Journal of the Neurological Sciences最新文献

英文中文

Diffusion-weighted imaging findings predictive of postoperative recurrence of chronic subdural hematoma 可预测慢性硬膜下血肿术后复发的弥散加权成像结果

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Journal of the Neurological Sciences

Pub Date : 2024-11-22 DOI: 10.1016/j.jns.2024.123324

Shuichiro Neshige , Masaru Kuriyama , Shinzo Ota

Objectives

To identify the brain magnetic resonance imaging (MRI) findings associated with the postoperative recurrence of chronic subdural hematoma (CSDH).

Methods

We examined 1099 consecutive patients admitted to our hospital with CSDH between 2005 and 2014. Of those, 1021 who underwent surgery for CSDH and were followed-up for >3 months after surgery were included. Preoperative brain MRI findings were classified as homogeneous, laminar, separate, or trabecular, according to the nature of the hematoma. Postoperative recurrence was defined in patients who required reoperation for ipsilateral hematoma growth within three months of surgery. The clinical and radiological factors associated with postoperative recurrence were evaluated using univariate and multivariate analyses.

Results

Of the 1021 CSDH patients with CSDH who underwent surgery, 91 (8.9%) experienced postoperative recurrence. Postoperative recurrence was significantly associated with male sex (p = 0.0004) and hematoma volume (p < 0.0001). Additionally, isotype or separate types of hematoma on computed tomography (CT) (p < 0.0001) and laminar/separate types of hematoma types on MRI (p = 0.0008) were significant. Multivariate analysis revealed odds ratios of 2.50 (95% CI, 1.45–4.61; p = 0.0007) for male sex and 3.05 (95% CI, 1.95–4.87; p < 0.0001) for iso/separate hematoma types in CT. Conversely, among the patients who underwent MRI, multivariate analysis revealed odds ratios of 4.33 (95% CI, 1.20–27.92; p = 0.001) for male sex and 4.88 (95% CI, 1.90–14.18; p = 0.023) for laminar/separate hematoma types.

Conclusion

While distinguishing the nature of hematomas is challenging with brain CT examination, detailed laminar/trabecular differentiation using MRI images may predict postoperative recurrence.

目的确定与慢性硬膜下血肿（CSDH）术后复发相关的脑磁共振成像（MRI）结果。方法我们对 2005 年至 2014 年间本院连续收治的 1099 例 CSDH 患者进行了检查。其中，1021 名患者因 CSDH 接受了手术，并在术后接受了 >3 个月的随访。根据血肿的性质，将术前脑磁共振成像结果分为均质血肿、层状血肿、分离血肿和小梁血肿。术后复发是指术后三个月内同侧血肿增大需要再次手术的患者。结果在接受手术的1021名CSDH患者中，91人（8.9%）术后复发。术后复发与男性性别（p = 0.0004）和血肿量（p < 0.0001）明显相关。此外，计算机断层扫描（CT）上的同型或分离型血肿（p <0.0001）和核磁共振成像（MRI）上的层状/分离型血肿（p = 0.0008）也有显著相关性。多变量分析显示，男性的几率比为 2.50 (95% CI, 1.45-4.61; p = 0.0007)，CT 中等/分离血肿类型的几率比为 3.05 (95% CI, 1.95-4.87; p < 0.0001)。相反，在接受 MRI 检查的患者中，多变量分析显示男性性别的几率比为 4.33 (95% CI, 1.20-27.92; p = 0.001)，层状/分离血肿类型的几率比为 4.88 (95% CI, 1.90-14.18; p = 0.023)。

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引用次数: 0

Prevalence of ipsilateral “vulnerable carotid plaques with <50 % stenosis” on CT angiography in embolic stroke of undetermined source 来源不明的栓塞性中风患者 CT 血管造影显示同侧 "狭窄程度小于 50% 的易损颈动脉斑块 "的患病率

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Journal of the Neurological Sciences

Pub Date : 2024-11-20 DOI: 10.1016/j.jns.2024.123316

Kazutaka Uchida , Salome Bosshart , Alexander Stebner , Mohammed A. Almekhlafi , Andrew M. Demchuk , Aravind Ganesh , Brian Buck , Alexandre Y. Poppe , Nishita Singh , Martha Marko , Michael D. Hill , Mayank Goyal , Johanna M. Ospel

Background

Carotid plaques may be an important etiology in ischemic stroke. We aimed to assess carotid plaque characteristics ipsilateral and contralateral to the ischemic stroke and assessed the prevalence of “vulnerable carotid plaques with <50% stenosis” based on different imaging-based definitions in patients with large vessel occlusion and source of embolic stroke of undetermined source (ESUS) on CT Angiography (CTA).

Methods

Data are from the ESCAPE-NA1 trial (Efficacy and safety of nerinetide for the treatment of acute ischemic stroke), a multicenter, randomized study that included anterior circulation large vessel occlusion patients undergoing thrombectomy. Various CTA features of plaque vulnerability were combined to define “vulnerable carotid plaques” in different ways. Within ESUS patients, prevalence of vulnerable plaques ipsilateral vs. contralateral to the intracranial occlusion was compared.

Results

We analyzed 132 patients whose ischemic stroke mechanism was determined to be ESUS. Plaques causing 30–50 % stenosis (as compared to no stenosis) and plaque surface irregularity were significantly more common in ipsilateral carotid arteries (37[28.0 %] vs. 18[13.6 %]; p < 0.001 and 102[77.3 %] vs. 78[59.1 %]; p = 0.002). The prevalence of ipsilateral “vulnerable carotid plaques” varied depending on imaging definition used for such plaques between 55 and 74 %, but irrespective of the definition used, the prevalence of “vulnerable carotid plaques” was consistently higher in ipsilateral carotid arteries compared to contralateral carotid arteries.

Conclusions

In ESUS patients undergoing thrombectomy for anterior circulation large vessel occlusion, vulnerable carotid plaques are more prevalent ipsilateral to the intracranial occlusion. Irregular plaque surface, and a higher degree of stenosis were the most common vulnerable plaque features.

背景颈动脉斑块可能是缺血性脑卒中的一个重要病因。我们旨在评估缺血性脑卒中同侧和对侧颈动脉斑块的特征，并根据不同的影像学定义评估大血管闭塞和 CT 血管造影（CTA）显示来源不明的栓塞性脑卒中（ESUS）患者中 "狭窄达 50%的易损颈动脉斑块 "的患病率。方法数据来自ESCAPE-NA1试验（奈奈奈德治疗急性缺血性卒中的疗效和安全性），这是一项多中心随机研究，纳入了接受血栓切除术的前循环大血管闭塞患者。结合斑块易损性的各种 CTA 特征，以不同方式定义了 "颈动脉易损斑块"。结果我们分析了 132 例缺血性卒中机制被确定为 ESUS 的患者。导致 30-50% 狭窄的斑块（与无狭窄相比）和斑块表面不规则在同侧颈动脉中明显更常见（37[28.0 %] vs. 18[13.6%]；p < 0.001 和 102[77.3 %] vs. 78[59.1%]；p = 0.002）。同侧 "易损颈动脉斑块 "的发生率因对此类斑块使用的成像定义而异，介于 55% 和 74% 之间，但无论使用何种定义，同侧颈动脉中 "易损颈动脉斑块 "的发生率始终高于对侧颈动脉。结论 ESUS 患者因前循环大血管闭塞而接受血栓切除术时，颅内闭塞同侧颈动脉易损斑块的发病率更高。斑块表面不规则和狭窄程度较高是易损斑块最常见的特征。

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引用次数: 0

Sex differences in treatment effect in neuroprotectant trials for acute ischemic stroke: A systematic review 急性缺血性脑卒中神经保护剂治疗效果的性别差异：一项系统综述

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Journal of the Neurological Sciences

Pub Date : 2024-11-20 DOI: 10.1016/j.jns.2024.123317

Irving Gabriel Calisaya-Madariaga

引用次数: 0

Three cases of multiple sclerosis presenting with palmoplantar pustulosis while receiving ofatumumab 三例多发性硬化症患者在接受奥妥木单抗治疗期间出现掌跖脓疱病。

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Journal of the Neurological Sciences

Pub Date : 2024-11-19 DOI: 10.1016/j.jns.2024.123315

Taichi Nomura , Ken Muramatsu , Hiroaki Yaguchi , Hisashi Uwatoko , Atsushi Kawashima , Kentaro Izumi , Hideyuki Ujiie , Toshiyuki Fukazawa , Ichiro Yabe

引用次数: 0

Small vessel disease in patients with restless legs syndrome evidenced by elevated peak width of skeletonized mean diffusivity 不宁腿综合征患者的小血管疾病，表现为骨架平均扩散峰值宽度升高。

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Journal of the Neurological Sciences

Pub Date : 2024-11-19 DOI: 10.1016/j.jns.2024.123310

Kang Min Park , Keun Tae Kim , Dong Ah Lee , Yong Won Cho

Peak width of skeletonized mean diffusivity (PSMD) is a novel marker of small vessel disease. This study aimed to investigate small vessel disease in patients with restless legs syndrome (RLS) using PSMD. We prospectively enrolled 65 patients with primary RLS and 59 age- and sex-matched healthy controls. Diffusion tensor imaging (DTI) was performed using a 3-T magnetic resonance imaging scanner in patients with RLS and healthy controls. We obtained PSMD by DTI in several steps, including preprocessing, skeletonization, application of a custom mask, and histogram analysis. We compared the PSMD between patients with RLS and healthy controls and performed a correlation analysis between the PSMD and clinical characteristics in patients with RLS. The PSMD significantly differed between patients with RLS and healthy controls; it was higher in patients with RLS than that in healthy controls (2.423 vs. 2.298 × 10⁻⁴ mm²/s, p = 0.017). The PSMD significantly differed according to the RLS severity (2.305 × 10⁻⁴ mm²/s, moderate RLS; 2.368 × 10⁻⁴ mm²/s, severe RLS; 2.477 × 10⁻⁴ mm²/s, very severe RLS; p = 0.003). Additionally, the PSMD was positively correlated with age (r = 0.522, p < 0.001) and RLS severity (r = 0.263, p = 0.033). Patients with RLS exhibited a higher PSMD than that in healthy controls, indicating the evidence of small-vessel disease in RLS and that the severity increased as RLS severity increased. These findings provide crucial information for clinical management and treatment strategies, highlighting the importance of addressing small vessel disease in patients with RLS.

骨架化平均扩散率峰值宽度（PSMD）是小血管疾病的新型标记物。本研究旨在利用 PSMD 调查不安腿综合征（RLS）患者的小血管疾病。我们前瞻性地招募了 65 名原发性 RLS 患者和 59 名年龄和性别匹配的健康对照者。我们使用 3 T 磁共振成像扫描仪对 RLS 患者和健康对照组进行了弥散张量成像 (DTI)。我们通过 DTI 分几个步骤获得了 PSMD，包括预处理、骨骼化、应用自定义掩膜和直方图分析。我们比较了 RLS 患者和健康对照组的 PSMD，并对 PSMD 和 RLS 患者的临床特征进行了相关分析。RLS 患者和健康对照组之间的 PSMD 存在明显差异；RLS 患者的 PSMD 高于健康对照组（2.423 vs. 2.298 × 10-4 mm2/s，p = 0.017）。PSMD 随 RLS 严重程度的不同而明显不同（2.305 × 10-4 mm2/s，中度 RLS；2.368 × 10-4 mm2/s，重度 RLS；2.477 × 10-4 mm2/s，极重度 RLS；p = 0.003）。此外，PSMD 与年龄呈正相关（r = 0.522，p = 0.003）。

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引用次数: 0

Oligoclonal IgG bands revealed to be constituted with NMDAR autoantibodies in a patient with anti-NMDA receptor encephalitis 在一名抗 NMDA 受体脑炎患者身上发现的由 NMDAR 自身抗体构成的少克隆 IgG 带。

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Journal of the Neurological Sciences

Pub Date : 2024-11-17 DOI: 10.1016/j.jns.2024.123312

Michiyo Fujita-Nakata , Naomi Minato , Megumi Nakanishi , Shigemi Nagayama , Masato Asahina , Keiko Tanaka

引用次数: 0

Disease characteristics of NMOSD and their relationship with disease burden: Observations from a large single-center cohort NMOSD 的疾病特征及其与疾病负担的关系：来自大型单中心队列的观察结果

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Journal of the Neurological Sciences

Pub Date : 2024-11-16 DOI: 10.1016/j.jns.2024.123311

Suban Amatya MBBS , Erum Khan MD , Yusuf Kagzi MD , Sema Akkus MBBS , Rajesh Gupta MD , Nicholas Hansen MS , Sijin Wen PhD , Shruti Jaiswal MS , Shitiz Sriwastava MD

Objective

To assess the demographic, clinical, and outcome data in patients with NMOSD across a single-center adult cohort and find out associations, if any, with the disease burden.

Background

Neuromyelitis Optica spectrum disorder is an autoimmune condition with unpredictable course and relapses. The clinical and economic burden of NMOSD has been studied less.

Design/methods

A retrospective analysis of patients diagnosed with NMOSD according to 2015 criteria at the UT Health Houston (UTH) system from 2010 to 2024 was done.

Results

Of the 68 patients, aged 40.03 yrs. (SD = 14.05), 56 (82.35 %) were females, and 17 (25.75 %) had a median household income below 2 times the poverty threshold. 51 (76.11 %) had positive aquaporin4 antibodies, 39 had optic neuritis (57.35 %), and 29 (42.63 %) had myelitis. We classified total relapses into less than 3 vs more than 3, cumulative days of hospitalization into less than 5 vs more than 5, and readmission frequency as less than 1 vs more than 1 per year.

The majority of cases had less than 3 relapses (S_N = 38 vs 11, M_N = 22 vs 6, p > .05), less than 5 days of cumulative hospitalizations (S_N = 29 vs 6, M_N = 15 vs 5, p > .05), and less than 1 readmissions in a year (S_N 15 vs 5, p > .05, M_N = 14 vs 10, p > .05).

Conclusion

The severity of the disease can be attributed to the major clinical criteria at the time of diagnosis. This can be helpful to identify cases that may have a higher disease burden to the patient and the hospital. Larger studies are needed to confirm the same.

背景神经脊髓炎谱系障碍是一种自身免疫性疾病，病程和复发难以预测。结果在68名年龄为40.03岁（SD=14.05）的患者中，56人（82.35%）为女性，17人（25.75%）的家庭收入中位数低于贫困线的2倍。51人（76.11%）的水光蛋白4抗体呈阳性，39人（57.35%）患有视神经炎，29人（42.63%）患有脊髓炎。我们将总复发次数分为少于 3 次与多于 3 次，累计住院天数分为少于 5 天与多于 5 天，每年再入院次数分为少于 1 次与多于 1 次。大多数病例的复发次数少于 3 次（SN = 38 vs 11，MN = 22 vs 6，p > .05），累计住院天数少于 5 天（SN = 29 vs 6，MN = 15 vs 5，p > .05），一年内再入院次数少于 1 次（SN = 15 vs 5，p > .05，MN = 14 vs 10，p > .05）。这有助于确定对患者和医院造成较大疾病负担的病例。需要更大规模的研究来证实这一点。

{"title":"Disease characteristics of NMOSD and their relationship with disease burden: Observations from a large single-center cohort","authors":"Suban Amatya MBBS , Erum Khan MD , Yusuf Kagzi MD , Sema Akkus MBBS , Rajesh Gupta MD , Nicholas Hansen MS , Sijin Wen PhD , Shruti Jaiswal MS , Shitiz Sriwastava MD","doi":"10.1016/j.jns.2024.123311","DOIUrl":"10.1016/j.jns.2024.123311","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the demographic, clinical, and outcome data in patients with NMOSD across a single-center adult cohort and find out associations, if any, with the disease burden.</div></div><div><h3>Background</h3><div>Neuromyelitis Optica spectrum disorder is an autoimmune condition with unpredictable course and relapses. The clinical and economic burden of NMOSD has been studied less.</div></div><div><h3>Design/methods</h3><div>A retrospective analysis of patients diagnosed with NMOSD according to 2015 criteria at the UT Health Houston (UTH) system from 2010 to 2024 was done.</div></div><div><h3>Results</h3><div>Of the 68 patients, aged 40.03 yrs. (SD = 14.05), 56 (82.35 %) were females, and 17 (25.75 %) had a median household income below 2 times the poverty threshold. 51 (76.11 %) had positive aquaporin4 antibodies, 39 had optic neuritis (57.35 %), and 29 (42.63 %) had myelitis. We classified total relapses into less than 3 vs more than 3, cumulative days of hospitalization into less than 5 vs more than 5, and readmission frequency as less than 1 vs more than 1 per year.</div><div>The majority of cases had less than 3 relapses (S<sub>N</sub> = 38 vs 11, M<sub>N</sub> = 22 vs 6, <em>p</em> > .05), less than 5 days of cumulative hospitalizations (S<sub>N</sub> = 29 vs 6, M<sub>N</sub> = 15 vs 5, p > .05), and less than 1 readmissions in a year (S<sub>N</sub> 15 vs 5, p > .05, M<sub>N</sub> = 14 vs 10, p > .05).</div></div><div><h3>Conclusion</h3><div>The severity of the disease can be attributed to the major clinical criteria at the time of diagnosis. This can be helpful to identify cases that may have a higher disease burden to the patient and the hospital. Larger studies are needed to confirm the same.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"467 ","pages":"Article 123311"},"PeriodicalIF":3.6,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142701065","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}

引用次数: 0

Corrigendum to “Hemorrhagic shock and encephalopathy syndrome: A call for new clinical criteria for early intervention” [Journal of the Neurological Sciences, 465 (2024) in press (JNS 123207)] 出血性休克和脑病综合征：呼吁制定早期干预的新临床标准"[《神经科学杂志》，465 (2024) 出版中（JNS 123207）]。

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Journal of the Neurological Sciences

Pub Date : 2024-11-15 DOI: 10.1016/j.jns.2024.123246

Tsuyoshi Aihara , Itaru Hayakawa , Kentaro Ide , Yuichi Abe

引用次数: 0

Letter to the Editor: Tricaprilin (CER-0001) for the preventive treatment of migraine: A phase 2 randomised, double-blind, placebo-controlled pilot study 致编辑的信：用于偏头痛预防性治疗的三氯匹林（CER-0001）：2期随机、双盲、安慰剂对照试验研究。

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Journal of the Neurological Sciences

Pub Date : 2024-11-15 DOI: 10.1016/j.jns.2024.123240

Mahnoor Aamir , Khadija Anwar , Shafin Bin Amin , Rabbia Aqeel

引用次数: 0

Response to Aanwat et al. on chow et al. Tricaprilin (CER-0001) for the preventive treatment of migraine: A phase 2 randomised, double-blind, placebo-controlled pilot study JONS July 22, 2024 对 Aanwat 等人关于 Chow 等人的三氯胰岛素（CER-0001）用于偏头痛预防性治疗的回应：第 2 期随机、双盲、安慰剂对照试验研究 JONS 2024 年 7 月 22 日。

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Journal of the Neurological Sciences

Pub Date : 2024-11-15 DOI: 10.1016/j.jns.2024.123239

Marc Cantillon

引用次数: 0

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