Journal of the Neurological Sciences最新文献

{"title":"Response to Letter","authors":"Qiaoshu Wang, Guodong Wang","doi":"10.1016/j.jns.2026.125800","DOIUrl":"10.1016/j.jns.2026.125800","url":null,"abstract":"","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"482 ","pages":"Article 125800"},"PeriodicalIF":3.2,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146190424","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":"Plasma neurofilament light chain in pediatric hereditary spastic paraplegia","authors":"Jacopo Sartorelli ,&nbsp;Sara Petrillo ,&nbsp;Giacomo De Luca ,&nbsp;Irene Mizzoni ,&nbsp;Gessica Vasco ,&nbsp;Viola Ceccatelli ,&nbsp;Andrea Sancesario ,&nbsp;Lorena Travaglini ,&nbsp;Adele D'Amico ,&nbsp;Enrico Bertini ,&nbsp;Fiorella Piemonte ,&nbsp;Francesco Nicita","doi":"10.1016/j.jns.2026.125788","DOIUrl":"10.1016/j.jns.2026.125788","url":null,"abstract":"<div><h3>Background</h3><div>Plasma neurofilament light chain (pNfL) is increasingly investigated as a biomarker of axonal damage in several neurological disorders, including hereditary spastic paraplegias (HSPs). Currently, very few studies are focused on pediatric HSPs.</div></div><div><h3>Methods</h3><div>Plasma NfL levels were measured in 40 pediatric (e.g., &lt;18 years) subjects affected by genetically solved or unsolved HSPs. For 31 subjects, longitudinal NfL evaluation was also available. Potential correlation between pNfL and disease-specific or non-specific features were explored.</div></div><div><h3>Results</h3><div>Median age at enrollment was 11.53 years, with a median disease duration of 9 years and a median NfL level of 8.5 pg/mL. At baseline, pNfL did not differ across SPG, vs non-SPG HSPs, GMFCS levels, pure vs complex phenotype (with a non-statistically significant increase in the latter) and early- vs childhood-onset forms. Higher levels were observed in subjects with shorter disease duration from onset. Genetically unsolved individuals exhibited non-significant reduced levels compared with genetically confirmed cases. Plasma NfL presented a similar age-related trajectory as in the healthy pediatric population, with a possible trend of increase in younger children. Finally, no differences were observed at longitudinal NfL evaluation after a median period of 9 months.</div></div><div><h3>Conclusions</h3><div>This study is the first pediatric-focused work exploring utility of pNfL in HSPs. NfL levels showed a tendency of increase especially in complex forms, in younger subjects and with shorter disease duration from onset. Lower levels were observed in genetically unsolved individuals. Larger and longer studies are warranted to further define NfL utility as a clinically relevant biomarker in pediatric HSPs.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"482 ","pages":"Article 125788"},"PeriodicalIF":3.2,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132254","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":"Long-term cognitive outcomes and persistent executive dysfunction in LGI1 autoimmune encephalitis","authors":"Dror Shir ,&nbsp;Orna Aizenstein ,&nbsp;Yael Paran ,&nbsp;Yifat Alcalay ,&nbsp;Avi Gadoth","doi":"10.1016/j.jns.2026.125789","DOIUrl":"10.1016/j.jns.2026.125789","url":null,"abstract":"<div><h3>Background</h3><div>Leucine-rich glioma-inactivated 1 (LGI1) antibody-associated autoimmune encephalitis (AE) presents with cognitive and behavioral disturbances. Although most patients improve with immunotherapy, long-term domain-specific cognitive outcomes have not been thoroughly studied. We examined long-term cognitive trajectories in LGI1-AE, with a focus on executive dysfunction.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study of 18 LGI1-AE patients followed at a single tertiary center (2015–2025) for a median of 44 months [range 6–82]. Cognitive function was assessed using Montreal Cognitive Assessment (MoCA) and its subscales, including a broad Executive Index Score (EIS), a narrow executive composite, and delayed recall. We studied the course of cognitive function using repeated evaluations on follow up visits. Longitudinal changes were analyzed using the Wilcoxon signed-rank test, and predictors of outcomes were evaluated by regression analysis.</div></div><div><h3>Results</h3><div>Global cognition improved significantly from first to last visit (median MoCA 20 to 24, <em>p</em> = 0.001). Executive function and delayed recall also showed gains (p = 0.001 and <em>p</em> = 0.024, respectively). Younger patients (≤65 y) outperformed older patients at presentation and follow-up, despite similar immunotherapy timing (MoCA: 26 vs. 19, <em>p</em> = 0.016 and EIS: 12.5 vs. 9.5, <em>p</em> = 0.009). Improvement magnitude was similar across ages. Regression showed initial MoCA predicted long-term global cognition (<em>p</em> = 0.001), while both initial EIS (<em>p</em> = 0.036) and age at onset (<em>p</em> = 0.007) independently predicted executive outcomes.</div></div><div><h3>Conclusions</h3><div>Cognitive outcomes in LGI1 autoimmune encephalitis improve after immunotherapy, yet executive dysfunction frequently persists as a long-term deficit. Older age independently predicts poorer outcomes, suggesting that age-related vulnerability may limit recovery.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"482 ","pages":"Article 125789"},"PeriodicalIF":3.2,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132292","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":"Correlation between blood biomarkers and patient-reported outcomes (PROs) of depression and mental health scores in individuals with multiple sclerosis (iwMS)","authors":"Moogeh Baharnoori ,&nbsp;Bonnie Glanz ,&nbsp;Mariann Polgar-Turcsanyi ,&nbsp;Shrishti Saxena ,&nbsp;Howard Weiner ,&nbsp;Brian Healy ,&nbsp;Tanuja Chitnis","doi":"10.1016/j.jns.2026.125786","DOIUrl":"10.1016/j.jns.2026.125786","url":null,"abstract":"<div><h3>Background</h3><div>Serum neurofilament light chain (sNfL) and glial fibrillary acidic protein (sGFAP) are promising biomarkers for Multiple Sclerosis (MS) disease activity. There is less known about their association with the symptomatic phenotypes such as depression and mental health outcomes.</div></div><div><h3>Objectives</h3><div>To investigate the association between sNfL and sGFAP and Patient-Reported Outcome (PRO) measures for depression and overall mental health in individuals with MS (iwMS).</div></div><div><h3>Methods</h3><div>Participants completed the Center for Epidemiological Studies Depression Scale (CES<img>D) and MS Quality of Life-54 (MSQOL-54)- at the time of the blood draw. Linear regression was used to estimate the association between the PRO measures as the outcome and the log-transformed biomarkers as the predictor. The association between baseline biomarkers and longitudinal change in PROs was estimated using linear mixed-effect models.</div></div><div><h3>Results</h3><div>Cross-sectional analysis showed a significant correlation between sNFL and CES-D (<em>p</em> = 0.035) and MSQOL-54 Mental Health Composite (MHC) (<em>p</em> = 0.003) scores. This association remained statistically significant after adjusting for sex, age, EDSS and MS treatment. Neither cross-sectional nor longitudinal analysis of sGFAP levels showed significant correlation with PROs scores.</div></div><div><h3>Conclusion</h3><div>Serum NfL is associated with depression and overall mental health scores in iwMS. We did not find a significant relationship between sGFAP and PRO measures.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"482 ","pages":"Article 125786"},"PeriodicalIF":3.2,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125404","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":"Author response to letter to the editor","authors":"A. Mameli ,&nbsp;L. Indovina ,&nbsp;F. Cocciolillo ,&nbsp;A. Serra ,&nbsp;F. Marongiu ,&nbsp;D. Barcellona","doi":"10.1016/j.jns.2026.125793","DOIUrl":"10.1016/j.jns.2026.125793","url":null,"abstract":"","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"482 ","pages":"Article 125793"},"PeriodicalIF":3.2,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137545","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":"Beyond chronology: A multi-faceted approach to optimizing endovascular treatment for unruptured aneurysms in the elderly","authors":"Zhaomei Li ,&nbsp;Xian Wang ,&nbsp;Wenxin Wang","doi":"10.1016/j.jns.2026.125790","DOIUrl":"10.1016/j.jns.2026.125790","url":null,"abstract":"<div><div>We commend Matsukawa et al. for their study on outcomes of endovascular treatment (EVT) for unruptured intracranial aneurysms (UIAs) across age groups. While their findings support EVT in the elderly, we highlight four areas for deeper consideration. First, the divergent 30- and 90-day outcomes in the ≥80-year group suggest a distinct recovery trajectory, warranting finer-grained functional assessments beyond the mRS to differentiate transient post-procedural stress from permanent injury. Second, we advocate for incorporating advanced morphological and hemodynamic analyses (e.g., CFD) to understand the interplay between age, aneurysm characteristics, and outcomes. Third, for long-term durability, we recommend using Kaplan-Meier curves and competing risk analysis to provide a more accurate estimate of EVT benefit in the elderly. Finally, we underscore the need to move beyond chronological age by integrating frailty scales (e.g., CFS) and call for prospective, multi-center registries to confirm these findings and establish best practices. A multi-faceted approach is crucial for personalizing UIA management in our aging population.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"482 ","pages":"Article 125790"},"PeriodicalIF":3.2,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137619","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":"Futile recanalisation in patients with anterior large vessel occlusion stroke randomised to mechanical thrombectomy","authors":"Hannah-Lea Handelsmann ,&nbsp;Lisa Herzog ,&nbsp;Arnolt-Jan Hoving ,&nbsp;Charles Majoie ,&nbsp;Wim Van Zwam ,&nbsp;Aad Van der Lugt ,&nbsp;Susanne Wegener ,&nbsp;for the MR CLEAN Investigators","doi":"10.1016/j.jns.2026.125772","DOIUrl":"10.1016/j.jns.2026.125772","url":null,"abstract":"<div><h3>Background</h3><div>Mechanical thrombectomy (MT) is an effective treatment of large vessel occlusion (LVO) stroke. However, about 50% of patients do not achieve a favourable functional outcome after successful recanalisation by MT, considered as futile recanalisation (FR). We aimed at identifying factors associated with treatment response, vessel recanalisation and clinical outcome in LVO stroke patients randomised to MT and to predict FR to evaluate the effect of single predictors on patient outcome.</div></div><div><h3>Methods</h3><div>We performed a retrospective analysis of the MR CLEAN trial cohort. Ordinal logistic regression with interaction terms between a treatment indicator and patient factors was used to evaluate response to MT in terms of 3-months modified Rankin scale (mRS). In logistic regression, we identified factors associated with vessel recanalisation and FR. We predicted FR in a five-fold cross validation using least absolute shrinkage and selection operator (LASSO) regression.</div></div><div><h3>Results</h3><div>195 of the 461 included patients were randomised to receive MT. Male sex (OR 0.41, 95% CI 0.21–0.82, <em>p</em> = 0.01) enhanced the treatment effect of MT. Only onset-to-groin time was associated with a technically successful recanalisation (OR 0.99, 95% CI 0.99–1.00, <em>p</em> = 0.01). Higher age (OR 1.05, 95% CI 1.01–1.09, <em>p</em> = 0.02) and worse collateral score (OR 0.05, 95% CI 0.01–0.19, <em>p</em> &lt; 0.01) were associated with FR. Female sex (OR 0.74) and worse collateral status (OR 0.19) showed the best predictive value for FR.</div></div><div><h3>Conclusions</h3><div>Different patient factors seem to be relevant for technical success and clinical success of MT in LVO stroke patients.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"482 ","pages":"Article 125772"},"PeriodicalIF":3.2,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146090429","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":"Letter to editor: Early real-life experience on zilucoplan for generalized myasthenia gravis: ZILU25 multicenter observational study","authors":"Muhammad Uzair ,&nbsp;Ali Momin","doi":"10.1016/j.jns.2026.125759","DOIUrl":"10.1016/j.jns.2026.125759","url":null,"abstract":"","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"482 ","pages":"Article 125759"},"PeriodicalIF":3.2,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137564","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":"Letter to the Editor RE: Functional imaging reveals cerebral microvascular dysfunction in primary antiphospholipid syndrome: Pathophysiologic insights and translational implications","authors":"Harriet A. Carroll","doi":"10.1016/j.jns.2026.125794","DOIUrl":"10.1016/j.jns.2026.125794","url":null,"abstract":"","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"482 ","pages":"Article 125794"},"PeriodicalIF":3.2,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137532","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":"Analysis of prognostic factors in acute encephalopathy with biphasic seizures and late reduced diffusion: a retrospective study on MRI findings and the treatments","authors":"Masataka Fukuoka ,&nbsp;Ichiro Kuki ,&nbsp;Megumi Nukui ,&nbsp;Takeshi Inoue ,&nbsp;Hideo Okuno ,&nbsp;Junichi Ishikawa ,&nbsp;Yasunori Otsuka ,&nbsp;Kiyoko Amo ,&nbsp;Masao Togawa ,&nbsp;Hiroshi Rinka ,&nbsp;Masashi Shiomi ,&nbsp;Shin Okazaki","doi":"10.1016/j.jns.2026.125760","DOIUrl":"10.1016/j.jns.2026.125760","url":null,"abstract":"<div><h3>Background</h3><div>Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is a subtype of acute encephalopathy diagnosed based on its characteristic clinical course and imaging findings. However, AESD presents with various symptoms and diverse neurological outcomes. We aimed to identify prognostic factors for AESD by analyzing clinical data.</div></div><div><h3>Methods</h3><div>This retrospective study included patients diagnosed with AESD at our institution between 1997 and 2015. 57 patients (29 male and 28 female) were included for analysis, with a median age at onset of 13 months (interquartile range: 11–22 months). Short-term outcome was defined as neurological status at 6 months post-onset, and long-term outcome as status at more than 2 years post-onset. Patients were categorized into favorable (Pediatric Cerebral Performance Category [PCPC] 1–2) and unfavorable (PCPC 3–6) outcome groups. We reviewed the clinical course, laboratory data (blood and cerebrospinal fluid during the early and late seizure phases), magnetic resonance imaging (MRI) findings, and treatment interventions. Univariate and multivariate logistic regression analyses were conducted to identify prognostic factors (<em>p</em> &lt; 0.05 was considered statistically significant).</div></div><div><h3>Results</h3><div>In the multivariate analysis, extensive MRI lesions were significantly associated with poor short-term outcomes (<em>p</em> = 0.009, odds ratio [OR] 8.333), while edaravone use was significantly associated with favorable long-term outcomes (<em>p</em> = 0.007, OR 0.105).</div></div><div><h3>Conclusions</h3><div>The extent of MRI lesions predicted short-term outcomes, while edaravone administration was associated with improved long-term outcomes in patients with AESD.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"482 ","pages":"Article 125760"},"PeriodicalIF":3.2,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146048952","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}