Neurological Sciences最新文献

{"title":"Characterizing practice-dependent motor learning after a stroke.","authors":"Annibale Antonioni, Nicola Cellini, Andrea Baroni, Giulia Fregna, Nicola Lamberti, Giacomo Koch, Fabio Manfredini, Sofia Straudi","doi":"10.1007/s10072-024-07815-y","DOIUrl":"https://doi.org/10.1007/s10072-024-07815-y","url":null,"abstract":"<p><strong>Background: </strong>After stroke, patients must learn to use residual motor function correctly. Consistently, motor learning is crucial in stroke motor recovery. We assessed motor performance, practice-dependent on-line motor learning, and factors potentially affecting them in stroke patients.</p><p><strong>Methods: </strong>This is a cross-sectional observational study. Twenty-six patients with first brain stroke leading to upper limb motor deficit in the subacute or chronic timeframe were enrolled. They performed a Finger Tapping Task (FTT) with both the affected and unaffected limbs. We assessed how patients learn to perform motor tasks despite the motor deficit and the differences in performance between the unaffected and affected limbs. Furthermore, by randomizing the order, we evaluated the possible inter-limb transfer of motor learning (i.e. transfer of a motor skill learned in one limb to the opposite one). Moreover, sleep, attention, anxiety, and depression were assessed through specific tests and questionnaires.</p><p><strong>Results: </strong>Improved FTT accuracy and completed sequences for the affected limb were observed, even if lower than for the unaffected one. Furthermore, when patients initially performed the FTT with the unaffected limb, they showed higher accuracy in subsequent task completion with the affected limb than subjects who started with the affected limb. Only anxiety and attentional abilities showed significant correlations with motor performance.</p><p><strong>Conclusions: </strong>This work provides relevant insights into motor learning in stroke. Practice-dependent on-line motor learning is preserved in stroke survivors, and an inter-limb transfer effect can be observed. Attentional abilities and anxiety can affect learning after stroke, even if the effect of other factors cannot be excluded.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142580944","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":"Long-term efficacy and safety of tacrolimus in anti-MuSK antibody-positive myasthenia gravis: a retrospective single-center cohort study.","authors":"Zhuajin Bi, Yue Li, Jing Lin, Mengcui Gui, Zhijun Li, Bitao Bu","doi":"10.1007/s10072-024-07819-8","DOIUrl":"https://doi.org/10.1007/s10072-024-07819-8","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the long-term efficacy and safety of tacrolimus in patients with muscle-specific kinase antibody-positive myasthenia gravis (MuSK-MG).</p><p><strong>Methods: </strong>We performed a retrospective, single-center, and cross-sectional study analyzing medical records of 18 MuSK-MG patients treated with tacrolimus for more than 1 year. The efficacy and safety of tacrolimus were evaluated by modified Osserman scale, Myasthenia Gravis Foundation of America post-intervention status, prednisone dosage, quantitative MG (QMG) scores, MG-activity of daily living (MG-ADL) scores, anti-MuSK antibody titers, blood routine, and serum biochemicals.</p><p><strong>Results: </strong>After 4 weeks of tacrolimus treatment, there was a significant improvement in prednisone dose, QMG, and MG-ADL scores, which continued to improve over 1 year. In addition, clinical grade of modified Osserman scale was improved in all patients, 16 (88.9%) of whom were asymptomatic at the last visit. More importantly, the mean titers of anti-MuSK antibody were significantly decreased from 0.777 ± 0.381 to 0.283 ± 0.178 nmol/L after a median of 1.4 years of tacrolimus treatment in 9 patients with MuSK-MG (P = 0.015). All patients achieved minimal manifestations status (MMS) after tacrolimus treatment (range, 4-32 weeks). Subsequently, seven patients (38.9%) underwent a taper of tacrolimus dosage. However, four patients (57.1%) experienced an exacerbation. Adverse events occurred in 2 patients (11.1%), all of which were mild and resolved after the tacrolimus dose was adjusted or discontinued.</p><p><strong>Conclusion: </strong>Our results suggest that tacrolimus may be an effective and safe steroid-sparing treatment for patients with MuSK-MG. However, tacrolimus should be carefully tapered to avoid disease exacerbation.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581402","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":"Exploring cognitive functions and brain structure in Hereditary Transthyretin amyloidosis using brain MRI and neuropsychological assessment.","authors":"Iara Senem, Maria Paula Foss, Carolina Lavigne-Moreira, Antonio Carlos Dos Santos, Renan Flávio de França Nunes, Marcondes Cavalcante França Júnior, Pedro Jose Tomaselli, Jan Axelsson, Jonas Wixner, Wilson Marques","doi":"10.1007/s10072-024-07846-5","DOIUrl":"https://doi.org/10.1007/s10072-024-07846-5","url":null,"abstract":"<p><strong>Background: </strong>Central nervous system symptoms, such as cognitive dysfunction, have been reported in Hereditary Transthyretin Amyloidosis (ATTRv). However, there is a lack of neuroimaging studies investigating structural alterations in the brain related to cognition in ATTRv amyloidosis. This study aimed to investigate cognition and cortical morphology in a cohort of ATTRv patients.</p><p><strong>Methods: </strong>29 ATTRv patients and 26 healthy controls completed neuropsychological assessment. 21 of these patients underwent 3T brain MRI, and 23 healthy subjects constituted the control group for MRI. Cortical measures of volume, thickness, fractional anisotropy (FA), and mean diffusivity (MD) were obtained for both groups. Correlation analyses between brain and cognitive measurements were performed.</p><p><strong>Results: </strong>Patients displayed worse performance than controls in executive functions, verbal and visual memory, visuospatial domains, and language tests. Our study indicated cortical thinning in ATTRv patients in the temporal, occipital, frontal, and parietal areas. The inferior temporal gyrus correlated with verbal memory. Insula and, pars opercularis correlated with both verbal memory and executive function.</p><p><strong>Conclusions: </strong>Cortical thickness in the inferior temporal gyrus, pars opercularis, and insula were linked to memory and executive function. We observed no correlations between cortical volume measures and cognition. Further investigations are imperative to confirm these findings across different populations.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581165","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":"Human herpesvirus 6 (HHV-6) encephalitis secondary to chimeric antigen receptor (CAR)-T cell therapy.","authors":"Fahang Yi, Ningxiang Qin, Liang Wang","doi":"10.1007/s10072-024-07860-7","DOIUrl":"https://doi.org/10.1007/s10072-024-07860-7","url":null,"abstract":"<p><strong>Background: </strong>Human herpesvirus (HHV)-6 encephalitis secondary to chimeric antigen receptor (CAR)-T cell therapyis relatively rare in clinical practice and needs to be differentiated from immune effector cell-associatedneurotoxicity syndrome (ICANS).</p><p><strong>Methods: </strong>We retrospectively reported a case of HHV-6 encephalitis secondary to CAR-T cell therapy.</p><p><strong>Results: </strong>A male patient from China with diffuse large B-cell lymphoma underwent chimeric CAR-T cell therapy anddeveloped a generalized rash on the 8^th day, followed by cognitive changes, memory loss, and disorientation onthe 14^th day after CAR-T cell therapy. Initially, ICANS was suspected. A lumbar puncture was performed on the 18^th day. The cerebrospinal fluid (CSF) analysis revealed slightly elevated protein levels and a high presence of HHV-6B sequences by mNGS. Brain MRI showed bilateral hippocampal abnormalities. The patient was ultimatelydiagnosed with HHV-6 encephalitis and treated with ganciclovir and dexamethasone. After one week of treatment,follow-up CSF analysis showed a reduction in HHV-6B sequences. The patient was discharged with improvedmemory and orientation.</p><p><strong>Conclusion: </strong>HHV-6 encephalitis secondary to CAR-T cell therapy may be easily confused with ICANS. Timely andaggressive diagnostic procedures, such as mNGS of CSF and cranial imaging, along with prompt antiviral therapy,are crucial for improving patient outcomes.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581397","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 impact of SARS-CoV-2 (COVID-19) pandemic on educational and professional growth of young Italian epileptologists: a survey of the Young Epilepsy Section-Italian chapter.","authors":"Silvia Masnada, Carlotta Spagnoli, Maddalena Duca, Daniela Chiarello, Tommaso Lo Barco, Bruna Nucera","doi":"10.1007/s10072-024-07836-7","DOIUrl":"https://doi.org/10.1007/s10072-024-07836-7","url":null,"abstract":"<p><strong>Objectives: </strong>In March 2020, the World Health Organization declared the coronavirus-related disease SARS-CoV-2 infection pandemic. Italy was one of the most affected countries and managed the emergency also by a health care reorganization.</p><p><strong>Methods: </strong>The Education and Career Development Task Force of the Young Epilepsy Section-Italy (YES-I) designed a survey to assess the impact of the pandemic on the training and work of young epileptologists (< 40 years).</p><p><strong>Results: </strong>Fifty-three responses were collected: 45.3% were resident, 9.4% PhD students and the remainder specialists. Clinical activity changed for most (83%) during the pandemic. Educational activity at epilepsy centers was reduced for 35.8% of the survey participants, while 30.2% of research projects involving patients participation were stopped to switch mainly to COVID-19-related research. For 73.6% of survey participants, attending online courses and congresses was easier in terms of cost and organization, although for 50.9% the level of training was lower in quality. In contrast, 58.5% rated the webinars organized by YES-I very educational. Less than 50% of the clinicians used telemedicine in the pandemic period and continue to use it. Despite several positive aspects of virtual medicine, a small number (32.1%) of our interviewees were satisfied from telemedicine and few of them (30.2%) reported that it led to improvement of clinical practice.</p><p><strong>Conclusions: </strong>Our survey showed that the pandemic has had a negative impact on training, research and clinical activity in the epilepsy field; moreover, it underlined the critical aspects of virtual communication methods in order to improve its use for the future.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576696","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":"Eculizumab in refractory myasthenia gravis: a real-world single-center experience.","authors":"Dario Ricciardi, Carmen Erra, Francesco Tuccillo, Bernardo Maria De Martino, Alessandra Fasolino, Francesco Habetswallner","doi":"10.1007/s10072-024-07861-6","DOIUrl":"https://doi.org/10.1007/s10072-024-07861-6","url":null,"abstract":"<p><strong>Introduction: </strong>Immunosuppressive treatment is effective in most Myasthenia gravis patients, but 10-15% of patients areconsidered refractory due to inadequate response or intolerance to therapy. Eculizumab, a humanized monoclonalantibody directed against C5 complement protein, was approved in Italy to treat Ab-AchR generalized refractoryMG (rMG) in October 2022.</p><p><strong>Aim: </strong>We aim to describe a real-world Italian experience in a population of refractory myasthenia gravis patients with oneyear follow up.</p><p><strong>Methods: </strong>A retrospective data analysis was conducted on patients with refractory generalized MG treated with eculizumabbetween November 2022 and May 2024. Clinical assessment through specific scales (MG ADL - QMG - MGFA -PIS), rescue, and background therapy was recorded after one, three, six, and twelve months.</p><p><strong>Results: </strong>21 rMG patients were treated with eculizumab with a medium follow up of 10.4 months and 14 patients had at leastone year follow up. A clinically meaningful reduction in total MG-ADL and QMG scores was achieved in the firstmonth. It was maintained throughout the first, third, sixth, and twelfth month along with concomitant reduction ofimmunosuppressive treatments. A drastic reduction of myasthenic exacerbations and crisis was observed duringfollow up and intravenous immunoglobulin treatment was discontinued in all patients except one. The total dailydose of prednisone was significantly reduced.</p><p><strong>Discussion: </strong>This single-center real-world study confirmes safety and effectiveness of eculizumab. Eculizumab improved rapidlyall clinical outcome measures, leading to discontinuation of intravenous immunoglobulin treatment and remarkable immunosuppressant-sparing benefits.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568071","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":"Comparison of different telerehabilitation protocols for urogenital symptoms in females with multiple sclerosis: a randomized controlled trial.","authors":"Manuela Deodato, Mia Fornasaro, Miriam Martini, Francesca Zelesnich, Arianna Sartori, Alessandra Galmonte, Alex Buoite Stella, Paolo Manganotti","doi":"10.1007/s10072-024-07742-y","DOIUrl":"10.1007/s10072-024-07742-y","url":null,"abstract":"<p><p>Telerehabilitation has been suggested to be equally effective than in-person rehabilitation, and could be helpful to increase participation and reduce barriers. People with multiple sclerosis (MS) often present urogenital dysfunctions, impairing independence and quality of life (QoL). Since the different available telerehabilitation protocols, the present study aimed to compare a live video urogenital rehabilitation intervention protocol (REMOTE) with a home-based pre-recorded video protocol (SELF). A randomized-controlled trial was performed, with 14 females with MS being allocated in the REMOTE group (36 ± 9 y) and 14 females in the SELF group (37 ± 7 y). Both telerehabilitation protocols were identical in terms of contents (including pelvic floor training and relaxation exercises), frequency and duration, consisting of 10 sessions of 45 min each, every 5 days. Questionnaires were administered at the beginning and the end of the study: Short Form Health Survey 36 (SF-36), Beck Depression Inventory (BDI), Female Sexual Function Index (FSFI), International Consultation on Incontinence Questionnaire (ICIQ) symptoms and related QoL, the main outcome being ICIQ incontinence score. Despite most of the outcomes improved in both groups, REMOTE was found to be more effective than SELF in most of the SF-36 domains (from p < 0.001 pη² 0.555 to p = 0.044 pη² 0.147), FSFI (p = 0.001 pη² 0.373), ICIQ (p = 0.003 pη² 0.291). Despite the home-based pre-recorded videos could be effective in improving urogenital symptoms, live video urogenital rehabilitation results in larger improvements. Telerehabilitation should be encouraged for urogenital dysfunctions in females with MS, and pre-recorded videos could represent an alternative when live sessions are not available. Clinical trial registration This randomized controlled trial was registered on ClinicalTrials.gov with the number NCT05984095.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":"5501-5509"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11470853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reversible cerebral vasoconstriction syndrome and bilateral Eagle Syndrome cause recurrent reversible carotid artery stenosis and cerebral infarction.","authors":"Qi Chao, Pingping Wang, He Li","doi":"10.1007/s10072-024-07842-9","DOIUrl":"https://doi.org/10.1007/s10072-024-07842-9","url":null,"abstract":"<p><p>A middle-aged male who has experienced recurrent, reversible carotid artery stenosis and cerebral infarction over the past decade. Recurrent cerebral infarction is highly prevalent in clinical practice, with an accurate diagnosis of the cause of the disease being crucial. However, the patient is suffering from three diseases that may be involved in the recurrent cerebral infarction, including Reversible Cerebral Vasoconstriction Syndrome (RCVS), Bilateral Eagle Syndrome, and Patent Foramen Ovale (PFO). Among them, both RCVS and Bilateral Eagle Syndrome can lead to recurrent stenosis of the carotid arteries. But the coexistence of these diseases is extremely rare. The symptoms of patients are not typical, and the coexistence of all the three diseases makes it a challenging diagnostic dilemma. This article presents a diagnostic approach to differentiate these possible diseases, thereby enhancing readers' ability to diagnose such situations.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558358","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":"Correlation between lateralized periodic discharges and arterial spin labeling perfusion imaging in patients with status epilepticus.","authors":"Tatsuya Sato, Masaya Katagiri, Yuka Terasawa","doi":"10.1007/s10072-024-07658-7","DOIUrl":"10.1007/s10072-024-07658-7","url":null,"abstract":"","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":"5547-5550"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141420077","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 home-based neurostimulation on outcomes after stroke: a systematic review and meta-analysis.","authors":"Auwal Abdullahi, Thomson W L Wong, Shamay S M Ng","doi":"10.1007/s10072-024-07633-2","DOIUrl":"10.1007/s10072-024-07633-2","url":null,"abstract":"<p><strong>Background: </strong>Home-based rehabilitation is a cost-effective means of making services available for patients. The aim of this study is to determine the evidence in the literature on the effects of home-based neurostimulation in patients with stroke.</p><p><strong>Method: </strong>We searched PubMED, Embase, Web of Science, Scopus, and CENTRAL for randomized controlled trials on the subject matter using keywords such as stroke, electrical stimulation and transcranial direct current stimulation. Information on participants' characteristics and mean scores on the outcomes of interest were extracted. Risks of bias and methodological quality of the included studies were assessed using Cochrane Risks of bias tool and PEDro scale respectively. The data was analyzed using both narrative and quantitative syntheses. In the quantitative synthesis, meta-analysis was carried out using random effect model analysis.</p><p><strong>Result: </strong>The results showed that, home-based neurostimulation is superior to the control at improving upper limb muscle strength (SMD = 0.72, 95% CI = 0.08 to 1.32, p = 0.03), functional mobility (SMD = -0.39, 95% CI = -0.65 to 0.14, p = 0.003) and walking endurance (SMD = 0.33, 95% CI = 0.08 to 0.59, p = 0.01) post intervention; and upper limb motor function (SMD = 0.9, 95% CI = 0.10 to 1.70, p = 0.03), functional mobility (SMD = -0.30, 95% CI = -0.56 to -0.05, p = 0.02) and walking endurance (SMD = 0.33, 95% CI = 0.08 to 0.59, p = 0.01) at follow-up.</p><p><strong>Conclusions: </strong>Home-based neurostimulation can be used to improve upper and lower limb function after stroke.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":"5157-5179"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11470900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141469698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}