Neurological research and practice最新文献

{"title":"Radiologic drivers of dysphagia after intracerebral haemorrhage: a flexible endoscopic evaluation of swallowing-guided retrospective analysis on intensive care unit.","authors":"Samra Hamzic, Omar Alhaj Omar, Linda Danielczik, Stefan T Gerner, Maxime Viard, Michael Bender, Heidrun H Kraemer, Priyanka Boettger, Martin Juenemann, Tobias Braun","doi":"10.1186/s42466-026-00498-0","DOIUrl":"10.1186/s42466-026-00498-0","url":null,"abstract":"<p><strong>Introduction: </strong>Dysphagia is a frequent and clinically relevant complication after intracerebral haemorrhage (ICH) and is associated with increased morbidity and mortality. While radiologic severity and lesion characteristics are known to influence neurological outcome, their relationship with objectively measured dysphagia severity (DS) and swallowing management remains insufficiently defined. This study investigated the association between radiologic ICH burden and DS assessed by flexible endoscopic evaluation of swallowing (FEES), and examined the clinical impact of FEES-guided swallowing management in an neuro intensive care unit (ICU) cohort.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of consecutive ICH patients treated in neurological ICU who underwent standardized bedside dysphagia assessment, with FEES performed when clinically indicated and feasible. DS and functional oral intake were quantified using the Fiberoptic Endoscopic Dysphagia Severity Scale (FEDSS) and the Functional Oral Intake Scale (FOIS-G). Multivariable regression models adjusted for age and clinical severity were used to examine associations between radiologic parameters (hematoma volume, location, ICH score, intraventricular and subarachnoid haemorrhage) and dysphagia outcomes.</p><p><strong>Results: </strong>Of 241 patients 120 (49.8%) were diagnosed with relevant dysphagia FEES was performed in 68 patients (28.2%) at a median of 13 days after admission. After FEES, the diet was modified in 67% of patients and the oral intake score improved from a median of one to four. Radiologic severity was independently associated with dysphagia outcomes: higher ICH score predicted lower odds of of favourable FOIS-G and FEDSS scores. Deep intracerebral haemorrhage, intraventricular haemorrhage and subarachnoid haemorrhage were associated with worse functional oral intake. FEES led to a modification of swallowing management in 67% of examined patients, most frequently allowing safer and more liberal oral intake compared with bedside assessment alone.</p><p><strong>Conclusion: </strong>In ICU-treated patients with ICH, dysphagia is common and closely linked to radiologic severity and lesion characteristics. FEES frequently reveals clinically relevant discrepancies between bedside assessment and actual swallowing function and substantially influences swallowing management. Integrating radiologic risk stratification with FEES-guided decision-making may improve safety, nutrition, and rehabilitation planning in this high-risk population.</p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13170179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147936474","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":"Multicentric prognostic observational study on biomarker profile in immunotherapy-naïve patients with highly active generalized myasthenia gravis (PROGNO-MG): a study protocol.","authors":"Felix Kohle, Franz Felix Konen, Ulrike Grittner, Daniel Schulze, Stefanie Glaubitz, Christopher Nelke, Christina B Schroeter, Niklas Huntemann, Peter Trillenberg, Julian Großkreutz, Benedikt Schoser, Charlotte Schubert, Jana Zschüntzsch, Michael Schroeter, Tobias Hegelmaier, Thomas Skripuletz, Jörn Peter Sieb, Tobias Ruck, Sven Meuth, Heinz Wiendl, Christian Wolfgang Keller, Jan D Lünemann, Sophie Lehnerer, Andreas Meisel, Frauke Stascheit","doi":"10.1186/s42466-026-00482-8","DOIUrl":"10.1186/s42466-026-00482-8","url":null,"abstract":"<p><strong>Background: </strong>Myasthenia gravis has a variable disease course. Early identification of patients with a highly active disease is crucial to prevent myasthenic exacerbations and crisis, necessitating more aggressive immunotherapy. However, no biomarkers currently exist to identify patients at risk for highly active disease course.</p><p><strong>Objective: </strong>The PROGNO-MG study aims to identify blood-based biomarker signatures associated with a highly active disease course in immunotherapy-naïve patients with acetylcholine-receptor-antibody positive (AChR⁺) generalized Myasthenia gravis (gMG).</p><p><strong>Methods: </strong>This is an investigator-initiated prospective, multicentric, observational study. Seventy newly diagnosed immunotherapy-naïve AChR⁺ gMG patients will be enrolled and followed up for 24 months. Blood samples and clinical data will be collected biannually. Biomarkers (calprotectin, neurofilament light chain, ITIH3, complement activation, kappa free light chains, and exploratory proteome-analyses and immune cell phenotyping) will be measured and their association with clinical outcomes will be evaluated.</p><p><strong>Perspective: </strong>The results will provide evidence for prognostic biomarkers, supporting risk stratification and early individualized treatment for AChR⁺ gMG patients.</p><p><strong>Trial registration: </strong>The study is registered in the German clinical trial register (DRKS00035457).</p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13169798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147936537","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 of neuroinfectious-diseases: high impact of vaccination programs - but the potential is not maxed out yet.","authors":"Matthias Klein, Maximilian Schöls, Hayrettin Tumani, Uta Meyding-Lamade, Julia Decker, Matthias Maschke, Judith Wagner","doi":"10.1186/s42466-026-00489-1","DOIUrl":"10.1186/s42466-026-00489-1","url":null,"abstract":"<p><strong>Background: </strong>The greatest impact on the burden of CNS infections resulted from preventive measures, mainly vaccination programs, that have decreased the incidence of many CNS infections significantly. Here, we highlight the main cornerstones of vaccination programs on bacterial and viral CNS infections and point at future chances of upcoming vaccines.</p><p><strong>Main body: </strong>Vaccination programs have significantly decreased the number of cases due to Haemophilus influenzae type B and Neisseria meningitidis. For pneumococcal meningitis, new vaccines that prevent neuroinvasive serotypes have the potential to decrease numbers in the future. Whereas a vaccine is available for tick-borne encephalitis, prevention of neuroborreliosis is limited to contact precautions. However, vaccination rates against tick-borne encephalitis remain too low in many countries. Another neurotropic virus that can be prevented effectively by vaccination is varicella zoster virus (VZV). Interestingly, vaccination against VZV also seems to reduce the risk of dementia as recently shown. While vaccination is important in general, patients with immunosuppression benefit most from vaccinations. Finally, recent measles outbreaks impressively underline the efficacy of vaccination programs and demonstrate what can happens if vaccination rates decrease.</p><p><strong>Conclusion: </strong>Vaccination programs have shown to be effective in reducing the burden of CNS infections. As vaccination rates are generally still too low and as new vaccines are coming up, it is obvious that the potential of vaccines to prevent CNS infections is not maxed out yet.</p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13162437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147877034","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":"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":"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":4.0,"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":"10.1186/s42466-026-00496-2","url":null,"abstract":"","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":""},"PeriodicalIF":4.0,"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":"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":4.0,"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":4.0,"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":"10.1186/s42466-026-00476-6","url":null,"abstract":"<p><p>INSPIRE-PNRM+ (short for InterdiSciPlinary and InteRsectoral telemedIcal Evaluation, Coordination and Therapy at the ParkinsonNet RheinMain+) is an one-year, multicentre, interventional, open-label, two-arm, 1:1 randomized controlled trial (RCT) with the goal to improve the quality of care for Parkinson’s disease (PD) patients outside of a specialized clinical context. The study is funded by the German Innovation Fund mandated by the Federal Joint Committee (G-BA). The three core characteristics are (1) the employment of specially trained advanced practice nurses (APN) in an (2) interdisciplinary network and (3) the use of a specifically designed digital platform. This platform serves for documentation and communication, thereby helping patients receive individualized, guideline-based treatment and support in adapting their lives to the effects of the disease. 844 patients will be recruited. They will be divided into two groups: a “usual care” group which continues traditional care (i.e., usually consultation with a neurologist in private practice) vs. the “intervention” group which will have APN contact every three months or more frequently as needed over the period of 12 months. Patients’ quality of life serves as primary outcome measure, combined with a process evaluation and health economic analysis (cost-utility analysis (CUA)). Recruitment was ongoing at time of submission of this paper. This innovative study is the first in Germany where APNs are dedicated to PD care. The study may serve as blueprint when incorporating APNs into routine healthcare, similar to other countries. TRIAL REGISTRATION: The study has been registered at www.clinicaltrials.gov , NCT06479083. Registered June 27, 2024. https://clinicaltrials.gov/study/NCT06479083?term=INSPIRE%20Parkinson&rank=1 . </p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":""},"PeriodicalIF":4.0,"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":"10.1186/s42466-026-00479-3","url":null,"abstract":"<p><p>BACKGROUND: Stroke is a leading cause of death and disability, and the top contributor to neurological disability-adjusted life years globally. Current trends suggest that stroke incidence will continue to rise, especially in low- and middle-income countries. MAIN BODY: Prevention opportunities are substantial because the majority of stroke burden is linked to modifiable risk factors. Thus, stroke incidence can effectively be reduced if proven interventions are implemented early, consistently, and at sufficient scale. Effective prevention requires both individualized, risk-based targets and interventions, and health-system approaches that support systematic detection, longitudinal control, and sustained adherence in routine care. Importantly, prevention benefits will be maximized only if access is equitable and if prevention goals can be achieved across the population at large, including so far underserved groups that combine multiple cardiovascular risk factors and low affinity to traditional health care prevention programs. FUTURE DIRECTIONS: Next steps may include strengthening of primary-care-based prevention programs, routine surveillance of risk-factor control, outreach to underserved groups, and transparent quality indicators. Long-term follow-up is essential to sustain risk-factor control and to enable translation of evidence into population-level impact. </p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":""},"PeriodicalIF":4.0,"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":"10.1186/s42466-026-00485-5","url":null,"abstract":"<p><p>INTRODUCTION: Myasthenia gravis (MG) is a chronic autoimmune disorder increasingly affecting older adults, with rising prevalence and comorbidity burden across Europe. Contemporary nationwide data describing MG-related hospital utilisation in European healthcare systems remain limited. We examined temporal trends and severity-related hospital outcomes in Spain between 2016 and 2022. METHODS: We conducted a retrospective, population-based analysis using the Spanish Minimum Basic Data Set, including all adult hospital episodes with a primary diagnosis of MG (ICD-10-ES G70.00, G70.01). Hospital admissions, day-hospital visits and emergency department (ED) encounters were evaluated. Variables included demographics, intensive care unit (ICU) admission, myasthenic crisis, in-hospital mortality and comorbidities. Temporal trends were analysed using segmented negative binomial regression models incorporating a breakpoint in 2018. RESULTS: A total of 20,251 MG-related episodes corresponding to 6,308 unique patients were identified. Following 2018, hospital admissions declined by 5.4% annually (95% CI − 8.4 to − 2.4), whereas day-hospital and ED utilisation increased markedly, particularly among older adults. In-hospital mortality remained low and stable (mean 2.6%). ICU admissions increased from 8.2% to 13.7% of hospitalised patients. Myasthenic crisis accounted for 4.5% of admissions and was strongly associated with ICU utilisation, representing 39% of all ICU stays. CONCLUSIONS: MG care in Spain is undergoing a sustained transition toward ambulatory management without evidence of worsening short-term hospital outcomes. Despite an ageing patient population and rising ICU utilisation, in-hospital mortality remained stable, supporting the safety of outpatient-based MG care models. These findings highlight the need for integrated clinical data to inform future healthcare planning in MG. </p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":""},"PeriodicalIF":4.0,"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}