European Journal of Neurology最新文献

{"title":"The effect of influenza vaccination on the rate of dementia amongst older adults","authors":"Andreas Moses Appel,&nbsp;Janet Janbek,&nbsp;Christina Jensen-Dahm,&nbsp;Thomas Munk Laursen,&nbsp;Gunhild Waldemar","doi":"10.1111/ene.16489","DOIUrl":"10.1111/ene.16489","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Previous studies have reported conflicting results regarding the association between influenza vaccination and dementia. This association was investigated in a nationwide register-based cohort study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using nationwide registries, dementia-free adults aged ≥65 years in Denmark from 2002 to 2018 without previous influenza vaccinations were included. Poisson regression facilitated confounder-adjusted comparisons of dementia rates for ever versus never vaccinated, number of vaccinations and within/after 5 years from first vaccination. Sensitivity analyses included stratification on age and sex.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Vaccination during follow-up was associated with a slightly higher rate of dementia when adjusted for sociodemographic factors and comorbidities, both within and after the first 5 years from first vaccination (incidence rate ratio [IRR] 1.04; 95% confidence interval [CI] 1.03–1.05). The rate of dementia decreased with increasing number of vaccinations. The highest rate was amongst those with only one vaccination (IRR 1.14; 95% CI 1.12–1.17) and the rate of dementia was only decreased amongst those with six or more vaccinations (IRR 0.95; 95% CI 0.93–0.97). Applying the same models to control outcomes of hip fracture and cancer resulted in higher rates amongst vaccinated people of 6% and 7%, respectively. Vaccinated people also had a 10% higher mortality rate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Our results do not support the case for a preventive effect of influenza vaccination on the risk of dementia in the general population, as reported by some previous studies. However, the higher dementia rate amongst vaccinated people found in this study is probably due to residual confounding, indicated by a higher rate for control outcomes and mortality.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"31 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11554864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral venous thrombosis in elderly patients","authors":"Victor Garcia,&nbsp;Louise Bicart-Sée,&nbsp;Isabelle Crassard,&nbsp;Nicolas Legris,&nbsp;Mathieu Zuber,&nbsp;Fernando Pico,&nbsp;Céline Guidoux,&nbsp;Michael Obadia,&nbsp;Naouel Boulenoir,&nbsp;Didier Smadja,&nbsp;Mikael Mazighi,&nbsp;Cecile Lavenu-Bombled,&nbsp;Elodie Baudry,&nbsp;Bertrand Lapergue,&nbsp;Guillaume Turc,&nbsp;Philippe Tuppin,&nbsp;Christian Denier","doi":"10.1111/ene.16504","DOIUrl":"10.1111/ene.16504","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and purpose</h3>\u0000 \u0000 <p>We aimed to report the characteristics of cerebral venous thrombosis (CVT) in elderly people (aged ≥65 years).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multicenter retrospective cohort included elderly patients hospitalized for a first CVT in nine Paris–Ile-de-France hospitals between 2011 and 2021. The estimated incidence was compared to CVT recorded by the French health insurance data system. Lariboisière Hospital's CVT registry allowed comparisons of our elderly cohort with individuals younger than 65 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One hundred fourteen patients were included in this study (mean age = 74.2 years, range = 65–93, 61% female). The CVT annual incidence in Ile-de-France was 5.9–7.1 per million elderly individuals versus 8.5 per million nationwide. Headaches and focal deficits were the most common initial clinical features (50% and 51%, respectively), followed by seizures and confusion (40% and 27%). Treatment included anticoagulation (93%) and, rarely, endovascular procedure (2%) or craniectomy (1%). Compared with adult patients aged &lt;65 years (younger adults), elderly patients presented fewer headaches (50% vs. 96%, <i>p</i> &lt; 0.01) and intracranial hypertension (7% vs. 22%, <i>p</i> &lt; 0.01) but more seizures and focal deficits (40% vs. 27% and 51% vs. 38%, respectively, <i>p</i> &lt; 0.01). Underlying cancer, hemopathy, and locoregional infections were more frequent in elderly patients than among younger adults (<i>p</i> &lt; 0.01). The prognosis of patients from our elderly cohort was poorer than that of younger adults; 8% died in the acute phase, and 73% had a favorable outcome at 1 year (vs. 1.7% and 87%, respectively, <i>p</i> &lt; 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CVT in elderly patients has a specific clinical presentation, epidemiology, and risk factors such as cancer or hemopathy, justifying specialized management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"31 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11554858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immune triggers preceding neuralgic amyotrophy","authors":"Davide Sparasci,&nbsp;Lenka Schilg-Hafer,&nbsp;Bettina Schreiner,&nbsp;Olivier Scheidegger,&nbsp;Anne-Kathrin Peyer,&nbsp;Agustina Maria Lascano,&nbsp;Alex Vicino,&nbsp;Bernhard Friedrich Décard,&nbsp;Pinelopi Tsouni,&nbsp;Andrea Monika Humm,&nbsp;Enea Pianezzi,&nbsp;Giulia Zezza,&nbsp;Thomas Hundsberger,&nbsp;Anelia Dietmann,&nbsp;Hans H. Jung,&nbsp;Thierry Kuntzer,&nbsp;Einar Wilder-Smith,&nbsp;Gladys Martinetti-Lucchini,&nbsp;Orlando Petrini,&nbsp;Stefano Fontana,&nbsp;Peter Gowland,&nbsp;Christoph Niederhauser,&nbsp;Claudio Gobbi,&nbsp;Paolo Ripellino","doi":"10.1111/ene.16462","DOIUrl":"10.1111/ene.16462","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and purpose</h3>\u0000 \u0000 <p>Infections and vaccinations have been identified as potential immunological triggers of neuralgic amyotrophy (NA), but the exact type and frequency of the preceding agents is unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a multicentre, prospective, observational, matched case–control study. NA was diagnosed by neuromuscular experts according to validated clinical criteria and electrodiagnostic studies. Clinical data and biological samples of NA patients were collected within 90 days from disease onset between June 2018 and December 2023. All NA patients were asked about prior infection and vaccination in the month before disease onset. Serological tests for hepatitis E virus, human immunodeficiency virus, severe acute respiratory syndrome coronavirus 2, Epstein–Barr virus, cytomegalovirus, parvovirus B19, varicella-zoster virus, <i>Borrelia burgdorferi</i>, <i>Mycoplasma pneumoniae</i> and <i>Bartonella henselae</i> were performed in a central laboratory. Each case was matched with a healthy control for age, sex, place of residence and time of blood collection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-seven patients and corresponding controls were included. The mean age was 45 years for both groups. NA onset was preceded by a symptomatic infectious trigger confirmed by microbiological tests in 15/57 (26.3%) patients. Coronavirus disease 2019 vaccination was considered a potential trigger in 7/57 (12.3%) subjects. An acute viral infection was associated with a bilateral involvement of the brachial plexus (<i>p</i> = 0.003, Cramèr's <i>V</i> = 0.43).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Confirmed immune triggers (infection or vaccination) preceded disease onset in 22/57 (38.6%) NA cases. We suggest to test NA patients in the acute phase for intracellular antigens, especially in the case of concomitant bilateral involvement and hepatitis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"31 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11554871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of enzyme substitution therapy on brain magnetic resonance imaging and cognition in adults with phenylketonuria: A case series of three patients","authors":"Alessandro P. Burlina,&nbsp;Renzo Manara,&nbsp;Jessica Carretta,&nbsp;Chiara Cazzorla,&nbsp;Christian Loro,&nbsp;Vincenza Gragnaniello,&nbsp;Alberto B. Burlina","doi":"10.1111/ene.16508","DOIUrl":"10.1111/ene.16508","url":null,"abstract":"<p>Phenylketonuria, the most common inherited metabolic disease, results from a deficiency of phenylalanine hydroxylase enzyme activity that causes high blood phenylalanine levels. Most adults do not adhere to the gold standard therapy: lifelong treatment with a low-phenylalanine diet. Elevated and fluctuating phenylalanine levels in untreated adults can cause white matter abnormalities, neurological symptoms, and cognitive dysfunction (executive function). Pegvaliase, a derivative of the phenylalanine ammonia-lyase enzyme, metabolizes phenylalanine to trans-cinnamic acid and ammonia, and is approved by the US Food and Drug Administration and European Medicines Agency for subcutaneous administration in adults with phenylketonuria and blood phenylalanine concentrations &gt; 600 μmol/L. In clinical trials, it reduced blood phenylalanine, even in patients consuming an unrestricted diet. We report longitudinal results on the first three such adults, in whom phenylalanine levels were quantified monthly, starting 1 year before pegvaliase administration and continuing through achievement of a pegvaliase response (defined as six consecutive monthly blood phenylalanine concentrations &lt; 360 μmol/L while consuming an unrestricted diet). Brain magnetic resonance imaging (MRI) and neuropsychological assessments were performed before starting therapy and after response was achieved. Our results show that all three patients had significantly reduced white matter hyperintensities on brain MRI and improved executive function on neuropsychological assessment, especially on the Paced Auditory Serial Addition Test, which is known to be very sensitive to white matter functioning. To the best of our knowledge, this is the first report of concomitant improvements in cognitive performance and white matter damage after a pharmacological intervention to normalize phenylalanine levels in adults with phenylketonuria consuming an unrestricted diet.</p>","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"31 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11554989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cholinergic dysfunction in isolated rapid eye movement sleep behaviour disorder links to impending phenoconversion","authors":"Miriam H. Terkelsen,&nbsp;Alex Iranzo,&nbsp;Mónica Serradell,&nbsp;Andreas M. Baun,&nbsp;Morten G. Stokholm,&nbsp;Erik Hvid Danielsen,&nbsp;Karen Østergaard,&nbsp;Marit Otto,&nbsp;Kristina B. Svendsen,&nbsp;Mette Møller,&nbsp;Erik L. Johnsen,&nbsp;Alicia Garrido,&nbsp;Dolores Vilas,&nbsp;Joan Santamaria,&nbsp;Arne Møller,&nbsp;Carles Gaig,&nbsp;David J. Brooks,&nbsp;Per Borghammer,&nbsp;Eduardo Tolosa,&nbsp;Nicola Pavese","doi":"10.1111/ene.16503","DOIUrl":"10.1111/ene.16503","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and purpose</h3>\u0000 \u0000 <p>Most patients with isolated rapid eye movement sleep behaviour disorder (iRBD) progress to a parkinsonian alpha-synucleinopathy. However, time to phenoconversion shows great variation. The aim of this study was to investigate whether cholinergic and dopaminergic dysfunction in iRBD patients was associated with impending phenoconversion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty-one polysomnography-confirmed iRBD patients underwent baseline ¹¹C-donepezil and 6-Fluoro-(¹⁸F)-l-3,4-dihydroxyphenylalanine (¹⁸F-DOPA) positron emission tomography (PET). Potential phenoconversion was monitored for up to 8 years. PET images were analysed according to patients' diagnoses after 3 and 8 years using linear regression. Time-to-event analysis was made with Cox regression, dividing patients into low and high tracer uptake groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Follow-up was accomplished in 17 patients. Eight patients progressed to either Parkinson's disease (<i>n</i> = 4) or dementia with Lewy bodies (<i>n</i> = 4), while nine remained non-phenoconverters. Compared with non-phenoconverters, 8-year phenoconverters had lower mean ¹¹C-donepezil uptake in the parietal (<i>p</i> = 0.032) and frontal cortex (<i>p</i> = 0.042), whereas mean ¹¹C-donepezil uptake in 3-year phenoconverters was lower in the parietal cortex (<i>p</i> = 0.005), frontal cortex (<i>p</i> = 0.025), thalamus (<i>p</i> = 0.043) and putamen (<i>p</i> = 0.049). Phenoconverters within 3 years and 8 years had lower ¹⁸F-DOPA uptake in the putamen (<i>p</i> &lt; 0.001). iRBD patients with low parietal ¹¹C-donepezil uptake had a 13.46 (95% confidence interval 1.42;127.21) times higher rate of phenoconversion compared with those with higher uptake <i>(p</i> = 0.023). iRBD patients with low ¹⁸F-DOPA uptake in the most affected putamen were all phenoconverters with higher rate of phenoconversion (<i>p</i> = 0.0002).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings suggest that cortical cholinergic dysfunction, particularly within the parietal cortex, could be a biomarker candidate for predicting short-term phenoconversion in iRBD patients. This study aligns with previous reports suggesting dopaminergic dysfunction is associated with forthcoming phenoconversion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"31 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11554850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of elevated lipoprotein(a) levels on the functional outcomes of ischemic stroke patients: A systematic review and meta-analysis","authors":"Huarong Liu,&nbsp;Bo Li,&nbsp;Ting Lu,&nbsp;Chong Chen,&nbsp;Xi Xiong,&nbsp;Xing Li,&nbsp;Rengui Yang","doi":"10.1111/ene.16501","DOIUrl":"10.1111/ene.16501","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and purpose</h3>\u0000 \u0000 <p>Elevated serum lipoprotein(a) (Lp[a]) levels have been linked to an increased incidence of stroke. This systematic review and meta-analysis aimed to evaluate the impact of serum Lp(a) on the functional outcomes of patients with ischemic stroke (IS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a comprehensive search of the MEDLINE, Web of Science, Embase, Wanfang, and China National Knowledge Infrastructure databases to identify relevant cohort studies. A random effects model was utilized to synthesize the data, accounting for study heterogeneity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysis included 11 cohort studies comprising 11,958 patients with IS. Pooled results indicated that high baseline Lp(a) levels were associated with an increased risk of poor functional outcomes during follow-up (odds ratio [OR] = 2.13, 95% confidence interval = 1.67–2.71, <i>p</i> &lt; 0.001, <i>I</i>² = 62%). Subgroup analyses revealed that the relationship between high Lp(a) levels and the risk of poor functional outcomes was more pronounced at discharge (OR = 3.25), 3 months (OR = 2.02), and 6 months (OR = 2.11) poststroke, compared to 12 months (OR = 1.25, <i>p</i> for subgroup difference &lt; 0.001). Furthermore, the association was attenuated yet remained significant in studies adjusting for low-density lipoprotein cholesterol (LDL-C) compared to those that did not adjust for LDL-C (OR = 1.69 vs. 2.63, <i>p</i> for subgroup difference = 0.03).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>High serum Lp(a) levels at baseline are significantly associated with poor functional outcomes in patients with IS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"31 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11554860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of expiratory muscle strength training on voluntary cough effectiveness in Huntington's disease","authors":"Romana Konvalinkova,&nbsp;Martin Srp,&nbsp;Kristyna Doleckova,&nbsp;Vaclav Capek,&nbsp;Ota Gal,&nbsp;Martina Hoskovcova,&nbsp;Radim Kliment,&nbsp;Jan Muzik,&nbsp;Evzen Ruzicka,&nbsp;Jiri Klempir","doi":"10.1111/ene.16500","DOIUrl":"10.1111/ene.16500","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and purpose</h3>\u0000 \u0000 <p>Dysfunction of the airway defence system in Huntington's disease (HD) is a significant but often overlooked problem. Although expiratory muscle strength training (EMST) is frequently utilized in cough effectiveness treatment, its specific impact in HD patients has not yet been explored. This study investigated the effects of EMST on voluntary peak cough flow (vPCF) in HD patients and evaluated the retention of potential gains post-intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this prospective case-controlled trial, 29 HD patients completed an 8-week wait-to-start period, which served to identify the natural development of expiratory muscle strength and vPCF. This was followed by 8 weeks of EMST training and an additional 8 weeks of follow-up. The study's outcome parameters, vPCF and maximum expiratory pressure (MEP), were measured against those of age- and sex-matched healthy controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Huntington's disease patients had significantly lower MEP (<i>p</i> &lt; 0.001) and vPCF (<i>p</i> = 0.012) compared to healthy controls at baseline. Following the EMST, significant improvements in MEP (<i>d</i> = 1.39, <i>p</i> &lt; 0.001) and vPCF (<i>d</i> = 0.77, <i>p</i> = 0.001) were observed, with HD patients reaching the cough performance levels of healthy subjects. However, these gains diminished during the follow-up, with a significant decline in vPCF (<i>d</i> = −0.451, <i>p</i> = 0.03) and in MEP (<i>d</i> = −0.71; <i>p</i> = 0.002).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Expiratory muscle strength training improves expiratory muscle strength and voluntary cough effectiveness in HD patients, but an ongoing maintenance programme is necessary to sustain the improvements.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"31 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved comprehension of influenza-related headaches: Perspectives and suggestions for incidence and prevalence of headache in influenza—Response","authors":"David García-Azorín,&nbsp;Laura Santana-López,&nbsp;Ana Ordax-Díez,&nbsp;José Eugenio Lozano-Alonso,&nbsp;Diego Macias Saint-Gerons,&nbsp;Yésica González-Osorio,&nbsp;Silvia Rojo-Rello,&nbsp;José M. Eiros,&nbsp;Javier Sánchez-Martínez,&nbsp;Álvaro Sierra-Mencía,&nbsp;Andrea Recio-García,&nbsp;Ángel Luis Guerrero-Peral,&nbsp;Ivan Sanz-Muñoz","doi":"10.1111/ene.16478","DOIUrl":"10.1111/ene.16478","url":null,"abstract":"&lt;p&gt;One of the strengths of this study was the systematic and consistent evaluation of a series of symptoms when patients seek medical attention at primary care [&lt;span&gt;1&lt;/span&gt;]. This was done through a clinical in-person interview by a trained healthcare provider. Since headache was one of the evaluated symptoms, its incidence and prevalence could be assessed.&lt;/p&gt;&lt;p&gt;Khan et al. provided a series of suggestions that we acknowledge and would like to comment on [&lt;span&gt;2&lt;/span&gt;]. In our understanding, the use of medication could have influenced the prevalence of headaches in the following ways: (a) symptomatic treatment could have decreased the duration of the headache, and by the time patients were evaluated in primary care the headache might not be present; (b) headaches could have started after the medical evaluation [&lt;span&gt;1&lt;/span&gt;]. However, according to other studies, headaches seem to be an early symptom that typically resolves within 4 days [&lt;span&gt;3&lt;/span&gt;]. If so, the true prevalence of headaches could be underestimated. Regarding the use of antiviral therapies, these require a medical prescription, so it is not possible that these could have modified the prevalence of headaches. It would be interesting for future studies to evaluate whether these therapies may modify the clinical phenotype and/or duration of headaches.&lt;/p&gt;&lt;p&gt;Regarding the role of epidemiological contacts and travel history, as an epidemic disorder it is common that the number of cases peaks during certain periods of the year when the transmission of the virus is higher within the population [&lt;span&gt;1&lt;/span&gt;]. According to the literature, the main factors that seem to influence the virulence are the specific circulating strains and variants and the proportion of vaccinated individuals [&lt;span&gt;4&lt;/span&gt;]. With more than 8000 studied patients and 12 influenza seasons, the picture seems comprehensive enough to evaluate possible annual differences, which did not seem to be that remarkable regarding headache epidemiology [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Concerning the probability of seeking medical attention, we believe that Khan et al. [&lt;span&gt;2&lt;/span&gt;] refer to another publication from the same study [&lt;span&gt;5&lt;/span&gt;]. In that study, as Khan et al. [&lt;span&gt;2&lt;/span&gt;] point out, we did not prospectively follow up with patients, and we were only able to compare whether patients with headaches were referred to hospitals more or less frequently. It was observed that patients with headaches had 54% lower odds of being referred to the hospital, and it seemed clear that this was not observed by chance [&lt;span&gt;5&lt;/span&gt;]. The reasons are not known with certainty. However, we hypothesize that the reason may be a more efficient immune response. Patients with headaches also had a higher frequency of other symptoms commonly associated with the immune response and the release of cytokines and interleukins. This has been observed with other acute viral infections, and we aim to validate it in future studies [","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"31 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11554866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pelvic autonomic dysfunction is common in patients with pure autonomic failure","authors":"E. Vichayanrat,&nbsp;C. Hentzen,&nbsp;S. Simeoni,&nbsp;M. Pakzad,&nbsp;V. Iodice,&nbsp;Jalesh N. Panicker","doi":"10.1111/ene.16486","DOIUrl":"10.1111/ene.16486","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Pure autonomic failure (PAF) presents primarily as cardiovascular autonomic failure and may phenoconvert to other neurodegenerative disorders. However, the involvement of other autonomic functions has been poorly evaluated. This study aims to characterize genitourinary and bowel dysfunction and explore their relationship with cardiovascular autonomic dysfunction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Pure autonomic failure patients underwent cardiovascular autonomic testing and an assessment of pelvic autonomic dysfunction using urinary, sexual symptoms questionnaires and a bladder diary. Demographic, clinical features and related medical comorbidities were assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-five patients (10 males) with PAF were included (mean age 71 ± 8 years; disease duration 13 ± 8 years). 96% (24/25) reported lower urinary tract symptoms, of which overactive bladder symptoms were most commonly reported (<i>n</i> = 23; 92%; median overactive subscore 8, interquartile range [IQR] 3–11), followed by voiding difficulties (<i>n</i> = 19; 76%; median low stream subscore 2, IQR 1–3) using the Urinary Symptom Profile; however, only four (16%) required clean intermittent self-catheterization. Sexual dysfunction was common (<i>n</i> = 21; 84%) using the Arizona Sexual Experience Scale. Mild faecal incontinence and constipation were reported. 86% (19/22) had nocturnal polyuria (NP) and the median NP index was 47% (IQR 38%–51%; normal range &lt;33%). 77% (10/13) had voiding dysfunction and 31% (4/13) had post-void residual urine &gt;100 mL. There were no significant correlations between the need for catheterization and the degree of NP with age, disease duration and cardiovascular autonomic parameters (<i>p</i> &gt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Nocturnal polyuria, genitourinary and bowel symptoms are commonly seen in PAF. The pathophysiology of NP in PAF is most likely multifactorial and may occur independent of cardiovascular autonomic failure.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"31 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conclusion","authors":"Paul Boon,&nbsp;Elena Moro","doi":"10.1111/ene.16474","DOIUrl":"10.1111/ene.16474","url":null,"abstract":"&lt;p&gt;We hope that the readers of this &lt;i&gt;European Journal of Neurology&lt;/i&gt; Special Issue have enjoyed the lively descriptions of the amazing journey in the past 10 years that our discipline, neurology, has achieved thanks to the extraordinary contribution of neurologists, neurological associations, and people with neurological diseases. In this context, we are also particularly proud to highlight the remarkable developments and achievements of the European Academy of Neurology (EAN), which celebrates its 10-year anniversary in 2024. The experience gained within the former European Federation of Neurological Societies (EFNS) and the European Neurological Society (ENS) has allowed the EAN to immediately start fulfilling its main mission and vision – to reduce the burden of neurological disorders and to provide a home of neurology – with many successful initiatives. The collegial and hard work of the members of the consecutive EAN Boards, the Head Office, the Scientific Panels, and the Committees has contributed to consolidate a society that now includes and represents 48 vibrant National Neurological Societies in Europe. EAN has exponentially grown within these 10 years in terms of increasing the number of members, particularly young neurologists, growing the number and quality of scientific and educational activities, increasing the number and strengthening of national and international partnerships, increasing overall quality standards, and increasing involvement at the European Union (EU) level in Brussels. During the COVID-19 pandemic, EAN has continued to help and serve the neurological community with several initiatives, including setting up a large European patient registry. In the past 10 years, the EAN Annual Congress has become one of the best attended and impactful neurological meetings for general neurologists and subspecialty neurologists alike. EAN is increasingly recognized as the European general neurology organization with a global reach. EAN is now at the forefront of global brain awareness and advocacy efforts.&lt;/p&gt;&lt;p&gt;The EAN has published a comprehensive Neurological Research Agenda for Europe, a patient-centered research strategy that was particularly missing for clinical neurology. EAN has also started a Brain Health Strategy, the Brain Health Mission (BHM), and a Strategic Brain Health Road Map involving patient representatives and patient organizations, the EAN Scientific Panels, the National Neurological Societies, a number of closely affiliated scientific societies, and a large number of other stakeholders and EU partners.&lt;/p&gt;&lt;p&gt;There are several other leading EAN actions and proposals in the pipeline. In these difficult, belligerent and divergent times, EAN wants to recognize diversity, inclusion, and equity as essential determinants when dealing with neurological diseases. To adequately address the exponential growth in knowledge and technology development, and the constant and rapid changes in environment and climate, and ","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"31 11","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}