Acta neurologica Belgica最新文献

{"title":"Breathe better, live better: the science of slow breathing and heart rate variability.","authors":"Federica Giorgi, Roberto Tedeschi","doi":"10.1007/s13760-025-02789-w","DOIUrl":"https://doi.org/10.1007/s13760-025-02789-w","url":null,"abstract":"<p><strong>Background: </strong>Slow breathing and heart rate variability (HRV) biofeedback have gained attention as non-invasive methods for enhancing autonomic regulation and promoting vagal tone. These techniques are associated with improvements in cardiovascular, respiratory, and neural outcomes, offering potential therapeutic applications for stress-related and chronic conditions.</p><p><strong>Methods: </strong>A scoping review was conducted by analyzing six studies focusing on slow breathing and HRV biofeedback. The included studies involved healthy adults aged between 18 and 60 years, free from major cardiovascular, respiratory, or neurological disorders. Studies were identified through systematic searches in MEDLINE (PubMed), Scopus, Web of Science, and other databases. Population characteristics, intervention protocols, and outcomes related to HRV, respiratory sinus arrhythmia (RSA), baroreflex sensitivity, and neural synchronization were extracted and synthesized. Interventions were applied both acutely (single or short-term sessions) and chronically (ranging from daily sessions over 4-8 weeks).</p><p><strong>Results: </strong>All six studies demonstrated significant improvements in HRV parameters, particularly the high-frequency (HF) band, reflecting enhanced parasympathetic activity. RSA increased significantly in studies utilizing tailored breathing patterns, especially those emphasizing longer exhalations. Baroreflex sensitivity improved in interventions combining HRV biofeedback and slow breathing, indicating better cardiovascular adaptability. One study reported neural synchronization between HRV and cortical potentials with decelerated breathing. Across studies, these interventions promoted relaxation, enhanced autonomic flexibility, and stabilized cardiovascular function. Autonomic flexibility refers to the dynamic ability of the autonomic nervous system to adapt to internal and external stressors by shifting between sympathetic and parasympathetic dominance.</p><p><strong>Conclusions: </strong>Slow breathing and HRV biofeedback are effective, non-invasive interventions for improving autonomic regulation, vagal tone, and stress resilience. These techniques hold promise for managing chronic conditions and enhancing cardiovascular and mental health. Standardization of protocols and long-term evaluations are needed to optimize clinical implementation.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955283","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 characteristics and treatment of patients hospitalized with status migrainosus: a retrospective analysis.","authors":"Xin Wang, Lijuan Zhang, Yali Lai, Yuanyuan Li, Xindong Liu","doi":"10.1007/s13760-025-02785-0","DOIUrl":"https://doi.org/10.1007/s13760-025-02785-0","url":null,"abstract":"<p><strong>Backgrounds: </strong>Status Migrainosus is not rare, but there is still very little research data on this aspect, and treatment and diagnosis face huge challenges.</p><p><strong>Objects: </strong>The purpose of this study was to characterize the clinical characteristics and current treatment status of status migrainosus patients hospitalized in the Department of Neurology.</p><p><strong>Methods: </strong>This retrospective study examined patients with status migrainosus who were hospitalized in the Department of Neurology at a tertiary hospital in Chengdu, China, from August 1, 2015, to July 31, 2024. This study analyzed the demographic characteristics, clinical features, and treatment approaches of these status migrainosus patients.</p><p><strong>Results: </strong>Among the 1,237 patients hospitalized with a primary complaint of headache, 26 were ultimately diagnosed with status migrainosus. Of these status migrainosus patients, 21 patients with complete information were analyzed. The cohort predominantly consisted of middle-aged women, with most reporting moderate to severe headache intensity. The most common triggers identified were lack of sleep (66.7%) and mood disorders (42.8%). The average duration of status migrainosus was 9.3 days. In terms of treatment, NSAIDs were the most frequently administered (95.2%). During hospitalization, the most commonly used oral analgesics were NSAIDs and triptans, while intravenous treatments primarily included dexamethasone and valproic acid. 87.5% (14 out of 16) of the patients received preventive migraine treatment following discharge.</p><p><strong>Conclusion: </strong>The clinical characteristics of Status Migrainosus are generally similar to those of episodic migraine. Treatment to terminate the headache attack often requires the combined use of multiple drugs.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963218","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":"Modified zipper method in steroid-resistant ADEM: a case report.","authors":"Nihal Akçay, İlyas Bingöl, Hilal Merve Dolu, Behice Kaniye Yılmaz, Demet Tosun","doi":"10.1007/s13760-025-02788-x","DOIUrl":"https://doi.org/10.1007/s13760-025-02788-x","url":null,"abstract":"<p><strong>Background: </strong>Acute disseminated encephalomyelitis (ADEM) is a rare, inflammatory, demyelinating central nervous system disorder typically responsive to corticosteroid therapy. However, some cases are resistant to steroids, requiring alternative treatment options.</p><p><strong>Case presentation: </strong>We present an 8-year-old male child with steroid-resistant ADEM who underwent treatment with the modified zipper technique, combining intravenous immunoglobulin (IVIG) and therapeutic plasma exchange (TPE). Despite initial high-dose intravenous methylprednisolone, which failed to improve his condition, the patient showed significant clinical and radiological improvement after five cycles of the modified zipper technique.</p><p><strong>Methods: </strong>The patient received alternating cycles of TPE and IVIG (0.4 g/kg/day) over five cycles, with a 48-hour interval between each TPE and IVIG session. TPE sessions used fresh frozen plasma, followed by IVIG to enhance antibody clearance and immunomodulation.</p><p><strong>Results: </strong>After two cycles of TPE, clinical improvement was observed. Follow-up MRI on day 15 showed marked regression of white matter lesions. The patient was discharged on day 20 with near-complete recovery. Follow-up at one, three, and six months showed no neurological deficits, and MRI lesions continued to regress.</p><p><strong>Conclusions: </strong>This case suggests the modified zipper technique as a promising alternative for steroid-resistant ADEM. The combination of TPE and IVIG may provide beneficial effects, but further controlled studies are needed to evaluate its efficacy and safety in broader populations.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958660","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":"GFPT1-related congenital myasthenic syndrome misdiagnosed as myopathy: clinical and genetic insights.","authors":"Fatma Zehra Calikusu, Emel Oguz-Akarsu, Sebnem Ozemri Sag, Sehime G Temel, Hamdi Necdet Karli","doi":"10.1007/s13760-025-02783-2","DOIUrl":"https://doi.org/10.1007/s13760-025-02783-2","url":null,"abstract":"<p><p>Congenital myasthenic syndrome (CMS) is a rare genetic disorder characterized by neuromuscular junction dysfunction, presenting fluctuating muscle weakness. This study presents a 25-year-old male patient of Turkish origin with suspected CMS due to a glutamine-fructose- 6-phosphate transaminase 1 (GFPT1) mutation, along with familial implications involving his mother and uncle. Clinical, electrophysiologic, and genetic assessments were conducted over several years, revealing progressive weakness predominantly affecting proximal limb muscles. Electrophysiologic studies indicated myogenic involvement, with repetitive nerve stimulation demonstrating significant decrements. Whole-exome sequencing revealed a homozygous GFPT1 mutation in both the patient and his mother. Treatment with acetylcholinesterase inhibitors yielded modest improvement. The study underscores the importance of considering CMS in cases of fluctuating weakness, highlighting diagnostic challenges and the role of genetic testing in familial cases. Further research is warranted to elucidate phenotypic correlations and expand understanding of CMS-associated manifestations.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952896","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 of ocrelizumab versus rituximab in patients with relapsing-remitting multiple sclerosis.","authors":"Nesma Mounir, Nevin Shalaby, Mohamed I Hegazy, Nirmeen Kishk, Hatem Shehata, Shaimaa Abdalaleem Abdalgeleel, Ahmed Mohammed Abdulrahman, Nahla Merghany","doi":"10.1007/s13760-025-02766-3","DOIUrl":"https://doi.org/10.1007/s13760-025-02766-3","url":null,"abstract":"<p><strong>Background: </strong>Ocrelizumab (OCR) and rituximab (RTX) are monoclonal antibodies binding to CD20, inducing B-cell depletion. The randomized controlled trials that compare their effectiveness in people with Multiple sclerosis (pwMS) are still ongoing. This study aims at comparing the efficacy of ocrelizumab (OCR) and rituximab (RTX) in treating pwMS.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study in patients with relapsing remitting multiple sclerosis (RRMS) treated with either OCR or RTX. Patients were recruited from the Kasr Al-Ainy MS research unit (KAMSU) at Cairo University, Egypt. Data was collected at least one year of the first anti-CD20 infusion. The primary outcome was the time to 3-month confirmed disability worsening (3 month-CDW). Secondary outcomes were time to first relapse (TTFR), 3-month confirmed disability improvement (CDI), annualized relapse rate (ARR), and magnetic resonance imaging (MRI) activity.</p><p><strong>Results: </strong>126 patients were included in the analysis: 64 (50.8%) received OCR, and 62 (49.2%) received RTX. There was no significant difference between patients receiving OCR and RTX in CDW (9.37% vs. 11.29%), CDI (21.87% vs. 30.64%), mean ARR (0.21 vs. 0.29). There was no significant difference in TTFR, cumulative hazard of relapses or time to 3 months-CDW between both groups.</p><p><strong>Conclusion: </strong>No difference in efficacy between ocrelizumab and rituximab in treating RRMS.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958082","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":"Migraine treatment with CGRP monoclonal antibodies: patient evaluation of a mandatory treatment holiday in Belgium.","authors":"Ruben De Praeter, Evelien Tuerlinckx, Jean Schoenen, Elizabet Boon, Simona Liliana Sava, Frederik Debruyne, Koen Delmotte, Adinda De Pauw, Annelies Van Dycke, Cindy Van Humbeeck, Jan Versijpt","doi":"10.1007/s13760-025-02782-3","DOIUrl":"https://doi.org/10.1007/s13760-025-02782-3","url":null,"abstract":"<p><strong>Background: </strong>Monoclonal antibodies targeting the calcitonin gene-related peptide (CGRP) pathway have emerged as a promising preventive treatment for migraine. In Belgium, patients receiving these antibodies must adhere to a mandatory treatment holiday of three months. This study investigated the patients' experiences during this treatment holiday.</p><p><strong>Methods: </strong>A prospective study was conducted among 243 patients from nine headache clinics in Belgium receiving treatment with erenumab, fremanezumab or galcanezumab. Participants completed a structured questionnaire during their yearly follow-up visit after the treatment holiday. The questionnaire assessed the subjective migraine evolution and anxiety levels, and perceived usefulness of the treatment holiday.</p><p><strong>Results: </strong>The majority of patients (86.0%) reported worsening of migraine symptoms during the treatment holiday, 59.4% of them experiencing deterioration already within the first month. For 5.9% of patients, this occurred beyond the 3-month mandatory holiday period, delaying treatment resumption. Improvement was reported by 3.0% of patients, while 11.0% experienced no change. Anxiety surrounding the treatment holiday was reported by 45.0% of participants, with 18.6% experiencing very high levels of anxiety. A significant association was found between anxiety and subjective migraine deterioration (p = 0.012). Nearly half (49.1%) of the respondents found the drug holiday overall useful in gaining insight into the need for continued treatment, 22.6% considered it even very useful.</p><p><strong>Conclusion: </strong>A rigid, mandatory treatment holiday of two to three months poses significant challenges for a substantial subset of patients, leading to rapid migraine deterioration and increased anxiety. The observed association between migraine deterioration and anxiety highlights the need for patient education strategies. Policy makers should consider these findings to develop more flexible, patient-centered treatment approaches that optimize outcomes.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962514","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":"Statins and the risk of dementia: a meta-analysis.","authors":"Xue Li, Yuzhen Liu, Tiantian Song, Xiaoxuan Wu, Ying Xing","doi":"10.1007/s13760-025-02758-3","DOIUrl":"https://doi.org/10.1007/s13760-025-02758-3","url":null,"abstract":"<p><p>Clarify the relationship between the use of statins and the risk of dementia, and further guide the clinical application of statins. This paper uses computer search Chinese and foreign language databases Pubmed, Medline, Cochrane, Embase, Web of Science, Weipu, CBM, Wanfang, CNKI, etc., to include the literature that meets the standards from the establishment of the library to December 2020, and uses Revman 5.1 software and Stata15.0 software for meta-analysis. Of the 34 included observational studies, stratified subgroup analyses were performed based on the type of clinical trial, sex of participants, presence or absence of apolipoprotein E-4 (ApoEε4) allele, and duration of use. The conclusions showed that (1) the use of statins can significantly reduce the risk of dementia; (2) There is no significant sex difference in reducing the risk of dementia; (3) Continuous use of statins for ≥ 1 year can significantly reduce the risk of dementia compared with the time of taking the drug for < 1 year; (4) Compared with subjects with negative ApoEε4 allele, the use of statins has a more significant effect on reducing the risk of dementia in subjects carrying the ApoEε4 allele.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810120","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":"Acta neurologica belgica regarding the manuscript entitled 'Safety and efficacy of extended versus standard interval dosing of natalizumab in multiple sclerosis patients: a systematic review and meta-analysis'.","authors":"Mike Boggild, Zinat Mohammadpour, Liza van Eijk, Lachlan Williams","doi":"10.1007/s13760-025-02781-4","DOIUrl":"https://doi.org/10.1007/s13760-025-02781-4","url":null,"abstract":"","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787431","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":"Parental smoking before childbirth and multiple sclerosis onset in their child: a case-control study.","authors":"Sanaz Khodadadi, Sahar Nikkhah Bahrami, Shima Jahani, Nasim Rezaeimanesh, Zahra Ebadi, Khadijeh Haji Naghi Tehrani, Abdorreza Naser Moghadasi, Mohammad Ali Sahraian","doi":"10.1007/s13760-025-02777-0","DOIUrl":"https://doi.org/10.1007/s13760-025-02777-0","url":null,"abstract":"<p><strong>Background: </strong>Multiple sclerosis (MS) pathogenesis involves both environmental and genetic factors. Any stage of life, including the prenatal and perinatal years, may be impacted by environmental factors linked to the onset and progression of MS. It is essential to assess these environmental elements in order to avoid the start of illness. However, there is a lack of research on the effects of parental smoking before childbirth.</p><p><strong>Objective: </strong>This study aimed to investigate the association between MS and parental cigarette consumption before childbirth.</p><p><strong>Design and methods: </strong>We conducted a case-control study at Sina Hospital, Tehran, Iran, from June 2023 to June 2024. MS diagnosis was confirmed using 2017 revised McDonald's criteria. Experts created a questionnaire to gather information on parental smoking habits, sex, and age. Patients with incomplete questionnaires or parents with MS were not included in the analysis. The control group comprised patients' companions at the Surgical Ward of Sina Hospital. Binary logistic regression was used to estimate the adjusted odds ratios (AOR) and 95% confidence intervals (CI) for MS onset due to paternal and maternal cigarette smoking, adjusting for potential confounders.</p><p><strong>Results: </strong>A total of 379 MS patients and 379 controls were included in the study. The mean age of the MS patients was 37.97 ± 9.09 years, while the control group had a mean age of 36.13 ± 12.93 years. Our findings indicated that paternal daily cigarette consumption before pregnancy, adjusted for age and sex, increased the risk of MS onset in offspring by 65% (AOR = 1.65, 95% CI: 1.17-2.31, p < 0.004). Furthermore, paternal daily cigarette consumption during maternal pregnancy increased the risk by 71% (AOR = 1.71, 95% CI: 1.21-2.42, p < 0.002). However, no significant association was found between maternal cigarette smoking, either before or during pregnancy, and the onset of MS in offspring.</p><p><strong>Conclusions: </strong>Paternal cigarette smoking, before and during pregnancy, significantly increased the risk of MS in offspring. These findings highlight the need for further investigation and public awareness, as paternal smoking may represent a preventable risk factor for MS development.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787436","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":"Low-level laser therapy for intractable hiccups following stroke: a novel use case report.","authors":"Mingyue Liu, Shasha Jin, Liang Wu, Zhe Li, Jianghua Zhu","doi":"10.1007/s13760-025-02778-z","DOIUrl":"https://doi.org/10.1007/s13760-025-02778-z","url":null,"abstract":"","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778668","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}