JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY神经病学、神经外科与精神病学杂志
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY(英文缩写 J NEUROL NEUROSUR PS),ISSN 0022-3050,eISSN 1468-330X,中文译名:神经病学、神经外科与精神病学杂志 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-11-01 至 2026-10-31，按本站收录文献的发表日期统计。
期刊介绍
历年影响因子趋势
| JCR 数据年份 | 影响因子 | JCR 分区 |
|---|---|---|
| 2021 | 13.654 | Q1 |
| 2022 | 11.000 | Q1 |
| 2023 | 8.700 | Q1 |
| 2024 | 7.500 | Q1 |
| 2025 | 7.700 | Q1 |
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY 最新收录文献
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1. Comparative effectiveness of inebilizumab versus conventional immunotherapies in AQP4-IgG-positive NMOSD: a prospective cohort study with time-varying treatment effects.
PMID:日期:2026-09-15To compare relapse and disability outcomes of inebilizumab, azathioprine (AZA), mycophenolate mofetil (MMF) and rituximab (RTX) in maintenance-therapy-naive patients with aquaporin-4 IgG-positive neuromyelitis optica spectrum disorder. We prospectively enrolled 566 patients (inebilizumab n=72, AZA n=196, MMF n=170, RTX n=128). Primary effectiveness analyses were conducted in the per-protocol cohort (n=528), with supportive analyses in the full cohort. Both used inverse probability of treatment weighting to estimate the average treatment effect on the treated, with inebilizumab as reference. Primary outcomes were annualised relapse rate (ARR) and time to first relapse; disability progression was secondary. Adverse events (AEs) were assessed in the full cohort. In the per-protocol cohort, median age was 37 years, 477 (90.3%) were female and median follow-up was 21.5 months. Compared with inebilizumab, ARR was higher with AZA (incidence rate ratio (IRR) 4.78), MMF (IRR 4.33) and RTX (IRR 2.26; all p<0.05). Average relapse hazards were higher with AZA (HR 3.77; p=0.006) and MMF (HR 4.05; p=0.003), but not significantly different with RTX (hazard ratio (HR) 2.08; p=0.178). Time-varying analysis suggested a higher relapse hazard with RTX only during the first 6 months. Supportive analyses in the full cohort yielded consistent results. AZA and MMF were associated with greater disability progression than inebilizumab, whereas RTX was not. Severe AEs did not differ across groups. Inebilizumab was associated with better relapse and disability outcomes than AZA or MMF. Compared with RTX, inebilizumab was associated with lower ARR, whereas no significant differences were detected in time to first relapse or disability progression.
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2. MRI activity in pre-symptomatic multiple sclerosis: the role of paramagnetic rim lesions beyond the 2024 McDonald diagnostic criteria.
PMID:日期:2026-09-15The 2024 McDonald criteria allow multiple sclerosis (MS) diagnosis in pre-symptomatic individuals but their association with MRI activity remains uncertain. We assessed whether paramagnetic rim lesions (PRL) predict future MRI activity beyond the 2024 McDonald criteria. We retrospectively included individuals with incidental MRI findings suggestive of MS, ≥6 months of radiological follow-up, 3D T2*-weighted echo-planar-imaging MRI. Clinico-radiological data included PRL, central vein sign (CVS) Select-6, cerebrospinal fluid positivity, optic nerve, spinal cord involvement and disease-modifying treatment. Time to first MRI activity and annualised lesion rate (ALR) were analysed using multivariable-penalised Cox and mixed-effects Poisson models. Among 68 patients (mean age 38 years; 79.4% female; mean follow-up 55.7 months), 21 showed MRI activity. PRL were associated with shorter time to first MRI activity (HR 5.66, 95% CI 1.33 to 28.39, p=0.019). PRL (RR 3.45, 95% CI 1.40 to 8.47, p=0.007) and CVS positivity (RR 4.09, 95% CI 1.17 to 14.27, p=0.027) predicted higher ALR. Fulfilment of the 2024 McDonald criteria associated with increased risk of future MRI activity (HR=11.95, 95% CI 2.77 to 51.51, p=0.001; Cox regression). Adding PRL presence to the criteria changed classification performance (χ=18, p<0.001; McNemar's test), improving specificity and accuracy while reducing sensitivity. PRL are associated with subsequent radiological activity in pre-symptomatic MS, featuring complementary predictive value beyond biomarkers currently included in the 2024 McDonald criteria.
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3. Age and treatment class modify inflammatory risk after disease-modifying therapy discontinuation in older people with MS.
PMID:日期:2026-09-14The effectiveness of disease-modifying therapies (DMTs) in multiple sclerosis (MS) declines with age, while treatment-related adverse events increase. Although discontinuation is increasingly considered in older patients, factors influencing post-withdrawal inflammatory risk remain incompletely defined. We evaluated whether age, treatment class, treatment duration and prior disease stability modify the risk of disease reactivation after DMT discontinuation. We included individuals aged ≥50 years with MS exposed for ≥6 months to first-line therapies, anti-trafficking agents or anti-CD20 monoclonal antibodies. Discontinuation was defined as treatment cessation for ≥6 months. A propensity score-matched continuation group (1:6) was constructed accounting for demographic, clinical and treatment-related factors. The primary outcome was per-protocol time to inflammatory reactivation (relapse or new MRI lesion), with 48-week confirmed disability worsening (CDW) as a secondary outcome. Prespecified interaction analyses were performed. Among 563 treated individuals, 113 (20.1%) discontinued therapy (median age 58 (IQR 54-65) years; 74% female). In the matched cohort (110 discontinuations; 581 continuations; median follow-up 5.1 vs 4.4 years), discontinuation was associated with increased inflammatory activity (HR 2.04; 95% CI 1.33 to 3.14), predominantly subclinical. This association was attenuated in individuals aged >60 years (HR 1.35; 95% CI 0.68 to 2.69) compared with those aged ≤60 years (HR 3.71; 95% CI 1.99 to 6.90; P for interaction=0.027). No difference in 48-week CDW was observed (HR 1.24; 95% CI 0.86 to 1.78). In people with MS aged ≥50 years, the inflammatory consequences of DMT discontinuation, mainly driven by MRI, are modified by age, with attenuation in those aged >60 years and no associated increase in mid-term disability progression.
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4. Frailty and accelerated dementia onset in genetic, sociodemographic and neuropathologic subgroups.
4. 在遗传、社会人口学和神经病理学亚组中，衰弱与痴呆发病加速PMID:日期:2026-09-14Quantifying how risk factors shape the timing of dementia onset can inform care and prevention strategies. We aimed to establish the degree to which and in whom frailty accelerates time to a diagnosis of dementia. Longitudinal data came from community-dwelling participants of the Rush Memory and Aging Project in Northeastern Illinois. At baseline, participants had data on age, education, sex, ε4 status and sufficient health/functional variables to calculate a frailty index score. In a subset of participants who underwent autopsy, neuropathologic burden was quantified using a 10-item index of markers of Alzheimer's disease and mixed brain pathology. Accelerated failure time models estimated associations of frailty and age at dementia diagnosis. In 1614 participants (mean age 79.6 years, 75% female) over 23.9 years of follow-up, frailty (frailty index scores ≥0.25) was associated with 3.6% younger age at dementia diagnosis (time ratio, TR 0.96 (95% CI 0.95, 0.98)), equating to 2-3 years earlier. That association was stronger in males than females, but present across each sex, education and ε4 subgroup. In the autopsy subset (n=906), frailty was associated with 9.8% younger dementia diagnosis among those who died with low neuropathologic burden (TR 0.90 (95% CI 0.85, 0.96)) but had no association in those with intermediate or high burden. Frailty appears to independently accelerate dementia onset, particularly for individuals whose neurodegenerative lesions might be insufficient to explain their dementia diagnosis. Its routine measurement in clinical practice could hold benefit for risk stratification and care.
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5. Cost of waiting: association of EEG delay and poor functional outcome in adult status epilepticus.
5. 等待的代价：脑电图延迟与成人癫痫持续状态功能预后不良的关联PMID:日期:2026-09-14Status epilepticus (SE) is associated with substantial mortality and morbidity that increase with seizure duration. Prompt diagnosis is essential, but access to electroencephalography (EEG) is often limited outside regular working hours. We examined whether EEG delay due to prolonged waiting times for EEG is associated with worse outcomes. This retrospective cohort study comprised adults (≥18 years; n=163) with first-time, non-anoxic, EEG-verified non-convulsive SE treated at Odense University Hospital, Denmark (2008-2017). EEG delay was defined as the time from last antiseizure treatment or clinical suspicion of SE to EEG confirmation. Outcomes were new neurological deficit at discharge and 2-year all-cause mortality. External validation used two retrospective German cohorts (n=906) differing in weekend EEG availability. Median EEG delay was 11.7 hours (IQR 3.5-22.6) and correlated with SE duration (r=0.2, p<0.01). Longer delay was associated with new neurological deficits at discharge (p<0.001 across delay groups; ρ=0.152, p=0.03) and higher long-term mortality (log-rank p=0.007), driven mainly by delays>22.6 hours. Multivariable analyses for 1 year mortality adjusting for factors including aetiology and age supported an independent association between delay and higher mortality. Delays were longer for Friday/Saturday admissions when next-day EEG was unavailable, with lower survival. In validation, lack of weekend EEG access showed etiology-dependent weekend-weekday mortality differences (eg, +18.8% in remote symptomatic SE; p=0.01) not seen in centres with weekend EEG availability. In this cohort, prolonged waiting times for EEG for the diagnosis of SE were associated with worse neurological outcomes at discharge and higher mortality. Improving timely EEG access, including weekends, may be a modifiable system-level target to improve SE outcomes.
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6. Differentiating aetiologies in perimesencephalic SAH: clinical insights into basilar artery perforator aneurysms.
PMID:日期:2026-09-14Perimesencephalic subarachnoid haemorrhage (pmSAH) has traditionally been considered benign and of venous origin. However, advanced imaging increasingly identifies basilar artery perforator aneurysms (BAPAs) as a subset of cases historically labelled as non-aneurysmal, atraumatic (NAA) pmSAH. The objective was to compare clinical characteristics and outcomes of patients with NAA, BAPA and ruptured posterior circulation aneurysms (r-pc-AN), assessing the impact of pmSAH aetiology on patient outcomes. This retrospective, multicentre, observational cohort study included BAPA cases from the international PERForator Aneurysm registry (2013-2025, 60 centres, 19 countries). Comparison cohorts were from a single high-volume tertiary care centre (2004-2025). The study included 444 patients (n=167 NAA, n=157 BAPA, n=120 r-pc-AN). Excellent outcome was defined as a modified Rankin Scale score of 0-1 at 3-6 months. Excellent outcomes were achieved in 137/167 (82%) of NAA, 96/140 (69%) of BAPA and 56/102 (55%) of r-pc-AN cohorts (p<0.001). Mortality rates were 1% (NAA), 11% (BAPA) and 18% (r-pc-AN). cCompared with BAPA, NAA patients had significantly higher odds of excellent outcome (adjusted OR, aOR 2.0, 95% CI 1.2 to 3.4, p=0.01), while r-pc-AN were associated with significantly lower odds of excellent outcome (aOR 0.5, 95% CI 0.3 to 0.9, p=0.01). Hydrocephalus and external ventricular drain rates were highest in r-pc-AN (83% and 87%), followed by BAPA (48% and 44%) and NAA (28% and 16%) (p<0.001). While pmSAH has been considered benign, our findings challenge this assumption. Patients with BAPA-related pmSAH demonstrated significantly worse outcomes than NAA but better outcomes than r-pc-AN. Further research is needed to distinguish BAPA-pmSAH from NAA-related pmSAH and to establish diagnostic and therapeutic guidelines. NCT06189014.
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7. Inter-attack serum GFAP and NfL remain stable over 9 years in AQP4 IgG NMOSD.
7. 在AQP4 IgG NMOSD患者中，发作间期血清GFAP和NfL在9年内保持稳定PMID:日期:2026-09-14Disability in aquaporin-4 antibody-positive neuromyelitis optica spectrum disease (AQP4-IgG NMOSD) is considered relapse-driven although subclinical injury has been suggested by neuroimaging and visual pathway assessments. We investigated longitudinal changes in serum glial fibrillar acidic protein (sGFAP) and neurofilament light chain (sNfL) during relapse-free periods. We conducted a retrospective longitudinal study (2008-2025) at a UK national referral centre for NMOSD. Patients with ≥3 serum samples collected over ≥3 years were included; samples within 3 months of relapses were excluded. Longitudinal changes in sGFAP and sNfL were assessed using linear mixed-effects models with random intercepts and generalised estimating equations, adjusting for age, sex and time. 40 patients (87.5% females; 162 samples; median onset age 40.1 years) and 28 matched controls were included. Over the course of four measurements and a median sampling over 9 years, stability was observed in sGFAP levels (99.2 pg/mL at 0-2.5 years (95% CI 84.2 to 117.0) to 90.3 pg/mL at 7.5-10 years (95% CI 74.7 to 109.0), p=0.65) and sNfL levels (12.0 pg/mL at 0-2.5 years (95% CI 10.8 to 13.3) to 10.4 pg/mL (9.1 to 11.8) at 7.5-10 years, p=0.12) after adjustment for covariates. In this longitudinal study, mean sGFAP and sNfL levels remained stable over 9 years of sequential measurements during relapse-free periods, supporting the relapse-driven nature of NMOSD pathology.
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8. Diagnostic accuracy of a two-cut-off approach using the FAQ/MMSE ratio and FAQ for clinical preselection of patients for anti-amyloid therapy.
8. 使用FAQ/MMSE比值和FAQ进行双重截断法在抗淀粉样蛋白治疗患者临床预筛选中的诊断准确性PMID:日期:2026-09-14Anti-amyloid therapies for Alzheimer's disease (AD) require efficient patient selection. The Clinical Dementia Rating (CDR) scale is the reference standard for staging, but it is time-consuming to administer. Simple tools to distinguish early-stage cognitive impairment (CDR 0.5-1) from more advanced stages (CDR 2-3) would therefore be of substantial clinical value. Participants from the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohorts 1-3 with CDR ≥0.5 were analysed. Three logistic regression models using Mini-Mental State Examination (MMSE), Functional Assessment Questionnaire (FAQ) or the FAQ/MMSE ratio as predictors were developed. Two cut-offs per model were selected to ensure minimum sensitivity and specificity of 0.99, defining rule-out, rule-in and intermediate (uncertain) zones. Performance was assessed using discrimination, calibration and decision curve analysis. Among 1533 ADNI participants with CDR ≥0.5, two-thirds (n=1022) were assigned to the training set and one-third (n=511) to the test set. FAQ/MMSE and FAQ showed excellent discrimination (area under the curve, AUC 0.97-0.98), outperforming MMSE (AUC 0.94-0.95). FAQ/MMSE demonstrated the best overall performance, although differences compared with FAQ were small and not statistically significant. Dual cut-offs for FAQ/MMSE (0.67 and 1.44) and FAQ (12 and 27) enabled clinically meaningful stratification, with 80% and 70% of participants classified into high-confidence zones, respectively. Results were consistent across the training and test sets. The FAQ/MMSE ratio and FAQ score show high accuracy in distinguishing early-stage (CDR 0.5-1) from more advanced cognitive impairment (CDR 2-3). These simple measures may support the clinical preselection of patients for further evaluation in the context of anti-amyloid therapy.
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9. Cancer risk and mortality in patients with multiple sclerosis in Finland: a retrospective population-based cohort study.
9. 芬兰多发性硬化症患者的癌症风险与死亡率：一项基于人群的回顾性队列研究PMID:日期:2026-09-14Risk and outcome of cancer for patients with multiple sclerosis (pwMS) remain disputed. We aimed to investigate cancer incidence and cancer-specific mortality rates in pwMS compared with a matched population sample. In this nationwide retrospective population-based study, pwMS in Finland were identified from the National MS-registry and the Care Register for Healthcare and matched to up to five population controls with data from 1974 until 2021. Standardised incidence rates, relative risks and HRs were calculated for all cancers and cancer subtypes utilising the Finnish Cancer Registry. A standardised mortality ratio (SMR) for cancer-specific causes was calculated, and survival analysis using a cumulative incidence function with a competing risk model of the probability of death was performed. We found 16 815 MS patients and selected 80 950 controls. Follow-up time was a median of 15.2 (8.2-22.9) years for pwMS and 17.5 (9.5-26.0) years for controls. Mean age at the diagnosis of first cancer was lower in pwMS (61.4y; SD 11.89) compared with controls (64.5y; 12.53; p<0.001). PwMS had a similar risk for all cancers (SIR 0.96; 95% CI 0.90 to 1.03) compared with controls. For males, the risk was lower (SIR 0.83; 95% CI 0.72 to 0.94). SMR showed that cancer-specific mortality for all cancers was similar to controls (1.02; 95% CI 0.93 to 1.11). Patients with MS have a similar risk for cancer and equal cancer-specific mortality compared with population controls. However, pwMS are diagnosed with cancer at a younger age compared with controls.
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10. Visuospatial working memory in Huntington's disease: behavioural and structural brain correlates.
10. 亨廷顿病中的视觉空间工作记忆：行为与脑结构的相关性PMID:日期:2026-09-14Visuospatial working memory (VSWM) deficits are among the earliest cognitive impairments evident in Huntington's disease (HD). They often precede motor symptoms and likely reflect early disruption of cortico-striatal circuits. Both the cognitive components and brain correlates are, however, poorly delineated. This study aims to characterise the progression of VSWM deficits across HD stages and identify their structural brain correlates. In this prospective international study, 92 HD mutation carriers (HDmc) (21 premanifest and 71 manifest) and 39 healthy controls underwent cognitive and clinical assessments and structural MRI at baseline; 49 manifest HD and 36 controls completed a 1-year follow-up. VSWM was assessed using the object-location task (OLT), providing continuous measures of location error, object recognition and object-location binding. MRI analyses included caudate, putamen and hippocampal volumes and cortical thickness. We found increased location error and spatial imprecision under high memory load, without binding errors in premanifest HD with an area under the curve of 0.731. Across all HDmc, these location deficits correlated with striatal atrophy and cortical thinning in parietal and middle cingulate regions. Manifest HD individuals exhibited swap errors and hippocampal atrophy. Both location and swap errors worsened over time alongside progressive striatal and hippocampal volume loss. Principal component analysis confirmed a dissociation between spatial location-related deficits (striato-cortically mediated) and binding errors (hippocampally mediated), supporting a hierarchical model of VSWM decline. HD-related VSWM impairment follows a staged, anatomically dissociable trajectory. The OLT offers sensitive, mechanistic markers of cognitive decline with potential utility for early detection and clinical trial stratification.