Acta neurologica Belgica最新文献

{"title":"Lipid metabolism, neuroinflammation, and oxidative stress in Alzheimer disease: an integrated mechanistic review.","authors":"Lijuan Lai, Yanfen Tang, Guojun Song, Yongmei Long, Cuiyu Chen, Chao Chen, Wei Li","doi":"10.1007/s13760-026-03064-2","DOIUrl":"https://doi.org/10.1007/s13760-026-03064-2","url":null,"abstract":"<p><p>Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterised by the accumulation of amyloid-β plaques, tau tangles, and extensive synaptic and neuronal loss. Increasing evidence suggests that the condition develops through the combined effects of protein misfolding, lipid dysregulation, oxidative stress, and chronic neuroinflammation. Among these processes, the APOE ε4 allele has a central role by linking disrupted lipid metabolism to impaired amyloid clearance, abnormal tau phosphorylation, and heightened neuronal vulnerability. This relationship highlights lipidopathy as a potential upstream driver of disease progression rather than a secondary feature. Advances in biomarker research, including cerebrospinal fluid and plasma assays, molecular imaging, and microRNA profiles, now enable detection of AD pathology years before clinical symptoms become evident and allow patient stratification based on molecular signatures. Despite these advances, currently available symptomatic and disease-modifying therapies remain limited in their ability to halt or reverse cognitive decline. This review synthesises recent findings across amyloid, tau, and lipid-driven mechanisms, while providing a comparative analysis of therapeutic strategies and their limitations. A lipid-focused, multi-target framework is proposed in which correcting metabolic imbalance enhances the effectiveness of amyloid- and tau-directed interventions. Such an approach may strengthen precision medicine and offer a realistic path toward improved outcomes in AD.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863364","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":"Exploring the fatigue phenomenon in individuals with Parkinson's disease: an Italian multicenter cross-sectional study.","authors":"Elisabetta Sarasso, Elisa Pelosin, Ilaria Ruotolo, Manuela Maieron, Alessandro Ferrero, Francesca Quarone, Andrea Grassi, Martina Putzolu, Andrea Gardoni, Giovanna Lagravinese, Francesca Di Biasio, Federica Agosta, Giovanni Galeoto, Giovanni Fabbrini, Laura Avanzino, Massimo Filippi, Susanna Mezzarobba","doi":"10.1007/s13760-026-03039-3","DOIUrl":"https://doi.org/10.1007/s13760-026-03039-3","url":null,"abstract":"<p><strong>Background: </strong>Fatigue is a common and disabling non-motor symptom in Parkinson's disease (PD), significantly affecting patients' quality of life. However, it is often underdiagnosed due to its subjective nature and the lack of a clear definition, hindering the development of effective treatments.</p><p><strong>Objectives: </strong>This study aims to investigate the prevalence of fatigue and its associations with sociodemographic factors, disease severity, levodopa equivalent daily dosage (LEDD) and motor, non-motor, and cognitive symptoms in an Italian cohort of patients with PD.</p><p><strong>Methods: </strong>An observational cross-sectional study was carried out in three Italian centers from January to May 2024. One hundred PD patients (H&Y ≤ 4) were assessed using validated tools: Parkinson Fatigue Scale (PFS), Fatigue Severity Scale, and Modified Fatigue Impact Scale. Motor and non-motor signs and symptoms, cognitive status, and LEDD were analyzed using non-parametric tests and Spearman's correlations. Fatigue prevalence was determined based on PFS score ≥ 3.09.</p><p><strong>Results: </strong>Fatigue was present in 36% of patients, more prevalent in women and more severe in those with H&Y > 2. Fatigue correlated strongly with non-motor symptoms (MDS-UPDRS Part I; ρ > 0.6, p < 0.001) and moderately with motor complications (0.4 < ρ < 0.5, p < 0.001), but weakly with disease duration, LEDD and age (ρ < 0.3, 0.002 < p < 0.05). Significant intercorrelations among fatigue scales supported their ability to consistently measure the fatigue construct.</p><p><strong>Conclusions: </strong>Fatigue in PD is a multidimensional phenomenon influenced mainly by non-motor symptoms. Gender-specific differences and the association with disease progression underscore the need of comprehensive and integrated management strategies to address this challenging symptom.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147809368","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":"Clinico-radiological suspicion and empirical therapy ameliorates a syndrome resembling a rare movement disorder: a lesson from a resource-constrained setting!","authors":"Ishita Desai, Nikita Dhar, Niraj Kumar","doi":"10.1007/s13760-026-03077-x","DOIUrl":"https://doi.org/10.1007/s13760-026-03077-x","url":null,"abstract":"","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147809340","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":"Data-driven outcome prediction and rational resource allocation in severe traumatic brain injury: a multicenter retrospective study integrating survival analysis and machine learning ensembles.","authors":"Shuyue Li, Xingzhi Liu, Jun Lei, Hao Lin, Min Li, Seidu A Richard, Zhigang Lan, Ling Feng","doi":"10.1007/s13760-026-03081-1","DOIUrl":"https://doi.org/10.1007/s13760-026-03081-1","url":null,"abstract":"<p><strong>Introduction: </strong>Severe traumatic brain injury (sTBI), is a leading cause of death and disability among young and middle-aged populations worldwide.</p><p><strong>Objective: </strong>sTBI is associated with high mortality and disability rates, and reliable risk estimation with quantified uncertainty is crucial for optimizing intensive care unit (ICU) bed allocation and nursing resource deployment. This study aimed to establish a prognostic model for sTBI patients using multicenter clinical, imaging, and nursing data, and to explore its value in guiding clinical resource allocation.</p><p><strong>Methods: </strong>A total of 1000 sTBI patients from multiple medical centers were enrolled in this retrospective cohort study. Clinical data including vital signs, CT/MRI imaging features, and detailed neurosurgical nursing records were collected.</p><p><strong>Results: </strong>Multivariate Cox regression analysis identified age, GCS score on admission, pupillary light reflex, CT findings such as midline shift, and hematoma volume, mean arterial pressure, and nursing-related indicators such as incidence of pulmonary infection, and pressure ulcer grade as independent prognostic factors for sTBI patients. The resource allocation strategy guided by risk stratification significantly reduced ICU bed occupancy rate from 89.2% to 75.6% and improved the utilization efficiency of specialized nursing resources, while the overall prognosis of patients was not negatively affected.</p><p><strong>Conclusion: </strong>The ML ensemble model constructed based on multicenter clinical, imaging, and nursing data has high accuracy in predicting short-term and long-term outcomes of sTBI patients. Risk stratification using this model can provide a scientific basis for rational allocation of ICU beds and resources, which is of great significance for improving the overall treatment level of sTBI patients.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147809391","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":"Levetiracetam- associated B-cell lymphopenia in a neonate: a rare case report.","authors":"Muhammed Ibrahim Ozsuer, Ilknur Kulhas Celik, Murat Konak, Hasibe Artac","doi":"10.1007/s13760-026-03079-9","DOIUrl":"https://doi.org/10.1007/s13760-026-03079-9","url":null,"abstract":"<p><p>While antiseizure medications (ASMs) exhibit the ability to influence the immune system, the specific immunosuppressive consequences in neonates remain insufficiently delineated. Levetiracetam is regarded a safe and effective second-line treatment following phenobarbital, particularly in cases where first-line agents are ineffective or result in adverse reactions in neonatal seizures. We present a neonate who developed B-cell lymphopenia due to levetiracetam administration, which constitutes a previously unrecognized adverse effect of the medication in neonates. To our knowledge, this case marks the initial documented occurrence of B-cell lymphopenia associated with levetiracetam in a neonate.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147809338","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 missed clinical clue: congenital mydriasis and broomstick-like cerebrovascular imaging in ACTA2 mutation.","authors":"Fatma Pınar Tabanlı, Miraç Yıldırım, Seda Kaynak Şahap, Ömer Bektaş, Serap Teber","doi":"10.1007/s13760-026-03078-w","DOIUrl":"https://doi.org/10.1007/s13760-026-03078-w","url":null,"abstract":"","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759408","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":"Indirect revascularization in Moyamoya vasculopathy: clinical and radiological outcomes of multiple burr hole surgery.","authors":"Vincent Raymaekers, Maarten Vanloon, Maurits Voormolen, Thijs Van der Zijden, Caroline Loos, Tomas Menovsky","doi":"10.1007/s13760-026-03075-z","DOIUrl":"https://doi.org/10.1007/s13760-026-03075-z","url":null,"abstract":"","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759386","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":"Diplopia possibly induced by safinamide in parkinson's disease.","authors":"Hortensia Alonso-Navarro, Miguel Angel Martín-Gómez, Margarita Arroyo-Solera, Silvina Espada-Rubio, Paula Salgado-Cámara, Félix Javier Jiménez-Jiménez","doi":"10.1007/s13760-026-03076-y","DOIUrl":"https://doi.org/10.1007/s13760-026-03076-y","url":null,"abstract":"","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759432","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":"Rheumatoid meningitis: clinicoradiological clues in two case reports.","authors":"Annelore Sofie Van Bleyenbergh, Laurens Jaak Lieve De Cocker, Liesbeth De Groote, Anaïs Depicker, Vincent Keereman","doi":"10.1007/s13760-026-03080-2","DOIUrl":"https://doi.org/10.1007/s13760-026-03080-2","url":null,"abstract":"","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759528","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":"Fatal hemorrhagic transformation following recurrent cerebral infarction in adult-onset cerebral small vessel disease matching the COL4A1/COL4A2 duplication phenotype.","authors":"Shao-Ting Tai, Shu-Hua Tsai, Chang-Hsiu Liu","doi":"10.1007/s13760-026-03071-3","DOIUrl":"https://doi.org/10.1007/s13760-026-03071-3","url":null,"abstract":"","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759356","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}