Neurology International最新文献

{"title":"Magnetic Resonance Imaging-Defined Cerebral Small Vessel Disease Burden and Longitudinal Neuropsychiatric and Functional Recovery After Stroke: A Prospective Cohort Study.","authors":"Aishah Ibrahim Albakr, Alia Alokley, Feras Alsulaiman, Abdulrahman Abdulwahab, Mohammad AlWatban, Dalal Albakr, Feras A Al-Awad, Mustafa Ahmed Alqarni, Saud A Alnaaim, Ali Hafiz Alhashim, Noman Ishaque, Modhi AlKhaldi, Azra Zafar, Fatimah AlSaihati, Saleh Saad Alotaibi, Firas Saad Alahmari, Norah A AlKhaldi","doi":"10.3390/neurolint18090179","DOIUrl":"10.3390/neurolint18090179","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Cerebral small vessel disease (CSVD) is an established determinant of functional outcome after stroke; however, its influence on the longitudinal course of neuropsychiatric recovery remains incompletely understood. We aimed to investigate the association between MRI-defined CSVD burden and longitudinal depressive symptom trajectories, as well as cognitive, anxiety, and functional outcomes after stroke. <b>Methods:</b> This prospective longitudinal cohort study included consecutive patients with acute ischemic stroke or intracerebral hemorrhage treated at a tertiary comprehensive stroke center between January 2022 and November 2025. CSVD burden was quantified using a validated MRI-based Global CSVD Score and categorized as none-to-mild (0-1) or moderate-to-severe (2-4). Depressive symptoms were assessed using the 17-item Hamilton Depression Rating Scale (HDRS-17), anxiety using the Generalized Anxiety Disorder-7 (GAD-7), cognitive function using the Montreal Cognitive Assessment (MoCA), and functional outcome using the modified Rankin Scale (mRS) at baseline and 3, 6, and 9-12 months after stroke. Longitudinal depressive symptom trajectories were evaluated using linear mixed-effects models, and multivariable logistic regression was used to assess associations with incident and persistent post-stroke depression, cognitive impairment, and functional outcome. <b>Results:</b> Of 550 participants enrolled, 480 (87.3%) underwent brain MRI and were included in the MRI-defined CSVD analyses. Moderate-to-severe CSVD burden was associated with a less favorable longitudinal depressive symptom trajectory, reflected by a significant CSVD burden × time interaction (β = 0.68, 95% CI 0.25-1.11; <i>p</i> = 0.002). Moderate-to-severe CSVD burden was also independently associated with poor functional outcome (adjusted odds ratio [aOR] 1.56, 95% confidence interval [CI] 1.04-2.32; <i>p</i> = 0.030). In contrast, baseline CSVD burden was not independently associated with incident post-stroke depression, persistent post-stroke depression, or global cognitive impairment after multivariable adjustment. <b>Conclusions:</b> Greater MRI-defined CSVD burden was associated with a less favorable longitudinal depressive symptom trajectory and poorer functional recovery after stroke, whereas it was not independently associated with incident or persistent post-stroke depression or global cognitive impairment. These findings suggest that cumulative MRI-defined CSVD burden may provide complementary information regarding longitudinal emotional and functional recovery, although its incremental prognostic value and clinical utility require further validation. Multicenter studies with longer follow-up and quantitative neuroimaging are needed to confirm these associations and determine whether CSVD assessment improves risk stratification and individualized post-stroke monitoring and rehabilitation.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 9","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13610538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurological Complications After Lateral Lumbar Interbody Fusion: Incidence, Patterns, and Risk Factors in a 545-Patient Cohort.","authors":"Atef F Hulliel, Dana Saleh, Ahmad Zayd Alkadri, David J Boughanem, Rafal Chociej, Daven Mejica, Bryan Clampitt, Srujan Kopparapu, Jay Kumar, Patrick Kim, Mohsen Rostami, Puya Alikhani","doi":"10.3390/neurolint18090178","DOIUrl":"10.3390/neurolint18090178","url":null,"abstract":"<p><p><b>Introduction</b>: Lateral lumbar interbody fusion (LLIF) provides effective anterior column reconstruction while avoiding extensive posterior dissection; however, its transpsoas trajectory places the lumbar plexus at risk of neurological complications. The incidence, clinical patterns, and predictors of these events remain incompletely defined because of heterogeneous reporting across studies. <b>Method</b>: We performed a retrospective cohort study of consecutive adult patients undergoing transpsoas LLIF at a tertiary spine centre between 2016 and 2023. Demographic, clinical, and operative variables were collected, and postoperative neurological complications were identified from clinical documentation and imaging when available. Multivariable logistic regression was performed to determine independent predictors of transient motor weakness, acute thigh paraesthesia, and transient paraesthesia. <b>Results</b>: Among 545 patients, 167 (30.6%) experienced at least one neurological complication. The most common events were acute thigh paraesthesia (14.4%) and transient motor weakness (13.2%), whereas hip flexion weakness (2.1%), femoral palsy (1.3%), and psoas haematoma (1.4%) were uncommon. Obesity was independently associated with transient motor weakness (OR 1.77, 95% CI 1.06-2.93; <i>p</i> = 0.028). Younger age independently predicted acute thigh paraesthesia (OR 0.96 per year, 95% CI 0.94-0.99; <i>p</i> = 0.002) and transient paraesthesia (OR 0.97 per year, 95% CI 0.94-1.00; <i>p</i> = 0.049). Multilevel surgery was independently associated with acute thigh paraesthesia (OR 1.67, 95% CI 1.02-2.74; <i>p</i> = 0.043). <b>Conclusions</b>: Neurological complications following LLIF are relatively frequent but are predominantly transient sensory disturbances or temporary motor weakness. Obesity, younger age, and multilevel surgery identify patients with increased risk of specific neurological events. These findings support individualized counselling, careful surgical planning, and continued investigation into anatomical and intraoperative factors underlying LLIF-related neurological morbidity.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 9","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13610711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Microstructural and Molecular Brain Changes in Early Cognitive Decline Using Multiparametric 3T Magnetic Resonance Imaging.","authors":"Zongpai Zhang, Jingpu Wu, Isabel M Rios Pulgar, Elizabeth H T Chang, Keyi Chai, Puyang Wang, Shanshan Jiang, Xu Li, Kenichi Oishi, Gwenn S Smith, Carrie Wagandt, Gregory M Pontone, Abhay Moghekar, Arnold Bakker, Jinyuan Zhou","doi":"10.3390/neurolint18090177","DOIUrl":"10.3390/neurolint18090177","url":null,"abstract":"<p><p><b>Objectives</b>: Developing sensitive imaging biomarkers is critical for capturing early brain alterations in Alzheimer's disease. This exploratory study aimed to evaluate how multiparametric magnetic resonance imaging (MRI) measures, including chemical exchange saturation transfer (CEST) imaging, can detect early cognitive impairment and to compare their diagnostic performance across multiple brain regions. <b>Methods</b>: 18 cognitively normal participants and 18 patients with mild cognitive impairment or mild dementia were recruited to undergo CEST and other MRI sequences. Imaging metrics included CEST measures (amide proton transfer-weighted or APTw, APT^#, nuclear Overhauser enhancement or NOE^#), alongside conventional measures (T₁, T₂) and advanced measures (magnetization transfer ratio or MTR, quantitative susceptibility mapping or QSM, apparent diffusion coefficient or ADC). Quantitative analyses were performed in the hippocampus, caudate, putamen, posterior cingulate cortex, and amygdala. Associations between MRI measures and cognition were evaluated using Pearson correlation analysis, and the diagnostic performance of single-parameter and multiparameter models were assessed using logistic regression and receiver operating characteristic analysis. <b>Results</b>: Among all evaluated MRI measures, APTw, APT^#, NOE^#, MTR, T₁, and QSM demonstrated statistically significant group differences (cognitively normal vs. mild cognitive impairment or mild dementia), with medium to very large effect sizes in at least one region. Across all evaluated regions, APT^# and NOE^# signals were consistently and positively associated with clinical dementia severity (based on the Clinical Dementia Rating), whereas MTR showed consistently negative associations. In contrast, APTw, T₁, T₂, QSM, and ADC exhibited weaker or more region-dependent associations. Correlations with the Mini-Mental State Examination were generally weaker across MRI measures and regions. Among these, APT^# showed the strongest and most consistent associations with clinical severity, and was the best single-parameter classifier in most regions. <b>Conclusions</b>: Multiparametric MRI with CEST imaging shows potential for detecting microstructural and molecular alterations associated with cognitive dysfunction in individuals at risk for early cognitive decline.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 9","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13610878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Corn Oil on Biochemical and Neurochemical Markers in an Animal Model of Alzheimer's Disease.","authors":"Jadyellen Rondon Silva, Maria Elisa Fonseca Oliveira, Lira Kamila Palacios Campos, Marcos Jose Jacinto, Anderson Oliveira Souza","doi":"10.3390/neurolint18090176","DOIUrl":"10.3390/neurolint18090176","url":null,"abstract":"<p><strong>Background: </strong>The ingestion of polyunsaturated fatty acids is vital for brain health, supporting cognitive development and helping to prevent chronic diseases, including neurodegenerative processes.</p><p><strong>Objective: </strong>This study aimed to investigate the effects of corn oil on the biochemical and neurochemical parameters of <i>Drosophila melanogaster</i> expressing human amyloid precursor protein β42 (APP-β₄₂).</p><p><strong>Methods: </strong>The flies were fed a diet supplemented with 37.8 mg/mL of corn oil from the larval stage until adulthood.</p><p><strong>Results: </strong>A diet supplemented with corn oil induced significant changes in biochemical markers, such as a decrease in head cholesterol levels (<i>p</i> < 0.001); decreased catalase activity and hydrogen peroxide levels in the heads (<i>p</i> < 0.0001) and thoracic muscles (<i>p</i> < 0.0001); reduced glutathione levels in the heads (<i>p</i> < 0.0001) and muscles (<i>p</i> < 0.01); and reduced formazan production (<i>p</i> < 0.01) and citrate synthase (CS) activity (<i>p</i> < 0.0001) in the head. However, in thoracic muscle, ingestion of corn oil led to an increase in formazan production (<i>p</i> < 0.01) and no significant change in CS activity. Lactate levels decreased in the heads (<i>p</i> < 0.0001) and thoraces (<i>p</i> < 0.001) after flies were fed corn oil. Finally, ingestion of corn oil resulted in a significant rise in acetylcholinesterase activity in the heads (<i>p</i> < 0.001) and thoracic muscles (<i>p</i> < 0.01).</p><p><strong>Conclusions: </strong>These results suggest that consuming corn oil reduces the oxidative stress typical of an Alzheimer's disease model by enhancing antioxidant defenses.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 9","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13610347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatally Detected Neonatal Neuroblastoma Associated with Achondroplasia and an SDHA Variant.","authors":"Penka Petleshkova, Nevena Anesteva-Ivanova, Maya Krasteva, Nikoleta Parahuleva, Atanas Ivanov, Hristo Ivanov, Anna Mihaylova","doi":"10.3390/neurolint18090175","DOIUrl":"10.3390/neurolint18090175","url":null,"abstract":"<p><p><b>Background:</b> Neuroblastoma is the most common extracranial solid tumor in infancy and demonstrates marked clinical heterogeneity. To our knowledge, this is one of the very few reported cases of neonatal neuroblastoma associated with genetically confirmed achondroplasia and an additional SDHA variant. <b>Case Presentation:</b> We describe a male neonate with a prenatally detected right-sided suprarenal mass and skeletal abnormalities suggestive of achondroplasia. Postnatal evaluation was consistent with localized neuroblastoma, which was classified as low risk according to the available clinical documentation. Despite the initially favorable clinical risk profile, the tumor showed unexpected progression after initial chemotherapy, requiring treatment intensification and subsequent surgical resection. Next-generation sequencing identified a pathogenic FGFR3 c.1138G>A (p.Gly380Arg) variant confirming achondroplasia and an SDHA c.704T>C (p.Ile235Thr) variant of uncertain significance. At follow-up, the patient remained free of disease recurrence. <b>Conclusions:</b> This case expands the limited evidence on the coexistence of neonatal neuroblastoma and achondroplasia and highlights the potential value of comprehensive genomic testing in patients with atypical clinical behavior. It also demonstrates that an initially favorable clinical risk profile does not invariably predict subsequent disease behavior, emphasizing the importance of integrating clinical, radiological, and molecular findings in individualized patient management.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 9","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13610964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insertion of a Postoperative Drain After Surgeries for Intracranial Abscesses or Empyemas-A Single-Center Retrospective Study.","authors":"Harun Asoglu, Tim Lampmann, Saif-Eldin Abedellatif, Mohammed Jaber, Haitham Alenezi, Mohammed Banat, Hartmut Vatter, Motaz Hamed","doi":"10.3390/neurolint18090174","DOIUrl":"10.3390/neurolint18090174","url":null,"abstract":"<p><strong>Introduction: </strong>The routine insertion of a postoperative intracranial drain following surgical evacuation of brain abscesses or subdural empyemas is practiced by some surgeons to facilitate pus evacuation and to enable cavity lavage, but robust evidence for clinical benefit is lacking. This study evaluates whether postoperative drain placement affects reoperation rates, length of hospital stay, and duration of antibiotic therapy.</p><p><strong>Methods: </strong>We performed a retrospective review of consecutive adult patients who underwent surgical drainage or excision of a primary intracranial abscess or empyema at our tertiary center between January 2020 and January 2026. Patients were grouped by whether a postoperative intracranial drain was placed. The primary endpoint was recurrence requiring reoperation. Secondary endpoints included hospital length of stay, total duration of antibiotic therapy, and operative time. Continuous variables were compared with t-tests and categorical variables with Fisher's exact test; <i>p</i> < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Eighty procedures were identified, and 36 patients met inclusion criteria for final analysis; eight (22.2%) received a postoperative intracranial drain, and 28 (77.8%) did not. Overall, 13 patients (36.1%) required reoperation for radiological or clinical progression. Reoperation occurred in 50% of patients with a drain and 32.1% without a drain (<i>p</i> = 0.422). Median hospital stay and duration of antibiotic therapy did not differ significantly between groups (median hospital stay 27.1 vs. 23.0 days, <i>p</i> = 0.50; median antibiotic duration 67.3 vs. 51.7 days, <i>p</i> = 0.445). Operative time and infection volume rates were also similar between cohorts.</p><p><strong>Conclusions: </strong>In this single-center retrospective cohort, placement of a postoperative intracranial drain after surgical management of brain abscesses or empyemas was not associated with reduced reoperation rates, shorter hospitalization, or shorter antibiotic treatment. Given the absence of demonstrable clinical benefit and the potential risks related to drain placement, routine insertion of postoperative drains cannot be recommended.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 9","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13610210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vertebral Artery Dissection and PICA-Territory Stroke Associated with Chronic Atlantoaxial Structural Abnormality: A Case Report.","authors":"Mahika Khurana, Seyed Mostafa Razavi, Balaganesh Natarajan, Eman Elmasry, Ahmed Abd Elazim","doi":"10.3390/neurolint18090173","DOIUrl":"10.3390/neurolint18090173","url":null,"abstract":"<p><p>Upper cervical structural disease can alter vertebral artery biomechanics, although a mechanical contribution cannot be established by anatomical proximity alone. We describe an older woman with seronegative inflammatory arthritis and chronic atlantoaxial abnormality who developed abrupt vertigo, nausea, and inability to walk despite a National Institutes of Health Stroke Scale (NIHSS) score of 0. Computed tomography angiography (CTA) demonstrated left V3 vertebral artery dissection with pseudoaneurysmal dilation at the craniovertebral junction. Magnetic resonance imaging (MRI) showed a dominant acute left posterior inferior cerebellar artery (PICA)-territory infarction. Cervical imaging demonstrated atlantoaxial deformity, pannus-like peri-odontoid tissue, and a C1 arch abnormality adjacent to the affected V3 segment. Echocardiography and inpatient telemetry did not identify an embolic source. Anatomical colocalization of the C1-C2 abnormality and V3 lesion, together with the ipsilateral PICA infarction, suggests a possible mechanical contribution to the dissection, with subsequent artery-to-artery thromboembolism to the cerebellum. Dynamic compression was not demonstrated; spontaneous dissection, intracranial atherosclerosis, and occult embolism remain alternative or additional mechanisms. The patient received dual antiplatelet therapy followed by aspirin, statin therapy, and rehabilitation. This case emphasizes the limitations of the NIHSS in posterior circulation stroke and the importance of evaluating the craniovertebral junction when a V3 lesion occurs near upper cervical structural disease.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 9","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic Testing Abnormalities in Children with Autism Spectrum Disorder: Prevalence, Patterns, and Clinical Associations.","authors":"Viswabhaskar Susarla, Mariah George, Ananthi Rathinam, Danish Bhatti","doi":"10.3390/neurolint18090172","DOIUrl":"10.3390/neurolint18090172","url":null,"abstract":"<p><strong>Background: </strong>Genetic testing in autism spectrum disorder (ASD) can reveal a wide range of chromosomal and sequence-level abnormalities, yet large real-world neurology cohorts rarely report the full spectrum of findings alongside clinical correlates and patterns of testing. We characterized genetic findings in an 1884-patient ASD cohort and examined factors associated with both abnormal findings and the use of genetic testing.</p><p><strong>Methods: </strong>This retrospective cross-sectional study included 1884 patients. Genetic testing was performed in 1011 patients; the primary outcome was an abnormal versus normal genetic result among those tested. All 371 abnormal findings were catalogued in a de-identified supplement. The primary multivariable model included age, sex, seizure history, and EEG abnormality (N = 901); an MRI-inclusive sensitivity model used 422 complete cases, and a separate full-cohort model evaluated factors associated with genetic testing.</p><p><strong>Results: </strong>Abnormal genetic findings were documented in 371/1011 tested patients (36.7%, 95% CI 33.7-39.8%). In the primary model, female sex (aOR 1.483, 95% CI 1.089-2.018; <i>p</i> = 0.012) and seizure history (aOR 1.634, 95% CI 1.136-2.352; <i>p</i> = 0.008) were independently associated with abnormal findings, whereas EEG abnormality was not significant after adjustment (aOR 1.373, <i>p</i> = 0.084). In the MRI-inclusive sensitivity model, female sex and seizure history remained significant, while MRI abnormality was not independently associated (aOR 1.235, <i>p</i> = 0.302). Genetic testing was more common among patients who also underwent EEG or MRI (both <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>More than one-third of tested patients had an abnormal genetic finding, spanning a broad range of copy-number, sequence, homozygosity, Fragile X-related, chromosomal, and syndromic findings. Seizure history and female sex were the principal adjusted correlates of abnormal findings. Genetic testing clustered with EEG and MRI use, reflecting observed patterns of neurological work-up within this cohort rather than temporal or causal relationships.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 9","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13610493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-Amyloid Monoclonal Antibodies in Early Alzheimer Disease: Lecanemab and Donanemab.","authors":"Ülkü Figen Demir, Fatmanur Karakuş Dilbaz","doi":"10.3390/neurolint18090171","DOIUrl":"10.3390/neurolint18090171","url":null,"abstract":"<p><strong>Background/objectives: </strong>Alzheimer disease (AD) causes progressive cognitive and functional loss and substantial caregiver and healthcare burden. Anti-amyloid monoclonal antibodies represent a shift toward biology-directed treatment in biomarker-confirmed early symptomatic AD, but modest clinical effects must be balanced against amyloid-related imaging abnormalities (ARIA), intensive monitoring, and implementation burden. Heterogeneity in trial populations, endpoints, dosing, stopping rules, and follow-up complicates interpretation. This narrative review critically integrates efficacy, safety, durability, biomarker, and implementation evidence for lecanemab and donanemab while preserving study-family relationships and avoiding unsupported cross-trial superiority claims.</p><p><strong>Methods: </strong>For this revised narrative review, a targeted PubMed/MEDLINE search covering the period from database inception was initially conducted before manuscript submission and was subsequently updated through 21 August 2026, supplemented by reference-list and citation tracking. Search terms combined Alzheimer disease with lecanemab, donanemab, anti-amyloid monoclonal antibody, ARIA, APOE, amyloid PET, open-label extension, real-world, clinical meaningfulness, implementation, and access. Sixty-two sources were purposively selected for a comprehensive narrative synthesis; no meta-analysis or formal certainty grading was performed.</p><p><strong>Results: </strong>Pivotal trials demonstrated statistically significant but modest average slowing of decline: Clarity AD showed a 0.45-point between-group difference in CDR-SB worsening at 18 months, and TRAILBLAZER-ALZ 2 showed a 3.25-point iADRS difference in the low/medium-tau population at 76 weeks. ARIA-E occurred in 12.6% of lecanemab-treated and 24.0% of donanemab-treated participants in the pivotal trials, with higher risk in APOE ε4 carriers. Extensions and biomarker analyses suggest persistent biological effects but are less secure for causal inference, and real-world evidence is currently more mature for lecanemab.</p><p><strong>Conclusions: </strong>Both antibodies substantially reduce amyloid and modestly slow average clinical decline in selected patients, but neither restores lost function, greater amyloid clearance does not establish greater individual benefit, and cross-trial superiority cannot be inferred. Treatment requires biomarker-guided selection, APOE-informed risk counseling, serial MRI, infusion and ARIA-management capacity, and shared decision-making that incorporates cost, access, and patient/caregiver burden.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 9","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13610423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Aneurysm Occlusion Outcomes After Endovascular Treatment: A Descriptive Single-Center Cohort Evaluation.","authors":"Yasar Ünsal, Kadir Çetinkaya, Mehmet Özgür Özates, Oktay Gürcan, Oktay Algın, Gıyas Ayberk","doi":"10.3390/neurolint18090170","DOIUrl":"10.3390/neurolint18090170","url":null,"abstract":"<p><strong>Background: </strong>Early residual or recurrent aneurysm filling remains an important limitation after endovascular treatment of intracranial aneurysms, particularly in large and complex lesions. This study descriptively evaluated 6-month early residual or recurrent filling after coil embolization, stent-assisted coiling, flow-diverting stents, and the Woven EndoBridge (WEB) device in a single-center cohort.</p><p><strong>Methods: </strong>We retrospectively analyzed 151 patients with 161 intracranial aneurysms treated between January 2019 and July 2023. Follow-up imaging at approximately 6 months was performed using computed tomography angiography or magnetic resonance angiography, with digital subtraction angiography when residual filling was suspected. Aneurysm occlusion was evaluated using the Raymond-Roy Occlusion Classification. Clinical, morphological, anatomical, and treatment-related variables associated with early residual or recurrent aneurysm filling were analyzed.</p><p><strong>Results: </strong>Complete occlusion was achieved in 149 aneurysms (92.5%), whereas early residual or recurrent filling occurred in 12 aneurysms (7.5%). Residual or recurrent filling was observed in 4/35 aneurysms treated with coil embolization (11.4%), 1/58 treated with flow-diverting stents (1.7%), 7/60 treated with the WEB device (11.7%), and none of the 8 aneurysms treated with stent-assisted coiling; overall rates did not differ significantly among treatment modalities (<i>p</i> = 0.104). Aneurysm height > 10 mm was significantly associated with early residual or recurrent filling (<i>p</i> = 0.005), and mean aneurysm height was greater in aneurysms with residual or recurrent filling than in completely occluded aneurysms (<i>p</i> = 0.048). In the ICA subgroup, residual or recurrent filling was more frequent after WEB treatment than after other endovascular modalities (<i>p</i> = 0.019). This subgroup signal was based on sparse observations.</p><p><strong>Conclusions: </strong>Aneurysm height > 10 mm was significantly associated with early residual or recurrent aneurysm filling. No statistically significant difference in early residual or recurrent filling was detected among treatment groups. Given the retrospective design, non-random treatment allocation, heterogeneous aneurysm phenotypes, and non-uniform imaging follow-up, these data should be interpreted as a descriptive institutional experience rather than evidence of comparative superiority or equivalence. The ICA subgroup finding is preliminary and hypothesis-generating.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 9","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}