European Journal of Neurology最新文献

{"title":"“Code Headache”: Development of a protocol for optimizing headache management in the emergency room","authors":"Javier A. Membrilla,&nbsp;Alicia Alpuente,&nbsp;Laura Gómez-Dabo,&nbsp;García-Yu Raúl,&nbsp;Eduardo Mariño,&nbsp;Javier Díaz-de-Terán,&nbsp;Patricia Pozo-Rosich","doi":"10.1111/ene.16484","DOIUrl":"10.1111/ene.16484","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Patients presenting at the emergency room (ER) with headache often encounter a hostile atmosphere and experience delays in diagnosis and treatment. The aim of this study was to design a protocol for the ER with the goal of optimizing the care of patients with urgent headache to facilitate diagnosis and expedite treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A narrative literature review was conducted via a MEDLINE search in October 2021. The “Code Headache” protocol was then developed considering the available characteristics and resources of the ER at a tertiary care center within the Spanish National Public Health system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The Code Headache protocol comprises three assessments: two scales and one checklist. The assessments identify known red flags and stratify patients based on suspected primary/secondary headaches and the need for pain treatment. Initial assessments, performed by the triage nurse, aim to first exclude potentially high morbidity and mortality etiologies (HEAD1 scale) and then expedite appropriate pain management (HEAD2 scale) based on scoring criteria. HEAD1 evaluates vital signs and symptoms of secondary serious headache disorders that can most benefit from earlier identification and treatment, while HEAD2 assesses symptoms indicative of status migrainosus, pain intensity, and vital signs. Subsequently, ER physicians employ a third assessment that reviews red flags for secondary headaches (grouped under the acronym ‘PEACE’) to guide the selection of complementary tests and aid diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The Code Headache protocol is a much needed tool to facilitate quick clinical assessment and improve patient care in the ER. Further validation through comparison with standard clinical practice is warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"31 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ene.16484","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142250581","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":"European Academy of Neurology: First 10 years","authors":"Günther Deuschl,&nbsp;Franz Fazekas,&nbsp;Claudio Bassetti,&nbsp;Paul Boon,&nbsp;Elena Moro","doi":"10.1111/ene.16469","DOIUrl":"10.1111/ene.16469","url":null,"abstract":"<p>The European Academy of Neurology (EAN) was founded in May 2014 as the scientific society of all neurologists and all national neurological societies in Europe. The creation of EAN was based on the conscious decision of two predecessor societies (the European Federation of Neurological Societies and the European Neurological Society) to have a unique society for this continent with its 53 countries according to the World Health Organization and with the EU as the most important continental political decision level. In this report, the important milestones and the motivations of the decision-makers during the first 10 years are described. The development of the annual congress, the broad educational agenda, and the scientific groundwork including the European guidelines for the practise of neurology are described. Collaboration with and work for the national neurological societies is an important task for EAN. The political representation of neurology in Brussels and collaboration with the scientific societies of neighbouring medical disciplines and patient organizations are other major tasks on the agenda of the organization. EAN's goal is to reduce the burden of neurological diseases and to be the “home of neurology” in Europe for physicians, patients, and society. EAN communicates and interacts with its members, patients, partners, politicians, and the public through different channels. EAN is the owner of the scientifically independent <i>European Journal of Neurology</i>. EAN is based in Vienna, where its head office is located, but is also strongly represented in Brussels.</p>","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"31 11","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ene.16469","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142250628","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":"Stepwise dual-target magnetic resonance-guided focused ultrasound in tremor-dominant Parkinson disease: One-year follow-up","authors":"Jui-Cheng Chen,&nbsp;Chun-Ming Chen,&nbsp;Yu Aoh,&nbsp;Ming-Kuei Lu,&nbsp;Chon-Haw Tsai","doi":"10.1111/ene.16468","DOIUrl":"10.1111/ene.16468","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Magnetic resonance-guided focused ultrasound (MRgFUS) is a nonsurgical treatment for Parkinson disease (PD). Some selected anatomical structures can be targeted by MRgFUS in PD. However, there is no uniform target yet. We have reported that stepwise dual-target MRgFUS was successfully applied to treat refractory tremors with akinetic–rigid features in PD. It generated two precise thermal ablations in the ventral intermediate nucleus (VIM) and pallidothalamic tract (PTT). Here, we report more PD patients to verify the safety and efficacy of stepwise dual-target MRgFUS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Ten tremor-dominant PD patients (mean age = 66.7 ± 3.2 years, eight men) received the stepwise dual-target MRgFUS treatment with a series of primary and secondary outcome measures. The VIM and PTT were navigated based on brain magnetic resonance images. Outcome measures were categorized into primary and secondary assessments. The primary outcome measures consisted of resting tremor, action/kinetic tremor, rigidity, and bradykinesia. Secondary outcome measures encompassed non-motor symptoms scale of PD. Data collected at follow-up time points, including 1 day, 3 months, 6 months, and 1 year posttreatment, were compared with baseline data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The severity of tremor and motor deficits represented by Clinical Rating Scale for Tremor parts A and B during off-medication status and Unified Parkinson's Disease Rating Scale III on the treated side were significantly improved (<i>p</i> &lt; 0.05 by paired <i>t</i>-test) at 1-year follow-up. At the 1-year follow-up, significant improvement was observed in the non-motor symptoms scale. Additionally, no severe adverse effects were reported, except temporary treatment-related discomfort during the procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In conclusion, stepwise dual-target MRgFUS emerges as a safe and effective therapeutic modality for PD patients, particularly in addressing medication-refractory tremor and akinetic–rigid syndrome.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"31 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ene.16468","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142250582","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":"Repurposing chemotherapy-induced peripheral neuropathy grading","authors":"Roser Velasco,&nbsp;Andreas A. Argyriou,&nbsp;David R. Cornblath,&nbsp;Pere Bruna,&nbsp;Paola Alberti,&nbsp;Emanuela Rossi,&nbsp;Ingemar S. J. Merkies,&nbsp;Dimitri Psimaras,&nbsp;Chiara Briani,&nbsp;Roy I. Lalisang,&nbsp;Angelo Schenone,&nbsp;Guido Cavaletti,&nbsp;Jordi Bruna,&nbsp;CI-PeriNomS Group","doi":"10.1111/ene.16457","DOIUrl":"10.1111/ene.16457","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Chemotherapy-induced peripheral neuropathy (CIPN) is perceived differently by patients and physicians, complicating its assessment. Current recommendations advocate combining clinical and patient-reported outcomes measures, but this approach can be challenging in patient care. This multicenter European study aims to bridge the gap between patients' perceptions and neurological impairments by aligning both perspectives to improve treatment decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were pooled from two prospective studies of subjects (<i>n</i> = 372) with established CIPN. Patient and physician views regarding CIPN were assessed using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), Total Neuropathy Scale–clinical version (TNSc) items, and the disease-specific quality of life - Chemotherapy-Induced Peripheral Neuropathy questionnaire (QLQ-CIPN20) from the European Organization for Research and Treatment of Cancer (EORTC). To identify inherent neurotoxic severity patterns, we employed hierarchical cluster analysis optimized with k-means clustering and internally validated by discriminant functional analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Both NCI-CTCAE and TNSc demonstrated a significant difference in the distribution of severity grades in relation to QLQ-CIPN20 scores. However, a proportion of subjects with different neurotoxic severity grades exhibited overlapping QLQ-CIPN20 scores. We identified three distinct clusters classifying subjects as having severely impaired, intermediately impaired, and mildly impaired CIPN based on TNSc and QLQ-CIPN20 scores. No differences in demographics, cancer type distribution, or class of drug received were observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our results confirm the heterogeneity in CIPN perception between patients and physicians and identify three well-differentiated subgroups of patients delineated by degree of CIPN impairment based on scores derived from TNSc and QLQ-CIPN20. A more refined assessment of CIPN could potentially be achieved using the calculator tool derived from the cluster equations in this study. This tool, which facilitates individual patient classification, requires prospective validation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"31 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11554987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282443","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":"Association of anti-calcitonin gene-related peptide with other monoclonal antibodies for different diseases: A multicenter, prospective, cohort study","authors":"Luigi Francesco Iannone,&nbsp;Marina Romozzi,&nbsp;Antonio Russo,&nbsp;Gennaro Saporito,&nbsp;Federico De Santis,&nbsp;Raffaele Ornello,&nbsp;Grazia Sances,&nbsp;Gloria Vaghi,&nbsp;Cristina Tassorelli,&nbsp;Maria Albanese,&nbsp;Simona Guerzoni,&nbsp;Alfonsina Casalena,&nbsp;Catello Vollono,&nbsp;Paolo Calabresi,&nbsp;Maria Pia Prudenzano,&nbsp;Edoardo Mampreso,&nbsp;Giorgio Dalla Volta,&nbsp;Maria Rosaria Valente,&nbsp;Gianluca Avino,&nbsp;Alberto Chiarugi,&nbsp;Simona Sacco,&nbsp;Francesca Pistoia,&nbsp;the Italian Headache Registry (RICe) study group","doi":"10.1111/ene.16450","DOIUrl":"10.1111/ene.16450","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and purpose</h3>\u0000 \u0000 <p>Although there is extensive evidence about the safety of monoclonal antibodies against calcitonin gene-related peptide (anti-CGRP mAbs) in combination with traditional drugs, scarce data are available on the safety of their combination with other mAbs. This study aimed to evaluate the 6-month effectiveness and tolerability of anti-CGRP mAbs in combination with other mAbs for different diseases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients included in the Italian Headache Registry and treated concomitantly with an anti-CGRP mAb and another mAb were included. Effectiveness outcomes for migraine included reduction from baseline of monthly headache days (MHDs), Migraine Disability Assessment (MIDAS) score, Headache Impact Test-6 (HIT-6) scores, and Patients' Global Impression of Change (PGIC) scale. Adverse events (AEs) were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-eight patients were included. In 27 patients (71.1%), the anti-CGRP mAb was added to a previously ongoing mAb. Nine patients (23.7%) discontinued one of the two mAbs before the end of treatment (seven discontinued the anti-CGRP mAb and two the other mAb). One patient discontinued for AEs. Anti-CGRP mAbs were discontinued due to ineffectiveness (<i>n</i> = 5, 55.5%) and one each (11.1%) for clinical remission and lost to follow-up. MHDs significantly decreased from baseline to 3 months (<i>p</i> &lt; 0.0001) and 6 months (<i>p</i> &lt; 0.001), as did the MIDAS and the HIT-6 scores at 3 and 6 months (<i>p</i> &lt; 0.001). For anti-CGRP mAbs, 27.4% of patients reported PGIC ≥ 5 at 3 months and 48.3% at 6 months. Mild AEs associated with introduction of a second mAb were detected in six patients (15.8%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this real-world study, anti-CGRP mAbs showed safety and effectiveness when administered concomitantly with other mAbs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"31 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282436","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":"Pre- and post-skeletal muscle biopsy quantitative magnetic resonance imaging reveals correlations with histopathological findings","authors":"Anne-Katrin Güttsches,&nbsp;Johannes Forsting,&nbsp;Moritz Kneifel,&nbsp;Robert Rehmann,&nbsp;Alice De Lorenzo,&nbsp;Elena Enax-Krumova,&nbsp;Martijn Froeling,&nbsp;Matthias Vorgerd,&nbsp;Lara Schlaffke","doi":"10.1111/ene.16479","DOIUrl":"10.1111/ene.16479","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and purpose</h3>\u0000 \u0000 <p>Quantitative muscle magnetic resonance imaging (MRI) is a promising non-invasive method in the diagnostic workup as well as follow-up of neuromuscular disorders. The aim of this study was to correlate quantitative MRI (qMRI) parameters to histopathological changes in skeletal muscle tissue and thus to verify the data from our pilot study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty-six patients (eight females, 46.4 ± 15.1 years) were examined within 72 h before and within 24 h after a skeletal muscle biopsy using quantitative muscle MRI. Post-biopsy MRI was employed to pinpoint the exact localization of the biopsy. qMRI parameters including fat fraction, water T2 relaxation time and diffusion metrics including fractional anisotropy, mean diffusivity, axial diffusivity and radial diffusivity were extracted from the localization of the biopsy and correlated with histopathological findings. Additionally, three different segmentation masks were applied to the qMRI dataset, to evaluate whether the whole muscle represents the exact biopsy location.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fat fraction and water T2 relaxation time in qMRI correlated significantly with the fat fraction in the muscle biopsy and histopathological inflammatory markers. Fractional anisotropy correlated with the quantity of type 2 fibres, whilst mean diffusivity correlated with p62. No differences were found using different segmentation masks in qMRI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this follow-up study, the results from our previous study were verified regarding the correlation of qMRI parameters with histopathological features in muscle biopsies, indicating that qMRI serves as a suitable non-invasive method in the follow-up of patients with neuromuscular disorders. If post-biopsy MRI is not available, whole muscle volume can be used for histopathological correlations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"31 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282441","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":"Difference in trajectories according to early amyloid accumulation in cognitively unimpaired elderly","authors":"Young Ju Kim,&nbsp;Jihwan Yun,&nbsp;Sang Won Seo,&nbsp;Jun Pyo Kim,&nbsp;Hyemin Jang,&nbsp;Hee Jin Kim,&nbsp;Duk L. Na,&nbsp;Sookyoung Woo,&nbsp;Min Young Chun,&nbsp;for the Alzheimer's Disease Neuroimaging Initiative","doi":"10.1111/ene.16482","DOIUrl":"10.1111/ene.16482","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and purpose</h3>\u0000 \u0000 <p>Amyloid β (Aβ), a major biomarker of Alzheimer's disease, leads to tau accumulation, neurodegeneration and cognitive decline. Modelling the trajectory of Aβ accumulation in cognitively unimpaired (CU) individuals is crucial, as treatments targeting Aβ are anticipated. The evolution of Aβ levels was investigated to determine whether it could lead to classification into different groups by studying longitudinal Aβ changes in older CU individuals, and differences between the groups were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 297 CU participants were included from the Alzheimer's Disease Neuroimaging Initiative database, and these participants underwent apolipoprotein E (APOE) genotyping, neuropsychological testing, brain magnetic resonance imaging, and an average of 3.03 follow-up ¹⁸F-florbetapir positron emission tomography scans. Distinct Aβ trajectory patterns were classified using latent class growth analysis, and longitudinal cognitive performances across these patterns were assessed with a linear mixed effects model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The optimal model consisted of three classes, with a high entropy value of 0.947. The classes were designated as follows: class 1, non-accumulation group (<i>n </i> = 197); class 2, late accumulation group (<i>n </i> = 70); and class 3, early accumulation group (<i>n </i> = 30). The late accumulation and early accumulation groups had more <i>APOE ε4</i> carriers than the non-accumulation group. The longitudinal analysis of cognitive performance revealed that the early accumulation group showed the steepest decline (modified Preclinical Alzheimer's Cognitive Composite with digit symbol substitution [mPACCdigit], <i>p</i> &lt; 0.001; modified Preclinical Alzheimer's Cognitive Composite with trails B [mPACCtrailsB], <i>p</i> &lt; 0.001) and the late accumulation group showed a steeper decline (mPACCdigit, <i>p</i> = 0.014; mPACCtrailsB, <i>p</i> = 0.007) compared to the non-accumulation group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study showed the heterogeneity of Aβ accumulation trajectories in CU older individuals. The prognoses for cognitive decline differ according to the Aβ trajectory patterns.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"31 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ene.16482","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142250583","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":"‘Knock down the brain’: a nonlinear analysis of electroencephalography to study the effects of sub‐concussion in boxers","authors":"Renato De Donato, Natale Vincenzo Maiorana, Maurizio Vergari, Angelica De Sandi, Anisa Naci, Giada Aglieco, Tommaso Albizzati, Matteo Guidetti, Rosanna Ferrara, Tommaso Bocci, Sergio Barbieri, Roberta Ferrucci, Alberto Priori","doi":"10.1111/ene.16411","DOIUrl":"https://doi.org/10.1111/ene.16411","url":null,"abstract":"Background and purposeBoxing is associated with a high risk of head injuries and increases the likelihood of chronic traumatic encephalopathy. This study explores the effects of sub‐concussive impacts on boxers by applying both linear and nonlinear analysis methods to electroencephalogram (EEG) data.MethodsTwenty‐one boxers were selected (mean ± SD, age 28.38 ± 5.5 years; weight 67.55 ± 8.90 kg; years of activity 6.76 ± 5.45; education 14.19 ± 3.08 years) and divided into ‘beginner’ and ‘advanced’ groups. The Montreal Cognitive Assessment and the Frontal Assessment Battery were administered; EEG data were collected in both eyes‐open (EO) and eyes‐closed (EC) conditions during resting states. Analyses of EEG data included normalized power spectral density (nPSD), power law exponent (PLE), detrended fluctuation analysis and multiscale entropy. Statistical analyses were used to compare the groups.ResultsSignificant differences in nPSD and PLE were observed between the beginner and advanced boxers, with advanced boxers showing decreased mean nPSD and PLE (nPSD 4–7 Hz, <jats:italic>p</jats:italic> = 0.013; 8–13 Hz, <jats:italic>p</jats:italic> = 0.003; PLE frontal lobe F3 EC, <jats:italic>p</jats:italic> = 0.010). Multiscale entropy analysis indicated increased entropy at lower frequencies and decreased entropy at higher frequencies in advanced boxers (F3 EC, <jats:italic>p</jats:italic> = 0.024; occipital lobe O1 EO, <jats:italic>p</jats:italic> = 0.029; occipital lobe O2 EO, <jats:italic>p</jats:italic> = 0.036). These changes are similar to those seen in Alzheimer's disease.ConclusionNonlinear analysis of EEG data shows potential as a neurophysiological biomarker for detecting the asymptomatic phase of chronic traumatic encephalopathy in boxers. This methodology could help monitor athletes' health and reduce the risk of future neurological injuries in sports.","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"3 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142250586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","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","authors":"Saim Mahmood Khan,&nbsp;Jawairya Muhammad Hussain,&nbsp;Areeb Bin Khalid,&nbsp;Ramsha Sultan","doi":"10.1111/ene.16477","DOIUrl":"10.1111/ene.16477","url":null,"abstract":"&lt;p&gt;Upon examination of the article “Incidence and prevalence of headache in influenza: A 2010–2021 surveillance-based study” by García-Azorín et al. [&lt;span&gt;1&lt;/span&gt;], we commend the authors for their efforts to describe the occurrence and frequency of headaches in influenza patients. There are a few things to be concerned about, even if this work provides a useful investigation of headaches during influenza.&lt;/p&gt;&lt;p&gt;The study did not provide information regarding patients' medication use, particularly how their medications might have affected their symptoms or interacted with antiviral treatments. Furthermore, the study did not furnish detailed information concerning the patient's travel history, notably whether they had recently visited regions where influenza was prevalent. Additionally, there was no comparison of headache prevalence in influenza patients with other comorbidities such as diabetes or cardiovascular disease, which could elucidate associations with specific health conditions or comorbidities [&lt;span&gt;2&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;It was found that patients with perceived health in the headache state had 60% less chance of getting referred for more attention, suggesting less severe illness. Nevertheless, the investigation of the present research did not include data about those long-term consequences that may increase mortality rate or require intensive care [&lt;span&gt;3&lt;/span&gt;]. Furthermore, this research does not consider the re-evaluation of the results after the participants have regained normal health, thus lacking critical information regarding the effect of current treatments on the headache experience in patients with acute infections. Furthermore, the study also did not mention any prior influenza history. It is crucial to understand the significance of patients' prior influenza history as well as the influence of headaches.&lt;/p&gt;&lt;p&gt;Additionally, the research fails to examine whether other psychological states such as stress and anxiety trigger a headache. The case report shows that a 16-year-old boy was admitted to the hospital due to influenza and COVID-19. On the 5th day of the illness, he had hallucinations and delirium, even though he never had a drug or mental illness. It is important to note that psychotic symptoms and COVID-19 co-occurred in this case study [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Although the researchers deserve recognition for their study, which brings attention to a crucial aspect of influenza symptoms and sets the stage for further in-depth investigations, a more impartial assessment of competing perspectives would enhance the quality of the study. Our recommendations are intended to increase the effect and reach of the writers' excellent work in the field, which already has a solid foundation.&lt;/p&gt;&lt;p&gt;&lt;b&gt;Saim Mahmood Khan:&lt;/b&gt; Writing – original draft; writing – review and editing; investigation; funding acquisition; formal analysis; software; supervision; resources; conceptualization; methodology; validation; visualization; project a","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"31 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ene.16477","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142191315","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":"Stable excess mortality in a multiple sclerosis cohort diagnosed 1970–2010","authors":"M.-L. Sumelahti,&nbsp;A. Verkko,&nbsp;V. Kytö,&nbsp;J. O. T. Sipilä","doi":"10.1111/ene.16480","DOIUrl":"10.1111/ene.16480","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and purpose</h3>\u0000 \u0000 <p>Multiple sclerosis (MS) is associated with excess mortality. The use of disease-modifying treatments (DMTs) has recently been associated with survival benefits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A regional MS database was linked with national registries. People with MS (pwMS) diagnosed in 1971–2010 were included and followed up until the end of the year 2019. Five matched controls were acquired for every person with MS. DMTs included in the analyses were interferon and glatiramer acetate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Median follow-up time of the 1795 pwMS was 20.0 years (range 0.1–48.7 years). Survival did not differ between decades of diagnosis (<i>p</i> = 0.20). Amongst pwMS, male sex (adjusted hazard ratio [aHR] 1.70; 95% confidence interval [CI] 1.41–2.06), higher age at diagnosis (aHR 1.83; 95% CI 1.65–2.03 per 10-year increment) and primary progressive disease course (aHR 1.29; 95% CI 1.04–1.60) were independently associated with poorer survival. DMT use was associated with better survival (<i>p</i> &lt; 0.0001) and better survival during follow-up (aHR 0.56; 95% CI 0.38–0.81). Compared to matched controls, median life expectancy was 8–9 years shorter in pwMS with survival diverging from controls during the first decade after diagnosis, more clearly in men than women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite DMT use being associated with better survival, relative life expectancy of pwMS did not change over five decades in Western Finland. Male sex was an independent risk factor for death amongst pwMS, but excess mortality was higher in women. More work and methods are needed to improve survival in pwMS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"31 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ene.16480","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142191316","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}