BMC Neurology最新文献

{"title":"Re-irradiation for recurrent glioblastoma: a pattern of care analysis.","authors":"Susanne Rogers, Markus Gross, Ekin Ermis, Gizem Cosgun, Brigitta G Baumert, Thomas Mader, Christina Schroeder, Nicoletta Lomax, Sara Alonso, Adela Ademaj, Tessa Lazeroms, Seok-Yun Lee, Michael Mayinger, Christoph Mamot, Lucia Schwyzer, Gerrit A Schubert, Oliver Riesterer","doi":"10.1186/s12883-024-03954-z","DOIUrl":"10.1186/s12883-024-03954-z","url":null,"abstract":"<p><strong>Background: </strong>90% of glioblastomas (GBM) relapse within two years of diagnosis. In contrast to the initial setting, there is no standard management for recurrent disease and options include hypofractionated stereotactic re-irradiation (re-mHSRT). The aims of this study were to investigate re-mHSRT practice in Swiss neuro-oncology centres.</p><p><strong>Methods: </strong>A survey of 18 questions regarding re-irradiation for GBM was created and distributed electronically (SurveyMonkey, USA) to 11 radiation oncologists in Switzerland specialising in brain tumours. We evaluated the clinical outcomes of a multicentre series of patients treated with an established re-mHSRT schedule to benchmark these against the literature and investigated the radiological patterns of relapse after re-mHSRT.</p><p><strong>Results: </strong>8 of 11 (73%) radiation oncologists responded to the survey and re-irradiation practice was heterogeneous. The 10 × 3.5 Gy schedule (RTOG 1205, BRIOChe trials) was used by 5/8 respondents and 47/50 patients with recurrent GBM treated with re-mHSRT with this schedule in daily practice were included in the analysis. The median time to re-mHSRT following completion of adjuvant RT was 23.3 (7-224) months. The median PTV at re-mHSRT was 22.0 cm³ (0.9-190). Combined CTV + PTV margins ranged from 0 to 10 mm and median prescription isodose was 80% (67-100). 14/47 (30%) patients received temozolomide and four (8.5%) continued bevacizumab concomitantly. On multivariable analysis, concomitant systemic therapy predicted for progression-free survival (PFS), HR 2.87 (95% CI 1-03-7.96), p = 0.042. Median PFS following re-mHSRT was 6.6 (0.2-92.5) months and 26/47 patients (55%) received subsequent systemic therapy. The median overall survival (OS) following recurrence was 11.8 months (1.5-92.5), similar to the 10.8 months in the literature with the same schedule. The six-month OS rate was 37/47 (79%), which compares well with the 73% reported in a meta-analysis of 50 publications employing various schedules. In a subgroup analysis of 36/47 (79%) patients with MR follow-up after re-mHSRT, 8/36 (22%) had no radiological evidence of tumour progression at a median follow-up of 9.4 months. 21/28 (75%) radiological relapses were in-field, two were marginal and five were out of field.</p><p><strong>Conclusions: </strong>Re-mHSRT with 10 × 3.5 Gy can achieve local control in selected patients with recurrent GBM.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"24 1","pages":"462"},"PeriodicalIF":2.2,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic association of type 2 diabetes mellitus and glycaemic factors with primary tumours of the central nervous system.","authors":"Yongxue Li, Lihao Lin, Wenhui Zhang, Yan Wang, Yi Guan","doi":"10.1186/s12883-024-03969-6","DOIUrl":"10.1186/s12883-024-03969-6","url":null,"abstract":"<p><p>Type 2 diabetes mellitus (T2DM) is a pivotal chronic disease with an increasing prevalence. Recent studies have found associations between T2DM and the development of central nervous system (CNS) tumours, a special class of solid tumours with an unclear pathogenesis. In this study, we aimed to explore the relationship between T2DM and certain glycaemic factors with common CNS tumours by using genetic data to conduct Mendelian randomization (MR) and co-localisation analysis. We found a causal relationship between T2DM and glioblastoma, fasting glucose and spinal cord tumours, glycated haemoglobin and spinal cord tumours, and insulin-like growth factor-1 and spinal cord tumours, pituitary tumours, and craniopharyngiomas. These results clarify the relationship between T2DM, glucose-related factors, and common CNS tumours, and they provide valuable insight into further clinical and basic research on CNS tumours, as well as new ideas for their diagnosis and treatment.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"24 1","pages":"458"},"PeriodicalIF":2.2,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decoding neuronal genes in stroke-induced pain: insights from single-nucleus sequencing in mice.","authors":"Yan Niu, Xiaoping Chen, Yang Zhang, Yali Ge, Ju Gao, Tianfeng Huang","doi":"10.1186/s12883-024-03965-w","DOIUrl":"10.1186/s12883-024-03965-w","url":null,"abstract":"<p><strong>Background: </strong>The role of neurons in central post-stroke pain (CPSP) following thalamic hemorrhage remains unclear. This study aimed to identify key genes associated with post-thalamic hemorrhage pain and to explore their functions in neurons. Single-nucleus RNA sequencing (snRNA-seq) data from a mouse model was used for this analysis.</p><p><strong>Methods: </strong>First, snRNA-seq data were analyzed to identify cell types associated with CPSP induced by thalamic hemorrhage. Differentially expressed genes (DEGs) in neurons were then screened between control and model groups, followed by the construction of a protein-protein interaction (PPI) network for the DEGs. CytoNCA was used to assess node connectivity in the PPI network, and the top 5 key genes were identified. Subsequently, transcription factor (TF)-mRNA and miRNA-mRNA networks were constructed, and small-molecule drugs potentially targeting these key genes were predicted. Finally, the expression differences of key genes in neurons were compared between the model and control groups.</p><p><strong>Results: </strong>A total of 13 cell clusters were identified, categorized into 8 cell types: T cells, endothelial cells, monocytes, neural progenitor cells (NPCs), microglia, astrocytes, neurons, and oligodendrocytes. A total of 228 DEGs were detected in neurons when comparing the model group with the control group. The PPI network of the DEGs consisted of 126 nodes and 209 edges, identifying the top 5 key genes: Dlgap1, Cacna1c, Gria2, Hsp90ab1, and Gapdh. The miRNA-mRNA network included 68 miRNA-mRNA pairs, 62 miRNAs, and 5 mRNAs, while the TF-mRNA network consisted of 66 TF-mRNA pairs, 56 TFs, and 5 mRNAs. Drug prediction identified 110 small-molecule drugs (e.g., purpurogallin, nifedipine, and novobiocin) potentially targeting these key genes. Additionally, Cacna1c were significantly upregulated in model mice.</p><p><strong>Conclusion: </strong>This study identified the role of key genes in thalamic hemorrhage-induced CPSP through snRNA-seq, providing a scientific basis for further exploration of the molecular mechanisms underlying CPSP.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"24 1","pages":"459"},"PeriodicalIF":2.2,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resistance training improves functional capacities in women with multiple sclerosis: a randomized control trial.","authors":"Nasrin Niazi Nezhad, Abdolhossein Parnow, Kianoosh Khamoushian, Rasoul Eslami, Julien S Baker","doi":"10.1186/s12883-024-03964-x","DOIUrl":"10.1186/s12883-024-03964-x","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the effects of 12 weeks of resistance exercise training (RT) on oxidative status, muscle strength, functional capacity, quality of life (QoL), and fatigue in women with Multiple Sclerosis (MS).</p><p><strong>Methods: </strong>In this randomized control trial (ethical code: SSRI.REC-1402-101; IRCT registration code: IRCT20120912010824N3, 07.09.2023), Iran) twenty-five women with relapsing- remitting MS (aged 18-45 years and expanded disability status scale (EDSS) ≤ 4) were randomly divided in two groups MS without resistance exercise (MS + non-RT; n = 13) and with RT (12 weeks/3 times per week/ 60-80% of 1RM) (MS + RT; n = 12). \"Informed\" consent was obtained from all participants. Then, fifteen healthy aged-matched women participated as a control group (HCON; n = 15). Blood serum levels of oxidative stress [malondialdehyde (MDA)] and antioxidant capacity [superoxide dismutase (SOD) and glutathione peroxidase (GPx) activity] were obtained pre and post intervention. In addition, muscle strength by 5-RM test, functional capacity (for lower limb T25FWT, 2MWT, and 5STS tests and for Upper limb Manual dexterity of both hands with the (9-HPT) test and MSWS-12 questionnaire were also assessed over the same period. Also, Quality of life and fatigue were assessed pre- and post- intervention with by 31-MusiQoL questionnaire and FSMC questionnaire.</p><p><strong>Results: </strong>RT led to improvements in muscle strength for leg extension, lying leg curl, bench press movements (P < 0.001, P < 0.001, P < 0.001, respectively). Moreover, compared with the MS + non-RT group, RT demonstrated increased functional capacity (Timed 25 ft Walk Test, Two-Minute Walk Test, 5-Time Sit-To-Stand Test, Twelve Item MS Walking Scale (P < 0.001, P < 0.001, P < 0.001, P < 0.001, respectively). Dexterity of the left hand but not the right hand also improved (P < 0.01, P = 0.057, respectively). Improvements were also found for fatigue and QoL (P < 0.01, P < 0.05). However, the mean changes of MDA, SOD and GPx noted in RT group were not statistically significant (P˃0.05, P˃0.05, P˃0.05, respectively).</p><p><strong>Conclusions: </strong>RT has positive effects on muscle strength, functional capacity, and quality of life while reducing fatigue in this population. However, markers of oxidative stress were not affected. When we consider the clear role in MS pathogenesis and progression, antioxidant increases in relation to a reduction in pro-oxidant capacity would have provided a positive and important clinical development for people with MS.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"24 1","pages":"457"},"PeriodicalIF":2.2,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case report of an individual with Creutzfeldt-Jakob disease characterized by prolonged isolated thalamic lesions and rare MM2-cortical-type pathology.","authors":"Misako Kunii, Hitaru Kishida, Mikiko Tada, Mitsuo Okamoto, Keiichiro Asano, Haruko Nakamura, Keita Takahashi, Shunta Hashiguchi, Shun Kubota, Masaki Okubo, Hideyuki Takeuchi, Naohisa Ueda, Katsuya Satoh, Tetsuyuki Kitamoto, Hiroshi Doi, Fumiaki Tanaka","doi":"10.1186/s12883-024-03958-9","DOIUrl":"10.1186/s12883-024-03958-9","url":null,"abstract":"<p><strong>Background: </strong>Diffusion-weighted magnetic resonance imaging (DWI) is essential for diagnosing Creutzfeldt-Jakob disease (CJD). Thalamic lesions are rarely detected by DWI in sporadic CJD (sCJD) cases with methionine homozygosity at polymorphic codon 129 (129MM) of the prion protein (PrP) gene. Here, we describe an unusual sCJD case, characterized by prolonged isolated thalamic diffusion hyperintensities and atypical brain pathology, in combination with the 129MM genotype.</p><p><strong>Case presentation: </strong>A 72-year-old Japanese man developed a mild unsteady gait that had persisted for 1 year. DWI revealed isolated thalamic diffusion hyperintensities. Over the following 4 years, his condition progressed to include ataxia and cognitive decline. Repeated cerebrospinal fluid tests were negative for 14-3-3 protein, total tau protein, and real-time quaking-induced conversion assay. Electroencephalography did not show periodic sharp wave complexes or generalized periodic discharges. Despite these findings, thalamic DWI abnormalities persisted and evolved to include cortical lesions in the later stage of the disease. Genetic testing confirmed a 129MM genotype with no pathogenic PrP gene variants. Brain autopsy identified type 2 pathogenic PrP and the absence of the M2-thalamic prion strain, suggesting an MM2-cortical (MM2C)-subtype of sCJD. Histopathology revealed small vacuoles (sv) and patchy-perivacuolar PrP deposits without large vacuoles (lv). Patchy-perivacuolar deposits are a characteristic feature of the MM2C (lv) subtype and indicate MM2C (lv) pathology. Thus, this case was classified as a rare MM2C (sv + lv) subtype. No PrP protein staining was observed in the thalamus, despite spongiform changes with small vacuoles.</p><p><strong>Conclusions: </strong>This case underscores the diagnostic challenges of atypical CJD with isolated thalamic abnormalities on DWI. Despite negative cerebrospinal fluid findings and clinical diagnostic criteria, persistent DWI abnormalities and evolving clinical symptoms continued to raise suspicion of CJD. A definitive diagnosis, being the MM2C (sv + lv) subtype of sCJD, was confirmed upon pathological examination. Even when atypical findings, such as isolated thalamic abnormalities, are observed and various tests are negative, if suspicion of CJD cannot be ruled out, it is important to confirm the diagnosis and pathological subtypes via postmortem analysis.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"24 1","pages":"456"},"PeriodicalIF":2.2,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel TECPR2 variant in two cases of hereditary sensory and autonomic neuropathy type 9: insights from genetic characterization and comprehensive literature review.","authors":"Aysan Moeinafshar, Sahand Tehrani Fateh, Farzad Hashemi-Gorji, Parvaneh Karimzadeh, Elham Gholibeglou, Masoumeh Rostami, Hossein Sadeghi, Mohammad Miryounesi, Mohammad-Reza Ghasemi","doi":"10.1186/s12883-024-03963-y","DOIUrl":"10.1186/s12883-024-03963-y","url":null,"abstract":"<p><strong>Background: </strong>Hereditary sensory and autonomic neuropathy type 9 (HSAN9) is a rare genetic disorder caused by genetic alterations in the TECPR2 locus and is characterized by developmental and intellectual disability, respiratory dysfunction, gastroesophageal reflux disease (GERD), and sensory and autonomic dysfunction, which are shared among the HSAN family.</p><p><strong>Methods: </strong>Whole-exome sequencing (WES) was performed on samples from both probands, and the relevant genetic variants were confirmed in their families using Sanger sequencing. Additionally, a comprehensive literature review was conducted on previously reported cases of HSAN9, and the clinical and genetic data were assessed to provide insight into the genetic and clinical characteristics of the disease.</p><p><strong>Results: </strong>We identified two new cases of HSAN9 with a shared novel variant of TECPR2 (NM_014844.5), c.1568del: p.Ser523PhefsTer12, classified as pathogenic according to ACMG guidelines. The probands showed characteristics of GERD, respiratory dysfunction, gait abnormalities, and developmental and speech delay, and both cases were deceased as a result of severe respiratory infection. The results of the literature review included 34 cases from 9 studies, revealing a wide range of genetic and clinical characteristics.</p><p><strong>Conclusions: </strong>Our study identified two new cases of HSAN9 with a novel variant in TECPR2, confirmed by WES. The clinical characteristics of the patients as well as the conduction of a comprehensive literature review are crucial in the early diagnosis and management of the disease and establishment of genotype-phenotype correlations.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"24 1","pages":"455"},"PeriodicalIF":2.2,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11577655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 social and environmental factors on triggering multiple sclerosis onset, before and during the COVID-19 pandemic: a retrospective study from Iran.","authors":"Naghmeh Abbasi Kasbi, Fereshteh Ghadiri, Abdorreza Naser Moghadasi, Faezeh Khodaie, Kosar Kohandel, Nasim Rezaeimanesh, Maryam Karaminia, Mohammad Ali Sahraian","doi":"10.1186/s12883-024-03956-x","DOIUrl":"10.1186/s12883-024-03956-x","url":null,"abstract":"<p><strong>Background: </strong>Multiple sclerosis (MS) is a chronic, inflammatory, and demyelinating disease of the central nervous system. The first presentation's possible triggers are still controversial among scientists. The objective of this study is to investigate and compare the potential social, environmental, and physical factors that may have contributed to the onset of MS before and during the Coronavirus Disease 2019 (COVID-19) pandemic.</p><p><strong>Methods: </strong>A questionnaire was designed in the MS research center of Sina Hospital and also distributed as an online Google Form on social media among Iranian MS patients. Demographic information, MS disease-related data, and possible patients reported MS triggers were recorded. They were containing stressful life events, COVID-19 and other infections, COVID-19 and other vaccines, pregnancy or labor, head trauma, surgery, and weight loss. Patients were divided into two groups regarding the time of MS diagnosis (before and during the COVID-19 pandemic).</p><p><strong>Results: </strong>Of 920 participants, 670 (72.8%) were female, and the mean age ± SD was 35.63 ± 8.1. The majority of patients (69.2%) had non-progressive forms of MS, and only 7.6% needed assistance for ambulation. 69% of participants were diagnosed with MS before the onset of the COVID-19 pandemic. There was a statistically significant difference between the most common first MS symptom before and after the beginning of the pandemic (visual type (n: 317 (49.9%)) before and sensory type (n: 170 (59.6%)) after the COVID-19 pandemic). A stressful life event was the most common patient-reported trigger of MS first presentation in both groups. (56.1% before and 54% after the COVID-19 pandemic). Comparing two groups, economic problems (AOR: 1.81; 95% ACI: 1.23-2.65) and job losses (AOR: 2.89; 95% ACI: 1.37-6.08) were significantly more common triggers for the initial presentation of MS after the pandemic, while the stress of occupational or educational exams (AOR: 0.52; 95% ACI: 0.34-0.79) was more prevalent before the pandemic.</p><p><strong>Conclusion: </strong>Patients believe that stressful life events are closely linked to triggering their first MS symptoms. Since the beginning of the COVID-19 pandemic, economic problems and job losses have increased; however, occupational or educational exams stress decreased. Caring for social stress by societies may affect MS development or delay MS onset.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"24 1","pages":"453"},"PeriodicalIF":2.2,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11575067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between optic nerve sheath diameter measured by bedside ultrasound and intracranial pressure in neurologically ill patients in a Chinese population.","authors":"Xiuli Zhang, Dandan Ma, Wenqiang Li, Jinluan Ma, Kexia Bi, Yuling Qiao, Zhen Li","doi":"10.1186/s12883-024-03961-0","DOIUrl":"10.1186/s12883-024-03961-0","url":null,"abstract":"<p><strong>Background: </strong>We assessed the correlation between optic nerve sheath diameter (ONSD) values measured by bedside ultrasound and intracranial pressure (ICP) changes among patients under neurocritical care and evaluated the diagnostic performance of ONSD for increased ICP.</p><p><strong>Methods: </strong>Sixty-seven neurologically critical patients who were hospitalised in the intensive care unit (ICU) of Jining No.1 People's Hospital between September 2023 and March 2024 and underwent lumbar puncture were included. The ONSD was measured and recorded using bedside ultrasound before the lumbar puncture. Patients were divided into normal and increased ICP groups on the basis of the initial lumbar puncture pressure on admission, and both groups were compared. Spearman's correlation analysis was used for evaluating the correlation between ONSD values and ICP. Receiver operating characteristic (ROC) curves were employed for evaluating the diagnostic performance of ONSD for increased ICP.</p><p><strong>Result: </strong>At admission, the Glasgow Coma Scale scores of patients in the increased ICP group were significantly lower than those of patients in the normal ICP group (P < 0.05). The ONSD level of patients in the increased ICP group was significantly higher than that of patients in the normal ICP group (P < 0.05). Spearman's correlation analysis revealed that ONSD positively correlated with ICP among patients with severe neurological diseases (r = 0.777, P < 0.001). The area under the ROC curve when using ONSD for diagnosing lumbar puncture opening pressure ≥ 200 mmH₂O was 0.896 (95% confidence interval, 0.817-0.974). When using ONSD ≥ 4.74 mm as the threshold for diagnosing lumbar puncture opening pressure ≥ 200 mmH₂O, the sensitivity and specificity were 0.909 and 0.765, respectively.</p><p><strong>Conclusion: </strong>In patients with critical neurological illness, ONSD measured using bedside ultrasound positively correlated with ICP. Increased ICP can be diagnosed for ONSD ≥ 4.74 mm. The ONSD value measured by bedside ultrasound can be used for evaluating ICP among patients with critical neurological illness.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"24 1","pages":"452"},"PeriodicalIF":2.2,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11575027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing cognitive impairment using MACFIMS in patients with multiple sclerosis and healthy controls: a systematic review and meta-analysis.","authors":"Amirreza Nasirzadeh, Mohammad Mohammadi, Melika Arab Bafrani, Aynaz Mohammadi, Hossein Bakhtiari-Dovvombaygi","doi":"10.1186/s12883-024-03943-2","DOIUrl":"10.1186/s12883-024-03943-2","url":null,"abstract":"<p><strong>Background: </strong>Multiple sclerosis (MS) is a chronic autoimmune disorder affecting the central nervous system, leading to a range of symptoms that impact physical, psychiatric, and cognitive functions. Cognitive dysfunction is prevalent among patients with MS (pwMS), affecting at least 65% of patients, and includes deficits in processing speed, attention, learning, memory, and executive function. Despite the significant impact on daily life, cognitive impairment in MS patients is often underrecognized in clinical settings.</p><p><strong>Methods: </strong>This systematic review and meta-analysis aimed to evaluate cognitive function using the Minimal Assessment of Cognitive Function in Multiple Sclerosis (MACFIMS) battery among pwMS patients and healthy controls (HCs). A comprehensive search of the Web of Science, PubMed, Scopus, and Cochrane Library databases was conducted on January 2024 following the PRISMA guidelines. Eligible studies included peer-reviewed research assessing the validity of the MACFIMS in adult MS patients. Data extraction and quality assessment were performed using standardized tools, and statistical analyses were conducted using R4.2.3.</p><p><strong>Results: </strong>Eight studies met the inclusion criteria, including a total of 1,481 pwMS and 1,072 HCs. The meta-analysis revealed significant cognitive deficits in pwMS patients compared to HCs across all the MACFIMS subtests, including language, spatial processing, new learning and memory, processing speed, and executive function. Processing speed and working memory were the most affected domains, with 36% of pwMS showing impairment on the Symbol Digit Modalities Test (SDMT). Subgroup analyses indicated that the Expanded Disability Status Scale (EDSS) score significantly influenced cognitive impairment, while disease duration had a limited impact.</p><p><strong>Conclusions: </strong>The MACFIMS effectively discriminates between pwMS patients and HCs, demonstrating its validity as a comprehensive cognitive assessment tool for MS. Routine cognitive screening, particularly for processing speed and working memory, is crucial for early detection and intervention. Future research should focus on the sensitivity and specificity of the MACFIMS across diverse MS subtypes and cultural contexts to enhance its global applicability in clinical practice.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"24 1","pages":"454"},"PeriodicalIF":2.2,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11575216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of diabetes mellitus on the risk of Alzheimer's disease: a mendelian randomization study.","authors":"Weichao Wang, Jie Zhang, Man Zhang, Chengyuan Zhang, Huanli Liu, Wanlin Li, Yimeng Fan","doi":"10.1186/s12883-024-03955-y","DOIUrl":"10.1186/s12883-024-03955-y","url":null,"abstract":"<p><strong>Background: </strong>The impact of diabetes on the risk of Alzheimer's disease remains uncertain. This study aimed to explore this issue from multiple perspectives by using the Mendelian randomization (MR) approach.</p><p><strong>Methods: </strong>Instrumental variables for predicting six diabetic traits (including insulin and blood glucose), eight metabolic risk factors for diabetes (including total cholesterol and blood pressure), and seven diabetic genes were extracted from their summary data. These data were derived from multiple European cohorts and included 31,684 to 810,865 subjects respectively. The two-sample MR, multivariate MR, and summary-data-based Mendelian randomization (SMR) methods were employed to determine the associations of these traits or genes with the risk of Alzheimer's disease.</p><p><strong>Results: </strong>The two-sample MR showed that elevated fasting insulin and total cholesterol levels were associated with an increased risk of dementia in Alzheimer's disease (P = 0.022, P = 0.041). Elevated systolic and diastolic blood pressure levels were associated with a decreased risk of dementia in Alzheimer's disease (P = 0.036, P = 0.025). The multivariate MR reported that adjusting for telomere length (a well-established biomarker of aging) did not change these findings (P < 0.05). Additionally, the two-sample MR showed that type 1 and type 2 diabetes did not affect the risk of Alzheimer's disease. The SMR also indicated that the diabetic genes did not affect the risk of this disease.</p><p><strong>Conclusion: </strong>Multiple MR approaches concluded that fasting insulin, total cholesterol, and blood pressure, rather than diabetes, were potential metabolic variables that had an impact on the risk of Alzheimer's disease. However, aging might not be involved in these correlations.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"24 1","pages":"448"},"PeriodicalIF":2.2,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}