Acta neurologica Belgica最新文献

{"title":"No single treatment modality exhibits clear superiority for infantile spasms syndrome: insights from a retrospective cohort study.","authors":"Loes Laurijssen, Katrien Jansen, Lieven Lagae","doi":"10.1007/s13760-024-02713-8","DOIUrl":"https://doi.org/10.1007/s13760-024-02713-8","url":null,"abstract":"<p><strong>Background: </strong>Infantile spasms syndrome is a severe form of infantile epilepsy. It is commonly treated with hormonal therapies or vigabatrin, either alone or in combination. This study aimed to assess the efficacy of these treatment modalities and explore associations with aetiology, and pre-existing developmental delay.</p><p><strong>Methods: </strong>Patients diagnosed with and treated for infantile spasms syndrome at the University Hospital of Leuven between 1 January 2018 and 23 November 2022, were identified. Retrospective clinical data were analysed descriptively. Short-term and long-term outcomes determined the efficacy of the current treatments, with seizure freedom and sustained normal development at 6 and 12 months after treatment initiation as primary treatment goals.</p><p><strong>Results: </strong>The study included 26 patients. No single treatment modality demonstrated clear superiority in terms of both short-term and long-term outcomes. Patients with unknown aetiology showed better developmental outcomes after 12 months than those with proven aetiology (30.77% with normal development versus 7.69%.) Another clear difference in treatment efficacy emerged between patients with and without pre-existing developmental issues, with only 6.67% achieving normal development after 12 months compared to 36.36%, respectively.</p><p><strong>Conclusion: </strong>No single treatment modality demonstrated clear superiority. Associations were found between treatment efficacy and aetiology as well as pre-existing developmental delay, suggesting these as potential prognostic indicators.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909157","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 as potential disease-modifying therapy of Parkinson's disease: a systematic review and meta-analysis with trial sequential analysis.","authors":"Ocílio Ribeiro Gonçalves, Arquimedes Barros Nascimento, Victor Gonçalves Soares, David Abraham, Gabriel de Almeida Monteiro, João Luís Reis Freitas, Jonatas Paulino da Cunha Monteiro Ribeiro, Bianca Leal Ribeiro, João Victor Araújo de Oliveira, Marco Antonnio Rocha Dos Santos, João Paulo Mota Telles, Flávio Sekeff-Sallem, Kelson James Almeida","doi":"10.1007/s13760-024-02709-4","DOIUrl":"https://doi.org/10.1007/s13760-024-02709-4","url":null,"abstract":"<p><strong>Background: </strong>Recent evidence indicates that statins have anti-inflammatory and antioxidant effects, leading to several investigations of whether statins have a neuroprotective effect and may benefit patients with Parkinson's disease (PD). However, the potential mechanisms of this class of medications as modifiers of the course of PD in already diagnosed patients is still unclear.</p><p><strong>Objectives: </strong>To assess the effectiveness of statins as modifiers of established PD.</p><p><strong>Methods: </strong>Two investigators systematically searched for randomized clinical trials and observational studies comparing PD patients treated with statins versus those treated without statins. The search was conducted in PubMed, Embase, Cochrane, and Web of Science. The outcome of interest was the change in the MDS-UPDRS III (Movement Disorder society-Unified Parkinson's Disease Rating Scale Part III) and UPDRS III scores from baseline. Statistical analysis was performed using R Studio 4.3.2.</p><p><strong>Results: </strong>Four studies, totaling 472 patients, were included. The standardized mean difference for the MDS-UPDRS Part III and UPDRS Part III scales between statin and non-statin groups was - 0.13 (95% CI - 0.44 to 0.17; p = 0.39; I² = 58%), and there was no statistical significant difference regarding this outcome.</p><p><strong>Conclusion: </strong>There was no statistical significance for the potential clinical benefit of statins as modifiers of the disease course in PD patients.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909195","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 features and prognosis of transient global amnesia in Israel: 6 years' single-center experience.","authors":"Ido Gindes, Itzhak Kimiagar, Shlomi Peretz, Gilad Kenan","doi":"10.1007/s13760-024-02703-w","DOIUrl":"https://doi.org/10.1007/s13760-024-02703-w","url":null,"abstract":"<p><strong>Background: </strong>Transient global amnesia (TGA) is a benign neurological syndrome of unknown etiology, causing sudden anterograde amnesia that lasts up to 24 h. During the episode of TGA, other cognitive functions are normal. This is the first study describing the characteristics of the disease in Israel.</p><p><strong>Methods: </strong>A retrospective review of all patients with a confirmed diagnosis of TGA at Shamir Medical Center (SMC) between January 2016 and December 2021.</p><p><strong>Results: </strong>One-hundred and four patients with confirmed TGA were identified, with an average age of 64 years (range: 39-87). The annual incidence of TGA was 2.52 per 100,000 and 6.96 per 100,000 among those over 50, with a slight female predominance. The recurrence rate was 11.5%. 61.5% of patients had one or more cerebrovascular risk factors. A precipitating factor was described in 30.8% of cases, with emotional stress, Valsalva maneuver and sexual intercourse being the most prevalent. Chronic ischemic changes were the most common imaging abnormality. Focal slowing was found in nine patients, and epileptic activity was found in four patients.</p><p><strong>Conclusions: </strong>In this study, we showed that patient characteristics and clinical features of TGA patients in Israel were similar to those described in other reports worldwide. We were unable to demonstrate a specific risk factor or a causative agent. Interestingly, the annual incidence in Israel was lower than in other countries.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909127","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":"Diagnostic values of serum levels of α-synuclein, homocysteine and leucine-rich α2 glycoprotein for predicting cognitive impairment in Parkinson's disease.","authors":"Rongchuan Li, Jinhong Zhuang","doi":"10.1007/s13760-024-02710-x","DOIUrl":"https://doi.org/10.1007/s13760-024-02710-x","url":null,"abstract":"<p><strong>Background: </strong>α-synuclein, homocysteine (Hcy) and leucine-rich α2-glycoprotein (LRG) have been shown to correlate to Parkinson's disease (PD). However, it remains unclear whether these factors are associated with the occurrence of cognitive impairment (CI) in PD patients.</p><p><strong>Methods: </strong>This study initially enrolled eligible PD patients without cognitive impairment. Blood samples were collected to measure serum levels of α-synuclein, Hcy, and LRG using enzyme-linked immunosorbent assay. After one year of treatment, patients were divided into CI group and non-CI groups based on their Montreal Cognitive Assessment (MoCA) scores. Baseline clinical characteristics and the levels of these three factors were compared between the two groups. Additionally, Receiver Operating Characteristic (ROC) analysis was used to assess the predictive value of these factors for the occurrence of CI in PD patients.</p><p><strong>Results: </strong>The study included 102 eligible PD patients without baseline CI, divided into 65 patients in the non-CI group and 37 patients in the CI group after one year, based on the MoCA scores. Serum levels of α-synuclein, Hcy, and LRG in the CI group were 0.42 ± 0.33 ng/mL, 19.85 ± 6.31 µmol/L, and 14.53 ± 5.11 ng/mL respectively, compared to 0.04 ± 0.03 ng/mL, 14.32 ± 5.25 µmol/L, and 11.67 ± 3.10 ng/mL in the non-CI group. Patients in the CI group had MoCA scores below 26, indicating cognitive impairment. ROC analysis revealed that α-synuclein, Hcy, and LRG levels effectively predicted the occurrence of CI in PD patients.</p><p><strong>Conclusions: </strong>Serum levels of α-synuclein, Hcy and LRG were elevated in the CI group compared to the non-CI group, suggesting that these factors may serve as predictors of cognitive impairment in PD patients.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909128","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 disability, walking, manual dexterity, and quality of life with sexual dysfunction in multiple sclerosis patients.","authors":"Ayşe Merve Çıracıoğlu, Merih Özgen, Gülnur Tekgöl Uzuner, Suheyla Dal Erdoğan, Fezan Mutlu","doi":"10.1007/s13760-024-02708-5","DOIUrl":"https://doi.org/10.1007/s13760-024-02708-5","url":null,"abstract":"<p><strong>Background/objective: </strong>This study aims to examine the relationship between sexual dysfunction and walking ability, manual dexterity, disability, and quality of life in patients with multiple sclerosis.</p><p><strong>Methods: </strong>51 sexually active MS patients (28 females and 23 males) participated in the study. Demographic data were recorded for all patients. We used the Female Sexual Function Index (FSFI) and the International Index of Erectile Function (IIEF) to assess sexual function, the Expanded Disability Status Scale (EDSS) to determine disability, the SF-36 to assess quality of life, the Nine-Hole Peg test (9-HPT) to evaluate manual dexterity, and the Timed 25-Foot Walk test (T25FW) to assess walking ability.</p><p><strong>Results: </strong>Sexual dysfunction was found in 92.9% of females and 73.9% of males. Common issues in females included decreased sexual desire, decreased sexual arousal, and lubrication and orgasm problems, while males reported erectile dysfunction, decreased sexual desire, and decreased intercourse satisfaction. Significant correlations were observed between FSFI and SF-36 scores in females and between IIEF scores and the 9-HPT, EDSS, and SF-36 scores in males.</p><p><strong>Conclusions: </strong>Sexual dysfunction is common among both male and female MS patients and is associated with disability, manual dexterity, and quality of life. Raising awareness is essential to support appropriate treatment approaches and improve the quality of life for these patients.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909125","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":"Non convulsive status epilepticus caused by panhypopituitarism.","authors":"Ibrahim Ben Razek, Olivier Bodart","doi":"10.1007/s13760-024-02714-7","DOIUrl":"https://doi.org/10.1007/s13760-024-02714-7","url":null,"abstract":"","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909169","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":"Reversible subcortical Dark White Matter lesions in nonconvulsive status epilepticus: a rare but clinically significant finding.","authors":"Giuseppe Magro, Olindo Di Benedetto, Vincenzo Laterza, Federico Tosto","doi":"10.1007/s13760-024-02715-6","DOIUrl":"https://doi.org/10.1007/s13760-024-02715-6","url":null,"abstract":"","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891264","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":"Rethinking the diagnostic value of thymic CT in ocular myasthenia gravis.","authors":"Hung Youl Seok","doi":"10.1007/s13760-024-02716-5","DOIUrl":"https://doi.org/10.1007/s13760-024-02716-5","url":null,"abstract":"","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891262","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 potential role of cardiac CT in ischemic stroke: bridging cardiovascular and cerebrovascular health.","authors":"Jianwei Wang, Tingxia Zhang, Huan Zhou, Shenqiang Yan","doi":"10.1007/s13760-024-02707-6","DOIUrl":"https://doi.org/10.1007/s13760-024-02707-6","url":null,"abstract":"<p><p>Ischemic stroke, accounting for approximately 80% of all stroke cases, remains a leading cause of death and disability worldwide. Effective management of ischemic stroke is heavily influenced by its etiology, which can range from large-artery atherosclerosis and cardiac embolism to cerebral small-vessel occlusions and cryptogenic strokes. Cardioembolic stroke, which makes up about 30% of ischemic strokes, often leads to more severe symptoms and worse outcomes, necessitating anticoagulation therapy for prevention. Cryptogenic strokes, comprising over 25% of ischemic strokes, pose significant challenges for treatment and prevention due to their elusive nature. Thorough investigation of cardioembolic sources during the acute phase of stroke is crucial. While transthoracic and transesophageal echocardiography are traditional methods for detecting intracardiac thrombi and patent foramen ovale (PFO), cardiac CT has emerged as a non-invasive, efficient alternative. Cardiac CT can effectively visualize intracardiac thrombi, PFO, valvular abnormalities, tumors, and complex aortic plaques. This review discusses the potential applications of cardiac CT in ischemic stroke, emphasizing its role in identifying stroke etiology, predicting stroke risk, and assessing patient prognosis. The integration of advanced imaging technologies and artificial intelligence further enhances its diagnostic accuracy and clinical utility, promising to improve outcomes and reduce the healthcare burden associated with ischemic stroke.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891267","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":"Bromocriptine Versus Levodopa and other treatments in Parkinson's Disease: an updated Meta-analysis Involving more than 4000 patients across 12 randomized clinical trials.","authors":"Maziar Afshar, Negin Sane, Yousef Moradi","doi":"10.1007/s13760-024-02711-w","DOIUrl":"https://doi.org/10.1007/s13760-024-02711-w","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this meta-analysis was to conduct a comparative study by systematically examining and analyzing trials that studied the impacts of levodopa and bromocriptine, either separately or together, in treating Parkinson's disease (PD).</p><p><strong>Methods: </strong>An extensive literature search was conducted across PubMed (Medline), Scopus, and Web of Science databases, using targeted keywords for studies published up to October 2024. The methodological quality of included RCTs was assessed with the Cochrane Risk of Bias 2 (RoB 2) tool, and bias evaluation was performed using RevMan (version 5). Statistical analyses were conducted in STATA version 17, applying random-effects models. The overall quality of evidence was evaluated using the GRADE approach.</p><p><strong>Results: </strong>The thorough evaluation identified 12 randomized controlled trials with a total of 4,060 participants, 1,956 in the intervention group and 2,104 in the comparison group, all diagnosed with PD. A combined effect size of 0.18 (SMD: 0.18; 95% CI: -0.03, 0.39) was found through quantitative analysis of motor scales for the Unified Parkinson's Disease Rating Scale (UPDRS). An effect size of 0.50 (OR: 0.50; 95% CI: 0.31, 0.80) was determined for dyskinesia. Dystonia occurrences showed a significant effect size of 0.44 (OR: 0.44; 95% CI: 0.24, 0.81; I2: 87.28%; P value: 0.0001). Hallucination and dizziness occurrences showed effect sizes of 0.91 (OR: 0.91; 95% CI: 0.36, 2.30) and 1.36 (OR: 1.36; 95% CI: 0.91, 2.04) overall, respectively. Quality assessment revealed high-certainty evidence for dyskinesia and dystonia reduction with bromocriptine, while other outcomes showed low to very low certainty. Meta-regression analyses showed no significant correlation between population characteristics and outcomes.</p><p><strong>Conclusion: </strong>This thorough meta-analysis offers an understanding of how bromocriptine compares in effectiveness to levodopa and other treatments for managing PD.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881050","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}