Neurology International最新文献

{"title":"Vertebral Artery Hypoplasia and Posterior Circulation Vulnerability: A Systematic Review of Epidemiological, Hemodynamic, and Clinical Evidence.","authors":"Olja Mirkovic, Milos Stepovic, Jovana Milosavljevic, Maja Vulovic, Ivana Zivanovic-Macuzic, Dejan Aleksic, Milos N Milosavljevic, Melanija Tepavcevic, Ivona Marinkovic, Simonida Delic, Kristijan Jovanovic, Verica Vukicevic, Ana Tomic, Miljana Maric, Jelena Kostic","doi":"10.3390/neurolint18090169","DOIUrl":"10.3390/neurolint18090169","url":null,"abstract":"<p><strong>Background/objectives: </strong>Vertebral artery hypoplasia is a common congenital anatomical variant of the vertebral arteries, traditionally considered a benign finding. However, accumulating evidence suggests that VAH may influence vertebrobasilar hemodynamics and contribute to susceptibility to posterior circulation disorders. This systematic review aimed to synthesize current evidence regarding the epidemiology, hemodynamic significance, neurological manifestations, and cerebrovascular outcomes associated with VAH.</p><p><strong>Methods: </strong>This systematic review was conducted according to the PRISMA 2020 guidelines and registered in PROSPERO (CRD420261442242). A systematic search of PubMed/MEDLINE was performed from database inception to 8 June 2026, supplemented by manual reference screening and targeted searches. Studies evaluating VAH diagnosed using vascular imaging or anatomical assessment, including CTA, MRA, Doppler ultrasonography, and DSA, were eligible. Methodological quality was assessed using Joanna Briggs Institute critical appraisal tools, and the level of evidence was classified according to the Oxford Centre for Evidence-Based Medicine framework.</p><p><strong>Results: </strong>Forty-six studies were included in the qualitative synthesis. VAH prevalence varied substantially according to imaging modality, diagnostic criteria, and study population, ranging from approximately 3% to nearly 50%. Across clinical cohorts, VAH was frequently associated with posterior circulation ischemic stroke, transient ischemic attack, and vertebrobasilar insufficiency. Hemodynamic studies demonstrated reduced vertebral artery flow, increased vascular resistance, impaired cerebrovascular reactivity, and altered collateral flow redistribution. VAH was also associated with vestibular disorders, non-stroke neurological syndromes, vertebral artery dissection, and other cerebrovascular anatomical variations. Unlike previous reviews focusing primarily on prevalence or stroke associations, this review integrates epidemiological, anatomical, hemodynamic, computational, and neurological evidence within a unified clinically oriented framework and proposes an evidence-informed conceptual model of VAH as a context-dependent low-flow vascular susceptibility phenotype.</p><p><strong>Conclusions: </strong>Current evidence indicates that VAH represents a clinically relevant vascular susceptibility phenotype rather than merely an incidental anatomical variant. Its clinical significance appears to depend on the interaction between reduced vertebral artery flows, collateral capacity, vascular remodeling, and acquired cerebrovascular risk factors. Standardized diagnostic criteria and prospective multimodal studies are required to define its role in future cerebrovascular risk assessment.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 9","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13610102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039864","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":"Serum Levels of the Proinflammatory Cytokines IL-6, IL-16, IL-18, and IL-36 in Patients with Multiple Sclerosis from the Western Region of Saudi Arabia: Associations with Disease Duration and Disability.","authors":"Jehan Alrahimi, Yara Mualla, Alawiah Alhebshi, Hind A Alnajashi, Kawther Zaher","doi":"10.3390/neurolint18090168","DOIUrl":"10.3390/neurolint18090168","url":null,"abstract":"<p><p><b>Background:</b> Systemic inflammation contributes to the pathobiology of multiple sclerosis (MS), yet serum biomarker data from Middle Eastern populations remain limited. This study evaluated serum levels of IL-6, IL-16, IL-18, and IL-36 in Saudi adults with MS compared with matched healthy controls and examined associations with disease duration, phenotype, treatment, and disability. <b>Methods:</b> This single-center, cross-sectional, matched case-control study enrolled 26 MS patients and 26 age- and sex-matched controls. Serum cytokines were measured by ELISA. Disability was assessed using EDSS and the Timed 25-Foot Walk (T25FW). Matched comparisons used Wilcoxon signed-rank tests; subgroup comparisons used Wilcoxon rank-sum or Kruskal-Wallis tests; associations used Spearman's correlation. <b>Results:</b> No correction for multiple comparisons was applied given the exploratory design. All four interleukins were higher in MS patients than in controls (<i>p</i> < 0.001). Age correlated with EDSS (r = 0.573, <i>p</i> = 0.002) and T25FW (r = 0.464, <i>p</i> = 0.014). Only IL-6 showed a notable correlation with disability, with T25FW (r = 0.53, <i>p</i> = 0.008) and, weaker, EDSS (r = 0.38, <i>p</i> = 0.052); IL-18 showed a weak, non-significant correlation with T25FW (r = 0.35, <i>p</i> = 0.126); IL-16 and IL-36 showed no relevant associations. IL-16 was higher in newly diagnosed than in long-standing cases (<i>p</i> = 0.012); no differences by phenotype or treatment were observed for any marker. <b>Conclusions:</b> Serum IL-6, IL-16, IL-18, and IL-36 were elevated in Saudi MS patients versus controls. IL-6 alone showed a modest, unadjusted association with disability, supporting its evaluation as a candidate biomarker in larger, longitudinal, covariate-adjusted cohorts. These findings are hypothesis-generating and should not be interpreted as evidence of independent or clinically actionable biomarker utility.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 9","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13610939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039762","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":"Integrated Neurorehabilitation Including EEG-Neurofeedback for Unilateral Spatial Neglect After Right Thalamo-Mesencephalic Intracerebral Hemorrhage: A Case Report.","authors":"Anna Farella, Gianvito Lagravinese, Valerio Manippa, Paola Santacesaria, Rosanna Falcone, Maria Concetta Schiavariello, Pietro Fiore, Giorgia Francesca Scaramuzzi, Stefania De Trane, Paolo Taurisano","doi":"10.3390/neurolint18090167","DOIUrl":"10.3390/neurolint18090167","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Unilateral Spatial Neglect (USN) is a disabling attentional syndrome occurring after cortical or subcortical stroke, including thalamic lesions. EEG-based neurofeedback (EEG-NF) may support cortical self-regulation, but evidence in spatial neglect remains limited. This case report describes the clinical, neuropsychological, functional, and electrophysiological (quantitative EEG, qEEG) evolution of a patient with USN after a right thalamic hemorrhagic stroke who underwent multidisciplinary rehabilitation including EEG-NF. <b>Methods:</b> A 70-year-old patient underwent a 3-week inpatient multidisciplinary rehabilitation program including physiotherapy, speech and swallowing therapy, conventional cognitive stimulation, and 15 adjunctive EEG-NF sessions. Baseline and post-treatment assessments included clinical, neuropsychological, neglect-specific, functional, affective, and resting-state qEEG measures. Individual change was examined using the Reliable Change Index when suitable psychometric parameters were available, together with published normative and clinical thresholds. <b>Results:</b> After rehabilitation, the Montreal Cognitive Assessment total raw score increased from 20 to 24, reaching the published minimal clinically important difference but not the minimal detectable change. The Frontal Assessment Battery increased from 8 to 12; after adjustment for age and education according to Italian normative data, both scores remained below the normative cut-off. Neglect-specific measures showed reduced spatial asymmetry, increased contralesional target detection, and a Catherine Bergego Scale reduction from 17 to 5, indicating a shift from moderate to mild ecological neglect. Functional independence improved, with reliable change in Functional Independence Measure (FIM) total and cognitive scores and Modified Barthel Index scores. Exploratory qEEG analyses showed condition-dependent spectral and connectivity changes, but findings were heterogeneous and hypothesis-generating. EEG-NF was completed without adverse events. <b>Conclusions:</b> The adjunctive EEG-NF protocol was completed as planned, with no adverse events. Clinical improvement cannot be attributed specifically to neurofeedback because all rehabilitation components were delivered concurrently. Controlled studies are needed to clarify its specific contribution and the durability of the observed improvements in post-stroke spatial neglect.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 9","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13610569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040285","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":"Iatrogenic Brachial Plexus Injuries Evaluated in an Electrodiagnostic Lab.","authors":"Lisa B E Shields, Vasudeva G Iyer, Smita Ghare, Christopher B Shields","doi":"10.3390/neurolint18090166","DOIUrl":"10.3390/neurolint18090166","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Iatrogenic brachial plexus injuries (BPI) are known to occur following a host of surgeries, most often during procedures at the shoulder and cardiac procedures with a median sternotomy. The primary mechanisms include overstretching of the brachial plexus, direct trauma, or compression by hematoma or seroma. Our objective was to determine the pattern of iatrogenic BPI in patients referred to us for electrodiagnostic (EDX) evaluation. <b>Methods:</b> This is a review of 52 patients who were referred to our Neurodiagnostic Center for an iatrogenic BPI over a 16-year (9 July 2010-17 June 2026) period. All patients underwent a clinical examination and EDX studies. <b>Results:</b> The most frequent etiologies of the iatrogenic BPI were shoulder surgery in 28 [53.8%] patients and coronary artery bypass graft procedures with a median sternotomy in 13 [25.0%] patients. The topography of brachial plexus involvement was trunks in 22 (42.3%) and cords in 12 (23.1%). Ten (19.2%) patients had a pan-plexopathy, and the remaining eight (15.4%) patients had multiple sites involving the trunks, cords, and branches. The majority (48 [92.3%]) of patients sustained a stretch injury of the brachial plexus, and four (7.7%) sustained a direct injury. A total of 48 (92.3%) patients had reduced motor unit potential recruitment and/or increased polyphasic motor units on needle EMG, and a similar number had an absence of or low amplitude sensory nerve action potentials. <b>Conclusions:</b> Surgeons should take appropriate precautions to avoid BPI during many surgical procedures especially those of the shoulder and cardiac procedures with a median sternotomy. EDX studies are valuable in detecting and localizing an iatrogenic BPI as well as assessing reinnervation. Preoperative positioning limiting excessive shoulder abduction as well as intraoperative neuromonitoring are measures that may reduce the likelihood of an iatrogenic BPI.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 9","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040335","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":"Effects of Repetitive Peripheral Magnetic Stimulation Versus Sham Stimulation on Upper Limb Spasticity After Stroke: A Double-Blind Randomized Controlled Trial.","authors":"Sasithorn Khawprapa, Nuttaset Manimmanakorn, Yohei Otaka, Jittima Saengsuwan","doi":"10.3390/neurolint18090165","DOIUrl":"10.3390/neurolint18090165","url":null,"abstract":"<p><p><b>Background:</b> Upper limb spasticity after stroke occurs due to neural hyperexcitability and secondary alterations in muscle properties. Repetitive peripheral magnetic stimulation (rPMS) is a non-invasive technique used to reduce spasticity. This study aimed to compare the effects of rPMS versus sham stimulation on upper limb spasticity and muscle stiffness using shear wave elastography (SWE). <b>Methods:</b> This prospective, double-blind randomized controlled trial included 32 stroke patients with upper limb spasticity (Modified Ashworth Scale (MAS) ≥ 2 in the elbow flexors), who received rPMS or sham stimulation in addition to conventional rehabilitation (<i>n</i> = 16 per group). Spasticity was assessed using MAS, and muscle stiffness using SWE. <b>Results:</b> The rPMS group showed a transient short-term reduction in upper limb spasticity compared with the control group at the end of treatment (<i>p</i> = 0.045); however, this effect was not sustained at the 2-week follow-up. No significant between-group differences were observed in muscle stiffness, upper limb motor function, or activities of daily living. <b>Conclusions:</b> This study provides preliminary evidence that rPMS may produce a transient, short-term reduction in upper limb spasticity after stroke. However, this effect was not sustained at follow-up or accompanied by significant improvements in muscle stiffness or functional outcomes.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 9","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13610590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040302","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":"The Incidence and Electroencephalographic Features in Brain Tumor-Related Epilepsy.","authors":"Lejla Zonić, Renata Hodžić, Dževdet Smajlović, Larisa Kovačević, Samra Kadić-Vukas, Lejla Tandir-Lihić, Mirsad Hodžić","doi":"10.3390/neurolint18090164","DOIUrl":"10.3390/neurolint18090164","url":null,"abstract":"<p><p><b>Methods:</b> This retrospective-prospective study included 90 patients with BT. Based on the type of BT, the participants were divided into three groups of 30 patients each: patients with gliomas, with meningiomas and with brain metastasis. Demographic data such as age, sex, alcohol and cigarette consumption were collected. In all three study groups, the time of onset of the first ES, type, characteristics, and frequency were analyzed as well as abnormalities on electroencephalography (EEG). EEG was reviewed for any abnormal background or interictal epileptic discharges. <b>Results:</b> Brain tumor-related epilepsy (BTRE) was present in 46.7% of patients. The incidence of epilepsy secondary to brain tumors was 66.7% in patients with gliomas, 46.6% in those with meningiomas, and 26.7% in those with metastasis. The tumors associated with BTRE were most commonly located in the frontal (40%) and temporal (32.2%) lobes, followed by the parietal (25.6%) and occipital (2.2%) lobes. Focal to bilateral tonic-clonic ES represented the most common seizure type among the studied patients. Abnormalities on the initial EEG recordings were observed in 33 patients with BTRE. Focal EEG abnormalities were identified in 54.7% of patients, while diffuse changes were present in 23.8% of patients (<i>p</i> < 0.005). <b>Conclusions:</b> The highest incidence of BTRE was observed in patients with gliomas, followed by those with meningiomas, while the lowest incidence was recorded in the group with metastases. Smaller and slower growing tumors were associated with higher incidence of seizures than larger, more rapidly growing lesions. Focal to bilateral tonic-clonic seizures were the most common seizure type among patients with BTRE.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 9","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039744","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":"Factors Influencing Walking Improvement After Immersive Virtual Reality Training with a Bodyweight-Supporting System in Poststroke Patients: A Prospective Single-Arm Study.","authors":"Kanta Kitabayashi, Naoto Ogura, Naoki Yoshioka, Wataru Kakuda","doi":"10.3390/neurolint18090162","DOIUrl":"10.3390/neurolint18090162","url":null,"abstract":"<p><p><b>Objectives:</b> We developed an original protocol for standing balance and walking function training using immersive virtual reality (IVR) combined with a bodyweight-supporting (BWS) system. The purpose of this study was to evaluate the feasibility of IVR training in poststroke patients and to identify clinical characteristics associated with walking improvement. <b>Methods</b>: A total of 22 poststroke patients admitted to a rehabilitation ward were enrolled. All participants received conventional physical therapy daily, and IVR training was initiated when balance recovery plateaued. The original IVR training was conducted for 10 consecutive days using a BWS system, enabling safe and repetitive practice of standing weight shifting and advanced stepping tasks, with task difficulty individually adjusted. Primary outcomes were the Berg Balance Scale (BBS), Functional Reaching Test (FRT), and walking time on the 10-m walk test (10 MWT). Changes in 10 MWT (Δ10 MWT) were calculated, and participants were dichotomized into good and poor walking improvement groups based on Δ10 MWT to compare baseline clinical characteristics (e.g., BBS, FRT, and Functional Ambulation Categories [FAC]) between the groups. Receiver operating characteristic (ROC) curve analyses were conducted to identify cutoff values associated with greater improvements in walking. <b>Results</b>: BBS, FRT, and 10 MWT improved significantly after the 10-day IVR training (<i>p</i> < 0.01). ROC analyses identified FAC ≤ 3 and BBS ≤ 42 before training as cutoff values associated with greater improvement in walking performance. <b>Conclusions</b>: Our proposed IVR training approach using a BWS system could be safely implemented and might improve standing balance and walking function in poststroke patients with a balance disability.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 9","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13610560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040312","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":"Associations Between Nonspecific Blood-Derived Inflammatory Indices and MRI-Derived Frontal Network Degeneration in Progressive Supranuclear Palsy.","authors":"Bartosz Migda, Michał Kutyłowski, Natalia Madetko-Alster, Anna Migda, Karol Kutyłowski, Piotr Alster","doi":"10.3390/neurolint18090161","DOIUrl":"10.3390/neurolint18090161","url":null,"abstract":"<p><strong>Background: </strong>Progressive supranuclear palsy (PSP) is a primary 4-repeat tauopathy in which neurodegeneration may be accompanied by neuroinflammatory and peripheral immune alterations. Whether peripheral inflammatory activity reflects structural degeneration within vulnerable brain networks remains unclear.</p><p><strong>Methods: </strong>This retrospective case-control study included 12 patients with PSP and 12 patients with Parkinson's disease (PD). Automated volumetric analysis of 3-Tesla MRI was performed using volBrain 2.0. Blood-derived inflammatory indices included neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), systemic inflammation response index (SIRI), and red blood cell distribution with coefficient of variation (RDW-CV).</p><p><strong>Results: </strong>Patients with PSP showed significantly lower normalized superior frontal gyrus and pallidal volumes than patients with PD. Within the PSP group, higher values of selected blood-derived inflammatory indices were associated with lower frontal network volumes. After adjustment for age, MLR was inversely associated with the composite Frontal Network Score (partial r = -0.7333, <i>p</i> = 0.0067, FDR q = 0.020). The strongest regional association was observed between SIRI and medial frontal cortex volume (rho = -0.748, <i>p</i> = 0.0051); however, regional associations did not remain significant after FDR correction.</p><p><strong>Conclusions: </strong>Peripheral inflammatory markers were associated with MRI-derived measures of frontal network degeneration in PSP. The association between MLR and the composite Frontal Network Score supports a link between systemic immune alterations and network-level neurodegeneration in PSP.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 9","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13610019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040170","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":"Clinical and Epidemiological Characteristics of Multiple Sclerosis in a Peruvian Cohort: A Retrospective Study Across Three Lima Hospitals.","authors":"Ana Cruz Cruz, Julio Perez-Villegas, Eduardo Alvarado, Edward Smith, Ivan Dueñas-Pacheco","doi":"10.3390/neurolint18090160","DOIUrl":"10.3390/neurolint18090160","url":null,"abstract":"<p><p><b>Background/Objectives</b>: To describe the demographic, clinical, and epidemiological characteristics of a cohort of patients diagnosed with Multiple Sclerosis (MS) in Lima, Peru. <b>Methods</b>: A descriptive, retrospective cohort study conducted across three major hospitals in Lima. We included adult patients diagnosed with MS in any of its clinical phenotypes-Clinically Isolated Syndrome (CIS), Relapsing-Remitting MS (RRMS), Secondary Progressive MS (SPMS), and Primary Progressive MS (PPMS)-who were followed between 2007 and 2017. <b>Results</b>: A total of 103 patients were identified. The majority were women (58.3%), with a median age at onset of 38.4 years (Interquartile Range [IQR]: 28.9-46.5). The most common clinical phenotype at onset was RRMS (90.3%), which remained the most prevalent phenotype at the current evaluation (79.6%). Twelve patients (12.9%) progressed from RRMS to SPMS by their last control visit. The most frequent symptoms at onset were limb weakness (72.8%), sensory symptoms (72.8%), and blurred vision (42.0%). At the last evaluation, the most frequent symptoms were limb weakness (78.6%), sensory symptoms (71.8%), and spasticity (40.2%). The most common initial treatment was interferon-beta (44.7%), while two patients (1.9%) initiated therapy with a highly effective disease-modifying drug (DMD), Ocrelizumab. The most recent treatment reported remained interferon-beta (33.9%), but 12 patients (11.7%) were currently receiving Ocrelizumab. <b>Conclusions</b>: This study describes clinical characteristics at onset and during follow-up that are largely similar to those reported in international series. However, we found no evidence of improved disease evolution, a finding potentially attributable to the heterogeneity of treatment and management strategies employed across the cohort.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 9","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13610123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040181","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":"Neurocognitive and Neuropsychiatric Trajectories in a Post-COVID Cohort: A Descriptive Longitudinal Study.","authors":"Giulia Del Duca, Marta Camici, Isabella Sperduti, Anna Clelia Brita, Martina Maresca, Carmela Pinnetti, Ilaria Mastrorosa, Valentina Mazzotta, Andrea Antinori","doi":"10.3390/neurolint18090163","DOIUrl":"10.3390/neurolint18090163","url":null,"abstract":"<p><strong>Introduction: </strong>Cognitive dysfunction (\"brain fog\") is a common manifestation of post-acute COVID-19 syndrome (PACS) and may persist long after the acute infection. While cross-sectional studies have described cognitive deficits, longitudinal evidence on recovery trajectories remains limited.</p><p><strong>Methods: </strong>We conducted a longitudinal observational study of neurocognitive performance and neuropsychiatric symptoms in patients with PACS. Participants underwent assessment with 20 standardized tests covering five cognitive domains (memory, attention, language, executive functions, psychomotor processing speed); anxiety, depression, and sleep quality were assessed at three time points. Changes were analysed using the Friedman test.</p><p><strong>Results: </strong>Forty-two patients were included (median age 57 years; 35.7% female) from a predominantly hospitalized cohort (81% hospitalised; 66.7% requiring respiratory support). Patients who completed all three assessments (completers, n = 42) were compared with those who attended the first evaluation but did not complete follow-up (non-completers, n = 544); completers were more severely ill during the acute phase rather than healthier or more motivated. At the group level, statistically significant improvements over time were observed across the whole sample in verbal short-term learning, visuospatial memory, working memory, constructional praxis, phonological verbal fluency, and psychomotor processing speed (all <i>p</i> ≤ 0.05); after Benjamini-Hochberg adjustment across the twenty cognitive outcomes, visuospatial span forward and backward and psychomotor processing speed remained significant (all FDR-adjusted <i>p</i> ≤ 0.013), with the change confined to the first six months. Sleep quality also improved (<i>p</i> < 0.0001).</p><p><strong>Conclusion: </strong>In this cohort, group-level performance improved in six of the twenty tests administered, of which three remained significant after correction for multiple comparisons, while 28 of 42 patients (66.7%) still scored in the impaired range on at least one test at 12 months, and 17 (40.5%) on two or more. These findings highlight the importance of long-term neuropsychological monitoring and integrated cognitive-psychiatric evaluation in post-COVID care. Given the small, predominantly hospitalized sample, improvements should be interpreted cautiously and confirmed in larger controlled studies, although the use of alternate forms for part of the battery makes task-specific learning an incomplete explanation.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 9","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13610980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040296","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}