Acta Neurologica Scandinavica最新文献

{"title":"Prevalence of the Hot Cross Bun Sign and Factors Associated With HCBS Positivity in Patients With Multiple System Atrophy","authors":"Kaige Zhang,&nbsp;Yao Wang,&nbsp;Xuan Xu,&nbsp;Han Zhang,&nbsp;Yunxian Wang,&nbsp;Meiqi Wei,&nbsp;Zhigang Chen","doi":"10.1155/ane/9598542","DOIUrl":"https://doi.org/10.1155/ane/9598542","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>In patients with multiple system atrophy (MSA), the hot cross bun sign (HCBS) has been associated with disease severity in MSA. This study is aimed at investigating the prevalence of HCBS and its potential risk factors in Chinese MSA patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A total of 175 MSA patients who met “possible” or “probable” diagnostic criteria were included in this cross-sectional study. The Unified MSA Rating Scale (UMSARS), Nonmotor Symptoms Scale (NMSS), Hamilton Depression Rating Scale-17 (HDRS-17), Hamilton Anxiety Scale (HAMA), and Montreal Cognitive Assessment (MoCA, permission has been granted) were compared between MSA patients with and without HCBS (defined as pontine cruciform hyperintensity on T2-weighted fluid-attenuated inversion recovery [T2-FLAIR] sequences). Binary logistic regression analysis was used to identify the independent risk factors for the presence of HCBS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>HCBS was identified in 110 of 175 patients (62.86%). Univariate analysis revealed significant relationships between HCBS and female, cerebellar subtype, REM sleep behavior disorder (RBD), higher UMSARS-IV score, and moderate-to-severe white matter hyperintensities (WMHs). The occurrence of HCBS in MSA was independently associated with the MSA-C subtype (OR = 6.05, 95<i>%</i>CI = 2.55–14.38), RBD (OR = 2.56, 95<i>%</i>CI = 1.06–6.20), higher UMSARS-IV scores (OR = 2.48, 95<i>%</i>CI = 1.42–4.35), and moderate-to-severe WMH (OR = 4.10, 95<i>%</i>CI = 1.14–14.75).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>HCBS is a common neuroimaging observation in MSA patients. Our research shows that the MSA-C subtype, RBD, greater disability severity (as assessed by UMSARS-IV), and moderate-to-severe WMH are independent risk factors for HCBS. Higher UMSARS-IV scores were substantially linked to the presence of HCBS, but there was no association between the severity grade of HCBS and the degree of disability. The prevalence of HCBS and its clinical correlates in a Chinese MSA cohort are demonstrated cross-sectionally in this study, especially with regard to subtype, RBD, disability, and WMH burden.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/9598542","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148092731","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":"Computed Tomographic Perfusion Imaging Variables Versus Time From Stroke Onset to Acute Reperfusion Therapy in Predicting Functional Outcome","authors":"Laura Mannismäki,&nbsp;Nicolas Martinez-Majander,&nbsp;Olli P. Suomalainen,&nbsp;Aleksi J. Sihvonen,&nbsp;Gerli Sibolt,&nbsp;Miranda Nybondas,&nbsp;Maria Girfanova,&nbsp;Anni Sartanen,&nbsp;Sami Curtze","doi":"10.1155/ane/1792956","DOIUrl":"https://doi.org/10.1155/ane/1792956","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The rate of infarct growth from a yet salvageable penumbra into an ischemic core varies between individuals. Thus, computed tomographic perfusion (CTP) may improve patient selection for intravenous thrombolysis (IVT) and endovascular thrombectomy (EVT). We aimed to assess whether treatment delay and pretreatment CTP parameters are independent predictors of functional outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Consecutive patients who underwent CTP and received reperfusion therapy with a known stroke onset were identified retrospectively at Helsinki University Hospital between 1/2016 and 12/2023. Ordinal regression was used to analyze the association between the CTP parameters estimated by RAPID, an automated CTP postprocessing software, and onset-to-treatment time with an unfavorable shift on the 3-month modified Rankin Scale (mRS) in the entire cohort, in IVT-only patients, and in EVT patients with or without reperfusion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the univariable analyses of the total of 948 patients, increasing onset-to-treatment time (odds ratio 1.17, 95% confidence interval 1.11–1.25), ischemic core (12.5, 8.33–20.0), and penumbra (2.27, 1.89–2.70) volumes were associated with worse outcomes. In the multivariable analyses, ischemic core volume (4.76, 2.94–7.69) and onset-to-treatment time (1.20, 1.14–1.28) were significant predictors of worse outcomes, but not baseline penumbra volume (1.06, 0.86–1.30), which was compatible in IVT-only patients and in EVT patients with reperfusion. Also, larger severe hypoperfusion volume, higher hypoperfusion intensity ratio, and cerebral blood volume index were associated with functional outcomes in the total cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Both ischemic core and penumbra volumes and onset-to-treatment time predicted a worse outcome, but of these, only ischemic core and onset-to-treatment time were independent predictors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/1792956","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148089189","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 Endothelial Activation and Stress Index and Risk of Neurologic Deterioration and Mortality in Patients With Acute Ischemic Stroke: A Retrospective Cohort Study","authors":"Xiaolan Yang,&nbsp;Yameng Sun,&nbsp;Jieqing Wan","doi":"10.1155/ane/3332330","DOIUrl":"https://doi.org/10.1155/ane/3332330","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In-hospital neurologic deterioration (ND) in patients with acute ischemic stroke (AIS) is associated with worse prognosis, and endothelial dysfunction may be involved in this process. This study is aimed at evaluating the association between the endothelial activation and stress index (EASIX) and the risk of ND and short-term mortality in patients with AIS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study included patients with AIS from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database from 2008 to 2022. EASIX was calculated as (serum lactate dehydrogenase level [U/L] × creatinine level [mg/dL])/platelet count (10⁹/L). Multivariable logistic regression and Cox regression analyses were utilized to examine the associations of log-transformed EASIX (Ln (EASIX)) and ND and 28-day mortality, respectively. Propensity-score matching (PSM) and overlap weighting (OW) were performed to assess the robustness of the findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1157 AIS patients were enrolled; 305 (26.36%) died within 28 days, and 673 (58.17%) experienced ND. Patients with Ln (EASIX) ≥ 0.40 had a higher risk of ND (OR = 1.56, 95% CI: 1.17–2.07) and 28-day mortality (HR = 1.47, 95% CI: 1.12–1.94) compared with those with Ln (EASIX) &lt; 0.40. These associations remained significant after PSM and OW (all <i>p</i> &lt; 0.05). Mediation analysis suggested that ND partially mediated the relationship between Ln (EASIX) and 28-day mortality risk, with a mediation proportion of 89.34% (<i>β</i> = 0.35, 95% CI: 0.11–0.63).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Elevated EASIX was associated with an increased risk of ND and 28-day mortality in patients with AIS. ND may partially explain the EASIX-mortality association, but these hypothesis-generating findings warrant validation in future prospective studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/3332330","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148086734","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":"Thyroid-Stimulating Hormone (TSH) as a Blood Biomarker in the Acute Clinical Diagnosis of Adult Epilepsy","authors":"Andreas Posa,&nbsp;Alexander Emmer,&nbsp;Ole Hensel,&nbsp;Jennifer Nerger,&nbsp;Malte E. Kornhuber","doi":"10.1155/ane/3171577","DOIUrl":"https://doi.org/10.1155/ane/3171577","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Epileptic seizures (ESs) are among the most common neurological disorders. Early diagnosis can be supported by laboratory parameters. However, no single biomarker is sufficient to confirm or exclude ES. This study investigates the role of thyroid-stimulating hormone (TSH) in the acute diagnosis of bilateral tonic–clonic ES in adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this retrospective single-center study, patients with bilateral tonic–clonic ES admitted between April 2024 and March 2025 were screened. Patients meeting predefined inclusion and exclusion criteria were analyzed. TSH levels were measured within the first hour after ES and on the following day as part of routine clinical care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-four patients met the inclusion criteria (mean age: 68.4 ± 19.6 years). TSH levels were significantly elevated within the first hour after ES (mean: 6.39 <i>μ</i>U/mL) compared to the following day (mean: 2.37 <i>μ</i>U/mL), when values returned to the normal range (<i>p</i> &lt; 0.005; Cohen′s dz = 1.90).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>TSH levels show a transient postictal elevation in adult bilateral tonic–clonic ES. This finding suggests a potential role as an adjunctive biomarker in acute diagnostics. However, specificity remains uncertain and requires confirmation in prospective controlled studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/3171577","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148076246","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":"Increased Peak Width of Skeletonized Mean Diffusivity in Status Epilepticus: Implication for Diffuse White Matter Microstructural Alteration","authors":"Jinseung Kim,&nbsp;Dong Ah. Lee,&nbsp;Ho-Joon Lee,&nbsp;Kang Min Park","doi":"10.1155/ane/7155788","DOIUrl":"https://doi.org/10.1155/ane/7155788","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Peak width of skeletonized mean diffusivity (PSMD) serves as a new biomarker for diffuse white matter microstructural damage. This study is aimed at quantifying PSMD in patients with status epilepticus (SE) to investigate white matter microstructural abnormalities and their potential association with small vessel disease (SVD) mechanisms in SE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively enrolled patients with SE and healthy controls matched for age and sex. Diffusion tensor imaging (DTI) was performed using a 3.0 Tesla magnetic resonance imaging scanner to measure PSMD. We compared the PSMD values between patients with SE and healthy controls. Additionally, we analyzed correlations between PSMD and clinical factors in patients with SE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-eight patients with SE and 31 healthy controls were included in this study. PSMD values were significantly higher in patients with SE compared with controls (3.024 vs. 2.257, <i>p</i> &lt; 0.001). Additionally, in patients with SE, PSMD positively correlated with age (<i>r</i> = 0.721, <i>p</i> &lt; 0.001). However, PSMD was not significantly correlated with other clinical characteristics, including the duration of SE and the number of antiseizure medications (<i>r</i> = 0.031, <i>p</i> = 0.876; <i>r</i> = −0.340, <i>p</i> = 0.076, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients with SE exhibited significantly elevated PSMD, which was associated with white matter microstructural abnormalities. These findings suggested that PSMD may be a useful imaging marker for assessing white matter changes in SE and warrant further investigation into its association with underlying vascular and nonvascular mechanisms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/7155788","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148068530","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":"Impact of a 12-Week Telecoaching Aerobic Training Program in a Green Environment on Quality of Life and Migraine Frequency: A Pilot Study","authors":"Ignazio Leale,&nbsp;Angelo Torrente,&nbsp;Vincenzo Di Stefano,&nbsp;Francesco Cutaia,&nbsp;Salvatore Maria Lima,&nbsp;Paolo Alonge,&nbsp;Cecilia Camarda,&nbsp;Filippo Brighina,&nbsp;Giuseppe Battaglia","doi":"10.1155/ane/5829503","DOIUrl":"https://doi.org/10.1155/ane/5829503","url":null,"abstract":"<p>Growing evidence indicates that aerobic exercise can be considered among the nonpharmacological strategies for migraine management. The present pilot study investigated the effects of a 12-week telecoaching (TC) aerobic exercise, performed in a green environment, on migraine-related outcomes. The primary endpoint regarded headache characteristics, while quality of life (QoL) and physical activity levels were considered secondary outcomes. At baseline (T0), participants′ physical activity level and QoL were evaluated using the International Physical Activity Questionnaire (IPAQ) and the Migraine-Specific QoL Questionnaire (MSQ) v2.1. The study sample consisted of 20 individuals (18 females, mean age 48.95 ± 12.17 years). The intervention consisted of a structured, progressive walking program of moderate intensity, performed three times per week. Exercise duration progressively increased from 30 to 50 min across the 12-week intervention period. The subjects showed relatively high baseline physical activity levels that remained stable over time (total MET 4121.39 ± 8961.93 vs. 5399.45 ± 5968.58, <i>p</i> = 0.275). Migraine intensity did not change significantly (mean numeric rating scale [NRS] 5.86 ± 1.41 vs. 5.50 ± 2.14, <i>p</i> = 0.570). In contrast, subjects reported a significant improvement in migraine frequency, with a reduction in headache days over different recording windows (13.50 ± 7.29 vs. 11.40 ± 6.88, <i>p</i> = 0.012). Multivariate analysis did not reveal significant changes in secondary outcomes, including MSQ score. Overall, the results of such a pilot study confirm how a TC-based aerobic exercise intervention may reduce headache frequency in physically active individuals with migraine. Nevertheless, the approach did not modify migraine intensity or QoL but may still support general good health maintenance.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/5829503","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148065581","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":"Applicability of S100B in the Screening of Intracranial Injury in Patients With Mild Traumatic Brain Injury Intoxicated With Alcohol","authors":"J. Vicens,&nbsp;Gomila Muñiz,&nbsp;D. Sánchez-Cuadrado,&nbsp;M. A. Servera,&nbsp;F. Pou,&nbsp;F. Sarubbo","doi":"10.1155/ane/8819203","DOIUrl":"https://doi.org/10.1155/ane/8819203","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Traumatic brain injury (TBI) frequently occurs in patients with ethanol intoxication (EOI), complicating cranial CT evaluation. Therefore, it is necessary to identify simple alternative biomarkers of intracranial lesions (ICL). This study assesses whether the biomarker S100B can help rule out ICL in patients with mild TBI and EOI, according to Scandinavian TBI guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>An observational study with cross-sectional data collection was conducted at Son Llàtzer University Hospital (HUSLL), in Palma de Mallorca, including patients aged 18–65 years who sustained mild TBI in the context of EOI (<i>n</i> = 116), had an inconclusive Glasgow Coma Scale (GCS) score, and presented to the Emergency Department within 6 h of injury. Blood samples were collected to measure S100B and blood alcohol levels. All patients underwent cranial CT (the gold standard). CT results (positive/negative for ICL) were compared with S100B values, dichotomized at ≤ 0.1 <i>μ</i>g/L.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The primary objective was to analyze the relationship between S100B levels (≤ 0.1 <i>μ</i>g/L vs. &gt; 0.1 <i>μ</i>g/L) and cranial CT results. In 97.8% of patients with a negative CT result, S100B levels were ≤ 0.1 <i>μ</i>g/L. Conversely, among those with S100B &gt; 0.1 <i>μ</i>g/L, 12.7% had a positive CT result (<i>χ</i>² = 3.82, df = 1, <i>p</i> = 0.04; OR = 6.38; 95<i>%</i>CI = 1.01–52.25). S100B demonstrated a high sensitivity of 90% for detecting ICL, with a specificity of 42%, a positive predictive value of 13%, and a negative predictive value of 98%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>S100B appears to be a sensitive biomarker for ruling out ICL in mild TBI. Levels ≤ 0.1 <i>μ</i>g/L were associated with negative CT findings, whereas higher levels showed limited positive predictive value. S100B may help reduce unnecessary CT imaging in low-risk patients; however, its limited specificity requires interpretation within the clinical context.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/8819203","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148098357","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 Fatigue, Information Processing Speed and Plasma Levels of Glial Fibrillary Acidic Protein and Neurofilament Light in Patients With Relapsing–Remitting Multiple Sclerosis Treated With Natalizumab or Rituximab","authors":"Johan Hellgren,&nbsp;Maria Compagno Strandberg,&nbsp;Oskar Hansson,&nbsp;Shorena Janelidze,&nbsp;Kristina Källén,&nbsp;Anders Svenningsson","doi":"10.1155/ane/5453262","DOIUrl":"https://doi.org/10.1155/ane/5453262","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Patients with relapsing–remitting multiple sclerosis (RRMS) experience fatigue and impaired information processing speed (IPS) frequently, even in the absence of clinical or radiological disease activity. Previous studies investigating associations between fatigue, IPS, neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) have reported conflicting results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine potential associations between GFAP and NfL with fatigue and IPS in patients with RRMS treated with rituximab (RTX) or natalizumab (NTZ).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this Swedish multicentre cross-sectional study, we measured plasma GFAP and NfL levels using Simoa Neurology 2-PLEX B Kit in 121 clinically stable patients with RRMS treated with either RTX or NTZ for at least 24 months. Fatigue and IPS were assessed using the Fatigue Scale for Motor and Cognitive Functions (FSMC) and the Symbol Digit Modalities Test (SDMT), respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No significant associations were found between GFAP or NfL levels and FSMC or SDMT scores. No significant differences in GFAP or NfL levels were observed between RTX- and NTZ-treated groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>No associations were found between fatigue, IPS, GFAP and NfL. GFAP and NfL levels in stable RRMS patients treated with off-label RTX were low and did not significantly differ from those treated with NTZ, possibly suggesting a low risk of long-term disability progression for patients treated with either therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/5453262","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148095973","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":"Levodopa Use and Long-Term Benefit in Different Dystonia Phenotypes","authors":"Rebekka M. Ortiz,&nbsp;Jari Honkaniemi","doi":"10.1155/ane/8089933","DOIUrl":"https://doi.org/10.1155/ane/8089933","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Dopaminergic changes have been reported in various forms of dystonia beyond dopa-responsive dystonia (DRD). Besides DRD, levodopa (LDopa) is generally not considered effective in dystonia and may worsen it. This study assesses the impact of LDopa on different dystonia phenotypes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The patient database of Tampere University Hospital was screened with data mining over a 5-year period to identify individuals with dystonia who had been prescribed LDopa and was evaluated for the possible long-term responsiveness of LDopa in different dystonia phenotypes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The patient database was screened using data mining to identify dystonia patients associated with LDopa over a 5-year period. Clinical information and response to LDopa were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>LDopa was considered beneficial with 32 of 71 patients. All DRD patients had long-term benefit of LDopa, as well as 44% generalized dystonia patients and 25% segmental dystonia patients, but none of the focal dystonia patients. Of the seven patients with functional dystonia, four considered LDopa originally beneficial, but the effect was temporary with two patients, resulting in elevating LDopa doses. LDopa benefit was associated positively with lower limb dystonia (OR 7.0, <i>p</i> = 0.002) and negatively with cervical dystonia (OR 0.2, <i>p</i> = 0.001). Moreover, long-term LDopa benefit had a significant correlation with unspecified stiffness (OR 4.0, <i>p</i> = 0.014) and walking difficulties (OR 3.8, <i>p</i> = 0.022).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Other than DRD, LDopa should only be considered in generalized dystonia patients with lower limb dystonia and walking difficulties. Objective estimation of symptoms should be conducted if considering LDopa treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/8089933","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148095978","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":"Mechanism of Electroacupuncture at Jiaji Acupoints (EX-B2) Improving Neuropathic Pain in Cervical Spondylotic Radiculopathy Rats via Modulating Microglial STAT3 Phosphorylation and Mitochondrial Function","authors":"Shuai Luo,&nbsp;Wei-na Yuan,&nbsp;Jing-dong Gu,&nbsp;Pei-jun Zhang,&nbsp;Yi-jie Liu,&nbsp;Zheng Huang","doi":"10.1155/ane/9711693","DOIUrl":"https://doi.org/10.1155/ane/9711693","url":null,"abstract":"<p>Neuropathic pain in cervical spondylotic radiculopathy (CSR) remains a therapeutic challenge, with mounting evidence implicating microglia-driven neuroinflammation as a key contributor. Here, we demonstrate that electroacupuncture (EA) at Jiaji (EX-B2) acupoints relieves CSR-induced neuropathic pain by targeting microglial signal transducer and activator of Transcription 3 (STAT3) signaling. In a CSR rat model, EA significantly improved sensorimotor outcomes. EA suppressed STAT3 phosphorylation in dorsal horn microglia, accompanied by reduced expression of proinflammatory cytokines (TNF-<i>α</i> and IL-6) and reactive oxygen species (ROS). In vitro, serum from EA-treated rats replicated these anti-inflammatory effects in lipopolysaccharide (LPS)–activated BV-2 microglial cells. Mechanistically, EA inhibited microglial STAT3 activation and upregulated the mitochondrial complex I subunit NDUFA13, restoring mitochondrial membrane potential and limiting oxidative stress. Furthermore, EA reversed CSR-induced imbalances in spinal nociceptive (CGRP) and axonal structural (NF200) markers, promoting a homeostatic microenvironment. Together, these findings identify microglial STAT3 as a critical target of EA and reveal a “STAT3–mitochondrial axis” underlying its analgesic effect. Our study provides a mechanistic rationale for applying Jiaji acupoints EA in CSR-induced neuropathic pain and potentially other neuroinflammatory disorders.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/9711693","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148082410","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}