{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T05:06:50Z","timestamp":1789103210593,"version":"build-2803163510"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"\n Background<\/jats:title>\n \n Acute symptomatic anterior circulation intracranial atherosclerotic stenosis (ICAS; \u226570%) carries substantial risks of early neurological deterioration (END) and disability. We developed an ABCD\n 3<\/jats:sup>\n -I-informed clinical-imaging score incorporating pre-baseline progressive stroke, responsible-vessel stenosis, and diffusion-weighted imaging (DWI) infarct pattern for acute risk screening.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We retrospectively enrolled 133 consecutive patients (103 men, 30 women; mean age: 64.62\u202f\u00b1\u202f10.56\u202fyears) with acute symptomatic anterior circulation ICAS (\u226570% stenosis; onset \u22647\u202fdays) at a single center (January 2024\u2013June 2025). The score (0\u201313) categorized patients as high risk (\u22658;\n n<\/jats:italic>\n \u202f=\u202f102) or non-high risk (\n n<\/jats:italic>\n \u202f=\u202f31). The primary outcome was the ordinal 90-day modified Rankin Scale (mRS) score; the secondary outcomes were mRS scores \u22653 and END. Adjusted regression and receiver operating characteristic (ROC) analyses were performed, and discrimination was compared with the original ABCD\n 3<\/jats:sup>\n -I.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The high-risk group had higher admission National Institutes of Health Stroke Scale (NIHSS) scores (median 2.0 vs. 0.0;\n p<\/jats:italic>\n \u202f&lt;\u202f0.001). The ABCD\n 3<\/jats:sup>\n -I-informed clinical-imaging score discriminated END (area under the curve [AUC] 0.833, 95% CI 0.760\u20130.906; 50.0% vs. 19.4%,\n p<\/jats:italic>\n \u202f=\u202f0.005). The unadjusted 90-day mRS score distribution was worse in the high-risk group (z\u202f=\u202f\u22122.405,\n p<\/jats:italic>\n \u202f=\u202f0.016), but the ABCD\n 3<\/jats:sup>\n -I-informed clinical-imaging score was not significant after adjustment for admission NIHSS in the proportional-odds model (adjusted common OR 1.05 per point, 95% CI 0.88\u20131.26;\n p<\/jats:italic>\n \u202f=\u202f0.573). The dichotomized disability rate (mRS\u202f\u2265\u202f3: 18.6% vs. 9.7%) did not differ significantly (\n p<\/jats:italic>\n \u202f=\u202f0.285; adjusted OR 1.11, 95% CI 0.86\u20131.44). For 90-day disability, the AUC was 0.662 (95% CI 0.540\u20130.783;\n p<\/jats:italic>\n \u202f=\u202f0.017). At the prespecified \u22658-point threshold, 31 patients (23.3%) were classified as non-high-risk; the negative predictive value was 90.3% (95% CI 75.1\u201396.7%). Discrimination did not differ significantly from the original ABCD\n 3<\/jats:sup>\n -I score (\u0394AUC 0.068, 95% CI\u202f\u2212\u202f0.063 to 0.196; DeLong\n p<\/jats:italic>\n \u202f=\u202f0.312).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n The ABCD\n 3<\/jats:sup>\n -I-informed score may identify a non-high-risk subgroup and show strong END discrimination, but its association with a 90-day outcome was modest and NIHSS-dependent. It should complement, not replace, baseline neurological assessment and should not guide treatment selection; prospective multicenter validation is required.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fneur.2026.1897338","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T04:29:46Z","timestamp":1789100986000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk stratification of acute symptomatic anterior circulation intracranial atherosclerotic stenosis using an ABCD3-I-informed clinical-imaging score: an exploratory study"],"prefix":"10.3389","volume":"17","author":[{"given":"Zhuli","family":"Peng","sequence":"first","affiliation":[{"name":"Department of Cerebrovascular Diseases, Guangdong Provincial Hospital of Chinese Medicine (The Second Clinical College of Guangzhou University of Chinese Medicine)","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xibu","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Diseases, Guangdong Provincial Hospital of Chinese Medicine (The Second Clinical College of Guangzhou University of Chinese Medicine)","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zini","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Diseases, Guangdong Provincial Hospital of Chinese Medicine (The Second Clinical College of Guangzhou University of Chinese Medicine)","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haolin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Diseases, Guangdong Provincial Hospital of Chinese Medicine (The Second Clinical College of Guangzhou University of Chinese Medicine)","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaolong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Diseases, Guangdong Provincial Hospital of Chinese Medicine (The Second Clinical College of Guangzhou University of Chinese Medicine)","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxin","family":"Bai","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Diseases, Guangdong Provincial Hospital of Chinese Medicine (The Second Clinical College of Guangzhou University of Chinese Medicine)","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1287","DOI":"10.1212\/WNL.0b013e31828ab2ed","article-title":"Prevalence of stenoses and occlusions of brain-supplying arteries in young 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Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1897338\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T04:29:48Z","timestamp":1789100988000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1897338\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,11]]},"references-count":14,"alternative-id":["10.3389\/fneur.2026.1897338"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2026.1897338","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,11]]},"article-number":"1897338"}}