Canadian Journal of Neurological Sciences最新文献

{"title":"Assessing Motor Cortex Excitability and Its Relationship with Cortical Atrophy in Alzheimer's Dementia.","authors":"Renée P Lawson, Reza Zomorrodi, Michael Joseph, Hiba Alhabbal, Gifty Asare, Daniel M Blumberger, Zafiris J Daskalakis, Corinne E Fischer, Benoit H Mulsant, Bruce G Pollock, Tarek K Rajji, Aristotle N Voineskos, Sanjeev Kumar","doi":"10.1017/cjn.2025.79","DOIUrl":"https://doi.org/10.1017/cjn.2025.79","url":null,"abstract":"<p><strong>Background: </strong>Cortical excitability has been proposed as a novel neurophysiological marker of neurodegeneration in Alzheimer's dementia (AD). However, the link between cortical excitability and structural changes in AD is not well understood.</p><p><strong>Objective: </strong>To assess the relationship between cortical excitability and motor cortex thickness in AD.</p><p><strong>Methods: </strong>In 62 participants with AD (38 females, mean ± SD age = 74.6 ± 8.0) and 47 healthy control (HC) individuals (26 females, mean ± SD age = 71.0 ± 7.9), transcranial magnetic stimulation resting motor threshold (rMT) was determined, and T1-weighted MRI scans were obtained. Skull-to-cortex distance was obtained manually for each participant using MNI coordinates of the motor cortex (x = -40, y = -20, z = 52).</p><p><strong>Results: </strong>The mean skull-to-cortex distances did not differ significantly between participants with AD (22.9 ± 4.3 mm) and HC (21.7 ± 4.3 mm). Participants with AD had lower motor cortex thickness than healthy individuals (<i>t</i>(92) = -4.4, <i>p</i> = <0.001) and lower rMT (i.e., higher excitability) than HC (<i>t</i>(107) = -2.0, <i>p</i> = 0.045). In the combined sample, rMT was correlated positively with motor cortex thickness (<i>r</i> = 0.2, <i>df</i> = 92, <i>p</i> = 0.036); however, this association did not remain significant after controlling for age, sex and diagnosis.</p><p><strong>Conclusions: </strong>Patients with AD have decreased cortical thickness in the motor cortex and higher motor cortex excitability. This suggests that cortical excitability may be a marker of neurodegeneration in AD.</p>","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-8"},"PeriodicalIF":2.9,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251049","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":"Nerve ultrasound of multifocal motor neuropathy, motor and typical chronic inflammatory demyelinating neuropathy.","authors":"Jingwen Niu, Qingyun Ding, Nan Hu, Liying Cui, Mingsheng Liu","doi":"10.1017/cjn.2025.10136","DOIUrl":"https://doi.org/10.1017/cjn.2025.10136","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-22"},"PeriodicalIF":2.9,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251051","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":"Rural Field Consultation for Remote Acute Stroke Transport Decisions.","authors":"Marie-Andrée Panzini, Mary-Lou Halabi, Jillian Stang, Jessalyn K Holodinsky, Annette Bredenkamp, Shannon Erfle, Balraj Mann, Gregory Vogelaar, John Montpetit, Thomas Jeerakathil, Brian H Buck, Aravind Ganesh, Andrew M Demchuk, Michael D Hill","doi":"10.1017/cjn.2025.10138","DOIUrl":"10.1017/cjn.2025.10138","url":null,"abstract":"<p><strong>Background: </strong>The best prehospital transport strategy for patients with suspected stroke due to possible large vessel occlusion varies by jurisdiction and available resources. A foundational problem is the lack of a definitive diagnosis at the scene. Rural stroke presentations provide the most problematic triage destination decision-making. In Alberta, Canada, the implementation and 5-year experience with a rural field consultation approach to provide service to rural patients with acute stroke is described.</p><p><strong>Methods: </strong>The protocols established through the rural field consultation system and the subsequent transport patterns for suspected stroke patients during the first 5 years of implementation are presented. Outcomes are reported using home time and data are summarized using descriptive statistics.</p><p><strong>Results: </strong>From April 2017 to March 2022, 721 patients met the definition for a rural field consultation, and 601 patients were included in the analysis. Most patients (<i>n</i> = 541, 90%) were transported by ground ambulance. Intravenous thrombolysis was provided for 65 (10.8%) of patients, and 106 (17.6%) underwent endovascular thrombectomy. The median time from first medical contact to arterial access was 3.2 h (range 1.3-7.6) in the direct transfers, compared to 6.5 h (range 4.6-7.9) in patients arriving indirectly to the comprehensive stroke center (CSC). Only a small proportion of patients (<i>n</i> = 5, 0.8%) were routed suboptimally to a primary stroke center and then to a CSC where they underwent endovascular therapy.</p><p><strong>Conclusions: </strong>The rural field consultation system was associated with shortened delays to recanalization and demonstrated that it is feasible to improve access to acute stroke care for rural patients.</p>","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-7"},"PeriodicalIF":2.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210377","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":"Comparing clinical and kinematic based botulinum toxin injections for cervical dystonia therapy.","authors":"Olivia Samotus, Keith Sequeira, Mandar Jog","doi":"10.1017/cjn.2025.10109","DOIUrl":"https://doi.org/10.1017/cjn.2025.10109","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-19"},"PeriodicalIF":2.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210376","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":"Focused Ultrasound Thalamotomy for Essential Tremor in Patients on Anticoagulation: Case Report in a Patient with Factor V Leiden Mutation and Review of the Literature.","authors":"Vishal V Thakur, David M Fletcher, Ann Murray, Manish Ranjan","doi":"10.1017/cjn.2025.10130","DOIUrl":"10.1017/cjn.2025.10130","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-3"},"PeriodicalIF":2.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183339","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":"Checkerboard Visual Field Deficit in Bilateral Occipital Strokes.","authors":"Chijindu A Ukagwu, Anish Kapadia, Rahul A Sharma","doi":"10.1017/cjn.2025.10132","DOIUrl":"10.1017/cjn.2025.10132","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-2"},"PeriodicalIF":2.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183112","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":"Midbrain Atrophy in Mills Syndrome: A Rare Finding Pointing to Diagnosis.","authors":"Arnab Adhya, Supriya Uppula, Surojit Raidas, Anu Gupta, Rajesh Kumar Singh, Deepti Vibha, Ajay Garg, Manjari Tripathi","doi":"10.1017/cjn.2025.10135","DOIUrl":"10.1017/cjn.2025.10135","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-2"},"PeriodicalIF":2.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181505","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":"New Perspectives on Parkinson's Disease Subtyping: A Narrative Review.","authors":"Charlie Buchmann, Manon Bouchard","doi":"10.1017/cjn.2025.10134","DOIUrl":"https://doi.org/10.1017/cjn.2025.10134","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-28"},"PeriodicalIF":2.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182836","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":"Study of the Spectrum of Treatable Dementias: Insights from a Large South Asian Cohort (TREAT-Dem Study).","authors":"M M Samim, Faheem Arshad, Pallavi N Sastry, B S Keerthana, Aparna Somaraj, Sarath Govindaraj, Sandeep S Kumar, Priya Treesa Thomas, Subasree Ramakrishnan, Anita Mahadevan, Suvarna Alladi","doi":"10.1017/cjn.2025.10133","DOIUrl":"10.1017/cjn.2025.10133","url":null,"abstract":"<p><strong>Background and purpose: </strong>Dementia affects millions globally, with a subset of cases potentially reversible. This study evaluates the incidence, clinical markers and treatment outcomes of reversible dementias (ReDem).</p><p><strong>Method: </strong>This retrospective study included 370 ReDem cases from 1810 dementia patients. The ReDem cohort was split into potentially reversible dementias (PRD) and dual etiology (DE) groups. PRD encompassed secondary, potentially treatable dementia conditions, while DE included primary degenerative dementia (DD) with ≥1 uncontrolled comorbidity or new disease that worsened symptoms.</p><p><strong>Results: </strong>ReDem cases comprised 20.4% (<i>n</i> = 370 out of 1810) of dementia patients, with ReDem patients being younger (mean 56.2 vs. 61.9 years, <i>p</i> < 0.001) and exhibiting shorter illness durations than DD patients (<i>p</i> < 0.001). Key red flags, including young age (<45 years) at onset (DD = 8.6% vs. ReDem = 18.1%), fluctuation in symptoms (DD = 3.4% vs. ReDem = 11.6%), rapid cognitive decline (DD = 6.9% vs. ReDem = 18.4), high-risk exposures (DD = 0.1% vs. ReDem = 0.8%), high-risk behavior (DD = 0.1% vs. ReDem = 2.4%) and incongruent neuropsychological findings(DD = 1.0% vs. 12.7%), were significantly more frequent in ReDem cases (<i>p</i> < 0.05). Odds increased with each red flag present (≥1: OR = 5.94; ≥2: OR = 20.69; ≥3: OR = 25.14, <i>p</i> < 0.05). Reversible etiologies included immune (20.0%), neuroinfectious (6.6%), psychiatric (7.6%), nutritional/metabolic (10.5%), neurosurgical (14.6%) and other causes (12.2%). Of the 41% (152/370) followed, 19 expired, 63.9% (85/133) reported subjective improvement, and 31.6% (42/133) showed clinical dementia rating improvement.</p><p><strong>Discussion and conclusion: </strong>This large-scale study underscores the importance of comprehensive diagnostic evaluations for ReDem. Identifying and treating reversible conditions and comorbidities in DD can improve patient outcomes, emphasizing the need for thorough evaluations in memory clinics and targeted interventions in dementia care.</p>","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-11"},"PeriodicalIF":2.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183071","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":"Peer-Reviewing for the <i>Canadian Journal of Neurological Sciences</i>.","authors":"Yasamin Mahjoub, Amy Y X Yu, Jodie I Roberts, Tejas Sankar","doi":"10.1017/cjn.2025.10131","DOIUrl":"10.1017/cjn.2025.10131","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-5"},"PeriodicalIF":2.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181038","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}