{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T11:08:51Z","timestamp":1771153731074,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82460247"],"award-info":[{"award-number":["82460247"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004479","name":"Natural Science Foundation of Jiangxi Province","doi-asserted-by":"publisher","award":["20212BAB216023"],"award-info":[{"award-number":["20212BAB216023"]}],"id":[{"id":"10.13039\/501100004479","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["CNS Neurosci Ther"],"published-print":{"date-parts":[[2026,1]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n The mechanical thrombectomy (MT) strategy obviously differs for acute middle cerebral artery occlusion (MCAO) stroke caused by embolism or atherosclerosis. Our study aimed to develop and validate a simple and universally applicable score for predicting etiology [embolism or intracranial arteriosclerosis (ICAS)] before MT in patients with acute MCAO stroke.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Between November 2019 and September 2022, we retrospectively enrolled eligible patients in our hospital as the training cohort. Additionally, consecutive patients between July 2023 and April 2024 were recruited as the validation cohort. Multivariate logistic regression analysis was used to identify the independent factors associated with etiology in the training group. Each factor was then point assigned based on \u03b2\u2010coefficient, and a risk scoring system was developed. The scoring system was validated through the validation cohort. The\n C<\/jats:italic>\n \u2010statistic, Brier score, and Hosmer\u2010Lemeshow test were used to assess model discrimination and calibration.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The training group and validation group finally included 277 patients (154 embolism\u2010MCAO and 123 ICAS\u2010MCAO) and 101 patients (59 embolism\u2010MCAO and 42 ICAS\u2010MCAO), respectively. A scoring system (AHOC score) covering four variables (atrial fibrillation, hyperdense middle cerebral artery sign, stenosis\/occlusion in other arteries, and collateral status) was derived to help identify embolism\u2010MCAO or ICAS\u2010MCAO. The AHOC score showed good discrimination and calibration in the training cohort (\n C<\/jats:italic>\n \u2010statistic, 0.932 [0.902\u20130.963]; Brier score, 0.092 [0.070\u20130.115];\n p<\/jats:italic>\n value of the Hosmer\u2010Lemeshow test, 0.604) and in the validation cohort (\n C<\/jats:italic>\n \u2010statistic, 0.933 [0.888\u20130.978]; Brier score, 0.102 [0.067\u20130.140];\n p<\/jats:italic>\n value of the Hosmer\u2010Lemeshow test, 0.846). According to the AHOC score, patients with a score of 4\u20138 were identified as high\u2010risk for the embolism\u2010MCAO category. Conversely, a patient with a score of 0\u20133 was considered high\u2010risk for the ICAS\u2010MCAO category.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Our scoring system (AHOC score), consisting of atrial fibrillation, hyperdense middle cerebral artery sign, stenosis\/occlusion in other arteries and collateral status, is a valid and applicable model for predicting the etiology in patients with acute MCAO before MT.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/cns.70729","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T15:23:56Z","timestamp":1767194636000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Novel and Simple Score to Predict Embolic or Atherosclerotic Middle Cerebral Artery Occlusion Before Mechanical Thrombectomy:\n AHOC<\/scp>\n Score"],"prefix":"10.1002","volume":"32","author":[{"given":"Hudie","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Neurology The First Affiliated Hospital, Jiangxi Medical College, Nanchang University Nanchang Jiangxi China"},{"name":"Institute of Neurology, Jiangxi Academy of Clinical Medical Science, The First Affiliated Hospital Jiangxi Medical College, Nanchang University Nanchang Jiangxi China"},{"name":"Rare Disease Center, The First Affiliated Hospital, Jiangxi Medical College Nanchang University Nanchang Jiangxi China"},{"name":"Key Laboratory of Rare Neurological Diseases of Jiangxi Provincial Health Commission, Jiangxi Medical College Nanchang University Nanchang Jiangxi China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingwen","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Neurology The First Affiliated Hospital, Jiangxi Medical College, Nanchang University Nanchang Jiangxi 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