Neurological research and practice最新文献

{"title":"Comment on: ketogenic diet for status epilepticus in adult intensive care unit patients: a standard operating procedure.","authors":"Moritz L Schmidbauer, Konstantinos Dimitriadis","doi":"10.1186/s42466-026-00533-0","DOIUrl":"10.1186/s42466-026-00533-0","url":null,"abstract":"","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922256","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":"Delivering high-quality multiple sclerosis care in Germany: challenges and regional models.","authors":"Marc Pawlitzki, Niklas Huntemann, Lars Masanneck, Noah M Werner, Julian Zimmermann, Thomas Postert, Christoph Lassek, Sven G Meuth, Klaus Gehring, Joachim Havla, Philipp Albrecht, Tjalf Ziemssen, Matthias Grothe","doi":"10.1186/s42466-026-00531-2","DOIUrl":"10.1186/s42466-026-00531-2","url":null,"abstract":"<p><p>Multiple sclerosis (MS) care in Germany has entered a phase in which therapeutic progress is increasingly constrained by delivery capacity. Earlier diagnosis, broader access to high-efficacy disease-modifying therapies (DMTs), and more refined monitoring strategies have improved the potential for favourable long-term outcomes. At the same time, these advances have increased the need for specialised expertise, infusion and monitoring infrastructure, rapid imaging access, structured safety procedures, and cross-sector coordination. Real-world evidence from Germany indicates a shift towards early high-efficacy treatment but also shows regional variation in treatment initiation, therapy intensity, and the proportion of people with MS who remain DMT-untreated. This expert-informed narrative review combines a non-systematic literature review with selected regional implementation examples from German MS care. This review synthesises key delivery challenges in German MS care and maps regional models whose underlying organisational principles may be transferable across healthcare settings, while their specific implementation depends on the local regulatory and reimbursement context. The central argument is that high-quality MS care should be understood not only as a therapeutic decision but as a system property: evidence-based treatment must be embedded in reliable pathways for diagnosis, monitoring, escalation, de-escalation, rehabilitation, and long-term support. Regional models such as ambulatory specialist care structures, hub-and-spoke networks, Germany´s inpatient MS complex treatment programme, delegated task models, telemedical consultation pathways, and digital monitoring infrastructures provide practical building blocks. Implementation at scale will require measurable quality indicators, financing of coordination work, formalised skill-mix models, digital interoperability, and explicit strategies for ageing and multimorbid MS populations. For neurological practice, the challenge is therefore not whether modern MS care is possible, but how to make it reproducible, safe, and equitable across regions.</p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908491","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":"Discharge outcomes of intravenous alteplase 4.5-24 hours after symptom onset in selected patients with acute ischemic stroke: a propensity score-matched real-world study.","authors":"Lingshe Meng, Jinfeng Yin, Yingyu Jiang, Aichun Cheng, Yuting Xiong, Xiyue Cheng, Zihan Li, Chunjuan Wang","doi":"10.1186/s42466-026-00529-w","DOIUrl":"10.1186/s42466-026-00529-w","url":null,"abstract":"<p><strong>Background: </strong>Evidence for alteplase 4.5-24 h after acute ischemic stroke (AIS) onset remains limited in routine practice. We examined associations between late-window intravenous thrombolysis (IVT) and discharge outcomes in selected patients.</p><p><strong>Methods: </strong>We analyzed China Stroke Center Alliance patients arriving 4-23.5 h after onset. Alteplase-treated patients were matched 1:1 to non-IVT patients using propensity scores. The primary outcome was modified Rankin Scale (mRS) 0-1 at discharge. Secondary and safety outcomes included mRS 0-2, registry-recorded in-hospital intracranial hemorrhage (ICH), mortality, discharge against medical advice (DAMA), and mortality or DAMA.</p><p><strong>Results: </strong>Among 137,157 eligible AIS patients, 874 received IVT and were matched to 874 non-IVT patients. Median onset-to-needle time was 6.05 h (interquartile range 5.12-10.04); 48.4%, 23.7%, 6.6%, and 21.3% were treated at 4.5-<6, 6-<9, 9-<12, and 12-24 h, respectively. IVT was associated with higher rates of mRS 0-1 (30.4% vs. 17.0%, odds ratio [OR] 2.14, 95% confidence interval [CI], 1.70-2.69, p < 0.001) and mRS 0-2 (65.4% vs. 58.1%; OR, 1.36; 95% CI, 1.12-1.66, p = 0.002). In-hospital ICH was more frequent (1.7% vs. 0.6%, OR 3.04, 95% CI, 1.10-8.39, p = 0.03), whereas DAMA was less frequent (5.7% vs. 8.8%, OR 0.63, 95% CI, 0.44-0.92, p = 0.02). Length of hospital stay, mortality, and mortality or DAMA did not differ significantly.</p><p><strong>Conclusions: </strong>Late-window alteplase was associated with better discharge function but more registry-recorded ICH in selected patients. Because symptomatic status, hemorrhage subtype, severity, and fatality were unavailable, hemorrhagic safety remains incompletely characterized. These observational findings require cautious interpretation.</p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13545781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148893164","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":"Implementation of specialised care improves survival in patients with amyotrophic lateral sclerosis.","authors":"Omar Keritam, Daniel Bormann, Friedrich Haimberger, Diana Gharib, Merve Sener, Felix Gruber, Lukasz Antoniewicz, Ivan Fedak, Andreas Renner, Bernhard Fasching, Sabine Ullrich, Rafael Paternostro, Werner Dolak, Eva K Masel, Othmar Schuhfried, Jakob Rath, Gudrun Zulehner, Martin Krenn, Fritz Zimprich, Hakan Cetin","doi":"10.1186/s42466-026-00528-x","DOIUrl":"10.1186/s42466-026-00528-x","url":null,"abstract":"<p><strong>Objective: </strong>Access to multidisciplinary care influences survival in patients with amyotrophic lateral sclerosis (pwALS). However, real-world data comparing structured specialised care with general neurological management remain limited. We aimed to assess the influence of implementing a specialised outpatient clinic on survival in pwALS.</p><p><strong>Methods: </strong>This retrospective cohort study included pwALS meeting the Gold Coast criteria who were treated at the Department of Neurology of the Medical University of Vienna between January 2009 and July 2023. Demographic and clinical parameters and survival data were obtained from the local ALS registry, the Austrian Federation of Social Insurance databases, and the national mortality database of Statistik Austria. Data were censored in December 2024. Outcomes were compared between patients managed before (general care cohort) and after the establishment of a specialised ALS outpatient clinic in 2018 (specialised care cohort).</p><p><strong>Results: </strong>A total of 242 pwALS were included (47.5% female), of whom 43.8% received general neurological care and 56.2% specialised care. Spinal onset ALS was observed in 65.1% and 70.6%, respectively. Baseline demographic and clinical characteristics were comparable between both cohorts. Median survival time was 27.0 months (95% CI 23.0-35.0) in the general care cohort and 40.0 months (95% CI 32.0-47.0) in specialised care cohort (p = 0.0173). This survival difference was driven by patients with spinal onset ALS, whereas no benefit was observed in those with bulbar onset disease.</p><p><strong>Conclusions: </strong>Specialised care was associated with improved survival in this real-world ALS cohort, likely reflecting the cumulative effect of coordinated multidisciplinary management rather than individual interventions.</p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148883100","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":"Real-world experience with foslevodopa/foscarbidopa in Germany: therapeutic insights and lessons learned.","authors":"David Weise, Tobias Warnecke, Carsten Buhmann, Georg Ebersbach, Carsten Eggers, Björn Falkenburger, Günter Höglinger, Brit Mollenhauer, David Pedrosa, Martin Südmeyer, Daniel Weiss, Jan Kassubek, Wolfgang H Jost","doi":"10.1186/s42466-026-00530-3","DOIUrl":"10.1186/s42466-026-00530-3","url":null,"abstract":"<p><p>Patients with advanced Parkinson's disease (PD) often need to continue with device-aided therapies (DAT), such as intestinal and subcutaneous infusion therapies. Recently, continuous subcutaneous administration of foslevodopa/foscarbidopa (LDp/CDp) has emerged as a new therapeutic method. Two years after its approval in Germany, a large amount of real-world experience has been collected. Based on this, we present important practical recommendations to help clinicians optimise treatment. Key topics include identifying suitable patients, approaches to initiation and dose determination as well as strategies for balancing LDp/CDp with concomitant oral dopaminergic therapies. Practical challenges, particularly infusion site reactions and neuropsychiatric vulnerability in older or cognitively impaired patients, are discussed, and recommendations are presented on how to prevent and manage these adverse effects during routine management. The review also addresses reasons for discontinuation, organisational factors relevant to real-world implementation and future directions in pump technology. Overall, LDp/CDp is effective in managing motor fluctuations and provides sustained benefits with an overall favourable tolerability profile. Dermatological reactions are common but manageable, and careful adjustment of oral medication rather than rapid pursuit of monotherapy is advisable. The rate of early discontinuation has decreased with growing clinical experience.</p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868517","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 outcomes and unmet therapeutic needs in new-onset refractory status epilepticus: evidence from a retrospective cohort.","authors":"Clara Jünemann, Meike Menche, Marc Philipp Bergmann, Sascha Strehlau, Panagiota-Eleni Tsalouchidou, Joane Winkel, Ole J Simon, Lena Habermehl, Katja Menzler, Patrick Schramm, Lars Timmermann, Susanne Knake, Leona Möller","doi":"10.1186/s42466-026-00526-z","DOIUrl":"10.1186/s42466-026-00526-z","url":null,"abstract":"<p><strong>Background: </strong>New-onset refractory status epilepticus (NORSE) is a rare, life-threatening condition occurring in individuals without prior epilepsy or acute structural, toxic, or metabolic causes. Its etiology often remains cryptogenic, and inconsistent terminology hampers early recognition and treatment. This study aims to better characterize NORSE to support faster clinical diagnosis and management.</p><p><strong>Methods: </strong>We retrospectively identified all adult patients with status epilepticus (SE) admitted to the Department of Neurology, University Hospital Marburg, Germany, between 2011 and 2023. Demographic, etiologic, treatment, and outcome data from patients fulfilling consensus criteria for NORSE were compared with those of non-NORSE patients. We additionally performed a sensitivity analysis applying strict temporal diagnostic criteria (≤ 72 h) to assess the impact of consensus-based classification on cohort definition.</p><p><strong>Results: </strong>Of 779 patients with status epilepticus, 120 fulfilled criteria for NORSE, delineating a distinct clinical subgroup characterized by advanced age and a female predominance (67.5%, p = 0.028). Phenotypically, NORSE was strongly associated with generalized seizure semiology (70.7%, p < 0.001) and a higher burden of nonconvulsive status epilepticus (45.8%, p < 0.001), while the underlying etiology frequently remained cryptogenic (56.7%). This constellation translated into an adverse clinical trajectory, reflected by reduced rates of discharge home, increased in-hospital mortality (19.5%, p < 0.001), and greater reliance on rehabilitative care. Notably, these differences were not paralleled by alterations in metabolic indices such as HbA1c or cholesterol, underscoring the limited discriminatory value of these parameters in NORSE. Application of strict temporal criteria resulted in a smaller, more conservative NORSE cohort, while key clinical features and outcomes remained largely unchanged.</p><p><strong>Conclusions: </strong>NORSE defines a distinct and severe clinical syndrome within status epilepticus, characterized by older age, female predominance and adverse outcomes. Beyond the clinical severity of NORSE, our findings show that cohort composition is highly sensitive to the temporal operationalization of consensus criteria. Standardized application of diagnostic timing may therefore be essential for comparability across NORSE studies.</p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148852322","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":"Publisher Correction: Stimulation settings in subthalamic nucleus deep brain stimulation for parkinson's disease - a retrospective single-center observational study.","authors":"Charlotte Schedlich-Teufer, Gregor A Brandt, Christina van der Linden, Hannah Jergas, Juan Carlos Baldermann, Vasilija Stopic, Gereon R Fink, Veerle Visser-Vandewalle, Till A Dembek, Michael T Barbe, Jan Niklas Petry-Schmelzer","doi":"10.1186/s42466-026-00517-0","DOIUrl":"10.1186/s42466-026-00517-0","url":null,"abstract":"","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13508440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820867","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":"Accelerated long-term forgetting as an objective marker of subjective memory impairment in multiple sclerosis.","authors":"Christina Jansen, Johannes Stalter, Sigrid Reuter, Karsten Witt","doi":"10.1186/s42466-026-00527-y","DOIUrl":"10.1186/s42466-026-00527-y","url":null,"abstract":"<p><strong>Background: </strong>Accelerated long-term forgetting (ALF), defined as an increased rate of memory loss over extended intervals, has so far been detected in a pilot study of patients with mild multiple sclerosis (MS). This study aimed to (I) confirm the presence of ALF in a larger, heterogeneous MS sample, (II) explore associations with patient-reported outcomes, and (III) assess the diagnostic performance of ALF tests for subjective memory impairment.</p><p><strong>Methods: </strong>This study compared 62 MS patients and 65 age-, sex-, and education-matched healthy controls using standardized memory tests (RAVLT, WMS-IV Logical Memory subtest). Recall was assessed immediately, after 30 min, and after 7 days. Seven-day/30-minute recall ratios (Q_RAVLT, Q_WMS) served as primary outcomes. Self-report measures included memory complaints, fatigue, depression, and sleep disturbances. Spearman correlations and Receiver operating characteristic (ROC) analyses assessed associations and diagnostic accuracy.</p><p><strong>Results: </strong>ALF was observed in multiple sclerosis since Q_RAVLT was lower in patients than in controls (0.64 [95% CI 0.59-0.69] vs. 0.78 [0.73-0.82], p < 0.001), as was Q_WMS (0.79 [95% CI 0.74-0.84] vs. 0.95 [0.90-1.00], p < 0.001), despite comparable initial learning. Greater fatigue, higher memory complaints, sleep disturbances, older age, and greater disability were associated with lower ALF scores. The combined ALF score moderately discriminated subjective memory impairment (AUC 0.74; sensitivity 0.73; specificity 0.73).</p><p><strong>Conclusion: </strong>MS patients showed ALF despite normal initial learning, indicating a specific memory deficit undetected by standard tests. Long-delay recall using RAVLT and WMS-IV Logical Memory subtest may improve cognitive impairment detection in MS.</p><p><strong>Trial registration: </strong>German Clinical Trials Register (DRKS00035204), registered 17 April 2025.</p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815378","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":"German guideline on neurosyphilis.","authors":"Matthias Klein, Klemens Angstwurm, Stefan Esser, Juliane Fazio, Katrin Hahn, Simone Scheithauer, Anja Potthoff, Lara Chilver-Stainer, Jörg Weber, Ricardo Niklas Werner, Brigitte Wildmann, Matthias Maschke","doi":"10.1186/s42466-026-00525-0","DOIUrl":"10.1186/s42466-026-00525-0","url":null,"abstract":"<p><p>Neurosyphilis is a severe disease which can manifest with various clinical signs. The diagnosis can be challenging. Patients with positive syphilis serology and neurological or psychiatric symptoms should undergo cerebrospinal fluid (CSF) examination. The definite diagnosis is based on CSF findings, including evidence of inflammation, intrathecal production of treponemal antibodies (plus reactive non-treponema specific tests in the CSF). However, these criteria are not always fulfilled and a diagnosis of probable neurosyphilis may be established using less stringent diagnostic criteria. Treatment with intravenous penicillin or ceftriaxone is recommended for neurosyphilis. Here, a short version of the recommendations of the German guidelines on neurosyphilis that were published in 2026 is presented.</p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13499315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803983","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":"Heparin-calibrated anti-factor Xa activity as a surrogate marker for direct oral anticoagulant levels in acute stroke care: a large observational single-center study.","authors":"Martin Büchsel, Katharina Lisko, Hanna Gölz, Jürgen Bardutzky, Heinz Wiendl, Saúl Beltrán Felipa, Johann Lambeck","doi":"10.1186/s42466-026-00524-1","DOIUrl":"https://doi.org/10.1186/s42466-026-00524-1","url":null,"abstract":"<p><strong>Background and purpose: </strong>Direct oral anticoagulants (DOAC) complicate therapeutic decision-making, as rapid assessment of anticoagulant activity is critical in emergency patients, particularly in acute ischemic stroke (AIS). The administration of systemic thrombolysis (IVT) in anti-coagulated patients requires careful risk-benefit evaluation, given the potential for hemorrhagic complications. Substance-specific DOAC plasma level measurements are often unavailable outside tertiary centers. This study evaluated whether widely available heparin-calibrated anti-factor Xa (anti-Xa) activity can reliably estimate clinically relevant DOAC levels and support urgent clinical decision-making.</p><p><strong>Methods: </strong>This retrospective single-center study (2015-2023) analyzed 969 patients treated with apixaban, rivaroxaban, or edoxaban. All patients had parallel measurements of anti-Xa activity and specific DOAC levels. Correlations were assessed using Spearman's coefficient. Receiver operating characteristic (ROC) analyses were performed to derive anti-Xa cut-off values corresponding to DOAC concentrations of 30, 50, and 100 ng/mL.</p><p><strong>Results: </strong>Anti-Xa activity strongly correlated with DOAC plasma levels for all substances (Spearman's ρ ≈ 0.95-0.96). ROC analyses demonstrated excellent diagnostic accuracy, with areas under the curve ≥ 0.97 for all evaluated thresholds. Similar anti-Xa cut-offs were observed for apixaban and rivaroxaban, whereas these were lower for edoxaban. For all DOACs combined, anti-Xa cut-offs of approximately 0.36U/mL, 0.56U/mL, and 1.19U/mL corresponded to DOAC levels of 30, 50, and 100ng/mL, respectively, with high sensitivity and specificity.</p><p><strong>Conclusions: </strong>Heparin-calibrated anti-Xa activity is a reliable surrogate marker for clinically relevant DOAC levels. Defined anti-Xa cut-offs are highly specific and sensitive and enable rapid and standardized assessment of anticoagulant activity in this cohort.</p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13483506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803945","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}