Acta Neurologica Scandinavica最新文献

{"title":"Psychometric Properties of the Persian Multiple Sclerosis Vision Questionnaire in People With Multiple Sclerosis: A Cross-Sectional Study","authors":"Mohammad Mohammadi,&nbsp;Aysa Shaygannejad,&nbsp;Amirhosein Mahboubi Vand,&nbsp;Saeed Vaheb,&nbsp;Aynaz Mohammadi,&nbsp;Vahid Shaygannejad,&nbsp;Omid Mirmosayyeb","doi":"10.1155/ane/5660710","DOIUrl":"https://doi.org/10.1155/ane/5660710","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Up to 80% of people with multiple sclerosis (PwMS) experience various visual symptoms. The MS Vision Questionnaire (MSVQ-7) is a self-report tool that assesses visual function in PwMS. This study is aimed at validating the MSVQ-7 in Persian-speaking PwMS and comparing its screening ability with the National Eye Institute Visual Function Questionnaire (NEI VFQ-25).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A total of 140 PwMS were enrolled in this study. All participants completed the MSVQ-7 (higher scores indicate worse visual symptoms) and the NEI VFQ-25 (lower scores indicate worse visual symptoms). Reliability was assessed using Cronbach′s alpha. Exploratory factor analysis (EFA) was used to evaluate the structural validity. To assess convergent validity, correlations between the MSVQ-7 and the NEI VFQ-25 were examined. Receiver operating characteristic (ROC) curve analysis was used to compare the MSVQ-7 and NEI VFQ-25 in classifying PwMS by optic neuritis (ON) history.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The Persian MSVQ-7 demonstrated excellent reliability (Cronbach^′s alpha = 0.852). Test–retest reliability was excellent (ICC = 0.980; SEM = 0.65; MDC = 1.80), derived from the 63-participant retest subsample. The EFA revealed a unidimensional structure for the Persian MSVQ-7. There was a negative correlation between the MSVQ-7 and the NEI VFQ-25 (<i>r</i> = −0.72, <i>p</i> &lt; 0.001). The ROC curve analysis showed that the MSVQ-7 (AUC = 0.901, sensitivity = 98.3<i>%</i>, and specificity = 71.2<i>%</i>) had better screening ability than the NEI VFQ-25 (AUC = 0.826, sensitivity = 68.8<i>%</i>, and specificity = 83.3<i>%</i>) for classifying PwMS based on having ON history.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>MSVQ-7 is a valid and reliable patient-reported outcome measure in Persian PwMS. Its high sensitivity makes it an effective screening tool for assessment of visual function.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/5660710","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149145970","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":"Cognitive Impairment After Minor Stroke: Exploring Prevalence and Associations With WMH, Stroke Location, and Subtype","authors":"Vera Solianik,&nbsp;Åse Hagen Morsund,&nbsp;Magnus Tallaksen Reiestad,&nbsp;Halvor Næss,&nbsp;Rune Midgard,&nbsp;Ramune Grambaite","doi":"10.1155/ane/5290808","DOIUrl":"https://doi.org/10.1155/ane/5290808","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study is aimed at examining the prevalence of cognitive impairment following minor stroke and its associations with stroke subtype, location, and pre-existing vascular pathology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>We included 305 patients from stroke units at the Central Norway Health Trust and from Haukeland University Hospital. MRI was performed using 1.5-T scanners as part of the routine stroke protocol during hospitalization at stroke units at baseline. Minor stroke was classified according to NIHSS 0–7 and mRS 0–2. We registered left versus right hemispheric location as well as Fazekas classification of pre-existing white matter hyperintensities (WMHs). Study patients underwent cognitive assessment 3 months after the stroke using a wide range of neuropsychological tests. Cognitive impairment was defined as performance 1.5 SD below the norm-based average on ≥ 2 tests. Chi-square and regression analyses were conducted to consider the associations between cognitive impairment and WMH and infarction subtype and location.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>78.4% of participants had impaired results on at least one test, and 62% had impaired results on ≥ 2 tests. WMH and several infarction locations were associated with impaired cognitive performance in the initial analyses, but only the association between supratentorial infarctions and impaired memory recall remained significant after Benjamini–Hochberg correction. Higher education was associated with lower risk of impaired cognitive performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings showed a high prevalence of cognitive impairment 3 months after minor stroke in a younger cohort, largely irrespective of stroke location and subtype. Such substantial cognitive burden should be taken into consideration during clinical stroke assessment, while also accounting for demographic variables such as education. In future research, longer follow-up periods may provide a more nuanced understanding of the trajectory of cognitive impairment after minor stroke.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/5290808","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149146723","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":"MicroRNA-3651 Facilitates Glioma Progression by Targeting SCN3B and Serves as a Prognostic Indicator","authors":"Jun Wang,&nbsp;Yijun Deng,&nbsp;Dekang Nie,&nbsp;Guan Sun,&nbsp;Wei Zeng","doi":"10.1155/ane/7350637","DOIUrl":"https://doi.org/10.1155/ane/7350637","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study is aimed at ascertaining the expression, clinical implications, and cellular functions of miR-3651 in glioma, as well as its potential target gene, <i>Sodium Voltage-Gated Channel Beta Subunit 3</i> (<i>SCN3B</i>).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The expression of serum miR-3651 was determined in glioma using qRT-PCR. The relationship between miR-3651 expression and clinicopathological factors was assessed. Additionally, its prognostic value was evaluated using Cox regression analysis. The effects of miR-3651 on cellular processes were investigated, and its direct interaction with <i>SCN3B</i> was confirmed through a dual-luciferase reporter assay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with glioma exhibited significantly elevated serum levels of miR-3651, which were strongly correlated with higher WHO grades, decreased KPS scores, and poorer prognoses (<i>p</i> &lt; 0.001). It was established that miR-3651 serves as an independent predictor of clinical outcomes in glioma (HR = 5.387, <i>p</i> &lt; 0.001). Inhibition of miR-3651 expression significantly reduced the proliferation, migration, and invasion of glioma cells while promoting apoptosis. The direct targeting of <i>SCN3B</i> by miR-3651 was confirmed, revealing that <i>SCN3B</i> expression was downregulated in glioma. Rescue experiments indicated that the overexpression of <i>SCN3B</i> counteracted the antitumor effects of the miR-3651 inhibitor.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>miR-3651 is a potential prognostic marker for gliomas by targeting SCN3B to promote tumor progression. However, these findings are based on serum samples and require further validation in independent cohorts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/7350637","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148994281","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":"Cognitive Projection of Upper Cervical Spinal Cord Cross-Sectional Area in Multiple Sclerosis","authors":"Bilge Piri Çınar,&nbsp;Banu Alıcıoğlu,&nbsp;Osman İyilikçi,&nbsp;Mustafa Açıkgöz,&nbsp;Burcu Yüksel,&nbsp;Özlem Ethemoğlu,&nbsp;Nazlı Gamze Bülbül,&nbsp;Beste Dagdeviren Boz,&nbsp;Nursena Ceylan,&nbsp;Arzucan Toksal Uçar,&nbsp;Halimenur Nurlu,&nbsp;Sena Destan Bünül,&nbsp;Serkan Özakbaş","doi":"10.1155/ane/1697161","DOIUrl":"https://doi.org/10.1155/ane/1697161","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cervical spinal cord atrophy, typically assessed via measurements of the mean upper cervical cord area (MUCCA), is a significant factor in disability and disease progression in multiple sclerosis (MS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study is aimed at exploring the relationship between MUCCA, physical disability, and cognitive impairment in MS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Thirty-one MS patients participated in the study. Upper extremity function was assessed using the Nine-Hole Peg Test (9HPT), while lower extremity function was evaluated with the Timed 25-Foot Walk Test (T25FWT). Cognitive function was measured with the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS). MUCCA was measured at two levels (reflecting the mean value of C1 and C2) using 3D T2-weighted magnetic resonance imaging scans.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study found that MUCCA is associated with cognitive impairment. It was demonstrated that MUCCA predicts EDSS, 9HPT, SDMT, CVLT, and T25FWT outcomes. In addition, age was the significant predictor of all parameters. Cronbach′s alpha values were 0.96 for C1 and 0.98 for C2, indicating excellent internal consistency across the three observers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These findings demonstrate that spinal cord area measurements are associated with both clinical and cognitive outcomes in MS, even among patients with low disability. Additionally, the observed correlation coefficients indicate excellent reproducibility and strong interobserver agreement for manual measurements.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/1697161","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148994263","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":"Turkish Adaptation and Psychometric Evaluation of the Hamburg Quality of Life Questionnaire for Patients With Multiple Sclerosis","authors":"Gamze Oğuz,&nbsp;Zehra Durna","doi":"10.1155/ane/9213084","DOIUrl":"https://doi.org/10.1155/ane/9213084","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The aim of this study is to determine the validity and reliability of the Turkish version of the Hamburg Quality of Life Questionnaire in Multiple Sclerosis (HAQUAMS) in patients with multiple sclerosis (MS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study enrolled 200 patients, from whom demographic and clinical data were gathered via a patient information form alongside the HAQUAMS. Linguistic validity was established through expert review and a forward-backward translation procedure. Reliability was estimated using Cronbach′s alpha and test-retest analysis; item-total consistency and item discrimination served as indicators of intrinsic validity, whereas extrinsic validity was examined through the scale′s correlation with EDSS and other clinical and demographic variables. Confirmatory factor analysis (CFA) was performed to evaluate the construct validity and five-factor structure of the HAQUAMS-TR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Completing the HAQUAMS-TR itself took participants under 15 min, whereas the full face-to-face session—including the patient information form—averaged 25 min. Of the 200 participants, 131 were women and 69 were men, with a mean age of 41.45 ± 10.99; mean year of diagnosis was 2008.96 ± 7.89, mean treatment duration was 113.86 ± 85.27 months, and mean EDSS was 2.97 ± 1.70. Test-retest correlations were consistently high across subscales (0.764–0.914), as were Cronbach′s <i>α</i> values (0.710–0.901), and HAQUAMS subscale scores correlated significantly with EDSS (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The Turkish HAQUAMS-TR showed preliminary evidence of acceptable reliability and validity for identifying symptoms experienced by MS patients and assessing quality of life and functional status in the Turkish population. However, before broader clinical adoption, additional validation studies are needed, including comparison with an established quality-of-life scale and testing in more diverse samples.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/9213084","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148994537","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":"Clinical and Genetic Features of MUSK-Related Congenital Myasthenic Syndrome: A Case Series and a Proposal for Clinical Classification","authors":"Antonio Edvan Camelo-Filho,&nbsp;Henrique Alves Bezerra,&nbsp;Nicole Lopes Cavalcante Machado,&nbsp;Pedro Lucas Grangeiro Sá Barreto Lima,&nbsp;Pedro Braga-Neto,&nbsp;Eduardo de Paula Estephan,&nbsp;Paulo Victor Sgobbi,&nbsp;Maria Sheila Rocha,&nbsp;Cristiane Araujo Martins Moreno,&nbsp;Paulo Ribeiro Nóbrega","doi":"10.1155/ane/7230407","DOIUrl":"https://doi.org/10.1155/ane/7230407","url":null,"abstract":"<p>MUSK-related congenital myasthenic syndrome (MUSK-CMS) is a rare neuromuscular disorder caused by pathogenic variants in the <i>MUSK</i> gene. The phenotypic spectrum varies significantly, ranging from mild, fatigable muscle weakness to severe neonatal onset with respiratory failure. This study is aimed at presenting a case series of MUSK-CMS, highlighting its clinical diversity and diagnostic challenges, and proposing a clinical classification into three distinct phenotypes. We conducted clinical and genetic analyses of six patients diagnosed with MUSK-CMS from three tertiary centers in Brazil. Clinical evaluations encompassed assessments of muscle strength, respiratory function, bulbar symptoms, and functional performance using the 6-min walk test (6MWT) and MG-ADL scale. Genetic testing was performed using whole exome sequencing (WES). Treatment responses were documented. Patients ranged in age from 19 to 58 years, with symptom onset varying from congenital to 32 years of age. All but one patient exhibited bilateral ptosis, extraocular muscle weakness, and gaze limitations. Based on our cohort and a review of previously reported cases, MUSK-CMS appears to exhibit three overlapping clinical patterns: early-onset severe disease, ocular-predominant involvement, and late-onset limb-girdle presentation. In our cohort, these phenotypes were distributed as follows: early-onset severe (<i>n</i> = 1), ocular (<i>n</i> = 4), and late-onset limb-girdle (<i>n</i> = 1). Early recognition and genetic testing are critical for optimal patient outcomes, especially in atypical or adult-onset cases.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/7230407","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148994471","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":"The Effects of Greater Occipital Nerve Block in Patients With Migraine and Cervicogenic Headache: A Retrospective Clinical Study","authors":"Ebru Alanbay Yagci,&nbsp;Senay Yildiz,&nbsp;Halil Cetingok,&nbsp;Gul Koknel Talu","doi":"10.1155/ane/1553924","DOIUrl":"https://doi.org/10.1155/ane/1553924","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Greater occipital nerve (GON) block is used in both migraine and cervicogenic headache (CGH), but comparative clinical data using a standardized ultrasound-guided proximal technique remain limited. This study evaluated short- to midterm clinical outcomes after GON block in patients with episodic migraine without aura and CGH.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This retrospective observational study included patients aged 18–65 years who underwent ultrasound-guided proximal GON block between January 2021 and September 2025 and completed at least 3 months of follow-up. Patients were classified as having episodic migraine without aura or CGH according to ICHD-3 criteria. Outcomes included Visual Analog Scale (VAS) pain scores, Headache Disability Index (HDI), monthly headache attack frequency, monthly acute headache medication consumption, patient satisfaction, and procedure-related adverse events. Exploratory subgroup analyses compared single versus three-session GON block protocols in both diagnostic groups and unilateral versus bilateral applications in the migraine subgroup. In the CGH group, GON block was performed unilaterally on the symptomatic side.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A total of 213 patients were included, comprising 171 patients with episodic migraine without aura and 42 with CGH. Both groups showed significant reductions in VAS scores at 1 and 3 months compared with baseline (all &lt;i&gt;p&lt;/i&gt; &lt; 0.001), with no significant between-group differences at baseline, 1 month, or 3 months. In the migraine subgroup, the triple GON block protocol was associated with lower VAS scores than the single protocol at 1 month (3.9 ± 1.3 vs. 4.6 ± 1.4, &lt;i&gt;p&lt;/i&gt; = 0.01; Cohen′s &lt;i&gt;d&lt;/i&gt; = 0.52) and 3 months (4.4 ± 1.7 vs. 5.1 ± 1.8, &lt;i&gt;p&lt;/i&gt; = 0.02; Cohen′s &lt;i&gt;d&lt;/i&gt; = 0.39). No significant differences were observed between unilateral and bilateral applications in migraine or between single and triple protocols in CGH. HDI scores, monthly headache attack frequency, and monthly acute medication consumption improved significantly in both diagnostic groups. No serious or persistent procedure-related complications were recorded.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Ultrasound-guided proximal GON block was associated with significant improvements in pain intensity and headache-related outcomes in both episodic migraine without aura and CGH, with improvements remaining evident at 3 months. Triple GON block may provide additional short- to midterm pain reduction in selected migraine patients; ","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/1553924","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148994220","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":"Improved Glioblastoma Survival Across Sweden From 1999 to 2023: Nationwide Analysis Highlights Impact of Demographic and Prognostic Factors When Analysing Regional Variations—A Comprehensive Analysis of 7669 Glioblastoma Patients","authors":"Helena K. Bruhn,&nbsp;Björn Tavelin,&nbsp;Roger Henriksson","doi":"10.1155/ane/9958070","DOIUrl":"https://doi.org/10.1155/ane/9958070","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Glioblastoma, the most prevalent primary malignant brain tumour, has a median survival of 9–11 months for unselected populations. This nationwide Swedish study (1999–2023) assessed survival, regional differences and their correlation to clinical prognostic factors in patients diagnosed with glioblastoma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient/Material and Methods</h3>\u0000 \u0000 <p>Using the Swedish Registry for Primary Brain Tumours, 7669 patients with glioblastoma were identified. Data on overall survival (OS), relative survival (RS), age, sex, preoperative performance status (PPS), tumour size, surgical resection grade and oncological treatments were collected. Cox analyses were conducted stepwise, initially by regions, then adjusted for demographic and clinical variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Median OS was 10.5 months, with a 2-year OS rate of 17% and a similar 2-year RS of 0.17. Median OS improved from 9.2 months (1999–2009) to 11.2 months (2018–2023, <i>p</i> &lt; 0.001), whereas 1-year RS increased from 0.38 to 0.47. Gross total resection, concomitant chemoradiotherapy and MGMT methylation were associated with significantly longer survival. Partial resection was superior to biopsy. In univariate analysis of regional differences from 2018 to 2023, the most densely populated region had a better survival than the other regions; however, after logistic regression analysis, adjusting for demographic and clinical factors, differences were statistically minor and not clinically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this nationwide cohort of nearly all Swedish GBM patients over 25 years, OS improved significantly over time and was associated with extent of resection, concomitant chemoradiotherapy and MGMT methylation. After adjustment for demographic and clinical factors, there were no clinically relevant regional differences.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/9958070","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148942680","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":"Symptoms of Anxiety and Depression After Ischemic Stroke","authors":"Marthe Kristine Sve,&nbsp;Johanne Kiplesund,&nbsp;Bent Indredavik,&nbsp;Stian Lydersen,&nbsp;Kristin Haugskott Tiller,&nbsp;Ailan Phan,&nbsp;Torgeir Wethal","doi":"10.1155/ane/5591145","DOIUrl":"https://doi.org/10.1155/ane/5591145","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To estimate the prevalence of symptoms of anxiety and depression at 3 months, 1 year, and 3 years after ischemic stroke and assess if these are associated with reduced health-related quality of life (HRQOL) or functional disability.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study is a retrospective, longitudinal study.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Participants&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The participants are patients with first-ever ischemic stroke.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Mood was assessed using Hospital Anxiety and Depression Scale (HADS), HRQOL was determined using EQ-5D-5L. Modified Rankin Scale (mRS) was used to assess functional disability. Included participants had answered the HADS questionnaire at least once during the follow-up period (3 months, 1 year, and 3 years) of the MIDNOR STROKE study. We used logistic mixed effect regression to estimate the prevalence of symptoms of anxiety and depression, reduced HRQOL and functional disability at the three time points. Next, we also used logistic mixed effect regression with symptoms of anxiety or depression as dependent variable, time point as categorical covariate, reduced HRQOL or functional disability, and its interaction with time as covariates.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In total, 696 participants were included in our study. The prevalence estimates of participants with symptoms of depression were 16.5%, 18.4%, and 18.7% at 3 months, 1 year, and 3 years poststroke, respectively. The estimated prevalences of participants with symptoms of anxiety were 18.3%, 19.8%, and 20.3% at 3 months, 1 year, and 3 years, respectively. Participants with reduced HRQOL or functional disability had a higher risk of having symptoms of depression at 3 months (OR 4.63 [95% CI 2.25–9.81] and OR 4.39 [95% CI 1.83–10.52], respectively), 1 year (OR 5.58 [95% CI 2.86–10.89] and OR 5.43 [95% CI 2.53–11.68], respectively), and 3 years (OR 8.24 [95% CI 3.90–17.41] and OR 6.93 [95% CI 2.98–16.08], respectively). Participants with reduced HRQOL had a higher risk of having symptoms of anxiety at 1 year (OR 3.61 [95% CI 1.72–7.89]), whereas participants with functional disability had a higher risk of having anxiety symptoms at 3 months (OR 3.83 [95% CI 1.30–11.28]), and at 3 years (OR 3.40 [95% CI 1.24–9.36]). Sensitivity analyses with adjustment for age, sex, education, stroke severity, prestroke comorbidity burden, and prestroke cardiovascular disease had only mino","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/5591145","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148942296","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":"Clinical Judgment to Recognize Acute Brain Ischemia in the Emergency Department","authors":"Max Bieder,&nbsp;Felix L. Nägele,&nbsp;Simon Kessner,&nbsp;Moritz A. Link,&nbsp;Thies Ingwersen,&nbsp;Märit Jensen,&nbsp;Lukas Meyer,&nbsp;Bastian Cheng,&nbsp;Götz Thomalla,&nbsp;Eckhard Schlemm","doi":"10.1155/ane/2254119","DOIUrl":"https://doi.org/10.1155/ane/2254119","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite the development of scale-based stroke recognition tools, the accuracy of clinical judgment to detect acute ischemic stroke (AIS) and transient ischemic attack (TIA) is unknown. This study evaluated the real-world accuracy of stroke physicians′ assessment in AIS/TIA detection before imaging compared with Recognition of Stroke in the Emergency Room (ROSIER) scale and analyzed clinical features of patients with AIS/TIA compared with stroke mimics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with suspected acute stroke at a tertiary neurovascular center were rated for AIS/TIA likelihood before brain imaging (0%–100%). The diagnostic performance of clinical judgment and ROSIER scale was assessed using area under the receiver operating curve (AUC), sensitivity, specificity, positive (PPV) and negative predictive value (NPV). Associations with acute reperfusion treatments were examined using multivariable logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 540 patients, 50.6% (<i>n</i> = 273) had AIS/TIA, 43.1% (<i>n</i> = 233) SMs, and 6.3% (<i>n</i> = 34) intracerebral hemorrhage. Clinical judgment was performed for 242 patients, yielding an AUC of 0.85 (95% CI, [0.80–0.90]) with sensitivity, specificity, PPV, and NPV of 90.8%, 70.3%, 81.0%, and 84.5%, respectively. ROSIER scale had an AUC of 0.84 (95% CI [0.80–0.89]), sensitivity of 70.1%, specificity of 81.8%, PPV of 87.1%, and NPV of 61.0%. Logistic regression revealed a positive association between the clinical likelihood of brain ischemia, the ROSIER scale, and acute reperfusion therapies. The most frequent SMs were infections (24.9%; <i>n</i> = 58), seizures (18.5%; <i>n</i> = 43), and metabolic disturbances (9.0%; <i>n</i> = 21), with altered consciousness as the most common presenting symptom (45.1%; <i>n</i> = 105).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study is the first to quantify the accuracy of preimaging clinical judgment for AIS/TIA detection in an emergency setting, showing comparable results with the ROSIER scale but with higher sensitivity. Future research should explore how clinical expertise can be integrated into standardized stroke pathways to optimize early management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/2254119","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148943750","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}