Neurology perspectives最新文献

{"title":"Hematolgical parameters: Are they predictors of ischemic stroke subtypes?","authors":"O.A. Mahmood,&nbsp;M.G. Aliraqi","doi":"10.1016/j.neurop.2025.100208","DOIUrl":"10.1016/j.neurop.2025.100208","url":null,"abstract":"<div><h3>Introduction</h3><div>Hematological parameters are considered to be implicated in the pathogenesis of acute ischemic stroke. Otherwise, to our knowledge, it is still not known whether there are any differences between small and large vessel strokes, in terms of these parameters.</div></div><div><h3>Methods</h3><div>Prospectively included in the study, a hundred small-vessel stroke (<em>n</em> = 50) and large-vessel stroke patients (<em>n</em> = 50) were managed in Ibn-sena teaching hospital, Mosul between Oct. 2023 and Aug. 2024. Complete history, neurological examination was done at admission, and blood samples for CBC were collected within the first 48 h of admission. White blood cells (WBCs), neutrophils, lymphocytes, neutrophil/lymphocyte ratio (N/L ratio), monocytes, eosinophils, basophil, hemoglobin (HB), RBC count, packed cell volume (PCV), red cell distribution width (RDW), red cell distribution width index (RDWI), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), platelet count, platelet distribution width (PDW) and mean platelet volume (MPV) were obtained, and comparison between the two groups in terms of these parameters was done and with 50 control patients.</div></div><div><h3>Results</h3><div>Neutrophil to lymphocyte ratio was highest in large vessel disease group and lowest in control group (small versus large, small versus control, large versus control, <em>P =</em> 0.003, &lt;<!--> <!-->0.001, &lt;<!--> <!-->0.001 respectively), and the opposite was the case with lymphocyte count (small versus large, small versus control, large versus control <em>P =</em> 0.003, &lt;<!--> <!-->0.001, &lt;<!--> <!-->0.001, respectively). We have found expressively higher total white blood cell (<em>P =</em> 0.004, &lt;<!--> <!-->0.001), and lower monocyte count (<em>P =</em> 0.001, &lt;<!--> <!-->0.001) in patients with small and large vessel diseases respectively compared to controls. Platelet count and mean platelet volume were significantly higher in small vessel disease compared to controls (<em>P =</em> 0.04, 0.02, respectively). Neutrophil count and RDW were inferentially higher in the large vessel group compared to controls (<em>P =</em> 0.005, 0.03, respectively), and no other significant differences were found among groups.</div></div><div><h3>Conclusions</h3><div>Hematological parameters are invaluable tools to confirm the diagnosis of ischemic stroke and to predict stroke subtypes with modest sensitivity.</div></div>","PeriodicalId":74283,"journal":{"name":"Neurology perspectives","volume":"5 4","pages":"Article 100208"},"PeriodicalIF":0.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157547","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":"Association between radiological findings and clinical outcome in secondary dysnatremia to acute traumatic brain injury","authors":"P. Gruezo-Realpe ,&nbsp;D.J. Japón-Cueva ,&nbsp;C.R. Alarcón ,&nbsp;A. Noritz-Mero ,&nbsp;R. Cedeño-Morejon ,&nbsp;A. Chango-Pinargote ,&nbsp;L. Viñan-Paucar ,&nbsp;N. Aguirre-Verduga ,&nbsp;D.M. Andrade ,&nbsp;G.S. Suárez ,&nbsp;M.L. Iturralde ,&nbsp;J. García-Córdova ,&nbsp;M. Quintero-Jácome ,&nbsp;L. Villacis-Palma ,&nbsp;E. Velásquez-Barreiro ,&nbsp;R. Pilco-Rojas ,&nbsp;A. Suárez-Calderón ,&nbsp;M. Pérez-Román ,&nbsp;S. Borja-Landires ,&nbsp;D. Cabezas-Euvin ,&nbsp;V. Campozano","doi":"10.1016/j.neurop.2025.100207","DOIUrl":"10.1016/j.neurop.2025.100207","url":null,"abstract":"<div><h3>Background/objective</h3><div>Traumatic brain injury (TBI) is a major cause of morbidity and mortality, with symptoms ranging from seizures to speech disorders. TBI often requires stabilization, neuroimaging, and correction of metabolic imbalances like dysnatremia, which can worsen outcomes. This study evaluates the relationship between dysnatremia, clinical parameters, and neuroimaging findings in acute TBI patients.</div></div><div><h3>Methods</h3><div>A multicenter retrospective cohort study was conducted in three hospitals in Guayaquil, Ecuador, including 200 ICU patients with acute TBI from 2018 to 2023. Data were collected from clinical histories, neuroimaging, and biochemical analyses, with serum sodium levels measured at admission, 24, and 48 h post-admission. Statistical analyses included Chi-square tests, Kruskal-Wallis tests, Pearson correlation, and logistic regression to assess associations.</div></div><div><h3>Results</h3><div>Of the 200 patients, 85.5% were male. Alcohol consumption was higher in patients with dysnatremia (p = 0.010). Glasgow Coma Scale (GCS) and FOUR Scale scores were lower in hypernatremic patients at both admission and 48 h (p &lt; 0.001). Hypernatremia was linked to increased ventilatory support (94.5%) and higher mortality (41.8%) (p = 0.017). Neuroimaging showed associations between hypernatremia and subarachnoid hemorrhage, cerebral edema, and contusions (p &lt; 0.05). Logistic regression revealed that higher GCS scores were linked to reduced mortality (OR = 0.717, p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Hypernatremia correlates with lower neurological scores, abnormal neuroimaging findings, increased ventilatory support, and higher mortality in patients with acute TBI. Serum sodium monitoring may aid early risk stratification and guide critical care interventions. Prospective studies are warranted to standardize protocols and optimize dysnatremia management in TBI.</div></div>","PeriodicalId":74283,"journal":{"name":"Neurology perspectives","volume":"5 4","pages":"Article 100207"},"PeriodicalIF":0.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048579","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":"Bridging the gap: Unveiling the gut's influence on Parkinson's disease through probiotic interventions","authors":"A.Y. Nápoles-Medina ,&nbsp;B.R. Aguilar-Uscanga ,&nbsp;B.G. Nápoles-Medina ,&nbsp;P.A. Brand-Rubalcava ,&nbsp;A.R. Tejeda-Martínez ,&nbsp;M.E. Flores-Soto","doi":"10.1016/j.neurop.2025.100206","DOIUrl":"10.1016/j.neurop.2025.100206","url":null,"abstract":"<div><h3>Introduction</h3><div>Parkinson's disease (PD), a prevalent neurodegenerative disorder characterized by motor dysfunction, presents a significant therapeutic challenge due to the lack of disease-modifying treatments. Emerging evidence suggests a crucial role of the gut microbiota in PD pathogenesis, particularly through its influence on the gut-brain axis.</div></div><div><h3>Development</h3><div>The gut-brain axis, a bidirectional communication network involving neural, hormonal, and immune pathways, appears to be significantly modulated by the gut microbiota. Dysbiosis, an imbalance in gut microbial composition, has been implicated in PD progression. Metabolites produced by gut bacteria, such as short-chain fatty acids, are key mediators of gut-brain signaling and may contribute to PD pathogenesis. Preclinical studies utilizing animal models of PD have demonstrated the neuroprotective potential of probiotics, live microorganisms that confer health benefits to the host. These studies report improvements in motor symptoms, reduced neuroinflammation, decreased oxidative stress, and restoration of gut and blood–brain barrier integrity following probiotic administration.</div></div><div><h3>Conclusions</h3><div>While the precise mechanisms underlying the beneficial effects of probiotics in PD require further investigation, these interventions hold promise for disease management. Further research is warranted to elucidate the therapeutic potential of probiotics in PD and to develop targeted interventions for modulating the gut microbiota to improve clinical outcomes.</div></div>","PeriodicalId":74283,"journal":{"name":"Neurology perspectives","volume":"5 4","pages":"Article 100206"},"PeriodicalIF":0.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018486","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":"Transient receptor potential (TRP) in neuroglia and their role in pain. Brief review","authors":"L. Arce Gálvez ,&nbsp;J.M. Mancera Álzate ,&nbsp;M.F. Rosero Chamorro ,&nbsp;Á.J. Tellez Pérez ,&nbsp;A.F. Ausenón ,&nbsp;J.D. Cardona Bahamon ,&nbsp;L.M. Rodriguez Vélez","doi":"10.1016/j.neurop.2025.100205","DOIUrl":"10.1016/j.neurop.2025.100205","url":null,"abstract":"<div><div>Neuroglia has an essential role in pain perception that goes beyond neuropathic pain and is now considered to play a major role in the processes of sensitization, establishment of chronic pain and nociplasticity. In this intricate process of plasticity and neuroinflammation, there are multiple receptors, one of them the transient receptor potential (TRP) that has different types and subtypes in relation to their amino acids. These receptors vary in each person in relation to their sex, hormonal profile, genetics and age, which may explain the variability in pain perception. There are some treatments that intervene in these receptors and many more are in development, which could become a novel and interesting alternative therapy.</div></div>","PeriodicalId":74283,"journal":{"name":"Neurology perspectives","volume":"5 4","pages":"Article 100205"},"PeriodicalIF":0.0,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018487","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 and rheumatic diseases: Rheumatoid arthritis, antiphospholipid syndrome, and systemic lupus erythematosus","authors":"M.A. Hernández ,&nbsp;B. González ,&nbsp;Y. Contreras ,&nbsp;L.M. Armas","doi":"10.1016/j.neurop.2025.100197","DOIUrl":"10.1016/j.neurop.2025.100197","url":null,"abstract":"<div><h3>Introduction</h3><div>Multiple sclerosis (MS) may be associated with a range of rheumatic diseases. Rheumatoid arthritis is a chronic inflammatory disease typically affecting small- and medium-size joints. MS has been associated with antiphospholipid syndrome.</div></div><div><h3>Development</h3><div>The treatment of these patients must be carefully established, considering the presence of neurological symptoms or central nervous system comorbidities. Patients with MS and rheumatoid arthritis should not be treated with TNF inhibitors, as these may exacerbate the neurological symptoms. Most biological drugs may favour opportunistic infections of the central nervous system; therefore, patients developing neurological symptoms should undergo comprehensive examination, and biological treatment should be adapted according to the results.</div></div><div><h3>Conclusions</h3><div>We summarise the main recommendations for the treatment of patients with MS associated with rheumatic diseases.</div></div>","PeriodicalId":74283,"journal":{"name":"Neurology perspectives","volume":"5 3","pages":"Article 100197"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548769","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":"Inflammatory bowel disease and multiple sclerosis","authors":"M. Dominguez-Gallego,&nbsp;V. Meca-Lallana,&nbsp;C. Ana Belén","doi":"10.1016/j.neurop.2025.100199","DOIUrl":"10.1016/j.neurop.2025.100199","url":null,"abstract":"<div><h3>Introduction</h3><div>Inflammatory bowel disease (IBD), which mainly includes Crohn’s disease and ulcerative colitis, is characterised by chronic inflammation in the gastrointestinal tract, triggered and perpetuated by an altered immune response. An association has been established between this condition and other autoimmune diseases, including multiple sclerosis (MS). The prevalence of MS in patients with IBD is 0.2%; the association between the 2 conditions is attributed to shared genetic and environmental pathogenic mechanisms.</div></div><div><h3>Development</h3><div>In patients presenting with both diseases, several considerations should be taken into account when selecting the most appropriate treatment. Regarding MS treatment, interferons have been associated with worsening of IBD symptoms, whereas such monoclonal antibodies as rituximab and ocrelizumab may cause gastrointestinal toxicity, and alemtuzumab is not recommended due to increased risk of autoimmune complications. Natalizumab and sphingosine 1-phosphate modulators, such as ozanimod, constitute safer and more effective options for patients with IBD.</div><div>Regarding treatments for IBD, TNF-α antagonists are contraindicated in patients with MS due to the associated risk of central nervous system demyelination. Vedolizumab and ustekinumab are the recommended alternatives in these cases.</div></div><div><h3>Conclusions</h3><div>Though weak, the association between IBD and MS should be acknowledged; preferably, management of these patients should include medications that treat both conditions simultaneously.</div></div>","PeriodicalId":74283,"journal":{"name":"Neurology perspectives","volume":"5 3","pages":"Article 100199"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144570751","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":"Other autoimmune diseases and multiple sclerosis","authors":"S. Martínez-Yélamos ,&nbsp;Á. Pérez-Sempere","doi":"10.1016/j.neurop.2025.100196","DOIUrl":"10.1016/j.neurop.2025.100196","url":null,"abstract":"<div><h3>Introduction</h3><div>This study explores the association between multiple sclerosis (MS) and other autoimmune diseases, including myasthenia gravis (MG), autoimmune encephalitis (AE), and demyelinating polyneuropathies such as combined central and peripheral demyelination (CCPD), chronic inflammatory demyelinating polyneuropathy (CIDP), and Guillain-Barré syndrome (GBS).</div></div><div><h3>Development</h3><div>For each association, we discuss epidemiological data, clinical features, and therapeutic management strategies. The prevalence of MG is higher in patients with MS than in the general population. Certain MS treatments, such as alemtuzumab, may increase the risk of developing MG or AE. Among the most suitable therapeutic options for patients with coexisting MG or AE are azathioprine and rituximab. Antibody-mediated AE associated with MS is managed similarly to AE unrelated to MS. The association between MS and CIDP contributes to neurological disability and is likely underdiagnosed.</div></div><div><h3>Conclusions</h3><div>The coexistence of MS with other autoimmune diseases presents significant diagnostic and therapeutic challenges. Awareness of the therapeutic options available for each association is essential in order to identify the most appropriate approach in each case. Early recognition and adequate management of these comorbidities may improve clinical outcomes and enhance patients’ quality of life.</div></div>","PeriodicalId":74283,"journal":{"name":"Neurology perspectives","volume":"5 3","pages":"Article 100196"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144563032","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 and rheumatic diseases: Behçet disease, sarcoidosis, and Sjögren syndrome","authors":"M.A. Hernández ,&nbsp;Y. Contreras ,&nbsp;B. González ,&nbsp;L.M. Armas","doi":"10.1016/j.neurop.2025.100198","DOIUrl":"10.1016/j.neurop.2025.100198","url":null,"abstract":"<div><h3>Introduction</h3><div>Multiple sclerosis can be associated with a range of rheumatic processes. Behçet disease is a relapsing, multisystemic, immune-mediated chronic vasculitic disorder of unknown aetiology, whose symptoms overlap with those of many autoinflammatory processes. Sarcoidosis is a universally distributed multisystem granulomatous disease. Sjögren syndrome is a chronic, autoimmune, inflammatory disease characterised by lymphocytic infiltration in exocrine glands, which causes xerostomia (dry mouth) and xerophthalmia (dry eyes). The most frequent extraglandular manifestations of the syndrome are musculoskeletal problems.</div></div><div><h3>Development</h3><div>We describe the most significant neurological complications of these rheumatic diseases, as well as the pharmacological treatments that may be indicated for these conditions and the possible contraindications in patients receiving treatment for multiple sclerosis.</div></div><div><h3>Conclusions</h3><div>We provide a series of recommendations for the treatment of patients with multiple sclerosis who also present with Behçet disease, sarcoidosis, or Sjögren syndrome. Co-presence of any of these rheumatic diseases constitutes a contraindication for some treatments.</div></div>","PeriodicalId":74283,"journal":{"name":"Neurology perspectives","volume":"5 3","pages":"Article 100198"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144557469","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":"Autoimmune eye diseases in multiple sclerosis","authors":"M.L. Martínez Ginés ,&nbsp;P. Rojas Lozano","doi":"10.1016/j.neurop.2025.100195","DOIUrl":"10.1016/j.neurop.2025.100195","url":null,"abstract":"<div><h3>Introduction</h3><div>The eye is a complex organ that can present complications related to autoimmune diseases, including multiple sclerosis (MS). Ocular manifestations may act as early indicators of autoimmune diseases, and their early diagnosis and treatment are essential to guaranteeing patients' quality of life. This review analyses the main autoimmune eye diseases associated with MS, focusing on intermediate uveitis and its personalised management.</div></div><div><h3>Development</h3><div>MS-associated uveitis includes various forms of intraocular inflammation affecting different areas of the eye. The relationship between MS and uveitis is complex and involves shared immunological mechanisms and diagnostic and therapeutic challenges. The clinical presentation of uveitis varies from asymptomatic forms to severe vision-threatening complications. The treatment of uveitis involves careful assessment and the consideration of immunomodulatory or immunosuppressive treatment with a view to controlling inflammation and preventing visual sequelae.</div></div><div><h3>Conclusions</h3><div>Treatment of MS-related uveitis is complex and requires a multidisciplinary approach. Advances in immunomodulatory therapy offer new treatment options, as well as challenges related to adverse reactions and disease management. Further research is needed to better understand the relationship between MS and eye diseases, and to optimise therapeutic strategies and improve patients' visual and neurological outcomes.</div></div>","PeriodicalId":74283,"journal":{"name":"Neurology perspectives","volume":"5 3","pages":"Article 100195"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144536222","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":"Management of the most prevalent autoimmune diseases co-occurring with Multiple Sclerosi","authors":"A.B. Caminero","doi":"10.1016/j.neurop.2025.100194","DOIUrl":"10.1016/j.neurop.2025.100194","url":null,"abstract":"","PeriodicalId":74283,"journal":{"name":"Neurology perspectives","volume":"5 3","pages":"Article 100194"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144557116","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}