Acta neurologica Belgica最新文献

Introduction: The aim was to determine the prevalence and characteristics of pain in people with neuromyelitis optica spectrum disorders (pwNMOSD).

Methods: The Nordic Musculoskeletal Questionnaire (NMQ) was used to determine the participants' pain levels and pain localization. The PainDETECT Questionnaire (PD-Q) was used to differentiate between nociceptive and neuropathic pain. The scores ≤ 12 were considered as presence of musculoskeletal pain (MSP) and > 12 as neuropathic pain (NP). The Preference-Based Multiple Sclerosis Index (PBMSI) was used to measure health-related quality of life. Information such as Expanded Disability Status Scale (EDSS), disease duration and age of the participants were also recorded.

Results: The 62 participants included in the study were divided into 3 groups: 14 without pain, 17 with MSP and 31 with NP. There was no difference between the groups in terms of age, disease duration and EDSS scores (p > .05). When the pain distribution was analyzed, the regions with the most pain complaints in the last 12 months were neck (n = 22, 34.9%), foot-ankle (n = 16, 25.4%) and back (n = 15, 25.8%), respectively. When the quality of life of the three groups were compared, there was a difference between PBMSI-Walk, PBMSI-Fatigue and total score.

Conclusion: The results of this study showed that the neck, back, and foot-ankle were the most common and most disabling pain areas in pwNMOSD, regardless of the age, disease duration, and EDSS score of the participant. However, there was a difference between the groups in the parameters related to gait, fatigue and total quality of life against NP.

Background: Idiopathic intracranial hypertension (IIH) is marked by elevated intracranial pressure with risk of vision loss. Neurofilament light chain (NfL), a marker of axonal injury, may reflect optic nerve damage in IIH.

Objective: To assess the relationship between cerebrospinal fluid (CSF) and serum NfL levels, papilledema severity, and radiological findings in patients with IIH.

Methods: A cross-sectional study was performed on 34 women with IIH and 34 age- and sex-matched healthy controls. Demographics, clinical features, ophthalmological evaluation, lumbar puncture opening pressure measurement, brain MRI/MRV, and ONSD ultrasound were performed. NfL levels were measured in CSF and serum using ELISA. Correlations with papilledema grade (Frisén scale) and radiological findings were analyzed.

Results: IIH patients had higher BMI (34.2 vs. 27.3 kg/m², p < 0.001) and ONSD (6.39 vs. 5.40 mm, p < 0.001). CSF NfL levels were elevated (median 79.8 ng/L) and positively correlated with papilledema grade (r = 0.383, p = 0.031) but negatively with ONSD (r = -0.352, p = 0.041). ONSD correlated strongly with papilledema (r = 0.456, p = 0.009) and lumbar puncture pressure (r = 0.502, p = 0.002). Serum NfL showed no significant difference between patients and controls (p = 0.562) and no correlation with disease severity.

Conclusion: CSF NfL correlates with papilledema grade and may serve as an objective biomarker of optic nerve damage in IIH. Its complementary role alongside ONSD suggests potential for a dual biomarker approach, combining acute pressure assessment with cumulative axonal injury monitoring.

Post-traumatic hypopituitarism (PTHP), a condition primarily affecting the anterior pituitary, represents a significant and frequently underdiagnosed consequence of traumatic brain injury (TBI). Its clinical course is dynamic, with deficiencies that can be transient, persistent, or of late onset, profoundly impacting both acute prognosis and long-term cognitive and functional recovery. This review summarizes the complex pathophysiology of PTHP, covering established mechanisms such as mechanical and vascular insults, while also discussing emerging concepts including NLRP3 inflammasome-driven pyroptosis, cellular senescence, and the potential role of pituitary-resident folliculostatellate (FS) cells in the secondary injury cascade. From a clinical perspective, the review emphasizes a longitudinal approach to diagnosis and management that spans the acute to chronic phases, addressing key diagnostic pitfalls and summarizing evidence-based therapeutic strategies. By synthesizing current pathophysiological concepts and clinical practices, this review aims to enhance clinical awareness, bridge the knowledge-translation gap, and provide a resource to help optimize care for this vulnerable patient population.