Acta Neurologica Scandinavica最新文献

{"title":"Independent Predictors for Operative Treatment of Chronic Subdural Hematoma","authors":"J. M. B. Reimer,&nbsp;R. M. Brohet,&nbsp;B. Jacobs,&nbsp;J. Blaauw,&nbsp;R. M. Arntz,&nbsp;K. H. Kho,&nbsp;R. J. M. Groen,&nbsp;M. Foumani,&nbsp;J. van der Naalt,&nbsp;M. H. den Hertog","doi":"10.1155/ane/2759676","DOIUrl":"https://doi.org/10.1155/ane/2759676","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Treatment of chronic subdural hematoma (CSDH) can be conservative or operative. Since clinical guidelines are lacking, a large variation in daily management of CSDH exists. We aimed to quantify the number of CSDH patients that are treated operatively and conservatively and to develop a prediction model that provides insight into the arguments behind the choice for operative treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>All consecutive CSDH patients ≥ 18 years that were treated in three neurosurgical centers in the Netherlands between 2003 and 2019 were retrospectively included. Our outcome measure was the decision for operative treatment after initial diagnosis. Combining conventional multivariable logistic regression analysis and machine learning, four prediction models were developed and compared. The prediction model with the best performance was used for further analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 684 included patients (29% female, median age 75 years), 428 (63%) were treated operatively. The multivariable logistic regression model performed best with an area under the curve of 0.90, a sensitivity of 0.87, and a specificity of 0.78. Independent predictors for operative treatment were treating facility, younger age, premorbid mRS ≤ 1, focal neurological deficit, cognitive impairment, and MGS score on admission, larger hematoma volume, and ≥ 10 mm midline shift on baseline CT. The highest predictive value for operative treatment was found for treating facility, hematoma volume, and ≥ 10 mm midline shift.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>While most CSDH patients are treated operatively, over a third are treated conservatively. Decisions for operative treatment are influenced by premorbid level of functioning, symptoms on admission, CT parameters, and, notably, interhospital variation, highlighting the need for standardized treatment guidelines.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2025 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/2759676","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145469766","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":"Urinary and Bowel Symptoms in Idiopathic Normal Pressure Hydrocephalus","authors":"Andreas Eleftheriou,&nbsp;Johanna Rydja,&nbsp;Susanna Walter,&nbsp;Rafael Holmgren,&nbsp;Fredrik Lundin","doi":"10.1155/ane/9580070","DOIUrl":"https://doi.org/10.1155/ane/9580070","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Idiopathic normal pressure hydrocephalus (iNPH) patients have gait and balance disturbance, cognitive impairment and urinary urgency/incontinence. Gait and balance symptoms have been examined carefully. There is presently a lack of evidence-based criteria to make recommendations regarding the characteristics and evaluation of urinary incontinence. Additionally, patients with urinary incontinence may also have faecal incontinence. The aims of this prospective single-centre study with a pre–post design and a control group were to characterise the urinary symptoms, to investigate possible bowel symptoms and to evaluate possible reversibility after shunt surgery.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Patients and Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Fifty-seven iNPH patients (27 females, median age 77 years) answered the questionnaires preoperatively, and 42 patients postoperatively. Meanwhile, 42 healthy individuals (HIs) (25 females, median age 71 years) were included. Before and 3 months after the shunt surgery, patients and HIs were asked to answer three questionnaires: the International Consultation on Incontinence Questionnaire – Urinary Incontinence Short Form (ICIQ-UI), Wexner’s Faecal Incontinence Score in the Swedish language (Wexner’s FI) and a bowel function questionnaire. The HIs followed the study protocol only once.&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;The mean duration of iNPH-related symptoms was 24 months (range 6–120). Urinary incontinence appeared in 84.6% of the patients. Urinary leakage was always present in 13.5% vs. none of the HIs, with an improvement in some patients after the shunt operation. Bowel disturbances (more frequent bowel movements, a longer defecation time, incomplete evacuation feeling, abdominal pain and bloating, involuntary gas leakage and soiling) were reported by 67.5% of patients. The patients’ bowel function influenced their daily life as compared to the HIs. Postoperatively, bowel symptoms were improved with fewer bowel function-dependent limitations in social life. The total ICIQ-UI score was significantly different between the patients and HIs (&lt;i&gt;p&lt;/i&gt; &lt; 0.001) and improved significantly postoperatively (&lt;i&gt;p&lt;/i&gt; &lt; 0.001).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Urinary and bowel incontinence symptoms were notable features in this cohort of iNPH patients, causing limitations in their social life. Postoperatively, both symptoms improved to some extent.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Trial Registration&lt;/h3&gt;\u0000 ","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2025 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/9580070","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145407004","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":"Poor Academic Performance in University Students With Primary Headache Disorders: A Systematic Review","authors":"Valeria Velasquez-Sanchez,&nbsp;Gabriela Vilchez-Aranibar,&nbsp;Victor Velásquez-Rimachi","doi":"10.1155/ane/9503632","DOIUrl":"https://doi.org/10.1155/ane/9503632","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Primary headache disorders, including migraines, tension-type headaches, and cluster headaches, significantly impact university students′ academic performance through absenteeism, lack of concentration, reduced productivity, and poor grades. This systematic review aims to determine the proportion of university students with impaired academic performance due to primary headache disorders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The review protocol is registered in PROSPERO (CRD42023414524). We conducted a systematic review following the PRISMA guidelines. Cross-sectional observational studies assessing academic performance in university students with primary headache disorders were included. We excluded studies on secondary headaches, studies involving mixed populations (i.e., those combining university students with schoolchildren or postgraduate students without separate data), and intervention designs. We searched in multiple databases including MEDLINE, EMBASE, SCOPUS, PsycInfo, and Web of Science, up to January 3, 2023. Search strategies were developed incorporating keywords related to “headache disorders,” “cephalalgia,” and “academic performance.” Two independent reviewers conducted study selection and data extraction, with disagreements resolved by a third reviewer. We used the Joanna Briggs Institute (JBI) tool for prevalence studies to assess the risk of bias. Due to study heterogeneity, meta-analyses were not feasible, and a narrative synthesis was performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twelve cross-sectional observational studies with 8685 participants (predominantly female, 74%) were included. Migraine was the most reported headache type (83%). According to the JBI tool, only one study had a low risk of bias, while most showed moderate to high bias levels. Among students with primary headache disorders, 53% exhibited poor academic performance, 18% reported low productivity, 14% low concentration, 11% absenteeism, and 4% below-average grades.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A substantial proportion of university students with primary headache disorders show impaired academic performance, with poor performance being the most frequent outcome. This review highlights the need for further research with standardized assessment tools to better quantify and address the academic impact of primary headache disorders.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2025 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/9503632","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145406936","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":"Translation and Validation of the Quality of Life in Essential Tremor Rating Scale","authors":"Victor S. Hvingelby,&nbsp;Lisa Østergaard Bak,&nbsp;Martin Andreasen,&nbsp;Rikke Nan Valdemarsen,&nbsp;Mette Møller,&nbsp;Andreas Nørgaard Glud","doi":"10.1155/ane/1373319","DOIUrl":"https://doi.org/10.1155/ane/1373319","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Essential tremor is a common movement disorder, characterized by kinetic tremor, most commonly of the upper extremities. The Quality of Life in Essential Tremor (QUEST) scale is an oft-used subjective rating scale of tremor severity and quality of life (QoL) in these patients, including for monitoring subjective improvement after advanced treatment. It contains subdomains concerned with overall and health-related QoL, a self-assessment of tremor severity and of the functional impact of tremor on activities of daily living. The questionnaire has not been validated in Danish. This study was aimed at translating and validating the QUEST and piloting it among Danish ET patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The translation and cultural adaptation of the QUEST was carried out per the guidelines of the World Health Organization (WHO) and the International Society of Pharmacoeconomics and Outcomes Research (ISPOR) task force for translation and cultural adaptation. It was subsequently disseminated among a cohort of ET patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The QUEST was successfully translated and piloted among 112 ET patients. Respondents found the QUEST to be understandable (75/77; 97.4%). For categorical items, there was a high degree of agreement in responses at retest (60.0%–94.0%). According to Cohen′s kappa, agreement was mostly strong. Continuous outcomes were more variable, particularly the subdomains of the functional self-assessment. The mean score for each subdomain ranged from 19.46 (SD 21.87) for work and finance, 24.13 (SD 25.31) for communication, 32.49 (SD 23.21) for psychosocial, 40.21 (SD 34.11) for hobby and leisure, and 42.77 (SD 27.08) for physical. In general, subdomains were weakly to moderately correlated with overall health and QoL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We have successfully translated and validated the QUEST questionnaire for use among Danish ET patients. The questionnaire is now available for Danish clinicians and researchers treating ET patients. The results indicate some unmet needs in the Danish cohort of tremor patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2025 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/1373319","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145406620","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":"Nonmotor Symptoms Reduce Quality of Life in Parkinson′s Disease Depending on Disease Stage and Age at Onset","authors":"Roberta Bovenzi,&nbsp;Matteo Conti,&nbsp;Valerio Chiurchiù,&nbsp;Valentino De Franco,&nbsp;Alessandra Di Pucchio,&nbsp;Mariangela Pierantozzi,&nbsp;Tommaso Schirinzi,&nbsp;Rocco Cerroni,&nbsp;Alessandro Stefani,&nbsp;Nicola Biagio Mercuri,&nbsp;Claudio Liguori","doi":"10.1155/ane/2145092","DOIUrl":"https://doi.org/10.1155/ane/2145092","url":null,"abstract":"<p>In this observational study, which presents a secondary analysis related to a previously published work from our group, we aimed to examine the impact of nonmotor symptom (NMS) burden on HR-QoL in 154 outpatients with Parkinson′s disease (PD), ranging from mild to moderate-advanced disease stages, with a specific focus on motor disease progression and age at onset (AAO). To this purpose, NMS burden was measured using the NMS scale (NMSS), overall HR-QoL using the Parkinson′s Disease Questionnaire-39 (PDQ-39), and sleep disturbances using the Parkinson′s Disease Sleep Scale-2nd version (PDSS-2). The scores of the three scales were correlated with motor impairment and the amount of dopaminergic therapy. Furthermore, NMSS, PDQ-39, and PDSS-2 scores were compared between early onset PD (EOPD, AAO ≤ 50) and late-onset PD (LOPD, AAO &gt; 50), as well as between “poor sleepers” and “good sleepers” based on the validated PDSS-2 cutoff of 18/60. We found that total NMSS, PDSS-2, and PDQ-39 scores significantly increased with advancing disease stage. EOPD patients had lower NMSS and PDSS-2 global scores compared to LOPD patients, despite the latter having longer disease duration and similar PDQ-39 scores. The NMSS global score correlated with each single domain of the PDQ-39, with the strongest associations observed in the “mobility,” “activity of daily living,” and “cognition” domains. Over one-third of patients were classified as “poor sleepers” (PDSS-2 ≥ 18) and exhibited higher NMSS and PDQ-39 total scores compared to “good sleepers.” In conclusion, this study enlightens the increasing impact of NMS and sleep disturbances on patients′ HR-QoL with disease progression and across different AAO, underscoring the need to address such modifiable factors to alleviate the burden of the disease.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2025 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/2145092","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145406566","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":"N-Methyl-D-Aspartate Receptor (NMDAR) Antibodies Induce Diverse Calcium Activity Patterns on Cultured Astrocytes and Astrocyte–Neuron Cocultures","authors":"Neşe Ayşit,&nbsp;Sevginur Bostan,&nbsp;Canan Aysel Ulusoy,&nbsp;Erdem Tüzün,&nbsp;Fazlı Kemal Bayat","doi":"10.1155/ane/2861013","DOIUrl":"https://doi.org/10.1155/ane/2861013","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Preliminary evidence suggests that astrocytes might contribute to the disease mechanisms of N-methyl-D-aspartate receptor (NMDAR) encephalitis. However, the precise role of astrocytes in the pathogenesis of encephalitis is poorly understood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>To characterize the impact of NMDAR antibodies on the activity of astrocytes, we isolated and purified serum IgG from three patients with NMDAR encephalitis and three healthy controls. Primary cultured mouse astrocytes and neuron–astrocyte cocultures were incubated with 5 <i>μ</i>g patient or control IgG for 12 and 24 h. Cell viability and astrocyte activity were assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) and calcium (Ca²⁺) imaging studies (using a vector expressing a genetically encoded indicator under the GFAP promoter), respectively. Supernatant levels of TNF-<i>α</i>, a mediator of astrocyte–neuron interactions, were measured by ELISA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Purified serum IgG from N-methyl-D-aspartate receptor-antibody positive patients (NMDAR-Ab+ IgG) and healthy controls did not alter the viability of isolated astrocytes and cocultures. NMDAR-Ab+ IgG suppressed the duration and amplitude of Ca²⁺ activity of isolated astrocytes at 12 and/or 24 h, whereas all parameters of Ca²⁺ activity were enhanced by NMDAR-Ab+ IgG in astrocyte–neuron cocultures at 12 h. TNF-<i>α</i> levels were increased in supernatants of NMDAR-Ab+ IgG–administered astrocyte–neuron cocultures but not isolated astrocytes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This study provides the first preliminary evidence on the impact of patient-derived NMDAR-Ab+ IgG on astrocytic activity. Our results imply that the interaction of NMDAR-Abs with neurons and astrocytes creates a positive feedback loop reinforcing the activation of astrocytes. TNF-<i>α</i> might be one of the perpetrators of this loop.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2025 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/2861013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145366861","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":"Peroneal Electrical Transcutaneous Neuromodulation (Peroneal eTNM) in the Treatment of Essential Tremor","authors":"Petra Bártová,&nbsp;Eva Augste,&nbsp;Filip Strouhal,&nbsp;Jan Krhut,&nbsp;Martin Slovák,&nbsp;Lukáš Peter,&nbsp;Martin Schmidt,&nbsp;David Školoudík","doi":"10.1155/ane/5231029","DOIUrl":"https://doi.org/10.1155/ane/5231029","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Given the limitations of the currently available treatment options for essential tremor (ET), the development of a safe and effective method to manage ET is warranted. The aim of this study is to investigate the safety and feasibility of peroneal electrical transcutaneous neuromodulation (peroneal eTNM) in patients with ET.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients enrolled in the study were treated with peroneal eTNM daily for 30 min over 6 weeks, followed by a 6-week follow-up period without stimulation. Peroneal eTNM was administered alongside their chronic medication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 12 patients (eight men, mean age 60.2 ± 17.7 years, mean disease duration 9.2 ± 7.8 years) were enrolled. All patients were able to use the stimulation at home without assistance. During the study, only two transient treatment-related adverse events were reported. Seven patients (58.3%) reported subjective improvement using the Patient Global Impression of Improvement questionnaire at the end of treatment (EoT), and five patients (41.7%) reported improvement at the end of study (EoS). We observed a significant reduction in the total Essential Tremor Rating Assessment Scale (TETRAS) score, with median (IQR) values decreasing from 38.3 (30.5–49.0) at baseline to 36.5 (20.8–41.5) at EoT and 34.5 (13.0–36.8) at EoS. Similarly, tremor severity, as measured visually and with an accelerometer, showed significant improvement. However, no significant changes were observed in tools assessing quality of life and general disability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This pilot study demonstrates that peroneal eTNM is safe and feasible for patients with ET. Despite the limited sample size, ET patients treated with peroneal eTNM showed significant improvement in tremor severity as measured by both subjective and objective tools. Future studies with a larger sample size and sham-controlled design are needed to confirm these findings and further validate the potential of peroneal eTNM in the treatment of patients with ET.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov identifier: NTC06036368</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2025 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/5231029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145366489","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 Relationship Between Alcohol Consumption and Persistent Posttraumatic Headache After Mild Traumatic Brain Injury: A Single-Center Study","authors":"Yuanrun Zhu,&nbsp;Gengjing Chen,&nbsp;Jin Huang,&nbsp;Ping He,&nbsp;Zhifeng Wu,&nbsp;Chen Jiang","doi":"10.1155/ane/8359474","DOIUrl":"https://doi.org/10.1155/ane/8359474","url":null,"abstract":"<p>Traumatic brain injury (TBI) is a prevalent neurosurgical emergency that imposes a significant healthcare burden. Even mild TBI can lead to chronic headache. However, the relationship between posttraumatic headache and alcohol use remains unclear. This study is aimed at investigating the association between alcohol consumption and the development of persistent posttraumatic headache following mild TBI. Adult patients with mild TBI, treated between January 2023 and December 2023, were included. Follow-up interviews were conducted at least 6 months after hospital discharge. Logistic regression analysis was employed to adjust for baseline characteristics and other comorbidities. A total of 207 patients were analyzed, with an overall incidence of persistent posttraumatic headache of 36.2%. The regression analysis revealed an inverse relationship between alcohol consumption and persistent posttraumatic headache (OR: 0.355, 95% CI: 0.175, 0.717) after adjusting for confounding factors. This association remained unchanged after accounting for TBI- or headache-related alcohol avoidance (OR: 0.436, 95% CI: 0.212, 0.897). Female sex emerged as an independent risk factor for persistent posttraumatic headache (OR: 2.206, 95% CI: 1.107, 4.393). Other variables, including age, duration of hospital stay, in-hospital neurological symptoms, vomiting, sleep disorders, education level, and comorbidities, did not significantly affect the risk of persistent posttraumatic headache in the regression model. In conclusion, alcohol consumption is inversely associated with persistent posttraumatic headache in mild TBI patients. Although TBI- or headache-induced alcohol avoidance provides a plausible explanation for this inverse relationship, it may not fully account for the phenomenon. Female patients are at a higher risk of developing persistent posttraumatic headache after mild TBI. Further studies with low bias are needed to explore this relationship. Medical recommendations regarding alcohol consumption should be provided cautiously, considering the latest evidence, to inform patients with mild TBI about the potential risk of posttraumatic headache.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2025 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/8359474","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272423","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":"Higher High-Density Lipoprotein Cholesterol Levels Are Associated With an Unfavorable Outcome After Thrombolysis for Stroke: The Lipid Paradox","authors":"Ming-Ya Luo,&nbsp;Fu-Liang Zhang,&nbsp;Shan Lv,&nbsp;Yu Song,&nbsp;Yao Yu,&nbsp;Zhen-Ni Guo,&nbsp;Yi Yang","doi":"10.1155/ane/1668467","DOIUrl":"https://doi.org/10.1155/ane/1668467","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Effects of serum cholesterol levels on stroke outcomes remain controversial, especially in intravenous thrombolysis (IVT)–treated patients. This study explored the association between lipid levels and outcomes in patients with acute ischemic stroke (AIS) who received IVT with recombinant tissue plasminogen activator (rt-PA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>AIS patients who received rt-PA thrombolysis from April 2015 to December 2018 were retrospectively enrolled. Fasting lipid profiles, including total cholesterol, triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol (HDL-C), were collected. Stroke outcomes included hemorrhagic transformation, 3-month unfavorable outcome (modified Rankin scale &gt; 2), and 3-month mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We enrolled 698 IVT-treated patients with AIS. Binary logistic regression analysis showed that a higher HDL-C level was independently associated with a higher risk of a 3-month unfavorable outcome (odds ratio 1.999, 95% confidence interval 1.204–3.320, <i>p</i> = 0.007). Patients were then divided into high and low HDL-C groups according to a cutoff HDL-C of 1.415 mmol/L. After propensity score matching to adjust for baseline factors, patients in the high HDL-C group were more likely to experience a 3-month unfavorable outcome than those in the low HDL-C group (<i>p</i> = 0.041).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A higher HDL-C level was independently associated with a 3-month unfavorable outcome in IVT-treated patients with AIS. The current study received approval from the Ethics Committee of the First Hospital of Jilin University (No. NCT05028868).</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2025 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/1668467","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145224025","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":"Risk Factors of Oropharyngeal Dysphagia and Malnutrition in Neurological Patients","authors":"Līga Savicka,&nbsp;Baiba Kubile,&nbsp;Guna Bērziņa","doi":"10.1155/ane/3715519","DOIUrl":"https://doi.org/10.1155/ane/3715519","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Oropharyngeal dysphagia (OD) and malnutrition are prevalent among neurological patients, particularly those with cerebrovascular disease and neurodegenerative conditions. Both conditions can significantly impact the health and recovery of these individuals. The study was aimed at identifying risk factors associated with OD and malnutrition, using the biopsychosocial model to explore the relationships between these outcomes and various risk factors, including body structures, body functions, level of activity and participation, and contextual factors.&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 cross-sectional study included 144 neurological patients, aged 19–93 years. Data were collected on a range of factors, including oral and pharyngeal structures, appetite, cognitive function, and social participation. The prevalence of OD and malnutrition was assessed using the Standardized Swallowing Assessment and Global Leadership Initiative on Malnutrition (GLIM) criteria. Risk factors were evaluated using logistic regression models based on the biopsychosocial model.&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;The prevalence of OD and malnutrition in the study sample was 27.1% and 35.4%, respectively. Significant risk factors for OD included impaired oral structures (tongue, lips, and soft palate), cognitive dysfunction, and appetite loss. Malnutrition was associated with soft palate impairment, reduced calf circumference, weight loss, and social isolation. Higher scores in the WHO Disability Assessment Schedule (WHODAS 2.0) getting along domain (indicating poor social functioning) and living alone were linked to increased malnutrition risk. No significant relationship was found between environmental factors or health conditions and OD or malnutrition. While most dysphagia patients retained some ability to eat orally, dietary adaptations were frequently required.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study highlights the high prevalence of OD and malnutrition among neurological patients and identifies key risk factors, including both physical impairments and psychosocial elements. Early screening and targeted interventions, such as dietary modifications and cognitive support, are essential for improving patient outcomes. A biopsychosocial approach is effective in understanding the multifactorial nature of these conditions and informs clinical practice. Future longitudinal studies are necessary to better understand causal relationships and enhance the generalizability of these findings.&lt;/p&gt;\u0000 ","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2025 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/3715519","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145223934","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}