BMC Neurology最新文献

{"title":"Clinical and electrophysiological features of pure sensory Guillain-Barré syndrome: retrospective analysis of 22 patients across 14 provinces in Southern China.","authors":"Songyan Liu, Hong Chu, Bin Peng, Yanping Zeng, Jia Liu, Zuneng Lu, Chao Weng","doi":"10.1186/s12883-025-04103-w","DOIUrl":"10.1186/s12883-025-04103-w","url":null,"abstract":"<p><strong>Objective: </strong>Currently, there are limited reports, both nationally and internationally, regarding Guillain-Barré Syndrome (GBS) that manifests solely with isolated sensory impairment. This study aims to explore the epidemiological and clinical features of GBS patients experiencing only paresthesia in southern China.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of the medical records of GBS patients admitted to 31 hospitals across 14 provinces in southern China from January 1, 2013, to September 30, 2016.</p><p><strong>Results: </strong>A total of 1,056 patients diagnosed with GBS were identified from medical records, of whom 276 had paresthesia as their first symptom. Among these 276 patients, a total of 41 patients with GBS who exhibited only paresthesia were analyzed. Among them, 19 patients served as a control group and showed abnormal compound muscle action potential (CMAP). We identified 22 cases of pure sensory disturbances in GBS patients and named them \"pure sensory GBS\", characterized by normal CMAP. Comparative analysis revealed no statistically significant differences between the two groups in terms of age at onset, gender, residence, or antecedent events; however, the pure sensory GBS group demonstrated a higher incidence of onset during the spring. Electrophysiological evaluations revealed that the pure sensory GBS group had a lower likelihood of reduced amplitude in sensory nerve action potential (SNAP) compared to the control group. However, there were no significant differences between the two groups in sensory conduction latency, velocity, H-reflex, or F-wave detection. Additionally, no significant differences were observed in cerebrospinal fluid (CSF) studies, treatment modalities, discharge Hughes scores, or peak time. Notably, patients in the pure sensory GBS group had lower Hughes scores at admission and a shorter hospital stay, with these differences reaching statistical significance.</p><p><strong>Conclusion: </strong>Among GBS patients, those presenting solely with sensory disturbances are relatively uncommon, with only 22 cases. Compared to the control group, those patients are more frequently diagnosed in the spring, demonstrate a milder degree of reduction in amplitude of SNAP, present with milder symptoms at admission, and have shorter hospital stays.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"87"},"PeriodicalIF":2.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572145","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":"Dynamic changes in neuron-specific enolase level to glasgow coma scale score ratio predict long-term neurological function of diffuse axonal injury patients.","authors":"Weiliang Chen, Jiayi Wu, Shengwen Li, Chunyu Yao, Rui Chen, Wen Su, Guanjun Wang","doi":"10.1186/s12883-025-04116-5","DOIUrl":"10.1186/s12883-025-04116-5","url":null,"abstract":"<p><strong>Background: </strong>Patients with diffuse axonal injury (DAI) are often plagued by sequelae, and the current indicators for predicting long-term neurological function are not accurate enough. Our previous studies have found that serum Neuron-specific enolase (NSE) level to Glasgow Coma Scale (GCS) score ratio(NGR) at admission could be used as an independent predictor of DAI.</p><p><strong>Objective: </strong>To explore the accuracy of dynamic changes of NGR in predicting long-term neurological function in patients with DAI.</p><p><strong>Methods: </strong>Patients with DAI were included based on clinical MRI as the diagnostic standard, and divided into two groups with favorable and unfavorable outcome according to the 6-month Extended Glasgow Outcome Scale (GOSE) as the prognosis indicator. The differences in clinical parameters between the two groups of patients were compared by Pearson correlation analysis. The trend of dynamic changes in NSE, GCS, and NGR at 1st, 3rd, 5th, 7th and 14th days after injury were shown by line graphs. The predictive efficacy of various parameters for long-term neurological function were further analyzed by receiver operator characteristic (ROC) curves.</p><p><strong>Results: </strong>Among the 102 DAI patients, 75 (73.5%) were classified to favorable outcome group (GOSE5-8) and 27 (26.5%) to unfavorable outcome (GOSE1-4). The NSE, NGR and Marshall CT grade at the first day after injury in the favorable outcome group were significantly lower than those in the unfavorable outcome group (p = 0.005, p < 0.001, p = 0.002), but the GCS score was significantly higher than that of the latter (p = 0.006). There was a negative correlation between NGR at 1st, 3rd, 5th, 7th, and 14th days post-TBI (r1=-0.557, r3=-0.746, r5=-0.761, r7=-0.727, r14=-0.694), and the 6-month GOSE. DAI patients with a favorable outcome exhibited a gradual decline in NGR. The area under the ROC curves (AUC) of NGR at 1st, 3rd and 5th days post-TBI were 0.751 (95% CI, 0.646-0.856, p < 0.001), 0.913 (95% CI, 0.859-0.967, p < 0.001), 0.934 (95% CI, 0.886-0.982, p < 0.001), which were the largest among the three parameters.</p><p><strong>Conclusions: </strong>The dynamic changes of NGR may be an accurate predictor of long-term neurological function in patients with DAI.</p><p><strong>Clinical trial registration: </strong>Trial Registration Number ChiCTR2100044352, registration date was March 17, 2021.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"89"},"PeriodicalIF":2.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572146","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":"Exploring the causal relationship between serum EFNB2 levels and epilepsy: a bidirectional Mendelian randomization and co-localization analysis.","authors":"Xudong Zhang, Yuhao Xu, Zehan Wu, Xiang Zou","doi":"10.1186/s12883-025-04115-6","DOIUrl":"10.1186/s12883-025-04115-6","url":null,"abstract":"<p><strong>Background: </strong>Epilepsy is a severe neurological disorder characterized by persistent seizures and, in some patients, associated neurobiological, cognitive, and psychosocial consequences. It is influenced by various genetic factors, including the Ephrin-B2 (EFNB2) gene.</p><p><strong>Methods: </strong>This study utilized bidirectional Mendelian randomization (MR) to explore the potential causal relationship between serum levels of EFNB2 and epilepsy using data from extensive genome-wide association studies (GWAS). We selected serum levels of EFNB2 and generalized epilepsy traits, applying strict criteria for instrumental variables to ensure validity and mitigate confounding influences. The analysis included sensitivity tests like the MR pleiotropy residuals and outliers test, as well as co-localization to evaluate shared genetic influences.</p><p><strong>Results: </strong>Our results indicated a significant causal relationship between serum levels of EFNB2 and epilepsy, suggesting that EFNB2 could be involved in the pathogenesis of epilepsy through mechanisms that may not be directly linked to shared genetic pathways.</p><p><strong>Conclusion: </strong>These results suggest a potential association between EFNB2 and epilepsy, highlighting the need for further studies to clarify its role and explore its possible relevance as a therapeutic target.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"84"},"PeriodicalIF":2.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566173","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":"Acute onset of anti-IgLON5 disease with meningeal enhancement: a case report.","authors":"Huasheng Huang, Yizhi Wei, Jie Li","doi":"10.1186/s12883-025-04104-9","DOIUrl":"10.1186/s12883-025-04104-9","url":null,"abstract":"<p><strong>Background: </strong>Anti-IgLON5 disease is a relatively rare autoimmune disease of the nervous system. The clinical course of this disease is generally chronic and progressive, exhibiting heterogeneity in clinical presentation and the lack of specific imaging features. We now report a case of a Anti-IgLON5 antibody-positive patient demonstrated two distinctive features. Firstly, the onset was marked by acute encephalopathy symptoms, including fever, with consciousness disturbance as the initial manifestation. Secondly, imaging studies revealed multiple lesions within the meninges and intracranial regions, characterized by extensive thickening and enhancement of the dura mater.</p><p><strong>Case presentation: </strong>A previously healthy 78-year-old male patient presented with impaired consciousness and was admitted to the hospital. Brain MRI demonstrated abnormal signal located in the bilateral basal ganglia, frontal and parietal lobes. Post-contrast enhancement demonstrated thickening and enhancement of the dura mater in the bilateral frontal regions, along with mild enhancementin the cortical areas of the bilateral temporal lobes. Cerebrospinal fluid (CSF) analysis indicated the presence of oligoclonal bands in both serum and CSF, with a higher count in the CSF compared to serum. IgG antibodies against IgLON5 were detected in serum and CSF at a titer of 1:100. CSF concentrations of total Tau protein (t-Tau) and phosphorylated Tau protein (p-Tau) were normal. In conjunction with a positive serum and CSF IgLON5 antibody and exclusion of other diseases, diagnosis of anti-IgLON5 disease was made. Symptoms resolved completely after intravenous methylprednisolone and immunoglobulin therapy were administered. At 3-week follow-up the small patchy abnormal signal in the bilateral basal ganglia, frontal and parietal lobes have resolved. Additionally, post-contrast imaging reveals the absence of the previously noted abnormal dural enhancement. and there was no recurrence 18 months after the onset of the disease.</p><p><strong>Conclusions: </strong>Anti-IgLON5 disease is a heterogeneous disorder characterized by a wide spectrum of clinical manifestations. IgLON5 encephalopathy characterized mainly by symptoms of acute neurological symptoms and MRI evidence of meningeal enhancement has not been reported previously. The appropriate diagnostic strategy should encompass a thorough clinical evaluation, testing for anti-IgLON5 antibodies in both CSF and serum, as well as HLA genotyping. Timely diagnosis and early Intravenous methylprednisolone and/or IVIG therapy are beneficial in improving prognosis and preventing recurrence.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"86"},"PeriodicalIF":2.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566101","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":"Prevalence and incidence of multiple sclerosis in healthcare district IV of Asturias, Spain.","authors":"Pedro Oliva-Nacarino, Marina Simal Antuña, Carmen Santos Varela, Javier Villafani Echazú, Jessica Fernández Domínguez, Raquel García Rodríguez, Agustín Oterino Durán, Patricia Suarez Santos, Miguel Ángel Llaneza González","doi":"10.1186/s12883-025-04108-5","DOIUrl":"10.1186/s12883-025-04108-5","url":null,"abstract":"<p><strong>Background: </strong>Multiple sclerosis is an inflammatory demyelinating autoimmune disease of the central nervous system. Studies conducted in recent years point to an increase in its prevalence and a change in the age profile of patients. This study aims to analyse the prevalence and incidence of multiple sclerosis in healthcare district IV of the region of Asturias, in north-western Spain.</p><p><strong>Methods: </strong>We conducted a retrospective epidemiological study of the population of said healthcare district with a diagnosis of multiple sclerosis according to the 2017 McDonald criteria. The prevalence of the disease was calculated cross-sectionally (prevalence date: December 31, 2022), while the incidence was determined retrospectively over a six-year period, from 2017 to 2022. We gathered data from the registries and databases of the tertiary hospital in healthcare district IV, and from one private hospital. Relevant demographic and clinical data were gathered from electronic records.</p><p><strong>Results: </strong>The prevalence of multiple sclerosis in the population studied was 198 cases per 100 000 population. The incidence of multiple sclerosis during the study period (2017-2022) was 6.6 cases per 100 000 person-years. On the prevalence date, 66.5% of patients were women and 82.4% presented relapsing-remitting multiple sclerosis. Mean age was 33.98 years at symptom onset and 50.84 years on the prevalence date.</p><p><strong>Conclusions: </strong>Asturias currently presents the highest multiple sclerosis prevalence rate in Spain; the estimated rate represents an increase with respect to those reported in studies conducted in the same region in the 1990s.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"85"},"PeriodicalIF":2.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566177","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 blood triglycerides and stroke-associated pneumonia: a prospective cohort study.","authors":"Xiujuan Yuan, Shicun Huang, Jianqiang Ni, Wanli Dong","doi":"10.1186/s12883-025-04060-4","DOIUrl":"10.1186/s12883-025-04060-4","url":null,"abstract":"<p><strong>Background: </strong>Cerebral infarction requires the reduction of blood lipids, but low triglycerides are associated with poor prognosis. stroke-associated pneumonia (SAP) can also lead to poor prognosis. Therefore, the purpose of this study is to investigate the correlation between triglycerides (TG) and SAP.</p><p><strong>Methods: </strong>This prospective cohort study was conducted at the First Affiliated Hospital of Soochow University and enrolled consecutive patients with acute ischemic stroke admitted between March 2019 and March 2021. Univariate analysis, Multivariable logistic regression analysis, subgroup analysis, curve fitting, inflection point analysis, stratified and interaction analyses was performed to examine the relationship between blood TG and SAP.</p><p><strong>Results: </strong>The study included 240 patients with acute ischemic stroke (92 females, mean age 68 years), of whom 94 developed SAP. Multivariate logistic regression analysis demonstrated that TG levels were independently associated with SAP. The fitting curve shows a linear relationship between TG level and SAP incidence, with a decrease in SAP incidence as TG increases. The inflection point value is TG = 2.6mmol/L.</p><p><strong>Conclusions: </strong>The findings suggest that TG levels may be inversely associated with the risk of SAP in elderly patients with acute ischemic stroke.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"83"},"PeriodicalIF":2.2,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555754","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":"Mendelian randomization of plasma proteomics identifies novel ALS-associated proteins and their GO enrichment and KEGG pathway analyses.","authors":"Chuan Lu, Xiao-Xiao Huang, Ming Huang, Chaoning Liu, Jianwen Xu","doi":"10.1186/s12883-025-04091-x","DOIUrl":"10.1186/s12883-025-04091-x","url":null,"abstract":"<p><strong>Background: </strong>Amyotrophic lateral sclerosis (ALS) is a progressive and fatal neurological disorder with an increasing incidence rate. Despite advances in ALS research over the years, the precise etiology and pathogenic mechanisms remain largely elusive.</p><p><strong>Objective: </strong>To identify novel plasma proteins associated with ALS through Mendelian randomization methods in large-scale plasma proteomics and to provide potential biomarkers and therapeutic targets for ALS treatment.</p><p><strong>Methods: </strong>This study employed a large-scale plasma proteomic Mendelian randomization approach using genetic data from 80,610 individuals of European ancestry (including 20,806 ALS patients and 59,804 controls) derived from a genome-wide association study (GWAS). Protein quantitative trait loci (pQTLs) data were obtained from Ferkingstad et al. (2021), which measured 4,907 proteins in 35,559 Icelandic individuals. Multiple Mendelian randomization (MR) techniques were utilized, including weighted median, MR-Egger, Wald ratio, inverse-variance weighting (IVW), basic model, and weighted model. Heterogeneity was evaluated using Cochran's Q test. Horizontal pleiotropy was assessed through the MR-Egger intercept test and MR-PRESSO outlier detection. Sensitivity analysis was performed via leave-one-out analysis.</p><p><strong>Results: </strong>MR analysis revealed potential causal associations between 491 plasma proteins and ALS, identifying 19 novel plasma proteins significantly linked to the disease. Proteins such as C1QC, UMOD, SLITRK5, ASAP2, TREML2, DAPK2, ARHGEF10, POLM, SST, and SIGLEC1 showed positive correlations with ALS risk, whereas ADPGK, BTNL9, COLEC12, ADGRF5, FAIM, CRTAM, PRSS3, BAG5, and PSMD11 exhibited negative correlations. Reverse MR analyses confirmed that ALS negatively correlates with ADPGK and ADGRF5 expression. Enrichment analyses, including Gene Ontology (GO) functional analysis, indicated involvement in critical biological processes such as external encapsulating structure organization, extracellular matrix organization, chemotaxis, and taxis. KEGG pathway analysis highlighted significant enrichment in the PI3K-Akt signaling pathway, cytokine-cytokine receptor interactions, and axon guidance.</p><p><strong>Conclusion: </strong>This study enhances the understanding of ALS pathophysiology and proposes potential biomarkers and mechanistic insights for therapeutic development. Future research should explore the clinical translation of these findings to improve ALS patient outcomes and quality of life.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"82"},"PeriodicalIF":2.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540260","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 physical activity and intensity on clot mechanical microstructure and contraction in middle-aged/older habitual runners.","authors":"J C Zaldua, O Watson, D J Gregoire, S Pillai, Y Hellsten, K Hawkins, P A Evans","doi":"10.1186/s12883-025-04074-y","DOIUrl":"10.1186/s12883-025-04074-y","url":null,"abstract":"<p><strong>Background: </strong>Exercise in healthy individuals is associated with a hypercoagulable phase, leading to a temporary increase in clot mass and strength, which are controlled by an effective fibrinolytic system. Conversely, people with cardiovascular diseases often have a reduced fibrinolytic pathway, increased clot mass and abnormal clot contraction, resulting in poorer outcomes. We assessed clot microstructure, particularly the contractile forces of clot formation, in response to two exercise intensities in middle-aged/older runners.</p><p><strong>Methods: </strong>Twenty-eight habitual male and female runners aged over 40 years completed a 10 km moderate-intensity run; 14 of them performed a 3 km high-intensity run. Blood samples were collected at baseline, immediately postexercise and after 1 h of rest. Clot structural biomarkers d_f, gel time, and measurements of mature clot mechanical properties (gel time, G'_Max and CF_max) were analysed alongside conventional plasma markers.</p><p><strong>Results: </strong>Both exercise intensities altered markers of coagulant activity (PT, APTT and FVIII) and fibrinolysis (D-dimer), indicating hypercoagulability. Compared with longer-duration lower-intensity exercise, d_f was greater after short-duration intensified exercise bouts. Following an hour of rest, d_f dropped to baseline levels. Additionally, CF_max decreased across timepoints at both exercise intensities. This effect was noted after one hour of rest compared with baseline, suggesting continuous fibrinolytic activity postexercise.</p><p><strong>Conclusion: </strong>Exercise transiently induces an intensity-dependent hypercoagulable state, resulting in denser clot formation and a reduced clot contractile force due to fibrinolysis. These findings can help guide the safe commencement of rehabilitation exercise programs for cerebrovascular patients.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"81"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536629","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 expression changes endothelial and fibrinolytic biomarkers in acute ischemic stroke patients with OSA.","authors":"Zhencan Huang, Yanan Zhang, Qingqing Sun, Zan Wang","doi":"10.1186/s12883-025-04084-w","DOIUrl":"10.1186/s12883-025-04084-w","url":null,"abstract":"<p><strong>Objective: </strong>To assess the expression changes of serum fibrinogen, E-selectin, and tissue-type plasminogen activator (t-PA) in acute ischemic stroke (AIS) patients with varying degrees of obstructive sleep apnea syndrome (OSA), and evaluate their value in diagnosing AIS with OSA.</p><p><strong>Methods: </strong>Data were gathered from 80 patients with AIS who were admitted to the First Hospital of Jilin University between January 2023 and December 2023. Out of these, 60 patients completed the NIHSS Scale, ESS Scale, STOP-Bang Scale, and underwent polysomnography within a week of symptom onset. Based on the apnea-hypopnea index (AHI) score, patients were categorized into three groups: 15 in the non-exposed group (AHI < 5), 15 in the mildly exposed group (5 ≤ AHI ≤ 15), and 30 in the moderately to severely exposed group (AHI > 15). Serum levels of fibrinogen, E-selectin, and t-PA were determined using enzyme-linked immunosorbent assay.</p><p><strong>Results: </strong>Polysomnography results indicated AIS with OSA had an increased arousal index and oxygen desaturation index (P < 0.001). Additionally, serum levels of fibrinogen, E-selectin, and t-PA were markedly elevated in the moderately-severely exposed group compared to the non-exposed group (P < 0.001), and these levels positively correlated with the severity of OSA. ROC curves showed the sensitivities of serum of fibrinogen, E-selection, and t-PA was 84.4%, 80%, and 82.2%, respectively, and the specificities of 60%, 66.7%, and 66.7%, compared with that of PSG respectively.</p><p><strong>Conclusion: </strong>The expression of serum fibrinogen, E-selectin, and t-PA is elevated in AIS with OSA and correlates with the severity of OSA.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"80"},"PeriodicalIF":2.2,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514706","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":"Fast-acting treatment of myasthenic crisis with efgartigimod from the perspective of the neonatal intensive care unit.","authors":"Fangyi Shi, Rong Lai, Li Feng, Hongyan Zhou, Xunsha Sun, Cunzhou Shen, Jiezhen Feng, Zhilong Xu, Haiyan Wang, Huiyu Feng","doi":"10.1186/s12883-025-04063-1","DOIUrl":"10.1186/s12883-025-04063-1","url":null,"abstract":"<p><strong>Background: </strong>Myasthenic crisis (MC) refers to rapid deterioration of myasthenia gravis (MG), affecting lung and bulbar muscles and causing breathing difficulties. Currently, efgartigimod has shown good therapeutic effects in patients with generalized myasthenia gravis (GMG). This retrospective real-world study explored the effectiveness of efgartigimod in patients with MC.</p><p><strong>Method: </strong>Reviewing the clinical data of five patients (including four patients with refractory MC) with MC who received efgartigimod at the First Affiliated Hospital of Sun Yat-sen University, all of these patients were admitted from September 2023 to December 2023.</p><p><strong>Results: </strong>Each patient received 20 mg/kg of efgartigimod on the first and fifth day. After discharge, all patients showed a clinically meaningful decrease in Myasthenia Gravis Activities of Daily Living (MG-ADL) scale (a decrease of ≥ 2 points) and an improvement in their lung function. Additionally, all patients had a decrease in IgG levels (58.59 ± 18.48% after one cycle of efgartigimod). We also explored the ICU stay and mechanical ventilation (MV) duration for these five patients, and found no significant improvement compared to a large sample data. In terms of safety, four patients experienced adverse events (AEs), all of which were mild. At the last follow-up, four patients achieved the minimal symptom expression (MSE) status (an MG-ADL score of 0 or 1) after 6.25 ± 3.30 weeks. Only one patient experienced a worsening of symptoms in the second week after discharge, but she also achieved the MSE status after receiving a second cycle of efgartigimod treatment.</p><p><strong>Conclusions: </strong>Given the conclusion that intravenous efgartigimod is a non-invasive fast-acting treatment with fewer AEs, this may provide NICU workers with another option for managing patients with MC.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"79"},"PeriodicalIF":2.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514626","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}