Revue neurologique最新文献

英文中文

Impact of HIV on disability progression in multiple sclerosis: An observational retrospective matched cohort study HIV对多发性硬化症致残进展的影响：一项观察性回顾性匹配队列研究。

IF 2.3 4区医学 Q2 CLINICAL NEUROLOGY

Revue neurologique

Pub Date : 2026-01-01 DOI: 10.1016/j.neurol.2025.11.001

A. Moulignier , J. Guillaume , V. Pourcher , E. Maillart , E. Januel , C. Papeix

Background

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.

Objectives

To compare long-term disability outcomes in persons living with HIV (PLWHIVs) with MS (MS-PLWHIVs) versus matched HIV-negative MS controls (MS-controls).

Methods

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.

Results

We identified 16 MS-PLWHIVs and 75 matched MS-controls, with comparable baseline MS characteristics and a median follow-up > 20 years. MS-PLWHIVs received significantly fewer MS disease-modifying therapies (MS-DMTs) (median: 0 [0–1] vs. 2 [1–3.5], P < 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, P = 0.05). However, the risk of reaching EDSS-6 did not differ significantly (adjusted HR: 1.60 [95% CI: 0.6–4.2], P = 0.6). One-third of patients in each group converted to secondary progressive MS.

Conclusion

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.

背景：HIV感染和多发性硬化症（MS）共存是不常见的，并且缺乏特征。hiv相关的免疫调节是否影响MS的进展仍不确定。尽管存在理论上的免疫相互作用，但实际数据很少。目的：比较艾滋病病毒感染者（PLWHIVs）合并多发性硬化症（MS-PLWHIVs）与匹配的HIV阴性多发性硬化症对照组（MS-对照）的长期残疾结局。方法：这项观察性回顾性匹配队列研究使用了两个法国三级MS中心（1991-2021）的数据库。每个MS- plwhiv与MS亚型（复发缓解型或原发进行性）、性别、首次MS发作年龄（±5年）和首次到第二次发作间隔（±5年）匹配多达5个MS对照。主要终点是达到持续EDSS-6的时间（手杖使用≥12个月）。时间-事件分析使用Kaplan-Meier估计和Cox回归调整匹配变量。结果：我们确定了16例MS- plwhivs和75例匹配的MS对照，具有相似的MS基线特征，中位随访时间为20年。MS- plwhivs接受的MS疾病改善治疗（MS- dmts）明显较少（中位数：0[0-1]对2[1-3.5]）。结论：尽管MS- dmts较少，MS- plwhivs并没有表现出更严重的残疾进展，甚至似乎进展更慢。虽然艾滋病毒相关的免疫调节可能有所贡献，但这仍然是推测性的。这些发现，虽然受到小样本量和回顾性设计的限制，但提供了这种未充分研究的合并症的罕见长期数据。

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引用次数: 0

Fertility ratio of functional/dissociative seizures compared to other neuropsychiatric disorders 功能性/解离性癫痫发作与其他神经精神疾病的生育比率。

IF 2.3 4区医学 Q2 CLINICAL NEUROLOGY

Revue neurologique

Pub Date : 2026-01-01 DOI: 10.1016/j.neurol.2025.11.002

A. Nishi

引用次数: 0

IF 2.3 4区医学 Q2 CLINICAL NEUROLOGY

Revue neurologique

Pub Date : 2026-01-01

引用次数: 0

Assessment of social cognition impairments in patients with amyotrophic lateral sclerosis: How can it be improved? A systematic review 肌萎缩侧索硬化症患者社会认知障碍的评估：如何改善？系统回顾。

IF 2.3 4区医学 Q2 CLINICAL NEUROLOGY

Revue neurologique

Pub Date : 2026-01-01 DOI: 10.1016/j.neurol.2025.11.003

B. Vovard , J. Faure-de Baets , P. Codron , P. Allain , J. Cassereau

Objectives

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.