Advanced neurology最新文献

{"title":"Evoked potential response in patients with idiopathic Parkinson’s disease and atypical parkinsonian syndromes: A comparative study","authors":"Manoj Roy, A. Misra, Joydeep Mukherjee, Manamita Mandal, Jasodhara Chaudhuri, Kartik Chandra Ghosh, B. Mohanty","doi":"10.36922/an.1907","DOIUrl":"https://doi.org/10.36922/an.1907","url":null,"abstract":"Patients with idiopathic Parkinson’s disease (IPD) and atypical parkinsonian syndromes (APSs) suffer from a range of disorders, especially in balance and locomotion, which necessitate visual, auditory, and somatosensory inputs. In this study, IPD patients, APS patients, and healthy controls (HCs) (n = 50 per group) underwent a series of assessments for visual evoked potentials (VEP), brainstem auditory evoked response (BAER), and short-latency somatosensory evoked potentials (SSEP). Results showed that VEP P100 latency was prolonged in multiple system atrophy-cerebellar type (MSA-C), multiple system atrophy-parkinsonian type (MSA-P), and corticobasal ganglionic degeneration (CBD) patients. The latency of peaks III and V was prolonged in IPD, MSA-C, dementia with Lewy bodies (DLB), and Parkinson’s disease dementia (PDD). BAER I-III and I-V interpeak latency were prolonged in IPD, DLB, and PDD, whereas BAER I-III, III-V, and I-V interpeak latencies were increased and the V/I amplitude ratio was decreased in MSA-C. The central sensory conduction time (N20-N13) was increased in MSA-P and MSA-C in SSEP. IPD patients had prolonged VEP P100 latency (P < 0.001), lower VEP N75-P100 amplitude (P < 0.001), prolonged BAER I, II, II, IV, V peak latencies (P < 0.001), I-III, I-V interpeak latencies (P < 0.001), lower BAER V/I amplitude ratio (P < 0.001), and prolonged SSEP N13, N20, central sensory conduction time (N20-N13) (P < 0.001) than HCs. IPD patients also had prolonged BAER I, II, II, IV, V peak latencies (P < 0.001), prolonged I-III, I-V interpeak latencies (P < 0.001), and shorter SSEP N13, N20, central sensory conduction time (N20-N13) (P < 0.001) than APS patients. Moreover, APS patients had prolonged VEP P100 and N145 latencies (P < 0.001) and decreased N75-N145 amplitude (P < 0.001) compared to HCs. APS patients also had prolonged BAER II, II, IV, V peak latencies (P < 0.001), prolonged I-III, III-V, I-V interpeak latencies (P < 0.001), decreased V/I amplitude ratio, and prolonged SSEP N13, N20, central sensory conduction time (N20-N13) (P < 0.001) than HCs. Postural instability and gait disorder (PIGD) IPD had significantly prolonged BAER III, V peak latencies (P < 0.05), and prolonged III-V interpeak latencies (P < 0.05) compared to tremor-dominant IPD. Overall, the IPD and APS patients had significant VEP, BAER, and SSEP abnormalities of demyelination and axonal variety in the visual, auditory, and somatosensory pathways. The changes were also correlated with the disease duration and severity. Although the diseases are predominantly motor disorders with significant non-motor components, these electrophysiological abnormalities might open a new avenue to assess the non-motor symptoms.","PeriodicalId":72072,"journal":{"name":"Advanced neurology","volume":"80 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139001264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual behavior and risk of diagnosis with multiple sclerosis: A retrospective case–control study","authors":"Matthew Kennis, Katherine Thompson, Elijah W. Hale","doi":"10.36922/an.1383","DOIUrl":"https://doi.org/10.36922/an.1383","url":null,"abstract":"Adolescence is a critical window during which psychosocial factors have significant effects on the lifetime risk of multiple sclerosis (MS). Sexual behavior is relevant early in adulthood and has not been described in its relationship to MS. Using a retrospective secondary analysis of cross-sectional data in the TriNetX database, we investigated the connection between orientation of sexual behavior and MS risk. We identified 13,595 males and 9,589 females with same-sex behavior and 64,409 males and 137,450 females with opposite-sex behavior. Cohorts were balanced on age, race, and ethnicity. Males engaging in same-sex behavior had a 2.80-fold higher risk of MS diagnosis (95% confidence interval [CI]: 1.66 – 4.73), and females engaging in same-sex behavior had a 2.30-fold higher risk of MS diagnosis (95% CI: 1.65 – 3.20). Our findings thus advance the understanding of MS risk in the context of social determinants of health.","PeriodicalId":72072,"journal":{"name":"Advanced neurology","volume":"43 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139007170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding the spectrum of gene-associated reflex seizures: A case report of a “bidet-induced” reflex epilepsy","authors":"Tommaso Lo Barco, J. Proietti, Luna Fontanelli, Ilaria Campari, Benedetta Piccolo, Francesca Ormitti, Emanuela Claudia Turco","doi":"10.36922/an.1379","DOIUrl":"https://doi.org/10.36922/an.1379","url":null,"abstract":"In this case report, we present the case of a 20-month-old girl who manifested paroxysmal “bidet-induced” episodes characterized by impaired awareness, pallor, and hypotonia, with a duration of less than a minute. Initial neurological examination yielded unremarkable results, prompting further investigation. A video-electroencephalogram recording documented the epileptic nature of these episodes, revealing an ictal discharge originating from the right central-temporal region. A brain magnetic resonance imaging exhibited a sulcal/gyral asymmetry within the central sulci, along with the presence of the “power button sign” within the right central sulcus. These findings were indicative of a focal cortical dysplasia type-2. Subsequent genetic analysis through a gene panel identified the presence of an NPRL2 variant. Mutations affecting this particular gene are known to disrupt the normal functioning of the GATOR1 complex, potentially causing focal cortical dysplasia and various forms of epilepsy, including familial focal epilepsy with variable foci. On the diagnosis, the patient received levetiracetam, and the ictal episodes promptly ceased. At the most recent follow-up (at 4 years old), the patient remained free of seizures without the need for any treatment, and her neurodevelopment so far had exhibited no abnormalities. Considering the landscape of epilepsy-related GATOR1 variants, it is conceivable that this gene family may play a significant role in the pathogenesis of benign forms of focal reflex seizures, including bathing epilepsy.","PeriodicalId":72072,"journal":{"name":"Advanced neurology","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139257090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seizure as the first symptom of cavernous sinus dural arteriovenous fistula: A case report and literature review","authors":"Mengxin Li, Shuai Jia, Jian Li, Jianhong Geng, Xiaojun Zhang, Yanqiang Wang","doi":"10.36922/an.0980","DOIUrl":"https://doi.org/10.36922/an.0980","url":null,"abstract":"Cavernous sinus dural arteriovenous fistula (CS-DAVF) is an abnormal arteriovenous communication associated with a variety of clinical manifestations. The previous literature has rarely reported the occurrence of CS-DAVF with seizures and cerebral hemorrhage, signaling the need for more case reports and literature review in this area. A 62-year-old Chinese female presented with a paroxysmal loss of consciousness, accompanied with involuntary eye movement to the left, chewing issues, salivation at the right corner of the mouth, and bit tongue. The brain computed tomography revealed that the left temporal lobe was hemorrhagic. Brain scan and contrast-enhanced magnetic resonance imaging showed diffuse meningeal enhancement and lesions in the left frontoparietal temporal lobe, insular lobe, and hippocampal head region. Electroencephalography demonstrated continuous emission of spike and slow waves in the left hemisphere. With the aid of digital subtraction angiography, the patient was confirmed with a diagnosis of CS-DAVF draining into the ipsilateral cavernous sinus, intercavernous sinus, contralateral cavernous sinus, left superior ophthalmic vein, left lateral fissure vein, and left pterygoid venous plexus. The fistula was closed with interventional embolization through the femoral vein, and immediate angiography showed complete resolution of CS-DAVF after operation. The patient did not manifest any post-operative complications. This case highlights that the prevention of epilepsy, cerebral hemorrhage, and other serious complications is extremely important for good prognosis, especially in some patients presenting with serious clinical symptoms. It also sheds light on the necessity to consider the diagnosis of CS-DAVF if seizures, although extremely rare, are present.","PeriodicalId":72072,"journal":{"name":"Advanced neurology","volume":" 12","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135291314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple sclerosis: Unveiling current immunogenetic factors and their role in etiopathogenesis and clinical aspects","authors":"Benediktas Trumpulis, Rasa Liutkeviciene, Renata Balnyte","doi":"10.36922/an.1319","DOIUrl":"https://doi.org/10.36922/an.1319","url":null,"abstract":"Multiple sclerosis (MS) is the most common cause of neurological deficits among the young population. While the prevalence of MS is increasing worldwide, the incidence rate of MS is also undergoing a similar trend in Lithuania. Globally, women are twice as likely to be affected by MS as men. Unilateral optic neuritis is the most common initial symptom of MS. The signs and symptoms of MS vary greatly from patient to patient and depend on the location and severity of the nerve fiber damage in the central nervous system. Most people with MS have a relapsing-remitting disease course or clinically isolated syndrome. They experience periods of new symptoms or relapses that develop over days or weeks and usually resolve partially or completely. These relapses are followed by quiet periods of disease remission that may last months or even years. Data accumulated over the years suggest a complex interplay between environment and immunogenetics (strong associations with a large number of immune and genetic markers), and an increasingly convincing role of an underlying degenerative process leading to demyelination (in both white and gray matter), axonal and neurosynaptic damage, and a persistent innate inflammatory response, with T-cell-mediated autoimmunity appearing to play a diminishing role as the MS develops and progresses. In the absence of clinically proven, accurate, and reliable biomarkers, the disease can take a progressive course in case of late treatment, signifying the critical need for early diagnosis. This article therefore discusses the etiopathogenesis and clinical aspects of MS.","PeriodicalId":72072,"journal":{"name":"Advanced neurology","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135296116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimated glomerular filtration rate and serum neurofilament light chain: insight from NHANES","authors":"Jiangwen Liu","doi":"10.36922/an.1394","DOIUrl":"https://doi.org/10.36922/an.1394","url":null,"abstract":"The neurofilament light chain is a protein biomarker associated with neurodegenerative diseases. Neurofilament light chain levels may increase as kidney function declines due to reduced clearance. However, the relationship between estimated glomerular filtration rate (eGFR) and serum neurofilament light chain (sNfL) has not been extensively studied. Therefore, the objective of this study was to examine the association between eGFR and sNfL levels. Health survey data from 2071 eligible participants in the National Health and Nutrition Examination Survey (NHANES) were used in three multivariate-adjusted weighted linear regression models to analyze the correlation between eGFR and sNfL. Subsequently, segmental linear regression analysis was employed to determine the inflection point of eGFR. Finally, through subgroup analysis, we aimed to assess the impact of all covariates on the association between eGFR and sNfL. According to our results, sNfL levels decreased as eGFR increased. The segmental linear regression model analysis identified an inflection point at 59.9. When eGFR reached 59.9 or exceeded it, each unit increase in eGFR was associated with a 1 pg/mL decrease in sNfL (&amp;beta; = &amp;minus;0.1, P = 0.01). Furthermore, subgroup analysis revealed that hypertension exhibited a significant interaction with the association between eGFR and sNfL (P = 0.01). These findings suggest that eGFR holds promise as a potential marker for neurodegenerative disorders, and hypertension could affect this association to some extent. Moreover, these results could have significant implications for the early detection and prevention of neurodegenerative diseases in patients with kidney disease. However, further research is needed to corroborate these results and elucidate the underlying mechanisms.","PeriodicalId":72072,"journal":{"name":"Advanced neurology","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135537113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of surgical management and implant consideration for depressed skull fractures: A systematic review.","authors":"Andrew Nguyen, Akshay Reddy, Ramy Sharaf, Lauren Ladehoff, Michael Joseph Diaz, Brandon Lucke-Wold","doi":"10.36922/an.247","DOIUrl":"10.36922/an.247","url":null,"abstract":"<p><strong>Background: </strong>Traumatic brain injuries (TBIs) are associated with high mortality and morbidity. Depressed skull fractures (DSFs) are a subset of fractures characterized by either direct or indirect brain damage, compressing brain tissue. Recent advances in implant use during primary reconstruction surgeries have shown to be effective. In this systematic review, we assess differences in titanium mesh, polyetheretherketone (PEEK) implants, autologous pericranial grafts, and methyl methacrylate (PMMA) implants for DSF treatment.</p><p><strong>Methods: </strong>A literature search was conducted in PubMed, Scopus, and Web of Science from their inception to September 2022 to retrieve articles regarding the use of various implant materials for depressed skull fractures. Inclusion criteria included studies specifically describing implant type/material within treatment of depressed skull fractures, particularly during duraplasty. Exclusion criteria were studies reporting only non-primary data, those insufficiently disaggregated to extract implant type, those describing treatment of pathologies other than depressed skull fractures, and non-English or cadaveric studies. The Newcastle-Ottawa Scale was utilized to assess for presence of bias in included studies.</p><p><strong>Results: </strong>Following final study selection, 18 articles were included for quantitative and qualitative analysis. Of the 177 patients (152 males), mean age was 30.8 years with 82% implanted with autologous graft material, and 18% with non-autologous material. Data were pooled and analyzed with respect to the total patient set, and additionally stratified into those treated through autologous and non-autologous implant material.There were no differences between the two cohorts regarding mean time to encounter, pre-operative Glasgow coma scale (GCS), fracture location, length to cranioplasty, and complication rate. There were statistically significant differences in post-operative GCS (p < 0.0001), LOS (p = 0.0274), and minimum follow-up time (p = 0.000796).</p><p><strong>Conclusion: </strong>Differences in measurable post-operative outcomes between implant groups were largely minimal or none. Future research should aim to probe these basic results deeper with a larger, non-biased sample.</p>","PeriodicalId":72072,"journal":{"name":"Advanced neurology","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9215928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Woven Endobridge embolization: Indications and innovation.","authors":"Ashley M Carter, Bethsabe Romero, Harrison Dai, Simran Phuyal, Danxun Li, Brandon Lucke-Wold","doi":"10.36922/an.293","DOIUrl":"10.36922/an.293","url":null,"abstract":"<p><p>The treatment of intracranial aneurysms has seen incredible advancements over the last few decades. Long-term occlusion of wide-neck bifurcation aneurysms remains technically challenging. The Woven Endobridge (WEB) embolization device is innovative in its construction and uses. The design of the device has evolved over the last decade. Pre-clinical and clinical trials are ongoing and continue to inform the development of intrasaccular flow-diverting devices. The WEB device is currently approved by the U.S. Food and Drug Administration (FDA) for treating wide-neck aneurysms. The safety and efficacy of the WEB device have yielded promising clinical results that may have additional indications. This review aims to discuss the development of the WEB device and the current state of the WEB device in the treatment of wide-neck aneurysms. We also summarize ongoing clinical studies and potential innovative uses.</p>","PeriodicalId":72072,"journal":{"name":"Advanced neurology","volume":"2 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9734905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral venous sinus stenting in idiopathic intracranial hypertension.","authors":"Persis Desai, Oluwaferanmi Dada, Jamie Warner, Kevin Pierre, Brandon Lucke-Wold","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Cerebral venous sinus stenting (CVSS) is a minimally invasive procedure using endovascular stent placement to relieve elevated intracranial pressure secondary to venous sinus stenosis. Increased venous sinus pressure secondary to stenosis is commonly associated with elevated intracranial pressure without intracranial lesions on imaging or idiopathic intracranial hypertension (IIH). While the etiology of IIH remains unknown, stenosis of one or more of the dural sinuses has been implicated as a possible underlying mechanism. The manifestations of IIH include headaches, transient vision loss, pulsatile tinnitus, and neck pain. In this review, we discuss the recent studies that have demonstrated the e!ectiveness of CVSS for patients with IIH and also the indications, technical challenges, potential complications, and emerging developments in CVSS.</p>","PeriodicalId":72072,"journal":{"name":"Advanced neurology","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9278951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}