Acta neurologica Belgica最新文献

{"title":"Effectiveness of telerehabilitation in reducing motor disability and enhancing quality of life in parkinson's disease: a systematic review and meta-analysis.","authors":"Anas Zakarya Nourelden, Mohamed Mamdouh, Ibrahim Kamal, Osama Khalid Abdelgawad Ahmed, Adel Reda Abd Elwahab, Mohammed Elkholy, Abdelrahman G Tawfik, Mohamed Hesham Gamal, Ahmed Hashem Fathallah","doi":"10.1007/s13760-025-02838-4","DOIUrl":"https://doi.org/10.1007/s13760-025-02838-4","url":null,"abstract":"<p><strong>Objective: </strong>This review and meta-analysis explored the effectiveness of telerehabilitation in reducing motor disability and improving quality of life in patients with Parkinson's disease (PD).</p><p><strong>Background: </strong>PD is characterized by motor and non-motor symptoms. Motor function decline averages 3-5 points per year on the Unified Parkinson's Disease Rating Scale, Part III (UPDRS-III). Sedentary behavior worsens symptoms, while exercise improves motor function and quality of life. Telerehabilitation has proven effective in increasing exercise adherence in PD patients.</p><p><strong>Methods: </strong>We searched Web of Science, Cochrane, PubMed, Scopus, and Embase for relevant articles till June 2024, including studies that compared telerehabilitation to no exercise, traditional face-to-face rehabilitation, or any studies with no comparator group. Data were pooled using a random effects model, and differences were presented using mean differences (MD) alongside 95% confidence intervals (CI).</p><p><strong>Results: </strong>This review included 44 articles with 1614 participants. In assessing the quality of studies, four cohort/cross-sectional studies were rated fair, one good; one case-control study was good. Eight single-arm and four NRCTs were good, and the others were of fair quality. All 20 RCTs had a high risk of bias; one case report was deemed to have fair quality.Double-arm studies demonstrated no significant difference between telerehabilitation and in-person programs regarding UPDRS-III scores (MD: 0.69). Pooled Parkinson's Disease Questionnaire (PDQ)-39 scores exhibited the same non-significant pattern, but in longer-duration programs, telerehabilitation demonstrated a significant edge (MD:-5.45). Similarly, the difference between telerehabilitation and traditional exercise was not significant in PDQ-8 scores, nonetheless, TUG times were significantly shorter for telerehabilitation (MD: 1.17). In the single-arm analysis of telerehabilitation, UPDRS-III scores showed an improvement (MD:-2.58). Likewise, PDQ-39 scores decreased significantly (MD:-2.98). Both PDQ-8 scores (MD:-5.52) and Timed Up and Go Test (TUG) times (MD:-2.15) decreased significantly, while Activities-specific Balance Confidence (ABC) scores improved (MD: 8.65%).</p><p><strong>Conclusion: </strong>Telerehabilitation decreases the progress in motor disability and improves the quality of life in PD patients, possibly due to increased exercise adherence, while costing less than in-person exercise.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral middle cerebellar peduncle infarcts in a patient with systemic lupus erythematosus.","authors":"Sandra Perillo, Francesco Barbato, Teresa Perillo, Lorenzo Pinto, Fabio Giuliano Numis","doi":"10.1007/s13760-025-02842-8","DOIUrl":"https://doi.org/10.1007/s13760-025-02842-8","url":null,"abstract":"<p><p>Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease with multiorgan involvement, including the central nervous system. Neuropsychiatric manifestations (NPSLE) are observed in a significant proportion of patients and may include ischemic strokes, often related to antiphospholipid syndrome (APS) or small vessel vasculitis. We report the case of a 38-year-old woman who presented to the emergency department with acute dysarthria and a history of fever. Brain imaging demonstrated multiple subacute ischemic lesions affecting the bilateral middle cerebellar peduncles and frontal regions, and diffuse leukoencephalopathy. Laboratory investigations revealed high-titer antinuclear, anti-dsDNA, anticardiolipin antibodies, and lupus anticoagulant. The overall clinical, radiological, and immunological profile was consistent with neuropsychiatric SLE. The possible underlying causes of ischemic events were antiphospholipid syndrome and small vessel vasculitis. This case highlights the importance of considering NPSLE in the differential diagnosis of diseases involving bilateral middle cerebellar peduncles. Early recognition and therapy of NPSLE are crucial for improving outcomes in this complex clinical scenario.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impaired trunk position sense and its relationship with trunk control and balance in cervical dystonia patients.","authors":"Selda Çoban, Fatih Söke, Mehmet Fevzi Öztekin, Bilge Koçer, Çağrı Gülşen, Funda Kaplan, Hatice Ayşe Tokçaer Bora","doi":"10.1007/s13760-025-02843-7","DOIUrl":"https://doi.org/10.1007/s13760-025-02843-7","url":null,"abstract":"<p><strong>Background: </strong>Trunk position sense is an essential component of proprioception for maintaining balance. Although the loss of balance is a well-documented phenomenon in cervical dystonia (CD) patients, the evaluation of trunk position sense in this population remains a gap in the existing research.</p><p><strong>Aims: </strong>The primary aim of this study was to compare trunk position sense between CD patients and healthy people. The secondary aim was to investigate the relationship between trunk position sense and trunk control, balance, and disease severity in CD patients.</p><p><strong>Methods: </strong>This cross-sectional study included 34 CD patients and 34 healthy people. Trunk position sense was evaluated with a digital inclinometer, which measures the amount of trunk reposition error (TRE). Trunk control was assessed with the Trunk Impairment Scale (TIS), while balance was evaluated with the Berg Balance Scale (BBS), the One Leg Stance Test (OLST), the Four Square Step Test (FSST), and the Activities-specific Balance Confidence Scale (ABC). The Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) was used to determine disease severity.</p><p><strong>Results: </strong>CD patients had higher scores on the TRE compared to healthy people (p = 0.007). The TRE value had a fair to moderate correlation with the TIS total, TIS-dynamic sitting subscale, FSST, BBS, ABC, TWSTRS-total, TWSTRS-severity subscale, and TWSTRS-disability subscale scores in CD patients (p < 0.05). There was no correlation between the TRE value and the TIS-static sitting subscale, TIS-coordination subscale, OLST, and TWSTRS pain subscale scores (p > 0.05) in CD patients.</p><p><strong>Conclusions: </strong>Trunk position sense was reduced in CD patients. Trunk position sense was also associated with trunk control, balance, and disease severity. These findings suggest that the assessment of trunk position sense should be taken into consideration in the rehabilitation of CD patients.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of a novel MTM1 pathogenic variant in neonatal X-linked centronuclear myopathy: a case report from East Asia.","authors":"Wei Xiong, Qi Chen","doi":"10.1007/s13760-025-02840-w","DOIUrl":"https://doi.org/10.1007/s13760-025-02840-w","url":null,"abstract":"","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The value of unilateral limb-kinetic apraxia in localizing occult brain lesions.","authors":"Maurizio Giorelli, Diletta Nigri, Maria Stella Aniello, Sarah Idrissi","doi":"10.1007/s13760-025-02841-9","DOIUrl":"https://doi.org/10.1007/s13760-025-02841-9","url":null,"abstract":"","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroprotective effect of Glibenclamide in stroke: a systematic review and meta-analysis of randomized controlled trials.","authors":"Guilherme José da Costa Borsatto, Heitor Pereira Vale da Costa, Laís Silva Santana, Mauri Brandão de Medeiros Neto, Victor Zanetti Strutz, Pedro Henrique Mouty Rabello, Vitor Nagai Yamaki, João Paulo Mota Telles, Eberval Gadelha Figueiredo","doi":"10.1007/s13760-025-02837-5","DOIUrl":"https://doi.org/10.1007/s13760-025-02837-5","url":null,"abstract":"<p><strong>Background: </strong>Stroke is a leading cause of death and disability, with cerebral edema contributing to poor outcomes. Glibenclamide, a sulfonylurea with potential neuroprotective properties, has shown effect in reducing cerebral edema in preclinical studies. This meta-analysis aimed to evaluate its efficacy in functional outcomes, cerebral edema, and mortality in patients with acute ischemic stroke (AIS), intracerebral hemorrhage (ICH), and aneurysmal subarachnoid hemorrhage (aSH).</p><p><strong>Methods: </strong>A systematic review and meta-analysis of randomized controlled trials (RCTs) comparing Glibenclamide to standard care in the acute management of stroke was conducted. Outcomes included functional status (mRS 0-3 at 3 months), cerebral edema (midline shift at 72-96 h), mortality, and hypoglycemia events.</p><p><strong>Results: </strong>Seven RCTs involving 1,225 patients met inclusion criteria. Glibenclamide did not improve functional status at 3 months in AIS and aSH but showed modest functional benefits in ICH (RR = 1.16; 95% CI: 1.04-1.28). No significant reduction in cerebral edema was observed in AIS (mean difference = 1.36 mm; 95% CI: -4.21 to 1.48). Mortality rates remained unchanged at discharge in aSH (RR = 0.78; 95% CI: 0.41-1.48) or at 3 months in AIS (RR = 0.97; 95% CI: 0.53-1.79). However, Glibenclamide increased hypoglycemia risk (RR = 3.57; 95% CI: 1.19-10.68).</p><p><strong>Conclusion: </strong>This meta-analysis found no significant benefits in functional outcomes, cerebral edema, or mortality with Glibenclamide in acute stroke. Despite an increased hypoglycemia risk, encouraging results in individual trials suggest potential benefits in specific subgroups. Further research should focus on identifying these subpopulations to refine Glibenclamide's role as a neuroprotective therapy.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case series of functional movement disorders in paediatric population-phenomenology and clinical characteristics.","authors":"Ajith Cherian, Divya Kalikavil Puthanveedu, Amod R, Soumya Sundaram","doi":"10.1007/s13760-025-02836-6","DOIUrl":"https://doi.org/10.1007/s13760-025-02836-6","url":null,"abstract":"<p><strong>Background: </strong>Literature on functional movement disorders (FMD) in paediatric age group is scarce.</p><p><strong>Objectives: </strong>To study the phenomenology and characteristics of FMDs in paediatric age group.</p><p><strong>Methods: </strong>The study included 13 children (8 girls and 5 boys) from a tertiary-care centre. Assessment of FMD was based on Fahn and Williams criteria. Data included phenomenology, socioeconomic background, electrophysiological, and imaging investigations.</p><p><strong>Results: </strong>Mean age of onset was 12.1 ± 2.3 years. Sudden onset and triggers like minor injuries and stressors were common precipitants. 68% of the children were from urban areas, 61% belonged to low socioeconomic status and 61.5% had intellectual disability. 72% had a precipitating factor. The most common phenomenology was myoclonus (38%), followed by tremor (30%), dystonia (23%), and abnormal gait (15%). Clues to suggest a functional etiology were, isolated or predominant involvement of the dominant upper limb, distractibility, and entrainment in the case of tremor. Significant variability in frequency, amplitude, and distribution of the FMD by distracting manoeuvres were helpful in establishing the diagnosis. Tremor and dystonia predominated in girls, while myoclonus manifested more often in boys. Ten subjects (76%) presented with an isolated movement disorder, while 3 patients (24%) had a combination of ≥ 2. Nine patients had other sensory symptoms most commonly headache.</p><p><strong>Conclusions: </strong>FMDs were more common in children with intellectual disability than in those with normal IQ. Myoclonus was the most observed phenomenology. Among other comorbidities headache was the most common and depression followed by generalised anxiety were the most common psychiatric associations. Complete recovery is often possible with early intervention.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of methylphenidate and amantadine co-administration on functional outcome of patients with blunt traumatic brain injury: A randomized controlled trial.","authors":"Amirmohammad Farrokhi, Reza Mosaed, Hosseinali Khalili, Amin Niakan, Seyed Shahab Ghazi Mirsaeed","doi":"10.1007/s13760-025-02803-1","DOIUrl":"https://doi.org/10.1007/s13760-025-02803-1","url":null,"abstract":"<p><strong>Introduction: </strong>Traumatic brain injury (TBI) poses a large burden and cost on the patients, being among the most prevalent causes for emergency department visits. One of the major issues with TBI is the long-term functional outcome of patients, causing disabilities affecting the patient and the surrounding members of society. Several attempts have been made in order to address functional outcomes via means such as pharmacotherapy, physical therapy, and newer methods. In this study, we aimed to conduct a double-blinded, randomized controlled trial with the administration of methylphenidate and amantadine, two drugs proven effective separately in previous studies, to evaluate the functional outcome of patients with blunt TBI.</p><p><strong>Methods: </strong>Patients with blunt TBI were randomly assigned into treatment and control groups. Patients in the treatment group received 100 mg of amantadine and 20 mg of methylphenidate twice daily while patients in the control group received similarly shaped placebos. The patients age, gender, GCS, ICU and hospital length of stay and GOSE were evaluated and calculated for evaluation of outcome and initial condition. The main target was GOSE evaluated 6 months after discharge.</p><p><strong>Results: </strong>A total of 184 patients were included in our study, randomly and equally divided into the treatment and control groups. The mean age of patients was 40.63 ± 17.46, and 84.8% of patients were male. There was no significant difference between the two groups' age, gender, and initial GCS. Regarding outcome measures, there was no statistical difference between the groups in hospital and ICU length of stay. GOSE was significantly higher in patients in the treatment group (6.22 ± 2.06 vs. 5.37 ± 2.54, p = 0.014).</p><p><strong>Conclusion: </strong>Co-administering methylphenidate and amantadine could help patients with blunt TBI, especially in long-term settings, regarding their functional outcome.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National survey of current practices and attitudes regarding discharge disposition for older adults with mild traumatic brain injury and traumatic intracranial hemorrhage.","authors":"Juliette A L Santing, Robert Croese, Joukje van der Naalt, Heleen den Hertog, Korné Jellema","doi":"10.1007/s13760-025-02834-8","DOIUrl":"https://doi.org/10.1007/s13760-025-02834-8","url":null,"abstract":"<p><strong>Background: </strong>Older patients with traumatic intracranial hemorrhage (tICH) following mild traumatic brain injury (mTBI) are commonly seen by neurologists in clinical practice. Due to the lack of clear evidence on optimal management, most guidelines recommend hospital admission for these patients. However, some studies have shown that selected low-risk patients can be safely discharged from the Emergency Department (ED). In light of these differing opinions and a lack of Class 1 evidence, we aimed to explore current management practices and attitudes toward tICH in older mTBI patients in the Netherlands.</p><p><strong>Methods: </strong>A national online survey, involving the disposition strategies for five case vignettes of tICH, was sent to neurology residents and neurologists to explore current variations in clinical practice. We evaluated patient and hemorrhage characteristics influencing decisions regarding the discharge disposition of a patient from the ED.</p><p><strong>Results: </strong>The survey was completed by 113 respondents, including 36 (32%) residents and 77 (68%) neurologists. In all the cases, over 70% of respondents preferred hospital admission over ED discharge for older mTBI patients with tICH. There was substantial variation in the respondents' willingness to participate in a randomized trial evaluating the necessity of hospital admission after mTBI with tICH. Factors influencing admission varied between cases. A secondary deterioration risk of 1-2% was considered acceptable by the majority (53%) to allow direct ED discharge.</p><p><strong>Conclusion: </strong>Our findings demonstrate limited willingness among clinicians to discharge older mTBI patients with tICH directly from the ED. To support safe and consistent decision-making, high-quality evidence is urgently needed to guide disposition decisions for older mTBI patients with tICH.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Egocentric mental rotation in individuals with multiple sclerosis: relationship with disability and cognitive parameters.","authors":"Merve Ünal, Ayla Fil Balkan, Nazire Pınar Acar Özen, Aslı Tuncer, Yeliz Salcı","doi":"10.1007/s13760-025-02827-7","DOIUrl":"https://doi.org/10.1007/s13760-025-02827-7","url":null,"abstract":"<p><strong>Background: </strong>This study aims to examine whether egocentric-based mental rotation is affected in individuals with Multiple Sclerosis (MS) and to analyze its relationship with disability, functional system scores (FSS), and cognitive parameters.</p><p><strong>Methods: </strong>The study involved 57 right-dominant individuals with MS and 40 right dominant healthy subjects. Disability was assessed using the Neurostatus-Expanded Disability Status Scale (Neurostatus-EDSS). Participants' performance on mental rotation tasks was evaluated with the Recognise Hand App™, Recognise Foot App™, measuring reaction times (seconds) and accuracy (%) for hand and foot stimuli. Cognitive functioning was assessed using the Brief International Cognitive Assessment for MS (BICAMS).</p><p><strong>Results: </strong>MS patients exhibited lower performance in right hand mental rotation reaction time (p = 0.042), right hand accuracy percentage (p < 0.001), right foot accuracy percentage (p = 0.035). Positive correlations were found between disease duration, EDSS total score, cerebellar FSS, bladder-bowel FSS, and ambulation scores with reaction times, while negative correlations were observed with accuracy percentages (p < 0.05). Additionally, a positive correlation was identified between accuracy percentages and BICAMS (p < 0.05).</p><p><strong>Conclusions: </strong>The study revealed substantial impairments in right-hand and right-foot performance in right dominant individuals with MS. Mental rotation abilities were found to be related to disease duration, higher EDSS and FSS scores, as well as cognitive functioning. Identifying the cognitive domains and functional systems associated with egocentric mental rotation will contribute to better understanding this underexplored area and developing potential treatment strategies to enhance functionality.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144537732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}