Acta Neurologica Scandinavica最新文献

{"title":"Rechargeable and Nonrechargeable Implantable Pulse Generators for Deep Brain Stimulation in Parkinson’s Disease: Long-Term Experience","authors":"Pietro Antenucci,&nbsp;Fabiana Colucci,&nbsp;Andrea Gozzi,&nbsp;Chiara Angelini,&nbsp;Michele Alessandro Cavallo,&nbsp;Alba Scerrati,&nbsp;Ilaria Casetta,&nbsp;Mariachiara Sensi","doi":"10.1155/ane/6097313","DOIUrl":"https://doi.org/10.1155/ane/6097313","url":null,"abstract":"<p><b>Objectives:</b> The study’s objective is to assess long-term experience with rechargeable (r-IPG) and nonrechargeable implant pulse generators (nr-IPGs) for deep brain stimulation (DBS) in Parkinson’s disease (PD).</p><p><b>Material and Methods:</b> Qualitative semistructured interviews, clinical outcomes, and care load estimations were retrospectively collected for a PD-DBS population implanted at our center from 2006 to 2022.</p><p><b>Results:</b> Thirty-seven nr-IPG patients (follow-up 85.3 ± 32.0 months) and 43 r-IPG patients (follow-up 73.1 ± 7.7 months) were analyzed. Long-term satisfaction was sustained in both groups (100% of r-IPG carriers and 75.7% of nr-IPGs, <i>p</i> = 0.001). In r-IPGs, 97.7% recharged the battery easily, and recharging time did not impact everyday life. The percentage of malfunctioning problems (32.6%) in the r-IPG group was in line with previous observations on short-term follow-ups. The size of the IPG was considered too big for 16.2% and 4.2% for nr-IPGs and r-IPGs (<i>p</i> = 0.086), and concerns of interventions for IPG replacements were still present in the nr-IPG group (48.6%). The total amount of days of hospitalization (19.6 ± 9.9 vs. 9.3 ± 4.8, <i>p</i> &lt; 0.001) and the number of complications after the first implant (13 vs. 5, <i>p</i> &lt; 0.05) and during subsequent admissions for IPG substitutions (4 vs. 0, <i>p</i> &lt; 0.05) were higher for the nr-IPGs.</p><p><b>Conclusions:</b> The overall level of long-term satisfaction with IPGs is consistent over time regardless of type. R-IPGs reported no discomfort with recharging even in the long-term evaluation. IPG replacement surgeries and sizes are still a concern, especially for the nr-IPG carriers, but did not affect a high level of sustained satisfaction. Resource burden remains higher for nr-IPGs even in the long term.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2025 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/6097313","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144681317","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":"Anatomical Dimensions of the Proximal Carpal Tunnel Entrance and Its Relationship With Carpal Tunnel Syndrome","authors":"Pablo González-Uriel,&nbsp;Juan Suárez-Quintanilla","doi":"10.1155/ane/9106684","DOIUrl":"https://doi.org/10.1155/ane/9106684","url":null,"abstract":"<p><b>Background:</b> Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy in humans. It is characterized by paresthesias in the median nerve (MN) area, distal to the carpal tunnel (CT). It is more common in middle-aged women. Its incidence increases with repetitive manual activity and obesity, although its ultimate etiology is not well known. Our aim was to determine the ultrasound anatomical dimensions of the proximal CT entrance and their relationship with sex, age, anthropometric data, MN, and the presence or absence of CTS and to assess their possible etiological role in this neuropathy.</p><p><b>Methods:</b> We analyzed the anatomical measurements of the proximal entrance of 793 CTs using ultrasound—height, width, and ellipsoid area—in patients with CTS (578) and in healthy subjects (215). We also analyzed their relationships with age, sex, height, weight, dominant hand, and degree of nerve involvement.</p><p><b>Results:</b> The three anatomical variables studied at the proximal entrance of the CT were height (12.63 ± 1.44 mm), width (22.06 ± 2.01 mm), and ellipsoid area (173 ± 22 mm²). All three measurements studied were higher in cases than in controls and in male than in female. Height and area were strongly associated with the degree of MN involvement.</p><p><b>Conclusions:</b> These results suggest that the proximal CT entrance is a site of adaptability rather than the site of greatest biomechanical stress within the CT in the pathophysiology of CTS.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2025 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/9106684","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144647211","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":"Challenges in Access to Diagnosis and Treatment of Autoimmune Encephalitis in Hospitals in Latin America and the Caribbean","authors":"Miguel A. Vences,&nbsp;Julián A. Rivillas,&nbsp;Rocío N. Campos-Gamarra,&nbsp;Virgilio E. Failoc-Rojas,&nbsp;Daniel A. Godoy","doi":"10.1155/ane/1934971","DOIUrl":"https://doi.org/10.1155/ane/1934971","url":null,"abstract":"<p>This study is aimed at determining the characteristics of access to diagnosis and treatment of autoimmune encephalitis (AE) in hospitals in Latin America and the Caribbean. The descriptive, prospective, and multicenter study was conducted from October to November 2023. Categorical variables were presented as frequencies and percentages in the descriptive analysis, whereas measures of central tendency and dispersion were shown for quantitative data. A distribution map was created based on the number of participating countries. A total of 108 doctors from 19 Latin America and the Caribbean participated, and participants’ median age and years of medical practice were 40 and 13 years, respectively. Regarding specialties, individuals who responded the most to the survey were general intensivists (31.5%), neurologists (28.7%), and neurointensivists (17.6%). There were significant limitations in access to diagnostic methods (resonance, antibody testing, and electroencephalogram), absence of institutional protocols, potential high out-of-pocket costs in financing antibody tests, and low patient follow-up. Heterogeneous diagnostic strategies and therapeutic approaches were found in the countries evaluated, and there was acceptable access to first-line immunotherapy and anticrisis. This first multinational study addressing the existing limitations in Latin America and the Caribbean for treating patients with AE revealed great difficulties and possible inequities. It is important to conduct multidisciplinary collaborations to increase awareness of this disease among decision-makers, clinicians, and investors to reduce its negative impact on the well-being and productivity of affected populations.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2025 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/1934971","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144624832","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":"Impulsivity in Male Episodic Cluster Headache","authors":"Joana Rodríguez-Montolío,&nbsp;Javier Cajape-Mosquera,&nbsp;Belén del Moral-Sahuquillo,&nbsp;Miriam Lasry-Mizzi,&nbsp;Elena Bellosta-Diago,&nbsp;Sonia Santos-Lasaosa","doi":"10.1155/ane/5587883","DOIUrl":"https://doi.org/10.1155/ane/5587883","url":null,"abstract":"<p><b>Background:</b> Cluster headache (CH) is the most prevalent trigeminal-autonomic cephalalgia. Research evidence supports the hypothesized involvement of the posterior hypothalamus, the trigeminal-vascular system, and other central pain-processing regions in the pathogenesis of pain. Because of the role of the hypothalamus, CH patients should be at greater risk of developing an altered emotional response. Impulsivity is associated with depression, bipolar disorders, suicide attempts, and addictive disorders, which can be frequent in CH.</p><p><b>Objective:</b> Our objective is to evaluate the prevalence of impulsivity in CH patients.</p><p><b>Methods:</b> This is a cross-sectional observational study. Barratt Impulsiveness Scale (BIS-11) was administered to evaluate impulsivity.</p><p><b>Results:</b> Fifty CH patients outside the bout and 60 matched controls were included. Patients were recruited from an outpatient headache unit. The percentage of episodic CH patients with a diagnosis of impulsivity (BIS-11 ≥ 73) was 14.2% compared to 1.6% in the control group (<i>p</i> = 0.02). The mean score on the BIS-11 was 58.5 (SD: 14.3) in the case group and 57.1 (SD: 9.2) in the control group. Although the global score on the scale did not differ between both groups, there were differences in cognitive (16.2 [SD: 4.4] vs. 14.5 [SD: 3.5]; <i>p</i> = 0.01) but not in motor and nonplanning impulsivity.</p><p><b>Conclusion:</b> Our findings suggest that CH patients have greater cognitive impulsivity. If impulsivity plays an important role in the risk of suicide and substance use disorders, early detection and an effective multidisciplinary management could reduce CH-related burden and impact.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2025 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/5587883","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144492743","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":"Enlarged Perivascular Space Burden Predicts the Risk of Relapse in Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease Patients","authors":"Ya Chen,&nbsp;Xia Zhang,&nbsp;Chengyu Pan,&nbsp;Zhongxiang Xu,&nbsp;Zucai Xu","doi":"10.1155/ane/8858684","DOIUrl":"https://doi.org/10.1155/ane/8858684","url":null,"abstract":"<p><b>Background and Objectives:</b> Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is an immune-mediated inflammatory demyelinating disease of the central nervous system, with a complex relapse mechanism involving various factors. The connection between enlarged perivascular spaces (EPVSs) and MOGAD is currently unclear. This study is aimed at exploring the risk factors associated with an increased number of EPVS in MOGAD patients and the association with relapse.</p><p><b>Methods:</b> A retrospective study was conducted on 23 patients with MOGAD. We analyzed the correlation between the number of EPVS and age, disease duration, cerebrospinal fluid (CSF) leukocytes, CSF protein, EDSS scores, albumin quotient, and MOG-IgG titer. We employed linear regression to assess the independent risk factors for the number of EPVS, and Cox regression was used to elucidate the independent factors associated with relapse.</p><p><b>Results:</b> The median total EPVS counts were 8 (IQR 4–9) at the initial brain MRI in patients with MOGAD. The number of total EPVS in patients with MOGAD was significantly positively correlated with CSF protein (<i>ρ</i> = 0.42, <i>p</i> = 0.044), EDSS (<i>r</i> = 0.74, <i>p</i> &lt; 0.0001), QAlb (<i>ρ</i> = 0.48, <i>p</i> = 0.022), serum MOG-IgG titer (<i>ρ</i> = 0.48, <i>p</i> = 0.019), and CSF MOG-IgG titer (<i>ρ</i> = 0.46, <i>p</i> = 0.029). Univariate linear regression analysis indicated that CSF protein (<i>β</i> = 0.45, <i>p</i> = 0.03), EDSS scores (<i>β</i> = 0.6, <i>p</i> = 0.002), serum MOG-IgG titer (<i>β</i> = 0.51, <i>p</i> = 0.014), and CSF anti-MOG-IgG titer (<i>β</i> = 0.64, <i>p</i> = 0.001) were independent factors associated with EPVS counts. EDSS scores (<i>β</i> = 0.49, <i>p</i> = 0.002) and CSF MOG-IgG titer (<i>β</i> = 0.54, <i>p</i> = 0.001) were independent predictors associated with EPVS count in the multivariable linear regression model. Multivariable Cox regression analysis showed that the total number of EPVS was the only variable that revealed a significant effect on relapse (HR = 1.22, 95% CI 1.01–1.47, <i>p</i> = 0.04).</p><p><b>Conclusion:</b> In our cohort, we preliminary explored independent risk factors for increased EPVS. Moreover, EPVS might independently predict the risk of relapse in patients with MOGAD.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2025 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/8858684","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144472888","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":"Evaluation of the Clinical and Prognostic Characteristics of Myasthenia Gravis Patients Followed Up in a Tertiary Neuromuscular Disease Center in Thrace Region of Turkey","authors":"Abdullah Uyar,&nbsp;Enes Durak,&nbsp;Nilda Turgut","doi":"10.1155/ane/6259666","DOIUrl":"https://doi.org/10.1155/ane/6259666","url":null,"abstract":"<p><b>Objective:</b> This study is aimed at comparing the clinical, serological, and prognostic characteristics of myasthenia gravis (MG) subtypes based on data obtained from patients monitored at a tertiary neuromuscular disease center in Türkiye, within the framework of MGFA and MGFA-PIS classifications. The limited number of published studies from Türkiye in this field enhances the originality and potential contribution of this study to the regional literature on the local patient profile.</p><p><b>Methods:</b> A total of 190 patients who were monitored between 2012 and 2023 and diagnosed with MG according to clinical, serological, or electrophysiological criteria were included in the study. Patients were classified according to antibody profile, involved muscle group, and age at disease onset. Clinical and demographic characteristics, treatment strategies, and prognosis were assessed.</p><p><b>Results:</b> In the classification of MG based on age at onset, 78.3% of patients in the early-onset MG (EOMG) subgroup were female, while 57.9% of those in the late-onset MG (LOMG) subgroup were male (<i>p</i> &lt; 0.001). Significant differences were found between the EOMG and LOMG groups in the use of azathioprine and corticosteroids (<i>p</i> = 0.006 and <i>p</i> = 0.002, respectively). LOMG was more frequently observed in both the ocular MG (OMG) and generalized MG (GMG) groups. Electrophysiological abnormalities were detected more frequently in the GMG group (<i>p</i> = 0.045). Among patients initially diagnosed with OMG, 41.2% developed generalization during a median follow-up period of 5 years.</p><p><b>Conclusion:</b> This study revealed significant differences among MG subtypes in terms of clinical features, autoantibody profiles, and treatment requirements. The MGFA and MGFA-PIS classifications offer useful tools for individualized treatment planning. The findings provide valuable insights into the potential role of early immunosuppressive therapy in reducing the risk of generalization in patients with OMG.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2025 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/6259666","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144206607","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":"Cortical and Network Reorganization in Glioma-Related Epilepsy: Insights From Structural and Machine Learning Analyses","authors":"Xibiao Yang,&nbsp;Jingyuan Zhou,&nbsp;Simin Zhang,&nbsp;Xinke Li,&nbsp;Huaiqiang Sun,&nbsp;Qiang Yue","doi":"10.1155/ane/8965514","DOIUrl":"https://doi.org/10.1155/ane/8965514","url":null,"abstract":"<p><b>Background:</b> Epilepsy is a common symptom in patients with diffuse lower-grade glioma (DLGG). However, the specific role of cortical alterations in glioma-related epilepsy (GRE) remains unclear. This study is aimed at investigating the reorganization of cortical architecture and network changes associated with GRE.</p><p><b>Materials and Methods:</b> High-resolution T1-weighted and T2-weighted images were acquired from patients with DLGG (GRE = 68, non-GRE = 79) and 94 healthy controls (HCs). Cortical thickness and myelin content were calculated using the Human Connectome Project pipeline. Characteristics of structural covariance networks were computed using graph theory and network-based statistic. Cortical thickness, myelin content, and network characteristics were compared among three groups. A GRE individual prediction model was constructed using an automated machine learning approach.</p><p><b>Results:</b> Compared with HCs, both GRE and non-GRE groups exhibited cortical thinning in the tumor ipsilateral hemisphere, whereas there was cortical thickening in the contralateral hemisphere. Regarding the connectome characteristics, both GRE and non-GRE groups showed decreased nodal efficiency and connections in multiple regions. When comparing GRE with non-GRE, the GRE group exhibited more pronounced cortical thickening and demyelination in the contralateral orbitofrontal gyrus and superior frontal gyrus, with further decreased connections in the sensorimotor network, default mode network, and salience network. Finally, an XGBoost model based on cortical features enabled classification of GRE individuals with an accuracy of 0.80 and an AUC of 0.87.</p><p><b>Conclusion:</b> These findings deepen our understanding of the comprehensive cortical alterations in patients with DLGG and simultaneously provide novel insights into the potential pathophysiological mechanisms underlying GRE.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2025 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/8965514","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144197195","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":"From Traditional to Transformative: Gait Analysis With Wearable Technology and Machine Learning in CSVD Diagnosis and Research","authors":"Ming Yi,&nbsp;Shaoyi Fan,&nbsp;Chi Xiao,&nbsp;Jing Yang,&nbsp;Jiayu Guo,&nbsp;Lei Yu,&nbsp;Bin Hu,&nbsp;Chao Dang,&nbsp;Fuping Xu,&nbsp;Yuhua Fan","doi":"10.1155/ane/1369705","DOIUrl":"https://doi.org/10.1155/ane/1369705","url":null,"abstract":"<p><b>Background:</b> Cerebral small vessel disease (CSVD) often manifests with gait impairment, a critical yet overlooked aspect of early disease progression. Our study is aimed at leveraging wearable sensors and machine learning to analyse gait characteristics, providing a cost-effective and scalable method for early CSVD diagnosis.</p><p><b>Methods:</b> We collected baseline and gait data from 115 individuals diagnosed with CSVD and 120 community healthy controls. All participants underwent a quantitative gait assessment utilizing the wearable device Ambulosono. The study applied an affordable digital 6-min walk test (6MWT) for standardized assessment, employing machine learning to build a prediction model.</p><p><b>Results:</b> Traditional binary logistic regression statistical analysis revealed that the most distinguished gait thresholds during a 6-min walk were walking speed (≤ 70.34 m/min; sensitivity 0.625, specificity 0.791, AUC 0.760) and cadence (≤ 117.45; sensitivity 0.658, specificity 0.748, AUC 0.738). Gait variability was not statistically significantly different. Compared with traditional statistics, the machine learning model greatly improved the ability of gait characteristics to predict CSVD. We used a random forest model to train the selected features, and the AUC of the CSVD prediction mode increased from 0.83 to 0.94 (<i>p</i> = 0.006 DeLong’s test), with 82% accuracy, 78% specificity, 86% sensitivity, 79% precision, and an <i>F</i>1-score of 0.82.</p><p><b>Conclusions:</b> Our findings underscore the innovative application of gait features and machine learning in CSVD diagnosis. The integration of the affordable digital 6MWT gait tool with machine learning represents a promising approach for early detection and large-scale population screening.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2025 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/1369705","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144074446","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":"Prehospital Clinical Presentations and Sex Differences in Stroke Cases and Mimics: A 1-Year Study in a Stroke Unit","authors":"Dag Seeger Halvorsen,&nbsp;Åshild Bjørnerem,&nbsp;Hanne M. Frøyshov,&nbsp;Nina Johnsen Garborg,&nbsp;Torgeir Engstad,&nbsp;Ieva Martinaityte","doi":"10.1155/ane/9292185","DOIUrl":"https://doi.org/10.1155/ane/9292185","url":null,"abstract":"<p><b>Introduction:</b> Stroke is a condition demanding prompt treatment. Differentiating stroke cases from mimics poses a challenge in the prehospital setting. An optimal prehospital scale to identify stroke is still not available. The aims of the study were to (i) explore whether dysphagia, visual impairment, skin sensory loss, or combinations of these symptoms could improve diagnostic stroke accuracy beyond FAST (face, arm, speech, and time) scale and (ii) identify sex differences in stroke diagnostic models.</p><p><b>Materials and Methods:</b> We included 319 patients with stroke or transient ischemic attack (TIA) and 119 stroke mimics in a 1-year period in 2013–2014 and 258 stroke/TIA cases and 90 mimics in a validation cohort in 2023, admitted to the Stroke Unit at the University Hospital of North Norway. Retrospective data on clinical presentations were collected from patient records.</p><p><b>Results:</b> Stroke cases were older than mimics and a larger proportion were men. Age explained 7.5% of the variance in odds ratio (OR) for stroke in women and 1.7% in men, while hypertension or coronary heart disease explained 10.2% in women and 3.7% in men. Adding dysphagia to FAST increased OR for stroke from 3.95 (95% confidence interval (CI) 2.00–7.81) to 4.30 (95% CI 2.14–8.64) and explained variance in OR for stroke by 0.5% in women. Adding visual impairment to FAST increased OR from 5.72 (95% CI 2.74–12.0) to 7.69 (95% CI 3.50–16.9) and explained variance in OR for stroke by 1.9% in men. In the validation cohort, the explained variance in OR for stroke did not increase by adding any more clinical presentations to FAST. Stroke mimics accounted for 27.2% and 25.9% in the two cohorts.</p><p><b>Conclusions:</b> By adding clinical presentations to FAST, no meaningful change in diagnostic performance was gained. An optimal scale for prehospital stroke identification is still needed.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2025 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/9292185","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143939569","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":"Nocturnal Hypoxemia and Daytime Sleepiness in Epilepsy With Obstructive Sleep Apnea-Hypopnea Syndrome: A Case–Control Polysomnography Study","authors":"Meina Wu,&nbsp;Sangru Wu,&nbsp;Sihang Wang,&nbsp;Fang Lin,&nbsp;Xiaolin Ji,&nbsp;Jinzhu Yan","doi":"10.1155/ane/6336114","DOIUrl":"https://doi.org/10.1155/ane/6336114","url":null,"abstract":"<p>Sleep disorders are common in patients with epilepsy, affecting their quality of life. In this study, we aimed to explore the sleep structure of adult patients with epilepsy and determine its correlation with different degrees of obstructive sleep apnea-hypopnea syndrome (OSAHS). We also examined the impact of intermittent hypoxemia on nocturnal sleep structure, respiratory-related events, and excessive daytime sleepiness (EDS). This case–control polysomnography study included 81 patients with epilepsy and 86 healthy controls. Polysomnography combined with video electroencephalography was used to assess sleep structure, respiratory-related events, and factors related to EDS. Patients with epilepsy had a higher prevalence of sleep disorders, hypoxemia, and EDS than controls. Comorbid moderate-to-severe OSAHS was associated with increased risk of severe hypoxemia and awakening. Intermittent and mean hypoxemia worsened with increasing apnea-hypopnea index. The incidence of EDS increased drastically in patients with comorbid moderate-to-severe OSAHS. The total sleep period time was a significant independent predictor of the occurrence of EDS in patients with comorbid moderate-to-severe OSAHS. The study findings indicate that patients with epilepsy experience changes in sleep structure, and the coexistence of OSAHS increases the risk of hypoxemia and EDS. These findings are useful in clinical prognostication of patients with epilepsy comorbid with OSAHS.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2025 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/6336114","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143861611","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}