Acta Neurologica Scandinavica最新文献

{"title":"Follow-Up of Clinical Symptoms, Neuronal Biomarkers, and Antibodies in Patients With COVID-19 and Neurological Manifestations","authors":"Can Karakoyun,&nbsp;Johan Virhammar,&nbsp;Elham Rostami,&nbsp;Henrik Zetterberg,&nbsp;Eva Kumlien","doi":"10.1155/ane/6656280","DOIUrl":"https://doi.org/10.1155/ane/6656280","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Biomarkers for neuronal damage have been shown to be elevated during the acute phase of COVID-19 in plasma and cerebrospinal fluid (CSF) of patients with neurological symptoms. Little is known about the temporal dynamics of these biomarkers and their pathophysiological relationship to neurocognitive post-COVID condition (neuro-PCC). Our aim was to conduct a follow-up of clinical symptoms and biomarkers of patients with neurological symptoms in the acute phase of COVID-19.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Follow-up was conducted &gt; 4 months after onset of COVID-19 symptoms. Twenty-eight patients were included and underwent neurological examination, neuropsychiatric and cognitive assessments, and serological testing. Eight patients underwent lumbar puncture. Neurofilament light (NfL), total tau (T-tau), glial fibrillary acidic protein (GFAP), and neuronal antibodies were analyzed in serum or plasma and CSF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>New-onset symptoms post-COVID were reported in 82%. Neurological examination revealed abnormalities in 32% of patients. GFAP and T-tau had normalized in CSF in all patients. However, one patient still showed elevated NfL chain levels in CSF, while two patients had elevated NfL in plasma. New-onset neuronal antibodies in serum were found in 5/27 (19%) and in one patient in CSF. No correlation was found between biomarker levels during acute COVID-19 disease and subsequent neurological symptoms or examination findings at follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Several patients reported new-onset neurological and cognitive symptoms, despite the absence of evidence of ongoing neuronal damage. Additionally, the presence of newly developed autoantibodies was detected in several patients, potentially signaling the emergence of post-COVID autoimmunity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/6656280","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148079212","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":"Molecular Diagnosis in a Specialised Neurogenetic Clinic With Access to Whole-Genome Sequencing","authors":"Patrick B. Moloney,&nbsp;Nicholas W. Wood","doi":"10.1155/ane/2779360","DOIUrl":"https://doi.org/10.1155/ane/2779360","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Rare diseases, collectively affecting 1 in 17 people in the United Kingdom and Ireland, require coordinated care. Specialised multidisciplinary clinics offer a streamlined approach for diagnosis and management of rare neurogenetic disorders. The neurogenetic clinic at the National Hospital for Neurology and Neurosurgery (NHNN) provides a comprehensive service, incorporating whole-genome sequencing (WGS). This study was aimed at characterising the clinic′s patient population, assessing the proportion with a confirmed molecular diagnosis and determining the percentage requiring disease-specific surveillance or receiving precision treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective review of consecutive patients attending the NHNN neurogenetic clinic from January to April 2022 captured data on phenotypes, genotypes, diagnostic methods and management strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 208 attendees (mean age 46.6 years; range 16–81 years), 182 exhibited neurological signs or symptoms, while 26 were referred for predictive testing. The predominant phenotypes were spastic paraplegia (28%), ataxia (22%) and neuromuscular presentations (16.5%). The molecular diagnosis rate among affected families was 59.1% (107/181). Among patients with a genetic diagnosis, 29.6% (32/108) were established through WGS-based panels since 2016. Almost 15% required coordinated multisystem surveillance. While many received symptomatic treatments, only one patient, with homozygous variants in <i>ADCK3</i>, received what could be considered precision treatment (coenzyme Q10). Three patients with severe neurogenetic disorders died prematurely, highlighting the pressing need for therapeutic advancement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The ‘general’ neurogenetics clinic supports a highly diverse patient group, with most symptomatic patients achieving a molecular diagnosis, though many remain unsolved despite access to advanced genomic testing. The clinic plays a key role in coordinating multisystem surveillance and facilitating access to appropriate therapies. While precision treatments remain limited, recent gene therapy developments offer optimism, and accurately genotyped patients will be best positioned to benefit from therapeutic advances.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/2779360","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148082008","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 Perimenstrual Migraine Attacks Using “Headache Diary” Data","authors":"Meltem Duraklı Ulukök,&nbsp;Mine Güray Uzun,&nbsp;Cetın Kılıccı","doi":"10.1155/ane/8811389","DOIUrl":"https://doi.org/10.1155/ane/8811389","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Menstrual migraine (MM), a hormone-related migraine type, is frequently underdiagnosed because current classification systems, especially the International Classification of Headache Disorders (ICHD)-3, are inadequate. Alternative diagnostic models for MM, which consider aura and attack timing, have recently been proposed to improve clinical spectrum capture. This research investigated the occurrence and clinical traits of MM in reproductive-aged women, contrasting the diagnostic effectiveness of the ICHD-3 and Chalmer et al.′s proposed criteria via prospective headache diary data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional observational study included 138 menstruating women aged 18–50 diagnosed with migraine. Over a 6-month period, participants used diaries to record headache attacks, noting frequency, intensity, aura presence, and menstrual cycle phase. Migraine subtypes were classified using the ICHD-3 and Chalmer et al.′s criteria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Based on the ICHD-3 criteria, the study found that 2.2% of participants had pure menstrual migraine (PMM), 29.0% had menstrually related migraine (MRM), and 68.8% were classified as non-MRM. The revised criteria revealed a subtype redistribution, improving the identification of perimenstrual attacks. PMM correlated with significantly increased vomiting (70.0%) and recurrent attacks within the same cycle (90.0%). MRM groups showed significantly fewer visual auras (<i>p</i> = 0.001). The classification systems showed substantial agreement, as indicated by Cohen′s kappa (<i>κ</i> = 0.729, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This research highlights the variable clinical presentation of MM and proposes that using the revised criteria could lead to better diagnoses and more specific treatment plans.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/8811389","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147708222","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":"Characteristics of the Gut Microbiota in Multiple Sclerosis Patients: An Analytical Observational Study","authors":"Cihadiye Elif Ozturk,&nbsp;Sengul Cangur,&nbsp;Banu Humeyra Keskin,&nbsp;Alper Aziz Hudai Ayasli,&nbsp;Pelin Duran,&nbsp;Ayhan Ozturk","doi":"10.1155/ane/9266094","DOIUrl":"https://doi.org/10.1155/ane/9266094","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background:&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Multiple sclerosis (MS) is a chronic disease of the central nervous system characterized by autoimmune inflammation, demyelination, and axonal damage. MS has been linked to neuroinflammatory effects originating in the gut. Recently, research has focused on the gut microbiota composition and the differences in the abundance of specific taxa in patients with MS. We aim to determine the distribution of bacterial composition in the intestinal microbiota of patients with MS and to compare them with healthy controls.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods:&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A total of 27 individuals were selected for the study, 18 of whom were in the MS group and nine in the healthy control group. Participants were surveyed to obtain some demographic and clinical information, body mass index, vitamin D use, and weekly consumption levels of prebiotics–probiotics, carbohydrates, fast-food, and some other foods. Stool samples were also collected.16S rRNA gene sequencing was executed on the samples using the Illumina MiSeq platform. Bioinformatics (alpha and beta diversity indices) and statistical analyses (analysis of similarity, principal coordinate analysis, permutational multivariate analysis of variance, linear discriminant analysis effect size, Ward′s hierarchical clustering method, etc.) were applied to compare the gut microbiome composition of the groups.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results:&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In the bioinformatics analysis process, all samples were analyzed for 391 taxa. However, due to the complete absence of some taxa or the very low relative abundance of some taxa (n&lt;sub&gt;excluded−taxa&lt;/sub&gt; = 249), only 142 taxa were included in the analysis. No significant differences were provided between the groups for microbiota diversity indices (&lt;i&gt;p&lt;/i&gt; &gt; 0.05). However, we found that 22 taxa were discriminatory in the gut microbiota compositions of groups. &lt;i&gt;Actinomyces&lt;/i&gt; from the phylum &lt;i&gt;Actinobacteria&lt;/i&gt;, unclassified some genera (&lt;i&gt;Barnesiellaceae_, Barnesiellaceae_g_&lt;/i&gt;, and &lt;i&gt;Desulfovibrionaceae_g&lt;/i&gt;) from the families &lt;i&gt;Barnesiellaceae&lt;/i&gt;, &lt;i&gt;Desulfovibrionaceae,&lt;/i&gt; a genus classified as other (&lt;i&gt;Veillonellaceae_g_other&lt;/i&gt;) from the family &lt;i&gt;Veillonellaceae&lt;/i&gt; showed higher levels in the MS patients compared with the healthy controls (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). The control group showed significant increases in relative abundance of &lt;i&gt;Blautia&lt;/i&gt;, &lt;i&gt;Peptococcus&lt;/i&gt; from the phylum &lt;i&gt;Firmicutes&lt;/i&gt;, &lt;i&gt;Pseudomonas&lt;/i&gt; from the phylum &lt;i&gt;Proteobacteria&lt;/i&gt;, unclassified genus (&lt;i&gt;Streptophyta_g_&lt;/i&gt;) from the order &lt;i&gt;Streptophyta&lt;/i&gt;, unclassified genera (&lt;i&gt;Pseudomonadaceae_g_, Lachnospiraceae_g_&lt;/i&gt;) from th","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/9266094","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147708080","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":"Structural and Functional Abnormalities in Women With Catamenial Epilepsy","authors":"Yujie Chen,&nbsp;Maojia Ran,&nbsp;Enhui Zhang,&nbsp;Nanya Hao,&nbsp;Chenyang Zhao,&nbsp;Hesheng Zhang,&nbsp;Zhujing Ou,&nbsp;Zhijun Le,&nbsp;Raowei Yan,&nbsp;Weizhi Tian,&nbsp;Muke Zhou,&nbsp;Qiang Yue,&nbsp;Dong Zhou,&nbsp;Xintong Wu","doi":"10.1155/ane/6589710","DOIUrl":"https://doi.org/10.1155/ane/6589710","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Catamenial epilepsy (CE) is a neuroendocrine disorder characterized by seizure exacerbation during specific phases of the menstrual cycle. The pathophysiology of CE remains elusive. This study investigates structural and functional brain alterations in women with Type-I CE, focusing on the interaction between hormonal fluctuations and epileptic networks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirty-three CE women with Type-I CE and 27 healthy controls (HCs) underwent longitudinal multimodal MRI scans during the perimenstrual and midluteal phases. Voxel-based morphometry was used to detect abnormal gray matter volume (GMV), while amplitude of low-frequency fluctuation (ALFF) and fractional ALFF (fALFF) evaluated local signal changes. Functional connectivity was explored with brain regions showing abnormal GMV, fALFF, or ALFF as seed regions. Mediation analysis evaluated structural–functional relationships between hormonal changes and seizure frequency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Reduced GMV was found in the CE group within the superior frontal gyrus, mediodorsal thalamus, insula, and limbic regions. Resting-state functional MRI demonstrated cycle-related fluctuations in the anterior cingulate cortex and the inferior temporal gyrus that were specific to women with CE relative to the HC group. In the seed-based FC analysis, the CE group exhibited hypoconnectivity within the temporo–limbic regions compared to HCs. In contrast to the temporal stability observed in HCs, women with CE displayed extensive hyperconnectivity involving the thalamo–striatal and fronto–parietal regions during the perimenstrual phase relative to the midluteal phase. Correlation analysis indicated that perimenstrual estradiol levels were negatively associated with ALFF value in the inferior temporal gyrus. Mediation analysis suggested mediodorsal thalamus GMV atrophy as a critical substrate linking estradiol fluctuations to perimenstrual seizure exacerbation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings may implicate a hormone-sensitive network with widespread cortical alterations anchored in the thalamo–temporolimbic hub as central to CE pathophysiology. The structural vulnerability of the mediodorsal thalamus acts as a modulator where estradiol withdrawal might trigger functional network instability, suggesting a potential precision target for neuromodulation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/6589710","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147708066","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":"Treatment Challenges in Triple Seronegative Myasthenia Gravis: A Single-Center Experience and Narrative Review of the Literature","authors":"Dimitra Veltsista,&nbsp;John Tzartos,&nbsp;Ioannis Liampas,&nbsp;Zinovia Kefalopoulou,&nbsp;Elisabeth Chroni","doi":"10.1155/ane/5532283","DOIUrl":"https://doi.org/10.1155/ane/5532283","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Triple seronegative myasthenia gravis (tSNMG) constitutes a distinct subgroup of MG that, despite the absence of recognized pathogenetic antibodies directed against the acetylcholine receptor (AChR), muscle-specific tyrosine kinase (MuSK), or low-density lipoprotein receptor–related protein 4 (LRP4), is considered to have an autoimmune origin and is frequently treated with immunosuppressive medications. Limited data exist regarding long-term prognosis and treatment response in tSNMG patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a single-center, retrospective study to investigate the clinical profile and responsiveness to conventional treatment in tSNMG patients, with particular focus on refractory tSNMG patients, compared with nonrefractory tSNMG patients, based on predefined criteria. We also present a narrative overview of therapeutic approaches and treatment response in SNMG in the past decade.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-six out of the 196 (13.3%) MG patients were identified as tSN, and nine of the tSN patients (34.6%) met criteria for refractory MG. Refractoriness in tSNMG patients was associated with female sex and thymic abnormalities (<i>p</i> ≤ 0.005) for both). Less than half of tSNMG patients reached an optimal outcome, defined as minimum manifestation status or better. Prednisone more commonly resulted in a favorable outcome (76.9%), followed by azathioprine (50%). In the subgroup analysis, azathioprine showed a similar response rate (<i>p</i> = 0.193), while significantly lower favorable response rates were achieved with other conventional immunosuppressants in refractory compared to nonrefractory tSNMG patients (<i>p</i> ≤ 0.034 for all).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Treatment challenges in tSNMG are closely linked to the fact that a high proportion of patients in this subgroup exhibit a suboptimal response to conventional immunosuppressants.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/5532283","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147708120","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":"Investigating the Dual Role of Lactate in Temporal Lobe Epilepsy: Energy Substrate Versus HCAR1-Mediated Inhibitory Signaling","authors":"Jian-Ping Song,&nbsp;Kai-Feng Shen,&nbsp;Bin Yu,&nbsp;Li Wang,&nbsp;Ya Lei,&nbsp;Lu-Kang Wang,&nbsp;Xiao-Lin Yang,&nbsp;Gang Zhu,&nbsp;Zhi-Feng Wu,&nbsp;Sheng-Qing Lv,&nbsp;Shi-Yong Liu,&nbsp;Hui Yang,&nbsp;Chun-Qing Zhang","doi":"10.1155/ane/4657460","DOIUrl":"https://doi.org/10.1155/ane/4657460","url":null,"abstract":"<p>Temporal lobe epilepsy (TLE) is the most common type of drug-resistant epilepsy in adults, yet further mechanistic understanding is still needed. Lactate is mass-produced during seizures and serves as epileptic fuel afterward, while it also acts as an inhibitory molecule by activating its receptor, hydroxycarboxylic acid receptor 1 (HCAR1). This study is aimed at clarifying the balance between lactate′s role in fueling or inhibiting seizures in patients and animal models with TLE. Lactate was measured in the hippocampus with magnetic resonance spectroscopy (MRS). The expression of lactate dehydrogenase (LDH), monocarboxylate transporter 4 (MCT4), and HCAR1 was quantified with immunostaining and immunoblotting. shRNA and pharmacological manipulation were used to modulate the function of MCT4 or HCAR1 in in vitro and in vivo recording. Results showed that lactate was accumulated in the hippocampal lesions of TLE patients, attributing to the increased lactate catalytic activity of astrocytic LDH. The expressional level of MCT4, which mediated the transmembrane lactate transportation in astrocytes, was increased, whereas inhibition of MCT4 decreased the excitatory synaptic transmission and knockdown of astrocytic <i>Mct4</i> ameliorated seizure activities in TLE mice. HCAR1 was increased in the hippocampal lesions, and activation of lactate-HCAR1 signaling attenuated seizure activities in TLE mice. Additionally, the alteration in lactate homeostasis was correlated with seizure frequency in TLE patients and could be modulated by ketogenic diet in TLE mice. These data suggest that the inhibitory signaling effect of lactate is outweighed by its fueling role in TLE. Precisely targeting MCT4 or HCAR1 could be effective antiepileptic strategies.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/4657460","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147707926","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":"Nutritional Deficiency as a Risk Factor for Cerebral Venous Thrombosis in Parts of Southern India: A Case-Control Study","authors":"Agam Jain,&nbsp;S. Mythirayee,&nbsp;P. R. Srijithesh,&nbsp;Rita Christopher,&nbsp;Vijay Kumawat,&nbsp;Mailankody Pooja,&nbsp;Ravi Yadav,&nbsp;Girish Baburao Kulkarni,&nbsp;Pritam Raja,&nbsp;D. V. Sheshagiri,&nbsp;V. S. Binu","doi":"10.1155/ane/2596557","DOIUrl":"https://doi.org/10.1155/ane/2596557","url":null,"abstract":"<p>The incidence of cerebral venous thrombosis (CVT) is anecdotally considered to be higher in parts of South India as compared with the West. The higher prevalence of CVT in this population is not accounted for by genetic thrombophilias, implicating acquired risk factors. As hyperhomocysteinemia and vitamin B12 deficiency are common in this population, we expected unique risk factors related to the diet. This case-control study was done to examine the acquired risk factors and dietary patterns in these patients. Patients with CVT admitted from June 2021 to January 2023 were included in the study. Healthy attendants of other patients attending the emergency department for other neurological illnesses were recruited as controls. Clinical and biochemical data of patients were collected. Diet was assessed using a food frequency questionnaire. The contribution of food items to various nutrients (calories, protein, methionine, vitamin B12, folate, pyridoxine, and riboflavin) was calculated and compared with the recommended dietary allowance (RDA) and controls. The study enrolled 104 patients and 109 controls. The mean age of patients was 34.9 years (SD = 13.4). Hyperhomocysteinemia, anemia, alcohol consumption, folate deficiency, and vitamin B12 deficiency were observed in 63.5%, 46.2%, 45.2%, 37.5%, and 26%, respectively. Patients with a history of alcohol consumption had significantly higher homocysteine and lower folate. The diet of the patients had significantly higher odds of being protein-deficient <span></span><math></math> and folate-deficient <span></span><math></math> as compared with controls on multiple linear regression analysis. Poor nutrition, in the form of hyperhomocysteinemia and anemia, was the most common risk factor in the study population. Crucially, these risk factors are modifiable. Further large-scale studies are needed to determine the incidence of CVT in this area and to evaluate the role of dietary interventions for risk modification.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/2596557","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147615443","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":"Effectiveness and Safety of Noninvasive Neuromodulation for Migraine Prevention: A Network Meta-Analysis","authors":"Quan Feng,&nbsp;Fang Liu,&nbsp;Na Li,&nbsp;Xiran Yu,&nbsp;Lu Ning,&nbsp;Yichen Li,&nbsp;Ge Tan","doi":"10.1155/ane/7971285","DOIUrl":"https://doi.org/10.1155/ane/7971285","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Migraine, a common chronic neurovascular disorder, has a global incidence rate of approximately 14%. Limited evidence exists for clinical decision-making related to migraine preventive treatment via noninvasive neuromodulation. To bridge this gap, we conducted a network meta-analysis (NMA) aimed at comparing and ranking the efficacy and safety of diverse noninvasive neuromodulation treatments in preventing migraine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We systematically searched for randomized controlled trials (RCTs) in four databases and included the final articles through strict screening. Subsequently, we carried out data extraction and quality assessment. Then, an NMA (PROSPERO ID CRD42024617371) based on the frequentist model was performed. Finally, we drew conclusions based on the surface under the cumulative ranking curve (SUCRA) and the league table.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty four RCTs involving 2347 patients were included. Although no modality significantly reduced monthly migraine days versus placebo (<i>p</i> &gt; 0.05), percutaneous mastoid electrical stimulation (PMES) emerged as the most effective and safest intervention (SUCRA: 78.8%) compared with placebo in achieving a 50% responder rate (OR = 16.58, 95% CI: 5.17, 53.17) and reducing monthly acute antimigraine medication use (MD = −0.90, 95% CI: −1.28, −0.52). Noninvasive vagus nerve stimulation (nVNS) exhibited the best safety profile (SUCRA: 72.2%) when high-risk trials were excluded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Among the noninvasive neuromodulation interventions discussed, PMES appears to be a favorable choice for migraine prevention, pending verification through cross-regional investigations. And nVNS shows the best safety profile when high-risk trials were excluded.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/7971285","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147579876","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":"Network Analysis Identifies T-Type Voltage-Sensitive Calcium Channels, Kainate Receptors and cAMP Signalling Regulators as Potential Mediators Linking the Pathophysiology of Obsessive Compulsive Disorder (OCD) and Dementia","authors":"Antara Joshi,&nbsp;Bhumika Mitra,&nbsp;Ravi Sudesh,&nbsp;Mohanapriya Arumugam,&nbsp;Balaji Balakrishnan,&nbsp;Shafiul Haque,&nbsp;Miguel Angel Prieto Lage,&nbsp;Faraz Ahmad","doi":"10.1155/ane/7255903","DOIUrl":"https://doi.org/10.1155/ane/7255903","url":null,"abstract":"<p>Obsessive compulsive disorder (OCD) is a challenging mental health condition marked by intrusive thoughts and repetitive actions intended to reduce anxiety or prevent potential harm. Dementia encompasses a range of degenerative brain conditions distinguished by diminished cognitive abilities, memory impairment and challenges in everyday activities. Clinical data suggests a probable association between OCD and dementia, with individuals exhibiting obsessive–compulsive symptoms showing higher risk of developing dementia, like Alzheimer′s disease. However, the underlying mechanisms linking the two conditions are largely unknown. This in silico network analysis is aimed at understanding the common molecular determinants underlying the pathophysiology of OCD and dementia. For this purpose, genome-wide association study (GWAS) databases were used to identify the genes involved in the pathogeneses of both conditions. Subsequent network analyses of the common genes found to be altered in OCD and dementia was performed to identify potential shared biological pathways and their pathophysiological implications. Our findings indicated significant pathway enrichment and common dysregulated gene modules in both diseases, indicating potential convergence spots for targeted therapeutic approaches. In particular, T-type voltage-sensitive calcium channels, kainate receptors and cAMP signalling regulators were recognized as key mediators linking the pathophysiology of OCD and dementia. Although further experimental data is warranted, our gene set enrichment analysis results may aid in understanding the pathophysiology of these disorders, particularly in cases where they coexist. Further, hub genes linking the two conditions constitute hypothesis-generating leads and promising targets for experimental validation aimed at tackling the intricately interlinked aetiology of dementia and OCD.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/7255903","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147579875","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}