Journal of the Neurological Sciences最新文献

{"title":"Multiple sclerosis twin study reveals distinct genetic, disease-specific, and psychometric impact on coping with critical life events","authors":"Daniel Engels ,&nbsp;Andrea Flierl-Hecht ,&nbsp;Gabriela Shalaginova ,&nbsp;Stephanie Rek ,&nbsp;Daniel Keeser ,&nbsp;Matthias A. Reinhard ,&nbsp;Frank Padberg ,&nbsp;Tania Kümpfel ,&nbsp;Lisa Ann Gerdes","doi":"10.1016/j.jns.2024.123381","DOIUrl":"10.1016/j.jns.2024.123381","url":null,"abstract":"<div><h3>Background</h3><div>Critical life events challenge our competence to develop coping strategies. In people with multiple sclerosis (MS), the impact of genetics, disease-specific, and psychometric factors on coping strategies have not been explored to date.</div></div><div><h3>Methods</h3><div>In a unique cohort of 56 monozygotic twins discordant for MS, we applied comprehensive psychometric and clinical testing to measure factors influencing the psychosocial impact (including stressors and coping strategies) of a critical life event, exemplified by the COVID-19 pandemic (measured by the COVID-19 Pandemic Mental Health Questionnaire, CoPaQ). CoPaQ results were compared to an independent age- and sex-matched control cohort. We applied factor analysis, structural equation modeling, hypothesis testing, and regression models.</div></div><div><h3>Results</h3><div>We detected no differences in the perception of 14 CoPaQ subscales between MS and non-MS co-twins. However, compared to the independent control group, MS co-twins valued 5/14 CoPaQ subscales differently. Strong perception of pandemic-related stressors in MS co-twins was accompanied by higher HADS-Anxiety (<em>ρ</em> = 0.69, Hospital Anxiety and Depression Scale), HADS-Depression (<em>ρ</em> = 0.57), BDI-II (<em>ρ</em> = 0.74, Beck Depression Inventory), and MSIS-29-psychological scores (<em>ρ</em> = 0.58, Multiple Sclerosis Impact Scale 29). In a generalized linear mixed model, individuals who perceived pandemic-related stressors as more burdensome relied on inner resources, with a notable dependency on twinship.</div></div><div><h3>Discussion</h3><div>Using a unique twin approach, our study suggests that coping with critical life events is mainly driven by the genetic background. However, in people with MS, coping and the perception of stressors is further confounded by psychometric and disease-related factors.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"469 ","pages":"Article 123381"},"PeriodicalIF":3.6,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971580","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":"Should antinuclear antibodies (ANA) be used to screen for connective tissue disease in neurological patients?","authors":"Erez Magiel ,&nbsp;Yuval Kozlov ,&nbsp;Tomer Goldberg ,&nbsp;Roni Loebenstein ,&nbsp;Abdualla Watad ,&nbsp;Omer Gendelman ,&nbsp;Saar Anis","doi":"10.1016/j.jns.2024.123374","DOIUrl":"10.1016/j.jns.2024.123374","url":null,"abstract":"<div><h3>Background</h3><div>Patients with connective tissue diseases (CTD) can have a wide range of neurological manifestations. Neurological complaints may be the presenting symptom of CTD. Therefore, screening for CTD using anti-nuclear antibodies (ANA) is a common practice. However, due to the abundance of positive ANA in a healthy population, interpretation of the results may be complex.</div></div><div><h3>Methods</h3><div>we retrospectively evaluated files of patients hospitalized for evaluation of neurological symptoms in Sheba Medical Center during the years 2007–2022. Data was collected regarding epidemiology, ANA status, and rheumatological diagnosis.</div></div><div><h3>Results</h3><div>4723 patients' files were reviewed. Of them, 46.6 % were positive for ANA. 6.9 % of them were diagnosed with CTD. This population had significantly higher rates of positive ANA status (71.2 % vs 28.8 %, <em>p</em> &lt; 0.001), was significantly older (59.4 vs 53.4 years, p &lt; 0.001) and had a significantly higher ANA titer (1:484.8, 1:268 p &lt; 0.001) compared to patients without CTD. Factors which were found predictive for CTD diagnosis included female gender, older age, ANA titer above 1:160, and the diagnosis of a non-vascular etiology for the neurological disease.</div></div><div><h3>Conclusion</h3><div>Females, older patients, patients with high ANA titer and with diagnosis of a non-vascular cause to their neurological complains may be more likely to harbor a CTD and should probably be further evaluated.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"469 ","pages":"Article 123374"},"PeriodicalIF":3.6,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prognostic role of iron deficiency in acute ischemic stroke patients: A prospective multicentric cohort study","authors":"Antonio Ciacciarelli ,&nbsp;Anne Falcou ,&nbsp;Ettore Nicolini ,&nbsp;Aldobrando Broccolini ,&nbsp;Giovanni Frisullo ,&nbsp;Serena Abruzzese ,&nbsp;Irene Scala ,&nbsp;Sabrina Anticoli ,&nbsp;Elisa Testani ,&nbsp;Ennio Montinaro ,&nbsp;Cristina Ranchicchio ,&nbsp;Manuela De Michele ,&nbsp;Danilo Toni","doi":"10.1016/j.jns.2024.123371","DOIUrl":"10.1016/j.jns.2024.123371","url":null,"abstract":"<div><h3>Background and aims</h3><div>Iron deficiency (ID) is a prognostic factor in heart failure and acute coronary syndrome. However, its role in cerebrovascular diseases is controversial. We aimed to determine the impact of ID on the functional outcome of acute ischemic stroke patients.</div></div><div><h3>Methods</h3><div>This was an observational prospective multicentric cohort study. From January to December 2023, we enrolled acute ischemic stroke patients admitted to the stroke units of four comprehensive stroke centers. Venous blood samples were collected at admission to determine the iron status (serum iron, ferritin, transferrin). ID was defined as a serum ferritin concentration &lt; 100 ng/mL or 100–299 ng/mL with transferrin saturation (TSAT) &lt;20 %. The primary endpoint was the poor functional outcome at 90 days defined as modified Rankin Scale (mRS) 3–6. We used binary logistic regression models including confounding factors to test the association between ID and the primary outcome.</div></div><div><h3>Results</h3><div>The analysis included 442 patients (mean age 73 ± 13, 47.5 % female, median NIHSS 7 [IQR 3–15], 61.3 % treated with intravenous thrombolysis and/or endovascular treatment). ID prevalence was 65.6 %. In all binary logistic regression models, ID predicted poor functional outcome at 3 months irrespective from demographics, stroke severity and characteristics, anemia, risk factors, signs/symptoms of heart failure, glucose at admission, and inflammatory biomarkers (aOR 2.328, 95 % CI 1.272–4.263, <em>p</em> = 0.006).</div></div><div><h3>Conclusions</h3><div>ID was strongly associated with poor functional outcome at 90 days in acute ischemic stroke patients. Further research is required to explore whether iron supplementation could be a potential therapeutic strategy to improve patient outcomes.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"469 ","pages":"Article 123371"},"PeriodicalIF":3.6,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052954","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":"Clinical features of FOSMN syndrome in Korea: A comparative analysis with bulbar-onset amyotrophic lateral sclerosis","authors":"Woohee Ju ,&nbsp;Young Gi Min ,&nbsp;Jong-Su Kim ,&nbsp;Seokgeun Ryu ,&nbsp;Suk-Won Ahn ,&nbsp;Yoon-Ho Hong ,&nbsp;Seok-Jin Choi ,&nbsp;Jung-Joon Sung","doi":"10.1016/j.jns.2024.123372","DOIUrl":"10.1016/j.jns.2024.123372","url":null,"abstract":"<div><div>Facial onset sensory and motor neuronopathy (FOSMN) syndrome is a rare neurodegenerative disorder initially characterized by facial sensory deficits, which later progress to motor deficits in a rostral-caudal distribution. This study investigated the prevalence, clinical features, and prognosis of FOSMN syndrome and compared these aspects with those of bulbar-onset amyotrophic lateral sclerosis (ALS) within a single institutional cohort of motor neuron diseases. We identified four patients with FOSMN syndrome who had been misclassified as having bulbar-onset ALS, representing approximately 2 % of such ALS cases. The median age of onset for FOSMN syndrome was similar to that of bulbar-onset ALS. However, patients with FOSMN syndrome were often diagnosed at more advanced stages and had lower ALS Functional Rating Scale-revised (ALSFRS-R) scores. Despite the slower progression of FOSMN syndrome, therapeutic interventions such as gastrostomy or non-invasive ventilation were frequently required. In conclusion, this study provides detailed clinical profiles of patients with FOSMN syndrome and deepens our understanding of a heterogeneous group of neurodegenerative disorders.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"469 ","pages":"Article 123372"},"PeriodicalIF":3.6,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of white matter lesions and subclinical cerebral ischemia on postoperative cognitive training outcomes after heart valve surgery: A randomized clinical trial","authors":"Marius Butz ,&nbsp;Tibo Gerriets ,&nbsp;Gebhard Sammer ,&nbsp;Jasmin El-Shazly ,&nbsp;Tobias Braun ,&nbsp;Laura Sünner ,&nbsp;Rolf Meyer ,&nbsp;Marlene Tschernatsch ,&nbsp;Patrick Schramm ,&nbsp;Stefan T. Gerner ,&nbsp;Thorsten R. Doeppner ,&nbsp;Thomas Mengden ,&nbsp;Yeong-Hoon Choi ,&nbsp;Markus Schoenburg ,&nbsp;Martin Juenemann","doi":"10.1016/j.jns.2024.123370","DOIUrl":"10.1016/j.jns.2024.123370","url":null,"abstract":"<div><h3>Background</h3><div>White matter lesions and subclinical cerebral ischemia (SCI) are described as risk factors for postoperative cognitive decline (POCD) following cardiac surgery. This report aims to investigate the effect of brain lesions on postoperative cognitive training outcomes.</div></div><div><h3>Methods</h3><div>In a randomized, treatment-as-usual controlled trial, elderly patients scheduled for elective heart valve surgery participated. The postoperative cognitive training comprised paper-and-pencil exercises. Neuropsychological parameters were assessed preoperatively, at discharge from rehabilitation (immediately post-training), and at the 3-month follow-up. In addition, depression and anxiety (HADS) as well as health-related quality of life (SF-36) were evaluated. Brain lesions were identified using magnetic resonance imaging (training group: <em>n</em> = 18; control group: <em>n</em> = 21). Specifically, periventricular white matter lesions (PVWML) and deep white matter lesions (DWML) were assessed using T2-weighted/FLAIR sequences and categorized according to Fazekas scale. Volumetric analysis of SCI was conducted using diffusion-weighted imaging. To statistically control the impact of brain lesions on training outcomes, we employed analysis of covariance.</div></div><div><h3>Results</h3><div>Three-month follow-up results: When controlling for the independence of SCI on training outcomes, effects were evident for global cognition (<em>p</em> = 0.022) and SF-36 mental component summary (<em>p</em> = 0.003). Considering the impact of PVWML on training outcomes, trained participants showed better values in depression (<em>p</em> = 0.046) and SF-36 mental component summary (<em>p</em> = 0.013). In a subgroup analysis for patients with PVWML the training group demonstrated superior performance for language (<em>p</em> = 0.037). After adjusting for DWML, training effects were noticeable in the SF-36 mental component summary (<em>p</em> = 0.013).</div></div><div><h3>Conclusion</h3><div>Patients with brain lesions may benefit from cognitive training after cardiac surgery.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"469 ","pages":"Article 123370"},"PeriodicalIF":3.6,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A spectrum of neurological diseases with elevated cerebrospinal fluid adenosine deaminase levels","authors":"Hideo Handa ,&nbsp;Akiyuki Uzawa ,&nbsp;Atsuhiko Sugiyama ,&nbsp;Hajime Yokota ,&nbsp;Manato Yasuda ,&nbsp;Akio Kimura ,&nbsp;Takayoshi Shimohata ,&nbsp;Satoshi Kuwabara","doi":"10.1016/j.jns.2024.123368","DOIUrl":"10.1016/j.jns.2024.123368","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to investigate cerebrospinal fluid (CSF) adenosine deaminase (ADA) levels in various neurological disorders and examine the relationships between CSF ADA levels and immunological parameters.</div></div><div><h3>Methods</h3><div>Overall, 276 patients whose CSF ADA levels were measured for suspected tuberculous meningitis (TBM) were evaluated. Data on baseline characteristics, final diagnoses, CSF ADA levels, and other laboratory parameters were collected. Thereafter, CSF ADA levels were compared based on final diagnoses, and correlations between CSF ADA levels and other CSF and blood laboratory parameters were evaluated.</div></div><div><h3>Results</h3><div>Five diseases exhibited a significant increase in CSF ADA levels relative to the noninflammatory disease control group (<em>n</em> = 40): (1) TBM (<em>n</em> = 15, <em>p</em> &lt; 0.0001), (2) fungal meningitis (<em>n</em> = 7, <em>p</em> = 0.0400), (3) autoimmune glial fibrillary acidic protein astrocytopathy (GFAP-A, <em>n</em> = 7, <em>p</em> &lt; 0.0001), (4) neurosarcoidosis (<em>n</em> = 7, <em>p</em> = 0.0028), and (5) lymphoproliferative disorders (<em>n</em> = 18, <em>p</em> = 0.0001). Strong positive correlations were observed between CSF ADA and CSF parameters, including soluble IL2 receptor (<em>r_s</em> = 0.7566, <em>p</em> &lt; 0.0001), albumin (<em>r_s</em> = 0.6693, <em>p</em> &lt; 0.0001), lactate dehydrogenase (<em>r_s</em> = 0.6452, <em>p</em> &lt; 0.0001), white blood cell count (<em>r_s</em> = 0.6035, <em>p</em> &lt; 0.0001), protein (<em>r_s</em> = 0.6334, <em>p</em> &lt; 0.0001), and lymphocytes (<em>r_s</em> = 0.5954, <em>p</em> &lt; 0.0001).</div></div><div><h3>Discussion</h3><div>CSF ADA levels were elevated in various inflammatory neurological diseases, especially in TBM, fungal meningitis, GFAP-A, neurosarcoidosis, and lymphoproliferative disorders. CSF ADA levels may reflect T-cell hyperactivation in the central nervous system.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"469 ","pages":"Article 123368"},"PeriodicalIF":3.6,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927408","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 importance of early immunotherapy in anti-GluK2 antibody-positive autoimmune cerebellar ataxia: A case report","authors":"Yuto Takeishi ,&nbsp;Hiroaki Yaguchi ,&nbsp;Akihiko Kudo ,&nbsp;Shintaro Fujii ,&nbsp;Ikuko Iwata ,&nbsp;Taichi Nomura ,&nbsp;Mamiko Anada ,&nbsp;Kosuke Iwami ,&nbsp;Masanao Yoshino ,&nbsp;Daiki Tanaka ,&nbsp;Keiichi Mizushima ,&nbsp;Hisashi Uwatoko ,&nbsp;Shinichi Shirai ,&nbsp;Masaaki Matsushima ,&nbsp;Akio Kimura ,&nbsp;Keiko Tanaka ,&nbsp;Ichiro Yabe","doi":"10.1016/j.jns.2024.123306","DOIUrl":"10.1016/j.jns.2024.123306","url":null,"abstract":"","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"467 ","pages":"Article 123306"},"PeriodicalIF":3.6,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute DWI volume is a strong imaging predictor of favorable outcomes in patients with acute stroke and treated with mechanical thrombectomy","authors":"Yuki Sakamoto,&nbsp;Junya Aoki,&nbsp;Yuji Nishi,&nbsp;Sotaro Shoda,&nbsp;Ryutaro Kimura,&nbsp;Tomonari Saito,&nbsp;Takuya Kanamaru,&nbsp;Kentaro Suzuki,&nbsp;Takehiro Katano,&nbsp;Akihito Kutsuna,&nbsp;Shinichiro Numao,&nbsp;Takashi Shimoyama,&nbsp;Kazumi Kimura","doi":"10.1016/j.jns.2024.123334","DOIUrl":"10.1016/j.jns.2024.123334","url":null,"abstract":"<div><h3>Background</h3><div>Infarct volume on diffusion-weighted imaging (DWI) is a promising imaging marker for clinical outcomes in patients with acute stroke treated with mechanical thrombectomy (MT), but its predictive value has not been well evaluated, especially in consecutive patients. The present study aimed to elucidate the relationship between infarct volume and its change and favorable functional outcomes in consecutive patients with acute stroke who underwent MT.</div></div><div><h3>Method</h3><div>Of patients with consecutive acute stroke who underwent MT from September 2014 through December 2019, those who were pre-morbidly independent were enrolled. Infarct volume on DWI was measured at admission (DWI_initial) and 24 h after admission (DWI_24h) with semi-automated imaging software. Infarct growth (IG) was calculated as the difference between DWI_24h and DWI_initial. Factors associated with a favorable outcome (mRS score 0–2) 3 months after stroke onset were assessed by multivariable analyses. Model performance was evaluated with the C-statistic.</div></div><div><h3>Results</h3><div>A total of 251 patients (165 male [66 %], median age 75 [IQR 67–81] years, median NIHSS score 15 [7–21]) were enrolled in the present study. Multivariable logistic regression analysis showed that DWI_24h (OR 0.74, 95 % CI 0.62–0.87 for every 10-mL increment) and IG (0.74, 0.62–0.88 for every 10-mL increment) were independently and negatively associated with a favorable outcome. These associations were observed in patients with diverse vessel occlusions. Adding DWI_24h or IG to the conventional predictors of favorable outcomes improved predictive accuracy (<em>p</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>DWI infarct volume 24 h after admission and IG can be strong imaging predictors of favorable outcomes after MT.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"468 ","pages":"Article 123334"},"PeriodicalIF":3.6,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142756996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality and prognosis in herpes simplex Virus-1 encephalitis long-term follow up study","authors":"Mark Katson ,&nbsp;Alon Gorenshtein ,&nbsp;Jack Pepys ,&nbsp;Yair Mina ,&nbsp;Shahar Shelly","doi":"10.1016/j.jns.2024.123330","DOIUrl":"10.1016/j.jns.2024.123330","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Herpes simplex virus-1 (HSV-1) encephalitis is the most prevalent form of viral encephalitis worldwide. Consensus statements on the rate of mortality are lacking, with most studies emphasizing short-term mortality risks</div><div>. We aimed to describe variables effecting mortality for HSV-1 encephalitis in a long term well defined HSV cohorts.</div></div><div><h3>Methods</h3><div>This is a retrospective study, encephalitis patients who were HSV-positive (HSV- 1,HSV-2 and VZV) in the cerebrospinal fluid (CSF) in 23 years' time frame were compared. Clinical, electrophysiological, imaging, and laboratory data were analyzed.</div></div><div><h3>Results</h3><div>We identified 47 HSV-1, 8 HSV-2 and 216 with VZV patients with a molecular CSF PCR diagnosis. The median age at diagnosis was 63.3 (interquartile range(IQR) 50.42–72.52) for HSV-1, 46.79 (IQR 36.55–55.05) for HSV-2 and 60.33.</div><div>(IQR 33.78–74.11) for VZV (<em>p</em> = 0.14). The mean follow up time was 6.25 ± 5.92 years for the group as whole. Among HSV-1 patients, during the follow-up period, 26 patients (55.31 %) died. Ten deaths occurred within the first year, with a median age of death of 70.6 [63.53–75.39]. Patients who died were older (70.6 [63.53–75.39 vs.</div><div>48.59 [37.88–61.71], <em>p</em> &lt; 0.001), had a longer time to treatment initiation (4.01 ± 5.69 vs. 1.96 ± 3.58 days, <em>p</em> = 0.026), with cancer comorbidities more prevalent (42.3 % vs. 0 %, <em>p</em> &lt; 0.001). Univariate analysis showed older age (HR 1.07, 95 % CI 1.03–1.10, <em>p</em> &lt; 0.01), and cancer comorbidity (HR 5.55, 95 % CI 2.31–13.33, <em>p</em> &lt; 0.001) were associated with significantly higher risk for mortality. Multivariate analysis confirmed that older age (HR 1.096, 95 % CI 1.04–1.15, <em>p</em> &lt; 0.001), cancer comorbidity (HR 11.02, 95 % CI 2.76–43.9, p &lt; 0.001) and lower lymphocyte count (HR 0.97, 95 % CI 0.95–0.99, <em>p</em> = 0.032) influenced mortality risk. The optimal cut-off age to predict mortality based on AUC-ROC curve was 63.29 (AUC = 0.83, sensitivity = 0.76, specificity = 0.80, PPV = 0.83, NNV = 0.73, <em>p</em> &lt; 0.001). Patients above this age cutoff had a significantly greater cumulative incidence of mortality than did those aged 50–63 years (<em>p</em> &lt; 0.01).</div></div><div><h3>Discussion</h3><div>Mortality due to HSV-1 was high and highest in patients &gt;63 years or immunocompromised patients. Favorable outcomes were associated with increased lymphocyte levels in CSF, and early antiviral treatment. These finding may help explain the wide discrepancies in reported mortality rates for HSV encephalitis patients.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"468 ","pages":"Article 123330"},"PeriodicalIF":3.6,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142756995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent and future advances in intracerebral hemorrhage","authors":"Laurent Puy ,&nbsp;Nils Jensen Boe ,&nbsp;Melinda Maillard ,&nbsp;Gregory Kuchcinski ,&nbsp;Charlotte Cordonnier","doi":"10.1016/j.jns.2024.123329","DOIUrl":"10.1016/j.jns.2024.123329","url":null,"abstract":"<div><div>Spontaneous intracerebral hemorrhage (ICH) is defined by the rupture of a cerebral blood vessel and the entry of blood into the brain parenchyma. With a global incidence of around 3.5 million, ICH accounts for almost 30 % of all new strokes worldwide. It is also the deadliest form of acute stroke and survivors are at risk of poor functional outcome. The pathophysiology of ICH is a dynamic process with key stages occurring at successive times: vessel rupture and initial bleeding; hematoma expansion, mechanical mass effect and secondary brain injury (peri-hematomal edema). While deep perforating vasculopathy and cerebral amyloid angiopathy are responsible for 80 % of ICH, a prompt diagnostic work-up, including advanced imaging is require to exclude a treatable cause. ICH is a neurological emergency and simple therapeutic measures such as blood pressure lowering and anticoagulant reversal should be implemented as early as possible as part of a bundle of care. Although ICH is still devoided of specific treatment, recent advances give hope for a cautious optimism. Therapeutic approaches under the scope are focusing on fighting against hemorrhage expansion, promoting hematoma evacuation by minimally invasive surgery, and reducing secondary brain injury. Among survivors, the global vascular risk is now better established, but optimal secondary prevention is still unclear and is based on an individual benefit-risk balance evaluation.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"467 ","pages":"Article 123329"},"PeriodicalIF":3.6,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}