Neurologia最新文献

{"title":"Pronóstico funcional de pacientes con NORSE y FIRES tratados con inmunoterapia: revisión sistemática","authors":"","doi":"10.1016/j.nrl.2022.03.005","DOIUrl":"10.1016/j.nrl.2022.03.005","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the frequency of good functional outcomes in patients with NORSE and FIRES treated with immunotherapy.</div></div><div><h3>Methods</h3><div>We performed a systematic search of the MedLine and EMBASE databases to gather studies including at least 5 patients with NORSE or FIRES and at least one patient treated with immunotherapy, and reporting functional outcomes. Good functional outcome was defined as a modified Rankin Scale (mRS) score ≤ 2 (or an equivalent measure) at the last available follow-up assessment. Only patients with known functional outcomes were included in the analysis.</div></div><div><h3>Results</h3><div>We analysed 16 studies, including a total of 161 patients with NORSE (10 studies) and 64 patients with FIRES (6 studies). Of the 161 patients with NORSE, 141 (87.5%) received immunotherapy. Outcome data were available for 135, 56 of whom (41.4%) achieved good functional outcomes. Twenty-four of the 58 patients with FIRES treated with immunotherapy and for whom outcome data were available achieved good functional outcomes (41.3%). Mortality rates in patients with NORSE and FIRES treated with immunotherapy were 20/121 (16.5%) and 6/58 (10.3%), respectively. By type of immunotherapy, good functional outcomes were achieved in 36/89 patients receiving glucocorticoids (40.4%), 27/71 patients receiving IV immunoglobulins (38%), 11/37 patients treated with plasma exchange (29.7%), 5/17 patients receiving rituximab (29.4%), and 2/13 patients receiving cyclophosphamide (15.3%).</div></div><div><h3>Conclusion</h3><div>Despite the lack of randomised clinical trials, immunotherapy is frequently prescribed to patients with NORSE and FIRES. However, rates of functional dependence and mortality remain high in these patients. Second-line therapies achieved lower rates of good outcomes, probably because they were administered to patients with more severe, refractory disease.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 8","pages":"Pages 629-638"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42084952","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":"Psychometric properties of the Spanish version of the Frontal Assessment Battery (FAB-E) and normative values in a representative adult population sample","authors":"M. Hurtado-Pomares ,&nbsp;I. Juárez-Leal ,&nbsp;V. Company-Devesa ,&nbsp;A. Sánchez-Pérez ,&nbsp;P. Peral-Gómez ,&nbsp;C. Espinosa-Sempere ,&nbsp;D. Valera-Gran ,&nbsp;E.-M. Navarrete-Muñoz","doi":"10.1016/j.nrl.2022.09.002","DOIUrl":"10.1016/j.nrl.2022.09.002","url":null,"abstract":"<div><h3>Background</h3><div>The Frontal Assessment Battery is a short bedside test used to assess executive functions (EF). The aims of the present study were, first, to evaluate the psychometric proprieties of the Spanish version of the FAB (FAB-E) in a representative sample, and second, to establish cut-off points for impairment in executive function according to age and education level.</div></div><div><h3>Methods</h3><div>A sample of 798 healthy Spanish adult subjects aged 19 to 91 participated in this study. Neuropsychological assessment of participants was conducted using the FAB-E, Mini-Mental State Examination (MMSE) and Trail Making Test (TMT). We examined internal consistency, intraclass correlation, test-retest reliability, and concurrent and divergent validity. In addition, we established a cut-off point for detecting executive function impairment based on the 5th percentile by age group and education level.</div></div><div><h3>Results</h3><div>The analysis of the psychometric properties of the FAB-E showed good internal consistency (Cronbach’s α = 0.60), intraclass correlation (0.72), test-retest reliability (0.70) and concurrent and divergent validity between the TMT (<em>r</em> = −0.523), MMSE (<em>r</em> = 0.426) and the FAB-E. The cut-off points for each age group were 16 points for the ≤ 29 group, 15 points for the 30-39 group, 14 points for the 40-49 and 50-59 groups, 12 points for the 60-69 group, and 10 points for the ≥ 70 age group.</div></div><div><h3>Conclusions</h3><div>The psychometric analysis showed that the FAB-E has good validity and reliability. Thus, FAB-E may be a helpful tool to evaluate EF in a healthy Spanish population. In addition, this study provides information on reference data that will be very valuable for clinicians and researchers.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 8","pages":"Pages 694-700"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142424714","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":"Encefalitis después de vacunación para COVID-19","authors":"","doi":"10.1016/j.nrl.2023.03.001","DOIUrl":"10.1016/j.nrl.2023.03.001","url":null,"abstract":"","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 8","pages":"Pages 716-719"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140465109","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":"Análisis del valor pronóstico de la analítica urgente en el ictus isquémico","authors":"J. Marta-Enguita ,&nbsp;I. Rubio-Baines ,&nbsp;N. Aymerich ,&nbsp;M. Herrera ,&nbsp;B. Zandio ,&nbsp;S. Mayor ,&nbsp;C. Roncal ,&nbsp;M. Mendioroz ,&nbsp;J. Orbe ,&nbsp;R. Muñoz","doi":"10.1016/j.nrl.2022.03.004","DOIUrl":"10.1016/j.nrl.2022.03.004","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to evaluate the prognostic value of emergency blood test results in patients with acute ischaemic stroke.</div></div><div><h3>Methods</h3><div>We evaluated 592 prospectively patients with neuroimaging-confirmed ischaemic stroke admitted to our stroke unit between 2015 and 2018. We gathered emergency blood test results and calculated the neutrophil-to-lymphocyte ratio and the neutrophil-to-platelet ratio (neutrophils<!--> <strong>×</strong> <!-->1.000/platelets). The association between blood test results and functional prognosis (as measured with the modified Rankin Scale) and such complications as haemorrhagic transformation was evaluated by logistic regression analysis. The additional predictive value of blood test parameters was assessed with receiver operating characteristic curves and the net reclassification index.</div></div><div><h3>Results</h3><div>An neutrophil-to-lymphocyte ratio ≥ 3 at admission was associated with a two-fold increase in the risk of functional dependence at 3 months (OR: 2.24; 95%CI: 1.35-3.71) and haemorrhagic transformation (OR: 2.11; 95%CI: 1.09-4.05), while an neutrophil-to-lymphocyte ratio ≥ 3.86 resulted in an increase of 2.4 times in the risk of mortality at 3 months (OR: 2.41; 95%CI: 1.37-4.26) after adjusting for the traditional predictors of poor outcomes. Patients with neutrophil-to-platelet ratio ≥ 32 presented 3 times more risk of haemorrhagic transformation (OR: 3.17; 95%CI: 1.70-5.92) and mortality at 3 months (OR: 3.07; 95%CI: 1.69-5.57). Adding these laboratory parameters to standard clinical-radiological models significantly improved discrimination and prognostic accuracy.</div></div><div><h3>Conclusions</h3><div>Basic blood test parameters provide important prognostic information for stroke patients and should therefore be analysed in combination with standard clinical and radiological parameters to optimise ischaemic stroke management.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 8","pages":"Pages 617-628"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142424637","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":"Fenómeno de Kernohan-Woltman: ¿un cuadro neurológico excepcional?","authors":"R. Carrasco Moro ,&nbsp;J.M. Pascual Garvi ,&nbsp;C. Vior Fernández ,&nbsp;E.E. Espinosa Rodríguez ,&nbsp;G. Martín Palomeque ,&nbsp;L. Cabañes Martínez ,&nbsp;M. López Gutiérrez ,&nbsp;A. Acitores Cancela ,&nbsp;E. Barrero Ruiz ,&nbsp;J.S. Martínez San Millán","doi":"10.1016/j.nrl.2022.09.009","DOIUrl":"10.1016/j.nrl.2022.09.009","url":null,"abstract":"<div><h3>Introduction</h3><div>Ipsilateral hemiparesis (IH) can be defined as a paradoxical dysfunction of the first motor neuron involving the extremities on the opposite side to that expected, given the location of the triggering intracranial pathology. Compression of the corticospinal tract (CSt) along its course through the contralateral cerebral peduncle against the free edge of the tentorium, known as the Kernohan-Woltman notch phenomenon (KWNP), represents the main cause of IH.</div></div><div><h3>Methods</h3><div>This retrospective study analyzes a series of 12 patients diagnosed with IH secondary to KWNP treated at our institution, including a descriptive study of epidemiological, clinical, radiological, neurophysiological, and prognostic variables.</div></div><div><h3>Results</h3><div>In 75% of the cases, symptoms had an acute or subacute onset. Initial imaging studies showed signs of significant mass effect in half of the patients, whereas magnetic resonance imaging (MRI) identified a structural lesion in the contralateral cerebral peduncle in two thirds of them. Impairment of the motor evoked potentials (MEP) was verified in 4 patients. During follow-up 7 patients experienced improvement in motor activity, and near half of the cases were classified in the first three categories of the modified Rankin scale.</div></div><div><h3>Conclusions</h3><div>In contrast to prior historical series, most of our patients developed a KWNP secondary to a traumatic mechanism. MRI represents the optimal method to identify both the classic cerebral peduncle notch and the underlying structural lesion of the CSt. The use of MEP can help to establish the diagnosis, especially in those cases lacking definite radiological findings.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 8","pages":"Pages 683-693"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142424713","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":"Trombectomía con aspiración por captura (embaspiración) en el ictus isquémico agudo","authors":"","doi":"10.1016/j.nrl.2021.09.017","DOIUrl":"10.1016/j.nrl.2021.09.017","url":null,"abstract":"<div><h3>Background</h3><p>In addition to stent retrievers, direct aspiration has become a reasonable thrombectomy strategy.</p></div><div><h3>Objectives</h3><p>We carried out the thrombectomy by guiding the aspiration catheter fully over the clot and performing immediate manual aspiration; we call this procedure “embed aspiration”.</p></div><div><h3>Methods</h3><p>In this prospective, non-randomised, single-centre study, we included all patients treated at a high volume-of-care stroke centre between 2017 and 2018 for the TRIANA (Thrombectomy in Andalusia using Aspiration) registry. Thrombectomy was carried out by embed aspiration. Patients were classified according to the success (eTICI 2b67-2c-3) or failure (eTICI 0-1-2a-2b50) of the procedure. Baseline clinical data and outcomes were compared, and multivariate analysis was performed.</p></div><div><h3>Results</h3><p>The embed aspiration technique was used in 370 patients. Treatment was successful in 90.3% of patients. Mean puncture-to-recanalisation time was 25<!--> <!-->minutes. The overall rate of good outcomes (mRS 0-2) at 3 months was 64%.</p></div><div><h3>Conclusions</h3><p>This study supports real-life evidence that standardised embed aspiration may be an alternative to stent retrievers for thrombectomy.</p></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 7","pages":"Pages 530-539"},"PeriodicalIF":2.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213485321002875/pdfft?md5=cf6fa42c4ca018ef6d37c2fc7e9dcf04&pid=1-s2.0-S0213485321002875-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42248466","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":"Fuerza de asociación de factores de riesgo vascular clásicos en pacientes jóvenes con ictus isquémico: un estudio de casos y controles","authors":"","doi":"10.1016/j.nrl.2022.07.006","DOIUrl":"10.1016/j.nrl.2022.07.006","url":null,"abstract":"<div><h3>Introduction</h3><p>Recent studies have reported an increasing incidence of ischaemic stroke among young adults. However, the strength of the association between traditional vascular risk factors has not been fully established.</p></div><div><h3>Methods</h3><p>We compared 120 patients with a first ischaemic stroke before the age of 55 years admitted to the stroke unit of our centre with 600 healthy non-stroke controls from a population-based cohort study (HERMEX), matched for sex. Risk factors assessed included: hypertension, obesity, auricular fibrillation, current smoking, estimated glomerular filtration rate (eGFR), total cholesterol, low-density lipoprotein cholesterol (LDL-C), triglycerides, high-density lipoprotein cholesterol (HDL-C) and diabetes mellitus. We used logistic regression analysis and calculated population attributable risk. We performed an overall analysis, by sex and aetiological subgroup.</p></div><div><h3>Results</h3><p>Using logistic regression analysis we found that overall the significant risk factors were: hypertension (OR: 1.58; 95%CI: 1.01-2.50), auricular fibrillation (OR: 4.77; 95%CI: 1.20-19.00), low eGFR (OR: 4.74; 95%CI: 1.3-21.94) and low HDL-C (OR: 5.20; 95%CI: 3.29-8.21), as well as smoking for males (OR: 1.86; 95%CI: 1.14-3.03). LDLc showed an inverse association with stroke. The population attributable risk for HDL-C was 37.8% and for hypertension 21.1%. In terms of aetiological subgroups, only low HDL-C was associated with stroke of undetermined aetiology.</p></div><div><h3>Conclusions</h3><p>Hypertension, auricular fibrillation, low eGFR and low HDL-C, plus tobacco use in men, are the main risk factors among patients under 55 years of age with a first ischaemic stroke. We believe that it would be of particular interest to further explore the management of low HDL-C levels as part of preventive strategies in young stroke patients.</p></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 7","pages":"Pages 604-613"},"PeriodicalIF":2.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213485322001979/pdfft?md5=892f500175aa8bfda43e0f0c22b0def2&pid=1-s2.0-S0213485322001979-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42750065","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":"Infiltración de toxina botulínica tipo A en espasticidad y distonía cervical. La morfología muscular, la gran olvidada","authors":"","doi":"10.1016/j.nrl.2021.09.016","DOIUrl":"10.1016/j.nrl.2021.09.016","url":null,"abstract":"<div><h3>Introduction</h3><p>Botulinum toxin type<!--> <!-->A is used to treat spasticity and dystonia. However, its relationship with muscle morphology has not been studied. The action mechanism of botulinum toxin is based on the inhibition of acetylcholine release. Therefore, larger doses of toxin would be needed to treat larger muscles. This study aims to establish whether there is a discrepancy between muscle morphology and the botulinum toxin doses administered.</p></div><div><h3>Methods</h3><p>We dissected, and subsequently measured and weighed, muscles from the upper and lower limbs and the head of a fresh cadaver. We consulted the summary of product characteristics for botulinum toxin type<!--> <!-->A to establish the recommended doses for each muscle and calculated the number of units infiltrated per gramme of muscle.</p></div><div><h3>Results</h3><p>Different muscles present considerable morphological variability, and the doses of botulinum toxin administered to each muscle are very similar. We observed great variability in the amount of botulinum toxin administered per gramme of muscle, ranging from 0.3<!--> <!-->U/g in the biceps femoris to 14.6<!--> <!-->U/g in the scalene muscles. The mean dose was 2.55<!--> <!-->U/g. The doses administered for nearly all lower limb muscles were below this value.</p></div><div><h3>Conclusions</h3><p>There are significant differences in morphology between the muscles of the lower limbs, upper limbs, and head, but similar doses of botulinum toxin are administered to each muscle. These differences result in great variability in the number of units of botulinum toxin administered per gramme of muscle.</p></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 7","pages":"Pages 523-529"},"PeriodicalIF":2.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213485321002838/pdfft?md5=32487b5b438ee09c2d85e26f56ae6af1&pid=1-s2.0-S0213485321002838-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42122150","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":"Evaluation of the effect of botulinum toxin A on the physical and mental health of patients with hemifacial spasm","authors":"","doi":"10.1016/j.nrl.2021.11.006","DOIUrl":"10.1016/j.nrl.2021.11.006","url":null,"abstract":"<div><h3>Background</h3><p>Hemifacial spasm (HFS) is a debilitating disease characterized by involuntary tonic and clonic contractions of muscles innervated by the facial nerve. Botulinum toxin A (BTX-A) is the first-line option and the most effective medical treatment for HFS. The objective of this study was to evaluate the effect of BTX-A therapy on the physical and mental health of HFS patients.</p></div><div><h3>Methods</h3><p>Participants included 65 HFS patients and 65 matched healthy controls in the study. Cornell Medical Index (CMI) self-assessment questionnaire was used to detect the psychological health of all participants. Local injection of BTX-A was applied, and the Cohen hierarchical criteria were employed to stratify the degree of spasticity, further evaluating the efficacy of BTX-A before and two months after treatment in HFS patients. The HFS patients at two months post-treatment were re-evaluated by CMI self-assessment questionnaire, and the evaluated factors of these patients were compared with those of patients before treatment.</p></div><div><h3>Results</h3><p>The scores of somatization, depression, anxiety, inadaptation, sensitivity, anger, tension, M-R, and total scores in the HFS group were significantly higher than those in the control group (all <em>P</em> <!-->&lt;<!--> <!-->0.05). Two months post-treatment, among 65 HFS patients who received with BTX-A treatment, 42 (64.6%) were completely relieved, 16 (24.6%) were significantly relieved, 7 (10.8%) were partially relieved, and 0 (0%) cases were invalid, and the total effective rate was 89.2%. Two months after BTX-A treatment, the scores of somatization, tension, anxiety, depression, sensitivity, M-R and total scores of patients with HFS were lower than those before treatment (all <em>P</em> <!-->&lt;<!--> <!-->0.05).</p></div><div><h3>Conclusions</h3><p>Patients with HFS are often accompanied by somatization, anger, inadaptation, sensitivity, anxiety, depression, and tension. BTX-A can not only alleviate the symptoms of HFS, but also improve the somatization, tension, anxiety, depression, and sensitivity.</p></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 7","pages":"Pages 540-548"},"PeriodicalIF":2.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213485321002899/pdfft?md5=e5108405f79a304324a6cd2485fe8769&pid=1-s2.0-S0213485321002899-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49607128","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":"Circulating microRNAs as potential biomarkers for the diagnosis of Parkinson's disease: A meta-analysis","authors":"","doi":"10.1016/j.nrl.2022.03.002","DOIUrl":"10.1016/j.nrl.2022.03.002","url":null,"abstract":"<div><h3>Background and objective</h3><p>Parkinson's disease (PD) is the one of the most common neurodegenerative diseases. Many investigators have confirmed the possibility of using circulating miRNAs to diagnose PD. However, the results were inconsistent. Therefore, the aim of this meta-analysis was to systematically evaluate the diagnostic accuracy of circulating miRNAs in the diagnosis of PD.</p></div><div><h3>Methods</h3><p>We carefully searched PubMed, Embase, Web of Science, Cochrane Library, Wanfang database and China National Knowledge Infrastructure for relevant studies (up to January 1, 2022) based on PRISMA statement. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), the diagnostic odds ratio (DOR), and area under the curve (AUC) were calculated to test the diagnostic accuracy. Furthermore, subgroup analyses were performed to identify the potential sources of heterogeneity, and the Deeks’ funnel plot asymmetry test was used to evaluate the potential publication bias.</p></div><div><h3>Results</h3><p>Forty-four eligible studies from 16 articles (3298 PD patients and 2529 healthy controls) were included in the current meta-analysis. The pooled sensitivity was 0.79 (95% CI: 0.76–0.81), specificity was 0.82 (95% CI: 0.78–0.84), PLR was 4.3 (95% CI: 3.6–5.0), NLR was 0.26 (95% CI: 0.23–0.30), DOR was 16 (95% CI: 13–21), and AUC was 0.87 (95% CI: 0.84–0.90). Subgroup analysis suggested that miRNA cluster showed a better diagnostic accuracy than miRNA simple. Moreover, there was no significant publication bias.</p></div><div><h3>Conclusions</h3><p>Circulating miRNAs have great potential as novel non-invasive biomarkers for PD diagnosis.</p></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 7","pages":"Pages 573-583"},"PeriodicalIF":2.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213485322000263/pdfft?md5=28c4a88bf59de5de17c6b600c5f18642&pid=1-s2.0-S0213485322000263-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49072531","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}