BMC Neurology最新文献_第2页

Association of oral frailty and gait characteristics in patients with cerebral small vessel disease 脑小血管疾病患者口腔虚弱与步态特征的关系

IF 2.6 3区医学 Q3 CLINICAL NEUROLOGY

BMC Neurology

Pub Date : 2024-09-10 DOI: 10.1186/s12883-024-03848-0

Hong-yang Xie, Jun-li Chen, Cui-qiao Xia, Nan Zhang, Zhen-xi Xia, Hong-yi Zhao, Yong-hua Huang

The objectives of this study were twofold: (1) to compare gait characteristics between cerebral small vessel disease (CSVD) patients with low-risk oral frailty (OF) and high-risk OF, particularly during dual-task walking (DTW); (2) to investigate the association of OF, the gait characteristics of DTW, and falls among older adults patients with CSVD. A total of 126 hospitalized patients diagnosed with CSVD were recruited and classified into a low-risk group (n = 90) and a high-risk group (n = 36) based on OF status in our study. Comprehensive data pertaining to basic parameters (cadence, as well as stride time, velocity and length), variability, asymmetry, and coordination were gathered during both single-task walking (STW) and DTW. Additionally, the number of falls was calculated. Subsequently, t-test or chi-squared test was used for comparison between the two groups. Furthermore, linear regression analysis was employed to elucidate the association of the OF index-8 score and gait parameters during cognitive DTW. Also, logistic regression models were utilized to assess the independent association of OF risk and falls. During cognitive DTW, the high-risk group demonstrated inferior performance in terms of basic parameters (p < 0.01), coefficient of variation (CV) of velocity and stride length (p < 0.05), as well as phase coordination index (PCI) when compared with the low-risk group (p < 0.05). Notably, differences in basic gait parameters were observed in cognitive DTW and STW conditions between the two groups (p < 0.01). However, only the high-risk group evinced significant variations in CV and PCI during cognitive DTW, as opposed to those during STW (p < 0.05). Furthermore, our findings also revealed the association of OF, the gait characteristics of cognitive DTW, (p < 0.01) and falls (p < 0.05). CSVD patients with a high risk of OF need to pay more attention to their gait variability or coordination. Also, they are recommended to undergo training involving dual-task activities while walking in daily life, thereby reducing the deterioration and mitigating the risk of falls. Besides, this study has confirmed an association of OF and DTW gait as well as falls in patients with CSVD.

本研究的目的有二：（1）比较低风险口腔虚弱（OF）和高风险口腔虚弱的脑小血管病（CSVD）患者的步态特征，尤其是在双任务步行（DTW）时；（2）研究口腔虚弱、DTW步态特征与老年脑小血管病患者跌倒的相关性。本研究共招募了 126 名确诊为 CSVD 的住院患者，并根据 OF 状态将其分为低风险组（90 人）和高风险组（36 人）。在单任务步行（STW）和DTW过程中，我们收集了有关基本参数（步幅以及步幅时间、速度和长度）、变异性、不对称和协调性的综合数据。此外，还计算了跌倒的次数。随后，采用 t 检验或卡方检验对两组进行比较。此外，还采用了线性回归分析来阐明 OF 指数-8 评分与认知 DTW 期间步态参数的关联。此外，还采用了逻辑回归模型来评估 OF 风险与跌倒之间的独立关联。与低风险组相比，高风险组在认知 DTW 期间的基本参数（p < 0.01）、速度和步长变异系数（CV）（p < 0.05）以及相位协调指数（PCI）方面表现较差（p < 0.05）。值得注意的是，两组在认知 DTW 和 STW 条件下的基本步态参数存在差异（P < 0.01）。然而，只有高风险组在认知 DTW 条件下的 CV 和 PCI 与 STW 条件下的 CV 和 PCI 存在显著差异（p < 0.05）。此外，我们的研究结果还显示，认知 DTW 的步态特征 OF（p < 0.01）与跌倒（p < 0.05）有关。OF风险高的CSVD患者需要更加关注他们的步态变异性或协调性。同时，建议他们在日常生活中进行行走时的双任务活动训练，从而减少病情恶化，降低跌倒风险。此外，本研究还证实了 CSVD 患者的 OF 和 DTW 步态以及跌倒之间存在关联。

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引用次数: 0

Neurological hospitalisations in childhood cancer survivors treated before 2001: findings from the French Childhood Cancer Survivor Study cohort 2001 年前接受治疗的儿童癌症幸存者的神经系统住院情况：法国儿童癌症幸存者研究队列的发现

IF 2.6 3区医学 Q3 CLINICAL NEUROLOGY

BMC Neurology

Pub Date : 2024-09-10 DOI: 10.1186/s12883-024-03797-8

David Rajaonera, Daniel Bejarano-Quisoboni, Jacques Grill, Rodrigue S. Allodji, Nathalie Pelletier-Fleury, Neige Journy, Marjorie Boussac, François Doz, Giao Vu-Bezin, Monia Zidane, Boris Schwartz, Nadia Haddy, Stéphanie Bolle, Chiraz El-Fayech, Christelle Dufour, Ibrahima Diallo, Gudrun Schleiermacher, Brice Fresneau, Florent de Vathaire

Childhood cancer survivors (CCS) have an increased risk of developing late chronic diseases, which can be influenced by the cancer type and its treatment. These chronic diseases can be severe and disabling, typically emerging years to decades after treatment. These deficits negatively impact quality of life, intelligence quotient, and memory. This study investigated how much the cancer type and treatment could affect the neurological hospitalisations in the French Childhood Cancer Survivors Study (FCCSS). We included 5579 childhood cancer survivors (CCS), diagnosed with solid tumours or lymphoma between 1945 and 2000, treated before 2001 and below the age of 21 years at initial treatment. The follow-up period was from 2006 to 2018. Hospitalisation data were obtained by linkage with the National Health Data System. We calculated the relative hospitalisation rate (RHRs) and absolute excess rate (AERs). Multivariable analyses were conducted using a Generalized Linear Model (GLM) with a Poisson distribution to estimate the association between neurological hospitalisation and patient characteristics. The expected number of hospitalisations served as an offset to compare the risk for FCCSS survivors with that of the reference population. Risk estimates were reported as relative risk (RR) with 95% confidence intervals. The hospitalisation rate for CCS was 114.2 per 10,000 person-years (PY), compared to 48.4 in the reference population. The highest hospitalisation rates were observed for epilepsy (AER = 27.1 per 10000 PY, 95%CI: 23.5–31.2 and RHR = 5.1, 95%CI 4.4–5.7). In multivariable analyses, central nervous system (CNS) tumours survivors had the highest relative risk (RR) of hospitalisation (RR = 9.4, 95%CI: 6.7–13.1) followed by neuroblastoma survivors (RR = 2.5, 95%CI: 1.7–3.7). In the whole population, survivors who received radiation to the head and neck had a significantly higher risk of hospitalisation (RR = 3.9, 95%CI: 3.3–4.7) compared to those who did not receive radiotherapy. Head and neck irradiation was identified as a strong risk factor for hospitalisation. This underlines the importance of implementing specific neurologic surveillance programs for at-risk individuals.

儿童癌症幸存者（CCS）罹患晚期慢性病的风险增加，这可能受到癌症类型及其治疗方法的影响。这些慢性疾病可能严重致残，通常在治疗后数年至数十年才出现。这些缺陷会对生活质量、智商和记忆力造成负面影响。本研究调查了法国儿童癌症幸存者研究（FCCSS）中癌症类型和治疗方法对神经系统住院治疗的影响程度。我们纳入了5579名儿童癌症幸存者（CCS），他们在1945年至2000年间被诊断患有实体瘤或淋巴瘤，在2001年之前接受过治疗，初次治疗时年龄在21岁以下。随访期为 2006 年至 2018 年。住院数据通过与国民健康数据系统的连接获得。我们计算了相对住院率（RHRs）和绝对超额率（AERs）。我们使用泊松分布的广义线性模型（GLM）进行了多变量分析，以估计神经系统住院与患者特征之间的关联。预期住院次数作为抵消，用于比较 FCCSS 幸存者与参照人群的风险。风险估计值以相对风险 (RR) 的形式报告，并附有 95% 的置信区间。CCS 的住院率为每 10,000 人年 (PY) 114.2 例，而参照人群为 48.4 例。癫痫的住院率最高（AER = 27.1/10000人年，95%CI：23.5-31.2；RHR = 5.1，95%CI：4.4-5.7）。在多变量分析中，中枢神经系统（CNS）肿瘤幸存者的住院相对风险（RR）最高（RR = 9.4，95%CI：6.7-13.1），其次是神经母细胞瘤幸存者（RR = 2.5，95%CI：1.7-3.7）。在所有人群中，与未接受放射治疗的幸存者相比，接受头颈部放射治疗的幸存者住院风险明显更高（RR = 3.9，95%CI：3.3-4.7）。头颈部照射被认为是住院的一个重要风险因素。这强调了针对高危人群实施特定神经监测计划的重要性。

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引用次数: 0

Family member reported symptom burden, predictors of caregiver burden and treatment effects in a goal-oriented community-based randomized controlled trial in the chronic phase of traumatic brain injury 创伤性脑损伤慢性期以目标为导向的社区随机对照试验中家庭成员报告的症状负担、照顾者负担的预测因素和治疗效果

IF 2.6 3区医学 Q3 CLINICAL NEUROLOGY

BMC Neurology

Pub Date : 2024-09-10 DOI: 10.1186/s12883-024-03841-7

Marianne Løvstad, Ida Maria Henriksen Borgen, Solveig Lægreid Hauger, Ingerid Kleffelgård, Cathrine Brunborg, Cecilie Røe, Helene Lundgaard Søberg, Marit Vindal Forslund

Family members are often affected by the long-term consequences of traumatic brain injury, but are rarely involved in rehabilitation programs in the chronic phase. We thus do not know what family members´ main concerns are in the chronic phase, what factors are associated with perceived caregiver burden, and whether family members´ health and functioning improves due to rehabilitation efforts received by the patients. This study explored family-members` functioning, predictors of caregiver burden and effect for family members of a goal-oriented intervention in the chronic phase of traumatic brain injury. Family members self-reported data measuring their caregiver burden, depression, general health, loneliness, and their evaluation of patient competency in everyday life, patient awareness levels, main problem areas (target outcomes) for the patient related to the brain injury, and demographic data were collected. Regression models were used to explore predictors of caregiver burden, and mixed models analysis was used to explore treatment effects. In total, 73 family members were included, 39 in the intervention group and 34 in the control group. Moderate to high caregiver burden was reported by 40% of family members, and 16% experienced clinical levels of depression. Family member loneliness and their evaluation of the patient`s level of functional competency explained 57% of the variability in caregiver burden. There were no treatment-related changes in caregiver burden, family member depression or general health. At T2 there was however a significant reduction in how family members rated severity of target outcomes that the family members had nominated at baseline (-0.38, 95% CI, -0.75 to -0.02, p = 0.04), but not for the target outcomes the patients had nominated. A significant proportion of family members to patients in the chronic phase of TBI continue to experience challenging caregiver burden and emotional symptoms. Both family member-related and patient factors contribute to caregiver burden. Interventions targeting patient complaints do not automatically alleviate family members´ burden. It is important to address social support for family members early after injury, and there is a need for more interventions specifically targeting family members´ needs. The trial was registered at ClinicalTrials.gov, NCT03545594 on the 4th of June 2018.

家庭成员经常受到脑外伤长期后果的影响，但却很少参与慢性阶段的康复计划。因此，我们不知道家庭成员在慢性期的主要关注点是什么，哪些因素与感知到的照顾者负担有关，以及家庭成员的健康和功能是否因患者接受康复治疗而得到改善。本研究探讨了家庭成员的功能、照顾者负担的预测因素以及脑外伤慢性期目标导向干预对家庭成员的影响。研究收集了家庭成员的自我报告数据，包括他们的照顾者负担、抑郁、一般健康状况、孤独感，以及他们对患者日常生活能力的评价、患者认知水平、患者与脑损伤相关的主要问题领域（目标结果）和人口统计学数据。研究人员使用回归模型来探究照顾者负担的预测因素，并使用混合模型分析来探究治疗效果。共纳入了 73 名家庭成员，其中 39 名在干预组，34 名在对照组。40%的家庭成员报告了中度到高度的照顾者负担，16%的家庭成员出现了临床水平的抑郁。家庭成员的孤独感和他们对患者功能能力水平的评价解释了照顾者负担变化的 57%。照顾者负担、家庭成员抑郁或总体健康状况没有发生与治疗相关的变化。然而，在第二阶段，家庭成员对基线时提名的目标结果严重性的评价显著降低（-0.38，95% CI，-0.75 至 -0.02，p = 0.04），但对患者提名的目标结果的评价却没有降低。在创伤性脑损伤的慢性阶段，相当一部分患者的家庭成员仍然承受着具有挑战性的护理负担和情绪症状。与家庭成员相关的因素和患者因素都会造成照顾者的负担。针对患者主诉的干预措施并不能自动减轻家庭成员的负担。重要的是要在伤后早期解决家庭成员的社会支持问题，并且需要更多专门针对家庭成员需求的干预措施。该试验于2018年6月4日在ClinicalTrials.gov上注册，编号为NCT03545594。

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引用次数: 0

Olanzapine vs. magnesium valproate vs. lamotrigine in anti-N-methyl-D-aspartic acid receptor encephalitis: a retrospective study 奥氮平与丙戊酸镁与拉莫三嗪治疗抗N-甲基-D-天冬氨酸受体脑炎：一项回顾性研究

IF 2.6 3区医学 Q3 CLINICAL NEUROLOGY

BMC Neurology

Pub Date : 2024-09-09 DOI: 10.1186/s12883-024-03811-z

Yinhua Yan, Chenxiao Yao, Bo Zhang, Zhenyu Yang, Jiahui Xie, Miao Tang, Qiong Long, Ewen Tu, Xuanqi Dong

This study aimed to compare the impact of olanzapine, magnesium valproate, and lamotrigine as adjunctive treatments for anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. And it is expected to add supporting points related to the rebalance of neurotransmitters in the brain through adjuvant therapy in the clinical management of anti-NMDAR encephalitis. This retrospective study included patients diagnosed with anti-NMDAR encephalitis who received standardized immunotherapy at Hunan Brain Hospital between January 2018 and December 2020. Compared to the olanzapine group, both the magnesium valproate and lamotrigine groups showed lower scores on the positive and negative symptom scale (PANSS) total score after 3 weeks of treatment (all P < 0.05). The Montreal Cognitive Assessment Scale (MoCA) scores in the magnesium valproate and lamotrigine groups were significantly higher than in the olanzapine group after 3 weeks and 3 months of treatment (all P < 0.05). After 3 months of treatment, the proportions of patients with a modified Rankin scale score (mRS) of 0–1 in the magnesium valproate and lamotrigine groups were significantly higher than in the olanzapine group (all P < 0.05). The electroencephalogram (EEG) abnormality ranks at 3 months were significantly lower in the magnesium valproate and lamotrigine groups compared with the olanzapine group (all P < 0.05). Furthermore, the Glx/Cr ratio significantly decreased after 3 months of treatment (all P < 0.05) in the magnesium valproate and lamotrigine groups, while the Glx/Cr ratio in the olanzapine group showed no significant change (P > 0.05). Compared with olanzapine, the addition of magnesium valproate or lamotrigine to immunotherapy might be associated with a lower PANSS score, higher MoCA score, and lower mRS score. The improvement of neurological functions and cognitive function may be related to the decreased Glx/Cr ratio.

本研究旨在比较奥氮平、丙戊酸镁和拉莫三嗪作为抗N-甲基-D-天冬氨酸受体（NMDAR）脑炎辅助治疗的影响。此外，该研究还希望为抗 NMDAR 脑炎的临床治疗增加与通过辅助治疗重新平衡脑内神经递质相关的支持点。这项回顾性研究纳入了2018年1月至2020年12月期间在湖南省脑科医院接受规范化免疫治疗的确诊为抗NMDAR脑炎的患者。与奥氮平组相比，丙戊酸镁组和拉莫三嗪组在治疗3周后的阳性和阴性症状量表（PANSS）总分均较低（均为P 0.05）。与奥氮平相比，在免疫疗法中添加丙戊酸镁或拉莫三嗪可能会降低 PANSS 评分、提高 MoCA 评分和降低 mRS 评分。神经功能和认知功能的改善可能与 Glx/Cr 比值的降低有关。

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引用次数: 0

Rescue therapy of early neurological deterioration in lacunar stroke. 腔隙性中风早期神经功能恶化的抢救治疗。

IF 2.2 3区医学 Q3 CLINICAL NEUROLOGY

BMC Neurology

Pub Date : 2024-09-07 DOI: 10.1186/s12883-024-03825-7

Soo-Hyun Park, Jonguk Kim, Cindy W Yoon, Hee-Kwon Park, Joung-Ho Rha

Background: Early neurological deterioration (END) occurs in many patients with acute ischemic stroke due to a variety of causes. Although pharmacologically induced hypertension (PIH) and anticoagulants have been investigated in several clinical trials for the treatment of END, the efficacy and safety of these treatments remain unclear. Here, we investigated whether PIH or anticoagulation is better as a rescue therapy for the progression of END in patients with lacunar stroke.

Methods: This study included patients with lacunar stroke who received rescue therapy with END within 3 days of symptom onset between April 2014 and August 2021. In the PIH group, phenylephrine was administered intravenously for 24 h and slowly tapered when symptoms improved or after 5 days of PIH. In the anticoagulation group, argatroban was administered continuously intravenously for 2 days and twice daily for next 5 days. We compared END recovery, defined as improvement in NIHSS from baseline, excellent outcomes (0 or 1 mRS at 3 months), and safety profile.

Results: Among the 4818 patients with the lacunar stroke, END occurred in 147 patients. Seventy-nine patients with END received PIH (46.9%) and 68 patients (46.3%) received anticoagulation therapy. There was no significant difference in age (P = 0.82) and sex (P = 0.87) between the two groups. Compared to the anticoagulation group, the PIH group had a higher incidence of END recovery (77.2% vs. 51.5%, P < 0.01) and excellent outcomes (34.2% vs. 16.2%, P = 0.04). PIH was associated with END (HR 2.49; 95% CI 1.06-5.81, P = 0.04). PIH remained associated with END recovery (adjusted HR 3.91; 95% CI 1.19-12.90, P = 0.02). Safety outcomes, like hemorrhagic conversion and mortality, were not significantly different between the two groups.

Conclusions: As a rescue therapy for the progression of END in lacunar stroke patients, PIH with phenylephrine was more effective with similar safety compared to anticoagulation with argatroban.

背景：许多急性缺血性卒中患者会因各种原因出现早期神经功能恶化（END）。虽然药物性高血压（PIH）和抗凝药物已在多项临床试验中用于治疗END，但这些治疗方法的有效性和安全性仍不明确。在此，我们研究了PIH或抗凝作为腔隙性卒中患者END进展的抢救疗法是否更好：本研究纳入了 2014 年 4 月至 2021 年 8 月间在症状出现 3 天内接受END 抢救治疗的腔隙性脑卒中患者。在PIH组，苯肾上腺素静脉注射24小时，症状改善或PIH 5天后缓慢减量。在抗凝组，阿加曲班持续静脉注射 2 天，随后 5 天每天两次。我们比较了END的恢复情况（定义为NIHSS较基线有所改善）、优良疗效（3个月时mRS为0或1）和安全性：在 4818 名腔隙性中风患者中，有 147 名患者发生了END。79名END患者接受了PIH治疗（46.9%），68名患者（46.3%）接受了抗凝治疗。两组患者在年龄（P = 0.82）和性别（P = 0.87）方面无明显差异。与抗凝治疗组相比，PIH 组的END 恢复率更高（77.2% 对 51.5%，P 结论：PIH 组的END 恢复率低于抗凝治疗组：作为腔隙性卒中患者END进展的抢救疗法，与阿加曲班抗凝相比，使用苯肾上腺素的PIH更有效，且安全性相似。

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引用次数: 0

Assessing the effectiveness of greater occipital nerve block in chronic migraine: a systematic review and meta-analysis. 评估枕大神经阻滞对慢性偏头痛的疗效：系统回顾和荟萃分析。

IF 2.2 3区医学 Q3 CLINICAL NEUROLOGY

BMC Neurology

Pub Date : 2024-09-07 DOI: 10.1186/s12883-024-03834-6

Muhamad Saqlain Mustafa, Shafin Bin Amin, Aashish Kumar, Muhammad Ashir Shafique, Syeda Mahrukh Fatima Zaidi, Syed Ali Arsal, Burhanudin Sohail Rangwala, Muhammad Faheem Iqbal, Adarsh Raja, Abdul Haseeb, Inshal Jawed, Khabab Abbasher Hussien Mohamed Ahmed, Syed Muhammad Sinaan Ali, Giustino Varrassi

Background & aims: Chronic migraine poses a global health burden, particularly affecting young women, and has substantial societal implications. This study aimed to assess the efficacy of Greater Occipital Nerve Block (GONB) in individuals with chronic migraine, focusing on the impact of local anesthetics compared with placebo.

Methods: A meta-analysis and systematic review were conducted following the PRISMA principles and Cochrane Collaboration methods. Eligible studies included case-control, cohort, and randomized control trials in adults with chronic migraine, adhering to the International Classification of Headache Disorders, third edition (ICHD3). Primary efficacy outcomes included headache frequency, duration, and intensity along with safety assessments.

Results: Literature searches across multiple databases yielded eight studies for qualitative analysis, with five included in the final quantitative analysis. A remarkable reduction in headache intensity and frequency during the first and second months of treatment with GONB using local anesthetics compared to placebo has been reported. The incidence of adverse events did not differ significantly between the intervention and placebo groups.

Conclusion: The analysis emphasized the safety and efficacy of GONB, albeit with a cautious interpretation due to the limited number of studies and relatively small sample size. This study advocates for further research exploring various drugs, frequencies, and treatment plans to enhance the robustness and applicability of GONB for chronic migraine management.

背景与目的：慢性偏头痛给全球健康造成了负担，尤其影响到年轻女性，并对社会产生了重大影响。本研究旨在评估大枕神经阻滞术（GONB）对慢性偏头痛患者的疗效，重点关注局麻药与安慰剂相比的影响：方法：按照 PRISMA 原则和 Cochrane 协作方法进行了荟萃分析和系统综述。符合条件的研究包括病例对照、队列和随机对照试验，研究对象为慢性偏头痛成人患者，符合《国际头痛疾病分类》第三版（ICHD3）。主要疗效结果包括头痛频率、持续时间和强度以及安全性评估：结果：通过多个数据库的文献检索，我们获得了八项定性分析研究，其中五项纳入了最终的定量分析。据报道，与安慰剂相比，在使用局麻药进行 GONB 治疗的第一和第二个月中，头痛的强度和频率明显降低。干预组和安慰剂组的不良反应发生率没有明显差异：分析强调了 GONB 的安全性和有效性，但由于研究数量有限且样本量相对较小，因此需要谨慎解释。本研究主张进一步研究探索各种药物、频率和治疗方案，以提高 GONB 用于慢性偏头痛治疗的稳健性和适用性。

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引用次数: 0

Urdu translation and cross-cultural validation of neurological fatigue index on post stroke. 中风后神经疲劳指数的乌尔都语翻译和跨文化验证。

IF 2.2 3区医学 Q3 CLINICAL NEUROLOGY

BMC Neurology

Pub Date : 2024-09-06 DOI: 10.1186/s12883-024-03827-5

Sadia Nazir, Mehwish Ikram, Maryam Ikram, Syed Shakil Ur Rehman, Hafiza Rabia Javed

Background: The Neurological Fatigue Index (NFI) is the instrument used to evaluate stroke patients' fatigue. There was no Urdu version of NFI available officially.

Objective: This study aimed to translate the Neurological Fatigue Index into Urdu and to determine the validity and reliability of Urdu NFI among stroke patients.

Methodology: It is a cross-cultural validation study. According to international guidelines in phase I, a process of translation was carried out. In phase II, using the sample of 120 participants, validity and reliability of the Urdu version of the Neurological Fatigue Index scale was conducted. The Urdu version's content validity, convergent/concurrent validity, test-retest reliability, and internal consistency were determined. The latest version of SPSS was used for the data analysis.

Results: The Urdu version of NFI was drafted after the expert's review. The content validity index was used to analyze the content validity. The reliability and validity of the Urdu version NFI were evaluated by calculating Cronbach's alpha (α = 0.86), and intra-class correlation coefficient (ICC = 0.823). Correlations with other scales were the fatigue Severity Scale (FSS) (r = 0.76), Mental Fatigue Scale (MFS) (r = 0.68), Beck Depression Inventory (BDI) (r = 0.53) and Epworth Sleepiness Scale (ESS) (r = 0.47).

Conclusion: The Urdu Version was linguistically acceptable for the fatigue assessment in post-stroke patients. It showed good content validity, convergent/concurrent validity, internal consistency, and test-retest reliability.

背景：神经疲劳指数（NFI）是用于评估中风患者疲劳程度的工具。目前还没有乌尔都语版的 NFI 正式版本：本研究旨在将神经疲劳指数翻译成乌尔都语，并确定乌尔都语 NFI 在中风患者中的有效性和可靠性：这是一项跨文化验证研究。在第一阶段，根据国际指南进行了翻译。在第二阶段，以 120 名参与者为样本，对乌尔都语版神经疲劳指数量表进行了效度和信度分析。确定了乌尔都语版量表的内容效度、收敛/并发效度、重测信度和内部一致性。数据分析使用了最新版本的 SPSS：乌尔都语版 NFI 是在专家评审后起草的。内容效度指数用于分析内容效度。通过计算 Cronbach's alpha（α = 0.86）和类内相关系数（ICC = 0.823），评估了乌尔都语版 NFI 的信度和效度。与其他量表的相关性为疲劳严重程度量表（FSS）（r = 0.76）、精神疲劳量表（MFS）（r = 0.68）、贝克抑郁量表（BDI）（r = 0.53）和埃普沃斯嗜睡量表（ESS）（r = 0.47）：结论：乌尔都语版可用于脑卒中后患者的疲劳评估。结论：乌尔都语版对脑卒中后患者的疲劳评估在语言上是可接受的，它显示了良好的内容效度、收敛/并发效度、内部一致性和测试-再测试可靠性。

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引用次数: 0

Lifetime exposure to smoking and substance abuse may be associated with late-onset multiple sclerosis: a population-based case-control study. 终生吸烟和滥用药物可能与晚发性多发性硬化症有关：一项基于人群的病例对照研究。

IF 2.2 3区医学 Q3 CLINICAL NEUROLOGY

BMC Neurology

Pub Date : 2024-09-06 DOI: 10.1186/s12883-024-03815-9

Naghmeh Abbasi Kasbi, Sajjad Ghane Ezabadi, Kosar Kohandel, Faezeh Khodaie, Amir Hossein Sahraian, Sahar Nikkhah Bahrami, Mahsa Mohammadi, Amir Almasi-Hashiani, Sharareh Eskandarieh, Mohammad Ali Sahraian

Background: Late-onset multiple sclerosis (LOMS), defined as the development of MS after the age of 50, has shown a substantial surge in incidence rates and is associated with more rapid progression of disability. Besides, studies have linked tobacco smoking to a higher chance of MS progression. However, the role of smoking on the risk of developing LOMS remains unclear. This study aims to evaluate the possible association between lifetime exposure to cigarette and waterpipe smoking, drug abuse, and alcohol consumption and the risk of LOMS.

Methods: This population-based case-control study involved LOMS cases and healthy sex and age-matched controls from the general population in Tehran, Iran. The primary data for confirmed LOMS cases were obtained from the nationwide MS registry of Iran (NMSRI), while supplementary data were collected through telephone and on-site interviews. Predesigned questionnaire for multinational case-control studies of MS environmental risk factors was used to evaluate the LOMS risk factors. The study employed Likelihood ratio chi-square test to compare qualitative variables between the two groups and utilized two independent sample t-test to compare quantitative data. Adjusted odds ratio (AOR) for age along with 95% confidence intervals (CI) were calculated using matched logistic regression analysis in SPSS 23.

Results: Totally, 83 LOMS cases and 207 controls were included in the analysis. The female to male ratio in the cases was 1.5: 1. The mean ± SD age of 83 cases and 207 controls was 61.14 ± 5.38) and 61.51 ± 7.67 years, respectively. The mean ± SD expanded disability status scale (EDSS) score was 3.68 ± 2.1. Although the results of waterpipe exposure had no significant effect on LOMS development (P-value: 0.066), ever cigarette-smoked participants had a significantly higher risk of developing LOMS than those who never smoked (AOR: 2.57, 95% CI: 1.44-4.60). Furthermore, people with a history of smoking for more than 20 years had 3.45 times the odds of developing MS than non-smokers. Drug and alcohol abuse were both associated with LOMS in our study; of which opioids (AOR: 5.67, 95% CI: 2.05-15.7), wine (AOR: 3.30, 95% CI: 1.41-7.71), and beer (AOR: 3.12, 95% CI: 1.45-6.69) were found to pose the greatest risk of LOMS, respectively.

Conclusion: For the first time, we identified smoking, drug, and alcohol use as potential risk factors for LOMS development. According to the global increase in cigarette smoking and alcohol use, these findings highlight the importance of conducting interventional approaches for prevention.

背景：晚发性多发性硬化症（LOMS）是指 50 岁以后发病的多发性硬化症，其发病率大幅上升，并与残疾进展更快有关。此外，研究还发现吸烟与多发性硬化症的进展几率有关。然而，吸烟对罹患多发性硬化症风险的影响仍不明确。本研究旨在评估终生暴露于吸烟和水烟、滥用药物和饮酒与 LOMS 风险之间可能存在的关联：这项基于人群的病例对照研究涉及伊朗德黑兰普通人群中的LOMS病例和性别与年龄匹配的健康对照者。LOMS确诊病例的主要数据来自伊朗全国多发性硬化症登记处（NMSRI），补充数据则通过电话和现场访谈收集。研究采用了为多发性硬化症环境风险因素多国病例对照研究预先设计的问卷来评估 LOMS 风险因素。研究采用似然比卡方检验比较两组之间的定性变量，并采用两个独立样本 t 检验比较定量数据。使用 SPSS 23 中的配对逻辑回归分析计算了年龄调整后的几率比（AOR）和 95% 的置信区间（CI）：共有 83 例 LOMS 病例和 207 例对照病例参与了分析。83 例病例和 207 例对照的平均（± SD）年龄分别为 61.14 ± 5.38 岁和 61.51 ± 7.67 岁。残疾状况量表（EDSS）的平均（± SD）分值为 3.68 ± 2.1。虽然水烟暴露对 LOMS 的发展没有显著影响（P 值：0.066），但曾经吸烟的参与者患 LOMS 的风险明显高于从不吸烟者（AOR：2.57，95% CI：1.44-4.60）。此外，吸烟史超过20年的人患多发性硬化症的几率是不吸烟者的3.45倍。在我们的研究中，药物滥用和酗酒都与LOMS有关；其中阿片类药物（AOR：5.67，95% CI：2.05-15.7）、葡萄酒（AOR：3.30，95% CI：1.41-7.71）和啤酒（AOR：3.12，95% CI：1.45-6.69）分别被认为是LOMS的最大风险来源：我们首次发现吸烟、吸毒和酗酒是导致LOMS发生的潜在风险因素。鉴于全球吸烟和饮酒人数的增加，这些研究结果凸显了采取干预措施进行预防的重要性。

{"title":"Lifetime exposure to smoking and substance abuse may be associated with late-onset multiple sclerosis: a population-based case-control study.","authors":"Naghmeh Abbasi Kasbi, Sajjad Ghane Ezabadi, Kosar Kohandel, Faezeh Khodaie, Amir Hossein Sahraian, Sahar Nikkhah Bahrami, Mahsa Mohammadi, Amir Almasi-Hashiani, Sharareh Eskandarieh, Mohammad Ali Sahraian","doi":"10.1186/s12883-024-03815-9","DOIUrl":"10.1186/s12883-024-03815-9","url":null,"abstract":"Background: Late-onset multiple sclerosis (LOMS), defined as the development of MS after the age of 50, has shown a substantial surge in incidence rates and is associated with more rapid progression of disability. Besides, studies have linked tobacco smoking to a higher chance of MS progression. However, the role of smoking on the risk of developing LOMS remains unclear. This study aims to evaluate the possible association between lifetime exposure to cigarette and waterpipe smoking, drug abuse, and alcohol consumption and the risk of LOMS.Methods: This population-based case-control study involved LOMS cases and healthy sex and age-matched controls from the general population in Tehran, Iran. The primary data for confirmed LOMS cases were obtained from the nationwide MS registry of Iran (NMSRI), while supplementary data were collected through telephone and on-site interviews. Predesigned questionnaire for multinational case-control studies of MS environmental risk factors was used to evaluate the LOMS risk factors. The study employed Likelihood ratio chi-square test to compare qualitative variables between the two groups and utilized two independent sample t-test to compare quantitative data. Adjusted odds ratio (AOR) for age along with 95% confidence intervals (CI) were calculated using matched logistic regression analysis in SPSS 23.Results: Totally, 83 LOMS cases and 207 controls were included in the analysis. The female to male ratio in the cases was 1.5: 1. The mean ± SD age of 83 cases and 207 controls was 61.14 ± 5.38) and 61.51 ± 7.67 years, respectively. The mean ± SD expanded disability status scale (EDSS) score was 3.68 ± 2.1. Although the results of waterpipe exposure had no significant effect on LOMS development (P-value: 0.066), ever cigarette-smoked participants had a significantly higher risk of developing LOMS than those who never smoked (AOR: 2.57, 95% CI: 1.44-4.60). Furthermore, people with a history of smoking for more than 20 years had 3.45 times the odds of developing MS than non-smokers. Drug and alcohol abuse were both associated with LOMS in our study; of which opioids (AOR: 5.67, 95% CI: 2.05-15.7), wine (AOR: 3.30, 95% CI: 1.41-7.71), and beer (AOR: 3.12, 95% CI: 1.45-6.69) were found to pose the greatest risk of LOMS, respectively.Conclusion: For the first time, we identified smoking, drug, and alcohol use as potential risk factors for LOMS development. According to the global increase in cigarette smoking and alcohol use, these findings highlight the importance of conducting interventional approaches for prevention.","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A comparative study of vestibular projection connectivity and balance in healthy young adults and elderly subjects. 健康年轻人和老年人前庭投射连通性与平衡的比较研究。

IF 2.2 3区医学 Q3 CLINICAL NEUROLOGY

BMC Neurology

Pub Date : 2024-09-06 DOI: 10.1186/s12883-024-03819-5

Sang Seok Yeo, Seunghue Oh, In Hee Cho

Objective: Vestibular function is controlled by interactions between various neuropathways that have different effects on balance and are connected to various brain areas. However, few studies have investigated the relation between changes in VN connectivity and aging using neuroimaging. We investigated neural connectivities in the vestibular nucleus (VN) and ventralis intermedius (VIM) nucleus of the thalamus in young and old healthy adults by diffusion tensor imaging.

Methods: This study recruited twenty-three normal healthy adults with no history of a neurological or musculoskeletal disease, that is, eleven old healthy adults (6 males, 5 females; mean age 63.36 ± 4.25 years) and 12 young healthy adults (7 males, 5 females; mean age 28.42 ± 4.40 years). Connectivity was defined as the incidence of connection between the VN, VIM, and target brain regions. Incidence of connection was counted from VN and VIM to each brain region. The subjective visual vertical (SVV) and the Berg balance scale (BBS) were used to assess vestibular function and balance.

Results: The VN showed high connectivity with brainstem (dentate nucleus, medial longitudinal fasciculus, and VIM), but relatively low connectivity with cerebral cortex (parieto-insular vestibular cortex (PIVC) and primary somatosensory cortex) at a threshold of 30 streamlines. In particular, VN connectivity with PIVC was significantly lower in elderly adults (> 60 years old) than in young adults (20-40 years old) (p < 0.05). VIM showed high to mid connectivity with brainstems and cerebral cortexes at a threshold of 30, but no significant difference was observed between young and old adults (p > 0.05). SVV and BBS showed no significant differences between young and old adults (p > 0.05).

Conclusion: We investigated incidences of neural connectivities of VN and VIM in young and old healthy adults. Our results provide basic data that might be clinically useful following injury of vestibular-related areas.

目的：前庭功能受控于各种神经通路之间的相互作用，这些神经通路对平衡有不同的影响，并与不同的脑区相连。然而，很少有研究使用神经影像学方法研究前庭神经核连接变化与衰老之间的关系。我们通过弥散张量成像研究了年轻和老年健康成人丘脑前庭核（VN）和腹侧中间核（VIM）的神经连接性：本研究招募了 23 名无神经系统或肌肉骨骼疾病史的正常健康成年人，即 11 名老年健康成年人（6 名男性，5 名女性；平均年龄为 63.36 ± 4.25 岁）和 12 名年轻健康成年人（7 名男性，5 名女性；平均年龄为 28.42 ± 4.40 岁）。连接性定义为 VN、VIM 和目标脑区之间的连接发生率。连接发生率是从 VN 和 VIM 到每个脑区的计数。主观视觉垂直度（SVV）和伯格平衡量表（BBS）用于评估前庭功能和平衡能力：结果：在 30 条流线的阈值下，VN 与脑干（齿状核、内侧纵筋膜和 VIM）的连接性较高，但与大脑皮层（顶叶内侧前庭皮层（PIVC）和初级体感皮层）的连接性相对较低。特别是，老年人（60 岁以上）的 VN 与前庭皮层的连接性明显低于年轻人（20-40 岁）（P 0.05）。SVV 和 BBS 在年轻人和老年人之间没有明显差异（P > 0.05）：我们研究了年轻和年老健康成年人 VN 和 VIM 神经连接的发生率。我们的研究结果提供了前庭相关区域损伤后可能对临床有用的基本数据。

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引用次数: 0

Attitudes and beliefs towards medication burden and deprescribing in Parkinson disease. 帕金森病患者对用药负担和停药的态度和观念。

IF 2.2 3区医学 Q3 CLINICAL NEUROLOGY

BMC Neurology

Pub Date : 2024-09-06 DOI: 10.1186/s12883-024-03830-w

Thanh Phuong Pham Nguyen, Dylan Thibault, Ali G Hamedani, Allison W Willis

Background: Deprescribing of potentially inappropriate medications is recommended for older adults and may improve health outcomes and quality of life in persons living with Parkinson disease (PD). Patient attitudes, beliefs, and preferences play a crucial role in the success of deprescribing interventions. We aimed to examine the attitudes and beliefs about medication burden and deprescribing among persons living with PD.

Methods: We administered a survey to participants of Fox Insight, a prospective longitudinal study of persons living with PD. The survey included the revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire and additional questions about adverse drug effects. We used logistic regression models to explore potential predictors of treatment dissatisfaction and willingness to deprescribe.

Results: Of the 4945 rPATD respondents, 31.6% were dissatisfied with their current medications, and 87.1% would be willing to deprescribe medications. Male sex was associated with a greater willingness to deprescribe (adjusted odds ratio [aOR] 1.62, 95% confidence interval [CI] 1.37-1.93). A greater belief that the medication burden was high or that some medications were inappropriate was associated with treatment dissatisfaction (aORs 3.74, 95% CI 3.26-4.29 and 5.61, 95% CI 4.85-6.50), and more willingness to deprescribe (aORs 1.74, 95% CI 1.47-2.06 and 2.87, 95% CI 2.41-3.42). Cognitive impairment was the adverse drug effect participants were most concerned about when prescribed new medications to treat nonmotor symptoms.

Conclusions: Persons with PD are often dissatisfied with their overall medication load and are open to deprescribing. Medications that are associated with cognitive impairment might be prioritized targets for deprescribing interventions in this population.

背景：建议老年人停用可能不合适的药物，这可改善帕金森病（PD）患者的健康状况和生活质量。患者的态度、信念和偏好对减药干预的成功与否起着至关重要的作用。我们旨在研究帕金森病患者对用药负担和减药的态度和信念：我们对 "福克斯洞察"（Fox Insight）项目的参与者进行了一项调查，该项目是一项针对帕金森病患者的前瞻性纵向研究。调查内容包括经修订的 "患者对去处方化的态度"（rPATD）问卷以及有关药物不良反应的附加问题。我们使用逻辑回归模型探讨了治疗不满意度和处方意愿的潜在预测因素：在 4945 名 rPATD 受访者中，31.6% 的人对目前的药物治疗不满意，87.1% 的人愿意停药。男性与更愿意停药有关（调整赔率[aOR]1.62，95% 置信区间[CI]1.37-1.93）。更认为用药负担重或某些药物不合适与治疗不满意度有关（aORs 3.74，95% CI 3.26-4.29 和 5.61，95% CI 4.85-6.50），也与更愿意停药有关（aORs 1.74，95% CI 1.47-2.06 和 2.87，95% CI 2.41-3.42）。认知障碍是参与者在处方治疗非运动症状的新药时最担心的药物不良反应：结论：帕金森病患者通常对其总体用药量不满意，并愿意减药。在这一人群中，与认知障碍相关的药物可能是优先考虑的减药干预目标。

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引用次数: 0