European Neurology最新文献

{"title":"Berlin Bowel Bothers: Might Adolf Hitler's Gut Problems Have Been Parkinson-Related?","authors":"Milan Beckers, Peter J Koehler, Geert J A Wanten, Bastiaan R Bloem","doi":"10.1159/000530166","DOIUrl":"10.1159/000530166","url":null,"abstract":"<p><p>It has been argued that Adolf Hitler (1889-1945) had Parkinson's disease. He also experienced several gastrointestinal symptoms, for which various explanations have been sought, both contemporaneously and by later authors. In this Historical Note, a possible relationship between Hitler's Parkinson's disease and his gastrointestinal symptoms is explored. Specifically, we posit the hypothesis that Hitler may have suffered from small-intestinal bacterial overgrowth (SIBO), thus providing an early example of SIBO occurring as a prodromal Parkinson's disease symptom.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"86 3","pages":"222-227"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11226199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10164701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Respiratory Function and Motor Function in Different Stages of Parkinson's Disease.","authors":"Chong Xi,&nbsp;Xiao-Chen Bai,&nbsp;Ce Li,&nbsp;Wei-Ning Wang,&nbsp;Shan Tian,&nbsp;Yi-Lin Tang,&nbsp;Bo Shen,&nbsp;Jian Wang,&nbsp;Yi-Min Sun,&nbsp;Yu-Lian Zhu","doi":"10.1159/000530390","DOIUrl":"https://doi.org/10.1159/000530390","url":null,"abstract":"<p><strong>Introduction: </strong>Respiratory dysfunction in patients with Parkinson's disease (PD) could present in the early stage and worsen in the late stages. These changes could be a factor affecting the ability of daily living and quality of life of patients with PD. The primary objective of this study was to assess the respiratory function and its association with motor function in patients with different stages of PD.</p><p><strong>Methods: </strong>This was a cross-sectional study conducted at the Huashan Hospital of Fudan University in Shanghai, China. The study included 65 patients diagnosed with PD (the Hoehn and Yahr scale between 1 and 4) and 20 healthy individuals of similar age, gender, weight, and height. The ventilatory function was assessed using the spirometry. Motor function was evaluated using subscale III of the United Parkinson's disease rating scale (UPDRS-III). After confirming the normality of data distribution, we performed one-way ANOVA with a Tukey's post hoc test.</p><p><strong>Results: </strong>Compared with the healthy individuals, there was no statistical significance in forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) in the H&amp;Y 1 group and H&amp;Y 2 group (p &gt; 0.05) but reduced peak expiratory flow (PEF) in the H&amp;Y 2 group (p = 0.002). Reduced FVC, FEV1, and PEF was seen in the H&amp;Y 3 group (p = 0.002, p = 0.001, and p = 0.0001, respectively). Reduced FVC, FEV1, PEF, and FEF25-75% was seen in the H&amp;Y 4 group (p = 0.001, p = 0.0001, p = 0.0001, and p = 0.025, respectively). The correlation analysis revealed that there was a significant negative correlation between FVC and UPDRS-III scores (r = -0.248, p = 0.046), disease duration (r = -0.276, p = 0.026), H&amp;Y scale (r = -0.415, p = 0.001). FEV1 was negatively correlated with UPDRS-III scores (r = -0.277, p = 0.025), disease duration (r = -0.291, p = 0.019), H&amp;Y scale (r = -0.434, p = 0.0001). FEF25-75% was negatively correlated with disease duration (r = -0.247, p = 0.047), H&amp;Y scale (r = -0.278, p = 0.025).</p><p><strong>Conclusion: </strong>Our findings revealed that respiratory impairment is present in moderate and advanced PD patients, and directly related to the severity of the disease. It is important to conduct respiratory function test in the clinical practice.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"86 4","pages":"242-249"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10193611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Initiation of Exoskeletal Robotic Gait Training Improves Functional Outcomes in the Patients with Stroke: A Retrospective Observational Study.","authors":"Akira Degami,&nbsp;Shingo Taki,&nbsp;Takeshi Imura,&nbsp;Yuji Iwamoto,&nbsp;Naoki Imada,&nbsp;Ryo Tanaka,&nbsp;Susumu Urakawa,&nbsp;Tetsuji Inagawa,&nbsp;Hayato Araki,&nbsp;Osamu Araki","doi":"10.1159/000527710","DOIUrl":"https://doi.org/10.1159/000527710","url":null,"abstract":"<p><strong>Introduction: </strong>The effect of early initiation of gait training using hybrid assistive limb (HAL) remains unclear. This observational study aimed to investigate whether early initiation of gait training using HAL improves functional outcomes in patients with stroke.</p><p><strong>Methods: </strong>We retrospectively analyzed patients with acute stroke admitted to our facility. HAL was used for exoskeletal robotic gait training. Study participants were median split into an early group and a late group based on the days from stroke onset to initiation of gait training using HAL. The functional outcomes, defined by the Brunnstrom recovery stage (BRS), modified Rankin Scale (mRS), and Functional Independence Measure (FIM) at discharge, were compared using propensity score-matched analysis.</p><p><strong>Results: </strong>We performed a propensity score-matched analysis in 63 patients with stroke (31 from the early group and 32 from the late group), and 17 pairs were matched. There were no significant differences in discharge in the BRS of the upper limb and finger in the post-matched cohort. On the other hand, the BRS of the lower limb in the early group was significantly higher than that in the late group. In addition, the mRS, but not FIM scores, was significantly better in the early group than that in the late group.</p><p><strong>Conclusions: </strong>In conclusion, early initiation of gait training using HAL might improve the motor function of the paralyzed lower limb and disability in patients with stroke.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"86 2","pages":"121-127"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9156434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acknowledgement to Reviewers","authors":"","doi":"10.1159/000527760","DOIUrl":"https://doi.org/10.1159/000527760","url":null,"abstract":"<br />Eur Neurol 2022;85:494","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"21 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2022-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138542000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contents Vol. 85, 2022","authors":"","doi":"10.1159/000527761","DOIUrl":"https://doi.org/10.1159/000527761","url":null,"abstract":"<br />Eur Neurol 2022;85:I–VI","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"51 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2022-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138533633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of MRI in the Treatment of Drug-Resistant Focal Epilepsy","authors":"A. Bernasconi, N. Bernasconi","doi":"10.1159/000525262","DOIUrl":"https://doi.org/10.1159/000525262","url":null,"abstract":"Background: Epilepsy is a prevalent chronic condition affecting about 50 million people worldwide. A third of patients with focal epilepsy suffer from seizures unresponsive to medication. Uncontrolled seizures damage the brain, are associated with cognitive decline, and have negative impact on well-being. For these patients, the surgical resection of the brain region that gives rise to seizures is the most effective treatment. Summary: Magnetic resonance imaging (MRI) plays a central role in detecting epileptogenic brain lesions. In this review, we critically discuss advances in neuroimaging acquisition, analytical post-acquisition techniques, and machine leaning methods for the detection of epileptogenic lesions, prediction of clinical outcomes, and identification of disease subtypes. Key Message: MRI is a mandatory investigation for diagnosis and treatment of epilepsy, particularly when surgery is being considered. Continuous progress in imaging techniques, combined with machine learning, will continue to push the boundaries of lesion visibility and provide increasingly precise predictors of clinical outcomes. Current efforts aiming at strengthening the competences of epileptologists in neuroimaging will ultimately reduce the need for invasive diagnostics.","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"85 1","pages":"333 - 341"},"PeriodicalIF":2.4,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47109963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antioxidants for Treatment of Duchenne Muscular Dystrophy: A Systematic Review and Meta-Analysis","authors":"S. Ren, Chunmei Yao, Ya-ling Liu, G. Feng, Xiaohuan Dong, B. Gao, S. Qian","doi":"10.1159/000525045","DOIUrl":"https://doi.org/10.1159/000525045","url":null,"abstract":"Introduction: Increasing evidence has shown that oxidative stress is involved in the pathogenesis of Duchenne muscular dystrophy (DMD). Oxidative stress impairs muscle function, reduces regenerative capacity, and leads to atrophy and muscle weakness. The present study aimed to evaluate the effectiveness and safety of antioxidants in treatment of DMD patients. Methods: Medline, Embase, EBSCOhost, and Cochrane Library databases were searched using relevant keywords regarding DMD and antioxidants. The risk of bias for all included studies was assessed using the Cochrane risk of bias tool. The effectiveness of antioxidants in improving pulmonary function and muscle strength in DMD patients and their rate of adverse events was evaluated by meta-analysis. Results: A total of nine eligible studies were identified. Among these, two studies involving 85 patients compared idebenone with placebo. Pooled data showed a significant improvement in pulmonary function after idebenone treatment. Flavonoids- and omega 3-based compounds (FLAVOMEGA) significantly improved muscle strength. Two studies evaluated coenzyme Q10 (CoQ10) and reported clinical improvement in physical activity. The remaining four studies evaluated pentoxifylline, superoxide dismutase, vitamin E combination with penicillamine and penicillamine alone, respectively, and found no significant differences between the intervention and placebo groups, measured by pulmonary function, muscle strength, movement function, or quality of life. Most adverse events were mild, while the rates of dropout and serious adverse events were low with respect to antioxidants. Conclusions: Idebenone appeared to be safe and effective in improving pulmonary function in DMD patients, while pentoxifylline, superoxide dismutase, penicillamine, or a combination of vitamin E with penicillamine did not show a significant therapeutic effect. CoQ10 and FLAVOMEGA might be beneficial in improving muscle strength or physical activity in DMD patients. However, additional trials with more participants are warranted in the future.","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"85 1","pages":"377 - 388"},"PeriodicalIF":2.4,"publicationDate":"2022-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42622780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Mechanical Thrombectomy for Acute Ischemic Stroke When Multiple Passes Are Required and Associated Risk Factors","authors":"Hong He, Yi-Sheng Liu, Haimao Liang, Yi Li, Jian-Ren Liu","doi":"10.1159/000522559","DOIUrl":"https://doi.org/10.1159/000522559","url":null,"abstract":"Introduction: This study aimed to evaluate the outcomes of mechanical thrombectomy for acute ischemic stroke when multiple passes are required and to identify the associated risk factors. Methods: Consecutive patients with acute ischemic stroke treated with mechanical thrombectomy at the Neurology Department of Ninth People’s Hospital and the Neurosurgery Department of Xinhua Hospital of Shanghai Jiao Tong University School of Medicine from 2013 to 2018 were included. Patients were divided into 2 groups: those who received ≤2 passes and those who received >2 passes. Outcomes of the 2 groups were compared. Multivariate linear regression was used to determine factors associated with the need for >2 passes. All patient data were reviewed retrospectively. Results: A total of 122 patients were included, of whom 83 patients required ≤2 passes and 39 patients required >2 passes. After adjusting for sex, atrial fibrillation history, smoking history, and involvement of middle cerebral artery and internal cerebral artery, the National Institutes of Health Stroke Scale (NIHSS) score was associated with a 1.08-times greater risk of >2 passes (95% confidence interval [CI]: 1.01–1.17), and internal carotid artery with a 5.13-times greater risk of >2 passes (95% CI: 1.02–25.69). Having more than 2 passes was associated with significantly higher 7-day (25.6% vs. 6%), 90-day mortality rates (34.2% vs. 16%) and a significantly lower recanalization rate (66.7% vs. 89.2%). Conclusion: Needing more than 2 passes during mechanical thrombectomy is associated with poorer outcomes. Higher preprocedural NIHSS scores and internal carotid artery thrombi are associated with more than 2 passes.","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"85 1","pages":"300 - 307"},"PeriodicalIF":2.4,"publicationDate":"2022-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49224239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electroencephalographic-Based Functional Connectivity Networks of Visual Hallucinations and Visuospatial Dysfunctions in Parkinson’s Disease","authors":"K. Kinugawa, T. Mano, T. Takatani, A. Kido, K. Sugie","doi":"10.1159/000524365","DOIUrl":"https://doi.org/10.1159/000524365","url":null,"abstract":"Visual dysfunction is an important nonmotor symptom of Parkinson’s disease (PD). Visual hallucinations (VHs) and visuospatial dysfunctions (VSDs) are common visual dysfunctions in PD; however, the underlying mechanisms remain unclear. Our study aimed to evaluate neuronal synchronization between patients with PD with and without VH or VSD using electroencephalographic (EEG) coherence analysis. Twenty-four patients with sporadic PD were evaluated for the presence of VH and VSD, and were divided into VH-negative and VH-positive groups, and these groups were further subdivided by VSD status. Coherence analysis was performed on EEG data. Whole-brain and regional coherences were calculated and compared between the groups. There was a significant difference in frontal-frontal coherence between the VH+ VSD− and VH+ VSD+ groups (p = 0.026). Our findings suggest that reduced EEG coherence in frontal regions might be involved in VSD in patients with PD. Reduced neuronal synchronization between the frontal lobes may contribute to the disruption of visual processing in PD.","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"85 1","pages":"404 - 409"},"PeriodicalIF":2.4,"publicationDate":"2022-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42392870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Huntington’s Disease Progression and Caregiver Burden","authors":"Ewa Modrzejewska-Zielonka, M. Ren, Andrzej Młodak, J. Marcinkowski, D. Zielonka","doi":"10.1159/000524146","DOIUrl":"https://doi.org/10.1159/000524146","url":null,"abstract":"Huntington’s disease (HD) is a neurodegenerative, progressive disorder conditioned by a mutation in the HTT gene. Its progression is dependent on the causative mutation extension. Caregivers of individuals affected by HD, most often patients’ relatives, are burdened with the care. This study aims to assess the caregivers’ burden cross-sectionally and longitudinally and look for biological and clinical patients-related burdening factors. In total, 144 caregiver-patient pairs observed annually for up to 8 years were included in the study. In all of the patients, demographic data were collected, Unified Huntington's Disease Rating Scale (UHDRS) assessments were conducted, and disease burden (DB) was calculated when caregivers were assessed in Caregiver Burden Inventory (CBI). Caregivers’ burden measured in CBI at the first visit reached 18.7 ± 18.4 scores. Longitudinal observation showed no evidence for any discrepancy between clinical progression measured in UHDRS, nor biological progression measured in DB and the caregivers’ burden progression measured in CBI. Caregivers were burdened mostly by patients’ dependence and a discrepancy between reality and life expectations. This study indicates factors to be addressed to reduce caregivers’ burden. Strict relation between caregivers’ burden and biological and clinical progression denies conception of overloaded with care tasks or adaptation to the burden.","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"85 1","pages":"398 - 403"},"PeriodicalIF":2.4,"publicationDate":"2022-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48055166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}