Journal of Clinical Neurology最新文献

{"title":"Global Incidence and Prevalence of Trigeminal Neuralgia, 1945-2024: A Systematic Review and Meta-Regression Analysis.","authors":"Yi Deun Jeong, Yeona Jo, Yejun Son, Dong Kyu Kim, Tae Hyeon Kim, Jaehyeong Cho, Soeun Kim, Jiseung Kang, Lee Smith, Ho Geol Woo, Dong Keon Yon","doi":"10.3988/jcn.2025.0433","DOIUrl":"10.3988/jcn.2025.0433","url":null,"abstract":"<p><strong>Background and purpose: </strong>Although trigeminal neuralgia (TN) imposes a substantial burden on quality of life and mental health, epidemiological estimates of its incidence and prevalence remain limited. Thus, we aimed to comprehensively assess the epidemiological and clinical features of TN from 1945 to 2024.</p><p><strong>Methods: </strong>A comprehensive literature search was performed using PubMed/MEDLINE, Embase, CINAHL, and Google Scholar databases up to January 22, 2025, with search terms related to \"trigeminal neuralgia.\" TN was defined according to the International Classification of Headache Disorders (ICHD)-1, Rushton and Olafson criteria, and International Classification of Diseases (ICD) codes prior to 2004, which primarily relied on clinical features for diagnosis, whereas the ICHD-2, ICHD-3, Read codes, and ICD codes after 2004 were grouped together, as these criteria incorporated imaging modalities into the diagnostic process. A random-effects model was applied to calculate pooled estimates with 95% confidence intervals (CIs) for the incidence, prevalence and lifetime prevalence of TN. In addition, meta-regression models were also fitted using inverse-variance weighting.</p><p><strong>Results: </strong>A total of 17 eligible studies, comprising over 170 million participants and 109,070 patients with TN, were included in the analysis. Global pooled incidence of TN was estimated at 25.33 cases per 100,000 person-years (95% CI, 11.87-54.02), while the global pooled annual prevalence was 45.38 cases per 100,000 inhabitants (15.41-133.61), and the global pooled lifetime prevalence was 108.43 cases per 100,000 inhabitants (30.54-384.18). Incidence and prevalence estimates tended to be higher in females than in males, more often right-sided, and more frequent in the maxillary and mandibular divisions than in the ophthalmic division; however, the certainty of these subgroup differences was low. Lastly, the incorporation of imaging modalities into diagnostic criteria may have contributed to the increased prevalence of TN.</p><p><strong>Conclusions: </strong>This study highlights substantial global variations in TN incidence and prevalence, with how the evolving diagnostic criteria affects the epidemiological features of TN.</p>","PeriodicalId":15432,"journal":{"name":"Journal of Clinical Neurology","volume":"22 1","pages":"102-112"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12802065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145944059","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":"Eight Decades of Data Reveal a Far Greater Global Burden of Trigeminal Neuralgia.","authors":"Sung Hyun Jo, Min Kyung Chu","doi":"10.3988/jcn.2025.0679","DOIUrl":"10.3988/jcn.2025.0679","url":null,"abstract":"","PeriodicalId":15432,"journal":{"name":"Journal of Clinical Neurology","volume":"22 1","pages":"4-5"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12802039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145943958","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":"Efficacy, Safety, and Tolerability of Subcutaneous Efgartigimod PH20 in Chinese Patients With Chronic Inflammatory Demyelinating Polyneuropathy: A Prespecified Subpopulation Analysis of the Multicentre, Randomised-Withdrawal, Double-Blind, Placebo-Controlled, Phase II ADHERE Trial.","authors":"Jie Lin, Man Ding, Qinzhou Wang, Ting Chang, Yuanqi Zhao, Yuwei Da, Song Tan, Daojun Hong, Haishan Jiang, Zhangyu Zou, Huan Yang, Bitao Bu, Hui Liang, Yiqi Wang, Aihong Guo, Dian He, Yuzhong Wang, Jing Ding, Junhong Guo, Jianquan Shi, Yali Zhang, Jing Liu, Jia Liu, Lijuan Chen, Junlong Wu, Jing Shao, Erik Hofman, Benjamin Van Hoorick, Trevor Mole, Wei Li, Zuneng Lu","doi":"10.3988/jcn.2025.0247","DOIUrl":"10.3988/jcn.2025.0247","url":null,"abstract":"<p><strong>Background and purpose: </strong>Efgartigimod, a neonatal Fc receptor inhibitor, reduces IgG recycling and thus decreases pathogenic IgG autoantibody levels. This subpopulation analysis aimed to assess the efficacy, safety, and tolerability of subcutaneous efgartigimod PH20 in Chinese participants with chronic inflammatory demyelinating polyneuropathy (CIDP).</p><p><strong>Methods: </strong>ADHERE was a multistage, randomised-withdrawal, placebo-controlled phase II trial in adult participants with active CIDP. Eligible participants received open-label treatment with efgartigimod weekly for ≤12 weeks (Stage A) and those with confirmed evidence of clinical improvement (ECI) were randomised to receive double-blind treatment with efgartigimod or placebo weekly for ≤48 weeks (Stage B). Primary endpoints were proportion of participants with confirmed ECI (Stage A) and time to clinical deterioration as measured by adjusted Inflammatory Neuropathy Cause and Treatment score (Stage B). This descriptive analysis reports the results from the Chinese subpopulation.</p><p><strong>Results: </strong>ADHERE enrolled 58 participants from mainland China for Stage A and of those, 47 were randomised (21 efgartigimod, 26 placebo) for Stage B. In Stage A, 45 (77.6%; 95% confidence interval [CI], 64.7%-87.5%) participants achieved confirmed ECI. In Stage B, median time to clinical deterioration was not reached with efgartigimod vs. 113.0 days (95% CI, 43.0-181.0 days) with placebo (hazard ratio, 0.313; 95% CI, 0.109-0.905). Across stages, most adverse events were mild or moderate, and no death occurred. No adverse events led to treatment discontinuation.</p><p><strong>Conclusions: </strong>Subcutaneous efgartigimod PH20 demonstrated clinical response and lowered the risk of clinical deterioration compared to placebo in Chinese participants with CIDP, while maintaining favourable safety and tolerability profiles.</p>","PeriodicalId":15432,"journal":{"name":"Journal of Clinical Neurology","volume":"22 1","pages":"76-88"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12802028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145944020","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":"The Oral Microbiome in Amyotrophic Lateral Sclerosis Shows Differentially Abundant Organisms in Limb Versus Bulbar Onset Disease: A Binational Study.","authors":"Sarah M Jacob, Bugyeong Son, Sahar Bagheri, Sukyoung Lee, Jamie Leckie, Bhavneet Chohan, Cole Belway, James Mascarenhas, Theodore Mobach, Lawrence W Korngut, Keith A Sharkey, Jinseok Park, Minh Dang Nguyen, Seung Hyun Kim, Gerald Pfeffer","doi":"10.3988/jcn.2025.0219","DOIUrl":"10.3988/jcn.2025.0219","url":null,"abstract":"<p><strong>Background and purpose: </strong>Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease of upper and lower motor neurons leading to progressive disability and death. Approximately 10% of cases are caused by single-gene disorders with the remaining 90% of cases presumed to be caused by a combination of environmental and genetic factors. The microbiome (the ensemble of microorganisms that colonize body surfaces and organs) was recently identified for its importance in the pathogenesis of ALS.</p><p><strong>Methods: </strong>In this study, we recruited 100 participants from two ethnically and geographically distinct sites (71 from Calgary, Canada, and 29 from Seoul, Republic of Korea) which included 59 ALS participants and 41 controls. All participants provided saliva samples for oral microbial analysis using 16S rRNA sequencing. Basic demographic information was collected from all participants, and ALS participants provided additional clinical information including site of disease onset, disease duration, and ALS Functional Rating Scale - Revised score.</p><p><strong>Results: </strong>Significant differences in beta diversity of the oral microbiomes were seen between limb- and bulbar-onset ALS participants. Two bacterial genera were differentially abundant between these groups, Bifidobacteriaceae <i>Bifidobacterium</i> was enriched in bulbar-onset cases, while Pasteurellaceae <i>Haemophilus</i> was enriched in limb-onset cases. No significant differences were found between ALS participants and controls, but there were significant differences when comparing participants from different sites of recruitment. Amongst household pairs (<i>n</i>=35 pairs), ALS participants differed from control participants at the Seoul site.</p><p><strong>Conclusions: </strong>Despite the cohort and household effects, our study identified differentially abundant organisms that may be important to the phenotypic variability of ALS and should be considered for future study. Our study provides novel insights into design for future multi-site microbiome research in ALS.</p>","PeriodicalId":15432,"journal":{"name":"Journal of Clinical Neurology","volume":"22 1","pages":"66-75"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12802088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145944083","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":"Otolith Deterioration: Factors Affecting Microvascular and Structural Integrity.","authors":"Eun-Hyeok Choi, Ji-Hyung Park, Hanim Kwon, Ileok Jung, Hyo-Jung Kim, Jeong-Yoon Choi, Ji-Soo Kim","doi":"10.3988/jcn.2025.0439","DOIUrl":"10.3988/jcn.2025.0439","url":null,"abstract":"<p><strong>Background and purpose: </strong>Otoliths degenerate with aging, but the underlying factors are not well understood. We aimed to identify risk factors associated with otolith function in patients with dizziness and vertigo.</p><p><strong>Methods: </strong>This cross-sectional study analyzed 624 patients with benign paroxysmal positional vertigo, benign recurrent vertigo, or persistent postural-perceptual dizziness who presented at a tertiary referral center between March 2017 and July 2021. Otolith function was assessed using summated amplitudes of cervical and ocular vestibular evoked myogenic potentials (SA-cVEMPs and SA-oVEMPs). The relationships between otolith function and potential risk factors were analyzed using two types of generalized linear model: a zero-adjusted gamma model for SA-cVEMPs and a standard gamma model for SA-oVEMPs.</p><p><strong>Results: </strong>In the multivariable model, SA-cVEMP was negatively associated with age (β=-0.012, effect=-1.23%), female sex (β=-0.110, effect=-10.42%), and free thyroxine (β=-0.298, effect=-25.74%), and positively associated with high-density lipoprotein cholesterol (β=0.005, effect=0.46%). SA-oVEMP was negatively associated with age (β=-0.008, effect=-0.84%) and positively associated with female sex (β=0.141, effect=15.19%).</p><p><strong>Conclusions: </strong>The findings of this study suggest that various systemic factors beyond age and sex are related to otolith function via effects on the microvasculature and structural constituents. These findings provide new insights into potential mechanisms of otolith degeneration and highlight the impact of systemic factors on otolith function.</p>","PeriodicalId":15432,"journal":{"name":"Journal of Clinical Neurology","volume":"22 1","pages":"89-101"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12802077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145944136","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":"Re: Comments on \"Potentially Inappropriate Medication Use in Patients With Parkinson's Disease: Analysis of Korean National Health Insurance Claims Data\".","authors":"Yu Jin Jung, Jieun Shin, Do-Young Kwon, Seon-Min Lee","doi":"10.3988/jcn.2025.0504","DOIUrl":"10.3988/jcn.2025.0504","url":null,"abstract":"","PeriodicalId":15432,"journal":{"name":"Journal of Clinical Neurology","volume":"22 1","pages":"137-138"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12802070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145944092","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":"Concurrent Use of Contact Aspiration and a Stent Retriever Is Associated With Successful Recanalization in Patients With Cancer-Associated Stroke.","authors":"Soo Jeong, Dongwhane Lee, Hyuk Sung Kwon, Deok Hee Lee, Sang Hee Ha, Jae Young Park, Dong-Wha Kang, Sun U Kwon, Jong S Kim, Bum Joon Kim","doi":"10.3988/jcn.2025.0216","DOIUrl":"10.3988/jcn.2025.0216","url":null,"abstract":"<p><strong>Background and purpose: </strong>The optimal thrombectomy technique in emergent large vessel occlusion due to cancer-associated coagulopathy remains uncertain. We aimed to investigate the efficacy and safety of concurrent contact aspiration and stent retriever in this stroke subtype.</p><p><strong>Methods: </strong>We retrospectively analyzed consecutive ischemic stroke patients who had undergone endovascular thrombectomy. Patients were characterized as having cancer-associated stroke (CAS) or non-cancer-associated stroke (non-CAS). Thrombectomy technique was classified as a single strategy (either contact aspiration or a stent retriever) or a combined technique (concurrent use of contact aspiration and a stent retriever at least once). Successful recanalization was defined as a modified TICI grade 2b or 3 at the end of the procedure. Factors associated with successful recanalization were analyzed.</p><p><strong>Results: </strong>The present study enrolled 393 patients. Of these patients, 56 (14.2%) were found to have cancer-associated stroke. Rates of recanalization (69.6% vs. 91.7%, <i>p</i><0.001) and 3-month good clinical outcomes (25.5% vs. 42.0%, <i>p</i>=0.025) were significantly lower in patients with CAS than non-CAS, respectively. Although the combined technique was not associated with successful recanalization in the entire cohort, the combined technique was associated with successful recanalization in patients with CAS (odds ratio 6.256, 95% confidence interval, 1.224-31.970; <i>p</i>=0.028). The interaction term between the combined technique and the stroke subtype (CAS vs. non-CAS) was independently associated with successful recanalization (<i>p</i>=0.029).</p><p><strong>Conclusions: </strong>The combined technique was associated with successful recanalization in patients with cancer-associated stroke and emergent large vessel occlusion.</p>","PeriodicalId":15432,"journal":{"name":"Journal of Clinical Neurology","volume":"22 1","pages":"50-58"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12802058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145943955","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":"α-Synuclein Real-Time Quaking-Induced Conversion Assay as a Biomarker for Parkinson's Disease: Clinical Implications and Perspectives.","authors":"Je Kook Yu, Yun Kyung Lee, Dong A Yea, Young Eun Kim","doi":"10.3988/jcn.2025.0235","DOIUrl":"10.3988/jcn.2025.0235","url":null,"abstract":"<p><p>Parkinson's disease (PD) has traditionally been diagnosed through clinical motor symptoms and the postmortem identification of pathological α-synuclein aggregates in Lewy bodies. The focus of diagnostic paradigms has recently moved from clinical approaches toward biological measures. The cerebrospinal-fluid-based real-time quaking-induced conversion (RT-QuIC) assay demonstrates high sensitivity and specificity, significantly enhancing its diagnostic accuracy. Although the RT-QuIC assay has not yet been fully integrated into clinical practice, rapid increases in its application have made it essential to diagnostic protocols. This review examines the development, current applications, and efficacy of the RT-QuIC assay in PD, dementia with Lewy bodies, multiple-system atrophy, prodromal conditions, and elucidating clinical-pathological discrepancies. The findings can provide clear guidance for clinicians and researchers, facilitate accurate interpretations of RT-QuIC results, support informed clinical decision-making, and ultimately improve diagnostic precision and personalized management strategies across the spectrum of synucleinopathies.</p>","PeriodicalId":15432,"journal":{"name":"Journal of Clinical Neurology","volume":"22 1","pages":"42-49"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12802064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145944039","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":"HLA-A*2402 May Be Associated With Antiseizure Medication-Induced Severe Mucocutaneous Adverse Events in Korean Population.","authors":"Dong Won Kwack, Young-Gon Kim, Jeehun Lee, Dong Wook Kim","doi":"10.3988/jcn.2025.0560","DOIUrl":"10.3988/jcn.2025.0560","url":null,"abstract":"","PeriodicalId":15432,"journal":{"name":"Journal of Clinical Neurology","volume":"22 1","pages":"122-124"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12802073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145944110","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":"Verification of Efficacy of Cognitive Function Test Using the Cognitive Impairment Screening Test.","authors":"Hyuk Sung Kwon, Jeewon Suh, Geun U Park, Hong Keun Yoo, Im Seok Koh, Hojin Choi","doi":"10.3988/jcn.2025.0383","DOIUrl":"10.3988/jcn.2025.0383","url":null,"abstract":"<p><strong>Background and purpose: </strong>The Cognitive Impairment Screening Test (CIST) was developed to detect early-stage cognitive impairment. The clinical utility of this test has not yet been validated in real-world settings. This study compared the diagnostic performance of the CIST with that of the previously used screening test (PST).</p><p><strong>Methods: </strong>We used research data from the ANSYS database of the National Institute of Dementia, Republic of Korea. Individuals who underwent screening tests between 2017 and 2023 were analyzed. Scores were compared among participants stratified by age, sex, and education duration. The discriminative performance of both screening tests in detecting cognitive impairment was assessed. The equipercentile equating method was used to enable score conversion between the CIST and PST.</p><p><strong>Results: </strong>In total, 7,492,613 individuals (CIST: 3,195,129; PST: 4,297,484) were analyzed. The average screening score was higher for PST than for CIST. A larger proportion of cognitively impaired individuals was identified by the CIST (12.68%) than by the PST (10.72%, <i>p</i><0.001). The CIST score (area under the receiver operating characteristic curve [AUC]=0.790, 95% confidence interval [CI]=0.70-0.850) outperformed the PST score (AUC=0.776, 95% CI=0.700-0.850) in predicting cognitive impairment based on diagnostic tests. CIST scores of 20, 15, and 5 were found to correspond to PST scores of 24, 20, and 10, respectively.</p><p><strong>Conclusions: </strong>This study supports the validity and utility of the CIST as a screening tool for cognitive impairment. The CIST outperformed the PST in predictive accuracy. However, direct score conversion between the two tests should be approached with caution.</p>","PeriodicalId":15432,"journal":{"name":"Journal of Clinical Neurology","volume":"22 1","pages":"59-65"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12802069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145944115","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}