Canadian Journal of Neurological Sciences最新文献

{"title":"Longest Intracranial/Subarachnoid Cranial Nerve.","authors":"Onder Ertem","doi":"10.1017/cjn.2025.10508","DOIUrl":"https://doi.org/10.1017/cjn.2025.10508","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Mixed Perfusion Pattern on Single-Photon Emission CT in Hashimoto's Encephalopathy.","authors":"Taiki Matsubayashi, Ryoko Muramatsu, Misako Furuki, Masato Obayashi","doi":"10.1017/cjn.2026.10534","DOIUrl":"10.1017/cjn.2026.10534","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-2"},"PeriodicalIF":2.2,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographic Differences in Healthcare Utilization Outcomes in Ischemic Stroke: A Population-Level Study from Manitoba.","authors":"Angela Buchel, Anwer Zohaib Siddiqi, Esseddeeg Ghrooda, Anurag Trivedi, Ankur Wadhwa, Claudia Candale-Radu, Radhika Kadangot, Babawale Arabambi, Chetan Vekhande, Naveed Akhtar, Nima Kashani, Nishita Singh","doi":"10.1017/cjn.2026.10533","DOIUrl":"10.1017/cjn.2026.10533","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate differences in healthcare utilization among patients with ischemic stroke in metropolitan versus non-metropolitan Manitoba.</p><p><strong>Methods: </strong>This study is a population-level analysis using the Discharge Abstract Database from Manitoba. The database includes all patients who received care in a Manitoba facility for ischemic stroke between April 2019 and March 2023. Data were collected on patient demographics, comorbidities and geographical location of stroke presentation (metropolitan Winnipeg vs non-metropolitan). Outcomes included length of stay (LOS), treatment, discharge disposition and mortality. Regression analysis was performed to analyze outcomes, adjusting for age, sex and comorbidities.</p><p><strong>Results: </strong>3704 (71.6%) patients were admitted in Winnipeg, and 1471 (28.4%) patients were admitted in non-metropolitan Manitoba. Patients presenting to Winnipeg were younger (mean age 72.3 vs 74.3 years) and had higher rates of atrial fibrillation, hypertension, diabetes, chronic kidney disease and heart failure. Patients presenting to Winnipeg had a shorter LOS (16.1 days vs 18.4 days, coefficient 0.05, 95% CI -4.54 to -1.27), had higher rates of intravenous thrombolysis (adjOR 5.13, 95% CI 3.85-6.84), were less likely to be discharged home (39.8% vs 57.5%, adjOR 0.47, 95% CI 0.41-0.53) and were more likely to be transferred for inpatient stroke rehabilitation (adjOR 3.46, 95% CI 2.64-4.54). There were no differences in in-hospital mortality. There was a higher incidence of stroke in Winnipeg compared to non-metropolitan Manitoba (<i>F</i>-statistic 23.84, <i>p</i> = 0.0028).</p><p><strong>Conclusions: </strong>This study illustrates differences in healthcare utilization outcomes between patients living in metropolitan Winnipeg versus non-metropolitan Manitoba presenting with ischemic stroke.</p>","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-7"},"PeriodicalIF":2.2,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146004787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived Cognitive Fatigability in Multiple Sclerosis: Input from People with Lived Experience on Unmet Needs.","authors":"Tamanna Islam, Jason A Berard, Lisa A S Walker","doi":"10.1017/cjn.2026.10531","DOIUrl":"10.1017/cjn.2026.10531","url":null,"abstract":"<p><strong>Purpose: </strong>Cognitive fatigability (CF), which refers to a decline in performance during sustained cognitive effort, can significantly impact people with multiple sclerosis (PwMS). This study examined the unmet needs related to perceived CF in PwMS.</p><p><strong>Methods: </strong>One hundred PwMS completed a survey assessing factors known to contribute to CF. Participants indicated whether each factor, including CF itself, was disruptive and whether adequate support was available to address these concerns. A factor identified as disruptive and insufficiently addressed was considered an unmet need (Need Index [NI] ≥50%).</p><p><strong>Results: </strong>Group-level analysis revealed no significant unmet needs, although fatigue (NI = 30.23), CF (NI = 22.96) and physical activity (NI = 19.55) were more frequently reported. Individual-level analyses revealed that unmet needs varied by community setting (rural vs urban) and socioeconomic status (SES) (lower vs higher SES), with rural participants and those with lower SES reporting higher rates of unmet needs. In addition, PwMS who indicated CF was an unmet need reported more difficulties across most contributory factors, including <i>sleep quality</i>, <i>fatigue</i>, <i>cognitive impairment</i>, <i>depression</i> and <i>contextual factors</i>. The presence of fatigue and CF combined contributed to greater unmet needs across various domains, especially <i>fatigue</i>, <i>CF</i> and <i>cognitive impairment</i>, compared to fatigue alone.</p><p><strong>Conclusions: </strong>Participants from rural and low socioeconomic backgrounds were more likely to have unmet needs. Notably, 36% of participants (<i>N</i> = 33) reported unmet needs related to perceived CF. The findings highlight the importance of tailoring future interventions to address identified needs more adequately.</p>","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-10"},"PeriodicalIF":2.2,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146004816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reviewer Comment on Randall et al. \"Calcitonin Gene-Related Peptide Inhibitor Use in 2018-2023: A Retrospective Cohort Study Across Six Canadian Provinces\".","authors":"Ioana Medrea","doi":"10.1017/cjn.2025.10507","DOIUrl":"https://doi.org/10.1017/cjn.2025.10507","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146004835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CAPS Plus: A Clinical Biomarker Scoring System to Predict Aβ Positivity and Facilitate Enrollment in Anti-Amyloid Clinical Trials.","authors":"Durjoy Lahiri, Jennifer Cooper, Bruna Seixas-Lima, Carlos Roncero, Cheryl Wellington, Howard Cherktow","doi":"10.1017/cjn.2026.10530","DOIUrl":"10.1017/cjn.2026.10530","url":null,"abstract":"<p><strong>Background: </strong>A critical step toward determining eligibility for experimental and clinical treatment with anti-amyloid therapies in Alzheimer's disease (AD) is to select appropriate subjects having a high likelihood of being Aβ+. We propose a clinical biomarker composite score, named Clinical β-Amyloid Positivity Prediction Score Plus (CAPS Plus), for Aβ+ prediction in people presenting with clinical Alzheimer's syndrome including both prodromal and mild AD.</p><p><strong>Methods: </strong>The original CAPS incorporated scores from the neuropsychiatry inventory questionnaire, mini-mental state examination score loss per year and Fazekas score. Plasma p-tau-217, a novel addition to CAPS, was measured using the Simoa HD-X with the AlzPATH p-tau217 Advantage Plus assay. To incorporate p-tau-217 into CAPS Plus, an intra-cohort cut-off (>0.698 pg/ml) for p-tau217 was generated using logistic regression and Yoden's index. CAPS Plus had a maximum score of 5, with those ≥4 indicating a high probability of being Aβ+. The accuracy of CAPS Plus was computed through logistic regression and area under the receiver operating characteristic curve (AUROC) analysis.</p><p><strong>Results: </strong>Of <i>n</i> = 44 patients, <i>n</i> = 25 (57%) were Aβ+. Plasma p-tau-217 was significantly higher in the Aβ+ subgroup (1.36 vs 0.46 pg/mL, <i>p</i> < 0.0001). The AUROC was 0.89 for a CAPS Plus score of 4 or more, suggesting excellent discrimination and improving the accuracy of the original CAPS (0.86). CAPS Plus has a notably better specificity (89%) than the original CAPS (80%) and p-tau-217 alone (74%).</p><p><strong>Conclusion: </strong>CAPS Plus is potentially a useful screening tool for enrollment in anti-Aβ therapy and clinical trials for AD, specifically addressing people with prodromal and mild AD.</p>","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-8"},"PeriodicalIF":2.2,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146004771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Value of Brain T2* Weighted and FLAIR Imaging for Diagnosing Amyotrophic Lateral Sclerosis.","authors":"Portia Cooper, Mindy Lu, Michael Chan, Alan Wilman, Sanjay Kalra, Amer A Ghavanini","doi":"10.1017/cjn.2026.10527","DOIUrl":"10.1017/cjn.2026.10527","url":null,"abstract":"<p><strong>Objectives: </strong>Early diagnosis of amyotrophic lateral sclerosis (ALS) is essential for treatment initiation and symptom management, yet it remains challenging due to nonspecific symptoms and the lack of reliable diagnostic biomarkers. Although conventional MRI sequences such as T2* weighted and fluid-attenuated inversion recovery (FLAIR) have shown potential in identifying upper motor neuron abnormalities, their diagnostic utility in ALS is not well established. This study aimed to evaluate the sensitivity and specificity of brain T2* weighted and FLAIR MRI sequences in diagnosing ALS using prospectively collected data and to assess associations with disease severity.</p><p><strong>Methods: </strong>Data were analyzed from 20 patients with ALS and 20 healthy controls enrolled at the Edmonton site of the Canadian ALS Neuroimaging Consortium 1 (CALSNIC-1) study. Single-slice 2D axial susceptibility-weighted echo planar imaging (SWEPI) and FLAIR images were independently rated by a blinded neurologist and radiologist for signs of corticospinal tract and motor cortex abnormalities. Sensitivity and specificity were calculated, and linear regression was used to examine associations with ALS Functional Rating Scale-Revised (ALSFRS-R) scores.</p><p><strong>Results: </strong>T2* weighted and FLAIR MRI sequences showed high specificity (0.95 and 0.85, respectively) but low sensitivity (both 0.25) for ALS diagnosis. No significant correlation was found between imaging abnormalities and ALSFRS-R scores. Inter-rater reliability was poor (<i>κ</i> = 0.25 for SWEPI; <i>κ</i> = 0.14 for FLAIR).</p><p><strong>Conclusion: </strong>While T2* weighted and FLAIR MRI sequences may have some specificity for ALS, our study suggests they are not sufficiently sensitive to be used as reliable diagnostic tools for ALS.</p>","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-6"},"PeriodicalIF":2.2,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reviewer Comment on Kamal et al. \"Geographic modeling of EVT access across Canada demonstrates need to lower door-in-door-out times\".","authors":"Sucharita Ray","doi":"10.1017/cjn.2025.10496","DOIUrl":"https://doi.org/10.1017/cjn.2025.10496","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145968002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antecedents and Potential Risk Factors for Temporal Lobe Epilepsy: Data From a Canadian Epilepsy Clinic.","authors":"Huda Matbuli, Jill Koebel, Lysa Boissé Lomax, Gavin Paul Winston, Garima Shukla","doi":"10.1017/cjn.2025.10517","DOIUrl":"10.1017/cjn.2025.10517","url":null,"abstract":"<p><strong>Background: </strong>Despite extensive research on temporal lobe epilepsy (TLE), most work focuses on treatment outcomes and their determinants. Detailed evaluation of causal factors has not been adequately addressed in most published studies. This study aimed to explore potential etiologic risk factors for TLE through a chart review of prospectively collected data from a Canadian epilepsy clinic.</p><p><strong>Methods: </strong>Consecutive patients diagnosed with TLE at a Canadian epilepsy clinic were included. Consecutive patients with genetic generalized epilepsy (GGE) served as a comparison group. The study database comprised prospectively collected demographic and epilepsy data, including birth history, development, antecedents, imaging and EEG findings. Statistical analysis compared antecedent factors between the TLE and GGE groups.</p><p><strong>Results: </strong>Eighty-nine TLE patients (mean age 42.3 ± 15.9 years, 45M), and 69 GGE patients (mean age 32.8 ± 14 years, 36M) were included. TLE was strongly associated with prior significant head trauma (<i>p</i> < 0.001) and seizure following major neurological insult (<i>p</i> = 0.044). MRI showed mesial temporal sclerosis in 13 TLE patients (14.6%) and was normal in 45 (50.5%). Among EEG abnormalities in TLE, 48% localized to the posterior temporal region.</p><p><strong>Conclusion: </strong>Significant head trauma and early post-insult seizures were the strongest associated risk factors for TLE in this Canadian cohort.</p>","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-8"},"PeriodicalIF":2.2,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microvascular Decompression for Glossopharyngeal Neuralgia and Hemi-Laryngopharyngeal Spasm Syndrome.","authors":"Patrick Toyota, Braeden Newton, Eva Liu, Nicole Coote, Alexander David Rebchuk, Jonathan A Norton, Amit R L Persad, Aleksander Vitali","doi":"10.1017/cjn.2025.10504","DOIUrl":"https://doi.org/10.1017/cjn.2025.10504","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-3"},"PeriodicalIF":2.2,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}