Acta Neurologica Scandinavica最新文献

{"title":"Awake Surgery for Tumors of the Parietal Lobe: A Preliminary Experience with a New Protocol of Intraoperative Neuropsychological Test for the Monitoring of the Sensory Area Function","authors":"Alba Scerrati,&nbsp;Pasquale De Bonis,&nbsp;Clarissa A. E. Gelmi,&nbsp;Paola Milani,&nbsp;Stefania Labanti,&nbsp;Sara Stefanelli,&nbsp;Daniela Gragnaniello,&nbsp;Francesco Travaglini,&nbsp;Giorgio Mantovani,&nbsp;Chiara Angelini,&nbsp;Michele Alessandro Cavallo","doi":"10.1155/2024/8823351","DOIUrl":"10.1155/2024/8823351","url":null,"abstract":"<p><i>Background</i>. Nowadays, there is a lack of studies reporting techniques for the selective monitoring of the primary somatosensory cortex and the adjacent areas of the superior and inferior parietal lobules. We hypothesized a more specific and targeted test for awake surgery for monitoring the sensory area during resection of tumors involving it. <i>Materials and Methods</i>. We collected patients suffering from tumors involving the parietal areas and undergoing awake surgery for the resection. Intraoperative standard neurophysiological monitoring was performed, and we added a new intraoperative test. It consisted of a series of different objects with standard 3D conformations. The patient was asked to recognize the object shape using only the tactile sensibility, without seeing the object itself; in some cases, he was also asked to put the object in the corresponding hole, according to the shape. <i>Results</i>. We collected 6 patients. One patient with a right parieto-occipital lesion, at the stimulation of the anterior cortical margin of the surgical field, showed problems in naming the objects and collocating them in the corresponding spaces, while he was touching them with the left hand. Therefore, the areas of proprioception and perception of the objects were mapped and numbered. This deficit got better in the postoperative days with a total remission of the ideomotor apraxia and the psychomotor slowdown. The other 5 patients did not show an impairment with the new test. <i>Conclusions</i>. This is a preliminary study with the aim of enhancing the specificity of the neuropsychological test performed during awake surgery to allow the surgeon to monitor the neurological functions of the parietal cortex. More cases are needed to validate it.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139389832","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":"Neurofilament and Brain Atrophy and Their Association with Cognition in Multiple Sclerosis: A 10-Year Follow-Up Study","authors":"Alok Bhan,&nbsp;Cecilie Jacobsen,&nbsp;Ingvild Dalen,&nbsp;Guido Alves,&nbsp;Niels Bergsland,&nbsp;Kjell-Morten Myhr,&nbsp;Henrik Zetterberg,&nbsp;Robert Zivadinov,&nbsp;Elisabeth Farbu","doi":"10.1155/2023/7136599","DOIUrl":"10.1155/2023/7136599","url":null,"abstract":"<div>\u0000 <p><i>Introduction</i>. Cognitive impairment is an important contributor to disability in multiple sclerosis (MS). Disconnection of neuronal circuits due to axonal injury is probably an important underlying mechanism for this disability. Neurofilament light chain (NfL) is a neuron-specific constituent of axons and has gained increasing attention as a biomarker of axonal injury. <i>Objective.</i> To assess the association between NfL in serum (sNfL) and cerebrospinal fluid (cNfL) and cognitive function over 10 years and compare these associations with volumetric brain magnetic resonance imaging (MRI) measurements. <i>Methods</i>. Newly diagnosed MS patients were followed prospectively with baseline NfL and MRI as well as with clinical and cognitive assessments for up to 10 years. <i>Results</i>. Forty-one patients were included. Baseline sNfL correlated negatively with symbol digit modalities test (SDMT) at baseline (<i>r</i> = −0.45, <i>p</i> = 0.005), year 5 (<i>r</i> = −0.41, <i>p</i> = 0.017), and at year 10 (<i>r</i> = −0.52, <i>p</i> = 0.008). Baseline cNfL correlated with baseline SDMT (<i>r</i> = −0.34, <i>p</i> = 0.030) and SDMT at year 10 (<i>r</i> = −0.44, <i>p</i> = 0.037). Baseline volumes of whole brain (<i>r</i> = 0.476, <i>p</i> = 0.002), gray matter (<i>r</i> = 0.467, <i>p</i> = 0.002), T1 (<i>r</i> = −0.627, <i>p</i> &lt; 0.001), and T2 lesion volumes (<i>r</i> = −0.475, <i>p</i> = 0.002) correlated significantly with baseline SDMT. Longitudinal analyses showed that both MRI volumes and EDSS were associated with the rate of SDMT decline, whereas sNfL and cNfL were not. <i>Conclusion</i>. NfL levels measured in serum and cerebrospinal fluid were both associated with cognitive functioning in MS patients over a 10-year period from diagnosis. However, MRI volumes correlated strongly in addition to the rate of cognitive decline.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/7136599","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139161895","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":"High Quality of Early Ischemic Stroke Care but Poorer Clinical Outcomes among Patients with a History of Mental Illness","authors":"Julie Mackenhauer,&nbsp;Erika Frischknecht Christensen,&nbsp;Grethe Andersen,&nbsp;Jan Mainz,&nbsp;Søren Paaske Johnsen","doi":"10.1155/2023/4141850","DOIUrl":"10.1155/2023/4141850","url":null,"abstract":"<div>\u0000 <p><i>Objectives</i>. The aim of this study was to compare early stroke care and clinical outcomes among patients with and without a history of mental illness. <i>Materials/Methods</i>. A nationwide registry-based cohort study of patients with acute ischemic stroke treated in a tax-financed healthcare system. We used process and outcome measures from the Danish Stroke Registry 2007-2018 combined with the data from multiple Danish registries. We combined the process measures in two composite measures: an <i>opportunity-based score</i> (the proportion of all relevant process measures fulfilled for each patient) and an <i>all-or-none score</i> (the proportion of patients fulfilling all relevant process measures). Patients were categorized according to severity of mental health history. <i>Results</i>. We included 117 548 admissions with acute ischemic stroke: 20.8%, 3.5%, and 3.4% of admissions concerned patients with a history of minor, moderate, or major mental illness, respectively. Patients received a median of 85.7% (IQR, 66.7; 100.0) of the relevant processes (opportunity-based score). Patients with a history of mental illness were less likely to receive guideline-recommended acute stroke care within the defined time frames; however, differences were not clinically relevant. Patients with a history of mental illness were significantly more likely to die within 30 days, compared to patients with no history of mental illness: Risk ratios (RR) for 30-day mortality adjusted for age, sex, and country of origin were 1.31 (CI, 1.25; 1.37) for minor, 1.18 (CI, 1.05; 1.33) for moderate, and 1.44 (CI, 1.30; 1.60) for major mental illness. The corresponding adjusted RRs for recurrent stroke/TIA were 1.69 (CI, 1.58; 1.80) for minor, 1.39 (CI, 1.19; 1.61) for moderate, and 1.36 (CI, 1.17; 1.59) for major mental illness. The associations were weakened for 30-day mortality but not recurrent stroke/TIA after additional adjustment for potential mediating factors (comorbidity and stroke severity). <i>Conclusion</i>. More than one-quarter of patients with ischemic stroke had a history of mental illness. The overall performance of acute stroke care was high in all groups. Mental illness was associated with a higher risk of death and recurrent stroke compared to patients without a history of mental illness which may at least partly be due to a more adverse prognostic profile at the time of admission, including a higher stroke severity.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/4141850","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138948151","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":"Circulating Factor Seven Activating Protease (FSAP) in the Hyperacute Phase of Stroke","authors":"Henriette S. Jæger,&nbsp;Karianne Larsen,&nbsp;Christian Foerch,&nbsp;Kristi G. Bache,&nbsp;Sandip M. Kanse","doi":"10.1155/2023/8901284","DOIUrl":"10.1155/2023/8901284","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Factor VII activating protease (FSAP) is a circulating serine protease that could be involved in the pathophysiology of stroke. We analyzed the temporal changes in FSAP antigen and FSAP activity after acute cerebral ischemia (ACI) and tested if FSAP could be used to differentiate between stroke subtypes in the hyperacute phase (&lt;4.5 hours after symptom onset). <i>Methods</i>. Of the 118 suspected stroke patients enrolled, 76 had ACI; of which 20 suffered from large vessel occlusion (LVO), 19 had intracerebral hemorrhage (ICH), and 23 had stroke mimics. Median time from symptom onset to the two plasma sample collections, &lt;4.5 hours, were 66 and 107 minutes for the entire study population. Additional samples were collected up to 90 days post stroke in a subset of ACI patients (<i>n</i> = 19). FSAP antigen, FSAP activity, FSAP-<i>α</i>2-antiplasmin-complex (FSAP-AP complex), and nucleosomes were measured by activity assays or ELISA. <i>Results</i>. ACI patients treated with tissue plasminogen activator (tPA) had elevated FSAP activity &lt; 4.5 hours (<i>p</i> = 0.016) that subsequently normalized after 6 hours. FSAP-AP complex levels decreased significantly from &lt;4.5 hours (<i>p</i> = 0.015) to 6 hours after symptom onset. tPA did not increase FSAP activity significantly in plasma <i>in vitro</i>. FSAP antigen significantly decreased &lt; 4.5 hours after symptom onset in LVO (<i>p</i> = 0.008) and ICH (<i>p</i> = 0.017) patients. FSAP could not differentiate ACI from ICH or strokes (ACI and ICH) from stroke mimics. FSAP did not correlate with stroke severity. <i>Conclusion</i>. LVO and ICH seem to influence FSAP levels in the hyperacute phase of stroke, but FSAP does not differentiate between stroke subtypes in a hyperacute setting.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/8901284","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139006833","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 Theory of Mind Deficit Associated with Executive Dysfunction in Cervical Dystonia","authors":"Christin Kupper,&nbsp;Hannah Lochmann,&nbsp;Michelle Wyrobnik,&nbsp;Oliver Steiner,&nbsp;Fabian Klostermann","doi":"10.1155/2023/8873653","DOIUrl":"10.1155/2023/8873653","url":null,"abstract":"<div>\u0000 <p><i>Introduction</i>. Cervical dystonia (CD) is viewed as a circumscribed movement disorder. However, beyond motor symptoms, it can imply subtle cognitive change, among others with respect to theory of mind (ToM) capacities. Here, affective and cognitive ToM performances and potential relations to other mental functions were investigated to refine the concept of social cognitive dysfunction in CD. <i>Methods</i>. 20 persons with CD were clinically assessed, together with 20 healthy controls engaged in overview cognitive testing, executive function (EF) tasks, and the Faux Pas Recognition Test (FPRT) as well as the Reading the Mind in the Eyes Tests (RMET) addressing cognitive and affective ToM functions, respectively. <i>Results</i>. Persons with CD showed lower cognitive, but not affective ToM performance than controls. Further, they had abnormally low word production in verbal fluency (VF) tasks, imposing high EF demands. Generally, ToM performance correlated with VF and, further, with the decreased quality of life score in persons with CD. <i>Conclusion</i>. Cognitive ToM deficits seem to occur in the context of executive dysfunction in CD. They belong to an underrecognized spectrum of nonmotor symptoms of likely clinical relevance.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/8873653","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138590792","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":"Sarcopenia and Hypoxia in Patients with Obstructive Sleep Apnea","authors":"Jinseung Kim,&nbsp;Ho-Joon Lee,&nbsp;Dong Ah. Lee,&nbsp;Kang Min Park","doi":"10.1155/2023/4310809","DOIUrl":"10.1155/2023/4310809","url":null,"abstract":"<div>\u0000 <p><i>Objectives</i>. Obstructive sleep apnea (OSA) is associated with a variety of health issues. Both OSA and sarcopenia are associated with metabolic disorders; however, there is limited literature assessing the correlation between them. Therefore, we aimed to investigate sarcopenia using temporal muscle thickness (TMT) in patients with obstructive sleep apnea (OSA) and the association between sarcopenia and hypoxia. <i>Methods</i>. We enrolled patients with OSA and healthy controls. Both groups underwent brain magnetic resonance imaging (MRI) scans, including three-dimensional T1-weighted imaging. TMT, a marker for sarcopenia, was obtained based on the T1-weighted imaging and compared between the groups. Additionally, we analyzed the correlation between TMT and clinical factors in patients with OSA. <i>Results</i>. In total, 40 patients with OSA and 52 healthy controls were evaluated. There was no difference in TMT between patients with OSA and healthy controls (10.425 ± 2.13 vs. 10.400 ± 1.94 mm, <i>p</i> = 0.953). In the correlation analysis, age was negatively correlated with TMT (<i>r</i> = −0.356, <i>p</i> = 0.023), and lowest oxygen saturation (<i>r</i> = −0.558, <i>p</i> &lt; 0.001) in patients with OSA. <i>Conclusion</i>. Our results demonstrated negative correlations between TMT and lowest oxygen saturation in the patients with OSA. These findings suggest potential relationships between sarcopenia and hypoxia in patients with OSA. Thus, these results underline the importance of maintaining oxygen saturation in patients with OSA by implementing active treatment. This study also demonstrates the feasibility of sarcopenia assessment by measuring TMT through conventional head MRI in patients with various neurological disorders.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/4310809","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138596059","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":"Real-Life Effectiveness and Tolerability of Brivaracetam in Focal to Bilateral and Primary Generalized Tonic-Clonic Seizures","authors":"Elena Fonseca,&nbsp;Ariadna Gifreu,&nbsp;Javier Abril Jaramillo,&nbsp;Luis Redondo Vergé,&nbsp;Manuel Quintana,&nbsp;Sofía Lallana,&nbsp;Samuel López-Maza,&nbsp;Laura Abraira,&nbsp;Daniel Campos-Fernández,&nbsp;Estevo Santamarina,&nbsp;Juan Rodríguez Uranga,&nbsp;Manuel Toledo","doi":"10.1155/2023/6636730","DOIUrl":"10.1155/2023/6636730","url":null,"abstract":"<div>\u0000 <p><i>Purpose</i>. Brivaracetam (BRV), an antiseizure medication indicated for focal-onset seizures, has shown efficacy in the treatment of focal to bilateral tonic-clonic seizures (FBTCS). We aimed to determine the effectiveness and safety of BRV in patients with FBTCS and generalized tonic-clonic seizures (GTCS). <i>Methods</i>. We performed a multicenter, retrospective, longitudinal study in adult patients with epilepsy who experienced at least one FBTCS or GTCS before starting BRV (baseline visit). Data were collected from consecutive outpatient visits over a 4-year period. All patients had been followed for at least 3 months before the baseline visit and completed a minimum follow-up of 3 months after starting BRV. Response (≥50% reduction in FBTCS/GTCS frequency) and retention rates, as well as seizure freedom and presence of adverse events at 3, 6, and 12 months, were recorded as outcome measures. <i>Results</i>. 114 patients were included (mean age 36.3 ± 18.0 years, 52% male, 36.6% genetic generalized epilepsy); 94 had a 12-month follow-up period. At 12 months’ follow-up, the response rate was 83%, and 73.4% of patients were FBTCS/GTCS-free. Retention was 79% at 12 months. Adverse events occurred in 29.8% of patients, the most common being drowsiness (14.9%). No significant differences were found in response rates between FBTCS and GTCS. Drug resistance was independently associated with lower response and seizure freedom rates at follow-up. The absence of a titration period predicted seizure freedom and response at 3 months. <i>Conclusions</i>. BRV is an effective and well-tolerated treatment in patients with focal to bilateral tonic-clonic seizures and generalized tonic-clonic seizures.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/6636730","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138603736","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":"Sex Differences in the Association between Hemoglobin A1c and Cerebral White Matter Lesions in the General Japanese Population","authors":"Honghao Li,&nbsp;Jing Yu,&nbsp;Shougang Guo","doi":"10.1155/2023/9580116","DOIUrl":"10.1155/2023/9580116","url":null,"abstract":"<div>\u0000 <p>The influence of diabetes and associated sex differences on cerebral white matter lesions (WML) is unclear. We used data from a cross-sectional study uploaded to the DATADRYAD website by Shinkawa et al. to investigate differences in the association between hemoglobin A1c (HbA1c) levels and cerebral WML between men and women. The average age of all participants was 56.4 ± 11.5 years old, and approximately 51.89% of them were men. A linear relationship between HbA1c and cerebral WML was detected in men. Fully adjusted binary logistic regression showed no association of HbA1c with cerebral WML in men. A nonlinear relationship between HbA1c and cerebral WML was detected in women, whose cutoff point was 5.6%. The effect sizes and confidence intervals of the left and right sides of the inflection point were OR = 0.21 (95% CI 0.06, 0.69, <i>P</i> = 0.0098) and OR = 3.5 (95% CI 1.50, 8.15, <i>P</i> = 0.0037), respectively. In the higher HbA1c group, further subgroup analysis showed a stronger association between HbA1c and cerebral WML in women (OR = 3.83, 95% CI 1.68, 8.72 <i>P</i> = 0.0014) than in men (OR = 1.02, 95% CI 0.76, 1.36 <i>P</i> = 0.8986) (<i>P</i> for interaction with sex was 0.0004). A stronger effect of HbA1c on the risk of cerebral WML in women than in men was found in the higher HbA1c group.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/9580116","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141150579","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":"Serum Biomarkers of Olfactory Identification Deficits in Patients with Parkinson’s Disease","authors":"Fu-Jia Li,&nbsp;Yang-Dan-Yu Li,&nbsp;Xu Liu,&nbsp;Jie Zu,&nbsp;Wei Zhang,&nbsp;Qi-Hua Xiao,&nbsp;Xue-Bin Niu,&nbsp;Li Du,&nbsp;Chen-Chen Cui,&nbsp;Ru-Yu Zhang,&nbsp;Xiao-Qing He,&nbsp;Gui-Yun Cui,&nbsp;Chuan-Ying Xu","doi":"10.1155/2023/8860125","DOIUrl":"10.1155/2023/8860125","url":null,"abstract":"<div>\u0000 <p>To investigate whether glial fibrillary acidic protein (GFAP), neurofilament light chain (NFL), and 12 cytokines can serve as serum biomarkers of olfactory identification dysfunction in patients with Parkinson’s disease (PD). GFAP and NFL levels were measured in 75 patients with PD and 36 healthy controls (HCs). The levels of 12 cytokines were assayed in 41 patients with PD. The 16-item Sniffin’ Sticks test and the Mini-Mental State Examination (MMSE) were used to assess olfactory identification ability and cognitive function, respectively. Linear regression models were applied to control for confounding effects. Receiver operating characteristic curves were used to examine the diagnostic accuracy of serum NFL, GFAP, and interleukin-6 (IL-6) levels. The cut-off value for the SS-16 test in diagnosing dysosmia was equal to 9.5 points. Serum GFAP levels were higher in patients with PD with olfactory identification dysfunction than in those without. GFAP, NFL, and IL-6 levels were correlated with SS-16 scores. Moreover, combining these three biomarkers yielded the best-fitting model for distinguishing patients with PD with or without dysosmia. We found a prominent indirect effect of GFAP on MMSE scores through its contribution to SS-16 scores. GFAP, NFL, and IL-6 can serve as serum biomarkers for olfactory identification dysfunctions in PD. We inferred that astrogliosis might promote the occurrence of dysosmia by releasing proinflammatory factors and causing neuronal damage and may indirectly impair cognition through its effect on olfactory function.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/8860125","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139275457","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":"Diagnosis and Prognosis in Disorders of Consciousness: An Active Paradigm fMRI Study","authors":"Laura Schnetzer,&nbsp;Verena S. Schätzle,&nbsp;Lisa Kronbichler,&nbsp;Jürgen Bergmann,&nbsp;Stefan Leis,&nbsp;Alexander B. Kunz,&nbsp;Julia S. Crone,&nbsp;Eugen Trinka,&nbsp;Martin Kronbichler","doi":"10.1155/2023/3991087","DOIUrl":"10.1155/2023/3991087","url":null,"abstract":"<div>\u0000 <p>Diagnoses in patients with disorders of consciousness are prone to misdiagnosis; thus, research has sought approaches to increase reliability, for instance, with functional MRI. By applying a motor imagery task, patients showing covert command following despite the absence of behavioural signs of awareness can be identified as being in a cognitive motor dissociation. This study seeks to determine the proportion of patients, with unresponsive wakefulness syndrome and minimally conscious state, who display covert command following. Moreover, the prognostic value of the improved diagnosis and different methodical approaches to analyse the functional MRI data were evaluated. 73 disorder of consciousness patients (35 unresponsive, 35 minimally conscious, and three already recovered) underwent weekly standardized behavioural assessments with the coma-recovery scale—revised and one functional MRI examination comparing their brain activations in the supplementary motor area between phases of imaging playing tennis and rest. 27 healthy controls served as a control group. The data was evaluated using different region-of-interest analyses (one- and two-tailed small-volume correction and region-of-interest exploration approaches) and a whole-brain analysis. Based on the one-tailed small volume correction data, seven patients, all of nontraumatic aetiology, showed covert command following. The one-tailed region-of-interest exploration identified three additional responders. 10 patients showed significantly more activation during rest than during the imagery paradigm (negative responders). 40% of patients (minimally conscious patients being three times more likely) showed significant activations in the whole brain analysis. Besides, no significant further associations were found between covert command following and clinical parameters. The analyses showed that the tennis paradigm could identify patients with cognitive motor dissociation with a nontraumatic aetiology, but our data failed to show any short-term prognostic validity. The relevance of negative responders and activated regions outside of the region of interest should be further investigated.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/3991087","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136281946","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}