Neurological research and practice最新文献

{"title":"Restless legs syndrome: abbreviated guidelines by the German sleep society and the German neurological society.","authors":"Claudia Trenkwalder, Ambra Stefani, Cornelius G Bachmann, Christian Maihöfner, Johannes Mathis, Lucia Muntean, Julian Mollin, Joachim Paulus, Anna Heidbreder","doi":"10.1186/s42466-024-00353-0","DOIUrl":"10.1186/s42466-024-00353-0","url":null,"abstract":"","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584994","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":"Iatrogenic botulism after intragastric botulinum neurotoxin injections - a major outbreak.","authors":"Tsepo Goerttler, Martin B Dorner, Christina van der Linden, Ricardo Kienitz, Stephan Petrik, Stephan Blechinger, Jonah Spickschen, Iris R Betz, Carl Hinrichs, David Steindl, Frederike Weber, Thomas Musacchio, Gilbert Wunderlich, Maria Adele Rueger, Michael T Barbe, Haidar Dafsari, Seda Demir, Sriramya Lapa, Pia S Zeiner, Adam Strzelczyk, Peter Tinnemann, Christian Kleine, Andreas Totzeck, Stephan Klebe, Agata Mikolajewska, Brigitte G Dorner, Elisabeth Fertl, Christian Grefkes-Hermann, Gereon Fink, Christoph Kleinschnitz, Tim Hagenacker","doi":"10.1186/s42466-024-00350-3","DOIUrl":"https://doi.org/10.1186/s42466-024-00350-3","url":null,"abstract":"<p><strong>Background: </strong>Intragastric botulinum neurotoxin injections (IBNI) are offered off-label in the private medical sector in a few European countries as a safe and effective weight-loss measure. In February and March 2023, an outbreak of iatrogenic botulism occurred in several European countries following IBNI treatment in Turkey. This case series describes the clinical features of severe iatrogenic botulism after IBNI.</p><p><strong>Methods: </strong>We retrospectively summarize the clinical course and emergency department and intensive care unit interventions in ten cases of severe iatrogenic botulism that occurred after receiving IBNI in this sudden outbreak in Austria and Germany.</p><p><strong>Results: </strong>Seven out of ten cases initially showed characteristic symptoms of botulism with diplopia, dysphagia, dysarthria, dysarthrophonia, and descending paralysis. All patients were hospitalized, six in an intensive care unit and partially requiring mechanical ventilation. All patients recovered and were discharged without relevant permanent deficits.</p><p><strong>Conclusion: </strong>Our study highlights ten clinical cases in this iatrogenic botulism outbreak, representing the largest reported outbreak worldwide. Clinicians should be aware of the risks associated with medical procedures involving botulinum neurotoxins and ensure measures to minimize the risk of iatrogenic botulism.</p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549870","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":"Large-fiber neuropathy in Parkinson's disease: a narrative review.","authors":"Eun Hae Kwon, Julia Steininger, Raphael Scherbaum, Ralf Gold, Kalliopi Pitarokoili, Lars Tönges","doi":"10.1186/s42466-024-00354-z","DOIUrl":"10.1186/s42466-024-00354-z","url":null,"abstract":"<p><strong>Background: </strong>Numerous studies reported a higher prevalence of polyneuropathy (PNP) in patients with Parkinson's disease (PD) compared to the general population. Importantly, PNP symptoms can aggravate both motor and sensory disturbances in PD patients and negatively impact the disease course. Recent analyses indicate distinct PNP patterns in PD.</p><p><strong>Main text: </strong>This review aims to provide an overview of the current insights into etiological factors, diagnostic methods, and management strategies of large fiber neuropathy in PD. Despite the higher prevalence, the causes of PNP in PD are still not fully understood. A genetic predisposition can underlie PNP onset in PD. Main research attention is focused on long-term levodopa exposure which is suggested to increase PNP risk by depletion of methylation cofactors such as vitamin B12 and accumulation of homocysteine that altogether can alter peripheral nerve homeostasis. Beyond a potential \"iatrogenic\" cause, alpha-synuclein deposition has been detected in sural nerve fibers that could contribute to peripheral neuronal degeneration as part of the systemic manifestation of PD. Whereas mild axonal sensory PNP predominates in PD, a considerable proportion of patients also show motor and upper limb nerve involvement. Intriguingly, a correlation between PNP severity and PD severity has been demonstrated. Therefore, PNP screening involving clinical and instrument-based assessments should be implemented in the clinical routine for early detection and monitoring. Given the etiological uncertainty, therapeutic or preventive options remain limited. Vitamin supplementation and use of catechol-O-methyltransferase-inhibitors can be taken into consideration.</p><p><strong>Conclusion: </strong>PNP is increasingly recognized as a complicating comorbidity of PD patients. Long-term, large-scale prospective studies are required to elucidate the causative factors for the development and progression of PD-associated PNP to optimize treatment approaches. The overall systemic role of \"idiopathic\" PNP in PD and a putative association with the progression of neurodegeneration should also be investigated further.</p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515554","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":"Cognitive recovery of post critical care patients with and without COVID-19: differences and similarities, an observational study.","authors":"Anna Gorsler, Christiana Franke, Anneke Quitschau, Nadine Külzow","doi":"10.1186/s42466-024-00349-w","DOIUrl":"https://doi.org/10.1186/s42466-024-00349-w","url":null,"abstract":"<p><strong>Background: </strong>Coronavirus disease (COVID-19) patients treated in an intensive care unit (ICU) are at high risk of developing cognitive impairments of a \"post-intensive care syndrome\" (PICS). We explored whether critically ill COVID-19 and non-COVID-19 survivors differ in their post-ICU recovery course in terms of severity and affected cognitive domains.</p><p><strong>Methods: </strong>An observational prospective study was conducted in a German post-acute neurological early rehabilitation clinic. Critically ill patients with or without SARS-CoV-2 infection (at least mechanically ventilated for one week) underwent repeated standardized assessments during their subsequent inpatient rehabilitation stay. Cognitive functions (information processing speed, learning, recognition, short-term and working-memory, word fluency, flexibility) assigned to different domains (attention, memory, executive functions) were assessed as primary outcome. Secondary outcomes included mental (depression, anxiety) and physical (Barthel index, modified ranking scale) state.</p><p><strong>Results: </strong>Out of 92 eligible patients (screened between June 2021 and August 2023), 34 were examined, and 30 were available for analysis (15 per group). Both groups were ventilated for a similar period (COVID-19 vs. Non-COVID-19: median: 48 vs. 53 days). Patients of COVID-19 group spend on average 10 days longer at ICU and developed slightly more complications, but subsequent inpatient rehabilitation was of comparable duration (median: 36.5 vs. 37 days). On the group-level both groups showed similar cognitive dysfunctions with striking impairments (normative T-scores < 41) in information processing speed, word fluency, flexibility, and recognition memory on admission. Significant gains until discharge were only revealed for information processing speed in both groups (main effect visit, mean difference [95%CI] - 7.5 [- 13.1, - 2.0]). Physical and mental state were also similarly affected in both groups on admission, but improved over time, indicating that overall recovery for higher-order cognitive functions is slowest. Interestingly, majority of patients stated correctly being still physically disabled, while a discrepancy was found between subjective and objective evaluation of cognitive health.</p><p><strong>Conclusions: </strong>Results suggest a substantial overlap of cognitive, mental and physical dysfunction in post-acute recovery of ICU survivors independent of SARS-CoV-2 infection which warrants further monitoring to reduce the risk of long-term burden and enable a return to previous functionality.</p><p><strong>Trial registration: </strong>Retrospectively registered at https://drks.de/search/de/trial/DRKS00025523 , 21.06.2021.</p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515553","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":"Stiripentol for the treatment of refractory status epilepticus.","authors":"Leona Möller, Ole J Simon, Clara Jünemann, Meike Austermann-Menche, Marc-Philipp Bergmann, Lena Habermehl, Katja Menzler, Lars Timmermann, Adam Strzelczyk, Susanne Knake","doi":"10.1186/s42466-024-00348-x","DOIUrl":"10.1186/s42466-024-00348-x","url":null,"abstract":"<p><strong>Background: </strong>Status epilepticus (SE) is one of the most common neurological emergencies and an acutely life-threatening condition characterized by high mortality and morbidity. Despite the well-established staged therapy of status epilepticus, especially stages 1 and 2, more than one third of patients develop (super-) refractory SE. Despite a large variety of potential treatment options for super-refractory SE, there is an unmet clinical need of potential new treatment ideas in this often desperate clinical situation. A number of studies have demonstrated the safety and efficacy of stiripentol (STP) in patients with Dravet syndrome (DS) and in children with focal epilepsy and generalized epilepsies. Some smaller series and case reports have documented the use of STP in the treatment of status epilepticus in adult patients.</p><p><strong>Methods: </strong>We retrospectively analyzed all patients who were admitted to the Department of Neurology at Marburg University Hospital between 2013 and 2023 with a diagnosis of (super)-refractory status epilepticus and who received additional treatment of SE with STP. All patients who received STP during the SE were included, regardless of previous medication.</p><p><strong>Results: </strong>SE ceased in 64% of 25 patients (13 female and 12 male). The mean age was 58.6 ± 21.9 years (mean ± SD). 72% had a structural epilepsy. In 20% of patients, SE was terminated by the administration of STP alone in 32% of cases, while in a further 32% of patients, the simultaneous administration of multiple anti-seizure medications (ASMs) including STP was potentially responsible for the cessation of the SE, with valproic acid (VPA), benzodiazepines and STP, being the most frequently implicated ASMs. In 12% of patients, there was at least a temporary improvement in the electroencephalogram (EEG). Stiripentol had to be discontinued in three cases due to a reduction in vigilance or hypercalcemia.</p><p><strong>Conclusions: </strong>Stiripentol may represent a promising additional treatment option for refractory and super-refractory status epilepticus. The tolerability of this treatment has already been demonstrated in previous studies, and was also reflected in these data. Further prospective investigation in larger patient populations are necessary to ascertain the efficacy of stiripentol in SE.</p><p><strong>Trial registration: </strong>NCT06540378, retrospectively registered.</p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11492756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484586","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":"Nerve ultrasound in amyotrophic lateral sclerosis: systematic review and meta-analysis.","authors":"Ramy Abdelnaby, Ahmed Samy Shabib, Mostafa Hossam El Din Moawad, Talal Salem, Merna Wagih Youssef Awad, Peter Dawoud Awad, Imene Maallem, Hany Atwan, Salma Adel Rabie, Khaled Ashraf Mohamed, Hossam Abdelmageed, Ali M Karkour, Mohamed Elsayed, Michael S Cartwright","doi":"10.1186/s42466-024-00346-z","DOIUrl":"https://doi.org/10.1186/s42466-024-00346-z","url":null,"abstract":"<p><strong>Background/ aim: </strong>Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease affecting upper and lower motor neurons, causing progressive atrophy of muscles, hypertonia, and paralysis. This study aimed to evaluate the current evidence and effectiveness of ultrasound in investigating nerve cross-sectional area (CSA) of peripheral nerves, vagus and cervical roots in those with ALS compared with healthy controls and to pool the CSA measurements.</p><p><strong>Methods: </strong>A systematic search was conducted on Cochrane, Clarivate Web of Science, PubMed, Scopus, and Embase for the mesh terms nerve, ultrasonography, and amyotrophic lateral sclerosis. A quality assessment was performed using the New-Ottawa scale. In addition, a double-arm meta-analysis using Review Manager 5 software version 5.4 was performed.</p><p><strong>Results: </strong>From the seventeen studies included in this review, the overall mean difference showed that individuals with ALS had a significantly smaller CSA in comparison to healthy controls for median, ulnar, C6 root, and phrenic nerves. However, no significant difference in the CSA was found in radial, vagal, sural, and tibial nerves.</p><p><strong>Discussion: </strong>This study confirmed results of some of the included studies regards the anatomic sites, where nerve atrophy in ALS could be detected to potentially support the diagnosis of ALS. However, we recommend further large, prospective studies to assess the diagnostic value of these anatomical sites for the diagnosis of ALS.</p><p><strong>Conclusions: </strong>Our findings confirmed specific anatomic sites to differentiate ALS patients from healthy controls through ultrasound. However, these findings cannot be used to confirm the ALS diagnosis, but rather assist in differentiating it from other diagnoses.</p><p><strong>Trial registration: </strong>Retrospectively registered on July 30th 2024 in PROSPERO (PROSPERO (york.ac.uk)) with ID574702.</p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11484457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484584","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":"Quality in Acute Stroke Care (QASC) Germany: improving efficiency in stroke care with nurse-initiated FeSS-protocols.","authors":"Anne-Kathrin Cassier-Woidasky, Sandy Middleton, Simeon Dale, Kelly Coughlan, Catherine D'Este, Elizabeth McInnes, Dominique A Cadilhac, Waltraud Pfeilschifter","doi":"10.1186/s42466-024-00352-1","DOIUrl":"https://doi.org/10.1186/s42466-024-00352-1","url":null,"abstract":"<p><strong>Background: </strong>Nurse-initiated supported implementation of protocols to manage fever, hyperglycaemia (sugar) and swallowing (FeSS) following acute stroke reduced 90-day death and disability in the landmark Australian Quality in Acute Stroke Care (QASC)-Trial. An international interprofessional collaboration sought to evaluate the effects of nurse-led FeSS implementation on FeSS Protocol adherence in German stroke units.</p><p><strong>Methods: </strong>This pre-test/post-test study was conducted in eight German stroke units between 2020 and 2022. Stroke nurses as clinical champions, supported by the project team, conducted multidisciplinary workshops discussing pre-implementation medical record audit results, barriers and facilitators to FeSS Protocol implementation, developed action plans and provided education, with ongoing support from Australia. Medical record audit data were collected by nurses, pre-implementation and three months post-implementation.</p><p><strong>Results: </strong>In 771 (pre-implementation) and 679 (post-implementation) patients there were improvements in overall FeSS adherence (pre 20%, post 28%; adjusted difference in proportions (95% CI) 11%, (5.1%, 16%); p < 0.001), adherence to hyperglycaemia (pre 43%, post 55%; adjusted difference 23%, (17%, 29%); p < 0.001) and swallowing (pre 52%, post 61%; adjusted difference 11%, (5.2%, 17%); p < 0.001) but not fever protocol (pre 76%, post 78%; adjusted difference 1.5%, (-2.6%, 5.7%); p = 0.474). Improvements also were noted in administration of anti-pyretics (pre 29%, post 59%; adjusted difference 32%, (20%, 44%); p < 0.001); and insulin (pre 41%, post 60%; adjusted difference 14%, (1.1%, 28%); p < 0.034) both within one hour, as well as in performing a swallow screen within 24 h of admission (pre 65%, post 74%; adjusted difference 18% (8.8%, 26%); p < 0.001).</p><p><strong>Conclusions: </strong>Supported implementation of the FeSS Protocols significantly improved acute care for post stroke complications of fever, hyperglycaemia and dysphagia in terms of higher adherence and shorter time to treatment.</p><p><strong>Trial registration: </strong>As this is a pre-test/post-test study and does not meet the WHO/ICMJE definition of a clinical trial, registration was not required.</p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11484436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484585","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":"Association of intraprocedural near admission-level blood pressure with functional outcome in stroke patients treated with mechanical thrombectomy.","authors":"Min Chen, Lukas Daniel Sauer, Mika Herwig, Jessica Jesser, Meinhard Kieser, Arne Potreck, Markus Möhlenbruch, Peter Arthur Ringleb, Silvia Schönenberger","doi":"10.1186/s42466-024-00345-0","DOIUrl":"10.1186/s42466-024-00345-0","url":null,"abstract":"<p><strong>Background: </strong>Optimal blood pressure management during endovascular stroke treatment is not certain. We hypothesized that time or proportion of intraprocedural systolic blood pressure spent in a range around admission blood pressure might be associated with better clinical outcome.</p><p><strong>Methods: </strong>We conducted a retrospective observational study at a single center at a university hospital, which included patients from August 2018 to September 2020 suffering from acute ischemic stroke with anterior circulation vessel occlusion and treated with endovascular therapy. Time and proportion of procedure time where systolic blood pressure (SBP) was near the baseline SBP on admission (bSBP) were used as exposure variables. The primary outcome was the occurrence of mRS score 0-2 three months after stroke. The primary analysis was performed by fitting a logistic regression model adjusted for baseline NIHSS, pre-stroke mRS, mTICI score, intubation, age and sex.</p><p><strong>Results: </strong>We included 589 patients in the analysis. Mean (SD) age was 76 (12) years, 315 were women (53%) and mean (SD) NIHSS score at admission was 15 (7.5). Mean (SD) bSBP was 167 (28) mmHg and mean (SD) intraprocedural SBP was 147 (21) mmHg. The proportion of time where intraprocedural SBP was in range of bSBP ± 20% was associated with a slightly higher odds of achieving favorable outcome (adjusted OR, 1.007; 95% CI, 1.0003-1.013).</p><p><strong>Conclusion: </strong>A higher proportion of intraprocedural time with systolic blood pressure in range of ± 20% of the admission level is associated with higher odds of favorable functional outcome.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11443703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362622","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":"Differential diagnosis of Guillain-Barré syndrome: steroid-responsive radiculopathy in Evans syndrome.","authors":"Thomas Schulten, Ansgar Meyer, Utz Krug, Helmar C Lehmann","doi":"10.1186/s42466-024-00344-1","DOIUrl":"https://doi.org/10.1186/s42466-024-00344-1","url":null,"abstract":"<p><p>Guillain-Barré syndrome is the most common acute inflammatory demyelinating peripheral nerve condition. Occasionally, other autoimmune conditions can mimic Guillain-Barré syndrome but may require different diagnostic workup and treatment. We report here two patients with Evans syndrome, a rare hematological autoimmune condition who developed a subacute inflammatory radiculopathy. Similarities and distinguishing clinical and diagnostic features are discussed.</p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11414215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305114","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":"Prognostic models in multiple sclerosis: progress and challenges in clinical integration.","authors":"Joachim Havla, Kelly Reeve, Begum Irmak On, Ulrich Mansmann, Ulrike Held","doi":"10.1186/s42466-024-00338-z","DOIUrl":"10.1186/s42466-024-00338-z","url":null,"abstract":"<p><p>As a chronic inflammatory disease of the central nervous system, multiple sclerosis (MS) is of great individual health and socio-economic significance. To date, there is no prognostic model that is used in routine clinical care to predict the very heterogeneous course of the disease. Despite several research groups working on different prognostic models using traditional statistics, machine learning and/or artificial intelligence approaches, the use of published models in clinical decision making is limited because of poor model performance, lack of transferability and/or lack of validated models. To provide a systematic overview, we conducted a \"Cochrane review\" that assessed 75 published prediction models using relevant checklists (CHARMS, PROBAST, TRIPOD). We have summarized the relevant points from this analysis here so that the use of prognostic models for therapy decisions in clinical routine can be successful in the future.</p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11376049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134963","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}