Neurology International最新文献

{"title":"Cluster Headache and Hypoxia: Breathing New Life into an Old Theory, with Novel Implications.","authors":"Jonathan M Borkum","doi":"10.3390/neurolint16060123","DOIUrl":"10.3390/neurolint16060123","url":null,"abstract":"<p><p>Cluster headache is a severe, poorly understood disorder for which there are as yet virtually no rationally derived treatments. Here, Lee Kudrow's 1983 theory, that cluster headache is an overly zealous response to hypoxia, is updated according to current understandings of hypoxia detection, signaling, and sensitization. It is shown that the distinctive clinical characteristics of cluster headache (circadian timing of attacks and circannual patterning of bouts, autonomic symptoms, and agitation), risk factors (cigarette smoking; male gender), triggers (alcohol; nitroglycerin), genetic findings (GWAS studies), anatomical substrate (paraventricular nucleus of the hypothalamus, solitary tract nucleus/NTS, and trigeminal nucleus caudalis), neurochemical features (elevated levels of galectin-3, nitric oxide, tyramine, and tryptamine), and responsiveness to treatments (verapamil, lithium, melatonin, prednisone, oxygen, and histamine desensitization) can all be understood in terms of hypoxic signaling. Novel treatment directions are hypothesized, including repurposing pharmacological antagonists of hypoxic signaling molecules (HIF-2; P2X3) for cluster headache, breath training, physical exercise, high-dose thiamine, carnosine, and the flavonoid kaempferol. The limits of current knowledge are described, and a program of basic and translational research is proposed.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"16 6","pages":"1691-1716"},"PeriodicalIF":3.2,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11679651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896253","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":"Co-Existent Central and Peripheral Demyelination: Related or Coincidental?","authors":"Camila Narvaez-Caicedo, Shireen M Jacob, Laura Wu, Chilvana Patel","doi":"10.3390/neurolint16060121","DOIUrl":"10.3390/neurolint16060121","url":null,"abstract":"<p><strong>Background: </strong>Hereditary Sensory Motor Neuropathy (HSMN) 1A and Multiple Sclerosis (MS) are distinct demyelinating disorders affecting the peripheral and central nervous systems, respectively. We present a case of simultaneous occurrence of both conditions, exploring the clinical presentation, diagnostic workup, and potential interplay between these diseases. Case presentation and clinical approach: A 49-year-old male with a history of optic neuritis presented with progressive numbness, weakness, and sensory loss in all extremities over four years. Neurological examination revealed distal weakness, sensory deficits in a stocking-glove distribution, pes cavus, and hammer toes. Nerve conduction studies and electromyography confirmed sensory motor demyelinating polyneuropathy. The patient's lack of response to intravenous immunoglobulin therapy suggested hereditary neuropathy as an etiology. Genetic testing identified a PMP22 gene duplication, confirming HSMN 1A. Elevated cerebrospinal fluid protein level and oligoclonal bands, combined with magnetic resonance of the brain showing multiple T2 hyperintense lesions in the brain and spinal cord, fulfilled the diagnostic criteria for MS.</p><p><strong>Discussion: </strong>This case of co-existing HSMN 1A and MS highlights a rare overlap of peripheral and central demyelination. While HSMN 1A results from PMP22 gene duplication, primarily affecting peripheral myelin, MS is driven by immune-mediated central myelin attacks. The co-existence of these disorders suggests potential shared mechanisms, such as immune dysregulation. Some evidence suggests that overexpression of PMP22 in HSMN 1A may disturb immune tolerance, possibly triggering autoimmune responses linked to MS. Further research is needed to explore the genetic and autoimmune interplay between these two diseases, expanding our understanding of demyelinating disorders.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"16 6","pages":"1666-1673"},"PeriodicalIF":3.2,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11678117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896256","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":"Mechanisms of Neurosyphilis-Induced Dementia: Insights into Pathophysiology.","authors":"Aya Fadel, Hussain Hussain, Robert J Hernandez, Amanda Marie Clichy Silva, Amir Agustin Estil-Las, Mohammad Hamad, Zahraa F Saadoon, Lamia Naseer, William C Sultan, Carla Sultan, Taylor Schnepp, Arumugam R Jayakumar","doi":"10.3390/neurolint16060120","DOIUrl":"10.3390/neurolint16060120","url":null,"abstract":"<p><p>Neurosyphilis-induced dementia represents a severe manifestation of tertiary syphilis, characterized by cognitive and neuropsychiatric impairments. This condition arises from the progression of syphilis to the central nervous system, where the spirochete causes damage through invasion, chronic inflammation, and neurodegeneration. The pathophysiology involves chronic inflammatory responses, direct bacterial damage, and proteinopathies. <i>Treponema pallidum</i> triggers an inflammatory cascade, resulting in neuronal injury and synaptic dysfunction. Abnormal protein accumulations, including TAR DNA-binding protein 43 (TDP-43) and tau, contribute to neuronal loss and cognitive decline. Seizures, psychiatric symptoms, and motor deficits further complicate the progression of dementia. Diagnosis includes clinical assessment, cerebrospinal fluid analysis, and neuroimaging. Diagnostic tests include CSF-VDRL, FTA-ABS, and neuroimaging techniques such as MRI and PET scans, which help detect structural changes and confirm neurosyphilis. Management of neurosyphilis-induced dementia involves antibiotic therapy and psychotropic medications to address both infectious and symptomatic components. While penicillin remains the cornerstone of treatment, psychotropic agents, including haloperidol, risperidone, quetiapine, and divalproex sodium, can manage psychiatric symptoms. However, careful monitoring is required due to potential side effects and interactions with ongoing treatment. Overall, early diagnosis and comprehensive management are crucial for mitigating the cognitive and neuropsychiatric impairments associated with neurosyphilis-induced dementia.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"16 6","pages":"1653-1665"},"PeriodicalIF":3.2,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11679807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896318","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":"Pretreatment Cranial Computed Tomography Perfusion Predicts Dynamic Cerebral Autoregulation Changes in Acute Hemispheric Stroke Patients Having Undergone Recanalizing Therapy: A Retrospective Study.","authors":"Lehel-Barna Lakatos, Manuel Bolognese, Mareike Österreich, Martin Müller, Grzegorz Marek Karwacki","doi":"10.3390/neurolint16060119","DOIUrl":"10.3390/neurolint16060119","url":null,"abstract":"<p><strong>Objectives: </strong>Blood pressure (BP) management is challenging in patients with acute ischemic supratentorial stroke undergoing recanalization therapy due to the lack of established guidelines. Assessing dynamic cerebral autoregulation (dCA) may address this need, as it is a bedside technique that evaluates the transfer function phase in the very low-frequency (VLF) range (0.02-0.07 Hz) between BP and cerebral blood flow velocity (CBFV) in the middle cerebral artery. This phase is a prognostically relevant parameter, with lower values associated with poorer outcomes. This study aimed to evaluate whether early cranial computed tomography perfusion (CTP) can predict this parameter.</p><p><strong>Methods: </strong>In this retrospective study, 165 consecutive patients with hemispheric strokes who underwent recanalizing therapy were included (median age: 73 years; interquartile range (IQR) 60-80; women: 43 (26%)). The cohort comprised 91 patients treated with intravenous thrombolysis (IV-lysis) alone (median National Institute of Health Stroke Scale (NIHSS) score: 5; IQR 3-7) and 74 patients treated with mechanical thrombectomy (median NIHSS: 15; IQR 9-18). Regression analysis was performed to assess the relationship between pretreatment CTP-derived ischemic penumbra and core stroke volumes and the dCA VLF phase, as well as CBFV assessed within the first 72 h post-stroke event.</p><p><strong>Results: </strong>Pretreatment penumbra volume was a significant predictor of the VLF phase (adjusted r² = 0.040; <i>β</i> = -0.001, 95% confidence interval (CI): -0.0018 to -0.0002, <i>p</i> = 0.02). Core infarct volume was a stronger predictor of CBFV (adjusted r² = 0.082; <i>β</i> = 0.205, 95% CI: 0.0968-0.3198; <i>p</i> = 0.0003) compared to penumbra volume (<i>p</i> = 0.01). Additionally, in the low-frequency range (0.07-0.20 Hz), CBFV and BP were inversely related to the gain, an index of vascular tone.</p><p><strong>Conclusion: </strong>CTP metrics appear to correlate with the outcome-relevant VLF phase and reactive hyperemic CBFV, which interact with BP to influence vascular tone and gain. These aspects of dCA could potentially guide BP management in patients with acute stroke undergoing recanalization therapy. However, further validation is required.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"16 6","pages":"1636-1652"},"PeriodicalIF":3.2,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11676266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896338","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":"Evolution of Cognitive Disorders in Patients with Mild Cognitive Impairment (MCI) After Ischemic Stroke: Secondary Data Analysis from the Improved Health Care in Neurology and Psychiatry-Longer Life (IHCNP) Study.","authors":"Dragoș-Cătălin Jianu, Ligia Petrica, Traian Flavius Dan, Georgiana Munteanu, Bianca Bora, Sergiu Florin Arnăutu, Sorin Ursoniu, Diana Chira, Ștefan Strilciuc, Cristian Falup-Pecurariu, Dafin Fior Mureșanu","doi":"10.3390/neurolint16060118","DOIUrl":"10.3390/neurolint16060118","url":null,"abstract":"<p><strong>Background: </strong>The Improved Health Care in Neurology and Psychiatry-Longer Life (IHCNP) study was an 18-month prospective, observational, non-interventional research study focused on patients with mild cognitive impairment (MCI) following ischemic stroke.</p><p><strong>Objectives: </strong>Our secondary analysis of the IHCNP data aimed to document the progression of MCI in this patient group.</p><p><strong>Methods: </strong>A total of 100 patients from Romania were recruited, all of whom underwent cognitive assessments using the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Rey Auditory Verbal Learning Test (RAVLT). Clinical evaluations were also conducted as part of the study. Baseline cognitive scores were recorded, and subsequent follow-ups documented cognitive changes over time.</p><p><strong>Results: </strong>At baseline, cognitive scores indicated mild impairment, with averages of MMSE 25.41, MoCA 23.27, and RAVLT 33.63. By the end of the study, patients exhibited a significant cognitive decline, with MMSE scores dropping by 8.7%, MoCA by 10.0%, and RAVLT by 29.5% (<i>p</i> < 0.0001 for all measures), reflecting the progressive nature of MCI post-stroke.</p><p><strong>Conclusions: </strong>These findings highlight the importance of early diagnosis and intervention to mitigate cognitive decline in post-stroke patients. The study underscores the need for ongoing cognitive monitoring to improve patient outcomes and manage MCI progression effectively.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"16 6","pages":"1626-1635"},"PeriodicalIF":3.2,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710722","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":"Macamides as Potential Therapeutic Agents in Neurological Disorders.","authors":"Karin J Vera-López, Gonzalo Davila-Del-Carpio, Rita Nieto-Montesinos","doi":"10.3390/neurolint16060117","DOIUrl":"10.3390/neurolint16060117","url":null,"abstract":"<p><p>Therapeutic treatment of nervous system disorders has represented one of the significant challenges in medicine for the past several decades. Technological and medical advances have made it possible to recognize different neurological disorders, which has led to more precise identification of potential therapeutic targets, in turn leading to research into developing drugs aimed at these disorders. In this sense, recent years have seen an increase in exploration of the therapeutic effects of various metabolites extracted from Maca (Lepidium meyenii), a plant native to the central alpine region of Peru. Among the most important secondary metabolites contained in this plant are macamides, molecules derived from N-benzylamides of long-chain fatty acids. Macamides have been proposed as active drugs to treat some neurological disorders. Their excellent human tolerance and low toxicity along with neuroprotective, immune-enhancing, and and antioxidant properties make them ideal for exploration as therapeutic agents. In this review, we have compiled information from various studies on macamides, along with theories about the metabolic pathways on which they act.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"16 6","pages":"1611-1625"},"PeriodicalIF":3.2,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710755","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":"Sensitization and Habituation of Hyper-Excitation to Constant Presentation of Pattern-Glare Stimuli.","authors":"Thomas Jefferis, Cihan Dogan, Claire E Miller, Maria Karathanou, Austyn Tempesta, Andrew J Schofield, Howard Bowman","doi":"10.3390/neurolint16060116","DOIUrl":"10.3390/neurolint16060116","url":null,"abstract":"<p><strong>Background/objectives: </strong>Pattern glare, associated with cortical hyperexcitability, induces visual distortions and discomfort, particularly in individuals susceptible to migraines or epilepsy. While previous research has primarily focused on transient EEG responses to patterned stimuli, this study aims to investigate how continuous presentation of pattern-glare stimuli affects neural adaptation over both fine (seconds) and coarse (entire experiment) temporal scales.</p><p><strong>Methods: </strong>EEG recordings were obtained from 40 healthy participants exposed to horizontal square-wave gratings at three spatial frequencies presented continuously for three seconds each across multiple trials. Participants' susceptibility to visual stress, headaches, and discomfort was assessed using questionnaires before and during the experiment. The experiment employed a two-by-two design to evaluate habituation (exponentially decreasing response) and sensitisation (exponentially increasing response) effects at two different time granularities. Mass univariate analysis with cluster-based permutation tests was conducted to identify significant brain response changes during the period of constant stimulation, which we call the DC-shift period.</p><p><strong>Results: </strong>Significant effects were observed during the DC-shift period, indicating sustained hyper-excitation to the medium-pattern glare stimulus. In particular, the mean/intercept analysis revealed a consistent positive-going response to the medium stimulus throughout the DC-shift period, suggesting continued neural engagement. Participants reporting higher discomfort exhibited sensitisation at fine temporal granularity and habituation at coarser temporal granularity. These effects were predominantly localised to the right posterior scalp regions.</p><p><strong>Conclusions: </strong>The study demonstrates that individuals sensitive to pattern-glare stimuli exhibit dynamic neural adaptation characterised by short-term sensitisation and long-term habituation. These findings enhance the understanding of cortical hyperexcitability mechanisms and may inform future interventions for visual-stress-related conditions, such as migraines and epilepsy. Further research is needed to explore the underlying neural processes and validate these effects in clinical populations.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"16 6","pages":"1585-1610"},"PeriodicalIF":3.2,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709747","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":"Mindfulness-Based Interventions and the Hypothalamic-Pituitary-Adrenal Axis: A Systematic Review.","authors":"Hernando Vargas-Uricoechea, Alejandro Castellanos-Pinedo, Karen Urrego-Noguera, Hernando D Vargas-Sierra, María V Pinzón-Fernández, Ernesto Barceló-Martínez, Andrés F Ramírez-Giraldo","doi":"10.3390/neurolint16060115","DOIUrl":"10.3390/neurolint16060115","url":null,"abstract":"<p><strong>Background: </strong>Numerous studies have evaluated the effect that mindfulness-based interventions (MBIs) have on multiple health outcomes. For its part, stress is a natural response to environmental disturbances and within the associated metabolic responses, alterations in cortisol levels and their measurement in different tissues are a way to determine the stress state of an individual. Therefore, it has been proposed that MBIs can modify cortisol levels.</p><p><strong>Methods and results: </strong>The objective of this systematic review was to analyze and summarize the different studies that have evaluated the effect of MBIs on cortisol levels. The following databases were consulted: MEDLINE, AMED, CINAHL, Web of Science, Science Direct, PsycINFO, SocINDEX, PubMed, the Cochrane Library and Scopus. The search terms \"mindfulness\", \"mindfulness-based interventions\" and \"cortisol\" were used (and the search was limited to studies from January 1990 to May 2024). In order to reduce selection bias, each article was scrutinized using the JBI Critical Appraisal Checklist independently by two authors. We included those studies with specified intervention groups with at least one control group and excluded duplicate studies or those in which the intervention or control group was not adequately specified. Significant changes in cortisol following MBIs were found in 25 studies, while 10 found no changes. The small sample size, lack of randomization, blinding, and probable confounding and interaction variables stand out in these studies.</p><p><strong>Conclusion: </strong>MBIs have biological plausibility as a means of explaining a positive effect on cortisol levels; however, the weakness of the studies and the absence of robust designs makes it difficult to establish a causal association between both variables.</p><p><strong>Registration number: </strong>INPLASY2024110017.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"16 6","pages":"1552-1584"},"PeriodicalIF":3.2,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710757","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":"Slow Subcutaneous Release of Glatiramer Acetate or CD40-Targeting Peptide KGYY₆ Is More Advantageous in Treating Ongoing Experimental Autoimmune Encephalomyelitis.","authors":"Gisela M Vaitaitis, David H Wagner","doi":"10.3390/neurolint16060114","DOIUrl":"10.3390/neurolint16060114","url":null,"abstract":"<p><strong>Background/objectives: </strong>One of the first-line disease-modifying treatments of multiple sclerosis (MS) is Glatiramer Acetate (GA), which requires daily or three-times-weekly subcutaneous injections. Disease progression, while slowed, still occurs with time. Increasing the impact of the treatment while decreasing the frequency of injections would be ideal. The mechanism of action of GA remains undefined. We developed an alternate approach, KGYY₆, whose mechanism of action targets the CD40 receptor with promising results in an Experimental Autoimmune Encephalomyelitis (EAE) model.</p><p><strong>Methods: </strong>GA and a CD40-targeting peptide, KGYY₆, were formulated as slow-release particles used to treat EAE in C57BL/6 mice.</p><p><strong>Results: </strong>Compared to liquid formulations, the particle formulations vastly improved drug efficacy in both cases, which would be advantageous in treating MS. GA is a combination of randomly generated peptides, in the size range of 5000-9000 Da, using the amino acids E, A, Y, and K. This approach introduces batch differences that impacts efficacy, a persistent problem with GA. KGYY₆ is generated in a controlled process and has a motif, K-YY, which could be generated when manufacturing GA. When testing two different lots of GA or KGYY₆, the latter performed equally well across lots, while GA did not.</p><p><strong>Conclusions: </strong>Slow-release formulations of both GA and KGYY₆ vastly improve the efficacy of both, and KGYY₆ is more consistent in efficacy across different lots.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"16 6","pages":"1540-1551"},"PeriodicalIF":3.2,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709749","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":"Risk of Stroke or Heart Attack in Mild Cognitive Impairment and Subjective Cognitive Impairment.","authors":"Michele Lauriola, Luigi Esposito, Grazia D'Onofrio, Filomena Ciccone, Annamaria la Torre, Filomena Addante, Annagrazia Cocomazzi, Leandro Cascavilla, Olga Ariano, Gaetano Serviddio, Antonio Greco","doi":"10.3390/neurolint16060113","DOIUrl":"10.3390/neurolint16060113","url":null,"abstract":"<p><strong>Background: </strong>The study aimed to identify Mild Cognitive Impairment (MCI) as an alert clinical manifestation of increased probability of major acute vascular events (MVEs), such as Ischemic Stroke and heart attack.</p><p><strong>Methods: </strong>In a longitudinal study, 181 (M = 81, F = 100; mean age of 75.8 ± 8.69 years) patients were enrolled and divided into three groups based on diagnosis: Subjective Cognitive Impairment (SCI), amnestic MCI Single Domain (aMCI-SD), and amnestic MCI More Domain (aMCI-MD). Clinical assessment and the presence of vascular risk factors were collected.</p><p><strong>Results: </strong>The distribution of MVEs showed a higher incidence in the first two years of follow-up of 7.4% in SCI, 12.17% in aMCI-SD, and 8.57% in aMCI-MD. Acute Myocardial Infarction showed a major incidence in one year of follow-up (41%) and in two years of follow-up (29%). Also, Ischemic Stroke showed a major incidence in one year of follow-up (30%) and in two years of follow-up (40%). A statistically significant difference in the progression to dementia was shown (SCI 3.75%; aMCI-SD 10.43%; aMCI-MD 37%; <i>p</i>-value < 0.001).</p><p><strong>Conclusions: </strong>MCI is considered an expression of the systemic activation of mechanisms of endothelial damage, representing a diagnosis predictive of increased risk of MVEs.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"16 6","pages":"1528-1539"},"PeriodicalIF":3.2,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709519","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}