Neurological research and practice最新文献

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Ischemia/reperfusion injury in acute human and experimental stroke: focus on thrombo-inflammatory mechanisms and treatments. 急性人类中风和实验性中风的缺血再灌注损伤:关注血栓-炎症机制和治疗方法。
Neurological research and practice Pub Date : 2024-11-25 DOI: 10.1186/s42466-024-00355-y
Guido Stoll, Bernhard Nieswandt, Michael K Schuhmann
{"title":"Ischemia/reperfusion injury in acute human and experimental stroke: focus on thrombo-inflammatory mechanisms and treatments.","authors":"Guido Stoll, Bernhard Nieswandt, Michael K Schuhmann","doi":"10.1186/s42466-024-00355-y","DOIUrl":"10.1186/s42466-024-00355-y","url":null,"abstract":"<p><strong>Background: </strong>Despite high recanalization rates of > 90% after endovascular thrombectomy (EVT) clinical outcome in around 50% of treated acute ischemic stroke (AIS) patients is still poor. Novel treatments augmenting the beneficial effects of recanalization are eagerly awaited, but this requires mechanistic insights to explain and overcome futile recanalization.</p><p><strong>Main body: </strong>At least two mechanisms contribute to futile recanalization after cerebral large vessel occlusions (LVO): (i) the no reflow phenomenon as evidenced by randomly distributed areas without return of blood flow despite reperfusion of large cerebral arteries, and (ii) ischemia/reperfusion (I/R) injury, the paradoxically harmful aspect of blood flow return in transiently ischemic organs. There is accumulating evidence from experimental stroke models that platelets and leukocytes interact and partly obstruct the microvasculature under LVO, and that platelet-driven inflammation (designated thrombo-inflammation) extends into the reperfusion phase and causes I/R injury. Blocking of platelet glycoprotein receptors (GP) Ib and GPVI ameliorated inflammation and I/R injury providing novel therapeutic options. Recently, MRI studies confirmed a significant, up to 40% infarct expansion after recanalization in AIS thereby proofing the existance of I/R injury in the human brain. Moreover, analysis of minute samples of ischemic arterial blood aspirated directly from the pial cerebral collateral circulation under LVO during the routine EVT procedure confirmed platelet activation and platelet-driven leukocyte accumulation in AIS and, thus, the principal transferability of pathophysiological stroke mechanisms from rodents to man. Two recently published clinical phase 1b/2a trials targeted (thrombo-) inflammation in AIS: The ACTIMIS trial targeting platelet GPVI by glenzocimab provided encouraging safety signals in AIS similar to the ApTOLL trial targeting toll-like receptor 4, a central receptor guiding stroke-induced innate immunity. However, both studies were not powered to show clinical efficacy.</p><p><strong>Conclusions: </strong>The fact that the significance of I/R injury in AIS has recently been formally established and given the decisive role of platelet-leukocytes interactions herein, new avenues for adjunct stroke treatments emerge. Adjusted study designs to increase the probability of success are of outmost importance and we look forward from what can be learned from the so far unpublished, presumbably negative ACTISAFE and MOST trials.</p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"6 1","pages":"57"},"PeriodicalIF":0.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142712359","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}
引用次数: 0
Letter to the editor in response to Professor Josef Finsterer. 致编辑的信,回应约瑟夫-芬斯特尔教授。
Neurological research and practice Pub Date : 2024-11-18 DOI: 10.1186/s42466-024-00337-0
Sreelakshmi V, Amrita Pattanaik, Srilatha Marate, Reeta S Mani, Aparna R Pai, Chiranjay Mukhopadhyay
{"title":"Letter to the editor in response to Professor Josef Finsterer.","authors":"Sreelakshmi V, Amrita Pattanaik, Srilatha Marate, Reeta S Mani, Aparna R Pai, Chiranjay Mukhopadhyay","doi":"10.1186/s42466-024-00337-0","DOIUrl":"10.1186/s42466-024-00337-0","url":null,"abstract":"","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"6 1","pages":"58"},"PeriodicalIF":0.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649816","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}
引用次数: 0
MS brain health quality standards: a survey on the reality in clinical practice in Germany. 多发性硬化症脑健康质量标准:德国临床实践现状调查。
Neurological research and practice Pub Date : 2024-11-18 DOI: 10.1186/s42466-024-00333-4
Isabel Voigt, Katja Akgün, Hernan Inojosa, Judith Haas, Herbert Temmes, Sven G Meuth, Gavin Giovannoni, Tjalf Ziemssen
{"title":"MS brain health quality standards: a survey on the reality in clinical practice in Germany.","authors":"Isabel Voigt, Katja Akgün, Hernan Inojosa, Judith Haas, Herbert Temmes, Sven G Meuth, Gavin Giovannoni, Tjalf Ziemssen","doi":"10.1186/s42466-024-00333-4","DOIUrl":"10.1186/s42466-024-00333-4","url":null,"abstract":"<p><strong>Background: </strong>The quality of treatment is especially critical in the context of complex and chronic diseases such as multiple sclerosis (MS). The Brain Health Initiative, an independent international consortium of neurologists, reached a consensus on time-based quality standards prioritizing brain health-focused care for people with MS.</p><p><strong>Objectives: </strong>To gain deeper insights into the transferability of these quality standards to a specific area, we conducted a survey among MS experts across various MS centers in Germany.</p><p><strong>Methods: </strong>Participants were asked about time frames considered high standards and those currently being implemented in daily routine based on their experience.</p><p><strong>Results: </strong>The results reveal a large gap between ideal conceptions and their adaptation in the real world, mostly due to a lack of resources.</p><p><strong>Conclusions: </strong>Nevertheless, these guidelines and recommendations can be aspired to as ideals. Consensual and inclusive clinical pathways complemented by measurable quality indicators are needed to improve care and approach these ideals. Neither exists in the current management of MS.</p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"6 1","pages":"59"},"PeriodicalIF":0.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649818","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}
引用次数: 0
Chikungunya-related Guillain-Barre syndrome is most commonly demyelinating and affects multiple cranial nerves. 与基孔肯雅病毒相关的格林-巴利综合征最常见的症状是脱髓鞘,会影响多个颅神经。
Neurological research and practice Pub Date : 2024-11-18 DOI: 10.1186/s42466-024-00336-1
Josef Finsterer
{"title":"Chikungunya-related Guillain-Barre syndrome is most commonly demyelinating and affects multiple cranial nerves.","authors":"Josef Finsterer","doi":"10.1186/s42466-024-00336-1","DOIUrl":"10.1186/s42466-024-00336-1","url":null,"abstract":"","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"6 1","pages":"56"},"PeriodicalIF":0.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649836","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}
引用次数: 0
Prevalence of comorbid autoimmune diseases and antibodies in newly diagnosed multiple sclerosis patients. 新诊断的多发性硬化症患者合并自身免疫性疾病和抗体的患病率。
Neurological research and practice Pub Date : 2024-11-12 DOI: 10.1186/s42466-024-00351-2
Konstantin Fritz Jendretzky, Lisa-Marie Lezius, Thea Thiele, Franz Felix Konen, André Huss, Lena Heitmann, Yunus Emre Güzeloglu, Philipp Schwenkenbecher, Kurt-Wolfram Sühs, Jelena Skuljec, Mike Peter Wattjes, Torsten Witte, Christoph Kleinschnitz, Refik Pul, Hayrettin Tumani, Stefan Gingele, Thomas Skripuletz
{"title":"Prevalence of comorbid autoimmune diseases and antibodies in newly diagnosed multiple sclerosis patients.","authors":"Konstantin Fritz Jendretzky, Lisa-Marie Lezius, Thea Thiele, Franz Felix Konen, André Huss, Lena Heitmann, Yunus Emre Güzeloglu, Philipp Schwenkenbecher, Kurt-Wolfram Sühs, Jelena Skuljec, Mike Peter Wattjes, Torsten Witte, Christoph Kleinschnitz, Refik Pul, Hayrettin Tumani, Stefan Gingele, Thomas Skripuletz","doi":"10.1186/s42466-024-00351-2","DOIUrl":"10.1186/s42466-024-00351-2","url":null,"abstract":"<p><strong>Background: </strong>Diagnosing multiple sclerosis (MS) is challenging due to diverse symptoms and the absence of specific biomarkers. Concurrent autoimmune diseases (AID) or non-specific antibodies further complicate diagnosis, progression monitoring, and management. Data on AID prevalence in MS patients are sparse. This study aims to identify concurrent AIDs alongside MS.</p><p><strong>Methods: </strong>In this retrospective single-center study, we analyzed patient records at our university hospital from 2010 to 2017, focusing on cases suspected of inflammatory demyelinating disease. The 2017 McDonald criteria were applied. Additionally, we measured neurofilament light (NfL) levels from available CSF samples in our biobank.</p><p><strong>Results: </strong>We identified a total of 315 patients, of whom 66% were women. In total, 13.7% of all patients had concurrent AID, while 20.3% had isolated antibody findings without AID. The most common AID was autoimmune thyroiditis (8.9%), followed by chronic inflammatory skin diseases (1.6%), arthritis (1%), type 1 diabetes (1%), Sjögren's syndrome (0.6%), and inflammatory bowel diseases (0.6%). Cardiolipin antibodies were the most frequent isolated antibody finding (8.6%). Our data showed that, from the perspective of the initial demyelinating event, neither comorbid AID nor isolated antibodies significantly influenced relapses or MS progression over a median follow-up of 9 months. Standard CSF parameters and NfL levels were similar between the groups at the time of MS diagnosis.</p><p><strong>Conclusion: </strong>Our study shows that AIDs, particularly autoimmune thyroiditis, frequently occur at the onset of MS. The proportion of AIDs commonly treated with immunomodulatory therapy in our cohort was similar to that observed in the general population. Comorbid AID did not affect NfL levels, indicating similar disease activity. Future research should explore new AID emergence during the course of MS, especially considering the increased incidence of rheumatic diseases later in life.</p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"6 1","pages":"55"},"PeriodicalIF":0.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635172","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}
引用次数: 0
Prevalence, diagnosis and management of intracranial atherosclerosis in White populations: a narrative review. 白种人颅内动脉粥样硬化的患病率、诊断和管理:叙述性综述。
Neurological research and practice Pub Date : 2024-11-11 DOI: 10.1186/s42466-024-00341-4
Evangelos Panagiotopoulos, Maria-Ioanna Stefanou, George Magoufis, Apostolos Safouris, Odysseas Kargiotis, Klearchos Psychogios, Sofia Vassilopoulou, Aikaterini Theodorou, Maria Chondrogianni, Eleni Bakola, Frantzeska Frantzeskaki, Tatiana Sidiropoulou, Stavros Spiliopoulos, Georgios Tsivgoulis
{"title":"Prevalence, diagnosis and management of intracranial atherosclerosis in White populations: a narrative review.","authors":"Evangelos Panagiotopoulos, Maria-Ioanna Stefanou, George Magoufis, Apostolos Safouris, Odysseas Kargiotis, Klearchos Psychogios, Sofia Vassilopoulou, Aikaterini Theodorou, Maria Chondrogianni, Eleni Bakola, Frantzeska Frantzeskaki, Tatiana Sidiropoulou, Stavros Spiliopoulos, Georgios Tsivgoulis","doi":"10.1186/s42466-024-00341-4","DOIUrl":"10.1186/s42466-024-00341-4","url":null,"abstract":"<p><strong>Background: </strong>Intracranial atherosclerotic disease (ICAD) represents a leading cause of ischemic stroke worldwide, conferring increased risk of recurrent stroke and poor clinical outcomes among stroke survivors. Emerging evidence indicates a paradigm shift, pointing towards increasing detection rates of ICAD among White populations and an evolving epidemiological profile across racial and ethnic groups. The present review aims to provide a comprehensive overview of ICAD, focusing on its pathophysiology, diagnostic approach, and evolving epidemiological trends, including underlying mechanisms, advanced neuroimaging techniques for diagnostic evaluation, racial disparities in prevalence, and current and emerging management strategies.</p><p><strong>Main body: </strong>Atherosclerotic plaque accumulation and progressive arterial stenosis of major intracranial arteries comprise the pathophysiological hallmark of ICAD. In clinical practice, the diagnosis of intracranial artery stenosis (ICAS) or high-grade ICAS is reached when luminal narrowing exceeds 50% and 70%, respectively. Advanced neuroimaging, including high-resolution vessel wall MRI (HRVW-MRI), has recently enabled ICAD detection before luminal stenosis occurs. While earlier studies disclosed significant racial disparities in ICAS prevalence, with higher rates among Asians, Hispanics, and Blacks, recent evidence reveals rising detection rates of ICAD among White populations. Genetic, environmental and epigenetic factors have been suggested to confer an increased susceptibility of certain ethnicities and races to ICAD. Nevertheless, with improved accessibility to advanced neuroimaging, ICAD is increasingly recognized as an underlying stroke etiology among White patients presenting with acute ischemic stroke and stroke of undetermined etiology. While conventional management of ICAS entails risk factor modification, pharmacotherapy, and endovascular treatment in selected high-risk patients, substantial progress remains to be made in the management of ICAD at its early, pre-stenotic stages.</p><p><strong>Conclusion: </strong>ICAD remains a critical yet underappreciated risk factor for ischemic stroke across all populations, highlighting the need for increased awareness and improved diagnostic strategies. The emerging epidemiological profile of ICAD across racial groups necessitates a reassessment of risk factors, screening protocols and preventive strategies. Future research should focus on refining the diagnostic criteria and expanding the therapeutic options to cover the full spectrum of ICAD, with the aim of improving patient outcomes and reducing the global burden of intracranial atherosclerosis and stroke.</p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"6 1","pages":"54"},"PeriodicalIF":0.0,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635177","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}
引用次数: 0
Restless legs syndrome: abbreviated guidelines by the German sleep society and the German neurological society. 不宁腿综合征:德国睡眠学会和德国神经学会的简略指南。
Neurological research and practice Pub Date : 2024-11-06 DOI: 10.1186/s42466-024-00353-0
Claudia Trenkwalder, Ambra Stefani, Cornelius G Bachmann, Christian Maihöfner, Johannes Mathis, Lucia Muntean, Julian Mollin, Joachim Paulus, Anna Heidbreder
{"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":"6 1","pages":"53"},"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}
引用次数: 0
Iatrogenic botulism after intragastric botulinum neurotoxin injections - a major outbreak. 胃内注射肉毒杆菌神经毒素后的先天性肉毒中毒--一次大爆发。
Neurological research and practice Pub Date : 2024-10-29 DOI: 10.1186/s42466-024-00350-3
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
{"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":"6 1","pages":"52"},"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}
引用次数: 0
Large-fiber neuropathy in Parkinson's disease: a narrative review. 帕金森病的大纤维神经病变:叙述性综述。
Neurological research and practice Pub Date : 2024-10-28 DOI: 10.1186/s42466-024-00354-z
Eun Hae Kwon, Julia Steininger, Raphael Scherbaum, Ralf Gold, Kalliopi Pitarokoili, Lars Tönges
{"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":"6 1","pages":"51"},"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}
引用次数: 0
Cognitive recovery of post critical care patients with and without COVID-19: differences and similarities, an observational study. 一项观察性研究:有 COVID-19 和没有 COVID-19 的重症监护后患者的认知恢复:异同。
Neurological research and practice Pub Date : 2024-10-22 DOI: 10.1186/s42466-024-00349-w
Anna Gorsler, Christiana Franke, Anneke Quitschau, Nadine Külzow
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