Neuroepidemiology最新文献

Background: Motor neuron disease (MND), a rare and fatal neurodegenerative disorder, poses significant challenges to healthcare systems. Existing research has limitations, such as sparse data in some regions, insufficient exploration of sociodemographic impacts, and a lack of long-term burden projections. Understanding its global, regional, and national impact is crucial for healthcare planning.

Objective: This study comprehensively evaluates the worldwide MND burden from 1990 to 2021, forecasts trends until 2036, and identifies key determinants of disease burden changes. The findings aim to support evidence-based healthcare resource allocation and policy-making.

Method: Data from the Global Burden of Disease 2021 database were analyzed for 204 countries and territories. Analytical methods included trend analysis, Joinpoint regression, sociodemographic index (SDI) correlation, age-period-cohort modeling, decomposition analysis, and autoregressive integrated moving average projections.

Results: From 1990 to 2021, global MND cases, deaths, and disability-adjusted life-years (DALYs) increased, while age-standardized prevalence and incidence rates declined. Disease burden varied by gender and age, and had nonlinear associations with SDI. Decomposition analysis showed population growth and aging worsened the absolute burden. Projections indicated different post-2021 trends by gender, with a projected rise in male DALYs.

Conclusions: MND burden has grown globally, with variations by gender, age, and socioeconomic status. Targeted public health interventions, better diagnostic strategies, and more research on etiological factors are needed. The findings help with healthcare planning for MND.

Background: Central nervous system (CNS) tumors represent a significant global health burden, with notable regional disparities in incidence, mortality, and survival. The Arab world, comprising 22 countries across the Middle East and North Africa, faces unique epidemiological challenges influenced by population demographics, healthcare access, and genetic factors. This study aims to analyze the incidence, mortality, and 5-year prevalence of CNS tumors in Arab countries using Global Cancer Observatory (GLOBOCAN) 2020 and 2022 data, with comparisons by country, gender, and age-group.

Methods: Data were extracted from the GLOBOCAN "Cancer Today" portal for the years 2020 and 2022. We included all Arab countries and examined trends in crude rates, age-standardized incidence rates (ASIRs), age-standardized mortality rates (ASMRs), and incidence-to-mortality ratios (IMRs), stratified by sex and age-group.

Results: Globally, CNS tumor cases rose from 308,102 in 2020 to 321,731 in 2022 (4.4%), while Arab countries saw an increase from 14,177 to 14,823 cases, (4.6%). Egypt reported the highest incidence, mortality, and prevalence in both years. Iraq demonstrated the highest ASIR and ASMR, while Jordan (in 2020) and Syria (in 2022) had unexpectedly high ASIR and ASMR among males. Older adults (≥50 years) bore the highest disease burden across all regions. Despite modest improvements in survival, the IMR remained relatively low, indicating continued challenges in achieving favorable outcomes, particularly among children and older adults.

Conclusion: The burden of CNS tumors is increasing in the Arab region, with significant inter-country variation. These findings highlight the need for improved cancer registries, early detection programs, and region-specific strategies to enhance diagnosis and treatment outcomes.

Introduction: Guillain-Barré syndrome (GBS) is a rare autoimmune disorder of the peripheral nervous system with incidence rates varying across regions. Based on hospital discharge data, this study aimed to analyze the incidence and mortality of GBS in Chile between 2013 and 2019.

Methods: A retrospective review of GBS cases, identified using the ICD-10 code G61.0, was conducted using national hospital discharge records. The incidence rates were calculated annually and adjusted for the population. Demographic and clinical variables, including sex, age, insurance type, and outcomes, were analyzed.

Results: A total of 1,696 cases were identified, yielding an annual incidence rate of 1.46 per 100,000 (95% CI: 1.28-2.64). Most cases occurred in males (58.8%), with a mean age of 46.62 years. The mortality rate was 1.7%, and the high survival rate was 98.3%.

Conclusion: The incidence of GBS in Chile is comparable to the global rates, with a slight male predominance and a high survival rate. Further studies are warranted to explore the potential rurality and climatic factors influencing GBS incidence in Chile.

Introduction: Epidemiological studies on peripheral neuropathy (PN) in sub-Saharan Africa (SSA) have been conducted out in various target populations. This systematic review and meta-analysis aim to present and update available descriptive data on PN in SSA from 2000 to 2020.

Methods: Research was performed in indexed databases PubMed (MEDLINE), Web of Science, Google Scholar, Scopus, African Journals Online, and grey literature databases. Studies were selected according to the PRISMA methodology and data were extracted using a collection grid. A meta-analysis with a random-effects model was performed to determine the pooled frequency measures of PNs.

Results: Overall, 116 studies were included in this review, comprising 75,227 subjects (59.71% male, mean age range 9-68.8 years). The highest number of studies were conducted in East Africa (n = 47; 40.5%). The pooled hospital frequency of PN was 39.6% ([95% CI: 34.2-45.2], I2 = 99.32%), the pooled prevalence was 4.30% ([95% CI: 2.50-6.50], I2 = 97.52%), and the pooled hospital incidence was 15.60% per year ([95% CI: 5.10-29.70], I2 = 98.78%). Pooled hospital frequency of PN was higher in diabetic patients (50.30% [95% CI: 28.30-66.70], I2 = 99%) and in Southern Africa (44.30% [95% CI: 27.80-61.10], I2 = 99%). For using electroneuromyogram as a diagnostic tool, the pooled hospital frequency of PN was 76.80% ([95% CI: 67.30-85.40], I2 = 67%). The frequency of polyneuropathy subgroup was 34.40% ([95% CI: 29.90-46.90], I2 = 99.20%).

Conclusion: PNs are frequent in SSA and particularly in certain target groups. It is important to improve preventive measures for HIV and diabetes and increase the understanding of risk factors associated with PN.

Introduction: The global ageing trend is accelerating, leading to an increase in chronic diseases, and posing a significant health challenge. Stroke, characterised by high rates of disability and mortality, is emerging as one of the most critical public health issues. The aim of this study was to examine current trends in global ageing and, under this condition, to assess the burden of stroke, with a focus on the elderly population at high risk of stroke.

Methods: The data utilised in this study was obtained from the Global Burden of Diseases Study 2021, which estimated the burden of stroke and its subtypes, including ischaemic stroke, intracerebral haemorrhage, and subarachnoid haemorrhage focusing on incidence, mortality, and disability-adjusted life year (DALY) rates. To investigate the correlation between ageing and stroke burden as well as its temporal trends, Pearson correlation analysis, decomposition analysis, and estimated annual percentage change were conducted.

Results: Globally, the proportion of countries entering ageing society has almost doubled, rising from 30.4% in 1990 to 52.5% in 2021. The Pearson correlation coefficient showed a significant positive association between stroke burden and the degree of ageing, particularly for incidence rate (R = 0.64, p < 2.2e-16) and mortality rate (R = 0.44, p = 5.3e-16). In addition, the global increase in stroke DALYs from 1990 to 2021 was largely attributable to population ageing, which accounted for 99.9% of this increase. In more than half of the countries, the burden of stroke was mainly concentrated in the elderly population aged 65 years and above, especially for ischaemic stroke, while the younger population predominantly borne the burden of haemorrhagic stroke.

Conclusions: Despite the observed reductions in the incidence, mortality and DALY rates of stroke and its subtypes, the overall absolute numbers were still on an upward trajectory. Significantly, the majority of the burden of stroke was borne by the elderly. Therefore, the promotion of healthy ageing worldwide is critical and requires the rapid and effective development and implementation of appropriate public health policies and preventive management strategies to reduce the expected increase in the burden of stroke in the near future, particularly in the face of the challenges of global ageing wave.

Introduction: Screening questions are important in identifying subgroups of individuals within a target population. Dystonic movements and postures are not uncommon in patients with essential tremor (ET). There is a gap in knowledge - no studies have assessed the validity of a self-report of dystonia in ET patients. We assessed the concordance between self-reported dystonia and the presence or absence of dystonia on examination (DOE).

Methods: We obtained self-report data from 274 ET cases in a serial study with up to five follow-up evaluations. At each assessment, participants could self-report dystonia, and they underwent a detailed neurological examination, from which a movement disorders neurologist assessed for the presence of DOE.

Results: Across time, the prevalence of self-reported dystonia and DOE ranged from 0.0% to 4.3% and 8.6% to 17.5%, respectively. There were 74 cases with either self-reported dystonia or DOE; in only 3 (4.1%) was there a positive concordance between the two at each of their evaluations. Values for sensitivity ranged from 0.0% to 40%; specificity from 96.1% to 100%; positive predictive value from 0.0% to 67.0% (median 30.0%); and negative predictive value from 83.1% to 94.4%.

Conclusion: Our study provides important insights into the validity of self-report data on dystonia in ET and the prevalence of DOE in ET. Our findings suggest that self-reported dystonia was not a valid means to identify DOE in ET.

Introduction: The influence of ambient temperature on the risk of stroke has remained unclear, particularly in relation to stroke subtypes. This study aimed to investigate the association between ambient temperature and the risk of ischaemic stroke from various aetiologies.

Methods: We investigated the onset of acute ischaemic stroke in the prospective stroke registry conducted from October 2007 to September 2019 in Fukuoka, Japan. Stroke aetiology was classified into cardioembolism (CE), large-artery atherosclerosis (LAA), small-vessel occlusion (SVO), and other aetiologies. Hourly, maximum, and minimum temperature data were obtained from the Japan Meteorological Agency. After controlling for the non-linear and delayed effects of daily average temperature, we employed a quasi-Poisson generalised additive model with the natural logarithm of daily stroke counts as a function of predictors, including temperature metrics and humidity.

Results: A total of 17,755 patients with acute ischaemic stroke (mean age ± SD: 73.1 ± 12.6 years; 41.4% female) were included in the analysis. Lower temperatures were associated with an increased risk of CE and LAA but not with that of SVO. Conversely, higher temperatures were associated with a decreased risk of CE, whereas no association was found with LAA or SVO. The association was observed within 5 days before stroke onset for LAA but after a longer period for CE. The risk of CE increased with rising variability in daily temperature preceding stroke onset.

Conclusion: We observed distinct associations between ambient temperature and the risk of ischaemic stroke, contingent upon stroke aetiology, temperature levels, exposure duration, and patient characteristics.

Background: Neurological disorders impose a significant health burden globally, particularly in regions like North Africa and the Middle East (NAME) with unique healthcare and societal challenges. Despite progress in addressing neurological conditions, understanding the burden in pediatric and adolescent populations remains limited. This study analyzes the trends and burden of neurological conditions in individuals under 20 years old across the NAME super region from 1990 to 2021 using Global Burden of Disease (GBD) data.

Methods: GBD 2021 data were analyzed to assess prevalence, incidence, years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life years (DALYs), and mortality rates. The data were stratified by age, sex, and sociodemographic index (SDI). Population attributable fraction was used to estimate the burden attributable to risk factors, and uncertainty intervals (UIs) were calculated using 500 posterior draws, reporting 95% UIs based on the 2.5th and 97.5th percentiles. All visualizations and analyses were conducted using Python (version 3.12.4).

Results: Neurological condition prevalence in 2021 was 21,797.5 per 100,000, with tension-type headaches and migraines accounting for the majority of cases. Idiopathic epilepsy remained a leading cause of mortality, although it had a decrease of -50.9% in YLLs compared to 1990. Migraine affected about 9,161.9 per 100,000, increasing by 9.9% from 1990. It also accounted for the highest YLD rate (350.9). Despite decreases in YLLs and deaths, YLDs showed minimal change. Similarly, DALYs did not show significant change from 1990 (17.9%; 95% UI: -12.17 to 36.05). Higher SDI was associated with reduced DALYs but increased prevalence and YLDs.

Conclusion: The burden of neurological disorders in pediatric and adolescent populations in NAME highlights regional disparities and the need for targeted healthcare strategies. Enhanced screening, early diagnosis, and management are essential to reducing the burden of these disorders.

Background: Sleep disorders and neurodegeneration (NDG) are mutually related but the nature of this relationship is unclear. We aimed to better understand the relationship between sleep and neurodegenerative disease by performing a critical review of epidemiological studies that investigated the association of sleep disorders and the subsequent development of Alzheimer's disease (AD), Parkinson's disease (PD), or general dementia.

Methods: We searched for all case-control or prospective cohort studies published in PubMed until August 8 2024 evaluating a series of sleep features and subsequent development of AD, PD, or general dementia over certain observation periods. Patient data, sleep features, and outcome data related to PD, AD, and general dementia were extracted following the PRISMA guidelines. Relative risks for the different NDG diseases were extracted. Study quality was assessed with the Newcastle-Ottawa quality assessment scale.

Results: Of 1,139 identified articles 52 were selected from 30 independent studies (29 cohort and one case-control study), including >2.9 million individuals with follow-up periods ranging from 3 to 40 years. The included articles reported on 18,765 AD outcomes, 14,312 PD outcomes, and 100,453 dementia outcomes. Forty-five articles were classified as having a high-quality. Despite that, there was a great variability in the main aim of the studies, the sleep features evaluated, the diagnostic system employed, or the duration of the follow-ups. Only twelve studies assessed sleep with objective measures. The influence of sleep duration and sleep quality, chronotype, and the presence of excessive daytime sleepiness, insomnia, obstructive sleep apnea, snoring, restless legs syndrome showed varying risk ratios or no statistically significant association with PD, AD, and dementia over time.

Conclusion: Our systematic review underlines the need for further comprehensive epidemiological studies with homogenous and objective sleep measures to evaluate the different sleep features and understand the relationship between sleep and NDG disease.

Introduction: In China, ischemic stroke has a high recurrence rate, with recurrent events often resulting in greater disability and mortality than initial strokes. This study aimed to evaluate the current knowledge, attitudes, and practices (KAP) of family members of patients with cerebral infarction regarding stroke recurrence and secondary prevention.

Methods: A cross-sectional study was conducted from March 2024 to July 2024 in hospitals across Heilongjiang Province. Structured questionnaires were used to collect demographic data and assess KAP scores among family members of patients with cerebral infarction.

Results: A total of 561 valid questionnaires were collected. The median scores (25th, 75th percentiles) for KAP were 8 (7, 10) out of 11, 37 (35, 39) out of 45, and 32 (30, 35) out of 40, respectively. Multivariate logistic regression analysis showed that practice scores were independently associated with the following factors: attitude score (OR = 1.218, 95% CI: [1.134, 1.309], p < 0.001), being a farmer (OR = 0.145, 95% CI: [0.033, 0.648], p = 0.011), being retired (OR = 0.097, 95% CI: [0.018, 0.521], p = 0.007), being unemployed (OR = 0.123, 95% CI: [0.027, 0.559], p = 0.007), patient diagnosed with hypertension for less than 1 year (OR = 2.526, 95% CI: [1.157, 5.514], p = 0.020), frequent smoking (OR = 0.436, 95% CI: [0.269, 0.709], p = 0.001), patient occasionally forgetting medication (OR = 0.434, 95% CI: [0.216, 0.874], p = 0.019), patient frequently forgetting or stopping medication (OR = 0.255, 95% CI: [0.108, 0.602], p = 0.002), patient diagnosed with cerebral infarction 2-3 times (OR = 0.497, 95% CI: [0.315, 0.786], p = 0.003), holding a college diploma (OR = 6.634, 95% CI: [1.128, 39.010], p = 0.036), holding a bachelor's degree (OR = 6.434, 95% CI: [1.113, 37.182], p = 0.038), and not living with the patient (OR = 0.326, 95% CI: [0.180, 0.593], p < 0.001).

Conclusion: Family members of patients with cerebral infarction demonstrated moderate knowledge, positive attitudes, and proactive practices regarding stroke recurrence and secondary prevention.