Pub Date : 2025-09-01DOI: 10.1016/j.nrl.2023.02.008
A. Murueta-Goyena , R. Del Pino , M. Carmona-Abellán , B. Tijero , M. Ruiz-Lopez , M. Acera , T. Morera-Herreras , C. Miguelez , O. Sáez-Atxukarro , T. Fernández-Valle , I. Gabilondo , J.C. Gómez-Esteban
Introduction
Differences in the trajectory of non-motor symptoms (NMS) between male and female Parkinson's disease (PD) patients over the course of the disease are not well-understood.
Methods
PD patients were rated with Non-Motor Symptom Scale (NMSS) at two time points with a median follow-up of 3.8 years (IQR 2.1–5.6 years). Sex, age, disease duration, Unified Parkinson's Disease Rating Scale and doses of PD-related medication were registered. Linear mixed models (LMMs) and multinomial logistic regression (MLR) models were fitted to explore the association of sex with changes in NMSS domains over time.
Results
Eighty-seven PD patients (30 females and 57 males) were enrolled. Baseline demographic and clinical characteristics were similar between female and male PD patients. The mean increase in NMS frequency and severity over time was non-significant, as well as the interaction term for disease duration × sex. However, gastrointestinal symptoms worsened in both males and females. According to the minimal detectable change of NMSS, <50% of PD patients experienced changes at follow-up beyond measurement error of the scale. Male sex predicted sexual function worsening (adjusted OR = 10.1, p = 0.038). Also, PD patients with more severe symptoms at baseline had increased odds of improving over time. However, high initial scores in attention/memory and cardiovascular domains also posed individuals at a higher risk of symptom worsening (OR [95% CI] = 1.4 [1.0-1.8], p = 0.034 and OR [95% CI] = 2.1 [1.2-3.7], p = 0.01, respectively).
Conclusion
NMS progression over the disease course in PD shows large inter-individual variability without observable effect of sex.
男性和女性帕金森病（PD）患者在病程中的非运动症状（NMS）轨迹差异尚不清楚。方法spd患者在两个时间点采用非运动症状量表（NMSS）进行评分，中位随访3.8年（IQR 2.1-5.6年）。登记性别、年龄、病程、统一帕金森病评定量表和pd相关药物剂量。采用线性混合模型（lmm）和多项逻辑回归模型（MLR）探讨性别与NMSS域随时间变化的关系。结果共纳入87例PD患者，其中女性30例，男性57例。女性和男性PD患者的基线人口学和临床特征相似。NMS频率和严重程度随时间的平均增加不显著，疾病持续时间×性别的相互作用项也不显著。然而，男性和女性的胃肠道症状都恶化了。根据NMSS最小可检出变化，50%的PD患者随访时出现超出量表测量误差的变化。男性预测性功能恶化（校正OR = 10.1, p = 0.038）。此外，在基线时症状更严重的PD患者随着时间的推移改善的几率增加。然而，注意/记忆和心血管领域的高初始得分也使个体具有更高的症状恶化风险（OR [95% CI] = 1.4 [1.0-1.8], p = 0.034, OR [95% CI] = 2.1 [1.2-3.7], p = 0.01）。结论PD患者nms在病程中的进展具有较大的个体差异，无明显的性别影响。
{"title":"Effect of sex on the progression of non-motor symptoms in Parkinson's disease: A registry-based cohort study","authors":"A. Murueta-Goyena , R. Del Pino , M. Carmona-Abellán , B. Tijero , M. Ruiz-Lopez , M. Acera , T. Morera-Herreras , C. Miguelez , O. Sáez-Atxukarro , T. Fernández-Valle , I. Gabilondo , J.C. Gómez-Esteban","doi":"10.1016/j.nrl.2023.02.008","DOIUrl":"10.1016/j.nrl.2023.02.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Differences in the trajectory of non-motor symptoms (NMS) between male and female Parkinson's disease (PD) patients over the course of the disease are not well-understood.</div></div><div><h3>Methods</h3><div>PD patients were rated with Non-Motor Symptom Scale (NMSS) at two time points with a median follow-up of 3.8 years (IQR 2.1–5.6 years). Sex, age, disease duration, Unified Parkinson's Disease Rating Scale and doses of PD-related medication were registered. Linear mixed models (LMMs) and multinomial logistic regression (MLR) models were fitted to explore the association of sex with changes in NMSS domains over time.</div></div><div><h3>Results</h3><div>Eighty-seven PD patients (30 females and 57 males) were enrolled. Baseline demographic and clinical characteristics were similar between female and male PD patients. The mean increase in NMS frequency and severity over time was non-significant, as well as the interaction term for <em>disease duration</em> <!-->×<!--> <em>sex</em>. However, gastrointestinal symptoms worsened in both males and females. According to the minimal detectable change of NMSS, <50% of PD patients experienced changes at follow-up beyond measurement error of the scale. Male sex predicted sexual function worsening (adjusted OR<!--> <!-->=<!--> <!-->10.1, <em>p</em> <!-->=<!--> <!-->0.038). Also, PD patients with more severe symptoms at baseline had increased odds of improving over time. However, high initial scores in attention/memory and cardiovascular domains also posed individuals at a higher risk of symptom worsening (OR [95% CI] = 1.4 [1.0-1.8], <em>p</em> <!-->=<!--> <!-->0.034 and OR [95% CI] = 2.1 [1.2-3.7], <em>p</em> <!-->=<!--> <!-->0.01, respectively).</div></div><div><h3>Conclusion</h3><div>NMS progression over the disease course in PD shows large inter-individual variability without observable effect of sex.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"40 7","pages":"Pages 620-629"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144921882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.nrl.2023.03.009
M. Torrente , M. Pino , J. Peña-Casanova
Introduction
The assessment of activities of daily living (ADL) is considered essential in the evaluation of mild cognitive impairment (MCI), dementia and for its correct differential diagnosis. There are many scales for the functional assessment of these entities, although they are not exempt from drawbacks. The Barcelona Test ADL scale was published in 2019 with the aim of having a retrogenetic instrument that could overcome most of the problems encountered by its predecessors.
Method
A study was carried out to evaluate the properties of this scale. A total sample of 68 subjects (healthy controls, patients with amnestic-type MCI, and patients with Alzheimer's-type dementia) stratified according to the Global Cognitive Impairment Scale -Global Deterioration Scale- completed with the Functional Assessment Staging- Scale (GDS-FAST). The scores of each group on the scale, as well as on other cognitive tests, were studied to obtain the descriptive and internal consistency, concurrent validity, and discriminative capacity indices.
Results
The scale means differed significantly between all stratification groups. A high internal consistency index was obtained (Cronbach's α 0.975), excellent concurrent validity (Spearman's ρ of 0.95) and very good discriminative capacity, especially between the GDS-FAST 3 and 4 groups, and the GDS-FAST 4 and 5 groups.
Conclusions
The Barcelona Test ADL scale allows adequately evaluating the retrogenetic functional level of patients and discriminating between the different phases of the GDS-FAST, positioning itself as a very complete and useful scale in our sociocultural environment.
{"title":"Desarrollo y validación concurrente de un instrumento retrogenético para la valoración de las actividades de la vida diaria: la Escala de Evaluación Funcional del Test Barcelona","authors":"M. Torrente , M. Pino , J. Peña-Casanova","doi":"10.1016/j.nrl.2023.03.009","DOIUrl":"10.1016/j.nrl.2023.03.009","url":null,"abstract":"<div><h3>Introduction</h3><div>The assessment of activities of daily living (ADL) is considered essential in the evaluation of mild cognitive impairment (MCI), dementia and for its correct differential diagnosis. There are many scales for the functional assessment of these entities, although they are not exempt from drawbacks. The Barcelona Test ADL scale was published in 2019 with the aim of having a retrogenetic instrument that could overcome most of the problems encountered by its predecessors.</div></div><div><h3>Method</h3><div>A study was carried out to evaluate the properties of this scale. A total sample of 68 subjects (healthy controls, patients with amnestic-type MCI, and patients with Alzheimer's-type dementia) stratified according to the Global Cognitive Impairment Scale -Global Deterioration Scale- completed with the Functional Assessment Staging- Scale (GDS-FAST). The scores of each group on the scale, as well as on other cognitive tests, were studied to obtain the descriptive and internal consistency, concurrent validity, and discriminative capacity indices.</div></div><div><h3>Results</h3><div>The scale means differed significantly between all stratification groups. A high internal consistency index was obtained (Cronbach's α 0.975), excellent concurrent validity (Spearman's ρ of 0.95) and very good discriminative capacity, especially between the GDS-FAST 3 and 4 groups, and the GDS-FAST 4 and 5 groups.</div></div><div><h3>Conclusions</h3><div>The Barcelona Test ADL scale allows adequately evaluating the retrogenetic functional level of patients and discriminating between the different phases of the GDS-FAST, positioning itself as a very complete and useful scale in our sociocultural environment.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"40 7","pages":"Pages 651-660"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144921884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01DOI: 10.1016/j.nrl.2024.06.001
J. Rodríguez Vico , J. Fernández Domínguez , F.J. Julián Villaverde , N. González García , C. García-Cabo Fernández , A. Jaimes Sanchez , O. Ayo Martín , J.A. Membrilla López , R.G. Martínez Martín , J. García Ull , P. Martínez Sánchez , L. Dorado Bouix , R. Belvis Nieto , P. Irimia
Introduction
Neurosonology is a medical discipline that utilizes ultrasound techniques to study the nervous system, with its applications progressively increasing. The indications and methodology for applying these techniques in patients with headaches are not well defined, thus there is a need for a consensus guideline, based on expert opinion, to standardize their application in clinical practice.
Development
Experts in headaches and neurosonology, appointed by the Headache Study Group of the Spanish Society of Neurology and the Spanish Society of Neurosonology, identified primary and secondary headaches where neurosonology has the greatest clinical application. A qualitative systematic review of the literature was conducted, based on available scientific evidence.
Conclusions
Cervical color duplex is considered a screening technique in patients with a high clinical suspicion of arterial dissection and may also be indicated for follow-up. Transcranial Doppler is a useful technique for evaluating the presence of vasospasm based on changes in mean flow velocity, and resistance and pulsatility indexes. Identification of the «halo sign» is highly specific for temporal arteritis. Measurement of the optic nerve sheath allows evaluation of the presence of intracranial hypertension. Finally, neurosonology may assist in occipital infiltration procedures or lumbar puncture and enables identification of changes in structures involved in the pathophysiology of migraine such as the periaqueductal gray matter and the raphe nuclei.
{"title":"Documento de consenso sobre técnicas neurosonológicas en cefaleas","authors":"J. Rodríguez Vico , J. Fernández Domínguez , F.J. Julián Villaverde , N. González García , C. García-Cabo Fernández , A. Jaimes Sanchez , O. Ayo Martín , J.A. Membrilla López , R.G. Martínez Martín , J. García Ull , P. Martínez Sánchez , L. Dorado Bouix , R. Belvis Nieto , P. Irimia","doi":"10.1016/j.nrl.2024.06.001","DOIUrl":"10.1016/j.nrl.2024.06.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Neurosonology is a medical discipline that utilizes ultrasound techniques to study the nervous system, with its applications progressively increasing. The indications and methodology for applying these techniques in patients with headaches are not well defined, thus there is a need for a consensus guideline, based on expert opinion, to standardize their application in clinical practice.</div></div><div><h3>Development</h3><div>Experts in headaches and neurosonology, appointed by the Headache Study Group of the Spanish Society of Neurology and the Spanish Society of Neurosonology, identified primary and secondary headaches where neurosonology has the greatest clinical application. A qualitative systematic review of the literature was conducted, based on available scientific evidence.</div></div><div><h3>Conclusions</h3><div>Cervical color duplex is considered a screening technique in patients with a high clinical suspicion of arterial dissection and may also be indicated for follow-up. Transcranial Doppler is a useful technique for evaluating the presence of vasospasm based on changes in mean flow velocity, and resistance and pulsatility indexes. Identification of the «halo sign» is highly specific for temporal arteritis. Measurement of the optic nerve sheath allows evaluation of the presence of intracranial hypertension. Finally, neurosonology may assist in occipital infiltration procedures or lumbar puncture and enables identification of changes in structures involved in the pathophysiology of migraine such as the periaqueductal gray matter and the raphe nuclei.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"40 6","pages":"Pages 599-607"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01DOI: 10.1016/j.nrl.2023.11.007
R.C. Braña Miranda , N.E. Quintanal Cordero , N. Pavón Fuentes , I. Pedroso Ibáñez , R. Macías González , C.J. Teijeiro Amador , A. Abreu Duque , R. Garbey Fernández
Introduction
Functional neurosurgery constitutes a therapeutic alternative for patients with Parkinson's disease (PD). It is known that both bilateral subthalamotomy and bilateral pallidotomy cause neurological complications, so in ablative techniques a bilateral approach to the GPi is not recommended in PD and caution is suggested with the indication of bilateral subthalamotomy. Our group has refined the surgical technique for the ablation of the subthalamic nucleus seeking to reduce the appearance of dyskinesias induced by surgery and obtain a better therapeutic effect, so the approach to the NST in a second surgical procedure in the opposite hemisphere to the one performed previously pallidotomy, would avoid the complications derived from bilateral pallidotomy and can be a safe alternative for patients even when they present symptoms of dyskinesias. We set out to evaluate the effect and safety of the combination of GPi and NST lesion in opposite cerebral hemispheres in PD patients.
Method
A retrospective study was carried out that included all patients operated on at the CIREN in a period of 22 years, who underwent a pallidotomy contralateral to the most affected hemibody; followed by a subthalamotomy of the opposite hemisphere in a second surgical procedure. The effect on the neurological condition was evaluated using section III of the MDS-UPDRS scale. Safety was evaluated according to the adverse effects scale and the Clavien and Dindo scale.
Results
Both surgical interventions had a positive impact on the patients’ pharmacological treatment, significantly reducing the doses of L-dopa. A significant improvement was observed in the motor condition of the patients in relation to dyskinesias, as well as rigidity, bradykinesia and tremor.
Conclusions
The pallidotomy/Subthalamotomy combination showed to be an effective alternative for the treatment of complicated PD, capable of allowing better motor control and a reduction in the dose of L-Dopa with a low rate of complications; It also allows to avoid complications derived from bilateral pallidotomy and subthalamotomy, proving to be a safe alternative for patients even when they present symptoms of dyskinesias.
{"title":"Efecto de la combinación palidotomía-subtalamotomía realizada en hemisferios cerebrales opuestos para el tratamiento de los signos motores en la enfermedad de Parkinson","authors":"R.C. Braña Miranda , N.E. Quintanal Cordero , N. Pavón Fuentes , I. Pedroso Ibáñez , R. Macías González , C.J. Teijeiro Amador , A. Abreu Duque , R. Garbey Fernández","doi":"10.1016/j.nrl.2023.11.007","DOIUrl":"10.1016/j.nrl.2023.11.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Functional neurosurgery constitutes a therapeutic alternative for patients with Parkinson's disease (PD). It is known that both bilateral subthalamotomy and bilateral pallidotomy cause neurological complications, so in ablative techniques a bilateral approach to the GPi is not recommended in PD and caution is suggested with the indication of bilateral subthalamotomy. Our group has refined the surgical technique for the ablation of the subthalamic nucleus seeking to reduce the appearance of dyskinesias induced by surgery and obtain a better therapeutic effect, so the approach to the NST in a second surgical procedure in the opposite hemisphere to the one performed previously pallidotomy, would avoid the complications derived from bilateral pallidotomy and can be a safe alternative for patients even when they present symptoms of dyskinesias. We set out to evaluate the effect and safety of the combination of GPi and NST lesion in opposite cerebral hemispheres in PD patients.</div></div><div><h3>Method</h3><div>A retrospective study was carried out that included all patients operated on at the CIREN in a period of 22 years, who underwent a pallidotomy contralateral to the most affected hemibody; followed by a subthalamotomy of the opposite hemisphere in a second surgical procedure. The effect on the neurological condition was evaluated using section III of the MDS-UPDRS scale. Safety was evaluated according to the adverse effects scale and the Clavien and Dindo scale.</div></div><div><h3>Results</h3><div>Both surgical interventions had a positive impact on the patients’ pharmacological treatment, significantly reducing the doses of L-dopa. A significant improvement was observed in the motor condition of the patients in relation to dyskinesias, as well as rigidity, bradykinesia and tremor.</div></div><div><h3>Conclusions</h3><div>The pallidotomy/Subthalamotomy combination showed to be an effective alternative for the treatment of complicated PD, capable of allowing better motor control and a reduction in the dose of L-Dopa with a low rate of complications; It also allows to avoid complications derived from bilateral pallidotomy and subthalamotomy, proving to be a safe alternative for patients even when they present symptoms of dyskinesias.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"40 6","pages":"Pages 518-532"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141845651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01DOI: 10.1016/j.nrl.2023.03.003
Y. Zhang , Y. Lin , C.C.W. Zhong , F.F. Ho , I.X.Y. Wu , C. Mao , X. Yang , V.C.H. Chung
Background
Systematic reviews (SR) of high methodological quality can provide the best evidence for clinical practice. However, the methodological quality of SRs on Parkinson's disease treatments has not been evaluated comprehensively. The study aims to assess the methodological quality of a representative sample of SRs on Parkinson's disease treatments.
Methods
Four databases were searched to obtain potentially eligible SRs published between January 2016 and December 2021. A pre-designed questionnaire was used to extract the bibliographical characteristics of the included SRs. The AMSTAR-2 (Assessing the Methodological Quality of Systematic Reviews) tool was used to assess the methodological quality of SRs. Factors associated with methodological quality were assessed using multivariate regression analyses.
Results
A total of 119 eligible SRs were included and appraised. Only one SR (0.8%) was of high overall methodological quality. Four (3.4%) and 7 (5.9%) SRs were of moderate and low overall methodological quality, respectively. Among the appraised SRs, only 3 (2.5%) applied a comprehensive literature search strategy, 11 (9.2%) provided a list of excluded studies with justifications for exclusion, and 4 (3.4%) reported the sources of funding among the original studies included in the SR. Cochrane SRs and SRs published in journals with higher impact factors had relatively higher overall methodological quality.
Conclusions
This study demonstrated that SRs on Parkinson's disease treatments are of low methodological quality. To enhance the quality and hence the trustworthiness of SRs, the protocols of future reviews should be designed and registered a priori, and researchers should conduct a comprehensive literature search, provide a list of excluded studies with justifications for exclusion, and report sources of funding for the included original studies.
{"title":"Methodological quality of systematic reviews on treatments for Parkinson's disease: A cross-sectional study","authors":"Y. Zhang , Y. Lin , C.C.W. Zhong , F.F. Ho , I.X.Y. Wu , C. Mao , X. Yang , V.C.H. Chung","doi":"10.1016/j.nrl.2023.03.003","DOIUrl":"10.1016/j.nrl.2023.03.003","url":null,"abstract":"<div><h3>Background</h3><div>Systematic reviews (SR) of high methodological quality can provide the best evidence for clinical practice. However, the methodological quality of SRs on Parkinson's disease treatments has not been evaluated comprehensively. The study aims to assess the methodological quality of a representative sample of SRs on Parkinson's disease treatments.</div></div><div><h3>Methods</h3><div>Four databases were searched to obtain potentially eligible SRs published between January 2016 and December 2021. A pre-designed questionnaire was used to extract the bibliographical characteristics of the included SRs. The AMSTAR-2 (Assessing the Methodological Quality of Systematic Reviews) tool was used to assess the methodological quality of SRs. Factors associated with methodological quality were assessed using multivariate regression analyses.</div></div><div><h3>Results</h3><div>A total of 119 eligible SRs were included and appraised. Only one SR (0.8%) was of high overall methodological quality. Four (3.4%) and 7 (5.9%) SRs were of moderate and low overall methodological quality, respectively. Among the appraised SRs, only 3 (2.5%) applied a comprehensive literature search strategy, 11 (9.2%) provided a list of excluded studies with justifications for exclusion, and 4 (3.4%) reported the sources of funding among the original studies included in the SR. Cochrane SRs and SRs published in journals with higher impact factors had relatively higher overall methodological quality.</div></div><div><h3>Conclusions</h3><div>This study demonstrated that SRs on Parkinson's disease treatments are of low methodological quality. To enhance the quality and hence the trustworthiness of SRs, the protocols of future reviews should be designed and registered a priori, and researchers should conduct a comprehensive literature search, provide a list of excluded studies with justifications for exclusion, and report sources of funding for the included original studies.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"40 6","pages":"Pages 507-517"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01DOI: 10.1016/j.nrl.2024.01.002
M.J. Abenza Abildúa , T. Olmedo Menchen , A. Pérez Villena , S. Ruhland Paulete , F. José Navacerrada Barrero , J. de Ojeda Ruíz de Luna , C. Algarra Lucas , G. Cordero Martín , S. Martínez Ubierna , C. Jimeno Montero , I.J. Navarro López , E. Suárez Gisbert , Á. Gómez de la Riva , C. Pérez López , M.L. Herreros Fernández
Introduction
We analyze the diagnostic utility of urgent EEG (electroencephalogram) performed in children under 16 years of age in our center.
Material and methods
Descriptive, retrospective, observational study of consecutive patients from 0 to 16 years of age, who underwent an urgent EEG for any reason, from January to December 2022.
Results
Of the 388 patients, 70 were children: 37 (52.85%) women, and 33 (47.14%) men. Average age: 6.27 ± 4.809. Of the 70 patients, 6 (8.57%) had previous epilepsy. Reasons for consultation: 17 febrile seizures, 10 first focal seizures, 10 first TCG seizures, 6 paroxysmal episodes, 6 absences, 3 myoclonus of extremities, 3 syncope, 2 SE, 2 visual alterations, 2 low level of consciousness, 2 cyanosis, 2 suspected meningitis or encephalitis, 1 choking, 1 atypical headache, 1 chorea, 1 presyncope, 1 language delay. Of the 70 patients, 47 had a normal EEG (67.14%). Of the 47 patients with a normal EEG, 10 were diagnosed with epilepsy, and 3 of them began receiving antiepileptic treatment upon discharge. None of the patients with suspected syncope or paroxysmal disorder (17 patients, 24.28%) had EEG abnormalities. Of the 17 patients with atypical febrile seizures, 3 had EEG abnormalities.
Conclusions
A third of the EEG records performed in the Emergency Department showed alterations, probably due to the time taken. Almost half of the patients with suspected epilepsy or EE showed EEG abnormalities, which confirmed the diagnosis in these cases and encouraged the clinician to start drug treatment. No case with a high suspicion of epilepsy was dismissed due to the normality of the EEG recording in our series. No patient diagnosed with syncope or paroxysmal disorder had EEG abnormalities. Nearly a quarter of patients with atypical febrile seizures showed EEG abnormalities. We barely register cases of status epilepticus, probably due to the degree of complexity of our center.
{"title":"Valoración de la utilidad diagnóstica del electroencefalograma en urgencias pediátricas","authors":"M.J. Abenza Abildúa , T. Olmedo Menchen , A. Pérez Villena , S. Ruhland Paulete , F. José Navacerrada Barrero , J. de Ojeda Ruíz de Luna , C. Algarra Lucas , G. Cordero Martín , S. Martínez Ubierna , C. Jimeno Montero , I.J. Navarro López , E. Suárez Gisbert , Á. Gómez de la Riva , C. Pérez López , M.L. Herreros Fernández","doi":"10.1016/j.nrl.2024.01.002","DOIUrl":"10.1016/j.nrl.2024.01.002","url":null,"abstract":"<div><h3>Introduction</h3><div>We analyze the diagnostic utility of urgent EEG (electroencephalogram) performed in children under 16 years of age in our center.</div></div><div><h3>Material and methods</h3><div>Descriptive, retrospective, observational study of consecutive patients from 0 to 16 years of age, who underwent an urgent EEG for any reason, from January to December 2022.</div></div><div><h3>Results</h3><div>Of the 388 patients, 70 were children: 37 (52.85%) women, and 33 (47.14%) men. Average age: 6.27<!--> <!-->±<!--> <!-->4.809. Of the 70 patients, 6 (8.57%) had previous epilepsy. Reasons for consultation: 17 febrile seizures, 10 first focal seizures, 10 first TCG seizures, 6 paroxysmal episodes, 6 absences, 3 myoclonus of extremities, 3 syncope, 2 SE, 2 visual alterations, 2 low level of consciousness, 2 cyanosis, 2 suspected meningitis or encephalitis, 1 choking, 1 atypical headache, 1 chorea, 1 presyncope, 1 language delay. Of the 70 patients, 47 had a normal EEG (67.14%). Of the 47 patients with a normal EEG, 10 were diagnosed with epilepsy, and 3 of them began receiving antiepileptic treatment upon discharge. None of the patients with suspected syncope or paroxysmal disorder (17 patients, 24.28%) had EEG abnormalities. Of the 17 patients with atypical febrile seizures, 3 had EEG abnormalities.</div></div><div><h3>Conclusions</h3><div>A third of the EEG records performed in the Emergency Department showed alterations, probably due to the time taken. Almost half of the patients with suspected epilepsy or EE showed EEG abnormalities, which confirmed the diagnosis in these cases and encouraged the clinician to start drug treatment. No case with a high suspicion of epilepsy was dismissed due to the normality of the EEG recording in our series. No patient diagnosed with syncope or paroxysmal disorder had EEG abnormalities. Nearly a quarter of patients with atypical febrile seizures showed EEG abnormalities. We barely register cases of status epilepticus, probably due to the degree of complexity of our center.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"40 6","pages":"Pages 499-506"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01DOI: 10.1016/j.nrl.2023.05.006
J. Fernández-Ferro , C. Ordás-Bandera , J. Rejas-Gutiérrez , B. Ferro-Rey , S. Gómez-Lus , J.M. Láinez Andrés
Background
Migraine is a chronic highly disabling disease that manifests itself with recurrent episodes of headache. The objective of the study was to ascertain the cost-of-illness (COI) of migraine from the perspective of Society in Spain and to characterize its excess cost.
Methods
The nationwide year-2020 European-Health-Survey-in-Spain was used; 1,442 persons with migraine (77.3% women, 52.5 years) and 4,288 without migraine (76.7% women, 52.8 years) were abstracted by propensity score optimal matching. COI accounted healthcare resources utilization (HRU) and non-HRU (productivity loss). Costs were expressed as Per-Patient-Per-Year (PPPY) in Euros year 2020, and the excess cost was computed as the difference between persons with and without migraine.
Results
The PPPY cost was more than double in persons with migraine; €5,862 vs €2,981; excess cost of €2,881€ (95% CI: 2,410-3,353, p < 0.001), mainly attributable to labour productivity loss; €1,928 (1,532-2,325, p < 0.001) annually (66.9% of total excess cost). This excess labour cost is explained by the greater number of additional days of absenteeism, 22.35 (16.12; 28.57), and presenteeism, 31.39 (27.36; 35.41) in persons with migraine, p < 0.001 in both cases. National Health System (NHS)-funded healthcare PPPY cost represented the 29.0% of total excess cost; €836 (618-1,055), this because higher utilization of all-type medical visits.
Conclusion
In Spain, persons with migraine showed a meaningful excess cost compared with persons without migraine, particularly due to labour cost component, although the economic cost to the NHS was also considerable. Given the high prevalence of migraine, its overall attributable economic impact for Spain might range between 10,394 and 14,230 million Euros in year 2020.
{"title":"La carga económica de la migraña: un enfoque nacional del coste de la enfermedad desde la Encuesta Europea de Salud en España en el año 2020","authors":"J. Fernández-Ferro , C. Ordás-Bandera , J. Rejas-Gutiérrez , B. Ferro-Rey , S. Gómez-Lus , J.M. Láinez Andrés","doi":"10.1016/j.nrl.2023.05.006","DOIUrl":"10.1016/j.nrl.2023.05.006","url":null,"abstract":"<div><h3>Background</h3><div>Migraine is a chronic highly disabling disease that manifests itself with recurrent episodes of headache. The objective of the study was to ascertain the cost-of-illness (COI) of migraine from the perspective of Society in Spain and to characterize its excess cost.</div></div><div><h3>Methods</h3><div>The nationwide year-2020 European-Health-Survey-in-Spain was used; 1,442 persons with migraine (77.3% women, 52.5 years) and 4,288 without migraine (76.7% women, 52.8 years) were abstracted by propensity score optimal matching. COI accounted healthcare resources utilization (HRU) and non-HRU (productivity loss). Costs were expressed as Per-Patient-Per-Year (PPPY) in Euros year 2020, and the excess cost was computed as the difference between persons with and without migraine.</div></div><div><h3>Results</h3><div>The PPPY cost was more than double in persons with migraine; €5,862 vs €2,981; excess cost of €2,881€ (95% CI: 2,410-3,353, p<!--> <!--><<!--> <!-->0.001), mainly attributable to labour productivity loss; €1,928 (1,532-2,325, p<!--> <!--><<!--> <!-->0.001) annually (66.9% of total excess cost). This excess labour cost is explained by the greater number of additional days of absenteeism, 22.35 (16.12; 28.57), and presenteeism, 31.39 (27.36; 35.41) in persons with migraine, p<!--> <!--><<!--> <!-->0.001 in both cases. National Health System (NHS)-funded healthcare PPPY cost represented the 29.0% of total excess cost; €836 (618-1,055), this because higher utilization of all-type medical visits.</div></div><div><h3>Conclusion</h3><div>In Spain, persons with migraine showed a meaningful excess cost compared with persons without migraine, particularly due to labour cost component, although the economic cost to the NHS was also considerable. Given the high prevalence of migraine, its overall attributable economic impact for Spain might range between 10,394 and 14,230 million Euros in year 2020.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"40 6","pages":"Pages 533-547"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01DOI: 10.1016/j.nrl.2023.11.008
V.M.M. Anlacan , F.G.C. Gabriel , R.D.G. Jamora , E.Q. Villanueva III , M.C.C. Sy , M.H.L. Lee Yu , A.I. Espiritu
Introduction
This study aimed to determine whether encephalopathy is associated with such COVID-19 outcomes as disease severity, mortality, respiratory failure, intensive care unit (ICU) admission, duration of ventilator dependence, and length of ICU and hospital stay.
Methods
We performed a subgroup analysis comparing outcomes in patients with and without encephalopathy, based on data from a nationwide retrospective cohort study among adult patients hospitalized with COVID-19 at 37 hospital sites in the Philippines. The patient outcomes included for analysis were disease severity, mortality, respiratory failure, ICU admission, duration of ventilator dependence, and length of ICU and hospital stay.
Results
Of a total of 10 881 COVID-19 admissions, 622 patients had encephalopathy. The adjusted hazard ratios (aHR) for mortality among mild and severe cases were 9.26 and 1.63 times greater (P < .001), respectively, in the encephalopathy group compared to the no-encephalopathy group. Encephalopathy was associated with increased risk of severe COVID-19 (adjusted odds ratio [aOR]: 7.95; P < .001), respiratory failure (aHR: 5.40; P < .001), longer hospital stays (aOR: 1.36; P < .001), and admission to the ICU (aOR: 4.26; P < .001). We found no sufficient evidence that encephalopathy was associated with length of ICU stay (aOR: 1.11; P = .522) or duration of ventilator dependence (aOR: 0.88; P = .428).
Conclusions
Encephalopathy was associated with COVID-19 severity, mortality, respiratory failure, ICU admission, and longer hospital stays.
{"title":"Association between encephalopathy and clinical outcomes of COVID-19: Findings from the Philippine CORONA Study","authors":"V.M.M. Anlacan , F.G.C. Gabriel , R.D.G. Jamora , E.Q. Villanueva III , M.C.C. Sy , M.H.L. Lee Yu , A.I. Espiritu","doi":"10.1016/j.nrl.2023.11.008","DOIUrl":"10.1016/j.nrl.2023.11.008","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to determine whether encephalopathy is associated with such COVID-19 outcomes as disease severity, mortality, respiratory failure, intensive care unit (ICU) admission, duration of ventilator dependence, and length of ICU and hospital stay.</div></div><div><h3>Methods</h3><div>We performed a subgroup analysis comparing outcomes in patients with and without encephalopathy, based on data from a nationwide retrospective cohort study among adult patients hospitalized with COVID-19 at 37 hospital sites in the Philippines. The patient outcomes included for analysis were disease severity, mortality, respiratory failure, ICU admission, duration of ventilator dependence, and length of ICU and hospital stay.</div></div><div><h3>Results</h3><div>Of a total of 10<!--> <!-->881 COVID-19 admissions, 622 patients had encephalopathy. The adjusted hazard ratios (aHR) for mortality among mild and severe cases were 9.26 and 1.63 times greater (<em>P</em> <!--><<!--> <!-->.001), respectively, in the encephalopathy group compared to the no-encephalopathy group. Encephalopathy was associated with increased risk of severe COVID-19 (adjusted odds ratio [aOR]: 7.95; <em>P</em> <!--><<!--> <!-->.001), respiratory failure (aHR: 5.40; <em>P</em> <!--><<!--> <!-->.001), longer hospital stays (aOR: 1.36; <em>P</em> <!--><<!--> <!-->.001), and admission to the ICU (aOR: 4.26; <em>P</em> <!--><<!--> <!-->.001). We found no sufficient evidence that encephalopathy was associated with length of ICU stay (aOR: 1.11; <em>P</em> <!-->=<!--> <!-->.522) or duration of ventilator dependence (aOR: 0.88; <em>P</em> <!-->=<!--> <!-->.428).</div></div><div><h3>Conclusions</h3><div>Encephalopathy was associated with COVID-19 severity, mortality, respiratory failure, ICU admission, and longer hospital stays.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"40 6","pages":"Pages 567-576"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141853964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01DOI: 10.1016/j.nrl.2023.02.006
M.E. Ramos-Araque , M. Castellanos , L. Naya Rios , E. López-Cancio , J. Molina Gil , J. Marta-Moreno , H. Tejada-Meza , M. Temprano Fernández , C. Antón González , D. Vidal de Francisco , J. Tejada-García , J.L. Maciñeiras Montero , P. Vicente Alba , J.M. García-Sánchez , B. Aguilera Irazabal , M. Martínez-Zabaleta , I.N. Diez , A. Pinedo Brochado , I. Azkune Calle , M.M. Freijo , J.F. Arenillas
Background
Our primary aim was to investigate the incidence of non-cardioembolic minor acute ischemic stroke (AIS) and high-risk transient ischemic attack (TIA) and to identify predictors of stroke recurrence/death and severe bleeding. We also evaluated the rates of TIA, major vascular events, therapeutic management and predictors of poor functional outcome at 3 months in these patients.
Methods
We retrospectively reviewed data from all stroke patients evaluated at the emergency department of 19 hospitals belonging to the NORDICTUS stroke network between July and December 2019. Consecutive patients with non-cardioembolic minor AIS (NIHSS ≤5) and high-risk TIA (ABCD2 ≥6 or ipsilateral stenosis ≥50%) were included. We recorded clinical, neuroimaging and therapeutic variables. Follow-up was performed at 30 and 90 days. Functional prognosis was assessed with the modified Rankin scale score (mRS).
Results
Of 8275 patients, 1679 (20%) fulfilled IMMINENT criteria (1524 AIS/155 TIA), resulting in a global incidence of 48/100,000 inhabitants per-year. Recurrent stroke/death occurred in 73 (4.3%) patients. Extracranial ipsilateral stenosis (>50%): HR 1.999 (95% CI: 1.115–3.585, p = 0.020) and lack of hyperacute cerebral arterial assessment: HR 1.631 (95% CI: 1.009–2.636, p = 0.046) were associated with recurrent stroke/death at 90 days. Intracranial stenosis was associated with poor prognosis (p = 0.044). Reperfusion therapy was given to 147 (9%) and urgent double antiplatelet therapy (DAPT) to 320 (21%) patients.
Conclusion
Twenty percent of our stroke patients presented as non-cardioembolic high-risk TIA or minor AIS. Extracranial ipsilateral stenosis and lack of hyperacute cerebral arterial assessment were predictors of stroke recurrence/death; intracranial stenosis was associated with poor outcome. Despite current recommendations there was a low penetrance of DAPT.
本研究的主要目的是调查非心源性轻微急性缺血性卒中（AIS）和高风险短暂性脑缺血发作（TIA）的发生率，并确定卒中复发/死亡和严重出血的预测因素。我们还评估了这些患者在3个月时TIA的发生率、主要血管事件、治疗管理和功能不良预后的预测因素。方法回顾性分析2019年7月至12月NORDICTUS卒中网络所属19家医院急诊科评估的所有卒中患者的数据。纳入连续的非心源性轻微AIS （NIHSS≤5）和高危TIA （ABCD2≥6或同侧狭窄≥50%）患者。我们记录了临床、神经影像学和治疗变量。随访时间分别为30天和90天。采用改良Rankin评分（mRS）评价功能预后。结果在8275例患者中，1679例（20%）达到了迫在眉睫的标准（1524例AIS/155例TIA），导致每年全球发病率为48/100,000居民。73例（4.3%）患者发生卒中复发/死亡。颅外同侧狭窄（>50%）： HR 1.999 （95% CI: 1.115-3.585, p = 0.020）和缺乏超急性脑动脉评估：HR 1.631 （95% CI: 1.009-2.636, p = 0.046）与90天卒中复发/死亡相关。颅内狭窄与预后不良相关（p = 0.044）。147例（9%）患者接受再灌注治疗，320例（21%）患者接受紧急双重抗血小板治疗。结论20%的脑卒中患者表现为非心源性高危TIA或轻微AIS。颅内外同侧狭窄和缺乏超急性脑动脉评估是卒中复发/死亡的预测因素；颅内狭窄与预后不良相关。尽管目前的建议，但DAPT的外显率很低。
{"title":"Incidence and outcoMes of MInor stroke and high-risk traNsient ischEmic attack in NordicTus. IMMINENT study","authors":"M.E. Ramos-Araque , M. Castellanos , L. Naya Rios , E. López-Cancio , J. Molina Gil , J. Marta-Moreno , H. Tejada-Meza , M. Temprano Fernández , C. Antón González , D. Vidal de Francisco , J. Tejada-García , J.L. Maciñeiras Montero , P. Vicente Alba , J.M. García-Sánchez , B. Aguilera Irazabal , M. Martínez-Zabaleta , I.N. Diez , A. Pinedo Brochado , I. Azkune Calle , M.M. Freijo , J.F. Arenillas","doi":"10.1016/j.nrl.2023.02.006","DOIUrl":"10.1016/j.nrl.2023.02.006","url":null,"abstract":"<div><h3>Background</h3><div>Our primary aim was to investigate the incidence of non-cardioembolic minor acute ischemic stroke (AIS) and high-risk transient ischemic attack (TIA) and to identify predictors of stroke recurrence/death and severe bleeding. We also evaluated the rates of TIA, major vascular events, therapeutic management and predictors of poor functional outcome at 3 months in these patients.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed data from all stroke patients evaluated at the emergency department of 19 hospitals belonging to the NORDICTUS stroke network between July and December 2019. Consecutive patients with non-cardioembolic minor AIS (NIHSS ≤5) and high-risk TIA (ABCD2 ≥6 or ipsilateral stenosis ≥50%) were included. We recorded clinical, neuroimaging and therapeutic variables. Follow-up was performed at 30 and 90 days. Functional prognosis was assessed with the modified Rankin scale score (mRS).</div></div><div><h3>Results</h3><div>Of 8275 patients, 1679 (20%) fulfilled IMMINENT criteria (1524 AIS/155 TIA), resulting in a global incidence of 48/100,000 inhabitants per-year. Recurrent stroke/death occurred in 73 (4.3%) patients. Extracranial ipsilateral stenosis (>50%): HR 1.999 (95% CI: 1.115–3.585, <em>p</em> <!-->=<!--> <!-->0.020) and lack of hyperacute cerebral arterial assessment: HR 1.631 (95% CI: 1.009–2.636, <em>p</em> <!-->=<!--> <!-->0.046) were associated with recurrent stroke/death at 90 days. Intracranial stenosis was associated with poor prognosis (<em>p</em> <!-->=<!--> <!-->0.044). Reperfusion therapy was given to 147 (9%) and urgent double antiplatelet therapy (DAPT) to 320 (21%) patients.</div></div><div><h3>Conclusion</h3><div>Twenty percent of our stroke patients presented as non-cardioembolic high-risk TIA or minor AIS. Extracranial ipsilateral stenosis and lack of hyperacute cerebral arterial assessment were predictors of stroke recurrence/death; intracranial stenosis was associated with poor outcome. Despite current recommendations there was a low penetrance of DAPT.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"40 6","pages":"Pages 489-498"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141708150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01DOI: 10.1016/j.nrl.2023.06.012
J. Rodríguez-Pardo , J. Carneado-Ruiz , M. Martínez-Martínez , J.M. Moltó-Jordá , P. Irimia , J. Serena-Leal , Ó. Ayo-Martín , P. Martínez-Sánchez , J. Pagola , J. Fernández-Domínguez , en nombre de la Sociedad Española de Neurosonología (SONES)
Introduction
Neurosonology is the field of study of the ultrasound techniques applied to neurological diseases. The Spanish Society of Neurosonology –SONES– was funded in 1997 to promote training and education in these techniques, especially focused on the study of cerebrovascular diseases. After 25 years, the increased use of other advanced neurovascular imaging techniques and the emergence of novel applications of ultrasound in other fields of neurology have modified the classic role of neurosonology. From the SONES we aimed to evaluate the current status of neurosonology in Spain.
Methods
Cross-sectional survey of neurologists and neurology residents working in Spain regarding training, education, and local daily practice, including a strengths, weaknesses, opportunities and threats –SWOT– analysis.
Results
One-hundred seventy-eight neurologists and 34 neurology residents participated in the survey. A wide experience in vascular neurosonology (90% of respondents’ Neurology departments) and limited experience in brain parenchyma sonography (34%), cardiac echoscopy (25%), ultrasound-guided techniques (24%), and nerve ultrasound (14%) was reported. Fifty-three percent of the participants reported to have a full-time neurosonology lab in their department and only 14% reported to have neurologists dedicated exclusively to neurosonology. Most participants (53%) reported to lack continuous learning opportunities, and 97% to need training in one or more neurosonology techniques. Main SWOT were requiring expertise, shortage of time, versatility and comprehensive management of the neurological patient, respectively.
Conclusions
Vascular neurosonology is widely instituted in Spain, but the implementation of full-time neurosonology labs and training in non-vascular neurosonology techniques is yet scarce.
{"title":"Estado de la neurosonología en España. Un estudio de la Sociedad Española de Neurosonología (SONES)","authors":"J. Rodríguez-Pardo , J. Carneado-Ruiz , M. Martínez-Martínez , J.M. Moltó-Jordá , P. Irimia , J. Serena-Leal , Ó. Ayo-Martín , P. Martínez-Sánchez , J. Pagola , J. Fernández-Domínguez , en nombre de la Sociedad Española de Neurosonología (SONES)","doi":"10.1016/j.nrl.2023.06.012","DOIUrl":"10.1016/j.nrl.2023.06.012","url":null,"abstract":"<div><h3>Introduction</h3><div>Neurosonology is the field of study of the ultrasound techniques applied to neurological diseases. The Spanish Society of Neurosonology –SONES– was funded in 1997 to promote training and education in these techniques, especially focused on the study of cerebrovascular diseases. After 25 years, the increased use of other advanced neurovascular imaging techniques and the emergence of novel applications of ultrasound in other fields of neurology have modified the classic role of neurosonology. From the SONES we aimed to evaluate the current status of neurosonology in Spain.</div></div><div><h3>Methods</h3><div>Cross-sectional survey of neurologists and neurology residents working in Spain regarding training, education, and local daily practice, including a strengths, weaknesses, opportunities and threats –SWOT– analysis.</div></div><div><h3>Results</h3><div>One-hundred seventy-eight neurologists and 34 neurology residents participated in the survey. A wide experience in vascular neurosonology (90% of respondents’ Neurology departments) and limited experience in brain parenchyma sonography (34%), cardiac echoscopy (25%), ultrasound-guided techniques (24%), and nerve ultrasound (14%) was reported. Fifty-three percent of the participants reported to have a full-time neurosonology lab in their department and only 14% reported to have neurologists dedicated exclusively to neurosonology. Most participants (53%) reported to lack continuous learning opportunities, and 97% to need training in one or more neurosonology techniques. Main SWOT were requiring expertise, shortage of time, versatility and comprehensive management of the neurological patient, respectively.</div></div><div><h3>Conclusions</h3><div>Vascular neurosonology is widely instituted in Spain, but the implementation of full-time neurosonology labs and training in non-vascular neurosonology techniques is yet scarce.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"40 6","pages":"Pages 548-557"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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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