Publications by authors named "Natalia Shor"

Background: Currently, there are no available recommendations or guidelines on how to perform MRI monitoring in the management of neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). The issue is to determine a valuable MRI monitoring protocol to be applied in the management of NMOSD and MOGAD, as previously proposed for the monitoring of multiple sclerosis.

Objectives: The objectives of this work are to establish proposals for a standardized and feasible MRI acquisition protocol, and to propose control time points for systematic MRI monitoring in the management of NMOSD and MOGAD.

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  • Langerhans cell Histiocytosis (LCH) and Erdheim-Chester disease (ECD) are linked to certain genetic mutations and pose a heightened risk for neurodegeneration, revealing microglia mutant clones in patients' brains.
  • These mutant clones lead to symptoms like microgliosis and neuronal loss, notably affecting specific brain regions, with symptoms correlating to the disease's duration and the size of these clones.
  • Research suggests that targeting these mutant microglia with a CSF1R-inhibitor could prevent neuronal loss, presenting a potential new treatment option distinct from current MAPK inhibitors.
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Cerebrotendinous xanthomatosis is a rare and treatable metabolic disorder related to the accumulation of cholestanol. This disorder is primarily associated with motor and cognitive impairments, although the latter has not been extensively characterized. The objectives of this work were to define the cognitive profile found in cerebrotendinous xanthomatosis patients, investigate the progression of cognitive impairment over time, and search for radio-clinical correlations.

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Background: Erdheim-Chester disease (ECD) is a rare histiocytosis that may overlap with Langerhans Cell Histiocytosis (LCH). This "mixed" entity is poorly characterized. We here investigated the clinical phenotype, outcome, and prognostic factors of a large cohort of patients with mixed ECD-LCH.

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The prognosis of relapsed primary central nervous system lymphoma (PCNSL) remains dismal. CAR T-cells are a major contributor to systemic lymphomas, but their use in PCNSL is limited. From the LOC network database, we retrospectively selected PCNSL who had leukapheresis for CAR-T cells from the third line of treatment, and, as controls, PCNSL treated with any treatment, at least in the third line and considered not eligible for ASCT.

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  • Optic nerve head edema (ONHE) is commonly found in patients with optic neuritis (ON) and its connection to MRI abnormalities is not well understood, prompting this study to examine how effectively T2 FLAIR MRI can identify ONHE in acute ON cases.
  • This study analyzed data from 102 patients with acute ON and found a high agreement (92%) between MRI findings and fundus photography, indicating that MRI can reliably detect ONHE.
  • The research concluded that T2 FLAIR MRI is a sensitive and specific method for diagnosing ONHE, which can aid in the assessment of patients with optic neuritis.
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  • Previous studies on acute optic neuritis (ON) often had equal patient groups, which doesn't reflect real-life occurrences, leaving it unclear what features effectively differentiate ON causes.
  • This study evaluated adult patients with recent acute ON to determine if clinical assessments, CSF analysis, and MRI imaging can help differentiate ON causes in a practical setting.
  • Results showed that factors like bilateral visual involvement and specific CSF and MRI findings were key in identifying ON types, while traditional eye tests showed no significant differences.
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Background: The kappa free light chains index (κ-index) is increasing in importance as a fast, easy, cost-effective, and quantitative biomarker in multiple sclerosis (MS), which can replace cerebrospinal fluid (CSF)-restricted oligoclonal bands (OCB) detection. In previous studies, controls often included mixed patients with several inflammatory central nervous system disorders. The aim of the present study was to assess the κ-index in patients with serum aquaporin-4 (AQP4)-IgG or myelin-oligodendrocyte-glycoprotein (MOG)-IgG.

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  • Invasive aspergillosis is a significant risk for patients with weakened immune systems, potentially leading to aggressive cerebral vasculitis caused by Aspergillus infection.
  • The study presents a retrospective analysis of three cases confirmed by autopsy, highlighting the effects of this infection on major cerebral vessels.
  • It concludes that Aspergillus-related cerebral vasculitis is uncommon but should be considered in immunocompromised patients who exhibit related symptoms in imaging studies, and may be linked to aseptic neutrophil meningitis.
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Background And Purpose: This study was undertaken to determine the role of optical coherence tomography (OCT) in predicting the final visual and structural outcome, and to evaluate the correlation between functional eye outcome and retinal changes, in patients with a first episode of optic neuritis (ON).

Methods: In this prospective study, consecutive adult patients with acute ON underwent ophthalmological evaluation at baseline and at 1 and 12 months, including OCT measurements of peripapillary retinal nerve fiber layer (pRNFL), macular ganglion cell and inner plexiform layer, and inner nuclear layer thicknesses; high- and low-contrast visual acuity; visual field assessment; and baseline brain magnetic resonance imaging. Univariate and multivariate linear regressions were used to assess predictive factors of outcome.

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  • The study aimed to analyze how epilepsy develops in patients with LGI1 antibody-associated limbic encephalitis and to identify factors linked to drug-resistant epilepsy (DRE).
  • Researchers conducted a retrospective review of 39 patients' medical data from two epilepsy centers over a 14-year period, focusing on seizure history and responses to anti-seizure medications.
  • Results showed that 28% of patients achieved epilepsy remission, with longer delays in starting treatment linked to persistent epilepsy, while MRI changes, especially hippocampal atrophy, were main predictors of developing DRE.
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Erdheim-Chester disease (ECD) is a rare L-group histiocytosis. Orbital involvement is found in a third of cases, but few data are available concerning the radiological features of ECD-related orbital disease (ECD-ROD). Our aim was to characterize the initial radiological phenotype and outcome of patients with ECD-ROD.

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  • Neurometabolic diseases are a diverse group of rare genetic disorders often identified in children but also found in adults, where they can resemble more common neurological issues.
  • Many of these conditions are treatable, yet they often face delayed diagnosis due to their complex symptoms and numerous biochemical tests required.
  • This review aims to provide a simplified diagnostic approach for neurologists, emphasizing the importance of quick diagnosis for effective treatment and family screening, and discusses the role of advanced sequencing technologies in improving diagnostic accuracy.
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Objective: To highlight specific characteristics of seizure semiology and EEG features associated with different subtypes of autoimmune encephalitis (AE).

Methods: We systematically reviewed the seizure semiology and all the EEG recordings from patients with AE managed in a tertiary referral centre for epilepsy and a neuro-intensive care unit. Each characteristic across the different subtypes of AE was compared by post hoc analysis.

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Purpose: The purpose of this prospective study was to determine the capabilities of intravoxel incoherent motion (IVIM) MRI at 3 Tesla in discriminating between IgG4-related orbital disease (IgG4-ROD) and other causes of orbital inflammation.

Materials And Methods: Main selection criteria for the patients enrolled in this prospective study were age over 18 years and histopathologicaly proven orbital inflammatory lesion. MRI examinations were performed prior to surgery and treatment in all patients with suspected orbital inflammation.

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Objectives: Progressive multifocal leukoencephalopathy (PML) is a very rare and opportunistic encephalitis caused by JC polyomavirus that is linked to profound immunosuppression and is usually fatal unless immune function can be restored. Immune checkpoint inhibitors (ICI) are monoclonal antibodies (mAbs) that block either CTLA-4 or PD-1 inhibitor receptors, thus enhancing antiviral T-cell activity. Successful treatment of PML by ICI has recently generated some enthusiasm in case reports/small series of patients.

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Objectives: Preoperative embolization of hypervascular spinal metastases (HSM) is efficient to reduce perioperative bleeding. However, intra-arterial digital subtraction angiography (IA-DSA) must confirm the hypervascular nature and rule out spinal cord arterial feeders. This study aimed to evaluate the reliability and accuracy of time-resolved contrast-enhanced magnetic resonance angiography (TR-CE-MRA) in assessing HSM prior to embolization.

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Importance: Vitamin-responsive inherited diseases are among the rare genetic disorders with a specific pharmacological treatment. Many of these conditions have a prominent neurological phenotype that is mainly reported in children. Being rare and often strikingly different in adult-onset forms, they are still poorly known in the medical fields specific to adults.

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Background: Neuro-ophthalmologic manifestations are uncommon in sarcoidosis. We aim to assess the prognostic factors and outcome of neuro-ophthalmic sarcoidosis.

Methods: We conducted a multicenter retrospective study on patients with neuro-ophthalmic sarcoidosis.

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