Pub Date : 2025-06-01DOI: 10.1016/j.nrleng.2025.04.007
T. Julio-Ramos , C. Foncea-Gonzalez , C. Farias-Ulloa , S. Inostroza-Rojas , J. Conejeros-Pavez , D. Gutierrez-Vasquez , B. Soler-Leon , J. Saez-Martinez , P. Solinas-Ivys , N. Demeyere , S. Martinez-Ferreiro , C. Mendez-Orellana
Introduction
Cognitive impairment is a typical sequel and a solid long-term disability predictor that can be screened at early stages post-stroke. However, most routinely used cognitive screening tools were designed to detect dementia, which differs significantly from post-stroke cognitive impairment, including focal cognitive deficits. The Oxford Cognitive Screen (OCS), a cognitive bedside screening tool specifically designed for acute stroke, provides a good alternative for clinical practice.
Aim
This study aims at validating an American-Spanish version of the OCS (OCS-Sp) in healthy participants and acute stroke patients.
Methods
The original version of the OCS was linguistically and culturally adapted into American Spanish. A total of 152 volunteers were recruited, 87 healthy controls and 65 acute stroke patients. Normative data analysis for determining cut-off scores and psychometric validation and reliability analyses in the stroke cohort were completed.
Results
Following a linear regression model demonstrating age, gender, and particularly years of education affecting the performance of the OCS-Sp, the cut-off scores obtained for all subtests were adjusted by these demographic variables. Logistic regression classification analyses revealed that all subtests could discriminate between patients and healthy volunteers. No differences in performance between versions A and B of the test (p > 0.05) were found. The test–retest reliability results in patients showed high agreement between the scores obtained at both time points.
Conclusions
The OCS-Sp obtained similar psychometric scores to the original English version, demonstrating its validity and reliability as an instrument to assess cognitive impairments in American Spanish-speaking acute stroke patients.
{"title":"Validation of the American-Spanish Oxford Cognitive Screen (OCS-Sp): Normative data and psychometric properties in acute stroke patients","authors":"T. Julio-Ramos , C. Foncea-Gonzalez , C. Farias-Ulloa , S. Inostroza-Rojas , J. Conejeros-Pavez , D. Gutierrez-Vasquez , B. Soler-Leon , J. Saez-Martinez , P. Solinas-Ivys , N. Demeyere , S. Martinez-Ferreiro , C. Mendez-Orellana","doi":"10.1016/j.nrleng.2025.04.007","DOIUrl":"10.1016/j.nrleng.2025.04.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Cognitive impairment is a typical sequel and a solid long-term disability predictor that can be screened at early stages post-stroke. However, most routinely used cognitive screening tools were designed to detect dementia, which differs significantly from post-stroke cognitive impairment, including focal cognitive deficits. The Oxford Cognitive Screen (OCS), a cognitive bedside screening tool specifically designed for acute stroke, provides a good alternative for clinical practice.</div></div><div><h3>Aim</h3><div>This study aims at validating an American-Spanish version of the OCS (OCS-Sp) in healthy participants and acute stroke patients.</div></div><div><h3>Methods</h3><div>The original version of the OCS was linguistically and culturally adapted into American Spanish. A total of 152 volunteers were recruited, 87 healthy controls and 65 acute stroke patients. Normative data analysis for determining cut-off scores and psychometric validation and reliability analyses in the stroke cohort were completed.</div></div><div><h3>Results</h3><div>Following a linear regression model demonstrating age, gender, and particularly years of education affecting the performance of the OCS-Sp, the cut-off scores obtained for all subtests were adjusted by these demographic variables. Logistic regression classification analyses revealed that all subtests could discriminate between patients and healthy volunteers. No differences in performance between versions A and B of the test (<em>p</em> <!-->><!--> <!-->0.05) were found. The test–retest reliability results in patients showed high agreement between the scores obtained at both time points.</div></div><div><h3>Conclusions</h3><div>The OCS-Sp obtained similar psychometric scores to the original English version, demonstrating its validity and reliability as an instrument to assess cognitive impairments in American Spanish-speaking acute stroke patients.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 5","pages":"Pages 422-432"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01DOI: 10.1016/j.nrleng.2025.04.009
M. Rodrigo-Gisbert , E. Caronna , A. Alpuente , M. Torres-Ferrús , P. Pozo-Rosich
Introduction
Posterior reversible encephalopathy syndrome (PRES) is a neurological disorder consisting in cerebrovascular dysregulation with acute neurological symptoms, including headache. However, there is a paucity of data that point to headache as a sequela of PRES. We aimed to explore its prevalence, characteristics, and impact.
Methods
We retrospectively included all consecutive patients with PRES attended at our institution from April 2018 to January 2022. We collected demographic and clinico-radiological data from the acute phase. During a mean follow-up time of 16 (14) months, we assessed the presence of headache after PRES and evaluated its impact using validated questionnaires.
Results
Of the 27 cases detected, after excluding 16 patients (11 deceased and 5 lost to follow-up), we evaluated 11 patients with a mean age of 38 (14) years; 63.6% were female. After PRES resolution, 9/11 (81.8%) patients presented headache, with migraine-like features in 8/9 (88.9%). Seven patients completed validated questionnaires; on the Migraine Disability Assessment scale, 71.4% (5/7) had moderate–severe disability. The Short Form-36 Health Survey dimensions of general health, physical role, and vitality reflected a deterioration in the quality of life.
Conclusions
Our data suggest that headache is a potential sequela of PRES that could imply subsequent disability. Migraine-like features point to the existence of shared pathophysiological mechanisms with migraine, which may mainly involve vascular and endothelial functions; however, more studies are needed.
{"title":"Headache: A potential sequela of posterior reversible encephalopathy syndrome","authors":"M. Rodrigo-Gisbert , E. Caronna , A. Alpuente , M. Torres-Ferrús , P. Pozo-Rosich","doi":"10.1016/j.nrleng.2025.04.009","DOIUrl":"10.1016/j.nrleng.2025.04.009","url":null,"abstract":"<div><h3>Introduction</h3><div>Posterior reversible encephalopathy syndrome (PRES) is a neurological disorder consisting in cerebrovascular dysregulation with acute neurological symptoms, including headache. However, there is a paucity of data that point to headache as a sequela of PRES. We aimed to explore its prevalence, characteristics, and impact.</div></div><div><h3>Methods</h3><div>We retrospectively included all consecutive patients with PRES attended at our institution from April 2018 to January 2022. We collected demographic and clinico-radiological data from the acute phase. During a mean follow-up time of 16 (14) months, we assessed the presence of headache after PRES and evaluated its impact using validated questionnaires.</div></div><div><h3>Results</h3><div>Of the 27 cases detected, after excluding 16 patients (11 deceased and 5 lost to follow-up), we evaluated 11 patients with a mean age of 38 (14) years; 63.6% were female. After PRES resolution, 9/11 (81.8%) patients presented headache, with migraine-like features in 8/9 (88.9%). Seven patients completed validated questionnaires; on the Migraine Disability Assessment scale, 71.4% (5/7) had moderate–severe disability. The Short Form-36 Health Survey dimensions of general health, physical role, and vitality reflected a deterioration in the quality of life.</div></div><div><h3>Conclusions</h3><div>Our data suggest that headache is a potential sequela of PRES that could imply subsequent disability. Migraine-like features point to the existence of shared pathophysiological mechanisms with migraine, which may mainly involve vascular and endothelial functions; however, more studies are needed.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 5","pages":"Pages 442-446"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01DOI: 10.1016/j.nrleng.2025.04.006
L. Amaya-Pascasio , J. Rodríguez-Pardo de Donlebún , A. Arjona-Padillo , J. Fernández-Domínguez , M. Martínez-Martínez , R. Muñoz-Arrondo , J.M. García-Sánchez , J. Pagola Pérez de la Blanca , J. Carneado-Ruiz , P. Martínez-Sánchez
In recent years, there has been increasing recognition of the benefits offered by rapid-access transient ischemic attack (TIA) clinics for the early assessment of patients with suspected TIA. These clinics, designed to deliver specialized diagnoses and treatments, play an important role in mitigating the risk of stroke recurrence. Most of these clinics benefit from using ultrasound diagnostic imaging conducted by qualified neurologists, which guides the treatment and management of TIA patients. This consensus document, developed by a working group from the Spanish Society of Neurosonology, introduces a novel concept for point-of-care ultrasound (POCUS), specifically focusing on optimizing the diagnostic process for TIA patients in the outpatient setting. The aim is to encourage experienced neurovascular clinicians to adopt a standardized, disease-oriented POCUS that can identify ultrasonographic findings related to the underlying cause of the TIA. Additionally, the document seeks to centralize the recommended diagnostic evaluations for TIA patients. By doing so, the goal is to optimize the diagnostic workup and subsequent treatment performed by the neurologist, fostering a more cohesive and effective approach to managing TIA cases.
{"title":"Point-of-care ultrasound for transient ischemic attack assessment in transient ischemic attack clinics: Consensus document of the Spanish Society of Neurosonology","authors":"L. Amaya-Pascasio , J. Rodríguez-Pardo de Donlebún , A. Arjona-Padillo , J. Fernández-Domínguez , M. Martínez-Martínez , R. Muñoz-Arrondo , J.M. García-Sánchez , J. Pagola Pérez de la Blanca , J. Carneado-Ruiz , P. Martínez-Sánchez","doi":"10.1016/j.nrleng.2025.04.006","DOIUrl":"10.1016/j.nrleng.2025.04.006","url":null,"abstract":"<div><div>In recent years, there has been increasing recognition of the benefits offered by rapid-access transient ischemic attack (TIA) clinics for the early assessment of patients with suspected TIA. These clinics, designed to deliver specialized diagnoses and treatments, play an important role in mitigating the risk of stroke recurrence. Most of these clinics benefit from using ultrasound diagnostic imaging conducted by qualified neurologists, which guides the treatment and management of TIA patients. This consensus document, developed by a working group from the Spanish Society of Neurosonology, introduces a novel concept for point-of-care ultrasound (POCUS), specifically focusing on optimizing the diagnostic process for TIA patients in the outpatient setting. The aim is to encourage experienced neurovascular clinicians to adopt a standardized, disease-oriented POCUS that can identify ultrasonographic findings related to the underlying cause of the TIA. Additionally, the document seeks to centralize the recommended diagnostic evaluations for TIA patients. By doing so, the goal is to optimize the diagnostic workup and subsequent treatment performed by the neurologist, fostering a more cohesive and effective approach to managing TIA cases.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 5","pages":"Pages 473-482"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01DOI: 10.1016/j.nrleng.2025.04.008
J. Alonso-Pérez , O. Barrachina-Esteve , L. González-Quereda , M.L. Viguera-Martinez , M. Luján-Torné , M. Guitart-Feliubadaló , J. Miguel Martínez , Á. Carbayo , P. Gallano , J. Díaz-Manera , M. Olivé , R. Rojas-Garcia
Background
Desminopathies are a clinically heterogeneous group of myopathies, with common histological findings in muscle biopsy. Clinically, they usually present with distal and/or proximal muscle weakness often associated with cardiomyopathy. We present 8 patients from 3 unrelated families manifesting isolated respiratory insufficiency without skeletal muscle weakness or heart disease, because of a mutation in the DES gene.
Methods
Clinical and demographic data were acquired from medical records. Muscle MRI studies were performed in 6 patients. A muscle biopsy study was performed in the index case from each family.
Results
Isolated restrictive respiratory dysfunction was observed in all symptomatic patients, with 2 requiring non-invasive ventilation. Three patients were asymptomatic at the time of the study. None of the patients presented skeletal muscle weakness or heart disease, even after 20 years of disease progression. Muscle MRI showed a common pattern with predominant involvement of the semitendinosus muscle. Muscle biopsy showed patches of cytoplasmic inclusions corresponding to desmin aggregates. The genetic study showed heterozygous presence of the p.Arg415Trp mutation in the DES gene in all patients.
Conclusions
We present 5 patients carrying a p.Arg415Trp mutation in the DES gene, manifesting as isolated restrictive respiratory insufficiency without associated skeletal muscle weakness or heart disease. These cases represent a new phenotype associated with DES mutations, thus suggesting that desminopathy should be considered in the diagnostic workup of patients presenting isolated respiratory failure.
{"title":"Novel DES mutation presenting with isolated restrictive respiratory failure. Expanding the clinical spectrum","authors":"J. Alonso-Pérez , O. Barrachina-Esteve , L. González-Quereda , M.L. Viguera-Martinez , M. Luján-Torné , M. Guitart-Feliubadaló , J. Miguel Martínez , Á. Carbayo , P. Gallano , J. Díaz-Manera , M. Olivé , R. Rojas-Garcia","doi":"10.1016/j.nrleng.2025.04.008","DOIUrl":"10.1016/j.nrleng.2025.04.008","url":null,"abstract":"<div><h3>Background</h3><div>Desminopathies are a clinically heterogeneous group of myopathies, with common histological findings in muscle biopsy. Clinically, they usually present with distal and/or proximal muscle weakness often associated with cardiomyopathy. We present 8 patients from 3 unrelated families manifesting isolated respiratory insufficiency without skeletal muscle weakness or heart disease, because of a mutation in the <em>DES</em> gene.</div></div><div><h3>Methods</h3><div>Clinical and demographic data were acquired from medical records. Muscle MRI studies were performed in 6 patients. A muscle biopsy study was performed in the index case from each family.</div></div><div><h3>Results</h3><div>Isolated restrictive respiratory dysfunction was observed in all symptomatic patients, with 2 requiring non-invasive ventilation. Three patients were asymptomatic at the time of the study. None of the patients presented skeletal muscle weakness or heart disease, even after 20 years of disease progression. Muscle MRI showed a common pattern with predominant involvement of the semitendinosus muscle. Muscle biopsy showed patches of cytoplasmic inclusions corresponding to desmin aggregates. The genetic study showed heterozygous presence of the p.Arg415Trp mutation in the <em>DES</em> gene in all patients.</div></div><div><h3>Conclusions</h3><div>We present 5 patients carrying a p.Arg415Trp mutation in the <em>DES</em> gene, manifesting as isolated restrictive respiratory insufficiency without associated skeletal muscle weakness or heart disease. These cases represent a new phenotype associated with <em>DES</em> mutations, thus suggesting that desminopathy should be considered in the diagnostic workup of patients presenting isolated respiratory failure.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 5","pages":"Pages 433-441"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01DOI: 10.1016/j.nrleng.2025.05.003
G. Prieto-Berchez , M.T. González-Campillo , J. Vicente-Rueda , E. López-Laso
Introduction
Mineralizing angiopathy of lenticulostriate arteries has been reported as etiology of acute arterial ischemic stroke of basal ganglia after minor head trauma, mostly in infants. Patients present with focal neurological deficit, commonly hemiparesis, minutes to hours after head trauma. Diagnostic clue is the finding of ischemic stroke of basal ganglia after minor head trauma together with basal ganglia calcifications.
Results
We present a 21-month-old infant with an acute right hemiparesis preceded by mild head trauma 8 h before. Neuroimaging studies showed an ischemic stroke of left basal ganglia together with bilateral basal ganglia calcifications. Other ancillary studies were normal. The patient received treatment with acetylsalicylic acid for antiplatelet therapy. Prognosis was excellent, he recovered the focal neurological deficit, and no recurrences nor neurological sequelae were found after a 6 year follow-up.
Conclusions
A high index of suspicion is necessary to identify mineralizing angiopathy of lenticulostriate arteries as etiology of an acute arterial ischemic stroke of basal ganglia after minor head trauma in early infancy. Stroke recurrence is possible.
{"title":"Mineralizing angiopathy: A cause of arterial ischemic stroke in early childhood after mild head trauma","authors":"G. Prieto-Berchez , M.T. González-Campillo , J. Vicente-Rueda , E. López-Laso","doi":"10.1016/j.nrleng.2025.05.003","DOIUrl":"10.1016/j.nrleng.2025.05.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Mineralizing angiopathy of lenticulostriate arteries has been reported as etiology of acute arterial ischemic stroke of basal ganglia after minor head trauma, mostly in infants. Patients present with focal neurological deficit, commonly hemiparesis, minutes to hours after head trauma. Diagnostic clue is the finding of ischemic stroke of basal ganglia after minor head trauma together with basal ganglia calcifications.</div></div><div><h3>Results</h3><div>We present a 21-month-old infant with an acute right hemiparesis preceded by mild head trauma 8<!--> <!-->h before. Neuroimaging studies showed an ischemic stroke of left basal ganglia together with bilateral basal ganglia calcifications. Other ancillary studies were normal. The patient received treatment with acetylsalicylic acid for antiplatelet therapy. Prognosis was excellent, he recovered the focal neurological deficit, and no recurrences nor neurological sequelae were found after a 6<!--> <!-->year follow-up.</div></div><div><h3>Conclusions</h3><div>A high index of suspicion is necessary to identify mineralizing angiopathy of lenticulostriate arteries as etiology of an acute arterial ischemic stroke of basal ganglia after minor head trauma in early infancy. Stroke recurrence is possible.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 5","pages":"Pages 468-472"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01DOI: 10.1016/j.nrleng.2025.05.001
F. Acebrón , R. Valverde
Introduction
Stroke is the leading cause of acquired disability in adults and the second leading cause of death. The SEGUICTUS project was carried out with the aim of knowing its clinical management in different hospitals in Spain, in order to promote corrective measures to reduce its incidence and derived consequences.
Methods
This cross-sectional multicenter research was carried out through a survey of 40 questions on opinion, attitude and behavior. The survey was answered by 205 neurology specialists from different regions of Spain.
Results
The availability of resources for stroke management was statistically lower in tertiary and regional hospitals. 36.6% of the participants assessed the presence of cognitive impairment in more than half of the patients, and 37.6% used specific questionnaires to assess cognitive impairment in less than 10% of the patients. The best considered therapeutic options for its treatment were acetylcholinesterase inhibitors and citylcholine. Statistically significant differences were observed in the percentage of participants who began rehabilitation treatment during admission, being lower in tertiary hospitals.
Conclusions
The shortage of stroke units, protocols and specialised consultations for the care of stroke patients may have an impact on the treatment of potential sequelae of stroke, such as cognitive impairment and motor sequelae. It is necessary to evaluate the deficit points in stroke management and implement the appropriate corrective measures.
{"title":"SEGUICTUS study: management and follow-up of patients with stroke in Spain","authors":"F. Acebrón , R. Valverde","doi":"10.1016/j.nrleng.2025.05.001","DOIUrl":"10.1016/j.nrleng.2025.05.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Stroke is the leading cause of acquired disability in adults and the second leading cause of death. The SEGUICTUS project was carried out with the aim of knowing its clinical management in different hospitals in Spain, in order to promote corrective measures to reduce its incidence and derived consequences.</div></div><div><h3>Methods</h3><div>This cross-sectional multicenter research was carried out through a survey of 40 questions on opinion, attitude and behavior. The survey was answered by 205 neurology specialists from different regions of Spain.</div></div><div><h3>Results</h3><div>The availability of resources for stroke management was statistically lower in tertiary and regional hospitals. 36.6% of the participants assessed the presence of cognitive impairment in more than half of the patients, and 37.6% used specific questionnaires to assess cognitive impairment in less than 10% of the patients. The best considered therapeutic options for its treatment were acetylcholinesterase inhibitors and citylcholine. Statistically significant differences were observed in the percentage of participants who began rehabilitation treatment during admission, being lower in tertiary hospitals.</div></div><div><h3>Conclusions</h3><div>The shortage of stroke units, protocols and specialised consultations for the care of stroke patients may have an impact on the treatment of potential sequelae of stroke, such as cognitive impairment and motor sequelae. It is necessary to evaluate the deficit points in stroke management and implement the appropriate corrective measures.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 5","pages":"Pages 456-467"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01DOI: 10.1016/j.nrleng.2025.04.010
L. Cayuela , C. García-Muñoz , S. Sainz de la Maza , A. Cayuela
Introduction
The global prevalence of multiple sclerosis (MS) has increased in recent decades. However, there is a need for updated prevalence data for Spain.
Objective
To analyze the prevalence of MS in Spain using data from the Primary Care Clinical Database (BDCAP, for its Spanish initials) and to compare the prevalence results in different autonomous communities (AC) according to sex in 2021.
Methods
This cross-sectional study extracted data from the BDCAP on patients with MS according to sex, age, and place of residence in 2021. Crude prevalence rates were calculated, using the population assigned for each year of the study as the denominator. The geographic pattern of MS prevalence was analyzed using the following risk estimators: standardized prevalence ratio, smoothed relative risk (RR), and posterior probability of RR >1.
Results
We estimated 61 753 cases of MS, with a crude estimated prevalence rate of 132.0 cases per 100 000 person-years and a female/male ratio of 2.0. The age-standardized prevalence rate was 123.5 cases per 100 000 person-years. Age-specific prevalence rates were lower in men than in women. All indicators showed a north-south gradient. Seven ACs for women and 5 ACs for men showed a significant excess risk (primarily in the north of Spain), whereas 8 ACs for both women and men presented lower risk (mainly in the south).
Conclusions
Our results provide the most recent prevalence data for MS and the geographic patterns at the ACs level in Spain, revealing a north-south gradient. Our results pave the way for future strategies to manage the impact of MS in Spain and to understand causal hypotheses.
近几十年来，多发性硬化症（MS）的全球患病率有所上升。然而，需要更新西班牙的流行率数据。目的利用西班牙初级保健临床数据库（Primary Care Clinical Database， BDCAP）的数据分析西班牙MS的患病率，并比较2021年不同性别自治区（AC） MS的患病率结果。方法：本横断面研究根据性别、年龄和居住地提取2021年MS患者BDCAP数据。计算粗患病率，使用分配给研究的每一年的人口作为分母。使用以下风险估计值分析MS患病率的地理分布：标准化患病率、平滑相对风险（RR）和RR >；1的后验概率。结果我们估计了61 753例MS，粗略估计患病率为每10万人年132.0例，男女比为2.0。年龄标准化患病率为每10万人年123.5例。男性按年龄划分的患病率低于女性。所有指标都显示出南北梯度。女性有7例ACs，男性有5例ACs，显示出明显的过度风险（主要在西班牙北部），而女性和男性都有8例ACs，风险较低（主要在南部）。结论sour结果提供了西班牙ACs水平MS的最新患病率数据和地理分布，呈现南北梯度。我们的结果为未来管理西班牙MS影响的策略和理解因果假设铺平了道路。
{"title":"Prevalence of multiple sclerosis in Spain. Estimates from the Primary Care Clinical Database (BDCAP)","authors":"L. Cayuela , C. García-Muñoz , S. Sainz de la Maza , A. Cayuela","doi":"10.1016/j.nrleng.2025.04.010","DOIUrl":"10.1016/j.nrleng.2025.04.010","url":null,"abstract":"<div><h3>Introduction</h3><div>The global prevalence of multiple sclerosis (MS) has increased in recent decades. However, there is a need for updated prevalence data for Spain.</div></div><div><h3>Objective</h3><div>To analyze the prevalence of MS in Spain using data from the Primary Care Clinical Database (BDCAP, for its Spanish initials) and to compare the prevalence results in different autonomous communities (AC) according to sex in 2021.</div></div><div><h3>Methods</h3><div>This cross-sectional study extracted data from the BDCAP on patients with MS according to sex, age, and place of residence in 2021. Crude prevalence rates were calculated, using the population assigned for each year of the study as the denominator. The geographic pattern of MS prevalence was analyzed using the following risk estimators: standardized prevalence ratio, smoothed relative risk (RR), and posterior probability of RR >1.</div></div><div><h3>Results</h3><div>We estimated 61<!--> <!-->753 cases of MS, with a crude estimated prevalence rate of 132.0 cases per 100<!--> <!-->000 person-years and a female/male ratio of 2.0. The age-standardized prevalence rate was 123.5 cases per 100<!--> <!-->000 person-years. Age-specific prevalence rates were lower in men than in women. All indicators showed a north-south gradient. Seven ACs for women and 5 ACs for men showed a significant excess risk (primarily in the north of Spain), whereas 8 ACs for both women and men presented lower risk (mainly in the south).</div></div><div><h3>Conclusions</h3><div>Our results provide the most recent prevalence data for MS and the geographic patterns at the ACs level in Spain, revealing a north-south gradient. Our results pave the way for future strategies to manage the impact of MS in Spain and to understand causal hypotheses.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 5","pages":"Pages 447-455"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01DOI: 10.1016/j.nrleng.2025.05.002
M. Rodríguez-Rodríguez , Y. Rodríguez-Agudelo , F.J. Soto-Moreno , A. García-Santos , D. López-González , M. González-Navarro , F. Paz-Rodríguez , M. Chávez-Oliveros , S. Lozano-Tovar , K. González-Alonso , A. Castorena-Maldonado , R. Carrillo-Mezo , O. Marrufo-Meléndez , A. Gutiérrez-Romero , M. Del Río Quiñones , A. Arauz-Góngora , S. Avila-Rios
Background
Cognitive impairments are one of the most common, insidious, and disabling symptoms of post-COVID-19 syndrome (PC-19), which have been correlated with damage to different brain structures.
Objective
To describe cognitive impairments in PC-19, identify associated variables, and compare the impact of mechanical ventilation on cognitive and neuroimaging outcomes.
Methods
A cohort of COVID-19 survivors was evaluated with neuropsychological tests (NPT) and cranial magnetic resonance imaging (MRI) 12 weeks after hospital discharge. Patients were classified into two groups based on whether they required invasive mechanical ventilation (IMV) or non-invasive mechanical ventilation (nIMV).
Results
60 patients completed the study, 41 received IMV and 19 nIMV, with an average age of 57.11 years. 66% scored below 26 points on the MoCA test and 83.3% reported everyday memory failures (EMF). 85% showed impairments in at least one NPT. When comparing results between groups, significant differences were observed in the total MoCA test score (P = .045) and EMF (P = .032). Significant relationships were observed between the Boston Naming Test (−0.287; P = .035), the Rey Figure Recall Test (−0.324; P = .017) with parietal atrophy, as well as phonological verbal fluency with frontal atrophy (−0.276; P = .042). The HVLT (learning trial) test was related to hippocampal hyperintensity (−0.266; P = .050) and cingulate hyperintensity (0.311; P = .021). The TMT-B test was related to white matter hyperintensity (0.345; P= .010). The presence of poor functional prognosis was correlated with anxiety (P < .001), depression (P < .001), elevated D-dimer levels (P = .002) and the increase in days of intubation (P = .005).
Conclusion
Our study suggests that COVID-19 survivors who had moderate-to-severe infection experience subjective complaints and cognitive impairments in executive function, attention, and memory, regardless of whether invasive mechanical ventilation was used during treatment. We found white matter lesions and cerebral atrophy in frontal and parietal regions that were associated with cognitive deficits. Our findings highlight the clinical need for longitudinal programmes capable of evaluating the real impact of SARS-CoV-2 infection on the central nervous system, particularly in the cognitive and emotional domains.
{"title":"Variables associated with cognitive alterations in a cohort of COVID-19 survivors at a tertiary hospital in Mexico","authors":"M. Rodríguez-Rodríguez , Y. Rodríguez-Agudelo , F.J. Soto-Moreno , A. García-Santos , D. López-González , M. González-Navarro , F. Paz-Rodríguez , M. Chávez-Oliveros , S. Lozano-Tovar , K. González-Alonso , A. Castorena-Maldonado , R. Carrillo-Mezo , O. Marrufo-Meléndez , A. Gutiérrez-Romero , M. Del Río Quiñones , A. Arauz-Góngora , S. Avila-Rios","doi":"10.1016/j.nrleng.2025.05.002","DOIUrl":"10.1016/j.nrleng.2025.05.002","url":null,"abstract":"<div><h3>Background</h3><div>Cognitive impairments are one of the most common, insidious, and disabling symptoms of post-COVID-19 syndrome (PC-19), which have been correlated with damage to different brain structures.</div></div><div><h3>Objective</h3><div>To describe cognitive impairments in PC-19, identify associated variables, and compare the impact of mechanical ventilation on cognitive and neuroimaging outcomes.</div></div><div><h3>Methods</h3><div>A cohort of COVID-19 survivors was evaluated with neuropsychological tests (NPT) and cranial magnetic resonance imaging (MRI) 12 weeks after hospital discharge. Patients were classified into two groups based on whether they required invasive mechanical ventilation (IMV) or non-invasive mechanical ventilation (nIMV).</div></div><div><h3>Results</h3><div>60 patients completed the study, 41 received IMV and 19 nIMV, with an average age of 57.11 years. 66% scored below 26 points on the MoCA test and 83.3% reported everyday memory failures (EMF). 85% showed impairments in at least one NPT. When comparing results between groups, significant differences were observed in the total MoCA test score (<em>P</em> = .045) and EMF (<em>P</em> = .032). Significant relationships were observed between the Boston Naming Test (−0.287; <em>P</em> = .035), the Rey Figure Recall Test (−0.324; <em>P</em> = .017) with parietal atrophy, as well as phonological verbal fluency with frontal atrophy (−0.276; <em>P</em> = .042). The HVLT (learning trial) test was related to hippocampal hyperintensity (−0.266; <em>P</em> = .050) and cingulate hyperintensity (0.311; <em>P</em> = .021). The TMT-B test was related to white matter hyperintensity (0.345; <em>P</em>= .010). The presence of poor functional prognosis was correlated with anxiety (<em>P</em> < .001), depression (<em>P</em> < .001), elevated D-dimer levels (<em>P</em> = .002) and the increase in days of intubation (<em>P</em> = .005).</div></div><div><h3>Conclusion</h3><div>Our study suggests that COVID-19 survivors who had moderate-to-severe infection experience subjective complaints and cognitive impairments in executive function, attention, and memory, regardless of whether invasive mechanical ventilation was used during treatment. We found white matter lesions and cerebral atrophy in frontal and parietal regions that were associated with cognitive deficits. Our findings highlight the clinical need for longitudinal programmes capable of evaluating the real impact of SARS-CoV-2 infection on the central nervous system, particularly in the cognitive and emotional domains.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 5","pages":"Pages 409-421"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01DOI: 10.1016/j.nrleng.2025.04.012
R. Ghosh , M. León-Ruiz , A.S. Mondal , S. Dubey , J. Benito-León
{"title":"Cockayne syndrome B with axonal sensorimotor polyneuropathy caused by a de novo mutation of the gene ERCC6: A novel phenotypic and genotypic variant","authors":"R. Ghosh , M. León-Ruiz , A.S. Mondal , S. Dubey , J. Benito-León","doi":"10.1016/j.nrleng.2025.04.012","DOIUrl":"10.1016/j.nrleng.2025.04.012","url":null,"abstract":"","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 5","pages":"Pages 484-487"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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