Frontiers in Neurology最新文献

{"title":"Distinctive clinical features of early and late-onset Ménière's disease.","authors":"Jianwei Lin, Heng Xiao, Chenxin Lin, Gengliang Huang, Xiaojing Guo, Huimin Cai, Shengnan Ye","doi":"10.3389/fneur.2025.1581670","DOIUrl":"https://doi.org/10.3389/fneur.2025.1581670","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the clinical characteristics of patients with early and late-onset Ménière's disease (MD) and to investigate the impact of psychological factors between the two groups.</p><p><strong>Methods: </strong>The patients were divided into two groups based on their age of onset: early-onset (<45 years old) and late-onset (>55 years old). The differences in clinical symptoms, auditory, vestibular examination, gadolinium-enhanced MRI, vertigo, and psychological assessment were compared. To assess the severity of vertigo, the Dizziness Handicap Inventory (DHI) and Visual Analogue Scale (VAS) were used. The Patient Health Questionnaire 9-item (PHQ-9) and the Generalized Anxiety Disorder 7-item (GAD-7) scales were used to assess the patient's psychological status.</p><p><strong>Results: </strong>Thirty-five patients were included in the early-onset and thirty-seven in the late-onset MD groups. Tinnitus was more common in the early-onset group. The aggravating (fatigue) and alleviating (ambient quiet; acute rest) factors of a vertigo episode were statistically different between the two groups. The severity of vestibular endolymphatic hydrops, abnormal rate of canal paresis (CP) value of the caloric test, total DHI score, and VAS score were all higher in the late-onset group. PHQ-9 and GAD-7 scores were significantly correlated with total DHI score in the early-onset group.</p><p><strong>Conclusion: </strong>Early-onset patients have a higher incidence of tinnitus and are more prone to experience vertigo bouts brought on by fatigue. In late-onset patients, vestibular endolymphatic hydrops are more severe, and the vertigo symptoms are more pronounced. Psychological factors are more closely related to the symptoms of vertigo in early-onset patients.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1581670"},"PeriodicalIF":2.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981514","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":"Hyperventilation during rest and exercise in orthostatic intolerance and Spiky-Leaky Syndrome.","authors":"Amir Hashemizad, Jerriel Dela Cruz, Aditya Narayan, Andrew J Maxwell","doi":"10.3389/fneur.2025.1512671","DOIUrl":"https://doi.org/10.3389/fneur.2025.1512671","url":null,"abstract":"<p><strong>Background: </strong>Orthostatic intolerance, with or without postural orthostatic tachycardia syndrome (POTS), is collectively referred to as orthostatic intolerance dysautonomia syndromes (OIDS). This condition often presents with daytime hyperventilation, which is considered to be secondary to sympathetic hyperactivity. This hyperventilation appears to be a key characteristic in a newly described subset of patients with OIDS who also exhibit craniocervical instability, mast cell activation syndrome (MCAS), hypermobility spectrum disorder (HSD), and the phenomenon of alternating intracranial hypertension with hypotension due to cerebrospinal fluid (CSF) leaks, collectively termed Spiky-Leaky Syndrome (SLS).</p><p><strong>Methods: </strong>We performed a retrospective review of clinical metabolic exercise data in young patients with SLS, comparing them to matched patients with OIDS and healthy controls (CTL). We assessed metabolic parameters at rest, at the anaerobic threshold (AT), and at maximal oxygen consumption (VO₂max). The parameters included end-tidal CO₂ (ETCO₂), end-tidal O₂ (ETO₂), peak oxygen pulse, total work performed, and peak oxygen uptake efficiency slope (OUESp).</p><p><strong>Results: </strong>Of 323 reviewed exercise stress tests, 44 were conducted on patients with SLS, 210 on those with OIDS, and 53 on healthy controls. VO₂max, AT, peak oxygen pulse, total work performed, and OUESp were all significantly reduced in patients with OIDS and were further reduced in those with SLS. ETCO₂ levels were notably lower at rest, at the time of the anaerobic threshold, and at the time of maximal oxygen uptake in the OIDS group, and even more so in the SLS group. These lower levels of ETCO₂ persisted throughout exercise. In contrast, ETO₂ demonstrated a similarly strong but opposite trend.</p><p><strong>Conclusion: </strong>Compared to the control group, patients with OIDS-and especially those with SLS-exhibited reduced metabolic parameters, particularly a decrease in peak oxygen pulse and ETCO₂ levels during both rest and exercise. These findings suggest a reduction in ventricular preload and chronic daytime hyperventilation. These exercise parameters may serve as markers for POTS physiology and sympathetic hyperactivity, both of which could play a role in the pathophysiology of SLS.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1512671"},"PeriodicalIF":2.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017188","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":"Neurocysticercosis detected by targeted next-generation sequencing of cerebrospinal fluid: a case report.","authors":"Xintong Ren, HuiQin Sun, Yanghong Cheng, Yunzhou Zhang, Daiquan Gao","doi":"10.3389/fneur.2025.1504348","DOIUrl":"https://doi.org/10.3389/fneur.2025.1504348","url":null,"abstract":"<p><p>The patient, a middle-aged male with a long history of the disease, had experienced recurrent headaches for 26 years and episodic shaking of the right limb with slurred speech for the past month. He was previously diagnosed with cerebral cysticercosis and had shown improvement after anthelmintic treatment. In recent years, he noted a resurgence of headaches. One month prior, he developed right limb shaking and occasional slurred speech. A clinical neurological examination was unremarkable, but cranial MRI and cerebrospinal fluid sequencing confirmed a diagnosis of cerebral cysticercosis. Anthelmintic treatment was administered, resulting in symptom improvement.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1504348"},"PeriodicalIF":2.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967493","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":"Subjective assessment of sleep quality in adult patients with hereditary angioedema.","authors":"Esra Karabiber, Ezgi Yalçın Güngören, Ahmet Özen, Safa Barış, Elif Karakoc-Aydiner","doi":"10.3389/fneur.2025.1555562","DOIUrl":"https://doi.org/10.3389/fneur.2025.1555562","url":null,"abstract":"<p><strong>Background: </strong>Hereditary angioedema (HAE) is a rare disorder characterized by recurrent swelling episodes, including painful abdominal attacks and life-threatening angioedema of the larynx that significantly affects patients' quality of life, including sleep. Sleep disorders have not yet been elucidated in HAE patients.</p><p><strong>Methods: </strong>This study evaluated sleep quality and insomnia by comparing attack-free periods with abdominal, head-neck, and extremity attacks. Sleep quality and insomnia were assessed using two validated questionnaires with the Basic Scale on Insomnia and Quality of Sleep (BaSIQS) and the Pittsburgh Sleep Quality Index (PSQI): sleep latency, difficulty falling asleep, night awakenings, problems returning to sleep, and overall sleep quality.</p><p><strong>Results: </strong>The study included 23 HAE patients; the median age was 31 years [interquartile range (IQR): 25-37], with a female predominance (<i>n</i> = 16, 69.5%). During the attack-free period, the median PSQI total score was 5 (IQR: 3.75 7.25), with 56.2% of the participants (<i>n</i> = 13) classified as good sleepers. Total PSQI scores significantly increased during attack periods compared to the attack-free period (median: 10 for abdomen, 8.5 for extremities, and 7.5 for head-neck; <i>p</i> < 0.001 for all). Whereas during the attack-free period, only 40.9% of patients exhibited good sleep quality (BaSIQS <9), with a median score of 10 (IQR: 7-14.2).Scores of BaSIQS significantly increased during angioedema attacks, with medians of 15 (extremity), 16 (abdominal), and 17 (head-neck), reflecting a notable decline in sleep quality. Among the components of PSQI, compared to the attack-free period, scores except the one assessing the need for medication to sleep all domains showed statistically significant increase.</p><p><strong>Conclusion: </strong>This study demonstrates that poor sleep quality, prolonged sleep latency, and increased awakenings are prevalent among HAE patients. Screening for sleep disorders and targeted interventions may help improve disease control and overall quality of life in HAE patients.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1555562"},"PeriodicalIF":2.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974375","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":"Serial casting for contractures in SMA: consensus derived guidelines for treatment.","authors":"Laurey Brown, Katie Hoffman, Chiara Corbo-Galli, Carolyn Kelley, Terri Carry, Matt Civitello, Giorgia Coratti, Roberto DeSanctis, Tina Duong, Brigid Driscoll, Jean Flickinger, Allan M Glanzman, Jennifer Jones, Elizabeth Maczek, Dionne Moat, Jacqueline Montes, Robert Muni-Lofra, Leslie Nelson, Amy Pasternak, Melanie Valle, Kristin J Krosschell","doi":"10.3389/fneur.2025.1502495","DOIUrl":"https://doi.org/10.3389/fneur.2025.1502495","url":null,"abstract":"<p><strong>Background: </strong>Individuals with Spinal Muscular Atrophy (SMA) often present with muscle contractures. Serial casting has been used in a variety of other peripheral nerve, muscle, and central nervous system disorders to improve knee and ankle range of motion limitations and functional performance in both ambulatory and non-ambulatory individuals.</p><p><strong>Objective: </strong>The goal of this study was to reach a consensus about the parameters, considerations and general guidelines that should inform practice when serial casting to improve flexibility in individuals with SMA.</p><p><strong>Methods: </strong>This international effort was conducted between August 2020 and May 2023. An expert panel of physical therapists was assembled with multiple panel meetings and a 2-round Delphi survey performed covering topics relevant to serial casting which included three domains: clinical appropriateness, program-based considerations and program adherence/feasibility. Consensus was reached for all items in the three topic areas using a validity index of >75%. Following completion of the Delphi survey, community insights from patients and caregivers were collected via semi-structured interview.</p><p><strong>Results: </strong>This study included the synthesis of meetings from the initial expert panel which produced a comprehensive survey for the different considerations when performing serial casting for an individual with SMA. The study also included the completion of a Delphi survey by 18 therapists in round 1 and 15 therapists in round 2 for a consensus on 296 items. Strong consensus was obtained in all three domains with 96.6% agreement for clinical appropriateness, 95.0% agreement for program-based considerations, and 96.9% for program adherence/feasibility. A guideline document was developed enumerating the specific items detailed in the survey. Community perspectives were utilized to support the results of the Delphi survey and to add insight into real-world experience.</p><p><strong>Conclusion: </strong>The serial casting guidelines developed upon collaborative discussions from the expert panel and from the Delphi survey consensus and semi-structured interviews, should be utilized when applying serial casts to patients with spinal muscular atrophy. Future endeavors should look to apply the guideline recommendations to determine casting efficacy for improving joint contracture and impact on function for those with SMA.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1502495"},"PeriodicalIF":2.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961519","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":"Head position control strategies in progressive Supranuclear Palsy versus Idiopathic Parkinson's Disease during dynamic-on-static platform tilt.","authors":"Stefan Kammermeier, Kathrin Maierbeck, Lucia Dietrich, Annika Eissner, Stefan Lorenzl, Arun Singh, Kai Bötzel, Christoph Maurer","doi":"10.3389/fneur.2024.1477493","DOIUrl":"https://doi.org/10.3389/fneur.2024.1477493","url":null,"abstract":"<p><strong>Objectives: </strong>We investigated differences in head stabilization among Progressive Supranuclear Palsy (PSP), advanced Idiopathic Parkinson's Disease (IPD) and healthy controls during passive anteroposterior platform tilting to determine factors for disease-specific falling.</p><p><strong>Methods: </strong>Seventeen PSP, eleven IPD and eighteen control subjects were exposed to pseudorandom multi-frequency antero-posterior platform tilts, while recording 3D motion of body segments with a Zebris ultrasound positioning system. Fourier transforms were computed from the time series datasets to assess transfer functions between stimuli (platform tilts) and responses (angles of the head, trunk and hip in space).</p><p><strong>Results: </strong>Overall head excursions in space among PSP was several times increased in relation to IPD and controls. The stimulus driven contribution to the head movement, i.e., the GAIN of the transfer function between platform stimulus and head movement, was double the amount of the values derived from IPD and 5-fold relative to controls. GAIN of the transfer function was the highest among the middle tilt frequencies 0.15-0.4 Hz, and was independent from the eyes open vs. closed condition.</p><p><strong>Conclusion: </strong>PSP patients' head excursions with respect to the shoulder girdle and trunk were exceptionally increased, compared to IPD and controls. The source for the larger excursions, however, was not related to an unspecific lack of head stabilization, but was instead determined by a central strategy. Consistent with pathoanatomical degeneration of mesencephalic supracollicular pathways processing visual flow or vestibular pathways, PSP resorted to egocentric proprioceptive-dominated stabilization to the surface, rather than allocentric stabilization in space like IPD. Passive neck rigidity in PSP did not contribute significantly.</p><p><strong>Significance: </strong>The axial muscle rigidity emphasized in PSP versus IPD did not contribute to body instability in the sensory context of unstable surfaces. Instead, deficits in processing of visual and vestibular information played a larger role in PSP falling than previously known.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"15 ","pages":"1477493"},"PeriodicalIF":2.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983215","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":"Post-stroke mortality in ICU patients with serum glucose-potassium ratio: an analysis of MIMIC-IV database.","authors":"Zhen Yuan, Aoli Chen, Yunqing Zeng, Jiwei Cheng","doi":"10.3389/fneur.2025.1578268","DOIUrl":"https://doi.org/10.3389/fneur.2025.1578268","url":null,"abstract":"<p><strong>Introduction: </strong>Acute ischemic stroke (AIS) patients admitted to the intensive care unit (ICU) have a high mortality rate, necessitating the early identification of those at risk of a poor prognosis. This study investigated the association between the blood glucose-to-potassium ratio (GPR) and the prognosis of AIS patients.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. The primary outcomes were 28-day, 90-day, and 1-year mortality rates following ICU admission. Multivariate Cox proportional hazards regression models were used to estimate adjusted hazard ratios (HRs) with 95% confidence intervals (CIs). Subgroup analyses, Kaplan-Meier survival curves, and restricted cubic spline models were employed to further evaluate the relationship between the GPR and mortality in AIS patients.</p><p><strong>Results: </strong>A total of 2,636 AIS patients were included in the study, with a mean age of 69.4 ± 15.6 years. The 1-year mortality rate was 36.8% (<i>n</i> = 969). After adjusting for confounders, compared with the first quartile (Q1, GPR ≤ 1.39), the 1-year mortality risks for the second quartile (Q2, 1.39 < GPR ≤ 1.74), third quartile (Q3, 1.74 < GPR ≤ 2.25), and fourth quartile (Q4, GPR ≥ 2.25) were HR = 1.17 (95% CI: 0.95-1.43, <i>p</i> = 0.132), HR = 1.42 (95% CI: 1.17-1.73, <i>p</i> < 0.001), and HR = 1.61 (95% CI: 1.33-1.96, <i>p</i> < 0.001), respectively. Similar trends were observed for 28-day and 90-day mortality. Kaplan-Meier (KM) analysis revealed that groups with higher GPRs had higher mortality rates at 28 days, 90 days, and 1 year. Non-linear analysis further confirmed the presence of an inflection point in the association between the GPR and 365-day mortality, which was identified at GPR = 2.75. At ratios less than this threshold, the risk of mortality increased significantly with increasing GPR (HR: 1.466; 95% CI: 1.239-1.735; <i>p</i> < 0.001). However, above this ratio, the association plateaued and was no longer statistically significant (HR: 0.899; 95% CI: 0.726-1.113; <i>p</i> = 0.095).</p><p><strong>Conclusion: </strong>The GPR is an independent predictor of poor prognosis in AIS patients admitted to the ICU. Higher GPRs are associated with increased 28-day and 90-day mortality rates, highlighting the potential utility of this ratio in risk stratification and clinical decision-making. A non-linear relationship was observed between the GPR and 365-day mortality, with an inflection point identified at GPR = 2.75.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1578268"},"PeriodicalIF":2.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009974","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":"Research progress in Pusher Syndrome after stroke.","authors":"Huayong Wu, Haoyang Duan","doi":"10.3389/fneur.2025.1591872","DOIUrl":"https://doi.org/10.3389/fneur.2025.1591872","url":null,"abstract":"<p><p>Post-stroke Pusher Syndrome is a postural control disorder. It is characterized by active tilting toward the hemiplegic side and resistance to correction. This significantly impacts patients' motor function and quality of life. Its incidence varies greatly due to different research designs and assessment criteria. Literature reports an incidence ranging from 5% to 63%, and the incidence in patients with right brain damage (17.4%) is much higher than that in patients with left brain damage (9.5%). Etiological studies indicate that damage to the parietal lobe, thalamus, insula, and postcentral gyrus is the main pathological basis. The key mechanism is the interruption of thalamocortical connections. Typical clinical manifestations include trunk tilting in supine position, asymmetric weight-bearing in sitting, weight shift in standing, and impaired weight transfer during gait. Patients often have unilateral spatial neglect, which exacerbates balance disorders. Prognosis shows about 90% of patients recover within 6 months, but 10% to 15% may have long-term symptoms. Early rehabilitation intervention can significantly improve functional outcomes. This article comprehensively reviews the nomenclature, incidence, etiology, lesion sites, clinical manifestations, and prognosis of Pusher Syndrome, providing a research foundation for future studies on post-stroke Pusher Syndrome.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1591872"},"PeriodicalIF":2.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010588","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":"Analysis of headache burden Chinese in the global context from 1990 to 2021.","authors":"Wenxuan Zhao, Yonglin Chen, Yushi Tang, Shiqing Du, Xiaojie Lu","doi":"10.3389/fneur.2025.1559028","DOIUrl":"https://doi.org/10.3389/fneur.2025.1559028","url":null,"abstract":"<p><strong>Background: </strong>Headache is one of the leading causes of disability in worldwide and in China, and the second most burden disease of the nervous system after stroke. We aimed to analyze the global trends in the burden of headache disorders, migraine and TTH among people in China in an international context.</p><p><strong>Methods: </strong>Data were taken from the Global Burden of Disease (GBD) Study 2021 database to examine trends in the incidence, prevalence, and disability-adjusted life year of headache disorders.</p><p><strong>Results: </strong>In the context of a large scale in the world, headache is currently in a state of high incidence in China, and female middle-aged and young patients are the main body of this disease.</p><p><strong>Conclusions: </strong>Need to focus on the vulnerable population in China, while formulating effective health policies and developing good treatment measures to reduce the incidence of headache disorders and improve the DALYs rate of headache.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1559028"},"PeriodicalIF":2.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981276","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":"Association between vitamin D, vitamin D supplementation and benign paroxysmal positional vertigo: a systematic review and meta-analysis.","authors":"Yanyan Li, Peng Gao, Rui Ding, Ying Xu, Zhicheng Wang, Xiaorui Pei, Lianhe Li","doi":"10.3389/fneur.2025.1560616","DOIUrl":"https://doi.org/10.3389/fneur.2025.1560616","url":null,"abstract":"<p><strong>Background: </strong>Benign paroxysmal positional vertigo (BPPV) is one of the most prevalent peripheral vestibular dysfunctions encountered in clinical practice, including dizziness and vertigo, which has a significant impact on people's everyday lives and affects their quality of life in many ways. Researches indicate that individuals with recurrent benign paroxysmal positional vertigo (BPPV) may exhibit vitamin D insufficiency, and certain studies suggest that correcting severe vitamin D deficiency might effectively reduce BPPV recurrence; nevertheless, the findings have been inconsistent. As a result, we conducted the current Meta-analysis to investigate potential associations of vitamin D levels with the occurrence and recurrence of BPPV. In the meantime, the current study was done to evaluate the impact of vitamin D supplementation on the prevention of benign paroxysmal positional vertigo recurrence.</p><p><strong>Methods: </strong>Electronic databases (PubMed, EMBASE, SCOPUS and the Cochrane Library) were identified to search for relevant studies about (vitamin D or vitamin D supplementation) and (Benign paroxysmal positional vertigo incidence or recurrence) from inception to Dec 22, 2024. 60 studies with a total of 16,368 participants were included into this meta-analysis.</p><p><strong>Results: </strong>(1) The aggregated weighted mean difference (WMD) demonstrated that there was a significant reduction in vitamin D level in the BPPV cohort (WMD = -2.84; 95% CI -4.53 to -1.15) relative to the control cohort. Likewise, Recurrent BPPV groups had significantly lower levels of vitamin D compared to non-recurrent groups (WMD = -5.01; 95% CI -6.94 to -3.08). When the cupulolithiasis BPPV groups were compared to the canalolithiasis BPPV groups, the vitamin D level was lower in the cupulolithiasis groups (WMD = 5.09; 95% CI 2.05 to 8.12); (2) In this meta-analysis, the multivariable-adjusted relative risk (RR) indicated that increased vitamin D was inversely related to BPPV incidence (RR = 1.36; 95% CI 1.31, 1.41), but not significantly related to the recurrence (RR = 0.95, 95% CI 0.91, 0.99); (3) Vitamin D supplementation group had a lower recurrence rate than the control group which did not accepted vitamin D supplementation (RR =0.45, 95% CI = 0.36-0.55).</p><p><strong>Conclusion: </strong>The serum level of vitamin D is lower in patients with BPPV, especially recurrent BPPV, than in controls. There was a negative correlation between occurrence rate of BPPV episodes and vitamin D deficiency, which means that vitamin D deficiency may have a role in occurrence of BPPV. The present study indicates that vitamin D supplementation can significantly lower recurrence in benign paroxysmal positional vertigo. The level of vitamin D was lower in canalolithiasis than in cupulolithiasis BPPV groups.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1560616"},"PeriodicalIF":2.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009984","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}