Neurology International最新文献

{"title":"Cannabinoids in Chronic Pain: Clinical Outcomes, Adverse Effects and Legal Challenges.","authors":"Aleksandar Sic, Conor George, Daniela Ferrer Gonzalez, Vasilis-Spyridon Tseriotis, Nebojsa Nick Knezevic","doi":"10.3390/neurolint17090141","DOIUrl":"10.3390/neurolint17090141","url":null,"abstract":"<p><p>Cannabinoids have gained increasing attention as potential therapeutic agents in chronic pain management. Their mechanisms of action, mediated through CB1 and CB2 receptors, provide a pharmacological alternative to conventional analgesics. The evidence is strongest for neuropathic pain and multiple sclerosis-related spasticity, while the results for fibromyalgia, osteoarthritis, and musculoskeletal pain remain inconsistent. The average pain reduction is modest, often not exceeding 0.5-1.0 points on a 10-point scale, and therapeutic gains are offset by safety concerns. Quantitative data show that discontinuation rates range from 4.3% at low-dose CBD to 12.9% at high-dose CBD, compared with 3.5% on placebo, while nabiximols (THC + CBD spray) are associated with dizziness in 25% of patients, somnolence in 8%, and treatment discontinuation in 12%. High-dose CBD also carries a measurable risk of hepatotoxicity. Regulatory heterogeneity further constrains trial feasibility, scalability, and patient access, with disparities evident across the United States, Europe, Canada, and Australia. Overall, cannabinoids provide modest, condition-specific analgesia and should be considered adjunctive rather than first-line options, reserved for patients unresponsive to conventional therapy. Future progress requires standardized formulations, harmonized international regulations, long-term safety data, and large-scale randomized controlled trials to clarify their role in evidence-based pain management.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12472909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149889","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":"Epidemiological and Clinical Characteristics of Acute Stroke in a Multi-Ethnic South Asian Population.","authors":"Kim H Tran, Naveed Akhtar, Yahia Imam, Md Giass Uddin, Sujatha Joseph, Deborah Morgan, Blessy Babu, Ryan Ty Uy, Ashfaq Shuaib","doi":"10.3390/neurolint17090140","DOIUrl":"10.3390/neurolint17090140","url":null,"abstract":"<p><strong>Objective: </strong>Stroke is one of the leading causes of death and disability worldwide. Compared to developed countries, the prognosis of stroke is less favourable in developing countries. The objective of this study is to identify inter-ethnic variation in risk profiles and stroke outcomes amongst Bangladeshi, Indian, Nepalese, Pakistani, and Sri Lankan expatriates living in Qatar.</p><p><strong>Methods: </strong>Data from the Qatar Stroke Registry were retrospectively analyzed from April 2014 to June 2025. A total of 8825 patients were included. The chi-square test was used to analyze sociodemographic variables, while the Kruskal-Wallis test was used to analyze continuous variables. Post hoc analysis was performed. Multivariate logistic regression and multivariate multiple regression were used to identify the predictors associated with poor clinical outcomes and mortality at 90 days.</p><p><strong>Results: </strong>Ischemic stroke was the predominant stroke type in all groups, with Nepalese patients presenting with stroke at a younger age, whilst Pakistanis tended to be older (<i>p</i> < 0.001). In terms of stroke outcomes, Nepalese patients had the highest proportion of a poor functional outcome at 90 days as well as NIHSS at discharge (<i>p</i> < 0.05). However, Bangladeshis had the highest proportion of mortality at 90 days compared to the other cohorts. Multivariable logistic regression revealed that undiagnosed dyslipidemia, Nepalese ethnicity, and moderate and severe NIHSS admission scores were independent predictors of a poor functional outcome at 90 days, whilst male sex and prior antidiabetic therapy were protective factors (<i>p</i> < 0.001). In terms of mortality at 90 days, only a severe NIHSS admission score (>10) was a significant predictor (<i>p</i> < 0.001). A severe NIHSS admission score was also the only predictive factor of mortality and poor functional outcome at 90 days (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>There was a significant variation in stroke presentation and outcomes among South Asian subpopulations in Qatar, suggesting the importance of tailored public health strategies as a uniform approach to stroke care is insufficient for this diverse population.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12472970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150021","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":"Relationship Between Each of the Four Major Motor Symptoms and At-Home Physical Activity in Individuals with Parkinson's Disease: A Cross-Sectional Study.","authors":"Yuichi Hirakawa, Hiroaki Sakurai, Kazuya Takeda, Soichiro Koyama, Masanobu Iwai, Ikuo Motoya, Yoshikiyo Kanada, Nobutoshi Kawamura, Mami Kawamura, Shigeo Tanabe","doi":"10.3390/neurolint17090139","DOIUrl":"10.3390/neurolint17090139","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Individuals with Parkinson's disease (PD) often experience four major motor symptoms-tremor, rigidity, bradykinesia, and postural instability/gait disorder. Although these symptoms have been shown to affect activities of daily living, their impact on the level of at-home physical activity (PA) in this population remains unexplored. We aimed to investigate the relationship between the four major motor symptoms of PD and at-home PA in these individuals. <b>Methods</b>: This retrospective cross-sectional study included 17 individuals with PD. We examined the relationship between the Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale Part 3 score and the time spent in three PA intensities (sedentary behavior, light PA [LPA], and moderate-to-vigorous PA) within the home. Pearson's correlation coefficient was used for statistical analysis. <b>Results</b>: In the initial step analysis, a significant negative correlation was observed between the overall motor symptom score and the time spent in LPA inside the home (r_s [95% confidence interval]: -0.72 [-0.93 to -0.25]; <i>p</i> < 0.01). In the second step analysis, a significant negative correlation was observed between the bradykinesia score and the time spent in LPA inside the home (r_s: -0.74 [-0.92 to -0.30]; <i>p</i> < 0.01). <b>Conclusions</b>: Among the four major motor symptoms, only the severity of bradykinesia influenced the time spent in LPA inside the home. Thus, rehabilitation treatment focusing on bradykinesia may be beneficial for increasing the time spent in LPA inside the home for individuals with PD.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12472460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150061","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 Effects of Co-Culturing ND7/23 Sensory Neuron-like Cells and IFRS1 Schwann Cells on Myelination: A Single-Arm Nonrandomized Study.","authors":"Shizuka Takaku, Kazunori Sango","doi":"10.3390/neurolint17090138","DOIUrl":"10.3390/neurolint17090138","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Co-culture models of neurons and Schwann cells have been used to explore the mechanisms of myelination during development, axonal regeneration after injury, and the pathogenesis of various demyelinating neuropathies. A spontaneously immortalized Fischer rat Schwann cell line 1 (IFRS1), established from the primary culture of adult Fischer344 rat peripheral nerves, can myelinate neurites in co-cultures with primary cultured dorsal root ganglion neurons and neuronal cell lines, such as nerve growth factor (NGF)-primed PC12 cells and NSC-34 motor neuron-like cells. In this study, we aimed to establish a stable co-culture system using IFRS1 cells and ND7/23 sensory neuron-like cells. <b>Methods</b>: ND7/23 cells were seeded at a low density (2 × 10³/cm²) and maintained for 7 days in serum-containing medium supplemented with NGF (10 ng/mL) and the Rho kinase inhibitor Y27632 (5 μM) to promote neurite elongation. The cells were then treated with the anti-mitotic agent mitomycin C (1 μg/mL) for 12-16 h to suppress proliferative activity. Following this, the cells were co-cultured with IFRS1 cells (2 × 10⁴/cm²) and maintained at 37 °C in serum-containing medium supplemented with ascorbic acid (50 μg/mL), NGF (10 ng/mL), and ciliary neurotrophic factor (10 ng/mL). <b>Results</b>: Double-immunofluorescence staining performed on day 21 of the co-culture revealed myelin protein 22- or myelin basic protein-immunoreactive IFRS1 cells surrounding βIII tubulin-immunoreactive neurites emerging from ND7/23 cells. Myelin formation was further confirmed via Sudan Black B staining and electron microscopy. <b>Conclusions</b>: This co-culture system may provide a valuable tool for studying the processes of myelination in the peripheral nervous system, as well as the pathogenesis of various sensory neuropathies and potential novel therapeutic approaches for these conditions.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12472592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150114","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":"Carpal Tunnel Syndrome in the Very Elderly: Clinical, Electrodiagnostic, and Ultrasound Features in a Cohort of 187 Patients.","authors":"Lisa B E Shields, Vasudeva G Iyer, Theresa Kluthe, Yi Ping Zhang, Christopher B Shields","doi":"10.3390/neurolint17090137","DOIUrl":"10.3390/neurolint17090137","url":null,"abstract":"<p><strong>Background/objectives: </strong>Elderly patients with carpal tunnel syndrome (CTS) have more severe clinical, ultrasonic, and electrodiagnostic (EDX) findings compared to younger patients. Thenar weakness and atrophy are more common at initial presentation in the elderly population with CTS.</p><p><strong>Methods: </strong>This is a retrospective review of 187 very elderly patients (aged 80 years and older) with EDX confirmation of CTS. We describe the clinical, EDX, and US features in these patients and compare the severity of the median nerve entrapment at the carpal tunnel (CT) by EDX findings to a middle-aged cohort (ages 40-50 years).</p><p><strong>Results: </strong>The total number of very elderly hands with CTS was 289 (187 patients total, with bilateral symptoms in 102 patients). Of the 289 hands, thenar atrophy was observed in 75 (26.0%) hands, weakness of the abductor pollicis brevis (APB) muscle was detected in 178 (61.6%) hands, and pinprick decrease/loss was noted in 265 (91.7%) hands. Of the total 289 hands, 57 (66.3%) hands' median nerve stimulation did not evoke compound muscle action potentials over the APB and second lumbrical muscles. Sensory nerve action potentials were not detected in 211 (76.2%) hands. Comparing the sensitivities of various US measurements in diagnosing CTS, the cross-sectional area at the CT inlet had the highest sensitivity among the various measurements. As the CSA at the CT inlet increases, the odds of a greater CTS severity by EDX studies also increase (OR = 1.109, <i>p</i>-value = 0.001). The very elderly patients with CTS more frequently had more severe CTS compared to the middle-aged patients with CTS (chi-squared = 102.65₃, <i>p</i>-value < 0.001).</p><p><strong>Conclusions: </strong>The very elderly patients appear to seek medical care only when the CTS has become severe. The primary care physicians should look for signs and symptoms of CTS in the very elderly and encourage prompt treatment. Surgeons should be cognizant of the differences in the clinical, EDX, and US studies in the very elderly patient cohort with CTS. US is highly useful in evaluating CTS when the EDX studies become non-localizing in severe CTS, as often seen in the very elderly patients.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12472666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149851","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":"Sulbactam: A β-Lactam Compound with Neuroprotective Effects in Epilepsy.","authors":"Fang-Chia Chang, Chiung-Hui Liu, Wen-Chieh Liao, Yu-Shiuan Tzeng, Ru-Yin Tsai, Li-Ho Tseng, Ching-Sui Hung, Shey-Lin Wu, Ying-Jui Ho","doi":"10.3390/neurolint17090135","DOIUrl":"10.3390/neurolint17090135","url":null,"abstract":"<p><p><b>Background:</b> The pathophysiology of epilepsy is characterized by increased neuronal activity due to an excess of the excitatory neurotransmitter glutamate and a deficiency in the inhibitory neurotransmitter gamma-aminobutyric acid (GABA). Epilepsy presents with seizures, neuronal loss, and hyperactivity in the subthalamic nucleus (STN). Astrocytes play a crucial role by absorbing extracellular glutamate through glutamate transporter-1 (GLT-1), thereby reducing neuronal excitation. Upregulating the expression of astrocytic GLT-1 is a promising therapeutic strategy for epilepsy. Sulbactam (SUL), a β-lactam antibiotic, has been demonstrated to exert neuroprotective effects by upregulating GLT-1 expression. <b>Objectives:</b> This study investigated the impact of SUL on neuronal and behavioral changes in epilepsy by using a pentylenetetrazol (PTZ)-induced rat model of epilepsy. <b>Methods:</b> Rats were treated with saline, SUL (50 and 150 mg/kg), or a combination of SUL and the GLT-1 blocker dihydrokainate (DHK) for 20 days. Subsequently, behavioral tasks were conducted to assess recognition, anxiety, and memory. <b>Results:</b> Histological analyses revealed that SUL ameliorated neuronal deficits, increased astrocytic GLT-1 expression, and reduced hyperactivity in the STN. Additionally, SUL promoted astrocyte proliferation, indicating a new dimension of its neuroprotective properties. However, the beneficial effects of SUL were prevented by DHK. <b>Conclusions:</b> This pioneering study highlights multiple benefits of SUL, including seizure suppression, increased GLT-1 expression, and astrocyte proliferation, underscoring its high potential as a treatment for epilepsy.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150081","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":"Novel Computed Tomography Perfusion and Laboratory Indices as Predictors of Long-Term Outcome and Survival in Acute Ischemic Stroke.","authors":"Eray Halil, Kostadin Kostadinov, Nikoleta Traykova, Neli Atanasova, Kiril Atliev, Elizabet Dzhambazova, Penka Atanassova","doi":"10.3390/neurolint17090136","DOIUrl":"10.3390/neurolint17090136","url":null,"abstract":"<p><strong>Background/objectives: </strong>Acute ischemic stroke is a leading cause of mortality and long-term disability globally, with limited reliable early predictors of functional outcomes and survival. This study aimed to assess the prognostic value of two novel predictors: the hypoperfusion intensity ratio calculated from mean transit time and time-to-drain maps (HIR-MTT-TTD), derived from computed tomography perfusion (CTP) imaging parameters, and the Inflammation-Coagulation Index (ICI), which integrates systemic inflammatory (C-reactive protein and white blood cell count) and hemostatic (D-dimer) markers.</p><p><strong>Methods: </strong>This prospective, single-center observational study included 60 patients with acute ischemic stroke treated with intravenous thrombolysis and underwent pre-treatment CTP imaging. HIR-MTT-TTD evaluated collateral status and perfusion deficit severity, while ICI integrated C-reactive protein (CRP), white blood cell (WBC) count, and D-dimer levels. Functional outcomes were assessed using the National Institutes of Health Stroke Scale (NIHSS), Barthel Index, and modified Rankin Scale (mRS) at 24 h, 3 months, and 1 year.</p><p><strong>Results: </strong>Of 60 patients, 53.3% achieved functional independence (mRS 0-2) at 1 year. Unadjusted Cox models showed HIR-MTT-TTD (HR = 6.25, 95% CI: 1.48-26.30, <i>p</i> = 0.013) and ICI (HR = 1.08, 95% CI: 1.00-1.17, <i>p</i> = 0.052) were associated with higher 12-month mortality, worse mRS, and lower Barthel scores. After adjustment for age, BMI, smoking status, and sex, these associations became non-significant (HIR-MTT-TTD: HR = 2.83, 95% CI: 0.37-21.37, <i>p</i> = 0.314; ICI: HR = 1.07, 95% CI: 0.96-1.19, <i>p</i> = 0.211). Receiver operating characteristic (ROC) analysis indicated moderate predictive value, with ICI (AUC = 0.756, 95% CI: 0.600-0.867) outperforming HIR-MTT-TTD (AUC = 0.67, 95% CI: 0.48-0.83) for mortality prediction.</p><p><strong>Conclusions: </strong>The study introduces promising prognostic tools for functional outcomes. Elevated HIR-MTT-TTD and ICI values were independently associated with greater initial stroke severity, poorer functional recovery, and increased 1-year mortality. These findings underscore the prognostic significance of hypoperfusion intensity and systemic thrombo-inflammation in acute ischemic stroke. Combining the use of the presented indices may enhance early risk stratification and guide individualized treatment strategies.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12472316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150065","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":"High-Accuracy Classification of Parkinson's Disease Using Ensemble Machine Learning and Stabilometric Biomarkers.","authors":"Ana Carolina Brisola Brizzi, Osmar Pinto Neto, Rodrigo Cunha de Mello Pedreiro, Lívia Helena Moreira","doi":"10.3390/neurolint17090133","DOIUrl":"10.3390/neurolint17090133","url":null,"abstract":"<p><p><b>Background</b>: Accurate differentiation of Parkinson's disease (PD) from healthy aging is crucial for timely intervention and effective management. Postural sway abnormalities are prominent motor features of PD. Quantitative stabilometry and machine learning (ML) offer a promising avenue for developing objective markers to support the diagnostic process. This study aimed to develop and validate high-performance ML models to classify individuals with PD and age-matched healthy older adults (HOAs) using a comprehensive set of stabilometric parameters. <b>Methods</b>: Thirty-seven HOAs (mean age 70 ± 6.8 years) and 26 individuals with idiopathic PD (Hoehn and Yahr stages 2-3, on medication; mean age 66 years ± 2.9 years), all aged 60-80 years, participated. Stabilometric data were collected using a force platform during quiet stance under eyes-open (EO) and eyes-closed (EC) conditions, from which 34 parameters reflecting the time- and frequency-domain characteristics of center-of-pressure (COP) sway were extracted. After data preprocessing, including mean imputation for missing values and feature scaling, three ML classifiers (Random Forest, Gradient Boosting, and Support Vector Machine) were hyperparameter-tuned using GridSearchCV with three-fold cross-validation. An ensemble voting classifier (soft voting) was constructed from these tuned models. Model performance was rigorously evaluated using 15 iterations of stratified train-test splits (70% train and 30% test) and an additional bootstrap procedure of 1000 iterations to derive reliable 95% confidence intervals (CIs). <b>Results</b>: Our optimized ensemble voting classifier achieved excellent discriminative power, distinguishing PD from HOAs with a mean accuracy of 0.91 (95% CI: 0.81-1.00) and a mean Area Under the ROC Curve (AUC ROC) of 0.97 (95% CI: 0.92-1.00). Importantly, feature analysis revealed that anteroposterior sway velocity with eyes open (V-AP) and total sway path with eyes closed (TOD_EC, calculated using COP displacement vectors from its mean position) are the most robust and non-invasive biomarkers for differentiating the groups. <b>Conclusions</b>: An ensemble ML approach leveraging stabilometric features provides a highly accurate, non-invasive method to distinguish PD from healthy aging and may augment clinical assessment and monitoring.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12472432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149952","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":"Deciphering the Structural Biology of GFAP: Connotations of Its Potency in Presaging the Diagnosis for Traumatic Brain Injury and AD.","authors":"Sri Harsha Kanuri, Prapthi Jayesh Sirrkay","doi":"10.3390/neurolint17090134","DOIUrl":"10.3390/neurolint17090134","url":null,"abstract":"<p><p>In Alzheimer's disease, accumulation of Aβ and tau aggregates in the limbic and cortical regions of the brain forms the pathological basis for the onset of memory loss and cognitive abnormalities. The neuronal desecration inflicted by these toxic pile-ups will rouse the onset of innate immune defense mechanisms including astrogliosis within the neuronal milieu. A potential ramification of astrogliosis is the overproduction and spillage of GFAP into the brain circulation. Execution of GFAP vital physiological functions rests upon the preservation of its filamentous structure as well as its cytoskeletal interactions. Any anomaly that hampers the structural integrity of GFAP will engender filament disassembly, cytoplasmic aggregation, and decreased solubility with the resultant deleterious consequences. The potency of GFAP as a reliable biomarker in the blood also rests on its ability to navigate the glymphatic excretory pathways and spill into the systemic circulation. Recent reports have suggested GFAP is a dependable marker for auguring subtle disease changes in traumatic brain injury (TBI) and AD. However, pathological anomalies such abnormal structural integrity, cleavage, impaired drainage pathways, and alternative isoforms will lessen its potency and thwarts its ability from becoming a full-fledged and stable biomarker for neurological diseases. Understanding the GFAP biology, including factors that influence its structural integrity and excretory pathways, will be crucial and this review underscores these sections in a succinct manner. Thorough comprehension of GFAP biology is the principal step in unearthing its potential as a powerful marker for auguring disease initiation, and progression in TBI and AD.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12472827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149869","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 Role of Pre-Operative Biopsy in Malignant Peripheral Nerve Sheath Tumours: A Review and Retrospective Series with a Management Algorithm from a Single-Center Experience.","authors":"Francesca Vincitorio, Leonardo Bradaschia, Enrico Lo Bue, Alice Antico, Paolo Titolo, Bruno Battiston, Diego Garbossa, Fabio Cofano","doi":"10.3390/neurolint17090132","DOIUrl":"10.3390/neurolint17090132","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Peripheral nerve tumours are commonly encountered in clinical practice. Although most are benign, a subset can exhibit aggressive and invasive behaviour, evolving into malignant peripheral nerve sheath tumours (MPNSTs). Due to their rarity and overlapping features with benign lesions, MPNSTs are frequently misdiagnosed during the initial evaluation. Preoperative biopsy may aid in distinguishing malignant from benign lesions. This single-center study aimed to develop and validate a diagnostic algorithm-based on a systematic literature review and institutional case series-to assess the role of preoperative biopsy in the diagnostic workflow. <b>Methods</b>: A systematic review of the literature was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, covering the period from 1998 to 2024. Additionally, a retrospective case series of patients with peripheral nerve lesions treated at the authors' institution between January 2018 and June 2024 was analysed. <b>Results</b>: Forty-eight articles met the inclusion criteria and were categorized into five key domains: radiological features of MPNSTs, associated risk factors and genetic conditions, the role of preoperative biopsy, use of radiotherapy, and general clinical management strategies. The proposed diagnostic algorithm was applied to a series of 36 patients, four of whom met the criteria for preoperative biopsy. In three of these cases, early diagnosis of MPNSTs was achieved. <b>Conclusions</b>: Preoperative biopsy appears to be a safe and cost-effective tool for the early identification of MPNSTs. Early diagnosis may facilitate the use of neoadjuvant therapies-such as radiotherapy or chemotherapy-potentially enabling more radical surgical resection and improving overall patient outcomes.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12473013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150050","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}