Neurological Sciences最新文献

{"title":"Bioelectric; Neuromodulation; Epilepsy; DBS; High-frequency stimulation; Low frequency stimulation.","authors":"Faeze Sadat Ahmadi Tabatabaei, Sam Zarbakhsh, Mohammad Taghi Joghataei, Samaneh Dehghan, Marzieh Khodadai, Nooshin Ahmadirad","doi":"10.1007/s10072-025-08552-6","DOIUrl":"https://doi.org/10.1007/s10072-025-08552-6","url":null,"abstract":"<p><p>Drug-resistant epilepsy affects a significant portion of epileptic patients, necessitating alternative treatment strategies beyond pharmacological interventions. Bioelectric medicine, employing techniques like vagus nerve stimulation, deep brain stimulation, and responsive neurostimulation, has emerged as a promising approach. This review comparatively analyzes the mechanisms and clinical outcomes of high-frequency stimulation and low-frequency stimulation in the context of epilepsy treatment. We delve into the synaptic plasticity, neuronal network modulation, and neurochemical alterations induced by these stimulation paradigms, highlighting their potential to disrupt pathological synchronization and reduce seizure frequency. Furthermore, we discuss the rationale for selecting specific stimulation frequencies and target brain regions, considering the heterogeneity of epilepsy syndromes. By synthesizing existing literature, this review aims to provide a comprehensive overview of bioelectric approaches in epilepsy, informing future research and clinical applications.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244616","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":"Correction to: Lower risk of seizure recurrence with levetiracetam and oxcarbazepine after withdrawal in pediatric epilepsy: a pilot study.","authors":"Dilek Cebeci, Ebru Arhan, Ercan Demir, Tugba Hirfanoglu, Kivilcim Gucuyener, Esra Serdaroglu, Kursad Aydin, Ayse Serdaroglu","doi":"10.1007/s10072-025-08573-1","DOIUrl":"https://doi.org/10.1007/s10072-025-08573-1","url":null,"abstract":"","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244622","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 burden and management of emergency room neurological consultation in hub and spoke Italian hospitals: the nationwide surveys of the Italian Association for Emergency Neurology (ANEU).","authors":"Arturo de Falco, Giuseppe Micieli, Anna Cavallini, Federico Rea, Massimo Del Sette, Pietro Cortelli, Giovanni Cossu, Marialuisa Zedde, Shalom Haggiag, Silvia Cenciarelli, Matteo Grazzini, Maria Guarino, Francesca Romana Pezzella, Rocco Quatrale, Valeria Terruso, Carla Zanferrari, Paolo Cerrato, Bruno Giometto, Francesca Pistoia, Giovanni Maria Franco, Vincenzo Andreone, Patrizia De Massis, Francesca Gragnani, Elisa Giorli, Chiara Scarabozzi, Simone Tonietti, Claudia Cagnetti, Roberto Carmelo Labate, Vito Marco Rossi, Giuseppe Fenu, Paolino La Spina, Gino Volpi, Luca Caumo, Ernesto Gastaldo, Antonella Picchioni","doi":"10.1007/s10072-025-08521-z","DOIUrl":"https://doi.org/10.1007/s10072-025-08521-z","url":null,"abstract":"","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244699","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":"Fasciculation in limbs serves as the predictor of ALS progression: an ultrasound study.","authors":"Nan Hu, Ming Qi, Huihong Tian, Jianfeng Ding, Dongchao Shen, Xunzhe Yang, Liying Cui, Jingwen Niu, Mingsheng Liu","doi":"10.1007/s10072-025-08533-9","DOIUrl":"https://doi.org/10.1007/s10072-025-08533-9","url":null,"abstract":"<p><strong>Objective: </strong>To explore the predictive effects of fasciculation by ultrasound in amyotrophic lateral sclerosis (ALS) progression.</p><p><strong>Methods: </strong>Sporadic ALS patients were consecutively recruited and followed up 3 to 6 months after the initial visit. Muscle ultrasound examination was conducted at the baseline to detect the severity score of fasciculations on bilateral elbow flexor and extensor, ankle dorsiflexor and plantar flexor of each patient, the sum of which was defined as the total fasciculation score. Baseline and follow-up ALS functional research scale-revised (ALSFRS-R) score and muscle strength were collected. The progression of ALS was reflected by the decline rate of ALSFRS-R score and proportion of muscles with decreased strength.</p><p><strong>Results: </strong>Among 33 ALS patients who completed the follow-up, the total fasciculation score was positively correlated with the ALSFRS-R progression rate (rho = 0.029, p < 0.001). Patients with low levels of the total fasciculation score had a significantly lower risk of rapid ALSFRS-R progression during follow-up compared to those with high levels of the total fasciculation score (HR 0.132, 95%CI 0.037-0.476). The frequencies of decline in muscle strength at the follow up were 76.32% and 16.54% among muscles with and without high-grade fasciculation (p < 0.001) after exclusion of muscles with 0-1 the medical research council (MRC) levels of strength at the baseline.</p><p><strong>Conclusion: </strong>The severity of fasciculations was correlated with the rate of decrease in ALSFRS-R score and the decline in muscle strength, which might be used as a biological marker to predict the progression rate of ALS for prognostic judgment or clinical trial grouping.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251907","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":"IL-1β contributes to neurological disability in NMOSD AQP4 + Patients.","authors":"Antonio Bruno, Angela Borrelli, Gianluca Lauritano, Sonia Di Lemme, Veronica Di Caprio, Roberta Fantozzi, Ettore Dolcetti, Federica Azzolini, Luana Gilio, Giovanni Galifi, Roberto Furlan, Annamaria Finardi, Francesca De Vito, Alessandra Musella, Georgia Mandolesi, Mario Stampanoni Bassi, Diego Centonze, Fabio Buttari","doi":"10.1007/s10072-025-08526-8","DOIUrl":"https://doi.org/10.1007/s10072-025-08526-8","url":null,"abstract":"<p><strong>Background: </strong>Neuromyelitis Optica Spectrum Disorder (NMOSD) is a central nervous system inflammatory disease that causes severe disability. Differently from relapsing-remitting multiple sclerosis (RRMS) a group of patients present aquaporin-4 (AQP4) antibodies in the serum. Although its pathogenesis is unclear, cytokine profiles may impact disease activity and severity.</p><p><strong>Objective: </strong>To analyze cerebrospinal fluid (CSF) cytokine levels in NMOSD AQP4 + and their relationship with neurological disability, comparing findings with RRMS patients and non-inflammatory controls (NIC).</p><p><strong>Methods: </strong>Sixty-four participants were recruited: 11 NMOSD AQP4+, 29 RRMS, and 24 NIC. CSF cytokine levels were measured using a multiplex assay. Group comparisons were performed with Kruskal-Wallis and Mann-Whitney U tests, while linear regression models evaluated the association between cytokine levels and Expanded Disability Status Scale (EDSS) scores.</p><p><strong>Results: </strong>NMOSD AQP4 + patients displayed significantly higher CSF levels of IL-1β (p = 0.040), TNF-α (p < 0.001), G-CSF (p = 0.003), Eotaxin (p = 0.008), and MIP-1α (p = 0.005) compared to RRMS and NIC. Moreover, IL-1β CSF levels were positively associated with disability at the time of lumbar puncture (β = 22.24, SE = 7.73, p = 0.018), a relationship that remained significant after adjusting for age (β = 18.96, SE = 6.33, p = 0.040).</p><p><strong>Conclusions: </strong>Expression of proinflammatory cytokines may differ between NMOSD and RRMS. Elevated IL-1β levels in NMOSD AQP4 + patients are associated with neurological disability, suggesting a potential role as a biomarker of disease severity. Further studies are needed to confirm these findings and evaluate the therapeutic potential of targeting IL-1β in NMOSD.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244652","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":"Myelin-oligodendrocyte glycoprotein (MOG) antibody-associated acute disseminated encephalomyelitis (ADEM) in an adult with dengue.","authors":"Leonardo Torioni, Isidro Gonzales Quispe, Michel Elyas Jung Haziot, Mariana Vaz-Curado, Rene L M Rivero, José Ernesto Vidal","doi":"10.1007/s10072-025-08512-0","DOIUrl":"https://doi.org/10.1007/s10072-025-08512-0","url":null,"abstract":"<p><p>Dengue is the most worldwide arbovirus and uncommonly causes encephalitis or acute disseminated encephalomyelitis (ADEM). Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) has recently been recognized as a spectrum of monophasic or relapsing course demyelininating syndromes. We present the first case of MOGAD ADEM in an adult with dengue from Brazil. The patient was a 21-year-old man with no relevant medical or epidemiological history and a confirmed diagnosis of dengue with no warning signs after three days of classical clinical manifestations. In the next days, the patient had lower limb weakness, acute urinary retention, diplopia, sonolence, and mental confusion. MRI showed multiple cerebral and spinal cord lesions compatible with ADEM. CSF analysis demonstrated pleocytosis (135 WBC/μL) and elevated protein (155 mg/L). Dengue-IgM antibodies were positive in the CSF. Serum MOG-IgG cell-based immunofluorescence assay was positive with a titer >1:160. The patient received methylprednisolone for five days, showing progressive and unequivocal improvement of neurological manifestations and he was discharged with oral prednisone This report suggests an emerging association between dengue induced immune dysregulation and the development of MOGAD-associated ADEM. The presence of MOG antibodies should be considered in adults with dengue-related ADEM and timely syndromic management may determine favorable outcomes.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252016","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":"Neurology training in italy: a perceived proficiency-based survey on Italian residency programmes and compliance with European training standards.","authors":"Matteo Farè, Andi Nuredini, Bruna Nucera, Giulia Fiume, Sandy Maria Cartella, Alessandro Bombaci, Luca Angelini","doi":"10.1007/s10072-025-08523-x","DOIUrl":"https://doi.org/10.1007/s10072-025-08523-x","url":null,"abstract":"<p><strong>Background: </strong>Since 2005, the European Training Requirements in Neurology (ETRN) have defined the clinical, practical, and research competencies expected in European neurology residency programmes. However, significant variability in training quality persists among Italian programmes. This survey, conducted by the Italian Section of Young Neurologists, aimed to assess how closely Italian neurology residency programmes with ETRN standards and to evaluate residents' and early-career neurologists' self-reported perceived knowledge, practical skills, and access to specialized training.</p><p><strong>Methods: </strong>An anonymous, online survey was distributed in November 2023 to neurology residents and recently qualified neurologists across Italy. The 39-item questionnaire covered four sections: demographics, residency programme structure, learning objectives, and out-of-network internship opportunities. Responses were evaluated using descriptive statistics and comparative analyses across institution sizes and training years.</p><p><strong>Results: </strong>Of 248 respondents (45.2% female, mean age 28.9 years), only 70.5% of ETRN's basic training objectives were met, with lower compliance observed for advanced competencies. Practical skills like lumbar puncture and history-taking were widely acquired, but advanced diagnostic techniques (e.g., EMG, neuro-sonography) and subspecialty training (e.g., neuro-oncology, palliative care) showed limited availability. Out-of-network internship participation was low (21.7%), mainly due to institutional constraints and lack of financial support, limiting exposure to diverse clinical environments.</p><p><strong>Conclusions: </strong>Residency programmes demonstrate moderate adherence to ETRN standards at the basic level, though significant gaps remain in advanced training, diagnostic techniques, and interdisciplinary skills. Enhanced standardization, improved funding for extra-network internships, and focused efforts on advanced training are essential to elevate Italian neurology residency programmes to meet European standards more fully.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252067","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":"Thrombectomy-capable vs. comprehensive stroke centers: impact on endovascular therapy outcomes in acute large vessel occlusion.","authors":"Shujuan Gan, Tingyu Yi, Jintao Chen, Wenli Zhang, Yanmin Wu, Meihua Wu, Weifeng Huang, Ya Shao, Lihua Xu, Dongsheng Ju, Liqun Jiao, Wenhuo Chen","doi":"10.1007/s10072-025-08571-3","DOIUrl":"https://doi.org/10.1007/s10072-025-08571-3","url":null,"abstract":"<p><strong>Background: </strong>Although data on the outcomes of endovascular therapy (EVT) for acute ischemic stroke in different stroke centers are limited, this study aimed to evaluate EVT quality and outcomes in thrombectomy-capable stroke centers (TSCs) versus comprehensive stroke centers (CSCs) for ischemic stroke patients with large vessel occlusion.</p><p><strong>Materials and methods: </strong>This study included 37 stroke centers (11 CSCs, 26 TSCs) dispersed across 20 provinces. Patients with acute anterior circulation large vessel occlusion within 24 hours of symptom onset were enrolled. Regression models were used to control for baseline characteristics and time metrics to assess outcomes by center type.</p><p><strong>Results: </strong>A total of 947 patients (423 from TSCs, 524 from CSCs; median age: 69 years; 585 [61.8%] men) who underwent EVT were analyzed. Functional independence (modified Rankin Scale score [mRS] 0-2 at 90 days) was 43.5% in TSCs and 49% in CSCs (adjusted odds ratio [aOR], 1.02; 95% CI, 0.693-1.5). Compared to TSCs, CSCs exhibited lower mortality (aOR, 0.466; 95% CI, 0.284-0.767) and higher rates of successful reperfusion (aOR, 3.29; 95% CI, 1.76-6.15). No significant differences were found in terms of symptomatic intracranial hemorrhage or procedural complications. Sensitivity and subgroup analyses supported these findings.</p><p><strong>Conclusions: </strong>In patients with anterior circulation large vessel occlusion undergoing EVT, CSCs had similar functional independence rates to TSCs but lower mortality and better reperfusion without higher hemorrhage risk.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239251","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":"Impact of vascular aging on stroke prognosis: the novel severity and arterial stiffness (SASt) score.","authors":"Nikolaos Kakaletsis, Athanase D Protogerou, Naohisa Hosomi, Tomohisa Nezu, Patrik Michel, Thevoz Guillaume, Davide Strambo, Young Seo Kim, Wonjae Sung, Konstantinos Vemmos, Eleni Korompoki, Maurizio Acampa, Jukka Putaala, Lauri Tulkki, Matthias Hermann, Protazy Rejmer, Philip M Bath, Lisa J Woodhouse, Elpida Athanasopoulou, Haralampos Milionis, George Ntaios, Vasilios Kotsis, Christos Savopoulos","doi":"10.1007/s10072-025-08527-7","DOIUrl":"https://doi.org/10.1007/s10072-025-08527-7","url":null,"abstract":"<p><strong>Introduction: </strong>Assessing vascular aging to identify and categorize the residual risk of adverse outcomes in acute ischemic stroke (AIS) is important for improving AIS prognoses. This study aimed to investigate the prognostic value and correlation among three indirect measures of vascular aging derived from 24-hour blood pressure monitoring (24 h-BPM) following AIS. Furthermore, it aimed to develop a new score that includes vascular aging metrics to enhance the prognostic accuracy for stroke outcomes.</p><p><strong>Methods: </strong>A total of 2,730 AIS patients with a mean age of 72.0 ± 14.4 years who underwent 24 h-BPM were included. Three vascular aging indexes derived from 24 h-BPM: estimated pulse wave velocity (ePWV), early vascular aging ambulatory score (EVAAs), and 24-hour pulse pressure (24 h-PP) were evaluated. Primary outcome was the modified Rankin Scale (mRS) score > 2 at 3 months post-stroke.</p><p><strong>Result: </strong>ePWV showed superior predictive value for poor functional outcome (AUC: 0.77, 95% CI: 0.74-0.79) at 3 months post-stroke. Optimal cutoff points for predicting poor functional outcome at 3 months were 12.2 m/s for ePWV (sensitivity: 79.4%, specificity: 61.7%), 65% for EVAAs (sensitivity: 66.4%, specificity: 51.5%), and 51.1mmHg for 24 h-PP (sensitivity: 66.7%, specificity: 46.6%). A new \"Severity and Arterial Stiffness\" (SASt) score was formulated: SASt = NIHSS + 2*ePWV, which demonstrated excellent discriminatory power for predicting poor functional outcome (AUC: 0.87, 95% CI: 0.85-0.88) at 3 months post-stroke.</p><p><strong>Conclusions: </strong>The ePWV and the new SASt score show promising potential as tools for identifying patients at higher risk for poor outcomes at 3 months post-stroke. While these findings are encouraging, further prospective studies are needed to validate their utility before they can be adopted in clinical practice.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239259","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":"Two paths for turning the tide: complement and FcRn inhibition to overcome refractory myasthenia gravis.","authors":"Silvia Falso, Sofia Marini, Jacopo Morroni, Martina Marini, Raffaele Iorio","doi":"10.1007/s10072-025-08570-4","DOIUrl":"https://doi.org/10.1007/s10072-025-08570-4","url":null,"abstract":"","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239314","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}