Special Issue "Nordic Neurology"

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: 3 April 2023 | Viewed by 1991

Special Issue Editor

1. North Karelia Central Hospital, Joensuu, Finland
2. Clinical Neurosciences, University of Turku, 80210 Turku, Finland
Interests: clinical neuroepidemiology; clinical (adult) neurology; movement disorders; Huntington's disease; Parkinson's disease; Guillain-Barré syndrome; multiple sclerosis; stroke; amyotrophic lateral sclerosis, myoclonic epilepsy

Special Issue Information

Dear Colleagues,

In recent decades, clinical neurology and neuroscience have witnessed both marvelous advances and frustrating disappointments despite best efforts. The prognosis of some disorders has turned from dismal to (nearly) curable, whereas some diseases still lack treatment. Moreover, the etiology and pathomechanisms of a wide range of neurological disease remain uncertain—especially degenerative ones. This research theme covers a wide range of disorders affecting the nervous system, ranging from acute (strokes, traumatic brain injuries, infectious and autoimmune neurological diseases, etc.) to chronic (rare diseases, neurodegenerative disorders, autoimmune nervous system diseases, CNS tumors, etc.), as well as those in between (e.g., functional neurological disorders).

A collated Nordic perspective on these is expected to provide new insights. Nordic countries boast advanced welfare societies with equality and high-quality healthcare, although even they are affected by social and health disparities and uncertainty in this changing world. Advances and innovations in treatment protocols have been necessitated by low population densities and long distances and made possible by advanced public healthcare systems. Furthermore, the environment is quite different from where homo sapiens apparently originated, with populations small and often far apart. There are marked differences in the epidemiology of many diseases within Nordic countries as well as when compared to the rest of the world. These differences provide opportunities for etiological and pathogenesis research. All these research aspects are facilitated by Nordic high-quality registries.

This Special Issue aims to gather research that elucidates the current epidemiological landscapes, clinical pictures, pathological and genetic correlates, as well as treatment pathways and their outcomes in the Nordic region. We welcome original articles, reviews, and other acceptable types of articles We encourage authors to provide insights into the development status and research fronts of neurology, neuroepidemiology, and clinical neuroscience. We also welcome all suggestions of possible other authors for this theme issue.

Dr. Jussi Sipilä
Guest Editor

Manuscript Submission Information

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Keywords

  • clinical neurology
  • delivery of health care
  • genetics
  • neuroepidemiology
  • neurosciences
  • scandinavian 
  • nordic countries

Published Papers (3 papers)

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Research

Article
Longitudinal Optical Coherence Tomography Measurement of Retinal Ganglion Cell and Nerve Fiber Layer to Assess Benign Course in Multiple Sclerosis
J. Clin. Med. 2023, 12(6), 2240; https://doi.org/10.3390/jcm12062240 - 14 Mar 2023
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Abstract
A benign form of multiple sclerosis (BMS) is not easily diagnosed, but changes of the retinal ganglion cell layer-inner plexiform layer (GCL-IPL) and retinal nerve fiber layer (RNFL) may be sensitive to the disease. The aim of this study was to use optical [...] Read more.
A benign form of multiple sclerosis (BMS) is not easily diagnosed, but changes of the retinal ganglion cell layer-inner plexiform layer (GCL-IPL) and retinal nerve fiber layer (RNFL) may be sensitive to the disease. The aim of this study was to use optical coherence tomography (OCT) to investigate longitudinal changes of GCL-IPL and RNFL in BMS. Eighteen patients with BMS and 22 healthy control (HC) subjects were included, with a mean follow-up period of 32.1 months in BMS and 34.3 months in HC. Mean disease duration in BMS was 23.3 years, with 14 patients left untreated. Unilateral optic neuritis (ON) was found in eight patients. Non-ON eyes showed thinner GCL-IPL layer in the BMS group relative to HC (p < 0.001). The thinning rate of GCL-IPL in non-ON BMS, however, was −0.19 ± 0.15 µm/year vs. 0 ± 0.11 µm/year for HC (p = 0.573, age-adjusted). Thinning rate of RNFL in non-ON BMS was −0.2 ± 0.27 µm/year vs. −0.05 ± 0.3 µm/year for HC (p = 0.454, age adjusted). Conclusions: Thinning rate of the GCL-IPL and RNFL in BMS is similar to the healthy population but differs from the thinning rate in relapsing-remitting MS, presenting a non-invasive OCT-based criterion for assessing a benign course in multiple sclerosis. Full article
(This article belongs to the Special Issue Nordic Neurology)
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Communication
The Importance of Optical Coherence Tomography in the Diagnosis of Atypical or Subclinical Optic Neuritis: A Case Series Study
J. Clin. Med. 2023, 12(4), 1309; https://doi.org/10.3390/jcm12041309 - 07 Feb 2023
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Abstract
Background: Optic neuritis (ON) is an inflammatory condition of the optic nerve. ON is associated with development of demyelinating diseases of the central nervous system (CNS). CNS lesions visualized by magnetic resonance imaging (MRI) and the finding of oligoclonal IgG bands (OB) in [...] Read more.
Background: Optic neuritis (ON) is an inflammatory condition of the optic nerve. ON is associated with development of demyelinating diseases of the central nervous system (CNS). CNS lesions visualized by magnetic resonance imaging (MRI) and the finding of oligoclonal IgG bands (OB) in the cerebrospinal fluid (CSF) are used to stratify the risk of MS after a “first” episode of ON. However, the diagnosis of ON in absence of typical clinical manifestations can be challenging. Methods and Materials: Here we present three cases with changes in the optic nerve and ganglion cell layer in the retina over the disease course. (1) A 34-year-old female with a history of migraine and hypertension had suspect amaurosis fugax (transient vision loss) in the right eye. This patient developed MS four years later. Optical coherence tomography (OCT) showed dynamic changes of the thickness of peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) over time. (2) A 29-year-old male with spastic hemiparesis and lesions in the spinal cord and brainstem. Six years later he showed bilateral subclinical ON identified using OCT, visual evoked potentials (VEP) and MRI. The patient fulfilled diagnosis criteria of seronegative neuromyelitis optica (NMO). (3) A 23-year-old female with overweight and headache had bilateral optic disc swelling. With OCT and lumbar puncture, idiopathic intracranial hypertension (IIH) was excluded. Further investigation showed positive antibody for myelin oligodendrocyte glycoprotein (MOG). Conclusions: These three cases illustrate the importance of using OCT to facilitate quick, objective and accurate diagnosis of atypical or subclinical ON, and thus proper therapy. Full article
(This article belongs to the Special Issue Nordic Neurology)
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Communication
Treatment Courses of Patients Newly Diagnosed with Multiple Sclerosis in 2012–2018
J. Clin. Med. 2023, 12(2), 595; https://doi.org/10.3390/jcm12020595 - 11 Jan 2023
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Abstract
Treatment options for multiple sclerosis (MS) are now numerous, but it is unclear which Disease-Modifying Treatment (DMT) is the optimal choice for a given patient. Treatment switches are common, both because of side effects and because of lack of efficacy. There are few [...] Read more.
Treatment options for multiple sclerosis (MS) are now numerous, but it is unclear which Disease-Modifying Treatment (DMT) is the optimal choice for a given patient. Treatment switches are common, both because of side effects and because of lack of efficacy. There are few data available on the treatment courses of patients newly diagnosed with MS in the current DMT era. All patients newly diagnosed with MS in 2012–2018 at North Karelia Central Hospital were identified (N = 55), and those with complete follow-up data available (N = 43) were included. The minimum follow-up from diagnosis was 44 months with a maximum of 9 years. Seven patients (16%) had no DMT at any time during the follow-up. Treatment was most often initiated with interferon or glatiramer acetate (69%), but 72% of these treatments were discontinued. After cladribine, teriflunomide and fingolimod showed the best treatment persistence. Patients who experienced their first MS symptoms at ≥40 years of age all continued with their initial treatment category until the end of the follow-up. In a third of the patients who had received a DMT, at the end of the follow-up, the treatment had been escalated to fingolimod, cladribine or natalizumab. Only 13 patients (28%) continued with their initial DMT until the end of the follow-up. Full article
(This article belongs to the Special Issue Nordic Neurology)
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