Revue neurologique最新文献

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IF 2.3 4区医学 Q2 CLINICAL NEUROLOGY

Revue neurologique

Pub Date : 2026-01-01

引用次数: 0

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.

Methods

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.

Results

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.

Conclusion

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.

目的：本综述旨在评估肌萎缩侧索硬化症（ALS）患者在情绪识别、情感共情和心理理论（ToM）中哪部分社会认知受损的现有证据，并提出社会认知测试方案的改进建议。方法：根据PRISMA指南进行系统评价。我们纳入了2024年9月1日之前以英文发表的对照横断面或纵向研究，这些研究评估了非痴呆性ALS患者的社会认知。在Medline， Embase， Web of Science和PsycINFO中使用特定的MeSH术语进行搜索。使用社会认知测试作为主要或次要结果的研究被纳入。结果：共分析34项研究。情绪识别障碍——尤其是负面情绪——经常被报道，甚至在认知能力完好的ALS患者中也是如此。认知性汤姆的结果是混杂的，可能与执行功能障碍或测试限制相混淆。相比之下，情感性ToM缺陷的识别更为一致。然而，没有纳入研究直接评估情感共情。所审查的研究中使用的测试通常过于具体，缺乏生态有效性，这可能解释了跨领域结果不一致以及与成像或执行功能的弱相关性。结论：社会认知被越来越多的人认为是ALS患者受影响的关键非运动领域。然而，目前的评估工具可能缺乏捕捉现实生活中的缺陷所需的敏感性和生态有效性。实施动态、多模式的评估，如现实生活中的社会互动测试或社会认知电影评估（MASC）等测试，可以提高检测和指导临床干预，但仍有待于对ALS患者进行验证。

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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

IF 2.3 4区医学 Q2 CLINICAL NEUROLOGY

Revue neurologique

Pub Date : 2026-01-01

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

IF 2.3 4区医学 Q2 CLINICAL NEUROLOGY

Revue neurologique

Pub Date : 2026-01-01

引用次数: 0

Refining the definition of severe migraine: Evidence from a prospective observational study 改进严重偏头痛的定义：来自前瞻性观察研究的证据。

IF 2.3 4区医学 Q2 CLINICAL NEUROLOGY

Revue neurologique

Pub Date : 2026-01-01 DOI: 10.1016/j.neurol.2025.12.002

J. Henri , S. Redon , A. Donnet

Introduction

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.

Methods

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 (< 8 vs. ≥ 8 days/month), HIT-6 (< 60, 60–64, ≥ 65), and MIGSEV grades (1–3).

Results

Median monthly frequency was 8 days. Patients with ≥ 8 days/month had significantly higher HIT-6 scores (P = 0.044). Among patients with < 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.

Discussion

A multidimensional definition of severe migraine is supported: (A) ≥ 8 days/month, or (B) < 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.

偏头痛的严重程度通常通过发作频率来评估，但这一单一维度无法反映疾病的全部负担。我们的目的是验证三级医疗环境中严重偏头痛的实用多维定义。方法：我们在一家三级疼痛中心（马赛，2024年1月至4月）进行了一项观察性研究，包括96名根据ICHD-3标准诊断的连续成年偏头痛患者。收集的数据包括偏头痛天数/月、HIT-6、MIGSEV和HAD评分。患者按频次分类(结果：中位月频次为8天。≥8天/月的患者HIT-6评分显著高于对照组（P=0.044）。讨论：支持重度偏头痛的多维定义：(A)≥8天/月，或(B)

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