Journal of Neurology, Neurosurgery, and Psychiatry最新文献

{"title":"Postsurgical psychogenic non-epileptic seizure: a treatment-related functional neurological disorder.","authors":"Shin-Ichiro Osawa, Maimi Ogawa, Hirotaka Iwaki, Yuko Akitsuki, Mayu Fujikawa, Kazushi Ukishiro, Kazutaka Jin, Atsushi Sakuma, Hiroaki Tomita, Kyoko Suzuki, Nobukazu Nakasato, Hidenori Endo","doi":"10.1136/jnnp-2025-336913","DOIUrl":"https://doi.org/10.1136/jnnp-2025-336913","url":null,"abstract":"","PeriodicalId":16418,"journal":{"name":"Journal of Neurology, Neurosurgery, and Psychiatry","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Midlife plasma proteomic profiles indicate altered amyloid and tau processing in former elite rugby players.","authors":"Neil Graham, Karl Zimmerman, Jessica Hain, Erin Rooney, Ying Lee, Martina Del Giovane, Thomas Parker, Mathew Wilson, Maneesh Patel, Elena Veleva, Owen Swann, Amanda J Heslegrave, Lucia M Li, Henrik Zetterberg, Daniel Friedland, Richard Sylvester, David Sharp","doi":"10.1136/jnnp-2025-336593","DOIUrl":"https://doi.org/10.1136/jnnp-2025-336593","url":null,"abstract":"<p><strong>Background: </strong>Contact sports, including rugby union, are associated with higher rates of neurodegenerative dementia, due to various underlying pathologies such as Alzheimer's disease (AD) and chronic traumatic encephalopathy (CTE). New ultrasensitive multiplexed immunoassays may clarify disease mechanisms after repetitive head impacts (RHI) and traumatic brain injury, potentially aiding risk-stratification, early diagnosis and dementia treatment.</p><p><strong>Methods: </strong>Midlife participants in the ABHC cohort underwent plasma biomarker quantification (NULISA - NUcleic acid Linked Immuno-Sandwich Assay; n=124 markers), 3T MRI, trauma exposure ascertainment and phenotyping. Regressions quantified exposure-specific protein expression, relationship to trauma (including position) and brain atrophy, using cluster analysis to test correlates of traumatic encephalopathy syndrome (TES).</p><p><strong>Results: </strong>197 former elite rugby players and 33 controls were assessed. 24 (12.2%) met criteria for TES but none had dementia. Ex-players returned reduced plasma glial fibrillary acidic protein (GFAP), kallikrein-6 (KLK6) and synaptosomal-associated protein 25 (SNAP25). Ex-forwards specifically showed reduced plasma beta-site amyloid precursor protein cleaving enzyme 1 (BACE1), amyloid beta-38 (Aβ38), and increased phospho-tau₁₈₁ (p-tau₁₈₁). KLK6 was lower in ex-backs than controls. No biomarkers related to career duration, concussion load or regional brain volume, nor did clustering relate to TES.</p><p><strong>Conclusions: </strong>Ex-players showed distinctive plasma biomarker changes, more prominently in ex-forwards, possibly reflecting greater RHI exposure. Plasma KLK6, an endothelial serine protease, was reduced across the ex-player group, with potential diagnostic or prognostic utility in future. Reduced GFAP and SNAP25 in ex-forwards has an uncertain basis, while elevated p-tau-₁₈₁ more so than p-tau₂₁₇ points towards non-AD tau pathology. Our findings motivate longitudinal characterisation, including comparison with other neurodegenerative diseases.</p>","PeriodicalId":16418,"journal":{"name":"Journal of Neurology, Neurosurgery, and Psychiatry","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global burden of disease study highlights the global, regional and national trends of stroke.","authors":"Sha Yang, Mei Deng, Xiangqian Ren, Fang Wang, Zhuo Kong, Junchi Luo, Yalin Cao, Guoqiang Han, Hao Yin, Xin Xiang, Jian Liu, Jiqin Zhang, Ying Tan","doi":"10.1136/jnnp-2025-335954","DOIUrl":"https://doi.org/10.1136/jnnp-2025-335954","url":null,"abstract":"<p><strong>Background: </strong>Stroke remains a significant global health challenge, especially in low- and middle-income countries, despite advances in treatment and prevention. Understanding stroke trends is crucial for guiding prevention and healthcare strategies.</p><p><strong>Methods: </strong>We analysed global data from the Global Burden of Disease Study 2021 on stroke incidence, prevalence, disability-adjusted life years and mortality from 1990 to 2021. The study focused on the major subtypes of stroke-ischaemic stroke (IS), intracerebral haemorrhage and subarachnoid haemorrhage-examining the effects of age, sex and sociodemographic index (SDI) on stroke outcomes. Decomposition analysis assessed the contributions of population growth, ageing and other factors to stroke burden. The Nordpred Prediction Model was used to forecast stroke trends from 2022 to 2046.</p><p><strong>Results: </strong>From 1990 to 2021, global stroke incidence and deaths increased by 70.20% and 32.17%, respectively, driven by population ageing (45.3%) and growth (29.1%). However, age-standardised incidence and mortality rates declined by 21.78% and 39.10%, reflecting improvements in healthcare and risk factor control. IS saw the largest increase in crude incidence (87.97%), with regional disparities, especially in low-SDI countries. By 2046, global stroke incidence and mortality are projected to rise by 20.3% and 35.7%, primarily in low- and middle-SDI countries.</p><p><strong>Conclusions: </strong>The global stroke burden is rising, particularly in low-SDI regions, due to ageing and population growth. Declines in age-standardised rates emphasise the importance of healthcare improvements. Region-specific strategies are needed to address the rising burden and reduce disparities in stroke outcomes.</p>","PeriodicalId":16418,"journal":{"name":"Journal of Neurology, Neurosurgery, and Psychiatry","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home-based EXergames To impRovE cognitive function in MUltiple Sclerosis (EXTREMUS).","authors":"Luca Prosperini, Andrea Tacchino, Serena Ruggieri, Giampaolo Brichetto, Jessica Podda, Denise Anastasi, Rebecca Cardini, Chiara Corrini, Maria Esmeralda Quartuccio, Irene Alcamisi, Rachele Di Giovanni, Giulia Gamberini, Erica Grange, Erika Pietrolongo, Marianna Gabriella Rispoli, Valentina Tomassini, Davide Cattaneo, Claudio Solaro","doi":"10.1136/jnnp-2025-336609","DOIUrl":"https://doi.org/10.1136/jnnp-2025-336609","url":null,"abstract":"<p><strong>Background: </strong>Motor and cognitive dysfunctions are common and disabling features in multiple sclerosis (MS) that remain challenging to treat. Here, we aimed to explore the effect of exergames as a stand-alone approach for people with MS and impaired processing speed.</p><p><strong>Methods: </strong>This was a three-arm, randomised, rater-blinded, sham-controlled trial. People with MS and impaired processing speed were randomised in a 1:1:1 ratio to an 8-week home-based training with exergames (intervention of interest), adaptive Cognitive Training Kit (COGNI-TRAcK) (working memory training as comparator intervention) or sham intervention. A postintervention assessment was scheduled at week 16 postrandomisation. Statistical analyses were conducted to test the hypotheses that exergames were superior to sham intervention and non-inferior to adaptive COGNI-TRAcK on the symbol digit modalities test (SDMT).</p><p><strong>Results: </strong>We screened 165 people with MS, of whom 102 were randomised (34 per arm). At week 8, both exergames and adaptive COGNI-TRAcK yielded improvements in SDMT, with adjusted mean differences versus sham intervention of 4.3 (95% CI 0.1 to 8.5) and 5.7 (95% CI 1.3 to 10.1) points, respectively. The non-inferiority analysis was inconclusive, as the mean between-arm difference (adaptive COGNI-TRAcK versus exergames) was 1.3 points (90% CI -1.7 to 4.3), crossing the predefined non-inferiority margin of 4 SDMT points. Exergames additionally demonstrated benefits on executive function, dynamic balance, fatigue and reduced work absenteeism. None of these benefits was retained at week 16.</p><p><strong>Conclusion: </strong>This study provides evidence that home-based exergames are suitable as a standalone approach to improve some specific MS-related cognitive and motor dysfunctions, but there is no evidence about their non-inferiority to working memory training.</p><p><strong>Trial registration number: </strong>NCT04169750.</p>","PeriodicalId":16418,"journal":{"name":"Journal of Neurology, Neurosurgery, and Psychiatry","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personalised dual-site alpha transcranial alternating current stimulation (tACS) targeting right frontoparietal network reduces craving in heroin use disorder.","authors":"Dongcheng Wang, Zhe Du, Jiahao Zhao, Ruowan Li, Suping Cai, Xin Liu, Pengquan Tu, Gailing Sun, Cunfeng Yuan, Jun Liu, Xinwen Wen, Yanxue Xue, Kai Yuan","doi":"10.1136/jnnp-2025-336516","DOIUrl":"https://doi.org/10.1136/jnnp-2025-336516","url":null,"abstract":"","PeriodicalId":16418,"journal":{"name":"Journal of Neurology, Neurosurgery, and Psychiatry","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomarkers to predict relapse in myelin oligodendrocyte glycoprotein antibody-associated disease: a systematic review and meta-analysis.","authors":"Jane Andersen, Benjamin Peter Trewin, Russell C Dale, Sudarshini Ramanathan, Fabienne Brilot","doi":"10.1136/jnnp-2025-337039","DOIUrl":"https://doi.org/10.1136/jnnp-2025-337039","url":null,"abstract":"<p><strong>Background: </strong>Detection of immunoglobulin G targeting myelin oligodendrocyte glycoprotein (MOG-IgG) is the mainstay of laboratory diagnosis of MOG antibody-associated disease. Laboratory biomarkers have the potential to predict disease course and activity, thus informing prompt therapeutic decisions to minimise relapse-associated disability accrual.</p><p><strong>Methods: </strong>This systematic review with meta-analysis was registered in PROSPERO (CRD42024554429). MEDLINE, Embase and Scopus databases were searched. Random-effects or mixed-effects modelling was performed and OR or HR with 95% CIs reported.</p><p><strong>Results: </strong>106 studies with ≥1710 individuals were included. A relapsing course was associated with persistent seropositivity on serial samples collected ≥3 months apart (OR 2.7 (95% CI 1.8 to 4.0), p<0.0001), lower likelihood of seroreversion to negative status (HR 0.19 (95% CI 0.14 to 0.26), p<0.0001) and delayed seroreversion compared with monophasic participants (median 19 years vs 2.5 years, p<0.0001). Acute disseminated encephalomyelitis was associated with a non-relapsing course (OR 0.049 (95% CI 0.0029 to 0.84), p=0.037). Serum MOG-IgG titre-negative, low positive or clear positive-discriminated disease state: attack was associated with clear positive titre (OR 3.6 (95% CI 2.6 to 5.0), p<0.0001), but not negative titre (OR 0.073 (95% CI 0.028 to 0.19), p<0.0001). Cerebrospinal fluid (CSF) leucocytosis (≥5 cells/µL) was associated with attack (OR 3.1 (95% CI 1.7 to 5.9), p=0.0004). Neither serum glial fibrillary acidic protein nor neurofilament light chain correlated with disease activity. Novel biomarkers of disease course and activity have also been assessed qualitatively.</p><p><strong>Conclusions: </strong>MOG-IgG serostatus and titre and CSF leucocytosis are biomarkers of disease course and activity. The findings provide rationale for serial serum MOG-IgG testing at an interval of 3-6 months in the first 12 months of disease to assist in relapse risk stratification.</p><p><strong>Prospero registration number: </strong>CRD42024554429.</p>","PeriodicalId":16418,"journal":{"name":"Journal of Neurology, Neurosurgery, and Psychiatry","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beneficial impact of physical activity on multiple sclerosis disability progression.","authors":"Anna Karin Hedström, Tomas Olsson, Fredrik Piehl, Lars Alfredsson","doi":"10.1136/jnnp-2025-336738","DOIUrl":"https://doi.org/10.1136/jnnp-2025-336738","url":null,"abstract":"<p><strong>Background: </strong>Physical activity has been associated with neuroprotective and immunomodulatory benefits, potentially influencing long-term disability outcomes in multiple sclerosis (MS). However, longitudinal evidence on its role in modifying disease progression remains limited.</p><p><strong>Methods: </strong>We analysed 3284 individuals with incident relapsing-remitting MS from the Swedish Epidemiologic Investigation of MS. Participants were followed for up to 15 years through the Swedish MS Registry. Physical activity at diagnosis was categorised into low, moderate, moderate-high and high activity. The primary outcomes were time to confirmed disability worsening (CDW) and progression to Expanded Disability Status Scale (EDSS) 3 and 4. Changes in physical activity post diagnosis were analysed in a subsample (n=1724). Cox regression models were used to estimate HRs adjusting for clinical and lifestyle factors.</p><p><strong>Results: </strong>Higher levels of physical activity at diagnosis were associated with reduced risk of disability progression. Compared with low physical activity, the risk of CDW was reduced for moderate (HR 0.77, 95% CI 0.61 to 0.97), moderate-high (HR 0.71, 95% CI 0.54 to 0.94) and high physical activity (HR 0.64, 95% CI 0.46 to 0.90). Similar trends were observed for reaching EDSS 3 and EDSS 4. Increasing activity post-diagnosis was associated with more favourable outcomes, while physical activity before diagnosis showed no significant association with long-term disability progression.</p><p><strong>Conclusions: </strong>Our findings suggest that physical activity may beneficially influence disease progression in MS. The observed associations highlight the importance of maintaining regular physical activity for ongoing clinical benefits. Our results support including physical activity promotion as a component of standard MS care to optimise long-term outcomes.</p>","PeriodicalId":16418,"journal":{"name":"Journal of Neurology, Neurosurgery, and Psychiatry","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated serum β-synuclein predicts cognitive decline and progression to dementia.","authors":"Nayeong Kong, Joon Hyung Jung","doi":"10.1136/jnnp-2025-336234","DOIUrl":"https://doi.org/10.1136/jnnp-2025-336234","url":null,"abstract":"<p><strong>Background: </strong>Synapses are essential for cognitive processes, and synaptic dysfunction is a hallmark of Alzheimer's disease (AD). Beta (β)-synuclein, a homologue of alpha-synuclein, is a presynaptic phosphoprotein abundantly expressed in the brain. It has emerged as a promising candidate biomarker for synaptic dysfunction. However, its role in longitudinal clinical progression has not been fully elucidated. This study investigated the associations of serum β-synuclein levels with AD pathologies, cognitive performance and progression to dementia.</p><p><strong>Methods: </strong>We examined 474 participants from the AD Neuroimaging Initiative cohort with serum β-synuclein measurements. 233 participants also had corresponding cerebrospinal fluid (CSF) AD pathology data. Multiple linear regressions, linear mixed-effects models and Cox proportional hazards models were applied to explore the associations of serum β-synuclein level with CSF AD pathologies, cognition and dementia risk.</p><p><strong>Results: </strong>Higher serum β-synuclein levels were associated with greater CSF phosphorylated tau181 and total tau levels and lower β-amyloid (1-42) levels. Serum β-synuclein predicted worse baseline cognitive performance and a longitudinal decline in AD Assessment Scale-Cognitive Subscale 13, Mini-Mental State Examination and Clinical Dementia Rating-Sum of Boxes scores. Participants with higher serum β-synuclein levels showed a greater progression to dementia over 84 months compared with those with lower levels. Furthermore, even after adjusting for AD pathologies, elevated β-synuclein levels were associated with increased risk of dementia.</p><p><strong>Conclusions: </strong>Our findings underscore serum β-synuclein as a promising biomarker for AD progression and cognitive decline. Further research is warranted to clarify its role in the pathogenesis of AD and validate its utility in clinical settings.</p>","PeriodicalId":16418,"journal":{"name":"Journal of Neurology, Neurosurgery, and Psychiatry","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beta-synuclein: a dynamic biomarker and modulator in neurodegenerative dementia.","authors":"Marco Bucci","doi":"10.1136/jnnp-2025-337033","DOIUrl":"https://doi.org/10.1136/jnnp-2025-337033","url":null,"abstract":"","PeriodicalId":16418,"journal":{"name":"Journal of Neurology, Neurosurgery, and Psychiatry","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global burden of early-onset Parkinson's disease, 1990-2021: results from the Global Burden of Disease Study 2021.","authors":"Qiwei Ji, Zujie Chen, Yuning Ma, Qing Guan, Feifan Chu, Lumin Chen, Jinzhong Ji, Mingxin Sun, Gaozhan Ren, Tingyang Huang, Haihan Song, Xiaojun Xu, Xiuquan Lin, Hao Zhou","doi":"10.1136/jnnp-2024-335535","DOIUrl":"https://doi.org/10.1136/jnnp-2024-335535","url":null,"abstract":"<p><strong>Objectives: </strong>Early-onset Parkinson's disease (EOPD) is an increasingly serious disorder, yet there is currently a scarcity of epidemiological data and reports on this disease worldwide.</p><p><strong>Methods: </strong>By using data from the 2021 Global Burden of Disease Study, we analysed the number of incident cases, prevalent cases and years lived with disability (YLDs) for EOPD (diagnosis after the age of 20 years and before the age of 50 years) from 1990 to 2021, along with their corresponding age-standardised rates. Additionally, we calculated the average annual percent change of the age-standardised rates and analysed the negative correlation between smoking and the disability-adjusted life years (DALYs) burden for EOPD.</p><p><strong>Results: </strong>From 1990 to 2021, the incidence, prevalence and YLDs associated with EOPD have tripled globally. Most countries have seen a consistent increase in the age-standardised incidence and prevalence rates of this disease, especially those with high-middle Socio-Demographic Index scores. In 2021, smoking contributed to a 9.03% decrease in the global burden of DALYs, a decline from -14.14% in 1990.</p><p><strong>Conclusions: </strong>EOPD is increasing at an alarming rate worldwide, necessitating the attention of global health organisations and the implementation of effective intervention measures to address this serious challenge.</p>","PeriodicalId":16418,"journal":{"name":"Journal of Neurology, Neurosurgery, and Psychiatry","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}