Journal of the Neurological Sciences最新文献

{"title":"A transdisciplinary, evidence-based model of ambulatory care may reduce emergency department presentations for patients with functional neurological disorder: A retrospective pre-post-intervention service evaluation","authors":"Lauren Maassen ,&nbsp;Nathan Fox ,&nbsp;Kathy Stiller","doi":"10.1016/j.jns.2025.123671","DOIUrl":"10.1016/j.jns.2025.123671","url":null,"abstract":"<div><h3>Background</h3><div>Functional neurological disorder (FND) results in high levels of physical and psychological disability, significant healthcare costs due to delayed diagnosis, repeated healthcare visits and medical investigations. New evidence-based models of care, involving multidisciplinary input centered around the biopsychosocial model, emphasizing each patient's strengths and promoting self-management, have been shown to improve patient outcomes and may reduce healthcare costs.</div></div><div><h3>Aim</h3><div>To investigate the effect of a new evidence-based, transdisciplinary model of ambulatory care for FND on the frequency of presentations for FND-related symptoms to emergency departments (EDs) before, during and after treatment completion.</div></div><div><h3>Methods</h3><div>A retrospective service evaluation was undertaken. An outpatient transdisciplinary team provided either a comprehensive rehabilitation program to participants (lasting a mean of 12.1 weeks) or an education-only program (lasting a mean of 3.0 weeks).</div></div><div><h3>Results</h3><div>Twenty-nine participants (22 [75.9 %] female, mean [SD] age 42.9 [17.9] years) who received 38.8 [26.6] occasions of service were included in analyses. Twenty-four were assessed as requiring and subsequently received the comprehensive rehabilitation program and 5 were deemed to require and received the education-only program. The mean (SD) number of ED presentations significantly decreased from 1.3 (1.8) pre-program to 0.1 (0.4) during the program (<em>p</em> = 0.000) and to 0.1 (0.4) post-program (<em>p</em> = 0.001).</div></div><div><h3>Conclusions</h3><div>A reduction in the number of FND-related presentations to ED was found after the provision of a transdisciplinary model of ambulatory care, provided in an out-patient setting. However, the nature of the study means that cause/effect cannot be proved.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"477 ","pages":"Article 123671"},"PeriodicalIF":3.2,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922464","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 expanding clinical utility of blood neurofilament light chain (bNfL): a multi-disciplinary diagnostic tool","authors":"Peter Körtvelyessy ,&nbsp;Burak Arslan ,&nbsp;Jonah Nietiet ,&nbsp;Christoph Leithner ,&nbsp;Petra Hühnchen ,&nbsp;Wolfgang Böhmerle ,&nbsp;Matthias Endres ,&nbsp;Christoph J. Ploner ,&nbsp;Heiner Audebert ,&nbsp;Katrin Hahn ,&nbsp;Thomas Meyer ,&nbsp;Andreas Lüschow ,&nbsp;Claudia Weiss ,&nbsp;Lisa-Valerie Biztan ,&nbsp;Sebastian Spethmann ,&nbsp;Adriaan J. Graw ,&nbsp;Nadine Unterwalder ,&nbsp;Christian Meisel ,&nbsp;Nicholas J. Ashton ,&nbsp;Kaj Blennow ,&nbsp;Laura Göschel","doi":"10.1016/j.jns.2025.123669","DOIUrl":"10.1016/j.jns.2025.123669","url":null,"abstract":"<div><h3>Background</h3><div>The protein neurofilament light chain in blood (bNfL) has become a valuable biomarker in the diagnosis, monitoring, and prognosis of neurological diseases. However, its potential use beyond neurology in routine clinical practice remains unexplored. This study aimed to examine the clinical utility of bNfL by investigating its expanding use (i) assessing its integration into in- and outpatient routine practice, (ii) both within and outside of academic hospitals, and (iii) across different medical disciplines and various departments.</div></div><div><h3>Methods</h3><div>This study examined data from two large clinical chemistry laboratories that provide bNfL measurements for the clinical routine: Labor Berlin, Germany, and the Clinical Neurochemistry Laboratory at Sahlgrenska University Hospital, Sweden. Together, this large-scale retrospective study acquired data on bNfL measurements from <em>n</em> = 22,122 individuals during the years 2021 to 2023.</div></div><div><h3>Results</h3><div>Our findings revealed that (i) outpatient clinics and (ii) non-academic healthcare settings are gradually integrating bNfL into their routine practice and (iii) its use has expanded across an increasing number of medical disciplines over time, indicating its growing importance as a diagnostic tool, beyond neurology. Notably, departments such as cardiology, hematology/oncology and intensive care units increasingly incorporated bNfL into their clinical repertoire.</div></div><div><h3>Discussion</h3><div>This study underscores the developing impact of easily accessible bNfL on clinical routine, not only enhancing neurologists' diagnostic tools but also offering valuable insights into diverse medical fields, in- and outside the academic environment.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"478 ","pages":"Article 123669"},"PeriodicalIF":3.2,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144989731","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":"Corrigendum to: “Pilot study of on-treatment platelet reactivity at low shear stress and platelet activation status on aspirin or clopidogrel monotherapy in patients with TIA or ischaemic stroke” [JNS 2025 Vol 475, 123540]","authors":"S.T. Lim ,&nbsp;S.J.X. Murphy ,&nbsp;D.R. Smith ,&nbsp;D.R. Collins ,&nbsp;T. Coughlan ,&nbsp;S.M. Murphy ,&nbsp;A.J. McCarthy ,&nbsp;B. Egan ,&nbsp;S.-Y. Lim ,&nbsp;D. Cox ,&nbsp;D.J.H. McCabe","doi":"10.1016/j.jns.2025.123646","DOIUrl":"10.1016/j.jns.2025.123646","url":null,"abstract":"","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"477 ","pages":"Article 123646"},"PeriodicalIF":3.2,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890734","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":"Limb-girdle muscular dystrophy D3: The first North American family and review of the literature","authors":"Adam S. Deardorff ,&nbsp;Michael C. Isfort","doi":"10.1016/j.jns.2025.123670","DOIUrl":"10.1016/j.jns.2025.123670","url":null,"abstract":"<div><div>Limb-girdle muscular dystrophy type D3 is a rare, late-onset muscular dystrophy that has, to date, only been identified in European, South American, and Asian populations. Here we present the index patient of the first North American family with LGMDD3. We review this disorder and highlight both common and uncommon clinical features. We also discuss new insights into disease pathogenesis.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"477 ","pages":"Article 123670"},"PeriodicalIF":3.2,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144896692","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: MR fingerprinting for epileptogenic cortical malformations – A path to precision epilepsy care","authors":"Daniel Matovu","doi":"10.1016/j.jns.2025.123662","DOIUrl":"10.1016/j.jns.2025.123662","url":null,"abstract":"","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"477 ","pages":"Article 123662"},"PeriodicalIF":3.2,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144892334","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":"Effect of renal function on dual antiplatelet therapy using cilostazol for stroke prevention: a CSPS.com trial post hoc analysis","authors":"Junpei Koge ,&nbsp;Kazunori Toyoda ,&nbsp;Masatoshi Koga ,&nbsp;Mayumi Fukuda-Doi ,&nbsp;Shinichiro Uchiyama ,&nbsp;Kazumi Kimura ,&nbsp;Haruhiko Hoshino ,&nbsp;Keiji Yamaguchi ,&nbsp;Yasushi Okada ,&nbsp;Nobuyuki Sakai ,&nbsp;Kaori Miwa ,&nbsp;Kazuo Minematsu ,&nbsp;Takenori Yamaguchi ,&nbsp;CSPS.com Trial Investigators","doi":"10.1016/j.jns.2025.123661","DOIUrl":"10.1016/j.jns.2025.123661","url":null,"abstract":"<div><h3>Background</h3><div>The effect of renal function on long-term dual antiplatelet therapy using cilostazol for secondary stroke prevention is unknown. We investigated the effect of estimated glomerular filtration rate (eGFR) on the efficacy and safety of long-term dual antiplatelet therapy involving cilostazol.</div></div><div><h3>Methods</h3><div>We performed a <em>post hoc</em> analysis of a multicenter, open-label, randomized controlled trial of patients with high-risk non-cardioembolic ischemic stroke who were randomly assigned to take aspirin or clopidogrel alone, or a combination of cilostazol with aspirin or clopidogrel and followed for 0.5–3.5 years. Patients were divided into three groups according to their baseline eGFR [normal or increased eGFR (≥90); mildly decreased eGFR (60–89); moderately decreased eGFR (&lt;60 mL/min/1.73m²)].</div></div><div><h3>Results</h3><div>A total of 1749 patients with complete eGFR data were included. The recurrence of ischemic stroke was less common with dual therapy than with monotherapy in patients with mildly decreased eGFR (adjusted HR, 0.35; 95 % CI, 0.19–0.66), but there was no difference between dual therapy and monotherapy in patients with moderately decreased eGFR (0.78; 0.34–1.82) or in those with normal or increased eGFR (0.48; 0.14–1.64).</div></div><div><h3>Conclusions</h3><div>Long-term dual antiplatelet therapy with cilostazol was more efficacious in decreasing recurrent ischemic stroke than monotherapy for patients with mildly decreased eGFR, but not for those with moderately decreased eGFR or those with normal or increased eGFR.</div><div><strong>Trial Registration Information</strong>: <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> <span><span>NCT01995370</span><svg><path></path></svg></span></div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"477 ","pages":"Article 123661"},"PeriodicalIF":3.2,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144887283","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":"Enhancing prognostic models for stroke outcomes in older patients: Insights from prestroke frailty and disability assessments","authors":"Yonghao Wang ,&nbsp;Qi Zhang","doi":"10.1016/j.jns.2025.123660","DOIUrl":"10.1016/j.jns.2025.123660","url":null,"abstract":"<div><div>This letter addresses the manuscript titled “Comparison of Prestroke Frailty and Disability for Outcome Prediction in Older Stroke Patients” by Paola Forti et al. The study explores the predictive role of prestroke frailty in stroke outcomes for older patients, demonstrating its potential to guide clinical decision-making. While the large cohort enhances the study's validity, several methodological concerns are raised, including the retrospective use of frailty assessments and the lack of subgroup analyses by stroke type or severity. Suggestions for future research include validating frailty scales prospectively, integrating them with other clinical measures, and exploring their impact on rehabilitation outcomes. Despite these limitations, the study significantly contributes to the understanding of frailty as a predictor in stroke care.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"477 ","pages":"Article 123660"},"PeriodicalIF":3.2,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144887284","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":"Enhancing prognostic models for stroke outcomes in older patients: Insights from Prestroke frailty and disability assessments","authors":"Paola Forti ,&nbsp;Marianna Ciani ,&nbsp;Fabiola Maioli","doi":"10.1016/j.jns.2025.123659","DOIUrl":"10.1016/j.jns.2025.123659","url":null,"abstract":"","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"477 ","pages":"Article 123659"},"PeriodicalIF":3.2,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144878122","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":"Association of paramagnetic rim lesions with patient-reported neuropsychiatric symptoms in multiple sclerosis","authors":"Dimitrios C. Ladakis ,&nbsp;Mahsa Ghajarzadeh ,&nbsp;Pavan Bhargava ,&nbsp;Martina Absinta ,&nbsp;Peter A. Calabresi ,&nbsp;Bardia Nourbakhsh","doi":"10.1016/j.jns.2025.123657","DOIUrl":"10.1016/j.jns.2025.123657","url":null,"abstract":"<div><h3>Background</h3><div>Paramagnetic rim lesions (PRLs) mark chronic active lesions in multiple sclerosis (MS) and have been linked to disability progression and objective cognitive decline, but their relationship with invisible symptoms such as fatigue, mood disturbance and perceived cognition remains unclear.</div></div><div><h3>Methods</h3><div>We prospectively enrolled adults with MS who underwent 3T susceptibility-weighted imaging. Supratentorial PRLs were counted and participants were categorised into 0, 1–3 or &gt; 3 PRLs. Neuro-QoL T-scores for fatigue, depression, anxiety and perceived cognition were collected at baseline and annually for up to five years (median 3.1 years, 419 person-visits). Cross-sectional associations were examined with multivariable linear regression; longitudinal change was modelled with linear mixed-effects models adjusted for age, sex, race and MS course, applying false-discovery-rate correction.</div></div><div><h3>Results</h3><div>Among 92 adults with MS (mean age 51 ± 13 years; 78 % women), 41 participants (45 %) had no PRLs, 27 (29 %) had 1–3, and 24 (26 %) had &gt; 3. At baseline, PRL burden did not correlate with fatigue, depression, anxiety, or cognition (all FDR-adjusted <em>p</em> &gt; 0.70). During follow-up, PRL category did not influence trajectories of fatigue, depression, or cognition. Participants with &gt;3 PRLs experienced a modest annual reduction in anxiety (−1.8 T-score points/year; 95 % CI -3.05 to −0.56; FDR <em>p</em> = 0.02).</div></div><div><h3>Conclusions</h3><div>Supratentorial PRL burden is not a major determinant of common invisible symptoms in MS. The unexpected inverse association with anxiety may in part reflect regression to the mean or adaptive coping over time and needs replication in larger cohorts incorporating lesion volume, location, and treatment exposure.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"477 ","pages":"Article 123657"},"PeriodicalIF":3.2,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144863820","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: Causal inference concerns in comparing prestroke frailty and disability for outcome prediction","authors":"Guoxin Zhang ,&nbsp;Wenwen Xu ,&nbsp;Junxiong Yin","doi":"10.1016/j.jns.2025.123655","DOIUrl":"10.1016/j.jns.2025.123655","url":null,"abstract":"","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"477 ","pages":"Article 123655"},"PeriodicalIF":3.2,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958953","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}