Neurologia i neurochirurgia polska最新文献

{"title":"Assessment of redox balance parameters among patients with acute ischaemic stroke.","authors":"Anna Mirończuk, Katarzyna Kapica Topczewska, Jacek Jamiołkowski, Monika Grabia, Agata Czarnowska, Agnieszka Mitrosz, Dominika Jakubowicz Lachowska, Joanna Tarasiuk, Joanna Kulikowska, Paulina Matys, Cezary Grunwald, Monika Chorąży, Katarzyna Socha, Alina Kułakowska, Jan Kochanowicz","doi":"10.5603/pjnns.104354","DOIUrl":"https://doi.org/10.5603/pjnns.104354","url":null,"abstract":"<p><strong>Clinical rationale for study: </strong>Oxidative stress (OS) is believed to play a crucial role in the development of neuronal injury associated with ischaemic stroke (IS). The evaluation of redox homeostasis in patients with acute ischaemic stroke (AIS) and its relation to stroke subtypes and short-term outcomes has scarcely been studied, and the findings are unclear.</p><p><strong>Aim of study: </strong>This study evaluates OS and antioxidant status in patients with AIS in the Podlaskie Voivodeship in Poland within 2-5 days of stroke onset, compared to healthy controls.</p><p><strong>Material and methods: </strong>The study involved 187 patients with AIS, with 85 receiving intravenous thrombolysis and/or mechanical thrombectomy, and included 94 healthy controls as a comparison group. The research measured serum total oxidant status (TOS) and total antioxidant status (TAS) using Erel's method-based kits, and calculated the oxidative stress index (OSI).</p><p><strong>Results: </strong>Significant differences were found in TOS levels between patients with AIS and healthy controls (p = 0.049). Serum TAS concentrations were significantly higher in patients with AIS due to large artery atherosclerosis (LAA) than in those with cardioembolism (CE) or small vessel occlusion (SVO) aetiology, as classified by the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria (p = 0.043). Receiver Operating Characteristic (ROC) curve analysis established cut-off values as potential indicators of OS in patients with AIS: TAS < 1.34 mmol/L, TOS > 5.6 μmol H2O2 equiv./L, and OSI > 3.96.</p><p><strong>Conclusions and clinical implications: </strong>Our findings demonstrate that an imbalance of oxidant and antioxidant status might play a role in the pathogenesis of IS. Patients in the initial phase of IS showed increased TOS, but no change in TAS, compared to healthy controls. This suggests effective initial antioxidant defence. TOS levels exhibited potential utility as clinical diagnostic biomarkers in patients with AIS. Although an imbalance towards oxidants may play a role in the pathogenesis of IS, these markers alone do not adequately predict stroke severity. Therefore, an analysis of the oxidant and antioxidant balance could play a crucial role in clarifying the pathogenic pathways of IS, presenting valuable diagnostic and prognostic tools, and identifying novel targets for antioxidant-focused therapies with neuroprotective agents.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for complications in bolt-connected external ventricular drains.","authors":"Raquel Gutiérrez-González, Teresa Mediavilla, Celia Ortega-Angulo, Teresa Kalantari, Alvaro Zamarron","doi":"10.5603/pjnns.105168","DOIUrl":"https://doi.org/10.5603/pjnns.105168","url":null,"abstract":"<p><strong>Introduction: </strong>This study was aimed at identifying risk factors for the main complications following bolt-connected external ventricular drain (EVD) insertion.</p><p><strong>Material and methods: </strong>This was a single-centre cohort study. All patients who underwent bolt-connected EVD placement between March 2015 and February 2024 were included. The complications analysed were infection, haemorrhage, misplacement, obstruction, and accidental pull-out. The need for EVD replacement was also recorded. Univariable and Cox regression multivariate analyses were performed.</p><p><strong>Results: </strong>A total of 119 procedures were analysed. The duration of ventriculostomy (OR 1.14; 95% CI 1.02-1.27) and the occurrence of cerebrospinal fluid leak (OR 409.86; 95% CI 1.36-12,353.36) or system obstruction (OR 31.44; 95% CI 2.04-484.85) were confirmed to be independent risk factors for infection. No risk factors were identified for misplacement or obstruction. Thicker catheters (OR 25.56; 95% CI 2.28-286.33) and antiplatelet or anticoagulant use (OR 7.29; 95% CI 1.75-30.41) were found to be independent risk factors for EVD-related haemorrhage. Men showed a 72% increased risk of accidental EVD pull-out. Finally, involuntary pull-out (OR 79.36; 95% CI 8.32-756.99), misplacement (OR 39.38; 95% CI 3.21-482.64), and obstruction (OR 31.55; 95% CI 2.70-368.40) were found to be independent risk factors for a new drain replacement.</p><p><strong>Conclusions: </strong>We have confirmed the duration of ventriculostomy, cerebrospinal fluid leak, and catheter obstruction to be independent risk factors for infection. Thicker catheters and antiplatelet or anticoagulant drug use were identified as independent risk factors for EVD-related haemorrhage. Male gender increased the risk for involuntary catheter pull-out. Finally, accidental removal, obstruction, and misplacement were confirmed as independent risk factors for re-inserting a new EVD. Neither surgeon's experience nor bedside placement in the intensive care unit increased the risk.</p><p><strong>Clinical implications: </strong>Our study has identified the risk factors for the most common complications associated with a specific type of ventricular catheter (bolt-connected EVDs), which allows the targeting of preventive measures. This is the first study to have analysed this specific group of drains, which are increasingly being used in clinical practice.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomarkers of functional movement disorders - a systematic review.","authors":"Anna Dunalska, Kamila Saramak, Katarzyna Śmiłowska, Vanessa Carvalho, Rachael Nicholls, Ali Abusrair, Jaroslaw Slawek, Simon Schmitt, Carolin Klages, Kirsten R Müller-Vahl, Natalia Szejko","doi":"10.5603/pjnns.103052","DOIUrl":"https://doi.org/10.5603/pjnns.103052","url":null,"abstract":"<p><strong>Introduction: </strong>Functional movement disorders (FMD) are defined by diverse phenotypes of altered movements that lack corresponding pathology in an anatomical region, and are typically characterized by inconsistent findings on neurological examination.</p><p><strong>State of the art: </strong>While there are several suggestive clinical features indicating FMD, objective biomarkers are still lacking. We conducted a systematic review of the literature with an emphasis on literature published after February 2019 aiming to summarise current knowledge on biomarkers of FMD. We divided our findings into four main categories: genetic, biofluid, neuroimaging, and electrophysiological biomarkers. For the differential diagnosis of functional tremor, functional tic-like behaviours (FTLB), and functional myoclonus, previous studies support the use of electrophysiological biomarkers. Evidence from neuroimaging research supports the multi-network model of FMD as a condition affecting the attentional, sensorimotor, self-agency/multimodal integration, and limbic/salience circuits. Biomarkers such as neurofilament light chain, inflammatory, and autoimmune factors should still be considered experimental, since results are based on small sample sizes. There is preliminary evidence from a genetic study that in FMD there is a complex interaction between individual predisposing risk genes involved in the serotonergic pathway.</p><p><strong>Clinical implications: </strong>Although the diagnosis of FMD remains challenging, and depends mainly on clinical judgement, research is underway to identify potential biomarkers to improve diagnostic confidence. Previous studies indicate that, in addition to psychological symptoms, biological changes can be detected in patients with FMD. This is evidenced by different patterns of neurotransmission related to stress responses and emotional regulation.</p><p><strong>Future directions: </strong>We believe it is vital to conduct larger trials in diverse populations from different regions of the world in order to find more reliable biomarkers of FMD.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of multiple sclerosis: global trends, regional differences, and clinical implications.","authors":"Katarzyna Kapica-Topczewska, Alina Kulakowska, Jan Kochanowicz, Waldemar Brola","doi":"10.5603/pjnns.103955","DOIUrl":"https://doi.org/10.5603/pjnns.103955","url":null,"abstract":"<p><strong>Introduction: </strong>Multiple sclerosis (MS) is one of the most common chronic neurological diseases. It predominantly affects young adults. Recent advances in diagnostic and therapeutic approaches have led to increased recognition and reporting of the disease.</p><p><strong>State of the art: </strong>Global MS prevalence varies significantly by region, and is influenced by environmental, genetic, and healthcare factors. Higher rates are observed in northern latitudes, which has been linked to reduced sunlight exposure and vitamin D deficiency. Advances in diagnostic tools, particularly MRI, have contributed to earlier detection and increased incidence rates.</p><p><strong>Clinical implications: </strong>Gender and age differences in MS epidemiology highlight unique challenges in management. Women are more frequently affected, while men tend to experience a more severe disease course. Paediatric and late-onset MS forms require distinct diagnostic and treatment strategies.</p><p><strong>Future directions: </strong>Research should prioritise understanding regional and demographic variability, the role of genetic-environmental interactions, and the long-term impact of new therapies. Improved global access to healthcare and advanced diagnostics is crucial for addressing disparities in MS management.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequently observed polyneuropathy expands phenotypic spectrum of apparently pure autosomal dominant hereditary spastic paraplegias.","authors":"Iwona Stępniak, Maria Rakowicz, Wanda Lipczyńska-Łojkowska, Anna Sobańska, Ewelina Elert-Dobkowska, Wioletta Krysa, Marta Rajkiewicz, Anna Wasielewska-Hobot, Monika Rudzińska, Jacek Pilch, Grzegorz Makowicz, Jacek Zaremba, Anna Sułek","doi":"10.5603/pjnns.101154","DOIUrl":"https://doi.org/10.5603/pjnns.101154","url":null,"abstract":"<p><strong>Background: </strong>Hereditary spastic paraplegias (HSPs) are a group of genetically heterogeneous, progressive disorders with a broad spectrum of clinical presentation. Among autosomal dominant inherited forms of HSP, the most common are SPG4, SPG3 and SPG31.</p><p><strong>Material and methods: </strong>Our aim was the clinical characterisation of a large group of patients with SPG4, SPG3 and SPG31. Neurological assessments as well as neuroimaging, electrophysiological, neuropsychological and ophthalmological examinations were performed to characterise in detail the clinical picture in HSP patients.</p><p><strong>Results: </strong>In our study group of 179 individuals from 60 families, three forms of AD-HSP: SPG4, SPG3 and SPG31 were diagnosed in 125, 36 and 18 patients, respectively. 48 of the probands had a positive family history of autosomal dominant hereditary disorder, while the other 12 probands represented apparently isolated cases. The pure form of HSP (pHSP) was found in a large majority (138 symptomatic patients), whereas a distinctly complex phenotype (cHSP) was found only in 32 individuals. The number of patients with cHSP became greater after including the results of electroneurography.</p><p><strong>Conclusions: </strong>The primarily pure form of HSP is present in patients with SPG4, SPG3 and SPG31. Nevertheless, the presence of additional symptoms provides evidence that in AD-HSP not only the cortico-spinal tract is involved. The most common additional symptom is polyneuropathy. We suggest that all patients with a genetic diagnosis of SPG4 and SPG3 should have electrophysiological testing performed, and then periodically repeated, for the purpose of controlling the involvement of peripheral nerves. We found a considerable variability, including in terms of age at onset and the progression rate of disability, mainly in SPG4.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sequence of language acquisition as a factor determining language comprehension centre location in cerebral cortex in sequential multilinguals.","authors":"Tomasz Wolak, Julia M Nowak, Iwona Chaberska, Radosław Kuliński, Andrzej Friedman","doi":"10.5603/pjnns.104340","DOIUrl":"https://doi.org/10.5603/pjnns.104340","url":null,"abstract":"<p><strong>Aim of study: </strong>The objective of this study was to identify cerebral regions specifically involved in speech comprehension for each sequentially acquired language (L1, L2, L3, L4) in multilingual individuals, and to explore the relationship between the sequence of language acquisition and its cortical representation.</p><p><strong>Clinical rationale for study: </strong>Multilingualism is increasingly prevalent worldwide. However, the cortical representation of sequentially acquired languages remains inadequately explored. Currently, there are no established guidelines for the perioperative neurosurgical management of multilingual patients, presumably due to a lack of research on this topic.</p><p><strong>Material and methods: </strong>Participants with a high communicative proficiency in at least three sequentially acquired foreign languages, learned after the age of three, were recruited. A passive listening paradigm was applied for this study. Brain anatomy was visualized using T1-weighted MRI, while functional brain activity (BOLD signal) was measured using echo-planar imaging. Cortical activity elicited by foreign languages (L2, L3, L4) was compared with native language (L1) and an 'unknown' (LN). Data processing and statistical analysis were conducted using SPM12 software.</p><p><strong>Results: </strong>Twenty multilingual participants were included. A gradual decrease in left-hemisphere dominance was observed from L1 through L4. Compared to L1, L2 demonstrated increased cortical activation in the right middle temporal gyrus and left middle occipital gyrus, whereas L3 showed higher activation in the left fusiform gyrus. No areas of greater activation were identified for L4 compared to L1. Conversely, L1 showed numerous regions of heightened activation relative to subsequently acquired languages. When compared to LN, both L2 and L3 exhibited increased activity in the right insula. Additionally, L3 and L4 displayed elevated activity in the right hippocampus compared to LN.</p><p><strong>Conclusions and clinical implications: </strong>Our study found distinct cortical localizations for sequentially acquired languages. We recommend routine perioperative cortical mapping for languages L2 and L3, in addition to L1. Mapping for L4 should be considered on a case-by-case basis. Further research into cortical areas involved in multilingual speech production is warranted.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parkinson's Disease and glucose dysregulation: shared pathophysiological mechanisms and clinical implications.","authors":"Tomasz Chmiela, Zbigniew K Wszolek, Jessica R Wilson","doi":"10.5603/pjnns.104405","DOIUrl":"https://doi.org/10.5603/pjnns.104405","url":null,"abstract":"<p><strong>Introduction: </strong>The relationship between Parkinson's Disease (PD) and type 2 diabetes mellitus (T2DM) is attracting increasing research interest. Epidemiological data shows a remarkable association between these two age-related diseases. Evidence is emerging to suggest a common pathological pathway linking PD and T2DM, involving factors such as altered insulin signalling, insulin resistance, oxidative stress, mitochondrial dysfunction, neuroinflammation, and misfolded protein accumulation. The precise mechanisms underlying this interplay, however, remain less clear, and are likely to be bidirectional. The aim of this review was to examine the epidemiological association between PD and T2DM, summarise potential common mechanisms, and evaluate the role of antidiabetic medications in the treatment and prevention of PD progression.</p><p><strong>Clinical implications: </strong>A deeper understanding of the shared pathophysiological pathways between PD and T2DM may pave the way for novel therapeutic approaches for patients with both diseases. Research into antidiabetic drugs, particularly GLP-1 receptor agonists, shows promise in potentially modifying the progression of PD.</p><p><strong>Future directions: </strong>Investigation of the common pathophysiological mechanisms of PD and T2DM may lead to new treatment strategies for both diseases. Ongoing studies of the efficacy and safety of antidiabetic drugs in PD, particularly in larger populations, are essential to validate their long-term benefits and therapeutic potential.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurological manifestations as first symptom of acute aortic syndrome: a case report.","authors":"Kamil Banasik, Joanna Pokrzywa, Dominika Kowalczyk, Rafał Celiński, Marcin Łubiarz","doi":"10.5603/pjnns.104959","DOIUrl":"https://doi.org/10.5603/pjnns.104959","url":null,"abstract":"","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CANVAS as example of genetic and clinical complexity of RFC1-related disorders.","authors":"Filip Tomczuk, Anna Sulek, Piotr Janik","doi":"10.5603/pjnns.103747","DOIUrl":"https://doi.org/10.5603/pjnns.103747","url":null,"abstract":"<p><p>Cerebellar ataxia with neuropathy and bilateral vestibular areflexia syndrome (CANVAS) is a late-onset, autosomal recessive neurodegenerative disorder characterised by the triad of cerebellar ataxia, bilateral vestibular areflexia, and sensory neuropathy. First identified more than 30 years ago, its clinical phenotype has since expanded to include chronic cough, dysautonomia, and pain, with isolated neuronopathy reported in some cases. The discovery of biallelic AAGGG repeat expansions in intron 2 of the RFC1 gene in 2019 established the genetic basis for CANVAS, with the pathogenic expansions disrupting gene function via secondary structures such as G-quadruplexes. Despite this breakthrough, the precise pathophysiological mechanisms behind CANVAS remain elusive, necessitating further research into the molecular, clinical, and genetic aspects of this disease. This review consolidates the current understanding of CANVAS, encompassing the expanding spectrum of RFC1-related disorders, clinical manifestations, molecular underpinnings, and epidemiology, while exploring future directions for diagnostics and therapeutic advancements.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rowland Payne syndrome mimicking motor neuron disease.","authors":"Krzysztof Nieporęcki, Piotr Szczudlik, Marta Lipowska, Edyta Rosiak, Magdalena Kuźma-Kozakiewicz","doi":"10.5603/pjnns.103859","DOIUrl":"https://doi.org/10.5603/pjnns.103859","url":null,"abstract":"","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}