Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · May 2023
ReviewPsychiatric symptoms in multiple sclerosis: a biological perspective on synaptic and network dysfunction.
Psychiatric symptoms frequently occur in multiple sclerosis (MS), presenting with a complex phenomenology that encompasses a large clinical spectrum from clear-cut psychiatric disorders up to isolated psychopathological manifestations. Despite their relevant impact on the overall disease burden, such clinical features are often misdiagnosed, receive suboptimal treatment and are not systematically evaluated in the quantification of disease activity. ⋯ Here, we review MS psychopathological manifestations under a biological perspective, highlighting the pathogenic relevance of synaptic and neural network dysfunction. Evidence obtained from human and experimental disease models suggests that MS-related psychiatric phenomenology is part of a disconnection syndrome due to diffuse inflammatory and neurodegenerative brain damage.
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J. Neurol. Neurosurg. Psychiatr. · May 2023
Deep learning-based personalised outcome prediction after acute ischaemic stroke.
Whether deep learning models using clinical data and brain imaging can predict the long-term risk of major adverse cerebro/cardiovascular events (MACE) after acute ischaemic stroke (AIS) at the individual level has not yet been studied. ⋯ Deep learning models using clinical data and brain images could improve the prediction of MACEs and provide personalised outcome prediction for patients with AIS. Deep learning models will allow us to develop more accurate and tailored prognostic prediction systems that outperform traditional models.
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J. Neurol. Neurosurg. Psychiatr. · May 2023
Timing of physical activity across adulthood on later-life cognition: 30 years follow-up in the 1946 British birth cohort.
To assess how timing, frequency and maintenance of being physically active, spanning over 30 years in adulthood, is associated with later-life cognitive function. ⋯ Being physically active at any time in adulthood, and to any extent, is linked with higher later-life cognitive state, but lifelong maintenance of physical activity was most optimal. These relationships were partly explained by childhood cognition and education, but independent of cardiovascular and mental health and APOE-E4, suggestive of the importance of education on the lifelong impacts of physical activity.
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J. Neurol. Neurosurg. Psychiatr. · May 2023
Adult-onset epilepsy and risk of traumatic brain injury: a nationwide cohort study.
A knowledge gap exists regarding the risk of traumatic brain injury (TBI) in patients with epilepsy. ⋯ Patients with adult-onset epilepsy have a significantly increased risk of severe and fatal TBI. The results underline the importance of TBI prevention in epilepsy.
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J. Neurol. Neurosurg. Psychiatr. · May 2023
Spasticity treatment patterns among people with multiple sclerosis: a Swedish cohort study.
Spasticity is common among people with multiple sclerosis (MS), but there are few studies of spasticity treatment patterns. We aim to describe associations with spasticity treatment measured primarily by oral baclofen use. ⋯ Younger patients with MS are more likely to receive baclofen compared with older patients with MS. High rates of baclofen discontinuation highlight the need for more tolerable and efficacious spasticity treatments and monitoring of spasticity among people with MS.