Neurological Sciences最新文献

Restless legs syndrome (RLS) is a common, sleep-related, neurological disorder. Various treatments are available but some have side effects. Therefore, alternative treatment options with minimal side effects are being actively sought. Palmitoylethanolamide (PEA) is an endogenous lipid signalling molecule known to have anti-inflammatory and analgesic properties. According to the literature, oral PEA supplementation can decrease the levels of pain associated with central and peripheral neurological conditions, such as migraine and peripheral neuropathy. For the first time, we report of a gabapentin-treated patient whose painful symptoms of RLS decreased in intensity following the initiation of supplementation with PEA. No adverse events were reported.

Poliomyelitis is a neuroinvasive viral disease that, despite near-global eradication, has left millions of survivors worldwide with lifelong motor-system injury. Many develop delayed neurological decline decades later in the form of Post-polio syndrome, characterised by progressive weakness, fatigue, pain, and respiratory compromise. Disease trajectories are highly heterogeneous, unpredictable, and shaped by complex interactions between residual motor-neuron pools, muscle adaptation, ageing, metabolism, and immune tone. Conventional care relies on episodic clinical review and reactive rehabilitation, with limited capacity for long-term personalised forecasting. Digital-twin technology, defined as an adaptive computational model that continuously mirrors an individual's biological and functional state, offers a transformative framework for predictive and precision-guided lifelong polio care. By integrating neuromuscular physiology, biomechanics, metabolic status, wearable sensor data, and rehabilitation responses, digital twins could enable real-time modelling of motor-unit decline, functional reserve, respiratory vulnerability, and fatigue dynamics. This article outlines a focused conceptual framework for polio digital twins, emphasising model architecture, feedback loops, and translational applications, rather than virological biology. The proposed framework positions digital twins as a missing precision-medicine layer for a neglected global survivor population.

Background: The clinical characteristics of multiple sclerosis (MS) in individuals aged 65 years and older remain scarcely studied. This retrospective study compared late-onset MS (LOMS, onset ≥ 50 years) and adult-onset MS (AOMS, onset 18-49 years) in older adults with MS (OAwMS) aged ≥ 65 years.

Methods: Data of subjects aged ≥ 65 years with a confirmed MS diagnosis and a recorded age at onset were collected from the Finnish MS registry at Tampere University Hospital, excluding individuals with paediatric-onset MS. Demographics, disease-modifying therapy (DMT) use, relapse history and Expanded Disability Status Scale (EDSS) scores were compared between LOMS and AOMS groups.

Results: The cohort included 248 subjects (41 LOMS, 207 AOMS). Primary progressive MS (PPMS) was more common in LOMS when compared to AOMS (41.5% vs. 12.6% at data acquisition, p < 0.001). Among subjects with a history of relapsing-remitting MS (RRMS) (32 LOMS, 178 AOMS), DMT had been used by 25.0% and 27.5% of subjects with LOMS and AOMS, and relapses after age 65 occurred in 18.8% and 7.3% of subjects with LOMS and AOMS, respectively. Subjects with LOMS discontinued DMT at an older age when compared to those with AOMS (mean 64.0 vs. 58.8 years, p = 0.04). No age-related differences in EDSS were observed after age 65.

Conclusions: PPMS was more common among subjects with LOMS. Among subjects with a current or previous diagnosis of RRMS, occasional relapses were observed after age 65 in both groups, though multiple relapses were rare. These findings support the need for individualised care of OAwMS.

Autoimmune autonomic ganglionopathy (AAG) is an acquired disease characterized by the dysfunction of the autonomic system, involving the sympathetic, parasympathetic and enteric divisions. We describe the case of a 49-years-old woman who presented with an acute abdomen due to diverticulitis and a severe orthostatic hypotension. During hospitalization she developed fixed mydriasis, xerophthalmia, xerostomia, anhidrosis, and urinary retention. The patient was diagnosed as seropositive AAG. She was treated with intravenous immunoglobulin (IVIg) plus high-dose oral prednisone (OP), followed by plasma exchange (PLEX). The patient showed a good response to the combined therapy and was discharged after nearly one month of hospitalization. Ten days later she experienced a symptomatic relapse, for which a treatment with rituximab (RTX) 1 g once a week was initiated and maintained for 4 weeks. During the second week of infusion, she was readmitted to the hospital due to intestinal perforation. After recovery, RTX was resumed with clinical benefit. In addition to the case report, we present a review of AAG case reports available in the literature.