Acta Neurologica Scandinavica最新文献

{"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}

{"title":"Modifiable Lifestyle Factors and Cognitive Function: A Population-Based Study Amongst Nondemented Men","authors":"Kayla B. Corney,&nbsp;Amanda L. Stuart,&nbsp;Mohammadreza Mohebbi,&nbsp;Julie A. Pasco,&nbsp;Bianca E. Kavanagh,&nbsp;Sophia X. Sui,&nbsp;Lana J. Williams","doi":"10.1155/2024/1935091","DOIUrl":"https://doi.org/10.1155/2024/1935091","url":null,"abstract":"<p><b>Background</b>: As cognitive decline and dementia-related diseases are currently incurable, identifying modifiable and preventative factors is imperative. Thus, we aimed to investigate the associations between modifiable lifestyle factors and cognitive function in a population-based sample of nondemented men.</p><p><b>Methods:</b> Data for 537 men were drawn from the ongoing, population-based, Geelong Osteoporosis Study (GOS). The CogState Brief Battery (CBB) was utilised to determine cognitive function (overall cognitive function [OCF], psychomotor function, attention, working memory, and visual learning). Demographic and lifestyle factors (diet, smoking, physical activity [sport, work/home, and leisure time], alcohol use, and body mass index [BMI]) were self-reported and documented across three waves of data collection. Generalised estimating equation (GEE) models were used to determine associations between the time-updating exposures of interest and each of the cognitive domains.</p><p><b>Results:</b> Age was associated with OCF (<i>η</i>² = 0.298), psychomotor function (<i>η</i>² = 0.163), attention (<i>η</i>² = 0.210), working memory (<i>η</i>² = 0.215), and visual learning (<i>η</i>² = 0.097). Playing sport was associated with all aspects of cognition: OCF (<i>η</i>² = 0.014), psychomotor function (<i>η</i>² = 0.007), attention (<i>η</i>² = 0.004), working memory (<i>η</i>² = 0.013), and visual learning (<i>η</i>² = 0.004), and being physically active during leisure time was associated with visual learning (<i>η</i>² = 0.008). Being physically active at work and home, smoking, diet quality, energy consumed per day, alcohol intake, and BMI were not associated with any of the cognitive domains.</p><p><b>Conclusion:</b> In this study of nondemented men, elements of a healthy lifestyle such as playing sport and being physically active during leisure time were associated with better cognition. Further studies into whether these factors, amongst others, prevent the onset and progression of dementia are needed.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/1935091","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142077845","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":"Gut Microbiota, Metabolites, Circulating Cytokines and Growth Factors, Plasma Proteins, and Risk of Intracranial Aneurysms: A Two-Sample Mendelian Randomization Study","authors":"Aierpati Maimaiti,&nbsp;Zhihao Xie,&nbsp;Mirzat Turhon,&nbsp;Alimasi Abulizi,&nbsp;Wenxuan Wang,&nbsp;Pengfei Wu,&nbsp;Qingyu Yang,&nbsp;Maimaitili Aisha,&nbsp;Zengliang Wang,&nbsp;Yongxin Wang","doi":"10.1155/2024/9764442","DOIUrl":"https://doi.org/10.1155/2024/9764442","url":null,"abstract":"<p><b>Background:</b> Increasing evidence implicates the gut microbiota, metabolites, circulating cytokines and growth factors, and plasma proteins as potential susceptibility factors for intracranial aneurysm (IA). However, due to their complexity, the causal relationship between these factors and IA remains unclear. Our goal was to determine whether these factors are causally associated with IA, UIA, and SAH and provide suggestions for the prevention and treatment of these cerebrovascular diseases.</p><p><b>Methods:</b> Utilizing data from genome-wide association studies (GWAS), we conducted a large-scale Mendelian randomization (MR) analysis between these factors and diseases using five different models (Wald ratio, IVW, MR-Egger, weighted median, and MRPRESSO). Several sensitivity analyses were also applied to ensure the robustness of the results.</p><p><b>Results:</b> Our MR analysis revealed several significant causal relationships between 18 gut microbiota taxa (genus.<i>Bilophila</i>-SAH, beta[95<i>%</i>CI] = −1.08[−1.61 ~ −0.54]), 55 blood metabolites (7-alpha-hydroxy-3-oxo-4-cholestenoate-IA, beta[95<i>%</i>CI] = −2.78[−4.47 ~ −1.08]), 2 cytokines (IL-6-UIA, beta[95<i>%</i>CI] = 0.73[0.34 ~ 1.39]), 45 plasma proteins (RELT-UIA, beta[95<i>%</i>CI] = −0.8[−1.22 ~ −0.38]), and IA, UIA, and SAH. Many of these were reported for the first time.</p><p><b>Conclusions:</b> In conclusion, our study provides reference of the potential causal effects of gut microbiota, blood metabolites, cytokines, and plasma proteins on IA, UIA, and SAH. These findings may contribute to a better understanding of the pathogenesis and potential therapeutic targets for these cerebrovascular diseases.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/9764442","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141994268","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":"Fatigue and Sleepiness in Multiple Sclerosis and Their Response to Short-Term Treatment With Modafinil","authors":"Ann-Katrine Roswalld Thomsen,&nbsp;Marit Otto,&nbsp;Thor Petersen,&nbsp;Kristina Bacher Svendsen","doi":"10.1155/2024/2269483","DOIUrl":"10.1155/2024/2269483","url":null,"abstract":"<p><b>Background:</b> Patients with multiple sclerosis (pwMS) often experience significant fatigue. Simultaneously, previous studies show that pwMS frequently suffer from sleepiness and sleep problems. We aimed to contribute to the understanding of correlations between sleep and sleepiness/fatigue in pwMS to better identify responders to the wake-inducing drug, modafinil.</p><p><b>Methods:</b> This open-label, two-centre study included 26 pwMS suffering from daytime tiredness. Sleepiness, fatigue, and sleep were evaluated by questionnaires (Epworth Sleepiness Scale [ESS], Modified Fatigue Impact Scale [MFIS]/Multidimensional Fatigue Inventory [MFI-20], and Pittsburgh), daily sleep diary, and a wrist-worn actigraph before and after 3-week modafinil treatment.</p><p><b>Results:</b> One-third of the pwMS fulfilled the criteria of excessive daytime sleepiness (EDS, defined as ESS ≥ 10). Eighty-two percent (MFIS) of the patients were fatigued, and a high proportion (96%) of the pwMS were poor sleepers. Sleepiness (ESS) was inverse correlated to the subjective sleep quality. Actigraph data did not relate to subjective sleep, but total sleep time (TST) and higher sleep efficacy (SE) estimated by actigraph were positively correlated to the degree of fatigue. Modafinil had a positive effect on EDS.</p><p><b>Discussion:</b> In the present study, we found that the tired multiple sclerosis (MS) patient may suffer from both EDS and fatigue. We found an inverse correlation between EDS and subjective sleep quality. On the contrary, fatigue was positively correlated with longer TST and higher SE, estimated by actigraph. Sleepiness and fatigue did not correlate, and thus, it is highly relevant to distinguish these two symptoms. Modafinil only showed an effect on fatigue when the patient also suffered from EDS, which could suggest that ESS is a possible screening tool for responders to modafinil treatment.</p><p><b>Conclusion:</b> Sleepiness and fatigue do not seem to correlate in pwMS, and we recommend screening tools for sleepiness as well as sleep quality before initiating modafinil treatment to identify potential responders to the treatment.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/2269483","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141777133","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}