Annals of Indian Academy of Neurology最新文献

{"title":"Vitamin D Deficiency and Supplementation in Migraine: A Scoping Review of Clinical Efficacy, Evidence Gaps, and Research Priorities.","authors":"Amey Marathe, Shailly Vaghasiya, Arth Shah, Soaham Desai","doi":"10.4103/aian.aian_417_25","DOIUrl":"10.4103/aian.aian_417_25","url":null,"abstract":"<p><strong>Background and objectives: </strong>Migraine is a debilitating neurological disorder affecting 10%-20% of the global population, with significant socioeconomic burdens. Vitamin D deficiency, prevalent in over 1 billion individuals, has been proposed as a modifiable risk factor in migraine management due to its potential role in pain modulation and neuroinflammation. This scoping review aimed to map global vitamin D deficiency prevalence across migraine subtypes and geographic regions, synthesize clinical correlations between vitamin D status and migraine characteristics, and explore heterogeneity in therapeutic evidence across paediatric, chronic, and refractory migraine subgroups.</p><p><strong>Methods: </strong>A systematic search of PubMed, Scopus, and Embase was conducted, identifying 3,447 records initially. After screening and eligibility assessment, 30 studies were included. These encompassed observational studies (n = 14), randomized controlled trials (n = 9), and systematic reviews (n = 7). Data were synthesized narratively due to clinical heterogeneity and the predominance of cross sectional evidence.</p><p><strong>Results: </strong>Vitamin D deficiency (serum 25 hydroxyvitamin D [25(OH) D] <20 ng/mL) was highly prevalent among migraine patients (65%-88%), particularly in chronic migraine (80%-92%) and high latitude populations (>40°N: 75%-90%). Inverse correlations were observed between vitamin D levels and headache frequency and disability scores. High dose vitamin D supplementation (≥50,000 IU/week) reduced migraine attacks by 50%-72% in deficient adults, while minimal benefit was seen in replete individuals. Single trials revealed enhanced efficacy when combined with probiotics or topiramate in refractory and paediatric cases, respectively, but this requires further validation.</p><p><strong>Conclusion: </strong>Vitamin D deficiency is consistently associated with increased migraine burden. Supplementation shows context dependent efficacy, particularly in deficient individuals and specific subgroups. Future research should focus on mechanistic trials, global standardization of assays, and comprehensive outcome assessments. Clinically, baseline 25(OH)D testing is recommended to guide targeted supplementation strategies.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"10-18"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145511514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leptomeningeal Carcinomatosis as the Initial Presentation of Occult Colorectal Cancer: Diagnostic and Management Challenges.","authors":"Vishal Chandra Sharma, Akshata Huddar, Neeharika Doddi, Raghunandan Nadig, G G Sharath Kumar, Chandana Nagaraj","doi":"10.4103/aian.aian_744_25","DOIUrl":"10.4103/aian.aian_744_25","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"119-122"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145931951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Familial Dystonia Due to Homozygous TPI1 c.718G>A (p.Glu240Lys): A Three-Sibling Case Series Including Two Treated with Deep Brain Stimulation of the Globus Pallidus Internus.","authors":"Zehra Yavuz, Halil Önder, Özlem Bizpınar Munis, Selim Selçuk Çomoğlu","doi":"10.4103/aian.aian_882_25","DOIUrl":"10.4103/aian.aian_882_25","url":null,"abstract":"<p><p>Triosephosphate isomerase (TPI) deficiency is a rare autosomal recessive disorder caused by mutations in the TPI1 gene, typically presenting with anemia, infections, and neurological decline. We report three siblings with a homozygous c.718G>A (p.Glu240Lys) variant presenting predominantly with dystonia. Clinical and genetic evaluations were performed in three affected siblings from a consanguineous Turkish family. Neurological examinations, imaging, and surgical outcomes were reviewed. All three siblings exhibited truncal and axial dystonia with orthopedic deformities but without anemia or cardiac involvement. Cognitive functions were preserved. Two underwent bilateral deep brain stimulation of the globus pallidus internus (GPi-DBS), resulting in partial yet clinically meaningful improvement in posture and gait. The third sibling received orthopedic interventions. Notably, one homozygous sibling remained asymptomatic, highlighting incomplete penetrance. This is the first genetically confirmed report of TPI1 -associated dystonia treated with GPi-DBS. Our findings expand the clinical spectrum of TPI deficiency, showing a neurologically predominant phenotype without hematologic manifestations. The observed variability suggests the role of modifier factors, and GPi-DBS may provide symptomatic benefit in severe cases.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"87-90"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146199922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Role of Nuclear Factor Kappa B in the Immunobiology of Inflammatory Neuropathies.","authors":"Madhu Nagappa, Sandipan Mondal, B Pradeepkumar, Thrinath Mullapudi, Srinath Rajeevan, Pokala Akhil, Lakshminarayanapuram Gopal Viswanathan, Monojit Debnath","doi":"10.4103/aian.aian_821_25","DOIUrl":"10.4103/aian.aian_821_25","url":null,"abstract":"<p><strong>Background and objectives: </strong>Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) are inflammatory conditions, representing prototype examples of immune-mediated disorders of the peripheral nervous system. Activation of the nuclear factor-κB (NF-κB) pathway is crucial for generating immune and inflammatory responses and creating an inflammatory milieu; however, this has not been studied in inflammatory neuropathies. We aimed to quantify the expression levels of two critical genes in the NF-κB pathway ( Nfkb1 and Nfkb2 ), together with a prototype inflammatory gene, Tnfα , in inflammatory neuropathies.</p><p><strong>Methods: </strong>Forty-nine patients with inflammatory neuropathies (GBS = 38, CIDP = 11) were recruited prospectively from a single neurology unit. Gene expression levels of Nf κ b1 , Nf κ b2 , and Tnfα were quantified using quantitative real-time polymerase chain reaction.</p><p><strong>Results: </strong>There were significantly increased expression levels of Nf κ b1 in the inflammatory neuropathy group compared to healthy controls ( P = 0.001), GBS versus healthy controls ( P = 0.03), and CIDP versus healthy controls ( P = 0.003). There were no significant differences in the expression levels of Nf κ b2 and Tnfα genes between cases and controls. There was no correlation between the expression levels of these genes and the clinical severity scores.</p><p><strong>Conclusions: </strong>The present study provides evidence for NF-κB pathway activation in inflammatory neuropathies, including both GBS and CIDP, suggesting that this spectrum of disorders may share a common central pathway for immune activation. Thus, the NF-κB pathway plays a critical role in the immunopathogenesis of inflammatory neuropathies; however, the molecular interacting partners within the immune system need to be studied to identify the differential immune trajectories in GBS and CIDP.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"46-51"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146199934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Response in Pediatric Transverse Myelitis: A Case-Control Study from Vietnam.","authors":"Do Thanh Huong, Ha Thi Lieu, Dao Thi Nguyet, Cao Vu Hung, Le Thi Thuy Dung","doi":"10.4103/aian.aian_175_25","DOIUrl":"10.4103/aian.aian_175_25","url":null,"abstract":"<p><strong>Background and objectives: </strong>Acute transverse myelitis (ATM) is a rare inflammatory spinal cord disorder causing significant motor, sensory, and autonomic dysfunction in children. Although advances in diagnosis and therapy have improved outcomes, data on early treatment response and associated factors remain limited, particularly in Southeast Asia. This study aimed to identify clinical, radiological, and immunological factors associated with early in-hospital response in children with ATM in Vietnam.</p><p><strong>Methods: </strong>This retrospective case-control study included 56 children under 18 years of age diagnosed with ATM between 2018 and 2023. Participants were divided into a case group (poor early response, n = 29) and a control group (good early response, n = 27) based on their functional status at discharge, as assessed by the Paine and Byers scale. Clinical, cerebrospinal fluid (CSF), and magnetic resonance imaging (MRI) findings, as well as myelin oligodendrocyte glycoprotein (MOG) and aquaporin-4 (AQP4) antibody results, were analyzed. Logistic regression was performed to identify factors associated with poor early response.</p><p><strong>Results: </strong>Severe lower limb motor weakness (Medical Research Council [MRC] muscle strength scale ≤ 1) at admission was independently associated with poor early response (OR 14.7, 95% CI: 3.0-73.2, p < 0.05). Respiratory muscle weakness, the need for mechanical ventilation, and the absence of MOG antibodies were also linked to poor early outcomes. Radiological features, including longitudinally extensive transverse myelitis (LETM), cervical involvement, and gadolinium enhancement, were not significantly associated with early response.</p><p><strong>Conclusions: </strong>Severe motor and respiratory involvement at presentation were key indicators of poor early treatment response in pediatric ATM. Recognizing these factors promptly may guide risk stratification and early management. Longitudinal studies are needed to evaluate their predictive value for long-term recovery.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"41-45"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146111994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical Cervical Myelopathy with Medullary Involvement from Intracranial Dural Arteriovenous Fistula: The Steroid Trap.","authors":"Ujjwal Agarwal, Vipul Gupta, Radhey S Singla, Rajsrinivas Parthasarathy","doi":"10.4103/aian.aian_685_25","DOIUrl":"10.4103/aian.aian_685_25","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"115-118"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146177570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correspondence: \"Prevalence, Risk Factors, and Psychosocial Impact of Restless Legs Syndrome in End-Stage Renal Disease Patients Undergoing Hemodialysis\".","authors":"Raahin Rahim","doi":"10.4103/aian.aian_833_25","DOIUrl":"10.4103/aian.aian_833_25","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"135-136"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146211651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Assessment of Executive and Visuospatial Function Recovery and Its Relationship with Functional Outcomes in Ischemic Stroke Patients.","authors":"Ashwini Naik, Aparna R Pai, Sankar P Gorthi, Arvind N Prabhu, Jyothi Chakrabarty, Shashikiran Umakanth","doi":"10.4103/aian.aian_935_25","DOIUrl":"10.4103/aian.aian_935_25","url":null,"abstract":"<p><strong>Background and objectives: </strong>Cognitive impairments in the executive and visuospatial domains are common after ischemic stroke and significantly affect a patient's independence. These impairments can affect problem-solving abilities, planning, decision-making, and spatial awareness, which are critical for functional recovery. Understanding the trajectory of recovery and its association with functional outcomes is essential for improving the quality of life of stroke survivors. The Objectives of the study are to evaluate the recovery patterns of executive and visuospatial functions 90 days after ischemic stroke and to examine their relationship with functional outcomes.</p><p><strong>Methods: </strong>In this longitudinal study, 401 patients with neuroimaging-confirmed ischemic stroke were assessed at admission and on Days 7, 30, and 90 post-stroke. Executive function was measured using the alternate Trail Making Test, and visuospatial function was assessed using the cube-copying and clock-drawing tests. Functional outcomes were evaluated using the modified Rankin Scale (mRS) and Barthel Index. Repeated measures ANOVA (analysis of variance) was employed to assess cognitive recovery over time, and Spearman's correlation was used to examine the relationship between cognitive and functional outcomes.</p><p><strong>Results: </strong>Significant improvements in executive and visuospatial functions were observed over the 90-day period, with the greatest gains noted within the first 30 days. A moderate-to-strong negative correlation between mRS and cognitive function was identified at all time points, peaking on Day 7.</p><p><strong>Conclusions: </strong>Executive and visuospatial functions show dynamic recovery in the first 90 days post-stroke, particularly during the acute and subacute phases. Functional disability is closely associated with cognitive performance, underscoring the importance of early cognitive assessment.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"35-40"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146211819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lip-Pursing Stereotypies as a Manifestation of Dravet Syndrome in Adulthood.","authors":"Shivam Mirg, Ranjot Kaur, Divyani Garg, Ayush Agarwal, Roopa Rajan, Achal K Srivastava","doi":"10.4103/aian.aian_653_25","DOIUrl":"10.4103/aian.aian_653_25","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"110-111"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145817452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuro-Behçet's Disease Presenting as Recurrent Demyelinating Illness.","authors":"S Abirami, S Sivakumar, S Vignesh Kumar","doi":"10.4103/aian.aian_1085_25","DOIUrl":"10.4103/aian.aian_1085_25","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"137-139"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146103638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}