Neurologia最新文献

{"title":"Post-COVID-19 memory complaints: Prevalence and associated factors","authors":"M. Ahmed ,&nbsp;S. Roy ,&nbsp;M.A. Iktidar ,&nbsp;S. Chowdhury ,&nbsp;S. Akter ,&nbsp;A.M.K. Islam ,&nbsp;M.D.H. Hawlader","doi":"10.1016/j.nrleng.2024.09.001","DOIUrl":"10.1016/j.nrleng.2024.09.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Memory complaints resulting from COVID-19 may have a significant impact on the survivors’ quality of life. Unfortunately, there is insufficient information available on memory loss and its relationship to COVID-19. Therefore, the purpose of this research was to determine the prevalence of memory complaints in post-COVID-19 patients and to find potential contributing factors.</div></div><div><h3>Method</h3><div>A cross-sectional survey was conducted on 401 individuals who had previously been diagnosed with COVID-19 at four COVID testing centers situated across Bangladesh. The MAC-Q questionnaire was used to evaluate memory. A binary logistic regression model was fit to study the variables related to memory complaints, with a <em>p</em>-value of &lt;0.05 deemed statistically significant.</div></div><div><h3>Result</h3><div>Memory complaints was prevalent in 19.2% of the post-COVID patients. Individual predictor analysis revealed that among the treatment modalities, steroids and antibiotics were associated with impaired memory. Multiple logistic regression showed that individuals who recovered from COVID-19 within six to twelve months were more likely to have memory deficits. Even though age, sex, oxygen demand, and hospitalization were not linked with memory complaints, rural residents exhibited more significant memory complaints than urban residents.</div></div><div><h3>Conclusion</h3><div>Nearly one-fifth of the COVID-19 patients suffer from various degrees of memory complaints within one year. However, no association was found between COVID-19 severity to memory complaints.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 8","pages":"Pages 651-657"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142425828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strength of association of classical vascular risk factors in young patients with ischaemic stroke: a case-control study","authors":"","doi":"10.1016/j.nrleng.2022.07.006","DOIUrl":"10.1016/j.nrleng.2022.07.006","url":null,"abstract":"<div><h3>Introduction</h3><p>Recent studies have reported an increasing incidence of ischaemic stroke among young adults. However, the strength of the association between traditional vascular risk factors has not been fully established.</p></div><div><h3>Methods</h3><p>We compared 120 patients with a first ischaemic stroke before the age of 55 years admitted to the stroke unit of our centre with 600 healthy non-stroke controls from a population-based cohort study (HERMEX), matched for sex. Risk factors assessed included: hypertension, obesity, auricular fibrillation, current smoking, estimated glomerular filtration rate (eGFR), total cholesterol, low-density lipoprotein cholesterol (LDL-C), triglycerides, high-density lipoprotein cholesterol (HDL-C) and diabetes mellitus. We used logistic regression analysis and calculated population attributable risk. We performed an overall analysis, by sex and aetiological subgroup.</p></div><div><h3>Results</h3><p>Using logistic regression analysis, we found that overall, the significant risk factors were: hypertension (OR: 1.58; 95%CI: 1.01-2.50), atrial fibrillation (OR: 4.77; 95%CI: 1.20-19.00), low eGFR (OR: 4.74; 95%CI: 1.3-21.94) and low HDL-C (OR: 5.20; 95%CI: 3.29-8.21), as well as smoking for males (OR: 1.86; 95%CI: 1.14-3.03). LDL-C showed an inverse association with stroke. The population attributable risk for HDL-C was 37.8% and for hypertension 21.1%. In terms of aetiological subgroups, only low HDL-C was associated with stroke of undetermined aetiology.</p></div><div><h3>Conclusions</h3><p>Hypertension, auricular fibrillation, low eGFR, and low HDL-C, plus tobacco use in men, are the main risk factors among patients under 55 years of age with a first ischaemic stroke. We believe that it would be of particular interest to further explore the management of low HDL-C levels as part of preventive strategies in young stroke patients.</p></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 7","pages":"Pages 604-613"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2173580822001420/pdfft?md5=4c95ffad50c9af71107613f15bfeeaa7&pid=1-s2.0-S2173580822001420-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40456578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Botulinum toxin type A infiltration in spasticity and cervical dystonia. Muscle morphology: an overlooked factor","authors":"","doi":"10.1016/j.nrleng.2021.09.012","DOIUrl":"10.1016/j.nrleng.2021.09.012","url":null,"abstract":"<div><h3>Introduction</h3><p>Botulinum toxin type A is used to treat spasticity and dystonia. However, its relationship with muscle morphology has not been studied. The action mechanism of botulinum toxin is based on the inhibition of acetylcholine release. Therefore, larger doses of toxin would be needed to treat larger muscles. This study aims to establish whether there is a discrepancy between muscle morphology and the botulinum toxin doses administered.</p></div><div><h3>Methods</h3><p>We dissected, and subsequently measured and weighed, muscles from the upper and lower limbs and the head of a fresh cadaver. We consulted the summary of product characteristics for botulinum toxin type A to establish the recommended doses for each muscle and calculated the number of units infiltrated per gramme of muscle.</p></div><div><h3>Results</h3><p>Different muscles present considerable morphological variability, and the doses of botulinum toxin administered to each muscle are very similar. We observed great variability in the amount of botulinum toxin administered per gramme of muscle, ranging from 0.3 U/g in the biceps femoris to 14.6 U/g in the scalene muscles. The mean dose was 2.55 U/g. The doses administered for nearly all lower limb muscles were below this value.</p></div><div><h3>Conclusions</h3><p>There are significant differences in morphology between the muscles of the lower limbs, upper limbs, and head, but similar doses of botulinum toxin are administered to each muscle. These differences result in great variability in the number of units of botulinum toxin administered per gramme of muscle.</p></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 7","pages":"Pages 523-529"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2173580823000287/pdfft?md5=ba59c6ad5a3cb0124100df065b292d4b&pid=1-s2.0-S2173580823000287-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9445188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional correlation between cerebellum and basal ganglia: A parkinsonism model","authors":"L. Vásquez-Celaya ,&nbsp;G. Marín ,&nbsp;M.E. Hernández ,&nbsp;P. Carrillo ,&nbsp;C.A. Pérez ,&nbsp;G.A. Coria-Avila ,&nbsp;J. Manzo ,&nbsp;M. Miquel ,&nbsp;L.I. García","doi":"10.1016/j.nrleng.2024.07.002","DOIUrl":"10.1016/j.nrleng.2024.07.002","url":null,"abstract":"<div><h3>Introduction</h3><p>The cerebellar response has been studied for years with different models of alteration of other brain structures to understand its complex functioning and its relationship with the rest of the body. Studies in patients with Parkinson's disease (PD) showed that the cerebellar function is modified by deficit of the basal ganglia; which supports the hypothesis that both structures are related anatomically and functionally.</p></div><div><h3>Methods</h3><p>In our study, the ventrolateral striatum (VLS) of the basal ganglia was altered by an electrolytic lesion, in order to produce a similar jaw frequency of jaw tremor movements presented in parkinsonism, thereafter we analyzed the effect of the lesion on the expression of multiunit activity (MUA) of the cerebellum.</p></div><div><h3>Results</h3><p>We found cerebellar activation during mandibular movements and increment during oral jaw tremor movements. In addition, the amplitude of baseline MUA registered in animals with alteration of the VLS decreased with respect to the intact group.</p></div><div><h3>Conclusions</h3><p>Accordingly, we conclude that cerebellar changes in MUA may be due to a decrease in the cerebellar inflectional or as a possible compensatory function between cerebellum and basal ganglia.</p></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 7","pages":"Pages 555-563"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2173580824000658/pdfft?md5=5a40fac51f62ce86fe2778197601442e&pid=1-s2.0-S2173580824000658-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142122410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cross-sectional area of the median nerve: An independent prognostic biomarker in amyotrophic lateral sclerosis","authors":"J.J. Martínez-Payá ,&nbsp;J. Ríos-Díaz ,&nbsp;M.E. del Baño-Aledo ,&nbsp;D. Hervás ,&nbsp;J.I. Tembl-Ferrairó ,&nbsp;T. Sevilla-Mantecón ,&nbsp;J.F. Vázquez-Costa","doi":"10.1016/j.nrleng.2024.07.003","DOIUrl":"10.1016/j.nrleng.2024.07.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Ultrasound changes in the cross-sectional area of the median nerve (CSAmn) could be of interest as biomarkers in patients with amyotrophic lateral sclerosis (ALS).</p></div><div><h3>Methods</h3><p>Eighty-four ALS patients (51 men [60.7%]; mean 62.0 [SD 11.46] years old) and forty-six controls (27 men [58.7%]; mean 59.9 [SD 8.08] years old) of two different cohorts were recruited between September 2013 and February 2018. The CSAmn was measured bilaterally in each cohort, by two different examiners with two different ultrasound machines (one in each cohort). Its association with clinical variables (disease duration, muscle strength, disability, progression rate and tracheostomy-free survival) was assessed.</p></div><div><h3>Results</h3><p>The CSAmn was smaller in patients than in controls, and the study cohort did not influence its values. A mild correlation between the strength of the wrist flexor and the CSAmn was found. In the multivariable analysis, the probability of this association being true was 90%. In the cox regression, both a faster progression rate and a larger CSAmn independently predicted poor survival (HR<!--> <!-->=<!--> <!-->4.29, [Cr.I95%: 2.71–6.80], <em>p</em> <!-->&lt;<!--> <!-->0.001; and HR<!--> <!-->=<!--> <!-->1.14, [Cr.I95%: 1.03–1.25], <em>p</em> <!-->=<!--> <!-->0.01), after adjusting by age, body mass index, bulbar onset, and diagnostic delay.</p></div><div><h3>Conclusions</h3><p>The CSAmn is an easy to assess biomarker that seems reliable and reproducible. Our data also suggest that it could act as a progression and prognostic biomarker in ALS patients. Longitudinal studies with repeated measures are warranted to confirm its usefulness in the clinical practice.</p></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 7","pages":"Pages 564-572"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S217358082400066X/pdfft?md5=538e3f37fafb0132b313683a428f23c9&pid=1-s2.0-S217358082400066X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142122411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuropsychological rehabilitation for post–COVID-19 syndrome: results of a clinical programme and six-month follow up","authors":"","doi":"10.1016/j.nrleng.2022.06.007","DOIUrl":"10.1016/j.nrleng.2022.06.007","url":null,"abstract":"<div><h3>Introduction</h3><p>Patients with post-COVID-19 syndrome may present cognitive and emotional symptomatology. This study aims to analyse the results of an outpatient neuropsychological intervention programme for post-COVID-19 syndrome.</p></div><div><h3>Method</h3><p>In June 2020 Institut Guttmann started an outpatient post-COVID-19 neurorehabilitation programme, including respiratory therapy, physiotherapy, and neuropsychological rehabilitation. Before and after the programme, the cognitive-emotional state of all participants is assessed. Six months after treatment, a follow-up assessment is administered (which includes a collection of information on various aspects of daily life).</p></div><div><h3>Results</h3><p>The sample analysed consisted of 123 patients (mean age: 51 years, SD: 12.41). Seventy-four per cent (n = 91) had cognitive impairment and underwent cognitive treatment (experimental group); the remaining 26% (n = 32) constituted the control group. After the intervention, the experimental group improved in working memory, verbal memory (learning, recall and recognition), verbal fluency and anxious-depressive symptomatology. The control group showed changes in immediate memory, verbal memory (learning and recognition) and depressive symptomatology, although the effect size in the latter two was smaller than in the experimental group. Six months after treatment, 44.9% of the patients were unable to perform their pre-COVID-19 work activity, and 81.2% reported difficulties in their activities of daily living.</p></div><div><h3>Conclusions</h3><p>Neuropsychological rehabilitation is an effective tool to treat the cognitive-emotional deficits present in post-COVID-19 syndrome. However, months after the end of treatment, not all patients recover their pre-COVID-19 functional level.</p></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 7","pages":"Pages 592-603"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9476330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9548210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Volume of hippocampal activation as a determining factor for the lateralisation of the epileptogenic zone in patients with drug-resistant mesial temporal lobe epilepsy","authors":"","doi":"10.1016/j.nrleng.2022.02.003","DOIUrl":"10.1016/j.nrleng.2022.02.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Approximately 30% of patients with mesial temporal lobe epilepsy (MTLE) will develop drug resistance, which requires early surgical treatment. The success of the surgical procedure largely depends on the correct lateralisation of the epileptogenic zone, which can only be determined in 70% of patients with such conventional diagnostic tools as video electroencephalography and volumetric structural magnetic resonance imaging. We evaluated the performance of a memory functional magnetic resonance imaging (fMRI) paradigm in lateralising the epileptogenic zone in patients with drug-resistant MTLE.</p></div><div><h3>Methods</h3><p>We included 18 patients with MTLE attended at the Instituto Neurológico Colombiano in Medellin (Colombia) between 2018 and 2019. The volume of functional activation in both temporal lobes was determined with a memory fMRI paradigm. A concordance analysis was performed to compare the performance of fMRI against that of conventional tests.</p></div><div><h3>Results</h3><p>In patients with left MTLE, lower total activation was found in the hemisphere ipsilateral to the epileptogenic zone as compared to the contralateral hemisphere (121.15 ± 16.48 voxels vs 170.23 ± 17.8 voxels [<em>P</em> &lt; .001]), showing substantial concordance with conventional tests. Patients with right MTLE displayed lower hippocampal activation ipsilateral to the epileptogenic zone (18.5 ± 3.38 voxels vs 27.8 ± 3.77 voxels in the contralateral hippocampus [<em>P</em> = .048]), showing moderate concordance with conventional tests.</p></div><div><h3>Conclusions</h3><p>These findings suggest that lower functional activation as determined by a memory fMRI paradigm has a high level of concordance with conventional tests for lateralising the epileptogenic zone in patients with drug-resistant MTLE.</p></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 7","pages":"Pages 584-591"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2173580822001754/pdfft?md5=d003c84ef8e34690847de920050a2682&pid=1-s2.0-S2173580822001754-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40695739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Creutzfeldt–Jakob disease in a heterozygous GBA mutation carrier: Coincidence or consequence?","authors":"I.V. Carvalho ,&nbsp;D. Damas ,&nbsp;I. Baldeiras ,&nbsp;M.R. Almeida ,&nbsp;H. Gens ,&nbsp;G.C. Santo","doi":"10.1016/j.nrleng.2024.07.005","DOIUrl":"10.1016/j.nrleng.2024.07.005","url":null,"abstract":"","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 7","pages":"Pages 614-616"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2173580824000683/pdfft?md5=187a41b651794a732165a10e8f660b4a&pid=1-s2.0-S2173580824000683-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142122322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating microRNAs as potential biomarkers for the diagnosis of Parkinson's disease: A meta-analysis","authors":"W.T. Zhang ,&nbsp;Y.J. Wang ,&nbsp;Y.F. Yao ,&nbsp;G.X. Zhang ,&nbsp;Y.N. Zhang ,&nbsp;S.S. Gao","doi":"10.1016/j.nrleng.2024.07.004","DOIUrl":"10.1016/j.nrleng.2024.07.004","url":null,"abstract":"<div><h3>Background and objective</h3><p>Parkinson's disease (PD) is the one of the most common neurodegenerative diseases. Many investigators have confirmed the possibility of using circulating miRNAs to diagnose PD. However, the results were inconsistent. Therefore, the aim of this meta-analysis was to systematically evaluate the diagnostic accuracy of circulating miRNAs in the diagnosis of PD.</p></div><div><h3>Methods</h3><p>We carefully searched PubMed, Embase, Web of Science, Cochrane Library, Wanfang database and China National Knowledge Infrastructure for relevant studies (up to January 1, 2022) based on PRISMA statement. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), the diagnostic odds ratio (DOR), and area under the curve (AUC) were calculated to test the diagnostic accuracy. Furthermore, subgroup analyses were performed to identify the potential sources of heterogeneity, and the Deeks’ funnel plot asymmetry test was used to evaluate the potential publication bias.</p></div><div><h3>Results</h3><p>Forty-four eligible studies from 16 articles (3298 PD patients and 2529 healthy controls) were included in the current meta-analysis. The pooled sensitivity was 0.79 (95% CI: 0.76–0.81), specificity was 0.82 (95% CI: 0.78–0.84), PLR was 4.3 (95% CI: 3.6–5.0), NLR was 0.26 (95% CI: 0.23–0.30), DOR was 16 (95% CI: 13–21), and AUC was 0.87 (95% CI: 0.84–0.90). Subgroup analysis suggested that miRNA cluster showed a better diagnostic accuracy than miRNA simple. Moreover, there was no significant publication bias.</p></div><div><h3>Conclusions</h3><p>Circulating miRNAs have great potential as novel non-invasive biomarkers for PD diagnosis.</p></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 7","pages":"Pages 573-583"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2173580824000671/pdfft?md5=b25a2085afa43ffd027bc10248093d00&pid=1-s2.0-S2173580824000671-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142122412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Valproic acid could help in the fight against COVID-19: A case–control study","authors":"O. Moreno-Pérez ,&nbsp;E. Merino ,&nbsp;J. Manuel Ramos ,&nbsp;J. Carlos Rodríguez ,&nbsp;C. Diaz ,&nbsp;P. Mas ,&nbsp;S. Reus ,&nbsp;R. Sánchez-Martínez ,&nbsp;V. Boix ,&nbsp;P. Chico-Sánchez ,&nbsp;J. Sánchez-Payá ,&nbsp;J. Portilla ,&nbsp;On behalf COVID19-ALC research group","doi":"10.1016/j.nrleng.2023.12.009","DOIUrl":"10.1016/j.nrleng.2023.12.009","url":null,"abstract":"<div><h3>Objective</h3><p>There is early evidence about Valproic acid (VPA) antiviral effect. Our aim was to investigate the incidence and severity of SARS-CoV-2 infection in VPA users as compared with the general population.</p></div><div><h3>Material and methods</h3><p>A case-control study nested within a cohort, carried out between March 1 and December 17, 2020. Retrospectively, we identified confirmed SARS-CoV-2 infection patients exposed to VPA in our health department (defined as case). We ascertained VPA regimen (all the time (AT) (292 days) or at least 20% of the study period (notAT) (≥58 days) and if VPA levels were in therapeutic range (ATR) (50–100<!--> <!-->mcg/mL) in the last 24 months. We calculated the cumulative incidence of SARS-CoV-2 infection and hospital admission in the cases, comparing it with the general unexposed VPA population (controls).</p></div><div><h3>Results</h3><p>During the study period, 6183 PCR+ were detected among 281,035 inhabitants, of these, 746 were hospitalized. 691 patients were on VPA notAT and 628 (90.1%) AT. The indication for VPA use was epilepsy in 54.9%. The incidence of PCR+ was 1.736% (OR 0.785 (95%CI 0.443–1.390) and 1.910% (OR 0.865 (95%CI 0.488–1.533), on VPA notAT and VPA AT patients, respectively vs. 2.201% in people without VPA regimen. Those patients with VPA ATR had a lower risk of PCR + (OR 0.233 (95%CI 0.057–0.951) notAT; OR 0.218 (95%CI 0.053–0.890) AT). Hospital admission incidence was lower in patient on VPA (OR was 0.543 (95% CI 0.076–3.871).</p></div><div><h3>Conclusion</h3><p>Patients with VPA within the therapeutic range had a reduction of SARS-Cov-2 infection incidence greater than 75%. There is a downward trend in the risk of COVID-19 admission by SARS-CoV-2 in patients on VPA therapy. These findings warrant further investigation.</p></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 7","pages":"Pages 549-554"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2173580823000779/pdfft?md5=6b9d346c962f2cb227f986f1ec687e0c&pid=1-s2.0-S2173580823000779-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142122408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}