Clinical and Translational Neuroscience

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14 pages, 1453 KiB

Open AccessArticle

Sex and Gender Disparities in Missed Acute Ischemic Stroke: A Nested Case-Control Study

by Cécile Barras, Michael Amiguet, Joëlle Schwarz, Patrik Michel and Carole Clair

Clin. Transl. Neurosci. 2025, 9(2), 22; https://doi.org/10.3390/ctn9020022 - 2 Apr 2025

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Abstract

Backround: The aim is to analyze whether sex and gender are associated with missed acute ischemic stroke (M-AIS). Methods: We performed a nested case-control study, using data collected from March 2003 to December 2020 from ASTRAL (Acute STroke Registry and Analysis of Lausanne). [...] Read more.

Backround: The aim is to analyze whether sex and gender are associated with missed acute ischemic stroke (M-AIS). Methods: We performed a nested case-control study, using data collected from March 2003 to December 2020 from ASTRAL (Acute STroke Registry and Analysis of Lausanne). M-AIS were compared with a randomly selected control sample of acute ischmemic stroke (AIS). We extracted six gender-related socioeconomic variables. A gendered socioeconomic position (SEP) score was constructed reflecting the level of correspondence with feminine characteristics. Associations between M-AIS and the gender-related socioeconomic variables and the gendered SEP score were investigated using logistic regression. Results: Of the 6007 AIS, 182 (3%) were M-AIS. 80 (44%) were women. No association between administrative sex and M-AIS was found (OR 1.25, 95% CI 0.78–2.00). Differences were found for gender-related socioeconomic variables, women in the middle professional category had higher odds of an M-AIS compared to women in the lower professional category (OR 3.93, 95% CI 1.19–13.03). Men with higher education had lower odds of an M-AIS compared to men with lower education (OR 0.31, 95% CI 0.10–0.92). For women, a 20-unit increase in the gendered SEP score was associated with lower odds of an M-AIS (OR 0.66, 95% CI 0.46–0.94). For men, the same increase in the score tended to higher the odds of an M-AIS (OR 1.52, 95% CI 1.00–2.32). Conclusions: The interaction of administrative sex with gender-related socioeconomic variables revealed different associations with M-AIS for women and men. Correspondence to expected gender norms may have a protective effect against M-AIS. Full article

(This article belongs to the Special Issue Brain Health)

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Review

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16 pages, 1409 KiB

Open AccessReview

Headache and Facial Pain in Multiple Sclerosis: A Narrative Review

by Lukasz Kolakowski, Katarina Alexandra Ebner and Athina Papadopoulou

Clin. Transl. Neurosci. 2025, 9(1), 16; https://doi.org/10.3390/ctn9010016 - 6 Mar 2025

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Abstract

Headache and facial pain syndromes are frequently observed in people with multiple sclerosis (MS), often affecting young adults during pivotal stages of their lives. These conditions can disrupt their ability to work, maintain relationships, and engage in daily activities, leading to significant socio-economic [...] Read more.

Headache and facial pain syndromes are frequently observed in people with multiple sclerosis (MS), often affecting young adults during pivotal stages of their lives. These conditions can disrupt their ability to work, maintain relationships, and engage in daily activities, leading to significant socio-economic and personal challenges. This narrative review summarizes key epidemiological data and diagnostic insights into headache and facial pain disorders in people with MS. It addresses the complexities of diagnosing these overlapping conditions and highlights specific therapeutic considerations. Full article

(This article belongs to the Special Issue Brain Health)

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9 pages, 206 KiB

Open AccessReview

Brain Health in Neuroradiology

by Karl-Olof Lövblad, Isabel Wanke, Daniele Botta, Felix T. Kurz, Roland Wiest, Daniel Rüfenacht and Luca Remonda

Clin. Transl. Neurosci. 2025, 9(1), 1; https://doi.org/10.3390/ctn9010001 - 31 Dec 2024

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Abstract

Neuroradiology, as a modern branch of the neurosciences and radiological sciences, has an impact on global health, particularly on brain health. On the one hand, neuroradiology directly impacts diseases of the nervous system, such as stroke and inflammatory diseases, by providing an all-in-one [...] Read more.

Neuroradiology, as a modern branch of the neurosciences and radiological sciences, has an impact on global health, particularly on brain health. On the one hand, neuroradiology directly impacts diseases of the nervous system, such as stroke and inflammatory diseases, by providing an all-in-one package combining imaging, diagnosis, treatment, and follow-up. This has been impacted by the continuous evolution over the last decades of both diagnostic and interventional tools in parallel: this was the case in stroke, where the endovascular treatment was followed closely by developments in fast MRI techniques and multi-slice CT imaging. Additionally, inflammatory diseases of the brain, as well as tumors of the central nervous system, can be imaged and localized in order to set in place both an early diagnosis and initiate treatment. Neurodegenerative diseases such as Alzheimer’s disease, in which treatment options are appearing on the horizon, also benefit from the use of modern neuroimaging techniques. On the other hand, neuroradiology plays an important role in the prevention and prediction of brain diseases and helps in building up the so-called digital twin, often from birth till late in life. Additionally, the practice of neuroradiology itself is evolving to not only improve patient health but also the health of the practitioners of neuroradiology themselves. By improving the overall work environment also, neuroradiologists will be working under better conditions and will suffer less fatigue and burn-out, thereby providing better service to patients and population. By using less radiation for diagnostic tests and shifting to techniques that rely more and more on either magnetic resonance or ultra-sound techniques, the radiation load on the population and on the neuroradiologists will decrease. Furthermore, using less contrast, such as gadolinium, has been shown to result in fewer deposits in the brains of patients, as well as less pollution at the ocean level, thus contributing to general well-being. Additionally, the implementation and use of artificial intelligence at many levels of the diagnostic and treatment chain will be beneficial to patients and physicians. In this paper, we discuss the place and potential not just of the techniques but of neuroradiology and the neuroradiologist as promoters of brain health and thus global health. Full article

(This article belongs to the Special Issue Brain Health)

15 pages, 1374 KiB

Open AccessReview

Sleep Health

by Albrecht P. A. Vorster, Eus J. W. van Someren, Allan I. Pack, Reto Huber, Markus H. Schmidt and Claudio L. A. Bassetti

Clin. Transl. Neurosci. 2024, 8(1), 8; https://doi.org/10.3390/ctn8010008 - 24 Jan 2024

Cited by 5 | Viewed by 5800

Abstract

Together with (physical and mental) exercise, diet, and social activities, sleep is a key health behavior that occupies one third of our lives, yet remains neglected. In the first part of this review, we present the current knowledge on how sleep promotes body, [...] Read more.

Together with (physical and mental) exercise, diet, and social activities, sleep is a key health behavior that occupies one third of our lives, yet remains neglected. In the first part of this review, we present the current knowledge on how sleep promotes body, brain, mental, occupational, and social health as well as creativity, productivity, and well-being. In the second part, we discuss how good sleep and screening for sleep–wake disorders may improve health and reduce the burden of brain, mental, cardiovascular, metabolic disorders and cancer. We also review the literature on measurements of sleep health and present the Bernese Sleep Health Questionnaire, a new and simple tool to assess sleep health and screen for sleep–wake circadian disorders in clinical practice. Full article

(This article belongs to the Special Issue Brain Health)

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Other

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16 pages, 300 KiB

Open AccessPerspective

The Interdisciplinary Synergy Between Neurology and Psychiatry: Advancing Brain Health

by Alice Accorroni, Umberto Nencha and Indrit Bègue

Clin. Transl. Neurosci. 2025, 9(1), 18; https://doi.org/10.3390/ctn9010018 - 15 Mar 2025

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Abstract

The study of brain disorders has long been central to both neurology and psychiatry, with these two disciplines evolving as distinct yet deeply interconnected fields. In fact, these specialties often share overlapping symptoms, neural pathways, and treatment modalities, making interdisciplinary collaboration essential. Despite [...] Read more.

The study of brain disorders has long been central to both neurology and psychiatry, with these two disciplines evolving as distinct yet deeply interconnected fields. In fact, these specialties often share overlapping symptoms, neural pathways, and treatment modalities, making interdisciplinary collaboration essential. Despite this, such collaborations remain sparse, particularly in clinical settings, research, training, and policy development. The increasing global burden of brain disorders has induced a paradigm shift, emphasizing the need for cooperative efforts to preserve brain health. Effective interdisciplinary collaborations between neurology and psychiatry as well as with other partners involved in brain health and other medical specialties is crucial to improving patient outcomes and societal well-being. Furthermore, the development of comprehensive training programs in brain health is vital, aligning with the recent rise in brain medicine as a unified field. This article reviews the historical evolution of neurology and psychiatry, explores current synergies, and identifies areas for future collaboration, particularly in enhancing research, education, and shared preventative strategies. Ultimately, fostering interdisciplinary collaboration between neurology and psychiatry along with other medical specialties and relevant partners will be key to advancing brain health and addressing the global burden of brain disorders. Full article

(This article belongs to the Special Issue Brain Health)

6 pages, 501 KiB

Open AccessCase Report

Brain Health for All? Influence of Glycemic Control and Neuropsychiatric Symptoms in Dementia with Lewy Bodies: A Case Report and Literature Review

by Patrick Stancu, Duarte Janela, Samuel Gurary, Lukas Sveikata and Frédéric Assal

Clin. Transl. Neurosci. 2025, 9(1), 8; https://doi.org/10.3390/ctn9010008 - 17 Feb 2025

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Abstract

Background: Dementia with Lewy bodies (DLBs) often presents with neuropsychiatric symptoms (NPSs), yet the role of hyperglycemia, a common cause of delirium in older adults, as a contributing factor remains under-recognized. This article aims to explore the relationship between hyperglycemia and NPSs. [...] Read more.

Background: Dementia with Lewy bodies (DLBs) often presents with neuropsychiatric symptoms (NPSs), yet the role of hyperglycemia, a common cause of delirium in older adults, as a contributing factor remains under-recognized. This article aims to explore the relationship between hyperglycemia and NPSs. Methods: We report the case of a 71-year-old male with DLBs and type 2 diabetes mellitus (T2DM) who experienced worsening NPSs closely associated with periods of hyperglycemia. Initial pharmacological and nonpharmacological interventions were insufficient, prompting adjustments to insulin therapy and dietary modifications to stabilize blood glucose levels. Results: Improved glycemic control resulted in a clinically significant reduction in NPSs. Conclusions: This case suggests a potential link between hyperglycemia and NPSs in DLB patients, emphasizing the importance of maintaining glycemic control in managing NPSs. Although the exact mechanisms remain incompletely understood, adopting a holistic framework for brain health could offer a comprehensive approach to cognitive care. Further studies are needed to elucidate the biological pathways involved, validate these findings in larger populations, and develop evidence-based clinical guidelines. Full article

(This article belongs to the Special Issue Brain Health)

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10 pages, 666 KiB

Open AccessSystematic Review

Long-Term Return to Work After Mild and Moderate Traumatic Brain Injury: A Systematic Literature Review

by Emilia Westarp, Tim Jonas Hallenberger, Karl-Olof Lövblad, Thomas Mokrusch, Claudio Bassetti and Raphael Guzman

Clin. Transl. Neurosci. 2024, 8(4), 31; https://doi.org/10.3390/ctn8040031 - 20 Dec 2024

Viewed by 918

Abstract

Background: Traumatic brain injury (TBI) is referred to as a “silent epidemic” due to its limited awareness in the general public. Nevertheless, it can cause chronic, lifelong physical and cognitive impairments with severe impact on quality of life, resulting in high healthcare costs [...] Read more.

Background: Traumatic brain injury (TBI) is referred to as a “silent epidemic” due to its limited awareness in the general public. Nevertheless, it can cause chronic, lifelong physical and cognitive impairments with severe impact on quality of life, resulting in high healthcare costs and loss of employment. To evaluate the outcome after mild and moderate TBI, “return to work (RTW)” is a relevant parameter, reflecting the socio-economic consequences of TBI. Our study aims to summarize RTW-rates to raise awareness on the impact of non-severe TBI. Methods: We performed a systematic literature review screening the databases Medline, Embase and Web of Science for studies reporting RTW in mild to moderate TBI. Studies that reported on RTW after mild or moderate TBI (defined by GCS > 9) in adults, with a minimum follow-up of six months were included. Risk of bias was assessed using the QUIPS tool. Results: We included 13 studies with a total 22,550 patients. The overall RTW rate after at least six months, varies between 37% and 98%. Full RTW is reported in six of the included 13 studies and varies between 12% and 67%. In six studies (46%) the RTW-rate by the end of follow-up was ≤60%, with four studies being from high-income countries. Conclusion: Mild and moderate TBI have a high impact on employment rates with diverging rates for RTW even between high-income countries. Increasing the societal awareness of this silent epidemic is of utmost importance and is one of the missions of the Swiss Brain Health Plan. Full article

(This article belongs to the Special Issue Brain Health)

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8 pages, 1424 KiB

Open AccessCase Report

Frequently Suspected, Rarely Confirmed: The Complex Diagnostic Journey of Adult-Onset MELAS—Clinical Evaluation and Cost Implications

by Sebastian Finkener, Arkady Ovchinnikov, Ronald Bauer, Michael Diepers and Markus Gschwind

Clin. Transl. Neurosci. 2024, 8(4), 30; https://doi.org/10.3390/ctn8040030 - 30 Nov 2024

Viewed by 1067

Abstract

Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) is a rare mitochondrial disorder primarily presenting in pediatric patients, with onset after 40 years being exceptionally rare (1–6%). Here, we report a complex diagnostic journey of a 47-year-old male presenting with new-onset seizures, hemiparesis, [...] Read more.

Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) is a rare mitochondrial disorder primarily presenting in pediatric patients, with onset after 40 years being exceptionally rare (1–6%). Here, we report a complex diagnostic journey of a 47-year-old male presenting with new-onset seizures, hemiparesis, and neurocognitive deficits. Initial work-up, including MRI, CSF analysis, and extensive antibody screening, yielded inconclusive results, prompting differential considerations such as autoimmune encephalitis and neoplastic conditions. Finally muscle biopsy findings, coupled with genetic confirmation of the m.3243A>G mutation in the MT-TL1 gene, ultimately established the diagnosis of MELAS. This case depicts the atypical presentation of adult-onset MELAS without initial lactic acidemia, diabetes, or hearing impairment. The prolonged diagnostic process underscores the challenges of identifying rare diseases under today’s financial and administrative constraints. Still ee emphasize the importance of comprehensive diagnostics in rare cases to advance generall understanding and improve future patient outcomes, also amidst resource limitations. Full article

(This article belongs to the Special Issue Brain Health)

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