Neurologia i neurochirurgia polska最新文献

{"title":"Improving Quality of Life in Polish patients with multiple sclerosis: a multicentre analysis.","authors":"Joanna Tarasiuk, Katarzyna Kapica-Topczewska, Agata Czarnowska, Monika Chorąży, Katarzyna K Snarska, Jan Kochanowicz, Halina Bartosik-Psujek, Iwona Rościszewska-Żukowska, Jolanta Czarnota, Alicja Kalinowska, Karolina Kania, Wojciech Ambrosius, Joanna Siuda, Weronika Galus, Anna Walawska-Hrycek, Aleksandra Kaczmarczyk, Martyna Odzimek, Piotr Dubiński, Anna Jamroz-Wiśniewska, Konrad Rejdak, Marta Milewska-Jędrzejczak, Andrzej Głąbiński, Izabela Domitrz, Patryk Sochań, Natalia Bednarczyk, Katarzyna Kubicka-Bączyk, Robert Kwinta, Monika Adamczyk-Sowa, Ewa Krzystanek, Anetta Lasek-Bal, Katarzyna Maciejowska, Jacek Zaborski, Aleksandra Podulka, Marek Klus, Małgorzata Dorobek, Justyna Zielińska-Turek, Witold Palasik, Anna Pokryszko-Dragan, Justyna Chojdak-Łukasiewicz, Monika Nojszewska, Aleksandra Podlecka-Piętowska, Kinga Sujkowska, Beata Zakrzewska-Pniewska, Jacek Zwiernik, Anna Litwin, Aleksandra Chmielewska, Ihor Kazmierchuk, Magdalena Piwowarska, Beata Szajnoga, Natalia Kliszczak, Sonia Wiercimok, Monika Poziombka-Kaźmierczak, Beata Zwiernik, Marcin Mycko, Tomasz Siwek, Waldemar Brola, Alina Kułakowska","doi":"10.5603/pjnns.105052","DOIUrl":"10.5603/pjnns.105052","url":null,"abstract":"<p><strong>Introduction: </strong>Multiple sclerosis (MS) is a progressive disease leading to disability, that mostly affects young and middle-aged adults. This study was aimed at evaluating the impact of sociodemographic and clinical factors, including changes in access to disease-modifying therapies (DMTs), on the quality of life (QoL) of Polish individuals with MS and to compare the findings to earlier national studies.</p><p><strong>Material and methods: </strong>Data was collected from patients with MS across 19 MS treatment centres in Poland between February and April 2024. QoL was assessed using the EuroQol five-dimension, five-level (EQ-5D-5L) index and the EQ Visual Analogue Scale (EQ-VAS). Sociodemographic and clinical data was obtained via a standardised questionnaire.</p><p><strong>Results: </strong>The study included 3,165 patients with MS (mean age: 42.03 years; disease duration: 10.6 ± 7.85 years; female-to-male ratio 2.2:1). The mean EQ-5D-5L index score was 0.89 (± 0.15), and the mean EQ-VAS score was 71.58 (± 18.67), indicating an overall moderate-to-good QoL in the studied cohort. Pain/discomfort (80.7%) and anxiety/depression (79.6%) were the most frequently reported problems. Higher QoL scores were associated with younger age, relapsing-remitting MS, lower disability (EDSS ≤ 3.5), shorter disease duration, lack of comorbidities, employment, urban residence, childlessness, DMT usage, and infrequent DMTs switches (p < 0.001). When compared to earlier Polish studies, these results suggest a meaningful improvement in QoL over the past decade.</p><p><strong>Conclusions: </strong>The QoL of Polish patients with MS remains diminished compared to that of the general population. However, there has been a notable improvement compared to previous national data. This trend probably reflects advances in MS care, including wider access to novel DMTs and optimised treatment strategies.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333593","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":"Role of central vein sign in multiple sclerosis management: a systematic literature review.","authors":"Justyna Wołos, Olga Grodzka, Jan Kochanowski, Izabela Domitrz","doi":"10.5603/pjnns.103964","DOIUrl":"https://doi.org/10.5603/pjnns.103964","url":null,"abstract":"<p><strong>Introduction: </strong>Multiple sclerosis (MS) is known to be an inflammatory disease of the central nervous system (CNS), with its typical neuropathological characteristics being demyelinating white matter lesions, relative preservation of axons, and astrogliosis. Although the criteria for MS diagnosis have been regularly updated, two main elements have remained unchanged: the obligatory proof for dissemination of pathological lesions in both time and space. However, not all presentations are clear, and doubts about the diagnosis sometimes arise. The central vein sign (CVS) is a neuroimaging feature that has attracted growing interest in terms of MS diagnosis, differentiation, and general management. The evidence regarding the use of CVS as an MS imaging marker has accumulated rapidly, with diverse CVS assessment rules being proposed for implementation into the diagnostic criteria.</p><p><strong>Material and methods: </strong>We aimed to thoroughly assess the utility of CVS in MS management. A systematic review was conducted according to the Preferred Research Items for Systematic Reviews and Metanalyses (PRISMA 2020) guidelines. The PubMed and Embase databases were searched, and, after detailed analysis, 48 of the most recent studies were included in this review.</p><p><strong>Results: </strong>Significant differences in terms of CVS positivity have been found between MS and its mimics. Moreover, CVS is able to distinguish patients with radiologically isolated syndrome (RIS) from subjects with non-MS conditions. Furthermore, some of the analysed studies have reported a promising performance of CVS rules in MS diagnosis.</p><p><strong>Conclusions: </strong>The results of the reviewed studies are undoubtedly encouraging, reinforcing CVS's role as a valuable tool in multiple sclerosis management.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266861","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":"Metabolic effects of deep brain stimulation in Parkinson's disease - a systematic review and meta-analysis.","authors":"Julia Węgrzynek-Gallina, Tomasz Chmiela, Amadeusz Kasprzyk, Michał Borończyk, Joanna Siuda","doi":"10.5603/pjnns.100297","DOIUrl":"https://doi.org/10.5603/pjnns.100297","url":null,"abstract":"<p><strong>Introduction: </strong>Deep brain stimulation (DBS) is an effective therapy for patients with advanced Parkinson's Disease (PD). The significant improvement in motor symptoms is undeniable. However, adverse events from the procedure can also occur.</p><p><strong>Clinical rationale for study: </strong>Several sources have confirmed metabolic changes after a DBS procedure. However, there is no summary of the current state of knowledge about the impact of DBS on metabolic parameters changes expressed in weight gain in PD individuals, something which could guide further research.</p><p><strong>Material and methods: </strong>We conducted a systematic review following PRISMA recommendations on articles evaluating a gain of weight and/or body mass index (BMI) after subthalamic nucleus (STN) DBS, globus pallidus internus (GPi) DBS, and ventral intermediate nucleus of the thalamus (VIM) DBS in patients with PD. Four databases were searched by two independent authors according to the established criteria. The collected data involved body mass, BMI or changes in these parameters before DBS and after the procedure, mean age of patients, disease duration, gender, L-dopa equivalent daily dose, and the Unified Parkinson's Disease Rating Scale part III.</p><p><strong>Results: </strong>Of 1,290 articles found, 30 were evaluated as eligible and were included in the analysis. The study sample size ranged from 10 to 124 patients (mean, 32.6 ± 23.5, N = 1,110). The mean age across studies was 59.8 ± 7.5 (range 51.8 - 66, N = 636) years with mean value of the last follow-up point 13.6 ± 8.9 (range 1-38) months. A meta-analysis was performed for STN-DBS only, due to limited data on GPi-DBS and VIM-DBS. The mean body weight was higher by 6.15 kg one year after STN-DBS procedure (p < 0.001, 95% CI: 4.49-7.81), which was associated with statistically non-significant heterogeneity. It showed an increase in BMI of 1.87 kg/m2 (p < 0.001, 95% CI: 1.11-2.64). In this comprehensive review, possible causes of this state are identified, as well as the DBS impact on glucose and lipid profile.</p><p><strong>Conclusions: </strong>STN-DBS procedures contribute to significant weight gain in PD patients. A precise mechanism of this phenomenon has several possible explanations. Until this issue is fully clarified, we believe it is necessary to continuously monitor metabolic parameters and closely observe cardiometabolic risk in this group of patients.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266860","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":"Clinical and neuroradiological red flags in differential diagnosis of pituitary metastases and PitNETs (adenomas): a surgeon's experience and systematic literature review.","authors":"Riccardo Antonio Ricciuti, Riccardo Paracino, Fabrizio Mancini, Pierfrancesco De Domenico, Vittorio Ricciuti, Francesca Romana Barbieri, Matteo Maria Ottaviani, Serena Pagano, Daniele Marruzzo","doi":"10.5603/pjnns.103406","DOIUrl":"https://doi.org/10.5603/pjnns.103406","url":null,"abstract":"<p><strong>Introduction: </strong>Pituitary metastases (PMs) are rare malignancy manifestations, generally deemed to have an extremely poor prognosis. Differential diagnosis from primary pituitary lesions is often difficult, as their features can mimic those of pituitary neuroendocrine tumours (PitNETs). This study aimed to report a single surgeon's experience in managing PMs and to gather the existing evidence on their clinical and neuroradiological presentation to build a model of 'red flags' that help raise the suspicion of PMs in the context of sellar lesions.</p><p><strong>Material and methods: </strong>We retrieved an original 10-year surgical series of patients undergoing endoscopic transsphenoidal (TNS) surgery for suspected PitNETs, and we additionally conducted a systematic review of case reports or series of patients with PMs.</p><p><strong>Results: </strong>The local series consisted of n = 6 PMs. The literature review yielded n = 149 works reporting n = 340 PMs. Overall, the clinical presentation and neuroradiological features of n = 346 PMs were analysed and compared to data retrieved from n = 361 PitNETs from our original cohort. Primary features associated with PMs were: the presence of headaches (OR 1.24, p = 0.001), visual field deficits (OR 1.19, p = 0.02), extraocular nerve palsies (OR 1.23, p = 0.001), diabetes insipidus (OR 2.13, p < 0.001), MRI features of pituitary stalk/infundibular involvement (OR 1.98, p = 0.001), cavernous sinus invasion (OR 1.57, p = 0.004), and T2w flow voids (OR 1.13, p = 0.001). An incidental diagnosis (OR 0.49, p < 0.001) and cystic changes (OR 0.77, p = 0.02) were less common among PMs. Secondary features involved an acute onset of symptoms (OR 1.25, p = 0.001), the presence of oncological history (OR 1.89, p = 0.001), sellar walls erosion (OR 1.55, p = 0.002), and gross appearance of a firm (OR 2.01, p < 0.001) and easily bleeding lesion (OR 1.99, p < 0.001). Sellar enlargement predicted a lower risk of PMs (OR 0.54, p = 0.001).</p><p><strong>Conclusion: </strong>We have compiled a list of primary and secondary red flags, including clinical and neuroradiological features, to serve as a guiding tool for clinicians to raise suspicion of PMs and aid in the differential diagnosis of various lesions centered in the sella.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266859","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":"Severity and predictors of internalised stigma among people with epilepsy in Poland.","authors":"Piotr Świtaj, Paweł Grygiel, Nina Kożuch, Halina Sienkiewicz-Jarosz","doi":"10.5603/pjnns.103495","DOIUrl":"https://doi.org/10.5603/pjnns.103495","url":null,"abstract":"<p><strong>Aim of study: </strong>This study was aimed at exploring the intensity and associated factors of internalised stigma (or self-stigma) among Polish patients diagnosed with epilepsy.</p><p><strong>Clinical rationale for study: </strong>People with chronic diseases are commonly stigmatised in society. Some patients tend also to self-stigmatise, i.e. apply to oneself, accept and internalise negative stereotypes about their condition, which can result in a variety of adverse health outcomes and an impaired quality of life.</p><p><strong>Material and methods: </strong>A total of 120 patients with epilepsy treated in the Institute of Psychiatry and Neurology in Warsaw were recruited. They were administered a set of self-report measures assessing internalised stigma, social network, material well-being, cultural capital, and level of disability. Socio-demographic and health-related data was also recorded. Hierarchical linear multiple regression analysis was used to identify factors independently related to the severity of internalised stigma.</p><p><strong>Results: </strong>66 (55.0%) participants reported experiencing minimal or no internalised stigma, 34 (28.3%) reported mild, 18 (15.0%) moderate, and two (1.7%) severe internalised stigma. In the final regression model, independent predictors of lesser internalised stigma turned out to be a larger and supportive social network (β = -0.36, p < 0.01) and greater cultural capital (β = -0.17, p < 0.05). Stronger internalised stigma was predicted when three or more antiseizure medications were used (β = 0.33, p < 0.01), and when there were higher levels of disability (β = 0.25, p < 0.01).</p><p><strong>Conclusions: </strong>Although only a minority of patients with epilepsy in our sample reported moderate or high levels of internalised stigma, this remains a major clinical and social problem. These research results highlight the importance of personal resources (such as a supportive social network and high cultural capital) as factors protecting against internalising epilepsy stigma. Also, the indicators of the severity of the disease (such as the number of antiseizure medications used and the degree of disability) have been predictive factors associated with greater vulnerability to the development of self-stigmatised identity.</p><p><strong>Clinical implications: </strong>In clinical practice, patients with epilepsy should be screened for their tendency to self-stigmatise. There is a need to devise effective interventions to target internalised stigma associated with epilepsy, and to incorporate them into comprehensive therapeutic programmes for patients with this diagnosis.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266862","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":"Age-related macular degeneration and risk of stroke and all-cause mortality.","authors":"Bhrugun Anisetti, Michael W Stewart, Daniela Markovic, Eric R Eggenberger, Nilufer Ertekin-Taner, James F Meschia, Michelle P Lin","doi":"10.5603/pjnns.98951","DOIUrl":"https://doi.org/10.5603/pjnns.98951","url":null,"abstract":"<p><strong>Introduction: </strong>Age-related macular degeneration (AMD) is the most common degenerative disorder of the retina and choroid. Retinal vascular diseases have been associated with adverse cardiovascular outcomes, but an association between AMD and stroke has not been well established. We aimed to test the relationship between AMD, stroke, and age-adjusted mortality.</p><p><strong>Material and methods: </strong>Data was obtained from the US National Health and Nutrition Examination Surveys 2005 to 2008, with linked mortality through to 2015. Participants aged 40 or older with gradable AMD on fundus photographs were included. AMD was classified as either early or late. Independent relationships between AMD and stroke were assessed using multivariable logistic regression models. Risk of all-cause mortality was assessed using Cox regression models, before and after adjusting for covariates.</p><p><strong>Results: </strong>Of the 5,481 participants included, 49.8% were women, 56.5% white, 20.3% black, and 15.5% Hispanic. 425 (7.8%) had AMD. After adjusting for vascular risk factors, we found that AMD was associated with an increased risk of stroke (aOR 1.87, 95% CI 1.25-2.79, p = 0.002). There was a relationship between AMD and stroke depending on whether participants had early AMD (aOR 1.66, 95% CI 1.09-2.51) or late AMD (aOR 3.32, 95% CI 1.36-8.12). All-cause mortality was higher in those with AMD (HR 1.35, 95% CI 1.06-1.72) and late AMD (HR 2.18, 95% CI 1.33-3.58).</p><p><strong>Conclusions: </strong>Age-related macular degeneration is associated with stroke and all-cause mortality, independent of age and vascular risk factors. Our findings suggest potential non-vascular mechanisms related to the aetiology of AMD may increase the risk of stroke.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266857","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":"Blood-brain barrier-associated serum proteins as potential diagnostic biomarkers of epilepsy aetiology.","authors":"Elżbieta Bronisz, Agnieszka Cudna, Aleksandra Wierzbicka, Iwona Kurkowska-Jastrzębska","doi":"10.5603/pjnns.103864","DOIUrl":"https://doi.org/10.5603/pjnns.103864","url":null,"abstract":"<p><strong>Aim of study: </strong>We aimed to assess serum levels of proteins associated with the blood-brain barrier (BBB) in two aetiological populations of patients with epilepsy in the interictal period: genetic and structural-metabolic epilepsy.</p><p><strong>Clinical rationale for study: </strong>Proteins associated with the BBB are emerging as potential indicators and/or inducers of pro-epileptogenic changes within the central nervous system (CNS). Dysfunction of BBB is known to contribute to the development of epilepsy, while on the other hand dysregulated BBB might be the result of seizures.</p><p><strong>Material and methods: </strong>Serum levels of MMP-9, MMP-2, TIMP-1, TIMP-2, S100B, CCL-2, ICAM-1, P-selectin, and TSP-2 were examined in a group of 100 patients who were seizure-free for a minimum of seven days and analysed by ELISA.</p><p><strong>Results: </strong>Serum level of TSP-2 was higher in patients with genetic epilepsy compared to structural-metabolic epilepsy (p < 0.05), while P-selectin was higher in patients with structural-metabolic epilepsy (p < 0.05). Additionally, generalised linear mixed models showed higher levels of MMP-9 and MMP-2 in patients with structural-metabolic epilepsy, and higher levels of TSP-2 in patients with genetic epilepsy. Levels of S100B, CCL-2, ICAM-1, TIMP-1 and TIMP-2 did not differ between the two groups.</p><p><strong>Conclusions and clinical implications: </strong>Serum levels of MMP-9, MMP-2, and P-selectin are elevated in patients with structural-metabolic epilepsy in the interictal period, which may indicate persistent impairment of the vascular part of the BBB. Serum level of TSP-2 was elevated in patients with genetic epilepsy, which may suggest its impact on synaptogenesis. Our study underlines the complexity of epilepsy, and indicates that different molecules participate in BBB disruption/restoration and neuroinflammation in different aetiological subgroups of epilepsy.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266858","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":"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}