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Thymectomy and disease duration in non-thymomatous acetylcholine receptor antibody-positive myasthenia gravis: a single-centre, cross-sectional study
Introduction Myasthenia gravis (MG) is an autoantibody-mediated disorder of the neuromuscular junction. Autoantibody against the acetylcholine receptor (AChR-Ab) is detected in 80% of MG patients, and its production is associated with thymic follicular hyperplasia (TFH) and germinal centres in the thymus. In non-thymomatous AChR-Ab positive MG (AChR-MG), the therapeutic effect of thymectomy has been demonstrated.1 Although thymectomy is generally performed on patients with short disease duration, few studies have directly evaluated the impact of disease duration on the therapeutic effect of thymectomy. In addition, it is u...
Source: Journal of Neurology, Neurosurgery and Psychiatry - March 14, 2023 Category: Neurosurgery Authors: Chung, H. Y., Kim, S. W., Lee, J. G., Shim, H. S., Shin, H. Y. Tags: PostScript Source Type: research

Beware next-generation sequencing gene panels as the first-line genetic test in Charcot-Marie-Tooth disease
Dear editor, The testing strategy for genetic conditions has evolved in recent years. Initially, sequential single gene tests were the mainstay. This was followed by gene panels performed through targeted gene panel sequencing. Now, in many countries, ‘virtual panels’ are applied to whole exome sequencing (WES) or whole genome sequencing (WGS) as first-line tests, where multiple genes can be tested in parallel. Improved reliability and cost efficiency of WES or WGS, combined with advancing bioinformatic technology, mean that next-generation sequencing (NGS), which includes WES and WGS, is preferable. One except...
Source: Journal of Neurology, Neurosurgery and Psychiatry - March 14, 2023 Category: Neurosurgery Authors: Record, C. J., Pipis, M., Poh, R., Polke, J. M., Reilly, M. M. Tags: PostScript Source Type: research

What is brain fog?
Conclusions ‘Brain fog’ is used on Reddit to describe heterogeneous experiences, including of dissociation, fatigue, forgetfulness and excessive cognitive effort, and in association with a range of illnesses, drugs and behaviours. Encouraging detailed description of these experiences will help us better understand pathophysiological mechanisms underlying cognitive symptoms in health and disease. (Source: Journal of Neurology, Neurosurgery and Psychiatry)
Source: Journal of Neurology, Neurosurgery and Psychiatry - March 14, 2023 Category: Neurosurgery Authors: McWhirter, L., Smyth, H., Hoeritzauer, I., Couturier, A., Stone, J., Carson, A. J. Tags: JNNP Patients' choice Neuropsychiatry Source Type: research

Distinct disease mechanisms may underlie cognitive decline related to hearing loss in different age groups
Conclusions 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. (Source: Journal of Neurology, Neurosurgery and Psychiatry)
Source: Journal of Neurology, Neurosurgery and Psychiatry - March 14, 2023 Category: Neurosurgery Authors: van 't Hooft, J. J., Pelkmans, W., Tomassen, J., Smits, C., Legdeur, N., den Braber, A., Barkhof, F., van Berckel, B., Yaqub, M., Scheltens, P., Pijnenburg, Y. A., Visser, P. J., Tijms, B. M. Tags: Cognitive neurology Source Type: research

Time to steroids impacts visual outcome of optic neuritis in MOGAD
Conclusions Time to MP affects functional but also structural visual outcomes of ON in MOGAD. (Source: Journal of Neurology, Neurosurgery and Psychiatry)
Source: Journal of Neurology, Neurosurgery and Psychiatry - March 14, 2023 Category: Neurosurgery Authors: Rode, J., Pique, J., Maarouf, A., Ayrignac, X., Bourre, B., Ciron, J., Cohen, M., Collongues, N., Deschamps, R., Maillart, E., Montcuquet, A., Papeix, C., Ruet, A., Wiertlewski, S., Zephir, H., Marignier, R., Audoin, B. Tags: Neuro-inflammation Source Type: research

Modified Erasmus GBS Respiratory Insufficiency Score: a simplified clinical tool to predict the risk of mechanical ventilation in Guillain-Barre syndrome
Conclusions The mEGRIS is a simple and accurate tool for predicting the risk of MV in GBS. Compared with the original model, the mEGRIS requires less information for predictions with equal accuracy, can be used to predict MV at multiple time points and is also applicable in less severely affected patients and GBS variants. Model performance was consistent across different regions. (Source: Journal of Neurology, Neurosurgery and Psychiatry)
Source: Journal of Neurology, Neurosurgery and Psychiatry - March 14, 2023 Category: Neurosurgery Authors: Luijten, L. W. G., Doets, A. Y., Arends, S., Dimachkie, M. M., Gorson, K. C., Islam, B., Kolb, N. A., Kusunoki, S., Papri, N., Waheed, W., Walgaard, C., Yamagishi, Y., Lingsma, H., Jacobs, B. C., The IGOS Consortium, the IGOS Consortium, Hughes, Cornblath Tags: Neuro-inflammation Source Type: research

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
Conclusions COVID-19 vaccine booster strengthens humoral and Th1-cell responses and increases TEM cells in PwMS. (Source: Journal of Neurology, Neurosurgery and Psychiatry)
Source: Journal of Neurology, Neurosurgery and Psychiatry - March 14, 2023 Category: Neurosurgery Authors: Aiello, A., Coppola, A., Ruggieri, S., Farroni, C., Altera, A. M. G., Salmi, A., Vanini, V., Cuzzi, G., Petrone, L., Meschi, S., Lapa, D., Bettini, A., Haggiag, S., Prosperini, L., Galgani, S., Quartuccio, M. E., Bevilacqua, N., Garbuglia, A. R., Agrati, Tags: Open access, COVID-19 Multiple sclerosis Source Type: research

Association between early treatment of multiple sclerosis and patient-reported outcomes: a nationwide observational cohort study
Conclusions 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. (Source: Journal of Neurology, Neurosurgery and Psychiatry)
Source: Journal of Neurology, Neurosurgery and Psychiatry - March 14, 2023 Category: Neurosurgery Authors: He, A., Spelman, T., Manouchehrinia, A., Ciccarelli, O., Hillert, J., McKay, K. Tags: Open access Multiple sclerosis Source Type: research

SARS-CoV-2 omicron breakthrough infections in patients with multiple sclerosis
Conclusions 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. (Source: Journal of Neurology, Neurosurgery and Psychiatry)
Source: Journal of Neurology, Neurosurgery and Psychiatry - March 14, 2023 Category: Neurosurgery Authors: van Kempen, Z. L. E., Stalman, E. W., Steenhuis, M., Kummer, L. Y. L., van Dam, K. P. J., Wilbrink, M. F., ten Brinke, A., van Ham, S. M., Kuijpers, T., Rispens, T., Eftimov, F., Wieske, L., Killestein, J., on behalf of the T2B! immunity against SARS-CoV- Tags: Multiple sclerosis Source Type: research

Contemporary study of multiple sclerosis disability in South East Wales
Conclusions These data provide a detailed contemporary model of disability outcomes in a representative population-based MS cohort. They support a trend of increasing time to disability milestones compared with historical reference populations, and document disability variation with the use of transitional matrices. In addition, they provide essential information for patient counselling, clinical trial design, service planning and offer a comparative baseline for assessment of therapeutic interventions. (Source: Journal of Neurology, Neurosurgery and Psychiatry)
Source: Journal of Neurology, Neurosurgery and Psychiatry - March 14, 2023 Category: Neurosurgery Authors: Harding, K. E., Ingram, G., Tallantyre, E. C., Joseph, F., Wardle, M., Pickersgill, T. P., Willis, M. D., Tomassini, V., Pearson, O. R., Robertson, N. P. Tags: Multiple sclerosis Source Type: research

Cerebroprotection 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. In this narrative review, we discuss potential reasons for those failures. We then outline the diverse, multicellular effects of ischaemic stroke and the complex temporal sequences of the pathophysiological cascade during and following ischaemia, reperfusion,...
Source: Journal of Neurology, Neurosurgery and Psychiatry - March 14, 2023 Category: Neurosurgery Authors: Schneider, A. M., Regenhardt, R. W., Dmytriw, A. A., Patel, A. B., Hirsch, J. A., Buchan, A. M. Tags: Editor's choice Cerebrovascular disease Source Type: research

Vagus nerve stimulation paired with rehabilitation for motor function, mental health and activities of daily living after stroke: a systematic review and meta-analysis
Conclusion The results suggest VNS+Rehab showed better motor function outcomes in patients after stroke, while no better than Rehab on mental health or ADL. Combinations of phase of stroke, specific parameters of VNS and VNS intervention frequency are key modulators of VNS effects. Trial registration number CRD42022310194 (Source: Journal of Neurology, Neurosurgery and Psychiatry)
Source: Journal of Neurology, Neurosurgery and Psychiatry - March 14, 2023 Category: Neurosurgery Authors: Gao, Y., Zhu, Y., Lu, X., Wang, N., Zhu, S., Gong, J., Wang, T., Tang, S.-W. Tags: Cerebrovascular disease Source Type: research

The prospects for poststroke neural repair with vagal nerve stimulation
Vagal nerve stimulation is a new candidate for promoting neural repair after stroke but there is work to do Stroke is one of the major global healthcare problems with over 100 million stroke survivors worldwide.1 It is no longer simply a disease of the elderly, with 63% of the one-in-four adults who will go on to have a stroke being under the age of 70.1 Treatment to help recovery is often restricted to the first 6 months, despite stroke being a long-term condition from which recovery can be a lifelong process. There are three key areas where advances will have a major impact. First, accept that higher doses of motor, lang...
Source: Journal of Neurology, Neurosurgery and Psychiatry - March 14, 2023 Category: Neurosurgery Authors: Ward, N. Tags: Open access Editorial commentaries Source Type: research

QEEG abnormalities in cognitively unimpaired patients with delirium
Introduction Delirium is an acute fluctuation in attention with reduced awareness, orientation, cognitive disturbances, sleep-wake cycle and emotional regulation. Psychomotor dysfunction represents a prominent feature defining three different delirium subtypes: hyperactive, marked by agitation, hypoactive, with lethargy and decreased motor activity, and mixed.1 Delirium prevalence increases with age. It is particularly frequent during hospitalisation (20%–60% in elderly individuals), and is associated with high mortality rates.1 Several factors may concur to delirium, as neurodegenerative diseases (it is considered a...
Source: Journal of Neurology, Neurosurgery and Psychiatry - February 14, 2023 Category: Neurosurgery Authors: Carrarini, C., Calisi, D., De Rosa, M. A., Di Iorio, A., DArdes, D., Pellegrino, R., Gazzina, S., Pilotto, A., Arighi, A., Carandini, T., Cagnin, A., Mozzetta, S., Gallucci, M., Bonifati, D. M., Costa, C., D'Antonio, F., Bruno, G., Cipollone, F., Babiloni Tags: PostScript Source Type: research

Serum peroxiredoxin 3 is reduced in genetic carriers of Parkinsons disease
Introduction Mutations in leucine rich repeat kinase 2 (LRRK2) are responsible for autosomal dominant Parkinson’s disease (PD). G2019S remains the most common mutation, but is rare in Asia, while LRRK2 Asian-specific variants are associated with increased risk of PD.1 LRRK2 interacts with human peroxiredoxin 3 (PRDX3),2 a mitochondrial member of the antioxidant family of thioredoxin (Trx) peroxidases, increasing its inhibition and leading to mitochondrial dysfunction and oxidative damage.2 Mutations in LRRK2 reduce peroxidase activity and increase neuronal cell death.2 Serum PRDX3 is a surrogate marker of peroxidase ...
Source: Journal of Neurology, Neurosurgery and Psychiatry - February 14, 2023 Category: Neurosurgery Authors: Ng, A. S., Tan, J., Ng, E., Tay, K. Y., Au, W. L., Tan, L. C., Tan, E. K. Tags: PostScript Source Type: research