European Neurology最新文献

{"title":"Digital Color Vision Testing Reveals Widespread Cone Dysfunction in Multiple Sclerosis Independent of Optic Neuritis.","authors":"Yehuda Warszawer, Aviva Gal, Terrace Waggoner, Yael Nissan, Anat Achiron","doi":"10.1159/000549814","DOIUrl":"10.1159/000549814","url":null,"abstract":"<p><p><p>Introduction: We aimed to investigate the prevalence and pattern of color vision deficiency (CVD) in relapsing-remitting multiple sclerosis (RRMS) patients, with or without a history of optic neuritis (ON), and to assess its potential as a marker of subclinical optic pathway dysfunction.</p><p><strong>Methods: </strong>Color vision was assessed in a large cohort of 345 RRMS patients using the Waggoner Computerized Color Vision Test, screening for protan, deutan, tritan, and composite color deficiencies, with severity grading based on score thresholds. Statistical differences between eyes with a history of ON, fellow eyes without ON, and eyes from MS patients with no history of ON were analyzed using multivariable logistic regression, controlled for age, gender, disease duration, Expanded Disability Status Scale, and treatment status.</p><p><strong>Results: </strong>Out of the 676 eyes analyzed, CVD was observed in 76.0% of ON-affected eyes, 65.1% of fellow eyes without ON, and 62.3% of eyes from patients without ON. Multivariable logistic regression showed ON-affected eyes had significantly higher odds of severe CVD compared to fellow eyes (OR = 2.48, p = 0.020), which in turn had higher odds of moderate CVD compared to the no-ON group (OR = 2.27, p = 0.010). Conversely, the no-ON group had higher odds of mild CVD compared to fellow eyes without ON (OR = 2.01, p = 0.003). Composite CVD was the most frequent type (57.7%), with tritan deficiencies being the most common pure type (39.9%). Fellow eyes demonstrated higher odds of composite CVD compared to the no-ON group (OR = 1.97, p = 0.016).</p><p><strong>Conclusions: </strong>CVD is highly prevalent in MS even without clinical ON, indicating diffuse, subclinical optic pathway damage. </p>.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"13-21"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12779286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145631467","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":"Recovery of Motor Function via Intraspinal Detour Circuits following Unilateral Spinal Cord Injury.","authors":"Hiroshi Nakagawa, Yuki Fujita, Toshihide Yamashita","doi":"10.1159/000549481","DOIUrl":"10.1159/000549481","url":null,"abstract":"<p><p><p>Introduction: Neuroplasticity is the ability of the central nervous system (CNS) to adapt structurally and functionally in response to motor and sensory dysfunction caused by injury and disease. Spinal interneurons are key components of neuroplastic changes that ameliorate impaired motor function after CNS injury. A lateral spinal cord hemisection model exhibited spontaneous motor recovery of the hind limb on the affected side. Hence, neuroplastic changes within the spinal cord on the affected and/or unaffected side may occur during motor recovery following unilateral spinal cord injury (SCI). However, it remains unclear how the spinal neurons on the affected and unaffected side contribute to motor recovery in the ipsilesional hind limb following unilateral SCI. Thus, we aimed to explore whether the thoracic spinal neurons above the lesion were involved in the motor recovery of the ipsilesional hind limb.</p><p><strong>Methods: </strong>In our SCl model, unilateral lesions were made at the tenth thoracic vertebral level.</p><p><strong>Results: </strong>Following unilateral SCI, hind limb motor function on the ipsilateral side was initially impaired but showed spontaneous recovery in the behavioral tests, which was subsequently lost after ablation of thoracic spinal neurons in the ipsilesional spinal cord above the lesion. In contrast, changes in the ipsilesional hind limb motor function were not observed after ablation of the contralesional thoracic spinal neurons.</p><p><strong>Conclusion: </strong>These results suggest that thoracic spinal neurons on the ipsilesional side above the lesion are key components for hind limb motor recovery in a model of unilateral SCI. </p>.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"22-32"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12755886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145476917","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":"Factors Affecting Prehospital Delay in Patients with Acute Ischemic Stroke in the Republic of Georgia: A Countrywide, Prospective Study.","authors":"Tamar Janelidze, Teona Janiashvili, Tamar Akhvlediani, Irine Pkhakadze, Nana Gelenidze, Natia Bitsadze, Ketevan Tsikhiseli, Mariam Ioseliani, Nino Sharia, Khatia Danelia, Ani Sergeenko, Vlasi Kakabadze, Nino Mdivnishvili, Nino Jalagonia, Giorgi Argvliani, Giorgi Abuladze, Giorgi Mamardashvili, Dali Mebonia, Ketevan Dzagoevi, Elene Koiava, Ketevan Paposhvili, Temur Margania, Nana Skhulukhia, Nino Fifia, Marine Todua, Zaza Katsarava","doi":"10.1159/000550217","DOIUrl":"10.1159/000550217","url":null,"abstract":"<p><strong>Introduction: </strong>Recently, a nationwide stroke care consisting of stroke care units (SCUs) and stroke centers (SCs) was established in the Republic of Georgia.</p><p><strong>Patients and methods: </strong>A hospital-based prospective registry to evaluate the quality of stroke care and an additional nationwide survey on factors leading to prehospital delay and subsequent low rate of intravenous thrombolysis (IVT) and endovascular thrombectomy (EVT).</p><p><strong>Results: </strong>A total of 5,385 consecutive patients with acute stroke (3,636 ischemic, 1,302 TIA, and 447 hemorrhagic) were included in the stroke registry, of whom 2,459 (46%) were female, with a mean age of 70.3±11.3 years. A total of 1,538 (28.6%) patients presented <6 h (1,160 [21.5%] <4.5 h). Of 3,636 patients with ischemic stroke, 121 (3.3%) patients received IVT, 72 (2.0%) received EVT, and 17 (0.5%) received both. An additional 1,067 patients with acute ischemic stroke (898) and TIA (169) were interviewed to understand the factors of prehospital delay. Of these, 472 (44.2%) were female, with a mean age of 70.5 ± 11.4 years, and 339 (31.8%) patients arrived <6 h (219 [20.5%] <4.5 h). Forty-two patients (4.7%) received IVT, 37 (4.1%) received EVT, and 6 (0.7%) received both. Pre-ictal education level, high socio-economic status, stroke awareness, calling the ambulance, and a knowledgeable ambulance team transferring patients to the stroke-ready hospital predicted timely arrival at the SC.</p><p><strong>Conclusions: </strong>The study reveals major problems in the prehospital management of acute stroke.</p><p><strong>Discussion: </strong>There is a great need for a nationwide geographic transfer plan for acute stroke service, connecting ambulances, SCUs, and SCs and for the educational campaigns to increase stroke awareness among the population.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"1-8"},"PeriodicalIF":2.4,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145862554","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":"Association between Internal Carotid Artery Tortuosity and Hemorrhagic Transformation in Patients with Acute Ischemic Stroke.","authors":"Jae-Chan Ryu, Sang-Hun Lee, Eun-Tae Jeon, Ha-Na Song, Hangseok Choi, Hwan-Ho Cho, Hyunjin Park, In Young Baek, Kyungseo Kim, Seongvin Ju, Jong-Un Choi, Seong-Hoon Lee, Yun-Hwa Ha, Ji-Eun Lee, Woo-Keun Seo","doi":"10.1159/000549765","DOIUrl":"10.1159/000549765","url":null,"abstract":"<p><strong>Introduction: </strong>Hemorrhagic transformation is one of the most common complications of acute ischemic stroke. However, the association between hemorrhagic transformation and internal carotid artery (ICA) tortuosity has rarely been investigated. This study investigated the effect of ICA tortuosity on hemorrhagic transformation after acute ischemic stroke.</p><p><strong>Methods: </strong>We conducted a retrospective analysis on stroke patients' data collected from prospective hospital-based stroke registry. The baseline demographics, clinical and radiological variables, including the Fazekas scale, advanced Fazekas scale (grade 0-9), white matter hyperintensity volume, presence of cerebral microbleeds, and hemorrhagic transformation, were compared based on the severity of ICA tortuosity and divided into quartiles (Q1: <25%, Q2+Q3: 25%-75%, and Q4: >75%). ICA tortuosity was examined using in-house vessel analysis software. The primary outcome was hemorrhagic transformation.</p><p><strong>Results: </strong>A total of 146 patients were analyzed, including 167 ICAs, which were vascular territories with acute cerebral infarction. Among the various risk factors considered, intravenous thrombolysis, endovascular thrombectomy, stroke severity, and ICA tortuosity index were associated with the occurrence of hemorrhagic transformation. In multivariate analysis, ICA tortuosity was also significantly associated with the occurrence of hemorrhagic transformation, while the severity of ICA tortuosity was negatively correlated (Q1: reference, Q2+Q3: 0.27 [0.09-0.84], Q4: 0.14 [0.03-0.70]; p = 0.023 for Q2+Q3, p = 0.016 for Q4).</p><p><strong>Conclusions: </strong>We identified a paradoxical relationship between ICA tortuosity and hemorrhagic transformation after acute ischemic stroke. Patients with more severe tortuosity experienced fewer hemorrhagic transformations, and vice versa. These findings highlight the potential of ICA tortuosity as a marker for identifying high-risk patients.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"1-11"},"PeriodicalIF":2.4,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12807496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145695922","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":"Acknowledgement to Reviewers.","authors":"","doi":"10.1159/000549162","DOIUrl":"https://doi.org/10.1159/000549162","url":null,"abstract":"","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"1"},"PeriodicalIF":2.4,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145488233","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":"Jean-Martin Charcot and the Clinical Foundations of Amyotrophic Lateral Sclerosis: A Historical Case Revisited.","authors":"Emmanuel Drouin, Patrick Hautecoeur, Arnaud Kwiatkowski","doi":"10.1159/000548249","DOIUrl":"10.1159/000548249","url":null,"abstract":"<p><p>This article revisits an original case of bulbar-onset amyotrophic lateral sclerosis (ALS) recorded by Jean-Martin Charcot in 1877-78, highlighting his clinical methodology and its enduring significance. The case of Eugénie Florentine P., a 62-year-old patient at the Salpêtrière, illustrates Charcot's rigorous approach: precise observation of clinical signs, longitudinal documentation of disease progression, and anatomoclinical correlation confirmed by autopsy findings. Charcot identified the combined role of anterior horn and lateral column lesions, establishing ALS as a distinct nosological entity. While predecessors such as Aran, Cruveilhier, and Duchenne contributed key observations, Charcot synthesized clinical and pathological data to define the disease later known as \"Charcot's disease.\" This historical perspective underscores the lasting value of bedside examination in an era dominated by neuroimaging and biomarkers. By comparing 19th-century clinical reasoning with current diagnostic and therapeutic challenges, the article demonstrates how Charcot's work continues to inform the modern multidisciplinary management of ALS.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"1-5"},"PeriodicalIF":2.4,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058499","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 History of the Evans Index.","authors":"Kimberley J R Fleuren, Peter J Koehler, Erik I Hoff","doi":"10.1159/000545917","DOIUrl":"10.1159/000545917","url":null,"abstract":"","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"92-96"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973828","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":"Circadian Rhythms in Ischemic Stroke: From Molecular Pathways to Chronotherapeutic Strategies.","authors":"Shramana Deb, Ritwick Mondal, Vramanti Sarkar, Gourav Shome, Rumela Mete, Subhajit Sarkar, Sourav Das, Jayanta Roy, Julián Benito-León","doi":"10.1159/000548456","DOIUrl":"10.1159/000548456","url":null,"abstract":"<p><strong>Background: </strong>Circadian rhythms - endogenous 24-h oscillations - shape the risk, pathophysiology, and recovery of ischemic stroke. Diurnal variation in stroke onset, severity, and treatment responsiveness reflects clock control over cardiovascular tone, hemostasis, immune activity, neurovascular integrity, and metabolic homeostasis. After a stroke, circadian misalignment can blunt repair programs, amplify neuroinflammation, and accelerate cognitive decline.</p><p><strong>Summary: </strong>We synthesize how circadian mechanisms act across the neurovascular unit to modulate neuronal excitability, receptor and transport cycles, glial reactivity, endothelial barrier function, hemostasis/fibrinolysis, and glymphatic clearance. Particular emphasis is placed on the ischemic penumbra, where intrinsic (BAX/BCL-2-regulated) and extrinsic death-receptor pathways show time-of-day sensitivity that influences salvageability. We link post-stroke circadian disruption to proteostasis and amyloid-β handling, providing a mechanistic bridge to long-term cognitive impairment. We also reconcile treatment-timing data, including biological phase (e.g., PAI-1/tPA rhythms, blood-brain barrier permeability), and operational factors jointly shape outcomes for thrombolysis and endovascular therapy. Finally, we outline chronotherapeutic avenues - light, melatonin, time-targeted pharmacology, personalized rehabilitation - and candidate biomarkers to guide timing.</p><p><strong>Key messages: </strong>The circadian phase is a key determinant of stroke susceptibility, tissue vulnerability, and recovery potential. Integrating chronobiology into prevention, reperfusion, and rehabilitation enables time-tailored strategies that align interventions with intrinsic rhythms, thereby improving outcomes and reducing disability.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"179-195"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191448","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":"Clinical and Brain MRI Characteristics of Patients with Anti-N-Methyl-<sc>d</sc>-Aspartate Receptor Encephalitis: A 10-Year Retrospective Study.","authors":"Yuliang Wang, Qin Zhou, Zhaojun Dai, Yingwei Qiu, Hongyan Zhou, Li Feng, Jing Zhao","doi":"10.1159/000546521","DOIUrl":"10.1159/000546521","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to investigate the diagnostic utility of brain Magnetic resonance imaging (MRI) in anti-N-methyl-<sc>d</sc>-aspartate receptor encephalitis (anti-NMDAR encephalitis) and analyze the relationship between clinical and brain MRI characteristics and disease prognosis.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on forty-six (59% female, median age: 24.5 years) clinically identified anti-NMDAR encephalitis patients from December 2012 to April 2022. All the patients underwent multiparametric MRI, with thirteen returning for follow-up. All the relevant clinical information was collected. The initial and follow-up brain MRI was sequentially analyzed for signal abnormalities, involvement of anatomy and structure, and brain/structure atrophy by two experienced neuroradiologists. Additionally, the relationship between clinical and brain MRI features and prognosis was examined.</p><p><strong>Results: </strong>The most common symptom (33/46, 72%) in anti-NMDAR encephalitis was aberrant psychiatric behavior. Five (10%) cases combined with other positive antibodies. Although 91% of patients with mRS >2 before treatment, a statistically significant decrease mRS were observed after treatment (mRS: 3.50 ± 0.94 vs. mRS: 1.91 ± 1.53, p < 0.001). More than half of the patients had abnormal MRI findings. T2-weighted fluid-attenuated inversion recovery (FLAIR) hyperintense lesions that involve the frontal lobe and the limbic system are the characteristic imaging predilection of anti-NMDAR encephalitis. On follow-up MRI, we noticed 5 patients with significant hippocampal atrophy. Further analysis showed that the hippocampal involvement was a significant factor in predicting worse mRS scores both before and after treatment (p < 0.05).</p><p><strong>Conclusion: </strong>T2-FLAIR hyperintense lesions in the frontal lobe and the limbic system are indicative of anti-NMDAR encephalitis. The involvement of the hippocampus is a risk factor for a poor prognosis.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"71-81"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625665","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":"Clinical Manifestations of Tuberous Sclerosis: A Retrospective Analysis of 20 Cases.","authors":"Xu Zhang, Cong Xie, Zhihua Si, Ju Liu, Aihua Wang, Meng Kong, Jinzhi Liu, Zhangyong Xia","doi":"10.1159/000546608","DOIUrl":"10.1159/000546608","url":null,"abstract":"<p><strong>Introduction: </strong>Tuberous sclerosis (TSC) is an autosomal dominant genetic disorder with a wide range of clinical manifestations. This study aimed to retrospectively analyze the clinical records of TSC patients, focusing on the first onset times and age ranges for various symptoms.</p><p><strong>Methods: </strong>The clinical data of TSC patients were analyzed retrospectively, including general information, clinical manifestations, and treatment plans, with particular attention to the first onset times and age ranges for different symptoms.</p><p><strong>Results: </strong>The study found that 15 patients presented with different types of skin lesions, 13 patients, including 6 with intellectual disabilities, experienced epileptic seizures. Additionally, 14 patients had kidney damage, 6 showed varying degrees of cardiac involvement, and 8 exhibited lung lesions.</p><p><strong>Conclusion: </strong>By integrating the clinical features and imaging characteristics of TSC, multiple manifestations of the disease were identified, providing further clinical evidence for its recognition. This is beneficial for early monitoring and effective disease prevention and improvement.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"82-91"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265769","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}