Acta neurologica Belgica最新文献

{"title":"Differential improvement in patient-reported outcomes measurement information system (PROMIS) domains after ventriculoperitoneal shunting (VPS) for idiopathic normal pressure hydrocephalus (iNPH).","authors":"Rahul Kumar, Abdelrahman M Hamouda, Zach Pennington, Gabriella L Paganucci, Jeremy K Cutsforth-Gregory, David T Jones, Neill R Graff-Radford, Ignacio Jusué-Torres, Jonathan Graff-Radford, Petrice M Cogswell, Benjamin D Elder","doi":"10.1007/s13760-026-03200-y","DOIUrl":"https://doi.org/10.1007/s13760-026-03200-y","url":null,"abstract":"<p><strong>Objective: </strong>Patient-Reported Outcomes Measurement Information System (PROMIS) is a patient-reported outcome tool to overview various functional domains of health. We describe longitudinal changes in various PROMIS domains after ventriculoperitoneal shunting (VPS) for patients with idiopathic normal pressure hydrocephalus (iNPH).</p><p><strong>Methods: </strong>Patients with \"probable\" iNPH who underwent VPS from December 2017 to January 2025 and had completed pre- and post-operative PROMIS computerized adaptive testing (CAT) were retrospectively reviewed. Domains assessed included anxiety, depression, fatigue, sleep disturbance, pain interference, social ability, and physical function. Generalized additive mixed models (GAMM) were utilized to assess longitudinal changes in each domain while controlling for variable follow-up time and patient-specific repeated measures. Principal component analysis (PCA) was performed to identify patterns of change.</p><p><strong>Results: </strong>A total of 173 patients with 461 PROMIS assessments (median 3 per patient) were included with median follow-up time of 10.3 months (IQR 3.3-13.1). Patients undergoing VPS for iNPH had statistically worse pre-operative PROMIS measures (Benjamini-Hochberg adjusted Wilcoxon p<0.05) in all domains except sleep disturbance. Overall, statistically significant and temporally durable T-score improvements after VPS were identified in fatigue, physical function, and social ability. Differential patterns of post-VPS PROMIS changes disclosed three distinct patient clusters with differing baseline PROMIS functions and comorbidity burdens.</p><p><strong>Conclusions: </strong>Approximately half of iNPH patients report significant improvement in various PROMIS domains longitudinally after VPS. Physical function demonstrated both the greatest magnitude of baseline dysfunction and improvement after VPS. With additional notable improvements in fatigue, and social ability, VPS may improve multiple functional healthcare-related quality of life domains.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023628","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":"High-grade B-cell lymphoma masquerading as brachial plexopathy: a diagnostic challenge.","authors":"Subhajit Roy, Saraswati Nashi, Arka Prabha Chattopadhyay, Prithvijit Chakraborty, Jitender Saini","doi":"10.1007/s13760-026-03196-5","DOIUrl":"https://doi.org/10.1007/s13760-026-03196-5","url":null,"abstract":"<p><p>Neurolymphomatosis, resulting from direct infiltration of the peripheral nervous system by lymphoma, is a rare presentation of aggressive B-cell lymphoma and an uncommon cause of brachial plexopathy. We report a 32-year-old man who presented with a painful swelling around the right shoulder followed by rapidly progressive weakness, complete sensory loss, and marked muscle wasting confined to the right upper limb, associated with a 10-kg unintentional weight loss over five months. Neurological examination localized the lesion to the right brachial plexus. Radiographs and computed tomography demonstrated an infiltrative soft-tissue lesion with cortical destruction of the proximal humerus. Magnetic resonance imaging of the shoulder and brachial plexus revealed diffuse thickening and T2/STIR hyperintensity of the distal divisions, cords, and branches of the brachial plexus, with contiguous infiltration of the humeral marrow, surrounding musculature, and adjacent soft tissues, strongly suggesting lymphomatous infiltration. Subsequent bone marrow biopsy confirmed Stage IV high-grade B-cell lymphoma with a high proliferative index. The patient was treated with R-CHOP chemoimmunotherapy and demonstrated significant clinical and neurological improvement on follow-up, with marked reduction in shoulder swelling and substantial recovery of motor and sensory function. This case highlights the importance of considering neurolymphomatosis in patients presenting with rapidly progressive painful brachial plexopathy, particularly when associated with shoulder swelling, constitutional symptoms, and infiltrative imaging findings. Early clinicoradiological recognition and prompt tissue diagnosis are essential for timely initiation of lymphoma-directed therapy and favorable neurological outcomes.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023595","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":"Association of MIR137 rs1625579 polymorphisms with cognitive function in patients with untreated first-episode depression.","authors":"Xiaoming Liu, Li Liu, Fan Xiao","doi":"10.1007/s13760-026-03175-w","DOIUrl":"https://doi.org/10.1007/s13760-026-03175-w","url":null,"abstract":"<p><strong>Background: </strong>Depression arises from genetic and environmental factors, and it may lead to cognitive dysfunction. This study aimed to explore the relationship between microRNA-137 (miR-137) and the MIR137 rs1625579 polymorphism and cognitive function in depression.</p><p><strong>Methods: </strong>This study enrolled 190 healthy controls and 340 untreated first-episode depressed patients, with the latter stratified into non-cognitive impairment (n = 134) and cognitive impairment (n = 206) subgroups. Genotyping of the MIR137 rs1625579 locus was performed using TaqMan polymerase chain reaction (PCR), while miR-137 expression was quantified via reverse transcription quantitative PCR (RT-qPCR). Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were used to analyze the core biological functions and key signaling pathways associated with miR-137 target genes. RNA pull-down assay, RNA immunoprecipitation (RIP) assay, and a dual luciferase assay were used to verify the targeted binding relationship between miR-137 and GSK3B.</p><p><strong>Results: </strong>miR-137 expression was significantly downregulated in depressed patients with cognitive impairment. The G allele (TG/GG genotype) of the MIR137 rs1625579 was identified as a protective factor for cognitive impairment in depression patients, whereas the T allele (TT genotype) was an independent risk factor. Reduced miR-137 expression was closely related to depression and cognitive impairment, exhibiting promising discriminatory capacity in this study, and warrants further validation as a candidate biomarker for both. Moreover, miR-137 expression was negatively correlated with the degree of depression (Hamilton Depression Rating Scale (HAMD) score) in depression patients and positively correlated with cognitive function (Montreal Cognitive Assessment (MoCA) / Mini-Mental State Examination (MMSE) score). Mechanistically, in vitro experiments confirmed that miR-137 directly targeted GSK3B, and elevated GSK3B expression observed in patients was significantly correlated with cognitive impairment in depression. In depressed patients with cognitive impairment, individuals carrying the G allele showed relatively higher miR-137 expression and lower GSK3B expression compared to TT carriers, suggesting a potential protective association. However, owing to the cross-sectional design, these clinical findings should be interpreted as correlational associations rather than definite in vivo mechanistic proof.</p><p><strong>Conclusion: </strong>The MIR137 rs1625579 polymorphism was associated with cognitive function in depression, and this association may be related to the miR-137/GSK3B axis.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015164","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":"Patient-reported outcomes after surgical treatment of spontaneous intracranial hypotension: a cross-sectional study.","authors":"Ali Kapan, Carolina Iten, Christian T Ulrich, Frank Donnerstag","doi":"10.1007/s13760-026-03198-3","DOIUrl":"https://doi.org/10.1007/s13760-026-03198-3","url":null,"abstract":"<p><strong>Background: </strong>Spontaneous intracranial hypotension (SIH) can cause substantial functional and psychosocial impairment, but patient-reported outcomes after surgical treatment remain incompletely understood. This study aimed to describe postoperative symptom burden, functional outcomes, psychosocial impact, and headache-related disability in surgically treated patients with self-reported SIH recruited through international patient support networks.</p><p><strong>Methods: </strong>A cross-sectional online survey (February-April 2025) recruited 92 surgically treated SIH patients via international patient support networks. Variables were obtained by participant report and included comorbidities, surgical characteristics, time metrics, symptom course, psychosocial factors, and HIT-6 scores. Multivariable linear regression was performed to examine factors associated with HIT-6.</p><p><strong>Results: </strong>Median age was 42 years (IQR 38-46), and 88.0% were female. Median time from diagnosis to most recent surgery was 21 months (IQR 13-41), and time since most recent surgery was 20 months (IQR 12-36). Structural abnormalities (e.g., pseudomeningoceles, neo-membranes) were reported by 33.7% of participants. Ventral dural leaks predominated (59.8%), followed by lateral leaks (15.2%) and CSF-venous fistulae (13.0%). Complete symptom resolution was reported by 15.2% of participants. Mean HIT-6 was 56.75 (SD 12.50). In exploratory adjusted analyses, no significant associations were observed between HIT-6 scores and pre-existing headache, number of surgeries, or CSF leak type.</p><p><strong>Conclusion: </strong>In this international cross-sectional sample of surgically treated patients with self-reported SIH, a substantial proportion reported persistent symptoms, self-reported rebound intracranial hypertension, headache-related disability, and psychosocial burden. These results suggest a heterogeneous postoperative status and emphasise the importance of structured long-term follow-up.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001132","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":"Prevalence of neurological manifestations among pregnant and postpartum women in a tertiary hospital in Egypt: a descriptive cross-sectional study.","authors":"Amany H Ragab, Nirmeen A Kishk, Passant M Mohammed, Dalia Abdelfatah, Sondos Y Baghdady, Habeba H M Abdelazim, Mohamed O Ibrahim, Ebtehal S Doma","doi":"10.1007/s13760-026-03187-6","DOIUrl":"https://doi.org/10.1007/s13760-026-03187-6","url":null,"abstract":"<p><strong>Background: </strong>Neurological diseases account for around 20% of maternal deaths. Some of the neurological diseases exacerbate during pregnancy, some retain the same course, while others remit during pregnancy.</p><p><strong>Objective: </strong>To assess the prevalence of neurological manifestations among pregnant and postpartum women attending Kasr Al Ainy clinics for antenatal care, or admitted after delivery, at Cairo University hospitals & to classify whether these manifestations started before pregnancy, developed during pregnancy, or puerperium.</p><p><strong>Methods: </strong>This is a cross-sectional study conducted over a period of 1 year, including 1.010 pregnant and postpartum women who were recruited from the obstetric departments and antenatal care clinics at Kasr Al Ainy Hospital, Cairo University. Demographic data and a full obstetric history were collected, along with past medical and medication history. Participants were screened for a range of neurological symptoms and manifestations.</p><p><strong>Results: </strong>Neurological manifestations were reported by 30.4% of our cohort. Symptom onset preceded pregnancy in 55.7% of cases. During pregnancy, symptoms worsened in 66% of affected patients. The most common neurological complaints were tingling (53.1%) and headache, predominantly migraine (50.5%). Autoimmune diseases were the strongest factors independently associated with neurological manifestations.</p><p><strong>Conclusion: </strong>Neurological symptoms occur in approximately one-third of pregnancies in our cohort. Headaches and sensory complaints are the most frequently reported manifestations. Early risk stratification and multidisciplinary management strategies are recommended to optimize maternal care and improve maternal outcomes.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001157","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":"Construction of a recurrence risk prediction model for benign paroxysmal positional vertigo.","authors":"Wenzhi Li, Jinlian Chen, Xiaoping Lin","doi":"10.1007/s13760-026-03190-x","DOIUrl":"https://doi.org/10.1007/s13760-026-03190-x","url":null,"abstract":"<p><strong>Objective: </strong>To investigate factors associated with recurrence in patients with benign paroxysmal positional vertigo (BPPV), develop a recurrence risk prediction model, and further evaluate the incremental value of vestibular evoked myogenic potential (VEMP) parameters in improving model predictive performance.</p><p><strong>Methods: </strong>In this retrospective study, patients with BPPV treated with standardized canalith repositioning maneuvers at Haicang Hospital of Xiamen between January 2022 and December 2024 were included. Demographic data, comorbidities, self-rating anxiety scale (SAS) scores, pittsburgh sleep quality index (PSQI) scores, VEMP parameters, and follow-up information were extracted. Univariable and multivariable logistic regression analyses were conducted to determine factors associated with recurrence, and a recurrence prediction model was developed accordingly. Model discrimination, calibration, and clinical utility were evaluated using receiver operating characteristic (ROC) curve analysis, area under the receiver operating characteristic curve (AUC), bias-corrected calibration curves, the Hosmer-Lemeshow goodness-of-fit test, and decision curve analysis (DCA).</p><p><strong>Results: </strong>A total of 257 patients with BPPV were included, of whom 64 (24.9%) experienced recurrence during follow-up. Multivariable logistic regression analysis identified diabetes mellitus, hypertension, abnormal ocular vestibular evoked myogenic potential (oVEMP), PSQI score, and SAS score as independent factors associated with BPPV recurrence. The model incorporating these variables showed good discrimination, with an AUC of 0.796 (95% CI, 0.734-0.857), which was significantly higher than that of the model excluding oVEMP abnormality (AUC = 0.736; 95% CI, 0.669-0.804; P = 0.021). The model demonstrated good calibration according to the Hosmer-Lemeshow test (P = 0.270). DCA indicated a favorable net benefit across threshold probabilities ranging from 0.20 to 0.60. Internal validation using bootstrap resampling yielded an optimism-corrected AUC of 0.777 (95% CI, 0.722-0.843).</p><p><strong>Conclusion: </strong>Diabetes mellitus, hypertension, PSQI score, SAS score, and abnormal oVEMP are associated with the recurrence of BPPV. The prediction model developed from these factors exhibited good discrimination and calibration. This model may facilitate risk‑stratification and inform individualized management considerations for patients with BPPV.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975284","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":"Adaptive versus conventional deep brain stimulation for bradykinesia in Parkinson's disease: a comparative effectiveness analysis.","authors":"Nana Tchantchaleishvili, Tariel Natsvaladze, Andrii Netliukh, Zhangjie Su, Mario Ganau","doi":"10.1007/s13760-026-03192-9","DOIUrl":"https://doi.org/10.1007/s13760-026-03192-9","url":null,"abstract":"<p><strong>Background: </strong>Conventional deep brain stimulation (cDBS) is an established treatment for motor complications in Parkinson's disease, whereas adaptive deep brain stimulation (aDBS) adjusts stimulation in response to physiological or behavioral feedback. This review examines whether aDBS provides clinically meaningful advantages over cDBS for bradykinesia and akinesia, while also considering stimulation delivery, adverse effects, and non-motor outcomes.</p><p><strong>Methods: </strong>A structured narrative review of relevant literature was conducted using PubMed/MEDLINE, Scopus, Web of Science, citation tracking, and focused searches. Evidence was grouped by comparison paradigm, adaptive control strategy, and outcome.</p><p><strong>Results: </strong>The clinical evidence consists mainly of proof-of-concept investigations, brief crossover studies, feasibility studies, and small cohorts. Selected short-term comparisons generally did not detect a motor-outcome difference from cDBS, but most were underpowered for equivalence or non-inferiority. Several beta-guided paradigms reduced stimulation time or energy delivery, but this was not universal and cannot be assumed to indicate better symptom control, fewer adverse effects, or longer device life. No adequately powered large-scale randomized trial has demonstrated the clinical superiority of aDBS over optimized cDBS. Evidence concerning gait, speech, cognition, mood, and other neuropsychiatric outcomes remains limited. Interpretation is further restricted by differences in patient selection, stimulation targets, biomarkers, adaptive algorithms, medication states, outcome measures, follow-up, and timing after implantation.</p><p><strong>Conclusions: </strong>Adaptive DBS is technically feasible and offers a promising approach to individualized stimulation, but its comparative clinical value remains uncertain. Larger randomized trials with standardized outcomes and long-term follow-up are needed before superiority over conventional stimulation can be established.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966089","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":"Association between cerebrospinal fluid LRRK2 and incident orthostatic hypotension differs by genetic background in Parkinson's disease.","authors":"Emadoddin Kazemi","doi":"10.1007/s13760-026-03194-7","DOIUrl":"https://doi.org/10.1007/s13760-026-03194-7","url":null,"abstract":"<p><strong>Background: </strong>Orthostatic hypotension (OH) is an important manifestation of cardiovascular autonomic dysfunction in Parkinson's disease (PD), but biomarkers associated with incident OH have not been well established. Cerebrospinal fluid (CSF) LRRK2 provides a measurable marker of LRRK2-related biology, but its association with incident OH is unknown.</p><p><strong>Objective: </strong>To determine whether baseline CSF LRRK2 is associated with incident OH and whether this association differs between sporadic PD and LRRK2-PD.</p><p><strong>Methods: </strong>We analyzed longitudinal Parkinson's Progression Markers Initiative (PPMI) data from 190 participants with PD, including 159 participants free of OH at baseline with follow-up orthostatic assessments. Cox proportional hazards models evaluated the association between standardized ln-transformed baseline CSF LRRK2 and time to incident OH, including a CSF LRRK2-by-genetic-group interaction and adjustment for age, sex, disease duration, and baseline systolic blood pressure change after standing.</p><p><strong>Results: </strong>During follow-up, 52 of 159 participants developed OH. Higher baseline CSF LRRK2 was associated with a higher hazard of incident OH in sporadic PD (HR 10.50 per 1-SD higher ln-transformed CSF LRRK2, 95% CI 2.95-37.35; p < 0.001), whereas no clear association was observed in LRRK2-PD (HR 1.74, 95% CI 0.63-4.79; p = 0.284). The CSF LRRK2-by-genetic-group interaction was significant (interaction HR 0.166, 95% CI 0.083-0.331; p < 0.001) and remained consistent across sensitivity analyses.</p><p><strong>Conclusions: </strong>The association between baseline CSF LRRK2 and incident OH differed by genetic background. Baseline CSF LRRK2 was associated with incident OH in sporadic PD, whereas no clear association was observed in LRRK2-PD. Independent replication is required.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966016","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 use of pembrolizumab in a patient with progressive multifocal leukoencephalopathy associated with Good's syndrome: a case report.","authors":"E Van Haute, L De Backer, O Pype, C De Vriendt, G Laureys","doi":"10.1007/s13760-026-03182-x","DOIUrl":"https://doi.org/10.1007/s13760-026-03182-x","url":null,"abstract":"","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148954635","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":"Comparisons between anosmia and ageusia with neurological symptoms and cardiorespiratory fitness among post-COVID-19 individuals: a cross-sectional study.","authors":"Luciana Lozza de Moraes Marchiori, Glória de Moraes Marchiori, Fabiano Mendes de Oliveira, Victor Augusto Santos Perli, Maurício Medeiros Lemos, Braulio Henrique Magnani Branco","doi":"10.1007/s13760-026-03189-4","DOIUrl":"https://doi.org/10.1007/s13760-026-03189-4","url":null,"abstract":"<p><strong>Background: </strong>Anosmia and ageusia are among the most frequent symptoms of post-COVID-19 syndrome, yet their association with neurological symptoms and cardiorespiratory fitness remains unclear.</p><p><strong>Objective: </strong>To compare the presence of anosmia and ageusia with neurological symptoms and cardiorespiratory fitness in post-COVID-19 individuals.</p><p><strong>Methods: </strong>This cross-sectional study included 201 post-COVID-19 individuals who completed a standardized questionnaire assessing anosmia, ageusia, and neurological symptoms. Cardiorespiratory fitness was assessed using the Bruce treadmill test with direct measurement of peak oxygen uptake (VO₂peak). Missing data were handled by multiple imputation. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using binary logistic regression, adjusted for age, sex, acute infection severity, medical history, body fat percentage, and skeletal muscle mass.</p><p><strong>Results: </strong>After adjustment, anosmia was independently associated with dizziness (OR = 2.22; 95% CI 1.15-4.31) and aural fullness (OR = 4.54; 95% CI 1.16-17.80), and ageusia with memory deficit (OR = 2.91; 95% CI 1.47-5.75) and aural fullness (OR = 4.08; 95% CI 1.02-16.30). No significant associations were found with tinnitus or hearing loss. VO₂peak did not differ significantly between participants with and without anosmia (mean difference 1.13 mL/kg/min; Cohen's d = 0.14; 95% CI - 0.14 to 0.42; p = 0.325) or ageusia (mean difference 1.36 mL/kg/min; Cohen's d = 0.17; 95% CI - 0.12 to 0.45; p = 0.244).</p><p><strong>Conclusions: </strong>Anosmia and ageusia are associated with neurological symptoms but not with cardiorespiratory fitness in post-COVID-19 individuals, suggesting partially independent phenotypes. These symptoms should be considered in therapeutic assessment and management.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148943886","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}