Unilateral microelectrode-guided pallidotomy has re-emerged as a therapeutic option for advanced Parkinson's disease (PD), particularly in resource-limited settings. This study evaluated motor and neuropsychological outcomes following radiofrequency ablation of the internal globus pallidus (GPi) using image fusion and intraoperative microelectrode recording. To assess the motor efficacy, cognitive impact, and safety profile of unilateral GPi pallidotomy guided by neurophysiological monitoring in patients with advanced idiopathic PD of the rigid-akinetic subtype.

This retrospective, single-center, observational case series included 12 patients with advanced PD who underwent unilateral radiofrequency pallidotomy targeting the internal segment of the GPi. Movement Disorder Society–Unified PD Rating Scale Part III (MDS-UPDRS-III), including both contralateral and ipsilateral domain sub scores. Levodopa-induced dyskinesias (UPDRS-IV) and cognitive performance (NEUROPSI Attention and Memory battery) were also assessed before and 12 months after surgery. Statistical analyses were conducted using paired t-tests or Wilcoxon signed-rank tests depending on data distribution, with significance set at p < 0.05.

At 12-month follow-up, motor outcomes improved significantly. Mean MDS-UPDRS-III scores decreased from 64.1 ± 27.1 preoperatively (OFF medication) to 37.8 ± 24.4 postoperatively, and from 23.5 ± 17.0 to 10.6 ± 8.5 in the ON state. The overall OFF-state improvement was 44.4% ± 21.2%. Paired t-tests confirmed a highly significant reduction in motor scores (t = 6.19, p < 0.0001; mean change –26.3 points, 95% confidence intervals (CI) –34.7 to –18.0). Domain-specific analysis showed significant contralateral improvements in rigidity (–48%, p = 0.0006), bradykinesia (–49.5%, p < 0.0001), resting tremor (–81%, p = 0.004), gait (–27.8%, p = 0.013), postural stability (–39%, p = 0.021), and dyskinesias (–56%, p = 0.017). Ipsilateral changes were mild and not statistically significant for rigidity (–14.6%, p = 0.519), bradykinesia (–25.0%, p = 0.084), or rest tremor (–50.0%, p = 0.121). No major surgical complications occurred. Neuropsychological assessment revealed modest postoperative gains in executive functioning and working memory, with preservation of global cognition.

Unilateral GPi pallidotomy guided by imaging and microelectrode recording is a safe and effective procedure that significantly improves motor symptoms while preserving cognitive function in appropriately selected patients with advanced PD, as demonstrated in our Guatemalan cohort.

To evaluate the association of the purinergic receptor P2Y, G-protein coupled, 12 (P2Y12) gene polymorphisms with susceptibility to different etiological stroke subtypes.

A total of 459 first-ever acute ischemic stroke patients were classified into large-artery atherosclerosis (LAA, n = 163), small-vessel occlusion (SVO, n = 204), and cardioembolism (CE, n = 92) based on the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria. Direct sequencing was used to screen these three stroke subtypes and non-stroke controls for P2Y12 polymorphisms: a T→C transition at 744 nucleotides (nt) downstream of intron 5's start site (i-T744C) and a C→T transition at 34 nt downstream of exon 2's start site (C34T). Based on the results of multivariate logistic analyses, a prediction model was established via a nomogram that incorporated genomic and clinical variables to quantify the risk of LAA stroke.

Significant differences in the P2Y12 i-T744C genotype and allele frequencies were observed between LAA patients and controls. After adjusting for confounding factors, the dominant model (p = 0.009) and additive model (p = 0.023) revealed that the i-T744C polymorphism was significantly associated with increased susceptibility to LAA. No significant associations were found for the SVO and CE stroke subtypes. Moreover, the C34T polymorphism was not an independent factor for any stroke subtype. We further constructed a nomogram prediction model for LAA stroke based on genomic and clinical variables, including age, hypertension, smoking, high-density lipoprotein cholesterol, and the i-T744C polymorphism. This nomogram exhibited satisfactory accuracy and predictive power for LAA stroke, as demonstrated by the area under the curve, calibration plot, and decision curve analysis.

The P2Y12 i-T744C polymorphism may serve as a predictor for LAA stroke. Furthermore, we constructed a genomic-clinical nomogram that may be valuable for predicting LAA stroke risk in the study population.

Headaches are the main reason for visits to Neurology clinics, and migraine is the most common primary headache. with migraine being the most frequent. Our objective was to develop a computer application (app) that could empower Primary Health Care (PHC) physicians in decision-making regarding migraine.

A rule-based artificial intelligence system was designed to process patients’ responses to the ID-Migraine screener and subsequently determine whether they met the diagnostic criteria for migraine or tension-type headache, according to the International Headache Society. The application, known as CefaleApp, is designed to generate a diagnosis of migraine, tension-type headache, or mixed headache.

CefaleApp was validated in 152 patients referred from PHC clinics with a suspected diagnosis of migraine or tension-type headache. Patients were evaluated in the Neurology Department of a secondary-level hospital and in two regional hospitals. Agreement between the diagnosis generated by CefaleApp and that issued by an expert headache neurologist (gold standard) was estimated using Cohen’s Kappa index and the Matthews correlation coefficient (MCC). Overall diagnostic accuracy was 90.8% (95% CI: 85.1–94.6%), Cohen’s Kappa index was 0.73 (95% CI: 0.59–0.87), and the MCC value was 0.73.

The migraine diagnosis generated by CefaleApp shows substantial-high agreement with that provided by the expert headache neurologist.

Nodding syndrome is a childhood-onset epileptic encephalopathy described in onchocerciasis-endemic regions of sub-Saharan Africa. Although characterized by recurrent atonic seizures with repetitive head-nodding movements, increasing evidence suggests that the condition extends beyond a purely motor epilepsy and involves progressive cognitive, behavioral, and emotional impairment.

This study was designed as a narrative review with a specific neuropsychological focus. A literature search was conducted in PubMed, Scopus, and Google Scholar for publications between 2013 and 2025. Studies describing cognitive, behavioral, emotional, psychiatric, neuroimaging, or neuropathological findings in patients with nodding syndrome were included. Due to heterogeneity in study design and assessment methods, findings were synthesized narratively.

Across studies, nodding syndrome is consistently associated with progressive cognitive decline affecting attention, processing speed, executive functions, memory, and global intellectual functioning. Behavioral disturbances such as irritability, aggression, and emotional lability are frequently reported, alongside depressive symptoms and social withdrawal. Neuroimaging findings commonly demonstrate cortical and cerebellar atrophy, while neuropathological studies report tau-protein deposition and neuronal loss, supporting diffuse cerebral involvement with possible neurodegenerative features.

Nodding syndrome represents a complex epileptic encephalopathy characterized not only by seizures but also by significant cognitive, behavioral, and emotional impairment. A clearer neuropsychological characterization may inform clinical assessment and guide future research aimed at improving supportive and rehabilitative interventions.