Neurology International

15 pages, 511 KB

Open AccessArticle

Cognition and Health-Related Quality of Life After aSAH: The Role of Objective and Subjective Impairment

by Angelka Pešterac-Kujundžić, Una Nedeljković, Ivana Sretenović, Aleksandar Milosavljević, Dragoslav Nestorović, Vojislav Bogosavljević and Ivan Vukašinović

Neurol. Int. 2026, 18(3), 62; https://doi.org/10.3390/neurolint18030062 - 23 Mar 2026

Viewed by 865

Abstract

Objectives: Survivors of mild-grade aneurysmal subarachnoid hemorrhage (aSAH) often achieve favorable neurological recovery, yet many continue to experience cognitive difficulties and reduced health-related quality of life (HRQoL). The relative contribution of objectively measured cognition and subjective cognitive complaints to long-term HRQoL in this [...] Read more.

Objectives: Survivors of mild-grade aneurysmal subarachnoid hemorrhage (aSAH) often achieve favorable neurological recovery, yet many continue to experience cognitive difficulties and reduced health-related quality of life (HRQoL). The relative contribution of objectively measured cognition and subjective cognitive complaints to long-term HRQoL in this population remains insufficiently clarified. Methods: This prospective cohort study assessed objective and subjective cognitive functioning one year after mild-grade aSAH (Hunt & Hess I–II) and examined their unique contributions to HRQoL. Forty endovascularly treated aSAH survivors and 80 neurologically healthy controls, matched for sex, age, and educational level, were assessed 12–14 months post-ictus using the Montreal Cognitive Assessment (MoCA), Cognitive Failures Questionnaire (CFQ), and SF-36. Results: Compared with controls, patients demonstrated significantly lower MoCA scores, with cognitive impairment present in 42.5% of cases, as well as reduced HRQoL. In multivariate regression analyses adjusted for demographic, clinical, and affective covariates, subjective cognitive complaints (CFQ) remained independently associated with the mental component summary score of the SF-36 (β = −0.47, p = 0.002). Objective cognitive performance (MoCA) was not associated with the SF-36 component summary scores but showed weaker, domain-specific associations in exploratory analyses. The correlation between MoCA and CFQ was weak (ρ = −0.33), indicating a dissociation between these two measures. Conclusions: One year after mild-grade aSAH, subjective cognitive complaints contribute to mental HRQoL above and beyond the influence of affective symptoms. These findings highlight a clinically relevant dissociation between perceived and objectively measured cognition and support the importance of incorporating patient-reported cognitive difficulties into long-term outcome assessment and rehabilitation planning. Full article

(This article belongs to the Section Aging Neuroscience)

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11 pages, 1148 KB

Open AccessArticle

Posterior Communicating Artery Configuration and Laterality of Thalamic and Lenticulostriate Infarction

by Junpei Nagasawa, Masamichi Hozumi, Tatsuhiro Yokoyama, Makiko Ogawa, Junya Ebina, Mari Shibukawa, Takehisa Hirayama and Osamu Kano

Neurol. Int. 2026, 18(3), 61; https://doi.org/10.3390/neurolint18030061 - 22 Mar 2026

Viewed by 739

Abstract

Background: Anatomical variations in the posterior communicating artery (PCoA) are common, but their association with ischemic stroke remains unclear. In this study, we investigated the relationship between PCoA configuration and the localization of perforator infarction. Methods: We conducted a single-center, retrospective observational study [...] Read more.

Background: Anatomical variations in the posterior communicating artery (PCoA) are common, but their association with ischemic stroke remains unclear. In this study, we investigated the relationship between PCoA configuration and the localization of perforator infarction. Methods: We conducted a single-center, retrospective observational study of consecutive patients admitted with acute ischemic stroke between April 2016 and July 2023. Patients with a single, unilateral lacunar infarction confined to the thalamic or lenticulostriate artery (LSA) territory were included. PCoA configuration was assessed using time-of-flight magnetic resonance angiography and dichotomized as present (normal PCoA or fetal-type posterior cerebral artery) or absent (hypoplastic or aplastic PCoA). Using a within-patient, hemisphere-based approach, the presence of PCoA on the infarcted side was directly compared with that on the contralateral side. McNemar’s test with continuity correction was used for laterality analysis. Results: A total of 64 patients met the inclusion criteria, including 45 with LSA infarction and 19 with thalamic infarction. The prevalence of PCoA presence on the infarcted hemisphere was 20.0% in the LSA group and 26.3% in the thalamic group, identical to that observed on the contralateral hemisphere in each group. Within-patient comparisons revealed no significant difference in PCoA presence between infarcted and non-infarcted hemispheres in either territory (all p > 0.05). Conclusions: In patients with unilateral perforator infarction involving the thalamic or LSA territories, PCoA configuration was not associated with infarct laterality. These findings suggest that variations in PCoA anatomy have a limited influence on hemispheric vulnerability to perforator infarction, supporting the predominant role of local small-vessel pathology rather than proximal collateral anatomy in the development of lacunar stroke. Full article

(This article belongs to the Special Issue Cerebrovascular Disease: Update on Diagnosis and Treatment)

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43 pages, 11344 KB

Open AccessReview

Duropathies as Unifying Concept—Part Two: A Narrative Overview of Clinical and Neuroradiological Features

by Marialuisa Zedde, Luigi Cirillo, Elisa Francesca Maria Ciceri, Nicola Limbucci, Mario Muto, Mauro Bergui, Francesco Causin and Rosario Pascarella

Neurol. Int. 2026, 18(3), 60; https://doi.org/10.3390/neurolint18030060 - 20 Mar 2026

Viewed by 1426

Abstract

Duropathies represent a spectrum of disorders associated with spinal dural tears and cerebrospinal fluid (CSF) leaks. Diagnosis and treatment is often complicated by overlapping clinical manifestations. This review aims to synthesize current literature on duropathies, focusing on their clinical, neuroradiological, and pathophysiological features. [...] Read more.

Duropathies represent a spectrum of disorders associated with spinal dural tears and cerebrospinal fluid (CSF) leaks. Diagnosis and treatment is often complicated by overlapping clinical manifestations. This review aims to synthesize current literature on duropathies, focusing on their clinical, neuroradiological, and pathophysiological features. A comprehensive literature review was conducted, analyzing various conditions classified as duropathies, including spontaneous intracranial hypotension (SIH), superficial siderosis (SS), spinal cord herniation, and, as added issue, arachnoid webs. The review emphasized the importance of imaging techniques such as MRI and CT myelography in diagnosing these conditions. Duropathies can arise from congenital anomalies, trauma, and degenerative changes, with SIH being characterized by orthostatic headaches and neurological deficits. Imaging typically reveals specific patterns, such as a widened dorsal subarachnoid space and ventral displacement of the spinal cord. Syringomyelia was frequently associated with arachnoid webs, and complications like SS and bibrachial amyotrophy were noted in patients with persistent ventral spinal CSF leaks. The unifying concept of duropathies is proposed, emphasizing the need for timely intervention to mitigate long-term neurological consequences. Enhanced diagnostic strategies are crucial for improving patient outcomes, and a multidisciplinary approach is recommended for the management of these complex disorders. Further research is warranted to clarify the pathophysiological mechanisms underlying duropathies and to establish standardized treatment protocols. Full article

(This article belongs to the Collection Exclusive Papers from the Editorial Board Members (EBMs) of Neurology International)

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14 pages, 417 KB

Open AccessReview

No New Relevant Treatment Options for L-DOPA-Induced Dyskinesia from a Clinician’s Point of View

by Thomas Müller

Neurol. Int. 2026, 18(3), 59; https://doi.org/10.3390/neurolint18030059 - 20 Mar 2026

Viewed by 1376

Abstract

Background: The term dyskinesia describes involuntary movements of the face, body and extremities. Frequently, they appear following and in relation with prior oral long-lasting and high-dose levodopa therapy in Parkinson’s disease patients. Onset of these motion sequences causes patient distress and caregiver embarrassment [...] Read more.

Background: The term dyskinesia describes involuntary movements of the face, body and extremities. Frequently, they appear following and in relation with prior oral long-lasting and high-dose levodopa therapy in Parkinson’s disease patients. Onset of these motion sequences causes patient distress and caregiver embarrassment with declined quality of life. Continuity of nigrostriatal postsynaptic dopamine receptor stimulation delays occurrence of dyskinesia. A pulsatile pattern with temporary too high dopamine receptor excitation promotes manifestation of dyskinesia. Methods: This narrative review describes past pharmacologic approaches for therapy of dyskinesia, such as the principle of continuous dopamine receptor stimulation. Discussion and Conclusions: Novel concepts were tested. They influenced neurotransmission of serotonin and altered stimulation of dopamine receptor subtypes. The translation of successful experimental research outcomes into valuable clinical trial results with consecutive approval of drugs with a new mode of action under the indication “antidyskinetic” repeatedly failed. An exception is the open-channel blocker of the N-methyl-D-aspartate receptor and dopamine reuptake inhibitor amantadine with its moderate dyskinesia-reducing effects, particularly in its extended-release formulation. This antiviral compound also improves impaired motor behavior and reduces “OFF” intervals. Therefore, amantadine is currently experiencing a certain resurgence in regions where its extended-release formulations are marketed for therapy of levodopa-induced dyskinesia. Full article

(This article belongs to the Collection Exclusive Papers from the Editorial Board Members (EBMs) of Neurology International)

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13 pages, 1289 KB

Open AccessArticle

Delta Power in SLC6A1-Related Neurodevelopmental Disorder: Operationalizing Quantitative EEG Metrics for Biomarker Development

by Hamza Dahshi, Marie Varnet, Kimberly Goodspeed, Jacob Tiller, Dallas Armstrong and Deepa Sirsi

Neurol. Int. 2026, 18(3), 58; https://doi.org/10.3390/neurolint18030058 - 18 Mar 2026

Viewed by 3288

Abstract

Introduction: SLC6A1-related neurodevelopmental disorder (SLC6A1-NDD) is an epileptic encephalopathy linked to mutations in the SLC6A1 gene and is characterized by early-onset seizures and developmental delays. Despite the growing recognition of SLC6A1 as a major cause of early-onset epilepsy, the electrophysiological changes associated with [...] Read more.

Introduction: SLC6A1-related neurodevelopmental disorder (SLC6A1-NDD) is an epileptic encephalopathy linked to mutations in the SLC6A1 gene and is characterized by early-onset seizures and developmental delays. Despite the growing recognition of SLC6A1 as a major cause of early-onset epilepsy, the electrophysiological changes associated with the disorder remain inadequately characterized. This study aims to identify electrophysiological biomarkers of SLC6A1-NDD by characterizing EEG delta power using automated tools, EEGLAB (v2023.1) and Persyst 13, exploring age- and state-related effects. Methods: We analyzed EEG recordings from 20 patients with SLC6A1-NDD and 20 neurotypical age- and sex-matched controls using EEGLAB and Persyst, quantifying delta power and related metrics. The Wilcoxon signed-rank method tested for differences between patients and controls, area under the curve (AUC) values evaluated patient classifier models, and Pearson’s correlation assessed concordance between EEGLAB and Persyst. Results: Patients with SLC6A1-NDD exhibited significantly elevated delta power (19.4 ± 4.1) compared to controls (14.2 ± 3.0; p < 0.001). The mean delta power showed an age-dependent increasing trend in patients (b = 0.5), contrasting with a decline in controls (b = −1.0; p < 0.001). In Persyst, the frequency of delta activity above an optimized threshold best differentiated patients from controls in wake epochs (AUC = 0.93). Concordance between EEGLAB and Persyst was one-to-one but with moderate variability (R² = 0.644; p < 0.001). Conclusions: Elevated delta power is a notable feature of SLC6A1-NDD. Cross-platform comparison demonstrates the feasibility of quantitative EEG analysis, while imperfect concordance highlights the need for pipeline standardization. Future work should validate these findings in larger cohorts and, as suitable reference data emerge, benchmark delta power metrics against age-matched children with other developmental and epileptic encephalopathies. Full article

(This article belongs to the Special Issue The Evolving Role of EEG in Neurological Disorders: Advanced Techniques and Future Directions)

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10 pages, 2782 KB

Open AccessCase Report

Ischemic Stroke as the First Manifestation of Takayasu Arteritis: A Case Report

by Dominika Jakubowicz-Lachowska, Magdalena Sarnowska, Monika Chorąży and Alina Kułakowska

Neurol. Int. 2026, 18(3), 57; https://doi.org/10.3390/neurolint18030057 - 18 Mar 2026

Viewed by 1516

Abstract

Introduction: Ischemic stroke in young adults is uncommon and is frequently associated with rare etiologies, including autoimmune diseases and vasculitis. Takayasu arteritis (TA) is a chronic inflammatory large-vessel arteriopathy involving the aorta and its major branches and may result in cerebral ischemia due [...] Read more.

Introduction: Ischemic stroke in young adults is uncommon and is frequently associated with rare etiologies, including autoimmune diseases and vasculitis. Takayasu arteritis (TA) is a chronic inflammatory large-vessel arteriopathy involving the aorta and its major branches and may result in cerebral ischemia due to arterial stenosis or thrombosis. Case Presentation: We report the case of a 26-year-old woman with a history of suspected rheumatoid arthritis and Lyme disease who presented with acute left-sided hemiparesis and dysarthria. At admission, large-vessel vasculitis had not yet been suspected, and the patient was treated according to standard acute stroke protocols. Computed tomography angiography (CTA) revealed occlusion of the right middle cerebral artery bifurcation and the right common carotid artery, with inflammatory changes involving the brachiocephalic trunk and subclavian arteries. Intravenous thrombolysis (iv rtPA) was followed by mechanical thrombectomy (MT), resulting in neurological improvement. Outcome: Further diagnostic work-up confirmed TA, and immunosuppressive therapy with cyclophosphamide and infliximab was initiated. Conclusion: This case underscores the importance of considering inflammatory large-vessel disease in young patients presenting with acute ischemic stroke and illustrates that endovascular reperfusion may be feasible in this clinical setting. Full article

(This article belongs to the Special Issue Cerebrovascular Disease: Update on Diagnosis and Treatment)

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11 pages, 705 KB

Open AccessArticle

Post-Transplant Tremor: Characteristics and Differences Based on Sex and Post-Transplant Therapy

by Srdjana Telarovic, Maja Vrdoljak Pazur, Nikolina Zupancic, Anamarija Strajduhar and Irma Telarovic

Neurol. Int. 2026, 18(3), 56; https://doi.org/10.3390/neurolint18030056 - 17 Mar 2026

Cited by 1 | Viewed by 1200

Abstract

Background/Objectives: Kidney transplantation is the standard of care for the majority of patients with end-stage kidney disease. Neurological complications are common, and among them, tremor is very frequent and usually attributed to immunosuppressive drug toxicity. Methods: In this retrospective study, we [...] Read more.

Background/Objectives: Kidney transplantation is the standard of care for the majority of patients with end-stage kidney disease. Neurological complications are common, and among them, tremor is very frequent and usually attributed to immunosuppressive drug toxicity. Methods: In this retrospective study, we investigate the incidence and characteristics of tremor in kidney transplant patients and analyze its occurrence with respect to a multitude of demographic and clinical parameters, thereby aiming to confirm the role of calcineurin inhibitor-induced neurotoxicity and to identify other putative predictive factors. Furthermore, we characterize post-transplant tremor with the goal of identifying its clinical features and determining the impact on quality of life. Results: A total of 129 kidney transplant recipients were screened; six patients were excluded due to a history of movement disorders prior to kidney transplantation. In total, 123 patients were included in the final analysis—69 male (56%) and 54 female patients (44%), with a median age of 50. A total of 36% (46 patients) developed tremor in the post-transplant period. Using both univariable and multivariable analyses, we found that female sex and tacrolimus use were independently associated with the development of post-transplant tremor. In addition, multivariable analysis identified an association between younger age and post-transplant tremor. Furthermore, we observed a trend in the duration of symptoms in relation to the calcineurin inhibitor choice. Conclusions: Despite a relatively high prevalence (36%), post-transplant tremor does not significantly impact the QoL and spontaneously resolves within 1 year in adult kidney transplant recipients. Female sex and tacrolimus were identified as independent predictors of post-transplant tremor in renal transplant recipients. Full article

(This article belongs to the Section Movement Disorders and Neurodegenerative Diseases)

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22 pages, 807 KB

Open AccessSystematic Review

Effectiveness of Physiotherapy Interventions on Executive Function in Patients with Chronic Pain: A Systematic Review

by Aser Donado-Bermejo, Silvia Di-Bonaventura, Pablo Barrenechea-Leal, Francisco Mercado-Romero, Marisa Fernández-Sánchez and Raúl Ferrer-Peña

Neurol. Int. 2026, 18(3), 55; https://doi.org/10.3390/neurolint18030055 - 16 Mar 2026

Viewed by 1998

Abstract

Background: Chronic pain is a prevalent and disabling condition that affects physical health but also cognitive domains. Executive functions, including inhibitory control, cognitive flexibility, and working memory, essentials for self-regulation, treatment adherence, and coping with symptoms, are particularly compromised. Physiotherapy interventions, traditionally aimed [...] Read more.

Background: Chronic pain is a prevalent and disabling condition that affects physical health but also cognitive domains. Executive functions, including inhibitory control, cognitive flexibility, and working memory, essentials for self-regulation, treatment adherence, and coping with symptoms, are particularly compromised. Physiotherapy interventions, traditionally aimed at physical outcomes, may also influence executive functions; however, their impact remains unclear. Objective: This review aimed to synthesize current evidence regarding the effects of physiotherapy-related interventions on executive function in adults with chronic pain. Methods: The review followed the Cochrane Handbook and Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines, and the protocol was registered in PROSPERO (CRD42024611800). A comprehensive search was performed. Randomized controlled trials (RCTs) included adults with chronic pain (≥3 months) whose executive function outcomes were evaluated after physiotherapy-based interventions. Results: Out of 12,391 records, 10 randomized controlled trials were included. Populations primarily had fibromyalgia, chronic low back pain, and chronic musculoskeletal pain. Interventions encompassed transcranial direct current stimulation (tDCS), transcranial magnetic stimulation (rTMS), neurofeedback, structured exercise, and multimodal physical-cognitive-mindfulness training. Intervention durations ranged from one session to 16 weeks. Executive function was assessed with diverse neuropsychological tests. tDCS improved attention, inhibitory control, cognitive flexibility, and working memory. Exercise interventions showed benefits in working memory and inhibitory control. Conclusions: Preliminary evidence suggests that physiotherapy interventions, particularly anodal tDCS and structured exercise, may improve executive functions in individuals with chronic pain. Future trials should incorporate long-term follow-up. Integrating cognitive targets into physiotherapy may enhance the multidimensional management of chronic pain. Full article

(This article belongs to the Special Issue Non-Invasive Neuromodulation in Treatment of Chronic Pain)

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14 pages, 658 KB

Open AccessArticle

EEG in the Emergency Department: When the Neurophysiological Test Can Be Avoided in Emergency Diagnostic Workups? The EMINENCE Study

by Maenia Scarpino, Antonello Grippo, Federica Barraco, Benedetta Piccardi, Laura Betti, Peiman Nazerian, Arianna Fabbri, Roberto Fratangelo, Cristina Mei and Andrea Nencioni

Neurol. Int. 2026, 18(3), 54; https://doi.org/10.3390/neurolint18030054 - 16 Mar 2026

Viewed by 1136

Abstract

Introduction: This study was conducted to determine whether specific emergency physician (EP) diagnoses and/or neurological signs/symptoms upon admission to the Emergency Department (ED) were associated with normal/non-informative emergency electroencephalogram (emEEG). Methods: Data from consecutive patients admitted to the ED of our tertiary [...] Read more.

Introduction: This study was conducted to determine whether specific emergency physician (EP) diagnoses and/or neurological signs/symptoms upon admission to the Emergency Department (ED) were associated with normal/non-informative emergency electroencephalogram (emEEG). Methods: Data from consecutive patients admitted to the ED of our tertiary hospital over a two-year period (1 January 2023–31 December 2024) were analyzed retrospectively. We evaluated the correlation between normal/non-specific emEEGs and EP admission diagnoses and neurological signs/symptoms on admission. Epileptic discharges and sharp waves with triphasic morphology were considered specific patterns. Results: A total of 2008 patients underwent emEEG recording during the study period. EmEEGs were considered non-informative in 100% of global amnesia diagnoses, 100% of cases of mild head trauma, 100% of cases of migraine with aura, 98.3% of transient ischemic attacks (TIAs), 95.6% of transient losses of consciousness (TLCs) when seizure was not the primary suspected diagnosis, and in 92.7% of falls of unknown dynamics. Epileptic patterns were detected in 4% of patients presenting with TLC and in 2.4% of those with falls of unknown dynamics, with approximately half of these patients having a pre-existing diagnosis of epilepsy. Triphasic waves were detected in 4.9% patients with falls of unknown dynamics, in 1.7% with TIA, and in 0.4% with TLC. All of these patients had fever/sepsis or metabolic/electrolyte disorders. Overall, across all clinical scenarios, emEEGs were considered non-informative in 385 (19.1%) tested patients. Conclusions: emEEGs are almost non-informative in the diagnostic pathway for patients with global amnesia, mild head trauma, and migraine with aura, and in patients with TIA, TLC, or falls of unknown dynamics. EPs can safely consider avoiding emEEGs in the absence of previous epilepsy diagnosis, fever/sepsis, metabolic/electrolyte disturbances, or drug abuse. Full article

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15 pages, 346 KB

Open AccessReview

Treating the Patient, Not Only the Amyloid: Symptomatic Management in Transthyretin Amyloidosis

by Christian Messina

Neurol. Int. 2026, 18(3), 53; https://doi.org/10.3390/neurolint18030053 - 13 Mar 2026

Cited by 5 | Viewed by 1159

Abstract

Transthyretin amyloidosis (ATTR) is a progressive multisystem disorder characterized by extracellular deposition of misfolded transthyretin fibrils, leading to neurological, cardiac, gastrointestinal, urogenital, sexual, and ophthalmological involvement. While disease-modifying therapies have significantly improved survival and slowed disease progression, a substantial proportion of patients continue [...] Read more.

Transthyretin amyloidosis (ATTR) is a progressive multisystem disorder characterized by extracellular deposition of misfolded transthyretin fibrils, leading to neurological, cardiac, gastrointestinal, urogenital, sexual, and ophthalmological involvement. While disease-modifying therapies have significantly improved survival and slowed disease progression, a substantial proportion of patients continue to experience a high symptomatic burden that markedly impairs quality of life. Symptomatic manifestations often occur early, may precede the diagnosis, and frequently persist despite etiological treatment. This review provides a comprehensive overview of the symptomatic management of ATTR, with particular emphasis on autonomic dysfunction and its systemic consequences. We discuss current therapeutic strategies for orthostatic hypotension, gastrointestinal dysmotility, nutritional impairment, sexual dysfunction, lower urinary tract dysfunction, and ophthalmological involvement, highlighting both pharmacological and non-pharmacological approaches. Special attention is given to treatment limitations related to cardiac involvement, autonomic failure, and drug tolerability. Despite the clinical relevance of symptom control in ATTR, evidence-based recommendations remain scarce, and no dedicated guidelines currently exist. Most therapeutic approaches are derived from observational studies, expert opinion, and clinical experience. Improved awareness of symptomatic manifestations, early intervention, and a multidisciplinary, individualized approach are essential to optimize patient outcomes. Future research should focus on prospective studies and the development of structured symptomatic treatment algorithms to complement disease-modifying therapies and enhance patient-centered care in ATTR. Full article

(This article belongs to the Topic Dysautonomia in Neurological Disorders)

8 pages, 1259 KB

Open AccessCase Report

Middle Meningeal Artery Embolization as Standalone Therapy for Chronic Subdural Hematoma with Radiological Herniation Features: A Case Report

by Gamaliel Wibowo Soetanto and Elvan Wiyarta

Neurol. Int. 2026, 18(3), 52; https://doi.org/10.3390/neurolint18030052 - 5 Mar 2026

Cited by 1 | Viewed by 1249

Abstract

Background: Chronic subdural hematoma is commonly managed with surgical evacuation when significant mass effect or herniation features are present. Although middle meningeal artery embolization has emerged as an effective adjunctive therapy, evidence supporting its use as standalone treatment in patients with radiological herniation [...] Read more.

Background: Chronic subdural hematoma is commonly managed with surgical evacuation when significant mass effect or herniation features are present. Although middle meningeal artery embolization has emerged as an effective adjunctive therapy, evidence supporting its use as standalone treatment in patients with radiological herniation remains limited. Case Presentation: We report a 51-year-old man who presented with a three-week history of progressive headache, intermittent confusion, and mild left-sided weakness. Magnetic resonance imaging demonstrated a right-sided chronic subdural hematoma with marked cortical compression and subfalcine herniation. Despite radiological severity, the patient remained neurologically stable. After multidisciplinary discussion, middle meningeal artery embolization was performed as sole therapy via right radial access using a liquid embolic agent. Selective angiography demonstrated pathological neovascular supply from the right middle meningeal artery, which was completely obliterated following embolization without procedural complications. The post-procedural course was uneventful, with progressive clinical improvement. Follow-up non-contrast computed tomography at eight months demonstrated near-complete resolution of the hematoma with normalization of midline structures, and no surgical evacuation was required. Conclusions: Standalone middle meningeal artery embolization may represent a feasible therapeutic option in carefully selected clinically stable patients with chronic subdural hematoma and radiological herniation features, though further studies are required to define optimal selection criteria and long-term outcomes. Full article

(This article belongs to the Section Brain Tumor and Brain Injury)

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12 pages, 748 KB

Open AccessArticle

Neurotrophins Plasma Levels Kinetics in Ischemic Stroke Patients—Potential Relation to Outcomes

by Radosław Opiła, Karolina Łuczkowska, Edyta Paczkowska, Przemysław Nowacki, Jarosław Peregud-Pogorzelski and Bogusław Machaliński

Neurol. Int. 2026, 18(3), 51; https://doi.org/10.3390/neurolint18030051 - 4 Mar 2026

Viewed by 713

Abstract

Background/Objectives: Neurotrophins are a family of structurally related growth factors known to play an important role in the physiology and pathophysiology of the central nervous system. In ischemic stroke, lower blood concentrations of brain-derived neurotrophic factor (BDNF) have been linked to worse [...] Read more.

Background/Objectives: Neurotrophins are a family of structurally related growth factors known to play an important role in the physiology and pathophysiology of the central nervous system. In ischemic stroke, lower blood concentrations of brain-derived neurotrophic factor (BDNF) have been linked to worse outcomes. However, data regarding blood levels of other neurotrophins remain limited. Methods: Plasma levels of BDNF, NGF, NT-3 and NT-4 of 93 patients with ischemic stroke were measured using Luminex immunoassay at two time points: within 24 h from onset and on the seventh day. Clinical data regarding co-existing risk factors, National Institutes of Health Stroke Scale (NIHSS) score and mortality were collected and analyzed in relation to analytes. Results: BDNF levels at both time points were lower in patients with severe stroke and correlated negatively with NIHSS scores. No such associations were observed for NGF and NT-3. Patients who died had lower baseline BDNF, NT-4 and higher NT-3. Conclusions: A lower BDNF level, but no other neurotrophins, is associated with worse outcomes in ischemic stroke patients. NT-3 and NT-4 levels change in response to ischemic stroke. Full article

(This article belongs to the Collection Biomarkers in Stroke Prognosis)

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25 pages, 3996 KB

Open AccessReview

Genetic Architecture of Cognitive Resilience in Alzheimer’s Disease: Mechanisms, Pathways, and Therapeutic Implications

by Gabriel Burdman, Juliet Akkaoui, Natalia Colon, Andres Perez and Madepalli K. Lakshmana

Neurol. Int. 2026, 18(3), 50; https://doi.org/10.3390/neurolint18030050 - 3 Mar 2026

Viewed by 2889

Abstract

Background/Objectives: Alzheimer’s disease (AD) is defined by amyloid-β plaques and tau neurofibrillary tangles and is typically associated with progressive cognitive decline. However, a substantial subset of individuals remains cognitively intact despite intermediate-to-high AD pathology, a phenomenon termed cognitive resilience. This review aims [...] Read more.

Background/Objectives: Alzheimer’s disease (AD) is defined by amyloid-β plaques and tau neurofibrillary tangles and is typically associated with progressive cognitive decline. However, a substantial subset of individuals remains cognitively intact despite intermediate-to-high AD pathology, a phenomenon termed cognitive resilience. This review aims to synthesize genetic variants and biological pathways associated with preserved cognition in the presence of AD neuropathology. Methods: We performed a narrative thematic synthesis of human genetic studies (GWAS, sequencing, biomarker-informed cohorts) and extreme resilience case reports. Variants were prioritized by replication, mechanistic plausibility, and relevance to clinicopathologic dissociation, and were organized by shared biological pathways. When applicable, cognitive resilience was operationalized using residual-based approaches modeling cognitive performance after adjustment for neuropathological burden, age, sex, and education or cognitive reserve proxies reported by each cohort. Results: Recurrent resilience-associated variants include APOE ε2, APOE3-Christchurch, RELN-COLBOS, ATP8B1, RAB10, PLCG2, PICALM, CLU, FN1, and synapse-linked markers such as NPTX2. These variants converge on lipid metabolism, synaptic function and neuroplasticity, tau regulation and proteostasis, immune and inflammatory signaling, vascular/BBB resilience, and RNA regulation. Conclusions: Genetic determinants of cognitive resilience highlight mechanisms that preserve neural integrity independent of pathological load. Targeting resilience pathways may enable precision therapies designed to maintain cognitive function in AD. Full article

(This article belongs to the Special Issue Molecular and Cellular Research of Neuroprotection and Neurodegeneration)

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11 pages, 645 KB

Open AccessArticle

Sleep-Disordered Breathing in Children with Cerebral Palsy Compared to Non-Neurological Controls: A Prospective Study from a Tertiary Center in Jordan

by Montaha Al-Iede, Abdallah Al-Ani, Amal Abu Libdeh, Amira Masri, Ahmad T. Qatawneh, Basim Alqutawneh and Nihad A. Almasri

Neurol. Int. 2026, 18(3), 49; https://doi.org/10.3390/neurolint18030049 - 2 Mar 2026

Viewed by 1161

Abstract

Background/Objectives: Our aim was to evaluate sleep quality and the prevalence of OSA among children with CP and other neurological conditions using both polysomnography (PSG) and validated sleep questionnaires. Methods: This study was conducted at the sleep laboratory of the Jordan University Hospital [...] Read more.

Background/Objectives: Our aim was to evaluate sleep quality and the prevalence of OSA among children with CP and other neurological conditions using both polysomnography (PSG) and validated sleep questionnaires. Methods: This study was conducted at the sleep laboratory of the Jordan University Hospital (JUH) between October 2023 and April 2025. Patients were consecutively recruited from pediatric neurology clinics. Patients completed a PSG session, while guardians/caregivers completed the pediatric sleep questionnaire (PSQ) and sleep disturbance scale for children (SDSC) tools on the behalf of the included patients. The cohort was matched with a control group composed of asthmatic children referred for sleep disturbances. Results: We recruited 296 patients, of whom 41.6% had neurological disorders and 58.4% were matched non-neurological controls. Among those with neurological diseases (n = 123), 46.3% were diagnosed with CP. Patients with CP showed significantly lower sleep efficacy than controls (p < 0.001). They also had reduced total sleep time compared to non-neurological controls but, notably, longer sleep time than children with Down Syndrome (all p < 0.05). Patients with CP had arousal index and apnea–hypopnea index values comparable to controls, but both measures were significantly lower than those observed in children with Down Syndrome and other syndromic patients (all p < 0.05). The risk of OSA according to the PSQ was insignificant for both controls and patients with neurological conditions (OR: 0.898; p = 0.720). According to the SDSC questionnaire, patients with neurological conditions had a significantly higher risk of sleep disturbances compared to controls (OR: 2.015; p = 0.043). Conclusion: Patients with neurological diseases are at a higher risk of sleep disturbances compared to controls. This was significantly more apparent in non-CP patients than in those with CP. At present, PSG remains the most objective and reliable tool to evaluate these disturbances. Full article

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28 pages, 2611 KB

Open AccessReview

Misfolded Proteins and Cognitive Decline: Mechanistic Insights into Neurodegenerative Disorders

by Elisa Duranti and Chiara Villa

Neurol. Int. 2026, 18(3), 48; https://doi.org/10.3390/neurolint18030048 - 2 Mar 2026

Cited by 3 | Viewed by 2320

Abstract

Cognitive decline represents one of the most common clinical manifestations of neurodegenerative diseases (NDs), substantially affecting the quality of life of both patients and their families. Alzheimer’s disease, Parkinson’s disease, and amyotrophic lateral sclerosis are major NDs characterized by a progressive degeneration of [...] Read more.

Cognitive decline represents one of the most common clinical manifestations of neurodegenerative diseases (NDs), substantially affecting the quality of life of both patients and their families. Alzheimer’s disease, Parkinson’s disease, and amyotrophic lateral sclerosis are major NDs characterized by a progressive degeneration of the central nervous system, with functional impairments extending beyond motor symptoms to multiple cognitive domains, including memory, attention, language, and executive functions. Increasing evidence highlights misfolded protein accumulation as a key driver of neuronal dysfunction and cognitive deterioration. This narrative review examines the major cognitive deficits associated with these disorders, focusing on the underlying molecular mechanisms, particularly protein aggregation, as well as clinical manifestations and their effects on daily life. Furthermore, current diagnostic tools and emerging therapeutic options for mitigating cognitive decline will be further discussed. Full article

(This article belongs to the Section Movement Disorders and Neurodegenerative Diseases)

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12 pages, 556 KB

Open AccessArticle

Exploring Trends and Sentiments in Epilepsy Discussions: A Thematic Analysis of the r/Epilepsy Subreddit (2023–2024)

by Kelly Fisher, Eliza Sejdiu, Michelle You, Rahim Hirani, Adam Karp and Mill Etienne

Neurol. Int. 2026, 18(3), 47; https://doi.org/10.3390/neurolint18030047 - 1 Mar 2026

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Abstract

Background: In 2024, Reddit, an emerging social media platform, saw a 50% increase in monthly users to nearly 100 million. Reddit has also emerged as a significant space for discussions about health conditions, including epilepsy, which affects about 50 million people globally. Purpose: [...] Read more.

Background: In 2024, Reddit, an emerging social media platform, saw a 50% increase in monthly users to nearly 100 million. Reddit has also emerged as a significant space for discussions about health conditions, including epilepsy, which affects about 50 million people globally. Purpose: This study aims to explore trends in the volume, timing, themes, emotional tone, and sentiment of posts on the r/Epilepsy subreddit from 1 December 2023 to 31 December 2024. Methods: We collected 25,222 original English-language posts from r/Epilepsy using Reddit’s Application Programming Interface (API). Data extraction was restricted to English-language submissions to ensure compatibility with sentiment and thematic analyses. We analyzed post volume and timing using chi-square tests and Poisson regression. Emotional tone was measured using TextBlob (version 0.19.0), while compound sentiment scores were calculated via VADER (Valence Aware Dictionary and Sentiment Reasoner) (NLTK version 3.9.1). A Pearson correlation assessed agreement between sentiment and emotional tone, with statistical significance set at p < 0.05. Thematic analysis was conducted using a KMeans clustering algorithm (scikit-learn version 1.6.1) to identify recurring discussion topics. Results: Total monthly posts steadily increased, with the highest number (2175) in December 2024. Peak posts in descending order were in December 2024, August 2024, and November 2024. Posts were not evenly distributed across the week, with a significant peak on Mondays (χ² = 86.75, p < 0.001) and Poisson regression confirming higher activity early in the week (p = 0.001). Emotional tones fluctuated, with positive sentiments in January and October 2024, and negative sentiments in March and August 2024. KMeans clustering identified five main themes: treatment experiences, community engagement, personal experiences, solidarity, and subreddit gratitude. Manual validation of a random subset of posts demonstrated moderate concordance between automated sentiment classification and human ratings. Conclusions: This study highlights temporal patterns, sentiment dynamics, and thematic structure in online discussions on epilepsy. Social media may offer valuable, real-time insights into patient-centered concerns and community engagement, which can inform healthcare professionals and advocacy groups in supporting individuals affected by epilepsy. Future studies may compare trends of epilepsy discussions across various social media platforms, such as X and Instagram, to further understand online patient experiences. Full article

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16 pages, 680 KB

Open AccessSystematic Review

The Driving Profile of Individuals with Schizophrenia: Cognitive Characteristics, Pharmacological Treatment and Driving Competence—A Scoping Review

by Elpida Stratou, Georgia-Nektaria Porfyri, Aikaterini Gamvroula, Katerina Theodorou, Symeon Dimitrios Daskalou, Nikolaos Gerosideris, Georgia Tsakni, Foteini Christidi, Anna Tsiakiri, Pinelopi Vlotinou and Ioanna Giannoula Katsouri

Neurol. Int. 2026, 18(3), 46; https://doi.org/10.3390/neurolint18030046 - 28 Feb 2026

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Abstract

Background/Objectives: Driving performance and competence represent a complex functional domain that may be affected in some individuals with schizophrenia. This scoping review aimed to map existing evidence characterizing driving-related functioning by identifying the cognitive, pharmacological and functional factors that influence driving ability [...] Read more.

Background/Objectives: Driving performance and competence represent a complex functional domain that may be affected in some individuals with schizophrenia. This scoping review aimed to map existing evidence characterizing driving-related functioning by identifying the cognitive, pharmacological and functional factors that influence driving ability and by synthesizing findings from experimental, neurocognitive and population-based studies. Methods: A structured search of the PubMed, Scopus and ScienceDirect databases was performed in accordance with PRISMA-ScR guidelines to identify studies published between 2015 and 2025 that examined cognitive, pharmacological and functional dimensions of driving in individuals with schizophrenia. Extracted data were narratively and thematically synthesized. Eleven studies met the inclusion criteria. Results: Findings clustered into three domains: cognitive, including attention, executive function, reaction time and visuospatial processing; pharmacological, encompassing drug comparisons, dosage, side effects and treatment stability; and functional, covering license status, driving participation, driving cessation, avoidance behaviors and self-regulation. Conclusions: This review integrates current evidence within a multidimensional and conditional framework, highlighting interactions between cognitive functioning, pharmacological factors, and compensatory self-regulation in individuals with schizophrenia. Understanding these interrelations may inform individualized fitness-to-drive evaluations and contribute to structured, context-sensitive interpretation of driving-related evidence in clinical and regulatory settings. Full article

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25 pages, 876 KB

Open AccessReview

Potential Effects of Music on Non-Motor Symptoms in Parkinson’s Disease: Translating Mechanisms to Therapy

by Christopher G. Ballmann, Daphne G. Schmid, Rebecca R. Rogers, Hannah K. Oakes and Shelby C. Osburn

Neurol. Int. 2026, 18(3), 45; https://doi.org/10.3390/neurolint18030045 - 26 Feb 2026

Cited by 4 | Viewed by 1850

Abstract

Non-motor symptoms (NMSs) are highly prevalent in Parkinson’s Disease (PD) and contribute significantly to disease severity, progression, and diminished quality of life. NMSs are rooted in both physiological and psychological domains and include emotional dysfunction, autonomic dysregulation, cognitive impairment, pain exacerbation, and neural [...] Read more.

Non-motor symptoms (NMSs) are highly prevalent in Parkinson’s Disease (PD) and contribute significantly to disease severity, progression, and diminished quality of life. NMSs are rooted in both physiological and psychological domains and include emotional dysfunction, autonomic dysregulation, cognitive impairment, pain exacerbation, and neural deficits. While pharmacological approaches are often employed for the alleviation of non-motor symptomology, modest efficacy and adverse side effects may limit their practical utility for individuals with PD, leaving the need for the identification of complementary approaches. Music interventions have emerged as potential adjunctive therapeutic approaches that may positively modulate NMSs in both physiological and psychological domains. Physiologically, music interventions have been shown to alter autonomic activity and pain/sensory perceptions and mediate neurotransmitter release related to arousal, physical effort, and stress. Psychologically, music interventions, both passive and active, have been shown to modulate emotional regulation, motivation, attention, and cognitive performance. Emerging evidence utilizing neuroimaging and behavioral techniques further supports this and suggests music-induced benefits even in the presence of advancing neurodegeneration. Overall, findings from this narrative review suggest music may serve as a potential non-invasive adjunctive therapeutic tool to counteract PD-induced NMSs by adaptively modulating physiological and psychological processes. This narrative review aims to gather current evidence on the physiological and psychological mechanisms underlying the benefits of music and proposes potential therapeutic translation for NMSs in PD. Furthermore, current difficulties, gaps in knowledge, and needs for future research are discussed with the goal of informing directions for clinical translation. Full article

(This article belongs to the Section Movement Disorders and Neurodegenerative Diseases)

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13 pages, 242 KB

Open AccessBrief Report

Dysphagia Symptoms in Patients with Postural Orthostatic Tachycardia Syndrome (POTS): A Qualitative Study

by Sherry Zimmermann and Svetlana Blitshteyn

Neurol. Int. 2026, 18(3), 44; https://doi.org/10.3390/neurolint18030044 - 25 Feb 2026

Viewed by 5357

Abstract

Background: Difficulty swallowing is a common complaint in patients with postural orthostatic tachycardia syndrome (POTS), but there are no qualitative studies that examine dysphagia in patients with POTS, resulting in a significant gap in clinical understanding and research. Methods: A structured [...] Read more.

Background: Difficulty swallowing is a common complaint in patients with postural orthostatic tachycardia syndrome (POTS), but there are no qualitative studies that examine dysphagia in patients with POTS, resulting in a significant gap in clinical understanding and research. Methods: A structured interview of patients with autonomic disorders was conducted utilizing the Dysphagia Handicap Index (DHI). Results: Eleven participants (age range 21–71, mean age 46 years, eight women) were selected using purposive sampling through online support communities and referrals from Dysautonomia Clinic. All had POTS, and eight had comorbid Ehlers–Danlos syndrome. The data gathered from participants were used to construct thematic descriptions of their lived experiences. The mean DHI score in this cohort was 4.5, indicating significant impairment in swallowing. Four themes emerged from the participant narratives: (1) the negative physical impact of dysphagia, (2) the negative psychological impact of dysphagia, (3) the impact on daily life and relationships, and (4) reduced healthcare satisfaction. Conclusions: We found significant impairment due to reported dysphagia symptoms in patients with POTS. Further studies are needed to elucidate the pathophysiology, severity and type of dysphagia in POTS and to develop targeted therapies. Full article

(This article belongs to the Special Issue Molecular Research of CNS Diseases and Neurological Disorders)

13 pages, 3103 KB

Open AccessCase Report

Pilocytic Astrocytoma Causing Brainstem Compression in Pregnancy: Case Report with Literature Review

by Muratbek A. Tleubergenov, Daniyar K. Zhamoldin, Nurzhan A. Ryskeldiyev, Aigul D. Tolepbergenova, Aisa Z. Nurpeisov, Zhanat T. Takenov and S. Akshulakov

Neurol. Int. 2026, 18(3), 43; https://doi.org/10.3390/neurolint18030043 - 25 Feb 2026

Viewed by 1198

Abstract

Background: Primary central nervous system tumours in pregnancy are exceptionally rare, with posterior fossa lesions presenting particular diagnostic and management challenges due to their confined anatomical location and proximity to critical neurovascular structures. Pilocytic astrocytoma (PA), typically a paediatric tumour, is uncommon in [...] Read more.

Background: Primary central nervous system tumours in pregnancy are exceptionally rare, with posterior fossa lesions presenting particular diagnostic and management challenges due to their confined anatomical location and proximity to critical neurovascular structures. Pilocytic astrocytoma (PA), typically a paediatric tumour, is uncommon in adults and exceedingly rare in pregnant patients. The physiological changes in pregnancy can obscure tumour-related symptoms, contributing to diagnostic delay and increased maternal–fetal risk. Methods: We report the case of a 24-year-old pregnant woman at 23 weeks and 5 days’ gestation who presented with progressive neurological deterioration secondary to a cystic mass in the right cerebellar hemisphere. MRI revealed significant brainstem compression and triventricular hydrocephalus. Results: A multidisciplinary team performed an urgent retrosigmoid craniotomy with gross total tumour resection under general anaesthesia and continuous intraoperative fetal monitoring. Histopathology confirmed PA (CNS WHO Grade I). Postoperative recovery was uneventful, and both maternal and fetal outcomes were favourable. Conclusions: This case highlights the importance of early neuroimaging, multidisciplinary coordination, and timely surgical intervention in managing posterior fossa tumours during pregnancy. Although PAs are considered low-grade gliomas, their behaviour in pregnancy can be unpredictable. With careful perioperative planning, neurosurgical treatment can be safely undertaken during gestation, offering optimal outcomes for both mother and fetus. Full article

(This article belongs to the Topic Innovations in Brain Tumor Surgery: Techniques and Outcomes)

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14 pages, 445 KB

Open AccessArticle

Subjective Cognitive Decline in Brazilian Adults: Prevalence and Associated Social, Lifestyle, and Health-Related Factors: A Nationally Representative Cross-Sectional Analysis from the ELSI-Brazil Cohort

by Johnnatas Mikael Lopes, Paola Bertuccio, Lorenzo Blandi, Riccardo Vecchio and Anna Odone

Neurol. Int. 2026, 18(3), 42; https://doi.org/10.3390/neurolint18030042 - 24 Feb 2026

Cited by 1 | Viewed by 1518

Abstract

Background/Objectives: Subjective cognitive decline (SCD) is an early stage of dementia, although its risk factors remain unclear. We estimated the prevalence of SCD and its associated dementia risk factors in Brazilian adults. Methods: This cross-sectional study is based on data from [...] Read more.

Background/Objectives: Subjective cognitive decline (SCD) is an early stage of dementia, although its risk factors remain unclear. We estimated the prevalence of SCD and its associated dementia risk factors in Brazilian adults. Methods: This cross-sectional study is based on data from the second wave (2019–2021) of the Brazilian longitudinal study of aging (ELSI-Brazil) and a nationally representative sample of adults aged ≥50 years. Prevalence of SCD was estimated and defined as self-reported cognitive decline without objective impairment or dementia diagnosis, and the adjusted odds ratios (OR) with 95% confidence intervals (CI) were estimated through logistic regression models. Results: Of 6631 participants, 57.5% were women, and 54.4% were non-white, with a mean age of 65.1 years (standard deviation: ±9.70). SCD prevalence was 19.7% (95% CI 18.6–20.9) for a total of 1346 individuals. Significantly strong positive associations with SCD were observed for sociodemographic factors, particularly lower education (OR = 2.79, 95% CI: 2.02–3.85), as well as older age, non-white ethnicity, and lower income (ORs ranging from 1.50 to 1.79). Lifestyle factors, including loneliness and sedentary behavior, showed moderate associations (OR = 1.33 and 1.35, respectively). Among health-related conditions, multimorbidity was significantly associated with higher odds of SCD (OR = 1.40 for ≥3 chronic diseases), with the strongest association observed for hearing loss (OR = 2.29, 95% CI: 1.93–2.71). Diabetes, visual loss, and depressive symptoms showed more modest significant associations (OR 1.25 to 1.31). Conclusions: Our findings support the prioritization of vulnerable populations in public health strategies aimed at promoting healthy ageing and reducing social and health inequalities. Longitudinal studies are needed to clarify whether modifying associated factors may influence SCD trajectories. Full article

(This article belongs to the Section Aging Neuroscience)

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21 pages, 2488 KB

Open AccessArticle

Olfactory and Cognitive Performance Improvement After Oxygen–Ozone Major Autohemotherapy in Mild Cognitive Impairment: A Retrospective Cohort Study

by Alessandro Micarelli, Simona Mrakic-Sposta, Sandro Malacrida, Alessandra Vezzoli, Riccardo Xavier Micarelli, Beatrice Micarelli, Ivan Granito and Marco Alessandrini

Neurol. Int. 2026, 18(3), 41; https://doi.org/10.3390/neurolint18030041 - 24 Feb 2026

Viewed by 1653

Abstract

Background/Objectives: Mild cognitive impairment (MCI) is accompanied by olfactory dysfunction, and few interventions target shared chemosensory–cognitive mechanisms. We retrospectively examined whether a 5-week oxygen–ozone major autohemotherapy (MAH) cycle is associated with coupled improvements in olfactory and cognitive performance in adults with MCI. [...] Read more.

Background/Objectives: Mild cognitive impairment (MCI) is accompanied by olfactory dysfunction, and few interventions target shared chemosensory–cognitive mechanisms. We retrospectively examined whether a 5-week oxygen–ozone major autohemotherapy (MAH) cycle is associated with coupled improvements in olfactory and cognitive performance in adults with MCI. Methods: We analyzed 81 individuals with MCI who completed 10 MAH sessions (twice weekly) and 93 matched healthy controls. In the MCI group, olfactory function was measured before and after MAH using Sniffin’ Sticks^® threshold–discrimination–identification (TDI) scores; global cognition was assessed with the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). We evaluated between-group and pre–post changes and used Spearman correlations to assess olfactory–cognitive coupling. Results: At baseline, MCI participants showed lower TDI and MoCA scores than controls and more hyposmia/anosmia. Following MAH, the proportion of normosmic patients increased from 32.1% to 50.6%, with fewer anosmic cases. TDI scores improved but remained lower than in controls. MMSE scores were unchanged, whereas MoCA total scores increased, with domain-level gains and a significant improvement in Language Repetition. TDI gains were modestly correlated with MoCA total and selected domain changes. Conclusions: In this retrospective cohort, MAH was associated with partial restoration improvements of olfactory function and improved cognitive performance. Correlated olfactory–cognitive changes were observed within the treated MCI group; however, causal attribution to O₂–O₃ MAH cannot be established without randomized, double-blind, sham-controlled trials with coupled olfactory–cognitive gains consistent with a shared, potentially modifiable substrate. Prospective randomized trials are needed to confirm efficacy and clinical utility. Full article

(This article belongs to the Section Aging Neuroscience)

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6 pages, 933 KB

Open AccessSystematic Review

Metformin Renders Survival Advantage to Patients with Glioblastoma Multiforme

by Daniel Gonzales-Portillo, Bhavya Vashi, Kirsten Bains Williams and Jorge Cervantes

Neurol. Int. 2026, 18(3), 40; https://doi.org/10.3390/neurolint18030040 - 24 Feb 2026

Viewed by 1656

Abstract

Purpose: Glioblastoma multiforme (GBM) is a highly aggressive cancer with limited survival despite current treatments. Rising treatment costs highlight the importance of identifying more affordable therapeutic alternatives. A body of literature has shown that metformin has the potential to act as an [...] Read more.

Purpose: Glioblastoma multiforme (GBM) is a highly aggressive cancer with limited survival despite current treatments. Rising treatment costs highlight the importance of identifying more affordable therapeutic alternatives. A body of literature has shown that metformin has the potential to act as an antineoplastic agent. Here, we examined the effects of metformin on GBM in humans. Methods: The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed to perform the review. A total of 469 studies were screened using comprehensive search terms. Of these, 4 studies were compatible for the meta-analysis. Results: Data analysis demonstrated an increase in median overall survival for GBM patients up to 18 months compared to controls (p = 0.00197). Conclusions: Overall, our findings support the efficacy of metformin as an anti-neoplastic agent, and that it may grant a survival advantage for patients diagnosed with GBM. Further analyses should find dose-dependent relationships between metformin and the targeted survival outcomes in larger, rigorous clinical trials. Full article

(This article belongs to the Section Brain Tumor and Brain Injury)

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Neurol. Int., Volume 18, Issue 3 (March 2026) – 23 articles

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