Neurology International最新文献

{"title":"Selective Serotonin Reuptake Inhibitor-Associated Intracranial Hemorrhage: Drug-Specific Risk Patterns and Patient-Level Modifiers.","authors":"Josef Yayan, Kurt Rasche","doi":"10.3390/neurolint17070111","DOIUrl":"10.3390/neurolint17070111","url":null,"abstract":"<p><strong>Background: </strong>Selective serotonin reuptake inhibitors (SSRIs) are among the most commonly prescribed antidepressants and are generally considered safe. However, emerging data suggest a potential association with intracranial hemorrhage (ICH), especially among elderly patients and those on anticoagulation.</p><p><strong>Methods: </strong>We conducted a retrospective pharmacovigilance analysis using data from the U.S. Food and Drug Administration's Adverse Event Reporting System (FAERS). Reports up to May 2025 listing an SSRI (sertraline, fluoxetine, paroxetine, escitalopram, citalopram, or fluvoxamine) as a suspect or interacting drug and involving an ICH event were included. Disproportionality was assessed using reporting odds ratios (RORs) with 95% confidence intervals.</p><p><strong>Results: </strong>Among 226 eligible ICH cases, sertraline (30.5%), paroxetine (28.8%), and fluoxetine (27.9%) were most frequently implicated. Sertraline showed a strong signal for cerebral hemorrhage (ROR = 4.97), while fluoxetine was associated with subarachnoid hemorrhage (ROR = 4.51). Sertraline had a pronounced signal among patients aged >60 years (ROR = 7.92) and in combination with anticoagulants (ROR = 9.56). Fluoxetine was underrepresented in elderly cases. Given the very small number of fluvoxamine-related cases (n = 2), interpretation should be cautious due to limited statistical power. Gender-stratified analyses showed female predominance in sertraline-related ICH and male predominance for paroxetine. Citalopram demonstrated a potentially protective profile with inverse association with cerebral hemorrhage.</p><p><strong>Conclusions: </strong>This study highlights significant differences in ICH reporting patterns across SSRIs, modified by patient age, gender, and co-medication. These findings underscore the need for individualized SSRI prescribing, particularly in patients receiving anticoagulant therapy particularly in elderly patients and those receiving anticoagulant therapy, where sertraline and fluoxetine may pose increased risk.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12299848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708325","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 Association of Axonal Damage Biomarkers and Osteopontin at Diagnosis Could Be Useful in Newly Diagnosed MS Patients.","authors":"Eleonora Virgilio, Chiara Puricelli, Nausicaa Clemente, Valentina Ciampana, Ylenia Imperatore, Simona Perga, Sveva Stangalini, Elena Boggio, Alice Appiani, Casimiro Luca Gigliotti, Umberto Dianzani, Cristoforo Comi, Domizia Vecchio","doi":"10.3390/neurolint17070110","DOIUrl":"10.3390/neurolint17070110","url":null,"abstract":"<p><p>(1) Background: Multiple sclerosis (MS) is a biologically highly heterogeneous disease and has poor predictability at diagnosis. Moreover, robust data indicate that early disease activity strongly correlates with future disability. Therefore, there is a need for strong and reliable biomarkers from diagnosis to characterize and identify patients who require highly effective disease-modifying treatments (DMTs). Several biomarkers are promising, particularly neurofilament light chains (NFLs), but the relevance of others is less consolidated. (2) Methods: We evaluated a panel of axonal damage and inflammatory biomarkers in cerebrospinal fluid (CSF) and matched serum obtained from a cohort of 60 newly diagnosed MS patients. Disability at diagnosis, negative prognostic factors, and the initial DMT prescribed were carefully recorded. (3) Results: We observed correlations between different axonal biomarkers: CSF and serum NFL versus CSF total tau; and between the inflammatory marker osteopontin (OPN) and axonal biomarkers CSF p-Tau, CSF total tau, and serum NFL. CSF and serum NFL and total tau, as well as CSF OPN, positively correlated with EDSS at diagnosis. Moreover, CSF and serum NFL levels were increased in patients with gadolinium-enhancing lesions (<i>p</i> = 0.01 and <i>p</i> = 0.04, respectively) and in those treated with highly effective DMT (<i>p</i> = 0.049). Furthermore, CSF OPN and both CSF and serum NFL levels significantly differentiated patients based on EDSS, with a combined ROC AUC of 0.88. We calculated and internally validated biomarker (in particular serum NFL) thresholds that significantly identified patients with higher disability. Finally, CSF OPN levels and dissemination in the spinal cord were significant predictors of EDSS at diagnosis. (4) Conclusions: These preliminary exploratory data confirm the pathological interconnection between inflammation and axonal damage from early disease stages, contributing to early disability. Follow-up data, such as longitudinal disability scores, repeated serum measurements, a healthy control group, and external validation of our results, are needed. We suggest that combining several fluid biomarkers may improve the clinical characterization of patients.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12300847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708328","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":"G-Protein-Coupled Estrogen Receptor (GPER) in Inflammatory Myopathies.","authors":"Delia Righi, Diego Lopergolo, Nila Volpi, Daniela Franci, Paola Lorenzoni, Margherita Aglianò, Gianna Berti, Carlo Manco, Nicola De Stefano, Federica Ginanneschi","doi":"10.3390/neurolint17070109","DOIUrl":"10.3390/neurolint17070109","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Given the multifaceted role of estrogen hormones in skeletal muscle pathophysiology and their well-established immunomodulatory properties, this study aimed to characterize the expression of the G-protein-coupled estrogen receptor (GPER) in patients with inflammatory myopathies (IM). <b>Methods</b>: Immunohistochemical analysis was performed on muscle biopsies from 13 patients with IM, 11 with non-inflammatory myopathies (N.IM), and 5control subjects. Intergroup differences in GPER score were statistically evaluated. We performed an analysis based on the Visual Analog Scale (VAS). The scoring system evaluates overall pathology (VAS score) based on four distinct components: inflammation, vascular involvement, myopathic changes, and connective tissue alterations. <b>Results</b>: Immunolocalization analysis demonstrated that GPER is constitutively expressed in human skeletal muscle and is upregulated in IM. Enhanced expression included both sarcolemmal and intracellular membrane localization. Notably, GPER upregulation showed a positive correlation with the severity of tissue inflammation. The IM group had significantly higher VAS scores compared to both the N.IM and control groups. <b>Conclusions</b>: We provide the first histopathological characterization of GPER expression in human skeletal muscle. In IM, GPER upregulation may play a protective role by negatively modulating the release of inflammatory mediators, as suggested by experimental evidence from other models of inflammation. The emerging therapeutic development of GPER agonists may represent a promising avenue for the treatment of inflammatory myopathies.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12298197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708238","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":"Cognitive Effects of Cannabis Use: A Comprehensive Review Across Domains.","authors":"Andréia Pucinelli de Souza Queiroz, Maria Olivia Pozzolo Pedro, Marcela Waisman Campos, Julio Torales, Antonio Ventriglio, João Mauricio Castaldelli-Maia","doi":"10.3390/neurolint17070107","DOIUrl":"10.3390/neurolint17070107","url":null,"abstract":"<p><p>Cannabis is the most widely consumed illicit substance worldwide, with rising use particularly among adolescents and young adults. Accumulating evidence indicates that chronic cannabis use may negatively impact several domains of cognition, yet findings across studies remain varied and fragmented. This comprehensive review synthesizes current knowledge on the long-term cognitive consequences of cannabis use, focusing on attention, executive functioning, learning, memory, language, motor coordination, and social cognition. Consistent impairments have been observed in domains such as attention, executive function, memory, and learning; however, most evidence derives from studies of acute or residual effects. Evidence of long-lasting deficits after extended abstinence remains more limited and methodologically heterogeneous. Acute motor coordination deficits are well established, but persistent impairments in this domain lack conclusive evidence. Effects on language remain inconclusive, and findings regarding social cognition, though limited, suggest potential deficits in emotion recognition and mental state inference. Early onset and high-frequency use are critical risk factors for more severe and enduring cognitive effects. Some deficits may partially reverse with abstinence, although many persist long after cessation. Overall, cannabis use is associated with widespread and lasting cognitive impairments. These findings underscore the need for targeted prevention strategies, especially among youth, and point to future longitudinal and mechanistic research to better understand the nature, persistence, and potential reversibility of these cognitive effects.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12300094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708235","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":"Effectiveness of a Cognitive Stimulation Program in Older Adults with Mild Neurocognitive Disorder: Insights from fNIRS Analysis in a Randomized Controlled Trial.","authors":"Susana I Justo-Henriques, Rosa C G Silva, Janessa O Carvalho, João L A Apóstolo, Débora Nogueira, Telmo A S Pereira","doi":"10.3390/neurolint17070108","DOIUrl":"10.3390/neurolint17070108","url":null,"abstract":"<p><strong>Background/objectives: </strong>Neurocognitive disorders (NCDs) encompass a spectrum of conditions that significantly impact cognitive domains, including attention, memory, and language. Mild NCD, increasingly prevalent with aging, represents an early stage of these disorders, characterized by cognitive deficits that do not interfere with daily functioning. Non-pharmacological therapies, especially cognitive stimulation, are widely recommended to preserve cognitive function of older adults. This study aimed to evaluate the effectiveness of a 12-week individual cognitive stimulation (iCS) program on cognitive performance, mood, and prefrontal cortex activation in older adults with mild NCD using a single-blind, randomized, parallel two-arm RCT.</p><p><strong>Methods: </strong>A sample of 36 older adults were selected from a central region of Portugal. The intervention group (<i>n</i> = 18) received 24 iCS sessions, twice weekly for 12 weeks. The control group (<i>n</i> = 18) completed their regularly scheduled activities. Outcomes included global cognitive function, executive functioning, and mood. All participants were assessed at baseline and after the intervention. Functional near infra-red spectroscopy (fNIRS) was also collected to measure prefrontal cortex activity at both time points in the intervention group.</p><p><strong>Results: </strong>The intervention group showed a significant improvement in global cognition and executive functions, and reduced depressive symptomatology compared to the control group. fNIRS data revealed enhanced activation and functional efficiency in the lateral prefrontal cortex following the iCS program. Adherence and degree of collaboration to the intervention were very high.</p><p><strong>Conclusions: </strong>These findings suggest that iCS is an effective approach to improving cognitive function and mood in mildly cognitively impaired older adults.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12298109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708236","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":"Implications for the Ergogenic Benefits of Self-Selected Music in Neurological Conditions: A Theoretical Review.","authors":"Christopher G Ballmann, Rebecca R Rogers, Sophia L Porrill, Nicholas B Washmuth","doi":"10.3390/neurolint17070106","DOIUrl":"10.3390/neurolint17070106","url":null,"abstract":"<p><p>The ergogenic effects of music have been well described across various modes of exercise with widespread use across competitive athletes and recreational exercisers alike. Underlying the acute beneficial effects of music during exercise are profound physiological and psychological changes which involve an array of different organ systems, including but not limited to cardiovascular, endocrine, skeletal muscle, and nervous systems. While the use of music to enhance physical performance and improve associated mechanisms has been largely optimized in healthy individuals, the investigations of the translation to individuals with neurological conditions are still ongoing. Recently, it has been established that the personalization of music interventions greatly influences performance-enhancing benefits and aids in physical performance optimization in healthy individuals. Self-selected music (SSM) has been documented to impart ergogenic advantages over pre-determined or non-preferred music, including improved cardiorespiratory endurance, power development, and velocity of movement which are characterized by adaptative physiological and psychological changes. Evidence of the benefits of SSM has progressed to the degree to which the overlap of possible benefits between healthy and clinical populations is becoming more apparent. This aim of this theoretical review is to discuss how personalized music influences psychophysiological determinants of exercise ability in healthy individuals and consider how these findings may be applicable to neurological conditions to enhance exercise capacity. The current knowledge on the role of SSM in augmenting physiological and psychological responses to exercise in healthy individuals is presented along with how these mechanisms might be leveraged to overcome exercise limitations in neurological conditions. Overall, SSM appears to have theoretical support to be a promising therapeutic approach to improving exercise ability in neurological conditions through similar ergogenic mechanisms documented in healthy individuals, but further investigation is warranted.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12300572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708239","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":"Visual Perception and Fixation Patterns in an Individual with Ventral Simultanagnosia, Integrative Agnosia and Bilateral Visual Field Loss.","authors":"Isla Williams, Andrea Phillipou, Elsdon Storey, Peter Brotchie, Larry Abel","doi":"10.3390/neurolint17070105","DOIUrl":"10.3390/neurolint17070105","url":null,"abstract":"<p><strong>Background/objectives: </strong>As high-acuity vision is limited to a very small visual angle, examination of a scene requires multiple fixations. Simultanagnosia, a disorder wherein elements of a scene can be perceived correctly but cannot be integrated into a coherent whole, has been parsed into dorsal and ventral forms. In ventral simultanagnosia, limited visual integration is possible. This case study was the first to record gaze during the presentation of a series of visual stimuli, which required the processing of local and global elements. We hypothesised that gaze patterns would differ with successful processing and that feature integration could be disrupted by distractors.</p><p><strong>Methods: </strong>The patient received a neuropsychological assessment and underwent CT and MRI. Eye movements were recorded during the following tasks: (1) famous face identification, (2) facial emotion recognition, (3) identification of Ishihara colour plates, and (4) identification of both local and global letters in Navon composite letters, presented either alone or surrounded by filled black circles, which we hypothesised would impair global processing by disrupting fixation.</p><p><strong>Results: </strong>The patients identified no famous faces but scanned them qualitatively normally. The only emotion to be consistently recognised was happiness, whose scanpath differed from the other emotions. She identified none of the Ishihara plates, although her colour vision was normal on the FM-15, even mapping an unseen digit with fixations and tracing it with her finger. For plain Navon figures, she correctly identified 20/20 local and global letters; for the \"dotted\" figures, she was correct 19/20 times for local letters and 0/20 for global letters (chi-squared NS for local, <i>p</i> < 0.0001, global), with similar fixation of salient elements for both.</p><p><strong>Conclusions: </strong>Contrary to our hypothesis, gaze behaviour was largely independent of the ability to process global stimuli, showing for the first time that normal acquisition of visual information did not ensure its integration into a percept. The core defect lay in processing, not acquisition. In the novel Navon task, adding distractors abolished feature integration without affecting the fixation of the salient elements, confirming for the first time that distractors could disrupt the processing, not the acquisition, of visual information in this disorder.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12299405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708331","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":"Susceptibility Weighted Imaging in Migraines with and Without Aura: A Case-Control Study.","authors":"Adrian Scutelnic, Tomas Klail, Diego Moor, Nedelina Slavova, Valentina Petroulia, Simon Jung, Mattia Branca, Urs Fischer, Franz Riederer, Roland Wiest, Christoph J Schankin","doi":"10.3390/neurolint17070104","DOIUrl":"10.3390/neurolint17070104","url":null,"abstract":"<p><strong>Background: </strong>The asymmetry of cortical veins in susceptibility weighted imaging (SWI) in MRI might be a biomarker for migraine auras and cortical spreading depression (CSD). The aim of this study was to assess in humans if SWI asymmetry can be found in patients who have migraine attacks without auras.</p><p><strong>Methods: </strong>We included patients (<i>n</i> = 100 per group) from the emergency room setting when they (i) presented with an acute neurological deficit or headache; (ii) had a discharge diagnosis of a migraine aura, a migraine without an aura, or neither (controls without stroke or epilepsy); and (iii) had a brain MRI with SWI in the acute setting.</p><p><strong>Results: </strong>In the migraines with auras group, SWI asymmetry was found in 26% (95% CI 18-35) compared to patients with migraines without auras (3%, [95% CI 1-8], <i>p</i> < 0.001) and controls 7% [95% CI 3-14], <i>p</i> < 0.001). There was no difference between patients with migraines without auras and controls (<i>p</i> = 0.19).</p><p><strong>Conclusions: </strong>The distinct SWI changes in migraines with and without auras suggest that CSD might not be involved in the pathophysiology of migraines without auras.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12300388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708327","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":"Viscoelastic Point-of-Care Testing (ClotPro^®) to Guide Intravenous Thrombolysis in Acute Ischemic Stroke Patients on DOACs: Replacing History with Hemostasis in a Proof-of-Concept Study.","authors":"Jessica Seetge, Balázs Cséke, Zsófia Nozomi Karádi, Edit Bosnyák, Eszter Johanna Jozifek, László Szapáry","doi":"10.3390/neurolint17070103","DOIUrl":"10.3390/neurolint17070103","url":null,"abstract":"<p><strong>Background: </strong>Administering intravenous thrombolysis (IVT) in patients with acute ischemic stroke (AIS) on direct oral anticoagulants (DOACs) remains a clinical challenge. Current guidelines restrict IVT within 48 h of DOAC intake unless anticoagulant activity can be confidently excluded. However, reliable medication histories are often unavailable, and conventional coagulation tests inadequately detect DOAC activity. This study evaluated whether viscoelastic point-of-care testing (ClotPro^®) could identify the absence of anticoagulant effect in AIS patients on DOACs, thus enabling IVT administration and potentially improving clinical outcomes.</p><p><strong>Methods: </strong>We conducted a prospective observational cohort study of 40 AIS patients with documented DOAC use, admitted between February 2023 and May 2025. ClotPro^® was performed at admission using the Russell's viper venom (RVV) assay for factor Xa inhibitors and the ecarin clotting time (ECT) assay for dabigatran. Subtherapeutic anticoagulation was defined as a clotting time (CT) of <100 s for RVV and <180 s for ECT, respectively. Patients identified as being subtherapeutic were assessed for IVT eligibility. To evaluate IVT effects, we performed propensity score-matched bootstrap resampling (1000 iterations), matching patients by age, admission National Institutes of Health Stroke Scale (NIHSS), and pre-stroke modified Rankin Scale (mRS). Primary endpoints were NIHSS-shift (change from admission to 72 h) and mRS-shift (change from pre-stroke mRS to 90-day mRS). Predictors of outcomes were analyzed using multivariate regression models.</p><p><strong>Results: </strong>ClotPro^® identified 15/40 patients (37.5%) as subtherapeutic, all on factor Xa inhibitors. Of these, seven received IVT. In matched analyses, IVT-treated patients showed a numerically greater neurological improvement than untreated patients (mean NIHSS-shift: -2.83 vs. 3.94; mean difference: -6.76, 95% confidence interval [CI]: -24.00 to 7.55; <i>p</i> = 0.495). Functional outcome by mRS-shift showed only minor differences between groups (2.74 vs. 2.10 mean difference: 0.64; 95% CI: -2.00 to 2.50; <i>p</i> = 0.510). IVT showed a favorable trend for early neurological recovery (<i>p</i> = 0.081) but was not independently associated with functional outcome (<i>p</i> = 0.380).</p><p><strong>Conclusions: </strong>ClotPro^® identified a substantial subset of AIS patients on DOAC therapy without measurable anticoagulant activity, enabling IVT in cases that would otherwise have been excluded based on medication history. These findings support the feasibility of ClotPro^®-guided decision-making in acute stroke care and highlight its potential to improve IVT selection by enabling real-time assessment of coagulation status at the bedside.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12299928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708330","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":"Exploratory Evaluation for Functional Changes of Six-Month Systematic Non-Invasive Electrical Stimulation in a Whole-Body Suit on Children with Cerebral Palsy GMFCS III-V.","authors":"Tina P Torabi, Kristian Mortensen, Josephine S Michelsen, Christian Wong","doi":"10.3390/neurolint17070102","DOIUrl":"10.3390/neurolint17070102","url":null,"abstract":"<p><strong>Background/objectives: </strong>Spasticity in children with cerebral palsy (CP) can impair motor-related functions. The objective of this exploratory, prospective study was to examine if transcutaneous electrical nerve stimulation (TENS) in a whole-body suit leads to changes in spasticity and other related effects.</p><p><strong>Methods: </strong>Thirty-one children with CP GMFCS III-V, with a median age of 11.0 years (age range of 7-17 years), were consecutively included, and they used the suit with TENS for 24 weeks. The primary outcome was spasticity measured using the Modified Ashworth Scale (MAS). Functional motor-related tasks were evaluated by the Goal Attainment Scale (SMART GAS). The Modified Tardieu Scale (MTS), passive Range of Motion (pROM), GMFM-66, and Posture and Postural Ability Scale (PPAS) assessments were performed.</p><p><strong>Results: </strong>Seventeen subjects (17/31) completed the 24 weeks. Dropout was due to difficulty in donning the suit. The level of overall spasticity, most pronounced in the proximal arms and legs, was reduced according to the MAS, but not the MTS or pROM. Subject-relevant motor-related goals improved significantly in standing/walking and hand/arm function. Changes in the GMFM-66 and PPAS were not significant.</p><p><strong>Conclusions: </strong>Although there were statistically significant but underpowered changes in the MAS after 24 weeks, there were no clinically relevant effects. Exploratorily, we found observer-reliant motor-related functional improvements, which, however, we were unable to detect when trying to quantify them. Donning the suit led to dropout throughout the study. Caregivers need to allocate time, mental capacity and have the physical skill set for donning the suit for long-term use.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12298194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708237","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}