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Neurology pioneers in Japan. 日本神经病学的先驱。
IF 1 4区 医学 Q4 NEUROSCIENCES Pub Date : 2025-01-01 Epub Date: 2025-01-15 DOI: 10.1055/s-0044-1791661
Hélio A Ghizoni Teive, Léo Coutinho, Francisco E C Cardoso, Shoji Tsuji

The pioneers of neurology in Japan were professors Hiroshi Kawahara and Kinnosuke Miura. Kawahara published the first description of progressive bulbar palsy and wrote the first neurology textbook in Japan. Miura, on the other hand, published studies about amyotrophic lateral sclerosis, in addition to participating in the founding of the Japanese Society of Neurology. The influence of European neurology, particularly French and German, in the figures of Professor Jean-Martin Charcot and Professor Erwin Bälz, was fundamental in the consolidation of neurology in Japan.

日本神经学的先驱是河原浩教授和三浦金介教授。河原发表了对进行性球麻痹的第一个描述,并撰写了日本第一本神经学教科书。另一方面,除了参与创立日本神经病学学会外,三浦还发表了关于肌萎缩性侧索硬化症的研究。欧洲神经学的影响,尤其是法国和德国,在Jean-Martin Charcot教授和Erwin教授Bälz的数据中,是日本神经学巩固的基础。
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引用次数: 0
Letter to "Cultural adaptation and reliability assessment of the Hammersmith neonatal neurological examination for Brazilian newborns at risk of cerebral palsy".
IF 1 4区 医学 Q4 NEUROSCIENCES Pub Date : 2025-01-01 Epub Date: 2025-02-06 DOI: 10.1055/s-0045-1802309
Tathiana Ghisi de Souza
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引用次数: 0
Charcot's Russian pupils. 沙尔科的俄罗斯学生
IF 1 4区 医学 Q4 NEUROSCIENCES Pub Date : 2024-12-01 Epub Date: 2024-09-10 DOI: 10.1055/s-0044-1789226
Hélio Afonso Ghizoni Teive, Léo Coutinho, Carlos Henrique Ferreira Camargo

The establishment of Russian neurology in the late 19th century was significantly shaped by the neurology department at La Salpêtrière Hospital under Professor Jean-Martin Charcot's leadership. A group of Russian neurologists, guided by Professor Kozhevnikov and featuring his disciples such as Korsakov, Minor, Darkshevich, and Bekhterev, had the privilege of being mentored by Professor Charcot. Subsequently, they played pivotal roles in founding various neurology services in Russia, greatly influenced by the teachings and insights they acquired under Charcot's tutelage.

让-马丁-沙尔科(Jean-Martin Charcot)教授领导下的萨尔佩特里耶尔医院(La Salpêtrière)神经科对 19 世纪末俄罗斯神经学的发展产生了重要影响。在科热夫尼科夫(Kozhevnikov)教授的指导下,以其弟子科萨科夫(Korsakov)、米诺尔(Minor)、达克舍维奇(Darkshevich)和别赫捷列夫(Bekhterev)为代表的一批俄罗斯神经病学家有幸得到了沙尔科教授的指导。随后,他们在俄罗斯创办了各种神经病学服务机构,并在很大程度上受到了沙尔科教导和启发的影响。
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引用次数: 0
Dengue and severe dengue with neurological complications: a challenge for prevention and control. 登革热和伴有神经系统并发症的严重登革热:预防和控制的挑战。
IF 1 4区 医学 Q4 NEUROSCIENCES Pub Date : 2024-12-01 Epub Date: 2024-12-03 DOI: 10.1055/s-0044-1792091
Emanuelle de Oliveira Francelino, Marzia Puccioni-Sohler

Dengue is the main urban arbovirus in the Americas. The disease manifests in a varied spectrum: from asymptomatic cases to those with neurological involvement, which is considered a severe form of the disease. Its annual reemergence represents a serious public health problem. The rise in the number of cases causes an increase in the number of patients with neurological manifestations of the disease, which can range from headaches to more serious conditions such as encephalitis and Guillain-Barré syndrome, with high potential of death or sequelae. Dengue prevention and control strategies should also be a concern for neurologists. The aim of the present study is to carry out a narrative review of the current methods to prevent dengue fever and its severe forms, such as cases with neurological complications. The main control measures include vaccination, which is still carried out on a small scale, vector control, and individual protection. The CYD-TDV/Dengvaxia and TAK-003/DENVax vaccines, licensed for use by the Brazilian National Health Regulatory Agency (Agência Nacional de Vigilância Sanitária, ANVISA, in Portuguese), show efficacy against hospitalizations of 72.7% (95% confidence interval [95%CI]: 62.3-80.3%) and of 90.4% (95%CI: 82.6-94.7%) respectively. The TV003/TV005 vaccine, which is being studied by Intituto Butantan in Brazil, shows promising results, with an efficacy of 79.6% for symptomatic dengue. Vector control is based on biotechnological and behavioral measures, as well as on the improvement of basic sanitation conditions. The main individual protection measure is the use of topical repellents (icaridin). All of these actions represent important tools for the prevention of dengue fever and its neurological complications.

登革热是美洲主要的城市虫媒病毒。该病表现多样:从无症状病例到神经系统受累,这被认为是该病的严重形式。它每年重新出现是一个严重的公共卫生问题。病例数量的增加导致患有该疾病神经系统症状的患者人数增加,这些症状可能从头痛到脑炎和格林-巴罗综合征等更严重的疾病,死亡或后遗症的可能性很大。登革热的预防和控制策略也应该是神经科医生关注的问题。本研究的目的是对目前预防登革热及其严重形式(如伴有神经系统并发症的病例)的方法进行叙述性审查。主要控制措施包括仍在小规模开展的疫苗接种、病媒控制和个人保护。CYD-TDV/ denvaxia和TAK-003/DENVax疫苗获得巴西国家卫生监管机构(Agência Nacional de vigilica Sanitária,葡萄牙语ANVISA)的使用许可,显示住院率分别为72.7%(95%置信区间[95% ci]: 62.3-80.3%)和90.4% (95% ci: 82.6-94.7%)。巴西Butantan研究所正在研究的TV003/TV005疫苗显示出令人鼓舞的结果,对有症状的登革热的有效率为79.6%。病媒控制以生物技术和行为措施以及改善基本卫生条件为基础。主要的个人防护措施是使用局部驱蚊剂(伊卡苷)。所有这些行动都是预防登革热及其神经系统并发症的重要工具。
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引用次数: 0
Median nerve impairment in leprosy: how does it differ from the classic carpal tunnel syndrome? 麻风病的正中神经损伤:与经典腕管综合征有何不同?
IF 1 4区 医学 Q4 NEUROSCIENCES Pub Date : 2024-12-01 Epub Date: 2024-12-10 DOI: 10.1055/s-0044-1792092
Pedro Henrique Sirotheau Corrêa Alves, Fernanda de Oliveira Cirino, Leonardo Peixoto Garcia, João Paulo Moreira Fernandes, Andrea De Martino Luppi, Douglas Eulálio Antunes, Raquel Campos Pereira, Wilson Marques Junior, Isabela Maria Bernardes Goulart, Diogo Fernandes Dos Santos

Background:  Carpal tunnel syndrome (CTS) has already been described as a possible form of neural leprosy presentation. However, the median nerve can be involved in this neuropathy in proximal segments and, sometimes, with an asymmetric impairment of the digital branches.

Objective:  To detail the pattern of median nerve impairment through nerve conduction study (NCS) and ultrasound evaluation.

Methods:  This cross-sectional study comprises 15 primary neural leprosy (PNL) patients and 14 patients with CTS who underwent peripheral nerve ultrasonography and NCS evaluation.

Results:  From the total, 92.8% of patients with CTS and 80% with PNL had bilateral impairment of the median nerve, with 27 nerves in each group. Considering the cross-sectional area (CSA) of the tunnel (Mt) segment, 63% of the nerves in the CTS and 74.1% in the PNL groups were found to be thickened, with an average CSA of 13.4 ± 4.4 and 12.4 ± 4.6, respectively (p = 0.18). The CSA of the proximal tunnel (Mpt) segment showed thickening in only 3.7% in the CTS group and 96.3% in the PNL (p < 0.0001), with an average of 6.6 ± 1.3 and 17.0 ± 6.7, respectively (p < 0.001). Finally, 88.9% of the nerves in the PNL group and only 7.4% in the CSA (p < 0.0001) showed a reduction in conduction velocity in the distal forearm, with an average of 41.0 ± 6.3 and 53.2 ± 5.2, respectively (p < 0.0001).

Conclusion:  The presence of neural thickening and demyelinating impairment in the segments proximal to the carpal tunnel favors the diagnosis of leprosy.

背景:腕管综合征(CTS)已被描述为神经性麻风病的一种可能表现形式。然而,正中神经可累及近端神经节段,有时指支不对称损伤。目的:通过神经传导研究(NCS)和超声检查,探讨正中神经损伤的表现。方法:对15例原发性神经性麻风(PNL)患者和14例CTS患者进行周围神经超声检查和NCS评价。结果:92.8%的CTS患者双侧正中神经受损,80%的PNL患者双侧正中神经受损,每组27条神经受损。从隧道(Mt)段的横断面积(CSA)来看,CTS组63%的神经增厚,PNL组74.1%的神经增厚,平均CSA分别为13.4±4.4和12.4±4.6 (p = 0.18)。CTS组Mpt节段CSA增厚率仅为3.7%,PNL组为96.3% (p p p p)结论:腕管近段神经增厚及脱髓鞘损伤有利于麻风的诊断。
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引用次数: 0
Neurovascular complications of antiphospholipid syndrome: a narrative review. 抗磷脂综合征的神经血管并发症:叙述性回顾。
IF 1 4区 医学 Q4 NEUROSCIENCES Pub Date : 2024-12-01 Epub Date: 2024-12-10 DOI: 10.1055/s-0044-1793932
George Nilton Nunes Mendes, Alessandra Braga Cruz Guedes de Morais, Laura Catherine Gioia, Grégory Jacquin, Alexandre Y Poppe, Felipe Hideki Soga, João Brainer Clares de Andrade

Background:  Antiphospholipid syndrome (APS) is a systemic autoimmune disorder characterized by thrombosis, pregnancy complications, and other nonthrombotic manifestations in the presence of antiphospholipid antibodies. Neurovascular complications, including ischemic stroke, cerebral venous thrombosis and cognitive impairment, pose significant challenges in management.

Objective:  To comprehensively review relevant and updated clinical aspects of neurovascular manifestations of APS.

Methods:  We conducted a narrative review using the PubMed, EMBASE, and Cochrane Library databases with medical terms related to APS and its neurovascular manifestations. English-language studies, published between January 1, 2015, and March 2024, were included. Key publications outside this timeframe were also considered. Studies with higher levels of evidence, such as randomized controlled trials and meta-analyses, were prioritized for inclusion.

Results:  Stroke is a prevalent complication in APS, with arterial thrombosis being a predominant mechanism. Despite recent trials, direct oral anticoagulants (DOACs) have not shown superiority over vitamin K antagonists (VKAs) for secondary prevention in this population. Cerebral venous thrombosis (CVT), although rare, can also occur in APS, and while DOACs have shown promise as a treatment in a general population, caution is warranted due to potential harm. Cognitive impairment affects a considerable proportion of APS patients, with thrombotic and nonthrombotic mechanisms contributing to its pathophysiology. Future research should focus on optimal management strategies for cognitive impairment and the efficacy of anticoagulation and immunosuppression.

Conclusion:  Understanding the complex interplay of neurovascular manifestations in APS is essential for guiding clinical decisions and improving patient outcomes. Despite advancements, some challenges remain in establishing effective preventive and treatment measures, highlighting the need for further research in this field.

背景:抗磷脂综合征(APS)是一种系统性自身免疫性疾病,以抗磷脂抗体存在时的血栓形成、妊娠并发症和其他非血栓性表现为特征。神经血管并发症,包括缺血性脑卒中、脑静脉血栓形成和认知障碍,对治疗构成重大挑战。目的:全面综述APS神经血管表现的相关临床和最新进展。方法:我们使用PubMed, EMBASE和Cochrane图书馆数据库对APS及其神经血管表现相关的医学术语进行了叙述性回顾。2015年1月1日至2024年3月期间发表的英语研究被纳入其中。在这个时间范围之外的重要出版物也得到了审议。证据水平较高的研究,如随机对照试验和荟萃分析,被优先纳入。结果:卒中是APS的常见并发症,动脉血栓形成是主要机制。尽管最近的试验,直接口服抗凝剂(DOACs)在这一人群的二级预防中并没有显示出维生素K拮抗剂(VKAs)的优势。脑静脉血栓形成(CVT)虽然罕见,但也可能发生在APS中,虽然DOACs在一般人群中显示出治疗的希望,但由于潜在的危害,需要谨慎。认知障碍影响相当大比例的APS患者,其血栓性和非血栓性机制有助于其病理生理。未来的研究应关注认知功能障碍的最佳治疗策略以及抗凝和免疫抑制的疗效。结论:了解APS中神经血管表现的复杂相互作用对指导临床决策和改善患者预后至关重要。尽管取得了进展,但在建立有效的预防和治疗措施方面仍然存在一些挑战,突出表明需要在这一领域进一步研究。
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引用次数: 0
Association of interleukin 4 and MTHFR gene polymorphisms with distal symmetrical polyneuropathy in young diabetics. 白细胞介素4和MTHFR基因多态性与青年糖尿病远端对称性多神经病变的关系
IF 1 4区 医学 Q4 NEUROSCIENCES Pub Date : 2024-12-01 Epub Date: 2024-12-15 DOI: 10.1055/s-0044-1793931
Raquel Garcia Rocco da Silva, Marcelo A Costa Lima, Claudia de Melo Moura, Jorge Luiz Luescher, Ludmila Nascimento Rodrigues Campos, Daniel de Souza E Silva, Márcia Gonçalves Ribeiro

Background:  It is believed that genetic factors play a role in the development and severity of neural injury among people with distal symmetrical polyneuropathy (DSP), because some genes are involved in specific biological pathways, acting in different ways in the pathogenic process.

Objective:  To identify potential associations involving the 5,10-methylenetetrahydrofolate reductase (MTHFR C677T) and interleukin 4 (IL-4 intron 3 variable number of tandem repeats [I3VNTR]) gene polymorphisms and DSP in the studied sample.

Methods:  In total, 70 children and adolescents with type-1 diabetes underwent a nerve conduction studie (NCS) of the sural nerve. Saliva samples were collected for DNA extraction and genotyping of the MTHFR C677T and IL-4 I3VNTR polymorphisms.

Results:  The prevalence of DSP was 15.71%. The participants with DSP presented higher mean levels of glycated hemoglobin, triglycerides, total cholesterol, and low-density lipoprotein (LDL) (p > 0.05). The NCS amplitudes were lower in individuals with DSP (p = 0.00). The mean conduction velocity was lower in people with the A1A1 genotype (p = 0.02). Maternal and paternal history of diabetes in great-grandparents were associated with DSP (p = 0.04 and 0.02, respectively). Glycated hemoglobin and impaired Achilles reflex were associated with the MTHFR CC genotype (p = 0.04 and 0.05 respectively) and high-density lipoprotein (HDL) cholesterol was associated with the MTHFR CT genotype (p = 0.05). We found no association between the polymorphisms investigated and DSP.

Conclusion:  In the present study, we found no association involving the MTHFR C677T and IL-4 I3VNTR polymorphisms and DSP. However, the study provides other associations and suggests possible implications for these findings.

背景:认为遗传因素在远端对称性多神经病变(DSP)患者神经损伤的发生和严重程度中起作用,因为一些基因参与了特定的生物学通路,在发病过程中以不同的方式起作用。目的:探讨研究样本中5,10-亚甲基四氢叶酸还原酶(MTHFR C677T)和白细胞介素4 (IL-4内含子3可变数目串联重复序列[I3VNTR])基因多态性与DSP的潜在关联。方法:对70例1型糖尿病儿童和青少年进行腓肠神经神经传导研究(NCS)。收集唾液样本进行DNA提取和MTHFR C677T和il - 4i3vntr多态性的基因分型。结果:DSP患病率为15.71%。患有DSP的参与者糖化血红蛋白、甘油三酯、总胆固醇和低密度脂蛋白(LDL)的平均水平较高(p < 0.05)。DSP患者的NCS振幅较低(p = 0.00)。A1A1基因型患者的平均传导速度较低(p = 0.02)。曾祖父母有糖尿病史与DSP相关(p分别为0.04和0.02)。糖化血红蛋白和跟腱反射受损与MTHFR CC基因型相关(p = 0.04和0.05),高密度脂蛋白胆固醇与MTHFR CT基因型相关(p = 0.05)。我们发现所调查的多态性与DSP之间没有关联。结论:在本研究中,我们没有发现MTHFR C677T和il - 4i3vntr多态性与DSP相关。然而,该研究提供了其他关联,并对这些发现提出了可能的含义。
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引用次数: 0
Neurophysiology combined with sonography as a useful tool in median nerve leprosy diagnosis. 神经生理学结合超声作为正中神经麻风病诊断的有用工具。
IF 1 4区 医学 Q4 NEUROSCIENCES Pub Date : 2024-12-01 Epub Date: 2025-01-08 DOI: 10.1055/s-0044-1801743
Osvaldo J M Nascimento
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引用次数: 0
Multiple cerebral cavernomas in linear scleroderma: an unusual association. 线性硬皮病中的多发性脑海绵状瘤:一种不寻常的关联。
IF 1 4区 医学 Q4 NEUROSCIENCES Pub Date : 2024-12-01 Epub Date: 2024-09-24 DOI: 10.1055/s-0044-1790574
Gabriela Rodrigues Tomaz, Maria Eduarda Slhessarenko Fraife Barreto, Rafael Tuzino Leite Neves Maffei, Renato Barradas Rodrigues, Sebastião Boanerges de Araujo Neto, Marianna Pinheiro Moraes de Moraes, José Luiz Pedroso, Orlando Graziani Povoas Barsottini
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引用次数: 0
Stroke in Brazil: prevalence, activity limitations, access to healthcare, and physiotherapeutic treatment. 巴西中风:患病率、活动限制、获得医疗保健和物理治疗
IF 1 4区 医学 Q4 NEUROSCIENCES Pub Date : 2024-12-01 Epub Date: 2024-12-20 DOI: 10.1055/s-0044-1792094
Luana Karoline Castro Silva, Cristian Douglas Dantas de Sousa, Ramon Távora Viana, Renata Viana Brígido de Moura Jucá, Johnnatas Mikael Lopes, Christina Danielli Coelho de Morais Faria, Shamyr Sulyvan de Castro, Lidiane Andrea Oliveira Lima

Background:  Stroke remains a public health problem, reported as the third cause of disability. Among survivors, the ability to perform usual daily activities may be reduced, requiring rehabilitation.

Objective:  To investigate the prevalence of self-reported stroke, the accessibility of healthcare, and the degree and percentage of patients with limitations in usual activities who are unassisted by physiotherapeutic treatment in different regions of the country.

Methods:  This cross-sectional study was conducted using data from the 2019 National Health Survey. Participants aged 15 years or older from all five geographic regions of Brazil who reported a diagnosis of stroke were included. The data were analyzed using sample weighting and expressed as estimates along with a 95% confidence interval (CI).

Results:  The national prevalence of self-reported stroke in Brazil was 1.9% (95%CI 1.7-2.0), equivalent to 1,975 individuals with diagnosis. Of these, 50.2% reported limitations in their daily activities, and more than half (54.6%) had regular follow-ups with healthcare professionals. However, only 24.6% reported having access to rehabilitation, while 73.4% of individuals with activity limitations received no physiotherapeutic treatment.

Conclusion:  The prevalence of' self-reported stroke in the Brazilian population was 1.9%, with more than half experiencing limitations in their activities. While more than half of the stroke patients underwent follow-ups from a health professional, only ¼ of them reported having access to rehabilitation. Government interventions are necessary to ensure effective access to healthcare, including rehabilitation for the Brazilian population.

背景:中风仍然是一个公共卫生问题,据报道是致残的第三大原因。在幸存者中,进行日常活动的能力可能会下降,需要康复。目的:了解全国不同地区脑卒中自诉患病率、医疗服务可及性、日常活动受限患者不借助物理治疗的程度和百分比。方法:采用2019年全国健康调查数据进行横断面研究。参与者年龄在15岁或以上,来自巴西所有五个地理区域,报告被诊断为中风。数据采用样本加权法进行分析,并以估计值和95%置信区间(CI)表示。结果:巴西自我报告卒中的全国患病率为1.9% (95%CI 1.7-2.0),相当于1,975名确诊患者。其中,50.2%的人报告他们的日常活动受到限制,超过一半(54.6%)的人定期与医疗保健专业人员进行随访。然而,只有24.6%的人接受了康复治疗,而73.4%的活动受限患者没有接受物理治疗。结论:巴西人群中自我报告的中风患病率为1.9%,其中一半以上的人活动受限。虽然超过一半的中风患者接受了健康专业人士的随访,但只有四分之一的人报告说他们接受了康复治疗。政府干预是必要的,以确保有效获得医疗保健,包括巴西人口的康复。
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引用次数: 0
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Arquivos de neuro-psiquiatria
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