Revue neurologique最新文献

{"title":"The importance of studying the history of neurosciences","authors":"G. Fénelon","doi":"10.1016/j.neurol.2025.12.001","DOIUrl":"10.1016/j.neurol.2025.12.001","url":null,"abstract":"","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"182 1","pages":"Pages 106-108"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145775569","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}

{"title":"Intranasal insulin for mild cognitive impairment and Alzheimer's disease: A systematic review and meta-analysis of randomized controlled trials","authors":"A.M.P. Silva ,&nbsp;O.R. Gonçalves ,&nbsp;G.C.N. Tudella ,&nbsp;M.V.S. Nascimento ,&nbsp;M.A.O.M. Pereira ,&nbsp;L.A.O Nantes ,&nbsp;J.V.A. Fernandes ,&nbsp;D.G. Quiroga ,&nbsp;D.V.S. Lima Jr ,&nbsp;E.S. Franco ,&nbsp;M.B.S. Maia","doi":"10.1016/j.neurol.2025.11.005","DOIUrl":"10.1016/j.neurol.2025.11.005","url":null,"abstract":"<div><h3>Background</h3><div>Central insulin resistance has been implicated in the pathophysiology of Alzheimer's disease (AD), supporting the hypothesis that, in some individuals, AD may represent “type 3 diabetes.” Intranasal insulin has been proposed as a non-invasive approach to enhance brain insulin signaling while minimizing peripheral metabolic effects, but clinical evidence remains inconsistent.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing intranasal insulin with placebo in patients with mild cognitive impairment (MCI) or mild-to-moderate AD. Primary outcomes included changes in cognitive performance (ADAS-Cog13, CDR-SB, DSRS, delayed recall) and functional ability (ADCS-ADL). Secondary outcomes included cerebrospinal fluid (CSF) biomarkers (Aβ42, total tau, phosphorylated tau) and safety endpoints. Literature searches were performed in PubMed, Embase, and Cochrane Central up to April 2025. Random-effects models were used to pool effect estimates, and risk of bias was assessed using the Cochrane RoB 2 tool.</div></div><div><h3>Results</h3><div>Five RCTs enrolling 540 participants met the inclusion criteria. Pooled analyses showed no significant differences between intranasal insulin and placebo for ADAS-Cog13 (mean difference: −1.09 [95% CI: −4.89; 2.71]), ADCS-ADL (mean difference 0.06 [−0.33; 0.45]), CDR-SB, DSRS, or delayed recall. No significant effects were observed on CSF Aβ42, total tau, or p-tau181. Gastrointestinal adverse events were more frequent with insulin (risk ratio: 1.57; [95% CI: 1.15; 2.14]), whereas cardiovascular events were less frequent (risk ratio: 0.30 [0.12; 0.79]). No differences were found for other safety outcomes, and discontinuation rates were comparable between groups.</div></div><div><h3>Conclusion</h3><div>Intranasal insulin was generally well tolerated but did not produce meaningful improvements in cognitive, functional, or biomarker outcomes in patients with MCI or mild-to-moderate AD. Current evidence does not support its routine clinical use, and further trials with standardized dosing, longer follow-up, and biomarker-stratified designs are warranted to clarify its therapeutic potential.</div></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"182 1","pages":"Pages 36-48"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145820592","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}

{"title":"Small vessel disease: Trigger or bystander of late-onset epilepsy of unknown origin?","authors":"E. Hologne ,&nbsp;Y. Chen ,&nbsp;S. Moulin ,&nbsp;L. Tyvaert","doi":"10.1016/j.neurol.2025.10.007","DOIUrl":"10.1016/j.neurol.2025.10.007","url":null,"abstract":"<div><div>Late-onset epilepsy of unknown origin (LOEU) is a prevalent and disabling condition. Emerging evidence suggests a potential link between LOEU and new-onset dementia. Cerebral small vessel disease (cSVD) is a common pathology and a major risk factor for both stroke and dementia. cSVD has been hypothesized to contribute to the development of LOEU and cognitive decline through blood-brain barrier dysfunction. This review summarizes current data exploring the association between LOEU and cSVD, highlighting conflicting results, probably due to major methodological limitations. Furthermore, in individuals over 60 years of age conditions such as obstructive sleep apnea (OSA), amyloidopathy, and tauopathy are frequently observed and independently associated with both LOEU and cSVD. To date, no robust evidence has established cSVD as a causal factor of LOEU. The complex interplay of these conditions necessitates further investigation to quantify the contribution of each pathology to the development of LOEU. Future studies using rigorous methodologies are required to determine whether cSVD acts as a primary trigger or merely represents a bystander in LOEU.</div></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"182 1","pages":"Pages 26-35"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145820513","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}

{"title":"Addressing sexual difficulties in Parkinson's disease","authors":"E. Oprea","doi":"10.1016/j.neurol.2025.10.004","DOIUrl":"10.1016/j.neurol.2025.10.004","url":null,"abstract":"<div><div>Sexual difficulties are common but under-recognized in Parkinson's disease (PD), significantly affecting quality of life. They include both sexual dysfunction (SD) — a non-motor symptom — and hypersexuality (HS) — an impulse control disorder (ICD). SD often presents as reduced libido, arousal issues, or orgasmic problems, while HS involves compulsive sexual thoughts or behaviors, often linked to dopamine agonists. These opposing symptoms may coexist, adding to diagnostic complexity. Sexual health in PD is influenced by neurological, vascular, endocrine, psychological, and medication-related factors. Despite its impact, sexual difficulties are rarely discussed in clinical settings due to limited time and patient reluctance. A proactive, nonjudgmental approach is essential. This review aims to equip neurologists with practical, time-efficient strategies to identify and manage sexual difficulties in both men and women with PD.</div></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"182 1","pages":"Pages 1-9"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145426794","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}

{"title":"Gerstmann–Sträussler–Scheinker syndrome neuropathology in a Creutzfeldt–Jakob disease-like phenotype patient caused by a novel 6-OPRI sequence in the PRNP gene","authors":"M. Sýkora ,&nbsp;S. Baranová ,&nbsp;E. Parobková ,&nbsp;T. Moško ,&nbsp;J. Keller ,&nbsp;K. Holada ,&nbsp;R. Rusina ,&nbsp;R. Matěj","doi":"10.1016/j.neurol.2025.11.007","DOIUrl":"10.1016/j.neurol.2025.11.007","url":null,"abstract":"<div><div>Gerstmann–Sträussler–Scheinker syndrome is an extremely rare hereditary human prion disease caused by distinct mutations in the prion protein<em>-encoding g</em>ene and is frequently associated with a positive family history. The disease typically presents with progressive cerebellar symptoms such as gaze apraxia with limb ataxia and axial ataxia; thus, the diagnostic process is often challenging due to nonspecific clinical presentation. We present a case of a 73-year-old patient with no family history of dementia and cerebellar symptomatology during the course of rapidly progressing dementia. Owing to the clinical suspicion of prion disease, <em>antemortem</em> analysis of cerebrospinal fluid using a real-time quaking-induced conversion (RT-QuIC) assay was performed, with positive results<em>. Postmortem</em> histopathological examination confirmed a familiar form of human prion disease with concomitant asymptomatic tauopathy. An additional finding was a novel 6 octapeptide repeat insertion mutation in the prion gene. Familiar cases with an increasing number of repeated insertions seem to be associated with a longer overall disease course, milder clinical deterioration and often false-negative RT-QuIC results. The performance of RT-QuIC in inherited prion diseases may vary. Our case, involving a 6 octapeptide repeat insertion mutation, is particularly noteworthy due to the rapidly progressive clinical course and positive RT-QuIC results in both <em>antemortem</em> and <em>postmortem</em> tissue analyses.</div></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"182 1","pages":"Pages 97-105"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145846223","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}

{"title":"Trends in the real-world management of cluster headache patients treated by subcutaneous sumatriptan and/or oxygen in France – An analysis of the French National Social Security System Open Data over eleven years (2014–2024)","authors":"E.K. Van Obberghen ,&nbsp;R. Fabre ,&nbsp;L. Bailly ,&nbsp;M. Lanteri-Minet","doi":"10.1016/j.neurol.2025.11.004","DOIUrl":"10.1016/j.neurol.2025.11.004","url":null,"abstract":"<div><div>The burden of cluster headache (CH) requires better knowledge of management to improve it.</div></div><div><h3>Objectives</h3><div>To describe changes in the real-world management of CH treated with subcutaneous sumatriptan and/or oxygen in France over the period 2014–2024.</div></div><div><h3>Methods</h3><div>This is an analysis of two open data databases from the French Social Health Insurance (‘Open Medic’ and ‘Open LPP’), providing an annual estimate from 2014 to 2024 of the delivery of subcutaneous sumatriptan and/or oxygen, the number of beneficiaries of these treatments and their socio-demographic profile.</div></div><div><h3>Results</h3><div>Annual deliveries of subcutaneous sumatriptan increased from 286,999 boxes in 2014 to 454,275 boxes in 2024 (58.2% increase). Beneficiaries of subcutaneous sumatriptan increased from 13,638 individuals in 2014 to 19,109 individuals in 2024 (40.1% increase). Annual deliveries of package for the weekly use of oxygen therapy equipment increased from 224,143 in 2014 to 790,768 in 2024 (2.5 times more). Beneficiaries of oxygen for CH increased from 7493 individuals in 2014 to 22,346 individuals in 2024 (2 times more). Over the period 2014–2024, the male to female ratio decreased from 2.3/1 to 1.5/1 and from 1.5/1 to 0.8/1 for individuals receiving subcutaneous sumatriptan and individuals receiving oxygen respectively.</div></div><div><h3>Conclusions</h3><div>The delivery of subcutaneous sumatriptan and oxygen increased from 2014 to 2024, reflecting an improvement in the management of cluster headache in France. Nevertheless, given the one year-prevalence of this disease and the number of people expected to suffer from it, the number of people benefiting from these two treatments in 2024 indicates that there are still unmet needs. This study confirms the increase in the number of women treated for cluster headache observed over the last twenty years.</div></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"182 1","pages":"Pages 75-81"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145775593","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}

{"title":"Impact of HIV on disability progression in multiple sclerosis: An observational retrospective matched cohort study","authors":"A. Moulignier ,&nbsp;J. Guillaume ,&nbsp;V. Pourcher ,&nbsp;E. Maillart ,&nbsp;E. Januel ,&nbsp;C. Papeix","doi":"10.1016/j.neurol.2025.11.001","DOIUrl":"10.1016/j.neurol.2025.11.001","url":null,"abstract":"<div><h3>Background</h3><div>The coexistence of HIV infection and multiple sclerosis (MS) is uncommon, and poorly characterized. Whether HIV-related immune modulation influences MS, progression remains uncertain. Despite theoretical immunological interactions, real-world data are scarce.</div></div><div><h3>Objectives</h3><div>To compare long-term disability outcomes in persons living with HIV (PLWHIVs) with MS (MS-PLWHIVs) versus matched HIV-negative MS controls (MS-controls).</div></div><div><h3>Methods</h3><div>This observational retrospective matched cohort study used databases from two French tertiary MS centers (1991–2021). Each MS-PLWHIV was matched with up to five MS-controls for MS subtype (relapsing-remitting or primary-progressive), sex, age at first MS attack (±5 years), and first-to-second attack interval (±5 years). The primary outcome was time to reach sustained EDSS-6 (cane use for<!--> <!-->≥<!--> <!-->12 months). Time-to-event analyses used Kaplan–Meier estimates and Cox regression adjusted for matching variables.</div></div><div><h3>Results</h3><div>We identified 16 MS-PLWHIVs and 75 matched MS-controls, with comparable baseline MS characteristics and a median follow-up<!--> <!-->&gt;<!--> <!-->20 years. MS-PLWHIVs received significantly fewer MS disease-modifying therapies (MS-DMTs) (median: 0 [0–1] vs. 2 [1–3.5], <em>P</em> <!-->&lt;<!--> <!-->0.001), and only 19% were still treated at study end versus 75% of controls. Notwithstanding this treatment gap, MS-PLWHIVs reached EDSS-6 a median of 8 years later than controls (22.8 vs. 14.5 years, <em>P</em> <!-->=<!--> <!-->0.05). However, the risk of reaching EDSS-6 did not differ significantly (adjusted HR: 1.60 [95% CI: 0.6–4.2], <em>P</em> <!-->=<!--> <!-->0.6). One-third of patients in each group converted to secondary progressive MS.</div></div><div><h3>Conclusion</h3><div>Despite fewer MS-DMTs, MS-PLWHIVs did not show worse disability progression and even appeared to progress more slowly. While HIV-related immune modulation could contribute, this remains speculative. These findings, though limited by small sample size and retrospective design, provide rare long-term data on this understudied comorbidity.</div></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"182 1","pages":"Pages 65-74"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769066","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}

{"title":"Fertility ratio of functional/dissociative seizures compared to other neuropsychiatric disorders","authors":"A. Nishi","doi":"10.1016/j.neurol.2025.11.002","DOIUrl":"10.1016/j.neurol.2025.11.002","url":null,"abstract":"","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"182 1","pages":"Pages 109-110"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769105","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}

{"title":"Assessment of social cognition impairments in patients with amyotrophic lateral sclerosis: How can it be improved? A systematic review","authors":"B. Vovard ,&nbsp;J. Faure-de Baets ,&nbsp;P. Codron ,&nbsp;P. Allain ,&nbsp;J. Cassereau","doi":"10.1016/j.neurol.2025.11.003","DOIUrl":"10.1016/j.neurol.2025.11.003","url":null,"abstract":"<div><h3>Objectives</h3><div>The aim of this review was to evaluate the current evidence on which part of social cognition is impaired in amyotrophic lateral sclerosis (ALS) patients among emotion recognition, affective empathy and Theory of Mind (ToM) and to suggest improvements in social cognition testing protocols.</div></div><div><h3>Methods</h3><div>A systematic review was conducted according to PRISMA guidelines. We included controlled cross-sectional or longitudinal studies published in English before September 1, 2024, that assessed social cognition in non-demented ALS patients. Searches were performed in Medline, Embase, Web of Science, and PsycINFO using specific MeSH terms. Studies using social cognition tests as a primary or secondary outcome were included.</div></div><div><h3>Results</h3><div>Thirty-four studies were analyzed. Impairments in emotion recognition — especially for negative emotions — were frequently reported, even in cognitively preserved ALS patients. Results for cognitive ToM were mixed and may be confounded by executive dysfunction or test limitations. In contrast, affective ToM deficits were more consistently identified. However, no included study directly assessed affective empathy. Tests used in the reviewed studies were often overly specific and lacked ecological validity, which may explain inconsistent results across domains and weak correlations with imaging or executive function.</div></div><div><h3>Conclusion</h3><div>Social cognition is increasingly recognized as a key non-motor domain affected in ALS. However, current assessment tools may lack the sensitivity and ecological validity needed to capture real-life deficits. The implementation of dynamic, multimodal assessments such as real-life social interaction tests or tests like the Movie Assessment for Social Cognition (MASC) could improve detection and guide clinical interventions but remain to be validated for ALS patients.</div></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"182 1","pages":"Pages 10-25"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769061","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}

{"title":"Refining the definition of severe migraine: Evidence from a prospective observational study","authors":"J. Henri ,&nbsp;S. Redon ,&nbsp;A. Donnet","doi":"10.1016/j.neurol.2025.12.002","DOIUrl":"10.1016/j.neurol.2025.12.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Migraine severity is often assessed by attack frequency, but this single dimension fails to reflect the full burden of disease. We aimed to validate a pragmatic multidimensional definition of severe migraine in a tertiary care setting.</div></div><div><h3>Methods</h3><div>We conducted an observational study including 96 consecutive adult migraine patients diagnosed according to ICHD-3 criteria at a tertiary pain center (Marseille, January–April 2024). Data collected included migraine days/month, HIT-6, MIGSEV, and HAD scores. Patients were categorized by frequency (&lt;<!--> <!-->8 vs. ≥<!--> <!-->8<!--> <!-->days/month), HIT-6 (&lt;<!--> <!-->60, 60–64,<!--> <!-->≥<!--> <!-->65), and MIGSEV grades (1–3).</div></div><div><h3>Results</h3><div>Median monthly frequency was 8<!--> <!-->days. Patients with<!--> <!-->≥<!--> <!-->8<!--> <!-->days/month had significantly higher HIT-6 scores (<em>P</em> <!-->=<!--> <!-->0.044). Among patients with<!--> <!-->&lt;<!--> <!-->8<!--> <!-->days/month, both HIT-6<!--> <!-->≥<!--> <!-->65 and MIGSEV grade 3 identified individuals with greater functional disability and higher depressive symptoms, comparable to those in the high-frequency group. No demographic or comorbidity variables significantly distinguished severe cases.</div></div><div><h3>Discussion</h3><div>A multidimensional definition of severe migraine is supported: (A)<!--> <!-->≥<!--> <!-->8<!--> <!-->days/month, or (B)<!--> <!-->&lt;<!--> <!-->8<!--> <!-->days/month with HIT-6<!--> <!-->≥<!--> <!-->65 and/or MIGSEV grade 3. This definition integrates frequency, functional impact, and perceived severity, providing a simple and reproducible framework to identify high-burden patients. It may improve preventive treatment decisions, referral to specialized care, and harmonization of research inclusion criteria.</div></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"182 1","pages":"Pages 92-96"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145820586","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}