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Eslam Shosha, Colleen Connolly, Adrian Budhram
Autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy is a recently emerging autoimmune disease of the central nervous system (CNS); GFAP astrocytopathy is characterized by optic neuritis and meningoencephalomyelitis. We report the case of a 55-year-old man, otherwise healthy, who presented with isolated headaches for three months, without other features of meningoencephalitis or myelitis. His neurological examination and fundoscopy were unremarkable. Gadolinium-enhanced brain MRI demonstrated increased T2 hyperintensity within the right sub-lenticular basal ganglia, with additional leptomeningeal enhancement along the bilateral perisylvian regions and mesial temporal lobes...
2024: Frontiers in Neurology
#2
JOURNAL ARTICLE
João Moura, Maria João Malaquias, Firmina Jorge, Eduarda Pinto, Ana Sardoeira, Inês Laranjinha, Vanessa Oliveira, Ana Paula Sousa, Joana Damásio, Luís Maia, Nuno Vila-Chã, Raquel Samões, Ricardo Taipa, Ana Martins da Silva, Ernestina Santos
INTRODUCTION: Neurological involvement in immunoglobulin G4-related disease (IgG4-RD) is increasingly recognized. Its diagnosis can be challenging due to clinical mimics and difficulty in obtaining nervous system biopsies. The aim of this study was to describe a cohort of neurological IgG4-RD patients. METHODS: Patients were recruited from a neuroimmunology tertiary center. Clinical, laboratory, neuroimaging and histological data were reviewed. RESULTS: Fifteen patients (60% women), with a median age of 53 years (48...
April 26, 2024: Acta Médica Portuguesa
#3
JOURNAL ARTICLE
Yoji Hoshina, Alen Delic, Ka-Ho Wong, Stephanie Lyden, Robert Kadish, Tammy L Smith, Melissa A Wright, Daisuke Shimura, Stacey L Clardy
BACKGROUND AND PURPOSE: For the management of central nervous system (CNS) vasculitis, it is crucial to differentiate between primary and secondary CNS vasculitis and to understand the respective etiologies. We assessed the etiology, characteristics, and outcomes of patients with CNS vasculitis. METHODS: A single-center retrospective chart review was conducted at the University of Utah, Department of Neurology, between February 2011 and October 2022. RESULTS: The median age of the 44 included patients at diagnosis was 54 years; 25...
April 2024: Neurohospitalist
#4
JOURNAL ARTICLE
Saeid Rasouli, Mohammad Sedigh Dakkali, Reza Azarbad, Azim Ghazvini, Mahdi Asani, Zahra Mirzaasgari, Mohammed Arish
INTRODUCTION: Predicting the conversion of clinically isolated syndrome (CIS) to clinically definite multiple sclerosis (CDMS) is critical to personalizing treatment planning and benefits for patients. The aim of this study is to develop an explainable machine learning (ML) model for predicting this conversion based on demographic, clinical, and imaging data. METHOD: The ML model, Extreme Gradient Boosting (XGBoost), was employed on the public dataset of 273 Mexican mestizo CIS patients with 10-year follow-up...
April 9, 2024: Multiple Sclerosis and related Disorders
#5
JOURNAL ARTICLE
Kathryn A W Knight, Catriona Barbour-Hastie, Angus Gane, Jonathan O'Riordan
A man in his 30s was referred to neurology with right-sided paraesthesia, tremors, chest pain and lower urinary tract and erectile dysfunction. He had a medical history of left acetabular dysplasia, and subjective memory impairment, the latter being in the context of depression and chronic pain with opioid use. There was no notable family history. On examination, he had a spastic paraparesis. Imaging revealed atrophy of the thoracic spine. Lumbar puncture demonstrated a raised protein but other constituents were normal, including no presence of oligoclonal bands...
April 17, 2024: BMJ Case Reports
#6
Andrew Lee, Ira Pande, Bruno Gran
We present a case where a 63-year-old right-handed man who presented with a 6-month history of progressive asymmetrical sensorimotor symptoms in lower limbs. This was associated with concomitant rash on the lower limbs, and mild sicca symptoms. MRI spine showed focal T2 hyperintensity in the left hemicord at C3-4 level. Skin biopsy of the rash revealed urticarial vasculitis, and lip biopsy revealed lymphocytic sialadenitis. Initial anti-Ro antibody was negative, but subsequent Ro52 antibody testing returned positive...
July 2023: Clinical Medicine: Journal of the Royal College of Physicians of London
#7
Yasser Hamed, Abd-Elaziz Shokry, Khaled Mohamed Ali Shehata, Salma Mokhtar Osman, Khaled Saad, Safwat Salama Sawy, Emad Abdelrazzak, Omran Mohamed Abdelmola, Tarek Mansour
BACKGROUND AND OBJECTIVES: Although immunization against coronavirus disease 2019 (COVID-19) is ongoing, adverse reactions to these vaccinations have been observed in isolated cases. We aimed to report different neurological complications developed after COVID-19 vaccination. MATERIALS AND METHODS: In our case series study, we report all cases of CNS demyelination following COVID-19 immunization. Clinical evaluation, brain MRI, and CSF analysis for oligoclonal bands and IgG index were performed for all patients...
February 2024: Journal of Pharmacy & Bioallied Sciences
#8
JOURNAL ARTICLE
Tereza Serranová, Matěj Slovák, Zuzana Forejtová, Tomáš Sieger, Petr Dušek, Barbora Srpová, Kateřina Mrázová, Evžen Růžička, Karel Šonka, Alberto J Espay, Petra Nytrová
OBJECTIVE: The role of inflammation and neuroimmune mechanisms, which have been documented in various neuropsychiatric disorders including the seizure subtype of functional neurological disorder, remains unclear in functional movement disorders (FMD). To explore these mechanisms, we analyzed selected inflammatory markers in cerebrospinal fluid (CSF) in patients with FMD. METHODS: We compared CSF markers in 26 patients with clinically established FMD (20 females; mean (SD) age 43...
March 25, 2024: Psychosomatic Medicine
#9
JOURNAL ARTICLE
Cathérine Dekeyser, Matthias Hautekeete, Melissa Cambron, Vincent Van Pesch, Francesco Patti, Jens Kuhle, Samia Khoury, Jeanette Lechner Scott, Oliver Gerlach, Alessandra Lugaresi, Davide Maimone, Andrea Surcinelli, Pierre Grammond, Tomas Kalincik, Mario Habek, Barbara Willekens, Richard Macdonell, Patrice Lalive, Tunde Csepany, Helmut Butzkueven, Cavit Boz, Valentina Tomassini, Matteo Foschi, José Luis Sánchez-Menoyo, Ayse Altintas, Saloua Mrabet, Gerardo Iuliano, Maria Jose Sa, Raed Alroughani, Rana Karabudak, Eduardo Aguera-Morales, Orla Gray, Koen de Gans, Anneke van der Walt, Pamela A McCombe, Norma Deri, Justin Garber, Abdullah Al-Asmi, Olga Skibina, Pierre Duquette, Elisabetta Cartechini, Daniele Spitaleri, Riadh Gouider, Aysun Soysal, Liesbeth Van Hijfte, Mark Slee, Maria Pia Amato, Katherine Buzzard, Guy Laureys
BACKGROUND: It remains unclear whether routine cerebrospinal fluid (CSF) parameters can serve as predictors of multiple sclerosis (MS) disease course. METHODS: This large-scale cohort study included persons with MS with CSF data documented in the MSBase registry. CSF parameters to predict time to reach confirmed Expanded Disability Status Scale (EDSS) scores 4, 6 and 7 and annualised relapse rate in the first 2 years after diagnosis (ARR2) were assessed using (cox) regression analysis...
April 3, 2024: Journal of Neurology, Neurosurgery, and Psychiatry
#10
JOURNAL ARTICLE
Assaf Tolkovsky, Keshet Pardo, Mark Hellmann, Itay Lotan, Eitan Auriel, Adi Wilf-Yarkoni
BACKGROUND: Detection of oligoclonal bands (OCBs) in the cerebrospinal fluid (CSF) is important for diagnosis of multiple sclerosis (MS). Previous studies reported that treatment with intravenous methylprednisolone (IVMP) before lumber puncture (LP) could suppress OCBs production. The aim of this study was to assess whether IVMP initiation prior to CSF collection affects OCBs results in patients with an acute demyelinating event. Additionally, we examined which clinical characteristics are associated with the presence of OCBs in the CSF...
March 16, 2024: Multiple Sclerosis and related Disorders
#11
REVIEW
Angelika Bauer, Harald Hegen, Markus Reindl
INTRODUCTION: Body fluid markers could be helpful to predict the conversion into clinically definite multiple sclerosis (MS) in people with a first demyelinating event of the central nervous system (CNS). Consequently, biomarkers such as oligoclonal bands, which are integrated in the current MS diagnostic criteria, could assist early MS diagnosis. AREAS COVERED: This review examines existing knowledge on a broad spectrum of body fluid markers in people with a first CNS demyelinating event, explores their potential to predict conversion to MS, to assess MS disease activity, as well as their utility to differentiate MS from atypical demyelinating disorders such as neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein associated disease...
March 27, 2024: Expert Review of Molecular Diagnostics
#12
JOURNAL ARTICLE
Giulia Mallucci, Ottavia Eleonora Ferraro, Maria Trojano, Maria Pia Amato, Antonio Scalfari, Mauro Zaffaroni, Elena Colombo, Eleonora Rigoni, Pietro Iaffaldano, Emilio Portaccio, Lorenzo Saraceno, Damiano Paolicelli, Lorenzo Razzolini, Cristina Montomoli, Roberto Bergamaschi
BACKGROUND: Predicting disease progression in patients with the first clinical episode suggestive of multiple sclerosis (MS) is crucial for personalized therapeutic approaches. This study aimed to develop the EUMUS score for accurately estimating the risk of early evidence of disease activity and progression (EDA). METHODS: Retrospective analysis was conducted on data from 221 patients with a first clinical MS episode collected from four Italian MS centers. Various variables including socio-demographics, clinical features, cerebrospinal fluid analysis, evoked potentials, and brain MRI were considered...
March 26, 2024: Journal of Neurology
#13
JOURNAL ARTICLE
Shan Qiao, Haiyun Li, Caisan Cui, Chong Zhang, Aihua Wang, Wenjing Jiang, Shanchao Zhang
PURPOSE: CSF inflammation in subtypes of antibody-defined autoimmune encephalitis (AE) ranges in intensity from moderate to severe. In a retrospective, cross-sectional study, we characterized CSF findings in Chinese patients with anti-N-methyl-D-aspartate receptor encephalitis (NMDAR-E), anti-leucine-rich glioma-inactivated 1 encephalitis (LGI1-E), and anti-gamma aminobutyric acid-B receptor encephalitis (GABABR-E). PATIENTS AND METHODS: The AE cases, including 102 NMDAR-E, 68 LGI1-E and 15 GABABR-E, were included...
2024: Journal of Inflammation Research
#14
REVIEW
Paolo Preziosa, Maria A Rocca, Massimo Filippi
The widespread use of magnetic resonance imaging (MRI) has led to increased detection of individuals exhibiting asymptomatic brain and spinal cord lesions suggestive of multiple sclerosis (MS), defined as "radiologically isolated syndrome" (RIS). Specific criteria have been proposed and updated over time to identify individuals with RIS. Moreover, a younger age, the presence of infratentorial, spinal cord or gadolinium-enhancing lesions, as well as of cerebrospinal fluid-specific oligoclonal bands have been recognized as relevant risk factors for the occurrence of a first clinical event...
March 19, 2024: Journal of Neurology
#15
JOURNAL ARTICLE
Renan Barros Domingues, Márcio Vega Dos Santos, Daiane Salomão, Carlos Senne
BACKGROUND: Oligoclonal bands (OCBs) and Kappa free light chains (FLCs) in the cerebrospinal fluid (CSF) are sensitive markers of intrathecal immunoglobulin (Ig)G synthesis in patients with multiple sclerosis. OBJECTIVE: To evaluate the concordance rate between OCBCs and the Kappa index (KI) in patients with suspected multiple sclerosis (MS). METHODS: Patients with suspected MS were referred to a specialized CSF laboratory as part of their diagnostic investigation...
March 2024: Arquivos de Neuro-psiquiatria
#16
JOURNAL ARTICLE
Valeria Rocha, Noelia Sorondo, Fabián Gómez, Lucía Castro, Daniel Ontaneda, Carlos Ketzoian
Background The worldwide incidence of multiple sclerosis (MS) is estimated at 0.5-10 cases per 100,000 person-years and is probably increasing. In 2014, a previous study estimated the incidence of multiple sclerosis in Uruguay at 1.2 cases per 100.000 person-years. Objectives We conducted an observational, prospective, population-based study to determine MS incidence from diagnosis in Uruguay. Methods The population studied included people older than 18 years of age, who were living in Uruguay between July 1, 2019, and June 30, 2021...
March 12, 2024: Neuroepidemiology
#17
MULTICENTER STUDY
Gemma Olivé-Cirera, Arlette L Bruijstens, Elianet G Fonseca, Li-Wen Chen, Eva Caballero, Eugenia Martinez-Hernandez, Mar Guasp, Maria Sepúlveda, Laura Naranjo, Raquel Ruiz-García, Yolanda Blanco, Albert Saiz, Josep O Dalmau, Thaís Armangue
OBJECTIVES: To assess the clinical significance of myelin oligodendrocyte glycoprotein antibodies (MOG-abs) restricted to CSF in children with inflammatory CNS disorders. METHODS: Patients included 760 children (younger than 18 years) from 3 multicenter prospective cohort studies: (A) acquired demyelinating syndromes, including acute disseminated encephalomyelitis (ADEM); (B) non-ADEM encephalitis; and (C) noninflammatory neurologic disorders. For all cases, paired serum/CSF samples were systematically examined using brain immunohistochemistry and live cell-based assays...
April 9, 2024: Neurology
#18
JOURNAL ARTICLE
Wenjun Shao, Xiaoni Liu, Jiatong Li, Tianyang Sheng, Yarong Li, Yuehua Gu, Bo Deng, Jingguo Wang, Wenbo Yang, Hai Yu, Xiang Zhang, Xiangjun Chen
OBJECTIVE: To analyze the immune parameters of cerebrospinal fluid (CSF) and oligoclonal band (OCB) type in patients with anti-myelin oligodendrocyte glycoprotein (MOG) antibody-associated diseases (MOGAD). METHODS: Patients who were seropositive for MOG-IgG and diagnosed with MOGAD according to the diagnosis criteria in the Department of Neurology, Huashan Hospital, Fudan University from December 2020 to June 2022 were retrospectively included in this study. Complete clinical data, blood and cerebrospinal fluid samples were collected from all the participants...
March 15, 2024: Heliyon
#19
JOURNAL ARTICLE
Mouna Maaloul, Sabrina Mejdoub, Salma Sakka, Hend Hachicha, Mariem Dammak, Faten Koubaa, Chokri Mhiri, Hatem Masmoudi, Sawsan Feki
Cerebrospinal fluid (CSF) isoelectrofocusing (IEF) is considered as the gold standard for detecting an intrathecal synthesis of IgG, which is a hallmark of multiple sclerosis (MS). This corresponds to the presence of CSF-restricted IgG oligoclonal bands (OCB) (typically type 2 pattern). Moreover, this technique can also detect a systemic immune reaction with passive transfer of IgG (type 3 and 4 patterns) for which the clinical relevance is less understood. The aim of our study was to determine the frequency and disease associations of IEF type 3 and 4 patterns and to investigate the potential usefulness of including quantitative data (IgG index and Reiber Diagram) in interpreting such IEF profiles...
February 18, 2024: Multiple Sclerosis and related Disorders
#20
JOURNAL ARTICLE
Nicola Warren, Cullen O'Gorman, Isabelle Horgan, Milleni Weeratunga, Sean Halstead, Joanna Moussiopoulou, Mattia Campana, Vladislav Yakimov, Elias Wagner, Dan Siskind
BACKGROUND: There is increasing evidence of immune dysregulation and neuroinflammation occurring in schizophrenia. The aim of this study is to combine studies on routine CSF parameters, as well as cytokines and inflammatory proteins, in individuals with schizophrenia spectrum disorders. METHODS: CSF parameters were summated and inverse variance meta-analyses using a random effects model were performed comparing mean difference or odds ratios. Between study heterogeneity was assessed using the I2 statistic...
April 2024: Schizophrenia Research
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