ORIGINAL RESEARCH article
Front. Hum. Neurosci.
Sec. Brain Health and Clinical Neuroscience
This article is part of the Research TopicNew horizons in stroke management: Volume IIView all 14 articles
Distinct Long-term Neurological Trajectories and their Predictors in Cerebral Venous Sinus Thrombosis: A Latent Class Mixed Model Analysis
Provisionally accepted
- 1The Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, China
- 2Department of Pediatric Orthopedics, Shanghai Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
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Background: The long-term neurological recovery of patients with Cerebral Venous Sinus Thrombosis (CVST) exhibits significant heterogeneity, and the mechanisms underlying these distinct trajectories remain poorly understood. Objective: This study aimed to identify distinct long-term trajectories of functional outcome in CVST patients and to investigate their baseline predictors. Methods: In a longitudinal cohort of 127 CVST patients with complete follow-up data, we employed Latent Class Mixed Models (LCMM) to analyze repeated measures of the modified Rankin Scale (mRS) over time. The optimal number of trajectory classes was determined using established information criteria. Multivariable logistic regression was then used to identify baseline factors independently associated with class membership. Results: A two-trajectory model best characterized the heterogeneity in long-term outcomes. Class 1 (the "Poor-Recovery" Class, n=66, 52%) was characterized by older age, poorer venous collateral circulation, higher D-dimer levels, more severe initial brain parenchymal changes, and a slower, incomplete functional recovery. Class 2 (the "Favorable-Recovery" Class, n=61, 48%) consisted of younger patients with better collateral circulation and a rapid, near-complete recovery. Multivariable analysis confirmed that increasing age (Odds Ratio [OR]: 1.11 per year, 95% Confidence Interval [CI]: 1.06-1.18, p=0.0001) was an independent risk factor, while a higher venous collateral circulation score (indicating better collateral function; OR: 0.255 per point, 95% CI: 0.108-0.540, p=0.0008) was a strong protective factor against belonging to the "Poor-Recovery" class. Conclusion: CVST patients follow one of two distinct long-term functional trajectories, which are predominantly driven by age and the status of the venous collateral circulation. These findings provide a mechanism-based framework for prognosis and highlight the potential for early risk stratification, paving the way for more personalized patient management.
Keywords: cerebral venous sinus thrombosis (CVST), Latent Class Mixed Models (LCMM), long-term follow-up, Neurological Trajectories, outcomes
Received: 16 Nov 2025; Accepted: 26 Jan 2026.
Copyright: © 2026 Ye, Zhang and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Wei Ye
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