Evidence map›Paper›PMID 34167480›Full record

ArticleBMC neurology2021

Cerebral large artery stenosis and occlusion in POEMS syndrome.

Atsuhiko Sugiyama, Hajime Yokota, Sonoko Misawa, Hiroki Mukai, Yukari Sekiguchi, Kyosuke Koide, Tomoki Suichi, Jun Matsushima, Takashi Kishimoto, Zen-Ichi Tanei and 3 more

Open access · goldAbstract read
In one paragraph

Article in BMC neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.2field-weighted citation impact, top 44% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 3 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 5 institutions in 1 country.

Atsuhiko SugiyamaDepartment of Neurology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, 260-8677, Chiba, Japan. asugiyama@chiba-u.jp.
Hajime YokotaDepartment of Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Sonoko MisawaDepartment of Neurology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, 260-8677, Chiba, Japan.
Hiroki MukaiDepartment of Radiology, Chiba University Hospital, Chiba, Japan.
Yukari SekiguchiDepartment of Neurology, JR Tokyo General Hospital, Tokyo, Japan.
Kyosuke KoideDepartment of Neurology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, 260-8677, Chiba, Japan.
Tomoki SuichiDepartment of Neurology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, 260-8677, Chiba, Japan.
Jun MatsushimaDepartment of Pathology, Saitama Medical Center, Dokkyo Medical University, Saitama, Japan.
Takashi KishimotoDepartment of Molecular Pathology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Zen-Ichi TaneiDepartment of Pathology and Laboratory Medicine, National Center of Neurology and Psychiatry, Tokyo, Japan.
Yuko SaitoDepartment of Pathology and Laboratory Medicine, National Center of Neurology and Psychiatry, Tokyo, Japan.
Shoichi ItoDepartment of Neurology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, 260-8677, Chiba, Japan.
Satoshi KuwabaraDepartment of Neurology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, 260-8677, Chiba, Japan.
Chiba University · JPNational Center of Neurology and Psychiatry · JPChiba University Hospital · JPDokkyo Medical University · JPJR Tokyo General Hospital · JP

Funding

Japan Agency for Medical Research and Development JP 18dm0107103
6 · The paper itself

Abstract

backgroundThis study aimed to investigate the frequency and risk factors for cerebral artery stenosis and occlusion in patients with polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes (POEMS) syndrome.

methodsWe reviewed results of magnetic resonance angiography (MRA) or computed tomography angiography (CTA) in 61 patients with POEMS syndrome seen between 2010 and 2017. Stenosis or occlusion was assessed in the initial MRA/CTA. Multivariate analysis was used to identify risk factors for artery stenosis/occlusion. In an autopsy case, pathologic examination was conducted of the occluded middle cerebral arteries.

resultsStenosis (> 50 %) or occlusion of the major cerebral arteries was found in 29 (47.5 %) patients on the initial MRA/CTA. The internal carotid artery was involved most frequently (32.8 %), followed by the anterior (21.3 %) and middle (16.4 %) cerebral arteries. The basilar (1.3 %) and vertebral (3.6 %) arteries were rarely affected. Cerebral infarction developed in eight (13.1 %) patients. The serum vascular endothelial growth factor (VEGF) level was an independent predictor for stenosis/occlusion (odds ratio, 1.228; 95 % confidence interval, 1.042-1.447; P = 0.014). An autopsy study showed occluded middle cerebral arteries by fibrous and myxomatous thickening of intima with splitting of the internal elastic lamina. Follow-up MRA in 23 patients showed improved, worsened, and unchanged stenosis in 20.7 %, 8.7 %, and 69.6 %, respectively.

conclusionsCerebral large-vessel stenosis or occlusion is frequently seen in approximately half of patients with POEMS syndrome. Vasculopathy was related to serum VEGF levels and thereby disease activity. Assessment of cerebral vessels is recommended in these patients to improve management.

Indexed as

Cerebrovascular DisordersPOEMS SyndromeHumansInfarction, Middle Cerebral ArteryCastleman diseaseCerebral infarctionComputed tomography angiographyMagnetic resonance angiographyVascular endothelial growth factorVasospasm

Identifiers

PMID34167480
PMCPMC8223276
OpenAlexW3174005822

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.