JNS.jpgThe December issue of the Journal of the Neurological Sciences Vol 455 is now available online.


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Issue highlights


Research Article

Progressive multifocal leukoencephalopathy analyzed using the Japanese Adverse Drug Event Report database

Sakurai et al.

Published online: November 14, 2023


Progressive multifocal leukoencephalopathy (PML) has been reported as the development of drugs with immunomodulatory properties, such as anticancer, immunosuppressive, and biological agents, has accelerated. To clarify an incidence profile of drug-associated PML in real-world clinical practice, the authors analyzed reported patients with PML using the Japanese Adverse Drug Event Report (JADER) database.

This was a retrospective, observational study evaluating the effects of causative drugs, underlying diseases, and the age of the patients on the annual number of PML reports.

The number of PML reports and reporting ratios have gradually increased in the past decade in Japan, and it considered that it was related to change in the treatment of malignancies and autoimmune diseases, and the increasing use of biologics, immunosuppressive agents, and antineoplastic agents.


Research Article | Open Access

Perampanel as only add-on epilepsy treatment in elderly: A subgroup analysis of real-world data from retrospective, multicenter, observational study

Pascarella et al.

Published online: November 13, 2023


Drug management of epilepsy in the elderly presents unique but data on this population are scarce. This study aimed to assess the effectiveness and tolerability of perampanel (PER) used as only add-on to a background anti-seizure medication (ASM) in the elderly in a real-world setting.

Adjunctive PER was effective and well-tolerated when used as only add-on treatment in elderly people with epilepsy in clinical practice, thus representing a suitable therapeutic option in this age category.


Research Article

Enteral tube nutrition for geriatric post-stroke dysphagia evaluation (ENGE) score to evaluate the risk of dysphagia after acute ischemic stroke

Ikenouchi et al.

Published online: November 14, 2023


Post-stroke dysphagia (PSD) is a common complication after stroke. Early PSD prediction is essential for patient stratification for intensive oral intake rehabilitation. The study aimed to develop a PSD prediction score using clinical data obtained at admission and examined consecutive patients with acute ischemic stroke between 2018 and 2019.

The dysphagia status 14 days after admission was assessed using the Functional Oral Intake Scale (FOIS). PSD was defined as FOIS 1–3, which represents tube-dependent nutrition. Using multivariable logistic regression analysis, the authors constructed the Enteral tube Nutrition for Geriatric post-stroke dysphagia Evaluation (ENGE) score. The discriminative performance of the ENGE score was analyzed by receiver operating curve analysis. The reproducibility of the ENGE score was validated using patient data in 2020. Results

The ENGE score predicts severe PSD after acute ischemic stroke with good reproducibility.


Research Article

Pathology of human organic mercury poisoning: Lessons from an autopsy case

Ekino et al.

Published online: November 20, 2023


We had an opportunity to perform a general autopsy of a case with chronic organic mercury toxicosis in 2017. He had been engaged in synthesizing a variety of organic mercury compounds throughout the four years from 1966 and developed chronic organic mercury poisoning in 1969.