Neuroepidemiology最新文献

{"title":"Association between Ambient Temperature and Risk of Ischaemic Stroke: An Observational Cohort Study.","authors":"Ryu Matsuo, Haruhiko Motomura, Fumi Irie, Yoshinobu Wakisaka, Tetsuro Ago, Masahiro Kamouchi, Takanari Kitazono","doi":"10.1159/000546068","DOIUrl":"10.1159/000546068","url":null,"abstract":"<p><strong>Introduction: </strong>The influence of ambient temperature on the risk of stroke has remained unclear, particularly in relation to stroke subtypes. This study aimed to investigate the association between ambient temperature and the risk of ischaemic stroke from various aetiologies.</p><p><strong>Methods: </strong>We investigated the onset of acute ischaemic stroke in the prospective stroke registry conducted from October 2007 to September 2019 in Fukuoka, Japan. Stroke aetiology was classified into cardioembolism (CE), large-artery atherosclerosis (LAA), small-vessel occlusion (SVO), and other aetiologies. Hourly, maximum, and minimum temperature data were obtained from the Japan Meteorological Agency. After controlling for the non-linear and delayed effects of daily average temperature, we employed a quasi-Poisson generalised additive model with the natural logarithm of daily stroke counts as a function of predictors, including temperature metrics and humidity.</p><p><strong>Results: </strong>A total of 17,755 patients with acute ischaemic stroke (mean age ± SD: 73.1 ± 12.6 years; 41.4% female) were included in the analysis. Lower temperatures were associated with an increased risk of CE and LAA but not with that of SVO. Conversely, higher temperatures were associated with a decreased risk of CE, whereas no association was found with LAA or SVO. The association was observed within 5 days before stroke onset for LAA but after a longer period for CE. The risk of CE increased with rising variability in daily temperature preceding stroke onset.</p><p><strong>Conclusion: </strong>We observed distinct associations between ambient temperature and the risk of ischaemic stroke, contingent upon stroke aetiology, temperature levels, exposure duration, and patient characteristics.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"1-10"},"PeriodicalIF":3.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden of Neurological Disorders in Children and Adolescents (&lt;20 Years Old) in North Africa and the Middle East from 1990 to 2021.","authors":"Reza Mehrizi, Iman Kiani, Ali Golestani, Leila Ghamkhar, Mohammad Effatpanah, Hossein Karami","doi":"10.1159/000545463","DOIUrl":"https://doi.org/10.1159/000545463","url":null,"abstract":"<p><strong>Background: </strong>Neurological disorders impose a significant health burden globally, particularly in regions like North Africa and the Middle East (NAME) with unique healthcare and societal challenges. Despite progress in addressing neurological conditions, understanding the burden in pediatric and adolescent populations remains limited. This study analyzes the trends and burden of neurological conditions in individuals under 20 years old across the NAME super region from 1990 to 2021 using Global Burden of Disease (GBD) data.</p><p><strong>Methods: </strong>GBD 2021 data were analyzed to assess prevalence, incidence, years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life years (DALYs), and mortality rates. The data were stratified by age, sex, and sociodemographic index (SDI). Population attributable fraction was used to estimate the burden attributable to risk factors, and uncertainty intervals (UIs) were calculated using 500 posterior draws, reporting 95% UIs based on the 2.5th and 97.5th percentiles. All visualizations and analyses were conducted using Python (version 3.12.4).</p><p><strong>Results: </strong>Neurological condition prevalence in 2021 was 21,797.5 per 100,000, with tension-type headaches and migraines accounting for the majority of cases. Idiopathic epilepsy remained a leading cause of mortality, although it had a decrease of -50.9% in YLLs compared to 1990. Migraine affected about 9,161.9 per 100,000, increasing by 9.9% from 1990. It also accounted for the highest YLD rate (350.9). Despite decreases in YLLs and deaths, YLDs showed minimal change. Similarly, DALYs did not show significant change from 1990 (17.9%; 95% UI: -12.17 to 36.05). Higher SDI was associated with reduced DALYs but increased prevalence and YLDs.</p><p><strong>Conclusion: </strong>The burden of neurological disorders in pediatric and adolescent populations in NAME highlights regional disparities and the need for targeted healthcare strategies. Enhanced screening, early diagnosis, and management are essential to reducing the burden of these disorders.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"1-18"},"PeriodicalIF":3.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Complex Interplay between Sleep and Neurodegenerative Diseases: An Epidemiological View.","authors":"Melanie Bergmann, Lena Tschiderer, Lisa Seekircher, Joan Santamaria, Federica Provini","doi":"10.1159/000546316","DOIUrl":"10.1159/000546316","url":null,"abstract":"<p><strong>Background: </strong>Sleep disorders and neurodegeneration (NDG) are mutually related but the nature of this relationship is unclear. We aimed to better understand the relationship between sleep and neurodegenerative disease by performing a critical review of epidemiological studies that investigated the association of sleep disorders and the subsequent development of Alzheimer's disease (AD), Parkinson's disease (PD), or general dementia.</p><p><strong>Methods: </strong>We searched for all case-control or prospective cohort studies published in PubMed until August 8 2024 evaluating a series of sleep features and subsequent development of AD, PD, or general dementia over certain observation periods. Patient data, sleep features, and outcome data related to PD, AD, and general dementia were extracted following the PRISMA guidelines. Relative risks for the different NDG diseases were extracted. Study quality was assessed with the Newcastle-Ottawa quality assessment scale.</p><p><strong>Results: </strong>Of 1,139 identified articles 52 were selected from 30 independent studies (29 cohort and one case-control study), including >2.9 million individuals with follow-up periods ranging from 3 to 40 years. The included articles reported on 18,765 AD outcomes, 14,312 PD outcomes, and 100,453 dementia outcomes. Forty-five articles were classified as having a high-quality. Despite that, there was a great variability in the main aim of the studies, the sleep features evaluated, the diagnostic system employed, or the duration of the follow-ups. Only twelve studies assessed sleep with objective measures. The influence of sleep duration and sleep quality, chronotype, and the presence of excessive daytime sleepiness, insomnia, obstructive sleep apnea, snoring, restless legs syndrome showed varying risk ratios or no statistically significant association with PD, AD, and dementia over time.</p><p><strong>Conclusion: </strong>Our systematic review underlines the need for further comprehensive epidemiological studies with homogenous and objective sleep measures to evaluate the different sleep features and understand the relationship between sleep and NDG disease.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"1-28"},"PeriodicalIF":3.2,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, Attitudes, and Practices of Family Members of Cerebral Infarction Patients in Heilongjiang Regarding Recurrence and Secondary Prevention.","authors":"Fei Wang, Jing Shang, Jiarong Wu, Dan Yu, Zhenqi Wang, Xiaolin Lv, Senlin Mao, Ye Chen, Xiaokun Wang","doi":"10.1159/000546247","DOIUrl":"10.1159/000546247","url":null,"abstract":"<p><strong>Introduction: </strong>In China, ischemic stroke has a high recurrence rate, with recurrent events often resulting in greater disability and mortality than initial strokes. This study aimed to evaluate the current knowledge, attitudes, and practices (KAP) of family members of patients with cerebral infarction regarding stroke recurrence and secondary prevention.</p><p><strong>Methods: </strong>A cross-sectional study was conducted from March 2024 to July 2024 in hospitals across Heilongjiang Province. Structured questionnaires were used to collect demographic data and assess KAP scores among family members of patients with cerebral infarction.</p><p><strong>Results: </strong>A total of 561 valid questionnaires were collected. The median scores (25th, 75th percentiles) for KAP were 8 (7, 10) out of 11, 37 (35, 39) out of 45, and 32 (30, 35) out of 40, respectively. Multivariate logistic regression analysis showed that practice scores were independently associated with the following factors: attitude score (OR = 1.218, 95% CI: [1.134, 1.309], p < 0.001), being a farmer (OR = 0.145, 95% CI: [0.033, 0.648], p = 0.011), being retired (OR = 0.097, 95% CI: [0.018, 0.521], p = 0.007), being unemployed (OR = 0.123, 95% CI: [0.027, 0.559], p = 0.007), patient diagnosed with hypertension for less than 1 year (OR = 2.526, 95% CI: [1.157, 5.514], p = 0.020), frequent smoking (OR = 0.436, 95% CI: [0.269, 0.709], p = 0.001), patient occasionally forgetting medication (OR = 0.434, 95% CI: [0.216, 0.874], p = 0.019), patient frequently forgetting or stopping medication (OR = 0.255, 95% CI: [0.108, 0.602], p = 0.002), patient diagnosed with cerebral infarction 2-3 times (OR = 0.497, 95% CI: [0.315, 0.786], p = 0.003), holding a college diploma (OR = 6.634, 95% CI: [1.128, 39.010], p = 0.036), holding a bachelor's degree (OR = 6.434, 95% CI: [1.113, 37.182], p = 0.038), and not living with the patient (OR = 0.326, 95% CI: [0.180, 0.593], p < 0.001).</p><p><strong>Conclusion: </strong>Family members of patients with cerebral infarction demonstrated moderate knowledge, positive attitudes, and proactive practices regarding stroke recurrence and secondary prevention.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"1-16"},"PeriodicalIF":3.2,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Burden of Ischemic Stroke in Middle-Aged Workforce Population, 1990-2021: Systematic Analysis of the Global Burden of Disease Study 2021.","authors":"Guangzhi Hao, Zuolin Shi, Bingying Zhang, Yushu Dong, Guobiao Liang","doi":"10.1159/000546067","DOIUrl":"10.1159/000546067","url":null,"abstract":"<p><strong>Background: </strong>Ischemic stroke remains a major cause of disability worldwide, especially impacting the middle-aged workforce (40-64 years). This study examines the global burden of ischemic stroke within this age group from 1990 to 2021, focusing on the attributable risk factors stratified by age, sex, and sociodemographic index (SDI).</p><p><strong>Methods: </strong>Utilizing data from the Global Burden of Disease (GBD) Study 2021 across 204 countries, the study employed the DisMod-MR 2.1 Bayesian meta-regression model to estimate the incidence, mortality, and disability-adjusted life years (DALYs) related to ischemic stroke. Data were analyzed by age, sex, and SDI categories to reveal variations over time and across regions. The study also assessed 88 risk factors, calculating population attributable fractions for DALYs.</p><p><strong>Results: </strong>In 2021, the global age-standardized incidence, DALY, and mortality rates for ischemic stroke among the middle-aged workforce were 107.5, 736.9, and 17.1 per 100,000, respectively. High-middle SDI countries exhibited the highest incidence and DALY rates, whereas low-middle SDI countries had the highest mortality rate. High SDI countries reported the lowest rates overall. Men, particularly aged 55-64, faced higher rates compared to women. Eastern Europe recorded the highest regional rates, with Turkmenistan showing the highest incidence and DALY rates, and Afghanistan the highest mortality rate. The primary risk factors contributing to DALYs were high systolic blood pressure, high LDL cholesterol, and smoking. In low SDI regions, household air pollution also played a significant role.</p><p><strong>Conclusion: </strong>Despite overall reductions in stroke burden, ischemic stroke remains a significant public health issue, especially in men and high-middle SDI regions. Effective control of major risk factors like high blood pressure, high LDL cholesterol, and smoking is crucial. Customized prevention programs based on regional and economic contexts are essential to address this persistent health challenge.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"1-18"},"PeriodicalIF":3.2,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methods Article for a Study Protocol: Refining Stroke Prediction in Atrial Fibrillation Patients in an Ethnically Diverse Population - A Study Protocol.","authors":"Karim M Mahawish, Irene Zeng, Harvey White, Valery Feigin, Rita Krishnamurthi","doi":"10.1159/000546212","DOIUrl":"10.1159/000546212","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) increases ischaemic stroke (IS) risk, which can be mitigated using risk prediction models to guide anticoagulation decisions. The resultant widespread use of anticoagulants has reduced IS rates globally. However, commonly used risk prediction scores were validated in mainly European cohorts. Cardiology society guidelines recommend the local refinement of such risk scores to improve risk prediction. This study aims (1) to determine trends in the prevalence of AF in IS in Auckland, (2) to perform a validation study of the CHA2DS2-VASc risk score (congestive heart failure, hypertension, age ≥75 [doubled], diabetes, IS/TIA/thromboembolism [doubled] - vascular disease [e.g., ischaemic heart disease and aortic plaque], age 65-74, and sex [female]) and determine if additional ethnicity factors (i.e., Māori and/or Pacific peoples) improve risk prediction, (3) to identify associations with anticoagulant failure (ie, IS on anticoagulation).</p><p><strong>Methods: </strong>This study will utilise data from the Auckland Regional Community Stroke Study (ARCOS IV [2011-12] and V [2020-21], respectively), a comprehensive registry of stroke patients. The comparative controls will be Auckland residents diagnosed with AF between 1988 and 2020, sampled from the National Minimum Dataset (NMD) - a database of hospital discharge codes collated by Manatū Hauora (the New Zealand Ministry of Health). Firstly, we will investigate trends in the prevalence of AF in IS in ARCOS IV and V. Secondly, we will use a nested case-control design by combining ARCOS V and NMD to determine the model performance of CHA2DS2-VASc and risk score refinements stratified by ethnicity. The effect of (a) stroke aetiology, (b) antithrombotic prescribing factors, and (c) potential interactions will also be assessed in the data analysis. Based on sample size estimations, we will require a sample of 1,493 controls and 374 cases with IS/TIA.</p><p><strong>Conclusion: </strong>Utilising data from three datasets will allow us to assess the burden and management of AF at a population level, identify trends in disease, address knowledge gaps in the management of ethnically diverse populations, and explore associations with treatment failure. Our reporting will adhere to the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) guidelines.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"1-9"},"PeriodicalIF":3.2,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Trends in the Burden of Migraine in China: A Comprehensive Analysis from 1990 to 2021 and Projections to 2035.","authors":"Cifeng Zhang, Xiaoping Wang","doi":"10.1159/000545886","DOIUrl":"10.1159/000545886","url":null,"abstract":"<p><strong>Introduction: </strong>Migraine is a widespread neurological disorder that significantly affects quality of life. However, data on its burden in China remain limited. This study analyzes long-term trends (1990-2021) and projects future patterns.</p><p><strong>Methods: </strong>Using the Global Burden of Disease (GBD) 2021 database, we examined migraine incidence, prevalence, and disability-adjusted life-years (DALYs). Temporal trends were assessed via joinpoint regression, while age-period-cohort (APC) analysis and decomposition analyses identified key influences. Bayesian APC modeling projected future trends through 2035.</p><p><strong>Results: </strong>Migraine imposes a substantial health burden in China, with an annual incidence of 13.04 million cases, a prevalence of 184.75 million cases, and 6.98 million DALYs cases. Females are disproportionately affected, with peak prevalence occurs in the 30-49 age group. Individuals born post-1960 show increased susceptibility, as linked to demographic and lifestyle shifts. Population growth is a major driver of rising prevalence, with projections indicating a continued increase through 2035.</p><p><strong>Conclusion: </strong>Migraine remains a significant public health concern in China, particularly among women. Targeted prevention, early detection, and intervention strategies are essential to mitigate its growing burden.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"1-13"},"PeriodicalIF":3.2,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"All-Cause and Cause-Specific Mortality in Parkinson's Disease: A Meta-Analysis.","authors":"Young Ho Lee, Gwan Gyu Song","doi":"10.1159/000546136","DOIUrl":"10.1159/000546136","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess the overall and cause-specific standardized mortality ratios (SMRs) in patients diagnosed with Parkinson's disease (PD).</p><p><strong>Methods: </strong>A systematic review was conducted, focusing on studies that evaluated SMRs for all-causes and specific causes in PD patients compared to the general population. Searches were performed extensively in Medline, Embase, and Cochrane databases to compile relevant literature. A meta-analysis was subsequently conducted to evaluate all-cause, sex-specific, region-specific, and cause-specific SMRs in individuals with PD.</p><p><strong>Results: </strong>Twenty-one studies including 26,114 PD patients and 10,247 deaths from 12 European, 4 Asian, 3 Oceanian, 1 North American, and 1 Middle Eastern country met the inclusion criteria. The overall SMR analysis revealed that PD patients exhibited a 1.617-fold higher risk of all-cause mortality compared to the general population (SMR 1.617, 95% confidence interval [CI] 1.295-2.020, p < 0.001). Region-specific analysis showed significant SMR increases across all regions. Sex-specific analysis indicated elevated SMRs for both women (SMR 1.702, 95% CI 1.426-2.033, p < 0.001) and men (SMR 1.588, 95% CI 1.365-1.848, p < 0.001). PD onset before 60 years of age was associated with a higher, albeit not statistically significant, SMR compared to onset after 60 (SMR 1.991, 95% CI 1.313-3.021 vs. SMR 1.589, 95% CI 1.109-2.277). Cause-specific analyses revealed significantly increased SMRs for pneumonia (SMR 3.414, 95% CI 2.227-5.234, p < 0.001), cerebrovascular accidents (CVAs) (SMR 1.484, 95% CI 1.048-2.102, p = 0.026), cardiovascular disease (SMR 1.449, 95% CI 1.156-1.816, p = 0.001), and suicide (SMR 2.049, 95% CI 1.383-3.035, p < 0.001), with no significant increase observed for cancer-related mortality.</p><p><strong>Conclusion: </strong>These findings highlight the increased mortality risk in PD patients, particularly due to causes such as pneumonia and CVA.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"1-12"},"PeriodicalIF":3.2,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Well Do Essential Tremor Patients Report whether or Not They Have Parkinson's Disease? Validity of Self-Report Data from a Large Cohort Study.","authors":"Elan D Louis, Vibhash D Sharma, Ethan Wainman, Ericka D Carter, Tomer O Guy, Nora C Hernandez, Diane S Berry, Stephanie Cosentino","doi":"10.1159/000546137","DOIUrl":"10.1159/000546137","url":null,"abstract":"<p><strong>Background/objective: </strong>In clinical and research studies in which one is dealing with essential tremor (ET) patients, the identification of related conditions, such as Parkinson's disease (PD), is important. A reasonable starting point is to directly ask the patient about their disease status. We are not aware of studies on the validity of ET patients' self-reports of PD (i.e., ETPD). Our aim was to assess the validity of a self-report of PD in this setting.</p><p><strong>Methods: </strong>ET cases were enrolled in a prospective study. At each visit, they were asked, \"Have you been diagnosed with Parkinson's disease?\", a videotaped neurological examination was performed, and PD diagnoses (i.e., ETPD) were assigned by a senior movement disorders neurologist.</p><p><strong>Results: </strong>291 ET cases underwent 899 study evaluations. Seven cases were diagnosed with ETPD. Summing data across all cases and all study evaluations, sensitivity = 56.3% and specificity = 98.1%. The positive predictive value of a report of PD was low (36.0%), whereas the negative predictive value of a report of no PD was high (99.2%).</p><p><strong>Conclusions: </strong>Screening, in general, can be a difficult process, but in the setting of ET and PD, the issues are particularly challenging. Our overarching goal is to fill a gap in knowledge and inform clinical researchers and treating physicians who are working with tremor populations. Although some information is garnered from asking ET patients whether they have been diagnosed with ETPD, the low sensitivity and low positive predictive values indicate that the value of self-reported PD diagnoses is limited.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"1-7"},"PeriodicalIF":3.2,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of a Modified Version of the Charlson Comorbidity Index in Predicting Multiple Sclerosis Disability Accrual.","authors":"Salvatore Iacono, Giuseppe Schirò, Paolo Aridon, Michele Andolina, Gabriele Sorbello, Andrea Calì, Marco D'Amelio, Giuseppe Salemi, Paolo Ragonese","doi":"10.1159/000539829","DOIUrl":"https://doi.org/10.1159/000539829","url":null,"abstract":"<p><strong>Background: </strong>The natural history of multiple sclerosis (MS) is highly heterogeneous and almost unpredictable since several factors may affect the disease course including comorbidities. The aims of this study were to predict the risk of disability worsening and disease progression at the first patient's visit by using a modified version of the Charlson Comorbidity Index (mCCI).</p><p><strong>Methods: </strong>the mCCI was obtained by incorporating the grade of pyramidal functional system scores extracted by the Expanded Disability Status Scale (EDSS) into the original CCI version. The risk of reaching EDSS 4, EDSS 6, and secondary MS progression (SPMS) associated to mCCI classes was calculated by carrying out multivariable Cox-regression models and it was reported as hazard ratios (HRs) and 95% confidence intervals (95% CIs). The accuracy of mCCI for the recognition of individuals who reached the study milestones was estimated by building the receiving operator curves and the optimal cut-off values were estimated.</p><p><strong>Results: </strong>A total of n = 622 individuals were enrolled (72.7% women; median age 30.8 years [24-40]). Compared with patients with a mCCI equal to zero, the HRs for those with a mCCI comprised between 1 and 2 at the first visit were 1.53 (1.1-2.1), 2.17 (1.48-2.96), and 1.57 (1.16-2.1) for the reaching of EDSS 4, EDSS 6, and SPMS, respectively. Moreover, individuals with a mCCI equal or higher than 3 were at even higher risk of reaching EDSS 6 (HR = 2.34 [1.44-3.8]) and SPMS conversion (HR = 2.38 [1.29-4.01]). The mCCI cut-off value of 3 reached a sensitivity and specificity of 88.1% and 77.8%, respectively, for the recognition of EDSS 4, while the mCCI cut-off of 4 reached a sensitivity of 83.1% and a specificity of 80.7% for the recognition of EDSS 6 and a sensitivity and a specificity of 76.8% and 87.5%, respectively, for the recognition of SPMS conversion.</p><p><strong>Conclusion: </strong>mCCI appeared a simple and fast tool for the prediction of MS prognosis since the first patient's visit and its best cut-off values showed higher sensitivity and specificity for the recognition of patients who undergo disability worsening and SPMS conversion.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"1-11"},"PeriodicalIF":3.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}