BMJ Neurology Open最新文献

{"title":"MOG positive primary autoimmune meningitis mimicking tuberculous meningitis: a case series.","authors":"Tejas Shivarthi, Mahima Sriram, Muddana Nikhilesh, Sudheeran Kannoth, Vivek Nambiar, Siby Gopinath, Saraf Udit Umesh, Gopikrishnan Unnikrishnan, Anand Kumar, Annamma Mathai, Meena Thevarkalam","doi":"10.1136/bmjno-2024-000999","DOIUrl":"https://doi.org/10.1136/bmjno-2024-000999","url":null,"abstract":"<p><strong>Objectives: </strong>Primary autoimmune meningitis presentation of myelin oligodendrocyte glycoprotein (MOG) IgG antibody positivity is infrequently reported. We aim to identify the patients with MOG IgG antibody positivity who were initially misdiagnosed and treated as tuberculous meningitis (TBM).</p><p><strong>Methods: </strong>A retrospective cross-sectional study conducted in the Neuroimmunology Laboratory and Department of Neurology of Amrita Institute of Medical Sciences, Kochi, Kerala, India between June 2018 and December 2023. MOG IgG antibody positive cases were identified from the Neuroimmunology Lab Registry, and the case sheets were screened for TBM-like presentation. Cases were included on the basis of MOG IgG positivity, an initial diagnosis of tuberculosis was suspected and antitubercular therapy was initiated with minimal response.</p><p><strong>Results: </strong>We described the clinical, microbiological, radiological and serological features of five patients with a TBM-like presentation eventually diagnosed with MOG-associated meningitis. Symptoms included headache, vomiting, visual impairment and weakness. Three patients showed normal MRIs and two patients showed MRI findings consistent with demyelination. Serum MOG antibody testing was positive only on serial testing of all five patients. The final diagnosis was MOG-associated meningitis in two patients and MOG-associated meningoencephalitis in three patients.</p><p><strong>Discussion: </strong>This case series highlights the rare presentation of MOG antibody positive patients presenting as primary autoimmune meningitis and its diagnostic challenges, especially in regions where tuberculosis is common. The study underscores the importance of considering autoimmune aetiology as a differential diagnosis when tuberculosis treatment fails or relapses occur, advocating for MOG IgG antibody testing to ensure accurate diagnosis and effective treatment.</p>","PeriodicalId":52754,"journal":{"name":"BMJ Neurology Open","volume":"7 1","pages":"e000999"},"PeriodicalIF":2.1,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Different patterns of fasciculation in spinal and bulbar muscular atrophy and amyotrophic lateral sclerosis: a muscle ultrasonographic study.","authors":"Takeru Nara, Kazumoto Shibuya, Shinobu Ikeda, Ryota Kuroiwa, Ryo Otani, Moeko Ogushi, Tomoki Suichi, Yuki Shiko, Kohei Takahashi, Sonoko Misawa, Astushi Murata, Satoshi Kuwabara","doi":"10.1136/bmjno-2025-001065","DOIUrl":"https://doi.org/10.1136/bmjno-2025-001065","url":null,"abstract":"<p><strong>Background: </strong>The usefulness of muscle ultrasonography for detection of fasciculations has been increasingly recognised, particularly in amyotrophic lateral sclerosis (ALS). This study aimed to elucidate distributions and characteristics of fasciculations in spinal and bulbar muscular atrophy (SBMA) and to compare the results of those in ALS.</p><p><strong>Methods: </strong>In 24 SBMA and 16 ALS patients, muscle ultrasonography was systematically performed in the tongue, upper limb muscles (biceps brachii, triceps brachii, first dorsal interosseous (FDI), abductor pollicis brevis and abductor digiti minimi), trunk muscles (Th10 paraspinals and rectus abdominis) and lower limb muscles (vastus lateralis, biceps femoris, tibialis anterior and gastrocnemius). We assessed the presence of fasciculations and the fasciculation intensity (scored from 0 to 3) for each muscle.</p><p><strong>Results: </strong>All SBMA and ALS patients showed fasciculations at least in two muscles. In SBMA patients, fasciculations were most frequently found in the tongue (100%), FDI (93%) and tibialis anterior (80%), whereas less frequently present in the proximal limb and trunk muscles, irrespective of age, disease duration and CAG repeat numbers. By contrast, in ALS patients, fasciculations were more diffusely distributed including the proximal limb and trunk muscles. When fasciculations were present, the intensity was higher in ALS patients, except for the tongue.</p><p><strong>Conclusions: </strong>Whereas both diseases exhibit extensive fasciculations, the distribution and intensity are different. SBMA is characterised by prominent involvement in the tongue and distal limb muscles, suggesting different pathophysiology of motor neuronal death in SBMA and ALS.</p>","PeriodicalId":52754,"journal":{"name":"BMJ Neurology Open","volume":"7 1","pages":"e001065"},"PeriodicalIF":2.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fundoscopy as a diagnostic biomarker in idiopathic normal pressure hydrocephalus: a pilot study.","authors":"Mathias Just Nortvig, Niclas Lynge Eriksen, Mikkel C Schou Andersen, Emma Tubæk Nielsen, Sune Munthe, Christian Bonde Pedersen, Frantz Rom Poulsen","doi":"10.1136/bmjno-2025-001103","DOIUrl":"https://doi.org/10.1136/bmjno-2025-001103","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic normal pressure hydrocephalus (iNPH) has a prevalence of approximately 5%. It is characterised by Hakim's triad of impaired gait, cognitive dysfunction and urinary incontinence. Despite radiological markers and liquor-dynamic tests, iNPH is difficult to diagnose due to many overlapping symptoms. The aim of this study was to evaluate funduscopy as a noninvasive method of screening patients with suspected iNPH.</p><p><strong>Methods: </strong>Patients with suspected iNPH who underwent a lumbar infusion test (LIT) were included. Funduscopy was performed before the start of the LIT, and intracranial pressure (ICP) was continually measured via lumbar cannulation. Retinal images were analysed using an artificial intelligence algorithm to determine the arteriole-venule (A/V) ratio. The A/V ratio and ICP measurements were compared with the iNPH diagnosis. In addition, the mean difference in shunt response was evaluated.</p><p><strong>Results: </strong>A significantly lower mean A/V ratio was found in the iNPH group compared with the non-iNPH group (p value: 0.02). Receiver operating characteristic curve analysis with an area under the curve of 0.75 showed a sensitivity of 88% and a specificity of 50% with an A/V cut-off of 0.86. Although not statistically significant, the mean A/V ratio was lower in the group with clinical shunt effect compared with those without (p value: 0.305).</p><p><strong>Conclusions: </strong>This study found a statistically significant difference in baseline A/V ratios between iNPH and non-iNPH groups. This pilot study suggests the A/V ratio might be able to serve as a screening tool for iNPH. If so, this would be highly beneficial for patients and could have significant medical and socioeconomic implications.</p>","PeriodicalId":52754,"journal":{"name":"BMJ Neurology Open","volume":"7 1","pages":"e001103"},"PeriodicalIF":2.1,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating TSPO-PET imaging with metabolomics for enhanced prognostic accuracy in multiple sclerosis.","authors":"Daniel E Radford-Smith, Abi G Yates, Tereza Kacerova, Marjo Nylund, Marcus Sucksdorff, Markus Matilainen, Eline Willemse, Johanna Oechtering, Aleksandra Maleska Maceski, David Leppert, Jens Kuhle, Fay Probert, Daniel C Anthony, Laura Airas","doi":"10.1136/bmjno-2025-001026","DOIUrl":"https://doi.org/10.1136/bmjno-2025-001026","url":null,"abstract":"<p><strong>Background: </strong>Predicting disease progression in multiple sclerosis (MS) remains challenging. PET imaging with 18 kDa translocator protein (TSPO) radioligands can detect microglial and astrocyte activation beyond MRI-visible lesions, which has been shown to be highly predictive of disease progression. We previously demonstrated that nuclear magnetic resonance (NMR)-based metabolomics could accurately distinguish between relapsing-remitting (RRMS) and secondary progressive MS (SPMS). This study investigates whether combining TSPO imaging with metabolomics enhances predictive accuracy in a similar setting.</p><p><strong>Methods: </strong>Blood samples were collected from 87 MS patients undergoing PET imaging with the TSPO-binding radioligand ¹¹C-PK11195 in Finland. Patient disability was assessed using the expanded disability status scale (EDSS) at baseline and 1 year later. Serum metabolomics was performed to identify biomarkers associated with TSPO binding and disease progression.</p><p><strong>Results: </strong>Greater TSPO availability in the normal-appearing white matter and perilesional regions correlated with higher EDSS. Serum metabolites glutamate (p=0.02), glutamine (p=0.006), and glucose (p=0.008), detected by NMR, effectively distinguished future progressors. These three metabolites alone predicted progression with the same accuracy as TSPO-PET imaging (AUC 0.78; p=0.0001), validated in an independent cohort. Combining serum metabolite data with PET imaging significantly improved predictive power, achieving an AUC of 0.98 (p<0.0001).</p><p><strong>Conclusion: </strong>Measuring three specific serum metabolites is as effective as TSPO imaging in predicting MS progression. However, integrating TSPO imaging with serum metabolite analysis substantially enhances predictive accuracy. Given the simplicity and affordability of NMR analysis, this approach could lead to more personalised, accessible treatment strategies and serve as a valuable tool for clinical trial stratification.</p>","PeriodicalId":52754,"journal":{"name":"BMJ Neurology Open","volume":"7 1","pages":"e001026"},"PeriodicalIF":2.1,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External validation of the MR PREDICTS@24H model: predicting functional outcome after endovascular treatment in stroke.","authors":"Jeanette Tas, Cristina Cerinza Sick, Caterina Kulyk, Bogdan-Andrei Ianosi, Patrizia Spiandorello, Milan R Vosko, Michael Sonnberger, Melanie Bergmann, Raimund Helbok","doi":"10.1136/bmjno-2024-000973","DOIUrl":"https://doi.org/10.1136/bmjno-2024-000973","url":null,"abstract":"<p><strong>Background: </strong>Chalos <i>et al</i> recently developed the MR PREDICTS@24H model to predict 90 days functional outcomes in ischaemic stroke patients following endovascular treatment (EVT). We aimed to validate this model in the real-world situation of endovascular stroke patients admitted to a tertiary care hospital.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study including a selection of adult (≥18 years old) ischaemic stroke patients eligible for EVT in a tretiary care center between January 2014 and May 2023. Model performance was assessed using C-statistics for discrimination and calibration plots for goodness of fit.</p><p><strong>Results: </strong>Among 254 eligible stroke patients, the model demonstrates a strong discriminatory performance for both functional independence (C-statistics 0.92; 95% CI 0.88 to 0.95) and survival (C-statistic 0.83; 95% CI 0.76 to 0.90). Compared with the MR CLEAN Registry, no significant differences were observed in discriminative ability (functional independence: z-score 0.54, p=0.590; survival: z-score -1.66, p=0.0962).</p><p><strong>Conclusions: </strong>The MR PREDICTS@24H model reliably predicts outcomes in a real-world setting and may help clinicians in the communication with patient relatives.</p>","PeriodicalId":52754,"journal":{"name":"BMJ Neurology Open","volume":"7 1","pages":"e000973"},"PeriodicalIF":2.1,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FVC-DiP correlates with neurofilament light chain levels in serum and cerebrospinal fluid in patients with ALS.","authors":"Yuko Kobayakawa, Senri Ko, Takumi Tashiro, Guzailiayi Maimaitijiang, Jun-Ichi Kira, Junji Kishimoto, Ryo Yamasaki, Noriko Isobe","doi":"10.1136/bmjno-2024-001012","DOIUrl":"10.1136/bmjno-2024-001012","url":null,"abstract":"<p><strong>Background: </strong>We previously reported a scale to assess the disease progression rate in patients with amyotrophic lateral sclerosis (ALS), the forced vital capacity decline pattern scale (FVC-DiP). In this study, we investigated the association between FVC-DiP scores and neurofilament light chain (NfL) in the serum and cerebrospinal fluid (CSF) in patients with ALS.</p><p><strong>Methods: </strong>We performed a retrospective study to examine the association between NfL levels and the rate of disease progression (N=41). The disease progression rate was assessed using three methods: the FVC-DiP score determined using the percentage of predicted FVC (%FVC) and disease duration at the %FVC measurement, the rate of decline in the ALS Functional Rating Scale Revised (ALSFRS-R) score (ΔFS) and the rate of decline in the %FVC (Δ%FVC).</p><p><strong>Results: </strong>The FVC-DiP scores were significantly correlated with NfL levels in both the serum and CSF (serum, R²=0.274, p<0.001; CSF, R²=0.274, p=0.001). Patients assessed as rapidly progressing by the FVC-DiP had high NfL levels, and patients assessed as slowly progressing had low NfL levels. In the group with a low ΔFS and/or Δ%FVC, although the disease progression rate assessed by the FVC-DiP may have differed from the assessments obtained using the ALSFRS-R and/or %FVC, the correlation between FVC-DiP scores and serum NfL levels remained consistent.</p><p><strong>Conclusions: </strong>The FVC-DiP was significantly associated with NfL levels in the serum and CSF, suggesting that the FVC-DiP is a reasonable scale to assess the rate of ALS progression.</p>","PeriodicalId":52754,"journal":{"name":"BMJ Neurology Open","volume":"7 1","pages":"e001012"},"PeriodicalIF":2.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology and 10-year clinical care of juvenile myasthenia gravis in England: a retrospective cohort study.","authors":"Ali Abbasi, Kerina Bonar, Piotr Zaremba, Anna Scowcroft, Sigrid Nilius, Frank Tennigkeit, Saiju Jacob, Sithara Ramdas","doi":"10.1136/bmjno-2024-001000","DOIUrl":"10.1136/bmjno-2024-001000","url":null,"abstract":"<p><strong>Background: </strong>Published evidence is limited on the clinical burden of juvenile myasthenia gravis (JMG). We aimed to assess epidemiology and the clinical characteristics of JMG in England.</p><p><strong>Methods: </strong>We performed a retrospective analysis of patients with newly diagnosed JMG identified in England via primary care and hospital data between 2010 and 2019.</p><p><strong>Results: </strong>32 children (aged 2-17 years) with newly diagnosed JMG were included. Prevalence of JMG ranged from 2.2 (95% CI 1.5 to 3.1) in 2012 to 2.5 (95% CI 1.8 to 3.4) per 100 000 in 2018. The annual incidence ranged from 0.8 (95% CI 0.1 to 5.7) in 2015 to 3.8 (95% CI 1.6 to 9.0) per million per year in 2017. Incidence fluctuated in females from 1.6 (95% CI 0.2 to 11.3) in 2016 to 6 (95% CI 2.3 to 16.1) per million per year in 2018. Overall, 20 patients received first acetylcholinesterase inhibitors or corticosteroids with no prior therapy during the study period. During the follow-up period (median, 3.3 years), 17 patients (53.1%) with JMG experienced a hospitalisation. No deaths were observed.</p><p><strong>Conclusions: </strong>This study confirms the rarity of JMG in England, with steady incidence and prevalence rates over a decade. Further research is required to assess unmet needs in JMG therapy and the importance of effective treatments for this condition.</p>","PeriodicalId":52754,"journal":{"name":"BMJ Neurology Open","volume":"7 1","pages":"e001000"},"PeriodicalIF":2.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visual processing capacity and cognitive decline in Parkinson's disease.","authors":"Katharina Gerner, Peter Bublak, Kathrin Finke, Simon Schrenk, Adriana L Ruiz-Rizzo, Franziska Wagner, Carsten Klingner, Stefan Brodoehl","doi":"10.1136/bmjno-2024-000953","DOIUrl":"10.1136/bmjno-2024-000953","url":null,"abstract":"<p><strong>Background: </strong>Parkinson's disease (PD) is a progressive neurodegenerative disorder characterised by motor symptoms. However, approximately half of patients with PD exhibit signs of dementia within a decade of diagnosis. While deficits in working memory and visuospatial abilities are recognised as hallmarks of cognitive decline in PD, these populations are rarely studied using detailed cognitive tools that link cognitive impairments to formal theoretical models, such as the theory of visual attention (TVA).</p><p><strong>Methods: </strong>This cross-sectional study addresses this gap by employing the TVA whole report paradigm to assess visual processing in a cohort of patients with PD, both with and without cognitive impairment. Participants were divided based on their Montreal Cognitive Assessment (MoCA) scores into two PD groups (n=25 each) and a healthy control group (n=25).</p><p><strong>Results: </strong>Our principal finding is that the visual processing speed (C) and visual short-term memory capacity (K) are significantly diminished in patients with PD with MoCA scores below 26 (Analysis of variance, p=0.016 for C and p<0.001 for K), while no notable differences were observed between controls and patients with PD with MoCA scores of 26 or above. Using a generalised linear model to assess the impact of factors such as age, gender and disease duration, we discovered that the C-parameter was significantly influenced by age, while the K<i>-</i>parameter was notably affected by gender.</p><p><strong>Conclusion: </strong>TVA parameters demonstrate their suitability for detecting cognitive deficits in PD. Given their independence from motor and non-motor symptoms, TVA parameters may prove to be valuable tools for early diagnosis and longitudinal monitoring of cognitive deficits in individual patients with PD.</p>","PeriodicalId":52754,"journal":{"name":"BMJ Neurology Open","volume":"7 1","pages":"e000953"},"PeriodicalIF":2.1,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vascular injury and occurrence of microthrombi after endovascular therapy for acute ischaemic stroke in a thromboembolic model.","authors":"Aladdin Taha, Magdolna Nagy, Hajo M Hund, Pieter Jan van Doormaal, Khay van Noorden, Henri M H Spronk, Angelique Ceulemans, Robert J van Oostenbrugge, Dirk J Duncker, Hugo Ten Cate, Diederik Dippel, Adriaan C G M van Es, Joaquim Bobi, Heleen M M van Beusekom","doi":"10.1136/bmjno-2024-000989","DOIUrl":"10.1136/bmjno-2024-000989","url":null,"abstract":"<p><strong>Background: </strong>Endovascular catheters and devices used for thrombectomy in patients who had a stroke can damage the vessel lumen leading to microthrombi. During stroke recanalisation, microthrombi could migrate distally and occlude cerebral microvasculature, potentially limiting the benefit of recanalisation therapy.</p><p><strong>Objectives: </strong>To describe vascular injury occurring after endovascular therapy (EVT), with stent retrievers (SR) and direct aspiration (DA), to open up avenues for further improvement of EVT technique.</p><p><strong>Methods: </strong>SR and DA were performed according to clinical procedures in extracranial vessels in a swine model of thromboembolic arterial occlusion. Treated vessels were collected at 2 hours or 3 days post-EVT to assess respectively acute injury and early healing (remnant vascular injury) as assessed by Evans-Blue (EB) dye exclusion. The presence of microthrombi was quantified using scanning electron microscopy. Markers of coagulation activation were measured periprocedurally in plasma.</p><p><strong>Results: </strong>Both SR and DA induced vascular injury. SR tended to result in larger EB positive areas than DA at 2 hours (99.5 vs 84.5; p=0.072) which reached statistical significance at day 3 (78.6 vs 48.6; p=0.040) post-EVT. Both EVT methods similarly yielded microthrombi in treated areas which were still observed at 3 days post-EVT. In addition, both EVT methods immediately increased systemic plasma levels of complexes of intrinsic-pathway coagulation activation: thrombin, Factor IX and Factor Xa:Antithrombin.</p><p><strong>Conclusions: </strong>In this preclinical thromboembolic model, SR thrombectomy and DA lead to acute vascular injury, yield microthrombi and trigger contact activation of the coagulation system. At 3 days after intervention, healing remains incomplete, showing remnant vascular injury in the treated arteries, especially in SR thrombectomy.</p>","PeriodicalId":52754,"journal":{"name":"BMJ Neurology Open","volume":"7 1","pages":"e000989"},"PeriodicalIF":2.1,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Future is now: an Australasian perspective on disease-modifying trials in Parkinson's and prodromal disease.","authors":"Simon Jg Lewis, Carolyn M Sue, Antony Cooper, Glenda M Halliday","doi":"10.1136/bmjno-2025-001070","DOIUrl":"10.1136/bmjno-2025-001070","url":null,"abstract":"<p><p>There is increasing interest in the role of platform trials, where several investigational products targeting disease modification in Parkinson's Disease can be assessed in parallel. Indeed, several initiatives are currently gearing up across North America and Europe to conduct such studies. However, to date, little attention has been paid to ongoing efforts that already exist in Australia and look soon to expand across to New Zealand as part of greater collaboration. This viewpoint will highlight some of these ongoing efforts addressing the challenges and potential solutions for delivering successful studies.</p>","PeriodicalId":52754,"journal":{"name":"BMJ Neurology Open","volume":"7 1","pages":"e001070"},"PeriodicalIF":2.1,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}