Global shifts in ischemic stroke research: Evolving focus on management, risk factors, and national contributions...

Ischemic stroke leads to significant morbidity and mortality. Although research into the field has remained pervasive over time, few studies have investigated how ischemic stroke research has changed. In the present study, we strive to characterize the changes in ischemic stroke research between 2012 and 2022 in order to gain insight into the major topics of interest and contributors to the field.

The Web of Science database isolated 92,535 articles. Subsequently, networks were constructed for the top keywords, terms, countries, and journals. The clusters in these networks were compared between 2012 and 2022 to isolate the items with the greatest changes. The degree of connectivity for items within the network was measured as link strengths for keywords, countries, and journals. Meanwhile, relevancy scores were determined for the top terms.

Keywords were categorized into five major clusters: cellular changes, risk factors, biological recovery, medical therapies, and cardiac associations. Among these, "stroke" remained the most popular keyword, showing the greatest increase in link strength over time. In addition, the terms "thrombectomy" and "atrial fibrillation" increased by 4,797 and 2,057, respectively. When examining individual countries, the United States had the greatest average link strength (1,664) between 2012 and 2022, with the largest number of documents in 2012 (1,720). However, by 2022, China produced the greatest number of documents (3,678).

Ischemic stroke literature has increased in prevalence. The growth of research in this stems from the development of endovascular techniques and the increasing incidence of atrial fibrillation with modern monitoring devices leading to greater awareness and identification, although the prevalence of atrial fibrillation itself is likely unchanged. Furthermore, both China and the United States continue to maintain the largest influence on ischemic stroke research. As both countries progress in ischemic stroke research, it will be important to continue to understand how areas of exploration change within the field.