Pub Date : 2024-11-01DOI: 10.1016/j.nrl.2022.04.010
D. García-Azorín , E. Lázaro , D. Ezpeleta , R. Lecumberri , R. de la Cámara , M. Castellanos , C. Iñiguez Martínez , L. Quiroga-González , G. Elizondo Rivas , A. Sancho-López , P. Rayón Iglesias , E. Segovia , C. Mejías , D. Montero Corominas
Background
We describe the epidemiological and clinical characteristics of thrombosis with thrombocytopenia syndrome (TTS) cases reported in Spain.
Methods
We included all venous or arterial thrombosis with thrombocytopenia following adenovirus vector-based vaccines (AstraZeneca or Janssen) to prevent COVID-19 disease between February 1st and September 26th, 2021. We describe the crude rate and the standardized morbidity ratio. We assessed the predictors of mortality.
Results
Sixty-one cases were reported and 45 fulfilled eligibility criteria, 82% women. The crude TTS rate was 4/1,000,000 doses and 14-15/1,000,000 doses between 30-49 years. The number of observed cases of cerebral venous thrombosis was 6-18 higher than the expected in patients younger than 49 years. Symptoms started 10 (interquartile range [IQR]: 7-14) days after vaccination. Eighty percent (95% confidence interval [CI]: 65-90%) had thrombocytopenia at the time of the emergency department visit, and 65% (95% CI: 49-78%) had D-dimer >2,000 ng/mL. Patients had multiple location thrombosis in 36% and fatal outcome in 24% cases. A platelet nadir < 50,000/μL (odds ratio [OR]: 7.4; CI 95%: 1.2-47.5) and intracranial hemorrhage (OR: 7.9; IC 95%: 1.3-47.0) were associated with fatal outcome.
Conclusion
TTS must be suspected in patients with symptoms 10 days after vaccination and thrombocytopenia and/or D-dimer increase.
{"title":"Síndrome de trombosis con trombocitopenia asociado a vacunas de adenovirus frente a la COVID-19: Epidemiología y presentación clínica de la serie española","authors":"D. García-Azorín , E. Lázaro , D. Ezpeleta , R. Lecumberri , R. de la Cámara , M. Castellanos , C. Iñiguez Martínez , L. Quiroga-González , G. Elizondo Rivas , A. Sancho-López , P. Rayón Iglesias , E. Segovia , C. Mejías , D. Montero Corominas","doi":"10.1016/j.nrl.2022.04.010","DOIUrl":"10.1016/j.nrl.2022.04.010","url":null,"abstract":"<div><h3>Background</h3><div>We describe the epidemiological and clinical characteristics of thrombosis with thrombocytopenia syndrome (TTS) cases reported in Spain.</div></div><div><h3>Methods</h3><div>We included all venous or arterial thrombosis with thrombocytopenia following adenovirus vector-based vaccines (AstraZeneca or Janssen) to prevent COVID-19 disease between February 1<sup>st</sup> and September 26<sup>th</sup>, 2021. We describe the crude rate and the standardized morbidity ratio. We assessed the predictors of mortality.</div></div><div><h3>Results</h3><div>Sixty-one cases were reported and 45 fulfilled eligibility criteria, 82% women. The crude TTS rate was 4/1,000,000 doses and 14-15/1,000,000 doses between 30-49 years. The number of observed cases of cerebral venous thrombosis was 6-18 higher than the expected in patients younger than 49 years. Symptoms started 10 (interquartile range [IQR]: 7-14) days after vaccination. Eighty percent (95% confidence interval [CI]: 65-90%) had thrombocytopenia at the time of the emergency department visit, and 65% (95% CI: 49-78%) had D-dimer >2,000 ng/mL. Patients had multiple location thrombosis in 36% and fatal outcome in 24% cases. A platelet nadir < 50,000/μL (odds ratio [OR]: 7.4; CI 95%: 1.2-47.5) and intracranial hemorrhage (OR: 7.9; IC 95%: 1.3-47.0) were associated with fatal outcome.</div></div><div><h3>Conclusion</h3><div>TTS must be suspected in patients with symptoms 10 days after vaccination and thrombocytopenia and/or D-dimer increase.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 9","pages":"Pages 721-732"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9124923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10619320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To estimate the pooled incidence of Bell’s palsy after COVID-19 vaccination.
Methods
PubMed, Scopus, EMBASE, Web of Science, and Google Scholar were searched by 2 independent researchers. We also searched the grey literature including references of the references and conference abstracts. We extracted data regarding the total number of participants, first author, publication year, the country of origin, sex, type of vaccines, and the number of patients who developed Bell’s palsy after COVID-19 vaccination.
Results
The literature search revealed 370 articles, subsequently deleting duplicates 227 remained. After careful evaluation of the full texts, 20 articles remained for meta-analysis. The most commonly administered vaccines were Pfizer followed by Moderna.
In total, 4.54e+07 individuals received vaccines against COVID-19, and 1739 cases developed Bell’s palsy. In nine studies, controls (individuals without vaccination) were enrolled. The total number of controls was 1 809 069, of whom 203 developed Bell’s palsy. The incidence of Bell’s palsy after COVID-19 vaccines was ignorable. The odds of developing Bell’s palsy after COVID-19 vaccines was 1.02 (95% CI: 0.79-1.32) (I2 = 74.8%, P < .001).
Conclusion
The results of this systematic review and meta-analysis show that the incidence of peripheral facial palsy after COVID-19 vaccination is ignorable and vaccination does not increase the risk of developing Bell’s palsy. Maybe, Bell’s palsy is a presenting symptom of a more severe form of COVID-19, so clinicians must be aware of this.
{"title":"Incidence of Bell’s palsy after coronavirus disease (COVID-19) vaccination: a systematic review and meta-analysis","authors":"Atena Soltanzadi , Omid Mirmosayyeb , Amin Momeni Moghaddam , Hamed Ghoshouni , Mahsa Ghajarzadeh","doi":"10.1016/j.nrl.2022.10.002","DOIUrl":"10.1016/j.nrl.2022.10.002","url":null,"abstract":"<div><h3>Objective</h3><div>To estimate the pooled incidence of Bell’s palsy after COVID-19 vaccination.</div></div><div><h3>Methods</h3><div>PubMed, Scopus, EMBASE, Web of Science, and Google Scholar were searched by 2 independent researchers. We also searched the grey literature including references of the references and conference abstracts. We extracted data regarding the total number of participants, first author, publication year, the country of origin, sex, type of vaccines, and the number of patients who developed Bell’s palsy after COVID-19 vaccination.</div></div><div><h3>Results</h3><div>The literature search revealed 370 articles, subsequently deleting duplicates 227 remained. After careful evaluation of the full texts, 20 articles remained for meta-analysis. The most commonly administered vaccines were Pfizer followed by Moderna.</div><div>In total, 4.54e+07 individuals received vaccines against COVID-19, and 1739 cases developed Bell’s palsy. In nine studies, controls (individuals without vaccination) were enrolled. The total number of controls was 1 809 069, of whom 203 developed Bell’s palsy. The incidence of Bell’s palsy after COVID-19 vaccines was ignorable. The odds of developing Bell’s palsy after COVID-19 vaccines was 1.02 (95% CI: 0.79-1.32) (I2 = 74.8%, <em>P</em> < .001).</div></div><div><h3>Conclusion</h3><div>The results of this systematic review and meta-analysis show that the incidence of peripheral facial palsy after COVID-19 vaccination is ignorable and vaccination does not increase the risk of developing Bell’s palsy. Maybe, Bell’s palsy is a presenting symptom of a more severe form of COVID-19, so clinicians must be aware of this.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 9","pages":"Pages 802-809"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142660391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.nrl.2022.05.005
A. Puig-Pijoan , G. García-Escobar , A. Fernández-Lebrero , R.M. Manero Borràs , G. Sánchez-Benavides , I. Navalpotro-Gómez , D. Cascales Lahoz , M. Suárez-Calvet , O. Grau-Rivera , A. Boltes Alandí , M.C. Pont-Sunyer , J. Ortiz-Gil , S. Carrillo-Molina , D. López-Villegas , M.T. Abellán-Vidal , M.I. Martínez-Casamitjana , J.J. Hernández-Sánchez , J. Peña-Casanova , J. Roquer , A. Padrós Fluvià , V. Puente-Périz
Introduction
The analysis of the core biomarkers of Alzheimer's disease (AD) in the cerebrospinal fluid (CSF) is recommended in the clinical units where it is available. Because of the absence of universal validated values, the determination of specific cut-off points (COP) for each center and its population is recommended. The main objective of the CORCOBIA study was to determine the COP of core AD CSF biomarkers for several centers (Parc de Salut Mar, Barcelona, and Hospital General de Granollers), which work with the same reference laboratory (Laboratori de Referència de Catalunya).
Methods
Prospective study including cognitively healthy subjects (n = 42), subjects with amnestic mild cognitive impairment (n = 35) and patients with dementia due to AD (n = 48), in whom clinical and neuropsychological assessment, neuroimaging, APOE genotyping and lumbar puncture to analyze amyloid beta peptides (Aβ42, Aβ40), total tau (tTau) and phosphorylated Tau (pTau181) using the Lumipulse® G600II (Fujirebio) was performed. The values of sensitivity, specificity, predictive values and area under the curve (AUC) were calculated, determining the COP according to the Youden index by comparing the groups of cognitively healthy subjects and AD.
Results
The resulting COP and their AUC were the following: Aβ42 750 pg/ml (AUC 0.809); Aβ42/Aβ40 0.062 pg/ml (AUC 0.78); pTau181 69.85 pg/ml (AUC 0.81); tTau 522.0 pg/ml (AUC 0.79); Aβ42/tTau 1.76 pg/ml (AUC 0.86); Aβ42/pTau181 10.25 pg/ml (AUC 0.86).
Conclusions
The determination of COP of core AD CSF biomarkers for the participating centers allows a better diagnostic accuracy. The ratio CSF Aβ42/pTau181 shows the highest AUC and better balance between sensitivity and specificity.
{"title":"Estudio CORCOBIA: determinación de puntos de corte de biomarcadores de enfermedad de Alzheimer en LCR en una cohorte clínica","authors":"A. Puig-Pijoan , G. García-Escobar , A. Fernández-Lebrero , R.M. Manero Borràs , G. Sánchez-Benavides , I. Navalpotro-Gómez , D. Cascales Lahoz , M. Suárez-Calvet , O. Grau-Rivera , A. Boltes Alandí , M.C. Pont-Sunyer , J. Ortiz-Gil , S. Carrillo-Molina , D. López-Villegas , M.T. Abellán-Vidal , M.I. Martínez-Casamitjana , J.J. Hernández-Sánchez , J. Peña-Casanova , J. Roquer , A. Padrós Fluvià , V. Puente-Périz","doi":"10.1016/j.nrl.2022.05.005","DOIUrl":"10.1016/j.nrl.2022.05.005","url":null,"abstract":"<div><h3>Introduction</h3><div>The analysis of the <em>core</em> biomarkers of Alzheimer's disease (AD) in the cerebrospinal fluid (CSF) is recommended in the clinical units where it is available. Because of the absence of universal validated values, the determination of specific cut-off points (COP) for each center and its population is recommended. The main objective of the CORCOBIA study was to determine the COP of <em>core</em> AD CSF biomarkers for several centers (Parc de Salut Mar, Barcelona, and Hospital General de Granollers), which work with the same reference laboratory (Laboratori de Referència de Catalunya).</div></div><div><h3>Methods</h3><div>Prospective study including cognitively healthy subjects (n<!--> <!-->=<!--> <!-->42), subjects with amnestic mild cognitive impairment (n<!--> <!-->=<!--> <!-->35) and patients with dementia due to AD (n<!--> <!-->=<!--> <!-->48), in whom clinical and neuropsychological assessment, neuroimaging, <em>APOE</em> genotyping and lumbar puncture to analyze amyloid beta peptides (Aβ42, Aβ40), total tau (tTau) and phosphorylated Tau (pTau181) using the Lumipulse® G600II (Fujirebio) was performed. The values of sensitivity, specificity, predictive values and area under the curve (AUC) were calculated, determining the COP according to the Youden index by comparing the groups of cognitively healthy subjects and AD.</div></div><div><h3>Results</h3><div>The resulting COP and their AUC were the following: Aβ42 750<!--> <!-->pg/ml (AUC 0.809); Aβ42/Aβ40 0.062<!--> <!-->pg/ml (AUC 0.78); pTau181 69.85<!--> <!-->pg/ml (AUC 0.81); tTau 522.0<!--> <!-->pg/ml (AUC 0.79); Aβ42/tTau 1.76<!--> <!-->pg/ml (AUC 0.86); Aβ42/pTau181 10.25<!--> <!-->pg/ml (AUC 0.86).</div></div><div><h3>Conclusions</h3><div>The determination of COP of <em>core</em> AD CSF biomarkers for the participating centers allows a better diagnostic accuracy. The ratio CSF Aβ42/pTau181 shows the highest AUC and better balance between sensitivity and specificity.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 9","pages":"Pages 756-765"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48847561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.nrl.2022.05.004
P. Lizandra Cortés , D. Poveda Verdú , A. Albert Férriz , N.C. Ñungo-Garzón , M.C. Domine , T. Sevilla-Mantecón , I. Pitarch-Castellano , J.F. Vázquez-Costa
Introduction
Spinal muscular atrophy 5q (SMA) is a genetic neurodegenerative disease that affects alpha motor neurons producing progressive weakness. New outcome measures are currently required to accurately characterize the disease progression and the efficacy of new available treatments. The objective of this work is to preliminarily validate a new intelligent keyboard (Neuromyotype) measuring typing strength and speed in patients with SMA.
Material and methods
Twenty two SMA patients older than 15 years, and 26 healthy controls were included. Three measurements were obtained with the keyboard (maximum strength, execution time of a random typing task, execution time of a sequential typing task) together with the time to complete the Nine-Hole Peg Test (9HPT). Patients were also administered motor (Hammersmith Functional Motor Scale Expanded [HFMSE], Revised Upper Limb Module [RULM]), and functional scales (Egen Klassification [EK2] and the revised version of Amyotrophic Lateral Sclerosis Functional Rating Scale [ALSFRS-R]). The viability and construct validity of the Neuromyotype were analyzed, measuring the discriminative power between patients and controls (using ROC curves and the Bangdiwala statistic), between the different functional types of SMA (walker, sitter and non-sitter) and their correlation with the rest of motor scales.
Results
Neuromyotype measurements could be performed in all patients, unlike the rest of the scales. Its administration was quick and easy. The 3 variables on the keyboard discriminated very well between patients and controls, with strength (ROC = 0.963) being the one that best differentiates from the 3, equaling 9HPT (ROC = 0.966). They also showed a good ability to differentiate by functional type (especially non-sitters from sitters and walkers), with sequential time (B = 0.83) being the tool that best discriminates between the three groups above the rest of motor scales. All motor and functional scales showed strong or very strong correlations with each other (rs = 0.71-0.99), with strength correlating better with motor scales and timed variables with functional scales.
Conclusion
This study shows the feasibility and validity of Neuromyotype for the evaluation of adolescent and adult patients with SMA. Data obtained with this tool could be of great clinical relevance, saving time and resources compared to the rest of the scales.
{"title":"Validación de Neuromyotype: un teclado inteligente para la evaluación de pacientes con atrofia muscular espinal 5q","authors":"P. Lizandra Cortés , D. Poveda Verdú , A. Albert Férriz , N.C. Ñungo-Garzón , M.C. Domine , T. Sevilla-Mantecón , I. Pitarch-Castellano , J.F. Vázquez-Costa","doi":"10.1016/j.nrl.2022.05.004","DOIUrl":"10.1016/j.nrl.2022.05.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Spinal muscular atrophy 5q (SMA) is a genetic neurodegenerative disease that affects alpha motor neurons producing progressive weakness. New outcome measures are currently required to accurately characterize the disease progression and the efficacy of new available treatments. The objective of this work is to preliminarily validate a new intelligent keyboard (Neuromyotype) measuring typing strength and speed in patients with SMA.</div></div><div><h3>Material and methods</h3><div>Twenty two SMA patients older than 15<!--> <!-->years, and 26 healthy controls were included. Three measurements were obtained with the keyboard (maximum strength, execution time of a random typing task, execution time of a sequential typing task) together with the time to complete the Nine-Hole Peg Test (9HPT). Patients were also administered motor (Hammersmith Functional Motor Scale Expanded [HFMSE], Revised Upper Limb Module [RULM]), and functional scales (Egen Klassification [EK2] and the revised version of Amyotrophic Lateral Sclerosis Functional Rating Scale [ALSFRS-R]). The viability and construct validity of the Neuromyotype were analyzed, measuring the discriminative power between patients and controls (using ROC curves and the Bangdiwala statistic), between the different functional types of SMA (walker, sitter and non-sitter) and their correlation with the rest of motor scales.</div></div><div><h3>Results</h3><div>Neuromyotype measurements could be performed in all patients, unlike the rest of the scales. Its administration was quick and easy. The 3 variables on the keyboard discriminated very well between patients and controls, with strength (ROC<!--> <!-->=<!--> <!-->0.963) being the one that best differentiates from the 3, equaling 9HPT (ROC<!--> <!-->=<!--> <!-->0.966). They also showed a good ability to differentiate by functional type (especially non-sitters from sitters and walkers), with sequential time (B<!--> <!-->=<!--> <!-->0.83) being the tool that best discriminates between the three groups above the rest of motor scales. All motor and functional scales showed strong or very strong correlations with each other (rs<!--> <!-->=<!--> <!-->0.71-0.99), with strength correlating better with motor scales and timed variables with functional scales.</div></div><div><h3>Conclusion</h3><div>This study shows the feasibility and validity of Neuromyotype for the evaluation of adolescent and adult patients with SMA. Data obtained with this tool could be of great clinical relevance, saving time and resources compared to the rest of the scales.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 9","pages":"Pages 733-742"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44068696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.nrl.2022.12.003
E. Fernández-Bermejo , Á. Planchuelo-Gómez , S. Quintas , A. Gonzalez-Martinez , D. García-Azorín , Á. Sierra-Mencía , Á.L. Guerrero , S. Santos-Lasaosa , M. Pilar Navarro-Pérez , N. González-García , J. Díaz-de-Terán , A.B. Gago-Veiga
Background
Despite the number of research studies regarding the individual burden of migraine, few studies have examined its impact on the patients’ partners. We aim to assess migraine effects on the patients’ partners on sentimental relationship, children relationship, friendship, and work, as well as the caregiver burden, anxiety and/or depression.
Methods
A cross-sectional observational study was conducted through an online survey of partners of patients with migraine followed-up in 5 Headache Units. Questions about the 4 areas of interest and 2 scales (Hospital Anxiety and Depression Scale and Zarit scale) were included. Scores were compared against the population prevalence.
Results
One hundred and fifty-five answers were analysed. Among the patient’s partners 135/155 (87.1%) were men, with a mean age of 45.6 ± 10.1 years. Migraine’s main effects on partners were observed in the sentimental relationship and items concerning children and friendships, with a minor impact at work. Partners showed a moderate burden (12/155 = 7.7% [4.1%–13.1%]), and a higher moderate-severe anxiety rate (23/155 = 14.8% [9.6%–21.4%]), and similar depression rate (5/155 = 3.2% [1.1%–7.3%]) compared to the National Health Survey.
Conclusions
The burden of migraine impacts the partners’ personal relationship, childcare, friendship and work. Moreover, certain migraine partners showed a moderate burden according to Zarit scale and higher anxiety levels than the Spanish population.
{"title":"Evaluation of the burden of migraine on the partner’s lifestyle","authors":"E. Fernández-Bermejo , Á. Planchuelo-Gómez , S. Quintas , A. Gonzalez-Martinez , D. García-Azorín , Á. Sierra-Mencía , Á.L. Guerrero , S. Santos-Lasaosa , M. Pilar Navarro-Pérez , N. González-García , J. Díaz-de-Terán , A.B. Gago-Veiga","doi":"10.1016/j.nrl.2022.12.003","DOIUrl":"10.1016/j.nrl.2022.12.003","url":null,"abstract":"<div><h3>Background</h3><div>Despite the number of research studies regarding the individual burden of migraine, few studies have examined its impact on the patients’ partners. We aim to assess migraine effects on the patients’ partners on sentimental relationship, children relationship, friendship, and work, as well as the caregiver burden, anxiety and/or depression.</div></div><div><h3>Methods</h3><div>A cross-sectional observational study was conducted through an online survey of partners of patients with migraine followed-up in 5 Headache Units. Questions about the 4 areas of interest and 2 scales (Hospital Anxiety and Depression Scale and Zarit scale) were included. Scores were compared against the population prevalence.</div></div><div><h3>Results</h3><div>One hundred and fifty-five answers were analysed. Among the patient’s partners 135/155 (87.1%) were men, with a mean age of 45.6 ± 10.1 years. Migraine’s main effects on partners were observed in the sentimental relationship and items concerning children and friendships, with a minor impact at work. Partners showed a moderate burden (12/155 = 7.7% [4.1%–13.1%]), and a higher moderate-severe anxiety rate (23/155 = 14.8% [9.6%–21.4%]), and similar depression rate (5/155 = 3.2% [1.1%–7.3%]) compared to the National Health Survey.</div></div><div><h3>Conclusions</h3><div>The burden of migraine impacts the partners’ personal relationship, childcare, friendship and work. Moreover, certain migraine partners showed a moderate burden according to Zarit scale and higher anxiety levels than the Spanish population.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 9","pages":"Pages 810-819"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142660272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.nrl.2022.06.005
Y. Broche-Pérez , R.M. Jiménez-Morales , L.O. Monasterio-Ramos , L.A. Vázquez-Gómez , Z. Fernández-Fleites
Introduction
Relapses are a hallmark of multiple sclerosis, being a characteristic feature of relapsing-remitting multiple sclerosis (RRMS). The occurrence of a relapse constitutes a source of significant discomfort that impacts all domains of daily life of patients with multiple sclerosis (PwMS). In this study we first explored the psychometric properties of the Spanish version of the Fear of Relapse Scale (FoR) in a sample of patients with RRMS. Besides, we explored the relationship between the Fear of Relapse Scale with fatigue and cognitive perceived deficits in our PwMS sample.
Methods
An online cross-sectional survey was conducted on 173 MS patients from 12 Spanish-speaking countries (Argentina, Mexico, Uruguay, Dominican Republic, Spain, Cuba, Colombia, Guatemala, Chile, Paraguay, Peru, and El Salvador). Confirmatory factor analysis (CFA) was performed to assess the factor structure of the scale. Multiple linear regression was used to evaluate the effects of health self-perception, fatigue, and perceived cognitive deficits over fear of relapse.
Results
The three-factor model in the CFA yielded a good model fit (χ2/df = 2.25, P < .001, RMSEA = .078, CFI = .91). McDonalds’ Omega of the FoR (Spanish version) was .91. There was a statistically significant inverse correlation between FoR and health self-perception, and a positive correlation between FoR, fatigue, and perceived cognitive deficits. Finally, level of fatigue was a predictor of fear of relapse.
Conclusions
The Spanish version of the Fear of Relapse Scale is a valid and reliable instrument to explore the experience of fear of relapse in patients with RRMS.
{"title":"Fear of Relapse Scale: Spanish version and psychometric characteristics in a sample of patients with Relapsing-Remitting multiple sclerosis","authors":"Y. Broche-Pérez , R.M. Jiménez-Morales , L.O. Monasterio-Ramos , L.A. Vázquez-Gómez , Z. Fernández-Fleites","doi":"10.1016/j.nrl.2022.06.005","DOIUrl":"10.1016/j.nrl.2022.06.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Relapses are a hallmark of multiple sclerosis, being a characteristic feature of relapsing-remitting multiple sclerosis (RRMS). The occurrence of a relapse constitutes a source of significant discomfort that impacts all domains of daily life of patients with multiple sclerosis (PwMS). In this study we first explored the psychometric properties of the Spanish version of the Fear of Relapse Scale (FoR) in a sample of patients with RRMS. Besides, we explored the relationship between the Fear of Relapse Scale with fatigue and cognitive perceived deficits in our PwMS sample.</div></div><div><h3>Methods</h3><div>An online cross-sectional survey was conducted on 173 MS patients from 12 Spanish-speaking countries (Argentina, Mexico, Uruguay, Dominican Republic, Spain, Cuba, Colombia, Guatemala, Chile, Paraguay, Peru, and El Salvador). Confirmatory factor analysis (CFA) was performed to assess the factor structure of the scale. Multiple linear regression was used to evaluate the effects of health self-perception, fatigue, and perceived cognitive deficits over fear of relapse.</div></div><div><h3>Results</h3><div>The three-factor model in the CFA yielded a good model fit (<em>χ</em><sup>2</sup><em>/df</em> = 2.25, <em>P</em> < .001, RMSEA = .078, CFI = .91). McDonalds’ Omega of the FoR (Spanish version) was .91. There was a statistically significant inverse correlation between FoR and health self-perception, and a positive correlation between FoR, fatigue, and perceived cognitive deficits. Finally, level of fatigue was a predictor of fear of relapse.</div></div><div><h3>Conclusions</h3><div>The Spanish version of the Fear of Relapse Scale is a valid and reliable instrument to explore the experience of fear of relapse in patients with RRMS.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 9","pages":"Pages 749-755"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142660388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.nrl.2022.06.009
Hongwei Wang , Wei Lei , Ye Tian , Jianwei Wu , Xiaosheng Ma , Feizhou Lyu , Xinlei Xia , Jingjuan Liang , Jianyuan Jiang , Hongli Wang
Introduction
To characterize Hirayama disease in female patients, and increase awareness among clinicians regarding the specifics of this disease.
Methods
Baseline data, clinical manifestations, characteristics of cervical-flexion magnetic resonance imaging, and electromyography were collected and compared among females and males with Hirayama disease. In addition, the literature on Hirayama disease in females up to October, 2021 was searched in PubMed and the relevant data were compared with the data from our study.
Results
Twenty female and 40 male patients were included in this study. The average ages of onset and menarche were 14.65 and 12.75 years old. All patients suffered from muscular weakness and atrophy of the upper limb(s), with flattening and/or atrophy of the lower cervical spinal cords in cervical-flexion magnetic resonance imaging, and neurogenic patterns in the atrophic muscles as determined using electromyography. The age of onset in females was about 2 years later than the age of menarche, and the age of onset in females was 2 years earlier than that in males. There were no obvious differences in clinical presentation between males and females.
Discussion
Although females presented with Hirayama disease two years earlier than males, no other clinical differences were observed. Hirayama disease is likely associated with growth and development in puberty, and early identification, regardless of whether patients are male or female, is critical to optimizing prognosis.
{"title":"The clinical characteristics of Hirayama disease in females","authors":"Hongwei Wang , Wei Lei , Ye Tian , Jianwei Wu , Xiaosheng Ma , Feizhou Lyu , Xinlei Xia , Jingjuan Liang , Jianyuan Jiang , Hongli Wang","doi":"10.1016/j.nrl.2022.06.009","DOIUrl":"10.1016/j.nrl.2022.06.009","url":null,"abstract":"<div><h3>Introduction</h3><div>To characterize Hirayama disease in female patients, and increase awareness among clinicians regarding the specifics of this disease.</div></div><div><h3>Methods</h3><div>Baseline data, clinical manifestations, characteristics of cervical-flexion magnetic resonance imaging, and electromyography were collected and compared among females and males with Hirayama disease. In addition, the literature on Hirayama disease in females up to October, 2021 was searched in PubMed and the relevant data were compared with the data from our study.</div></div><div><h3>Results</h3><div>Twenty female and 40 male patients were included in this study. The average ages of onset and menarche were 14.65 and 12.75 years old. All patients suffered from muscular weakness and atrophy of the upper limb(s), with flattening and/or atrophy of the lower cervical spinal cords in cervical-flexion magnetic resonance imaging, and neurogenic patterns in the atrophic muscles as determined using electromyography. The age of onset in females was about 2 years later than the age of menarche, and the age of onset in females was 2 years earlier than that in males. There were no obvious differences in clinical presentation between males and females.</div></div><div><h3>Discussion</h3><div>Although females presented with Hirayama disease two years earlier than males, no other clinical differences were observed. Hirayama disease is likely associated with growth and development in puberty, and early identification, regardless of whether patients are male or female, is critical to optimizing prognosis.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 9","pages":"Pages 792-801"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142660389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.nrl.2022.06.006
Ritwik Ghosh , Arpan Mandal , Moisés León-Ruiz , Dipayan Roy , Shambaditya Das , Souvik Dubey , Julián Benito-León
Introduction
Scrub typhus is a potentially life-threatening but curable disease that can produce multi-organ failure. Neurological manifestations in scrub typhus have gained attention recently, where the entire neural axis except the myoneural junction can be involved. Although the pathogenesis of neurological involvement has not been established, immune-mediated mechanisms are suspected. This article reports the clinicopathological features of scrub typhus cases presenting several rare neurological and neuropsychiatric manifestations.
Methods
Three hundred fifty-four serologically confirmed scrub typhus cases were admitted to the Department of General Medicine of Burdwan Medical College and Hospital (West Bengal, India) between May 2018 and May 2022. There were 50 patients who had predominantly neurological manifestations. Of these 50 cases, ten patients presented with extremely rare neurological manifestations.
Results
We report 10 cases of scrub typhus (four men and six women) who presented with complex neurological pictures (posterior reversible encephalopathy syndrome, Opalski syndrome, parkinsonism, cerebellitis, isolated opsoclonus, acute transverse myelitis, myositis, polyradiculoneuropathy with cranial neuropathy, acute transient behavioral changes, and fibromyalgia). Immune-mediated mechanisms might have mediated the pathogenesis of most cases following scrub typhus infection.
Conclusion
From a clinicopathological point of view, each case was unique in its presentation and treatment response. In any acute onset neurological disorders associated with febrile illness in the tropics or subtropics, scrub typhus infection should be included in the differential diagnosis, despite the absence of eschar and unremarkable neuroimaging findings. This otherwise curable disease may result in multi-organ dysfunction syndrome and death if the diagnosis is delayed.
{"title":"Rare neurological and neuropsychiatric manifestations of scrub typhus: a case series of 10 cases","authors":"Ritwik Ghosh , Arpan Mandal , Moisés León-Ruiz , Dipayan Roy , Shambaditya Das , Souvik Dubey , Julián Benito-León","doi":"10.1016/j.nrl.2022.06.006","DOIUrl":"10.1016/j.nrl.2022.06.006","url":null,"abstract":"<div><h3>Introduction</h3><div>Scrub typhus is a potentially life-threatening but curable disease that can produce multi-organ failure. Neurological manifestations in scrub typhus have gained attention recently, where the entire neural axis except the myoneural junction can be involved. Although the pathogenesis of neurological involvement has not been established, immune-mediated mechanisms are suspected. This article reports the clinicopathological features of scrub typhus cases presenting several rare neurological and neuropsychiatric manifestations.</div></div><div><h3>Methods</h3><div>Three hundred fifty-four serologically confirmed scrub typhus cases were admitted to the Department of General Medicine of Burdwan Medical College and Hospital (West Bengal, India) between May 2018 and May 2022. There were 50 patients who had predominantly neurological manifestations. Of these 50 cases, ten patients presented with extremely rare neurological manifestations.</div></div><div><h3>Results</h3><div>We report 10 cases of scrub typhus (four men and six women) who presented with complex neurological pictures (posterior reversible encephalopathy syndrome, Opalski syndrome, parkinsonism, cerebellitis, isolated opsoclonus, acute transverse myelitis, myositis, polyradiculoneuropathy with cranial neuropathy, acute transient behavioral changes, and fibromyalgia). Immune-mediated mechanisms might have mediated the pathogenesis of most cases following scrub typhus infection.</div></div><div><h3>Conclusion</h3><div>From a clinicopathological point of view, each case was unique in its presentation and treatment response. In any acute onset neurological disorders associated with febrile illness in the tropics or subtropics, scrub typhus infection should be included in the differential diagnosis, despite the absence of eschar and unremarkable neuroimaging findings. This otherwise curable disease may result in multi-organ dysfunction syndrome and death if the diagnosis is delayed.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 9","pages":"Pages 766-780"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.nrl.2022.06.004
M.A. Mireles-Ramírez , I.E. Velázquez-Brizuela , N. Sánchez-Rosales , Y. Márquez-Pedroza , M.R. Hernandez-Preciado , G. Gabriel Ortiz
Background
Neuromyelitis optica spectrum disorder (NMOSD) is characterised by recurrent attacks of optic neuritis and transverse myelitis. The purpose of this work was to identify the incidence and prevalence of NMOSD and its clinical characteristics in the population treated for demyelinating diseases in Western Mexico.
Material and method
A descriptive, retrospective study was carried out in the Department of Neurology, at the Sub-specialty Medical Unit, Specialties Hospital (known by its Spanish abbreviation UMAE-HE), of the National Western Medical Center (CMNO), Mexican Institute of Social Security (IMSS). A review of the electronic files for all patients with a diagnosis of NMOSD in 2019, was carried out in the State of Jalisco, Mexico.
Results
Fifty-eight patients with NMOSD were included in the study. The incidence was 0.71/100 000 (CI 0.60-0.85) and the prevalence was 1.09/100 000 (CI 0.84-1.42). There were 79.3% women, and 20.6% were men (P = .01). All (100%) patients presented with anti-aquaporin-4 immunoglobulin G, and 89.6% showed seropositivity for anti-aquaporin-4 (CI 82.6-94.9). Magnetic resonance imaging was performed on 100% of patients, where 34.4% were normal, and 65.5% (38) abnormal, presenting with non-specific subcortical lesions (P = 0.04). The initial clinical presentation was optic neuritis (ON) in 58.6%; where 31.0% was bilateral ON, 20.7% was left ON, and 6.9% were right ON; transverse myelitis in 26.0%, area postrema syndrome (APS) in 10.3%, among others.
Conclusions
The incidence of NMOSD exceeds 0.71/100 000, the prevalence is low at 1.09/100 000, and NMOSD is predominantly found in women.
{"title":"The prevalence, incidence, and clinical assessment of neuromyelitis optica spectrum disorder in patients with demyelinating diseases","authors":"M.A. Mireles-Ramírez , I.E. Velázquez-Brizuela , N. Sánchez-Rosales , Y. Márquez-Pedroza , M.R. Hernandez-Preciado , G. Gabriel Ortiz","doi":"10.1016/j.nrl.2022.06.004","DOIUrl":"10.1016/j.nrl.2022.06.004","url":null,"abstract":"<div><h3>Background</h3><div>Neuromyelitis optica spectrum disorder (NMOSD) is characterised by recurrent attacks of optic neuritis and transverse myelitis. The purpose of this work was to identify the incidence and prevalence of NMOSD and its clinical characteristics in the population treated for demyelinating diseases in Western Mexico.</div></div><div><h3>Material and method</h3><div>A descriptive, retrospective study was carried out in the Department of Neurology, at the Sub-specialty Medical Unit, Specialties Hospital (known by its Spanish abbreviation <em>UMAE-HE</em>), of the National Western Medical Center (<em>CMNO</em>), Mexican Institute of Social Security (<em>IMSS</em>). A review of the electronic files for all patients with a diagnosis of NMOSD in 2019, was carried out in the State of Jalisco, Mexico.</div></div><div><h3>Results</h3><div>Fifty-eight patients with NMOSD were included in the study. The incidence was 0.71/100 000 (CI 0.60-0.85) and the prevalence was 1.09/100 000 (CI 0.84-1.42). There were 79.3% women, and 20.6% were men (<em>P</em> = .01). All (100%) patients presented with anti-aquaporin-4 immunoglobulin G, and 89.6% showed seropositivity for anti-aquaporin-4 (CI 82.6-94.9). Magnetic resonance imaging was performed on 100% of patients, where 34.4% were normal, and 65.5% (38) abnormal, presenting with non-specific subcortical lesions (<em>P</em> = 0.04). The initial clinical presentation was optic neuritis (ON) in 58.6%; where 31.0% was bilateral ON, 20.7% was left ON, and 6.9% were right ON; transverse myelitis in 26.0%, area postrema syndrome (APS) in 10.3%, among others.</div></div><div><h3>Conclusions</h3><div>The incidence of NMOSD exceeds 0.71/100 000, the prevalence is low at 1.09/100 000, and NMOSD is predominantly found in women.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 9","pages":"Pages 743-748"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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