Pub Date : 2025-05-01DOI: 10.1016/j.nrleng.2025.04.013
L.A. Rodríguez de Antonio , R. Fernández de Córdoba-García , N. Herrero-Muñoz , A. Ontañón-Nasarre , I. García-Castañón
Introduction
Adherence is a modifiable factor to disease-modifying treatments response in patients with multiple sclerosis (MS). Our objective is to assess the risk factors associated with inadequate adherence.
Method
Retrospective study through review of medical records and review of the database of pharmaceutical dispensing of patients with MS of a tertiary hospital from 2004 to 2022. A multivariate logistic regression analysis of demographic, clinical, nosological, and therapeutic factors was performed between adherent and non-adherent patients and treatments.
Result
546 treatments of 284 patients (67.3% women, age 38.4 ± 10.0) were analysed, observing 87.5% adherence. Non-adherent patients presented a higher EDSS at the end of treatment, were more frequently patients with secondary progressive multiple sclerosis, and had a higher proportion of cognitive impairment, psychiatric pathology, polypharmacy, and alcohol and drug use. After the multivariable analysis, risk factors were cognitive impairment (OR: 3.82 [1.51−9.70], P = .005), and alcohol and drug use (OR: 22.83 [7.32−71.20], P < .001). On the contrary, oral drugs favored better adherence (OR 0.29 [0.12−0.75], P = .01).
Conclusions
Among many factors, alcohol or drug use and cognitive impairment are the major risk factors for low therapeutic adherence in patients with MS.
简介：依从性是多发性硬化症（MS）患者改善疾病治疗反应的一个可改变因素。我们的目的是评估与依从性不足相关的危险因素。方法：通过查阅某三级医院2004 ~ 2022年MS患者的病历资料和调剂数据库进行回顾性研究。在坚持治疗和不坚持治疗的患者之间进行人口统计学、临床、分类学和治疗因素的多因素logistic回归分析。结果：共分析284例患者546例治疗方案，其中女性67.3%，年龄38.4±10.0岁，依从性87.5%。非依从性患者在治疗结束时出现更高的EDSS，更多的是继发性进行性多发性硬化症患者，并且认知障碍、精神病理、多种药物、酒精和药物使用的比例更高。经多因素分析，危险因素为认知障碍（OR: 3.82 [1.51-9.70], P = 0.005）、酒精和药物使用（OR: 22.83 [7.32-71.20], P < 0.001）。相反，口服药物的依从性更好（OR 0.29 [0.12-0.75], P = 0.01）。结论：在诸多因素中，酒精或药物使用和认知障碍是MS患者治疗依从性低的主要危险因素。
{"title":"Treatment adherence in patients with multiple sclerosis: risk factors","authors":"L.A. Rodríguez de Antonio , R. Fernández de Córdoba-García , N. Herrero-Muñoz , A. Ontañón-Nasarre , I. García-Castañón","doi":"10.1016/j.nrleng.2025.04.013","DOIUrl":"10.1016/j.nrleng.2025.04.013","url":null,"abstract":"<div><h3>Introduction</h3><div>Adherence is a modifiable factor to disease-modifying treatments response in patients with multiple sclerosis (MS). Our objective is to assess the risk factors associated with inadequate adherence.</div></div><div><h3>Method</h3><div>Retrospective study through review of medical records and review of the database of pharmaceutical dispensing of patients with MS of a tertiary hospital from 2004 to 2022. A multivariate logistic regression analysis of demographic, clinical, nosological, and therapeutic factors was performed between adherent and non-adherent patients and treatments.</div></div><div><h3>Result</h3><div>546 treatments of 284 patients (67.3% women, age 38.4 ± 10.0) were analysed, observing 87.5% adherence. Non-adherent patients presented a higher EDSS at the end of treatment, were more frequently patients with secondary progressive multiple sclerosis, and had a higher proportion of cognitive impairment, psychiatric pathology, polypharmacy, and alcohol and drug use. After the multivariable analysis, risk factors were cognitive impairment (OR: 3.82 [1.51−9.70], <em>P</em> = .005), and alcohol and drug use (OR: 22.83 [7.32−71.20], <em>P</em> < .001). On the contrary, oral drugs favored better adherence (OR 0.29 [0.12−0.75], <em>P</em> = .01).</div></div><div><h3>Conclusions</h3><div>Among many factors, alcohol or drug use and cognitive impairment are the major risk factors for low therapeutic adherence in patients with MS.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 4","pages":"Pages 353-360"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046796","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 : 2025-04-01DOI: 10.1016/j.nrleng.2025.03.001
M. Saint-Gerons , M.A. Rubio , A. Matheu
Objective
To describe the prevalence and form of onset of different causes of binocular diplopia in our setting.
Methods
We conducted a single-centre, cross-sectional, retrospective study reviewing the medical records of all patients visiting a tertiary-level centre between May 2019 and June 2021 with binocular diplopia as the main symptom. All patients underwent a complete neuro-ophthalmological evaluation and complementary tests for the aetiological diagnosis of diplopia. Data were collected on demographic variables, ocular deviation pattern, complementary test results, and diagnosis.
Results
A total of 204 patients with binocular diplopia were identified during the study period. The most frequent causes of diplopia overall were fourth nerve palsy (19.12%), sixth nerve palsy (14.71%), decompensated strabismus (14.22%), sagging eye syndrome (12.25%), third nerve palsy (10.78%), myasthenia (7.35%), supranuclear disorders (6.37%), and myopic esotropia (5.88%). Presentation was acute (less than 2 weeks’ progression) in 51% of cases. The most frequent causes of acute-onset diplopia were sixth nerve palsy (27.88%), third nerve palsy (21.15%), fourth nerve palsy (19.23%), supranuclear disorders (12.5%), and decompensated strabismus (6.73%). The most frequent causes of subacute/chronic presentation (more than 2 weeks) were decompensated strabismus (22%), sagging eye syndrome (22%), fourth nerve palsy (19%), myopic esotropia (12%), and myasthenia (11%).
Conclusions
The most frequent aetiology of diplopia in our environment was fourth nerve palsy, followed by sixth nerve palsy, decompensated strabismus, and sagging eye syndrome. Knowing the frequency of each cause of diplopia can help prioritise neuroimaging studies in each case.
{"title":"Binocular diplopia: a retrospective study of 204 cases","authors":"M. Saint-Gerons , M.A. Rubio , A. Matheu","doi":"10.1016/j.nrleng.2025.03.001","DOIUrl":"10.1016/j.nrleng.2025.03.001","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the prevalence and form of onset of different causes of binocular diplopia in our setting.</div></div><div><h3>Methods</h3><div>We conducted a single-centre, cross-sectional, retrospective study reviewing the medical records of all patients visiting a tertiary-level centre between May 2019 and June 2021 with binocular diplopia as the main symptom. All patients underwent a complete neuro-ophthalmological evaluation and complementary tests for the aetiological diagnosis of diplopia. Data were collected on demographic variables, ocular deviation pattern, complementary test results, and diagnosis.</div></div><div><h3>Results</h3><div>A total of 204 patients with binocular diplopia were identified during the study period. The most frequent causes of diplopia overall were fourth nerve palsy (19.12%), sixth nerve palsy (14.71%), decompensated strabismus (14.22%), sagging eye syndrome (12.25%), third nerve palsy (10.78%), myasthenia (7.35%), supranuclear disorders (6.37%), and myopic esotropia (5.88%). Presentation was acute (less than 2 weeks’ progression) in 51% of cases. The most frequent causes of acute-onset diplopia were sixth nerve palsy (27.88%), third nerve palsy (21.15%), fourth nerve palsy (19.23%), supranuclear disorders (12.5%), and decompensated strabismus (6.73%). The most frequent causes of subacute/chronic presentation (more than 2 weeks) were decompensated strabismus (22%), sagging eye syndrome (22%), fourth nerve palsy (19%), myopic esotropia (12%), and myasthenia (11%).</div></div><div><h3>Conclusions</h3><div>The most frequent aetiology of diplopia in our environment was fourth nerve palsy, followed by sixth nerve palsy, decompensated strabismus, and sagging eye syndrome. Knowing the frequency of each cause of diplopia can help prioritise neuroimaging studies in each case.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 3","pages":"Pages 221-228"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675106","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 : 2025-04-01DOI: 10.1016/j.nrleng.2025.03.004
I. Saldaña-Inda , H. Tejada-Meza , B. Domínguez-Lagranja , M.R. Barrena-Caballo , A. Sancho-Saldaña , M. Serrano-Ponz , J. Marta-Moreno
Introduction
Posterior circulation stroke accounts for 15% to 20% of ischaemic strokes, but is associated with poor functional and vital prognosis in over 60% of cases. Due to its clinical and radiological peculiarities, diagnosis and management are more complex than in anterior circulation stroke. This study analyses and characterises patients with vertebrobasilar strokes treated with mechanical thrombectomy in our region.
Methods
We conducted a descriptive, retrospective analysis of patients with vertebrobasilar stroke and treated with mechanical thrombectomy at our centre, a reference centre for cerebrovascular emergencies for the region of Aragon. We recorded baseline characteristics, risk factors, signs and symptoms at onset, radiological assessment scale scores, procedure-related variables, management times, and functional prognosis at 3 months.
Results
We selected 37 patients (39.5% women; mean age [standard deviation], 68.34 [14.1] years). Cardioembolic stroke (42.1%) was the most common aetiology, followed by atherothrombosis (28.9%). The top of the basilar artery was the most common site of obstruction (55.3%). The most frequent clinical features were somnolence (76.3%), motor deficits (71.1%), and nausea (55.3%). Successful reperfusion (mTICI ≥ 2b) was achieved in 81.1% of patients. Functional outcome at 90 days was poor (mRS < 3) in 59% of patients.
Conclusions
Posterior circulation stroke is associated with high rates of morbidity and mortality. Its subacute, nonspecific clinical course prolongs management times and hinders early detection. Mechanical thrombectomy is a safe and effective procedure, although further studies are needed to establish the optimal patient profile.
{"title":"Endovascular treatment of vertebrobasilar ischaemic stroke in Aragon: clinical and radiological characteristics, management times, and prognosis at 3 months","authors":"I. Saldaña-Inda , H. Tejada-Meza , B. Domínguez-Lagranja , M.R. Barrena-Caballo , A. Sancho-Saldaña , M. Serrano-Ponz , J. Marta-Moreno","doi":"10.1016/j.nrleng.2025.03.004","DOIUrl":"10.1016/j.nrleng.2025.03.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Posterior circulation stroke accounts for 15% to 20% of ischaemic strokes, but is associated with poor functional and vital prognosis in over 60% of cases. Due to its clinical and radiological peculiarities, diagnosis and management are more complex than in anterior circulation stroke. This study analyses and characterises patients with vertebrobasilar strokes treated with mechanical thrombectomy in our region.</div></div><div><h3>Methods</h3><div>We conducted a descriptive, retrospective analysis of patients with vertebrobasilar stroke and treated with mechanical thrombectomy at our centre, a reference centre for cerebrovascular emergencies for the region of Aragon. We recorded baseline characteristics, risk factors, signs and symptoms at onset, radiological assessment scale scores, procedure-related variables, management times, and functional prognosis at 3 months.</div></div><div><h3>Results</h3><div>We selected 37 patients (39.5% women; mean age [standard deviation], 68.34 [14.1] years). Cardioembolic stroke (42.1%) was the most common aetiology, followed by atherothrombosis (28.9%). The top of the basilar artery was the most common site of obstruction (55.3%). The most frequent clinical features were somnolence (76.3%), motor deficits (71.1%), and nausea (55.3%). Successful reperfusion (mTICI ≥ 2b) was achieved in 81.1% of patients. Functional outcome at 90 days was poor (mRS < 3) in 59% of patients.</div></div><div><h3>Conclusions</h3><div>Posterior circulation stroke is associated with high rates of morbidity and mortality. Its subacute, nonspecific clinical course prolongs management times and hinders early detection. Mechanical thrombectomy is a safe and effective procedure, although further studies are needed to establish the optimal patient profile.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 3","pages":"Pages 239-248"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675110","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 : 2025-04-01DOI: 10.1016/j.nrleng.2025.03.002
M. Rubiera Valdés , O. Gutiérrez Remis , A. González Jáimez , C. Manzaneque Rodríguez , V. Chiminazzo , G. Morís
Objectives
The aim of this research is to present the clinical characteristics of phantom limb pain (PLP) in patients with amputation.
Methods
A retrospective cross-sectional observational study of patients with lower limb amputation is presented. Patients between 18 and 80 years of age with unilateral or bilateral amputation between the years 2015 and 2019 were included. Demographic data, medical history, data related to the amputation, and related abnormal sensations were collected.
Results
43 patients (34 men) and 53 amputees were studied, with a mean age of 62 years, with a time elapsed since amputation of 28 months. The most frequent cause of amputation was ischemic (70%). Twenty-three (60%) patients had PLP that began 1 month after amputation with a mean intensity of 3.9 on the VAS scale, in 15 patients the PLP was daily, three patients recognised the disappearance of PLP. 91% of the patients presented non-painful sensations in relation to the phantom limb. No differences were found in the development of the PLP between the 1st and 2nd amputation. A significant association was found between the development of PLP and residual limb pain.
Conclusions
PLP is a prevalent pathology among amputee patients, therefore multidisciplinary care with an active neurologic participation is essential. Studies are needed to deepen the knowledge of the factors that favour the development of PLP in order to focus early and targeted therapies to prevent the appearance of PLP.
{"title":"Clinical features of phantom limb pain in patients with lower limb amputation in a Spanish population","authors":"M. Rubiera Valdés , O. Gutiérrez Remis , A. González Jáimez , C. Manzaneque Rodríguez , V. Chiminazzo , G. Morís","doi":"10.1016/j.nrleng.2025.03.002","DOIUrl":"10.1016/j.nrleng.2025.03.002","url":null,"abstract":"<div><h3>Objectives</h3><div>The aim of this research is to present the clinical characteristics of phantom limb pain (PLP) in patients with amputation.</div></div><div><h3>Methods</h3><div>A retrospective cross-sectional observational study of patients with lower limb amputation is presented. Patients between 18 and 80 years of age with unilateral or bilateral amputation between the years 2015 and 2019 were included. Demographic data, medical history, data related to the amputation, and related abnormal sensations were collected.</div></div><div><h3>Results</h3><div>43 patients (34 men) and 53 amputees were studied, with a mean age of 62 years, with a time elapsed since amputation of 28 months. The most frequent cause of amputation was ischemic (70%). Twenty-three (60%) patients had PLP that began 1 month after amputation with a mean intensity of 3.9 on the VAS scale, in 15 patients the PLP was daily, three patients recognised the disappearance of PLP. 91% of the patients presented non-painful sensations in relation to the phantom limb. No differences were found in the development of the PLP between the 1st and 2nd amputation. A significant association was found between the development of PLP and residual limb pain.</div></div><div><h3>Conclusions</h3><div>PLP is a prevalent pathology among amputee patients, therefore multidisciplinary care with an active neurologic participation is essential. Studies are needed to deepen the knowledge of the factors that favour the development of PLP in order to focus early and targeted therapies to prevent the appearance of PLP.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 3","pages":"Pages 279-289"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675109","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 : 2025-04-01DOI: 10.1016/j.nrleng.2025.03.003
D. Alonso Modino , L. Perestelo Pérez , F.M. Rosa González , A. Toledo Chavarri , C. Valcarcel Nazco , F.I. Montón Álvarez
Introduction
Stroke has a significant impact on mental health and health-related quality of life (HRQoL); these aspects have not been sufficiently studied in young stroke.
Objectives
To evaluate HRQoL, mental health, and the relationship between these variables and the incorporation of young adults into working life after stroke.
Material and methods
We conducted a prospective descriptive study of patients with JS between 2016 and 2017, using such questionnaires and scales as EuroQol-5D, the 36-item Short Form Health Survey, National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), 12-item General Health Questionnaire, Hamilton Anxiety and Depression Rating Scales, and BURQOL-meter; tests were administered at 2 interviews, held 6 and 12 months after stroke.
Results
We analysed 41 patients, with a mean age of 41.8 years. At one year, the mean NIHSS score was 0.54 and mRS score was 0–2 in 95.1%. No differences were observed over time in quality of life or mental health scales. Prevalence rates for depression and anxiety at one year were 46.3% and 41.5%, respectively. Male sex and active employment were associated with better HRQoL. A total of 41.5% of patients were in work at one year after the stroke. Statistically significant associations were observed between quality of life, mental health, and incorporation into working life.
Conclusions
Young stroke affects HRQoL, and patients are at high risk of anxiety and depression, underdiagnosed and undertreated disorders that affect quality of life and the return to work, which decreases after stroke in young adults.
{"title":"Quality of life and mental health in young strokes","authors":"D. Alonso Modino , L. Perestelo Pérez , F.M. Rosa González , A. Toledo Chavarri , C. Valcarcel Nazco , F.I. Montón Álvarez","doi":"10.1016/j.nrleng.2025.03.003","DOIUrl":"10.1016/j.nrleng.2025.03.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Stroke has a significant impact on mental health and health-related quality of life (HRQoL); these aspects have not been sufficiently studied in young stroke.</div></div><div><h3>Objectives</h3><div>To evaluate HRQoL, mental health, and the relationship between these variables and the incorporation of young adults into working life after stroke.</div></div><div><h3>Material and methods</h3><div>We conducted a prospective descriptive study of patients with JS between 2016 and 2017, using such questionnaires and scales as EuroQol-5D, the 36-item Short Form Health Survey, National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), 12-item General Health Questionnaire, Hamilton Anxiety and Depression Rating Scales, and BURQOL-meter; tests were administered at 2 interviews, held 6 and 12 months after stroke.</div></div><div><h3>Results</h3><div>We analysed 41 patients, with a mean age of 41.8 years. At one year, the mean NIHSS score was 0.54 and mRS score was 0–2 in 95.1%. No differences were observed over time in quality of life or mental health scales. Prevalence rates for depression and anxiety at one year were 46.3% and 41.5%, respectively. Male sex and active employment were associated with better HRQoL. A total of 41.5% of patients were in work at one year after the stroke. Statistically significant associations were observed between quality of life, mental health, and incorporation into working life.</div></div><div><h3>Conclusions</h3><div>Young stroke affects HRQoL, and patients are at high risk of anxiety and depression, underdiagnosed and undertreated disorders that affect quality of life and the return to work, which decreases after stroke in young adults.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 3","pages":"Pages 229-238"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675044","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 : 2025-04-01DOI: 10.1016/j.nrleng.2025.03.006
A. López-Bravo , S. Quintas , A. Mínguez-Olaondo , A. Alpuente , C. Nieves-Castellanos , M. Pilar Navarro-Pérez , S. Pérez-Pereda , A. Layos Romero , C. Calle de Miguel , D. García-Azorín , M. Torres-Ferrús , S. Santos-Lasaosa
Background
Patients’ knowledge about their medications is key to guarantee therapeutic compliance in chronic diseases.
Aims of the study
To determine patients’ knowledge of oral preventive treatment (OPT) in migraine.
Methods
This is a cross-sectional study evaluating knowledge of medication with a validated questionnaire that assessed: therapeutic objective, process of use, safety and conservation.
Results
198 patients were included. Mean age was 45.4 ± 11.5 years-old and 92.4% were women. A 61.1% of migraine patients did not know the medication they used, 55.1% showed insufficient knowledge and 6.1% had no knowledge. The most known dimension was conservation (80.3%) and the most unknown dimension of was safety (33.7%). In this regard, 82.3% considered that they should not take precautions when taking the treatment, 80.3% stated that it had no contraindications and 82.8% were unaware of possible interactions with other medications. Worse knowledge about OPT was associated with longer time since migraine onset (p = .049), higher scores on the Hospital Anxiety and Depression Scale (p = .021), less qualified jobs (p = .045), use of monotherapy (p = .001) and longer periods since OPT initiation (p = .013).
Conclusions
The majority of migraine patients did not adequately know their preventive treatment, despite identifying some of the items related to their medication. The present study shows that knowledge of patients about their preventive treatment should be evaluated in clinical practice and could help migraine patients in the correct use of OPT.
{"title":"Knowledge about oral preventive treatments in patients with migraine: A nationwide study","authors":"A. López-Bravo , S. Quintas , A. Mínguez-Olaondo , A. Alpuente , C. Nieves-Castellanos , M. Pilar Navarro-Pérez , S. Pérez-Pereda , A. Layos Romero , C. Calle de Miguel , D. García-Azorín , M. Torres-Ferrús , S. Santos-Lasaosa","doi":"10.1016/j.nrleng.2025.03.006","DOIUrl":"10.1016/j.nrleng.2025.03.006","url":null,"abstract":"<div><h3>Background</h3><div>Patients’ knowledge about their medications is key to guarantee therapeutic compliance in chronic diseases.</div></div><div><h3>Aims of the study</h3><div>To determine patients’ knowledge of oral preventive treatment (OPT) in migraine.</div></div><div><h3>Methods</h3><div>This is a cross-sectional study evaluating knowledge of medication with a validated questionnaire that assessed: therapeutic objective, process of use, safety and conservation.</div></div><div><h3>Results</h3><div>198 patients were included. Mean age was 45.4 ± 11.5 years-old and 92.4% were women. A 61.1% of migraine patients did not know the medication they used, 55.1% showed insufficient knowledge and 6.1% had no knowledge. The most known dimension was conservation (80.3%) and the most unknown dimension of was safety (33.7%). In this regard, 82.3% considered that they should not take precautions when taking the treatment, 80.3% stated that it had no contraindications and 82.8% were unaware of possible interactions with other medications. Worse knowledge about OPT was associated with longer time since migraine onset (<em>p</em> = .049), higher scores on the Hospital Anxiety and Depression Scale (<em>p</em> = .021), less qualified jobs (<em>p</em> = .045), use of monotherapy (<em>p</em> = .001) and longer periods since OPT initiation (<em>p</em> = .013).</div></div><div><h3>Conclusions</h3><div>The majority of migraine patients did not adequately know their preventive treatment, despite identifying some of the items related to their medication. The present study shows that knowledge of patients about their preventive treatment should be evaluated in clinical practice and could help migraine patients in the correct use of OPT.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 3","pages":"Pages 249-255"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675112","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 : 2025-04-01DOI: 10.1016/j.nrleng.2025.03.007
O. Sáez-Atxukarro , J. Peña , R. del Pino , N. Ibarretxe-Bilbao , N. Ojeda
Introduction
Neuropsychological assessment often involves repeated testing in order to assess a cognitive change or conduct a longitudinal follow-up study of a patient. To assess whether the change between assessments is relevant or not, longitudinal reference data are needed. The aim of this study is to provide reference data to enable interpretation of score changes between assessments for 16 commonly used tests, at six different time intervals between successive assessments, using five reliable change indices.
Methods
The study is part of the Normacog project, in which 388 healthy participants recruited in Spain (aged 18–84 years) were assessed on two occasions. A baseline assessment was carried out, and then followed up at 1 month (n = 67), 3 months (n = 64), 6 months (n = 59), 9 months (n = 60), 12 months (n = 68), or 24 months (n = 70). Longitudinal data were analyzed, and reliable change indices were calculated.
Results
A significant improvement was observed between assessment scores for all time points, especially in memory-related variables. Reference data are provided using the following indices: discrepancy scores expressed in percentiles, standard deviation index (SDI), reliable change index (RCI), RCI + practice effect (RCI + PE), and standardized regression-based formulae.
Conclusions
This study provides data to analyze whether or not a cognitive change can be considered reliable. The results support the use of these reliable change indices to avoid biases related to successive assessments. This study will lay the foundations for the implementation of these tools in clinical practice, and will be a reference for the creation of reliable change indices.
{"title":"Reliable change indices for 16 neuropsychological tests at six different time points","authors":"O. Sáez-Atxukarro , J. Peña , R. del Pino , N. Ibarretxe-Bilbao , N. Ojeda","doi":"10.1016/j.nrleng.2025.03.007","DOIUrl":"10.1016/j.nrleng.2025.03.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Neuropsychological assessment often involves repeated testing in order to assess a cognitive change or conduct a longitudinal follow-up study of a patient. To assess whether the change between assessments is relevant or not, longitudinal reference data are needed. The aim of this study is to provide reference data to enable interpretation of score changes between assessments for 16 commonly used tests, at six different time intervals between successive assessments, using five reliable change indices.</div></div><div><h3>Methods</h3><div>The study is part of the Normacog project, in which 388 healthy participants recruited in Spain (aged 18–84 years) were assessed on two occasions. A baseline assessment was carried out, and then followed up at 1 month (<em>n</em> <!-->=<!--> <!-->67), 3 months (<em>n</em> <!-->=<!--> <!-->64), 6 months (<em>n</em> <!-->=<!--> <!-->59), 9 months (<em>n</em> <!-->=<!--> <!-->60), 12 months (<em>n</em> <!-->=<!--> <!-->68), or 24 months (<em>n</em> <!-->=<!--> <!-->70). Longitudinal data were analyzed, and reliable change indices were calculated.</div></div><div><h3>Results</h3><div>A significant improvement was observed between assessment scores for all time points, especially in memory-related variables. Reference data are provided using the following indices: discrepancy scores expressed in percentiles, standard deviation index (SDI), reliable change index (RCI), RCI<!--> <!-->+<!--> <!-->practice effect (RCI<!--> <!-->+<!--> <!-->PE), and standardized regression-based formulae.</div></div><div><h3>Conclusions</h3><div>This study provides data to analyze whether or not a cognitive change can be considered reliable. The results support the use of these reliable change indices to avoid biases related to successive assessments. This study will lay the foundations for the implementation of these tools in clinical practice, and will be a reference for the creation of reliable change indices.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 3","pages":"Pages 256-278"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859905","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 : 2025-04-01DOI: 10.1016/j.nrleng.2025.03.008
R. Mondal , S. Deb , G. Shome , V. Sarkar , D. Lahiri , S.S. Datta , J. Benito-León
Introduction
The complex process of amyloid-β (Aβ) transportation across the blood–brain and blood–cerebrospinal fluid barriers is crucial for preventing Aβ accumulation, which linked to dementia and neurodegeneration. This review explores therapeutic plasma exchange with albumin replacement in Alzheimer's disease, based on the dynamics of amyloid-β between the brain, plasma, and cerebrospinal fluid.
Methodology
A comprehensive literature review was conducted using PubMed/Medline, Cochrane Library, and open databases (bioRxiv, MedRixv, preprint.org) up to April 30, 2023. The first search utilized the following MeSH terms and keywords: ‘Plasma Exchange’, ‘Plasmapheresis’, ‘Therapeutic plasma exchange’, ‘Apheresis’, ‘Aβ’, ‘p-tau’, ‘Total-tau’, ‘Alzheimer's disease’, ‘Cognitive dysfunction’, ‘neurodegenerative diseases’, ‘centrifugation’, ‘membranous’, and ‘filtration’ in the Title/Abstract, yielding 146 results. A second search with the keywords: ‘Albumin’, ‘Aβ’, ‘BBB’, ‘Alzheimer's dementia’, and ‘Nerve degeneration’ resulted in 125 additional articles for analysis. Finally, a third search using keywords: ‘Albumin structural domains’, ‘Albumin-Aβ interactions’, ‘Albumin-endothelial interactions’, and ‘Post-Translational Modification’ produced 193 results for further review.
Results/Discussion
Therapeutic plasma exchange shows potential as a disease-modifying therapy for dementia, specifically for Alzheimer's disease. Additionally, the promising role of albumin supplementation in cognitive improvement has attracted attention. However, clinical evidence supporting therapeutic plasma exchange for dementia remains limited, necessitating further research and development to mitigate potential adverse effects. A deeper understanding of the molecular dynamics of Aβ transportation and the mechanisms of therapeutic plasma exchange is essential. A critical evaluation of existing evidence highlights the importance of balancing potential benefits with associated risks, which will guide the development and application of these treatments in neurodegenerative diseases.
{"title":"Molecular dynamics of amyloid-β transport in Alzheimer's disease: Exploring therapeutic plasma exchange with albumin replacement – Current insights and future perspectives","authors":"R. Mondal , S. Deb , G. Shome , V. Sarkar , D. Lahiri , S.S. Datta , J. Benito-León","doi":"10.1016/j.nrleng.2025.03.008","DOIUrl":"10.1016/j.nrleng.2025.03.008","url":null,"abstract":"<div><h3>Introduction</h3><div>The complex process of amyloid-β (Aβ) transportation across the blood–brain and blood–cerebrospinal fluid barriers is crucial for preventing Aβ accumulation, which linked to dementia and neurodegeneration. This review explores therapeutic plasma exchange with albumin replacement in Alzheimer's disease, based on the dynamics of amyloid-β between the brain, plasma, and cerebrospinal fluid.</div></div><div><h3>Methodology</h3><div>A comprehensive literature review was conducted using PubMed/Medline, Cochrane Library, and open databases (bioRxiv, MedRixv, preprint.org) up to April 30, 2023. The first search utilized the following MeSH terms and keywords: ‘Plasma Exchange’, ‘Plasmapheresis’, ‘Therapeutic plasma exchange’, ‘Apheresis’, ‘Aβ’, ‘p-tau’, ‘Total-tau’, ‘Alzheimer's disease’, ‘Cognitive dysfunction’, ‘neurodegenerative diseases’, ‘centrifugation’, ‘membranous’, and ‘filtration’ in the Title/Abstract, yielding 146 results. A second search with the keywords: ‘Albumin’, ‘Aβ’, ‘BBB’, ‘Alzheimer's dementia’, and ‘Nerve degeneration’ resulted in 125 additional articles for analysis. Finally, a third search using keywords: ‘Albumin structural domains’, ‘Albumin-Aβ interactions’, ‘Albumin-endothelial interactions’, and ‘Post-Translational Modification’ produced 193 results for further review.</div></div><div><h3>Results/Discussion</h3><div>Therapeutic plasma exchange shows potential as a disease-modifying therapy for dementia, specifically for Alzheimer's disease. Additionally, the promising role of albumin supplementation in cognitive improvement has attracted attention. However, clinical evidence supporting therapeutic plasma exchange for dementia remains limited, necessitating further research and development to mitigate potential adverse effects. A deeper understanding of the molecular dynamics of Aβ transportation and the mechanisms of therapeutic plasma exchange is essential. A critical evaluation of existing evidence highlights the importance of balancing potential benefits with associated risks, which will guide the development and application of these treatments in neurodegenerative diseases.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 3","pages":"Pages 306-328"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859907","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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