Neurological research and practice最新文献

{"title":"Response to the letter to the editor regarding \"safety of tenecteplase versus alteplase for intravenous thrombolysis in acute ischemic stroke patients with direct oral anticoagulation\".","authors":"Lena Mers, Stefan T Gerner","doi":"10.1186/s42466-026-00459-7","DOIUrl":"10.1186/s42466-026-00459-7","url":null,"abstract":"","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":"8"},"PeriodicalIF":3.2,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12888652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146151639","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":"Letter to the editor regarding \"Safety of tenecteplase versus alteplase for intravenous thrombolysis in acute ischemic stroke patients with direct oral anticoagulation: experience from a German stroke center\" by Mers et al.","authors":"Matija Zupan, Pawel Kermer, Senta Frol","doi":"10.1186/s42466-026-00458-8","DOIUrl":"10.1186/s42466-026-00458-8","url":null,"abstract":"","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":"7"},"PeriodicalIF":3.2,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12888728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146151633","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":"Consider autoimmune encephalitis in cases of headache, dizziness, and mild pleocytosis following SARS-CoV-2 infection.","authors":"Sinda Zarrouk, Josef Finsterer","doi":"10.1186/s42466-026-00469-5","DOIUrl":"10.1186/s42466-026-00469-5","url":null,"abstract":"","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":"10"},"PeriodicalIF":3.2,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12888302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146151657","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":"Diagnostic performance and safety of the edrophonium test in myasthenia gravis: a retrospective case-control study.","authors":"Omar Keritam, Julia Bettina Kräutler, Diana Gharib, Elnayer Ahmed Jabir, Rosa Weng, Fiona Jäger, Martin Krenn, Anna Paul, Walter Rinner, Hakan Cetin, Fritz Zimprich, Gudrun Zulehner, Jakob Rath","doi":"10.1186/s42466-026-00468-6","DOIUrl":"10.1186/s42466-026-00468-6","url":null,"abstract":"<p><p>BACKGROUND: Myasthenia gravis (MG) is an autoimmune disorder of the neuromuscular junction. The diagnosis typically relies on clinical features, serologic testing, and neurophysiological assessment but provocation tests such as the edrophonium test can provide rapid supportive information; however, data on its diagnostic performance are limited. Thus, we aimed to evaluate the diagnostic performance and safety of the edrophonium test in MG. METHODS: We conducted a retrospective case–control study of patients who underwent an edrophonium test at the Department of Neurology of the Medical University of Vienna between January 1991 and January 2024. We calculated sensitivity, specificity, and likelihood ratios and performed a multivariable logistic regression analysis to identify variables associated with a positive edrophonium test. Additionally, we assessed the safety of the edrophonium test. RESULTS: We included 182 patients with MG (41.2% female; mean age 55.8 years) and 324 controls (55.2% female; mean age 53.6 years). The edrophonium test had a sensitivity of 83.5% and a specificity of 87.7% in diagnosing MG. Patients with a decrement after repetitive nerve stimulation had higher odds of a positive response to the edrophonium test (OR 3.79, 95% CI 1.48–10.33, p = 0.0067), while odds were lower in patients with MuSK-MG compared to patients with AChR-MG (OR 0.08, 95% CI 0.01–0.82, p = 0.0254). Adverse events were reported in 58 patients (11.5%), in most of whom (53 patients, 91.4%) they were mild. CONCLUSIONS: We provide data on the diagnostic performance and safety of the edrophonium test, supporting its use as an adjunctive diagnostic test for the diagnosis of MG. </p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":"11"},"PeriodicalIF":4.0,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12888114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146151651","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":"Defining early surgery in traumatic spinal cord injury: admission-based versus injury-based timing.","authors":"Audai H Abudayeh, Iakiv Fishchenko","doi":"10.1186/s42466-026-00470-y","DOIUrl":"10.1186/s42466-026-00470-y","url":null,"abstract":"","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":"9"},"PeriodicalIF":3.2,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12888300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146151601","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":"Headaches and lymphocytic pleocytosis after COVID-19 require the exclusion of encephalitis.","authors":"Josef Finsterer","doi":"10.1186/s42466-026-00461-z","DOIUrl":"10.1186/s42466-026-00461-z","url":null,"abstract":"","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":"1"},"PeriodicalIF":3.2,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12870522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115441","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":"AI-assisted hemorrhage detection following endovascular stroke treatment: a retrospective diagnostic accuracy study.","authors":"Luise Endler, Miar Ouaret, Janos Sebestyen Gellén, Johannes A R Pfaff","doi":"10.1186/s42466-026-00457-9","DOIUrl":"10.1186/s42466-026-00457-9","url":null,"abstract":"<p><p>BACKGROUND: Antithrombotic therapy is essential for preventing strokes, but its use after reperfusion therapy requires careful monitoring due to the risk of hemorrhagic transformation. Non-contrast-enhanced computed tomography (NCCT) is the standard for detecting intracranial hemorrhages post-stroke. Artificial intelligence may enhance hemorrhage detection and improve patient safety. This study evaluates AI’s sensitivity and specificity in detecting hemorrhagic events in NCCT scans within 48 h after endovascular stroke treatment, compared to standard radiological assessment. METHODS: A retrospective, single-center study was conducted at a European stroke center, including 495 NCCT scans from 425 patients who underwent endovascular stroke treatment between 08/2021 and 06/2024. A CE-marked AI software based on convolutional neural networks (CNN) analyzed the scans independently. The reference standard was assessments of two board-certified neuroradiologists, and AI results were compared with routine radiological reports. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated, and inter-rater reliability was assessed using Cohen’s kappa. RESULTS: The reference standard identified hemorrhages in 197 NCCT scans. The AI system showed sensitivity of 95.9%, specificity of 84.6%, PPV of 80.4%, and NPV of 96.9%. Radiological reports had sensitivity of 91.9%, specificity of 96.3%, PPV of 94.3%, and NPV of 94.7%. Cohen’s kappa was higher for radiological reports (0.886) than AI (0.780), indicating stronger agreement with the reference standard. AI had a higher false-positive rate (15.4%) than radiological reports (3.7%). CONCLUSIONS: AI demonstrated high sensitivity for detecting intracranial hemorrhages but had a higher false-positive rate compared to routine radiological assessment. While AI can aid clinical decision-making, radiologists show superior overall diagnostic accuracy. Further research is needed to explore the impact of AI-assisted decision-making on stroke management and secondary prevention. </p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":"5"},"PeriodicalIF":4.0,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12870412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115345","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":"Collaborative neurocardiology board meetings for decision-making in stroke care: a real-world experience.","authors":"V Mafael, T Buck, H Stengl, S Hellwig, M G Klammer, M Endres, M Reinthaler, F Barbieri, H J Audebert, D M Leistner, U Landmesser, W Doehner, C Skurk, J F Scheitz","doi":"10.1186/s42466-026-00464-w","DOIUrl":"10.1186/s42466-026-00464-w","url":null,"abstract":"<p><p>BACKGROUND: Interdisciplinary collaboration between neurologists and cardiologists is needed to provide state-of-the art stroke care and individualized decisions about secondary prevention strategies. This highlights the need to establish working structures for joint decision-making between cardiologists and stroke neurologists. At present, studies describing the real-world decision-making as part of such brain-heart teams are scarce. METHODS: We established a structured heart–brain team approach with monthly virtual neurocardiology board (NCB) meetings within a neurovascular network. We conducted a retrospective analysis of the implementation phase of NCB meetings between 2021 and 2024. We describe the structure of board meetings, patient characteristics and therapeutic and diagnostic recommendations. RESULTS: During the study period, 46 board meetings were held, and 255 patients were discussed. The number of referred patients increased from 32 in 2021 to 89 in 2024. The majority of patients were evaluated for patent foramen ovale (PFO) closure (n = 189, 74.1%, median age 56 years, 59.8% female) and left atrial appendage occlusion (LAAO) (n = 32, 12.5%, median age 83 years, 50% female). Further questions centered around other individual secondary prevention strategies. Among patients referred to discuss PFO closure, closure was not recommended in 43.4% of patients (n = 82), recommended depending on additional diagnostic measures in 13.8% (n = 26), considered optional in 19.6% (n = 37) and clrearly recommended in 23.3% (n = 44). Patients for whom it was not recommended were older, had more cardiovascular risk factors and were less likely to have a large PFO shunt. The main reason for the recommendation against closure was that the PFO was not considered causal for the stroke (80.5%). Among LAAO patients, participation in a randomized controlled trial was recommended in 68.8%. CONCLUSIONS: We successfully established and steadily expanded regular NCB meetings to provide a platform for interdisciplinary exchange and personalized stroke treatment, in particular discussion of indications for interventional procedures against cardiac embolism. Our approach may serve as a blueprint for similar collaborative approaches. Future studies are needed to assess adherence to recommendations and patient outcomes as this study lacks follow-up data. </p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":"4"},"PeriodicalIF":4.0,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12870955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115331","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":"Letter to the editor regarding \"Recent intake of direct oral anticoagulants and acute ischemic stroke: real world data from a comprehensive stroke center\" by Pommeranz et al.","authors":"Matija Zupan, Pawel Kermer, Senta Frol","doi":"10.1186/s42466-026-00463-x","DOIUrl":"10.1186/s42466-026-00463-x","url":null,"abstract":"","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":"2"},"PeriodicalIF":3.2,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12870436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115483","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":"Functional outcome, five-year survival and burden of disease after size- and location-matched hemorrhagic versus ischemic stroke.","authors":"Stefanie Balk, Teresa Siller, Maximilian I Sprügel, David Haupenthal, Kathrin Kölbl, Stefan Hock, Daniel Heinze, Tobias Engelhorn, Bernd Kallmünzer, Stefan Schwab, Hagen B Huttner, Joji B Kuramatsu, Jochen A Sembill","doi":"10.1186/s42466-026-00456-w","DOIUrl":"10.1186/s42466-026-00456-w","url":null,"abstract":"<p><p>BACKGROUND: Worse functional outcome has been reported after hemorrhagic compared to ischemic stroke, yet it remains unclear whether the lesion size, location, or stroke etiology itself results in different degrees of disability. This study compares outcomes in ischemic vs. hemorrhagic stroke patients with matched lesion size and location. METHODS: Data from the longitudinal cohort study on intracerebral hemorrhage (ICH) care (2006–2015) and a retrospective registry on acute ischemic stroke (AIS) (2011–2015), both conducted at the university hospital Erlangen, were used to investigate patients with a single stroke lesion in the middle cerebral artery territory. Patient characteristics, lesion size and affected brain location according to the Alberta Stroke Program Early CT Score (ASPECTS) regions were balanced using propensity score matching. Functional outcomes (ordinal shift of modified Rankin scale (mRS) at 3 months), 5-year survival (Kaplan–Meier, Cox regression), and burden of disease (Disability-Adjusted Life Years [DALYs] = Years of Life Lost [YLL] + Years Lived with Disability [YLD]) were compared. RESULTS: After propensity score matching, we analyzed 194 patients, divided equally into AIS or ICH cases. We observed a shift in mRS distribution towards better functional outcomes in favor of AIS over ICH (OR: 1.69, 95% CI: 1.02–2.79, p = 0.04), especially in younger patients (age < 75 years, OR: 3.23, 95% CI: 1.58–6.59, p < 0.01) and smaller lesion volumes (< 15 mL, OR: 4.48, 95% CI: 1.85–10.89, p < 0.01). The 5-year survival did not differ between groups (log-rank 0.63). Mean number of DALYs was higher following ICH compared to AIS in general (8.39 ± 5.18 vs. 5.90 ± 4.61, p < 0.001) and per milliliter of parenchymal lesion volume (0.31[0.14–0.81] vs. 0.24[0.10–0.41], p = 0.04). The higher number of DALYs is attributable to the higher number of YLDs (ICH, 3.49 ± 3.3 vs. AIS, 2.31 ± 2.86, p < 0.01) and YLLs (ICH, 4.90 ± 3.27 vs. AIS, 3.59 ± 3.08, p < 0.01) in matched patients following ICH compared to AIS. CONCLUSIONS: For stroke lesions of matched size and location, patients with hemorrhagic stroke had worse functional outcome, greater disease burden in total and per ml, yet comparable long-term survival rates compared to those with ischemic stroke. </p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"8 1","pages":"6"},"PeriodicalIF":4.0,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12870224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115408","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}