Journal of Neurology最新文献

{"title":"Prodromal seizures in anti-MOG and anti-CASPR2 antibody co-positivity: a case report.","authors":"Vittorio Viti, Gianni Cutillo, Martina Rubin, Chiara Zanetta, Maria A Rocca, Massimo Filippi","doi":"10.1007/s00415-025-13096-y","DOIUrl":"10.1007/s00415-025-13096-y","url":null,"abstract":"","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 5","pages":"342"},"PeriodicalIF":4.8,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term dopaminergic therapy improves spoken language in de-novo Parkinson's disease.","authors":"Martin Subert, Tereza Tykalova, Michal Novotny, Ondrej Bezdicek, Petr Dusek, Jan Rusz","doi":"10.1007/s00415-025-13070-8","DOIUrl":"10.1007/s00415-025-13070-8","url":null,"abstract":"<p><strong>Background and objectives: </strong>The impact of dopaminergic medication on language in Parkinson's disease (PD) remains poorly understood. This observational, naturalistic study aimed to investigate the effects of long-term dopaminergic therapy on language performance in patients with de-novo PD based on a high-level linguistic analysis of natural spontaneous discourse.</p><p><strong>Methods: </strong>A fairy-tale narration was recorded at baseline and a 12-month follow-up. The speech samples were automatically analyzed using six representative lexical and syntactic features based on automatic speech recognition and natural language processing.</p><p><strong>Results: </strong>We enrolled 109 de-novo PD patients compared to 68 healthy controls. All subjects completed the 12-month follow-up; 92 PD patients were on stable dopaminergic medication (PD-treated), while 17 PD patients remained without medication (PD-untreated). At baseline, the PD-treated group exhibited abnormalities in syntactic domains, particularly in sentence length (p = 0.018) and sentence development (p = 0.042) compared to healthy controls. After 12 months of dopaminergic therapy, PD-treated showed improvements in the syntactic domain, including sentence length (p = 0.012) and sentence development (p = 0.030). Of all PD-treated patients, 37 were on monotherapy with dopamine agonists and manifested improvement in sentence length (p = 0.048), while 32 were on monotherapy with levodopa and had no language amelioration. No changes in language parameters over time were seen in both the PD-untreated group and healthy controls.</p><p><strong>Discussion: </strong>Initiation of dopaminergic therapy improved high-language syntactic deficits in de-novo PD, confirming the role of dopamine in cognitive-linguistic processing. Automated linguistic analysis of spontaneous speech via natural language processing can assist in improving the prediction and management of language deficits in PD.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 5","pages":"344"},"PeriodicalIF":4.8,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12006276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 weather conditions and migraine: a systematic review and meta-analysis.","authors":"Shiqin Li, Qian Liu, Mengmeng Ma, Jinghuan Fang, Li He","doi":"10.1007/s00415-025-13078-0","DOIUrl":"10.1007/s00415-025-13078-0","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have linked migraine to weather conditions, but variations in the factors examined and inconsistent focus have complicated comparisons. This underscores the need for a more comprehensive and clearer analysis.</p><p><strong>Methods: </strong>Studies published before December 2024 on the association between weather and migraine were searched from PubMed, Embase, Web of Science, and Cochrane. Meta-analyses based on effect sizes were performed using Review Manager version 5.4.1.</p><p><strong>Results: </strong>A total of 31 studies were included in the meta-analyses. It revealed a significant association between migraine attack and weather changes reported as a trigger factor (RD = 0.47, 95% CI = 0.40-0.54). Additionally, specific weather factors, such as temperature (OR = 1.15, 95% CI = 1.02-1.29) and ambient pressure (OR = 1.07, 95% CI = 1.01-1.15), were significantly associated with migraine attacks, while humidity (OR = 1.04, 95% CI = 0.97-1.11) did not show a significant association. Moreover, increased levels of air pollutants, including PM10 (OR = 1.07, 95% CI = 1.03-1.11), PM2.5 (OR = 1.04, 95% CI = 1.01-1.06), NO₂ (OR = 1.08, 95% CI = 1.03-1.14), CO (OR = 1.08, 95% CI = 1.01-1.16), and O₃ (OR = 1.12, 95% CI = 1.03-1.21), were significantly associated with an increased risk of migraine clinical visits, whereas SO₂ (OR = 1.02, 95% CI = 1.00-1.04) was not.</p><p><strong>Conclusions: </strong>This meta-analysis revealed that weather changes are significant trigger factors for migraine, with temperature and ambient pressure playing notable roles in this association. Additionally, increased levels of air pollutants are linked to a higher risk of migraine attacks. These findings could lead to new interventions for patients who are weather-sensitive and offer fresh perspectives for future research into the pathogenesis of migraine.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 5","pages":"346"},"PeriodicalIF":4.8,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing selectivity of the Cerebellar Cognitive Affective Syndrome Scale by use of correction formulas, and validation of its German version.","authors":"Andreas Thieme, Kerstin Rubarth, Raquel van der Veen, Johanna Müller, Jennifer Faber, Miriam Barkhoff, Martina Minnerop, Saskia Elben, Dana Huvermann, Friedrich Erdlenbruch, Adam M Berlijn, Patricia Sulzer, Kathrin Reetz, Imis Dogan, Heike Jacobi, Julia-Elisabeth Aktories, Giorgi Batsikadze, Qi Liu, Benedikt Frank, Martin Köhrmann, Elke Wondzinski, Mario Siebler, Jürgen Konczak, Matthis Synofzik, Thomas Klockgether, Frank Konietschke, Sandra Röske, Dagmar Timmann","doi":"10.1007/s00415-025-13083-3","DOIUrl":"10.1007/s00415-025-13083-3","url":null,"abstract":"<p><strong>Background: </strong>Cerebellar disease may result in Cerebellar Cognitive Affective Syndrome (CCAS). The CCAS-Scale, designed to screen for CCAS, has been validated in English Hoche (Brain 141:248-270, 2018) and adapted to other languages.</p><p><strong>Methods: </strong>Here, the German CCAS-Scale Thieme (Neurol Res Pract 2:39, 2020) was validated in 209 patients with cerebellar disorders and 232 healthy controls. Correction formulas for the outcome parameters [failed test items (range: 1-10) and sum raw score (range: 0-120)] were developed, controlling for age, education, and sex effects. Diagnostic accuracy and reliability were assessed.</p><p><strong>Results: </strong>Correction formulas improved selectivity in controls, reducing false positives (failed items: 40%; sum score: 13% vs. original method Hoche (Brain 141:248-270, 2018): 67%), while maintaining moderate sensitivity (failed items: 69%; sum score: 48% vs. original method Hoche (Brain 141:248-270, 2018): 87%). Word fluency tests differentiated best between patients and controls, while other items did not. Internal consistency (α = 0.71) was acceptable. Removal of word fluency tests worsened it. Retest and interrater reliability were high [intraclass correlation coefficients (ICC): 0.77-0.95]. However, these ICCs yielded a large minimal detectable change (MDC; 2.2-2.4 failed items, 9.5-11.4 raw score points) in patients, limiting the use of the CCAS-Scale in follow-up examinations.</p><p><strong>Conclusion: </strong>The correction formulas improved diagnostic accuracy of the CCAS-Scale, particularly for the sum raw score. Therefore, we recommend using the corrected sum raw score for evaluation instead of the uncorrected number of failed items, proposed originally Hoche (Brain 141:248-270, 2018). Some test items, however, did not differentiate well between patients and controls and MDCs were large, highlighting the need for refined CCAS assessment instruments as progression or treatment outcomes.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 5","pages":"343"},"PeriodicalIF":4.8,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12006234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adjunctive intra-arterial thrombolysis following successful endovascular reperfusion in acute ischemic stroke: a systematic review and meta-analysis of seven randomized controlled trials.","authors":"Zekun Wang, Kangxiang Ji, Qi Fang","doi":"10.1007/s00415-025-13092-2","DOIUrl":"10.1007/s00415-025-13092-2","url":null,"abstract":"<p><strong>Background: </strong>The benefits and risks of adjunctive intra-arterial thrombolysis (IAT) after successful endovascular thrombectomy (EVT) in acute ischemic stroke due to large vessel occlusion (AIS-LVO) remain uncertain. This study aimed to evaluate the efficacy and safety of IAT in this setting.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, Web of Science, CENTRAL, and ClinicalTrials.gov from inception to February 2025, and reviewed abstracts from the 2025 International Stroke Conference, to identify randomized controlled trials (RCTs) comparing IAT versus placebo or best medical management in AIS-LVO patients who achieved successful reperfusion after EVT. Outcome measures included 90-day excellent (modified Rankin Scale [mRS] 0-1) and good (mRS 0-2) functional outcomes, 90-day reduced disability (≥ 1-point mRS improvement), symptomatic intracranial hemorrhage (sICH), any ICH, and 90-day mortality. A random-effects model was employed for the meta-analysis.</p><p><strong>Results: </strong>Seven RCTs with 2131 patients (1083 assigned to IAT, and 1048 to control) were included. Compared to controls, IAT was associated with significantly higher likelihood of 90-day excellent functional outcomes (risk ratio 1.23, 95% confidence interval [CI] 1.11-1.36; I² = 0%) and reduced disability (common odds ratio 1.20, 95% CI 1.03-1.40; I² = 0%), but not with 90-day good functional outcomes. Risks of any ICH, sICH, and mortality were similar between groups. Subgroup analyses suggested numerically higher odds of excellent functional outcomes among patients with anterior circulation LVO or those receiving IA alteplase/tenecteplase.</p><p><strong>Conclusion: </strong>Adjunctive IAT following successful EVT in AIS-LVO patients led to improved 90-day excellent functional outcomes and reduced disability without increasing sICH or mortality risks.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 5","pages":"345"},"PeriodicalIF":4.8,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient journey and decision processes for anti-amyloid therapy in Alzheimer's disease.","authors":"Brant Mittler, Xavier Cambi, Morgan Biskach, Joel Reisman, Ying Wang, Dan Berlowitz, Peter Morin, Donald R Miller, Karla Brandao-Viruet, Sophie J Clare, Kevin Z Xia, Amir Abbas Tahami Monfared, Michael Irizarry, Quanwu Zhang, Weiming Xia","doi":"10.1007/s00415-025-13059-3","DOIUrl":"10.1007/s00415-025-13059-3","url":null,"abstract":"<p><strong>Introduction: </strong>We utilized the Veterans Affairs Healthcare System administrative database to study the clinical decision-making processes for anti-amyloid therapy (AAT).</p><p><strong>Methods: </strong>Patients with clinical notes mentioning lecanemab were identified (March 2023-June 2024) for manual review and structured database queries.</p><p><strong>Results: </strong>From an initial sample (N = 2499), 1064 patients (55,000 notes) were reviewed manually (mean age 76 years; 7.3% women; 9.2% Black; 3.9% Hispanic). The AAT group (n = 56) had lower rates of common comorbidities, except post-traumatic stress disorder, than patients excluded from AAT (n = 528). The documented notes including \"Lack of patient interest/resource constraints\" (24.6% vs 3.6%), \"anticoagulant use\" (23.1% vs 10.7%), and \"advanced AD\" (18.6% vs 0), supplied partial explanations on exclusion vs inclusion.</p><p><strong>Discussion: </strong>Only 5.3% of patients reached the point of care of being a candidate, scheduled for, or receiving AAT infusion. Patient preference and clinician discretion, especially regarding modifiable factors (e.g., medication regimens), appreciably influence the patient journey to AAT.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 5","pages":"341"},"PeriodicalIF":4.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated serum concentrations of GFAP in hereditary transthyretin amyloidosis since pre-symptomatic stages.","authors":"Domenico Plantone, Marco Luigetti, Carlo Manco, Angela Romano, Luca Leonardi, Valeria Guglielmino, Francesca Forcina, Marco Ceccanti, Maurizio Inghilleri, Fiore Manganelli, Stefano Tozza, Maria Ausilia Sciarrone, Francesca Vitali, Andrea Sabino, Delia Righi, Angela Stufano, Maria Laura Stromillo, Nicola De Stefano, Paolo Calabresi, Guido Primiano","doi":"10.1007/s00415-025-13072-6","DOIUrl":"10.1007/s00415-025-13072-6","url":null,"abstract":"<p><strong>Background: </strong>Hereditary transthyretin amyloidosis (ATTRv) is a rare disorder caused by pathogenic TTR gene variants. Glial fibrillary acidic protein (GFAP) and neurofilament light chain (NfL) are potential biomarkers for astrocyte activation and neuroaxonal damage, respectively. This study investigates serum GFAP (sGFAP) and NfL (sNfL) levels in ATTRv patients, pre-symptomatic subjects, and healthy controls (HCs) to evaluate their utility as biomarkers of disease progression and CNS involvement.</p><p><strong>Methods: </strong>Our multicenter cross-sectional study included 111 ATTRv patients (56 symptomatic, 55 pre-symptomatic subjects) and 183 HCs. Serum levels of sGFAP and sNfL were measured using ultrasensitive immunoassays. The statistical comparisons were performed using ANCOVA models (age and sex adjusted), with correlations examined between serum biomarkers and disease severity (Neuropathy Impairment Score, NIS).</p><p><strong>Results: </strong>sGFAP levels were elevated in symptomatic (median: 238.35 pg/ml) and pre-symptomatic subjects (median: 105.50 pg/ml) vs. HCs (median: 75.5 pg/ml, p < 0.001). sNfL was elevated only in symptomatic patients (median: 43.68 pg/ml) compared to pre-symptomatic subjects (median: 9.36 pg/ml) and HCs (median: 7.54 pg/ml, p < 0.001). Both biomarkers correlated significantly with NIS, reflecting disease severity. Female HCs had higher sGFAP levels than males (median 88.6 pg/ml vs. 59.8 pg/ml; p 0.011).</p><p><strong>Conclusion: </strong>sGFAP and sNfL mark distinct ATTRv stages, with sGFAP indicating early preclinical changes and sNfL correlating with neurological progression. Sex differences in sGFAP levels among HCs suggest that sex should be considered as a covariate in biomarker analyses.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 5","pages":"340"},"PeriodicalIF":4.8,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progression independent of relapse activity and relapse-associated worsening in seronegative NMOSD: an international cohort study.","authors":"Pakeeran Siriratnam, Saif Huda, Anneke Van der Walt, Paul Sanfilippo, Sifat Sharmin, Yi Chao Foong, Wei Zhen Yeh, Chao Zhu, Samia J Khoury, Tunde Csepany, Barbara Willekens, Masoud Etemadifar, Serkan Ozakbas, Petra Nytrova, Ayse Altintas, Abdullah Al-Asmi, Cristina Ramo-Tello, Guy Laureys, Francesco Patti, Dana Horakova, Matteo Foschi, Cavit Boz, Pamela McCombe, Recai Turkoglu, Izanne Roos, Jeannette Lechner-Scott, Tomas Kalincik, Vilija Jokubaitis, Helmut Butzkueven, Mastura Monif","doi":"10.1007/s00415-025-13064-6","DOIUrl":"10.1007/s00415-025-13064-6","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have indicated that progression independent of relapse activity (PIRA) is uncommon in patients with aquaporin- 4 antibody-positive (AQP4-IgG) neuromyelitis optica spectrum disorder (NMOSD). However, the patterns of disability accumulation in seronegative NMOSD are unknown. This study aimed to evaluate the prevalence of PIRA and relapse-associated worsening (RAW) in seronegative NMOSD.</p><p><strong>Methods: </strong>We conducted a retrospective, multicentre cohort study of seronegative NMOSD patients from the MSBase registry. Inclusion criteria required at least three recorded expanded disability status scale (EDSS) scores: baseline, progression, and 6 months confirmed disability progression (CDP). For those with 6-month CDP, the presence or absence of relapse between baseline and progression determined the classification as RAW or PIRA, respectively. Descriptive statistics were employed to present the data.</p><p><strong>Results: </strong>This study included 93 patients, with a median follow-up duration of 5.0 years (Q1 2.8, Q3 8.4). The cohort predominantly consisted of female patients (77.4%), with a median age of onset of 33.9 years (Q1 26.1, Q3 41.2). PIRA was observed in 1 case (1.1%), whilst RAW was documented in 7 cases (7.5%).</p><p><strong>Conclusion: </strong>This international cohort study confirms that CDP is uncommon in seronegative NMOSD. Given more than three quarters of CDP occur due to RAW, therapeutic strategies should focus primarily on preventing relapses.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 5","pages":"339"},"PeriodicalIF":4.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11996963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring cognitive change in secondary progressive MS: an analysis of the ASCEND cognition substudy.","authors":"Victoria Leavitt, Jop Mostert, Jacynthe Comtois, Ester Moral, Luis Brieva, Pavle Repovic, James D Bowen, Bernard Uitdehaag, Eva Strijbis, Gary Cutter, Marcus W Koch","doi":"10.1007/s00415-025-13066-4","DOIUrl":"10.1007/s00415-025-13066-4","url":null,"abstract":"<p><strong>Background: </strong>Cognitive impairment is common in multiple sclerosis (MS). Accurate measurement of cognitive change is essential for clinical trials.</p><p><strong>Methods: </strong>The change in cognitive scores, clinical metrics of physical disability, and neuroradiological metrics was quantified in data from a phase-3 randomized controlled trial of natalizumab in secondary progressive MS (SPMS). The adults diagnosed with SPMS for ≥ 2 years and Expanded Disability Status Scale (EDSS) scores from 3 to 6.5 were randomized to receive natalizumab or placebo for 96 weeks. We evaluated change in Symbol Digit Modalities Test (SDMT), Paced Auditory Serial Addition Test (PASAT), Selective Reminding Test (SRT), Brief Visuospatial Memory Test (BVMT-R), two subjective cognitive measures, Beck Depression Inventory (BDI-FS), Timed 25-foot Walk Test, Nine Hole Peg Test, measures of brain volume, and T2 lesion volume.</p><p><strong>Results: </strong>The outcomes were evaluated at baseline, 48-, and 96-week follow-up. There were no significant differences in cognitive change between treatment arms. SDMT and PASAT scores improved over 96-weeks: mean SDMT scores by 4.5 points (SD 9.3), mean PASAT scores by 2.4 points (SD 9.4). Verbal and visuospatial memory test performance showed no consistent change. All MRI measures showed decreased brain volumes. NHPT scores worsened little and T25FW showed steadily worsening scores.</p><p><strong>Conclusions: </strong>Improvements in SDMT and PASAT performance were observed regardless of treatment arm. These findings are consistent with prior studies in MS. As it is unlikely that cognition improves over time in people with a chronic neurologic disease, these results support the need for cognitive outcomes that overcome practice and learning effects to accurately quantify change.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 5","pages":"338"},"PeriodicalIF":4.8,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stellate ganglion block for refractory periodic limb movement disorder: case report.","authors":"Aaron Burshtein, Vineet Aggarwal, Jung H Kim","doi":"10.1007/s00415-025-13054-8","DOIUrl":"10.1007/s00415-025-13054-8","url":null,"abstract":"<p><strong>Objectives: </strong>Periodic limb movement disorder (PLMD) involves periodic, stereotypic movements of upper/lower extremities during sleep. Propriospinal myoclonus (PSM) involves repetitive, irregular, myoclonic jerks starting in the midthoracic region and propagating to adjacent segments through propriospinal pathways. Limited evidence exists for interventional modalities. This report discusses the utility of stellate ganglion block (SBG) for PLMD.</p><p><strong>Methods: </strong>A review of one patient record who underwent SGB for PLMD.</p><p><strong>Results: </strong>We present a case of successful treatment of refractory PLMD with SGB.</p><p><strong>Discussion: </strong>This case demonstrates complicated PLMD that was refractory to numerous treatment modalities. However, SGB was shown to significantly improve the patient's painful nocturnal spasms. The hallmark of PLMD is myoclonic movement of upper and lower extremity thought to be due to hyperactivity of propriospinal neurons. The stellate ganglion is thought to be the source of a sympathetic nervous system activation and blocking the ganglion with local anesthetic reduces sympathetic activity. SGB for PLMD has not been previously described. However, our results indicate that communication between motor neurons and sympathetic nervous system is possible due to the plasticity of propriospinal interneurons. While the indication for SBG is rapidly expanding, its application for PLMD is truly novel. Further research is desperately needed to establish SGB as a solid treatment modality for PLMD.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 5","pages":"335"},"PeriodicalIF":4.8,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}