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All Journal Sriwijaya Journal of Radiology and Imaging Research Sriwijaya Journal of Otorhinolaryngology
Brenda Jaleel
Department of Neuroscience, San Fernando General Hospital, San Fernando, Trinidad and Tobago
Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Medicine & Pharmacology Neuroscience Physics Public Health

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Genetically Proxied Circulating C-Reactive Protein and Selected Cytokines in Relation to Register-Defined Sensorineural Hearing Loss: A Two-Sample Mendelian Randomization Study Rizky Ayu; Adolfo Rawlings; Aleisha Wulandari; Brenda Jaleel
Sriwijaya Journal of Otorhinolaryngology Vol. 3 No. 2 (2025): Sriwijaya Journal of Otorhinolaryngology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjorl.v3i2.308

Abstract

Background: Circulating inflammatory biomarkers are associated with sensorineural hearing loss (SNHL), but observational studies cannot establish causality. Objective: To evaluate whether genetically proxied C-reactive protein (CRP) and eight cytokines are associated with SNHL. Methods: We used European-ancestry GWASs for CRP (N = 575,531) and eight cytokines (maximum N = 74,783), with FinnGen R13 outcomes of 48,388 SNHL cases and 432,132 controls; sudden idiopathic hearing loss (4,082 cases) was secondary. Variants were harmonized and pruned using 1000 Genomes Finnish linkage disequilibrium (r² < 0.001 within 10 Mb). Random-effects inverse-variance weighting or a Wald ratio was primary. Sensitivity analyses included MR-Egger, weighted median and mode, MR-RAPS, RadialMR, Steiger directionality, cis-only estimates, source-assay filters, and false-discovery-rate correction. Results: Of 301 unique exposure rsIDs, 279 were retrieved and 276 exposure rows passed harmonization. Finnish LD pruning left 238 CRP instruments. CRP was compatible with the null (OR per unit increase in ln[CRP mg/L], 1.005; 95% CI, 0.948–1.065; p = 0.868), consistent with weighted median, MR-Egger, weighted mode, and MR-RAPS estimates. No cytokine survived FDR correction (all q ≥ 0.393), source-assay filtering yielded no supported association, and secondary-outcome estimates were null. Steiger analyses favored the exposure-to-outcome direction. Conclusion: Results support no material effect of lifelong genetically proxied circulating CRP on register-defined SNHL. Cytokine evidence remains less definitive because instrument sets were small, predominantly trans acting, heterogeneous, and assay sensitive. The findings neither exclude acute or cochlea-specific inflammation nor evaluate corticosteroid effectiveness. Independent replication and cis-pQTL colocalization are required before therapeutic inference.
Resting-State Functional MRI Connectivity Disruption Predicts Post-Stroke Epileptogenesis: A Prospective Longitudinal Cohort Study Despian Januandri; Brenda Jaleel; Reza Andrianto
Sriwijaya Journal of Radiology and Imaging Research Vol. 4 No. 1 (2026): Sriwijaya Journal of Radiology and Imaging Research
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjrir.v4i1.324

Abstract

Introduction: Post-stroke epilepsy (PSE) complicates roughly 5–10% of ischaemic strokes, yet clinical and electroencephalographic markers predict unprovoked late seizures only modestly. Resting-state functional MRI (rs-fMRI) with graph theory can non-invasively quantify brain-network architecture. We tested whether subacute functional-connectivity disruption predicts PSE. Methods: In a prospective longitudinal cohort at a tertiary hospital in Palembang, Indonesia, 150 adults with first-ever supratentorial ischaemic stroke underwent 3.0-T rs-fMRI on day 7–14 and were followed for 24 months (reported per STARD 2015 and TRIPOD). Automated Anatomical Labelling 90-region graph metrics were derived (CONN/SPM12). The reference standard was an International League Against Epilepsy-defined unprovoked late seizure, adjudicated blind to imaging. A penalised support-vector-machine model was internally validated (nested cross-validation, optimism correction, calibration) and compared with a clinical model using DeLong, decision-curve and competing-risks analyses. Results: PSE occurred in 30 of 150 patients (cumulative incidence 19.2%). PSE patients showed thalamic degree-centrality overload (62.4±8.1 vs 45.2±6.8; p<0.001) and small-world collapse (σ 1.08±0.12 vs 1.25±0.11; p=0.008). The rs-fMRI model achieved sensitivity 86.7% (95% CI 70.3–94.7), specificity 88.3% (81.4–92.9), AUC 0.92 (0.85–0.99), LR+ 7.43 and LR− 0.15, versus clinical AUC 0.74 (DeLong p<0.001); inter-reader kappa was 0.84. Conclusion: Subacute rs-fMRI connectomic disruption is a strong, independent, internally validated predictor of PSE that outperforms clinical variables. External multicentre validation is warranted before clinical adoption.
Co-Authors Adolfo Rawlings Aleisha Wulandari Despian Januandri Reza Andrianto Rizky Ayu