may aid early risk stratification. Further studies should validate and explore its usefulness in clinical models for personalized management.

包括中性粒细胞与淋巴细胞比值、单核细胞与淋巴细胞比值、血小板与淋巴细胞比值（PLR）和全身免疫炎症指数（SII）在内的炎症血清生物标志物与急性脑血管疾病的预后相关。然而，它们在脑静脉血栓形成中的预后作用仍不确定。我们旨在通过确定最佳阈值并对其预测性能进行内部验证，评估这些生物标志物在急性脑静脉血栓形成中的预后价值。急性脑静脉血栓形成患者入院时中性粒细胞与淋巴细胞比值、PLR、单核细胞与淋巴细胞比值和SII水平升高与出院时及6个月预后不良独立相关。这些易于获取的生物标志物可能有助于早期风险分层。进一步的研究应验证并探索其在个性化管理临床模型中的实用性。

REF: Cruz-Criollo L, Galecio-Castillo M, Rodriguez-Calienes A, et al. Early Inflammatory Biomarkers Associated With Functional Outcomes in Acute Cerebral Venous Thrombosis: CLOT-VENUS Substudy. Stroke. Published online April 22, 2026. doi:10.1161/STROKEAHA.125.052774 PMID: 42017277

Endovascular Thrombectomy Versus Standard Medical Management in Acute Anterior Cerebral Artery Occlusion Stroke: The ORIENTAL-MeVO Registry Study

急性大脑前动脉闭塞性卒中血管内取栓术与标准药物治疗的比较：ORIENTAL - MeVO注册研究

The benefit of endovascular thrombectomy (EVT) in patients with stroke with proximal large vessel occlusion in the anterior circulation has been confirmed by several randomized controlled trials. However, evidence regarding EVT for anterior cerebral artery occlusion (ACAo) remains limited. This study aimed to compare clinical outcomes between EVT and standard medical management (SMM) in patients with ACAo. EVT for ACAo is associated with better clinical outcomes compared with SMM, particularly in patients with moderate to severe stroke, without increased risk of symptomatic intracranial hemorrhage or 90-day mortality.

多项随机对照试验已证实，血管内血栓切除术（EVT）对前循环近端大血管闭塞性卒中患者有益。然而，关于大脑前动脉闭塞（ACAo）采用EVT治疗的证据仍然有限。本研究旨在比较ACAo患者接受EVT治疗与标准药物治疗（SMM）的临床结局。与SMM相比，ACAo患者接受EVT治疗可获得更好的临床结局，尤其是在中重度卒中患者中，且不会增加症状性颅内出血风险或90天死亡率。

REF: Zhang K, Jing X, Abdalkader M, et al. Endovascular Thrombectomy Versus Standard Medical Management in Acute Anterior Cerebral Artery Occlusion Stroke: The ORIENTAL-MeVO Registry Study. Stroke. Published online April 22, 2026. doi:10.1161/STROKEAHA.125.054127 PMID: 42017224

Motor Impairment and Adaptation in a Novel Nonhuman Primate Model of Internal Capsule Infarct

内囊梗死新型非人灵长类动物模型中的运动障碍与适应

Loss of hand control is a major source of poststroke disability, particularly when infarcts involve subcortical white matter. Yet, most preclinical models target the cortex and infer recovery from task performance without quantifying whether improvements reflect restoration or adaptation. To address this, we developed a novel nonhuman primate model of focal internal capsule infarct. This study is exploratory and hypothesis-testing, including prespecified hypotheses regarding motor impairment and adaptation. This model recapitulates key features of human subcortical stroke, including persistent distal motor deficits, shifts in hand preference, systematic motor adaptation, and interindividual variability, establishing a translationally oriented platform for studying stroke mechanisms and evaluating recovery-promoting interventions.

手部控制能力丧失是中风后残疾的主要原因，尤其是当梗死灶累及皮质下白质时。然而，大多数临床前模型都以皮质为靶点，并根据任务表现推断恢复情况，而未量化这种改善是反映了功能恢复还是适应性调整。为解决这一问题，我们开发了一种全新的局灶性内囊梗死非人灵长类动物模型。本研究兼具探索性和假设检验性，包含了关于运动障碍和适应性调整的预设假设。该模型重现了人类皮质下中风的关键特征，包括持续的远端运动障碍、手部偏好改变、系统性运动适应以及个体间差异，为研究中风机制和评估促恢复干预措施搭建了一个具有转化导向的平台。

REF: Sivakumar SS, Anand SA, Brawer L, et al. Motor Impairment and Adaptation in a Novel Nonhuman Primate Model of Internal Capsule Infarct. Stroke. Published online April 22, 2026. doi:10.1161/STROKEAHA.125.054365 PMID: 42017256 PMCID: PMC13135776

Use of Imaging to Guide Eligibility for Reperfusion Therapies in Acute Ischemic Stroke

影像学检查用于指导急性缺血性卒中再灌注治疗的适应证评估

Imaging is pivotal across all stages of stroke care, particularly acutely where it is central to diagnosis, prognostication, and selecting patients with a favorable benefit-to-risk profile for thrombolysis and endovascular therapy. With new therapies emerging and treatment eligibility expanding to broader patient populations, imaging strategies have evolved. This review will highlight the evolution in acute stroke imaging, examine emerging and ongoing clinical trials in which imaging is integral to patient selection, and identify priority areas for future research and development.

影像学检查在中风治疗的各个阶段都至关重要，尤其是在急性期，它对诊断、预后评估以及筛选适合进行溶栓和血管内治疗且获益风险比良好的患者起着核心作用。随着新疗法的出现以及治疗适用范围扩大到更广泛的患者群体，影像学策略也在不断发展。本综述将着重介绍急性中风影像学的发展，探讨影像学检查对患者筛选至关重要的新兴及正在进行的临床试验，并确定未来研发的重点领域。

REF: Yogendrakumar V, Thomalla G, Xiong Y, et al. Use of Imaging to Guide Eligibility for Reperfusion Therapies in Acute Ischemic Stroke. Stroke. Published online April 16, 2026. doi:10.1161/STROKEAHA.125.052748 PMID: 41988724

Endovascular Thrombectomy in Patients With Largest Baseline Infarcts (ASPECTS 0–2): An Ancillary Analysis of the LASTE Trial

基线梗死灶最大（阿尔伯塔卒中项目早期 CT 评分 0 - 2 分）患者的血管内血栓切除术：LASTE 试验的一项补充分析

Endovascular thrombectomy (EVT) has demonstrated benefits in patients with ischemic stroke and large-vessel occlusions, but its efficacy and safety in patients with the largest baseline infarcts (Alberta Stroke Program Early Computed Tomography Score [ASPECTS] 0-2), remain controversial. This study aimed to evaluate the efficacy and safety of EVT in early presenting patients with ASPECTS 0 to 2 compared with medical care alone. EVT improves functional outcomes and reduces mortality in patients with ASPECTS 0 to 2. These findings support the concept that in patients aged <80 years presenting within early time window (6.5 hours) with unlimitedly large infarct (predominantly selected using magnetic resonance imaging), the infarct size in isolation should not be used to disqualify patients from endovascular treatment.

血管内血栓切除术（EVT）已证实对缺血性中风和大血管闭塞患者有益，但对于基线梗死面积最大（阿尔伯塔中风项目早期计算机断层扫描评分[ASPECTS]为0 - 2）的患者，其有效性和安全性仍存在争议。本研究旨在评估与单纯药物治疗相比，EVT对早期就诊的ASPECTS评分为0至2的患者的有效性和安全性。EVT可改善ASPECTS评分为0至2的患者的功能结局并降低死亡率。这些研究结果支持以下观点：对于在早期时间窗（6.5小时）内就诊、梗死面积极大（主要通过磁共振成像筛选）且年龄小于80岁的患者，不能仅依据梗死面积大小就排除其接受血管内治疗的可能性。

REF: Lapergue B, Arquizan C, Albucher JF, et al. Endovascular Thrombectomy in Patients With Largest Baseline Infarcts (ASPECTS 0-2): An Ancillary Analysis of the LASTE Trial. Stroke. Published online April 14, 2026. doi:10.1161/STROKEAHA.125.054161 PMID: 41979451

Subarachnoid Hemorrhage Induces mPFC CRF Neuronal Dysfunction Leading to Anxiety and Depression in Male Mice

蛛网膜下腔出血导致雄性小鼠内侧前额叶皮质促肾上腺皮质激素释放因子神经元功能障碍，引发焦虑和抑郁

Anxiety and depression are common neuropsychiatric sequelae after subarachnoid hemorrhage (SAH), yet the underlying neural mechanisms remain poorly understood. The CRF (corticotropin-releasing factor) system in the medial prefrontal cortex (mPFC) is critical for emotional regulation and stress adaptation; however, its involvement in SAH-induced affective disorders has not been defined. Dysfunction of mPFC CRF neurons is a key contributor to anxiety and depression after SAH. Basolateral amygdala inputs modulate mPFC CRF neuron activity, and SYT9 downregulation represents a critical molecular mechanism underlying their impairment. These findings identify mPFC CRF neuronal dysfunction as a core pathological feature of SAH-induced affective disorders and provide mechanistic insight into potential therapeutic targets.

焦虑和抑郁是蛛网膜下腔出血（SAH）后常见的神经精神后遗症，但其潜在的神经机制仍知之甚少。内侧前额叶皮质（mPFC）中的促肾上腺皮质激素释放因子（CRF）系统对情绪调节和应激适应至关重要；然而，其在SAH所致情感障碍中的作用尚未明确。mPFC的CRF神经元功能障碍是SAH后焦虑和抑郁的关键原因。基底外侧杏仁核输入可调节mPFC的CRF神经元活动，突触结合蛋白9（SYT9）表达下调是其功能受损的关键分子机制。这些发现表明，mPFC的CRF神经元功能障碍是SAH所致情感障碍的核心病理特征，并为潜在的治疗靶点提供了机制方面的见解。

REF: Yan J, Liang F, Wu N, et al. Subarachnoid Hemorrhage Induces mPFC CRF Neuronal Dysfunction Leading to Anxiety and Depression in Male Mice. Stroke. Published online April 13, 2026. doi:10.1161/STROKEAHA.125.054572 PMID: 41969095