Neurologia i neurochirurgia polska最新文献

{"title":"Rare brainstem tumefactive relapse after two decades of stable multiple sclerosis alleviated by rescue therapies and ofatumumab initiation.","authors":"Weronika Galus, Justyna Tabaka-Pradela, Aneta Zontek, Mateusz Winder, Oskar Bożek, Miłosz Zbroszczyk, Tomasz Jaworski, Piotr F Czempik, Malgorzata Siger, Joanna Siuda","doi":"10.5603/pjnns.110918","DOIUrl":"10.5603/pjnns.110918","url":null,"abstract":"","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":"494-496"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639373","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":"The triglyceride-glucose index in parkinsonian syndromes: a clinical dead end or a hint at central dysregulation?","authors":"Aleksandra Buczek, Emilia Jaworska, Hubert Bigajski, Julia Węgrzynek-Gallina, Tomasz Chmiela, Joanna Siuda","doi":"10.5603/pjnns.112043","DOIUrl":"https://doi.org/10.5603/pjnns.112043","url":null,"abstract":"<p><strong>Aim of the study: </strong>This study assessed the triglyceride-glucose (TyG) index for differentiating between Parkinson's disease (PD), multiple system atrophy (MSA), and progressive supranuclear palsy (PSP), and its association with cognitive profiles and clinical status.</p><p><strong>Material and methods: </strong>This retrospective cross-sectional study involved 329 patients (272 PD, 15 MSA, 42 PSP). Assessments included motor and non-motor symptoms, the TyG index, and metabolic profiles.</p><p><strong>Results: </strong>The TyG index did not differentiate PD from AP; however, PSP patients exhibited significantly lower fasting glucose levels than the PD and MSA groups (p < 0.05). The TyG index and lipid profiles did not differ significantly (p > 0.05) among the three groups. Cognitive function (Addenbrooke's Cognitive Examination III, ACE-III) was notably lower in PSP than in MSA and PD (p = 0.0019), especially in memory and fluency, while depressive symptoms (Beck Depression Inventory, BDI) remained similar (p = 1.0).</p><p><strong>Conclusions and clinical implications: </strong>The TyG index is not a reliable method for differentiating PD from atypical parkinsonism. Lower fasting glucose levels in PSP serve as a potential \"red flag\" associated with cognitive decline. Future research should incorporate homeostatic model assessment of insulin resistance (HOMA-IR) and continuous glucose monitoring to further explore these metabolic associations.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":"60 4","pages":"482-486"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840617","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":"An epidemiological study of Parkinson's disease in Chinese older adults using the Global Burden of Disease and China Health and Retirement Longitudinal Study databases.","authors":"Daiqing Tan, Pengcheng Du, Mengfan Yu, Li Wang, Enai Lin, Yan Tang, Aiqing Han","doi":"10.5603/pjnns.110988","DOIUrl":"10.5603/pjnns.110988","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of Parkinson's disease (PD) has increased globally, especially in China, and emerged as a critical public health challenge.</p><p><strong>Aim of the study: </strong>Based on the Global Burden of Disease (GBD) and the China Health and Retirement Longitudinal Study (CHARLS) databases, this study explores temporal trends in Parkinson's disease (PD) prevalence and its risk factors among middle-aged and older Chinese adults from 1992 to 2021.</p><p><strong>Material and methods: </strong>The age-period-cohort (APC) model was used to analyze the effects of age, period, and birth cohort on PD prevalence. Chi-square tests were used to determine risk and protective factors for PD. The autoregressive integrated moving average (ARIMA) model was used to predict trends in PD prevalence in China and worldwide over the next 10 years, and several machine learning models were used to develop a classifier for the early screening of PD.</p><p><strong>Results: </strong>The results showed that the average annual growth rate of PD prevalence in China was twice the global average, and this high growth rate is projected to continue in the next decade. Analysis of the CHARLS data showed that aging, urban residence, and metabolic diseases such as diabetes, hypertension, and dyslipidemia were significantly associated with the risk of PD, while moderate alcohol consumption may have a protective effect. Among the machine learning models, the random forest model had the best performance for the early screening of PD (sensitivity 0.968), confirming the significant value of artificial intelligence methods in the precise prevention of PD.</p><p><strong>Conclusions and clinical implications: </strong>This study revealed that population aging and advances in diagnostic and treatment systems have led to a heavy burden of PD in China. Public health prevention of PD in China should strengthen the precise screening of high-risk groups and early intervention for risk factors, thereby enabling public health departments to more effectively alleviate the medical and socioeconomic burden of the disease.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":"457-469"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147840829","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":"Deep brain stimulation or best medical treatment for Parkinson's disease patients: 36-month longitudinal neuropsychological and motor assessment - a prospective case-control study.","authors":"Stanisław Szlufik, Karolina Duszyńska-Wąs, Aleksandra Koźmińska, Łukasz Milanowski, Jürgen Germann, Andres Lozano, Agnieszka Drzewińska, Melanie Cohn, Tomasz Mandat, Monika Figura, Justyna Dutkiewicz, Dariusz Koziorowski","doi":"10.5603/pjnns.107017","DOIUrl":"10.5603/pjnns.107017","url":null,"abstract":"<p><strong>Introduction: </strong>Bilateral subthalamic nucleus deep brain stimulation (DBS STN) is a very effective surgical method of treating motor symptoms in Parkinson's disease (PD) patients. The long-term cognitive outcome after the surgery is still discussed. This study compared the impact of DBS STN to best medical treatment (BMT) in patients with PD on cognitive function and mood over a 36-month observation period.</p><p><strong>Material and methods: </strong>The study included PD patients divided into two groups: the BMT group (n = 17), receiving pharmacotherapy alone throughout the entire 36-month observation period, and the DBS group (n = 20), which underwent DBS STN after the baseline visit, and was subsequently observed for the next 36 months. Both groups were examined at Baseline, 9 months, 18 months and 36 months using neuropsychological assessment and the Unified Parkinson's Disease Rating Scale (UPDRS) motor examination.</p><p><strong>Results: </strong>At 36 months, neither group demonstrated a significant decline in visuospatial abilities, executive functions, or memory. Both groups showed longitudinal deterioration in attention/working memory measures; however, these changes were not associated with significant between-group differences. Language performance [Wechsler Adult Intelligence Scale - Revised (WAIS-R similarities)] improved over follow-up in the DBS group relative to BMT, and DBS was associated with a marked reduction in medication across all follow-up timepoints (p < 0.05).</p><p><strong>Conclusions: </strong>The study suggests that DBS STN does not have a significant additional impact on cognition performance in PD patients. Our results also suggest that while active DBS STN continues to improve motor symptoms, it did not prevent the longitudinal worsening of OFF-motor severity (UPDRS III OFF), which progressed similarly in both groups.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":"290-299"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147675356","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":"Monogenic forms of Parkinson's disease: a Czech cohort study.","authors":"Petr Hollý, Kateřina Hirschfeldová, Lucie Koktanová, Ivan Mazura, Petr Dušek, Kateřina Zárubová, Robert Jech, Petra Havránková, Filip Růžička, Tereza Serranová, Ondřej Fiala, Jiří Klempíř, Ondrej Bezdicek, David Kemlink, Aleš Hořínek, Lena Obeidová, Dan Mazura, Evžen Růžička","doi":"10.5603/pjnns.109210","DOIUrl":"10.5603/pjnns.109210","url":null,"abstract":"<p><strong>Aim of the study: </strong>This study aimed to analyze the most established genetic causes of Parkinson's disease (PD) in a cohort of patients from Czechia.</p><p><strong>Clinical rationale for the study: </strong>PD is the second most common neurodegenerative disorder, with both genetic and environmental factors contributing to its pathogenesis.</p><p><strong>Material and methods: </strong>We examined 214 patients with PD and 186 controls. Each patient underwent an examination using the Montreal Cognitive Assessment to assess the severity of cognitive impairment. Genetic analysis was performed using next- -generation sequencing and multiplex ligation-dependent probe amplification, focusing on mutations in GBA1, LRRK2, PINK1, PRKN, and SNCA genes.</p><p><strong>Results: </strong>Clinically relevant mutations in GBA1 (pathogenic/likely pathogenic or severe/mild/risk variants) were the most frequently observed variants (n = 30; 14.0% of the PD cohort in total), including both known pathogenic mutations and the mild risk allele p.Glu365Lys (n = 12; 5.6% of cases), which was associated with earlier disease onset. Pathogenic mutations were also detected in LRRK2 (n = 2; 0.9%), SNCA (n = 1; 0.5%), and compound heterozygous mutations in PRKN (n = 2; 0.9%). Carriers of heterozygous mutations in PRKN were equally represented in patients and controls. No pathogenic PINK1 mutations were identified. Cognitive impairment was not significantly more frequent in GBA1 mutation carriers (p = 0.320). A positive family history of PD was more common in patients than in healthy controls (n = 51; 24% vs. n = 6; 3%, p < 0.001).</p><p><strong>Conclusions and clinical implications: </strong>Our findings highlight notable genetic variability in Czech PD patients, particularly involving GBA1 mutations. However, these variants were not associated with early cognitive decline. The study underscores the value of genetic screening in PD and the need for further research into genotype-phenotype correlations.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":"329-338"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147974093","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 genetic characteristics of CANVAS patients - a single-center experience.","authors":"Mariusz Kwarciany, Kamila Boike, Filip Tomczuk, Bartosz Karaszewski, Riccardo Curro","doi":"10.5603/pjnns.105982","DOIUrl":"10.5603/pjnns.105982","url":null,"abstract":"","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":"370-372"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337346","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":"Migraine - atypical clinical presentations and the most common diagnostic challenges.","authors":"Marta Waliszewska-Prosół","doi":"10.5603/pjnns.110637","DOIUrl":"10.5603/pjnns.110637","url":null,"abstract":"<p><strong>Introduction: </strong>Migraine is the most common neurological disorder worldwide. However, despite its high prevalence and clear diagnostic criteria, migraine is frequently underdiagnosed or misidentified as other primary or secondary conditions.</p><p><strong>State of the art: </strong>Migraine remains one of the greatest diagnostic challenges due to its remarkable clinical diversity and tendency to mask other conditions. One major challenge in diagnosing primary headaches is the lack of available biomarkers, and diagnosis is largely based on criteria and patient self-reporting.</p><p><strong>Clinical implications: </strong>This article discusses different and often atypical clinical presentations of migraine and the most common diagnostic challenges encountered in clinical practice. The diagnostic difficulties of migraine with aura will be discussed, with particular emphasis on retinal migraine, migraine aura without headache, and vestibular migraine, as well as the most common misdiagnoses, including sinus headache, facial pain, neuralgias, and other primary headaches.</p><p><strong>Future directions: </strong>Future directions in headache medicine will include the accurate clinical characterization of primary headaches and facial pain. This will require detailed clinical observation, the identification of migraine-specific biomarkers, and precise phenotyping using the latest technologies.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":"222-229"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628250","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":"Dopamine agonist withdrawal syndrome - what do we really know?","authors":"Iga A Łobińska, Jarosław Sławek","doi":"10.5603/pjnns.110733","DOIUrl":"10.5603/pjnns.110733","url":null,"abstract":"<p><strong>Introduction: </strong>Dopamine agonist withdrawal syndrome (DAWS) comprises a wide range of neuropsychiatric and autonomic symptoms that occur in temporal relation with the reduction or withdrawal of dopamine agonists (DAs) in a dose-dependent manner. This syndrome was described as an important complication in Parkinson's disease (PD) and restless legs syndrome (RLS) treatment.</p><p><strong>State of the art: </strong>Dopamine agonist withdrawal syndrome affects even up to 24% of PD patients treated with DAs in whom the medication was tapered. Predominant symptoms include the following: anxiety, depression, irritability, panic attacks, sleep disorders, and suicidal thoughts along with autonomic problems such as fatigue, orthostatic hypotension, nausea, and vomiting. Dopamine agonist withdrawal syndrome remains a therapeutic challenge as it is refractory to levodopa (LD), other PD therapies, anti-depressants, and anti-psychotics. The therapy-resistant syndrome may be a pitfall for patients trapped between intolerable side effects of DAs (impulse control disorder [ICD]) and withdrawal symptoms.</p><p><strong>Clinical implications: </strong>Recognition of DAWS as a threatening condition is important for choosing the best treatment option for the patient. Due to the increasingly widespread use and efficacy of advanced therapies such as deep brain stimulation, enteral and subcutaneous LD, as well as apomorphine infusions, the risk of DAWS development should be considered. Dose reduction or discontinuation of DAs should be carefully planned and managed individually (personalized, based on main symptoms).</p><p><strong>Future directions: </strong>Further research should focus on the natural evolution, risk factors, and duration of DAWS. Development of new generation DAs, such as tavapadon, which may reduce the side effects of dopaminergic therapy, may set new standards for treatment. Guidelines on the taper velocity of DAs, risk factors, and management therapies are to be established to improve detection and treatment of DAWS.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":"169-178"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147499170","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":"Professor Zbigniew K. Wszolek, Co-Editor-in-Chief of Polish Journal of Neurology and Neurosurgery 2017-2025.","authors":"Jarosław Sławek","doi":"10.5603/pjnns.111394","DOIUrl":"https://doi.org/10.5603/pjnns.111394","url":null,"abstract":"","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":"60 1","pages":"1-2"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147308474","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":"Occupational burnout and perceived barriers at work in Polish neurologists.","authors":"Halina Sienkiewicz-Jarosz, Robert Bonek, Agnieszka A Borowiec, Waldemar Brola, Alina Kułakowska, Anetta Lasek-Bal, Konrad Rejdak, Jarosław Sławek, Piotr Świtaj","doi":"10.5603/pjnns.108149","DOIUrl":"10.5603/pjnns.108149","url":null,"abstract":"<p><strong>Rationale for the study: </strong>Burnout syndrome is a prolonged response to chronic work-related stress, characterized by exhaustion accompanied by mental and physical discomfort, a sense of reduced effectiveness and motivation, dysfunctional attitudes and behaviors at work. Neurologists are recognized as a high-risk group, but no large-scale study has previously examined burnout in this professional group in Poland.</p><p><strong>Aim of the study: </strong>This study aimed to determine the prevalence of burnout among Polish neurologists and to identify individual and organizational predictors, as well as perceived work-related barriers to effective practice.</p><p><strong>Material and methods: </strong>A cross-sectional online survey [Computer-Assisted Web Interview (CAWI)] was conducted among members of the Polish Neurological Society (n = 342). Burnout was assessed using the Oldenburg Burnout Inventory (OLBI), alongside validated measures of depressive symptoms, insomnia, loneliness, occupational hardiness, occupational self-efficacy, and psychosocial work conditions. Multiple linear regression analyses were performed to identify predictors of the dimensions of burnout: exhaustion and disengagement.</p><p><strong>Results: </strong>A high prevalence of burnout was found: 87.0% of respondents met the criteria for exhaustion and 77.5% for disengagement. Being of a younger age was a predictive factor for exhaustion, while living in a larger city slightly reduced disengagement. Severity of depression and work pace were significant predictors of higher levels of both burnout dimensions. More severe exhaustion was additionally associated with higher emotional and quantitative job demands, insomnia, and - unexpectedly - greater peer support. Protective factors included workplace commitment, occupational self-efficacy, professional development opportunities, and occupational hardiness. The most frequently cited barriers in the workplace were administrative overload (85.4%), high work pace (64.0%), and staff shortages (56.7%).</p><p><strong>Conclusions: </strong>Burnout is highly prevalent among Polish neurologists, driven by both individual vulnerabilities (belonging to a younger age group, depression, insomnia) and organizational stressors (workload, administrative burden). Strengthening professional resources such as self-efficacy and hardiness, enhancing career development opportunities, and reducing bureaucratic workload are essential strategies. Targeted interventions are needed, particularly for early-career neurologists, in order to maintain well-being and ensure sustainable neurological care.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":"310-319"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145636698","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}