Neurology International最新文献

{"title":"Point-of-Care Electroencephalography in Acute Neurological Care: A Narrative Review.","authors":"Roberto Fratangelo, Francesco Lolli, Maenia Scarpino, Antonello Grippo","doi":"10.3390/neurolint17040048","DOIUrl":"https://doi.org/10.3390/neurolint17040048","url":null,"abstract":"<p><p>Point-of-care electroencephalography (POC-EEG) systems are rapid-access, reduced-montage devices designed to address the limitations of conventional EEG (conv-EEG), enabling faster neurophysiological assessment in acute settings. This review evaluates their clinical impact, diagnostic performance, and feasibility in non-convulsive status epilepticus (NCSE), traumatic brain injury (TBI), stroke, and delirium. A comprehensive search of Medline, Scopus, and Embase identified 69 studies assessing 15 devices. In suspected NCSE, POC-EEG facilitates rapid seizure detection and prompt diagnosis, making it particularly effective in time-sensitive and resource-limited settings. Its after-hours availability and telemedicine integration ensure continuous coverage. AI-assisted tools enhance interpretability and accessibility, enabling use by non-experts. Despite variability in accuracy, it supports triaging, improving management, treatment decisions and outcomes while reducing hospital stays, transfers, and costs. In TBI, POC-EEG-derived quantitative EEG (qEEG) indices reliably detect structural lesions, support triage, and minimize unnecessary CT scans. They also help assess concussion severity and predict recovery. For strokes, POC-EEG aids triage by detecting large vessel occlusions (LVOs) with high feasibility in hospital and prehospital settings. In delirium, spectral analysis and AI-assisted models enhance diagnostic accuracy, broadening its clinical applications. Although POC-EEG is a promising screening tool, challenges remain in diagnostic variability, technical limitations, and AI optimization, requiring further research.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 4","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12029912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028855","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":"Preventive Role of Cocoa-Enriched Extract Against Neuroinflammation in Mice.","authors":"Ivan Carrera, Lola Corzo, Olaia Martínez-Iglesias, Vinogran Naidoo, Ramón Cacabelos","doi":"10.3390/neurolint17040047","DOIUrl":"https://doi.org/10.3390/neurolint17040047","url":null,"abstract":"<p><strong>Background: </strong>Chronic aberrant inflammation is a crucial step in mediating cerebrovascular and neurodegenerative pathologies, including Alzheimer's and Parkinson's disease. Due to their exceptional antioxidant properties and ability to alter imbalance metabolism and reactive inflammation response, cocoa-derived flavanols are being investigated as potential bioactive substances to modulate and reverse these inflammation-associated disorders.</p><p><strong>Objective: </strong>The present study will focus on the possible beneficial effects of cocoa-derived extract, enhanced with other bioactive phytochemicals such as spirulina and pineapple, on selected biomarkers of the inflammatory, metabolic, and neurodegenerative processes.</p><p><strong>Methods: </strong>A mice model of inflammation was treated with cocoa-derived extract cocktail, and biomolecular data was obtained by performing immunohistochemical and biochemical analysis.</p><p><strong>Results: </strong>Results show that the cocoa-derived extract mitigates the neuroinflammatory processes triggered (decreased expression of macrophage CD11b) and prevents the escalade of subsequent neurodegeneration pathologies.</p><p><strong>Conclusions: </strong>The results based on hypo-vitaminosis, neuroinflammation, and inmunoreactive analysis suggest that cocoa-derived extract is a powerful bioproduct for ameliorating neuroinflammatory processes that mediate metabolic and cerebrovascular diseases.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 4","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12029631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012445","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":"Pain and the Brain: A Systematic Review of Methods, EEG Biomarkers, Limitations, and Future Directions.","authors":"Bayan Ahmad, Buket D Barkana","doi":"10.3390/neurolint17040046","DOIUrl":"https://doi.org/10.3390/neurolint17040046","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Background:&lt;/b&gt; Pain is prevalent in almost all populations and may often hinder visual, auditory, tactile, olfactory, and taste perception as it alters brain neural processing. The quantitative methods emerging to define pain and assess its effects on neural functions and perception are important. Identifying pain biomarkers is one of the initial stages in developing such models and interventions. The existing literature has explored chronic and experimentally induced pain, leveraging electroencephalograms (EEGs) to identify biomarkers and employing various qualitative and quantitative approaches to measure pain. &lt;b&gt;Objectives&lt;/b&gt;: This systematic review examines the methods, participant characteristics, types of pain states, associated pain biomarkers of the brain's electrical activity, and limitations of current pain studies. The review identifies what experimental methods researchers implement to study human pain states compared to human control pain-free states, as well as the limitations in the current techniques of studying human pain states and future directions for research. &lt;b&gt;Methods&lt;/b&gt;: The research questions were formed using the Population, Intervention, Comparison, Outcome (PICO) framework. A literature search was conducted using PubMed, PsycINFO, Embase, the Cochrane Library, IEEE Explore, Medline, Scopus, and Web of Science until December 2024, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to obtain relevant studies. The inclusion criteria included studies that focused on pain states and EEG data reporting. The exclusion criteria included studies that used only MEG or fMRI neuroimaging techniques and those that did not focus on the evaluation or assessment of neural markers. Bias risk was determined by the Newcastle-Ottawa Scale. Target data were compared between studies to organize the findings among the reported results. &lt;b&gt;Results&lt;/b&gt;: The initial search resulted in 592 articles. After exclusions, 24 studies were included in the review, 6 of which focused on chronic pain populations. Experimentally induced pain methods were identified as techniques that centered on tactile perception: thermal, electrical, mechanical, and chemical. Across both chronic and stimulated pain studies, pain was associated with decreased or slowing peak alpha frequency (PAF). In the chronic pain studies, beta power increases were seen with pain intensity. The functional connectivity and pain networks of chronic pain patients differ from those of healthy controls; this includes the processing of experimental pain. Reportedly small sample sizes, participant comorbidities such as neuropsychiatric disorders and peripheral nerve damage, and uncontrolled studies were the common drawbacks of the studies. Standardizing methods and establishing collaborations to collect open-access comprehensive longitudinal data were identified as necessary future directions to generalize neuro markers of pain. ","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 4","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12029872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029512","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":"Artificial Intelligence in the Diagnosis of Neurological Diseases Using Biomechanical and Gait Analysis Data: A Scopus-Based Bibliometric Analysis.","authors":"Aikaterini A Tsiara, Spyridon Plakias, Christos Kokkotis, Aikaterini Veneri, Minas A Mina, Anna Tsiakiri, Sofia Kitmeridou, Foteini Christidi, Evangelos Gourgoulis, Triantafylos Doskas, Antonia Kaltsatou, Konstantinos Tsamakis, Dimitrios Kazis, Dimitrios Tsiptsios","doi":"10.3390/neurolint17030045","DOIUrl":"10.3390/neurolint17030045","url":null,"abstract":"<p><p>Neurological diseases are increasingly diverse and prevalent, presenting significant challenges for their timely and accurate diagnosis. The aim of the present study is to conduct a bibliometric analysis and literature review in the field of neurology to explore advancements in the application of artificial intelligence (AI) techniques, including machine learning (ML) and deep learning (DL). Using VOSviewer software (version 1.6.20.0) and documents retrieved from the Scopus database, the analysis included 113 articles published between 1 January 2018 and 31 December 2024. Key journals, authors, and research collaborations were identified, highlighting major contributions to the field. Science mapping investigated areas of research focus, such as biomechanical data and gait analysis including AI methodologies for neurological disease diagnosis. Co-occurrence analysis of author keywords allowed for the identification of four major themes: (a) machine learning and gait analysis; (b) sensors and wearable health technologies; (c) cognitive disorders; and (d) neurological disorders and motion recognition technologies. The bibliometric insights demonstrate a growing but relatively limited collaborative interest in this domain, with only a few highly cited authors, documents, and journals driving the research. Meanwhile, the literature review highlights the current methodologies and advancements in this field. This study offers a foundation for future research and provides researchers, clinicians, and occupational therapists with an in-depth understanding of AI's potentially transformative role in neurology.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730616","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":"Successful Long-Term Treatment of Pediatric Relapsing Idiopathic Optic Neuritis with Mycophenolate Mofetil.","authors":"Shuhei Fujino, Keiji Akamine, Eiichiro Noda, Sahoko Miyama","doi":"10.3390/neurolint17030044","DOIUrl":"10.3390/neurolint17030044","url":null,"abstract":"<p><p><b>Background:</b> Pediatric optic neuritis (ON) is a rare but severe condition characterized by acute visual impairment, with 3-5% of relapsing cases lacking identifiable markers for associated conditions, such as neuromyelitis optica spectrum disorder (NMOSD) or multiple sclerosis (MS); these cases are thus classified as relapsing idiopathic optic neuritis (RION). Corticosteroids are typically used for acute management; however, their prolonged use in children poses significant risks, including central obesity, hypertension, and growth impairment, underscoring the need for nonsteroidal, long-term treatment options. Current strategies for preventing recurrence in pediatric RION are limited due to a lack of data on immunosuppressive efficacy and safety. Given its rarity and the challenges of long-term immunosuppression in children, identifying optimal therapeutic approaches remains critical. <b>Case Presentation:</b> We report a case of a six-year-old girl with RION, who was initially treated with intravenous methylprednisolone (IVMP) and prednisolone (PSL) tapering, and who experienced recurrence eight months post-treatment. Additional corticosteroids and intravenous immunoglobulin (IVIg) were administered during relapse, but, due to adverse effects, treatment was transitioned to mycophenolate mofetil (MMF), enabling early PSL tapering. <b>Conclusions:</b> With MMF, the patient maintained stable vision and achieved a five-year recurrence-free period without notable side effects. In conclusion, this case suggests MMF's efficacy as a long-term management option for pediatric RION, potentially reducing corticosteroid-related risks.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11945395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730842","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":"Responsiveness and Minimal Important Change of the Mini- and Brief-Balance Evaluation Systems Tests in People with Incomplete Cervical Spinal Cord Injury: A Prospective Cohort Study.","authors":"Yusuke Morooka, Yosuke Kunisawa, Shigeru Obayashi, Yasuyuki Takakura","doi":"10.3390/neurolint17030043","DOIUrl":"10.3390/neurolint17030043","url":null,"abstract":"<p><strong>Background/objectives: </strong>Responsiveness and minimal important change (MIC) are key metrics that vary across conditions and should be determined for specific populations. However, these metrics have not yet been established for the Mini-Balance Evaluation Systems Test (Mini-BESTest) and Brief-BESTest in people with subacute traumatic incomplete cervical spinal cord injury (iCSCI). In this study, we aimed to determine the responsiveness and MIC of the Mini-BESTest and Brief-BESTest in people with subacute iCSCI.</p><p><strong>Methods: </strong>This study included people with iCSCI who could maintain the standing position for 30 s without assistance within 7 days of injury at the university hospital's advanced critical care center. Responsiveness was assessed by correlating Mini-BESTest and Brief-BESTest change scores with the Berg Balance Scale (BBS). MIC values were determined using the global rating of change scale as an anchor, employing receiver operating characteristic curve methods (MIC_ROC) and predictive modeling methods adjusted for the proportion of improved participants (MIC_adjusted).</p><p><strong>Results: </strong>Fifty people with iCSCI were included in the analysis. Changes in BBS scores were moderately positively correlated with changes in Mini-BESTest and Brief-BESTest scores. MIC_adjusted values were 3.7 for the Mini-BESTest and 2.2 for the Brief-BESTest. The MIC_ROC, based on an improvement rate of 64%, was deemed less appropriate for interpreting meaningful changes due to the high proportion of improved participants.</p><p><strong>Conclusions: </strong>MIC_adjusted benchmarks can help clinicians measure significant improvements in dynamic balance, design effective interventions, and evaluate rehabilitation outcomes in people with iCSCI.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730833","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":"Dysregulation of Retinal Melatonin Biosynthetic Pathway and Differential Expression of Retina-Specific Genes Following Blast-Induced Ocular Injury in Ferrets.","authors":"Chetan Pundkar, Rex Jeya Rajkumar Samdavid Thanapaul, Manoj Govindarajulu, Gaurav Phuyal, Joseph B Long, Peethambaran Arun","doi":"10.3390/neurolint17030042","DOIUrl":"10.3390/neurolint17030042","url":null,"abstract":"<p><strong>Background/objectives: </strong>Blast-induced traumatic ocular injuries (bTOI) pose a significant risk to military and civilian populations, often leading to visual impairment or blindness. Retina, the innermost layer of ocular tissue consisting of photoreceptor and glial cells, is highly susceptible to blast injuries. Despite its prevalence, the molecular mechanisms underlying retinal damage following bTOI remain poorly understood, hindering the development of targeted therapies. Melatonin, a neuroprotective indoleamine with antioxidant, anti-inflammatory, and circadian regulatory properties, is synthesized in the retina and plays a crucial role in retinal health. Similarly, retina-specific genes, such as <i>Rhodopsin</i>, <i>Melanopsin</i>, and RPE65, are essential for photoreceptor function, visual signaling, and the visual cycle. However, their responses to blast exposure have not been thoroughly investigated.</p><p><strong>Methods: </strong>In this study, we utilized a ferret model of bTOI to evaluate the temporal expression of melatonin-synthesizing enzymes, such as tryptophan hydroxylase 1 and 2 (<i>TPH</i>1 and <i>TPH</i>2), Aralkylamine N-acetyltransferase (<i>AANAT</i>), and Acetylserotonin-O-methyltransferase (<i>ASMT</i>), and retina-specific genes (<i>Rhodopsin</i>, <i>Melanopsin</i>) and retinal pigment epithelium-specific 65 kDa protein (<i>RPE65</i>) at 4 h, 24 h, 7 days, and 28 days post-blast. Ferrets were exposed to tightly coupled blast overpressure waves using an advanced blast simulator, and retinal tissues were collected for quantitative polymerase chain reaction (qPCR) analysis.</p><p><strong>Results: </strong>The results revealed dynamic and multiphasic transcriptional responses. <i>TPH</i>1 and <i>TPH</i>2 exhibited significant upregulation at 24 h, followed by downregulation at 28 days, indicating blast-induced dysregulation of tryptophan metabolism, including melatonin synthesis. Similarly, <i>AANAT</i> and <i>ASMT</i> showed acute downregulation post-blast, with late-phase disruptions. <i>Rhodopsin</i> expression increased at 24 h but declined at 28 days, while <i>Melanopsin</i> and <i>RPE65</i> demonstrated early upregulation followed by downregulation, reflecting potential disruptions in circadian regulation and the visual cycle.</p><p><strong>Conclusions: </strong>These findings highlight the complex regulatory mechanisms underlying retinal responses to bTOI, involving neuroinflammation, oxidative stress, and disruptions in melatonin synthesis and photoreceptor cell functions. The results emphasize the therapeutic potential of melatonin in mitigating retinal damage and preserving visual function.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730811","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":"Glial Cells in Spinal Muscular Atrophy: Speculations on Non-Cell-Autonomous Mechanisms and Therapeutic Implications.","authors":"Andrej Belančić, Tamara Janković, Elvira Meni Maria Gkrinia, Iva Kristić, Jelena Rajič Bumber, Valentino Rački, Kristina Pilipović, Dinko Vitezić, Jasenka Mršić-Pelčić","doi":"10.3390/neurolint17030041","DOIUrl":"10.3390/neurolint17030041","url":null,"abstract":"<p><p>Spinal muscular atrophy (SMA) is a neuromuscular disorder caused by homozygous deletions or mutations in the <i>SMN1</i> gene, leading to progressive motor neuron degeneration. While SMA has been classically viewed as a motor neuron-autonomous disease, increasing evidence indicates a significant role of glial cells-astrocytes, microglia, oligodendrocytes, and Schwann cells-in the disease pathophysiology. Astrocytic dysfunction contributes to motor neuron vulnerability through impaired calcium homeostasis, disrupted synaptic integrity, and neurotrophic factor deficits. Microglia, through reactive gliosis and complement-mediated synaptic stripping, exacerbate neurodegeneration and neuroinflammation. Oligodendrocytes exhibit impaired differentiation and metabolic support, while Schwann cells display abnormalities in myelination, extracellular matrix composition, and neuromuscular junction maintenance, further compromising motor function. Dysregulation of pathways such as NF-κB, Notch, and JAK/STAT, alongside the upregulation of complement proteins and microRNAs, reinforces the non-cell-autonomous nature of SMA. Despite the advances in SMN-restorative therapies, they do not fully mitigate glial dysfunction. Targeting glial pathology, including modulation of reactive astrogliosis, microglial polarization, and myelination deficits, represents a critical avenue for therapeutic intervention. This review comprehensively examines the multifaceted roles of glial cells in SMA and highlights emerging glia-targeted strategies to enhance treatment efficacy and improve patient outcomes.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730829","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 Impact of Biseasonal Time Changes on Migraine.","authors":"Carl H Göbel, Katja Heinze-Kuhn, Axel Heinze, Anna Cirkel, Hartmut Göbel","doi":"10.3390/neurolint17030040","DOIUrl":"10.3390/neurolint17030040","url":null,"abstract":"<p><p><b>Background</b>: Changes in the daily rhythm can trigger migraine attacks. The sensitivity for triggering attacks is closely linked to the regulation of biological rhythms controlled by the hypothalamus. In over 70 countries around the world, the time is changed between daylight savings time and standard time twice a year due to legal regulations. The aim of this study was to investigate whether the time change has an influence on migraine. <b>Methods</b>: In this retrospective study, the headache frequency of patients with episodic or chronic migraine at a tertiary headache center in the years 2020, 2021, and 2022 was evaluated. The primary outcome measure was the frequency of migraine occurrence on either Sunday or Monday of the time change weekend compared to Sunday or Monday before or Sunday or Monday after the time change. <b>Results</b>: Data from 258 patients were analyzed (86.8% women; average age: 51.5 years; average headache frequency: 7.7 days/month; 83.3% episodic migraine). Our results showed a significant increase of 6.4% in migraine frequency on the Sunday and/or Monday in the week after the time change in spring compared to the week before the change. In autumn, conversely, there was a significant reduction of 5.5% in migraine frequency on the Sunday and/or Monday one week after the time change compared to the week before the change. The factor responsible for the significant changes was the increase in migraines on Monday one week after the time change in spring and the decrease in migraines on Sunday one week after the time change in autumn. <b>Conclusions</b>: When switching from standard time to daylight savings time in the spring, the frequency of migraines increases significantly one week after the time change. In autumn, in comparison, there is an inverse trend with a reduction in migraine frequency. These data suggest that synchronization is disturbed when switching to daylight savings time. Conversely, synchronization normalizes in autumn. In view of the high prevalence of migraines, this can have extensive individual and social consequences.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730858","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 Impact of Age on Outcomes in Seizure Hospitalizations-Analysis of a National Sample.","authors":"Anudeep Surendranath, Saurabh Singhal, Rahul Khanna, Subhendu Rath, Temenuzhka Mihaylova","doi":"10.3390/neurolint17030039","DOIUrl":"10.3390/neurolint17030039","url":null,"abstract":"<p><p><b>Objective:</b> Seizures are a critical public health issue, with incidence rising significantly after age 50. Using this inflection point, we divided patients into two age groups to examine the impact of age on patient characteristics and hospitalization outcomes for seizures. <b>Methods:</b> Using the 2021 National Inpatient Sample (NIS), a nationally representative database, we conducted a retrospective cohort analysis of adult patients aged ≥18 years admitted with a principal diagnosis of seizures. Patients were divided into two age groups: 18-49 and ≥50 years. Outcomes included in-hospital mortality, length of stay, and hospital charges. Multivariate logistic and linear regression models adjusted for confounders were employed to assess the association between age and outcomes. <b>Results:</b> The cohort included 211,055 patients, with 59% aged ≥50 years. Older patients were more likely to have Medicare coverage (66% vs. 16%, <i>p</i> < 0.01), to reside in the south (41% vs. 38%, <i>p</i> < 0.01), and to have a higher proportion of White individuals (62% vs. 54%, <i>p</i> < 0.01). Younger patients were more likely to be Hispanic (15% vs. 9%, <i>p</i> < 0.01), admitted to urban hospitals (96% vs. 94%, <i>p</i> < 0.01), and treated at teaching hospitals (84% vs. 79%, <i>p</i> < 0.01). After adjusting for confounders, older adults had over twice the odds of in-hospital mortality compared with younger patients (adjusted OR 2.17; 95% CI, 1.61-2.92; <i>p</i> < 0.01). They also experienced longer hospital stays (mean difference 0.7 days; 95% CI, 0.54-0.92; <i>p</i> < 0.01) and higher hospital charges (mean increase USD 4322; 95% CI, USD 1914-6731; <i>p</i> < 0.01). <b>Significance:</b> Age is an independent predictor of in-hospital mortality, longer hospitalizations, and higher costs in seizure-related admissions. These findings underscore the need for age-specific management strategies to improve outcomes and optimize healthcare resource utilization for older adults with seizures.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730846","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}