European Neurology最新文献

{"title":"The Path of Discovery and Opioid-associated Amnestic Syndrome in \"The Memory Thief\". Book Review.","authors":"Mason Bennett","doi":"10.1159/000529634","DOIUrl":"https://doi.org/10.1159/000529634","url":null,"abstract":"<p><p>N/A.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2023-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10685287","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 Effects of Neuromodulators on Spasticity, Balance, and Gait in Patients with MS: A Systematic Review and Meta-Analysis Study","authors":"Alireza Emadi, Sara Halakoo, Cyrus Taghizadeh Delkhoush, F. Ehsani","doi":"10.1159/000528100","DOIUrl":"https://doi.org/10.1159/000528100","url":null,"abstract":"Introduction: Multiple sclerosis (MS) is a common neurological disorder in societies. The most common symptoms in patients with MS are gait disorders and spasticity. Pharmacological therapies have mild therapeutic influence with more side effects for management of these symptoms. There is evidence that neuro-rehabilitation techniques have more appropriate effects rather than pharmacological therapies. In this regard, some studies indicated the beneficial effects of brain stimulation techniques on gait improvement and decreasing spasticity in patients with MS, while the others have not shown any efficacy. Accordingly, conducting a meta-analysis study in this issue is very important. Methods: A systematic search was performed in PubMed, Scopus, and ISI Web of Science from database inception on December 6, 2020, to find interventional studies assessing the effects of neuromodulators (transcranial direct-current stimulation [tDCS] or transcranial magnetic stimulation [TMS]) on spasticity, balance, and gait in patients with MS. The included studies were qualitatively assessed by the Physiotherapy Evidence Database (PEDro) scale. Finally, the homogeneity studies were analyzed by Stata software. Study-specific results were pooled by using a random-effects model. Results: A total of seven studies were included in the analysis. In the pooled analysis of studies, a significant effect of the TMS technique on spasticity was observed in patients with MS: −0.80 (95% CI: −1.31, −0.29). In addition, no significant effect of the single-session tDCS technique on gait speed was observed in patients with MS: 0.11 (95% CI: −0.11, 0.32). Conclusions: One of the main causes of discrepancy in the findings of included studies is the number of sessions for using neuromodulator techniques. A single session of anodal tDCS is not enough to improve gait in patients with MS. In addition, meta-analysis shows that multi-session TMS is effective intervention for decreasing spasticity in patients with MS.","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"216 ","pages":"144 - 154"},"PeriodicalIF":2.4,"publicationDate":"2023-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41273622","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":"NOTCH4 Single-Nucleotide Polymorphism Is Associated with Brain Arteriovenous Malformation in a Chinese Han Population.","authors":"Ming Zhong,&nbsp;Jianbo Zhang,&nbsp;Zhenjun Li,&nbsp;Ziying Liu,&nbsp;Haiyan Fan,&nbsp;Hengxian Su,&nbsp;Hongliang Meng,&nbsp;Xin Zhang,&nbsp;Xifeng Li,&nbsp;Chuan-Zhi Duan,&nbsp;Xuying He","doi":"10.1159/000526434","DOIUrl":"https://doi.org/10.1159/000526434","url":null,"abstract":"<p><strong>Introduction: </strong>Brain arteriovenous malformations (BAVMs) are high-flow intracranial vascular malformations characterized by the direct connection of arteries to veins without an intervening capillary bed. They are one of the main causes of intracranial hemorrhage and epilepsy, although morbidity is low. Angiogenesis, heredity, inflammation, and arteriovenous malformation syndromes play important roles in BAVM formation. Animal experiments and previous studies have confirmed that NOTCH4 may be associated with BAVM development. Our study identifies a connection between NOTCH4 gene polymorphisms and BAVM in a Chinese Han population.</p><p><strong>Methods: </strong>We enrolled 150 patients with BAVMs confirmed by digital subtraction angiography (DSA) in the Department of Neurosurgery, Zhujiang Hospital, Southern Medical University from June 2017 to July 2019. Simultaneously, 150 patients without cerebrovascular disease were confirmed by computed tomography angiography/magnetic resonance angiography/DSA. DNA was extracted from peripheral blood and NOTCH4 genotypes were identified by PCR-ligase detection reaction. The χ2 test or Fisher's exact test was used to evaluate the differences in allele and genotype frequencies between the BAVM group, control group, bleeding group, and other complications.</p><p><strong>Results: </strong>Two single-nucleotide polymorphisms (SNPs), rs443198 and rs438475, were significantly associated with BAVM. No SNP genotypes were significantly associated with hemorrhage or epilepsy. SNPs rs443198_AA-SNP and rs438475_AA-SNP may be associated with a lower risk of BAVM (p = 0.011, odds ratio (OR) = 0.459, 95% confidence interval (CI): 0.250-0.845; p = 0.033, OR = 0.759, 95% CI: 0.479-1.204).</p><p><strong>Conclusion: </strong>NOTCH4 gene polymorphisms were associated with BAVM and may be a risk factor in a Chinese Han population.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"86 2","pages":"107-115"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9528003","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":"Imaging, Genetic, and Pathological Features of Vascular Dementia.","authors":"Xiaoni Yang,&nbsp;Chao Chen,&nbsp;Aishuai Wang,&nbsp;Changsheng Li,&nbsp;Guangqing Cheng","doi":"10.1159/000531088","DOIUrl":"https://doi.org/10.1159/000531088","url":null,"abstract":"<p><strong>Background: </strong>Over the past decades, marked progress has been made in detecting vascular dementia (VD) both through maturation of diagnostic concepts and advances in brain imaging, especially MRI. We summarized the imaging, genetic, and pathological features of VD in this review.</p><p><strong>Summary: </strong>It is a challenge for the diagnosis and treatment of VD, particularly in patients where there is no evident temporal relation between cerebrovascular events and cognitive dysfunction. In patients with cognitive dysfunction with poststroke onset, the etiological classification is still complicated.</p><p><strong>Key messages: </strong>In this review, we summarized the clinical, imaging, and genetic as well as pathological features of VD. We hope to offer a framework to translate diagnostic criteria to daily practice, address treatment, and highlight some future perspectives.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"86 4","pages":"277-284"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10192833","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":"Migraine Attacks Triggered by Ingestion of Watermelon.","authors":"Raimundo Pereira Silva-Néto,&nbsp;Gabriela Leal Bezerra,&nbsp;Natália Rebeca Alves Araújo,&nbsp;Sângela Fernandes Silva,&nbsp;Suyanne Kássia Soares Pereira,&nbsp;Layana Karine Farias Lima,&nbsp;Adriana Almeida Soares,&nbsp;Luciano Silva Lopes","doi":"10.1159/000531286","DOIUrl":"https://doi.org/10.1159/000531286","url":null,"abstract":"<p><strong>Introduction: </strong>Ingesting some foods can trigger headache attacks in migraine patients. Diet-sourced citrulline activates the <sc>l</sc>-arginine-nitric oxide pathway, acting on the pathophysiology of migraine.</p><p><strong>Methods: </strong>The study was a clinical trial, interventional, controlled, and with group comparison. The sample was non-random, composed of 38 volunteers with migraine and 38 without headache (control). Both groups ingested a portion of watermelon to determine the onset of headache attacks. Before and after ingesting watermelon, they underwent blood collections to determine serum nitrite levels.</p><p><strong>Results: </strong>There were 38 volunteers diagnosed with migraine without aura and 38 controls, whose mean age was, respectively, 22.4 ± 1.5 and 22.9 ± 3.1 years (p = 0.791). Headache was triggered by watermelon ingestion after 124.3 ± 20.5 min of ingestion in 23.7% (9/38) of the migraine volunteers and in none of the controls (p = 0.002). There was an increase in serum nitrite levels, both in migraine volunteers (23.4%) and in the control group (24.3%), after watermelon ingestion. This difference was significant (p &lt; 0.001).</p><p><strong>Discussion: </strong>Watermelon ingestion triggered headache attacks in migraine patients and increased serum nitrite levels, attesting to a possible activation of the <sc>l</sc>-arginine-nitric oxide pathway.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"86 4","pages":"250-255"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10192858","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":"When Cerebral Microbleed Meets Dilated Perivascular Space in Cerebral Amyloid Angiopathy.","authors":"Dimitri Renard, Anne Wacongne","doi":"10.1159/000531805","DOIUrl":"10.1159/000531805","url":null,"abstract":"","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"348-349"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9759503","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":"A Simplified Clinical Prediction Rule for Prognosticating Dependent Daily Living in Patients with Thoracic Spinal Cord Injury: A Multicenter Nationwide Japan Registry Study.","authors":"Takeshi Imura,&nbsp;Tomonari Hori,&nbsp;Ryo Tanaka","doi":"10.1159/000529780","DOIUrl":"https://doi.org/10.1159/000529780","url":null,"abstract":"<p><strong>Introduction: </strong>Clinical prediction rule (CPR) using decision tree analysis is able to show the branching of the variables under consideration in a clear, hierarchical manner, including specific reference values, which can be used as classifiers in clinical practice. However, CPRs developed by decision tree analysis for predicting the degree of independent living of patients with thoracic spinal cord injury (SCI) are few. The purpose of this study was to develop a simplified CPR for prognosticating dependent daily living in patients with thoracic SCI.</p><p><strong>Methods: </strong>We extracted data on patients with thoracic SCI from a national multicenter registry database, the Japan Rehabilitation Database (JRD). All patients with thoracic SCI who were hospitalized within 30 days after the injury onset were included. The independent living was categorized in the JRD as follows: independent socially, independent at home, needing care at home, independent at the facility, and needing care at the facility. These categories were used as the objective variables in classification and regression tree (CART) analysis. The CART algorithm was applied to develop the CPR for predicting whether patients with thoracic SCI achieve independent living at hospital discharge.</p><p><strong>Results: </strong>Three hundred ten patients with thoracic SCI were included in the CART analysis. The CART model identified, in a hierarchical order, patient's age, residual function level, and the bathing sub-score of Functional Independence Measure as the top three factors with moderate classification accuracy and area under the curve.</p><p><strong>Conclusions: </strong>We developed a simplified, moderately accurate CPR for predicting whether patients with thoracic SCI achieve independent living at hospital discharge.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"86 3","pages":"178-184"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9788882","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":"Close Your Eyes and See: Stroke Sequelae versus Functional Neurological Disorder in a Physician.","authors":"E Jennifer Weil,&nbsp;Harold Keyserling,&nbsp;Burt Feuerstein,&nbsp;Olwen Murphy","doi":"10.1159/000530753","DOIUrl":"10.1159/000530753","url":null,"abstract":"<p><p>The first author is a left-handed, 51-year-old nephrologist who experienced a neurologic event. She underwent neurosurgery complicated by hemorrhage. Postoperatively, she developed persistent vertigo and unilateral tongue pain which persisted for over 5 years. Early neuroimaging revealed expected encephalomalacia but no neuroanatomical basis for her symptoms. A functional neurological disorder was suspected, and she was seen by several psychiatrists and psychotherapists. However, she suspected a neuroanatomical lesion would better explain her unrelenting symptoms. After seeing many neurologists, a neuroanatomical diagnosis was finally made. The theory and practice of medicine mandate that subjective complaint guides the modality and interpretation of objective evidence. The final neurologist knew where on neuroimaging to look because she was guided by the patient's complaints - vertigo and unilateral tongue pain. In this case, detailed scrutiny of neuroimaging by a neurologist, after encephalomalacia and gliosis were fully completed, gave a more accurate neuroanatomical diagnosis and a more realistic prognosis.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"86 4","pages":"287-294"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10614251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10183766","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":"Efficacy and Safety of Ticagrelor versus Aspirin and Clopidogrel for Stroke Prevention in Patients with Vascular Disease: A Systematic Review and Meta-Analysis.","authors":"Xibo Ma,&nbsp;Danfeng Li,&nbsp;Shihua Liu,&nbsp;Yan Chen,&nbsp;Ping Zhong","doi":"10.1159/000530504","DOIUrl":"https://doi.org/10.1159/000530504","url":null,"abstract":"<p><strong>Introduction: </strong>Currently, it is still controversial to treat stroke with ticagrelor alone. The purpose of our study was to systematically review and analyze the efficacy and safety of ticagrelor on cerebrovascular outcomes in patients with vascular risk factors.</p><p><strong>Methods: </strong>The PubMed, Cochrane Library, and Embase databases were systematically searched using the keywords stroke, ticagrelor, clopidogrel, and aspirin to identify randomized controlled trials (RCTs). Primary outcomes included reported stroke, ischemic stroke, and complex events; the secondary outcome was hemorrhagic stroke. The safety outcomes included major bleeding events, major or minor bleeding, and intracranial bleeding. The pooled odds ratio (OR), hazard ratios (HRs), and 95% confidence interval (CI) were calculated. We used I2 statistics to assess statistical heterogeneity.</p><p><strong>Results: </strong>This meta-analysis included 15 RCTs involving 63,865 patients. Compared to the control group, ticagrelor reduced the risk of stroke (OR: 0.90; 95% CI: 0.81-0.99, p = 0.03; I2 = 3%), ischemic stroke (OR: 0.81; 95% CI: 0.74-0.90, p &lt; 0.0001; I2 = 0%). Ticagrelor was not associated with an increased risk of all-cause mortality (OR: 0.94; 95% CI: 0.84-1.06, p = 0.31; I2 = 62%), major bleeding (OR: 1.06; 95% CI: 0.97-1.15, p = 0.20; I2 = 17%), hemorrhagic strokes (OR: 1.22, 95% CI: 0.76-1.96, p = 0.41; I2 = 0%), and intracranial hemorrhage (OR: 1.06; 95% CI: 0.78-1.43, p = 0.71; I2 = 12%). There was an increased risk of major or minor bleeding with ticagrelor compared to the control group (OR: 1.40; 95% CI: 1.19-1.66, p &lt; 0.0001; I2 = 56%). Additional analyses demonstrated that ticagrelor reduced the risk of incident recurrent stroke (HR: 0.83; 95% CI: 0.75-0.93, p = 0.0009; I2 = 0%), recurrent ischemic stroke (HR: 0.79; 95% CI: 0.71-0.89, p &lt; 0.0001; I2 = 0%) among patients with a history of acute ischemic stroke (AIS) or transient ischemic attack (TIA). There were no significant differences in safety outcomes.</p><p><strong>Conclusion: </strong>Ticagrelor is slightly better than clopidogrel and aspirin in preventing stroke, especially ischemic stroke, with significant safety risks. For patients with a history of AIS/TIA, the use of ticagrelor was superior to the use of clopidogrel or aspirin in reducing the risk of subsequent stroke. We believe that ticagrelor is a potential alternative to aspirin or clopidogrel in some cases, especially for patients with CYP2C19 deficiency.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"86 4","pages":"229-241"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10195600","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":"Integrin β1 and the Repair after Nervous System Injury.","authors":"Lei Yan,&nbsp;Zhiming Cui","doi":"10.1159/000526690","DOIUrl":"https://doi.org/10.1159/000526690","url":null,"abstract":"<p><strong>Background: </strong>Integrin β1, as a member of the adhesion molecule family, is widely distributed in many kinds of cells and participates in multiple biological functions of the nervous system, including cytoskeleton reorganization, axon growth, and inflammatory injury.</p><p><strong>Summary: </strong>After nervous system injury, integrin β1 expressed by microglia is mainly involved in promoting inflammatory damage; integrin β1 expressed by astrocytes plays an important role in axon regeneration; integrin β1 expressed by endothelial cells mainly participates in vascular remodeling. We concluded that the function of integrin β1 depends on the location of the receptor cells. The mechanism of integrin β1, which is involved in the inflammatory response of immune regulatory cells and affects the axonal regeneration of neuronal cells, is the key to explore the repair after nervous system injury. The development of drugs targeting integrin β1 is expected to bring a breakthrough in the treatment of nervous system injury.</p><p><strong>Key messages: </strong>This paper expounds the important role of integrin β1 in neurons of the nervous system and emphasizes the central role of integrin β1 in regulating non-neuronal cells after nervous system damage.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"86 1","pages":"2-12"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9102509","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}