Acta Neurologica Scandinavica最新文献

{"title":"Periodic Limb Movements during Sleep in Children, Adolescents, and Adults with Narcolepsy: A Cross-Sectional Study in China","authors":"Xianchao Zhao,&nbsp;Jiafeng Ren,&nbsp;Guoyan Chen,&nbsp;Jinxiang Cheng,&nbsp;Danqing Shang,&nbsp;Min Wu,&nbsp;Yiqing Yang,&nbsp;Junying Zhou,&nbsp;Changjun Su","doi":"10.1155/2023/1715371","DOIUrl":"10.1155/2023/1715371","url":null,"abstract":"<div>\u0000 <p><i>Objectives</i>. This study is aimed at determining the prevalence and effects of periodic limb movements during sleep (PLMS) on nighttime sleep and daytime sleepiness in children/adolescents and adults with narcolepsy. <i>Methods</i>. A total of 94 patients with narcolepsy were recruited in this study. They were classified into two groups including children/adolescents (&lt;18 years, <i>n</i> = 41) and adults (≥18 years, <i>n</i> = 53). All participants completed face-to-face interviews and underwent polysomnography assessment followed by multiple sleep latency test. Demographic, clinical, and sleep parameters were compared between narcoleptic patients with and without PLMS. Linear regression analysis was performed to determine the association between PLMS and sleep parameters. <i>Results</i>. Thirty-eight (40.4%) patients with narcolepsy were defined as having PLMS, and there was a higher prevalence of PLMS in the children/adolescents than in the adults with narcolepsy (56.1% vs. 28.3%, respectively, <i>P</i> = 0.006). Narcoleptic patients with PLMS had a significantly shorter total sleep time, lower sleep efficiency (SE), and more wakefulness after sleep onset (WASO) than those without PLMS in adults (all <i>P</i> &lt; 0.05). After adjusting for the potential confounders, PLMS was significantly associated with lower SE (adjusted <i>β</i> = −0.327; 95% CI: -0.608, 0.044; <i>P</i> = 0.025) and more WASO (adjusted <i>β</i> = 0.330; 95% CI: 0.038, 0.520; <i>P</i> = 0.028) in adults with narcolepsy. <i>Conclusions</i>. There is a high prevalence of PLMS in narcolepsy, especially in children and adolescent patients. PLMS is associated with nighttime sleep disturbance in adults with narcolepsy but is not a risk factor for daytime sleepiness both in children/adolescents and adults with narcolepsy.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/1715371","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41874888","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 Impact of COVID-19 on Parkinson’s Disease: A Case-Controlled Registry and Questionnaire Study on Clinical Markers and Patients’ Perceptions","authors":"Gustav Cedergren Weber,&nbsp;Jonathan Timpka,&nbsp;Filip Bergquist,&nbsp;David Bäckström,&nbsp;Nil Dizdar,&nbsp;Karin Gunnarsson,&nbsp;Dag Nyholm,&nbsp;Per Svenningsson,&nbsp;Per Odin","doi":"10.1155/2023/8025566","DOIUrl":"10.1155/2023/8025566","url":null,"abstract":"<div>\u0000 <p><i>Introduction</i>. Parkinson’s disease (PD) is a neurodegenerative disease with motor and nonmotor symptoms. Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). <i>Objectives</i>. To explore how COVID-19 affects motor, nonmotor, and general health aspects of PD and to map how PD patients perceive their change in symptoms since falling ill with COVID-19. <i>Method</i>. The study was descriptive, case-controlled, and based on both registry and questionnaire data. At baseline, the controls were matched on age, sex, and disease severity. Information on the severity of the disease, nonmotor symptoms, motor symptoms, and general health was retrieved from the Swedish Registry for PD. Registry data from a COVID-19 group (<i>n</i> = 45) and a control group (<i>n</i> = 73), as well as questionnaires from a COVID-19 group (<i>n</i> = 24) and a control group (<i>n</i> = 42), were compared. <i>Results</i>. We did not find that SARS-CoV-2 infection affects any major aspect of nonmotor symptoms, motor symptoms, general health, and perception of change in PD patients’ post-COVID-19. Compared to controls, the COVID-19 group reported a more positive subjective experience of pain and quality of life and a perception of change post-COVID-19 regarding general motor function, sleep quality, and mood (all <i>p</i> &lt; 0.05). <i>Conclusion</i>. Although SARS-CoV-2 infection does not seem to affect PD symptoms in any major respect, the subjective experience of several aspects of life in PD patients might be slightly improved post-COVID-19 compared to a control group. The findings warrant further investigations due to the small sample size and possible survivorship bias.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/8025566","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64799494","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":"Agreement between Parkinson Disease Home Diary and Observer Assessments before and after Structured Patient Training","authors":"Carin Janz,&nbsp;Jonathan Timpka,&nbsp;Matthias Löhle,&nbsp;Alexander Bremer,&nbsp;Florin Gandor,&nbsp;Georg Ebersbach,&nbsp;Alexander Storch,&nbsp;Per Odin","doi":"10.1155/2023/8667591","DOIUrl":"10.1155/2023/8667591","url":null,"abstract":"<div>\u0000 <p><i>Objectives</i>. Recent studies showed only fair agreement between observer and patients’ motor state assessments on the Parkinson’s disease (PD) home diary (HD). This could possibly be explained by the patients’ insufficient knowledge about motor fluctuations. Therefore, the study is aimed at investigating the effect of structured training concerning motor fluctuations on the agreement between observer and HD ratings and daily motor state times. <i>Methods</i>. Participants from a previous validation study of the HD were invited back for a study extension. This interventional study consisted of a screening visit including a structured training concerning motor fluctuations and one day of motor ratings onsite during which observer and patient simultaneously and independently evaluated the patient’s motor state every half hour. <i>Results</i>. Observer and 20 patients completed 316 pairs of motor state assessments. The overall agreement was 68% before training and 76% after training (<i>P</i> = .093) and Cohen’s <i>κ</i> increased from .438 to .559 (<i>P</i> = .320). There was no significant improvement in the correlation/reliability of HD-documented daily motor state time when compared with observer ratings. Moreover, before training, the agreement in observed “on with dyskinesias” was 58%, and after training, it was 80% (<i>P</i> = .074). <i>Conclusion</i>. Our structured patient training in motor fluctuations did not significantly improve the agreement between observer and HD or the reliability of daily times spent in the different motor states as an aggregate measure of HD in this PD patient group. However, there are indications of an improvement in the participants’ ability to detect dyskinesias.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/8667591","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46142801","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":"A Predictive Model and Survival Analysis for Tube Feeding in ALS Patients: A Prospective Cohort Study in a Chinese ALS Clinic","authors":"Xi Chen,&nbsp;Jiawen Xu,&nbsp;Jingyan Guo,&nbsp;Ting Ye,&nbsp;Baocheng Zhao,&nbsp;Shiming Fang,&nbsp;Yan Chen,&nbsp;Yi Dong","doi":"10.1155/2023/1069443","DOIUrl":"10.1155/2023/1069443","url":null,"abstract":"<div>\u0000 <p><i>Objectives</i>. Tube feeding is an effective way to provide nutritional support for amyotrophic lateral sclerosis (ALS) patients with severe dysphagia. Currently, the predictors of tube feeding and the survival affected by tube feeding were poorly studied in Chinese ALS patients. Therefore, we aimed to explore predictive factors and establish a prediction model to quantitatively predict the risk of tube feeding. Furthermore, we explored the survival benefit provided by tube feeding. <i>Methods</i>. In this longitudinal, prospective cohort study, we included patients diagnosed with ALS using the Awaji criteria at the ALS clinic in Huashan Hospital. Follow-up was conducted by telephone interview from January 1, 2019, to December 30, 2021, or until death. All statistical analyses were performed using R software. <i>Results</i>. Overall, 218 patients were recruited for the study. The multivariate Cox regression analysis showed a high ALSFRS-R slope (adjusted hazard ratio (aHR) = 4.94 (95% confidence interval (95% CI: 2.26-10.81), <i>p</i> &lt; 0.001), low bulbar score (aHR = 0.81 (95% CI: 0.69-0.96), <i>p</i> = 0.01), history of ischemic stroke (aHR = 5.69 (95% CI: 1.3-24.82), <i>p</i> = 0.02), and bulbar involvement (aHR = 11.87 (95% CI: 1.42-99.31), <i>p</i> = 0.02) as independent risk factors of tube feeding. The nomogram model was established with moderate discrimination and calibration. Among 71 ALS patients with tube feeding indication, 33.8% accepted gastrostomy suggestion and 14.1% had nasogastric tube (NGT) insertion. However, gastrostomy and NGT did not accelerate disease progression (aHR = 0.57 (95% CI: 0.20-1.67), <i>p</i> = 0.31 and aHR = 1.72 (95% CI: 0.43-6.88), <i>p</i> = 0.43, respectively). <i>Conclusions</i>. We developed a nomogram that could be a prediction tool to predict individual timing of tube feeding for ALS patients. In addition, we found that gastrostomy and NGT did not affect ALS patients’ survival.</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/10.1155/2023/1069443","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48449726","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 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}