NeuroSci

Background: Prior SMA mortality studies have shown excess mortality in people with SMA, but the literature lacks data on disparities in SMA-related mortality. This study examined disparities in SMA-related mortality in the United States in the post-treatment era (2018–2023). Methods: This was a population-based study using the CDC Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database. The International Classification of Disease (ICD), 10th Revision, Clinical Modification codes, G12.0, G12.1, G12.8, and G12.9, were used to identify SMA. The data were stratified by biological sex, race/ethnicity (Non-Hispanic/NH White, NH Black, Hispanic, Asian) and Census regions (West, Northeast, Midwest, South). The analysis was conducted by calculating rate ratios (RR) of age-adjusted mortality rate (AAMR). Results: There were 821 (45.8% female) SMA-related deaths across the study period. Males were associated with higher AAMR than females (RR = 1.189, 95% CI: 1.035 to 1.366). The SMA-AAMR for NH White individuals was the highest compared to Hispanic individuals (RR = 1.808, 95% CI: 1.420 to 2.300), followed by NH Black and Asian individuals. The West carried the highest AAMR compared to the Northeast (RR = 1.581, 95% CI: 1.263 to 1.978), followed by the Midwest and the South. The age at death distribution showed a bimodal pattern, as follows: 5–14 years and 65–74 years. The infant age group (<1 year) was associated with the highest AAMR compared to all other age groups. Conclusion: Our findings showed that SMA-related mortality was highest in infants, NH White individuals, the West, and males. These data may assist future efforts to reduce the burden of SMA.

Developmental dyslexia (DD) often involves difficulties in phonological processing of speech. Objectives: While underlying neural changes have been identified in terms of stimulus- and task-related responses within specific brain regions and their neural connectivity, there is still limited understanding of how these changes affect the overall organization of brain networks. Methods: This study used EEG and functional network analysis, focusing on small-world propensity across various frequency bands (from δ to γ), to explore the global brain organization during the auditory discrimination of words and pseudowords in children with DD. Results: The main finding revealed a systemic inefficiency in the functional network of individuals with DD, which did not achieve the optimal small-world propensity. This inefficiency arises from a fundamental trade-off between localized specialization and global communication. During word listening, the δ-/γ1-networks (related to impaired syllabic and phonemic processing of words) and the θ-/β-networks (related to pseudoword listening) in the DD group showed lower local clustering and connectivity compared to the control group, resulting in reduced functional segregation. In particular, the θ-/β-networks for words in the DD group exhibited a less optimal balance between specialized local processing and effective global communication. Centralized midline hubs, such as the postcentral gyrus (PstCG) and inferior frontal gyrus (IFG), which are crucial for global coordination, attention, and executive control, were either absent or inconsistent in individuals with DD. Consequently, the DD network adopted a constrained, motor-compensatory, and left-lateralized strategy. This led to the redirection of information flow and processing effort toward the left PstCG/IFG loop, interpreted as a compensatory effort to counteract automatic processing failures. Additionally, the γ1-network, which is involved in phonetic feature binding, lacked engagement from posterior sensory hubs, forcing this critical process into a slow and effortful motor loop. The γ2-network exhibited unusual activation of right-hemisphere posterior areas during word processing, while it employed a simpler, less mature routing strategy for pseudoword listening, which further diminished global communication. Conclusions: This functionality highlights the core phonological and temporal processing deficits characteristic of dyslexia.

Objective: The safety of intravenous thrombolysis (IVT) for acute ischemic stroke (AIS) patients with pituitary neoplasms is unclear. This study aims to assess IVT’s safety and efficacy in this patient population. Methods: We reviewed PubMed, Scopus, EMBASE, and Web of Science through July 2025 for reports of IVT administration in AIS patients with pituitary neoplasia. We also performed a retrospective analysis of the Nationwide Readmissions Database (NRD) from 2016 to 2022 to compare outcomes of IVT versus no IVT for AIS patients with pituitary neoplasia, and outcomes of IVT-treated AIS patients with versus without pituitary neoplasia. Outcomes of interest include post-stroke functional status, intracranial hemorrhage (ICH), mortality, and pituitary apoplexy. Multivariate regression analyses were performed to adjust for confounders. Results: The literature review identified 5 AIS patients with pituitary neoplasia, of whom 3/5 (60%) experienced intracranial hemorrhage and none developed apoplexy. In the nationwide analysis of 1,246,750 AIS patients, 1661 (0.13%) had concomitant pituitary neoplasm. Among these patients, IVT was associated with higher odds of functional independence at discharge (adjusted OR 2.46 [95%CI 1.56–3.87]), without increased risk of ICH or in-hospital death (p > 0.05). No cases of pituitary apoplexy were observed. Outcomes among all IVT-treated AIS patients did not differ between those with and without pituitary neoplasms (all p > 0.05). Interpretation: Only five cases of IVT for AIS patients with pituitary neoplasia were identified, highlighting a striking lack of clinical data. In a large U.S. cohort of AIS patients, IVT was associated with improved hospitalization outcomes without increased risk of ICH or pituitary apoplexy.