Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Sep 2024
Imaging endolymphatic space of the inner ear in vestibular migraine.
Vestibular migraine (VM), the most frequent episodic vertigo, is difficult to distinguish from Ménière's disease (MD) because reliable biomarkers are missing. The classical proof of MD was an endolymphatic hydrops (EH). However, a few intravenous gadolinium-enhanced MRI studies of the inner ear (iMRI) also revealed an EH in VM. The major questions were the frequency and distribution characteristics of EH in VM for diagnostic use. ⋯ Three features of the iMRI evaluation were most supportive for the diagnosis of VM at group and individual levels: (1) the bilateral manifestation, (2) the low-grade EH and (3) the intraaural distribution.
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J. Neurol. Neurosurg. Psychiatr. · Sep 2024
Investigating colour vision and its structural correlates 15 years following a first demyelinating event.
We investigated the long-term colour and contrast vision outcomes, 15 years after a first demyelinating event, with their structural correlates using optical coherence tomography (OCT) and brain MRI. ⋯ Colour vision was impaired in unaffected eyes, especially in SPMS. GCIPL thinning underpinned this impairment more than pRNFL, suggesting neuroaxonal loss as the pathobiological substrate. The correlation between worse colour vision and increasing T2 lesion load suggests that colour dysfunction reflects overall greater disease burden. Quantitative evaluation of colour vision in addition to OCT may be useful to assess disease severity in patients after a first demyelinating event.
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J. Neurol. Neurosurg. Psychiatr. · Sep 2024
Distinct plasma lipids predict axonal injury and multiple sclerosis activity.
Lipids are of particular interest for the study of neuroinjury and neuroinflammation as structural lipids are major components of myelin, and a variety of lipid species modulate inflammation. In this study, we performed an in-depth lipidomics analysis to identify lipids associated with injury and disease activity. ⋯ There are two categories of lipids associated with MS processes. First, structural lipids strongly associated with NfL levels may result from cell lysis secondary to acute inflammation. In contrast, PUFAs, especially ω-3, had a protective effect on subsequent disease activity.
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J. Neurol. Neurosurg. Psychiatr. · Sep 2024
Long-term disability trajectories in multiple sclerosis: a group-based trajectory analysis of the AusLong cohort.
Previous natural history studies highlighted a consistent heterogeneity of disability trajectories among individuals with primary or secondary progressive multiple sclerosis (MS). However, evidence on disability progression in relapsing onset MS is scarce.The aim of this study was to investigate heterogeneity in disability accumulation over 10 years following a first clinical diagnosis of central nervous system demyelination (FCD) and identify genetic, demographic, environmental and clinical factors associated with these trajectories. ⋯ Those at higher risk of faster MS disability progression can be identified based on their early clinical characteristics with potential therapeutic implications for early intervention and treatment escalation.
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J. Neurol. Neurosurg. Psychiatr. · Sep 2024
Total bilirubin modified the association between diabetes and stroke: a cross-sectional study from NHANES 2011-2016.
Total bilirubin (TBIL) has antioxidant and anti-inflammatory properties. This study aimed to determine whether elevated TBIL could modify the association between diabetes and stroke. ⋯ Elevated TBIL modified the association between diabetes and stroke through inhibiting mediating effects of inflammatory factors.