Journal of the Neurological Sciences最新文献

{"title":"Functional imaging reveals cerebral microvascular dysfunction in primary antiphospholipid syndrome: Pathophysiologic insights and translational implications","authors":"A. Mameli ,&nbsp;L. Indovina ,&nbsp;F. Cocciolillo ,&nbsp;A. Serra ,&nbsp;F. Marongiu ,&nbsp;D. Barcellona","doi":"10.1016/j.jns.2026.125750","DOIUrl":"10.1016/j.jns.2026.125750","url":null,"abstract":"<div><div>Primary antiphospholipid syndrome (PAPS) is an autoimmune thromboinflammatory disorder primarily characterized by recurrent arterial and venous thromboses and persistently elevated antiphospholipid antibodies (aPL). Beyond its classical vascular manifestations, an expanding spectrum of neuropsychiatric symptoms—including cognitive impairment, mood disturbances, and attention deficits—has been reported in PAPS, often in the absence of overt ischemic lesions on structural neuroimaging. In this study, we present original data from a cohort of 25 well-defined PAPS patients who underwent brain single-photon emission computed tomography (SPECT) imaging with Statistical Parametric Mapping (SPM) analysis. Compared to age- and sex-matched controls, PAPS patients demonstrated a consistent pattern of cerebral hypoperfusion involving bilateral frontoparietal cortices, independent of clinical neurological manifestations or MRI findings. These abnormalities suggest functional microvascular impairment potentially mediated by chronic endothelial dysfunction, complement activation, and aPL-induced neuroinflammatory cascades. Our findings support the hypothesis that cerebral involvement in PAPS extends beyond thrombotic injury to include immune-mediated microvascular and neuroglial dysregulation. This study highlights the value of functional imaging in uncovering subclinical cerebral dysfunction and proposes a neuroimmunological framework for understanding and managing cognitive and psychiatric symptoms in PAPS. Early identification of such changes may offer a window for therapeutic intervention before irreversible neuronal damage occurs.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"481 ","pages":"Article 125750"},"PeriodicalIF":3.2,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The ongoing debate about the association between benzodiazepines and dementia","authors":"Diego Legrand ,&nbsp;Pasquale Roberge ,&nbsp;Christian Bocti","doi":"10.1016/j.jns.2026.125737","DOIUrl":"10.1016/j.jns.2026.125737","url":null,"abstract":"","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"481 ","pages":"Article 125737"},"PeriodicalIF":3.2,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146018995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodological considerations on benzodiazepine exposure and dementia risk: Commentary on Legrand et al.","authors":"Tian Ruan ,&nbsp;Tao Yu ,&nbsp;Fang Zhao ,&nbsp;Yaohua Tang","doi":"10.1016/j.jns.2026.125736","DOIUrl":"10.1016/j.jns.2026.125736","url":null,"abstract":"","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"481 ","pages":"Article 125736"},"PeriodicalIF":3.2,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146018976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor: Association between benzodiazepines and dementia: A case-control study from Canadian health surveys and medico-administrative databases","authors":"Zhiyi Chen ,&nbsp;Longyao Zhang ,&nbsp;Xuezhu Zhang","doi":"10.1016/j.jns.2026.125738","DOIUrl":"10.1016/j.jns.2026.125738","url":null,"abstract":"","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"481 ","pages":"Article 125738"},"PeriodicalIF":3.2,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145940313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of corticosteroid use on comorbidities in patients with myasthenia gravis in the US National Veterans Affairs Health Network","authors":"Cynthia Z. Qi ,&nbsp;Yilu Lin ,&nbsp;Yuebing Li ,&nbsp;Tuan Vu ,&nbsp;Deborah Gelinas ,&nbsp;Alexis A. Lizarraga ,&nbsp;Cécile Blein ,&nbsp;Femke De Ruyck ,&nbsp;Lizheng Shi","doi":"10.1016/j.jns.2025.125716","DOIUrl":"10.1016/j.jns.2025.125716","url":null,"abstract":"<div><h3>Background</h3><div>Corticosteroid use may increase the risk of common comorbidities in patients with myasthenia gravis (MG); however, limited longitudinal data are available to evaluate this risk over time.</div></div><div><h3>Methods</h3><div>This retrospective cohort study used electronic medical record data from the National Veterans Affairs Health Care Network database (January 1999–March 2024) to evaluate the impact of corticosteroid use on the development of selected comorbidities in patients with and without generalized MG. Index date was the first MG diagnosis for the MG cohort and a randomly chosen date for a propensity score-matched non-MG cohort; patients were followed until disenrollment, end-of-study, or death.</div></div><div><h3>Results</h3><div>In total, 10,632 patients with MG and 10,632 matched controls were included; mean follow-up was 7.8 years. Corticosteroids were received by 51.6% of MG and 21.2% of non-MG patients. Both MG and non-MG patients who received corticosteroids had a higher incidence of new-onset comorbidities during follow-up than MG and non-MG patients without corticosteroid use (<em>p</em> &lt; 0.0001). Among MG patients, multivariate analyses showed statistically significant increases in the annualized risk of new-onset diabetes (hazard ratios 1.32–1.76), infections (1.19–1.25), osteoporosis (1.33–1.69), and cardiovascular disease (1.19–1.31) across medium- and high-dose intensities (<em>p</em> &lt; 0.05). Statistically significant increases in annualized risk were observed for glaucoma (hazard ratio 1.81 at high dose; <em>p</em> &lt; 0.05) and depression (1.22 at medium dose; <em>p</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>Increased risks for the development of key comorbidities among patients with MG were associated with corticosteroid use, particularly at higher-dose intensities. Our findings support strategies to minimize corticosteroid usage in MG.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"481 ","pages":"Article 125716"},"PeriodicalIF":3.2,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 12-month observational study on the safety, efficacy on migraine-associated symptoms and satisfaction of CGRP monoclonal antibodies in Japanese patients with migraine","authors":"Shungo Imai ,&nbsp;Keiko Ihara ,&nbsp;Nobuyuki Takahashi ,&nbsp;Seiya Ohtani ,&nbsp;Narumi Watanabe ,&nbsp;Chisato Iba ,&nbsp;Kei Ishizuchi ,&nbsp;Ryo Takemura ,&nbsp;Jin Nakahara ,&nbsp;Satoko Hori ,&nbsp;Tsubasa Takizawa","doi":"10.1016/j.jns.2026.125751","DOIUrl":"10.1016/j.jns.2026.125751","url":null,"abstract":"<div><h3>Introduction</h3><div>Calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs) are effective in clinical trials and real-world settings. However, data other than headache frequency remains limited in East Asia. Thus, we investigated long-term efficacy, tolerability, and patient-reported satisfaction of CGRP mAbs in clinical practice.</div></div><div><h3>Methods</h3><div>This single-center observational study included patients with migraine who were administered one of three CGRP mAbs (erenumab, galcanezumab, and fremanezumab) between August 2021 and February 2023. Baseline demographic and headache characteristics were recorded, and treatment outcomes, adverse events, migraine-associated symptoms, and satisfaction levels were assessed over time.</div></div><div><h3>Results</h3><div>We enrolled 150 patients with episodic (<em>n</em> = 81) or chronic migraine (<em>n</em> = 69), including 40 with migraine aura. At six and twelve months, 36/67 (54%) and 22/42 (52%) patients achieved at least 50% reduction in monthly migraine days. Multivariate logistic regression showed that among differences in demographic and headache characteristics between responders and non-responders, the response rate at 3 months was associated with the 6-month response. Migraine-associated symptoms and aura showed improving trends until 5 months after CGRP mAbs initiation. As for safety, injection site reaction was seen in 35/146 (24%), 14/57 (25%), and 4/37 (11%) at 1, 6, and 12 months, respectively. Regarding satisfaction, 74%, 92%, and 94% answered “very satisfied” or “somewhat satisfied” at 1, 6, and 12 months, respectively.</div></div><div><h3>Conclusion</h3><div>This study highlighted the role of early response in predicting the long-term response to CGRP mAbs. We also emphasized the importance of documenting satisfaction, migraine aura frequency, in addition to migraine frequency, for deeper insights into migraine pathophysiology.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"481 ","pages":"Article 125751"},"PeriodicalIF":3.2,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of adding optical coherence tomography in MS diagnostic criteria on the classification of tumefactive demyelination","authors":"Fiorella S. Guido ,&nbsp;John J. Chen ,&nbsp;Paul A. Decker ,&nbsp;Mahboubeh Fereidan-Esfahani ,&nbsp;Kevin D. Chodnicki ,&nbsp;Deena A. Tajfirouz ,&nbsp;Eoin P. Flanagan ,&nbsp;Orhun H. Kantarci ,&nbsp;B. Mark Keegan ,&nbsp;Sean J. Pittock ,&nbsp;Jan-Mendelt Tillema ,&nbsp;Claudia F. Lucchinetti ,&nbsp;Jeanette E. Eckel-Passow ,&nbsp;W. Oliver Tobin","doi":"10.1016/j.jns.2026.125739","DOIUrl":"10.1016/j.jns.2026.125739","url":null,"abstract":"<div><h3>Background</h3><div>De novo tumefactive demyelination (TD) poses a diagnostic challenge, with lower rates of cerebrospinal fluid (CSF) oligoclonal bands and lower female-to-male ratio than typical onset multiple sclerosis (MS). Only about half fulfill the 2017 McDonald diagnostic criteria for MS at presentation. Therefore, our aim was to assess optic nerve involvement by optical coherence tomography (OCT) in patients with TD. Further, whether the presence of abnormalities on OCT would allow additional TD patients to be diagnosed with MS when the optic nerve is added as a fifth topography to the Barkhof criteria or 2017 McDonald criteria.</div></div><div><h3>Methods</h3><div>Observational retrospective chart review of patients seen at a tertiary referral center from 1/1/1990 to 2/21/2024 with TD. Inclusion criteria were: 1) brain MRI showing an active TD lesion; 2) medical records with at least one available clinical assessment by a neurologist; 3) available Cirrus OCT data to review. Exclusion criteria were: 1) patients with final diagnosis of vasculitis, abscess, CNS malignancies, or MOGAD; 2) presence of confounding ocular disease.</div></div><div><h3>Results</h3><div>OCT was available in 68 patients with TD. The tumefactive attack was the first demyelinating event in 45 (67 %) patients. At presentation, 29/68 (43 %) fulfilled 3 of 4 Barkhof criteria, and 34/68 (50 %) fulfilled the 2017 McDonald criteria for the diagnosis of MS. A clinical history of optic neuritis was present in 9/68 (13 %) patients and OCT was abnormal in 9/9 (100 %) of those patients. Regardless of clinical history, OCT was abnormal in 22/68 (32 %) patients. Therefore, OCT identified abnormalities suggestive of prior optic neuritis in 13/59 (22 %) TD patients without a clinical history of optic neuritis. If the optic nerve, as a firth topography, was assessed by OCT 39/68 (57 %) would fulfill McDonald criteria.</div></div><div><h3>Conclusions</h3><div>OCT in patients presenting with TD lesions can frequently identify both clinical and subclinical optic neuritis. The addition of the optic nerve as a fifth topography assessed by OCT to fulfill dissemination in space criteria would allow additional TD patients to be diagnosed with MS.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"481 ","pages":"Article 125739"},"PeriodicalIF":3.2,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital biomarkers in early Alzheimer's disease from wearable or portable technology: A scoping review","authors":"Mathias Holsey Gramkow ,&nbsp;Helena Sophia Coley Gleerup ,&nbsp;Anja Hviid Simonsen ,&nbsp;Gunhild Waldemar ,&nbsp;Kristian Steen Frederiksen","doi":"10.1016/j.jns.2026.125734","DOIUrl":"10.1016/j.jns.2026.125734","url":null,"abstract":"<div><h3>Background</h3><div>The pursuit of accurate biomarkers for early detection and disease monitoring of Alzheimer's disease (AD) has driven a growing interest in digital biomarkers. We aimed to map the research landscape of digital biomarkers in early AD obtained with wearable or portable digital health technologies (DHTs).</div></div><div><h3>Methods</h3><div>In our scoping review, we included original research on portable or wearable DHTs where digital biomarkers were measured in populations of early AD (mild cognitive impairment (MCI) or mild dementia). We searched MEDLINE, Web of Science and EMBASE with a wide search strategy with independent review and data extraction by two review team members. We charted data in tabular/graphical form.</div></div><div><h3>Results</h3><div>After deduplication and screening of 8893 records, we included 109 studies describing a wide array of wearable or portable DHTs that obtained digital biomarkers. The study population consisted of 3019 individuals with MCI due to AD (54 % female, weighted mean age 73 years), and 1942 individuals with mild AD (55 % female, weighted mean age 73 years). The most studied biomarkers were rest/activity (39 %), speech (17 %), and gait (14 %), with most studies focusing on one domain. Few studies reported outcomes associated with diagnosis (16 %) and prognosis (3 %).</div></div><div><h3>Conclusion</h3><div>We identified a growing evidence base investigating digital biomarkers in early AD. There is a paucity of studies examining diagnostic and prognostic properties, representing a knowledge gap. This overview may help to guide future research efforts to bridge the gap between the development and clinical implementation of digital biomarkers in early Alzheimer's disease.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"481 ","pages":"Article 125734"},"PeriodicalIF":3.2,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145940311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on ZILU25: Real-world efficacy of Zilucoplan in generalized myasthenia gravis","authors":"Bowen Zheng","doi":"10.1016/j.jns.2026.125741","DOIUrl":"10.1016/j.jns.2026.125741","url":null,"abstract":"","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"481 ","pages":"Article 125741"},"PeriodicalIF":3.2,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145940312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodological and clinical considerations on the association between COVID-19 vaccination and ischemic stroke","authors":"Yi Yang","doi":"10.1016/j.jns.2026.125742","DOIUrl":"10.1016/j.jns.2026.125742","url":null,"abstract":"","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"481 ","pages":"Article 125742"},"PeriodicalIF":3.2,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146018964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}