Aktualnosci Neurologiczne最新文献

{"title":"The impact of natalizumab treatment in pregnancy on neonatal outcomes","authors":"A. Karbicka","doi":"10.15557/an.2022.0025","DOIUrl":"https://doi.org/10.15557/an.2022.0025","url":null,"abstract":"Multiple sclerosis is a common autoimmune and neurodegenerative disease of the central nervous system in women of reproductive age. The average age of onset is around 30 years. A few decades ago, women with multiple sclerosis were often advised to avoid pregnancy, but this has changed. Discontinuation of treatment due to pregnancy is often associated with clinical and radiological progression of multiple sclerosis. According to current expert recommendations, if a patient presents with highly active multiple sclerosis, continuation of treatment with natalizumab may be considered even during pregnancy. Treatment can be continued until 30–34 weeks of gestation and resumed as soon as possible after delivery, 2–3 weeks after childbirth or 8–12 weeks after the last infusion, to reduce the risk of disease reactivation. The dosing interval should be extended to 6 weeks. Cases of mild to moderate transient thrombocytopenia and anaemia have been reported in infants born to mothers exposed to natalizumab in the third trimester of pregnancy. Haematological abnormalities have been shown to normalise within 4 months after birth in most infants. This article presents the case of a patient with multiple sclerosis who has been successfully treated with natalizumab for several years and decided to continue her treatment during pregnancy, with an emphasis on the impact of the drug on the newborn’s laboratory parameters.","PeriodicalId":41161,"journal":{"name":"Aktualnosci Neurologiczne","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47576925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Natalizumab as a high-efficacy therapy with proven confirmed long-term effectiveness and a new, subcutaneous administration formula","authors":"M. Adamczyk-Sowa","doi":"10.15557/an.2022.0026","DOIUrl":"https://doi.org/10.15557/an.2022.0026","url":null,"abstract":"","PeriodicalId":41161,"journal":{"name":"Aktualnosci Neurologiczne","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48395003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of sex hormones in multiple sclerosis","authors":"B. Lewandowska, B. Bielecki","doi":"10.15557/an.2022.0019","DOIUrl":"https://doi.org/10.15557/an.2022.0019","url":null,"abstract":"Biological differences associated with sexual dimorphism have an impact on many aspects of health, including disease susceptibility, course and prognosis. Significant differences in the incidence and severity of neurological diseases, especially those of autoimmune origin, were found between women and men. Although the reasons for the observed discrepancies are complex, research indicates the key role of sex hormones, which are known to be responsible for the differences in body structure, genitals and sexual behaviour in women and men. Recent data have drawn attention to their impact on the function of the immune and nervous systems, the brain and the spinal cord in particular. Multiple sclerosis is a chronic disease of the central nervous system that affects more than twice as many women as men. The etiopathogenesis of the disease is complex, with genetic and environmental factors playing an important role. There are three main components in the pathology of multiple sclerosis: inflammation, demyelination and neurodegeneration. Studies conducted so far have shown a significant influence of sex hormones, both male and female, on each of these elements. It has been shown in both clinical and experimental studies that sex hormones have not only a strong immunomodulatory, but also neuroprotective and neuroregenerative effect. Recent research on the role of sex hormones in multiple sclerosis has led to a better understanding of the mechanisms underlying the development of this disorder. They also gave hope for the introduction of sex hormones as diagnostic tools, i.e. biomarkers of progression and response to treatment, but above all, as breakthrough therapies.","PeriodicalId":41161,"journal":{"name":"Aktualnosci Neurologiczne","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67584829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of ischaemic stroke risk factors on imaging changes – a current literature review","authors":"Yehor Demianenko, Mateusz Kobierecki, Roman Leśniak","doi":"10.15557/an.2022.0021","DOIUrl":"https://doi.org/10.15557/an.2022.0021","url":null,"abstract":"Stroke is the leading cause of acquired disability in adults. Although all age groups may be affected, the risk of fatal outcome increases with age. Diagnostic imaging, including computed tomography and magnetic resonance imaging, is used in order to promptly initiate effective treatment. Imaging modalities make it possible to determine the type of stroke as well as the location and extent of damage. They are also used for treatment monitoring. It is essential to make an early diagnosis, identify the type of stroke and implement appropriate management. After the introduction of modern treatment modalities, such as thrombolytic therapy, time windows, i.e. periods of time during which a given intervention may bring benefits to the patient, were established for ischaemic stroke. The performance and life quality in a person after a stroke depends on the duration of neural ischaemia. The consequences of stroke also depend on the baseline condition of the patient. The incidence of stroke in the general population is shaped by risk factors that are often cumulative in nature. Scientific reports most often point to age, race, sex, blood glucose and diabetes, obesity, smoking and atherosclerosis. Ischaemic stroke is frequently caused by arterial stenosis or obstruction. According to one hypothesis, the activity of immune cells, including monocytes and basophils, in atherosclerosis leads to inflammation and formation of atherosclerotic plaques. As a result, wall thickening, atherosclerotic plaque rupture, regenerative responses and stenosis occur. The aim of the paper is to summarise the relationships between vasculitis, bacterial and viral infections or autoimmune disorders and stroke, in the etiopathogenesis of which, according to current research, they are involved. The paper also shows the importance of diagnostic imaging and attempts to explain the relationship between changes in computed tomography and magnetic resonance imaging and risk factors for stroke.","PeriodicalId":41161,"journal":{"name":"Aktualnosci Neurologiczne","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67585042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Second-generation gepants in the treatment of migraine – a review of the findings of randomised controlled trials","authors":"Marcin Kopka","doi":"10.15557/an.2022.0022","DOIUrl":"https://doi.org/10.15557/an.2022.0022","url":null,"abstract":"Pharmacological treatment of migraine may be either acute (abortive) or preventive (prophylactic), though patients with frequent migraine attacks may require both. The aim of acute treatment is to treat attacks quickly and consistently, prevent recurrences, and restore patients to normal functioning. The goal of preventive migraine therapy is to reduce the frequency, duration, and severity of attacks. Calcitonin gene-related peptide (CGRP) is a neuropeptide which plays a critical role in migraine pathophysiology. The first CGRP antagonist studied in patients with migraine was olcegepant. Despite the fact that the efficacy of CGRP antagonists in the treatment of migraine has been demonstrated in clinical trials, further research on CGRP antagonists has been suspended due to safety concerns related to their toxic effects on the liver. In recent years, newgeneration gepants have been developed. The efficacy of rimegepant and ubrogepant as acute migraine medications, as well as atogepant and rimegepant as migraine preventives, has been confirmed in randomised placebo-controlled phase three studies. The most commonly reported treatment-related emergent adverse events of gepants include nausea and constipation. No cardiovascular or hepatic adverse events have emerged so far. CGRP antagonists do not exhibit vasoconstrictive proprieties. Gepants may be used in patients with cardiovascular diseases when triptans are contraindicated. The results of studies investigating the efficacy and tolerability of CGRP antagonists are promising and it is hoped that in the future they will broaden the range of abortive and prophylactic options for the management of migraine.","PeriodicalId":41161,"journal":{"name":"Aktualnosci Neurologiczne","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49067723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late and very late onset neuromyelitis optica spectrum disorders – a case series","authors":"Katarzyna Zwiernik, Magdalena Kwaśniak-Butowska, R. Bonek, J. Sławek","doi":"10.15557/an.2022.0023","DOIUrl":"https://doi.org/10.15557/an.2022.0023","url":null,"abstract":"Background and purpose: Neuromyelitis optica spectrum disorders are a group of autoimmune diseases leading to severe visual and motor impairment with a median disease onset at 39 years. Materials and methods: We present a case series of four AQP4-Ab positive neuromyelitis optica spectrum disorders patients, with a median age at onset of 67 years (ranging 54–72), in whom neuromyelitis optica spectrum disorder was not suspected at first, given unusual age and age-associated comorbidities. Results: Severe spinal cord involvement was the main finding in all patients. Two patients additionally manifested brainstem impairment in the form of area postrema syndrome and double vision. The therapeutic process included intravenous steroid pulses followed by long-term immunosuppression. Two of the patients died within a year of the diagnosis due to respiratory failure (one due to SARS-CoV-2 infection). One patient was started on satralizumab therapy with a significant motor improvement and good tolerance. One patient decided to suspend immunosuppressive treatment due to treatment-related gastrointestinal complaints. Conclusion: Based on the presented case series and the literature review, we assume that neuromyelitis optica spectrum disorders diagnosis should be considered regardless of age and comorbidity. New highly effective therapies with monoclonal antibodies are currently available. Early diagnosis and proper treatment may improve the outcome and prevent further visual and motor disability.","PeriodicalId":41161,"journal":{"name":"Aktualnosci Neurologiczne","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67584999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"167 Effects of different doses of vitamin D supplementation on immune, inflammatory and oxidative stress parameters in the blood serum of patients with multiple sclerosis – a review","authors":"M. Lis, Jowita Adamczyk-Zostawa, M. Adamczyk-Sowa","doi":"10.15557/an.2022.0020","DOIUrl":"https://doi.org/10.15557/an.2022.0020","url":null,"abstract":"Multiple sclerosis is a chronic inflammatory disease of the central nervous system associated with demyelination and neurodegeneration. In recent years, vitamin D has gained attention in the medical community following suggestions that there is a correlation between the level of serum vitamin D and the risk of multiple sclerosis, disease progression and activity. The aim of this article was to review recent literature describing the effects of vitamin D supplementation on the immune, inflammatory and oxidative stress parameters in patients with multiple sclerosis. In clinical trials, vitamin D doses ranging from 800 IU/day to 14,000 IU/day were tested. Researchers noticed significant differences in the range of action of vitamin D. However, the overview of studies failed to yield a definite answer concerning an effective dose of vitamin D. We concluded that there was no clear evidence for the impact of vitamin D supplementation on inflammatory parameters in multiple sclerosis patients, even though studies show consistently that the vitamin has an influence on the immune system and contributes to a reduction of pro-inflammatory cytokines. What is more, little is still known about the effects of vitamin D supplementation on oxidative stress, especially with regard to the potential effective dose. Consequently, more research is needed to gain a better understanding of this issue. There is increasing evidence on the significant role of vitamin D in patients with multiple sclerosis but there are as yet no global recommendations regarding the benefits of vitamin D supplementation and the supplementation dose. It is necessary to conduct further studies on the influence of vitamin D on disease activity due to its potential role as an add-on therapy in this group of patients or even as a preventative measure.","PeriodicalId":41161,"journal":{"name":"Aktualnosci Neurologiczne","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67584899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paroxysmal left-sided hemidystonia as a relapse of multiple sclerosis","authors":"K. Jastrzębski, Jakub Jania","doi":"10.15557/an.2022.0018","DOIUrl":"https://doi.org/10.15557/an.2022.0018","url":null,"abstract":"Extrapyramidal disorders are a rare presentation of multiple sclerosis. One such presentation is paroxysmal hemidystonia. Dystonia is, in the strict sense, the result of damage to various sites in the central nervous system. In one published cases series, lesions causing dystonia occurred in heterogeneous locations, most commonly in the basal ganglia, followed by the thalamus, brainstem, and white matter. In a series of 62 patients with thalamic or peritalamic lesions, only about 5% patients had paroxysmal dystonia. So far, there have been few reported cases of patients with paroxysmal hemidystonic symptoms associated with a specific damage to the central nervous system in the course of multiple sclerosis, especially as a relapse. For these reasons, we present a case of a 57-year-old female patient with a medical history of about 30 years of multiple sclerosis, who developed symptoms of paroxysmal left-sided hemidystonia as a relapse of multiple sclerosis.","PeriodicalId":41161,"journal":{"name":"Aktualnosci Neurologiczne","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47859961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of selected inflammatory markers in bacterial and viral neuroinfections in children","authors":"Karol Lubarski, A. Mania, Katarzyna Mazur-Melewska, Paweł Małecki, Cezary Witczak, M. Figlerowicz","doi":"10.15557/an.2022.0014","DOIUrl":"https://doi.org/10.15557/an.2022.0014","url":null,"abstract":"Aim: The aim of the study was to assess the suggested biomarkers’ usefulness in diagnosing central nervous system infections in order to optimise treatment and minimise adverse outcomes. The study included a comprehensive comparison of the known parameters and a search for correlations with proposed biomarkers. Materials and methods: The data of 73 hospitalised children were reviewed. According to their final diagnoses, 42 participants were assigned to the control group, 13 to the cohort with bacterial and 18 to the cohort with viral neuroinfections. The children underwent clinically indicated blood and cerebrospinal fluid tests. The serum interleukin (IL)-1β, IL-6 and neopterin concentrations, and S100B protein and matrix metalloproteinase (MMP)-9 levels in the cerebrospinal fluid were determined. The results were compared between the groups and correlations were sought. Results: Serum IL-6 levels were found to have increased in viral (p = 0.0412) and bacterial (p < 0.0001) infections, with a predominance of the latter (p = 0.0403). In terms of serum neopterin and IL-1β, the neuroinfection cohort did not differ from the control group. The level of S100B in the cerebrospinal fluid in bacterial disease was higher compared with the viral aetiology (p = 0.0325). The cerebrospinal fluid S100B correlated positively with serum IL-6 (p = 0.0138, R = 0.6396) and reversely with IgA and IgG levels (p = 0.0499, R = −0.5325; p = 0.0022, R = −0.7451, respectively) in the neuroinfection cohort. The cerebrospinal fluid MMP-9 was linked with cerebrospinal fluid cytosis in patients with viral (p = 0.0018, R = 0.7547) and bacterial (p = 0.0124, R = 0.6935) disease. The serum IL-6 levels correlated with IgA in the viral aetiology (p = 0.0374, R = 0.9). Conclusions: The MMP-9 level correlated with blood–brain barrier permeability, expressed by cerebrospinal fluid proteins and cytosis, which may indicate the possibility of sequelae. The higher serum concentrations of IL-6 and S100B in bacterial neuroinfections may reflect a more intense immune reaction associated with this aetiology.","PeriodicalId":41161,"journal":{"name":"Aktualnosci Neurologiczne","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67584554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of hippotherapy on gross motor function in children and adolescents with cerebral palsy – a scoping review","authors":"Natalia Jagielska-Zwierz, N. Matysiak, Justyna Zając, J. Gąsior","doi":"10.15557/an.2022.0016","DOIUrl":"https://doi.org/10.15557/an.2022.0016","url":null,"abstract":"Introduction: Cerebral palsy is one of the most commonly diagnosed neurological syndromes in children today. The most prevalent abnormalities in the development of patients with cerebral palsy are related to general motor skills, body posture and muscle tension. The sum of these disorders affects, inter alia, gross motor skills, which are movements involving either the entire body or a significant part of it. These include, for example, walking, running, jumping, swimming, and cycling. Nowadays, medicine offers many types of therapy to patients with cerebral palsy. Properly adjusted, they provide a chance to maintain appropriate levels of activity and physical fitness, and prevent the patient’s clinical condition from worsening. One of the supportive forms of therapy for people suffering from cerebral palsy is hippotherapy, which, thanks to its universal status, is an important complement to the rehabilitation process. The aim of the study was to assess the effects of hippotherapy on gross motor skills in children with cerebral palsy based on a literature review. Materials and methods: The MEDLINE PubMed medical database was reviewed as recommended by PRISMA, using the following keywords: “cerebral palsy” in combination with “hippotherapy” and “gross motor function.” The review included clinical trials examining the effects of hippotherapy on gross motor skills in children with cerebral palsy. Results: A total of 25 articles published between 1998 and 2021 were identified. The effects of hippotherapy on changes in gross motor activity were assessed using the Gross Motor Function Measure (GMFM), Functional Status Scale, Pediatric Balance Scale, Bruininks–Oseretsky Test of Motor Proficiency. Second Edition (BOT-2) scales, Gross Motor Function Classification System (GMFCS), and changes in selected gait determinants including walking speed and stride length. Conclusions: Hippotherapy improves gross motor skills in children and adolescents with cerebral palsy aged 3–19, classified as GMFCS levels I–V. However, more research is needed to establish the long-term effects of hippotherapy.","PeriodicalId":41161,"journal":{"name":"Aktualnosci Neurologiczne","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67584639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}