Comparison of sex differences on outcomes after aneurysmal subarachnoid hemorrhage: a propensity score-matched analysis.

OBJECTIVE: Sex differences in outcomes of patients with aneurysmal subarachnoid hemorrhage (aSAH) remain controversial. Therefore, the aim of this study was to investigate the sex differences in the prognosis of patients with aSAH. METHODS: This study retrospectively analyzed the clinical data of aSAH patients admitted to the Department of Neurosurgery of General Hospital of Northern Theater Command, from April 2020 to January 2022. The modified Rankin Scale (mRS) was used to evaluate outcomes at 3-month post-discharge. Baseline characteristics, in-hospital complications and outcomes were compared after 1:1 propensity score matching (PSM). RESULTS: A total of 665 patients were included and the majority (63.8%) were female. Female patients were significantly older than male patients (59.3 ± 10.9 years vs. 55.1 ± 10.9 years, P < 0.001). After PSM, 141 male and 141 female patients were compared. Comparing postoperative complications and mRS scores, the incidence of delayed cerebral ischemia (DCI) and hydrocephalus and mRS ≥ 2 at 3-month were significantly higher in female patients than in male patients. After adjustment, the analysis of risk factors for unfavorable prognosis at 3-month showed that age, sex, smoking, high Hunt Hess grade, high mFisher score, DCI, and hydrocephalus were independent risk factors. CONCLUSION: Female patients with aSAH have a worse prognosis than male patients, and this difference may be because females are more vulnerable to DCI and hydrocephalus.

Classifying epileptic phase-amplitude coupling in SEEG using complex-valued convolutional neural network.

EEG phase-amplitude coupling (PAC), the amplitude of high-frequency oscillations modulated by the phase of low-frequency oscillations (LFOs), is a useful biomarker to localize epileptogenic tissue. It is commonly represented in a comodulogram of coupling strength but without coupled phase information. The phase-amplitude coupling is also found in the normal brain, and it is difficult to discriminate pathological phase-amplitude couplings from normal ones. This study proposes a novel approach based on complex-valued phase-amplitude coupling (CV-PAC) for classifying epileptic phase-amplitude coupling. The CV-PAC combines both the coupling strengths and the coupled phases of low-frequency oscillations. The complex-valued convolutional neural network (CV-CNN) is then used to classify epileptic CV-PAC. Stereo-electroencephalography (SEEG) recordings from nine intractable epilepsy patients were analyzed. The leave-one-out cross-validation is performed, and the area-under-curve (AUC) value is used as the indicator of the performance of different measures. Our result shows that the area-under-curve value is .92 for classifying epileptic CV-PAC using CV-CNN. The area-under-curve value decreases to .89, .80, and .88 while using traditional convolutional neural networks, support vector machine, and random forest, respectively. The phases of delta (1-4 Hz) and alpha (8-10 Hz) bands are different between epileptic and normal CV-PAC. The phase information of CV-PAC is important for improving classification performance. The proposed approach of CV-PAC/CV-CNN promises to identify more accurate epileptic brain activities for potential surgical intervention.

[Isolated effective coherence analysis of epileptogenic networks in temporal lobe epilepsy using stereo-electroencephalography].

Stereo-electroencephalography (SEEG) is widely used to record the electrical activity of patients' brain in clinical. The SEEG-based epileptogenic network can better describe the origin and the spreading of seizures, which makes it an important measure to localize epileptogenic zone (EZ). SEEG data from six patients with refractory epilepsy are used in this study. Five of them are with temporal lobe epilepsy, and the other is with extratemporal lobe epilepsy. The node outflow (out-degree) and inflow (in-degree) of information are calculated in each node of epileptic network, and the overlay between selected nodes and resected nodes is analyzed. In this study, SEEG data is transformed to bipolar montage, and then the epileptic network is established by using independent effective coherence (iCoh) method. The SEEG segments at onset, middle and termination of seizures in Delta, Theta, Alpha, Beta, and Gamma rhythms are used respectively. Finally, the K-means clustering algorithm is applied on the node values of out-degree and in-degree respectively. The nodes in the cluster with high value are compared with the resected regions. The final results show that the accuracy of selected nodes in resected region in the Delta, Alpha and Beta rhythm are 0.90, 0.88 and 0.89 based on out-degree values in temporal lobe epilepsy patients respectively, while the in-degree values cannot differentiate them. In contrast, the out-degree values are higher outside the temporal lobe in the patient with extratemporal lobe epilepsy. Based on the out-degree feature in low-frequency epileptic network, this study provides a potential quantitative measure for identifying patients with temporal lobe epilepsy in clinical.

DNA repair gene ERCC1 polymorphisms may contribute to the risk of glioma.

Polymorphisms in excision repair cross-complementing rodent repair deficiency complementation group 1 (ERCC1) gene have been shown to affect individual susceptibility to glioma, though studies have yielded conflicting results. This meta-analysis aims to derive a more precise estimation of the association between ERCC1 C8092A and C118T polymorphisms and glioma risk. A literature search of PubMed, Embase, Web of Science, Cochrane Library, and CBM databases was conducted to identify all eligible studies published before August 5, 2013. Crude odds ratios (ORs) with their corresponding confidence intervals (95% CIs) were used to assess the strength of this association. A meta-analysis was performed by reviewing seven studies on the C8092A polymorphism (2,978 cases and 4,051 controls) and four studies on the C118T polymorphism (1,390 Asian cases and 1,546 Asian controls). Pooled analysis yielded a significant association between the C8092A variant genotype and increased risk of glioma. As for ethnicity, the A allele was associated with increased risk of glioma in Asians, while no similar finding was observed in Caucasians. Stratified analyses by histological subtype indicated that the C8092A polymorphism showed a significant association with the risk of non-glioblastoma multiforme. For the C118T polymorphism, increased glioma susceptibility was also observed among Asians. Taken together, results from our meta-analysis support the view that common variants in ERCC1 may contribute to susceptibility to glioma, especially in Asians. However, further studies investigating the significance of these two polymorphisms as markers of susceptibility to and disease progression of glioma are still needed.

Lysyl oxidase genetic variants and the prognosis of glioma.

Lysyl oxidase (LOX) is a copper-dependent amine oxidase that plays important roles in the development and homeostasis of primary brain tumors such as glioma. The aim of this study was to investigate whether polymorphisms in the LOX gene were associated with susceptibility to glioma. We tested two functional polymorphisms of LOX, -22G/C and 473G/A, and compared them between 466 glioma cases and 502 healthy controls in the Chinese population. Results showed that the prevalence of 473AA genotype was significantly increased in cases than in controls (p = 0.001). Individuals who carried 473A allele had a 1.44-fold of increased risk for glioma than those with 473G allele (p = 0.002). In addition, when analyzing the survival time of glioma patients with LOX 473G/A polymorphism, cases with AA genotype had significantly shorter survival time compared to the patients carrying G allele (25.0 months vs 43.0 months, p = 0.0009). These results suggested that polymorphism in LOX gene was associated with increased susceptibility to glioma and could be used as prognostic factor for this malignancy.

Treatment of recurrent epileptic seizures in patients with neurological disorders.

This study aimed to investigate the clinical characteristics and the treatment principles and methods of recurrent epileptic seizures in patients with neurological disorders. A retrospective analysis was performed of the clinical data, treatment methods and results in 13 patients with recurrent epileptic seizures attending the neurosurgery department. Of the 13 patients, 10 had a history of epilepsy, 9 had organic frontal lobe brain lesions and 11 exhibited frontal lobe epilepsy. The causes of the epileptic seizure aggravation included drug withdrawal, dose reduction and dressing change (5 cases). The epileptic seizure types included partial and secondary full seizures and the seizure frequency ranged from 1 seizure/3 min to 1 seizure/several h. Following combined therapy with multiple anti-epileptic drugs (AEDs), including oral administration and injection, the epilepsy was controlled. The addition of orally administered levetiracetam improved the treatment efficiency. In cases of recurrent epileptic seizures in patients with neurological disorders, the combined administration of AEDs should be conducted with doses higher than the conventional initial dose to control the epileptic seizures as rapidly as possible.