Acta Neurologica Scandinavica最新文献

{"title":"Association of Lateralized Interictal Epileptiform Discharges with Postsurgical Seizure Outcomes in Patients with Tuberous Sclerosis Complex: A 10-Year Retrospective Study at a Single Center","authors":"Shujing Li,&nbsp;Zeng He,&nbsp;Yang Li,&nbsp;Kaixuan Huang,&nbsp;Xiaolin Yang,&nbsp;Shufang Wang,&nbsp;Xianjun Shi,&nbsp;Lihong Liu,&nbsp;Miao Wang,&nbsp;Shu Xiang,&nbsp;Wei Wang,&nbsp;Jingyi Zhang,&nbsp;Shengqing Lv,&nbsp;Zhonghong Liu,&nbsp;Chunqing Zhang,&nbsp;Hui Yang,&nbsp;Shiyong Liu,&nbsp;Zhongke Wang","doi":"10.1155/2023/3756290","DOIUrl":"10.1155/2023/3756290","url":null,"abstract":"<div>\u0000 <p><i>Objective</i>. Tuberous sclerosis complex (TSC) is a rare neurodevelopmental disorder often associated with intractable epilepsy, and surgical resection is the effective therapeutic approach to alleviate seizures in TSC patients. Scalp electroencephalogram (EEG) is a noninvasive method used to diagnose epilepsy; however, the relationship between scalp video-EEG findings and postsurgical seizure outcomes has not been fully evaluated in TSC patients. <i>Materials and Methods</i>. The relationship between clinical characteristics and seizure outcomes of TSC patients with 1-year, 5-year, and 10-year follow-ups was retrospectively analyzed. We explored the association of interictal epileptiform discharges (IEDs) with postsurgical seizure outcomes. Further, the differences in clinical characteristics among four IED patterns (focal, lateralized, multifocal, and generalized IEDs) were assessed. <i>Results</i>. A total of 82 patients were enrolled in this study. There were 82 patients with 1-year follow-up, 75 patients with 5-year follow-up, and 57 patients with 10-year follow-up, and the IEDs were associated with the postsurgical outcomes. Patients with focal, lateralized, and generalized IEDs had seizure freedom (SF) in 1-year follow-up, respectively. Intriguingly, patients with lateralized IEDs had long-term SF in 5-year and 10-year follow-ups. <i>Conclusions</i>. A significant association existed between IEDs and long-term postsurgical outcomes in TSC patients. TSC patients with lateralized IEDs often showed long-term SF and mild clinical epileptic characteristics. According to our study, IEDs may guide clinical care for TSC patients with intractable epilepsy.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/3756290","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49407097","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":"Postprocessing of MRIs Using FreeSurfer in Epilepsy Surgery Patients Provides an Excellent Imaging Marker of Hippocampal Sclerosis but Fails to Separate Subtypes","authors":"Ane G. Kloster,&nbsp;Giske Opheim,&nbsp;Kristin Å. Alfstad,&nbsp;Karen B. Larsen,&nbsp;Pitt Niehusmann,&nbsp;Emil Holm,&nbsp;Philip Fink-Jensen,&nbsp;Eva Løbner Lund,&nbsp;Bo Jespersen,&nbsp;Jugoslav Ivanovic,&nbsp;Guido Rubboli,&nbsp;Camilla G. Madsen,&nbsp;Pål B. Marthinsen,&nbsp;Melanie Ganz,&nbsp;Morten Lossius,&nbsp;Lars H. Pinborg","doi":"10.1155/2023/2366355","DOIUrl":"10.1155/2023/2366355","url":null,"abstract":"<div>\u0000 <p><i>Objective</i>. Histopathological examinations will diminish as minimally invasive epilepsy surgery increasingly replaces open surgery. The objective of this study was to test if visual and computer-aided quantitative analyses of presurgical high-quality 3 Tesla MRIs complying with the International League Against Epilepsy (ILAE) Neuroimaging Task Force recommendations can inform on histopathological diagnosis. <i>Methods</i>. Ninety-two patients from Copenhagen and Oslo University Hospitals fulfilled patient-, imaging-, and histopathological inclusion criteria: 69 patients were diagnosed with hippocampal sclerosis (HS) ILAE type 1 or 2, and 23 patients had normal appearing hippocampi or other histopathology than HS (no-HS). MRIs from 52 healthy controls (HC) were included. Image processing was performed in <i>FreeSurfer v.6.0</i> with the built-in cross-sectional hippocampal subfield segmentation tool and multimodal MRI input. Volume outputs were used to calculate volume asymmetry ratios (VARs) for whole hippocampus (WH) and subfields. <i>Results</i>. HS patients had significantly larger WH VARs compared to no-HS patients and HC, with a sensitivity = 0.93 and specificity = 1.0 for histopathological HS diagnosis. Visual MRI assessment yielded a sensitivity = 0.90 and specificity = 0.96 for histopathological HS diagnosis. CA1 and CA4 VARs and the number of seizure-free patients were not significantly different in HS ILAE type 1 compared to type 2 patients. <i>Significance</i>. FreeSurfer analyses of presurgical MRIs are excellent at separating patients histopathologically diagnosed with HS from patients with other pathology or normal appearing hippocampi. Using the FreeSurfer hippocampal subfield segmentation tool did not allow for separating HS ILAE subtypes.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/2366355","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41699584","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":"Shear Wave Elastography for the Assessment of Carotid Plaque Vulnerability: A Systematic Review","authors":"Joshua Mbroh,&nbsp;Johannes Tünnerhoff,&nbsp;Khouloud Poli,&nbsp;Benjamin Bender,&nbsp;Patricia Schwarz,&nbsp;Annerose Mengel,&nbsp;Alexandra Gomez-Exposito,&nbsp;Markus Kowarik,&nbsp;Katharina Feil,&nbsp;Marco Wisslicen,&nbsp;Yi Wang,&nbsp;Ulrike Ernemann,&nbsp;Ulf Ziemann,&nbsp;Sven Poli","doi":"10.1155/2023/5084699","DOIUrl":"10.1155/2023/5084699","url":null,"abstract":"<div>\u0000 <p>Evidence for the management of asymptomatic carotid stenosis and possibly symptomatic nonstenosing carotid artery disease is limited. In contrary to calcified plaques, soft plaques are considered vulnerable and prone to rupture. Shear wave elastography (SWE), a novel ultrasound technique which uses acoustic wave force to propagate shear wave in tissues, can quantify tissue stiffness through the estimation of Young’s modulus (YM) in kPa or shear wave velocity in meter/second. This systematic review is aimed at evaluating the feasibility of SWE in carotid plaque risk stratification in relation to ischemic stroke (PROSPERO registration: CRD42022309709). 18 studies, obtained via search on PubMed, Cochrane, and Embase from inception until November 1, 2022, assessed SWE’s feasibility in carotid plaque risk stratification in humans (13 studies) and phantom models (5 studies). Human studies showed heterogeneity with respect to SWE devices, acquisition settings, and methodology, which consequently reflected in the between-study variability of YM values used for distinguishing vulnerable/symptomatic (27–52 kPa) and stable/asymptomatic (28–115 kPa) carotid plaques. However, within-study assessment of all human studies indicated SWE’s feasibility in carotid plaque risk stratification. Furthermore, four out of five carotid plaque phantom studies showed the potential of SWE to discriminate tissues of different stiffness comparable to the carotid vessel wall, soft and hard plaques, and with good reproducibility. SWE may potentially offer a bedside risk stratification tool for identifying patients with vulnerable carotid plaques, who may benefit from carotid surgery, stenting, or prolonged dual antiplatelet therapy. Patients with stable carotid plaques could be spared the risks of potentially harmful treatments and complications. However, available data are not enough to facilitate the immediate clinical application of SWE, and therefore, larger prospective clinical are warranted.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/5084699","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46838243","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":"The Regulation of Plasma Interleukin-6 Levels Is Modified by Hippocampal Sclerosis and Its Lateralization in Drug-Resistant Temporal Lobe Epilepsy","authors":"Maria Peltola,&nbsp;Pabitra Basnyat,&nbsp;Suvi Liimatainen,&nbsp;Sirpa Rainesalo,&nbsp;Marko Pesu,&nbsp;Jukka Peltola","doi":"10.1155/2023/3030625","DOIUrl":"10.1155/2023/3030625","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Several studies have reported the association of the proinflammatory cytokine IL-6 with temporal lobe epilepsy (TLE), but the regulation of IL-6 in hippocampal sclerosis (HS) is less studied. <i>Objectives</i>. To analyse IL-6 levels and the IL-6/IL-10 ratio in a larger, well-characterized group of patients with drug-resistant focal epilepsy (DRE), focusing especially on TLE and TLE-associated HS. <i>Methods</i>. IL-6 levels were measured by ELISA in plasma in a cross-sectional cohort of 265 patients comprising TLE with HS (<i>n</i> = 34), TLE without HS (<i>n</i> = 103), extratemporal lobe epilepsy (<i>n</i> = 92), and idiopathic generalized epilepsy (<i>n</i> = 36). <i>Results</i>. The IL-6/IL-10 ratio was higher in TLE with HS than in TLE without HS (3.1 vs. 1.6, <i>p</i> = 0.042), whereas the median levels of IL-6 did not differ among epilepsy types. TLE without HS patients had a higher proportion of increased IL-6 levels than TLE with HS patients (<i>p</i> = 0.021). Additionally, IL-6 levels were higher in patients with right-sided HS than in those with left lateralization (1.71 vs. 0.80 pg/mL, <i>p</i> = 0.04). In TLE with HS patients, IL-6 levels showed a negative correlation with seizure frequency during the last month (<i>r</i> = −0.342; <i>p</i> = 0.047), whereas in TLE without HS patients, the correlation was positive but did not reach significance (<i>r</i> = 0.136; <i>p</i> = 0.169). <i>Conclusion</i>. IL-6 levels and the IL-6/IL-10 ratio are differentially regulated among patients with TLE depending on the presence of HS and its lateralization, suggesting that TLE with HS is a distinct category regarding cytokine activation.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/3030625","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48612474","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":"Antibody-Positive Autoimmune Encephalitis and Paraneoplastic Neurological Syndrome: Epidemiology and Outcome of Neuronal Antibody Testing in Sweden","authors":"Sonja Kosek,&nbsp;Barbro Persson,&nbsp;Rui Rodrigues,&nbsp;Clas Malmeström,&nbsp;Anna Rostedt Punga,&nbsp;Joachim Burman","doi":"10.1155/2023/6993615","DOIUrl":"10.1155/2023/6993615","url":null,"abstract":"<div>\u0000 <p><i>Objective</i>. To estimate the 5-year incidence rate of autoimmune encephalitis (AE) and paraneoplastic neurological syndrome (PNS) in Sweden. <i>Methods</i>. All patients who were tested for a neuronal antibody in Sweden between 2015 and 2019 were included. Patients in Healthcare region Mid Sweden (population 2.1 million) were invited to participate in a case ascertainment substudy. AE and PNS cases were defined using established diagnostic criteria. Crude and age-adjusted incidence rates of AE and PNS in Healthcare region Mid Sweden were estimated. <i>Results</i>. The number of tests for neuronal antibodies in Sweden increased between 2015 and 2019 from 1867 to 2505 (serum) and 863 to 1376 (CSF) per annum. The frequencies of positive results were stable over the entire study period, and the mean value was 6.1% for serum (CI95% 5.5–6.7) and 4.8% for CSF (CI95% 4.0–5.6). In total, 125 patients tested positive for neuronal antibodies in Healthcare region Mid Sweden between 2015 and 2019. Of these, 94 were included, and after case ascertainment, thirty-one cases of definite AE or PNS could be identified. The 5-year incidence rate of AE and PNS was 3.0 per million person-years (95% CI 1.9-4.1). The yearly incidence rates increased in the study period, from 1.5 per million person-years in 2015 (95% CI 0.0-3.2) to 4.3 per million person-years in 2019 (95% CI 1.5-7.1). <i>Conclusions</i>. In this first epidemiological study of AE and PNS in Sweden, the number of cases doubled from 2015 to 2019. This likely reflects increased availability of testing and awareness of these conditions.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/6993615","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41448763","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":"Cerebral Microinfarcts Are Common in Undiagnosed Lung Cancer Patients: A Population-Based Study","authors":"Jonathan Naftali,&nbsp;Rani Barnea,&nbsp;Ruth Eliahou,&nbsp;Assaf Tolkovsky,&nbsp;Keshet Pardo,&nbsp;Michal Zukerman,&nbsp;Noa Soback,&nbsp;Meital Adi,&nbsp;Avi Leader,&nbsp;Sivan Bloch,&nbsp;Walid Saliba,&nbsp;Eitan Auriel","doi":"10.1155/2023/9240247","DOIUrl":"10.1155/2023/9240247","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Cerebral microinfarcts (CMI) represent covert brain ischemia and were associated with stroke risk and cognitive impairment. Magnetic resonance imaging diffusion-weighted imaging (DWI) hyperintensities have been suggested to represent acute CMI. The relationship between malignancy and CMI is unknown. <i>Aims</i>. We aimed to examine whether CMI is more common in patients with undiagnosed lung cancer, and therefore might serve as a prediction marker for cognitive impairment or cancer-related stroke. <i>Methods</i>. We used the computerized database of Clalit Health Services (the largest healthcare provider in Israel) to identify adults diagnosed with lung cancer who had an MRI brain scan for any indication prior to cancer diagnosis. We analyzed DWI sequences, in order to evaluate CMI incidence in this population, and compared it to control groups of patients with other undiagnosed malignancies and patients without known cancer. <i>Results</i>. Altogether, we reviewed 1822 MRI brain scans, of which 497 scans were taken in patients with undiagnosed lung cancer, 543 scans of noncancer patients, and 793 scans of patients with other undiagnosed malignancies. In the lung cancer group, we found 24 CMI, compared with 4 in the noncancer group (<i>p</i> = 0.04) and 8 in the other cancer group (<i>p</i> = 0.07). <i>Conclusions</i>. CMI is common in undiagnosed lung cancer patients compare to other undiagnosed cancer types or noncancer patients. At the time of lung cancer diagnosis patients may be at risk for future stroke or cognitive decline.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/9240247","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46999126","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":"The Relationship between Motor Symptoms, Signs, and Parkinsonism with Facial Emotion Recognition Deficits in Individuals with 22q11.2 Deletion Syndrome at High Genetic Risk for Psychosis","authors":"Tommaso Accinni,&nbsp;Martina Fanella,&nbsp;Marianna Frascarelli,&nbsp;Antonino Buzzanca,&nbsp;Georgios D. Kotzalidis,&nbsp;Carolina Putotto,&nbsp;Bruno Marino,&nbsp;Alessia Panzera,&nbsp;Antonella Moschillo,&nbsp;Massimo Pasquini,&nbsp;Massimo Biondi,&nbsp;Carlo Di Bonaventura,&nbsp;Fabio Di Fabio","doi":"10.1155/2023/8546610","DOIUrl":"10.1155/2023/8546610","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. The 22q11.2 Deletion Syndrome (22q11.2DS) is a genetic condition at high risk of developing both psychosis and motor disorders. Social Cognition (SC) deficits have been associated not only with schizophrenia but also with Parkinson’s disease (PD). The present study assessed SC deficits in 22q11.2DS and investigated the interaction between motor symptoms and deficits in Facial Emotion Expressions (FEE) recognition and in Theory of Mind (ToM) tasks in people with 22q11.2DS. <i>Methods</i>. We recruited 38 individuals with 22q11.2DS without psychosis (<i>N</i> = 38, DEL) and 18 with 22q11.2DS and psychosis (<i>N</i> = 18, DEL_SCZ). The <i>Positive And Negative Syndrome Scale</i> (PANSS), <i>Ekman’s 60 Faces Test</i> (EK-60F), the <i>Awareness of Social Inference Test</i> (TASIT EmRec), and the <i>Movement Disorder Society-Unified Parkinson’s Disease Rating Scale part III</i> (UPDRS III) were administered. Correlations were sought between UPDRS III and both TASIT EmRec and EK-60F scores. Analyses were conducted separately for each psychopathological subgroup. <i>Results</i>. Higher UPDRS III (<i>p</i> = 0.04) and lower EK-60F (<i>p</i> = 0.025) scores were observed in the DEL_SCZ group. We found inverse correlations between UPDRS III and both TASIT EmRec (<i>r</i> = −0.289, <i>p</i> = 0.031) and EK-60F (<i>r</i> = −0.387, <i>p</i> = 0.006) scores in the whole sample. Correlations were no longer significant in the DEL_SCZ group (UPDRS III-TASIT EmRec <i>p</i> = 0.629; UPDRS III-EK60F <i>p</i> = 0.933) whilst being stronger in the DEL group (TASIT EmRec, <i>r</i> = −0.560, <i>p</i> &lt; 0.001; EK60F, <i>r</i> = −0.542, <i>p</i> &lt; 0.001). Analyses were adjusted for CPZ Eq and IQ. <i>Conclusions</i>. A modulation between FEE recognition deficits and motor symptoms and signs was observed in the 22q11.2DS group, likely affecting patients’ quality of life.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/8546610","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47113796","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":"Altered Cerebellar Volumes and Intrinsic Cerebellar Network in Juvenile Myoclonic Epilepsy","authors":"Ho-Joon Lee,&nbsp;Dong Ah Lee,&nbsp;Kang Min Park","doi":"10.1155/2023/7907887","DOIUrl":"10.1155/2023/7907887","url":null,"abstract":"<div>\u0000 <p><i>Objectives.</i> 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. <i>Methods.</i> 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. <i>Results.</i> 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%, <i>p</i> = 0.009; 3.35 vs. 3.49%, <i>p</i> = 0.009), corpus medullare (0.99 vs. 1.03%, <i>p</i> = 0.04), and left lobule V (0.19 vs. 0.22%, <i>p</i> = 0.002). 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, <i>p</i> = 0.04). <i>Conclusion.</i> 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.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/7907887","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":"OA","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":"Xianjin Shang,&nbsp;Ke Yang,&nbsp;Yapeng Guo,&nbsp;Liwei Su,&nbsp;Qian Yang,&nbsp;Zhiming Zhou","doi":"10.1155/2023/7152366","DOIUrl":"10.1155/2023/7152366","url":null,"abstract":"<div>\u0000 <p><i>Objectives</i>. 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. <i>Materials and Methods</i>. 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. <i>Results</i>. 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; <i>P</i> = 0.88). 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; <i>P</i> = 0.51), frequency of a favorable outcome (mRS 0–2: 39.7% versus 38.0%; aOR 1.59, 95% CI 0.37–6.70; <i>P</i> = 0.52), the 90-day mortality rate (34.5% versus 26.0%; aOR 2.31, 95% CI 0.50–10.63; <i>P</i> = 0.28), or frequency of symptomatic intracranial hemorrhage (6.9% versus 2.0%, respectively; <i>P</i> = 0.37). The subgroup analysis in patients with basilar artery occlusion found no significant between-group difference in any of the abovementioned clinical outcomes (all <i>P</i> &gt; 0.05). <i>Conclusion</i>. 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.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/7152366","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":"OA","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,&nbsp;Viktor Hamrefors,&nbsp;Bodil Roth,&nbsp;Artur Fedorowski,&nbsp;Bodil Ohlsson","doi":"10.1155/2023/3992718","DOIUrl":"10.1155/2023/3992718","url":null,"abstract":"<div>\u0000 <p><i>Objectives</i>. 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. <i>Materials and Methods</i>. 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). <i>Results</i>. 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 (<i>β</i>: 1.370; 95% CI: 0.004–2.737; <i>p</i> = 0.049), lower albumin levels (<i>β</i>: -1.443; 95% CI: -2.648–(-0.238); <i>p</i> = 0.019), and higher sodium levels (<i>β</i>: 1.392; 95% CI: 0.559–2.225; <i>p</i> = 0.001). Abdominal pain (<i>p</i> = 0.004) and intestinal symptoms’ influence on daily life (<i>p</i> = 0.025) were negatively associated with albumin levels. Abdominal pain (<i>p</i> = 0.011), vomiting and nausea (<i>p</i> = 0.003), and intestinal symptoms’ influence on daily life (<i>p</i> = 0.026) were associated with higher sodium levels. Serum levels representing iron and vitamin metabolism were equal between groups. <i>Conclusions</i>. 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.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/3992718","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}