Acta neurologica Belgica最新文献

{"title":"Anticipatory postural adjustments during gait initiation in people with parkinson's disease: a systematic review.","authors":"Mustafacan Salamci, Arzu Guclu-Gunduz","doi":"10.1007/s13760-025-02927-4","DOIUrl":"https://doi.org/10.1007/s13760-025-02927-4","url":null,"abstract":"<p><strong>Objective: </strong>To provide an overview of alterations in anticipatory postural adjustments (APAs) during gait initiation (GI) and its possible clinical applicability in people with Parkinson's disease (pwPD).</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed and Web of Science using the terms: \"Parkinson's disease\" AND \"postural adjustment\" AND (\"gait initiation\" OR \"step initiation\"). Variables commonly used to assess APAs, including center of pressure (CoP) displacement and electromyography (EMG), were extracted. Study quality was assessed with the Newcastle-Ottawa Scale.</p><p><strong>Results: </strong>Fourteen studies including 453 pwPD and 287 healthy subjects (HS) were reviewed. People with Parkinson's disease (PD) consistently exhibited smaller and slower CoP displacements in both anteroposterior and mediolateral directions, together with prolonged APAs durations. EMG findings indicated delayed onset and reduced amplitude, particularly in tibialis anterior and hip abductors, muscles pivotal for safe GI. Alterations were linked to disease severity and postural instability, with more pronounced changes in pwPD with freezing of gait (FoG). APAs-derived metrics showed sensitivity to subtle motor deficits even in early disease stages.</p><p><strong>Conclusions: </strong>The reviewed literature demonstrates bradykinetic and hypokinetic APAs during GI in pwPD. GI-based measures may complement functional assessment for postural stability, gait, and fall risk, and have potential value for rehabilitation strategies such as external cueing. Levodopa improves but does not normalize APAs. Standardized, clinically feasible GI protocols are required to define meaningful thresholds and responsiveness so that APA-derived measures can be translated into routine clinical practice.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145342800","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":"Posterior optic neuropathy as a rare manifestation in the progression of Medulloblastoma.","authors":"R Batata, S Sousa, L Rocha, E Cunha, A Calheiros","doi":"10.1007/s13760-025-02920-x","DOIUrl":"https://doi.org/10.1007/s13760-025-02920-x","url":null,"abstract":"","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145342587","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":"Cannabis-induced transient meningeal enhancement: A novel radiological finding.","authors":"Lancelot Coutinho, Sanjiv Chawda, Tomas P Teodoro, Renato Oliveira","doi":"10.1007/s13760-025-02926-5","DOIUrl":"https://doi.org/10.1007/s13760-025-02926-5","url":null,"abstract":"","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145342500","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":"Cyanotic apnea in stiff person syndrome.","authors":"Hicham El Otmani","doi":"10.1007/s13760-025-02917-6","DOIUrl":"https://doi.org/10.1007/s13760-025-02917-6","url":null,"abstract":"","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145342548","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":"Pathogenic variant in the RALA gene in a patient from North Macedonia with Hiatt-Neu-Cooper syndrome: genotypic and phenotypic spectrum.","authors":"Lјelja Muaremoska Kanzoska, Valentina Dukovska, Ana Poposka, Shpresa Useini Muaremoska","doi":"10.1007/s13760-025-02925-6","DOIUrl":"https://doi.org/10.1007/s13760-025-02925-6","url":null,"abstract":"","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145342579","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":"Headache symptoms in children and adolescents with ADHD: evaluating family history and the role of methylphenidate treatment.","authors":"Valentina Nicolardi, Giuseppe Accogli, Luigi Macchitella, Sara Scoditti, Isabella Fanizza, Anna Maria Spalluto, Antonio Trabacca","doi":"10.1007/s13760-025-02912-x","DOIUrl":"https://doi.org/10.1007/s13760-025-02912-x","url":null,"abstract":"<p><strong>Background: </strong>Clinical and epidemiological studies have reported a comorbidity between Attention Deficit Hyperactivity Disorder (ADHD) and migraine. Pharmacological treatments such as methylphenidate have also been hypothesized to contribute to the onset of headaches. This study aimed to investigate the percentage of headaches in a pediatric ADHD population, comparing children treated with methylphenidate to those not receiving pharmacological therapy, while also considering the potential influence of family history, sex, and age.</p><p><strong>Methods: </strong>A retrospective cross-sectional analysis was conducted on 118 children and adolescents diagnosed with ADHD (68 treated with methylphenidate, 50 untreated). Headache presence and features were assessed using a structured questionnaire based on international diagnostic criteria. Binomial and multinomial logistic regressions were used to evaluate the effects of methylphenidate use and family history on headache presence and type, controlling for age and sex.</p><p><strong>Results: </strong>Headache symptoms were significantly more frequent in participants with a family history of headache, regardless of medication status. No main effect of methylphenidate on overall headache percentage was observed. However, the combination of methylphenidate treatment and positive family history was significantly associated with migraine-compatible headache presentations. Cephalalgy was not significantly linked to any of the variables. The absence of family history was strongly associated with the absence of headache symptoms.</p><p><strong>Conclusions: </strong>Family history appears to be a key factor in headache percentage among children with ADHD. While methylphenidate alone does not increase headache risk, its interaction with familial predisposition may contribute to migraine-like symptoms. Family history should be carefully considered during clinical assessment.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312232","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":"Clinical implications of the recalibrated CHA₂DS₂-VA score for women after ischemic stroke: a prospective cohort study.","authors":"Priyanka Boettger, Jamschid Sedighi, Kerstin Piayda, Martin Juenemann, Omar Alhaj Omar, Bernhard Unsoeld, Samuel Sossalla, Michael Buerke","doi":"10.1007/s13760-025-02916-7","DOIUrl":"https://doi.org/10.1007/s13760-025-02916-7","url":null,"abstract":"<p><strong>Introduction: </strong>The 2024 ESC atrial fibrillation guidelines introduced the CHA₂DS₂-VA score by removing female sex as an independent risk criterion. Although intended to simplify risk stratification and avoid sex-based overtreatment, the real-world implications for women who present with AF-related ischemic stroke/TIA remain unclear. In this prospective observational study, we examined the clinical implications of CHA₂DS₂-VA recalibration in a post-stroke setting, focusing on sex-specific differences in stroke severity and early functional outcome, and on the proportion of women who newly fall below the anticoagulation threshold (score ≤ 1).</p><p><strong>Methods: </strong>In a prospective cohort of 714 consecutive stroke patients, 161 (22.5%) had documented AF. Risk stratification was performed using both CHA₂DS₂-VASc and the revised CHA₂DS₂-VA score. Stroke severity (NIHSS) and functional outcome (mRS) were analyzed by sex. Propensity score matching and multivariable logistic regression were used to examine the independent association between sex and stroke severity.</p><p><strong>Results: </strong>Female patients with AF were older and had a higher vascular risk burden than men. They presented with significantly more severe strokes (median NIHSS 12 vs. 8; P < 0.01) and tended toward worse outcomes. After score recalibration, 11 of 81 women (13.6%) had a CHA₂DS₂-VA score ≤ 1, falling below the ESC anticoagulation threshold-despite having experienced an ischemic stroke. Most of these patients had cardioembolic strokes and moderate-to-severe neurological deficits. In matched analyses, female sex remained independently associated with severe stroke (aOR 1.54, 95% CI 1.03-2.29).</p><p><strong>Conclusion: </strong>In this prospective cohort of AF-related ischemic stroke, women had greater comorbidity burden and higher stroke severity than men. A subgroup with CHA₂DS₂-VA ≤ 1 nonetheless sustained ischemic stroke, and exploratory 5-year follow-up suggested excess recurrence without anticoagulation. These findings require validation in larger cohorts.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278687","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":"Efficacy and safety of microvascular decompression in trigeminal neuralgia secondary to multiple sclerosis: a systematic review and meta-analysis.","authors":"Bardia Hajikarimloo, Salem M Tos, Ibrahim Mohammadzadeh, Ali Mortezaei, Arman Hasanzade, Dorsa Najari, Azin Ebrahimi, Mohammad Amin Habibi","doi":"10.1007/s13760-025-02909-6","DOIUrl":"https://doi.org/10.1007/s13760-025-02909-6","url":null,"abstract":"<p><strong>Background: </strong>The role of microvascular decompression (MVD) in patients with multiple sclerosis-related trigeminal neuralgia (MS-TN) remains unclear. Central demyelination is the primary underlying cause of MS-TN, and the absence of vascular compression raises questions about the role of MVD in MS-TN patients. We aimed to evaluate the efficacy and safety of MVD in MS-TN patients.</p><p><strong>Methods: </strong>On April 9, 2025, a thorough search was performed, including studies that reported outcomes of MVD in MS-TN patients.</p><p><strong>Results: </strong>Fifteen studies involving 230 patients were included. The meta-analysis revealed a pooled pain-free rate of 61% (95% CI: 10%-100%) and an adequate pain relief rate of 99% (95% CI: 93%-100%) at the initial follow-up. Our findings suggested that at the last follow-up, MVD resulted in a pooled pain-free rate of 29% (95% CI: 19%-41%) and an adequate pain relief rate of 76% (95% CI: 61%-89%), with a pooled complication rate of 16% (95% CI: 6%-29%).</p><p><strong>Conclusion: </strong>MVD is associated with favorable initial pain-free and adequate pain-relief outcomes, acceptable long-term pain-related outcomes, and a relatively low complication rate. In MS-TN individuals with apparent NVC and no sign of brainstem lesions in the MRI studies, MVD can be associated with more favorable outcomes.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278706","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":"Autonomic dysfunction in patients with episodic cluster headache during remission period.","authors":"Alba López-Bravo, Elena Bellosta Diago, Marisa de la Rica Escuín, Laura Díez Galán, Sonia Santos Lasaosa","doi":"10.1007/s13760-025-02915-8","DOIUrl":"https://doi.org/10.1007/s13760-025-02915-8","url":null,"abstract":"<p><strong>Background: </strong>The hypothalamus is involved in cluster headache (CH) pathophysiology and is a hub for autonomic control. While cranial autonomic symptoms are prominent during attacks, other autonomic manifestations may be present in CH. This study aims to explore the autonomic nervous system (ANS) in patients with CH during remission period.</p><p><strong>Methods: </strong>Cross-sectional study including 30 CH and 30 age- and sex-matched controls. We analysed time- and frequency-domain parameters of heart rate variability (HRV) and active orthostatic tests. To investigate the sympathetic nervous system, plasma norepinephrine (NE) levels were determined. All assessments were performed during remission period.</p><p><strong>Results: </strong>All HRV parameters were lower in CH; the percentage of adjacent R-R intervals that differ by more than 50 milliseconds (pNN50) and standard deviation of normal-to-normal R-R intervals in 24 h (SDNN) were significantly lower in CH (pNN50, 31.0 [5.3-44.3] vs. 44.5 [25.8-58.5], p = 0.043; SDNN, 79.6 ± 42.6 vs. 99.6 ± 42.6, p = 0.004). All other time-domain parameters, including the root mean square of successive R-R differences (RMSSD) were lower in CH than in controls (RMSSD 59.5 ± 36.9 vs. 77.3 ± 39.4, p = 0.077). Compared to controls, mean HR was significantly higher in CH (64.2 [59.6-75.8] vs. 60.4 [57.3-62.7], p = 0.038). Supine and upright NE levels were significantly higher in CH, (supine 228.9 [161.6-324.1] vs. 209.9 [151.2-314.1], p = 0.015; standing 376.1 [264.6-527.8 vs. 327.4 [256.4-400.9], p = 0.019).</p><p><strong>Conclusions: </strong>The present study indicates a significant decrease in HRV and an upward trend of plasmatic NE levels in CH during remission periods, suggesting an imbalance of the ANS in this state.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278663","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 therapeutic efficacy of nanoparticles in the treatment of alzheimer's disease.","authors":"Thabisa L Ntondini, Tobeka Naki, Sibusiso Alven","doi":"10.1007/s13760-025-02905-w","DOIUrl":"https://doi.org/10.1007/s13760-025-02905-w","url":null,"abstract":"<p><p>The build-up of beta-amyloid plaques in the brain leads to Alzheimer's disease (AD), a neurodegenerative condition. AD affects more than 30 million individuals globally every year. No cure for AD has been discovered yet. The available therapeutic options are administered to slow down the progress of the disease. The currently available treatment plans are used to relieve symptoms and improve cognitive abilities, thus slowing progression. Nanotechnology is highly effective and has demonstrated significant benefits across various medical applications. Nanoparticles have been explored as promising drug delivery systems for the targeted delivery of anti-AD therapeutics and for the precise diagnosis of the condition. Nanoparticles, such as dendrimers, lipid-based nanoparticles, polymer-based nanoparticles, and metal-based nanoparticles, have been designed and reported to inhibit Aβ aggregation, fibril formation, and disaggregating mature fibrils, prevent neuroinflammation and Aβ1-42-induced cell damage, treat oxidative stress and lower hallmark of Aβ, and display excellent capability to bypass blood-brain barrier (BBB). This review is focused on the preclinical therapeutic outcomes of nanoparticles and the challenges encountered in the treatment of AD. This review highlights the significant advancements of nanoparticles that are currently undergoing clinical trials for management of AD.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278672","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}