Acta Neurologica Scandinavica最新文献

{"title":"Telerehabilitation for Balance Disorders in People With Multiple Sclerosis: Does Therapist Presence Make a Difference?","authors":"Barbora Grosserová,&nbsp;Markéta Janatová,&nbsp;Dana Horáková,&nbsp;Klára Novotná","doi":"10.1155/ane/3369935","DOIUrl":"https://doi.org/10.1155/ane/3369935","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Balance impairments are common in people with multiple sclerosis (pwMS). Although traditional rehabilitation can improve balance, telerehabilitation has emerged as a promising alternative. We explored two approaches: an individualized telerehabilitation program using the Homebalance system and a video-based home exercise program. The objectives were to (1) assess the feasibility and (2) compare preliminary clinical effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a 12-week randomized feasibility study including pwMS who self-perceived balance difficulties. Participants were randomly assigned to three groups: an individualized telerehabilitation program using the Homebalance system (Group 1), a video-based home exercise program (Group 2), or a control group with no intervention. Primary outcomes were balance measures assessed using the Berg Balance Scale (BBS), the Single Leg Stance test, the Activities-Specific Balance Confidence (ABC) Scale, and the Falls Efficacy Scale International (FES-I). Secondary outcomes included functional mobility, subjective impact of MS on walking ability, and fatigue measures using the Timed Up and Go (TUG), TUG with cognitive task (TUG cognitive), the Multiple Sclerosis Walking Scale-12 (MSWS-12), and the Modified Fatigue Impact Scale (MFIS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-one pwMS (22 in Group 1, 19 in Group 2, and 20 in the control group) completed the study, with no significant baseline differences. Adherence rates were 98.5% in Group 1 and 73.5% in Group 2, with no adverse events reported. After 12 weeks, exploratory analyses showed that Group 1 demonstrated the largest improvements in balance, functional mobility, and subjective impact of MS on walking ability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Both telerehabilitation approaches were feasible, but only the individualized Homebalance program improved balance. It appears that real-time therapist interaction combined with an interactive balance system may enhance patient adherence and lead to better outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov identifier: NCT05839977</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/3369935","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148467135","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":"Sick Leave and Drug Use After Endovascular Versus Surgical Treatment of Unruptured Intracranial Aneurysms: A Nationwide Registry-Based Study","authors":"Erik Thurin,&nbsp;Eddie de Dios,&nbsp;Ole Solheim,&nbsp;Thomas Skoglund,&nbsp;Øyvind Salvesen,&nbsp;Asgeir S. Jakola","doi":"10.1155/ane/6565839","DOIUrl":"https://doi.org/10.1155/ane/6565839","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Both endovascular and surgical treatments are often reasonable alternatives in the treatment of unruptured intracranial aneurysms (UIAs). Studies on how these alternatives affect the well-being of patients beyond rebleeding and mortality are surprisingly scarce. We therefore aimed to study the rate of sick leave and use of antidepressant, sedative, and pain-relieving medication following surgical or endovascular treatment of UIA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>After identifying all 1659 patients treated endovascularly (<i>n</i> = 1021) or surgically (<i>n</i> = 638) for UIAs in the period from 2010 to 2020, we linked several population-based registries using SQL software to determine the use of medications and sick leave. The index date was defined as the day of treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>At 1 month after treatment, sick leave compensation was less frequent (<i>p</i> &lt; 0.001) in the endovascularly treated group (55.2%) compared with the surgically treated group (82.5%), but 2 years after the intervention, there was no meaningful difference between groups. Use of opioids was higher during the first month in the surgically treated group. Use of antidepressants and sedatives did not differ significantly.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interpretation</h3>\u0000 \u0000 <p>Sick leave was more common in patients treated for UIAs than age-matched controls, both 2 years before and 2 years after treatment. Endovascularly treated patients with UIAs have a lower rate of sick leave during the first months after treatment and a lower rate of opioid use during the first month after treatment, compared with surgically treated patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/6565839","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148466701","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":"Replicating Safety Signals for Natalizumab Treatment in Multiple Sclerosis Patients Using German Administrative Health Insurance Claims Data","authors":"Alicia Başoğlu,&nbsp;Mona Reifferscheid,&nbsp;Christine M. Marx,&nbsp;Maike Below,&nbsp;Ellen Kexel,&nbsp;Alexander Stahmann,&nbsp;Ursula Drechsel-Bäuerle,&nbsp;Brigitte Keller-Stanislawski,&nbsp;Klaus Berger","doi":"10.1155/ane/5896024","DOIUrl":"https://doi.org/10.1155/ane/5896024","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system. Immunotherapies such as natalizumab are associated with rare, serious adverse events that were identified by the spontaneous reporting system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To replicate safety signals from the spontaneous reporting system for natalizumab treatment in MS patients using two data sources (ds) of German statutory health insurance (SHI) data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed administrative SHI claims data from 44 company medical funds (ds1, 2010–2018) and 12 German physicians’ associations (ds2, 2013–2018). Patients with a validated MS diagnosis (ICD-10-GM G35) treated with natalizumab until either subsequent other immunotherapies (natalizumab-switcher) or no other following immunotherapy (natalizumab-non-switcher) were included. We searched for safety signals, based on a list of signals derived from the EMA spontaneous reporting system, and calculated odds ratios (ORs) for incident diseases using interferon therapy as a comparison.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 36,798 MS patients were included. Although case numbers were low for most investigated diseases, a safety signal of progressive multifocal leukoencephalopathy (PML) could be replicated for natalizumab-switcher (ds1: OR = 28.88 [6.02, 138.50]; ds2: OR = 59.94 [28.43, 147.32]) and natalizumab-non-switcher (ds1: OR = 28.74 [5.82, 141.88]; ds2: OR = 34.33 [15.43, 87.43]). For natalizumab-switcher, furthermore, a safety signal for herpes simplex was reproduced (ds1: OR = 1.84 [1.27, 2.68]; ds2: OR = 1.48 [1.24, 1.77]). In ds2, increased risks were observed also for herpes zoster (natalizumab-switcher: OR = 1.74 [1.49, 2.03]; natalizumab-non-switcher: OR = 1.36 [1.17, 1.58]) and “other polyneuropathies” (natalizumab-switcher: OR = 1.42 [1.17, 1.70]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Replication of safety signals for specific medications using German administrative SHI data is possible but requires very large datasets to obtain a sufficiently large study sample that allows the identification of rare adverse events such as PML.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/5896024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148462928","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":"Brain Iron Accumulation in Chronic Migraine: Pathophysiological Insights and Imaging Biomarkers for Personalized Therapy","authors":"Shoji Kikui,&nbsp;Daisuke Danno,&nbsp;Takao Takeshima","doi":"10.1155/ane/1977026","DOIUrl":"https://doi.org/10.1155/ane/1977026","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Aim</h3>\u0000 \u0000 <p>Chronic migraine (CM) is a disabling neurological disorder characterized by persistent alterations in central pain modulation pathways. Emerging evidence suggests that abnormal iron accumulation in deep brain nuclei, particularly the periaqueductal gray (PAG), may represent a potential pathophysiological mechanism and an imaging biomarker of disease progression. This review is aimed at synthesizing current knowledge on brain iron metabolism in migraine and its clinical relevance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We narratively reviewed the literature on conventional and advanced magnetic resonance imaging (MRI) techniques, including T2-weighted imaging, susceptibility-weighted imaging, and quantitative susceptibility mapping (QSM), and analyzed their findings regarding iron deposition in patients with migraine, especially CM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Multiple studies have demonstrated increased iron accumulation in the PAG, red nucleus, and nucleus accumbens in CM, correlating with disease duration, medication overuse, and poor treatment responsiveness. QSM has emerged as a sensitive method for quantifying regional iron loads. Three hypotheses have been proposed: iron accumulation as a consequence of repeated attacks, as a causal factor in chronification, or as a comorbid process linked to shared risk factors. Brain iron burden may be associated with therapeutic response to onabotulinumtoxinA and calcitonin gene-related peptide-targeted therapies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>At the molecular level, iron-mediated oxidative damage through ferritinophagy and ferroptosis may contribute to neuronal dysfunction in pain modulatory circuits. While inconsistencies exist across studies, converging evidence supports the importance of iron dysregulation in migraine chronification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Brain iron accumulation may represent a promising imaging biomarker and potential therapeutic target in CM. Further longitudinal and mechanistic studies are warranted to clarify its causal role and to validate iron-based metrics for personalized treatment strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/1977026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148462837","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":"Mini-Review: Vagus Nerve Stimulation and Thalamic Connectivity in Disorders of Consciousness","authors":"Wangxiao Bao,&nbsp;Yining Zhang","doi":"10.1155/ane/3600621","DOIUrl":"https://doi.org/10.1155/ane/3600621","url":null,"abstract":"<p>Disorders of consciousness (DoC), including coma, unresponsive wakefulness syndrome (UWS), and minimally conscious state (MCS), pose major challenges in clinical neuroscience. The thalamus serves as a central hub regulating arousal and awareness through its cortico–thalamo–cortical loops, whereas vagus nerve stimulation (VNS) and its noninvasive form, transcutaneous auricular vagus nerve stimulation (taVNS), have emerged as promising neuromodulatory strategies to promote recovery of consciousness. Recent studies suggest that VNS may influence thalamic and cortical activity, normalize neurotransmitter balance, and enhance functional connectivity across consciousness-related networks. This mini-review synthesizes current mechanistic insights and preliminary clinical evidence relevant to the proposed concept of a thalamic–vagal axis in the recovery of consciousness. We further discuss unresolved challenges, including heterogeneity of treatment response and stimulation parameters, and outline future directions toward biomarker-guided and precision neuromodulation strategies. Collectively, this review underscores the translational potential of VNS-based interventions for patients with DoC.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/3600621","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148386440","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":"Incidence and Clinical Features of Intracerebral Hemorrhage in the Cerebellum and Brainstem: 231 Consecutive Cases","authors":"Ebba Troberg,&nbsp;Birgitta Ramgren,&nbsp;Björn M. Hansen,&nbsp;Arne G. Lindgren,&nbsp;Erik Kronvall,&nbsp;Ola G. Nilsson","doi":"10.1155/ane/2499041","DOIUrl":"https://doi.org/10.1155/ane/2499041","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Intracerebral hemorrhage (ICH) in the posterior fossa, that is, cerebellum and brainstem, often has a poor prognosis. Treatment options are limited. However, primary preventive measures may have changed during the last decades. We aimed to study the hospitalization-based incidence and characteristics of posterior fossa ICH and examine whether these changed during a 13-year period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this cohort study, we identified patients hospitalized due to spontaneous posterior fossa ICH at Skåne University Hospital from 2003 to 2015 registered in Riksstroke, a national stroke quality registry. We calculated incidence by using the direct method, weighted to the Swedish and European populations. Baseline characteristics, clinical admission features, and radiology were obtained from medical records and Riksstroke. We also compared the first half with the latter half of the observation period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 139 cases of cerebellar and 92 of brainstem ICH. The hospitalization-based incidence was 2.7 for cerebellar and 1.8 for brainstem ICH per 100,000 person-years. The most prevalent comorbidities were hypertension and cerebral white matter lesions. Patients with cerebellar ICH were older, more frequently female, and more likely to have hypertension, heart disease, or anticoagulant/antiplatelet medications compared to those with brainstem ICH. Patients with brainstem ICH more often were unconscious or had abnormal pupillary reactions at admission. Patients affected during the latter half of the study period were older, and more often had hypertension or ongoing anticoagulant therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The hospitalization-based incidence of posterior fossa ICH was 4.4 per 100,000 per person-years in this large cohort study of a defined population. Posterior fossa ICH, particularly in the cerebellum, was strongly linked to cardiovascular disease risk factors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/2499041","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148386931","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":"Stroke Care Performance in the Baltic States: A Multicenter Registry-Based Observational Study","authors":"Rytis Masiliūnas,&nbsp;Edgaras Zaboras,&nbsp;Aurelija Daškevičiūtė,&nbsp;Kristaps Jurjāns,&nbsp;Janika Kõrv,&nbsp;Riina Vibo,&nbsp;Vaidas Matijošaitis,&nbsp;Antanas Vaitkus,&nbsp;Agnete Teivāne,&nbsp;Arta Grosmane,&nbsp;Evija Miglāne,&nbsp;Guntis Karelis,&nbsp;Dalius Jatužis,&nbsp;Vitalija Šumskienė,&nbsp;Katrin Gross-Paju,&nbsp;Katrin Sikk,&nbsp;Inga Samarüütel,&nbsp;Katrin Antsov,&nbsp;Saulius Taroza,&nbsp;Vaidotas Gudžiūnas,&nbsp;Paulius Puzinas,&nbsp;Erika Galvanauskaitė,&nbsp;Gintarė Paulėkienė,&nbsp;Robert Mikulik,&nbsp;Aleksandras Vilionskis","doi":"10.1155/ane/5552328","DOIUrl":"https://doi.org/10.1155/ane/5552328","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Stroke remains a major public health challenge in Europe with regional disparities. Although the Baltic states share similar demographic and socioeconomic profiles, they differ in stroke care networks and treatment infrastructure. To date, no direct cross-country comparison of stroke care has been published.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a multicenter cross-sectional analysis of ischemic stroke patients, prospectively recorded in the Registry of Stroke Care Quality (RES-Q) by 23 of 26 primary and comprehensive stroke centers across the Baltic states during at least 1 month of the first quarter of 2022. Data on demographic characteristics, stroke risk factors, acute management, and discharge destinations were compared with assess intercountry differences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 897 ischemic stroke patients were analyzed: 479 from Lithuania, 294 from Latvia, and 124 from Estonia. Although atrial fibrillation (AF) rates were uniformly high (overall 37.2%), anticoagulant use at stroke onset among patients with known AF was significantly higher in Estonia (72.7%) compared with Latvia (34.9%) and Lithuania (48.8%, <i>p</i> = 0.032). Estonia reported the highest intravenous thrombolysis (IVT) rates (44.4%), whereas Lithuania achieved the highest endovascular treatment (EVT) rates (17.7%). In contrast, Latvia had the lowest recanalization therapy rates (IVT 21.1%, EVT 5.1%). Rehabilitation access varied strikingly: Only 2.7% of Latvian patients were transferred to inpatient rehabilitation compared with 30.5% in Lithuania and 20.2% in Estonia (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This first comprehensive comparison of stroke care in the Baltic states highlights a high AF burden and important disparities in recanalization therapy and poststroke rehabilitation pathways.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Access Statement</h3>\u0000 \u0000 <p>The data supporting this study′s findings are available from the corresponding author upon reasonable request.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/5552328","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148324370","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":"Admission Net Water Uptake Predicts Short-Term Functional Outcomes After Endovascular Therapy in Anterior Circulation Large Vessel Occlusion Stroke","authors":"Junying Li,&nbsp;Min Kuang,&nbsp;Xuemin Zhong,&nbsp;Zhongjiao Lu,&nbsp;Jing Gou,&nbsp;Wen Zhou,&nbsp;Yanhui Li,&nbsp;Lanying He,&nbsp;Jian Wang","doi":"10.1155/ane/7000745","DOIUrl":"https://doi.org/10.1155/ane/7000745","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Net water uptake (NWU) on noncontrast computed tomography (NCCT) has emerged as a potential imaging biomarker for infarct age and tissue viability in acute ischemic stroke (AIS). This study is aimed at investigating the association between NWU and short-term clinical outcomes in AIS patients treated with endovascular therapy (EVT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this retrospective single-center study, 193 AIS patients with large vessel occlusion (LVO) who underwent EVT at Chengdu Second People′s Hospital between January 2021 and March 2025 were included. NWU was quantified using automated segmentation of ischemic lesions on NCCT. Functional outcomes were assessed by the modified Rankin Scale (mRS) at 90 days, with good functional outcome defined as mRS ≤ 2. Multivariable logistic regression and receiver operating characteristic (ROC) analyses were used to assess the predictive value of NWU.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 193 patients (mean age: 72.88 ± 12.45 years; 92 males), 37.82% achieved good functional outcomes at 90 days. Higher NWU values were significantly associated with poor functional outcomes (median NWU: 8.7% vs. 5.2%, <i>p</i> = 0.001). NWU was independently associated with unfavorable outcome (OR = 1.064; 95% CI, 1.003–1.129; <i>p</i> = 0.039). ROC analysis showed that NWU had moderate predictive accuracy (AUC = 0.645), which improved when combined with admission NIHSS (AUC = 0.802). NWU was also significantly associated with 90-day mortality or intracranial hemorrhage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Admission CT-derived NWU shows promise as a predictive marker for outcomes in patients with anterior circulation LVO stroke undergoing EVT.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/7000745","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148324350","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":"Video Consultation in Prehospital Stroke Care: Results From a Pilot Feasibility Study","authors":"Lise-Lotte Omran,&nbsp;Magnus Andersson Hagiwara,&nbsp;Hanna Maurin Söderholm,&nbsp;Robin Kindström,&nbsp;Bengt-Arne Sjöqvist,&nbsp;Annika Nordanstig","doi":"10.1155/ane/8271592","DOIUrl":"https://doi.org/10.1155/ane/8271592","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Timely prehospital stroke assessment and accurate triage are essential for improving patient outcomes, especially for those eligible for thrombectomy due to large vessel occlusion (LVO). This pilot study explores the feasibility of video consultations between ambulance nurses (ANs) and stroke neurologists to enhance decision-making in the prehospital stroke care pathway.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective observational cohort study was conducted over 12 months. Patients with suspected stroke were assigned to either video-assisted ambulances (<i>n</i> = 19) or standard ambulances (<i>n</i> = 44). The primary outcome was direct transport to the comprehensive stroke center (CSC). Secondary outcomes included prehospital time intervals and time to stroke treatment. Statistical analyses were performed using Mann–Whitney <i>U</i> and Fisher’s exact tests, with <i>p</i> &lt; 0.05 considered significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients in the video group had significantly longer transport times to the hospital (median 31 min vs. 17 min, <i>p</i> &lt; 0.05), reflecting geographic differences. However, total prehospital time and time to treatment did not differ significantly. A higher proportion of video group patients were transported directly to the CSC (9/19 [47%] vs. 13/44 [30%], <i>p</i> = 0.25). No patients in the video group required secondary transport, whereas 5/44 (11%) in the nonvideo group did. Thrombectomy rates were similar between groups (4/19 [21%] vs. 10/44 [23%], <i>p</i> = 1.00). However, among patients who underwent thrombectomy, a higher proportion in the video group were transported directly to the CSC, without requiring secondary transfer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Video consultations between ANs and neurologists may be feasible in terms of clinical workflow. The primary outcome, direct transport to the CSC, was higher in the video group, indicating potentially improved triage accuracy, and importantly, the intervention did not prolong on-scene time. Video support may reduce delays associated with secondary transport. Although the sample size limits statistical power, these initial findings warrant further investigation through larger studies to evaluate the impact of video support on clinical outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/8271592","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148324206","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 Swallowing and Cough Function in Older Patients With Parkinson′s Disease","authors":"Masahiro Nakamori,&nbsp;Megumi Toko,&nbsp;Hidetada Yamada,&nbsp;Ryotaro Matsuyama,&nbsp;Yuki Hayashi,&nbsp;Mineka Yoshikawa,&nbsp;Toshikazu Nagasaki,&nbsp;Hirofumi Maruyama","doi":"10.1155/ane/8838225","DOIUrl":"https://doi.org/10.1155/ane/8838225","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>With population aging, the number of older patients with Parkinson′s disease (PD) is rapidly increasing. Aspiration pneumonia is a major cause of morbidity and mortality in this population. This study is aimed at characterizing swallowing and cough functions in older patients with PD using a multidimensional assessment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This exploratory analysis used baseline data from an interventional cohort study investigating cervical percutaneous interferential current stimulation in patients with PD at Hoehn and Yahr Stages 2–4. Assessments included handgrip strength, calf circumference, tongue pressure, peak expiratory flow (PEF), 1% citric acid cough test, and videofluoroscopic examination. Factors were compared between patients aged ≥ 75 years (older group) and those aged &lt; 75 years (nonolder group).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-five patients were evaluated (mean age, 72.0 ± 5.9 years; nine women), including nine older patients. The older group demonstrated lower handgrip strength, calf circumference, and PEF. PEF was significantly associated with age, sex, body mass index, handgrip strength, calf circumference, cough test results, and hemoglobin levels. Changes observed after the 8-week intervention did not differ significantly between the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Older patients with PD exhibit a marked reduction in PEF, suggesting impaired airway clearance associated with sarcopenia-related and generalized physical vulnerability. Rehabilitation strategies targeting impaired airway clearance, including respiratory and generalized muscle strengthening and optimizing overall nutritional status, may be critical in this population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>Japan Registry of Clinical Trials: jRCTs062220013</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/8838225","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148282505","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}