Acta Neurologica Scandinavica最新文献

{"title":"Impact of Depression on Cognitive Function and Phenoconversion to Neurodegenerative Diseases in Patients With Isolated REM Sleep Behavior Disorder","authors":"Seock Hyeon Moon,&nbsp;Jung Kyung Hong,&nbsp;Minji Lee,&nbsp;Hak Hyeon Kim,&nbsp;In-Young Yoon","doi":"10.1155/ane/9980063","DOIUrl":"https://doi.org/10.1155/ane/9980063","url":null,"abstract":"<p><b>Background:</b> This study was aimed at analyzing cognitive function and quantitative electroencephalogram (qEEG) in patients with isolated REM sleep behavior disorder (iRBD) based on the presence of depression and at evaluating the impact of depression on phenoconversion to neurodegenerative diseases.</p><p><b>Methods:</b> Individuals diagnosed with iRBD via polysomnography were included. Based on the presence of depression, patients were categorized into two groups. Neuropsychological tests and qEEG were conducted following the diagnosis of iRBD, and outcomes were compared between the two groups. Patients were regularly followed to monitor their phenoconversion status. Cox regression analysis was performed to assess the hazard ratio associated with depression.</p><p><b>Results:</b> Ninety iRBD patients (70% males) were included, with a median age of 66.3 years. Depression was identified in 26 (28.9%) of these patients. The depressed group showed significantly poorer performance only in color reading subtest of Stroop (<i>p</i> = 0.029) compared to the nondepressed group, showing reduced processing speed. In qEEG, relative gamma power (<i>p</i> = 0.034) and high gamma power (<i>p</i> = 0.020) in the parietal region were significantly higher in the depressed group than in the nondepressed group. Depression was associated with a hazard ratio of 3.32 for the risk of phenoconversion to neurodegenerative diseases in iRBD patients (<i>p</i> = 0.011).</p><p><b>Conclusion:</b> Depressive symptoms in iRBD patients should be closely monitored as they could aggravate cognitive dysfunction and increase the risk of phenoconversion to neurodegenerative diseases.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/9980063","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142664827","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":"Capacity Limitations and Work Ability in Patients With Neurological Conditions With and Without Work Phobic Anxiety","authors":"Anne Henning,&nbsp;Beate Muschalla","doi":"10.1155/2024/6674418","DOIUrl":"https://doi.org/10.1155/2024/6674418","url":null,"abstract":"<p><b>Objective:</b> Work phobic anxiety can occur as an additional problem in any somatic illness and is often associated with work capacity limitations and sick leave. This study investigates work-related capacity limitations in patients with and without work phobic anxiety who are undergoing neurological rehabilitation. It was conducted in the rehabilitation facility Brandenburgklinik Berlin-Brandenburg in Germany.</p><p><b>Methods:</b> Work phobic anxiety was assessed with the Workplace Phobia Scale (WPS). The response rate was 69.51%. Capacity limitations (Mini-ICF-APP) were compared between 19 patients with neurological conditions and work phobic anxiety and 209 patients with neurological conditions without work phobic anxiety. Work participation restrictions were examined and compared using the self- and observer rated Index for Measuring Participation (IMET, IMEP-O). The work ability assessments regarding the patients’ last occupation as well as the general labor market were conducted by the treating physicians as part of their medical reports and compared between the subgroups. The work ability was rated as less than 3 h, 3 to less than 6 h, or 6 h or more a day for more than 6 months, with the latter being an indication for prognostic work ability and potential reintegration into the labor market. This is a common classification in sociomedical assessments in Germany.</p><p><b>Results:</b> Independent <i>t</i>-tests showed that patients with work phobic anxiety were significantly more limited in their planning and structuring of tasks (<i>t</i>[20.104] = 2.310, <i>p</i> = 0.032, <i>d</i> = 0.68), flexibility (<i>t</i>[217] = 3.586, <i>p</i> &lt; 0.001, <i>d</i> = 0.86), assertiveness (<i>t</i>[19.613] = 2.151, <i>p</i> = 0.044, <i>d</i> = 0.70), group integration (<i>t</i>[19.534] = 2.274, <i>p</i> = 0.034, <i>d</i> = 0.76), and mobility capacities (<i>t</i>[16.616] = 2.198, <i>p</i> = 0.042, <i>d</i> = 0.76) and significantly more restricted in participating in work compared to patients without work phobic anxiety (IMEP-O: <i>t</i>[23.549] = 2.298, <i>p</i> = 0.031, <i>d</i> = 0.40; IMET: <i>t</i>[27.191] = 4.581, <i>p</i> &lt; 0.001, <i>d</i> = 0.78). Chi-squared tests revealed no significant differences in the physicians’ work ability assessments between patients with and without work phobic anxiety.</p><p><b>Conclusions:</b> While work phobic anxiety seems to not be decisive concerning early retirement assessments, it is associated with greater capacity limitations and work participation restrictions. The results highlight the need for identifying work phobic anxiety and associated capacity limitations in clinical practice.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/6674418","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142664567","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":"Comparative Assessment of Simoa and Lumipulse for Measuring Serum Neurofilament Light Chain in Multiple Sclerosis Patients","authors":"Raquel Gasque-Rubio,&nbsp;Laura Cubas-Nuñez,&nbsp;Jordi Tortosa-Carreres,&nbsp;Lorena Forés-Toribio,&nbsp;Jéssica Castillo-Villalba,&nbsp;Sara Carratalá-Boscá,&nbsp;Carmen Alcalá-Vicente,&nbsp;Carlos Quintanilla-Bordás,&nbsp;David Gorriz,&nbsp;Francisco Gascón-Gimenez,&nbsp;Guillermo Cervera-Ygual,&nbsp;José Andrés Dominguez-Morán,&nbsp;María Carcelén-Gadea,&nbsp;Begoña Laiz Marro,&nbsp;Bonaventura Casanova,&nbsp;Francisco Pérez-Miralles","doi":"10.1155/2024/1950913","DOIUrl":"https://doi.org/10.1155/2024/1950913","url":null,"abstract":"<p><b>Background</b>: The assessment of serum neurofilament light chain (sNfL) is increasingly significant in the field of neurology. In multiple sclerosis (MS), it proves valuable as a marker for monitoring disease activity and treatment response.</p><p><b>Objective</b>: To compare the Simoa and Lumipulse platforms for measuring sNfL and to establish age-specific reference ranges within a substantial cohort of individuals diagnosed with MS.</p><p><b>Methods:</b> Two hundred sixty-one sNfL measurements from a cohort of 229 MS patients were analyzed with Simoa and Lumipulse. Reference ranges for sNfL were established for three age groups (18–39 years, 40–59 years, and &gt; 60 years) selecting data from 166 patients with stable relapsing–remitting MS.</p><p><b>Results:</b> While sNfL levels correlated between assays, Lumipulse exhibited values higher than Simoa. Passing–Bablok’s analysis confirmed linearity between the two datasets, and the Bland–Altman comparison further supported the agreement between the methods. Analyzing reference ranges for sNfL across three age groups in stable RRMS patients revealed significant differences between the groups on each of the platforms. Although the values followed the same trend, each technology utilized distinct reference ranges.</p><p><b>Conclusion:</b> Simoa and Lumipulse platforms proved equally effective in monitoring patients with MS. The enhanced accessibility of the Lumipulse platform facilitates the expansion of research on sNfL as a biomarker for monitoring MS, thus offering promising opportunities for broader accessibility and advancement in this field.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/1950913","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142579588","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":"Identifying Visual Impairment After Acquired Brain Injury—Current Practice, Referrals, and Barriers","authors":"Eike Wehling,&nbsp;Trine Schow,&nbsp;Karin Spangsberg Kristensen,&nbsp;Eirik Vikane,&nbsp;Helle K. Falkenberg","doi":"10.1155/2024/4858210","DOIUrl":"https://doi.org/10.1155/2024/4858210","url":null,"abstract":"<p><b>Purpose:</b> Visual impairment (VI) is still underdiagnosed in patients with acquired brain injury despite the large impact on daily life activities and rehabilitation. The aim of this study was to explore the current practice of identification of VI, management plans, referrals, and experienced barriers in Norwegian hospital settings.</p><p><b>Materials and Methods:</b> An online survey was sent out to leaders (<i>n</i> = 62) in hospitals treating patients with acquired brain injury. Data from 22 items covering routines, interdisciplinary collaboration, assessment tools, protocols, barriers, referral practice, and background information were collected.</p><p><b>Results:</b> Respondents (<i>n</i> = 108) comprised various professions from mainly acute or subacute settings. Visual field deficits, oculomotor dysfunction, and neglect were most commonly but not routinely assessed (53%–57%). Besides medical examination, patient interviews, and observations rather than standardized tests or questionnaires (82% vs.25%) were used. Few workplaces seemed to have interdisciplinary vision teams (13%). Barriers were patient characteristics such as cognitive and language impairment and limited resources. Below half (45%) felt competent in assessing VI or had attended courses on the topic (44%).</p><p><b>Conclusions:</b> The study highlights the need to implement standardized assessment, improve interdisciplinary collaboration, and facilitate training courses to enable hospital staff to assess VI after brain injury. These steps could contribute to improved assessment and management of VI and contribute to overcome the indicated barriers leading to better patient care and outcome.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/4858210","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563017","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":"Multiple Sclerosis: An Overview of Epidemiology, Risk Factors, and Serological Biomarkers","authors":"Mingzhi Shi,&nbsp;Yingying Liu,&nbsp;Qiuyue Gong,&nbsp;Xianrong Xu","doi":"10.1155/2024/7372789","DOIUrl":"https://doi.org/10.1155/2024/7372789","url":null,"abstract":"<p>Multiple sclerosis (MS) is a demyelinating disease of the central nervous system, which is a primary cause of neurological disability in young and middle-aged individuals in economically developed nations. Although MS is more prevalent and of ever-increasing incidence in developed countries, patients with MS in developing nations confront unique challenges marked by significant economic and social burdens due to their limited access to the advanced diagnostic and treatment resources that are available in developed regions. Timely diagnosis is paramount for effective intervention in MS cases. Regrettably, there is limited availability of neuroimaging evaluations in low- and middle-income nations, prompting the need to obtain alternative diagnostic approaches. In this article, we provide an overview of the worldwide epidemiology of MS, delving into associated risk factors, and examining serological biomarkers as alternatives to imaging. It is, therefore, imperative that strategies for the early diagnosis and treatment of MS are implemented in low- and middle-income countries. This will lead to improved prognoses and quality of life, with a particular focus on enhancing outcomes.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/7372789","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142524931","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":"Cluster Headache Decreases Life Expectancy: A Longitudinal Assessment During 40 Years in a Headache Clinic Cohort","authors":"Jorge Madera,&nbsp;Julio Pascual,&nbsp;Sara Pérez-Pereda,&nbsp;Pedro Muñoz,&nbsp;Vicente González-Quintanilla","doi":"10.1155/2024/3313195","DOIUrl":"https://doi.org/10.1155/2024/3313195","url":null,"abstract":"<p><b>Background:</b> Cluster headache (CH) is one of the most disabling primary headaches. Nowadays, it is unknown if it has an impact on reducing life expectancy.</p><p><b>Methods:</b> We calculated years of potential life lost (YPLL) in deceased individuals from a CH registry of a third-level hospital, using as cutoff the estimated life expectancy for our general population according to their sex and year of death. Furthermore, a descriptive and comparative analysis of the main causes of death, risk factors, and toxic habits was carried out.</p><p><b>Results:</b> There were 25 deaths among the 152 individuals included. Twenty-one (84%) died earlier than expected with a mean of 9.14 YPLL (<i>p</i> = 0.001). Cancer was the most common cause of death in CH patients (64% of deaths vs. 28.5% expected in general population, <i>p</i> ≤ 0.001). Eighty percent and 45% of our deceased patients were smokers and 60% and 45% regular alcohol consumers at the diagnosis of CH and at death, respectively. The percentage of smokers at diagnosis was significantly higher than that in the reference population (80% vs. 33.2%, <i>p</i> &lt; 0.001). There was a significantly higher frequency of arterial hypertension (76% vs. 19.82%, <i>p</i> &lt; 0.001) and diabetes mellitus (40% vs. 7.8%, <i>p</i> &lt; 0.001) at death in CH individuals compared to general population.</p><p><b>Conclusions:</b> CH implies a loss of almost one decade of life expectancy by an increase in cancer deaths. Tobacco and alcohol consumption seem to be the main underlying causes. These results call for an action plan for a better management of CH patients since their diagnosis.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/3313195","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142524706","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":"Diagnostic Panel of Three Genetic Biomarkers Based on Artificial Neural Network for Patients With Idiopathic Generalized Epilepsy","authors":"Ayşegül Yabacı Tak,&nbsp;Nihat Tak,&nbsp;Ferda Ilgen Uslu,&nbsp;Emrah Yucesan","doi":"10.1155/2024/8853018","DOIUrl":"https://doi.org/10.1155/2024/8853018","url":null,"abstract":"<p>The aim of this study is to evaluate the utility of an artificial neural network (ANN) model in diagnosing idiopathic generalized epilepsy (IGE) and to compare the results of the diagnostic model constructed by combining the expression levels of miR-146a, miR-155, and miR-132 genes using ANN, random forest (RF), and discriminant analysis (DA). qRT-PCR is employed to determine the expression levels of the three miRNA genes. Forty-six IGE patients and 51 healthy controls were included in the study. Three genetic biomarkers were employed to assess the discriminative power of the disease, and they were combined using ANN. Additionally, the performance of ANN was compared with RF and DA. Compared to healthy controls, the miR-132 gene was significantly higher (<i>p</i> &lt; 0.001) and the miR-155 and miR-146a genes were significantly lower in IGE patients (<i>p</i> &lt; 0.001). The area under the curve (AUC) for predictions made by the ANN, RF, and DA were 0.96, 0.87, and 0.75, respectively, with accuracy rates of 0.96, 0.88, and 0.76, respectively. We demonstrate that ANN exhibits the highest accuracy, AUC, sensitivity, and specificity values among the three methods. The obtained results indicate that the combination of the three genes used as markers in IGE plays a significant role in the diagnosis of the disease. Instead of assessing biomarkers individually for the disease, combining them using machine learning methods leads to improved model performance. Additionally, not relying on a single genetic biomarker for the disease enables discrimination based on the collective impact of all biomarkers.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/8853018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142429387","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":"Drug-Induced Intracranial Pressure Increase: Disproportionality Analysis of the Public Version of the FDA Event Reporting System","authors":"Caibing Xu,&nbsp;Jinghua Zhang,&nbsp;Yuxia Zhang,&nbsp;Qiuyan Sun,&nbsp;Xuedong Yang,&nbsp;Wei Fang","doi":"10.1155/2024/3153568","DOIUrl":"https://doi.org/10.1155/2024/3153568","url":null,"abstract":"<p><b>Objective:</b> This study is aimed at identifying the most common drugs associated with the risk of intracranial pressure increase (IPI) based on the US Food and Drug Administration Adverse Event Reporting System (FAERS) database.</p><p><b>Methods:</b> OpenVigil 2.1 was used to query the FAERS database and data from the first quarter of 2004 to the third quarter of 2022 were retrieved. Pharmacovigilance tools were employed for the quantitative detection of signals, where a signal represents a drug-induced adverse event, including the reporting odds ratio (ROR &gt; 1 with 95% confidence interval, the reports number ≥ 2) and proportional reporting ratio (PRR &gt; 2, <i>χ</i>² ≥ 4).</p><p><b>Results</b>: Among the 12,060,031 adverse event reports, there were 3113 cases in which drugs were the primary suspect cause of IPI. Drug-induced intracranial pressure increase (DIPI) was more often observed in young females. The Top 5 drugs with the highest ROR and PRR were minocycline, doxycycline, acetazolamide, somatropin recombinant, and cytarabine.</p><p><b>Conclusion</b>: Potential risks of DIPI should be closely monitored in clinical practice. Our study is consistent with clinical observations, which call for further research to establish the basis of these drugs and IPI.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/3153568","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142428940","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":"Pathological Spontaneous Activity in Different Thoracic Paraspinal Muscles in Amyotrophic Lateral Sclerosis","authors":"Yuting Ren,&nbsp;Na Chen,&nbsp;Kang Zhang,&nbsp;Bin Chen,&nbsp;Songtao Niu,&nbsp;Xingao Wang,&nbsp;Fan Jian,&nbsp;Zaiqiang Zhang,&nbsp;Hua Pan","doi":"10.1155/2024/7102913","DOIUrl":"https://doi.org/10.1155/2024/7102913","url":null,"abstract":"<p><b>Objective:</b> The aim of our study was to compare the clinical value of pathological spontaneous activity (PSA) in different thoracic paraspinal muscles (TPMs) in amyotrophic lateral sclerosis (ALS).</p><p><b>Methods:</b> A total of 116 ALS patients were retrospectively analyzed over 31 ± 8 months concerning the occurrence of PSA in T9–T11 TPM. The occurrence of PSA was correlated with pulmonary function and clinical disability.</p><p><b>Results:</b> The positive sharp wave (PSW) potentials were more frequently observed than fibrillation (fib) in T9–T11 segments. The PSA positive frequency of bulbar-onset ALS (B-ALS) is less than upper limb-onset ALS (U-ALS) and lower limb-onset ALS (L-ALS) at the levels of T10 and T11 TPM (<i>p</i> = 0.050, <i>p</i> = 0.001). The fibs/PSWs in TPM indicated high sensitivity and negative predictive value for forced vital capacity (FVC) &lt; 80%. Linear correlation analysis indicated that PSA of TPM was associated with pulmonary ventilation function (PVF). Associations also exist between clinical parameters and PVF as well as the disease severity.</p><p><b>Conclusions:</b> The occurrence of T9-TPM fibs/PSWs was correlated with clinical disability and is extremely helpful in implying an involvement of PVF. The T9-TPM typically provided a good practical indicator for comprehensive disease evaluation, which was irrelevant to the site of onset.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/7102913","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142234813","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":"Association Between Initial Corticosteroid Regimen and Treatment Response Time in Acetylcholine Receptor Antibody–Positive Myasthenia Gravis","authors":"Jinhee Kim,&nbsp;Hyung Jun Park,&nbsp;Seung Woo Kim,&nbsp;Ha Young Shin","doi":"10.1155/2024/1409983","DOIUrl":"https://doi.org/10.1155/2024/1409983","url":null,"abstract":"<p><b>Background:</b> Corticosteroids remain the cornerstone in the management of myasthenia gravis (MG). Initiation of corticosteroid treatment at a high dose and subsequently decreasing the dose or gradual escalation from a low dose is recommended. We aimed to investigate the association between the initial corticosteroid regimen and treatment response.</p><p><b>Methods:</b> A retrospective study was conducted on 234 acetylcholine receptor (AChR) antibody (Ab)–positive MG patients who visited our institution between January 2010 and February 2023. Patients were grouped based on prednisolone dosages received: initial high (IH, ≥50 mg/day) or initial low (IL, ≤20 mg/day). Time to initial improvement and the achievement of minimal manifestation (MM) status were the main outcomes.</p><p><b>Results:</b> Of the 234 patients, 135 were classified as IH and 99 as IL group. The IH group demonstrated a faster onset of improvement compared with the IL group (20.0 [16.0–29.0] vs. 40.0 [27.0–84.0] days), with the IH group being a significant prognostic factor for initial improvement (HR, 2.44; 95% CI, 1.76–3.39). However, the IH group had a higher incidence of steroid-induced exacerbation (51.9% vs. 2.0%, <i>p</i> &lt; 0.001). No significant difference between the IH and IL groups was found in terms of the proportion of patients achieving MM or the time to achieve MM within the first year after treatment initiation.</p><p><b>Conclusion:</b> While an initial high dose of corticosteroid treatment accelerated the onset of therapeutic responses in patients with AChR Ab–positive MG, it was associated with a higher cumulative steroid dose and an increased risk of steroid-induced exacerbations.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/1409983","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142165698","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}