Neurologia最新文献

{"title":"Consensus document of the Spanish Society of Neurology on the prevention of cognitive decline and dementia","authors":"M.J. Gil Moreno ,&nbsp;C. Terrón Cuadrado ,&nbsp;M.S. Manzano Palomo ,&nbsp;A. Delgado Alvarez ,&nbsp;M. Eimil Ortiz ,&nbsp;G. Garcia Ribas ,&nbsp;M. Llanero Luque ,&nbsp;A. Marcos Dolado ,&nbsp;J. Matias-Guiu Antem ,&nbsp;C. Ochoa Lopez ,&nbsp;N. Rodriguez Espinosa ,&nbsp;M. Salas Carrillo ,&nbsp;A. Vieira Campos","doi":"10.1016/j.nrleng.2026.501918","DOIUrl":"10.1016/j.nrleng.2026.501918","url":null,"abstract":"<div><div>Recent studies have demonstrated a relationship between the development of cognitive impairment and dementia and lifestyle-related risk factors, many of which are potentially modifiable, making it possible to prevent dementia through a public health approach that includes the implementation of key interventions to delay or slow cognitive decline or dementia.</div><div>This consensus statement was prepared by a group of experts in cognitive pathology and the Neurogeriatrics Study Group of the Spanish Society of Neurology.</div><div>This document consists of a review of the existing literature, and its main objective is to serve as a guide for healthcare professionals interested in cognitive impairment and dementia. The different modifiable risk factors related to cognitive decline and dementia are listed and related aspects are analysed; it also presents a series of basic recommendations.</div><div>This document has been drafted to be a useful tool in the clinical practice of professionals providing care to patients with cognitive impairment and dementia.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 501918"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redefining therapeutics in vATTR: Evaluation of response predictors to tafamidis and patisiran treatment in a non-endemic area. A proposal for a novel individualised therapeutic approach","authors":"L. Martínez-Vicente ,&nbsp;V. Gajate-García ,&nbsp;G. Gutiérrez-Gutiérrez ,&nbsp;Á.L. Guerrero-Peral ,&nbsp;A. Horga ,&nbsp;A. Guerrero-Sola ,&nbsp;J. Álvarez-Troncoso ,&nbsp;M.A. Restrepo-Córdoba ,&nbsp;J. Goirigolzarri-Artaza ,&nbsp;S. Martín-Albarrán ,&nbsp;A. Valverde-Megías ,&nbsp;E. González-López ,&nbsp;P. García-Pavía ,&nbsp;J. Matías-Guiu ,&nbsp;L. Galán-Dávila","doi":"10.1016/j.nrleng.2026.501920","DOIUrl":"10.1016/j.nrleng.2026.501920","url":null,"abstract":"<div><h3>Introduction</h3><div>Hereditary transthyretin amyloidosis (vATTR) is a progressive genetic disorder with several approved treatments. We investigated treatment responses to tafamidis and patisiran in vATTR patients to identify predictive response factors.</div></div><div><h3>Methods</h3><div>Retrospective analysis on vATTR patients treated with tafamidis or patisiran from October 2012 to September 2022. Treatment responses were assessed as “good,” “partial,” or “non-response.” We analysed pre-treatment clinical and laboratory data to identify predictors of treatment response.</div></div><div><h3>Results</h3><div>Of the 53 patients, 44 received tafamidis and 23 received patisiran; 14 were treated with both drugs sequentially. Predictors of good response to tafamidis were shorter diagnostic delay (≤1 year), less severe neurological impairment (Coutinho stage 1, Neuropathy Impairment Score [NIS]<!--> <!-->≤<!--> <!-->7), and better sudomotor function in the feet (≥50<!--> <!-->μS) before treatment. Factors associated with non-response were greater disability (baseline Polyneuropathy Disability score<!--> <!-->=<!--> <!-->2), large fibre involvement, and significant weight loss. Predictors of a good response to patisiran included lower pre-treatment disease severity (Coutinho stage 1, NIS<!--> <!-->≤<!--> <!-->40). We propose an individualised therapeutic approach using predictive factors to guide initial treatment.</div></div><div><h3>Conclusions</h3><div>This study identifies predictive factors for response to tafamidis and patisiran in vATTR patients, highlighting baseline NIS as a critical predictor. We propose a novel therapeutic algorithm for personalised treatment strategies with potential to avoid years of ineffective treatment.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 501920"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147631605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond indomethacin: a case report of chronic paroxysmal hemicrania with remarkable response to non-invasive vagus nerve stimulation","authors":"A. Jaimes,&nbsp;A. Gómez,&nbsp;O. Pajares,&nbsp;J. Rodríguez-Vico","doi":"10.1016/j.nrleng.2026.501917","DOIUrl":"10.1016/j.nrleng.2026.501917","url":null,"abstract":"","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 501917"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Usefulness of anesthetic block of the greater occipital nerve in the treatment of migraine in children and adolescents","authors":"M. Bote Gascón ,&nbsp;E. Arias Vivas ,&nbsp;U.A. Barrios Machain ,&nbsp;A. García Ron","doi":"10.1016/j.nrleng.2026.501915","DOIUrl":"10.1016/j.nrleng.2026.501915","url":null,"abstract":"<div><h3>Introduction</h3><div>Peripheral nerve blockade (PNB) is a common treatment in adults with headache. Although there is little evidence in pediatrics, its simplicity, safety and efficacy make it an option that can be extrapolated to our practice. Therefore, we conducted a study in which we evaluated the usefulness of anesthetic blockade of the NOM (greater occipital nerve) as a treatment for migraine in the pediatric population.</div></div><div><h3>Methods</h3><div>Prospective cohort study in children and adolescents with migraine. We collected demographic and clinical data (pain intensity using the verbal numeric scale) and data related to quality of life (PedMidas and PedsQL questionnaire) at baseline and after performing NOM block with 2.5 ml of 0.5% bupivacaine.</div></div><div><h3>Results</h3><div>We included 28 patients (89.3% women) with a mean age of 13.9 years. Mean frequency of 22.8 episodes/month and intensity of 7.7/10 on the verbal-numerical scale (VNS). Post-treatment: significant reduction (<em>P</em> &lt; .01) in frequency to 6.1 episodes/month and intensity: 3.9 points (30 minutes), 4.2 points (1 week), 3.9 points (15 days), 4.4 points (1 month) and 5.4 points (3 months). 100% had an effect on their quality of life, both on the PedMidas and PedsQL scales, the greater the effect, the better the response. Only 2 had adverse effects (syncope and local pain).</div></div><div><h3>Conclusions</h3><div>NOM blockade is a safe, effective and useful procedure for the acute and preventive treatment of migraine in pediatric age. It relieves the burden associated with headache and is associated with an improvement in the quality of life of patients.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 501915"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myasthenia gravis in Spain: A survey of specialized neurologists to uncover unmet needs","authors":"E. Cortés-Vicente ,&nbsp;C. Casasnovas ,&nbsp;R. Juntas ,&nbsp;T. Sevilla ,&nbsp;J. Pardo ,&nbsp;F. Rodríguez de Rivera ,&nbsp;A. Guerrero Sola","doi":"10.1016/j.nrleng.2026.501912","DOIUrl":"10.1016/j.nrleng.2026.501912","url":null,"abstract":"<div><h3>Introduction</h3><div>Myasthenia gravis (MG) is a neuromuscular autoimmune disease that requires prompt diagnosis and management by neurologists. The challenges of MG management are associated with the diagnostic process and the selection of an effective form of therapy enabling long-term remission of the disease. The objective of this study was to assess the state of MG in Spain to identify unaddressed needs in the clinical progression, diagnosis, and treatment approaches.</div></div><div><h3>Methods</h3><div>A survey was distributed via email between 19 July and 25 October 2022 to neurologists belonging to the Spanish Society of Neurology. A comprehensive descriptive analysis was conducted on all collected data.</div></div><div><h3>Results</h3><div>In total, 69 completed surveys, representing 64 Spanish hospitals, were analyzed and included in the results. The study identified that economic difficulties, such as departmental budgets, have led to a lack of access to antibody testing during diagnosis. Furthermore, corticosteroids were found to achieve the best clinical response, despite also being associated with a higher frequency of adverse effects. The results show that 34% of patients with MG present active symptoms. Eighteen percent have symptoms that limit their daily activities. Additionally, 29% of patients have requested an unscheduled follow-up visit within the last year.</div></div><div><h3>Conclusions</h3><div>Several areas present unmet needs in terms of improving access to diagnostic assays, residual disease burden in treated patients, and the management and diagnosis of MG.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 501912"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147631640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iatrogenic cerebral amyloid angiopathy in a young patient: aetiopathogenic hypothesis","authors":"M. De la Fuente Gómez-Morán ,&nbsp;F. Hernández-Fernández ,&nbsp;E.L. Setién ,&nbsp;R.M. Collado Jiménez ,&nbsp;C. Barrena López ,&nbsp;R.A. Barbella Aponte","doi":"10.1016/j.nrleng.2026.501916","DOIUrl":"10.1016/j.nrleng.2026.501916","url":null,"abstract":"","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 501916"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Parkinson's Real-World Impact Assessment (PRISM) project in the management and burden of Parkinson's disease in Spain","authors":"C. Painous Martí ,&nbsp;I. Pijuan Jiménez ,&nbsp;À. Bayés Rusiñol ,&nbsp;J.C. Martínez Castrillo ,&nbsp;Á. Sésar Ignacio ,&nbsp;E. Tolosa Sarró","doi":"10.1016/j.nrleng.2026.501921","DOIUrl":"10.1016/j.nrleng.2026.501921","url":null,"abstract":"<div><h3>Introduction</h3><div>Real-world data studies are a promising option for understanding everyday Parkinson's disease (PD) management and optimizing strategies and therapeutic options. The Parkinson's Real-World Impact Assessment (PRISM) project was conceived as a European survey to evaluate the burden of the disease in people with Parkinson's disease (PwP) and their caregivers. Here, we present the analysis of the Spanish PRISM cohort dataset to describe prescribing patterns, healthcare resource utilization, and the impact of PD on PwP and their caregivers.</div></div><div><h3>Methods</h3><div>Data were collected using an electronic questionnaire distributed through different patient advocacy groups and specialized PD clinics in Spain.</div></div><div><h3>Results</h3><div>A total of 149 PwP (mean age, 62.6 years; mean disease duration, 7.6 years) and 38 caregivers were included. Most PwP (87.1%) received levodopa during the 12 months preceding the survey. A high percentage of patients (62.1%) expressed interest in participating in a clinical trial, but only 20% reported a current or previous enrollment. PwP reported high incidence of non-motor symptoms and poor health-related quality of life. At least one impulse control behavior was reported in 57% of patients. Caregivers reported mild to moderate disease burden.</div></div><div><h3>Conclusions</h3><div>This study identified high rates of motor and non-motor symptoms, impulse control disorders, and considerable disease burden in PwP and their caregivers, even at a relatively young age and a mild/moderate stage of the disease. Also, it highlights the limited use of rehabilitation therapies. These data provide information for PD management and resource utilization in Spain.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 501921"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147631639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of tocilizumab in acute necrotising encephalitis secondary to influenza A","authors":"I. Comino-Hidalgo ,&nbsp;J. López Pequeño ,&nbsp;A. Aguado del Hoyo ,&nbsp;M. Vázquez López","doi":"10.1016/j.nrleng.2026.501914","DOIUrl":"10.1016/j.nrleng.2026.501914","url":null,"abstract":"","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 501914"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of hypertension on stroke. Are there different age profiles?","authors":"L. Castilla-Guerra ,&nbsp;M.C. Fernandez-Moreno ,&nbsp;M. de la Serna Fito ,&nbsp;A. Palomino-Garcia ,&nbsp;G.A. Escobar Rodriguez ,&nbsp;M.D. Jiménez Hernandez","doi":"10.1016/j.nrleng.2026.501913","DOIUrl":"10.1016/j.nrleng.2026.501913","url":null,"abstract":"<div><h3>Introduction</h3><div>Arterial hypertension is the most prevalent modifiable risk factor for stroke. We aim to establish if there is an association between hypertension and type of stroke, and if this varies with age.</div></div><div><h3>Methods</h3><div>Retrospective study of patients with a first stroke discharged from public hospitals in Seville (Spain) between 1999 and 2021. Only patients with hypertension as a risk factor were included. The sample was divided into 3 groups: patients ≤ 50 years, 51 to 79 years and ≥ 80 years.</div></div><div><h3>Results</h3><div>Of 42 855 strokes, 2141 (4.9%) hypertensive patients with a first stroke, mean age 68 (15) years, and 1010 (47.2%) women, were included. Included were 1274 (59.5%) ischaemic strokes and 867 (40.5%) haemorrhagic strokes, 309 (14.4%) patients ≤ 50 years of age, 1253 (58.3%) patients between 51 and 79 years of age, and 579 (27.3%) patients ≥ 80 years of age. The percentage of patients with a previous diagnosis of hypertension was 24.3% vs 51.3% vs 79.4% (<em>P</em> &lt; .001), with a mean time from diagnosis to stroke of 5.5 (3.7) vs 7.8 (4.9) vs 9.6 (5.1) years (<em>P</em> &lt; .001) respectively. The number of haemorrhagic strokes was: 171 (55.3%), 523 (41.7%), and 172 (29.7%) (<em>P</em> &lt; .001), with mortality at one year being 3.2%, 10%, and 35.6%, respectively (<em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>In hypertensive patients with a first stroke, the percentage of haemorrhagic strokes is higher than expected, especially in young patients, where it exceeds half of the cases. It is necessary to optimise prevention in these patients to reduce the enormous social and healthcare burden that stroke represents.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 501913"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protective effect of adult vaccination on the development of dementias: A systematic review","authors":"E. Mariscal-Lopez ,&nbsp;M. Agredano-Sanchez ,&nbsp;R.M. Lopez-Gigosos ,&nbsp;A. Mariscal ,&nbsp;F. Fariñas-Guerrero ,&nbsp;M. Gutierrez-Bedmar ,&nbsp;M. Guts-Chornoknyzha","doi":"10.1016/j.nrleng.2026.501939","DOIUrl":"10.1016/j.nrleng.2026.501939","url":null,"abstract":"<div><h3>Introduction</h3><div>Dementias currently impose a significant burden in terms of morbidity, mortality, socio-economic costs, and human suffering. Several studies have indicated that certain infectious diseases may increase the risk of dementia. Additionally, research has suggested that adult vaccines may help to prevent dementia. This systematic review looks into the possible association between adult vaccines and dementia in studies published between 2016 and April 2024.</div></div><div><h3>Development</h3><div>A search was conducted in accordance with the PRISMA 2020 guidelines to assess the potential association between adult vaccines and dementia in adults aged 50 and above. Quality and potential bias were evaluated using the revised Assessing the Methodological Quality of Systematic Reviews (AMSTAR-2) scale, the Newcastle–Ottawa scale, and the Risk-of-bias in Studies of Temporal Trends (ROBITT) tool. Fifteen out of the 16 selected studies showed a high degree of uniformity in terms of vaccinated adults having lower rates of dementia than unvaccinated adults. The observed risk reduction ranged from 4% to 50% (relative risk measures). The influenza vaccine has been the subject of the most extensive research, with 10 of the 16 studies focusing on it. Five studies demonstrated a dose–response relationship, indicating that a higher number of vaccines per patient is associated with a lower risk of dementia. Only one of the selected studies found an association between vaccination of adults and an increased risk of dementia.</div></div><div><h3>Conclusions</h3><div>The studies examined provide evidence supporting the hypothesis that adult vaccination may have a protective effect against the development of dementia. However, further molecular biology and pathophysiology studies are required to elucidate the underlying mechanisms and confirm the plausibility of this hypothesis.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 2","pages":"Article 501939"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}