Neurological Sciences最新文献

{"title":"Clinical diagnosis and communication in functional neurological disorders: a survey among Italian neurologists.","authors":"Vittorio Velucci, Angela Sandri, Mario Zappia, Alfredo Berardelli, Tommaso Ercoli, Laura Tassi, Francesco Brigo, Roberto Erro, Alessandro Padovani, Giovanni Fabbrini, Giovanni Defazio, Michele Tinazzi","doi":"10.1007/s10072-025-08383-5","DOIUrl":"https://doi.org/10.1007/s10072-025-08383-5","url":null,"abstract":"<p><strong>Introduction: </strong>Functional neurological symptom disorder (FND), including functional motor disorders (FMD) and psychogenic non-epileptic seizures (PNES), is a common yet under-recognized condition, often associated with diagnostic uncertainty. This national survey investigated how Italian neurologists apply validated clinical signs and communication strategies in FND diagnosis.</p><p><strong>Methods: </strong>A cross-sectional survey was distributed to approximately 2,700 members of three Italian neurological societies. The questionnaire assessed demographic and professional characteristics, the frequency of use of specific clinical signs for FMD and PNES, and strategies for communicating the diagnosis. Responses were rated on a five-point frequency scale and analyzed using ordinal generalized linear models and Spearman's correlations, adjusting for demographic covariates.</p><p><strong>Results: </strong>A total of 245 neurologists (43.3% general neurologists, 35.9% movement disorder specialists, 20.8% epileptologists) completed the survey. Movement disorder specialists more frequently assessed tremor entrainment and fixed dystonia in FMD, while epileptologists were more likely to assess signs such as eye closure and irregular jerks in PNES. Clinicians with greater experience more frequently evaluated established signs for both FMD and PNES and employed broader communication strategies. Communication practices were largely consistent across subspecialties. Written information was rarely provided across all groups.</p><p><strong>Conclusion: </strong>The application of validated clinical signs and communication strategies for FND varies by subspecialty and clinical experience. While epileptologists and movement disorder specialists demonstrate greater familiarity with signs relevant to their subspecialty, key diagnostic tools for FMD remain underutilized. These findings highlight the need for targeted educational interventions to improve diagnostic accuracy, enhance communication, and optimize care for people with FND.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732444","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":"Effects of coronavirus disease 2019 in patients with optic neuritis: a single-centre retrospective cohort study.","authors":"Rong Yan, Yanjun Guo, Chao Meng, Xiuyun Kong, Jiawei Wang","doi":"10.1007/s10072-025-08365-7","DOIUrl":"https://doi.org/10.1007/s10072-025-08365-7","url":null,"abstract":"<p><strong>Background: </strong>The relationship between coronavirus disease 2019 (COVID-19) and optic neuritis (ON) remains unclear, with limited evidence on its clinical features and outcomes. This study aimed to investigate the impact of COVID-19 on ON subtypes and prognosis.</p><p><strong>Methods: </strong>We conducted a single-centre retrospective cohort study, comparing acute ON patients with and without recent COVID-19 infection during the omicron wave (December 2022 to January 2023). A historical control group from the pre-COVID-19 era was included for comparison.</p><p><strong>Results: </strong>A total of 55 ON patients were included, of whom 12 had recent COVID-19 infection. COVID-19-associated ON showed a higher incidence of acute disseminated encephalomyelitis-associated ON (ADEM-ON, 25% vs. 0%) and a lower rate of aquaporin-4 antibody-associated ON (AQP4-ON, 0% vs. 31.4%). These patients presented more frequently with eye pain (75%) and respiratory symptoms (60%). At onset, 66.7% experienced severe visual loss (mean logMAR 1.10 ± 0.71), but most (83.3%) achieved good visual recovery (mean logMAR 0.08 ± 0.44) after immunotherapy. Only one relapse was observed during follow-up.</p><p><strong>Conclusions: </strong>COVID-19 may trigger distinct autoimmune processes in ON, particularly increasing ADEM-ON prevalence. Despite initial severe vision loss, outcomes are generally favourable with timely treatment. These findings expand understanding of neuro-ophthalmic complications related to COVID-19.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732445","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":"\"Crab sign\" in an ataxia patient with central nervous system Erdheim Chester disease: a novel neuroimaging finding with review of literature.","authors":"Farsana Mustafa, Chaithra Rajanna, Archita Makharia, Divyani Garg, Ayush Agarwal, Ajay Garg, Aanchal Kakkar, Shreya Ojha, Nishikant A Damle, Yamini Dharmashaktu, Divya M Radhakrishnan, Achal Kumar Srivastava","doi":"10.1007/s10072-025-08381-7","DOIUrl":"https://doi.org/10.1007/s10072-025-08381-7","url":null,"abstract":"<p><strong>Background: </strong>Erdheim-Chester disease (ECD) of the central nervous system is a neoplastic, non-Langerhans cell histiocytosis which can present with a multitude of symptoms. Intra-axial involvement commonly leads to a spastic ataxic syndrome, ophthalmoplegia, and diabetes insipidus while extra-axial involvement manifests as pachymeningitis.</p><p><strong>Objectives: </strong>To describe a novel imaging sign in Erdheim Chester Disease.</p><p><strong>Methods: </strong>We evaluated in detail a 55-year old lady with xanthelesmas and a progressive spastic ataxic syndrome over a 6 month period by history, examination, serological, radiological and histopathological investigations.</p><p><strong>Results: </strong>Our patient was diagnosed with Erdheim Chester disease based on histopathological evaluation. She had a novel neuroimaging finding of \"crab sign\" in the axial T2-FLAIR sections of her MRI brain.</p><p><strong>Conclusion: </strong>The \"crab sign\" has the potential to aid early diagnosis and enhance diagnostic yield of Erdheim Chester disease, facilitating earlier therapeutic intervention and better outcomes.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732443","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":"Reversible symmetric bilateral basal ganglia lesions in hemodialysis patients with acute movement disorders.","authors":"Jie-Qiang Xia, Yan-Mei Zhu, Jian Fan, Hao Sun","doi":"10.1007/s10072-025-08376-4","DOIUrl":"https://doi.org/10.1007/s10072-025-08376-4","url":null,"abstract":"","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732446","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":"A case of IgG4-related spinal pachymeningitis with a large spinal cord cavity: case report and updated systematic review.","authors":"Jiaqian Zhu, Yanni Yu, Peng Sun, Liming Cao","doi":"10.1007/s10072-025-08369-3","DOIUrl":"https://doi.org/10.1007/s10072-025-08369-3","url":null,"abstract":"<p><strong>Background: </strong>IgG4-related spinal pachymeningitis (IgG4-RSP) is rare, particularly in cases where spinal cord cavities develop after the removal of thickened dura mater, making diagnosis challenging. A 31-year-old male presented with IgG4-RSP, and the clinical presentation, diagnostic imaging, pathology, treatment, and follow-up outcomes were documented. We also conducted a thorough review of the relevant literature.</p><p><strong>Case report: </strong>The patient presented with two-year progressive lower limb weakness. He experienced lower back pain, numbness in both legs, and urinary and defecatory difficulties without a notable medical history. Initial magnetic resonance imaging (MRI) revealed dura mater lesions and thoracic spinal cord compression, leading to surgery that did not improve the symptoms. Pathological examination confirmed IgG4-related hypertrophic pachymeningitis. Physical examination revealed a reduced pain sensation below both rib margins and a muscle strength score of 3/5 in the lower limbs. Thoracic MRI revealed significantly enlarged spinal cord cavities compared to previous scans. Methylprednisolone treatment partially improved symptoms. Subsequent efgartigimod alfa treatment did not alleviate the symptoms further. The patient exhibited significant neurological deficits.</p><p><strong>Literature review: </strong>Studies were identified through PubMed, resulting in 20 case reports that met the criteria and were pathologically confirmed. More than half of all patients with IgG4-RSP experience neck or back pain, with lesions typically found in the cervical spine and extending to the thoracic level.</p><p><strong>Conclusions: </strong>Caution should be exercised in the post-surgical spinal cord cavity. One-quarter of patients have a poor prognosis. Further research is needed to understand the pathophysiology of IgG4-RSP and develop specific treatments.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718161","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":"Addressing inequities in neurological mortality: trends and disparities in anoxic brain injury deaths, 1999-2023.","authors":"Shree Rath, Dur E Sameen, Neha Waseem, Sahar Ahsan, Bushra Syed, Arham Khalid Farooq, Ahmad Kamal","doi":"10.1007/s10072-025-08382-6","DOIUrl":"https://doi.org/10.1007/s10072-025-08382-6","url":null,"abstract":"<p><strong>Purpose: </strong>Despite the slowly declining prevalence of anoxic brain injury (ABI) due to newer drugs and guidelines, there still exists inequity in timely receipt of treatment. This study aims to provide a comprehensive evaluation of ABI mortality trends and sociodemographic disparities in the United States from 1999 to 2023.</p><p><strong>Methods: </strong>Mortality data were obtained from the CDC-WONDER Database. The study focused on ABI-related deaths among adults aged 35 to 85 + years between 1999 and 2023. Demographic and regional variables were analyzed, including gender, race/ethnicity, age groups, census region, state, urbanization, and place of death. Average annual percentage changes (AAPC) were calculated, and trends were evaluated using the Joinpoint Regression.</p><p><strong>Results: </strong>From 1999 to 2023, there were a total of 117,148 ABI-related deaths. The overall age-adjusted mortality rate (AAMR) showed a mild increase from 1999 to 2004, followed by a sharp increase until 2017, and a subsequent decline (APC: -3.10% [95% CI, -4.1% to -2.37%]. Males consistently exhibited higher mortality rates compared to females. Significant racial disparities were observed, with African Americans demonstrating higher AAMRs (7.67) than other racial groups. Both urban and rural areas experienced trends in ABI mortality, with rural areas showing higher AAMRs.</p><p><strong>Conclusion: </strong>Despite recent declines in overall ABI mortality trends, significant disparities persist across demographic and geographic lines. Targeted public health interventions are necessary to address risk factors leading to ABI, particularly among high-risk groups such as racial minorities and rural populations.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718162","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":"Letter to Editor concerning \"rapidly progressive dementia in tacrolimus neurotoxicity: rare but reversible\".","authors":"Vincenzina Lo Re, Giuseppe Mamone, Alessandro Mattina","doi":"10.1007/s10072-025-08378-2","DOIUrl":"https://doi.org/10.1007/s10072-025-08378-2","url":null,"abstract":"","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708260","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":"Central nervous system demyelination associated with biological agents used in the treatment of rheumatologic diseases: a retrospective cohort study.","authors":"Doruk Arslan, Basak Sayinalp-Arslan, Emre Bilgin, Pinar Acar-Ozen, Rahsan Gocmen, Ihsan Ertenli, Sedat Kiraz, Rana Karabudak, Umut Kalyoncu, Asli Tuncer","doi":"10.1007/s10072-025-08354-w","DOIUrl":"https://doi.org/10.1007/s10072-025-08354-w","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the annual incidence rate and clinical characteristics of central nervous system (CNS) demyelinating disease in patients who receive biologic agents for rheumatic diseases.</p><p><strong>Methods: </strong>Patients who received biologic agents due to rheumatic diseases were identified in a retrospective manner and data of the patients who developed CNS demyelinating disease were recorded.</p><p><strong>Results: </strong>4838 out of 5926 patients who attended regular follow-up visits, were included in the study. CNS demyelinating disease was observed in 7 patients for 19.391 patient-years. 4 of 7 were diagnosed with multiple sclerosis (MS). 6 out of 7 were under anti-TNF therapy and mean duration was 13 months under causative drugs. While annual incidence rate of CNS demyelinating disease was 36.1/100000 (95% CI: 17-75), annual multiple sclerosis incidence rate in rheumatologic patients exposed to biologic agents was 19.6/100000 (95% confidence interval 7-52).</p><p><strong>Conclusion: </strong>When compared with the data obtained in our cohort with annual incidence rates of multiple sclerosis in Europe, it is possible to conclude that there is an increase in the incidence of demyelinating events. Therefore, clinicians must be aware of neurological signs and symptoms in patients who receive biologic agents.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699119","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":"Factors influencing the occurrence and characteristics of white matter hyperintensities on the brain imaging of migraine patients.","authors":"Mahmoud A Farid, Mohamed G Zeinhom, Sherihan Rezk Ahmed, Ehab S Ramadan","doi":"10.1007/s10072-025-08373-7","DOIUrl":"https://doi.org/10.1007/s10072-025-08373-7","url":null,"abstract":"<p><strong>Background: </strong>White matter hyperintensities (WMHs) increase the burden of migraine on the patients' lives and leading to migraine-related poor outcomes, so we aim to evaluate the association of different neurophysiological, psychological, and clinical factors with the presence and characteristics of WMHs on the brain imaging of migraine patients.</p><p><strong>Methods: </strong>Our study included 300 migraine patients who underwent clinical, psychological, and neurophysiological assessment, including P300, which represented an event-related potential (ERP) component elicited in the decision-making process. The goal was to evaluate the association of these factors with the presence and characteristics of WMHs on the brain imaging of migraine patients.</p><p><strong>Results: </strong>older age (OR, 1.213; 95% CI, 1.149 to 1.787; P-value 0.02), P300 Fz latency (OR, 1.852; 95% CI, 1.374 to 2.314; P-value < 0.001), P300 Pz latency (OR, 1.823; 95% CI, 1.397 to 4.237; P-value < 0.001), migraine with aura (OR, 7.115; 95% CI, 3.874 to 14.254; P-value 0.01), chronic migraine (OR, 6.105; 95% CI, 3.364 to 8.057; P-value < 0.001), and Montreal cognitive assessment (MoCA) (OR, 0.543; 95% CI, 0.169 to 0.723; P-value < 0.001) were associated with developing WMHs on the brain MRI of migraine patients.</p><p><strong>Conclusion: </strong>Prolonged P300 latency, older age, lower MoCA score, chronic migraine, and migraine with aura were associated with the presence of WMHs on the brain imaging of migraine patients. In addition, longer P300 latency was positively correlated with WMH diameter, number, and Schelten's score. In contrast, higher P300 amplitude and higher MoCA score were negatively correlated with WMH diameter, number, and Schelten's score in migraine patients.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691000","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 evolution of tremor in Parkinson's Disease: insights from a 4-year longitudinal assessment.","authors":"Carolina Cutrona, Matteo Costanzo, Giorgio Leodori, Maria Ilenia De Bartolo, Agnese Liguori, Francesco Marchet, Marco Mancuso, Giorgio Vivacqua, Antonella Conte, Giovanni Fabbrini, Alfredo Berardelli, Daniele Belvisi","doi":"10.1007/s10072-025-08363-9","DOIUrl":"https://doi.org/10.1007/s10072-025-08363-9","url":null,"abstract":"<p><strong>Introduction: </strong>While tremor is considered a cardinal motor sign in patients with Parkinson's disease (PD), little is known about the evolution of the different types of PD tremor over time.</p><p><strong>Aims: </strong>Our objectives were to assess the rate of progression of the various types of PD tremor over the disease course and to verify if the presence of different tremors is consistently associated with specific motor and non-motor burdens over time. Finally, we investigated whether the presence of different tremors can predict specific trajectories of disease progression.</p><p><strong>Methods: </strong>One hundred PD patients were enrolled and 73 completed a 4-year follow up. Clinical evaluations included the administration of standardized PD scales to assess the severity of motor and non-motor manifestations. The occurrence and severity of rest, re-emergent, and action tremors were accurately evaluated at baseline and 4 years later. Adjusted linear regression models were used to assess tremor type's influence on disease progression.</p><p><strong>Results: </strong>Tremor occurrence and severity decreased during PD progression, with a more significant reduction in action tremor compared to rest and re-emergent tremor. Patients with rest and re-emergent tremor had milder motor symptoms at baseline and milder motor and non-motor manifestations at follow-up. The presence of rest and re-emergent tremor predicted a lower progression of non-motor symptoms.</p><p><strong>Conclusions: </strong>This longitudinal study revealed that the various types of PD tremor have different evolutions over disease course, can predict distinct trajectories of disease progression and are underpinned by distinct pathophysiological mechanisms.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691001","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}