BMC Neurology最新文献

{"title":"Association between estimation of pulse wave velocity and all-cause mortality in critically ill patients with ischemic stroke: a retrospective cohort study and predictive model establishment based on machine learning.","authors":"Shuangmei Zhao, Chang Zhu, Yu Guo, Shiyin Ma, Chucheng Jiao, Liutao Sui, Rongyao Hou, Xiaoyan Zhu","doi":"10.1186/s12883-025-04385-0","DOIUrl":"10.1186/s12883-025-04385-0","url":null,"abstract":"<p><strong>Background: </strong>Estimated pulse wave velocity (ePWV) has been established as a simple yet effective tool for assessing arterial stiffness and predicting long-term cardiovascular and cerebrovascular mortality. However, the association between ePWV and poor prognosis in critically ill patients with ischemic stroke (IS) remains understudied. This study aimed to investigate the relationship between ePWV and adverse outcomes in critically ill IS patients.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using data from the Medical Information Mart for Intensive Care IV (MIMIC-IV, version 3.0), stratified by ePWV quartiles. Our primary objective was to examine mortality rates at pivotal timeframes: 30 days, 90 days, and 1-year post-observation. Kaplan-Meier (KM) curves complemented these analyses, along with a Cox proportional hazards model, restricted cubic spline curves (RCS), and subgroup analysis, to comprehensively evaluate the association between ePWV and all-cause mortality. To model the mortality risk, four machine learning algorithms were employed, namely Logistic Regression (LR), Random Forest (RF), XGBoost, and Naive Bayes (NB). Model interpretability was improved using Shapley Additive Interpretation (SHAP) analysis, with calibration validating predictive accuracy. We comprehensively compared four machine learning algorithms (LR, RF, XGBoost, NB) against five clinical risk scores.</p><p><strong>Results: </strong>Our analysis encompassed a cohort of 1,337 patients, with a male preponderance of 51.6%. The 30-day, 90-day, and 1-year mortality rates were 14.1%, 17.9%, and 23.4%, respectively. The RCS analysis revealed a dose-dependent increase in all-cause mortality risk with higher ePWV levels. Critically ill IS patients in the highest ePWV quartile had significantly higher mortality at all time points compared to lower quartiles. Boruta feature selection identified ePWV as a key predictor. The LR model demonstrated superior accuracy in predicting 30-day mortality, while XGBoost outperformed others for 90-day and 1-year mortality predictions.</p><p><strong>Conclusion: </strong>Elevated levels of the ePWV demonstrate strong prognostic value for both short- and long-term mortality in critically ill IS patients. Machine learning models incorporating ePWV outperformed traditional clinical scores, suggesting potential utility for risk stratification in acute stroke management.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"386"},"PeriodicalIF":2.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173814","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":"Neutrophil degranulation is increased at seven days after human intracerebral hemorrhage, but not at 72 h, and correlates with decreased miR-3613 and miR-3690.","authors":"Kyle B Walsh, Miranda C Marion, Dengfeng Li, Hannah C Ainsworth, Amy Zinnia, Xiang Zhang, Stacie L Demel, Brady Williamson, David J Roh, Robert Campbell, Frederik Denorme, Daniel Woo, Carl D Langefeld","doi":"10.1186/s12883-025-04408-w","DOIUrl":"10.1186/s12883-025-04408-w","url":null,"abstract":"","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"388"},"PeriodicalIF":2.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173798","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":"Enterococci-related healthcare-associated ventriculitis and meningitis: a multicenter retrospective case series from clinical practice.","authors":"Yuyang Qiu, Yi Ye, Qiujun Yang, Jixun Zhao, Xiaobo Gong, Yimin Ma, Guangzhi Shi, Guiyun Li, Guofeng Wu","doi":"10.1186/s12883-025-04393-0","DOIUrl":"10.1186/s12883-025-04393-0","url":null,"abstract":"<p><p>Healthcare-associated ventriculitis and meningitis (HCAVM) is a severe infection and is associated with high morbidity, mortality, and poor functional prognosis, and the associated microorganisms can be skin flora or nosocomial pathogens, most commonly Gram-negative bacteria. Enterococci-related HCAVM have rarely been discussed systemically, the related drug resistance and outcomes have been poorly researched. In this multicenter retrospective case series, we analyzed patients with Enterococci-related HCAVM from three tertiary hospitals. Our study assessed bacterial resistance patterns, antimicrobial treatment strategies, and clinical outcomes in this patient cohort. A total of 94 strains of Enterococci causing HCAVM were identified, including 58 strains of Enterococcus faecalis and 34 strains of Enterococcus faecium. Vancomycin resistance rate was 7.4%(7/94), which only occurred in E. faecium. The linezolid resistance rate was 1.1%(1/94). Ten tested antimicrobial agents showed higher resistance rates against E. faecium than against E. faecalis. Vancomycin was used in 88 patients as empirical treatment, which was changed to linezolid in 12 patients, including those with vancomycin-resistant E. faecium. Four (4.3%) patients experienced ineffective treatments, eight (8.5%) had poor outcomes, and the treatment course was 15.3 ± 10.9 days. In conclusion, our findings reveal the different resistance rates of Enterococcus faecalis and Enterococcus faecium to vancomycin and linezolid, reveal the clinical epidemiological characteristics of Enterococci-related HCAVM, and provide an important reference for the selection of antimicrobial agents.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"387"},"PeriodicalIF":2.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173810","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":"Machine learning-based models in prediction of the radiological outcomes of vestibular schwannoma following stereotactic radiosurgery: a systematic review and meta-analysis.","authors":"Bardia Hajikarimloo, Mohammad Ali Nazari, Mohammad Amin Habibi, Pourya Taghipour, Seyyed-Ali Alaei, Amirreza Khalaji, Rana Hashemi, Ibrahim Mohammadzadeh, Salem M Tos","doi":"10.1186/s12883-025-04093-9","DOIUrl":"10.1186/s12883-025-04093-9","url":null,"abstract":"<p><strong>Background: </strong>Prediction of the radiological outcomes of the vestibular schwannomas (VSs) following stereotactic radiosurgery (SRS) is critical in the management of these lesions. Predictions of tumor control can optimize therapeutic strategies and enhance treatment outcomes. Significant advancements in machine learning (ML) have led to the development of models to predict the radiological outcomes after SRS in VS individuals. This study evaluated the role of ML-based models in predicting the radiological outcomes of SRS in the setting of VS.</p><p><strong>Methods: </strong>On December 12, 2024, the four electronic databases, Pubmed, Embase, Scopus, and Web of Science, were systematically searched. Studies that evaluated the performance outcomes of the ML-based predictive models were included. The pooled sensitivity, specificity, area under the curve (AUC), and diagnostic odds ratio (DOR) were calculated through the R program. The hierarchical summary receiver operating characteristic (HSROC) model was utilized to form a summary ROC (SROC) curve.</p><p><strong>Results: </strong>Nine studies with 1095 patients were included. Most of the best performance models were ML-based (88.9 8/9). The most frequent algorithm was the support vector machine (SVM) (44.4%, 4/9). The meta-analysis revealed a pooled sensitivity rate of 86% (95%CI: 83-89%), a specificity rate of 78% (95%CI: 62-89%), and a DOR of 19.8 (95%CI: 9.12-42.9). The SROC curve exhibited an AUC of 0.845 for tumor response prediction.</p><p><strong>Conclusion: </strong>Clinical application of ML-based predictive models can optimize the therapeutic strategy and enhance the outcomes for patients with VS.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"385"},"PeriodicalIF":2.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173862","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":"Perioperative Efgartigimod treatment for acute myasthenia gravis exacerbation with retroperitoneal mass: a case report.","authors":"Jinyi Yan, Kalam Choi, Peicai Fu, Yue Li, Zhijun Li","doi":"10.1186/s12883-025-04438-4","DOIUrl":"10.1186/s12883-025-04438-4","url":null,"abstract":"<p><strong>Objective: </strong>This case demonstrates the efficacy and safety of efgartigimod in managing an acute exacerbation of myasthenia gravis (MG) with comorbid Castleman disease, particularly during the perioperative care of retroperitoneal mass resection.</p><p><strong>Methods: </strong>A 23-year-old female was admitted with the discovery of a retroperitoneal Mass, confirmed via abdominal enhanced CT and MRI. The patient had generalized MG since 2017, with controlled but fluctuating symptoms.</p><p><strong>Results: </strong>Preoperative assessment showed albumin levels were slightly reduced and respiratory function demonstrated severe restrictive ventilation impairment. There was acute exacerbation of muscle weakness (MG Foundation of America (MGFA) class IVb, MG-activities of daily living (ADL) score 8, and quantitative MG (QMG) score 20) with respiratory and medullary symptoms. Treatment with efgartigimod (10 mg/kg/week), prednisone 15 mg/day and pyridostigmine 270 mg/day was initiated. The symptoms improved substantially after four infusions (MG-ADL score 0, QMG score 6), and the lung function recovered. The patient continued efgartigimod treatment and underwent retroperitoneal mass resection. The mass showed massive lymph node hyperplasia (Castleman's disease, mixed type). Postoperatively, the patient experienced no infection, MG exacerbation, or other complications.</p><p><strong>Discussion: </strong>Efgartigimod had a rapid onset of action, swiftly improved symptoms during acute MG exacerbation, and maintained symptom stability during the perioperative care.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"384"},"PeriodicalIF":2.2,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147765","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":"Association between cytokines and neuropsychiatric symptoms in paediatric narcolepsy patients: a cross-sectional study.","authors":"Xing Wei, Shuman Feng, Liuyi Li, Shuyan Feng","doi":"10.1186/s12883-025-04359-2","DOIUrl":"10.1186/s12883-025-04359-2","url":null,"abstract":"<p><strong>Background: </strong>Narcolepsy is often accompanied by depressive and anxiety symptoms, but the underlying immunological mechanisms remain unclear. Inflammatory cytokines may play a role in both disease onset and psychiatric comorbidities. This study aimed to investigate the association between circulating inflammatory cytokines and neuropsychiatric symptoms in paediatric narcolepsy patients, in order to explore the potential role of immune dysregulation in disease pathogenesis and comorbid mood disorders.</p><p><strong>Methods: </strong>This cross-sectional study included 78 paediatric narcolepsy patients and 80 age-matched controls. Cytokine levels and lymphocyte subsets were measured using ELISA and flow cytometry. Depression and anxiety symptoms were assessed using the HAMD-24 and HAMA-14 scales. Logistic regression was used to identify immune markers associated with narcolepsy diagnosis, while linear regression assessed their relationships with depressive and anxiety symptoms.</p><p><strong>Results: </strong>Compared to healthy controls, paediatric narcolepsy patients exhibited significantly elevated levels of IL-6, IL-2, IL-4, TNF-α, IFN-γ, and IL-17 A, alongside reduced IL-10 levels (all P < 0.05). Logistic regression analysis identified IL-6 as an independent risk factor for narcolepsy (OR = 1.46, 95% CI: 1.02-1.93, P = 0.003). Furthermore, IL-6 and the IL-6/IL-10 ratio were positively associated with depressive symptom severity as measured by HAMD-24 scores (P = 0.023 and P = 0.018, respectively). The IFN-γ/IL-4 ratio was independently associated with anxiety symptoms, as reflected by HAMA-14 scores (P = 0.007), after adjusting for confounding variables.</p><p><strong>Conclusion: </strong>These findings suggest that pro-inflammatory cytokines, especially IL-6, are involved in the pathophysiology of paediatric narcolepsy and its related depressive and anxiety symptoms. IL-6 may serve as a potential biomarker and therapeutic target for early intervention.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"382"},"PeriodicalIF":2.2,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136598","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":"Rapid eye movement sleep without Atonia in healthy university students without clinical rapid eye movement sleep behavior disorder.","authors":"Yuka Kiyohara, Hajime Kumagai, Mitsuo Hayashi, Akiko Kanoh, Kana Asada, Misao Yokoyama, Moe Yamagami, Kengo Kawaguchi, Hiroyuki Sawatari, Noriyuki Konishi, Toshiaki Shiomi","doi":"10.1186/s12883-025-04401-3","DOIUrl":"10.1186/s12883-025-04401-3","url":null,"abstract":"","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"383"},"PeriodicalIF":2.2,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136511","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":"Sensitivity and specificity of the Montreal cognitive assessment using U.S. National alzheimer coordinating centre uniform data set: a retrospective analysis of 16,309 participants.","authors":"Youssef A Ismail, Huda A Auf, Shahd A Sadik, Nada M Ahmed, Yasmeen Ali","doi":"10.1186/s12883-025-04190-9","DOIUrl":"10.1186/s12883-025-04190-9","url":null,"abstract":"<p><strong>Background: </strong>Neurodegenerative diseases (NDDs), like Alzheimer's disease, are characterized by progressive cognitive decline, with limited effective treatments available. Several screening tools are available for diagnosing various types of dementia, including the Montreal Cognitive Assessment (MoCA), the Mini-Mental State Examination (MMSE), and the Dementia Rating Scale (DRS).</p><p><strong>Objective: </strong>This study aims to evaluate the sensitivity and specificity of MoCA to determine its suitability as a screening tool.</p><p><strong>Methods: </strong>This study analyzed data from participants aged 55 and older, recruited from U.S. Alzheimer's Disease Research Centers (ADRCs), using a National Alzheimer Coordinating Center Uniformed Data Set (NACC-UDS). Participants were classified based on patient records into demented and non-demented groups, with the non-demented group further categorized into those with normal cognition and cognitive impairment (CI). This analysis examines the correlation between these classifications and MoCA scores.</p><p><strong>Results: </strong>This study utilized an initial dataset of 188,700 participant records from NACC. After applying inclusion criteria, 16,309 participants were included. The participants had complete diagnostic information, clinician-conducted cognitive assessments, and MoCA scores. The participants were categorized into three groups: 7,624 with no cognitive impairment (NoCI), 4,893 with CI, and 3,792 with dementia. This study focused on MoCA scores, revealing significant differences among diagnostic groups. ROC analysis demonstrated the MoCA's strong diagnostic capability, with AUC values significantly above 0.5 (P <.001). Sensitivity and specificity were calculated in at the literature-recommended cutoff scores of 26 and 21, while the optimal cutoff scores were identified as (< 24) for detecting MCI and (< 21) for dementia based on the Youden index in reference to individuals with no cognitive impairment. Although PPV was generally low, the high NPV across comparisons underscores the MoCA's effectiveness in ruling out cognitive impairment.</p><p><strong>Conclusion: </strong>The study confirms MoCA as an effective tool for detecting dementia, showing 83% sensitivity and 82% specificity at a cutoff value of 21. With a high NPV of 94%, MoCA is particularly reliable for ruling out dementia. Its ability to detect MCI is moderate, with a sensitivity of 77.3% at cutoff of 24 among normal population.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"381"},"PeriodicalIF":2.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145129972","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":"MRI-negative cerebellar syndrome caused by medication-induced magnesium deficiency: a case report.","authors":"Marvin Jüchtern","doi":"10.1186/s12883-025-04399-8","DOIUrl":"10.1186/s12883-025-04399-8","url":null,"abstract":"<p><strong>Background: </strong>Cerebellar pathologies in adults can have a wide range of hereditary, acquired and sporadic-degenerative causes. Due to the frequency in daily hospital, especially intensive care, settings, electrolyte imbalances are an important, yet rare differential diagnosis. The hypomagnesemia-induced cerebellar syndrome (HiCS) constitutes a relevant disease entity with clinical and morphological variability due to a potential progression of symptoms and a promising causal treatment. Cases of HiCS without imaging abnormalities are scarcely reported and pose a particular challenge to practitioners.</p><p><strong>Case presentation: </strong>A 68-year-old female patient presented with subacute onset gait impairment and concomitant vertigo. Gaze induced nystagmus, ataxia and limb dysmetria became objectifiable. A broad diagnostic workup, including liquor puncture, whole-body positron emission tomography, antibody serology and most notably thin-layer magnetic resonance imaging remained unconclusive. Only a more detailed examination of chronic hypokalemia with the detection of severe magnesium deficiency under the intake of proton pump inhibitors and a recent gastrointestinal infection found a causal treatment through electrolyte substitution.</p><p><strong>Conclusions: </strong>Electrolyte disorders as a reason for central nervous pathologies remain underdiagnosed and underestimated, as a heterogeneous clinical appearance, the growing number of defined cerebellar diseases and, like in our case, lacking imaging abnormality aggravatingly contrast with a high intake prevalence of triggering medication. The presence of diarrhea or vomiting, electrolyte shortage, cardiac arrhythmia, alcoholism and particularly the intake of proton pump inhibitors in patients with cerebellar symptoms should result in thorough electrolyte diagnostics. Early recognition of this causally treatable cerebellar syndrome and prompt discontinuation of triggering medication are crucial to improve the often poor prognosis.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"380"},"PeriodicalIF":2.2,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145028989","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 forward and backward walking on gait parameters across parkinson's disease stages and severity: a prospective observational study.","authors":"Tracy Milane, Nicolas Vuillerme, Pascal Petit, Elke Warmerdam, Robbin Romijnders, Edoardo Bianchini, Walter Maetzler, Clint Hansen","doi":"10.1186/s12883-025-04321-2","DOIUrl":"10.1186/s12883-025-04321-2","url":null,"abstract":"<p><strong>Background: </strong>Parkinson's disease (PD) is characterized by motor symptoms altering gait domains such as slow walking speed, reduced step and stride length, and increased double support time. Gait disturbances occur in the early, mild to moderate, and advanced stages of the disease in both backward walking (BW) and forward walking (FW), but are more pronounced in BW. At this point, however, no information is available about BW performance and disease stages specified using the Hoehn and Yahr (H&Y) scale. The objectives of this study were to examine the link between clinical scores and gait parameters in PD, and to assess gait parameters in both FW and BW among PD patients in early disease stages (H&Y: 1-2) and advanced disease stages (H&Y: 3-4), as well as among PD patients with mild and moderate disease severity as per the Movement Disorder Society-Unified Parkinson's Disease Rating Scale Part III (MDS-UPDRS III).</p><p><strong>Methods: </strong>Spatiotemporal gait parameters were analyzed during FW and BW over a 5-meter walkway at a comfortable speed using 3D motion capture. Correlations and regressions between clinical scores and gait parameters were examined. Wilcoxon Mann-Whitney rank sum tests were used to compare PD patients in early and advanced disease stages and assess differences in gait parameters for both FW and BW conditions.</p><p><strong>Results: </strong>The study included a total of 25 PD patients (aged 65 ± 9 years), among whom 10 were in the H&Y stages 1-2 and 15 in stages 3-4. All participants were evaluated with the MDS-UPDRS III, with 17 having a total score ≤ 32 (mild impairment and disability) and 8 having a total score > 32 (moderate impairment and disability). During BW, PD patients with H&Y stages 1-2 had significantly (p < 0.05) longer step lengths, stride lengths, and a higher walk ratio compared to those with H&Y stage 3-4. Regardless of the walking condition, no difference was found between PD patients with a MDS-UPDRS III total score ≤ 32 and patients with a MDS-UPDRS III total score > 32.</p><p><strong>Discussion: </strong>The study demonstrates that individuals with PD in H&Y stages 3-4 exhibit compromised FW and BW abilities in comparison to those in stages 1-2. Notably, the disparities are more prominent in the realm of backward walking. These findings substantiate the existence of distinct gait patterns between the early and advanced stages of the disease, with the variations being particularly accentuated in the context of backward walking.</p><p><strong>Conclusions: </strong>Taken together, our results suggest that backward walking may hold greater clinical utility in assessing and managing PD patients.</p><p><strong>Trial registration: </strong>The research procedure was approved by the ethical committee of the Medical Faculty of Kiel University (D438/18). The study is registered in the German Clinical Trials Register on 20,200,904 (DRKS00022998).</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"379"},"PeriodicalIF":2.2,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145028913","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}