Therapeutic Advances in Neurological Disorders最新文献

{"title":"Consulting, diagnosis and treatment patterns in migraine: results from the Migraine in Poland cross-sectional survey.","authors":"Marta Waliszewska-Prosół, Marcin Straburzyński, Sławomir Budrewicz, Karol Marschollek, Magdalena Nowaczewska, Paweł Gać, Richard B Lipton","doi":"10.1177/17562864251338675","DOIUrl":"https://doi.org/10.1177/17562864251338675","url":null,"abstract":"<p><strong>Background: </strong>The Migraine in Poland study is a cross-sectional survey that assesses symptomatology, consulting, diagnosis, treatment and impact of migraine in Poland.</p><p><strong>Objectives: </strong>The purpose of this article is to define patterns of care for migraine in Polish patients.</p><p><strong>Methods: </strong>The survey was conducted from August 2021 to June 2022. Participants were recruited through various channels, targeting mostly persons suffering from headaches. The web survey included questions allowing for diagnosis according to the International Classification of Headache Disorders. A detailed questionnaire evaluated healthcare system utilization, history of diagnosis, as well as the use of acute or preventive treatment, including non-pharmacological methods.</p><p><strong>Results: </strong>In total, 3225 individuals aged 13-80 (mean age 38.9) responded to the questionnaire (87.1% were women). Migraine without aura (MwoA) diagnosis was confirmed in 1679 (52.7%) of subjects, and 1571 (93.6%) of them consulted a medical professional for their headaches in the past. Among those who consulted for headache, 91% reported having received a medical diagnosis of migraine. 92.5% of MwoA participants declared the current use of some form of treatment. Non-steroidal anti-inflammatory drugs and acetaminophen were the most frequently used acute medications (<i>n</i> = 1318, 78.5%) followed by combination analgesics, especially those containing codeine (<i>n</i> = 991, 59%). Triptans/ergots were used by 57.1%. A total of 22.8% of subjects used acute treatment with a frequency indicating medication-overuse. Prophylactic treatment was at some point used by 35.68%, while 11.49% were currently on preventive medications. The most frequently prescribed preventives were iprazochrome (8.99%), followed by flunarizine (8.10%) and topiramate (5.90%). A total of 23.28% subjects used nutraceuticals for migraine prevention (most frequently magnesium).</p><p><strong>Conclusion: </strong>Despite high consultation and diagnosis rates among Polish patients with migraine, there is a need for improving standards of care, especially in regard to choice of treatment. There is also a need to raise public awareness of the dangers of codeine-based medications (available over-the-counter in Poland).</p>","PeriodicalId":22980,"journal":{"name":"Therapeutic Advances in Neurological Disorders","volume":"18 ","pages":"17562864251338675"},"PeriodicalIF":4.7,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Admission systolic blood pressure and short-term outcomes after dual antiplatelet therapy in patients with minor ischemic stroke or transient ischemic attack.","authors":"Federico De Santis, Eleonora De Matteis, Lucio D'Anna, Michele Romoli, Tiziana Tassinari, Valentina Saia, Silvia Cenciarelli, Chiara Bedetti, Chiara Padiglioni, Bruno Censori, Valentina Puglisi, Luisa Vinciguerra, Maria Guarino, Valentina Barone, Marialuisa Zedde, Ilaria Grisendi, Marina Diomedi, Maria Rosaria Bagnato, Marco Petruzzellis, Domenico Maria Mezzapesa, Vincenzo Inchingolo, Manuel Cappellari, Cecilia Zivelonghi, Paolo Candelaresi, Vincenzo Andreone, Giuseppe Rinaldi, Alessandra Bavaro, Anna Cavallini, Stefan Moraru, Maria Grazia Piscaglia, Valeria Terruso, Marina Mannino, Alessandro Pezzini, Giovanni Frisullo, Francesco Muscia, Maurizio Paciaroni, Maria Giulia Mosconi, Andrea Zini, Ruggiero Leone, Carmela Palmieri, Letizia Maria Cupini, Michela Marcon, Rossana Tassi, Enzo Sanzaro, Giulio Papiri, Giovanna Viticchi, Daniele Orsucci, Anne Falcou, Simone Beretta, Roberto Tarletti, Patrizia Nencini, Eugenia Rota, Federica Nicoletta Sepe, Delfina Ferrandi, Luigi Caputi, Gino Volpi, Salvatore La Spada, Mario Beccia, Claudia Rinaldi, Vincenzo Mastrangelo, Francesco Di Blasio, Paolo Invernizzi, Giuseppe Pelliccioni, Maria Vittoria De Angelis, Laura Bonanni, Giampietro Ruzza, Emanuele Alessandro Caggia, Monia Russo, Agnese Tonon, Maria Cristina Acciarri, Chiara Di Fino, Cinzia Roberti, Giovanni Manobianca, Gaspare Scaglione, Francesca Pistoia, Alberto Fortini, Antonella De Boni, Alessandra Sanna, Alberto Chiti, Marcella Caggiula, Maela Masato, Massimo Del Sette, Francesco Passarelli, Maria Roberta Bongioanni, Manuela De Michele, Stefano Ricci, Raffaele Ornello, Simona Sacco, Matteo Foschi","doi":"10.1177/17562864251332720","DOIUrl":"https://doi.org/10.1177/17562864251332720","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Elevated baseline systolic blood pressure (SBP) was associated with poor outcomes following dual antiplatelet therapy (DAPT) in patients with non-cardioembolic minor ischemic stroke (MIS) or high-risk transient ischemic attack (TIA) in clinical trials.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;We aimed to assess the impact of admission SBP on the short-term outcomes after DAPT in patients with non-cardioembolic MIS or high-risk TIA.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We performed an inverse probability weighted (IPW) analysis from a prospective multicentric real-world study (READAPT) including patients with non-cardioembolic MIS (National Institute of Health Stroke Scale of 0-5) or high-risk TIA (ABCD2 ⩾4) who initiated DAPT within 48 h of symptom onset. The primary effectiveness outcome was the 90-day risk of new ischemic stroke or other vascular events. The secondary effectiveness outcomes were the 90-day modified Rankin Scale score ordinal shift, vascular and all-cause mortality, 24-h early neurological improvement or deterioration. The safety outcomes included the 90-day risk of moderate-to-severe and any bleedings, symptomatic intracranial hemorrhage, and 24-h hemorrhagic transformation. We used Cox proportional hazards regression with restricted cubic splines to model the continuous relationship between SBP and the hazard ratio (HR) of new vascular events. We selected SBP = 124 mm Hg as cut-off point for the IPW weighting. Outcomes were compared using Cox and generalized logistic regression analyses, adjusted for residual confounders.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;From 2278 patients in the READAPT cohort, we included 1291 MIS or high-risk TIAs (mean age 70.6 ± 11.4 years; 65.8% males). After IPW, patients with admission SBP ⩾124 mm Hg versus &lt;124 mm Hg had a significantly higher risk of 90-day ischemic stroke or other vascular events (adjusted HR: 2.14 (95% CI 1.07%-4.98%); &lt;i&gt;p&lt;/i&gt; = 0.033) and of 24-h early neurological deterioration (adjusted risk difference: 1.91% (95% CI 0.60%-3.41%); &lt;i&gt;p&lt;/i&gt; = 0.006). The overall risk of safety outcomes was low, although patients with SBP ⩾124 mm Hg on admission showed higher rates of 90-day moderate-to-severe and any bleeding events (adjusted risk difference: 1.24% (95% CI 0.38%-2.14%); &lt;i&gt;p&lt;/i&gt; = 0.004 and 6.18% (95% CI 4.19%-8.16%); &lt;i&gt;p&lt;/i&gt; &lt; 0.001; respectively), as well as of 24-h hemorrhagic transformation (adjusted risk difference: 1.57% (95% CI 0.60%-2.55%); &lt;i&gt;p&lt;/i&gt; = 0.001). Subgroup analysis showed a significant interaction between admission SBP, sex, and time to DAPT start in predicting 90-day new vascular events (&lt;i&gt;p&lt;/i&gt; for interaction &lt;0.001 and 0.007, respectively).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In patients with non-cardioembolic MIS or high-risk TIA, higher levels of admission SBP may be associated with an increased risk of new vascular events, early neurological deterioration, and bleeding after DAPT use. Future studies should further investigate if op","PeriodicalId":22980,"journal":{"name":"Therapeutic Advances in Neurological Disorders","volume":"18 ","pages":"17562864251332720"},"PeriodicalIF":4.7,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of ofatumumab for the treatment of relapsing forms of multiple sclerosis in the United Arab Emirates.","authors":"Jihad Inshasi, Yomna Nowier, Evelina A Zimovetz, Ahmed Moussa, Ahmed Shatila, Ali Hassan, Mohamed Farghaly, Mona Thakre, Mustafa Shakra, Sara Al Dallal, Suzan I A Noori, Tayseer Zain Alabdin, Sherouq Khattab, Bassem Yamout","doi":"10.1177/17562864251330260","DOIUrl":"https://doi.org/10.1177/17562864251330260","url":null,"abstract":"<p><strong>Background: </strong>Multiple sclerosis (MS) is an autoimmune disease of the central nervous system, associated with demyelination and inflammation. Relapsing forms of MS (RMS) encompass all patients with MS experiencing relapses. While there is currently no cure for MS, the introduction of several disease-modifying therapies (DMTs) has significantly reduced the risk of relapse and disability in patients with MS. There is a high unmet need for an easy-to-administer DMT that can be used early in the treatment pathway.</p><p><strong>Objectives: </strong>This study aimed to evaluate the cost-effectiveness of ofatumumab compared with other commonly used DMTs for the treatment of RMS from a health payer perspective in the United Arab Emirates (UAE).</p><p><strong>Design: </strong>A cost-effectiveness analysis.</p><p><strong>Methods: </strong>A Markov model, based on expanded disability status scale (EDSS) health states, was developed using the UAE payer's perspective and a 65-year time horizon. The baseline patient distribution across the EDSS states was aligned to the population of ASCLEPIOS I and II trials. The British Columbia database informed natural history transition probabilities. Treatment effects were applied by delaying disability progression and reducing the number of relapses and were sourced from a network meta-analysis. The health care resource utilization was derived from interviews with local experts, who also validated the model structure and comparators, and utility inputs from published studies. In the absence of an officially defined willingness-to-pay threshold in the UAE, it was assumed to be United Arab Emirates Dirham (AED) 369,854 per quality-adjusted life-year (QALY), which is twice the UAE gross domestic product per capita.</p><p><strong>Results: </strong>Base-case results indicated that ofatumumab was dominant over ocrelizumab, dimethyl fumarate, fingolimod, and natalizumab intravenous; was more cost-effective compared with teriflunomide, fingolimod (generic), glatiramer acetate, interferons, and best supportive care; and resulted in an incremental cost-effectiveness ratio of AED 713,068 per QALY versus cladribine. Sensitivity analyses were in line with the results of the base-case analysis.</p><p><strong>Conclusion: </strong>From the UAE payer's perspective, ofatumumab could be a cost-effective treatment alternative for patients with RMS.</p>","PeriodicalId":22980,"journal":{"name":"Therapeutic Advances in Neurological Disorders","volume":"18 ","pages":"17562864251330260"},"PeriodicalIF":4.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of CT perfusion parameters with outcomes in patients with medium vessel occlusion undergoing endovascular thrombectomy.","authors":"Yoel Schwartzmann, Hamza Joubran, Tamer Jubeh, Issa Metanis, Aviva Alpernas, Tali Jonas-Kimchi, Udi Sadeh, John M Gomori, Jose E Cohen, Hen Hallevi, Jeremy Molad, Ronen R Leker","doi":"10.1177/17562864251333515","DOIUrl":"https://doi.org/10.1177/17562864251333515","url":null,"abstract":"<p><strong>Background: </strong>Imaging biomarkers obtained on computed tomography perfusion (CTP) have proven effective in predicting outcomes after endovascular thrombectomy (EVT) in patients with large vessel occlusion stroke. However, the association of CTP imaging biomarkers with outcomes in medium-size vessel occlusion (MeVO) stroke patients remains unknown.</p><p><strong>Objectives: </strong>Therefore, we aimed to explore whether CTP parameters can be used for selection of a subset of MeVO patients that are more likely to benefit from EVT.</p><p><strong>Methods: </strong>Consecutively enrolled acute MeVO stroke patients treated with EVT were included. All patients underwent CTP on admission and follow-up noncontrast CT 24 h post-EVT. CTP parameters including core and penumbra volumes were obtained. Excellent outcome, defined as a modified Rankin score of 0-1 at 90 days poststroke was the primary outcome, and survival at 90 days was the safety outcome. Regression analyses were performed to examine the associations between different CTP parameters and outcomes.</p><p><strong>Results: </strong>Overall, 70 patients with MeVO were included (47% male, median age 75), and 66 (94%) had long-term follow-up data. Of those included, 26 patients (39%) had excellent outcomes and 2 (3%) had symptomatic intracerebral hemorrhage. On regression analysis, hypoperfused volumes on CTP were associated with excellent outcomes (adjusted odds ratio (aOR) 1.02, 95% confidence intervals (CI) 1.001-1.037), whereas core volume was not. Other factors associated with excellent outcome included admission National Institutes of Health Stroke Scale score (aOR 0.85, 95% CI 0.73-0.98) and lack of hypertension (aOR 0.07, 95% CI 0.07-0.62). Core or penumbral volumes were not associated with survival.</p><p><strong>Conclusion: </strong>Higher volumes of hypoperfused tissue on CTP are associated with a higher likelihood of excellent outcome. Core and penumbral volumes are not associated with increased mortality in patients with MeVO that undergo EVT.</p>","PeriodicalId":22980,"journal":{"name":"Therapeutic Advances in Neurological Disorders","volume":"18 ","pages":"17562864251333515"},"PeriodicalIF":4.7,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eculizumab as fast-acting rescue therapy for pembrolizumab-induced impending crisis state of myasthenia gravis: a case report.","authors":"Ying Huang, Futian Wu, Yihan Xiong, Kangling Huang, Xin Chang, Xiaofeng Chen, Xiali Chen, Qiwen Zhang, Liangyu Zou, Xuejun Fu, Huadong Zhang, Qianhui Xu","doi":"10.1177/17562864251333518","DOIUrl":"https://doi.org/10.1177/17562864251333518","url":null,"abstract":"<p><p>Immune checkpoint inhibitors, such as pembrolizumab, have demonstrated substantial therapeutic efficacy in the treatment of cancer. However, immune-related adverse events, including myasthenia gravis (MG), present significant clinical challenges. This study presents the case of a 75-year-old male patient who developed generalized acetylcholine receptor antibody-positive MG following the first infusion of pembrolizumab for cholangiocarcinoma. The patient's symptoms rapidly progressed to an impending myasthenic crisis (MGFA Class IVB) within 20 days of pembrolizumab administration. Eculizumab was used as a rescue therapy due to the unavailability of conventional treatments, resulting in rapid and significant symptom relief, with sustained improvement during maintenance therapy. The use of eculizumab as rescue therapy presents a viable treatment option for pembrolizumab-induced MG, owing to its rapid therapeutic effects.</p>","PeriodicalId":22980,"journal":{"name":"Therapeutic Advances in Neurological Disorders","volume":"18 ","pages":"17562864251333518"},"PeriodicalIF":4.7,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimized use of safinamide as an add-on therapy in Asian patients with Parkinson's disease: a narrative review and expert opinion.","authors":"Jong Sam Baik, Young Hee Sung, Ruey-Meei Wu, Chin-Song Lu, Roongroj Bhidayasiri","doi":"10.1177/17562864251329099","DOIUrl":"https://doi.org/10.1177/17562864251329099","url":null,"abstract":"<p><p>Parkinson's disease (PD) imposes a large burden on Asian countries and threatens to grow rapidly as Asian populations age. PD phenotypes in Asian patients differ from those reported in the West, yet management generally follows a similar approach. Levodopa (l-dopa) is a mainstay of therapy and is typically followed by the addition of a catechol-<i>O</i>-methyltransferase inhibitor or a monoamine oxidase-B (MAO-B) inhibitor to address the wearing-off effect. There is little guidance on switching between MAO-B inhibitors or other adjunct therapies that consider the newer evidence for safinamide as an add-on PD therapy in Asian patients. Therefore, a group of PD experts in Asia evaluated the evidence supporting safinamide for the treatment of PD with a focus on integrating this treatment option into local clinical practice. A narrative review was conducted to identify supportive evidence for the formulation of summary statements on key topics. The efficacy and safety of safinamide added to l-dopa in Asian patients with PD are supported by both clinical trials and observational data, including two randomized trials enrolling exclusively Asian patients (<i>n</i> = 406; <i>n</i> = 307) and an Asian subpopulation analysis from another randomized trial (<i>n</i> = 173). Safinamide reduces wear-off duration and has beneficial effects on motor symptoms of PD, with good tolerability outcomes. Safinamide may also have beneficial effects on non-motor symptoms of PD such as urinary symptoms, apathy and sleep disturbances, and it is a suitable treatment for older patients. Overall, safinamide is an effective and well-tolerated treatment for the wear-off effect of l-dopa in Asian patients and, during long-term treatment, might reduce the risk of dyskinesia in patients without pre-existing dyskinesia. Additional research is needed to better understand the role of safinamide for patients with fluctuating pain, the dose-effect relationship of safinamide in Asian patients and the efficacy of safinamide in Asian patients with early-onset PD.</p>","PeriodicalId":22980,"journal":{"name":"Therapeutic Advances in Neurological Disorders","volume":"18 ","pages":"17562864251329099"},"PeriodicalIF":4.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shifts in treatment initiation patterns among newly diagnosed multiple sclerosis patients in Germany: a claims data analysis from 2017 to 2022.","authors":"Ann-Sophie Stratil, Steffeni Papukchieva, Natalie Joschko, Sven Guenther Meuth, Benjamin Friedrich","doi":"10.1177/17562864251328576","DOIUrl":"https://doi.org/10.1177/17562864251328576","url":null,"abstract":"<p><strong>Background: </strong>Early use of high-efficacy therapies (EHT) in multiple sclerosis (MS) is a promising but novel treatment strategy. Its adoption in Germany's MS care warrants further research.</p><p><strong>Objectives: </strong>This study assessed treatment initiation patterns among newly diagnosed MS patients in Germany (2017-2022).</p><p><strong>Design: </strong>This is a retrospective observational study.</p><p><strong>Methods: </strong>Claims data from 4.5 million individuals insured by German statutory health insurance included 1448 newly diagnosed MS patients from 2017 to 2022. Patients were identified by International Statistical Classification of Diseases and Related Health Problems, 10th revision, German modification (ICD-10-GM) code G35 - in two different quarters of the same year, and a disease-modifying therapy (DMT) prescription, with no prior MS diagnosis or DMT prescription in the preceding 2 years. DMTs were categorized according to German Society of Neurology S2k guidelines: category 1 (low-efficacy), category 2 (moderate-efficacy) and category 3 (high-efficacy).</p><p><strong>Results: </strong>Of patients initiating treatment, 77.1% started with category 1, 8.1% with category 2 and 14.8% with category 3 DMTs. From 2017 to 2022, category 1 initiations declined by 7.6% points (pp), while categories 2 and 3 initiations increased by 2.8 and 4.8 pp, respectively. Escalation to category 3 occurred in 10.5% of category 1/2 starters, with 31.5% taking over 2 years. De-escalation to category 1/2 occurred in 3.3% of category 3 starters.</p><p><strong>Conclusion: </strong>Real-world data highlight a shift towards EHT in MS care.</p>","PeriodicalId":22980,"journal":{"name":"Therapeutic Advances in Neurological Disorders","volume":"18 ","pages":"17562864251328576"},"PeriodicalIF":4.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The therapeutic effects and mechanisms of glucagon-like peptide-1 receptor agonists in neurocognitive disorders.","authors":"Junchen Si, Kai Yu, Jiheng Hao, Jiyue Wang, Liyong Zhang","doi":"10.1177/17562864251332035","DOIUrl":"https://doi.org/10.1177/17562864251332035","url":null,"abstract":"<p><p>Chronic cerebral hypoperfusion (CCH) represents a key pathogenic contributor to neurocognitive disorders. It can lead to multifaceted pathological alterations including neuroinflammation, neuronal apoptosis, blood-brain barrier disruption, synaptic plasticity deficits, and mitochondrial dysfunction. The glucagon-like peptide-1 receptor (GLP-1R), ubiquitously expressed across multiple organ systems, exerts neuroprotective effects by maintaining intracellular homeostasis and mitigating neuronal damage triggered by oxidative stress, inflammatory cascades, apoptotic signaling, and ischemic insults. Furthermore, GLP-1R activity is modulated by gut microbiota composition and short-chain fatty acid abundance, implicating the gut-brain axis in its regulatory influence on neurological function. This review systematically examines the pathophysiological mechanisms underlying CCH and highlights the therapeutic potential of GLP-1R activation. Specifically, GLP-1R-targeted interventions attenuate hypoperfusion-induced damage through pleiotropic pathways and gut-brain crosstalk, thereby offering novel perspectives for advancing both fundamental research and clinical management of neurocognitive disorders.</p>","PeriodicalId":22980,"journal":{"name":"Therapeutic Advances in Neurological Disorders","volume":"18 ","pages":"17562864251332035"},"PeriodicalIF":4.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of acute symptomatic seizure in cerebral venous thrombosis patients-a multicenter cohort study.","authors":"Naaem Simaan, Jeremy Molad, Hen Hallevi, Issa Metanis, Rom Mendel, Rani Barnea, Eitan Auriel, Jonathan Naftali, Ruth Eliahou, Shorooq Aladdin, David Orion, Shlomi Peretz, Ronen R Leker, Asaf Honig","doi":"10.1177/17562864251330864","DOIUrl":"https://doi.org/10.1177/17562864251330864","url":null,"abstract":"<p><strong>Background: </strong>Acute symptomatic seizures (ASYS) is a common presentation in cerebral sinus venous thrombosis (CSVT) patients.</p><p><strong>Objectives: </strong>We aimed to characterize CSVT patients experiencing ASYS within 7 days from presentation. Additionaly, we aimed to find predictors for ASYS within CSVT patients.</p><p><strong>Methods: </strong>Prospective CSVT databases from six academic centers (January 2010-December 2023) were retrospectively analyzed. Clinical outcomes at the 90-day follow-up included seizure occurrence and the modified-Rankin-Scale (mRS).</p><p><strong>Results: </strong>From 529 included patients (mean age 42.4 ± 18.6 years, 64.3% females), 106 (20%) had ASYS. ASYS patients were more often males (47.2% vs 20.1%, <0.001), and presented more often with focal neurological deficits (50% vs 22%, <i>p</i> < 0.001) but less often with papilledema (13.2% vs 29.3%, <i>p</i> < 0.001). On multivariate analysis cortical-vein thrombosis (odds ratio (OR) 4.17, <i>p</i> < 0.001), intracerebral hemorrhage (ICH; OR 3.06, <i>p</i> = 0.002), any superior-sagittal-sinus (SSS) thrombosis (OR 2.49, <i>p</i> = 0.006), predicted ASYS. Conversely, presentation with papilledema (OR 0.39, <i>p</i> = 0.03) negatively predicted ASYS. ASYS patients had lower rates of 90-day-mRS-0-1 (51.9% vs 83.9%, <i>p</i> < 0.001). Patients who experienced seizures between the second and seventh day (n = 58) had similar baseline characteristics to those with seizures only on the day of presentation (n = 48) but were less likely to achieve a good functional outcome by day 90 (42.6% vs 58.9%, <i>p</i> < 0.05) and had a lower rate of complete recanalization on follow-up venous imaging (25.5% vs 57.5%, <i>p</i> = 0.02). Status-epilepticus in comparison to non-ASYS patients achieved lower rates of 90-day-mRS-0-1 (11% vs 84%, <i>p</i> < 0.001) and higher 90-day-mortality (44% vs 5.6%, <i>p</i> < 0.001). In a multivariate analysis ASYS was a negative predictor for 90-day-mRS-0-1 (OR 3.3, 95% confidence interval 1.43-7.5, <i>p</i> = 0.005).</p><p><strong>Conclusion: </strong>CSVT patients experiencing ASYS, and to a greater degree patients with either status epilepticus or ASYS between second and seventh day achieved less often 90-day-mRS-0-1. Possibly, they epitomize a different course of disease that may require a more suitable treatment strategy.</p>","PeriodicalId":22980,"journal":{"name":"Therapeutic Advances in Neurological Disorders","volume":"18 ","pages":"17562864251330864"},"PeriodicalIF":4.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in the treatment of neuromyelitis optic spectrum disorder.","authors":"Xiaolin Yang, Shaoru Zhang, Jinzhou Feng, Xinyue Qin","doi":"10.1177/17562864251328276","DOIUrl":"https://doi.org/10.1177/17562864251328276","url":null,"abstract":"<p><p>Neuromyelitis optic spectrum disorder (NMOSD) is a rare autoimmune disease characterized by recurrent episodes and severe debilitation. It primarily involves the central nervous system and is associated with the presence of aquaporin-4 antibodies. Effective management of NMOSD necessitates long-term therapeutic strategies that focus on alleviating symptoms during acute episodes and preventing relapse. In recent years, the approval of emerging biologics targeting B cells, interleukin-6 receptors, and the complement pathway has marked a transformative development in NMOSD treatment. This article provides a comprehensive review of therapeutic advances in NMOSD, integrating the current literature to serve as a theoretical basis for clinical decision-making of NMOSD patients.</p>","PeriodicalId":22980,"journal":{"name":"Therapeutic Advances in Neurological Disorders","volume":"18 ","pages":"17562864251328276"},"PeriodicalIF":4.7,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}