Frontiers in Neurology最新文献

{"title":"Altered metabolism and endoplasmic reticulum-mitochondria contacts in multiple sclerosis neurons.","authors":"Celina Böse, Adriana Rehm, Zhixiao Wu, Anna-Sophia Karl, Sanja Augustyniak, Pia Renk, Anke Salmen, Ralf Gold, Konstanze F Winklhofer, Barbara Gisevius, Verian Bader, Jeremias Motte","doi":"10.3389/fneur.2026.1915238","DOIUrl":"https://doi.org/10.3389/fneur.2026.1915238","url":null,"abstract":"<p><strong>Background: </strong>Genetic factors are estimated to account for approximately 30-50% of the risk for developing Multiple sclerosis (MS). Distinct mitochondrial variants, impairments in the respiratory chain, and mitochondrial dysfunction have been reported in individuals affected by MS. Mitochondria and the endoplasmic reticulum (ER) form membrane contact sites (ERMCs) that control important biological functions. Dysregulated ERMCs have been associated with a number of severe consequences for homeostasis, including altered mitochondrial calcium levels, impaired ATP production and abnormal lipid transfer. All of these mechanisms are thought to play an important role in the pathogenesis and disease progression of MS. Here, we investigated the hypothesis that the mitochondrial predisposition plays a crucial role in contributing to MS development.</p><p><strong>Methods: </strong>Mitochondrial functionality was analyzed in a model of human induced primary neurons (iPNs), and neuronal precursor cells (NPCs), differentiated from induced pluripotent stem cells (iPSCs) from people with MS and healthy controls (HCs). Seahorse analysis was performed for investigation of the bioenergetic profile of the cells. ERMC and mitochondrial morphological analysis were carried out to investigate the potential impact of mitochondrial dysfunction in MS-derived neurons.</p><p><strong>Results: </strong>Seahorse analysis revealed significant differences in the respiratory complexes (spare capacity: <i>p</i> = 0.0002; non-mitochondrial oxygen consumption: <i>p</i> = 0.0207) and glycolysis (<i>p</i> = 0.0001; glycolytic reserve <i>p</i> = 0.0018) from MS-derived iPNs compared to HCs. We further investigated mitochondrial dysfunction in NPCs (maximal respiration <i>p</i> = 0.0491; non-mitochondrial oxygen consumption: <i>p</i> = 0.0226) and a significant difference in glycolytic reserve (<i>p</i> = 0.0359) from MS-derived NPC compared to HCs. Furthermore, we identified a significantly higher amount of ERMCs (<i>p</i> < 0.0001) and altered mitochondrial morphology in MS-derived iPNs compared to HC.</p><p><strong>Discussion: </strong>Our data are highlighting the importance of genetic mitochondrial contribution to MS pathology, by showing that MS-derived NPCs and iPNs exhibit altered mitochondrial behavior and morphology compared to healthy control (HC)-derived cells.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"17 ","pages":"1915238"},"PeriodicalIF":3.3,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13710335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149286256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in the treatment of intracranial blood blister-like aneurysms: a comprehensive review from surgical approaches to endovascular therapy.","authors":"Ganghua Feng, Yuanbiao Lei, Yi Zhang, Qiuli Li, Fuyong Ou, Le Zhang, Xiaoxi Yao","doi":"10.3389/fneur.2026.1952908","DOIUrl":"https://doi.org/10.3389/fneur.2026.1952908","url":null,"abstract":"<p><p>Intracranial blood blister-like aneurysms (BBAs) constitute a rare but clinically challenging subset of cerebrovascular lesions, distinguished by their fragile, thin-walled morphology and a tendency to arise at non-branching sites of intracranial arteries, most frequently in the supraclinoid segment of the internal carotid artery (ICA). Managing BBAs is particularly difficult due to their high propensity for rupture, rapid progression, and the challenges they pose in intraoperative identification and repair. Traditional surgical approaches, including direct clipping, wrapping, and bypass with trapping, have been employed; however, these techniques are often associated with high complication rates and technical limitations given the delicate structure of BBAs. In recent years, advances in endovascular therapy, such as stent-assisted coiling (SAC) and flow-diverter (FD) placement, have expanded the therapeutic options, offering less invasive alternatives with encouraging outcomes. Nevertheless, the optimal management strategy remains controversial, as both surgical and endovascular approaches carry distinct indications, technical challenges, and risks of recurrence or procedural complications. This narrative review systematically explores the epidemiology and pathophysiology of BBAs, delineates key diagnostic features, and critically examines both reconstructive and deconstructive treatment modalities within a stepwise, two-pathway (endovascular and surgical) algorithm, highlighting reported efficacy, complication profiles, and recommended treatment selection for distinct aneurysm subtypes. By contrasting the strengths and limitations of each approach, this article aims to provide clinicians with evidence-based guidance to support individualized management strategies for patients with BBAs.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"17 ","pages":"1952908"},"PeriodicalIF":3.3,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13711506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149286314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term safety profile of opicapone in patients with Parkinson's disease and early fluctuations.","authors":"Joaquim J Ferreira, Fabrizio Stocchi, Angelo Antonini, Olivier Rascol, Nicola Pavese, Georg Ebersbach, Jaime Kulisevsky, Günter Höglinger, Daniel Ramos, José Francisco Rocha, Helena C Brigas, Joerg Holenz, Werner Poewe","doi":"10.3389/fneur.2026.1920359","DOIUrl":"https://doi.org/10.3389/fneur.2026.1920359","url":null,"abstract":"<p><strong>Background: </strong>Motor fluctuations frequently emerge within the first few years of levodopa treatment in Parkinson's disease (PD), increasing symptom burden and treatment complexity. While opicapone is an established adjunct therapy for motor fluctuations, its safety profile when initiated early in the course of fluctuating disease remains incompletely characterized.</p><p><strong>Methods: </strong>This pooled <i>post-hoc</i> analysis integrated individual patient-level data from two randomized, double-blind, placebo-controlled trials of opicapone 50 mg and their open-label extensions. Analyses focused on patients with recent onset of motor fluctuations (≤2 years). Safety outcomes included the incidence, severity, timing, and evolution of treatment-emergent adverse events (TEAEs) during double-blind and up to 1 year of open-label exposure, with comparisons between earlier (OPC-OPC) and delayed (PLC-OPC) initiation.</p><p><strong>Results: </strong>A total of 269 patients with recent motor fluctuations were included, of whom 228 entered open-label treatment. During the double-blind phase, TEAEs were reported in 55.9% of patients receiving opicapone and 50.9% receiving placebo, with no statistically significant difference between groups. Adverse events were mainly mild to moderate and occurred predominantly within the first 2-3 weeks declining thereafter. Dyskinesia was the most frequent TEAE (10.2% vs. 3.6%, <i>p</i> = 0.09), occurring early and resolving in most patients, either spontaneously or following modest levodopa dose adjustment. Across the combined study period, overall TEAE incidence and cumulative dyskinesia rates were comparable between early and delayed initiation groups (15.3% vs. 15.5%, <i>p</i> = 1.0), with no increase over time.</p><p><strong>Conclusion: </strong>Opicapone demonstrated a favorable and consistent safety profile in patients with recent onset of motor fluctuations, with adverse events predominantly transient and manageable. Earlier initiation was not associated with an increased safety burden and showed numerically lower rates of overall TEAEs and dyskinesia compared with broader trial populations. These findings support the hypothesis that early optimization of levodopa therapy with opicapone does not accelerate the development of motor complications, supporting early COMT-inhibition in fluctuating PD.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"17 ","pages":"1920359"},"PeriodicalIF":3.3,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13711507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149286374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"7 T MRI in moyamoya disease: current evidence and AI-assisted future directions-a narrative review.","authors":"Haiyang Wu, Jingchun Wang, Zhenhua Wang, Changfa Zhao, Rui Zhang, Shuai Jiang, Qingbao Guo","doi":"10.3389/fneur.2026.1941574","DOIUrl":"https://doi.org/10.3389/fneur.2026.1941574","url":null,"abstract":"<p><p>Infographic summarizes the use of 7T MRI in Moyamoya disease, showing individualized assessment, current standard-of-care, high-resolution microvascular phenotyping, evidence gaps, candidate clinical outputs, and AI-assisted future directions like feature extraction, segmentation, multimodal integration, and risk modeling, with relevant icons and MRI images.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"17 ","pages":"1941574"},"PeriodicalIF":3.3,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13712114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149286274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early differentiation of viral encephalitis and autoimmune encephalitis by clinical and basic laboratory data.","authors":"Tim Steinberg, Andreas Hierl, David Freudenstein, De-Hyung Lee, Ralf A Linker, Markus Bauswein, Hendrik Hartmann, Barbara Schmidt, Klemens Angstwurm","doi":"10.3389/fneur.2026.1827372","DOIUrl":"https://doi.org/10.3389/fneur.2026.1827372","url":null,"abstract":"<p><strong>Background and objectives: </strong>Timely differentiation between autoimmune and viral causes of encephalitis is critical for guiding disease-specific treatment. This study aimed to develop a scoring system to facilitate early (< 6 h after presentation) differentiation between viral encephalitis (VE) and autoimmune encephalitis (AE).</p><p><strong>Methods: </strong>We performed a retrospective, single-center analysis of all patients diagnosed with encephalitis for any etiology at the University Hospital Regensburg between January 1st, 2004 and December 31st, 2020. Based on patient history, clinical findings, and cerebrospinal fluid (CSF) parameters, we developed a scoring system to differentiate between VE and AE.</p><p><strong>Results: </strong>A total of 434 cases with encephalitis were included, of which 171 had <i>Herpes simplex</i> virus encephalitis, V<i>aricella zoster</i> virus encephalitis, tick-borne encephalitis or autoimmune encephalitis. Based on a homogeneous subgroup of 108 cases of VE and 44 cases of AE, we used a logistic regression model to derive a score including fever, headache, CSF white blood cell count, CSF lactate concentration, and CSF protein concentration for early differentiation. The score showed very good discrimination (AUC 0.94, 95% confidence interval (CI): 0.90-0.99), with a specificity of 87.0% and sensitivity of 88.6% in our cohort.</p><p><strong>Discussion and conclusion: </strong>Our scoring system might help to identify patients with VE or AE at presentation. Further validation is needed.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"17 ","pages":"1827372"},"PeriodicalIF":3.3,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13710236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149286311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adjunctive hyperbaric oxygen therapy for post-stroke cognitive impairment: a systematic review and meta-analysis of randomized controlled trials.","authors":"Xiaosai Hu, Shurong Zhao, Dandan Zhang, Xianguo Meng","doi":"10.3389/fneur.2026.1982226","DOIUrl":"https://doi.org/10.3389/fneur.2026.1982226","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effects of adjunctive hyperbaric oxygen therapy (HBOT) on cognitive, neurological, and functional outcomes in patients with post-stroke cognitive impairment (PSCI), and explore potential sources of heterogeneity.</p><p><strong>Methods: </strong>Eight databases were searched from inception to July 15, 2026. Randomized controlled trials (RCTs) evaluating adjunctive HBOT in patients with PSCI were included. The primary outcome was the Montreal Cognitive Assessment (MoCA); secondary outcomes included the Mini-Mental State Examination (MMSE), National Institutes of Health Stroke Scale (NIHSS), Modified Barthel Index (MBI), and Barthel Index (BI). Random-effects meta-analyses, prespecified subgroup analyses, and meta-regression were performed. Sensitivity analyses, funnel plots, Egger's tests, and GRADE assessments were conducted.</p><p><strong>Results: </strong>Thirty-five RCTs involving 3,036 participants, all conducted in China, were included. Adjunctive HBOT was associated with higher MoCA scores (MD = 2.90, 95% CI: 2.47-3.33; <i>p</i> < 0.00001; <i>I</i> ² = 84%) and MMSE scores (MD = 2.68, 95% CI: 2.20-3.16; <i>p</i> < 0.00001; <i>I</i> ² = 83%). Improvements were also observed in NIHSS (MD = -2.61, 95% CI: -3.34 to -1.89; <i>p</i> < 0.00001; <i>I</i> ² = 93%), MBI (MD = 6.64, 95% CI: 3.76-9.52; <i>p</i> < 0.00001; <i>I</i> ² = 82%), and BI (MD = 8.77, 95% CI: 4.72-12.82;<i>p</i> < 0.00001; <i>I</i> ² = 82%). No statistically significant subgroup differences were observed for MoCA (<i>p</i> = 0.10) or MMSE (<i>p</i> = 0.43). Higher baseline MoCA scores tended to be associated with smaller treatment effects in meta-regression (<i>β</i> = -0.1411, <i>p</i> = 0.0637; <i>R</i> ² = 15.42%). Substantial heterogeneity remained largely unexplained. Evidence certainty was low for MoCA, MMSE, and MBI and very low for NIHSS and BI.</p><p><strong>Conclusion: </strong>Adjunctive HBOT may provide cognitive and functional benefits in patients with PSCI. However, substantial unexplained heterogeneity, low-to-very-low certainty of evidence, and the exclusively Chinese evidence base warrant cautious interpretation and limit generalizability. Further well-designed RCTs involving diverse populations are needed.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD420261473579, PROSPERO, CRD420261473579.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"17 ","pages":"1982226"},"PeriodicalIF":3.3,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13710107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149286328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fifteen-year real-world pharmacovigilance of multiple sclerosis disease-modifying therapies: adverse event profiles, drug-specific safety signals and clinical implications.","authors":"Sen Lin, Bei Zhang, Yingzhao Zhang, Xinyu Zhang, Yijia Li, Weiqing Zhang, Li He","doi":"10.3389/fneur.2026.1845881","DOIUrl":"https://doi.org/10.3389/fneur.2026.1845881","url":null,"abstract":"<p><strong>Background: </strong>Disease-modifying therapies (DMTs) are the cornerstone of remission-phase management for multiple sclerosis (MS), a prevalent autoimmune neuroinflammatory disorder of the central nervous system. However, their immune-modulating mechanisms carry inherent risks of systemic and neurological adverse events (ADEs), which remain a major barrier to optimal long-term care. This study aimed to comprehensively characterize the real-world safety profiles of all major MS DMT classes and identify clinically actionable safety signals.</p><p><strong>Methods: </strong>We analyzed 15-year (2009Q1-2023Q4) ADE reports for 8 classes of FDA-approved MS DMTs from the FDA Adverse Event Reporting System (FAERS) database. Four disproportionality algorithms (ROR, PRR, BCPNN, MGPS) were used for signal detection. Time-to-onset (TTO) analysis with Weibull distribution and multivariate logistic regression were performed to assess temporal risk patterns and patient-specific risk factors for important medical events (IMEs).</p><p><strong>Results: </strong>A total of 498,847 ADE reports (1,048,575 events) were included, with nearly 50% involving IMEs. The most common ADEs were systemic symptoms, infections, liver injury and alopecia. Notably, progressive multifocal leukoencephalopathy (PML, ROR = 15.59) and spontaneous abortion (ROR = 2.54) were identified as high-risk severe events. Drug-specific analysis revealed distinct safety signatures: anti-CD20 antibodies carried the highest infection risk, natalizumab was strongly associated with PML (ROR = 45.62), and teriflunomide had the highest alopecia risk (ROR = 12.73). Approximately 70% of IMEs occurred within 2 years of treatment initiation. Multivariate analysis identified older age, male sex and longer treatment duration as independent risk factors for IMEs, while obesity was a protective factor.</p><p><strong>Conclusions: </strong>This long-term FAERS-based analysis identified potential safety signals associated with major MS DMTs, providing hypothesis-generating evidence to support clinical vigilance and prioritize further validation, but not to estimate incidence, comparative risk, or causality.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"17 ","pages":"1845881"},"PeriodicalIF":3.3,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13710093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149286442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicians' perspectives on complementary and alternative medicine use in headache care across Africa and West Asia: a cross-sectional survey.","authors":"Amr Hassan, Freda Dodd-Glover, Rehab Magdy, Aynur Ӧzge, Derya Uludüz, Najib Kissani, Ahmed Allioueche, Aussan Al-Athwari, Emna Ellouz, Sounga Bandzouzi Prince Eliot Galieni, Mendinatou Agbetou, Kigocha Okeng'o, Daniel Gams Massi, Evelyne Diarra, Agbo Panzo Cedric, Chiamaka Edith Okereke, Wael Alwachi, Osheik Seidi, Kadira Abdi Aden, Augustina Charway-Felli, Foksouna Sakadi, John N Jabang, Denis R Shatima, Athanase Millogo, Magnerou Annick Melanie, Fatimata Hassane Djibo, Tiwonge Elisa Phiri, Jamal Barros Baco, Grenaba-Duval Lewis Reinier Joël, Frighton Mutete, Jasem Alhashel, Mansoureh Togha, Ammar Fayez Mubaidin, Sarkhan Amirguliyev, Abderrahmane Moulaye, Hana Kedah, Aya Alsayyad, Doaa M Khalil, Mona Hussein","doi":"10.3389/fneur.2026.1849417","DOIUrl":"https://doi.org/10.3389/fneur.2026.1849417","url":null,"abstract":"<p><strong>Background: </strong>Headache disorders impose a substantial burden across Africa and West Asia, where limited access to healthcare may increase reliance on complementary and alternative medicine (CAM). The current study explored clinicians' perspectives on CAM use, safety concerns, and research needs across countries with different income status.</p><p><strong>Methods: </strong>A cross-sectional web-based survey of 123 neurologists and headache specialists with at least 5 years of experience in headache management from 37 countries was carried out. They were classified into Low/Lower-Middle Income Countries (LIC/LMIC) and Upper-Middle Income Countries/High Income Countries (UMIC/HIC) groups in accordance with the World Bank income classifications.</p><p><strong>Results: </strong>Of 123 participants (median age 42 years; 50.4% males), 52.8% were from LICs/LMICs. Clinicians reported that CAMs were frequently used in both groups, and there was no significant difference in overall frequency of CAM use (<i>p</i> = 0.116). Clinicians in both groups perceived migraine as the most common headache type for which patients used CAM. However, significant differences in CAM modalities were observed. Acupuncture (79.3% vs. 47.7%, <i>p</i> < 0.001), massage (86.2% vs. 63.1%, <i>p</i> = 0.004), yoga (56.9% vs. 20.0%, <i>p</i> < 0.001), and supplements (93.1% vs. 66.2%, <i>p</i> < 0.001) were reported by the clinicians as significantly higher in UMICs/HICs, whereas spiritual healing was significantly higher in LICs/LMICs (70.8% vs. 46.6%, <i>p</i> = 0.006). Clinicians reported that patients in LICs/LMICs were significantly more likely to consult CAM prior to seeking medical care (89.2% vs. 67.2%, <i>p</i> = 0.003), and perceived cost as a major factor influencing CAM use (81.5% vs. 27.6%, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>CAM appears to be commonly encountered in headache care across Africa and West Asia according to clinician reports. Although its use is shaped by cultural beliefs, accessibility, and perceived safety, concerns over unregulated products, herb-drug interactions, and delayed conventional medical treatments were also highlighted.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"17 ","pages":"1849417"},"PeriodicalIF":3.3,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13710024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149286265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Altered hippocampal morphology and its association with gait impairment in idiopathic normal-pressure hydrocephalus.","authors":"Jaeil Kim, Shin Young Jeong, Sang-Woo Lee, Uicheul Yoon, Kyunghun Kang","doi":"10.3389/fneur.2026.1914240","DOIUrl":"https://doi.org/10.3389/fneur.2026.1914240","url":null,"abstract":"<p><p>Background and purpose: This study aimed to characterize structural alterations of the hippocampus associated with idiopathic normal-pressure hydrocephalus (INPH), and to explore their relationship with gait disturbances in affected patients.</p><p><strong>Methods: </strong>A total of 48 patients with INPH and 25 β-amyloid-negative healthy controls underwent MRI-based, vertex-wise three-dimensional hippocampal shape analysis. Additionally, all participants received 18F-florbetaben positron emission tomography to assess amyloid status.</p><p><strong>Results: </strong>Hippocampal shape analysis revealed marked bilateral deformation in the INPH group compared to controls. Both hippocampi exhibited elongation and narrowing, with the middle and posterior regions showing upward curvature, indicating vertical displacement from the hippocampal body to the tail. The normalized hippocampal volume was significantly smaller in INPH patients. No substantial volumetric or morphological differences were observed between amyloid-positive and amyloid-negative individuals within the INPH group. Notably, localized shape deformities correlated with performance on the Timed Up and Go and 10-meter walk tests, more prominently in the right hippocampus. Bilateral inward deformations at the superomedial tail and inferior body of the hippocampus were consistently linked to worse gait performance. Furthermore, smaller right normalized hippocampal volumes were negatively associated with gait test outcomes.</p><p><strong>Conclusion: </strong>These findings indicate that INPH is associated with characteristic hippocampal shape abnormalities. The observed associations between hippocampal morphology and gait disturbances suggest that the hippocampus may contribute to gait and postural control in INPH.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"17 ","pages":"1914240"},"PeriodicalIF":3.3,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13710308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149286346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic performance of blood neurofilament light chain for functional outcomes in patients with ischemic stroke: a systematic review and meta-analysis.","authors":"Tong Tong He, Bo Wang, Jing Wang, Meng Li","doi":"10.3389/fneur.2026.1895703","DOIUrl":"10.3389/fneur.2026.1895703","url":null,"abstract":"<p><strong>Introduction: </strong>This meta-analysis aimed to assess the association between blood neurofilament light chain (NfL) and functional outcomes in patients with ischemic stroke.</p><p><strong>Methods: </strong>PubMed, Web of Science, Embase, Cochrane Library, and the China National Knowledge Infrastructure database were searched from inception through March 15, 2026. Odds ratios (ORs) and 95% confidence intervals (CIs) were pooled to quantify the association between blood NfL and functional outcomes in patients with ischemic stroke. We pooled the area under the curve (AUC), sensitivity, and specificity; conducted meta-regression and sensitivity analyses; and assessed publication bias.</p><p><strong>Results: </strong>A total of 18 studies involving 3,448 patients were included in this meta-analysis. The pooled results demonstrated that blood NfL was associated with poor functional outcomes after ischemic stroke (OR = 1.78, 95% CI: 1.41-2.24, <i>p</i> < 0.001, <i>I</i> ² = 87.5%, <i>p</i> < 0.01). The pooled AUC for blood NfL in predicting functional outcomes in patients with ischemic stroke was 0.79 (95% CI: 0.75-0.82), with 71% (95% CI: 62-79%) sensitivity and 74% (95% CI: 67-80%) specificity. Subgroup analyses and meta-regression revealed that participant age, sample size, study design, blood sample type, assay method, proportion of poor functional outcomes, blood sampling time, reperfusion therapy rate, National Institutes of Health Stroke Scale score, definition of poor functional outcome, and the proportion of large artery atherosclerosis were not identified as significant sources of heterogeneity. Sensitivity analysis indicated that the pooled estimate was robust. Begg's test also showed no evidence of publication bias (<i>p</i> = 0.753), although Egger's test suggested the presence of publication bias (<i>p</i> < 0.001). The trim-and-fill method showed that the overall effect of this meta-analysis was stable.</p><p><strong>Conclusion: </strong>This meta-analysis showed that elevated blood NfL levels may have prognostic value for functional outcomes in patients with ischemic stroke. However, given the substantial between-study heterogeneity and the presence of publication bias, these findings should be interpreted with caution.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD420261297284, identifier PROSPERO (CRD420261297284).</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"17 ","pages":"1895703"},"PeriodicalIF":3.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}