This study aims to evaluate the role of <50% stenotic cervical carotid artery plaques in embolic stroke of undetermined source (ESUS), focusing on plaque characteristics in symptomatic versus asymptomatic carotid arteries (contralateral). In this cross-sectional observational study, 81 patients who met the diagnostic criteria for ESUS and underwent were retrospectively analyzed. Carotid plaques causing <50% stenosis were examined, noting features such as plaque thickness, degree of luminal stenosis, irregularity, ulceration, calcification, and hypodensity. These characteristics were compared between the ipsilateral and contralateral carotid arteries. The study involved 33 men and 48 women, with plaques ≥3mm thick significantly more common in the ipsilateral carotid arteries (P < .05). Notable features such as plaque ulceration, irregularity, noncalcified plaque, and hypodensity were significantly more frequent ipsilaterally (P < .05). Of the plaque patients, 54.3% (44/81) were on the ipsilateral side, compared to 29.6% (24/81) on the contralateral side (P = .0024). Our findings underscore the potential significance of non-stenotic carotid plaques in ESUS. These plaques, especially those with certain high-risk characteristics, are more prevalent ipsilaterally and should be considered in clinical evaluations and treatment of ESUS.

Background/Objectives: Persistent pain after acute herpes zoster (HZ) carries substantial functional burden, but early markers of pain persistence remain uncertain. In an exploratory analysis, we examined whether baseline clinical features and a simple affected-to-contralateral pressure-pain threshold (PPT) ratio were associated with persistent zoster-associated pain approximately one month after rash onset. Methods: In this prospective multicenter observational cohort, 117 adults with acute HZ (mean age 58.7 ± 14.7 years, 60.7% women, 18.8% with diabetes mellitus, 16.2% immunosuppressed, 58.1% thoracic dermatome) were assessed 1–7 days after rash onset with clinical variables, the Douleur Neuropathique 4 (DN4) questionnaire, bedside sensory examination and standardized pressure algometry. Two equally reported outcome definitions were applied at follow-up: average and worst 24 h numerical rating scale (NRS) pain ≥ 3. Firth penalized logistic regression was used, with bootstrap internal validation that repeated the predictor-selection step within each resample. Results: Of 117 participants, 109 (93.2%) completed follow-up at a mean of 29.8 ± 3.3 days. Average 24 h NRS ≥ 3 occurred in 25/109 (22.9%) and worst 24 h NRS ≥ 3 in 42/109 (38.5%). Under the average-pain definition, age per 10 years (odds ratio [OR] 1.60, 95% confidence interval [CI] 1.03–2.59), baseline NRS per point (OR 1.43, 1.11–2.06) and PPT ratio per 0.1 increase (OR 0.69, 0.50–0.92) were associated with the outcome; under the worst-pain definition only baseline NRS remained associated (OR 1.18, 1.02–1.39), with attenuation of both age (OR 1.34, 0.98–1.86) and PPT ratio (OR 0.86, 0.68–1.08). Apparent areas under the receiver operating characteristic curve (AUCs) were 0.863 and 0.740, respectively; the optimism-corrected AUC for the average-pain model was 0.831. The PPT ratio was strongly correlated with bedside allodynia (Spearman ρ = −0.82). Conclusions: PPT asymmetry was associated with one-month pain persistence under one of two outcome definitions but overlapped substantially with clinically assessed allodynia. These exploratory associations require prespecified confirmation before any clinical application.

Introduction This study aimed to evaluate autonomic and cognitive functions in patients with essential tremor (ET) and investigate their correlation. Methods A total of 38 patients with ET and 35 healthy volunteers were included in the study. Electrophysiological assessment of the autonomic nervous system was performed using the sympathetic skin response (SSR) and RR interval variation analyses. Additionally, cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) for all participants. Results In the patient group, compared with the control group, median and tibial nerve SSR latencies were greater, and amplitudes were lower in both the upper and lower extremities. SSR latencies were prolonged in several upper- and lower-extremity recordings, and the right tibial SSR amplitude was significantly reduced (p < 0.05); the remaining amplitude differences showed a similar trend without reaching statistical significance. Although RR interval variation was lower in patients than in controls during both rest and deep breathing, no statistically significant difference was detected. MoCA scores were significantly lower in patients than in healthy volunteers. Subgroup analysis revealed that this difference was particularly prominent in visual-spatial/executive functions and language function. No correlation was detected between the SSR, RR interval variation, or MoCA in either the patient or control group. Conclusion Patients with ET demonstrated electrophysiological findings suggestive of altered sympathetic autonomic function, together with lower cognitive performance. However, parasympathetic dysfunction was not demonstrated by analysis of RR interval variation.