Martin Schulze Westhoff, Christina Massarou, Stefan Bleich, Johannes Heck, Konstantin Fritz Jendretzky, Alexander Glahn, Sebastian Schröder
{"title":"Drug interactions in a sample of inpatients diagnosed with cannabis use disorder.","authors":"Martin Schulze Westhoff, Christina Massarou, Stefan Bleich, Johannes Heck, Konstantin Fritz Jendretzky, Alexander Glahn, Sebastian Schröder","doi":"10.1007/s00702-025-02884-5","DOIUrl":"https://doi.org/10.1007/s00702-025-02884-5","url":null,"abstract":"<p><p>The majority of patients with cannabis use disorder (CUD) regularly take medication. Cannabinoids influence metabolism of some commonly prescribed drugs. However, little is known about the characteristics and frequency of potential cannabis-drug (CDIs) and drug-drug interactions (DDIs) in patients with CUD. Therefore, our study aimed to determine the prevalence and characteristics of drug interactions in patients with CUD during inpatient treatment on an addiction-specific ward over a six-year-period. To this aim, medication charts were analyzed and screened for potential CDIs and DDIs. Herein, the drugs.com classification for potential CDIs and UpToDate Lexicomp program for potential DDIs were utilized. The study cohort consisted of 301 patient cases, predominantly male (85.0%), with a median age of 37 years. 89.4% (269/301) of all cases involved were taking at least one drug that could potentially interact with cannabis. Levomethadone, buprenorphine and morphine were the most common drugs involved in potentially serious CDIs. In addition, 196 DDIs were identified, of which 25.5% were classified as 'avoid combination' and 74.5% as 'consider therapy modification'. Hereby, combinations of levomethadone with other psychotropic drugs most frequently accounted for potentially severe and mild DDIs. The results of our study indicate that especially patients diagnosed with CUD also receiving opioid substitution therapy are at risk for potential drug interactions. Therefore, a clinical monitoring of vigilance and respiratory function should be applied during inpatient treatment. Routine use of interaction check tools in patients diagnosed with CUD should also be considered by healthcare providers. In addition, therapeutic drug monitoring (TDM) should be used to increase medication safety in this patient population.</p>","PeriodicalId":16579,"journal":{"name":"Journal of Neural Transmission","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bora Jin, Eun Jin Yoon, Kyung Ah Woo, Seoyeon Kim, Seungmin Lee, Ryul Kim, Jung Hwan Shin, Yu Kyeong Kim, Jee-Young Lee
{"title":"Mild behavioral impairment in idiopathic REM sleep behavior disorder and Lewy body disease continuum.","authors":"Bora Jin, Eun Jin Yoon, Kyung Ah Woo, Seoyeon Kim, Seungmin Lee, Ryul Kim, Jung Hwan Shin, Yu Kyeong Kim, Jee-Young Lee","doi":"10.1007/s00702-024-02877-w","DOIUrl":"https://doi.org/10.1007/s00702-024-02877-w","url":null,"abstract":"<p><p>To investigate the clinical impact of mild behavioral impairment (MBI) in a predefined cohort with Lewy body disease (LBD) continuum. Eighty-four patients in the LBD continuum participated in this study, including 35 patients with video-polysomnography-confirmed idiopathic REM sleep behavior disorder (iRBD) and 49 clinically established LBD. Evaluations included the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), neuropsychological tests, and MBI Checklist (MBI-C). We examined the clinical associates of MBI-C and its diagnostic values in predicting disease severity and cognitive impairment across the LBD continuum. Participants were classified into 19 cognitively normal (CN), 45 mild cognitive impairment (MCI), and 20 dementia groups. Median MBI-C total scores were 1.0, 8.0, and 18.5 for CN, MCI, and dementia groups, respectively, with a significant increasing trend (p < 0.001). The MBI-C total score demonstrated significant correlations with the MDS-UPDRS part 1 (r = 0.504, p < 0.001) and total scores (r = 0.508, p < 0.001). Furthermore, significant correlations were observed between MBI-C and cognitive performances in frontal/executive (DSC: r = -0.314, p = 0.006; TMT-B: r = -0.338, p = 0.003) and attentional (TMT-A: r = -0.343, p = 0.002) domains. A cutoff 5.0 effectively differentiated the MCI from CN groups (area under the curve (AUC = 0.74). Furthermore, the MBI-C effectively discriminated the iRBD patients with high phenoconversion risk against those with low-risk (cut-off 4.0, AUC = 0.72). The MBI-C may be a useful screening questionnaire reflecting clinical severity across the LBD continuum. Longitudinal studies are needed to determine its value in monitoring disease progression in prodromal LBD.</p>","PeriodicalId":16579,"journal":{"name":"Journal of Neural Transmission","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Botulinum toxin treatment for hemifacial spasm: harmonising neurological and aesthetic outcomes.","authors":"Suppata Maytharakcheep, Roongroj Bhidayasiri","doi":"10.1007/s00702-024-02821-y","DOIUrl":"10.1007/s00702-024-02821-y","url":null,"abstract":"<p><p>Hemifacial spasm (HFS) represents a challenging cranial movement disorder primarily affecting the facial nerve innervated muscles, with significant prevalence among Asians. Botulinum toxin type A (BoNT/A) injections, established as a primary therapeutic intervention since FDA approval, offer considerable effectiveness in alleviating spasms, albeit accompanied by challenges such as temporary effects and potential adverse events including facial asymmetry. This comprehensive review underscores the crucial need for harmonising neurological benefits and aesthetic outcomes in HFS management. The discussion delves into the interplay between facial aesthetics and neurological objectives in BoNT/A injections, emphasising precise techniques, dosages, and site considerations. Distinct aspects in neurological and aesthetic domains are also examined, including detailing the targeted muscles and injection methodologies for optimal therapeutic and aesthetic results. Importantly, evidence regarding various BoNT/A formulations, recommendations, and reconstitution guidelines in both neurology and aesthetics contexts are provided, along with a schematic approach outlining the stepwise process for BoNT/A injection in HFS treatment, addressing critical areas such as orbicularis oculi muscle sites, eyebrow correction strategies, mid- and lower-face considerations, contralateral injection sites, and post-injection follow-up and complication management. By highlighting the culmination of neurological efficacy and facial esthetics in BoNT/A treatment for HFS patients, this review proposes a holistic paradigm to achieve balanced symptomatic relief and natural aesthetic expression, ultimately enhancing quality of life for individuals grappling with HFS.</p>","PeriodicalId":16579,"journal":{"name":"Journal of Neural Transmission","volume":" ","pages":"23-38"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142036085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Contribution of testosterone and estradiol in sexual dimorphism of early-onset Parkinson's disease.","authors":"Roberta Bovenzi, Matteo Conti, Clara Simonetta, Jacopo Bissacco, Davide Mascioli, Vito Michienzi, Massimo Pieri, Rocco Cerroni, Claudio Liguori, Mariangela Pierantozzi, Alessandro Stefani, Nicola Biagio Mercuri, Tommaso Schirinzi","doi":"10.1007/s00702-024-02811-0","DOIUrl":"10.1007/s00702-024-02811-0","url":null,"abstract":"<p><p>Early-onset Parkinson's disease (EOPD) occurs during the fertile life, when circulating neuroactive sex hormones might enhance the sexual dimorphism of the disease. Here, we aimed to examine how sex hormones can contribute to sex differences in EOPD patients. A cohort of 34 EOPD patients, 20 males and 14 females, underwent comprehensive clinical evaluation of motor and non-motor disturbances. Blood levels of estradiol, total testosterone, follicle-stimulating hormone, and luteinizing hormone were measured in all patients and correlated to clinical features. We found that female patients exhibited greater non-motor symptoms and a relatively higher rate of dystonia than males. In females, lower estradiol levels accounted for higher MDS-UPDRS-II and III scores and more frequent motor complications, while lower testosterone levels were associated with a major occurrence of dystonia. In male patients, no significant correlations emerged. In conclusion, this study highlighted the relevance of sex hormone levels in the sexual dimorphism and unique phenotype of EOPD.</p>","PeriodicalId":16579,"journal":{"name":"Journal of Neural Transmission","volume":" ","pages":"61-66"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141759206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Caterina Pauletti, Daniela Mannarelli, Flavia Pauri, Alessia Petritis, Andrea Maffucci, Antonio Currà, Francesco Fattapposta
{"title":"The role of fatigue in attentional processing in multiple sclerosis: data from event-related potentials.","authors":"Caterina Pauletti, Daniela Mannarelli, Flavia Pauri, Alessia Petritis, Andrea Maffucci, Antonio Currà, Francesco Fattapposta","doi":"10.1007/s00702-024-02827-6","DOIUrl":"10.1007/s00702-024-02827-6","url":null,"abstract":"<p><p>Fatigue is an extremely common symptom in in people with multiple sclerosis (PwMS) and has a severe impact on quality of life. The purpose of the present study was to verify whether fatigue in PwMS is associated with a selective covert attention impairment, as measured by event-related potentials and to assess whether it is more associated with an impairment of top-down or bottom-up attentional control. Twenty-two PwMS and fatigue-MSF, 17 without fatigue-MSnF and 35 healthy volunteers underwent a three-stimulus P300 novelty task that elicits both the P3a and the P3b components. P3b latency was comparable between groups, but PwMS, independently from the presence of fatigue displayed significantly greater P3b amplitudes. P3a latency was significantly prolonged in MSF alone, while P3a amplitude in MSnF group was greater than controls. MSF were able to categorize the task-relevant target stimulus but the orienting response to a novel salient stimulus was delayed, indicating an impairment in bottom-up attentional control mechanism related to ventral attention network. Fatigue is selectively associated with a covert attentional deficit related to the ability to reallocate attentional resources to salient stimuli, a crucial function of adaptive decision-making behaviour.</p>","PeriodicalId":16579,"journal":{"name":"Journal of Neural Transmission","volume":" ","pages":"105-115"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142080555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yuan Yang, Die Zhang, Yuchao Li, Cui Li, Liping Zhu, Guoshuai Luo
{"title":"Sleep disorders among frontline nurses after the COVID-19 outbreak: a large-scale cross-sectional study.","authors":"Yuan Yang, Die Zhang, Yuchao Li, Cui Li, Liping Zhu, Guoshuai Luo","doi":"10.1007/s00702-024-02836-5","DOIUrl":"10.1007/s00702-024-02836-5","url":null,"abstract":"<p><p>This large-scale cross-sectional multicenter study aims to investigate the prevalence of sleep disorders among frontline nurses in China after the COVID-19 pandemic and to identify potential influencing factors contributing to these sleep disturbances. A total of 2065 frontline nurses from 27 provinces in China participated in an online survey conducted through the Wenjuan Xing platform. Data on demographic characteristics, work-related factors, and mental health assessments, including the Pittsburgh Sleep Quality Index (PSQI), Zung Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS), were collected. Statistical analyses, including chi-square tests, t-tests, binary logistic regression, and ROC analysis, were conducted to explore the relationships between various factors and sleep disorders. Over half (52.7%) of the surveyed nurses exhibited sleep disorders, reflecting a considerable post-pandemic impact on sleep quality. Factors such as nursing titles, personality traits, COVID-19 infection status, and exercise frequency showed statistically significant associations with sleep disorders. Extraverted nurses and those who had recovered from COVID-19 displayed a lower risk of sleep disorders, while anxiety was identified as an independent risk factor. The study also identified a nuanced relationship between exercise frequency and sleep quality. The study highlights a high prevalence of sleep disorders among frontline nurses post-COVID-19, emphasizing the need for targeted interventions. Factors such as nursing titles, personality traits, COVID-19 infection status, exercise habits, and anxiety levels were found to influence sleep quality. Comprehensive support strategies addressing these factors are essential for improving the overall well-being of frontline nurses and, subsequently, sustaining a resilient healthcare workforce. Further research is recommended to explore additional influencing factors and consider diverse nurse populations.</p>","PeriodicalId":16579,"journal":{"name":"Journal of Neural Transmission","volume":" ","pages":"139-147"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Qiao Su, Qinghe Liu, Baozhu Li, Zhonghui Ma, Fengfeng Bai, Yanzhe Li, Xue Yu, Meijuan Li, Jie Li, Daliang Sun
{"title":"Exploration of plasma biomarkers for Alzheimer's disease by targeted lipid metabolomics based on nuclear magnetic resonance (NMR) spectroscopy.","authors":"Qiao Su, Qinghe Liu, Baozhu Li, Zhonghui Ma, Fengfeng Bai, Yanzhe Li, Xue Yu, Meijuan Li, Jie Li, Daliang Sun","doi":"10.1007/s00702-024-02844-5","DOIUrl":"10.1007/s00702-024-02844-5","url":null,"abstract":"<p><p>Alzheimer's disease (AD) is the most common cause of dementia, but the disease lacks convenient and cost-effective alternative biomarkers currently. We utilized targeted lipid metabolomics based on nuclear magnetic resonance (NMR) spectroscopy to identify plasma biomarkers in AD patients. Our study was a cross-sectional study that enrolled 58 AD patients and 40 matched health controls (HCs). Firstly, we identified plasma lipid metabolites that were significantly different between the two groups based on P < 0.05 and variable importance in the projection (VIP) > 1. Then we examined the correlation between the lipid metabolites and cognitive function using partial correlation analysis and assessed the diagnostic ability of the lipid metabolites using receiver operating characteristic (ROC) curves. Seventeen lipoproteins showed significant differences between AD patients and HCs among 114 lipid metabolites. All 17 lipoproteins were subtypes of low-density lipoprotein (LDL). Among them, LDL-3 particle number, LDL-3 apolipoprotein-B, LDL-3 phospholipids, LDL free cholesterol and LDL phospholipids were significantly correlated with cognitive function. The ROC curves showed that LDL-2 triglycerides (TG) and LDL-3 TG could significantly distinguish AD patients from HCs, with the area under the curve (AUC) above 0.7. In addition, we explored a strategy of combined diagnosis that significantly improved the diagnostic efficacy for AD (AUC = 0.879). Our study provides insight into the lipoprotein alterations associated with AD and potential biomarkers for its diagnosis and cognitive function assessment.</p>","PeriodicalId":16579,"journal":{"name":"Journal of Neural Transmission","volume":" ","pages":"129-138"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Monica Grigore, Mihai Andrei Ruscu, Dirk M Hermann, Ivan-Cezar Colita, Thorsten Roland Doeppner, Daniela Glavan, Aurel Popa-Wagner
{"title":"Biomarkers of cognitive and memory decline in psychotropic drug users.","authors":"Monica Grigore, Mihai Andrei Ruscu, Dirk M Hermann, Ivan-Cezar Colita, Thorsten Roland Doeppner, Daniela Glavan, Aurel Popa-Wagner","doi":"10.1007/s00702-024-02837-4","DOIUrl":"10.1007/s00702-024-02837-4","url":null,"abstract":"<p><p>Psychotropic drugs are vital in psychiatry, aiding in the management of mental health disorders. Their use requires an understanding of their pharmacological properties, therapeutic applications, and potential side effects. Ongoing research aims to improve their efficacy and safety. Biomarkers play a crucial role in understanding and predicting memory decline in psychotropic drug users. A comprehensive understanding of biomarkers, including neuroimaging, biochemical, genetic, and cognitive assessments, is essential for developing targeted interventions and preventive strategies. In this narrative review, we performed a comprehensive search on PubMed and Google using review-specific terms. Clinicians should use a multifaceted approach, including neurotransmitter analysis, neurotrophic factors, miRNA profiling, and cognitive tasks for early intervention and personalized treatment. Anxiolytics' mechanisms involve various neurotransmitter systems and emerging targets. Research on biomarkers for memory decline in anxiolytic users can lead to early detection and intervention, enhancing clinical practices and aligning with precision medicine. Mood stabilizer users can benefit from early detection of memory decline through RNA, neurophysiological, and inflammatory biomarkers, promoting timely interventions. Performance-enhancing drugs may boost athletic performance in the short term, but their long-term health risks and ethical issues make their use problematic. Long-term use of psychotropic performance enhancers in athletes shows changes in biomarkers of cognitive decline, necessitating ongoing monitoring and intervention strategies. Understanding these genetic influences on memory decline helps pave the way for personalized approaches to prevent or mitigate cognitive deterioration, emphasizing the importance of genetic screening and early interventions based on an individual's genetic profile. Future research should focus on refining these biomarkers and protective measures against cognitive deterioration. Overall, a comprehensive understanding of biomarkers in psychotropic drug users is essential for developing targeted interventions and preventive strategies.</p>","PeriodicalId":16579,"journal":{"name":"Journal of Neural Transmission","volume":" ","pages":"39-59"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Unraveling the mechanisms of high-level gait control in functional gait disorders.","authors":"Angela Sandri, Chiara Bonetto, Mirta Fiorio, Francesca Salaorni, Giulia Bonardi, Christian Geroin, Nicola Smania, Michele Tinazzi, Marialuisa Gandolfi","doi":"10.1007/s00702-024-02829-4","DOIUrl":"10.1007/s00702-024-02829-4","url":null,"abstract":"<p><p>Functional gait disorders (FGDs) are a disabling subset of Functional Neurological Disorders in which presenting symptoms arise from altered high-level motor control. The dual-task paradigm can be used to investigate mechanisms of high-level gait control. The study aimed to determine the objective measures of gait that best discriminate between individuals with FGDs and healthy controls and the relationship with disease severity and duration. High-level spatiotemporal gait outcomes were analyzed in 87 patients with FGDs (79.3% women, average age 41.9±14.7 years) and 48 healthy controls (60.4% women, average age 41.9±15.7 years) on single and motor, cognitive, and visual-fixation dual tasks. The area under the curve (AUC) from the receiver operator characteristic plot and the dual-task effect (DTE) were calculated for each measure. Dual-task interference on the top single-task gait characteristics was determined by two-way repeated measures ANOVA. Stride time variability and its standard deviation (SD) failed to discriminate between the two groups in single and dual-task conditions (AUC<0.80 for all). Significant group x task interactions were observed for swing time SD and stride time on the cognitive dual tasks (p<0.035 for all). Longer disease duration was associated with poor gait performance and unsteadiness in motor and cognitive DTE (p<0.003) but improvement in stride length and swing time on the visual dual tasks (p<0.041). Our preliminary findings shed light on measures of gait automaticity as a diagnostic and prognostic gait biomarker and underline the importance of early diagnosis and management in individuals with FGDs.</p>","PeriodicalId":16579,"journal":{"name":"Journal of Neural Transmission","volume":" ","pages":"95-104"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"An efficient ranking-based ensembled multiclassifier for neurodegenerative diseases classification using deep learning.","authors":"Palak Goyal, Rinkle Rani, Karamjeet Singh","doi":"10.1007/s00702-024-02830-x","DOIUrl":"10.1007/s00702-024-02830-x","url":null,"abstract":"<p><p>Neurodegenerative diseases are group of debilitating and progressive disorders that primarily affect the structure and functions of nervous system, leading to gradual loss of neurons and subsequent decline in cognitive, and behavioral activities. The two frequent diseases affecting the world's significant population falling in the above category are Alzheimer's disease (AD) and Parkinson's disease (PD). These disorders substantially impact the quality of life and burden healthcare systems and society. The demographic characteristics, and machine learning approaches have now been employed to diagnose these illnesses; however, they possess accuracy limitations. Therefore, the authors have developed ranking-based ensemble approach based on the weighted strategy of deep learning classifiers. The whole modeling procedure of the proposed approach incorporates three phases. In phase I, preprocessing techniques are applied to clean the noise in datasets to make it standardized according to deep learning models as it significantly impacts their performance. In phase II, five deep learning models are selected for classification and calculation of prediction results. In phase III, a ranking-based ensemble approach is proposed to ensemble the results of the five models after calculating the ranks and weights of them. In addition, the Magnetic Resonance Imaging (MRI) datasets named Alzheimer's Disease Neuroimaging Initiative (ADNI) for AD classification and Parkinson's Progressive Marker Initiative (PPMI) for PD classification are selected to validate the proposed approach. Furthermore, the proposed method achieved the classification accuracy on AD- Cognitive Normals (CN) at 97.89%, AD- Mild Cognitive Impairment (MCI) at 99.33% and CN-MCI at 99.44% and on PD-CN at 99.22%, PD- Scans Without Evidence of Dopaminergic Effect (SWEDD) at 97.56% and CN-SWEDD at 98.22% respectively. Also, the multi-class classification shows the promising accuracy of 97.18% for AD and 97.85% for PD for the proposed framework. The findings of the study show that the proposed deep learning-based ensemble technique is competitive for AD and PD prediction in both multiclass and binary class classification. Furthermore, the proposed approach enhances generalization performance in diagnosing neurodegenerative diseases and performs better than existing approaches.</p>","PeriodicalId":16579,"journal":{"name":"Journal of Neural Transmission","volume":" ","pages":"67-93"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}