European Neurology最新文献

筛选
英文 中文
Muybridge, Dercum, and the Early Use of Photography in the Study of Psychogenic Non-Epileptic Seizures. 迈布里奇,德克姆,和摄影在心因性非癫痫发作研究中的早期应用。
IF 2.4 4区 医学
European Neurology Pub Date : 2023-01-01 DOI: 10.1159/000528773
Richard Ho, Enrique J Carrazana
{"title":"Muybridge, Dercum, and the Early Use of Photography in the Study of Psychogenic Non-Epileptic Seizures.","authors":"Richard Ho,&nbsp;Enrique J Carrazana","doi":"10.1159/000528773","DOIUrl":"https://doi.org/10.1159/000528773","url":null,"abstract":"<p><p>The impact of the collaboration between photographer Eadweard Muybridge and neurologist Francis Dercum is detailed within the context of a photographic study of an artificially induced psychogenic non-epileptic seizure. Their contribution served as inspiration to other contemporary European neurologists and photographers to use motion photography to further understand psychogenic neurological disorders, such as seizures.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"86 3","pages":"217-221"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9842606","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}
引用次数: 1
Identifying the Basic Dimensions of Medication-Triggered Impulsive Compulsive Behaviours in Parkinson's Disease. 识别帕金森病患者药物引发的冲动行为的基本维度。
IF 2.4 4区 医学
European Neurology Pub Date : 2023-01-01 DOI: 10.1159/000528900
Nicky Edelstyn, Elisa Di Rosa, Alice Martini
{"title":"Identifying the Basic Dimensions of Medication-Triggered Impulsive Compulsive Behaviours in Parkinson's Disease.","authors":"Nicky Edelstyn,&nbsp;Elisa Di Rosa,&nbsp;Alice Martini","doi":"10.1159/000528900","DOIUrl":"https://doi.org/10.1159/000528900","url":null,"abstract":"<p><strong>Background: </strong>This review article integrates findings from published behavioural and neuroimaging studies of impulsive-compulsive behaviours (ICBs) in Parkinson's disease, with the aim of identifying the basic correlates of these problematic and distressing behaviours. The underlying premise is that for any feature to be a reliable marker of ICBs, it should be evident across multiple levels of analyses. When changes are evident only at one level, but not in the others, their reliability as indicators of ICBs should be questioned.</p><p><strong>Summary: </strong>To this end, we draw on the conclusions from three published systematic reviews of dopamine metabolic processes in the striatum, functional magnetic resonance imaging and cognitive, affective, and motivational assessments of medicated Parkinson's patients with and without ICBs (ICB+ and ICB-, respectively). The key findings are as follows: ICB+ showed abnormal dopaminergic of the striatum, including the brain network supporting reward processing. Fronto-striatal connectivity was also reduced. These findings are consistent with the broader evidence of psychological dysfunction, evident on assessments of cognitive control (goal-driven behaviour, impulsivity), reward-driven decision-making (temporal discounting, gambling), and elevated rates of self-report negative affect (anxiety, depression, anhedonia). The implications of these findings are discussed with reference to the research domain criteria and, relatedly, directions for future research.</p><p><strong>Key messages: </strong>The identification of markers of ICB that allow early diagnosis, monitoring, and optimisation of therapy is an ambitious goal. And whilst we have pulled together a number of convergent findings identified using different paradigms, we are still some distance off understanding the mechanism(s) that increase vulnerability to ICB. It is our hope that this review spurs future studies to further investigate the interaction between motivation and cognition with the twin aims of identifying markers of ICB that have both clinical utility and function as outcome measures in therapeutic clinical trials.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"86 2","pages":"81-84"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9152818","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}
引用次数: 0
Migraine Disability and Severity Improvement during Long-Term Treatment with Erenumab. 长期使用伊瑞那单抗治疗偏头痛的残疾和严重程度的改善。
IF 2.4 4区 医学
European Neurology Pub Date : 2023-01-01 DOI: 10.1159/000527674
Marco Bolchini, Francesca Schiano di Cola, Giulia Ceccardi, Salvatore Caratozzolo, Paolo Liberini, Renata Rao, Alessandro Padovani
{"title":"Migraine Disability and Severity Improvement during Long-Term Treatment with Erenumab.","authors":"Marco Bolchini,&nbsp;Francesca Schiano di Cola,&nbsp;Giulia Ceccardi,&nbsp;Salvatore Caratozzolo,&nbsp;Paolo Liberini,&nbsp;Renata Rao,&nbsp;Alessandro Padovani","doi":"10.1159/000527674","DOIUrl":"https://doi.org/10.1159/000527674","url":null,"abstract":"<p><p>The aim of the present study was to assess erenumab efficacy in migraine disability and intensity throughout the first treatment cycle, discontinuation, and the first 6 months of re-treatment in patients with high-frequency episodic migraine. The study design was retrospective and observational. Inclusion criteria were the following: diagnosis of high-frequency episodic migraine and ongoing treatment with erenumab 140 mg currently at their second treatment cycle. Data regarding migraine frequency, disability (MIDAS score), and severity of attacks (NRS score) were collected quarterly. Twenty-five patients were enrolled. At the end of the first treatment cycle, compared to baseline, a significant improvement of MIDAS scores was found (13.5 ± 11.1 vs. 72.5 ± 32.1; p = 0.005), with a subsequent worsening during treatment suspension (30.1 ± 26.9; p = 0.03). Pain intensity remained unmodified during the first treatment cycle (NRS score baseline: 7.6 ± 0.9 vs. 12 months: 7.5 ± 0.7; p = 0.13). During re-treatment, MIDAS scores documented a new significant improvement, reaching the same level at 6 months of re-treatment as at the end of the first cycle (30.1 ± 26.9 vs. 12.9 ± 5.4; p = 0.03). A significant improvement, compared to baseline, was observed for pain intensity during re-treatment (6.8 ± 2.2 vs. 5.6 ± 0.9 at RT3 vs. 5.2 ± 1.4 at RT6; p = 0.05). In conclusion, during re-treatment with erenumab 140 mg, migraine pain intensity and disability documented a significant and progressive improvement. Our data confirm the long-term efficacy, although in a very limited case series, of monoclonal antibodies targeting CGRP beyond headache frequency reduction.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"86 2","pages":"135-139"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9158163","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}
引用次数: 0
Summary of Safety and Efficacy of COVID Vaccination in Patients with Multiple Sclerosis. 多发性硬化症患者接种新冠疫苗的安全性和有效性总结。
IF 2.4 4区 医学
European Neurology Pub Date : 2023-01-01 Epub Date: 2023-03-04 DOI: 10.1159/000529982
Eva Pernicová, Petra Macounová, Martin Krsek, Rastislav Maďar
{"title":"Summary of Safety and Efficacy of COVID Vaccination in Patients with Multiple Sclerosis.","authors":"Eva Pernicová,&nbsp;Petra Macounová,&nbsp;Martin Krsek,&nbsp;Rastislav Maďar","doi":"10.1159/000529982","DOIUrl":"10.1159/000529982","url":null,"abstract":"<p><strong>Background: </strong>The SARS-CoV-2 pandemic represents one of the most challenging issues that have recently influenced everyday life in countries all over the world. Understanding the risk of this disease is of high importance in patients with multiple sclerosis (MS) as they represent a vulnerable population through their treatment with disease-modifying therapies (DMTs). Infective episodes may trigger relapses and lead to deterioration of the health condition.</p><p><strong>Summary: </strong>Vaccination is an important preventive measure against infectious diseases. In MS patients, concerns have been raised about the effectiveness of vaccines in patients on various immunomodulatory drugs and about their possible adverse effects including impairment of neurological functions. The objectives of this article were to summarize the current knowledge on immune responses to the COVID-19 vaccines and their safety in MS patients and to provide practical guidance based on the data available to date.</p><p><strong>Key messages: </strong>Although MS is not associated with a higher risk of COVID-19, this infection can trigger relapses or pseudo-relapses. Vaccines against SARS-CoV-2 are recommended for all MS patients who are not in the active phase of the disease, despite the fact that there is still a lack of long-term reliable data on the effectiveness and safety of vaccines against COVID-19. Some DMTs can reduce vaccine humoral responses, but might still provide some protection and adequate T-cell response. To optimize the effectiveness of vaccination, the ideal timing of vaccine application and DMTs dosing regimen is crucial.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"86 4","pages":"263-276"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10614228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10193572","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}
引用次数: 0
Endovascular Treatment plus Medical Treatment versus Medical Treatment Alone in Ischemic Stroke: A Systematic Review and Meta-Analysis. 缺血性卒中血管内治疗加药物治疗与单纯药物治疗:系统综述和荟萃分析。
IF 2.4 4区 医学
European Neurology Pub Date : 2023-01-01 Epub Date: 2023-09-25 DOI: 10.1159/000531285
Ahmad A Toubasi, Thuraya N Al-Sayegh, Farah H Albustanji, Layla M Al-Harasis
{"title":"Endovascular Treatment plus Medical Treatment versus Medical Treatment Alone in Ischemic Stroke: A Systematic Review and Meta-Analysis.","authors":"Ahmad A Toubasi, Thuraya N Al-Sayegh, Farah H Albustanji, Layla M Al-Harasis","doi":"10.1159/000531285","DOIUrl":"10.1159/000531285","url":null,"abstract":"<p><strong>Introduction: </strong>This study was conducted to assess the hypothesis that endovascular treatment in addition to medical treatment improve stroke mortality and post-stroke disability.</p><p><strong>Methods: </strong>In this systematic review and meta-analysis, the studies were included if they were randomized controlled trials in design and compared between endovascular treatment and medical therapy versus medical therapy alone in stroke management.</p><p><strong>Results: </strong>The search yielded 22 articles that included 5,049 patients. The analysis showed significant association between the intervention and reduction in disability measured by Modified Rankin Scale (mRS) (mRS = 0-2) (odds ratio [OR] = 1.61; 95% confidence intervals [95% CI]: 1.27-2.06) and National Institute of Health Stroke Scale (NIHSS) (NIHSS = 0-15) (OR = 2.13; 95% CI: 1.04-4.34). Also, we found a significant difference in disability scores between the intervention and the medical therapy group (mRS weighted mean difference [WMD] = -0.59; 95% CI: -1.15 to -0.02, NIHSS WMD = -4.52; 95% CI: -6.32 to -2.72). Additionally, there was significant reduction in mortality in the intervention group (OR = 0.79; 95% CI: 0.68-0.92). There was no significant difference in the rate of any serious adverse effects between the two study groups except for asymptomatic intracerebral hemorrhage.</p><p><strong>Conclusion: </strong>Our study provides strong evidence stemmed from randomized clinical trials that endovascular treatment combined with medical therapy is superior to medical therapy alone in the management of stroke.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":" ","pages":"295-304"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41120609","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}
引用次数: 0
Cerebral Gray Matter Volume Changes in Patients with Neuropathic Pain from Total Brachial Plexus Injury. 全臂丛神经损伤致神经性疼痛患者脑灰质体积的变化。
IF 2.4 4区 医学
European Neurology Pub Date : 2023-01-01 DOI: 10.1159/000525527
Jing-Wei Wang, Zhu-Qing Huang, Yu-Jie Lu, Ke Sha, Wen-Mei Li, Jin-Min Zhao
{"title":"Cerebral Gray Matter Volume Changes in Patients with Neuropathic Pain from Total Brachial Plexus Injury.","authors":"Jing-Wei Wang,&nbsp;Zhu-Qing Huang,&nbsp;Yu-Jie Lu,&nbsp;Ke Sha,&nbsp;Wen-Mei Li,&nbsp;Jin-Min Zhao","doi":"10.1159/000525527","DOIUrl":"https://doi.org/10.1159/000525527","url":null,"abstract":"<p><strong>Introduction: </strong>Total brachial plexus injury not only significantly affects the motor and sensory function of the affected upper limbs but also causes further physical and mental damage to patients with long-term intractable pain. Previous studies mainly focused on the surgical treatment, while only a few paid attention to the intractable neuropathic pain caused by this injury. Changes in the volume of gray matter in the brain are thought to be associated with chronic neuropathic pain.</p><p><strong>Methods: </strong>Voxel-based morphometry analysis was used to compare the difference in cerebral gray matter volume between total brachial plexus injury patients with neuropathic pain and healthy controls. Correlations between pain duration, pain severity, and GM changes were analyzed.</p><p><strong>Results: </strong>The volume of cerebral gray matter in the patient group was decreased significantly in multiple regions, including the parahippocampal gyrus, paracentric lobule, inferior frontal gyrus, auxiliary motor cortex, middle occipital gyrus, right middle temporal gyrus, while it was increased in the insular, pons, middle frontal gyrus, cingulate gyrus, inferior parietal lobule, bilateral thalamus, and globus pallidus. There were no significant correlations between pain duration and rGMV changes, while a positive correlation was observed between pain severity and rGMV changes in one specific region, involving the anterior cingulate cortex.</p><p><strong>Conclusion: </strong>Total brachial plexus injury patients with chronic pain have widespread regions of gray matter atrophy and hypertrophy. The only positive correlation was observed between pain severity and rGMV changes in one specific region, suggesting that nociceptive stimuli trigger a variety of nonpain-specific processes, which confirms the multidimensional nature of pain.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"86 1","pages":"45-54"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9109258","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}
引用次数: 1
Constipation in Parkinson's Disease: A Systematic Review and Meta-Analysis. 帕金森病便秘:系统回顾和荟萃分析。
IF 2.4 4区 医学
European Neurology Pub Date : 2023-01-01 DOI: 10.1159/000527513
Lulu Yao, Wei Liang, Jiahao Chen, Qian Wang, Xiaobo Huang
{"title":"Constipation in Parkinson's Disease: A Systematic Review and Meta-Analysis.","authors":"Lulu Yao,&nbsp;Wei Liang,&nbsp;Jiahao Chen,&nbsp;Qian Wang,&nbsp;Xiaobo Huang","doi":"10.1159/000527513","DOIUrl":"https://doi.org/10.1159/000527513","url":null,"abstract":"<p><strong>Introduction: </strong>Constipation is a common nonmotor symptom of Parkinson's disease (PD) and has been reported to increase the risk of developing PD. However, previous studies have yielded conflicting results. Understanding this correlation may promote early diagnosis and treatment of PD, which could help patients improve their quality of life. This study aimed to investigate the association between constipation and PD onset.</p><p><strong>Methods: </strong>The study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analyses of Observational Studies in Epidemiology (MOOSE) guidelines. We searched the Medline, Embase, Scopus, SINOMED, and Cochrane databases as well as specific journals from inception to September 2021 for observational studies that evaluated the association between constipation and the risk of PD. The Newcastle-Ottawa Scale was used to evaluate the methodological quality of the included studies. Associations were summarized as odds ratios (ORs) using a random-effects model. Subgroup, meta-regression, and sensitivity analyses were performed.</p><p><strong>Results: </strong>Seventeen studies comprising 3,024,193 participants (case-control = 1,636,831; cohort = 1,387,362) were eligible for inclusion. The pooled OR for the association between constipation and PD was 2.36 (95% confidence interval: 1.93-2.88), although strong heterogeneity was observed (I2 = 90%, p < 0.01). Subgroup and meta-regression analyses indicated that study design and disease duration were the major sources of heterogeneity. A sensitivity analysis confirmed the stability of the outcomes. In addition, the prevalence of among those with prodromal PD was 20%, whereas it was only 11% in the control group (p < 0.01). Moreover, there were no significant age-based differences in constipation between the prodromal stage of PD patients and the controls (p > 0.05).</p><p><strong>Conclusion: </strong>Constipation has a relatively high incidence in the prodromal phase of PD and is associated with an increased risk of developing PD.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"86 1","pages":"34-44"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9110713","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}
引用次数: 3
Association of Dietary Patterns with Parkinson's Disease: A Cross-Sectional Study Based on the United States National Health and Nutritional Examination Survey Database. 饮食模式与帕金森病的关系:基于美国国家健康和营养检查调查数据库的横断面研究。
IF 2.4 4区 医学
European Neurology Pub Date : 2023-01-01 DOI: 10.1159/000527537
Shulan Xu, Wei Li, Qing Di
{"title":"Association of Dietary Patterns with Parkinson's Disease: A Cross-Sectional Study Based on the United States National Health and Nutritional Examination Survey Database.","authors":"Shulan Xu,&nbsp;Wei Li,&nbsp;Qing Di","doi":"10.1159/000527537","DOIUrl":"https://doi.org/10.1159/000527537","url":null,"abstract":"<p><strong>Introduction: </strong>Although studies have explored some dietary patterns for Parkinson's disease (PD), more other dietary patterns and food item under the dietary pattern are needed to investigate. This study aimed to identify more categories of dietary patterns for PD and further explore the association of single food item with PD.</p><p><strong>Methods: </strong>The 2015-2018 US National Health and Nutritional Examination Survey (NHANES) database was used for data extraction. The data on demographics and nutrient intake were collected. Dietary patterns were derived from food categories by factor analysis. The association between dietary patterns or single food item and PD was explored using logistic regression analysis in the overall and only in secure PD cases, and results were expressed as odds ratio (OR) with 95% confidence intervals (CIs). Sensitivity analysis was performed by excluding participants using unsecure PD medication.</p><p><strong>Results: </strong>Among 5,824 participants aged over 50 years, 91 were diagnosed as PD. Factor analysis identified 5 major dietary pattern factors. We observed that the increased adherence to Mediterranean diet (MeDi) was associated with the reduced odds of PD (OR = 0.78, 95% CI: 0.65-0.93). The higher adherence to Western pattern was associated with the increased odds of PD (OR = 2.19, 95% CI: 1.16-4.14). In addition, high intake of sweets under Western pattern was found to be associated with the higher odds of PD (OR = 2.01, 95% CI: 1.08-3.71).</p><p><strong>Conclusions: </strong>The odds of PD decreased by higher MeDi adherence and increased by higher Western pattern adherence, especially sweets intake in this pattern, suggesting population ≥50 years should adhere to MeDi pattern and decrease the adherence to Western pattern, reducing the intake of sweets.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"86 1","pages":"63-72"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9110714","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}
引用次数: 2
The Friar with the Crutch: A Pictorial Hint of the Stroke Suffered by Bernardino da Fossa (1420-1503). 拄着拐杖的修士:贝纳迪诺·达·福萨中风的绘画暗示(1420-1503)。
IF 2.4 4区 医学
European Neurology Pub Date : 2023-01-01 DOI: 10.1159/000528032
Luca Ventura
{"title":"The Friar with the Crutch: A Pictorial Hint of the Stroke Suffered by Bernardino da Fossa (1420-1503).","authors":"Luca Ventura","doi":"10.1159/000528032","DOIUrl":"https://doi.org/10.1159/000528032","url":null,"abstract":"<p><strong>Background: </strong>Works of art may serve as a source of evidence of diseases and help to better understand their natural history.</p><p><strong>Summary: </strong>Bernardino da Fossa was a 15th-century Italian Franciscan friar who wrote sermons and historical works. He described the events of the Observance Reformation movement since its dawn, but the last chapter is unexplainably interrupted. This has been considered suggestive for an acute and disabling illness. A painting dating back 12 years after his death depicts Bernardino holding a crutch with his left arm. This may represent an important clue to establish a gait disturbance, whereas the permanent interruption in drafting his writing may be ascribed to a serious writing impairment.</p><p><strong>Key messages: </strong>The historical detail of the writing suspension and the crutch in this painting represent important hints of the stroke suffered by Bernardino da Fossa.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"86 2","pages":"155-160"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9156431","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}
引用次数: 0
Effects of Direct Oral Anticoagulants' Nonrecommended Dose in Atrial Fibrillation: A Meta-Analysis. 直接口服抗凝剂非推荐剂量对房颤的影响:一项荟萃分析。
IF 2.4 4区 医学
European Neurology Pub Date : 2023-01-01 DOI: 10.1159/000525407
Maria Giulia Mosconi, Giorgio Maraziti, Maurizio Paciaroni, Michela Giustozzi, Maria Cristina Vedovati, Giulio Bogliari, Chiara Urbini, Laura Traballi, Valeria Caso
{"title":"Effects of Direct Oral Anticoagulants' Nonrecommended Dose in Atrial Fibrillation: A Meta-Analysis.","authors":"Maria Giulia Mosconi,&nbsp;Giorgio Maraziti,&nbsp;Maurizio Paciaroni,&nbsp;Michela Giustozzi,&nbsp;Maria Cristina Vedovati,&nbsp;Giulio Bogliari,&nbsp;Chiara Urbini,&nbsp;Laura Traballi,&nbsp;Valeria Caso","doi":"10.1159/000525407","DOIUrl":"https://doi.org/10.1159/000525407","url":null,"abstract":"<p><strong>Background: </strong>The efficacy and safety profiles of nonrecommended direct oral anticoagulant (DOAC) doses in patients with nonvalvular atrial fibrillation (NVAF) are still undefined.</p><p><strong>Summary: </strong>We searched for randomized controlled trials and observational studies that compared nonrecommended versus recommended doses of DOACs, published up to December 2021. Primary study outcomes were ischemic stroke/transient ischemic attack/systemic embolism (IS/TIA/SE) and major bleeding (MB). All-cause mortality was a secondary outcome. We determined pooled odds ratios (ORs) between groups of patients with a random-effect model. Twenty-three studies with 175,801 patients were included. Nonrecommended doses were associated with a higher risk of IS/TIA/SE and all-cause mortality, but not of MB as compared to recommended doses of DOACs (OR 1.25 [95% CI: 1.14-1.38], OR 1.69 [95% CI: 1.31-2.18] and OR 1.10 [95% CI: 0.93-1.31], respectively). The nonrecommended low dose was associated with an increased risk of IS/TIA/SE and all-cause death (OR 1.21 [95% CI: 1.05-1.39] and OR 1.66 [95% CI: 1.18-2.35], respectively) but not of MB (OR 1.01 [95% CI: 0.83-1.22] as compared to recommended doses. Subgroup analysis of nonrecommended low doses of DOACs showed a nonsignificant increase in IS/TIA/SE in Asians (OR 1.17 [95% CI: 0.89-1.54] vs. non-Asian (OR 1.21 [95% CI: 1.07-1.36]).</p><p><strong>Key messages: </strong>Compared with recommended doses, nonrecommended low doses of DOACs increase the risk of ischemic events without decreasing the risk of bleeding. For Asians, the efficacy of DOACs seemed preserved despite the nonrecommended low-dose prescription. Clinicians should carefully adhere to recommended DOAC prescription advice in managing NVAF patients.</p>","PeriodicalId":12065,"journal":{"name":"European Neurology","volume":"86 1","pages":"13-24"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9163193","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}
引用次数: 1
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信