Arquivos de neuro-psiquiatria最新文献

{"title":"EMG versus US: a randomized clinical trial comparing the efficacy in guiding botulinum toxin treatment in cervical dystonia.","authors":"Mayara Thouin Graciani, Flávio Henrique de Rezende Costa, Ana Lucia Zuma de Rosso, Gil Fernando Salles","doi":"10.1055/s-0045-1809542","DOIUrl":"10.1055/s-0045-1809542","url":null,"abstract":"<p><p>Botulinum toxin type A (BoNT-A) is considered the first-line therapy for cervical dystonia.To compare, in a randomized trial, the efficacy of treatment with BoNT-A guided by ultrasound (US) and electromyography (EMG) in patients with idiopathic cervical dystonia.A total of 40 patients (20 in each group; mean age: 54 years; 45% of female subjects; mean disease duration: 10.7 years) were randomized to either US- or EMG-guided BoNT-A treatment. The efficacy of BoNT-A was assessed through changes in the scores on the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) before and 4 to 6 weeks after the treatment. The differences in the absolute and relative changes in the total TWSTRS scores and in its components (severity, incapacity, and pain) between the groups were evaluated.The US and EMG groups were well balanced in relation to baseline and demographic characteristics. After the BoNT-A treatment, there was a mean reduction in the TWSTRS score of 8 points (relative reduction of 23%) equally between the US and EMG groups (mean difference in absolute decrease of 0.1 point; <i>p</i> = 0.97; and mean difference in relative decrease of 2%; <i>p</i> = 0.89). There were no differences in the declines in the scores on the TWSTRS components, nor when the improvements in the TWSTRS scores were dichotomized as more significant or lower reductions (all <i>p</i>-values > 0.3).The present randomized trial did not demonstrate any difference in improvements between BoNT-A treatment guided by US or EMG in patients with idiopathic cervical dystonia.ReBEC Identifier: RBR-33dd4p4.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"83 6","pages":"1-8"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336288","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":"Amyloid immunotherapy for Alzheimer's disease: the case for cautious adoption.","authors":"Jonathan M Schott, Charles R Marshall","doi":"10.1055/s-0045-1807718","DOIUrl":"10.1055/s-0045-1807718","url":null,"abstract":"<p><p>The licensing of lecanemab and donanemab, disease-modifying immunotherapies for Alzheimer's disease (AD) targeting β-amyloid pathology, has been met with difference in opinion about efficacy, adverse effects, and cost-effectiveness. Here we summarize the current situation and make the case for cautious adoption of these treatments into clinical practice. This opinion is predicated on four main observations: 1) these treatments impact the core pathologies of AD and result in meaningful benefits; 2) while adverse effects can be serious, these are proving manageable in clinical practice; 3) upscaling services to deliver these agents is likely to provide wider benefits for diagnosing and treating dementia and facilitating the adoption of future treatments from the dementia drug pipeline; and 4) factoring in both the wider societal cost of care and potential for continued accrual of long term benefits will be likely to bring these treatments within acceptable cost-effectiveness thresholds.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"83 5","pages":"1-4"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960790","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":"The impact of multiple sclerosis on wellbeing, productivity, and societal relations.","authors":"Vinicius Eduardo Vergani, Bruna Rocha Silveira, Gustavo San Martin Elexpe Cardoso, Jean Faber, Denis Bernardi Bichuetti","doi":"10.1055/s-0045-1809400","DOIUrl":"10.1055/s-0045-1809400","url":null,"abstract":"<p><p>Multiple sclerosis (MS) is the main cause of nontraumatic neurological disabilities in the population under 50 years of age.To evaluate the most prevalent symptoms in a national sample of people with MS and to analyze their correlation with disease characteristics, demographics, quality of life, employment status, and use of social benefits.Cross-sectional, online, self-reported survey, concerning demographic and clinical data, employment status, and use of social benefits.A total of 466 patients answered the survey. The median age at onset was 30 years, the current age, of 39, and disease duration was 8 years. Furthermore, the median patient determined disease steps (PDDS) was 2, which indicates minor to moderate disability. The median MS impact and walking scale scores were 31 and 20%, which denotes minor to moderate quality of life and mobility compromise. Among the participants, 43% suffered fatigue and 51% reported not sleeping well. Unemployed patients had delayed diagnosis and higher disability rates. Furthermore, half of the unemployed patients are receiving some social benefit, compared with only 6.5% of the employed patients.The current study presents symptom prevalence in a national sample of patients with MS and discloses that those with a diagnosis delay and more disability have higher rates of unemployment and use of social benefits. Strategies for earlier diagnosis and better treatment plans can not only reduce patient disability but, possibly, increase employment retention and reduce the use of social benefits.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"83 5","pages":"1-8"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336287","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":"Monoclonal antibodies against beta-amyloid protein (lecanemab and donanemab) should not be used in the treatment of Alzheimer's disease.","authors":"Ricardo Nitrini, Adalberto Studart-Neto","doi":"10.1055/s-0045-1808082","DOIUrl":"10.1055/s-0045-1808082","url":null,"abstract":"<p><p>Two antiamyloid monoclonal antibodies (mAbs), lecanemab and donanemab, were recently launched for treatment of Alzheimer's disease (AD). These mAbs remove amyloid protein from the brain and cause statistically significant improvement in cognitive/functional tests, meaning a change in evolution of AD. This is important to reinforce the amyloid cascade hypothesis and to further concentrate studies on the pathways from the deposition of the beta-amyloid protein to synaptic loss and neuronal death. However, it is necessary to evaluate whether the results are clinically important. Analysis of the clinical trials showed that the statistically significant differences over placebo did not reach the minimum clinically important difference that would be meaningful for patients, caregivers and clinicians. Besides, the incidence of adverse events is high and potentially severe. Although there are reasons to celebrate this first step towards disease-modifying therapies for AD, lecanemab and donanemab should not be used to treat AD in clinical pratice.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"83 5","pages":"1-5"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961701","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":"Could minor neurological dysfunction be a type of non-cerebral palsy motor impairment?","authors":"Ana Paula Hamad, Carla Andrea Tanuri Cardoso Caldas, Isabella Cristina Mendes de Sá E Silva, Marina Estima Neiva Nunes","doi":"10.1055/s-0045-1809359","DOIUrl":"10.1055/s-0045-1809359","url":null,"abstract":"<p><p>Non-cerebral palsy motor impairments have been increasing over time, especially in preterm-born children, with a variety of labels, including, but not limited to, developmental coordination disorder and minor neurological dysfunction. They may not only negatively affect the child in their daily life activities, but are also associated with cognitive, emotional, and behavioral disorders, as well as decreased academic performance. Since there is a paucity of literature on non-cerebral palsy motor impairment, the main objective of the present study is to assess minor neurological dysfunction in the context of neurodevelopment. We reviewed the medical literature using the following search terms: <i>preterm infants</i>; <i>follow-up</i>; <i>non-cerebral palsy motor impairment or disability</i>; <i>minor neurological dysfunction</i>; <i>developmental coordination disorder</i>; <i>neurological soft signs</i>; and <i>Touwen Neurological Examination</i>. We compiled evidence-based data on minor neurological dysfunction critical domains, diagnosis, etiological factors and the influence of age and puberty in minor neurological signs. We also listed the cohort studies that used the Touwen Neurological Examination for premature or term-born follow-up, including those that suggest an association between minor neurological dysfunction and developmental coordination disorder as a motor impairment beyond cerebral palsy. Moreover, we found significant evidence of a correlation involving minor neurological dysfunction and cognitive, behavioral, and learning abilities, which, all in all, means that these children particularly deserve special attention regarding social, educational and healthcare resources. Furthermore, since motor activity seems to play an important role in the physical, mental, and neurological health of typical children, different approaches to education could have a positive impact on neurological development.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"83 5","pages":"1-11"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198206","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":"Cognitive and autonomic dysfunction in individuals with migraine: are they modifiable?","authors":"Raffaele Ornello","doi":"10.1055/s-0045-1809419","DOIUrl":"10.1055/s-0045-1809419","url":null,"abstract":"","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"83 5","pages":"1-2"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315791","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":"Phyllanthin from Phyllanthus amarus exerts neuroprotective effects against spinal cord injury in experimental rats.","authors":"Juan He, Yang Cheng, Yuekun Yang, Zhaofeng Fan","doi":"10.1055/s-0045-1809408","DOIUrl":"10.1055/s-0045-1809408","url":null,"abstract":"<p><p>Spinal cord injury (SCI) results in changes in autonomic function, impacting an individual's movement, sensory perception, and overall quality of life. Phyllanthin, a lignan from <i>Phyllanthus amarus</i>, is known for its neuronal protective effects.To evaluate the potential of phyllanthin identified in <i>P. amarus</i> methanolic extract (PAME) against SCI in experimental rats.The lignan was identified in PAME using high-performance liquid chromatography (HPLC). Spinal cord injury was induced in Sprague-Dawley rats using the laminectomy clip compression method. Rats received either a vehicle (distilled water) or methylprednisolone (30 mg/kg) or PAME (50, 100, and 200 mg/kg) orally for 4 weeks after SCI. Behavioral, histological, and molecular parameters were assessed to evaluate the neuroprotective effects of phyllanthin.During the HPLC analysis of PAME, phyllanthin was present at a retention time of 25.30 minutes with 75.22% weight per weight (w/w). The administration of standardized PAME (100 and 200 mg/kg) effectively ameliorated the alterations induced by SCI in thermal and mechano-tactile hyperalgesia, locomotor activity, and nerve conduction velocity (<i>p</i> < 0.05 each). The SCI-induced elevation in spinal interleukins (ILs: IL-1β and IL-6) and tumor necrosis factor alpha (TNF-α) protein levels was also effectively (<i>p</i> < 0.05) reduced by PAME. The PAME treatment markedly (<i>p</i> < 0.05) ameliorated SCI-induced alterations in protein expressions of B-cell leukemia/lymphoma 2 (Bcl-2), Bcl2-associated X protein (Bax), and caspase-3 in the spinal cord. Aberrations, such as inflammatory infiltration, edema, congestion, and necrosis induced in the spinal cord, were also effectively reduced by the PAME treatment (<i>p</i> < 0.05).Phyllanthin identified in <i>P. amarus</i> showed neuroprotective potential against SCI by moderating impairments in behavioral (allodynia, hyperalgesia, and nerve conduction velocity) parameters, elevated inflammatory mediators (IL-1β, IL-6, and TNF-α), and deactivating the apoptotic signaling (Bax/caspase-3) pathway.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"83 5","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315792","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":"Paul Hoffmann and the cutaneous silent period test.","authors":"Otto Jesus Hernández Fustes, Cláudia Suemi Kamoi Kay, Paulo José Lorenzoni, Renata Dal-Prá Ducci, Paula Raquel do Vale Pascoal Rodrigues, Rosana Herminia Scola","doi":"10.1055/s-0045-1806826","DOIUrl":"10.1055/s-0045-1806826","url":null,"abstract":"<p><p>We herein present aspects of the biography of Professor Paul Hoffmann, covering his main works, mainly the article describing the cutaneous silent period, a new technique when it was published in 1922, with a review of its importance, its role in clinical neurophysiology, and its clinical application.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"83 5","pages":"1-3"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198207","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":"Telemedicine transforming stroke care in Piauí: an analysis of a state-wide initiative's first year.","authors":"Irapuá Ferreira Ricarte, Ícaro Araújo de Sousa, Romilto Costa Pacheco Neto, Arthur de Oliveira Veras, Camila Victória da Silva, Cristina Calmon de Araújo Mascarenhas, Matheus Felipe da Silva, Gisele Sampaio Silva, Octávio Marques Pontes-Neto","doi":"10.1055/s-0045-1807719","DOIUrl":"https://doi.org/10.1055/s-0045-1807719","url":null,"abstract":"<p><p>Prior to October 2022, stroke patients in Piaui lacked access to both stroke unit care and thrombolytic treatment, until the implementation of a telemedicine-based stroke care program.To conduct a descriptive analysis of patients suspected of stroke who received telemedicine-based care in Piauí during the first year of the program's implementation.We conducted a retrospective analysis of 868 patients treated from October 2022 to September 2023 under the state-wide stroke care program, which includes 6 Stroke Treatment Centers distributed around the state. Utilizing data from the JOIN telemedicine platform, the analysis focused on patient demographics, stroke types, treatment timelines, and outcomes of thrombolytic treatment.The cohort included 868 patients, with a mean age of 67.2 years, out of whom 55.5% were male. Chronic hypertension was reported in 57.8% and diabetes in 22.5% of the patients. The average onset-to-door time was 3.3 hours, door-to-computed tomography time was 23 minutes, and door-to-needle time averaged 67 minutes. Thrombolysis was administered to 15.6% of all stroke cases, with 31.8% among those being ischemic strokes. Among patients who arrived within the thrombolytic time window, the rate was 27.3%.The introduction of a telemedicine-based stroke care program in Piauí has significantly enhanced access to essential stroke treatments, demonstrating its effectiveness in overcoming healthcare disparities. The initiative's success underscores the potential of telemedicine as a scalable model for improving stroke care in regions with limited healthcare resources. Future efforts will focus on reducing treatment times and expanding stroke care infrastructure to ensure comprehensive patient care.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"83 5","pages":"1-7"},"PeriodicalIF":1.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198208","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":"Erratum.","authors":"","doi":"10.1055/s-0045-1810451","DOIUrl":"10.1055/s-0045-1810451","url":null,"abstract":"","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"83 5","pages":"1"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726969","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}