<div><h3>Background</h3><div>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.</div></div><div><h3>Objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>Cross-sectional observational epidemiological study conducted with clinical data from female patients diagnosed with PD with matched healthy controls.</div></div><div><h3>Results</h3><div>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 (<em>p</em> = 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.</div></div><div><h3>Conclusions</h3><div>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.</div></div><div><h3>Unstructured abstract</h3><div>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 (<em>p</em> = 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
{"title":"Sexual dysfunction in Parkinson's disease: what about women?","authors":"Bárbara Santos Panichelli , Flora Rosa-Campos , Flávia Sieira Chaves , Carolina Godoy de Oliveira , Marcia Rodrigues Jardim , Mariana Spitz","doi":"10.1016/j.jns.2026.125757","DOIUrl":"10.1016/j.jns.2026.125757","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>Cross-sectional observational epidemiological study conducted with clinical data from female patients diagnosed with PD with matched healthy controls.</div></div><div><h3>Results</h3><div>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 (<em>p</em> = 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.</div></div><div><h3>Conclusions</h3><div>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.</div></div><div><h3>Unstructured abstract</h3><div>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 (<em>p</em> = 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}
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.
Objective
To investigate how MS specialists approach prognostication in practice and identify their priorities for improving prognosis-informed care.
Methods
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.
Results
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?.
Conclusion
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.
{"title":"Directions for advancing prognostic assessments in multiple sclerosis: Qualitative Insights from MS specialist Interviews","authors":"Sofie Aerts , Lotte Geys , Deborah Severijns , Mona Alkhawajah , Thomas Berger , Alexey Boyko , Nikolaos Grigoriadis , Hans-Peter Hartung , Melinda Magyari , Celia Oreja-Guevara , Carlo Pozzilli , Patrick Vermersch , Bassem Yamout , Magd Zakaria , Tjalf Ziemssen , Veronica Popescu , Liesbet M. Peeters , 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}
Pub Date : 2026-01-10DOI: 10.1016/j.jns.2026.125730
Yong Yi Tan , Gabriel Yi Ren Kwok , Chee Qing See , Jing En Toh , Nur Hafizah Mohd Amin , Pei Yi Loh , Maznah Marmin , Fadhlina Hassan , Shamala Thilarajah , Megan B.J. Ng , Xin Yuan Lim , Emma En Jia Peh , Ching-Hui Sia , Poay Huan Loh , Vijay K. Sharma , Bernard P.L. Chan , Leonard L.L. Yeo , Nirupama Yechoor , Christopher D. Anderson , Aftab Ahmad , Benjamin Y.Q. Tan
Purpose
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.
Methods
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.
Results
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, p < 0.001) and all multivariable analyses (OR = 1.07, 95% CI: 1.01–1.13, p = 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.
Conclusion
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.
{"title":"Impact of early cognitive and psychological status on return to work after acute ischemic stroke","authors":"Yong Yi Tan , Gabriel Yi Ren Kwok , Chee Qing See , Jing En Toh , Nur Hafizah Mohd Amin , Pei Yi Loh , Maznah Marmin , Fadhlina Hassan , Shamala Thilarajah , Megan B.J. Ng , Xin Yuan Lim , Emma En Jia Peh , Ching-Hui Sia , Poay Huan Loh , Vijay K. Sharma , Bernard P.L. Chan , Leonard L.L. Yeo , Nirupama Yechoor , Christopher D. Anderson , Aftab Ahmad , 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> < 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}
Pub Date : 2026-01-09DOI: 10.1016/j.jns.2026.125735
Diego Legrand, Pasquale Roberge, Christian Bocti
{"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}
Pub Date : 2026-01-09DOI: 10.1016/j.jns.2026.125755
Swathy Chandrashekhar , Long Davalos , Richeek Pradhan , Pritikanta Paul
Background
Diabetic Lumbosacral Radiculoplexus Neuropathy (DLRPN) is a rare form of debilitating neuropathy, usually preceded by rapid glycemic control.
Methods
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.
Results
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 (>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.
Discussion
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.
{"title":"Diabetic lumbosacral radiculoplexus neuropathy after glucagon-like peptide 1 receptor agonist use: A case series","authors":"Swathy Chandrashekhar , Long Davalos , Richeek Pradhan , 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 (>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}
Pub Date : 2026-01-09DOI: 10.1016/j.jns.2026.125754
Komal Shrivastav , Muskan Pandey , Hetarth Gor , Vijay Nema
The gut-brain axis (GBA) is a complex two-way communication system that links the gastrointestinal tract and the central nervous system (CNS) through neural, immune, hormonal, and microbial pathways. The microbiota-gut-brain axis (MGBA), a more specific concept, focuses on how gut microorganisms, including bacteria, viruses, and other microbes, modulate this communication and influence neurological health. This comprehensive review examines the intricate mechanisms through which gut microorganisms modulate neural function and contribute to neurological health and disease pathogenesis. The gut microbiota, comprising bacteria, viruses, fungi, and bacteriophages, produces essential neuroactive compounds including neurotransmitters- Gamma-Aminobutyric Acid (GABA), serotonin (5-HT), dopamine (DA), short-chain fatty acids (SCFAs), and metabolites that directly influence brain physiology through vagal, hormonal, and immunological pathways. Dysbiosis of the gut microbiota has been implicated in various neurological disorders, including Alzheimer's disease, Parkinson's disease, autism spectrum disorders, and schizophrenia. In healthy conditions, beneficial bacterial strains such as Lactobacillus species synthesize GABA and regulate mood, while SCFA-producing bacteria like Fecalibacterium prausnitzii maintain blood-brain barrier integrity and exert neuroprotective effects. Conversely, pathological states demonstrate altered microbial compositions, reduced bacterial diversity, and compromised production of beneficial metabolites. Emerging evidence highlights the previously underexplored role of the gut virome, particularly bacteriophages, in regulating bacterial populations and influencing neurodevelopment. Viral dysbiosis correlates with cognitive impairment and neurodegenerative processes through modulation of bacterial metabolism and inflammatory responses. Understanding these complex host-microbiome-virome interactions provides novel therapeutic opportunities for neurological disorders through targeted interventions including probiotics, fecal microbiota transplantation, and phage-based therapies, representing a paradigm shift toward microbiome-centered approaches in neurological medicine.
{"title":"Gut virome plays an extended role with bacteriome in neurological health and disease","authors":"Komal Shrivastav , Muskan Pandey , Hetarth Gor , Vijay Nema","doi":"10.1016/j.jns.2026.125754","DOIUrl":"10.1016/j.jns.2026.125754","url":null,"abstract":"<div><div>The gut-brain axis (GBA) is a complex two-way communication system that links the gastrointestinal tract and the central nervous system (CNS) through neural, immune, hormonal, and microbial pathways. The microbiota-gut-brain axis (MGBA), a more specific concept, focuses on how gut microorganisms, including bacteria, viruses, and other microbes, modulate this communication and influence neurological health. This comprehensive review examines the intricate mechanisms through which gut microorganisms modulate neural function and contribute to neurological health and disease pathogenesis. The gut microbiota, comprising bacteria, viruses, fungi, and bacteriophages, produces essential neuroactive compounds including neurotransmitters- Gamma-Aminobutyric Acid (GABA), serotonin (5-HT), dopamine (DA), short-chain fatty acids (SCFAs), and metabolites that directly influence brain physiology through vagal, hormonal, and immunological pathways. Dysbiosis of the gut microbiota has been implicated in various neurological disorders, including Alzheimer's disease, Parkinson's disease, autism spectrum disorders, and schizophrenia. In healthy conditions, beneficial bacterial strains such as <em>Lactobacillus</em> species synthesize GABA and regulate mood, while SCFA-producing bacteria like <em>Fecalibacterium prausnitzii</em> maintain blood-brain barrier integrity and exert neuroprotective effects. Conversely, pathological states demonstrate altered microbial compositions, reduced bacterial diversity, and compromised production of beneficial metabolites. Emerging evidence highlights the previously underexplored role of the gut virome, particularly bacteriophages, in regulating bacterial populations and influencing neurodevelopment. Viral dysbiosis correlates with cognitive impairment and neurodegenerative processes through modulation of bacterial metabolism and inflammatory responses. Understanding these complex host-microbiome-virome interactions provides novel therapeutic opportunities for neurological disorders through targeted interventions including probiotics, fecal microbiota transplantation, and phage-based therapies, representing a paradigm shift toward microbiome-centered approaches in neurological medicine.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"481 ","pages":"Article 125754"},"PeriodicalIF":3.2,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979229","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}
Pub Date : 2026-01-09DOI: 10.1016/j.jns.2026.125753
Tissa Wijeratne
{"title":"","authors":"Tissa Wijeratne","doi":"10.1016/j.jns.2026.125753","DOIUrl":"10.1016/j.jns.2026.125753","url":null,"abstract":"","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"481 ","pages":"Article 125753"},"PeriodicalIF":3.2,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979230","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}
Pub Date : 2026-01-09DOI: 10.1016/j.jns.2026.125750
A. Mameli , L. Indovina , F. Cocciolillo , A. Serra , F. Marongiu , D. Barcellona
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.
{"title":"Functional imaging reveals cerebral microvascular dysfunction in primary antiphospholipid syndrome: Pathophysiologic insights and translational implications","authors":"A. Mameli , L. Indovina , F. Cocciolillo , A. Serra , F. Marongiu , 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}
Pub Date : 2026-01-09DOI: 10.1016/j.jns.2026.125737
Diego Legrand , Pasquale Roberge , Christian Bocti
{"title":"The ongoing debate about the association between benzodiazepines and dementia","authors":"Diego Legrand , Pasquale Roberge , 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}
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