European Neurology最新文献

{"title":"Impact of the COVID-19 Pandemic on Acute Stroke Rehabilitation in Japanese Primary Stroke Centers: A Nationwide Cross-Sectional Study Using a Web-Based Questionnaire Survey.","authors":"Naoki Oyama, Koichi Oki, Makoto Nakajima, Koichi Matsumoto, Tomohiro Omori, Makoto Hayase, Tsuyoshi Ohta, Masatoshi Koga, Tetsuo Koyama, Shigeru Fujimoto, Yasuyuki Iguchi, Wataru Kakuda, Kuniaki Ogasawara","doi":"10.1159/000540231","DOIUrl":"10.1159/000540231","url":null,"abstract":"<p><strong>Introduction: </strong>Acute stroke rehabilitation is crucial for achieving good functional recovery, even during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to clarify the impact of the COVID-19 pandemic on acute stroke rehabilitation and identify which components in the acute stroke rehabilitation provision system were susceptible to the pandemic.</p><p><strong>Methods: </strong>A web-based questionnaire survey was conducted in all primary stroke centers (PSCs) in Japan between February 7 and April 21, 2022. The survey included questions about the current status of acute stroke rehabilitation and the influence of the pandemic. We classified the influences and investigated the relationship between the influence of the pandemic and the provision of rehabilitation. Additionally, we investigated a group of prefectures divided according to the grade of the pandemic.</p><p><strong>Results: </strong>The survey response rate was 67% (639 of 959 PSCs). Among them, 387 PSCs (61%) reported that the COVID-19 pandemic affected acute stroke rehabilitation. In PSCs affected by the pandemic, more rehabilitation-related staff were working, and the proportion of weekend/holiday rehabilitation implementation was higher compared to those unaffected. In PSCs from highly infected prefectures, no significant relationship was observed between the influence of the pandemic and the rehabilitation provision system.</p><p><strong>Conclusions: </strong>PSCs that provide denser acute stroke rehabilitation may be affected to a greater extent by the pandemic. We conclude that stroke hospitals should formulate infection control procedures for acute stroke rehabilitation in advance, depending on the conditions of the region and facility.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"169-176"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859436","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 Body Mass Index or Serum Albumin and Different Dementia Populations.","authors":"Xia Yang, Ling-Yun Ma, Moyu Li, Yong Ji","doi":"10.1159/000540317","DOIUrl":"10.1159/000540317","url":null,"abstract":"<p><strong>Introduction: </strong>There is limited understanding of body mass index (BMI) and serum albumin levels in patients with dementia. This study aimed to investigate the association between BMI, serum albumin levels, and dementia in patients with Alzheimer's disease (AD), dementia with Lewy bodies (DLB), and Parkinson's disease with dementia (PDD).</p><p><strong>Methods: </strong>A total of 336 patients with dementia (173 with AD, 112 with DLB, 51 with PDD) and 220 healthy controls were recruited. Pearson and Spearman correlation analyses were performed to examine the relationships between BMI or serum albumin and MMSE scores, as well as neuropathological markers. Logistic regression models were used to analyze the data, adjusting for confounding variables.</p><p><strong>Results: </strong>Using the highest BMI quartile (≥26.04 kg/m2) and serum albumin quartile (≥41.21 g/L) as reference groups, the lowest BMI quartile (&lt;21.91 kg/m2) was significantly associated with AD (p &lt; 0.001) and DLB (p = 0.003). The lowest serum albumin quartile (≤37.60 g/L) was independently associated with DLB (p &lt; 0.001) and AD (p = 0.006). In AD patients, BMI was associated with Aβ1-42 and p-Tau181 in cerebrospinal fluid after controlling for confounders, while serum albumin was correlated with T-Tau and T-tau/Aβ1-42 (p &lt; 0.05).</p><p><strong>Conclusion: </strong>Decreased serum albumin and BMI levels are associated with DLB and AD in dementia patients. Although no correlation was found between BMI or serum albumin and MMSE scores, there was a significant association with AD cerebrospinal fluid pathologic markers.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"159-168"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855298","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":"Role of Intraoperative Neurophysiological Monitoring in Predicting Postoperative Delirium in Patients Undergoing Carotid Endarterectomy Surgeries.","authors":"Abdullah M Al-Qudah, Sreeja Sivaguru, Katherine M Anetakis, Donald Crammond, Jeffrey R Balzer, Kathirvel Subramaniam, Senthilkumar Sadhasivam, Varun Shandal, Parthasarathy D Thirumala","doi":"10.1159/000540311","DOIUrl":"10.1159/000540311","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate the diagnostic utility of electroencephalography (EEG) and somatosensory evoked potentials (SSEP) as modalities of intraoperative neurophysiological monitoring (IONM) in predicting postoperative delirium (POD) in patients who underwent carotid endarterectomy (CEA) surgery.</p><p><strong>Methods: </strong>A total cohort of 425 patients was included in this study. Medical record data were reviewed retrospectively and their documented significant IONM data were analyzed and integrated into the study for each patient. The study cohort was assessed for POD with the Intensive Care Delirium Screening Checklist (ICDSC), and a score of >4 was positive for delirium.</p><p><strong>Results: </strong>Of the 425 patients who underwent CEA for carotid stenosis, 65 (15.29%) had documented significant IONM changes. Of those 65 patients with significant changes, 16 (24.61%) had POD. On the other hand, of the 360 patients without changes, 31 (8.61%) had POD. Utilizing logistic regression while adjusting for possible confounders, IONM changes were still significantly associated with POD (p value: <0.001; 95% confidence interval (CI): 1.91-7.98; adjusted odds ratio (ORadj): 3.94). Specifically, SSEP changes alone were significantly associated with POD (p value: <0.001; 95% CI: 2.36-11.08; ORadj: 5.15).</p><p><strong>Conclusion: </strong>Significant IONM changes increase the risk of developing POD in patients undergoing CEA. Despite the low overall risk of POD after CEA in our study, it is imperative to conclude that patients with POD are twice as likely to exhibit IONM changes.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"242-249"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142461241","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":"Beyond the Neurologist: Charles Foix as a Poet and a Playwright.","authors":"Camila Lorenzini Tessaro, João Gabriel Cavazzani Doubek, Matheus Kahakura Franco Pedro","doi":"10.1159/000539145","DOIUrl":"10.1159/000539145","url":null,"abstract":"<p><strong>Background: </strong>Charles Foix (1882-1927) may be mostly remembered today due to his contributions to vascular neurology and the syndromes that bear his name, such as the Foix-Alajouanine syndrome. However, he also developed a literary career and composed poetry and a vast collection of plays, often dealing with biblical themes or figures from Greek mythology.</p><p><strong>Summary: </strong>His poetry was often inspired by his own experiences during the First World War, in which he was assigned to serve as a medical officer in Greece, becoming enamored with his surroundings and the classical lore.</p><p><strong>Key messages: </strong>The authors explore Foix's poetry and drama and their relationship to his overall work as a neurologist, including his wartime experiences.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"140-146"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858980","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":"Pathophysiology of Contrast-Induced Neurotoxicity: A Narrative Review of Possible Mechanisms.","authors":"Frederick P Mariajoseph, Leon Lai, Justin Moore, Ronil Chandra, Tony Goldschlager, Adrian J Praeger, Lee-Anne Slater","doi":"10.1159/000535928","DOIUrl":"10.1159/000535928","url":null,"abstract":"<p><strong>Background: </strong>Contrast-induced neurotoxicity (CIN) is an increasingly observed event following the administration of iodinated contrast. It presents as a spectrum of neurological symptoms that closely mimic ischaemic stroke, however, CIN remains a poorly understood clinical phenomenon. An appreciation of the underlying pathophysiological mechanisms is essential to improve clinical understanding and enhance decision-making.</p><p><strong>Methods: </strong>A broad literature search of Medline (1946 to December 2022) and Embase (1947 to December 2022) was conducted. Articles discussing the pathophysiology of CIN were reviewed.</p><p><strong>Summary: </strong>The pathogenesis of CIN appears to be multifactorial. A key step is likely blood-brain barrier (BBB) breakdown due to factors including ischaemic stroke, uncontrolled hypertension, and possibly contrast agents themselves, among others. This is followed by passage of contrast agents across the BBB, leading to chemotoxic sequelae on neural tissue.</p><p><strong>Key messages: </strong>This review provides a clinically oriented review on the pathophysiology of CIN to enhance knowledge and improve decision-making among clinicians.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"26-35"},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11003557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138828958","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":"Causal Relationship between Parkinson's Disease with Heart and Vascular Disease: A Two-Sample Mendelian Randomization Study.","authors":"Lize Chen, Qiushi Zhang, Shiduo Li, Haoran Chen, Jing Guo, Zongmao Zhao, Jing Tong","doi":"10.1159/000536484","DOIUrl":"10.1159/000536484","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to investigate the causal relationship between Parkinson's disease (PD) and myocardial infarction (MI), atrial fibrillation and flutter (AF), and venous thromboembolism (VTE) by Mendelian randomization (MR) analysis.</p><p><strong>Methods: </strong>By using data from publicly available genome-wide association studies from databases, single nucleotide polymorphisms were screened as instrumental variables, and the MR analysis was finished by inverse-variance weighted (IVW), MR-egger, weighted median methods.</p><p><strong>Results: </strong>The primary IVW method showed a negative association between genetically predicted PD and risk of MI (OR = 0.9989; 95% CI: 0.9980-0.9998; p = 0.02). However, PD was not significantly associated with AF or VTE.</p><p><strong>Conclusion: </strong>This study suggests a negative association between PD with MI, which implies that PD has a protective effect on MI.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"11-16"},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10997265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139697194","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":"Rare Disorders as Models for De(Re)generation: Is the Vacuolar ATPase a Clue to Understanding Tauopathies?","authors":"Tommaso Nicoletti","doi":"10.1159/000541286","DOIUrl":"10.1159/000541286","url":null,"abstract":"","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"312-314"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139712","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":"D-Dimer and the Short-Term Prognosis of Patients with Subarachnoid Hemorrhage: A Meta-Analysis.","authors":"Xubin Shang, Xingmin Li","doi":"10.1159/000540163","DOIUrl":"10.1159/000540163","url":null,"abstract":"<p><strong>Introduction: </strong>Elevated plasma D-dimer has been observed in acute phase of subarachnoid hemorrhage (SAH), while a quantitative evaluation for the association between D-dimer level and prognosis of SAH remains lacking. The aim of the meta-analysis was to investigate the potential predictive role of D-dimer for the short-term functional outcome of patients with SAH.</p><p><strong>Methods: </strong>Relevant observational studies were retrieved by searching PubMed, Web of Science, Embase, Wanfang, and CNKI. A poor functional outcome was generally defined by the Glasgow Outcome Scale (1-3) or the modified Rankin Scale (≥3). A random-effects model was used to combine the data by incorporating the influence of between-study heterogeneity.</p><p><strong>Results: </strong>Eleven studies involving 3,748 patients with SAH were included. Among them, 1,131 patients (30.2%) developed a poor functional outcome within 6 months. The pooled results showed that a higher plasma D-dimer at admission was associated with a higher risk of poor functional outcome during follow-up (odds ratio per 1 mg/L increment of D-dimer: 1.65, 95% confidence interval: 1.49-1.82, p &lt; 0.001; I2 = 0%). Sensitivity analysis by excluding one study at a time showed similar results. Subgroup analyses suggested that the association between D-dimer and poor functional outcome of patients with SAH was not significantly affected by study design, country, mean age, proportion of men, follow-up duration, methods for defining poor outcome, study quality scores, timing of D-dimer measurement, or the publication year.</p><p><strong>Conclusion: </strong>A high plasma D-dimer at admission is associated with a poor short-term functional outcome of patients with SAH.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"188-202"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141590015","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":"Continuous versus Routine Electroencephalography in the Intensive Care Unit: A Review of Current Evidence.","authors":"Helene Fenter, Andrea O Rossetti, Isabelle Beuchat","doi":"10.1159/000535085","DOIUrl":"10.1159/000535085","url":null,"abstract":"<p><strong>Background: </strong>Electroencephalography (EEG) has long been used to detect seizures in patients with disorders of consciousness. In recent years, there has been a drastically increased adoption of continuous EEG (cEEG) in the intensive care units (ICUs). Given the resources necessary to record and interpret cEEG, this is still not available in every center and widespread recommendations to use continuous instead of routine EEG (typically lasting 20 min) are still a matter of some debate. Considering recent literature and personal experience, this review offers a rationale and practical advice to address this question.</p><p><strong>Summary: </strong>Despite the development of increasingly performant imaging techniques and several validated biomarkers, EEG remains central to clinicians in the intensive care unit and has been experiencing expanding popularity for at least 2 decades. Not only does EEG allow seizure or status epilepticus detection, which in the ICU often present without clinical movements, but it is also paramount for the prognostic evaluation of comatose patients, especially after cardiac arrest, and for detecting delayed ischemia after subarachnoid hemorrhage. At the end of the last Century, improvements of technical and digital aspects regarding recording and storage of EEG tracings have progressively led to the era of cEEG and automated quantitative analysis.</p><p><strong>Key messages: </strong>As compared to repeated rEEG, cEEG in comatose patients does not seem to improve clinical prognosis to a relevant extent, despite allowing a more performant of detection ictal events and consequent therapeutic modifications. The choice between cEEG and rEEG must therefore always be patient-tailored.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"17-25"},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11003555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89717422","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":"Altered Cerebrospinal Fluid Neurofilament Light Chain but Not Neurogranin Levels Are Associated with Response to Ocrelizumab Treatment in Relapsing-Remitting Multiple Sclerosis: A Preliminary Study.","authors":"Tuğçe Kızılay, Ece Akbayir, Ruziye Erol, Ayça Simay Demir, Duygu Özkan Yaşargün, Vuslat Yilmaz, Erdem Tuzun, Recai Turkoglu","doi":"10.1159/000539376","DOIUrl":"10.1159/000539376","url":null,"abstract":"<p><strong>Introduction: </strong>Ocrelizumab is a CD20-targeting monoclonal antibody used for treatment of multiple sclerosis (MS). Serum and cerebrospinal fluid (CSF) neurofilament light (NFL) chain levels are reduced in MS patients under ocrelizumab treatment indicating a preventive action against neuro-axonal degeneration. Our aim, in this preliminary study, was to explore the impact of ocrelizumab treatment on synaptic integrity through assessment of neurogranin levels.</p><p><strong>Methods: </strong>Thirteen relapsing-remitting multiple sclerosis (RRMS) patients resistant to first-line immunomodulating agents were enrolled and followed up for 24 months under ocrelizumab treatment. Disease activity was monitored by periodic EDSS, MSSS, and cranial-spinal MRI assessments. No evidence of disease activity (NEDA)-3 was determined, and CSF levels of NFL (marker of neuro-axonal integrity) and neurogranin (marker of synaptic integrity) were measured by ELISA at baseline and 12-month ocrelizumab treatment.</p><p><strong>Results: </strong>Seven RRMS patients, who preserved NEDA-3 status during 24-month follow-up, showed ≥30% NFL level decrease, whereas 6 patients with stable/increased NFL levels displayed relapse, MRI lesion, or disability progression. Although most RRMS patients exhibited increased CSF levels of neurogranin under ocrelizumab treatment, patients with and without neurogranin level increase did not differ in terms of clinical features and NEDA-3 status. Baseline neurogranin levels negatively correlated with baseline EDSS scores.</p><p><strong>Conclusion: </strong>Our results confirm that NFL effectively monitors treatment response of RRMS patients under ocrelizumab treatment. Neurogranin does not appear to exhibit a similar benefit in screening of RRMS disease activity. Nevertheless, lower neurogranin levels are associated with increased disability in RRMS indicating a potential disease activity biomarker function.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"203-210"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140955484","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}