Acta Neurologica Scandinavica最新文献

{"title":"Motor Band Sign in Motor Neuron Diseases Using Magnetic Resonance Imaging: A Systematic Review","authors":"Sana Mohammadi,&nbsp;Sadegh Ghaderi","doi":"10.1155/2023/6677967","DOIUrl":"10.1155/2023/6677967","url":null,"abstract":"<div>\u0000 <p>Motor neuron diseases (MNDs) like amyotrophic lateral sclerosis (ALS) are progressive neurodegenerative disorders affecting upper and lower motor neurons (UMN and LMN). Magnetic resonance imaging (MRI) often reveals a “motor band sign” (MBS) of hypointensity along the precentral gyri in ALS, considered a radiologic hallmark. This review comprehensively summarizes the literature on MBS in ALS and related MNDs using multiple MRI techniques. A systematic search was conducted in the PubMed and Scopus databases to identify relevant studies on MBS in MNDs published until August 2023. Twelve studies were included. Most patients had UMN involvement at the onset. MBS was correlated with UMN impairment severity. Susceptibility-weighted imaging (SWI) detected MBS in the majority of MND patients. The use of SWI could be particularly useful in detecting MBS, and it should be considered as part of the routine clinical MRI protocols. Recent studies suggest that hypointensity and atrophy of the primary motor cortex (M1) and nearby regions can be used as MRI markers of UMN impairment in MNDs. Other MRI techniques like T2-weighted (T2-w), T2 ^∗-w, and fluid-attenuated inversion recovery (FLAIR) also showed characteristic changes. Furthermore, quantitative susceptibility mapping (QSM) is an advanced MRI technique that allows sensitive quantification of iron deposition and has shown promise for accurately detecting MBS in MNDs. The findings suggest that MR neuroimaging techniques can provide valuable insights into the pathophysiology of MND and can be used to detect biomarkers such as MBS. The review demonstrates that advanced MRI techniques can detect cortical and white matter changes reflecting upper motor neuron degeneration in MNDs like ALS. To find out how sensitive and suggestive the MBS is in MNDs and neurodegenerative movement disorders and how well it works as a prognostic indicator, we will need to do more research that combines comprehensive prospective and longitudinal research.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/6677967","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49636984","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":"Brain Areas Predisposing to the Stroke-Related Epilepsy Development","authors":"Viktor Weiss,&nbsp;Pavel Říha,&nbsp;Irena Doležalová,&nbsp;Martin Kojan,&nbsp;Vladimír Červeňák,&nbsp;Julius Šimko,&nbsp;Roman Herzig,&nbsp;Ivan Rektor","doi":"10.1155/2023/1439121","DOIUrl":"10.1155/2023/1439121","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Stroke-related epilepsy (STRE) represents a significant health problem. We focused on identifying brain areas, which involvement in ischemia predisposes a patient to STRE development. <i>Methods</i>. We retrospectively identified a group of patients with STRE consisting of 33 subjects. Subsequently, age-, sex-, and territory-matched controls who underwent stroke but did not develop STRE (control group (CG)) were identified. The CG was composed of 37 patients. The total ischemia volume and distribution of ischemic changes were compared between STRE and CG. We also analyzed multivariate statistics to identify independent variables predisposing to STRE development. <i>Results</i>. The patients with STRE exhibited a bigger volume of ischemia than CG (average volume of ischemia in STRE 60.8 cm³, in CG 42.4 cm³, <i>p</i> = 0.029). When comparing STRE and CG, there were differences in the distribution of ischemic changes in the temporal lobe (transverse (Heschl’s) temporal gyri, superior temporal gyrus, and middle temporal gyrus) and parietooccipital region (postcentral gyrus, supramarginal gyrus, angular gyrus, parietal operculum, lingual gyrus, and superior occipital gyrus). The involvement of transverse temporal (Heschl’s) gyri (<i>p</i> = 0.0222, odds ratio 30.0767), age (<i>p</i> = 0.0110, odds ratio 1.0745), and SeLECT score (<i>p</i> = 0.0480, odds ratio 1.8682) were identified as independent predictors for STRE development. <i>Conclusion</i>. The higher volume of ischemia correlates with a higher risk of STRE development. Some areas, particularly in the temporal and parietal neocortex, predispose the brain to generate epilepsy after the stroke.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/1439121","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42924120","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":"Volume and Visual Field Defects in Occipital Stroke: The NOR-OCCIP Study","authors":"Ane R. Tharaldsen,&nbsp;Kathinka D. Kurz,&nbsp;Martin W. Kurz,&nbsp;Anna Midelfart,&nbsp;Kristin M. Sand,&nbsp;Ingvild Dalen,&nbsp;Jana M. Hoff","doi":"10.1155/2023/3564863","DOIUrl":"10.1155/2023/3564863","url":null,"abstract":"<div>\u0000 <p><i>Introduction</i>. The majority of patients with occipital infarcts display homonymous visual field defects (VFD), with negative implications on activities of daily living and quality of life. To overcome the disability, better prognostic markers in the acute phase, as well as more targeted rehabilitation, would be useful. The aim of the current study was to present an overview of the topographic distribution of occipital infarcts and to investigate whether lesion volume can predict VFD at baseline and after six months. <i>Materials and Methods</i>. Multicenter, prospective study including patients with acute occipital infarcts (NOR-OCCIP project). All patients were examined by a neurologist in the acute phase, admitted to a stroke unit, and further assessed by an ophthalmologist within two weeks. Topographic and volumetric data from brain imaging in 72 patients were analyzed and computed by an experienced neuroradiologist. <i>Results</i>. A majority (81%) had occipital infarcts with involvement of the primary visual cortex, and VFD were detected on perimetry in 80% of the examined patients. Higher infarct volume led to more severe VFD at baseline (<i>p</i> = 0.019); this was more evident if the infarct was located on the right side (<i>p</i> = 0.001). The odds for VFD improvement after six months were higher the larger the infarcts were (<i>p</i> = 0.020). There was a statistically significant association between volume of infarcts and atrial fibrillation (<i>p</i> = 0.016), previous myocardial infarction (<i>p</i> = 0.023), and modified Rankin Scale at three months (<i>p</i> = 0.007). <i>Conclusion</i>. Higher infarct volumes led to more severe VFD at baseline. More than half of the patients (54%) experienced improvement of their VFD at six months; a higher grade of improvement was seen in patients with larger occipital infarcts. Large infarcts were more common in patients with cardiovascular disease, strengthening the argument for secondary prevention.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/3564863","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45628458","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":"Multiple Sclerosis and Suicide Attempts: A Review including a Meta-Analysis of Prevalence","authors":"Trine Banke d’Andrade,&nbsp;Christina Petrea Larsen,&nbsp;Egon Stenager,&nbsp;Elsebeth Nylev Stenager,&nbsp;Erik Christiansen","doi":"10.1155/2023/1067257","DOIUrl":"10.1155/2023/1067257","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Multiple sclerosis is an autoimmune inflammatory demyelinating disorder, and persons diagnosed with multiple sclerosis have a shorter life expectancy than the general population. Recent meta-analyses have examined the association between MS and suicide and between MS and suicidal ideation. The objective of the present review was to examine if MS is associated with a higher risk of suicide attempt. We hypothesised that MS patients were at increased risk of suicide attempts. <i>Methods</i>. Four databases (PubMed including MEDLINE, EMBASE, Web of Science, and PsycINFO) were searched systematically for studies assessing the risk of attempted suicide in people with MS. Eligibility criteria were studies designed as cohort, case-control, or cross-sectional studies with attempted suicide as the outcome and published in English. Lifetime prevalence of suicide attempt was calculated through a meta-analysis, and the results were presented as a forest plot. Sensitivity analyses were used to investigate the heterogeneity among studies. <i>Results</i>. 13 studies were identified from 533 records, providing a total population of 50,004 participants of whom 599 had attempted suicide. The weighted overall prevalence of suicide attempts among people with MS was 0.04 (95% CI 0.02-0.06) with a Cochran’s <i>Q</i> value of 591.05, which rejected the null hypothesis of homogeneous studies. The performed sensitivity analysis resulted in an <i>I</i>² of 81% as the lowest possible value, which still indicated a high level of heterogeneity. <i>Conclusion</i>. To our knowledge, this is the first study to examine the association between MS and suicide attempts in a meta-analysis. The results suggest a significant association between MS and suicide attempts. However, the small number of the included studies and the heterogeneous nature of these studies indicate a need for more studies based on more homogeneous samples.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/1067257","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46931111","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":"Social Cognition in Idiopathic Generalized Epilepsies and Nonlesional Temporal Lobe Epilepsy","authors":"Giulia Maria Tallarita,&nbsp;Roberta Ciuffini,&nbsp;Katherine Turner,&nbsp;Barbara Pucci,&nbsp;Annalisa Parente,&nbsp;Anna Rita Giovagnoli","doi":"10.1155/2023/9450272","DOIUrl":"10.1155/2023/9450272","url":null,"abstract":"<div>\u0000 <p><i>Objectives</i>. Social cognition (SC) is a multifaceted concept involving mental processes to understand, store, and apply information regarding social relationships. Brain lesions in key areas can impair critical components of SC, but seizures and epileptiform discharges could also be associated with deficits in SC. To verify this hypothesis, this study evaluated SC in persons with generalized or focal epilepsy without detectable brain lesion. <i>Materials and Methods</i>. Forty-eight adult persons with idiopathic generalized epilepsy (IGE) or temporal lobe epilepsy without brain lesion (cryptoTLE) and 24 healthy controls were evaluated by means of the Faux Pas Test (FPT), Social Situation Test (SST), Moral/Conventional Distinction Test (MCDT), and Empathy Questionnaire (EQ) which assess theory of mind (ToM), recognition of social behaviors and moral and conventional rules, and empathy. Clinical work-up included information on age at seizure onset, epilepsy duration, seizure symptoms and frequency, demographic characteristics, and the presence of comorbidities. <i>Results</i>. Compared to controls, persons with IGE or cryptoTLE were impaired in the understanding of existent faux pas on the FPT. On the SST, persons with cryptoTLE also showed significant deficits, whereas the IGE persons only were less accurate in recognizing normative behaviors. In cryptoTLE persons, the capacity to recognize cognitive and affective mental states correlated with seizure frequency and age, whereas, in IGE persons, the SST and MCDT scores correlated with schooling and age, respectively. <i>Conclusions</i>. CryptoTLE can cause extensive deficits in ToM and recognition of social situations, whereas IGE is only associated with deficits in fewer domains. Dysfunction of temporolimbic areas could be related to seizure frequency and associated with more severe SC impairment in cryptoTLE. Older age and poor education may be associated with SC deficits in focal or generalized epilepsy.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2023 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/9450272","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49294385","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":"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}