Neurologia最新文献

{"title":"Myasthenia gravis in Spain: A survey of specialized neurologists to uncover unmet needs","authors":"E. Cortés-Vicente ,&nbsp;C. Casasnovas ,&nbsp;R. Juntas ,&nbsp;T. Sevilla ,&nbsp;J. Pardo ,&nbsp;F. Rodríguez de Rivera ,&nbsp;A. Guerrero Sola","doi":"10.1016/j.nrl.2025.501912","DOIUrl":"10.1016/j.nrl.2025.501912","url":null,"abstract":"<div><h3>Introduction</h3><div>Myasthenia gravis (MG) is a neuromuscular autoimmune disease that requires prompt diagnosis and management by neurologists. The challenges of MG management are associated with the diagnostic process and the selection of an effective form of therapy enabling long-term remission of the disease. The objective of this study was to assess the state of MG in Spain to identify unaddressed needs in the clinical progression, diagnosis, and treatment approaches.</div></div><div><h3>Methods</h3><div>A survey was distributed via email between 19 July and 25 October 2022 to neurologists belonging to the Spanish Society of Neurology. A comprehensive descriptive analysis was conducted on all collected data.</div></div><div><h3>Results</h3><div>In total, 69 completed surveys, representing 64 Spanish hospitals, were analyzed and included in the results. The study identified that economic difficulties, such as departmental budgets, have led to a lack of access to antibody testing during diagnosis. Furthermore, corticosteroids were found to achieve the best clinical response, despite also being associated with a higher frequency of adverse effects. The results show that 34% of patients with MG present active symptoms. Eighteen percent have symptoms that limit their daily activities. Additionally, 29% of patients have requested an unscheduled follow-up visit within the last year.</div></div><div><h3>Conclusions</h3><div>Several areas present unmet needs in terms of improving access to diagnostic assays, residual disease burden in treated patients, and the management and diagnosis of MG.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 501912"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147614733","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":"Redefining therapeutics in vATTR: Evaluation of response predictors to tafamidis and patisiran treatment in a non-endemic area. A proposal for a novel individualised therapeutic approach","authors":"L. Martínez-Vicente ,&nbsp;V. Gajate-García ,&nbsp;G. Gutiérrez-Gutiérrez ,&nbsp;Á.L. Guerrero-Peral ,&nbsp;A. Horga ,&nbsp;A. Guerrero-Sola ,&nbsp;J. Álvarez-Troncoso ,&nbsp;M.A. Restrepo-Córdoba ,&nbsp;J. Goirigolzarri-Artaza ,&nbsp;S. Martín-Albarrán ,&nbsp;A. Valverde-Megías ,&nbsp;E. González-López ,&nbsp;P. García-Pavía ,&nbsp;J. Matías-Guiu ,&nbsp;L. Galán-Dávila","doi":"10.1016/j.nrl.2025.501920","DOIUrl":"10.1016/j.nrl.2025.501920","url":null,"abstract":"<div><h3>Introduction</h3><div>Hereditary transthyretin amyloidosis (vATTR) is a progressive genetic disorder with several approved treatments. We investigated treatment responses to tafamidis and patisiran in vATTR patients to identify predictive response factors.</div></div><div><h3>Methods</h3><div>Retrospective analysis on vATTR patients treated with tafamidis or patisiran from October 2012 to September 2022. Treatment responses were assessed as “good,” “partial,” or “non-response.” We analysed pre-treatment clinical and laboratory data to identify predictors of treatment response.</div></div><div><h3>Results</h3><div>Of the 53 patients, 44 received tafamidis and 23 received patisiran; 14 were treated with both drugs sequentially. Predictors of good response to tafamidis were shorter diagnostic delay (≤1 year), less severe neurological impairment (Coutinho stage 1, Neuropathy Impairment Score [NIS]<!--> <!-->≤<!--> <!-->7), and better sudomotor function in the feet (≥50<!--> <!-->μS) before treatment. Factors associated with non-response were greater disability (baseline Polyneuropathy Disability score<!--> <!-->=<!--> <!-->2), large fibre involvement, and significant weight loss. Predictors of a good response to patisiran included lower pre-treatment disease severity (Coutinho stage 1, NIS<!--> <!-->≤<!--> <!-->40). We propose an individualised therapeutic approach using predictive factors to guide initial treatment.</div></div><div><h3>Conclusions</h3><div>This study identifies predictive factors for response to tafamidis and patisiran in vATTR patients, highlighting baseline NIS as a critical predictor. We propose a novel therapeutic algorithm for personalised treatment strategies with potential to avoid years of ineffective treatment.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 501920"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147614736","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":"Impacto de la hipertensión arterial en el ictus. ¿Existen distintos perfiles de edad?","authors":"L. Castilla-Guerra ,&nbsp;M.C. Fernandez-Moreno ,&nbsp;M. de la Serna Fito ,&nbsp;A. Palomino-Garcia ,&nbsp;G.A. Escobar Rodriguez ,&nbsp;M.D. Jiménez Hernandez","doi":"10.1016/j.nrl.2025.501913","DOIUrl":"10.1016/j.nrl.2025.501913","url":null,"abstract":"<div><h3>Introduction</h3><div>Arterial hypertension is the most prevalent modifiable risk factor for stroke. We aim to establish if there is an association between hypertension and type of stroke, and if this varies with age.</div></div><div><h3>Methods</h3><div>Retrospective study of patients with a first stroke discharged from public hospitals in Seville (Spain) between 1999 and 2021. Only patients with hypertension as a risk factor were included. The sample was divided into 3 groups: patients ≤<!--> <!-->50 years, between 51-79 years and ≥<!--> <!-->80 years.</div></div><div><h3>Results</h3><div>Of 42,855 strokes, 2,141 (4.9%) hypertensive patients with a first stroke, mean age 68 (±15) years, and 1,010 (47.2%) women, were included. Included were 1,274 (59.5%) ischemic strokes and 867 (40.5%) hemorrhagic strokes, 309 (14.4%) patients ≤<!--> <!-->50 years of age, 1,253 (58.3%) patients between 51 and 79 years of age, and 579 (27.3%) patients ≥<!--> <!-->80 years. The percentage of patients with a previous diagnosis of hypertension was 24.3% vs. 51.3% vs. 79.4% (p<!--> <!-->&lt;<!--> <!-->0.001), with a mean time from diagnosis to stroke of 5.5 (±3.7) vs. 7.8 (±4.9) vs. 9.6 (±5.1) years (p<!--> <!-->&lt;<!--> <!-->0.001) respectively. The number of hemorrhagic strokes was: 171 (55.3%), 523 (41.7%) and 172 (29.7%) (p<!--> <!-->&lt;<!--> <!-->0.001), with mortality at one year being 3.2%, 10% and 35.6% respectively (p<!--> <!-->&lt;<!--> <!-->0.001).</div></div><div><h3>Conclusions</h3><div>In hypertensive patients with a first stroke, the percentage of hemorrhagic strokes is higher than expected, especially in young patients, where it exceeds more than half of the cases. It is necessary to optimize prevention in these patients to reduce the enormous socio-sanitary burden that stroke represents.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 501913"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147614667","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":"Uso de tocilizumab en encefalitis aguda necrosante secundaria a gripe A","authors":"I. Comino-Hidalgo ,&nbsp;J. López Pequeño ,&nbsp;A. Aguado del Hoyo ,&nbsp;M. Vázquez López","doi":"10.1016/j.nrl.2025.501914","DOIUrl":"10.1016/j.nrl.2025.501914","url":null,"abstract":"","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 501914"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147614738","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":"Angiopatía amiloide cerebral iatrógena en paciente joven: hipótesis etiopatogénica","authors":"M. de la Fuente Gómez-Morán ,&nbsp;F. Hernández-Fernández ,&nbsp;E. Lozano Setién ,&nbsp;R.M. Collado Jiménez ,&nbsp;C. Barrena López ,&nbsp;R.A. Barbella Aponte","doi":"10.1016/j.nrl.2025.501916","DOIUrl":"10.1016/j.nrl.2025.501916","url":null,"abstract":"","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 501916"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147614739","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":"Neuroprimaria: evaluación de la teleconsulta como puerta única de entrada a neurología desde atención primaria","authors":"S. Pérez-Sánchez ,&nbsp;M.Á. Quesada García ,&nbsp;F. Sánchez Fernández ,&nbsp;P.L. Guardado Santervás ,&nbsp;J. Dotor ,&nbsp;E. Martínez Fernández ,&nbsp;M. Villagran García ,&nbsp;M. Ben Yelun ,&nbsp;J.D. Guerra Hiraldo ,&nbsp;M.Á. Acevedo ,&nbsp;J.M. Herrerías ,&nbsp;J. Moreno Conde ,&nbsp;Á. Rodríguez ,&nbsp;I. Muñoz Martínez ,&nbsp;J. Montaner","doi":"10.1016/j.nrl.2025.501919","DOIUrl":"10.1016/j.nrl.2025.501919","url":null,"abstract":"<div><h3>Introduction</h3><div>The demand for neurological care from primary care (PC) has grown in recent years. Teleconsultation (TC) is consolidating as another tool in the management of this demand. Therefore, we propose to analyze the TC activity carried out in our health area after its implementation as a single-entry point to neurology.</div></div><div><h3>Method</h3><div>TC from PC was implemented in the 2 health districts of our area in 2020 with a mixed referral system (face-to-face and TC). In March 2023, it was implemented as a single gateway to neurology for one of the health districts (the rural area, Sevilla Norte) and remains mixed for the other. Data were collected on its use during the 6 months after implementation (total number, average delay, resolution capacity –discharge, follow-up, consultation–). A comparison was made with the same semester of the previous year.</div></div><div><h3>Results</h3><div>A total of 7377 TC has been performed since its inception with an annual increase (1247 in 2020, 2370 in 2021, 2542 in 2022, and 3008 until August 2023). This increase is reflected in the access to neurology from PC between both periods. The mean delay for face-to-face referral decreased (41.92<!--> <!-->±<!--> <!-->15.96 days in 2022 vs. 12.66<!--> <!-->±<!--> <!-->11.34 days in 2023, p<!--> <!-->&lt;<!--> <!-->0.001) and the number of patients cited outside the decree (&gt;<!--> <!-->60 days) fell by 96.7% (1936 patients [44.2%] in 2022 and 64 patients [1.2%] in 2023). TC also improved accessibility with a decrease in the mean delay of 68.09% (35<!--> <!-->±<!--> <!-->27.17<!--> <!-->h in 2022 vs. 11.17<!--> <!-->±<!--> <!-->4.12<!--> <!-->h in 2023, p<!--> <!-->=<!--> <!-->0.060). In terms of TC resolution capacity, the number of discharges from TC remained above 50% (59.45<!--> <!-->±<!--> <!-->8.93% in 2022 and 54.07<!--> <!-->±<!--> <!-->6.02% in 2023, p<!--> <!-->=<!--> <!-->0.249).</div></div><div><h3>Conclusions</h3><div>TC as a single gateway is useful and efficient in demand management from PC. It improves accessibility to the population that is attended within hours of the consultation and allows more than half of the consultations to be resolved, avoiding unnecessary visits and trips to the hospital.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 501919"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147614734","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":"Corrigendum «Tendencia de la mortalidad por Esclerosis Múltiple según sexo: Chile 1997-2019» [Neurologia issue 40, Volume 9 (2025), 840-848/NRL_1872]","authors":"J. Arriagada Opazo ,&nbsp;V. Farah González ,&nbsp;M. González Delgadillo ,&nbsp;L. Núñez-Franz ,&nbsp;C. Morales Garcia ,&nbsp;P. Jiménez Rodríguez","doi":"10.1016/j.nrl.2026.502016","DOIUrl":"10.1016/j.nrl.2026.502016","url":null,"abstract":"","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 502016"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147614735","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":"Documento de consenso de la Sociedad Española de Neurologia sobre prevención del deterioro cognitivo y la demencia","authors":"M.J. Gil Moreno ,&nbsp;C. Terrón Cuadrado ,&nbsp;M.S. Manzano Palomo ,&nbsp;A. Delgado Alvarez ,&nbsp;M. Eimil Ortiz ,&nbsp;G. Garcia Ribas ,&nbsp;M. Llanero Luque ,&nbsp;A. Marcos Dolado ,&nbsp;J. Matias-Guiu Antem ,&nbsp;C. Ochoa Lopez ,&nbsp;N. Rodriguez Espinosa ,&nbsp;M. Salas Carrillo ,&nbsp;A. Vieira Campos","doi":"10.1016/j.nrl.2025.501918","DOIUrl":"10.1016/j.nrl.2025.501918","url":null,"abstract":"<div><div>Recent studies have demonstrated a relationship between the development of cognitive impairment and dementia with lifestyle-related risk factors, many of them potentially modifiable, meaning that dementia prevention is possible through a public health approach that includes the implementation of key interventions that delay or slow cognitive decline or dementia.</div><div>The current Consensus Document has been prepared by a group of experts in cognitive pathology and by the Neurogeriatrics Study Group of the Spanish Society of Neurology.</div><div>This document has been prepared from a review of the existing literature and its main objective is to serve as a guide for health professionals. with interest in cognitive impairment and dementia. The different modifiable risk factors are listed and aspects related to these risk factors related to cognitive decline and dementia are analyzed, as well as a series of basic recommendations.</div><div>This document aims to be a useful tool in the clinical practice of professionals dedicated to cognitive impairment and dementia.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 501918"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147614732","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":"Más allá de la indometacina: reporte de un caso de hemicránea paroxística crónica con gran respuesta a la estimulación no invasiva del nervio vago","authors":"A. Jaimes,&nbsp;A. Gómez,&nbsp;O. Pajares,&nbsp;J. Rodríguez-Vico","doi":"10.1016/j.nrl.2025.501917","DOIUrl":"10.1016/j.nrl.2025.501917","url":null,"abstract":"","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 501917"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147614740","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 Parkinson's Real-World Impact Assessment (PRISM) project in the management and burden of Parkinson's disease in Spain","authors":"C. Painous Martí ,&nbsp;I. Pijuan Jiménez ,&nbsp;À. Bayés Rusiñol ,&nbsp;J.C. Martínez Castrillo ,&nbsp;Á. Sésar Ignacio ,&nbsp;E. Tolosa Sarró","doi":"10.1016/j.nrl.2025.501921","DOIUrl":"10.1016/j.nrl.2025.501921","url":null,"abstract":"<div><h3>Introduction</h3><div>Real-world data studies are a promising option for understanding everyday Parkinson's disease (PD) management and optimizing strategies and therapeutic options. The Parkinson's Real-World Impact Assessment (PRISM) project was conceived as a European survey to evaluate the burden of the disease in people with Parkinson's disease (PwP) and their caregivers. Here, we present the analysis of the Spanish PRISM cohort dataset to describe prescribing patterns, healthcare resource utilization, and the impact of PD on PwP and their caregivers.</div></div><div><h3>Methods</h3><div>Data were collected using an electronic questionnaire distributed through different patient advocacy groups and specialized PD clinics in Spain.</div></div><div><h3>Results</h3><div>A total of 149 PwP (mean age, 62.6 years; mean disease duration, 7.6 years) and 38 caregivers were included. Most PwP (87.1%) received levodopa during the 12 months preceding the survey. A high percentage of patients (62.1%) expressed interest in participating in a clinical trial, but only 20% reported a current or previous enrollment. PwP reported high incidence of non-motor symptoms and poor health-related quality of life. At least one impulse control behavior was reported in 57% of patients. Caregivers reported mild to moderate disease burden.</div></div><div><h3>Conclusions</h3><div>This study identified high rates of motor and non-motor symptoms, impulse control disorders, and considerable disease burden in PwP and their caregivers, even at a relatively young age and a mild/moderate stage of the disease. Also, it highlights the limited use of rehabilitation therapies. These data provide information for PD management and resource utilization in Spain.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 501921"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147614737","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}