Background: Although recent advancements in ischemic stroke management have reduced associated mortality rates, there remains a pressing need for more reliable, efficacious, and well-tolerated therapeutic approaches due to the narrow therapeutic window of current treatment approaches. The current meta-analysis sought to evaluate the safety and efficacy of stem cell-based therapeutic options for patients with ischemic stroke. Methods: PubMed, Web of Science, and Cochrane library databases were searched to retrieve randomized controlled trials (RCTs) evaluating the efficacy and safety of stem cell therapy (SCT) in ischemic stroke patients. Key outcomes included the National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), Barthel Index (BI), Fugl–Meyer Assessment (FMA), infarct size, and safety profile. The random effects model with the continuous method was used to calculate the pooled effect size in Review Manager 5.4.1, and subgroup analyses were performed based on demographics, stroke duration, and SCT delivery protocols. Results: A total of 18 RCTs involving 1026 patients were analyzed, with 538 in the treatment group and 488 in the control group. The mean change in NIHSS score was comparable between groups [MD = −0.80; 95% CI: −2.25, 0.65, p < 0.0001]. However, SCT showed better outcomes in mRS [MD = −0.56; 95% CI: −0.76, −0.35, p = 0.30] and BI scores [MD = 12.00; 95% CI: 4.00, 20.00, p = 0.007]. Additionally, the mean change in FMA score was significantly greater with SCT [MD = 18.16; 95% CI: 6.58, 29.75, p = 0.03]. The mean change in infarct volume also favored stem cell therapy [MD = 8.89; 95% CI: −5.34, 23.12, p = 0.08]. The safety profile was favorable, with adverse event rates comparable to or lower than controls. Conclusions: SCT offers a safe and effective approach to improving functional outcomes in stroke patients, particularly with early intervention. These findings highlight the potential of SCT in ischemic stroke rehabilitation while underscoring the need for standardized protocols and long-term safety evaluation.

Background: Sleep disturbances are prevalent among stroke survivors, significantly impacting their recovery and quality of life. This study aimed to evaluate the prevalence of sleep disorders, sleep quality, risk of obstructive sleep apnea (OSA), and daytime sleepiness among stroke survivors and to identify potential associations with clinical and demographic factors. Materials and Methods: A retrospective observational study analyzed adult stroke survivors (aged ≥ 18 years) attending neurology clinics at our institution from November 2022 to November 2024. The primary outcome measures included overall sleep quality, sleep apnea and daytime sleepiness assessment. Data were collected using validated Arabic versions of the Pittsburgh Sleep Quality Index (PSQI), STOP-Bang Questionnaire, and Epworth Sleepiness Scale (ESS). Statistical analyses, including Chi-square tests and t-tests, were performed using SPSS version 30.1. Results: A total of 100 stroke survivors, mostly aged 40–60 years, were recruited in our study. The prevalence of sleep disorders was 60.0%, with poor sleep quality reflected by a mean global PSQI score of 9.13 ± 14.40. Additionally, 19.0% were at high risk of OSA, and 24.0% experienced abnormal daytime sleepiness. While no statistically significant associations were found between sleep disorders and clinical or demographic factors, trends indicated higher sleep disorder prevalence in those with hemorrhagic stroke and high-risk OSA profiles. Conclusions: Our study highlights a high prevalence of sleep disorders among stroke survivors, emphasizing the need for regular sleep assessments. Future studies should explore objective assessments and larger sample sizes to validate these findings and to assess their potential implication in stroke recovery and quality of life.

Background: Migraine is a common neurological condition marked by unilateral recurrent pulsating headaches, often associated with systemic signs and symptoms. Recently, calcitonin gene-related peptide (CGRP) antagonists, including atogepant, an oral CGRP receptor antagonist, have emerged as effective and safe treatments. The current study sought to assess the efficacy and safety of atogepant for preventing episodic migraines in adults. Methods: A comprehensive search, following PRISMA guidelines, was conducted using PubMed, Web of Science, and Cochrane Library to identify randomized, double-blind, placebo-controlled trials published up to June 2024. Results: The studies included adult participants with episodic migraine treated with atogepant. The primary outcomes assessed were changes in mean monthly migraine days (MMDs) and monthly headache days (MHDs) over 12 weeks. Secondary outcomes included reduction in acute medication use, 50% responder rates, and adverse events. A meta-analysis using a random-effects model was performed to evaluate efficacy and safety. Six trials with 4569 participants were included. Atogepant significantly reduced mean monthly migraine days (MMDs) and monthly headache days (MHDs) compared to placebo at all doses (10 mg, 30 mg, 60 mg), with the 60 mg dose showing the greatest reduction (mean difference: −1.48 days, p < 0.001). Significant reductions in acute medication use and improved 50% responder rates were also observed for all doses. The safety profile of atogepant was favorable, with common adverse events being mild to moderate, such as constipation and nausea. There were no significant differences in serious adverse events between the atogepant and placebo groups. Conclusions: Atogepant is an effective and well-tolerated option for preventing episodic migraines, showing significant reductions in migraine frequency and acute medication use. However, further studies are necessary to assess its long-term safety and efficacy, especially at higher doses, and to investigate its potential role in personalized treatment strategies for migraine prevention.

Background: Primary progressive aphasia (PPA) is a neurodegenerative disorder that worsens over time without appropriate treatment. Although referral to a speech and language pathologist is essential for diagnosing language deficits and developing effective treatment plans, there is no scientific consensus regarding the most effective treatment. Thus, our study aims to assess the efficacy and safety of various therapeutic interventions for PPA. Methods: Google Scholar, PubMed, Web of Science, and the Cochrane Library databases were systematically searched to identify articles assessing different therapeutic interventions for PPA. To ensure comprehensive coverage, the search strategy employed specific medical subject headings. The primary outcome measure was language gain; the secondary outcome assessed overall therapeutic effects. Data on study characteristics, patient demographics, PPA subtypes, therapeutic modalities, and treatment patterns were collected. Results: Fifty-seven studies with 655 patients were included. For naming and word finding, errorless learning therapy, lexical retrieval cascade (LRC), semantic feature training, smartphone-based cognitive therapy, picture-naming therapy, and repetitive transcranial magnetic stimulation (rTMS) maintained effects for up to six months. Repetitive rTMS, video-implemented script training for aphasia (VISTA), and structured oral reading therapy improved speech fluency. Sole transcranial treatments enhanced auditory verbal comprehension, whereas transcranial direct current stimulation (tDCS) combined with language or cognitive therapy improved repetition abilities. Phonological and orthographic treatments improved reading accuracy across PPA subtypes. tDCS combined with speech therapy enhanced mini-mental state examination (MMSE) scores and cognitive function. Several therapies, including smartphone-based cognitive therapy and VISTA therapy, demonstrated sustained language improvements over six months. Conclusions: Various therapeutic interventions offer potential benefits for individuals with PPA. However, due to the heterogeneity in study designs, administration methods, small sample sizes, and lack of standardized measurement methods, drawing a firm conclusion is difficult. Further studies are warranted to establish evidence-based treatment protocols.