Neurological research and practice最新文献

{"title":"Socioeconomic impact of depression and pain in patients with neuromyelitis optica spectrum disorders.","authors":"Daria Tkachenko, Ilya Ayzenberg, Louisa M Schöppe, Rasmus Schülke, Friedemann Paul, Ankelien Duchow, Judith Bellmann-Strobl, Nadja Siebert, Tania Kümpfel, Joachim Havla, Hannah Pellkofer, Sven Jarius, Brigitte Wildemann, Achim Berthele, Luisa Klotz, Marc Pawlitzki, Stefan Gingele, Olivia Schreiber-Katz, Martin S Weber, Makbule Senel, Jan-Patrick Stellmann, Vivien Häußler, Orhan Aktas, Marius Ringelstein, Kerstin Hellwig, Carolin Schwake, Ingo Kleiter, Corinna Trebst, Martin W Hümmert","doi":"10.1186/s42466-026-00486-4","DOIUrl":"https://doi.org/10.1186/s42466-026-00486-4","url":null,"abstract":"<p><strong>Background: </strong>Neuromyelitis optica spectrum disorders (NMOSD) are associated with a high burden of depression, pain, and physical disability, all of which significantly impair quality of life. At the same time, discussions on the cost-effectiveness of treatment strategies are gaining importance. However, it is not yet known whether specific symptom burdens are particularly cost-driving. This study aims to provide a comprehensive cost analysis considering depression and pain to optimise future healthcare strategies.</p><p><strong>Methods: </strong>This prospective cross-sectional multicentre study was conducted at twelve centres of the Neuromyelitis Optica Study Group (NEMOS). Over a three-year period, 115 NMOSD patients were recruited. Disease-related costs, pain, and depression were assessed using standardised questionnaires. A generalised linear model analysis and graphical sub-cost analysis were performed to identify key cost drivers. The robustness of our findings was confirmed using two independent depression rating scales.</p><p><strong>Results: </strong>In our sample of 115 patients, 77% suffered from chronic pain with a median pain intensity of 4.0 on the numeric rating scale (NRS). Moreover, 56% of patients reported depressive symptoms. In multivariate regression analysis, depression emerged as a significant predictor of total costs (p < 0.001) alongside the EDSS score (p < 0.001) and age (p = 0.004). In contrast, pain was not significantly influencing total costs (p = 0.057), despite being reported by the majority of patients. Graphical analyses highlighted informal costs as the main cost driver in patients with increasing depressive symptoms.</p><p><strong>Conclusions: </strong>Depressive symptoms are not only common in NMOSD patients but also represent a major cost driver alongside neurological disability. Addressing these symptoms is essential for optimal patient care and may help reduce the socioeconomic burden.</p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13141397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848304","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":"Comment on \"intracranial hemorrhage after ischemic stroke in patients on direct oral anticoagulants: results from a prospective observational study\".","authors":"Abhijeet Prasad Sinha","doi":"10.1186/s42466-026-00496-2","DOIUrl":"https://doi.org/10.1186/s42466-026-00496-2","url":null,"abstract":"","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147825211","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":"Clinical presentation of neurosyphilis - a single-center retrospective data analysis.","authors":"Susanne Dyckhoff-Shen, Ilias Masouris, Stefanie Völk, Konstantin Pusl, Ulrich Seybold, Matthias Klein","doi":"10.1186/s42466-026-00497-1","DOIUrl":"https://doi.org/10.1186/s42466-026-00497-1","url":null,"abstract":"<p><strong>Background: </strong>As cases of neurosyphilis are rising worldwide - especially in people living with HIV (PLWH) - current data on clinical presentation, diagnostics and management of neurosyphilis in Europe are of high interest.</p><p><strong>Methods: </strong>Clinical data from adult patients, who had been treated for neurosyphilis at a university hospital in Germany from 2005 to 2024, were retrospectively analyzed. Probable diagnosis was based on corresponding signs and symptoms, positive syphilis serology, Cerebrospinal fluid (CSF) abnormalities, and/or improvement after antibiotic therapy. In asymptomatic patients, diagnosis was based on CSF abnormalities with positive serology. A positive CSF/serum treponemal antibody index confirmed the diagnosis.</p><p><strong>Results: </strong>77 patients with neurosyphilis were identified, the majority being male (95%), with a high proportion of HIV co-infection (43%). Clinical presentation was most frequently asymptomatic or ocular neurosyphilis (both 26%), other common symptoms were cognitive deficits, headache, and psychiatric symptoms. CSF abnormalities and additional co-infections were more pronounced among PLWH. CSF cell count and protein concentration were significantly lower in asymptomatic (latent) neurosyphilis compared to symptomatic cases, yet between various symptomatic manifestations of neurosyphilis only minor differences were observed. CSF VDRL-test was negative in nearly half of patients with confirmed neurosyphilis. Penicillin G was the predominant treatment (71%), with ceftriaxone used as the main alternative (21%), and doxycycline in 3 patients mostly due to penicillin allergy. Clinical improvement was observed in 88% of symptomatic patients.</p><p><strong>Discussion: </strong>Our findings align with recent reports describing neurosyphilis as a heterogeneous infection strongly linked to HIV-infection. The limited sensitivity of CSF VDRL reinforces the need for multimodal diagnostics. Current CSF testing criteria may miss asymptomatic cases, warranting heightened clinical vigilance.</p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147825204","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":"Preventive strategies in neuroimmunology.","authors":"Karin Riemann-Lorenz, Anke Alberty, Maryam Balke, Anna Gorsler, Birte Elias-Hamp, Alex Maximilian Keller, Anke Lührs, Sina Cathérine Rosenkranz","doi":"10.1186/s42466-026-00490-8","DOIUrl":"10.1186/s42466-026-00490-8","url":null,"abstract":"<p><p>Neuroimmunological diseases arise from a complex interplay of genetic susceptibility, environmental exposures, and immune-mediated mechanisms. In this context, modifiable lifestyle and environmental factors may contribute to disease risk and disease course, at least in a subset of patients. Accordingly, while disease-modifying immunotherapy remains the cornerstone of treatment, lifestyle-related factors are increasingly recognized as relevant targets for prevention and supportive disease management. This review summarizes current evidence on physical activity, nutrition, substance use, sleep, stress, rehabilitation, and digital health interventions across all levels of prevention-primary to quaternary. Physical activity exerts immunomodulatory and potential neuroprotective effects through pathways involving cytokines, growth factors, cerebral perfusion, and immune cell redistribution, and is associated with improvements in symptoms, function, and quality of life. Nutritional factors, including obesity and vitamin D deficiency, may be associated with MS risk and disease progression, whereas evidence for specific diets or supplements remains limited. Smoking represents a well-established modifiable risk factor for both MS disease development and progression, while findings regarding alcohol consumption are inconsistent. Sleep disturbances and chronic stress could influence immune regulation and symptom burden and may act as both risk and disease-modifying factors. Rehabilitation constitutes a cornerstone of tertiary prevention, and emerging digital technologies, including tele-exercise and virtual reality, may offer promising low-threshold strategies to support long-term self-management. Overall, lifestyle and behavioral interventions represent powerful, supportive and complementary tools in neuroimmunology, that may enhance overall health and disease management. High-quality interventional studies are required to define the optimal role of preventive strategies alongside immunotherapy.</p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13130587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793417","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":"Protocol of the interdisciplinary and intersectoral randomized controlled trial in Parkinson patients in a specialized network in Germany: the INSPIRE Trial.","authors":"Susanne A Schneider, Sandra Paryjas, Franziska Beyer, Jan-Philipp Bach, Simon Baudrexel, Bernhard Baier, Moaz Al Ajia, Ilona Csoti, Klaus Gehring, Gabriel Gonzalez Escamilla, Damian M Herz, Markus Leisse, Leonore Köhler, Thea-Marie Krause, Daniel Martens, Uwe Meier, Maike Scheipers, Julia Schiffer, Nils Schröter, Rieke Schulz, Stefan Specht, Manfred Erbsland, Renate Stemmer, Sergiu Groppa","doi":"10.1186/s42466-026-00476-6","DOIUrl":"https://doi.org/10.1186/s42466-026-00476-6","url":null,"abstract":"","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793363","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":"Prevention in stroke - Current state, present gaps and probable next steps.","authors":"Christian S Thielscher, Felipe A Montellano, Dorothee Saur, Agnes Flöel, Gabor C Petzold, Karl Georg Haeusler","doi":"10.1186/s42466-026-00479-3","DOIUrl":"https://doi.org/10.1186/s42466-026-00479-3","url":null,"abstract":"","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793452","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":"Trends in hospitalisation, myasthenic crisis and intensive care use in myasthenia gravis: a nationwide population-based study in Spain (2016-2022).","authors":"Tania Garrido-Hernández, Javier Del-Águila-Mejía, Marta Rodríguez-Camacho, María Del Mar Martínez-Salmerón, Beatriz Vélez-Gómez","doi":"10.1186/s42466-026-00485-5","DOIUrl":"https://doi.org/10.1186/s42466-026-00485-5","url":null,"abstract":"","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The best treatment is prevention: prevention of cognitive decline and dementia - current state, gaps and next steps.","authors":"Kathrin Reetz, Inga Liepelt-Scarfone, Alexa Häger, Agnes Flöel, Jörg B Schulz","doi":"10.1186/s42466-026-00494-4","DOIUrl":"https://doi.org/10.1186/s42466-026-00494-4","url":null,"abstract":"","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793438","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":"Preventing Parkinson's disease in the context of movement disorders: a narrative review of current evidence and future directions.","authors":"Eva Schaeffer, Jos Steffen Becktepe, Kathrin Brockmann, Carsten Eggers, Eileen Gülke, Elke Kalbe, Tim W Rattay, Lars Tönges, Tobias Warnecke, Kirsten E Zeuner, Daniela Berg","doi":"10.1186/s42466-026-00488-2","DOIUrl":"10.1186/s42466-026-00488-2","url":null,"abstract":"<p><p>Parkinson's disease (PD) is the fastest growing neurological disorder worldwide and, together with other movement disorders, belongs to a group of chronic neurological conditions associated with a substantial burden for affected individuals, caregivers, and healthcare systems. Despite significant advances in symptomatic treatment, disease-modifying therapies remain unavailable, shifting increasing attention toward prevention as a key therapeutic strategy. In this narrative we primarily focus on PD, as the epidemiologically most challenging condition and the one for which the most comprehensive evidence base for preventive strategies has been established. Preventive approaches relevant to other movement disorders are briefly discussed to highlight other promising targets requiring further investigations. In recent years major progress has been achieved in the identification of modifiable factors relevant for primary prevention of PD. Well-supported factors include physical activity, adherence to a Mediterranean diet, and caffeine or tea consumption as protective factors, as well as pesticide exposure as a relevant risk factor. Advances in early and prodromal diagnosis of PD have opened new perspectives for secondary prevention. Earlier identification of individuals at risk may enable timely interventions aimed at attenuating early disease progression. However, despite this progress, the systematic implementation of early therapeutic interventions in the prodromal phase remains limited. Evidence is sparse and largely indirect, mainly inferred from later disease onset associated with physical activity and dietary patterns. Similarly, although early diagnosis and treatment of cognitive impairment are clearly recommended by clinical guidelines, they remain insufficiently integrated into routine clinical care. Finally, tertiary prevention strategies are supported by a broad evidence base. Multidisciplinary rehabilitative care models have demonstrated clear benefits in preventing complications, maintaining daily functioning and quality of life. While such rehabilitative approaches are widely implemented, the strong evidence supporting moderate- to high-intensity physical exercise remains insufficiently translated into routine practice. Looking ahead, a key goal for the coming decades is the development of personalized prevention strategies, including beyond other insights into gene-environment interactions and the integration of multi-omics data to tailor interventions to individual risk profiles. Such approaches hold promise to maximize preventive efficacy and reduce the overall burden of PD and related movement disorders.</p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147731046","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":"Three-territory sign in infective endocarditis and concomitant stroke: a retrospective analysis on characteristics and associated factors.","authors":"Hannah Schuermann, Regina von Rennenberg, Christoph Riegler, Simon Hellwig, Helena Stengl, Simon Litmeier, Jan F Scheitz, Wolfram Doehner, Heinrich Audebert, Tim Bastian Braemswig, Christian H Nolte","doi":"10.1186/s42466-026-00493-5","DOIUrl":"10.1186/s42466-026-00493-5","url":null,"abstract":"","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147731051","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}