Neurologia最新文献

{"title":"Impact of a perioperative protocol for Parkinson's disease patients on use of contraindicated drugs","authors":"P. Salgado-Cámara ,&nbsp;B. De la Casa-Fages ,&nbsp;A. Sánchez-Soblechero ,&nbsp;O. Mateo Sierra ,&nbsp;M.L. Martín-Barbero ,&nbsp;F. Grandas","doi":"10.1016/j.nrleng.2025.101897","DOIUrl":"10.1016/j.nrleng.2025.101897","url":null,"abstract":"<div><h3>Introduction</h3><div>During surgical admissions, the use of antidopaminergic drugs is associated with increased morbimortality and hospital stay in patients with Parkinson's disease (PD) and other parkinsonisms. We implemented a protocol to ensure adequate perioperative pharmacological management in our center, including educational sessions and complementary tools, such as an electronic Pharmacological Alert and a Patient Information Sheet.</div></div><div><h3>Objective</h3><div>The objective of this study was to analyze the changes in the prescription of contraindicated medications to PD or parkinsonism patients admitted for surgery, in the three years following implementation of the protocol, and to establish the compliance with the protocol among the medical staff involved in their hospital care over the same period.</div></div><div><h3>Methods</h3><div>This is an observational, analytical, prospective study with a before–after design.</div></div><div><h3>Results</h3><div>Prescription of contraindicated drugs decreased significantly over the study period (from 57.8% to 20.6%; <em>p</em> <!-->&lt;<!--> <!-->0.001). Patients without an activated Pharmacological Alert had a 13.31 times higher risk of being prescribed contraindicated drugs than patients with such an alert (<em>p</em> <!-->&lt;<!--> <!-->0.001). Neurologists and neurosurgeons used the protocol tools more than Emergency Department surgeons. There was very high compliance with the protocol in admissions for deep brain stimulation and related surgeries.</div></div><div><h3>Conclusions</h3><div>The protocol reduced the prescription of contraindicated drugs to PD and parkinsonism patients during their surgical admissions in our center. The Pharmacological Alert and Neurology clinics played a crucial role.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 1","pages":"Article 101897"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015553","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":"Unravelling the temporal evolution of Parkinson's disease mortality in Spanish autonomous communities (1999–2021)","authors":"L. Cayuela ,&nbsp;E. Zapata-Arriaza ,&nbsp;A. de Albóniga-Chindurza ,&nbsp;A. González García ,&nbsp;A. Cayuela","doi":"10.1016/j.nrleng.2025.501911","DOIUrl":"10.1016/j.nrleng.2025.501911","url":null,"abstract":"<div><h3>Objective</h3><div>This observational retrospective study aimed to analyse the mortality trends of Parkinson's disease (PD) in Spain from 1999 to 2021, by autonomous community and sex.</div></div><div><h3>Methods</h3><div>The study collected PD mortality data from 1999 to 2021 from the National Statistics Institute of Spain. Age-standardised mortality rates were analysed by sex and age group, using joinpoint analysis to identify significant trends.</div></div><div><h3>Results</h3><div>Over the study period, 72<!--> <!-->907 deaths due to PD were recorded in Spain, with 51% occurring in men and 49% in women. Both men and women showed a consistent upward trend in PD mortality rates at the national level, with annual increases of 2.1% for men and 2.0% for women. Joinpoint analysis revealed significant changes in trends within specific regions. Among men, rates in Catalonia stabilised after an initial increase, whereas Madrid showed a significant increase after a period of stability. Conversely, La Rioja exhibited a notable decrease after a period of increase. Similar patterns were observed for women, with certain regions showing stable rates while others displayed an upward trend. Cantabria, Galicia, and Valencia stabilised after an initial significant increase, Madrid showed a significant increase after a period of stability, and Andalusia demonstrated an acceleration after an initial increase.</div></div><div><h3>Conclusions</h3><div>Our findings underscore the significance of monitoring PD mortality trends and their varying impact across different regions and sexes. This valuable information can play a crucial role in shaping future healthcare policies and designing effective prevention strategies.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 1","pages":"Article 501911"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015556","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":"Brueghel syndrome: A missing entity. Case report","authors":"D. López Dominguez ,&nbsp;G. Álvarez Bravo","doi":"10.1016/j.nrleng.2025.101895","DOIUrl":"10.1016/j.nrleng.2025.101895","url":null,"abstract":"","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 1","pages":"Article 101895"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015662","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":"Association between comorbidities and health-related quality of life in patients with multiple sclerosis","authors":"O. Mirmosayyeb ,&nbsp;M. Barzegar ,&nbsp;M. Rezaei ,&nbsp;S. Houshi ,&nbsp;A. Afshari-Safavi ,&nbsp;M. Falahatian ,&nbsp;N. Nehzat ,&nbsp;V. Shaygannejad","doi":"10.1016/j.nrleng.2025.101901","DOIUrl":"10.1016/j.nrleng.2025.101901","url":null,"abstract":"<div><h3>Purpose</h3><div>Multiple sclerosis (MS) is a debilitating disease accompanied by physical and mental comorbidities. Little is known about the relation between different comorbidities and health-related quality of life (HRQOL) in people with MS (pwMS). Therefore, we designed this study to assess the association between comorbidities and HRQOL.</div></div><div><h3>Methods</h3><div>In this cross-sectional study, of 976 pwMS attending the MS clinic of Kashani Hospital in Isfahan, Iran were assessed. The data on comorbidity were extracted from patients’ medical records. The 36-Item Short Form Survey (SF-36) was used to measure HRQOL. Firstly, the association between each comorbidity and HRQOL was assessed. Then, the comorbidities were categorized into physical, psychiatric, and autoimmune, and the association of each comorbidity group with HRQOL was evaluated.</div></div><div><h3>Results</h3><div>The mean (SD) age and disease duration were 37.58 (9.22) and 7.41 (5.24); most of them were female (82.8%) and had a relapsing course (77.1%). The most common comorbidity was migraine (13.6%), followed by hypothyroidism (13.5%), obsessive–compulsive disorder (OCD) (13.5%), and anemia (11.5%). There was a significant association between the physical component score (PCS) of HRQOL and reduced epilepsy, coronary artery disease, eye diseases, OCD, major depressive disorder (MDD), and borderline personality disorder. Regarding mental component (MCS), ovarian failure, polycystic ovary syndrome, OCD, and MDD had an association with low MCS. After categorization, both physical and psychiatric comorbidities were related to less PCS and MCS score. However, no significant association between autoimmune comorbidities and HRQOL was found.</div></div><div><h3>Conclusion</h3><div>Our results show a significant association between comorbidities and HRQOL in MS patients.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 1","pages":"Article 101901"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015555","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":"Phenotypic and genotypic heterogeneity in a series of cases associated with dopa-responsive dystonia","authors":"I.G. Díaz ,&nbsp;E.O. Aguilar ,&nbsp;G.F. Pajarín ,&nbsp;I.C. López ,&nbsp;D.A.G. Estevez ,&nbsp;B.A. Pensado ,&nbsp;Á.S. Ignacio","doi":"10.1016/j.nrleng.2025.101900","DOIUrl":"10.1016/j.nrleng.2025.101900","url":null,"abstract":"<div><h3>Introduction</h3><div>Dopa-responsive dystonia (DRD) includes a group of neurological disorders that manifest with lower limb dystonia and an excellent response to levodopa. Parkinsonism is commonly associated with DRD, and many cases of <em>GCH1</em> gene mutations without dystonia but with evidence of nigrostriatal pathway degeneration, indistinguishable to idiopathic Parkinson's disease (PD), have been recently described. This phenotypic variability has been observed even among members of the same family.</div></div><div><h3>Method</h3><div>Clinical and genetic description of 14 patients from 4 different families with DRD associated mutations.</div></div><div><h3>Results</h3><div>The results showed <em>GCH1</em> mutations in three of the four families, while one family had a mutation in the <em>SPR</em> gene. Within patients with <em>GCH1</em> mutations, two showed DRD symptoms, five had PD phenotype, and four were asymptomatic. The only patient with <em>SPR</em> mutation clinically displayed symptoms of dystonia and parkinsonism. DaTscan® revealed degeneration of the nigroestriatal pathway in two PD patients. Furthermore, phenotypic variability of the same mutation was observed in two families.</div></div><div><h3>Conclusions</h3><div>DRD associated mutations have a heterogeneous clinical expression <em>GCH1</em> gene mutations can be manifested with PD phenotype along with the degeneration of the nigroestiatal pathway. Therefore, <em>GCH1</em> gene testing might be useful in cases of PD suggestive of genetic origin or with family history of dystonia.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 1","pages":"Article 101900"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015554","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":"Sleep disturbances in patients with myasthenia gravis: A cross-sectional study","authors":"J. Yan ,&nbsp;K. Choi ,&nbsp;P. Fu ,&nbsp;J. Lin ,&nbsp;M. Gui ,&nbsp;Y. Li ,&nbsp;L. Luo ,&nbsp;Z. Hu ,&nbsp;B. Bu ,&nbsp;Z. Li","doi":"10.1016/j.nrleng.2025.501925","DOIUrl":"10.1016/j.nrleng.2025.501925","url":null,"abstract":"<div><h3>Objective</h3><div>To explore sleep dysfunction in clinically stable patients with myasthenia gravis (MG) and to identify sleep disturbances and uncover their associated risk factors.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted, involving the recruitment of 306 patients with MG from three MG centers. Participants completed an online self-report questionnaire covering demographic variables, clinical characteristics, and assessments using the Pittsburgh Sleep Quality Index (PSQI) scale, STOP-Bang scale, Myasthenia Gravis Quality of Life 15 (MG-QOL 15) scale, Patient Health Questionnaire (PHQ-9), and Self-Rating Anxiety Scale (SAS), to evaluate sleep quality among patients with MG.</div></div><div><h3>Results</h3><div>Approximately 68% of patients with MG presented sleep disturbances (PSQI ≥6). Univariate analysis revealed that age, lower education level (≤12 years), being single, late disease onset (&gt;55 years old), generalized subtype, myasthenia crisis, positivity for AChR antibodies, thymoma, thymectomy, and type B thymoma were risk factors for sleep dysfunction in patients with MG. Within the sleep disturbances group, 51% of patients scored ≥3 on the STOP-Bang scale, indicating a higher risk of obstructive sleep apnea. PSQI global scores showed significant linear correlations with MG-QOL 15, STOP-Bang, PHQ-9, and SAS scores (<em>P</em> <!-->&lt;<!--> <!-->.001). Multivariate analysis revealed that sex, marital status, STOP-Bang score, SAS score, and MG-QOL 15 score were correlated with the PSQI score.</div></div><div><h3>Conclusion</h3><div>Sleep disturbances are prevalent among patients with MG, even in clinically stable cases. Psychological factors such as anxiety and health-related quality of life warrant increased attention in the management of these patients.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 1","pages":"Article 501925"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015660","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":"Dysautonomia after COVID-19 infection: A case report","authors":"C.H. Vera-Cáceres ,&nbsp;M. García-Huguet ,&nbsp;A. Gil de Genover ,&nbsp;S.D. Sagula ,&nbsp;L. Martín Muñóz ,&nbsp;D. López Domínguez","doi":"10.1016/j.nrleng.2025.101891","DOIUrl":"10.1016/j.nrleng.2025.101891","url":null,"abstract":"<div><h3>Introduction</h3><div>This case report discusses a case of a patient who experienced acute autonomic dysfunction during the parainfectious phase of COVID-19, attributed to Guillain-Barre Syndrome (GBS). This is the first well-documented case of such an association.</div></div><div><h3>Case presentation</h3><div>A 64-year-old woman, previously infected with COVID-19, was admitted to the emergency department due to altered mental status. Brain computed tomography (CT) revealed bilateral occipital diffuse hypodensity. Throughout her hospitalization, she exhibited elevated blood pressure necessitating intravenous treatment.</div><div>The initial brain MRI revealed T2-weighted image hyperintensity at the parietal and occipital levels, indicative of vasogenic edema. These neuroimaging findings were suggestive of posterior reversible encephalopathy syndrome (PRES). Euvolemic hyponatremia with concurrent low serum osmolality and high urine osmolality and sodium was observed, indicating a syndrome of inappropriate antidiuretic hormone (SIADH). Throughout the patient's stay, her level of consciousness exhibited significant improvement. However, she developed ascending symmetrical limb weakness and progressive loss of reflexes, along with a severe motor deficit and gait disturbance, accompanied by arterial blood pressure fluctuations and other signs of autonomic dysfunction.</div><div>Clinical manifestations, neurophysiological findings, and laboratory results were indicative of Guillain-Barre Syndrome (GBS), leading to a conclusive diagnosis of GBS with dysautonomia triggered by a COVID-19 infection.</div></div><div><h3>Conclusion</h3><div>This case reveals the relevance of diagnosing autonomic dysfunction (including PRES) as the initial manifestation of GBS linked to COVID-19 infection and the importance of early diagnosis to prevent potential complications.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 1","pages":"Article 101891"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015661","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":"Recommendations for the critical reading of clinical trials on disease-modifying drugs for multiple sclerosis","authors":"A. Rivero-de-Aguilar ,&nbsp;M. Mascareñas-García ,&nbsp;M. Pérez-Ríos ,&nbsp;M.A. Llaneza-Gonzalez ,&nbsp;P. Mulero ,&nbsp;M. Mendibe ,&nbsp;À. Rovira ,&nbsp;V. Meca-Lallana ,&nbsp;A.J. García-Ruiz ,&nbsp;L. Landete ,&nbsp;J.R. Vizoso Hermida ,&nbsp;P. Carrascal Rueda ,&nbsp;A. Ruano-Raviña ,&nbsp;M. Puente-Hernandez ,&nbsp;L. Varela-Lema","doi":"10.1016/j.nrleng.2025.08.003","DOIUrl":"10.1016/j.nrleng.2025.08.003","url":null,"abstract":"<div><h3>Introduction</h3><div>In recent years there has been an increase in the number of disease-modifying drugs (DMDs) approved for multiple sclerosis (MS). The evidence of their safety and efficacy has been obtained through several phase III and IV clinical trials. Acquiring the skills for their appraisal is indispensable for clinicians to assess the most pertinent treatment for patients. The objective of this study is to provide guidance in the critical reading of these trials.</div></div><div><h3>Methods</h3><div>A three-round e-Delphi study was carried out. In the preparatory phase, a multidisciplinary expert panel was established. Panel members were selected based on their scientific credentials and experience, seeking to include people involved in MS diagnosis, treatment and research. A semi-open questionnaire was developed based on key generic and MS-specific methodological instruments identified through a scoping bibliographic search. The experts were required to identify essential aspects for critically appraising clinical trials on DMDs for MS.</div></div><div><h3>Results</h3><div>The expert panel consisted of nine independent leading Spanish experts with long-standing experience with MS (five neurologists, a neuroradiologist, a pharmacologist, a research methodologist and an MS community representative). The e-Delphi study resulted in consensus recommendations intended to help readers in answering five major questions: “Is the study free of bias?”; “Are the included patients adequate?”; “Are the outcome measures appropriate?”; “Are the results relevant?”; and “Is the study transparent?”.</div></div><div><h3>Conclusion</h3><div>This study proposes consensus recommendations intended to guide neurologists in the critical reading of phase III and IV clinical trials on DMDs for MS.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 9","pages":"Pages 875-883"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145435360","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":"Adaptation and norming of the Spanish version of the Attention, Memory and Frontal Abilities Test (AMFAST) for people aged 55 years and older","authors":"J. Oltra-Cucarella ,&nbsp;B. Bonete-López ,&nbsp;E. Sitges-Maciá ,&nbsp;C. Iñesta ,&nbsp;M. Sánchez San-Segundo ,&nbsp;M. Berbegal Bernabeu ,&nbsp;M. Tomé Fernández ,&nbsp;A. Zaragoza-Martí ,&nbsp;B. Freilich ,&nbsp;J.A. Hurtado Sánchez","doi":"10.1016/j.nrleng.2025.10.002","DOIUrl":"10.1016/j.nrleng.2025.10.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Screening tests are useful to identify cognitive impairments during aging. However, they need to assess different cognitive abilities and be easily accessible to researchers and clinicians. The objective of this work is to develop normative data for the population 55 years of age or older for the Attention, Memory and Frontal Abilities Screening Test (AMFAST).</div></div><div><h3>Method</h3><div>One-hundred and fifty-five cognitively healthy participants between 55 and 82 years old were assessed both with a comprehensive neuropsychological battery and the AMFAST. The ability of the AMFAST to identify objective cognitive impairment in the neuropsychological assessment was analysed using binary logistic regression, and sensitivity (Sen), specificity (Spe), and positive (PPV) and negative (NPV) predictive values were calculated. Normative data were developed using linear regression controlling for the effects of age, gender, and educational level.</div></div><div><h3>Results</h3><div>The AMFAST total score was statistically associated with age and education, but not with sex. Using 3 or more low scores as the criterion for objective cognitive impairment, the AMFAST total score was associated with the number of low scores on the neuropsychological battery (<em>r</em> = −0.33, <em>p</em> &lt; .001), as well as with objective cognitive impairment (OR = 0.95, 95%CI: 0.92-0.98, <em>p</em> = .003). A total score lower than 74 was associated with Sen = 85.71%, Spe = 71.63%, PPV = 23.08%, and NPV = 98.06%.</div></div><div><h3>Conclusions</h3><div>As a simple and quick test, the AMFAST could help identify early objective cognitive impairment. Normative data of the Spanish adaptation of the AMFAST for its use in clinical and research are provided.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 9","pages":"Pages 813-821"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254384","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 fatigue on quality of life in adults with multiple sclerosis","authors":"R. Piñar-Morales ,&nbsp;P.A. Guirado-Ruiz ,&nbsp;F.J. Barrero Hernández","doi":"10.1016/j.nrleng.2025.10.006","DOIUrl":"10.1016/j.nrleng.2025.10.006","url":null,"abstract":"<div><h3>Introduction</h3><div>Fatigue in multiple sclerosis (MS) is defined as the lack of physical and/or mental energy perceived by the individual that interferes with normal activities. It is the most common symptom in MS, present in up to 90% of people with MS. Fatigue along with disability, depression, cognitive impairment, and disease-modifying therapy (DMT) affect quality of life (QoL).</div></div><div><h3>Method</h3><div>We designed a prospective observational study in patients with MS and DMT of moderate efficacy to assess the association between fatigue and the epidemiological, clinical, and pharmacological aspects that influence in the QoL. We analysed variables related to patients, disability, fatigue (MFIS), clinical and radiological activity, depression (BDI), cognitive impairment (SDMT), and QoL (EQ-5D).</div></div><div><h3>Results</h3><div>we included 91 people, 65.9% women, mean age 43.9 years. The DMT were: 27.4% interferon-β, 15.38% glatiramer acetate, 9.89% teriflunomide, and 47.25% dimethyl fumarate. The median of the EDSS was 1.5 points. 40.9% have presented fatigue, 36.3% cognitive deterioration and 30.7% of the patients depression.</div></div><div><h3>Conclusions</h3><div>Patients with fatigue are older, more disabled, have a higher prevalence of depression and worse QoL. Evolution time, relapses, MRI lesion load, and DMTs are not associated with fatigue. Fatigue is a frequent symptom in patients with MS that influences in the QoL, hence the importance of its diagnosis and treatment.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 9","pages":"Pages 864-874"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260383","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}