European Neurology最新文献

{"title":"Prediction of Mild Cognitive Impairment Progression to Alzheimer's Disease Based on Diffusion Tensor Imaging-Derived Diffusion Parameters: Construction and Validation of a Nomogram.","authors":"Xuefei Cheng, Dongxue Li, Jiaxuan Peng, Zhenyu Shu, Xiaowei Xing","doi":"10.1159/000534767","DOIUrl":"10.1159/000534767","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to construct and validate a nomogram that combines diffusion tensor imaging (DTI) parameters and clinically relevant features for predicting the progression of mild cognitive impairment (MCI) to Alzheimer's disease (AD).</p><p><strong>Method: </strong>A retrospective analysis was conducted on the MRI and clinical data of 121 MCI patients, of whom 32 progressed to AD during a 4-year follow-up period. The MCI patients were divided into training and validation sets at a ratio of 7:3. DTI features were extracted from MCI patient data in the training set, and their dimensionality was reduced to construct a radiomics signature (RS). Then, combining the RS with independent predictors of MCI disease progression, a joint model was constructed, and a nomogram was generated. Finally, the area under the receiver operating characteristic curve (AUC) and decision curve analysis (DCA) were used to evaluate the diagnostic and clinical efficacy of the nomogram based on the data from the validation set.</p><p><strong>Result: </strong>The AUCs of the RS in the training and validation sets were 0.81 and 0.84, with sensitivities of 0.87 and 0.78 and specificities of 0.71 and 0.81, respectively. Multiple logistic regression analysis showed that the RS, clinical dementia rating scale score, and Alzheimer's disease assessment scale score were the independent predictors of progression and were thus used to construct the nomogram. The AUCs of the nomogram in the training and validation sets were 0.89 and 0.91, respectively, with sensitivities of 0.78 and 0.89 and specificities of 0.90 and 0.88, respectively. DCA showed that the nomogram was the most valuable model for predicting the progression of MCI to AD and that it provided greater net benefits than other analysed models.</p><p><strong>Conclusion: </strong>Changes in white matter fibre bundles can serve as predictive imaging markers for MCI disease progression, and the combination of white matter DTI features and relevant clinical features can be used to construct a nomogram with important predictive value for MCI disease progression.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"408-417"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71479756","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":"Erratum.","authors":"","doi":"10.1159/000535278","DOIUrl":"10.1159/000535278","url":null,"abstract":"","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"430"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10836735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138298803","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":"Influence of Cardiovascular Risk Factors in Early Relapsing-Remitting Multiple Sclerosis: A Retrospective Analysis.","authors":"Pablo Arroyo-Pereiro,&nbsp;Albert Muñoz-Vendrell,&nbsp;Laura Bau,&nbsp;Elisabet Matas,&nbsp;Lucia Romero-Pinel,&nbsp;Antonio Martínez-Yélamos,&nbsp;Sergio Martínez-Yélamos","doi":"10.1159/000527673","DOIUrl":"https://doi.org/10.1159/000527673","url":null,"abstract":"<p><strong>Introduction: </strong>Prior studies have suggested that cardiovascular risk factors (CVRFs) can affect the prognosis of multiple sclerosis (MS). The aim of this study was to assess if CVRFs affect the early course of MS.</p><p><strong>Methods: </strong>A retrospective observational study was performed, including patients diagnosed with relapsing-remitting MS (RRMS) from 2010 to 2020, with at least 2 years of disease and 6 months follow-up. Age at onset, disease duration, number of relapses, time to confirmed Expanded Disability Status Scale (EDSS) 3.0 and 6.0, and time to secondary progressive MS (SPMS) were collected. Presence and date at onset of hypertension (HT), diabetes mellitus (DM), high low-density lipoprotein cholesterol (LDLc), and smoking during the study period were collected. The primary objective was to assess if CVRFs at the onset of MS are associated with lower time to EDSS 3.0, time to EDSS 6.0, and time to SPMS, using bivariate and multivariate analysis.</p><p><strong>Results: </strong>281 RRMS patients were included; median age at onset was 33 (IQR 26-39); 69.4% were female. Median EDSS at onset was 1.5 (IQR 1-2.5). Nine patients reached SPMS; 24 patients were diagnosed with HT, 9 with DM, 109 with high LDLc, and 123 were smokers during follow-up. No statistically significant association was found between the presence of CVRF at MS onset and the mentioned clinical outcomes during the MS course.</p><p><strong>Conclusion: </strong>No association was found between CVRFs and the early course of MS in our cohort.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"86 1","pages":"73-77"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9110712","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":"Editorial.","authors":"Julien Bogousslavsky","doi":"10.1159/000528909","DOIUrl":"10.1159/000528909","url":null,"abstract":"","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"86 1","pages":"1"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10711753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10646199","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":"Radiological Disease Activity in Secondary Progressive Multiple Sclerosis.","authors":"Daniela Noa Zohar,&nbsp;David Magalashvili,&nbsp;Sapir Dreyer-Alster,&nbsp;Chen Hoffmann,&nbsp;Gil Harari,&nbsp;Mark Dolev,&nbsp;Anat Achiron","doi":"10.1159/000527720","DOIUrl":"https://doi.org/10.1159/000527720","url":null,"abstract":"<p><strong>Introduction: </strong>MRI activity is less frequent among secondary progressive multiple sclerosis (SPMS) patients. In the current study, we aimed to identify SPMS patients with higher radiological disease activity (RDA) and determine their clinical characteristics.</p><p><strong>Methods: </strong>We evaluated the occurrence of RDA in SPMS patients followed at the Sheba Multiple Sclerosis Center between January 1, 2015, and December 31, 2020. All patients underwent brain and spinal cord MRI examinations as a routine follow-up unrelated to clinical disease activity. Patients were subdivided into RDA and non-RDA MRI groups based on the presence of active gadolinium-enhancing T1 lesions and/or new/enlarging T2 lesions. Demographic variables and disease-related data were compared.</p><p><strong>Results: </strong>One hundred consecutive SPMS patients, 74 females, median age of 50 years, disease duration of 19.5 years, and neurological disability by the Expanded Disability Status Scale (EDSS) score of 6.0, were included in the study. The RDA group comprised 35 patients (35%), of them 65.7% (n = 23) exhibited only brain MRI activity, 22.8% (n = 8) only spinal cord MRI activity, and 11.4% (n = 4) had both. Patients in the RDA group were diagnosed at a younger mean (SD) age of 28.2 (8.9) versus 33.7 (10.1) years and were younger with a mean (SD) age of 47.8 (9.9) versus 53.4 (10.1) years, as compared with the non-RDA group. No significant differences were found in relation to disease duration, EDSS, exposure to immunomodulatory treatments, and duration of immunomodulatory treatments.</p><p><strong>Conclusions: </strong>RDA unrelated to clinical symptomatology was more frequent in a subgroup of young SPMS patients.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"86 2","pages":"116-120"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9527509","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":"Long-Lasting COVID-Associated Brain Fog: A Follow-Up Study.","authors":"Ali A Asadi-Pooya,&nbsp;Mina Shahisavandi,&nbsp;Hamid Nemati,&nbsp;Afrooz Karimi,&nbsp;Anahita Jafari,&nbsp;Sara Nasiri,&nbsp;Seyyed Saeed Mohammadi,&nbsp;Meshkat Nemati,&nbsp;Zahra Rahimian,&nbsp;Hossein Bayat","doi":"10.1159/000529860","DOIUrl":"https://doi.org/10.1159/000529860","url":null,"abstract":"<p><strong>Introduction: </strong>We investigated the longevity of COVID-associated brain fog in patients who have survived the COVID-19.</p><p><strong>Methods: </strong>This was a follow-up study of 2,696 adult patients with COVID-19 from our previous study. We selected every other patient in our database. The follow-up data were collected during a phone call to the participants in January-February 2022 (11 months after the initial study): concentration difficulty and the patient's self-declared status in their ability to concentrate.</p><p><strong>Results: </strong>In total, 1,164 people were included; 35 people (3.0%) had concentration difficulty and 65 individuals (5.6%) had a worsened status in their ability to concentrate and think; 26 people (2.2%) responded yes to both questions and were considered as having long-lasting brain fog. People with long-lasting brain fog were more often admitted to ICUs during the initial hospitalization (23.1% vs. 9.3%; p = 0.032) compared with those without long-lasting brain fog.</p><p><strong>Conclusion: </strong>We may conclude that a minority of the hospitalized patients with COVID-19 may suffer from long-lasting post-COVID brain fog, at least for more than 1 year after their initial illness. Long-lasting post-COVID brain fog has a significant association with the severity of the initial illness.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"86 3","pages":"166-170"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9788854","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":"Interferon Beta-1a versus Glatiramer Acetate: Changes of Innate Immunity in a Group of Women with Multiple Sclerosis.","authors":"Marek Peterka, Martin Valis, Ondrej Soucek, Jan Krejsek, Lukáš Sobisek, Ilona Sejkorova, Blanka Klimova, Pavel Stourac, Zbysek Pavelek, Michal Novotny","doi":"10.1159/000532022","DOIUrl":"10.1159/000532022","url":null,"abstract":"<p><strong>Introduction: </strong>Multiple sclerosis (MS) is a chronic inflammatory autoimmune demyelinating disease that secondarily leads to axonal loss and associated brain atrophy. Disease-modifying drugs (DMDs) have previously been studied for their ability to affect specific immunity. This study investigates the effect of interferon beta-1a (INF) and glatiramer acetate (GA) administration on changes in innate immunity cell populations.</p><p><strong>Methods: </strong>Sixty Caucasian female patients with relapsing-remitting MS undergo blood sample testing for 15 blood parameters at baseline, 1 month, 3 months, and 6 months after treatment by GA or IFN (started as their first-line DMD).</p><p><strong>Results: </strong>A statistically significant difference in the change after 6 months was found in the parameter monocytes (relative count) in the group of patients treated with IFN. The median increase was 27.8%. Changes in many of the other 15 parameters studied were 10-20%.</p><p><strong>Conclusion: </strong>Innate immunity has long been neglected in MS immunopathology. The findings suggest that IFN treatment may modulate the immune response in MS by affecting monocyte function and may provide insight into the mechanisms of action of IFN in MS.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"334-340"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10623392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10222155","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":"Management of Status Epilepticus by Different Pediatric Departments: Neurology, Intensive Care, and Emergency Medicine.","authors":"Özge Dedeoglu, Halise Akça, Serhat Emeksiz, Ayşe Kartal, Neşe Çıtak Kurt","doi":"10.1159/000533191","DOIUrl":"10.1159/000533191","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to explore the differences in status epilepticus (SE) management among pediatric neurology, emergency medicine, and intensive care specialists in Turkey.</p><p><strong>Methods: </strong>A 22-item questionnaire regarding first-, second-, and third-line management strategies of SE including demographic characteristics and common etiologies according to the specialty of participants was mailed to 370 specialists working in Turkey.</p><p><strong>Results: </strong>A total of 334 participants (response rate 90%) comprising 136 pediatric neurologists, 102 pediatric emergency medicine specialists, and 96 pediatric intensive care specialists completed the survey. While intensive care specialists frequently managed SE due to metabolic and autoimmune reasons, the most common etiologies encountered by emergency medicine specialists were epilepsy and infections. More than half of the intensive care specialists (64.6%) reported using non-BZD antiseizure medications in the 5th minute of the seizure. Most of the neurologists (76.4%) preferred to administer intravenous (IV) levetiracetam infusion as a second-line agent. About half of intensive care specialists and neurologists tried immunomodulatory therapies in super-refractory SE. Intensive care and emergency medicine specialists were less likely to favor ketogenic diet and pyridoxine therapy for the treatment of super-refractory SE. The rate of requesting EEG monitoring to recognize nonconvulsive SE (NCSE) was found to be very low except for neurologists.</p><p><strong>Conclusion: </strong>There was no consensus among neurologists, intensive care specialists, and emergency medicine specialists in the management of SE in Turkey. Familiarity with particular antiseizure medications and the etiologies they manage seem to be the most important factors influencing the attitudes.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"315-324"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10623395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10476400","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":"André-Thomas (1867-1963), Initiator of Neonatal Neurology.","authors":"Olivier Walusinski","doi":"10.1159/000531863","DOIUrl":"10.1159/000531863","url":null,"abstract":"<p><p>After a brilliant career as a clinician and anatomopathologist, André-Thomas (1868-1963) spent the last 30 years of his life validating the components of neurological examinations of newborns and infants. This novel approach was developed through long examinations of several hundreds of normal and sick children, notably those with anencephaly. By combining his vast knowledge of physiology with the results of his experimental work, André-Thomas built the foundations of a speciality that did not exist before his time: neuropaediatrics. His Études neurologiques (neurological studies), medical in nature but also very literary, echoing his illustrious predecessors of the 19th century, made him a transmitter of knowledge, a man of transition, from the anatomoclinical method of the 19th century to the standardised investigation techniques of the 20th century.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"350-362"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10518902","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":"Delirium and Dementia in the Elderly: Sometimes Associated or Always Together?","authors":"Orso Bugiani","doi":"10.1159/000530226","DOIUrl":"https://doi.org/10.1159/000530226","url":null,"abstract":"<p><strong>Background: </strong>In the elderly, the association of delirium and dementia can cause diagnostic problems because they share the same symptom of confusion. Delirium is often misdiagnosed as dementia and treated inappropriately, ignoring that it could be successfully addressed, which can lead to increased health risks up to death.</p><p><strong>Summary: </strong>Confusion indicates that functional reserve fails to compensate for the action of stressors. The decline in reserve is linked to aging-related changes in blood flow, mitochondria, cerebrospinal fluid, and immune function, as well as the appearance of structural precursors of disease. It is greater in dementia that adds a large burden of pathology, especially degenerative and vascular.</p><p><strong>Key messages: </strong>Based on their common background linking normal and pathological brain aging, it can be argued that delirium and dementia are always associated to some extent and can aggravate each other. The clinical approach to their association, which currently relies on the preliminary diagnosis of delirium according to ad hoc protocols, could be simplified by taking delirium for granted so that its causative stressors, usually the most common diseases of old age and/or drug abuse, could be addressed immediately. This approach would benefit all demented patients: not only those who are in such a serious condition that they need to be hospitalized due to the risk of death, but also those with clouded delirium.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"86 3","pages":"161-165"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10147502","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}