Journal of Central Nervous System Disease最新文献

{"title":"Causal Effects of Gut Microbiota on Morning Chronotype, Insomnia and Sleep Duration: A Two-Sample Mendelian Randomization Study.","authors":"Yuqin He, Jiahuan Hao","doi":"10.1177/11795735261488260","DOIUrl":"10.1177/11795735261488260","url":null,"abstract":"<p><strong>Background: </strong>The gut microbiota has been shown to be closely associated with brain function; however, whether it exerts a causal influence on sleep traits remains to be further explored. Mendelian randomization (MR) is an emerging epidemiological approach that uses whole-genome sequencing data to infer causal relationships. In this study, we conducted a two-sample MR analysis to investigate the causal effects of gut microbiota on three domains of sleep traits: morning chronotype, insomnia, and sleep duration.</p><p><strong>Methods: </strong>Single nucleotide polymorphisms strongly associated with 196 gut microbiota taxa were selected as instrumental variables. Morning chronotype, insomnia, and sleep duration were used as outcomes. MR and sensitivity analyses were performed to assess the causal relationships between gut microbiota and sleep traits.</p><p><strong>Results: </strong>Three taxa (<i>Bifidobacteriales</i>, <i>Bifidobacteriaceae</i>, and <i>Bifidobacterium</i>) were negatively associated with morning chronotype, while <i>Tyzzerella 3</i> showed a positive causal effect on morning chronotype. <i>Oscillibacter</i> was negatively associated with insomnia, whereas four taxa (<i>Negativicutes</i>, <i>Selenomonadales</i>, the <i>Clostridium innocuum</i> group, and <i>Lachnoclostridium</i>) were identified as risk-increasing factors for insomnia. <i>Lentisphaerae</i> and <i>Victivallaceae</i> were positively associated with sleep duration. <i>Actinobacteria</i> and <i>Alistipes</i> had negative effects on long sleep duration, whereas <i>Ruminiclostridium 6</i> was positively associated with long sleep duration. Four taxa (<i>Victivallales</i>, <i>Anaerofilum</i>, <i>Lentisphaerae</i>, and <i>Lentisphaeria</i>) were negatively associated with short sleep duration.</p><p><strong>Conclusions: </strong>Our findings suggest that specific gut microbiota taxa may be positively or negatively associated with sleep traits. These results offer new insights into the potential role of gut microbiota in sleep regulation and provide a basis for future studies aimed at understanding whether modulating microbial composition could influence sleep health.</p>","PeriodicalId":15218,"journal":{"name":"Journal of Central Nervous System Disease","volume":"18 ","pages":"11795735261488260"},"PeriodicalIF":2.4,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Prevalence and Characteristics of Obstructive Sleep Apnea Among Patients With Multiple Sclerosis: A Systematic Review and Meta-Analysis.","authors":"Ahmad A Toubasi, Thuraya N Al-Sayegh","doi":"10.1177/11795735261485680","DOIUrl":"10.1177/11795735261485680","url":null,"abstract":"<p><strong>Background: </strong>Patients with multiple sclerosis (MS) report high prevalence of sleep fragmentation and poor sleep quality. However, the relationship between sleep and MS is poorly understood.</p><p><strong>Objectives: </strong>To identify the prevalence of obstructive sleep apnea (OSA) among patients with MS, assess the difference between patients with MS and healthy controls in sleep metrics detected by polysomnography, and evaluate the impact of OSA metrics on disability indices.</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Methods: </strong>On September 29, 2025, we searched PubMed, Embase, Scopus, CINAHL and CENTRAL. The inclusion criteria were observational studies that included patients with MS who underwent polysomnography and reported the prevalence of OSA, the difference in polysomnography data such as total sleep time, sleep efficiency, and apnea hypopnea index (AHI) between patients with MS and healthy controls or the correlation between the aforementioned polysomnography variables and MS disability indicated by expanded disability status scale (EDSS) or symbol digit modality test (SDMT). Weighted mean difference (WMD) and rho (r) correlation coefficient and their associated 95% confidence intervals (95%CI) were used as the effect measures in the analysis.</p><p><strong>Results: </strong>A total of 3,264 patients with MS and 679 healthy controls from 40 studies were included in the analysis. The prevalence of OSA among patients with MS was 44% (95%CI: 33%-56%). Patients with MS had lower total sleep time (WMD=-37.70; 95%CI: -62.27- -13.12) and sleep efficiency (WMD=-6.38; 95%CI: -9.71- -3.06) and higher AHI (WMD=1.76; 95%CI: 0.20-3.32) compared to healthy controls. Sleep efficiency (r=-0.16; 95%CI: -0.02- -0.29) and AHI (r=0.41; 95%CI: 0.26-0.54) were correlated with EDSS.</p><p><strong>Conclusions: </strong>It is fundamental to screen patients with MS for OSA and offer management options such as continuous positive airway pressure (CPAP) when appropriate.</p>","PeriodicalId":15218,"journal":{"name":"Journal of Central Nervous System Disease","volume":"18 ","pages":"11795735261485680"},"PeriodicalIF":2.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13530464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deutetrabenazine in Hyperkinetic Movement Disorders: VMAT2 Modulation From Choreiform Disorders to Hyperkinetic Dystonic Syndromes.","authors":"Yongkang Fang, Yuanbing Lu, Suiqiang Zhu, Shanshan Huang","doi":"10.1177/11795735261484948","DOIUrl":"10.1177/11795735261484948","url":null,"abstract":"<p><p>Hyperkinetic movement disorders, including dystonia and choreiform syndromes, are pathophysiologically linked to dysregulated dopamine metabolism within the basal ganglia-thalamo-cortical (BGTC) circuitry. Mounting research highlights dopaminergic hyperactivity as a driver of aberrant signaling and motor symptoms. Vesicular monoamine transporters (VMATs) package monoamines into synaptic vesicles, yet they remain pharmacologically underexplored compared to plasma membrane transporters. Recent advances in VMAT2 inhibitors offer a promising therapeutic avenue for hyperkinetic movement disorders. As a selectivity VMAT2 inhibitor, deutetrabenazine demonstrates unique advantages in dopamine modulation due to deuterium isotope-mediated metabolic stabilization, which extends the dynamics of dopamine receptor occupancy and reduces fluctuations in plasma concentration. Clinically, deutetrabenazine has emerged as a significant therapeutic approach for hyperkinetic movement disorders, with substantial evidence supporting its efficacy in the treatment of chorea associated with Huntington's disease (HD), tardive dyskinesia (TD), and Tourette syndrome. Future research should prioritize large-scale randomized trials incorporating rigorous subgroup analyses and extended safety monitoring to assess the distinct role of deutetrabenazine in other types of hyperkinetic movement disorders. This review unpacks the workings of VMAT2 inhibitors, paying particular attention to deutetrabenazine's distinct metabolic profile, and assesses their clinical promise across the range of choreiform disorders to hyperkinetic dystonic syndromes.</p>","PeriodicalId":15218,"journal":{"name":"Journal of Central Nervous System Disease","volume":"18 ","pages":"11795735261484948"},"PeriodicalIF":2.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13530455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facio-Brachial Dystonic Seizures as an Atypical Presentation of Anti-IgLON5 Disease.","authors":"Alexandru Lerint, Sakina Matcheswalla, Muhammad Ubaid Hafeez","doi":"10.1177/11795735261480714","DOIUrl":"https://doi.org/10.1177/11795735261480714","url":null,"abstract":"<p><p>Anti-IgLON5 disease is a rare neurological disorder with overlapping autoimmune and neurodegenerative mechanisms and a strong HLA haplotype association. It typically presents with sleep disturbances, though bulbar and neuropsychiatric symptoms contribute to clinical heterogeneity. The definitive diagnostic hallmark is the detection of anti-IgLON5 IgG antibodies. A 74-year-old female was initially admitted with pneumonia and persistent encephalopathy. Continuous video EEG monitoring captured multiple brief episodes of facial contraction with dystonic posturing of the left upper extremity, consistent with facio-brachial dystonic seizures (FBDS), arising from the right temporal region and evolution over the right temporo-parietal-occipital region. Magnetic resonance imaging of the brain showed T2-FLAIR and DWI hyperintensities in the right-temporoparietal and mesial temporal regions. The patient was initially treated with escalating anti-seizure therapy. Given concern for autoimmune-mediated encephalopathy and new-onset refractory status epilepticus (NORSE), along with an APE2 score of 10 and RITE2 score >7, high-dose corticosteroid therapy was initiated. Following the initiation of steroids, there was a notable rapid improvement in both clinical and electrographic parameters. Serum testing later returned positive for anti-IgLON5 antibodies. Epileptic seizures occur only in a minority of anti-IgLON5 cases, with focal or generalized events reported in approximately 5% of patients. Overall, the semiology observed is diverse, ranging from brief events of impaired consciousness, automotor seizures, to bilateral tonic-clonic seizures. FBDS, typically associated with LGI1 autoimmunity, has not previously been reported in this disorder. Neuroimaging is often nonspecific but may show brainstem or hippocampal involvement. Early immunotherapy, particularly intravenous immunoglobulin, is associated with improved outcomes, especially when initiated within six weeks of symptom onset. This case expands the known clinical spectrum of anti-IgLON5 disease by highlighting an atypical presentation characterized by facio-brachial dystonic seizures and response to immunotherapy.</p>","PeriodicalId":15218,"journal":{"name":"Journal of Central Nervous System Disease","volume":"18 ","pages":"11795735261480714"},"PeriodicalIF":2.4,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Stroke in Asia and Africa: Epidemiology, Etiology, and Resource-Stratified Care Across Geographic and System-Level Disparities.","authors":"Anne Francine Pino, Afton Widdershins, Gayatra Mainali","doi":"10.1177/11795735261478000","DOIUrl":"https://doi.org/10.1177/11795735261478000","url":null,"abstract":"<p><p>Pediatric stroke is a rare but serious cause of morbidity and mortality, with disproportionately high burden in low- and middle-income countries (LMICs). Asia and Africa report the highest global incidence and prevalence, driven by region-specific risk factors such as sickle cell disease (SCD), moyamoya disease (MMD), and infectious etiologies. Despite this substantial burden, data from these regions remain limited and fragmented, hindering effective clinical care and policy development. Incidence rates across Asia and Africa consistently exceed those in high-income countries. Western Sub-Saharan Africa, Southeast Asia, and Central Asia present some of the world's highest age-standardized rates. The most common etiologies include infections, particularly tuberculous meningitis, hematologic disorders such as SCD, and vasculopathies including MMD. Clinical features resemble those in high-income settings; however, children in LMICs experience delays in diagnosis due to limited diagnostic modalities, shortages of pediatric stroke expertise, and lack of standardized protocols. Management practices vary widely, consistent with global challenges due to lack of clinical data. LMICs are further constrained by resource limitations. Pediatric stroke care disparities in Asia and Africa reflect both geographic inequities between LMICs and HICs and system-level inequities within LMICs, where tertiary urban centers may provide advanced care while rural and secondary facilities remain limited. Emerging initiatives, including resource-adapted diagnostic algorithms, community screening tools, educational programs, and multicenter prevention trials, highlight growing efforts to strengthen pediatric stroke care. Improving outcomes require strengthening epidemiological surveillance, expanding regional and national stroke registries, developing resource-adapted diagnostic and treatment guidelines, and increasing access to preventive and therapeutic interventions. This review synthesizes available literature on pediatric stroke across Asian and African regions using the Global Burden of Disease (GBD) regional framework. Countries within Sub-Saharan Africa, North Africa and the Middle East, East Asia, High-Income Asia Pacific, South Asia, and Southeast Asia were examined. Key themes include epidemiology, etiologies, clinical presentations, and management strategies within these regions.</p>","PeriodicalId":15218,"journal":{"name":"Journal of Central Nervous System Disease","volume":"18 ","pages":"11795735261478000"},"PeriodicalIF":2.4,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13469770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated With Improved Physical Performance in Individuals With Parkinson's Disease Using the Fisior® Sequential Square Mat Walking Training Program: A Secondary Gender-Stratified Analysis of a Randomized Controlled Trial.","authors":"José Alegre-Tamariz, Carlos Ramírez-Moreno, Fernando M Runzer-Colmenares, José F Parodi, Alberto Bermejo-Franco","doi":"10.1177/11795735261458651","DOIUrl":"10.1177/11795735261458651","url":null,"abstract":"<p><strong>Background: </strong>Variability in functional response to exercise interventions in Parkinson's disease (PD) remains poorly understood. Sex-related differences in motor performance and rehabilitation outcomes have been described but are rarely examined within intervention studies. This study presents a secondary sex-stratified analysis of a previously published randomized controlled trial (RCT) to explore factors associated with differential improvements in physical performance.</p><p><strong>Objectives: </strong>To analyze sex-specific factors associated with improvements in physical performance following a 12-week SSM Fisior® walking training program in individuals with PD.</p><p><strong>Design: </strong>Secondary analysis of a RCT with a sex-stratified approach.</p><p><strong>Methods: </strong>Fifty-two community-dwelling older adults (57.7% men; mean age 71.4 ± 8.0 years) participated in the study. Physical performance was assessed using the Short Physical Performance Battery (SPPB), FallSkip system, and Timed Up and Go (TUG) test. Changes in SPPB scores were analyzed using sex-stratified Spearman correlations and multivariable linear regression models adjusted for age, body mass index, baseline Barthel Index, sensory aids, polypharmacy, falls history, and prosthesis use.</p><p><strong>Results: </strong>Women showed greater improvements in SPPB total score compared with men (0.73 ± 0.09 vs. 0.50 ± 0.09). In women, SPPB changes were significantly correlated with TUG performance, and TUG improvement remained independently associated with SPPB gains (β = 9.07; 95% CI: 1.34-19.49). In men, SPPB improvements were correlated with FallSkip gait, sit-to-stand performance, FallSkip total score, FallSkip time, and TUG performance. In adjusted models, SPPB gains were independently associated with age, TUG improvement, balance, and sit-to-stand performance.</p><p><strong>Conclusion: </strong>Functional improvements following the intervention differed by sex. In women, mobility performance was the primary determinant of SPPB improvement, whereas in men, gains were associated with multiple domains including balance, strength, gait, and age. These findings support sex-specific considerations in exercise-based interventions for older adults.</p>","PeriodicalId":15218,"journal":{"name":"Journal of Central Nervous System Disease","volume":"18 ","pages":"11795735261458651"},"PeriodicalIF":2.4,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13452925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurodegeneration in Parkinson's Disease: The Role of Environmental Toxins.","authors":"Jamir Pitton Rissardo, Megan Katz, Vishnu Vardhan Byroju, Ana Letícia Fornari Caprara, Ian M Walker","doi":"10.1177/11795735261461554","DOIUrl":"10.1177/11795735261461554","url":null,"abstract":"<p><p>Parkinson's disease (PD) is a rapidly growing global health challenge, with prevalence projected to reach 13-14 million cases by 2040. While aging and improved diagnostic awareness partly explain this trend, mounting evidence implicates environmental factors as critical contributors. This review synthesizes current literature on exposures such as pesticides, solvents, heavy metals, air pollutants, and infectious agents, emphasizing their mechanistic links to neurodegeneration. These factors interact with genetic susceptibility and aging, supporting the \"multiple-hit\" hypothesis, which posits that PD arises from cumulative insults rather than a single cause. Mitochondrial dysfunction, oxidative stress, neuroinflammation, and impaired protein clearance emerge as convergent pathways underlying dopaminergic vulnerability. Recent findings highlight viral infections-particularly SARS-CoV-2-as potential triggers or amplifiers of PD pathogenesis, raising concerns about long-term neurological sequelae following pandemics. Beyond individual toxins, the exposome concept underscores the lifelong interplay of physical, chemical, and social exposures in shaping disease risk. Climate-related changes, including increased air pollution and wildfire frequency, further compound these risks, suggesting a systemic dimension to PD etiology. Understanding these complex interactions is essential for developing preventive strategies, refining experimental models, and informing public health policies aimed at mitigating environmental contributions to neurodegeneration. This multifactorial perspective offers a foundation for future research targeting modifiable risk factors and resilience mechanisms in PD.</p>","PeriodicalId":15218,"journal":{"name":"Journal of Central Nervous System Disease","volume":"18 ","pages":"11795735261461554"},"PeriodicalIF":2.4,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148591466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Translational Readiness Checklist for Stem-Cell-Based Trials in Movement Disorders: A Practical Roadmap.","authors":"Sahar Hemeda, József Janszky, Dávid Pintér, Norbert Kovács","doi":"10.1177/11795735261463495","DOIUrl":"10.1177/11795735261463495","url":null,"abstract":"<p><p>Stem cell-based therapies for movement disorders show inconsistent translation due to variations in product characterisation, delivery, endpoints, safety, and follow-up. Regulatory guidance provides principles but lacks a unified trial framework. The objective was to create a practical framework that translates scientific, regulatory, manufacturing, ethical, and clinical expectations into an auditable pre-First Patient In (FPI) checklist for stem cell trials. A structured review of the literature, clinical trials, and guidance documents was conducted. Searches were performed in PubMed/MEDLINE, Embase, Google Scholar, and clinical trial registries, including ClinicalTrials.gov, Japan Registry, European Union Register, and Clinical Trials Registry-India, until January 2026. Key guidance documents from the FDA, EMA, ICH, ISSCR, and selected PMDA sources were reviewed. Recurring requirements related to nonclinical evidence, manufacturing quality, ethics, trial design, safety, and follow-up were identified and translated into auditable pre-FPI checklist items. A framework was developed, structured as a universal Core Gate plus three risk-proportionate modules: Module A for pluripotent-derived neural grafts, Module B for somatic neural grafts, and Module C for mesenchymal stromal cell/secretome approaches. The Core Gate outlines the minimum pre-FPI requirements across preclinical justification, GMP release documentation, regulatory and ethics readiness, patient selection, trial design, safety oversight, trial conduct, long-term follow-up, and transparency. The modules add platform-specific requirements according to biological and procedural risks, including tumourigenicity and genomic stability assessment, immunologic monitoring, and route-appropriate biodistribution and persistence expectations. Movement disorder-specific operational elements not defined in general guidance were also incorporated, including harmonised baseline phenotyping, disease-specific endpoint menus, practical imaging and biomarker options. This framework turns fragmented guidance into a practical, auditable pre-FPI roadmap for stem cell trials in movement disorders. By combining a universal Core Gate with risk-proportionate modules, it aims to reduce protocol heterogeneity, improve cross-trial comparability, strengthen regulatory planning, and support safer, interpretable clinical translation.</p>","PeriodicalId":15218,"journal":{"name":"Journal of Central Nervous System Disease","volume":"18 ","pages":"11795735261463495"},"PeriodicalIF":2.4,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13385596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of COVID-19 Infection and Vaccination on Neuromyelitis Optica Spectrum Disorder and Myelin Oligodendrocyte Glycoprotein Antibody Disease: A Narrative Review.","authors":"Jeffrey Hernandez, Silvia Delgado, Micheline McCarthy, Flavia Nelson, Kottil Rammohan","doi":"10.1177/11795735261467600","DOIUrl":"10.1177/11795735261467600","url":null,"abstract":"<p><p>Despite the estimated 776 million coronavirus disease 2019 (COVID-19) cases globally, little is known about its impact on immune-mediated neurological disorders such as neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody disorder (MOGAD). Scattered case reports, and reviews address this association, but none have collectively examined the impact of COVID-19 infection or vaccination on established and new-onset NMOSD and MOGAD. Reviewing all published reports of COVID-19 infection and vaccination in NMOSD and MOGAD from December 2019 to October 2024, this report examined the effects of infection and vaccination on patients with established disease and the occurrence of new-onset NMOSD and MOGAD. Outcomes associated with COVID-19 infection in NMOSD and MOGAD patients revealed similar hospitalization rates but a notable difference in deaths in NMOSD patients treated with rituximab. Following COVID-19 infection, twice as many patients developed new-onset MOGAD compared to NMOSD, with a similar larger number of patients who developed MOGAD than NMOSD post-COVID-19 vaccination. While the heavy female predominance in NMOSD is well-established, a greater ratio of male to female patients developed MOGAD post-infection and post-vaccination. Clinicians should closely monitor NMOSD patients with COVID-19 infection, particularly those receiving B-cell depleting therapies, among whom mortality was more frequently reported. The rise in NMOSD and MOGAD following COVID-19 infection and vaccination cases warrants further investigation of the underlying immunological mechanisms. Molecular mimicry and a bystander immune-mediated injury likely play a greater role in central nervous system damage than does direct viral injury.</p>","PeriodicalId":15218,"journal":{"name":"Journal of Central Nervous System Disease","volume":"18 ","pages":"11795735261467600"},"PeriodicalIF":2.4,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13354917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148421189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Following Severe Pediatric Malaria, Epilepsy Screening Is Needed Even Among Children Without Coma: Findings From a Prospective Cohort Study.","authors":"Archana A Patel, Shaida Nishat, Rasesh B Joshi, Suzanna Mwanza, Joseph Kasolo, Angela Masempela, Thelma Musakanya, Tina Mwale, Violet Nambeye, Rosemary Nyirongo, Ruth G Tembo, Nicole O'Brien, Karl B Seydel, Christopher Cortina, Bo Zhang, Maitreyi Mazumdar, Alexander Rotenberg, Gretchen L Birbeck","doi":"10.1177/11795735261467520","DOIUrl":"10.1177/11795735261467520","url":null,"abstract":"<p><strong>Background: </strong>Severe pediatric malaria with neurological presentation has a spectrum of severity, from frank coma (Cerebral Malaria (CM)) to impaired consciousness and/or complex seizures without coma (malaria with central nervous system signs, CNS-M). Approximately 9-16% of pediatric CM survivors develop post-malaria epilepsy (PME), but rates after CNS-M are understudied.</p><p><strong>Objective: </strong>Determine PME rates following severe pediatric malaria with neurologic signs, with and without coma (CM and CNS-M).</p><p><strong>Design: </strong>Prospective cohort study.</p><p><strong>Methods: </strong>Children 6 months-11 years who presented to a district level hospital in Zambia with CM or CNS-M between Nov 2021-June 2024 were enrolled. Children were excluded for pre-existing epilepsy or alternative explanation for acute neurologic symptoms. Primary outcome was PME at 1 year. Important covariates included coma, age, pre-illness neurodevelopment, acute hospitalization data, acute and follow-up EEG, and 1-year neurodevelopmental outcomes. Acute, 1-, 6-, and 12-month data were collected. EEGs were analyzed with conventional and quantitative methods. PME was determined by standardized screening and physician review using ILAE criteria.</p><p><strong>Results: </strong>141 children met inclusion criteria, 48 had CM, 93 CNS-M. CNS-M children were younger (mean 40.8 vs. 54.3 months, p=0.005) and male predominant (64.8% vs. 43.8%, p=0.006). 18.4% of the cohort developed PME, with no significant incidence difference between CNS-M (20.4%) and CM (14.6%) groups, p=0.495. Focal epilepsy was more common in CNS-M 78.9% vs. CM 28.6% (p=0.028). There were no differences in qualitative EEG findings. Quantitative EEG measures demonstrated more severe and prolonged cortical dysfunction in CM (p<0.01).</p><p><strong>Conclusions: </strong>CNS-M presentation was twice as frequent as CM at this district hospital. Quantitative EEG supports CM as a more severe acute illness, but PME developed in 15-20% of children within one year regardless of malarial coma. These findings suggest that severe malaria with neurologic involvement-regardless of coma during acute presentation-has significant secondary epilepsy risk.</p>","PeriodicalId":15218,"journal":{"name":"Journal of Central Nervous System Disease","volume":"18 ","pages":"11795735261467520"},"PeriodicalIF":2.4,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13354915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148421153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}