Acta Neurologica Scandinavica最新文献

{"title":"Altered Cerebellar Volumes and Intrinsic Cerebellar Network in Juvenile Myoclonic Epilepsy","authors":"H. Lee, Dong Ah Lee, K. Park","doi":"10.1155/2023/7907887","DOIUrl":"https://doi.org/10.1155/2023/7907887","url":null,"abstract":"Objectives. This study is aimed at investigating the alterations in cerebellar volumes and intrinsic cerebellar network in patients with juvenile myoclonic epilepsy (JME) in comparison with healthy controls. Methods. Patients newly diagnosed with JME and healthy controls were enrolled. Three-dimensional T1-weighted imaging was conducted, and no structural lesions were found on brain magnetic resonance imaging. Cerebellar volumes were obtained using the ACAPULCO program, while the intrinsic cerebellar network was evaluated by applying graph theory using the BRAPH program. The nodes were defined as individual cerebellar volumes and edges as partial correlations, controlling for the effects of age and sex. Cerebellar volumes and intrinsic cerebellar networks were compared between the two groups. Results. Forty-five patients with JME and 45 healthy controls were enrolled. Compared with the healthy controls, the patients with JME had significantly lower volumes of the right and left cerebellar white matter (3.33 vs. 3.48%, \u0000 \u0000 p\u0000 =\u0000 0.009\u0000 \u0000 ; 3.35 vs. 3.49%, \u0000 \u0000 p\u0000 =\u0000 0.009\u0000 \u0000 ), corpus medullare (0.99 vs. 1.03%, \u0000 \u0000 p\u0000 =\u0000 0.04\u0000 \u0000 ), and left lobule V (0.19 vs. 0.22%, \u0000 \u0000 p\u0000 =\u0000 0.002\u0000 \u0000 ). The intrinsic cerebellar networks also showed significant differences between the two groups. The small-worldness index in the patients with JME was significantly lower than that in the healthy controls (0.771 vs. 0.919, \u0000 \u0000 p\u0000 =\u0000 0.04\u0000 \u0000 ). Conclusion. The cerebellar volumes and intrinsic cerebellar network demonstrated alterations in the patients with JME when compared with those of the healthy controls. Our study results provide evidence that the cerebellum may play a role in the pathogenesis of JME.","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2023-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45180214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Endovascular Treatment for Posterior Circulation Stroke According to the Underlying Pathologic Mechanism: A Retrospective Single-Center Analysis","authors":"X. Shang, Ke Yang, Yapeng Guo, L. Su, Qian Yang, Zhiming Zhou","doi":"10.1155/2023/7152366","DOIUrl":"https://doi.org/10.1155/2023/7152366","url":null,"abstract":"Objectives. This study investigated the functional outcomes and safety of endovascular treatment in patients with posterior circulation stroke according to whether the underlying mechanism was arterial embolism or intrinsic atherosclerosis. Materials and Methods. A total of 108 consecutive patients with posterior circulation ischemic stroke who received endovascular treatment between January 2018 and December 2021, 58 with arterial embolism and 50 with intrinsic atherosclerosis, were identified. The overall and basilar artery occlusion subgroup analyses were retrospectively conducted between the two study groups using a logistic regression model. Results. The rate of successful reperfusion (modified Thrombolysis in Cerebral Infarction score 2b–3) was comparable in the embolism versus intrinsic group (96.6% versus 90.0%; adjusted odds ratio [aOR] 0.73, 95% confidence interval [CI] 0.01–42.74; \u0000 \u0000 P\u0000 =\u0000 0.88\u0000 \u0000 ). There was no significant difference in the frequency of a moderate outcome between the two groups (modified Rankin Scale [mRS] score 0–3: 43.1% versus 58.0%; aOR 0.63, 95% CI 0.15–2.50; \u0000 \u0000 P\u0000 =\u0000 0.51\u0000 \u0000 ), frequency of a favorable outcome (mRS 0–2: 39.7% versus 38.0%; aOR 1.59, 95% CI 0.37–6.70; \u0000 \u0000 P\u0000 =\u0000 0.52\u0000 \u0000 ), the 90-day mortality rate (34.5% versus 26.0%; aOR 2.31, 95% CI 0.50–10.63; \u0000 \u0000 P\u0000 =\u0000 0.28\u0000 \u0000 ), or frequency of symptomatic intracranial hemorrhage (6.9% versus 2.0%, respectively; \u0000 \u0000 P\u0000 =\u0000 0.37\u0000 \u0000 ). The subgroup analysis in patients with basilar artery occlusion found no significant between-group difference in any of the abovementioned clinical outcomes (all \u0000 \u0000 P\u0000 >\u0000 0.05\u0000 \u0000 ). Conclusion. This study indicated that the mechanism of posterior circulation stroke had no significant effect on the functional outcomes after endovascular treatment or on procedural safety.","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2023-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49427681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sociodemographic Factors, Nutritional Status, and Inflammatory Markers in Patients with Postural Orthostatic Tachycardia Syndrome","authors":"Hanna Tufvesson, V. Hamrefors, B. Roth, A. Fedorowski, B. Ohlsson","doi":"10.1155/2023/3992718","DOIUrl":"https://doi.org/10.1155/2023/3992718","url":null,"abstract":"Objectives. Postural orthostatic tachycardia syndrome (POTS) is characterized by cardiovascular autonomic dysfunction of unknown etiology with high a prevalence of gastrointestinal symptoms. The aim of the present study was to examine sociodemographic, lifestyle, and nutritional factors as well as inflammatory markers in patients with POTS. Materials and Methods. Forty-three patients with POTS and 61 healthy controls completed questionnaires about sociodemographic factors, lifestyle habits, and gastrointestinal symptoms. Blood samples were analyzed for serum levels of cobalamins, folic acid, iron, total iron-binding capacity (TIBC), ferritin, sodium, potassium, magnesium, phosphorus, albumin, high-sensitive C-reactive protein (CRP), and 25-hydroxyvitamin D (25-OH vitamin D). Results. POTS patients were predominantly women with a lower education level and were more often working part-time, on sick leave, and living alone compared with healthy controls. They reported lower alcohol intake and physical activity levels than controls. The nutrient intake was in general similar in both groups, but POTS patients had a higher intake of different drinks and reported more gastrointestinal symptoms than controls. POTS was associated with higher CRP levels (β: 1.370; 95% CI: 0.004–2.737; \u0000 \u0000 p\u0000 =\u0000 0.049\u0000 \u0000 ), lower albumin levels (β: -1.443; 95% CI: -2.648–(-0.238); \u0000 \u0000 p\u0000 =\u0000 0.019\u0000 \u0000 ), and higher sodium levels (β: 1.392; 95% CI: 0.559–2.225; \u0000 \u0000 p\u0000 =\u0000 0.001\u0000 \u0000 ). Abdominal pain (\u0000 \u0000 p\u0000 =\u0000 0.004\u0000 \u0000 ) and intestinal symptoms’ influence on daily life (\u0000 \u0000 p\u0000 =\u0000 0.025\u0000 \u0000 ) were negatively associated with albumin levels. Abdominal pain (\u0000 \u0000 p\u0000 =\u0000 0.011\u0000 \u0000 ), vomiting and nausea (\u0000 \u0000 p\u0000 =\u0000 0.003\u0000 \u0000 ), and intestinal symptoms’ influence on daily life (\u0000 \u0000 p\u0000 =\u0000 0.026\u0000 \u0000 ) were associated with higher sodium levels. Serum levels representing iron and vitamin metabolism were equal between groups. Conclusions. POTS is associated with poorer sociodemographic status, but malnutrition cannot explain POTS or related gastrointestinal symptoms. Higher CRP and lower albumin levels suggest low-grade inflammation as one possible etiological factor.","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2023-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42876949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Role of Tau Proteins in Amyotrophic Lateral Sclerosis: A Systematic Review and Meta-Analysis","authors":"Sangharsha Thapa, Abhinav Bhattarai, Sangam Shah, Swati Chand, Sara Bagherieh, O. Mirmosayyeb, S. K. Mishra","doi":"10.1155/2023/2791622","DOIUrl":"https://doi.org/10.1155/2023/2791622","url":null,"abstract":"Background. Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease that currently lacks reliable diagnostic biomarkers. The meta-analysis is performed with an aim to evaluate the diagnostic potential of cerebrospinal fluid (CSF) total tau (t-tau), phosphorylated-tau (p-tau), and their ratio in ALS patients. Methods. A comprehensive search for literature published between the 1st of January 2000 and the 15th of May 2022 was performed in databases PubMed, medRxiv, and Google Scholar. The retrieved articles were first screened by title and abstract, and later, full-text screening was performed based on the eligibility criteria. Data on p-tau and t-tau levels and p-tau/t-tau ratio in ALS patients and controls were extracted, and a meta-analysis was performed using random-effects models in Review Manager version 5.4. Results. Data were analyzed from seven studies reporting p-tau and t-tau levels and their ratio among ALS patients and controls. The number of total study participants was 1,100. In ALS patients, the levels of p-tau didn’t differ significantly with controls (standardized mean difference (SMD): 0.14 (95% CI: -0.41 to 0.70); \u0000 \u0000 p\u0000 =\u0000 0.61\u0000 \u0000 ). In contrast, there were significantly elevated levels of t-tau and significantly lowered p-tau/t-tau ratio in ALS (SMD: 1.76 (95% CI: 0.53 to 2.98); \u0000 \u0000 p\u0000 =\u0000 0.005\u0000 \u0000 and SMD: -3.09 (95% CI: -5.33 to -0.86); \u0000 \u0000 p\u0000 =\u0000 0.007\u0000 \u0000 , respectively). Conclusion. Our meta-analysis study supports the role of core CSF biomarkers of neurodegeneration: t-tau and p-tau/t-tau ratio as a diagnostic biomarker of amyotrophic lateral sclerosis. This study found that t-tau is elevated while p-tau/t-tau ratio is lowered in ALS.","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"12 5","pages":""},"PeriodicalIF":3.5,"publicationDate":"2023-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41267994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in Retinal Thickness and Brain Volume during 6.8-Year Escalating Therapy for Multiple Sclerosis","authors":"Max Borgström, M. Fredrikson, M. Vrethem, P. Mirabelli, H. Link, Y. Huang-Link","doi":"10.1155/2023/7587221","DOIUrl":"https://doi.org/10.1155/2023/7587221","url":null,"abstract":"Background. Different disease-modifying therapies (DMT) for multiple sclerosis (MS) have disparate effects on disability outcomes. Sweden has a leading position globally in initiating high-efficacy DMT instead of escalating DMT from 1st-line to high-efficacy DMT. With optical coherence tomography (OCT), retinal changes can be measured at a few micrometer level. OCT has been increasingly applied in diagnosing MS and monitoring disease course and therapeutic effect. Objective. We investigate the effects of 1st-line versus high-efficacy DMT for MS on retinal and brain atrophy and on functional outcomes during 6.8 years of escalating DMT. Materials and Methods. In this prospective longitudinal observational study, 18 MS patients were followed up for 6.8 years. Twelve of the patients were untreated at baseline. All patients underwent 1st-line DMT for median duration of 2.4 years and then switched to high-efficacy DMT for a median duration of 2.9 years. Findings from neurological examinations, MRI, and OCT measures were registered 2-4 times per year. Results. Ganglion cell-inner plexiform layer (GCIPL) thickness was significantly reduced during 1st-line DMT (73.75 μm, \u0000 \u0000 p\u0000 <\u0000 0.01\u0000 \u0000 ) compared to baseline (76.38 μm). During high-efficacy DMT, thickness reduction was slower (73.27 μm, \u0000 \u0000 p\u0000 <\u0000 0.05\u0000 \u0000 ), and MRI contrast-loading lesions vanished (\u0000 \u0000 p\u0000 <\u0000 0.01\u0000 \u0000 ). However, brain parenchymal fraction (BPF) decreased during high-efficacy DMT compared to 1st-line DMT. Estimated models showed similar results. Conclusion. GCIPL decline was most profound during 1st-line DMT and diminished during high-efficacy DMT. MRI contrast lesions vanished during high-efficacy DMT. However, brain atrophy continued regardless of high-efficacy DMT.","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2023-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45766154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-dsDNA Is Associated with Favorable Prognosis in Myasthenia Gravis: A Retrospective Study","authors":"Shiyin Li, Jiaxin Chen, Xu Yang, Xin Huang, Haiyan Wang, H. Feng","doi":"10.1155/2023/8939083","DOIUrl":"https://doi.org/10.1155/2023/8939083","url":null,"abstract":"Objectives. To investigate the presence of serum antinuclear antibody (ANA) and anti-double-stranded DNA antibody (anti-dsDNA) in patients with myasthenia gravis (MG) and analyze the clinical characteristics and prognostic factors associated with MG. Methods. We retrospectively enrolled 363 patients with MG and analyzed the clinical characteristics and follow-up data between patients positive and negative for ANA and anti-dsDNA. We defined a Myasthenia Gravis Activities of Daily Living (MG-ADL) reduction as a main prognosis predictor and used logistic regression to determine independent factors associated with prognosis. We built a nomogram to predict prognosis and evaluate the internal validity of the model. Results. Ninety-eight (27.0%) patients were positive for ANA, and 51 (14.0%) were positive for anti-dsDNA. Patients positive for ANA and anti-dsDNA antibodies tended to be female and positive for acetylcholine receptor antibody (AChR-Ab). The rate of thymoma was higher in anti-dsDNA-positive patients with MG (p-dsDNA-MG) than in patients negative for anti-dsDNA (49.0% vs. 26.0%, \u0000 \u0000 p\u0000 =\u0000 0.001\u0000 \u0000 ), and p-dsDNA-MG was associated with reduced MG-ADL score. Regression analysis showed that except for age of onset (\u0000 \u0000 OR\u0000 =\u0000 0.986\u0000 \u0000 , \u0000 \u0000 95\u0000 %\u0000 CI\u0000 =\u0000 0.973\u0000 –\u0000 0.999\u0000 \u0000 , \u0000 \u0000 p\u0000 =\u0000 0.037\u0000 \u0000 ), anti-dsDNA (\u0000 \u0000 OR\u0000 =\u0000 2.800\u0000 \u0000 , \u0000 \u0000 95\u0000 %\u0000 CI\u0000 =\u0000 1.381\u0000 –\u0000 5.679\u0000 \u0000 , \u0000 \u0000 p\u0000 =\u0000 0.004\u0000 \u0000 ), ptosis (\u0000 \u0000 OR\u0000 =\u0000 2.930\u0000 \u0000 , \u0000 \u0000 95\u0000 %\u0000 CI\u0000 =\u0000 1.827\u0000 –\u0000 4.699\u0000 \u0000 , \u0000 \u0000 p\u0000 <\u0000 0.001\u0000 \u0000 ), and eye movement disorder (\u0000 \u0000 OR\u0000 =\u0000 2.815\u0000 \u0000 , \u0000 \u0000 95\u0000 %\u0000 CI\u0000 =\u0000 1.672\u0000 –\u0000 4.741\u0000 \u0000 , \u0000 \u0000 p\u0000 <\u0000 0.001\u0000 \u0000 ) were independent predictive factors of a favorable prognosis of MG. These predictors were used to generate a nomogram with an excellent predictive value. Conclusions. Being female and the presence of AChR-Ab were features of ANA- or anti-dsDNA-positive MG. The presence of anti-dsDNA was associated with a favorable prognosis of MG.","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2023-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47055051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Effects Can Expressive Writing Have on Sexual Dysfunction in Women with Multiple Sclerosis? A Randomized Controlled Trial","authors":"B. Afshar, L. Amini, S. Nabavi, M. Hasani, M. Mohammadnoori, S. Jahanfar, A. Sahebkar","doi":"10.1155/2023/6754178","DOIUrl":"https://doi.org/10.1155/2023/6754178","url":null,"abstract":"Background. Sexual dysfunction is a common complication in women with multiple sclerosis due to limitation in physical and mental functioning. Expressive writing as a psychological intervention can significantly improve sexual dysfunction in women with other diseases. Aim. The aim of the current study was to determine the effect of expressive writing on sexual dysfunction in Iranian women with multiple sclerosis. Methods. A randomized controlled trial with a Solomon four-group design was conducted on 116 Iranian women with MS in February 2021. Participants were randomly assigned into two control subgroups of A1 (without pretest) and A2 (with pretest) and two intervention subgroups of B1 (without pretest) and B2 (with pretest). Expressive writing was conducted for six weeks at home including morning pages (writing three pages about everything that comes to mind everyday), date with inner child (once a week), and performing weekly creative assignments. Sexual dysfunction was assessed using MSISQ-19 before the intervention in two groups of A2 and B2 and follows in immediately, four weeks and eight weeks after the intervention in all subgroups. The control group was provided with routine care of treatment. Data were analyzed using the intention to treat method. \u0000 \u0000 P\u0000 <\u0000 0.05\u0000 \u0000 was considered significant. Results. Twenty-nine women were analyzed in each subgroup. Although expressive writing had a positive and significant effect on primary, tertiary, and overall sexual dysfunction in B2 intervention subgroup compared with A2 control subgroup (\u0000 \u0000 P\u0000 ≤\u0000 0.001\u0000 \u0000 ), it could not improve secondary sexual dysfunction. Since tertiary sexual dysfunction was related to psychological aspects and the present intervention was also a subset of psychotherapy, most of the changes were observed at this level, which included a decrease of 7-8 points. Comparison between the two groups of with and without pretest in each of the control and intervention groups revealed that completing the pretest questionnaire did not have a significant impact on sexual dysfunction score. Conclusion. As a cost-effective and noninvasive intervention, expressive writing can be used along with the main treatment for women suffering from multiple sclerosis to improve sexual dysfunction.","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2023-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42999286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Verified Parental Cardiovascular Events for Young and Middle-Aged Ischaemic Stroke Patients and Controls","authors":"Solveig Boland, Beenish Nawaz, H. Øygarden, A. Fromm, H. Næss, U. Waje-Andreassen","doi":"10.1155/2023/3864506","DOIUrl":"https://doi.org/10.1155/2023/3864506","url":null,"abstract":"Introduction. Nonmodifiable cardiovascular risk factors, like age and sex, are easily quantifiable. Due to immense technical progress in diagnostics and medical data storage, the aim of this study was to quantify, verify, and to compare parental cardiovascular events (CVE) as an additional nonmodifiable risk factor for young and middle-aged ischaemic stroke patients and controls. Methods. Information about parental CVE was first obtained by standardized questionnaires answered by 385 acute ischaemic stroke patients (15-60 years of age) and 260 controls. After consent to contact living and include deceased parents, patients and controls provided necessary personal identification of their parents. Thereafter, CVE were verified by standardized questionnaires answered by parents or medical records in case of deceased parents. Results. One hundred-and-nine (14.2%) of 770 patient parents vs. 128 (24.6%) of 520 control parents were not available for verification. Active participation was obtained for 229 (73.9%) of 310 patient parents vs.113 (58.2%) of 194 control parents. Medical record verification was obtained for 192 (54.7%) of 351 deceased patient parents, vs.103 (52.0%) of 198 deceased control parents. This study showed highest death rates of fathers (65.3% patient fathers and 57.6% control fathers) and highest numbers of CVE, especially myocardial infarction among patient fathers of patients aged 50-60 years. Discussion and Conclusion. Obtaining verified parental CVE as a nonmodifiable risk factor is still challenging, despite widely available digital medical information. To attain more accurate information on parental CVE, we recommend active involvement of family members in addition to medical record verification, especially for patients aged <50 years. Trial Registration. This trial is registered with NCT01597453","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2023-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45904216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunological, Clinical, and Epidemiological Features of Guillain-Barré Syndrome Associated with SARS-CoV-2 Infection","authors":"Juan Luis Restrepo-Vera, A. Llauradó, A. Palasí, V. González-Martínez, M. Gratacós, M. Salvadó, D. Sánchez-Tejerina, J. Sotoca, N. Raguer, R. Juntas-Morales","doi":"10.1155/2023/5380946","DOIUrl":"https://doi.org/10.1155/2023/5380946","url":null,"abstract":"Objectives. There is a growing interest in understanding the association between Guillain-Barré syndrome (GBS) and SARS-CoV-2 infection. The aim of this study was to analyse various characteristics of GBS before and after the pandemic outbreak and thus identify possible distinctive features of GBS associated with SARS-CoV-2 (GBS-S). Material and Methods. In our centre, we retrospectively reviewed the records of patients diagnosed with GBS between January 2018 and March 2022. Epidemiological, clinical, and immunological data were analysed and compared between patients with GBS according to the time of diagnosis and antecedent events. Results. Thirty-nine patients with GBS were included: nine (23.1%) were diagnosed with GBS-S. GBS-S was most frequent in 2020 (6/13, 46.1%). Most of these patients developed a postinfectious classic demyelinating variant (4/9, 44.4%) with frequent bilateral facial paralysis (4/9, 44.4%). Serum antiganglioside antibodies (AGAs) were found in 1/9 patients with GBS-S. Serum anti-SSA/Ro60 antibodies were highly prevalent in GBS-S (7/9 (77.8%) vs. 3/11 (27.3%), \u0000 \u0000 p\u0000 =\u0000 0.019\u0000 \u0000 ). Three cases associated with SARS-CoV-2 vaccination (GBS-V) were detected. Of note, two had bilateral facial paralysis and anti-SSA/Ro60 antibodies. Conclusion. Our findings suggest that SARS-CoV-2 has become an important antecedent event associated with GBS in our setting. GBS-S shows a postinfectious demyelinating immune-mediated profile with negative serological testing for AGAs. Serum anti-SSA/Ro60 antibodies were found frequently in these patients. Bilateral facial paralysis stands out as a possible characteristic clinical feature both in GBS-S and GBS-V. Larger, prospective studies are needed for a better understanding of its immunopathogenesis.","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2023-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48660420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Markers of Neuronal Damage and Astrocyte Activity in Patients with Chronic Epilepsy: Elevated Levels of Glial Fibrillary Acidic Protein","authors":"M. Mochol, E. Taubøll, P. Aukrust, T. Ueland, O. Andreassen, S. Svalheim","doi":"10.1155/2023/7246373","DOIUrl":"https://doi.org/10.1155/2023/7246373","url":null,"abstract":"Objectives. Blood-brain barrier (BBB) dysfunction is one of the key pathogenic mechanisms in the development of epilepsy. There is therefore an increasing need to identify BBB biomarkers as these will have prognostic and therapeutic implications. The purpose of this study was to assess the levels of the BBB permeability markers, glial fibrillary acidic protein (GFAP), neuron-specific enolase (NSE), S100B, and furin in patients with stable epilepsy compared with the levels in healthy controls. Materials and Methods. This cross-sectional study included 119 epilepsy patients and 80 healthy controls. Circulating levels of GFAP, NSE, S100B, and furin were measured and questionnaires regarding epilepsy, use of drugs, and comorbidities were completed by all participants. Results. GFAP levels were higher in epilepsy patients after adjustment for potential confounders (sex, age, and BMI) in linear regression (\u0000 \u0000 p\u0000 =\u0000 0.042\u0000 \u0000 ). No significant differences were found in levels of S100B, NSE, or furin. None of the markers were significantly associated with epilepsy duration, seizure type or severity, or seizures in the preceding six months. The majority of the patients (79.7%) did not report seizures within the last 6 months. Conclusion. Our main finding is elevated serum levels of GFAP in epilepsy patients. The results may suggest the presence of astrocyte activation in our patient population with stable epilepsy. Future prospective studies focusing on the longitudinal relationship between epilepsy debut, seizures, and time of blood sampling for BBB markers, also within CSF, could provide valuable knowledge including regarding novel treatment options. The study registration number is 2011/1096, 2018/1437.","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2023-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49569621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}