Acta neurologica Belgica最新文献

{"title":"Prevalence and clinical characterization of headache in patients with cranial bone defects: a single-center retrospective study.","authors":"Helbert de Oliveira Manduca Palmiero, Jefferson Rosi, Saul Almeida da Silva, Carlos Gilberto Carlotti, Eberval Gadelha Figueiredo","doi":"10.1007/s13760-026-03188-5","DOIUrl":"https://doi.org/10.1007/s13760-026-03188-5","url":null,"abstract":"<p><strong>Background and objectives: </strong>Headache is a poorly characterized symptom in patients with residual cranial bone defects. This study aimed to describe the prevalence and clinical features of headache-including intensity, quality, postural modulation, associated symptoms, and relief factors-in a cohort awaiting cranioplasty.</p><p><strong>Methods: </strong>A retrospective, cross-sectional study was conducted at a tertiary neurosurgical referral center (January 2016 - May 2026). Adults with residual cranial bone defects following craniotomy were evaluated at a specialized headache clinic. Headache was assessed using the Visual Analogue Scale (VAS), neuropathic features with the DN4 questionnaire, and relief factors were systematically recorded. Descriptive statistics and between-group comparisons (chi-squared, Fisher's exact, and independent-samples t-tests) were conducted.</p><p><strong>Results: </strong>Of 182 patients (mean age 45.4 ± 13.0 years; 60.4% male), 112 (61.5%) reported headache. Mean VAS was 5.7 ± 2.2, and 84.0% had at least moderate intensity. Headache was predominantly localized to the defect site (85.7%), with pressure/heaviness (68.8%) and tightness (66.9%) as the leading pain qualities. Neuropathic features were present in 6.2%. Associated symptoms-including vertigo (42.0%), photophobia (24.1%), and phonophobia (23.2%)-occurred exclusively or more frequently in the headache group (all p < 0.01). Relief factors were identified in 67.0% of patients, most commonly dipyrone (50.0%) and recumbency (10.7%).</p><p><strong>Conclusion: </strong>Headache affects most patients with cranial bone defects, presenting as a moderate-to-severe, defect-site-predominant syndrome with pressure-mediated features and a rich neurological accompaniment. Systematic headache assessment and evidence-based analgesic protocols are warranted in this population pending cranioplasty.</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":"148943895","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":"Temporal trends in NSAID prescribing by office-based neurologists in France: a nationwide repeated cross-sectional study.","authors":"Sylvain Redon, Anne Donnet","doi":"10.1007/s13760-026-03193-8","DOIUrl":"https://doi.org/10.1007/s13760-026-03193-8","url":null,"abstract":"","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":"148943995","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 relationship between health fatalism and caregiver burden in caregivers of patients with multiple sclerosis.","authors":"Afitap Ozdelikara, Sumeyye Koc, Murat Terzi","doi":"10.1007/s13760-026-03184-9","DOIUrl":"https://doi.org/10.1007/s13760-026-03184-9","url":null,"abstract":"<p><p>This study was conducted to determine the relationship between health fatalism and caregiver burden among caregivers of patients with MS. The study population consisted of 303 informal caregivers who provided care to patients with MS and presented to the Ondokuz Mayis University Health Practice and Research Center Neurology Clinic between September 2023 and August 2024. A descriptive information form developed by the researchers, the Health Fatalism Scale, and the Caregiver Burden Scale were used as data collection tools. Data were collected through face-to-face interviews. The data were analyzed with SPSS program, and p < 0.05 was considered statistically significant. The mean age of caregivers was 39.21 ± 12.02 years; 51.5% were female, 78.9% were married, and 47.9% were graduates of undergraduate/associate degree programs. The mean age of patients was 37.86 ± 10.94 years. Among patients receiving care, 79.5% were female, 45.9% were graduates of undergraduate/associate degree programs, and 86.5% did not use assistive devices. The mean score on the Health Fatalism Scale was determined as 41.54 ± 15.69. The median score on the Caregiver Burden Scale was determined as 16. No significant correlation was identified between the Health Fatalism Scale and the Caregiver Burden Scale; however, a statistically significant weak negative correlation was found between patient age and the Health Fatalism Scale score. Findings indicated that the level of health fatalism among caregivers of patients with MS was moderate. Findings also indicated that the education level of both patients and caregivers affected the understanding of health fatalism. Caregiver burden was determined to be low. However, patient sex and the use of assistive devices increased caregiver burden.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148904861","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":"Safety and efficacy of anti-CD20 monoclonal antibodies versus teriflunomide in relapsing multiple sclerosis: a systematic review and meta-analysis.","authors":"Hafiz Muhammad Haris, Hafiz Asad Ullah, Gul Sher Ghouri, Ali Hassan, Waleed Maqsood, Zainab Zaffar, Iman Fatima, Fnu Laiba, Rishmail Tariq, Muhammad Waleed Khan, Sakeena Qamar, Urooj Khan, Muhammad Umair Sarwar, Asma Iqbal, Syed Faqeer Hussain Bokhari","doi":"10.1007/s13760-026-03181-y","DOIUrl":"https://doi.org/10.1007/s13760-026-03181-y","url":null,"abstract":"<p><strong>Background: </strong>Anti-CD20 monoclonal antibodies are highly effective disease-modifying therapies for relapsing multiple sclerosis (RMS), but their comparative efficacy and safety versus teriflunomide, a dihydroorotate dehydrogenase inhibitor, remain clinically important. Teriflunomide is an oral platform treatment with moderate efficacy and a favorable administration profile, making it a relevant comparator for evaluating the benefit-risk profile of anti-CD20 therapies.</p><p><strong>Objectives: </strong>To assess the efficacy and safety of anti-CD20 monoclonal antibodies compared with teriflunomide in adults with RMS.</p><p><strong>Methods: </strong>A systematic search of PubMed, Cochrane Library, Embase, ScienceDirect, and Scopus was conducted from inception to April 30, 2026. Randomized controlled trials (RCTs) and observational studies comparing anti-CD20 therapies with teriflunomide were eligible. Outcomes included annualized relapse rate, gadolinium-enhancing T1 lesions, new or enlarging T2 lesions, brain volume change, adverse events, serious adverse events, and infections. Pooled mean differences, rate ratios or risk ratios with 95% confidence intervals were calculated using Review Manager (RevMan) version 5.4. Sensitivity analysis on the basis of leave-one-out principle was performed. Risk of bias of RCTs was assessed using Cochrane Risk of Bias Tool (ROB 2.0).</p><p><strong>Results: </strong>Six trials, reported in four studies, were included in the systematic review, and five trials were included in the quantitative synthesis. Anti-CD20 therapies significantly reduced annualized relapse rate compared with teriflunomide (rate ratio [RR] = 0.45, 95% CI [0.38, 0.53]; p < 0.00001), gadolinium-enhancing T1 lesions (MD = - 0.41, 95% CI - 0.52 to - 0.30), and new or enlarging T2 lesions (MD = - 3.05, 95% CI - 3.52 to - 2.58). However, no significant difference was observed in brain volume change. Overall adverse events and infections were comparable between groups, but serious adverse events were increased with anti-CD20 therapies (RR = 1.27, 95% CI 1.01 to 1.61).</p><p><strong>Conclusion: </strong>Anti-CD20 therapies provide effective control of relapse and MRI disease activity compared with teriflunomide in RMS. However, no clear advantage over teriflunomide was observed in reducing brain volume loss, and findings regarding disability progression were inconsistent. The modestly increased risk of serious adverse events highlight the need of large scale RCTs, individualized treatment decisions, and long-term safety monitoring.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148904906","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":"Neurosyphilis presenting with a PSP-like syndrome in HIV: a mimic or a true association?","authors":"Manoj Manyem, Grandhi Vyshnavi, Ramkumar Sugumaran, Saranya B Gomathy","doi":"10.1007/s13760-026-03191-w","DOIUrl":"https://doi.org/10.1007/s13760-026-03191-w","url":null,"abstract":"","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148904823","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":"Involuntary mouth movements associated with dementia in Parkinson's Disease.","authors":"Gabriele Riccio, Natascia De Lucia, Rosa Coppola, Maria Rosaria Chiariello, Augusta Giglio, Anna De Rosa","doi":"10.1007/s13760-026-03185-8","DOIUrl":"https://doi.org/10.1007/s13760-026-03185-8","url":null,"abstract":"","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148904826","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":"Painless legs and moving toes syndrome presenting with sensory trick-like phenomena: a case report.","authors":"Gohei Yamada, Kenji Okita, Tomoyuki Kuno, Eiichi Katada","doi":"10.1007/s13760-026-03186-7","DOIUrl":"https://doi.org/10.1007/s13760-026-03186-7","url":null,"abstract":"","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900048","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 neurological face of Kikuchi-Fujimoto disease.","authors":"Perrine Desonai, Solène Dauby, Martin Moïse, Olivier Malaise, Joan Somja","doi":"10.1007/s13760-026-03183-w","DOIUrl":"https://doi.org/10.1007/s13760-026-03183-w","url":null,"abstract":"","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148890581","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":"Exercise-induced neuropeptidergic and neurochemical neuroadaptation in stress regulation and emotional disorders.","authors":"Ziqi Wang, Zhinei Tan, Yaping Zhang, Yuzhou Li, Jinyan Lin, Yingli Xu, Yongxia Li, Ting Chen","doi":"10.1007/s13760-026-03168-9","DOIUrl":"https://doi.org/10.1007/s13760-026-03168-9","url":null,"abstract":"<p><p>Exercise is increasingly recognized not only as a behavioral and preventive health intervention but also as a biologically active stimulus that may influence stress-responsive neural systems across molecular, autonomic, neurochemical, neuroimmune, and network levels. Evidence from human intervention studies, neuroimaging research, peripheral biomarker analyses, and preclinical models suggests that repeated physical activity may modulate pathways involved in emotional regulation, motivational processing, stress responsivity, interoceptive signaling, and adaptive neuroplasticity. However, the strength of evidence varies across mechanisms, and several cellular, receptor-level, and circuit-specific processes remain supported primarily by animal studies or indirect peripheral markers rather than direct causal demonstration in humans. This review synthesizes experimental, clinical, and conceptual evidence on exercise-induced neuroadaptation, with emphasis on neurochemical and neuropeptidergic mechanisms relevant to stress regulation and emotional disorders. We discuss exercise-associated adaptations involving dopaminergic, serotonergic, noradrenergic, glutamatergic, GABAergic, endocannabinoid, and opioid-related signaling, together with stress-responsive neuropeptides including corticotropin-releasing hormone, neuropeptide Y, oxytocin, orexin, β-endorphin, and substance P. Beyond isolated transmitter systems, we highlight interactions among hypothalamic peptidergic regulation, autonomic function, neurotrophic signaling, neuroimmune pathways, and large-scale neural network organization. We also introduce the biphasic neuroadaptation of the exercise framework, the neuroadaptive feedback loop of movement, and personalized neuromodulatory exercise profiling as heuristic models for organizing existing evidence rather than established clinical paradigms. Collectively, exercise may represent an emerging biologically informed neuromodulatory approach, although precision-based clinical application requires stronger causal human evidence, standardized biomarkers, and longitudinal validation.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879036","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":"Cardiac cephalalgia: an underrecognized cause of secondary headache - a retrospective study.","authors":"Cansu Sarıkaya, Fatma Özge Salkın, Caner Sarıkaya, H Macit Selekler","doi":"10.1007/s13760-026-03177-8","DOIUrl":"https://doi.org/10.1007/s13760-026-03177-8","url":null,"abstract":"<p><strong>Background: </strong>Cardiac cephalalgia is a type of secondary headache that occurs in association with myocardial ischemia. It may present without typical chest pain, complicating early diagnosis and delaying optimal treatment. This study aims to evaluate the frequency of headache in a selected cohort of patients with myocardial infarction undergoing coronary angiography.</p><p><strong>Methods: </strong>We retrospectively reviewed 115 patients diagnosed with MI who underwent coronary angiography. The presence of headache prior to angiography was recorded, and follow-up was performed to assess its persistence after intervention. Statistical analyses included Chi-square, Mann-Whitney U and McNemar tests to evaluate associations between headache and clinical/laboratory parameters.</p><p><strong>Results: </strong>A total of 90 patients were included in the study (mean age 57.8 years; 71 males). Among them, 27 patients (30%) experienced headache prior to angiography. Following coronary intervention, headache persisted in only one patient, indicating a statistically significant reduction (p < 0.001). No significant relationship was found between headache presence and MI type (STEMI vs. NSTEMI), age, LDL cholesterol, blood pressure or other clinical parameters (p > 0.05).</p><p><strong>Conclusions: </strong>Cardiac cephalalgia may be an overlooked presentation of myocardial infarction, occurring in a subset of patients. The complete resolution of symptoms following revascularization underscores the need to consider cardiac cephalalgia in the differential diagnosis of unexplained headaches, especially in the absence of classic cardiac symptoms. Greater clinical awareness could improve early diagnosis and patient outcomes.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148860311","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}