Neurology International最新文献

{"title":"Alpha-Lipoic Acid and Biotin in Neurodegenerative Diseases: Convergent Mechanistic Insights from Preclinical Models to Clinical Perspectives.","authors":"Asdrubal Aguilera-Méndez, Karel Aguilera-Manuel, Alfredo Saavedra-Molina, Patricia Ríos-Chávez, Santiago Villafaña, Renato Nieto-Aguilar, Daniel Godínez-Hernández, Daniel Ortega-Cuellar, Zoraya Palomera-Sanchez, Marcia Gauthereau-Torres","doi":"10.3390/neurolint18040064","DOIUrl":"https://doi.org/10.3390/neurolint18040064","url":null,"abstract":"<p><strong>Background: </strong>Neurodegenerative diseases, including Alzheimer's disease, Parkinson's disease, multiple sclerosis, and amyotrophic lateral sclerosis, represent a major global health burden and share convergent pathogenic mechanisms, such as mitochondrial dysfunction, oxidative stress, neuroinflammation, calcium imbalance, and neuronal loss. Despite advances in symptomatic management, effective disease-modifying therapies remain limited.</p><p><strong>Objectives: </strong>This review aims to critically synthesize mechanistic, preclinical, and clinical evidence on α-lipoic acid and biotin as candidate neuroprotective agents in neurodegenerative diseases, with emphasis on shared signaling pathways, therapeutic potential, generally favorable safety profiles, and translational limitations.</p><p><strong>Methods: </strong>A narrative and integrative review was conducted, encompassing mechanistic studies, preclinical experimental models, and clinical trials and observational studies evaluating ALA and biotin in neurodegenerative diseases. The evidence was qualitatively analyzed with attention to biological plausibility, consistency across models, and clinical relevance.</p><p><strong>Results: </strong>ALA and biotin modulate key cellular pathways implicated in neurodegeneration, including mitochondrial metabolism, redox homeostasis, inflammatory signaling, and neurovascular function. Preclinical studies consistently report beneficial effects on mitochondrial efficiency, oxidative stress, and neuroinflammatory markers. In contrast, clinical evidence remains heterogeneous, with more extensive evaluation of biotin in progressive multiple sclerosis and more limited or exploratory findings for ALA across neurodegenerative disorders.</p><p><strong>Conclusions: </strong>ALA and biotin exhibit mechanistic convergence across pathways relevant to neurodegeneration and generally favorable safety profiles. Although current evidence supports their biological plausibility as adjunctive or exploratory therapeutic strategies, clinical outcomes remain inconsistent and appear to be influenced by dosing regimens, disease stage at intervention, and endpoint selection. Well-designed clinical studies are required to define their efficacy, optimal dosing, and disease-specific applicability.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13118431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777088","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":"Reversal of Endogenous Bioelectrical Network Collapse in Advanced Childhood Cerebral X-Linked Adrenoleukodystrophy.","authors":"Salvatore Rinaldi, Arianna Rinaldi, Vania Fontani","doi":"10.3390/neurolint18040063","DOIUrl":"https://doi.org/10.3390/neurolint18040063","url":null,"abstract":"<p><strong>Background/objectives: </strong>Advanced childhood cerebral X-linked adrenoleukodystrophy (cALD) is traditionally regarded as an irreversible terminal phase of neurodegeneration driven by inflammatory demyelination and axonal loss. Experimental evidence indicates that endogenous bioelectrical fields regulate central nervous system organisation, raising the possibility that functional network collapse in cALD may be biologically modifiable, even in the presence of persistent structural damage. This study examined whether longitudinal modulation of endogenous bioelectrical network organisation is associated with sustained clinical and neurophysiological stabilisation in advanced cALD.</p><p><strong>Methods: </strong>We performed a longitudinal observational analysis of two paediatric patients with advanced childhood cerebral X-linked adrenoleukodystrophy undergoing repeated neuroregenerative treatment cycles. Standardised scalp electroencephalography was recorded during spontaneous wakefulness and repeated over months under comparable vigilance conditions. Multimodal analysis included conventional EEG, quantitative EEG, independent component analysis, and standardised low-resolution electromagnetic tomography (sLORETA). Clinical function was assessed using validated measures of consciousness, swallowing, and voluntary motor behaviour.</p><p><strong>Results: </strong>Across patients, longitudinal recordings demonstrated sustained stabilisation of consciousness, swallowing, and voluntary motor function, accompanied by reproducible reorganisation of pathological brain rhythms. Delta and theta oscillations showed a consistent topographical redistribution from limbic-frontoinsular networks towards sensorimotor and parietal integrative cortices. These changes were observed across modalities and timepoints and are unlikely to reflect spontaneous fluctuation, delayed effects of haematopoietic stem cell transplantation, or state-dependent EEG variation.</p><p><strong>Conclusions: </strong>Advanced childhood cerebral X-linked adrenoleukodystrophy is associated with disorganisation of endogenous bioelectrical network activity. In this longitudinal analysis, large-scale network reorganisation was temporally associated with sustained clinical stabilisation, supporting a view of late-stage cALD as a dynamic disorder of network-level vulnerability, rather than a fixed terminal state.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13118975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777127","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":"Cognition and Health-Related Quality of Life After aSAH: The Role of Objective and Subjective Impairment.","authors":"Angelka Pešterac-Kujundžić, Una Nedeljković, Ivana Sretenović, Aleksandar Milosavljević, Dragoslav Nestorović, Vojislav Bogosavljević, Ivan Vukašinović","doi":"10.3390/neurolint18030062","DOIUrl":"10.3390/neurolint18030062","url":null,"abstract":"<p><p><b>Objectives:</b> Survivors of mild-grade aneurysmal subarachnoid hemorrhage (aSAH) often achieve favorable neurological recovery, yet many continue to experience cognitive difficulties and reduced health-related quality of life (HRQoL). The relative contribution of objectively measured cognition and subjective cognitive complaints to long-term HRQoL in this population remains insufficiently clarified. <b>Methods</b>: This prospective cohort study assessed objective and subjective cognitive functioning one year after mild-grade aSAH (Hunt & Hess I-II) and examined their unique contributions to HRQoL. Forty endovascularly treated aSAH survivors and 80 neurologically healthy controls, matched for sex, age, and educational level, were assessed 12-14 months post-ictus using the Montreal Cognitive Assessment (MoCA), Cognitive Failures Questionnaire (CFQ), and SF-36. <b>Results</b>: Compared with controls, patients demonstrated significantly lower MoCA scores, with cognitive impairment present in 42.5% of cases, as well as reduced HRQoL. In multivariate regression analyses adjusted for demographic, clinical, and affective covariates, subjective cognitive complaints (CFQ) remained independently associated with the mental component summary score of the SF-36 (<i>β</i> = -0.47, <i>p</i> = 0.002). Objective cognitive performance (MoCA) was not associated with the SF-36 component summary scores but showed weaker, domain-specific associations in exploratory analyses. The correlation between MoCA and CFQ was weak (<i>ρ</i> = -0.33), indicating a dissociation between these two measures. <b>Conclusions</b>: One year after mild-grade aSAH, subjective cognitive complaints contribute to mental HRQoL above and beyond the influence of affective symptoms. These findings highlight a clinically relevant dissociation between perceived and objectively measured cognition and support the importance of incorporating patient-reported cognitive difficulties into long-term outcome assessment and rehabilitation planning.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13028747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147531352","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":"Posterior Communicating Artery Configuration and Laterality of Thalamic and Lenticulostriate Infarction.","authors":"Junpei Nagasawa, Masamichi Hozumi, Tatsuhiro Yokoyama, Makiko Ogawa, Junya Ebina, Mari Shibukawa, Takehisa Hirayama, Osamu Kano","doi":"10.3390/neurolint18030061","DOIUrl":"10.3390/neurolint18030061","url":null,"abstract":"<p><p><b>Background:</b> Anatomical variations in the posterior communicating artery (PCoA) are common, but their association with ischemic stroke remains unclear. In this study, we investigated the relationship between PCoA configuration and the localization of perforator infarction. <b>Methods:</b> We conducted a single-center, retrospective observational study of consecutive patients admitted with acute ischemic stroke between April 2016 and July 2023. Patients with a single, unilateral lacunar infarction confined to the thalamic or lenticulostriate artery (LSA) territory were included. PCoA configuration was assessed using time-of-flight magnetic resonance angiography and dichotomized as present (normal PCoA or fetal-type posterior cerebral artery) or absent (hypoplastic or aplastic PCoA). Using a within-patient, hemisphere-based approach, the presence of PCoA on the infarcted side was directly compared with that on the contralateral side. McNemar's test with continuity correction was used for laterality analysis. <b>Results:</b> A total of 64 patients met the inclusion criteria, including 45 with LSA infarction and 19 with thalamic infarction. The prevalence of PCoA presence on the infarcted hemisphere was 20.0% in the LSA group and 26.3% in the thalamic group, identical to that observed on the contralateral hemisphere in each group. Within-patient comparisons revealed no significant difference in PCoA presence between infarcted and non-infarcted hemispheres in either territory (all <i>p</i> > 0.05). <b>Conclusions:</b> In patients with unilateral perforator infarction involving the thalamic or LSA territories, PCoA configuration was not associated with infarct laterality. These findings suggest that variations in PCoA anatomy have a limited influence on hemispheric vulnerability to perforator infarction, supporting the predominant role of local small-vessel pathology rather than proximal collateral anatomy in the development of lacunar stroke.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13029242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147531433","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":"No New Relevant Treatment Options for L-DOPA-Induced Dyskinesia from a Clinician's Point of View.","authors":"Thomas Müller","doi":"10.3390/neurolint18030059","DOIUrl":"10.3390/neurolint18030059","url":null,"abstract":"<p><strong>Background: </strong>The term dyskinesia describes involuntary movements of the face, body and extremities. Frequently, they appear following and in relation with prior oral long-lasting and high-dose levodopa therapy in Parkinson's disease patients. Onset of these motion sequences causes patient distress and caregiver embarrassment with declined quality of life. Continuity of nigrostriatal postsynaptic dopamine receptor stimulation delays occurrence of dyskinesia. A pulsatile pattern with temporary too high dopamine receptor excitation promotes manifestation of dyskinesia.</p><p><strong>Methods: </strong>This narrative review describes past pharmacologic approaches for therapy of dyskinesia, such as the principle of continuous dopamine receptor stimulation.</p><p><strong>Discussion and conclusions: </strong>Novel concepts were tested. They influenced neurotransmission of serotonin and altered stimulation of dopamine receptor subtypes. The translation of successful experimental research outcomes into valuable clinical trial results with consecutive approval of drugs with a new mode of action under the indication \"antidyskinetic\" repeatedly failed. An exception is the open-channel blocker of the N-methyl-D-aspartate receptor and dopamine reuptake inhibitor amantadine with its moderate dyskinesia-reducing effects, particularly in its extended-release formulation. This antiviral compound also improves impaired motor behavior and reduces \"OFF\" intervals. Therefore, amantadine is currently experiencing a certain resurgence in regions where its extended-release formulations are marketed for therapy of levodopa-induced dyskinesia.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13028972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147531413","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":"Duropathies as Unifying Concept-Part Two: A Narrative Overview of Clinical and Neuroradiological Features.","authors":"Marialuisa Zedde, Luigi Cirillo, Elisa Francesca Maria Ciceri, Nicola Limbucci, Mario Muto, Mauro Bergui, Francesco Causin, Rosario Pascarella","doi":"10.3390/neurolint18030060","DOIUrl":"10.3390/neurolint18030060","url":null,"abstract":"<p><p>Duropathies represent a spectrum of disorders associated with spinal dural tears and cerebrospinal fluid (CSF) leaks. Diagnosis and treatment is often complicated by overlapping clinical manifestations. This review aims to synthesize current literature on duropathies, focusing on their clinical, neuroradiological, and pathophysiological features. A comprehensive literature review was conducted, analyzing various conditions classified as duropathies, including spontaneous intracranial hypotension (SIH), superficial siderosis (SS), spinal cord herniation, and, as added issue, arachnoid webs. The review emphasized the importance of imaging techniques such as MRI and CT myelography in diagnosing these conditions. Duropathies can arise from congenital anomalies, trauma, and degenerative changes, with SIH being characterized by orthostatic headaches and neurological deficits. Imaging typically reveals specific patterns, such as a widened dorsal subarachnoid space and ventral displacement of the spinal cord. Syringomyelia was frequently associated with arachnoid webs, and complications like SS and bibrachial amyotrophy were noted in patients with persistent ventral spinal CSF leaks. The unifying concept of duropathies is proposed, emphasizing the need for timely intervention to mitigate long-term neurological consequences. Enhanced diagnostic strategies are crucial for improving patient outcomes, and a multidisciplinary approach is recommended for the management of these complex disorders. Further research is warranted to clarify the pathophysiological mechanisms underlying duropathies and to establish standardized treatment protocols.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13028763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147531290","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":"Ischemic Stroke as the First Manifestation of Takayasu Arteritis: A Case Report.","authors":"Dominika Jakubowicz-Lachowska, Magdalena Sarnowska, Monika Chorąży, Alina Kułakowska","doi":"10.3390/neurolint18030057","DOIUrl":"10.3390/neurolint18030057","url":null,"abstract":"<p><strong>Introduction: </strong>Ischemic stroke in young adults is uncommon and is frequently associated with rare etiologies, including autoimmune diseases and vasculitis. Takayasu arteritis (TA) is a chronic inflammatory large-vessel arteriopathy involving the aorta and its major branches and may result in cerebral ischemia due to arterial stenosis or thrombosis.</p><p><strong>Case presentation: </strong>We report the case of a 26-year-old woman with a history of suspected rheumatoid arthritis and Lyme disease who presented with acute left-sided hemiparesis and dysarthria. At admission, large-vessel vasculitis had not yet been suspected, and the patient was treated according to standard acute stroke protocols. Computed tomography angiography (CTA) revealed occlusion of the right middle cerebral artery bifurcation and the right common carotid artery, with inflammatory changes involving the brachiocephalic trunk and subclavian arteries. Intravenous thrombolysis (iv rtPA) was followed by mechanical thrombectomy (MT), resulting in neurological improvement.</p><p><strong>Outcome: </strong>Further diagnostic work-up confirmed TA, and immunosuppressive therapy with cyclophosphamide and infliximab was initiated.</p><p><strong>Conclusion: </strong>This case underscores the importance of considering inflammatory large-vessel disease in young patients presenting with acute ischemic stroke and illustrates that endovascular reperfusion may be feasible in this clinical setting.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13028751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147531344","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":"Delta Power in SLC6A1-Related Neurodevelopmental Disorder: Operationalizing Quantitative EEG Metrics for Biomarker Development.","authors":"Hamza Dahshi, Marie Varnet, Kimberly Goodspeed, Jacob Tiller, Dallas Armstrong, Deepa Sirsi","doi":"10.3390/neurolint18030058","DOIUrl":"10.3390/neurolint18030058","url":null,"abstract":"<p><strong>Introduction: </strong>SLC6A1-related neurodevelopmental disorder (SLC6A1-NDD) is an epileptic encephalopathy linked to mutations in the <i>SLC6A1</i> gene and is characterized by early-onset seizures and developmental delays. Despite the growing recognition of <i>SLC6A1</i> as a major cause of early-onset epilepsy, the electrophysiological changes associated with the disorder remain inadequately characterized. This study aims to identify electrophysiological biomarkers of SLC6A1-NDD by characterizing EEG delta power using automated tools, EEGLAB (v2023.1) and Persyst 13, exploring age- and state-related effects.</p><p><strong>Methods: </strong>We analyzed EEG recordings from 20 patients with SLC6A1-NDD and 20 neurotypical age- and sex-matched controls using EEGLAB and Persyst, quantifying delta power and related metrics. The Wilcoxon signed-rank method tested for differences between patients and controls, area under the curve (AUC) values evaluated patient classifier models, and Pearson's correlation assessed concordance between EEGLAB and Persyst.</p><p><strong>Results: </strong>Patients with SLC6A1-NDD exhibited significantly elevated delta power (19.4 ± 4.1) compared to controls (14.2 ± 3.0; <i>p</i> < 0.001). The mean delta power showed an age-dependent increasing trend in patients (b = 0.5), contrasting with a decline in controls (b = -1.0; <i>p</i> < 0.001). In Persyst, the frequency of delta activity above an optimized threshold best differentiated patients from controls in wake epochs (AUC = 0.93). Concordance between EEGLAB and Persyst was one-to-one but with moderate variability (R² = 0.644; <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Elevated delta power is a notable feature of SLC6A1-NDD. Cross-platform comparison demonstrates the feasibility of quantitative EEG analysis, while imperfect concordance highlights the need for pipeline standardization. Future work should validate these findings in larger cohorts and, as suitable reference data emerge, benchmark delta power metrics against age-matched children with other developmental and epileptic encephalopathies.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13029593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147531339","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":"Post-Transplant Tremor: Characteristics and Differences Based on Sex and Post-Transplant Therapy.","authors":"Srdjana Telarovic, Maja Vrdoljak Pazur, Nikolina Zupancic, Anamarija Strajduhar, Irma Telarovic","doi":"10.3390/neurolint18030056","DOIUrl":"10.3390/neurolint18030056","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Kidney transplantation is the standard of care for the majority of patients with end-stage kidney disease. Neurological complications are common, and among them, tremor is very frequent and usually attributed to immunosuppressive drug toxicity. <b>Methods</b>: In this retrospective study, we investigate the incidence and characteristics of tremor in kidney transplant patients and analyze its occurrence with respect to a multitude of demographic and clinical parameters, thereby aiming to confirm the role of calcineurin inhibitor-induced neurotoxicity and to identify other putative predictive factors. Furthermore, we characterize post-transplant tremor with the goal of identifying its clinical features and determining the impact on quality of life. <b>Results</b>: A total of 129 kidney transplant recipients were screened; six patients were excluded due to a history of movement disorders prior to kidney transplantation. In total, 123 patients were included in the final analysis-69 male (56%) and 54 female patients (44%), with a median age of 50. A total of 36% (46 patients) developed tremor in the post-transplant period. Using both univariable and multivariable analyses, we found that female sex and tacrolimus use were independently associated with the development of post-transplant tremor. In addition, multivariable analysis identified an association between younger age and post-transplant tremor. Furthermore, we observed a trend in the duration of symptoms in relation to the calcineurin inhibitor choice. <b>Conclusions</b>: Despite a relatively high prevalence (36%), post-transplant tremor does not significantly impact the QoL and spontaneously resolves within 1 year in adult kidney transplant recipients. Female sex and tacrolimus were identified as independent predictors of post-transplant tremor in renal transplant recipients.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13029305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147530717","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":"EEG in the Emergency Department: When the Neurophysiological Test Can Be Avoided in Emergency Diagnostic Workups? The EMINENCE Study.","authors":"Maenia Scarpino, Antonello Grippo, Federica Barraco, Benedetta Piccardi, Laura Betti, Peiman Nazerian, Arianna Fabbri, Roberto Fratangelo, Cristina Mei, Andrea Nencioni","doi":"10.3390/neurolint18030054","DOIUrl":"10.3390/neurolint18030054","url":null,"abstract":"<p><p><b>Introduction</b>: This study was conducted to determine whether specific emergency physician (EP) diagnoses and/or neurological signs/symptoms upon admission to the Emergency Department (ED) were associated with normal/non-informative emergency electroencephalogram (emEEG). <b>Methods:</b> Data from consecutive patients admitted to the ED of our tertiary hospital over a two-year period (1 January 2023-31 December 2024) were analyzed retrospectively. We evaluated the correlation between normal/non-specific emEEGs and EP admission diagnoses and neurological signs/symptoms on admission. Epileptic discharges and sharp waves with triphasic morphology were considered specific patterns. <b>Results</b>: A total of 2008 patients underwent emEEG recording during the study period. EmEEGs were considered non-informative in 100% of global amnesia diagnoses, 100% of cases of mild head trauma, 100% of cases of migraine with aura, 98.3% of transient ischemic attacks (TIAs), 95.6% of transient losses of consciousness (TLCs) when seizure was not the primary suspected diagnosis, and in 92.7% of falls of unknown dynamics. Epileptic patterns were detected in 4% of patients presenting with TLC and in 2.4% of those with falls of unknown dynamics, with approximately half of these patients having a pre-existing diagnosis of epilepsy. Triphasic waves were detected in 4.9% patients with falls of unknown dynamics, in 1.7% with TIA, and in 0.4% with TLC. All of these patients had fever/sepsis or metabolic/electrolyte disorders. Overall, across all clinical scenarios, emEEGs were considered non-informative in 385 (19.1%) tested patients. <b>Conclusions:</b> emEEGs are almost non-informative in the diagnostic pathway for patients with global amnesia, mild head trauma, and migraine with aura, and in patients with TIA, TLC, or falls of unknown dynamics. EPs can safely consider avoiding emEEGs in the absence of previous epilepsy diagnosis, fever/sepsis, metabolic/electrolyte disturbances, or drug abuse.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13028728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147531350","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}