Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Apr 2023
ReviewCerebroprotection in the endovascular era: an update.
Despite advances in clinical diagnosis and increasing numbers of patients eligible for revascularisation, ischaemic stroke remains a significant public health concern accounting for 3.3 million deaths annually. In addition to recanalisation therapy, patient outcomes could be improved through cerebroprotection, but all translational attempts have remained unsuccessful. ⋯ This evidence is linked with findings from prior cerebroprotective trials and interpreted for the modern endovascular era. Future cerebroprotective agents that are multimodal and multicellular, promoting cellular and metabolic health to different targets at time points that are most responsive to treatment, might prove more successful.
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J. Neurol. Neurosurg. Psychiatr. · Apr 2023
SARS-CoV-2 omicron breakthrough infections in patients with multiple sclerosis.
It is unclear which patients with multiple sclerosis (MS) are most susceptible for omicron breakthrough infections. ⋯ SARS-COV-2 omicron breakthrough infections are more prevalent in patients with MS on anti-CD20 therapies and S1PR modulators compared with other patients with MS, which correlated with decreased humoral responses after vaccination. Humoral responses after infection were higher in S1PR modulator-treated patients in comparison to patients on anti-CD20 therapies, suggesting that immunological protection from contracting infection or repeated exposures may differ between these therapies.
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J. Neurol. Neurosurg. Psychiatr. · Apr 2023
Longitudinal characterisation of B and T-cell immune responses after the booster dose of COVID-19 mRNA-vaccine in people with multiple sclerosis using different disease-modifying therapies.
The decline of humoral response to COVID-19 vaccine led to authorise a booster dose. Here, we characterised the kinetics of B-cell and T-cell immune responses in patients with multiple sclerosis (PwMS) after the booster dose. ⋯ COVID-19 vaccine booster strengthens humoral and Th1-cell responses and increases TEM cells in PwMS.
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J. Neurol. Neurosurg. Psychiatr. · Apr 2023
Observational StudyAssociation between early treatment of multiple sclerosis and patient-reported outcomes: a nationwide observational cohort study.
Timing of disease-modifying therapy affects clinical disability in multiple sclerosis, but it is not known whether patient reported outcomes are also affected. This study investigates the relationship between treatment timing and patient-reported symptoms and health-related quality of life. ⋯ Earlier commencement of disease-modifying treatment was associated with better patient-reported physical symptoms when measured using a disease-specific metric; however, general quality of life was not affected. This indicates that other factors may inform patients' overall quality of life.
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J. Neurol. Neurosurg. Psychiatr. · Apr 2023
Distinct disease mechanisms may underlie cognitive decline related to hearing loss in different age groups.
Hearing loss in older adults is associated with increased dementia risk. Underlying mechanisms that connect hearing loss with dementia remain largely unclear. ⋯ Hearing loss was associated with amyloid binding in younger-old individuals only, and with cognitive decline in both age groups. These results suggest that mechanisms linking hearing loss with risk for dementia depends on age.