Neurologia i neurochirurgia polska最新文献

{"title":"Low cellular fibronectin is associated with bleeding in patients with atrial fibrillation during long-term follow-up: a potential novel bleeding mechanism.","authors":"Kinga Glądys, Krzysztof P Malinowski, Elżbieta Paszek, Maria Szwarkowska, Anetta Undas","doi":"10.5603/pjnns.109467","DOIUrl":"https://doi.org/10.5603/pjnns.109467","url":null,"abstract":"<p><strong>Introduction: </strong>We examined whether cellular fibronectin (cFn) is associated with thromboembolic events or bleeding in anticoagulated patients with atrial fibrillation (AF).</p><p><strong>Clinical rationale for the study: </strong>Up to 5% of anticoagulated AF patients experience major bleeding, and identifying those at elevated risk remains challenging. Cellular fibronectin, a marker of endothelial dysfunction and vascular injury, has been linked to altered prothrombotic fibrin clot features in atherosclerosis, stroke, and venous thromboembolism, but its levels and role in AF are unknown.</p><p><strong>Material and methods: </strong>In this cohort study, we enrolled 185 consecutive AF patients on rivaroxaban aged 70.0 [interquartile range (IQR) 62.0-76.0] years with a median CHA₂DS₂-VASc of 3.0 (IQR 1.0-4.0). We determined plasma cFn along with clinical and laboratory parameters, including fibrin clot permeability. During a median follow-up of 49.0 (IQR 46.0-51.0) months, we recorded both clinically relevant major and nonmajor bleeding according to the International Society on Thrombosis and Haemostasis (ISTH) and a composite ischemic endpoint involving ischemic cerebrovascular events or cardiovascular (CV) death.</p><p><strong>Results: </strong>Plasma cFn (median 3.5, IQR 2.7-4.5 μg/mL) correlated positively with fibrinogen and C-reactive protein (CRP), and inversely with clot permeability. During follow-up, bleeding occurred in 25 patients (13.5%, 3.55/100 patient-years), including major bleeding in 13 (7.0%, 1.78/100 patient-years). Patients with cFn in the lowest quartile ( < 2.7 μg/mL) had an almost 4-fold higher risk of bleeding compared to those in the highest quartile ( > 4.5 μg/mL) [hazard ratio (HR) 3.85, 95% confidence interval (CI): 1.06-14.00]. On multivariate analysis adjusted for age and sex, low cFn was an independent predictor of bleeding and major bleeding, but not of the ischemic endpoint.</p><p><strong>Conclusions and clinical implications: </strong>Our results suggest that low cFn levels might help identify patients with AF at increased bleeding risk during long-term anticoagulation, and this association could partly be related to the formation of looser fibrin networks.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147355803","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":"High relative cerebral blood volume strongly predicts early neurological improvement and good functional outcome in ischemic stroke patients undergoing mechanical thrombectomy.","authors":"Paweł Wrona, Dominik Wróbel, Julia Staniszewska, Gabriela Kapral, Milena Derechowska, Gabriela Turaj, Tadeusz Popiela, Agnieszka Słowik, Wojciech Turaj","doi":"10.5603/pjnns.106870","DOIUrl":"https://doi.org/10.5603/pjnns.106870","url":null,"abstract":"<p><strong>Aim of the study: </strong>Despite advancements in mechanical thrombectomy (MT) in the treatment of acute ischemic stroke (AIS) due to large vessel occlusion, nearly half of patients with successful recanalization do not achieve good functional outcome (GFO). We aimed to analyze the association between novel perfusion-based biomarkers and prognosis after AIS.</p><p><strong>Clinical rationale for the study: </strong>The role of perfusion imaging biomarkers, particularly relative cerebral blood volume (rCBV), as an indicator of tissue-level collateral circulation and a predictor of post-MT clinical trajectory remains insufficiently explored.</p><p><strong>Material and methods: </strong>This single-center retrospective study included patients with anterior circulation AIS who achieved successful recanalization following MT at the Comprehensive Stroke Center, University Hospital, Krakow, between January 2019 and July 2023. We evaluated the predictive value of rCBV for early neurological improvement (ENI) and long-term GFO and compared its prognostic utility with other perfusion-based parameters. Furthermore, we assessed the extent to which the effect of rCBV on GFO was mediated by its influence on ENI. Early neurological improvement was defined as a ≥ 4-point reduction in the National Institutes of Health Stroke Scale score or complete symptom resolution within 24 hours post-admission. GFO was defined as a modified Rankin Scale score of < 3 at 90 days.</p><p><strong>Results: </strong>Relative cerebral blood volume was an independent predictor of 90-day GFO after multivariable adjustment (adjusted odds ratio [aOR] = 1.38; 95% confidence interval [CI]: 1.19-1.6; p < 0.001). Additionally, total hypoperfusion volume (T6max) independently contributed to GFO prediction when included alongside rCBV (aOR = 0.96 per 10 mL increase; 95% CI: 0.94-0.99; p = 0.019), enhancing prognostic accuracy. Relative cerebral blood volume was also a strong predictor of ENI (aOR = 1.35; 95% CI: 1.19-1.54; p < 0.001), with 35% (4-67%; p = 0.029) of its effect on GFO mediated through its impact on ENI.</p><p><strong>Conclusion and clinical implications: </strong>Relative cerebral blood volume is a robust predictor of both early neurological recovery and long-term functional outcome following MT. Moreover, T6max provides independent prognostic value when assessed in conjunction with rCBV, suggesting that these parameters complement each other. Their combined assessment provides a more comprehensive understanding of ischemic tissue fate, aiding clinical decision-making in patients selected for MT.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146220641","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":"Solo navigation with SOFIA 6F aspiration catheter (SNAKE Technique) as a first-line mechanical thrombectomy approach: a single-center, large-cohort, real-world experience.","authors":"Grzegorz Meder, Sara Kierońska-Siwak, Wojciech Skura, Paweł Gruchała, Piotr Płeszka, Aleksandra Szulc, Agnieszka Meder, Milena Świtońska","doi":"10.5603/pjnns.107135","DOIUrl":"https://doi.org/10.5603/pjnns.107135","url":null,"abstract":"<p><strong>Introduction: </strong>Several methods of clot extraction during mechanical thrombectomy (MT) have been developed, among which the SOFIA 6F aspiration catheter (SAC) solo navigation (SNAKE) and aspiration technique has become the preferred approach at our institution. We present a single-center, retrospective, large-cohort, real-world study focusing on the SAC's ability to navigate vascular anatomy without additional devices and its efficacy in clot removal.</p><p><strong>Material and methods: </strong>The cohort consisted of 109 consecutive patients who underwent MT with an intention to be treated with SNAKE and aspiration. We analyzed the efficacy of SAC navigation, clot extraction, costs, procedural safety and duration, as well as potential factors reducing SNAKE efficacy.</p><p><strong>Results: </strong>Overall, 76.1% of SNAKE procedures were successful. In the subgroup of 83 successful SNAKE procedures, subsequent SAC aspiration achieved a first-pass effect (FPE) Thrombolysis In Cerebral Infarction (TICI) 2c-3 in 57.8% of cases and final TICI 2b-3 in 83.1% of cases. Overall, regardless of SNAKE success or MT technique used, final TICI 2b-3 was achieved in 97.2% of cases, and the FPE rate was 57.7%. Successful SNAKE resulted in a significantly shorter groin puncture-to-recanalization time (mean 18.66 min vs. 29.46 min, p = 0.0004) and significant cost reduction in subsequent MTs (mean €2,824.02 vs. €3,948.34, p = 0.0017).</p><p><strong>Conclusions: </strong>SAC SNAKE navigation with aspiration is a safe, cost-effective, relatively simple, and fast MT method, achieving high first-pass rates and good final angiographic re sults. Se vere intracranial carotid artery at herosclerosis can significantly hinder SNAKE navigation. In cases of failed SNAKE or an insufficient aspiration effect, this method can be easily combined with a stent-retriever (SR) to ensure optimal navigation and high final angiographic success.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146213632","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":"Hemiconvulsion-hemiplegia-epilepsy syndrome in adults - clinical case of a 28-year-old female patient with a history of drug abuse.","authors":"Bartosz Ciemniejewski, Joanna Rybacka-Mossakowska, Agata Gradys, Krzysztof Kusza, Sławomir Michalak","doi":"10.5603/pjnns.109780","DOIUrl":"https://doi.org/10.5603/pjnns.109780","url":null,"abstract":"","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143058","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":"Beyond video-EEG: identifying functional/dissociative seizures through clinical assessment.","authors":"Tomasz Kałużny, Katarzyna Bosak, Kamil Wężyk, Agnieszka Słowik, Magdalena Bosak","doi":"10.5603/pjnns.109229","DOIUrl":"https://doi.org/10.5603/pjnns.109229","url":null,"abstract":"<p><strong>Aim of the study: </strong>This study compared the clinical features of functional/dissociative seizures (FDS) and epileptic seizures using video-EEG.</p><p><strong>Clinical rationale for the study: </strong>Early identification of functional/dissociative seizures based on clinical semiology.</p><p><strong>Material and methods: </strong>Seizure semiology was retrospectively analyzed in 51 FDS and 51 age- and sex-matched epilepsy patients. All diagnoses were confirmed by video-EEG. Evaluated features included sustained eye closure, side-to-side head movements, pelvic thrusting, opisthotonus, side-to-side body movements, grimacing, fluctuating course, limb tremors, vocalization, awareness, and seizure duration.</p><p><strong>Results: </strong>Functional/dissociative seizures patients more frequently exhibited sustained eye closure (90.2% vs. 31.4%), pelvic thrusting (43.1% vs. 5.9%), opisthotonus (27.5% vs. 0%), fluctuating course (66.7% vs. 21.6%), and limb tremors (76.5% vs. 39.2%) compared with epilepsy patients (all p < 0.001). FDS episodes were longer (median 180 s vs. 66 s, p < 0.001). Logistic regression identified sustained eye closure (OR: 56.9), pelvic thrusting (OR: 8.1), and seizure duration (OR: 1.011 per second) as independent predictors of FDS. Significant co-occurrences included opisthotonus with pelvic thrusting and grimacing, fluctuating course with tremor, and side-to-side body movement with head movement and pelvic thrusting.</p><p><strong>Conclusions and clinical implications: </strong>Sustained eye closure, pelvic thrusting, and prolonged duration are key indicators of FDS. Recognizing these signs can improve diagnostic accuracy when video-EEG is unavailable, prevent unnecessary antiseizure treatment, and facilitate timely psychological care, enhancing overall patient management.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113779","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":"Endovascular treatment of intracranial dural arteriovenous fistulas - a single center's experience and literature overview.","authors":"Tomasz Roman, Paweł Szmygin, Joanna Bosowska, Radosław Rola, Maciej Szmygin","doi":"10.5603/pjnns.109515","DOIUrl":"https://doi.org/10.5603/pjnns.109515","url":null,"abstract":"<p><strong>Aim of the study: </strong>Intracranial dural arteriovenous fistulas (DAVFs) are rare vascular malformations characterized by arteriovenous shunting within the dura mater. They are classified according to venous drainage patterns that correlate with clinical severity and hemorrhagic risk. Treatment options include surgery, radiosurgery and especially endovascular embolization. The aim of this article is to present our center's experience with endovascular treatment of DAVFs with a focus on the technical aspects and clinical results.</p><p><strong>Material and methods: </strong>In this single-center study, we reviewed data from consecutive patients with DAVF who underwent embolization from 2015 to 2024. The efficacy of embolization, the method of embolization, as well as the rate of complication, were noted.</p><p><strong>Results: </strong>A total of 48 patients with an average age of 53 years underwent selective embolization of DAVFs, the vast majority of them via the transarterial approach (46.96%). Prior to the procedure, the most common complaints included headache, intracranial hemorrhage and tinnitus. Satisfactory long-term embolization was achieved in 42 cases (88%). The most commonly used embolic agents included Onyx and nbutyl cyanoacrylate (n-BCA), and the most common culprit vessels were middle meningeal and occipital arteries. With the exception of minor intraprocedural difficulties, there were no serious complications associated with embolization. No neurological deficits occurred in relation to the endovascular procedure. Clinical improvement was reported by 35 patients (73%).</p><p><strong>Conclusions: </strong>The results of our study indicate that endovascular treatment of DAVFs achieves a high rate of complete occlusion in the majority of cases. It is associated with a low complication rate and can be successfully performed across all DAVF types.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146086572","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":"Intracranial hemorrhage after evacuation of chronic subdural hematoma: systematic review.","authors":"Rami Yuser, Justyna Fercho, Konrad Duszyński, Julia Stelmach, Klaudia Kokot, Michalina Dudra, Oskar Chasles, Mateusz Motowidło, Jacek Szypenbejl, Tomasz Szmuda, Mariusz Siemiński","doi":"10.5603/pjnns.109813","DOIUrl":"https://doi.org/10.5603/pjnns.109813","url":null,"abstract":"<p><strong>Introduction: </strong>Intracranial hemorrhage (ICH) after surgical evacuation of chronic subdural hematoma (cSDH) is a rare but serious complication associated with considerable morbidity and mortality. This review aims to provide an updated estimate, from existing literature, of the prevalence of ICH and to analyze the clinical features, potential risk factors, treatment approaches, and outcomes in a cohort of 76 patients.</p><p><strong>Clinical rationale for the study: </strong>Because postoperative ICH can rapidly deteriorate neurological status and complicate recovery, understanding its prevalence and determinants is essential for improving safety in cSDH surgery.</p><p><strong>Material and methods: </strong>Two systematic searches of the PubMed, Scopus, and Medical Literature Analysis and Retrieval System Online (MEDLINE) databases were conducted in accordance with Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA) guidelines on September 20th, 2025. The first search resulted in the inclusion of 18 articles, which were included in an analysis of the prevalence of ICH. The second search resulted in the inclusion of 56 articles, encompassing detailed clinical data on 76 patients who experienced postoperative ICH following surgical evacuation of cSDH.</p><p><strong>Results: </strong>The prevalence of ICH after cSDH surgery was 2.3%. Patients' ages ranged from 22 to 93 years (mean: 66.5 years), with 79% being male. The most common type of postoperative ICH was intraparenchymal hemorrhage (IPH) (73.7%), followed by subdural hemorrhage (14.5%). ICH occurred on average 1.7 days after the procedure. Dominant symptoms of ICH post evacuation included the following: altered mental status (47.4%), motor weakness (30.3%), and headache (21.05%). Significant correlations between preoperative hypertension, antiplatelet therapy, IPH, and worse outcome (mRS > 3) have been established.</p><p><strong>Conclusion and clinical implications: </strong>The data suggest that patients suffering from hypertension and using antiplatelet therapy may be predisposed to poorer outcomes. Stratification of patients based on comorbidities, scrupulous preparation of patients, and careful perioperative care may play a role in reducing ICH occurrence and improving patient prognosis.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146086551","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":"Intravenous thrombolysis in central retinal artery occlusion as an effective and safe treatment.","authors":"David Cernik, Zuzana Eichlova, Sona Bikova, Petr Jansky, Simona Vondrackova, Marta Vachova, Jan Macko, Roman Havlicek, Martina Odvarkova, Jan Bilik, David Cihlar, Jiri Neumann","doi":"10.5603/pjnns.108173","DOIUrl":"https://doi.org/10.5603/pjnns.108173","url":null,"abstract":"<p><strong>Introduction: </strong>Central retinal artery occlusion (CRAO) is a relatively rare but underestimated medical emergency leading to severe vision loss. It is considered the ocular equivalent of ischemic stroke. There is still no definite recommendation for treatment. Currently considered and one of the increasingly preferred options is intravenous thrombolysis (IVT). Presented here are the results of a multicenter retrospective study to assess the safety and effectiveness of thrombolytic treatment in CRAO.</p><p><strong>Material and methods: </strong>All patients with CRAO from eight centers who received IVT were included in the retrospective study. The effectiveness of the intervention was evaluated in two stages. The first stage was when the residual vision in the affected eye was achieved at least to the level of the ability to orientate in space (recognizing contours). The second stage was the improvement of vision to recognize objects and faces. The effectiveness was further evaluated depending on the duration of the difficulties before the intervention. Safety was assessed based on the symptomatic intracerebral hemorrhage (SICH).</p><p><strong>Results: </strong>Sixty-four patients (age 67.9 ± 12.0 years, 51.6% men) were treated for CRAO with IVT. The median time from onset of symptoms to treatment was 4.5 hours. Improvement after treatment occurred in 60.9% (recognition of contours) and significant improvement in 39.1% (recognition of faces, ability to read). Intracerebral hemorrhage occurred in 6.3%. One fatal SICH was recorded. Two patients had vitreous hemorrhage. In both cases, vision improved to excellent condition.</p><p><strong>Conclusions: </strong>Treatment of CRAO with IVT can be considered effective and safe. Secondary prevention should be in line with acute ischemic stroke (AIS) standards.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146086559","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":"Myotonia congenita - a diagnosis that can be made regardless of the patient's age.","authors":"Beata Śliwińska, Agata Pastorczak, Andrzej Zwierzchowski, Jacek Rożniecki, Mariusz Stasiołek, Mariola Świderek-Matysiak","doi":"10.5603/pjnns.106953","DOIUrl":"https://doi.org/10.5603/pjnns.106953","url":null,"abstract":"","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146065553","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":"Aging immunity - the role of T and B cells in neurological disorders among older adults.","authors":"Robert Kwinta, Natalia Morawiec, Joanna Bączyk, Katarzyna Kubicka-Bączyk, Monika Adamczyk-Sowa","doi":"10.5603/pjnns.106498","DOIUrl":"10.5603/pjnns.106498","url":null,"abstract":"<p><strong>Introduction: </strong>Immunosenescence is a natural process of immune system aging, which leads to significant changes in the functioning of both innate and adaptive immunity. Alterations in T and B lymphocytes can significantly impact the progression of neurological diseases including multiple sclerosis (MS), Alzheimer's disease (AD), Parkinson's disease (PD), and amyotrophic lateral sclerosis (ALS).</p><p><strong>State of the art: </strong>Immunosenescence affects T and B cell subsets, reducing their proliferative capacity and altering cytokine profiles. In MS, these changes promote disease progression and diminish responses to immunomodulatory therapies. In AD and PD, dysfunctional T and B cells contribute to sustained neuroinflammation, exacerbating neurodegeneration. ALS is similarly associated with altered adaptive immunity.</p><p><strong>Clinical implications: </strong>Recognizing how immunosenescent T and B cells contribute to disease in older adults is crucial for refining treatment strategies. These age-related immune changes may explain varied responses to therapies and highlight the need for novel approaches targeting the aged immune system in neurodegenerative diseases.</p><p><strong>Future directions: </strong>Future research should focus on identifying the mechanisms by which immunosenescent lymphocytes modulate neuroinflammation and neurodegeneration in aging populations. Novel biomarkers and immunomodulatory therapies tailored to older adults could significantly improve outcomes in patients with neurological diseases.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":"15-25"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145636776","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}