Journal of the Neurological Sciences最新文献

{"title":"Author response: Impact of dysphagia on early psychosocial consequences after acute ischemic stroke","authors":"Anel Karisik , Stefan Kiechl , Michael Knoflach , Lukas Mayer-Suess","doi":"10.1016/j.jns.2026.125763","DOIUrl":"10.1016/j.jns.2026.125763","url":null,"abstract":"","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"481 ","pages":"Article 125763"},"PeriodicalIF":3.2,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146018918","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":"Commentary on “Impact of dysphagia on early psychosocial consequences after acute ischemic stroke”","authors":"Yang Gao, Yingjie Lu, Xiaofei Li","doi":"10.1016/j.jns.2026.125764","DOIUrl":"10.1016/j.jns.2026.125764","url":null,"abstract":"","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"481 ","pages":"Article 125764"},"PeriodicalIF":3.2,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146030082","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":"Plasma but not salivary p-Tau181 reflects Alzheimer's disease in a Latin American Cohort","authors":"Lucas Tadeu Rocha Santos ,&nbsp;Fernanda Leitão Costa ,&nbsp;Isabele Dantas Rosa ,&nbsp;Annyta Fernandes Frota ,&nbsp;Jéssica Rabelo Bezerra ,&nbsp;Michelle Verde Ramo Soares ,&nbsp;Camilla de Souza Nepomuceno Barbosa ,&nbsp;Jorge Wambaster Freitas Farias ,&nbsp;Lucas Riquelme Albuquerque Magalhães da Silva ,&nbsp;Paulo Victor de Santiago Gonçalves ,&nbsp;João Macedo Coelho Filho ,&nbsp;Rômulo Rebouças Lôbo ,&nbsp;Antonio L. Teixeira ,&nbsp;Breno S. Diniz ,&nbsp;Arnaldo Aires Peixoto Junior ,&nbsp;Danielle S. Macedo","doi":"10.1016/j.jns.2026.125762","DOIUrl":"10.1016/j.jns.2026.125762","url":null,"abstract":"<div><div>Identifying accessible and reliable biomarkers for Alzheimer's disease (AD) remains a major challenge, particularly in low- and middle-income countries. Phosphorylated tau at threonine 181 (p-tau181) measured in plasma has shown strong diagnostic performance, but its potential in saliva, a truly noninvasive biofluid, remains uncertain. This study compared plasma and salivary p-tau181 levels, assessed their agreement, and evaluated their diagnostic accuracy in a Latin American cohort. Eighty participants were clinically classified as cognitively unimpaired (CU, <em>n</em> = 25), mild cognitive impairment (MCI, <em>n</em> = 22), or Alzheimer's dementia (AD, <em>n</em> = 33). Plasma and salivary p-tau181 concentrations were quantified using Single Molecule Array (Simoa) assays. Salivary p-tau181 levels were markedly higher than plasma levels (900.26 vs. 26.67 pg/mL; <em>p</em> &lt; 0.001) but showed no correlation. Bland–Altman analysis revealed a mean bias of −1.56 with significant proportional bias (β = 0.73; p &lt; 0.001), and Passing–Bablok regression confirmed the absence of a linear relationship between matrices. Plasma p-tau181 showed a numerical increase across the cognitive continuum, reaching statistically significant differences only when AD was compared with CU and MCI (AUC = 0.82; 95% CI 0.73–0.92), whereas salivary p-tau181 failed to discriminate clinical groups (AUC = 0.55, ns). These results demonstrate that plasma and salivary p-tau181 are not interchangeable and that current saliva-based quantification methods lack clinical reliability. This study provides the first evidence from Latin America supporting the diagnostic validity of plasma, but not salivary, p-tau181, and highlights the need for further investigation into pre-analytical and biological determinants of salivary biomarker variability.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"481 ","pages":"Article 125762"},"PeriodicalIF":3.2,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146010971","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":"Brain MRI to detect cervical spinal cord critical demyelinating lesions in progressive MS","authors":"Bianca Albites Coen ,&nbsp;Purnashree Chowdhury ,&nbsp;Steven A. Messina ,&nbsp;B. Mark Keegan","doi":"10.1016/j.jns.2026.125761","DOIUrl":"10.1016/j.jns.2026.125761","url":null,"abstract":"<div><h3>Background</h3><div>Critical demyelinating lesions anatomically associated with progressive motor impairment in multiple sclerosis (MS) are mostly found in the cervical spinal cord. In clinical practice and research studies, imaging of spinal cord is usually restricted to brain magnetic resonance imaging (MRI), which can show its most superior region.</div></div><div><h3>Objective</h3><div>To evaluate the ability of brain MRI to detect spinal cord critical lesions in progressive MS.</div></div><div><h3>Methods</h3><div>Individuals with one or two tandem spinal cord critical lesions were selected from a cohort of people with progressive MS, evaluated at Mayo Clinic between July 1, 2021-June 30, 2022. Lesions were cross-checked on spinal cord MRI to ensure visibility. Brain MRI performed at Mayo Clinic or an outside institution during clinical evaluation were assessed; if none were available, the most recent prior MRI was evaluated. Brain MRIs were defined “informative” if critical lesions were identified on axial and sagittal sequences and “incompletely informative” if not.</div></div><div><h3>Results</h3><div>Sixty-five participants were identified, brain MRIs were “informative” in 3 cases (4.6%) and “incompletely informative” in 62 (95.4%). Among those “incompletely informative”, 53 (81.5%) had no critical lesion visible on any sequence, 8 (12.3%) had a critical lesion visible only on sagittal sequences, and 1 (1.5%) had two tandem critical lesions with only the upper lesion detected. Detection of spinal cord critical lesions on brain scans was mainly successful by using MPRAGE and FLAIR sequences.</div></div><div><h3>Conclusions</h3><div>Brain MRI is inadequate for detecting spinal cord critical demyelinating lesions in progressive MS and dedicated spinal cord imaging is required.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"481 ","pages":"Article 125761"},"PeriodicalIF":3.2,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146030019","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":"Sexual dysfunction in Parkinson's disease: what about women?","authors":"Bárbara Santos Panichelli ,&nbsp;Flora Rosa-Campos ,&nbsp;Flávia Sieira Chaves ,&nbsp;Carolina Godoy de Oliveira ,&nbsp;Marcia Rodrigues Jardim ,&nbsp;Mariana Spitz","doi":"10.1016/j.jns.2026.125757","DOIUrl":"10.1016/j.jns.2026.125757","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Sexual dysfunction is a common and distressing non-motor symptom in Parkinson's Disease (PD). Nevertheless, few studies have specifically addressed sexual complaints in women with PD.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;To perform a comparative analysis of clinical and epidemiological characteristics among women with PD and sexual dysfunction, women with PD without dysfunction, and a control group.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Cross-sectional observational epidemiological study conducted with clinical data from female patients diagnosed with PD with matched healthy controls.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The study included 28 patients with PD and 28 women in the control group. Sexual dysfunction was present in 60.7% of patients and 17.9% of controls according to the Sexual Quotient-Female Version (&lt;em&gt;p&lt;/em&gt; = 0.004), while no statistically significant difference was found between the groups in relation to the Female Sexual Function Index. PD patients with sexual dysfunction had higher scores on the SCOPA-AUT and BDI-II. A higher proportion of dopamine agonist use was found among patients without sexual dysfunction.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;When compared to the general female population, women with PD attribute equivalent importance to sex but experience significantly higher levels of sexual dissatisfaction. They present more sexual dysfunction, affecting various phases of the sexual cycle. Sexual dysfunction in PD patients was directly related to depression and dysautonomia. Women without sexual dysfunction reported more frequent use of dopamine agonists, suggesting an association that warrants further investigation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Unstructured abstract&lt;/h3&gt;&lt;div&gt;Sexual dysfunction is a common and distressing non-motor symptom in Parkinson's disease (PD). Nevertheless, few studies have specifically addressed sexual complaints in women with PD. This study aimed to perform a comparative analysis of clinical and epidemiological characteristics between women with PD and sexual dysfunction, those without dysfunction, and a control group. We conducted a cross-sectional observational study using clinical data from female patients diagnosed with PD and age-matched healthy controls. The study included 28 patients with PD and 28 women in the control group. Sexual dysfunction was present in 60.7% of patients and 17.9% of controls, according to the Sexual Quotient – Female Version (&lt;em&gt;p&lt;/em&gt; = 0.004), while no statistically significant difference was found between the groups in relation to the Female Sexual Function Index. PD patients with sexual dysfunction had higher scores on SCOPA-AUT and BDI-II. A higher proportion of dopamine agonist use was found among patients without sexual dysfunction. When compared to the general female population, women with PD attribute equivalent importance to sex but experience significantly higher levels of sexual dissatisfaction. They present more sexual d","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"481 ","pages":"Article 125757"},"PeriodicalIF":3.2,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146035160","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":"Directions for advancing prognostic assessments in multiple sclerosis: Qualitative Insights from MS specialist Interviews","authors":"Sofie Aerts ,&nbsp;Lotte Geys ,&nbsp;Deborah Severijns ,&nbsp;Mona Alkhawajah ,&nbsp;Thomas Berger ,&nbsp;Alexey Boyko ,&nbsp;Nikolaos Grigoriadis ,&nbsp;Hans-Peter Hartung ,&nbsp;Melinda Magyari ,&nbsp;Celia Oreja-Guevara ,&nbsp;Carlo Pozzilli ,&nbsp;Patrick Vermersch ,&nbsp;Bassem Yamout ,&nbsp;Magd Zakaria ,&nbsp;Tjalf Ziemssen ,&nbsp;Veronica Popescu ,&nbsp;Liesbet M. Peeters ,&nbsp;Bart Van Wijmeersch","doi":"10.1016/j.jns.2026.125756","DOIUrl":"10.1016/j.jns.2026.125756","url":null,"abstract":"<div><h3>Background</h3><div>Reliable prognostication in multiple sclerosis (MS) is essential for personalized care, yet remains challenging. In the absence of widely implemented prognostic tools, how MS specialists today formulate prognostic judgments and manage related challenges in routine practice is underexplored.</div></div><div><h3>Objective</h3><div>To investigate how MS specialists approach prognostication in practice and identify their priorities for improving prognosis-informed care.</div></div><div><h3>Methods</h3><div>Twelve MS specialists from European and Middle Eastern regions participated in semi-structured interviews. Data were qualitatively analyzed using a two-phase content analysis. Priorities were topics mentioned by more than 50% of participants.</div></div><div><h3>Results</h3><div>Nine priority questions were identified for improving prognosis-informed MS care: 1) What minimal data are needed to estimate prognosis early?, 2) How should prognostic factors be combined and weighted?, 3) How can subclinical progression be detected and addressed?, 4) How can (less experienced) neurologists be better supported?, 5) How should prognosis-based decisions align with reimbursement and patient preferences?, 6) How can clinical intuition be used alongside evidence?, 7) How can prognosis be communicated, supporting patient optimism and empowerment?, 8) How to develop prognostic tools for MS?, 9) How can quality of life be integrated as a core prognostic outcome?.</div></div><div><h3>Conclusion</h3><div>MS prognostication in current practice remains fragmented and experience-driven. Addressing these questions could guide future research and the development of prognostic tools that embed prognosis-informed care into MS management.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"481 ","pages":"Article 125756"},"PeriodicalIF":3.2,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146030005","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 early cognitive and psychological status on return to work after acute ischemic stroke","authors":"Yong Yi Tan ,&nbsp;Gabriel Yi Ren Kwok ,&nbsp;Chee Qing See ,&nbsp;Jing En Toh ,&nbsp;Nur Hafizah Mohd Amin ,&nbsp;Pei Yi Loh ,&nbsp;Maznah Marmin ,&nbsp;Fadhlina Hassan ,&nbsp;Shamala Thilarajah ,&nbsp;Megan B.J. Ng ,&nbsp;Xin Yuan Lim ,&nbsp;Emma En Jia Peh ,&nbsp;Ching-Hui Sia ,&nbsp;Poay Huan Loh ,&nbsp;Vijay K. Sharma ,&nbsp;Bernard P.L. Chan ,&nbsp;Leonard L.L. Yeo ,&nbsp;Nirupama Yechoor ,&nbsp;Christopher D. Anderson ,&nbsp;Aftab Ahmad ,&nbsp;Benjamin Y.Q. Tan","doi":"10.1016/j.jns.2026.125730","DOIUrl":"10.1016/j.jns.2026.125730","url":null,"abstract":"<div><h3>Purpose</h3><div>As young ischemic stroke (IS) incidence increases worldwide, helping IS survivors return to work (RTW) remains challenging. Post-stroke cognitive impairment (PSCI) and mood changes represent important hindrances to RTW. However, it remains uncertain whether early psycho-cognitive assessment during the acute admission can prognosticate RTW outcomes toward personalized rehabilitation regimens. Hence, we aimed to evaluate the relationship between early psycho-cognitive status and three-month RTW status in a cohort of working-age Asian IS survivors.</div></div><div><h3>Methods</h3><div>Consecutive IS patients previously in active employment admitted to a primary stroke center in Singapore from 1st January 2020 to 31st December 2022 were included. Psychocognitive status was assessed within 24–72 h of IS admission using the Montreal Cognitive Assessment (MoCA) and Patient Health Questionnaire-9 (PHQ-9). RTW was assessed at post-stroke three-months. Univariate and multivariate logistic regression was done to evaluate associations between psychocognitive status and RTW.</div></div><div><h3>Results</h3><div>Overall, 322 IS survivors were included, with 33 (10.2%) patients experiencing post-stroke depression and 214 (66.5%) patients experiencing PSCI. 212 (65.8%) patients successfully RTW at post-stroke three-months. Only MoCA scores were significantly associated with RTW across univariable (OR = 1.10, 95% CI: 1.06–1.15, <em>p</em> &lt; 0.001) and all multivariable analyses (OR = 1.07, 95% CI: 1.01–1.13, <em>p</em> = 0.014). Lower occupational skill levels and increased stroke severity were also associated with lower odds of RTW. MoCA scores remained significantly associated with RTW across all levels of adjustment in both sensitivity analyses.</div></div><div><h3>Conclusion</h3><div>Early MoCA scores at 24–72 h post-stroke may help identify high-risk patients for early interventions. Longitudinal cohort studies are needed to better characterize longer-term cognitive and return-to-work trajectories in acute ischemic stroke.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"481 ","pages":"Article 125730"},"PeriodicalIF":3.2,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966601","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, Pasquale Roberge, Christian Bocti","doi":"10.1016/j.jns.2026.125735","DOIUrl":"https://doi.org/10.1016/j.jns.2026.125735","url":null,"abstract":"","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":" ","pages":"125735"},"PeriodicalIF":3.2,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146018932","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":"Diabetic lumbosacral radiculoplexus neuropathy after glucagon-like peptide 1 receptor agonist use: A case series","authors":"Swathy Chandrashekhar ,&nbsp;Long Davalos ,&nbsp;Richeek Pradhan ,&nbsp;Pritikanta Paul","doi":"10.1016/j.jns.2026.125755","DOIUrl":"10.1016/j.jns.2026.125755","url":null,"abstract":"<div><h3>Background</h3><div>Diabetic Lumbosacral Radiculoplexus Neuropathy (DLRPN) is a rare form of debilitating neuropathy, usually preceded by rapid glycemic control.</div></div><div><h3>Methods</h3><div>We describe a case series of patients with DLRPN who had been exposed to GLP-1 Receptor Agonists (GLP-1 RA) prior to symptom onset.</div></div><div><h3>Results</h3><div>Six patients (3 men; aged 53–73) with type 2 diabetes developed sudden-onset, asymmetric lower limb pain followed by weakness-bilateral in 5/6. Most had substantial weight loss (35–52 lbs) and rapid HbA1c decline (&gt;5) in months preceding symptoms. Four patients had electrophysiologic evidence of lumbosacral plexopathy; imaging was supportive in 2. One patient received intravenous steroids with improvement; others were managed supportively, with 3 showing stabilization or mild recovery.</div></div><div><h3>Discussion</h3><div>This series highlights a potential association between rapid glycemic and weight changes from GLP-1 RA use and DLRPN. Clinicians should be alert to subacute neuropathy with muscle weakness in patients undergoing aggressive glycemic control.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"481 ","pages":"Article 125755"},"PeriodicalIF":3.2,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979300","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":"Corticosteroids in myasthenia gravis: Rethinking oral corticosteroid therapy","authors":"U.K. Misra","doi":"10.1016/j.jns.2026.125752","DOIUrl":"10.1016/j.jns.2026.125752","url":null,"abstract":"","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"481 ","pages":"Article 125752"},"PeriodicalIF":3.2,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989903","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}