Glioblastoma (GBM) is a highly malignant primary brain tumor known for its heterogeneity, infiltrative growth, and poor prognosis. Standard treatment includes surgery, radiation, and chemotherapy. Although the therapeutic options remain limited, immunotherapy provides new hope for treating GBM that has relapsed following standard therapies by boosting the immune system to inhibit tumor growth. The tumor immune microenvironment (TME) plays crucial roles in GBM progression and immunotherapy resistance. Since activated immune cells can penetrate far-off and impenetrable tumor cells, immunotherapy is a viable alternative. Immunotherapy has improved patient outcomes for a number of cancers and may offer GBM patients new, more efficient treatment options. To address both the innate and acquired immune responses in GBM patients, researchers are currently investigating a variety of immunotherapeutic approaches. Immune checkpoint mechanisms are emerging as promising targets. Furthermore, CAR-T-cell therapy offers new hope for enhancing treatment efficacy. Understanding the interplay between the TME, immune checkpoints, and therapeutic modalities is crucial for developing new standards of treatment. Thus, this review discusses recent advancements, challenges, and future directions in immunotherapy for patients with glioblastoma.

Ipsilateral facial, neck, or retroauricular pain is a common but often underrecognized feature of peripheral facial nerve palsy. We report a rare case of posterior auricular nerve neuropathy following facial nerve palsy in the context of polyneuritis cranialis. This case highlights posterior auricular nerve neuropathy as a potential complication of peripheral facial nerve palsy and polyneuritis cranialis. Accurate identification of neuropathic pain and appropriate management are essential. Clinicians should remain vigilant for atypical pain patterns during the course of facial nerve palsy, particularly in the setting of polyneuritis cranialis.

This study performs a comprehensive in-silico multi-omic analysis to explore the genetic and molecular mechanisms of Multiple Sclerosis (MS), highlighting its psychoneuroimmunology link to stress-related pathways. High-throughput data from the Gene Expression Omnibus focused on corpus callosum gene expression, a key region in MS pathology. Using GEO2R, significant differentially expressed genes in MS were identified, followed by pathway analysis through KEGG databases to uncover implicated biological pathways. Functional enrichment and network analyses via DAVID and Cytoscape highlighted core biological processes, focusing on heat shock proteins and immune signalling pathways. Additionally, genome-wide association study (GWAS) data identified MS-associated genetic loci, aiding in building a robust multi-omic profile. A protein-protein interaction network using STRING emphasized key stress protein interactions: DNAJB1, HSPA6, HSPB1, and HSPH1. This integrative study provides a detailed framework linking psychoneuroimmunological pathways to MS pathology, identifying potential therapeutic targets and biomarkers, enhancing the understanding of MS's complex aetiology, and paving the way for novel interventions in stress-related neurological disorders.

Serum AQP4 antibody (AQP4-IgG) is the causative antibody of neuromyelitis optica spectrum disorder (NMOSD) but AQP4-IgG in cerebrospinal fluid (CSF) has been seldom studied. We aimed to explore the clinical value and influencing factors of CSF AQP4-IgG in NMOSD. In this study, we screened 137 patients with NMOSD diagnosed according to the 2015 International Consensus Diagnostic Criteria (IPND criteria). From this cohort, paired CSF and serum samples were simultaneously collected from 82 patients (including seropositive and seronegative subgroups) for antibody titer measurement. We explored the relationship between CSF AQP4-IgG and patient's clinical features. Their demographic, clinical, laboratory data and MRI images were collected and analyzed. 74 patients were seropositive for AQP4-IgG and 8 patients were seronegative. Among the 74 patients seropositive for AQP4-IgG, 46 were CSF-positive and 28 were CSF-negative, while none of the 8 seronegative patients were CSF-positive. CSF AQP4-IgG positive and negative patients showed significant differences in EDSS and relapse status. Out of the 82 patients, 67 patients were during relapse and only patients during relapse were included in the next analysis. Between the CSF-positive and CSF-negative patients, no significant differences were found in EDSS, relapse manifestation, CSF indicators, serum cytokine levels, lymphocyte subsets or MRI lesions. Responses to treatment during relapse and length of hospital stay showed no significant differences either. A positive correlation between the serum and CSF titers (rs: 0.64, p < 0.001) was found. Further binary logistic regression analysis revealed that CSF AQP4-IgG positivity was associated with serum AQP4-IgG titers and EDSS scores. CSF AQP4-IgG positivity primarily results from passive diffusion of serum antibodies across the blood-brain barrier, which is different from the CNS-restricted antibody production in MOG-IgG associated disorders (MOGAD). Limited prognostic value of CSF AQP4-IgG was revealed in this study.

Multiple sclerosis (MS) is a chronic immune-mediated demyelinating disease of the central nervous system that predominantly affects women of reproductive age. With ongoing therapeutic advances, ending common misconceptions related to the disease and pregnancy in MS is crucial for the adherence to MS treatment. The aim of our research was to assess the level of knowledge of MS as a disease in general, to estimate the awareness of reproductive issues in MS, and to evaluate the primary sources of information in persons with MS (PwMS) and persons without MS. The study included female PwMS aged 18-49 years and male PwMS aged 18-65 years, who were matched with persons without MS of the same age, gender, and education. After obtaining informed consent, participants filled out an online questionnaire distributed via electronic mail between November 1st, 2022 and November 1st, 2023. The questionnaire consisted of a different statements regarding the clinical aspects of MS, pregnancy and reproductive health, primary source of information and subjective assessment of the knowledge. The study included 410 PwMS and 400 persons without MS. The survey has shown higher levels of knowledge related to the disease in the PwMS group. Seven in ten PwMS disagreed with the false statement that all PwMS at some point lose the ability to walk, while 39.2% of persons without MS agreed. On the other hand, the most common answer, for all study participants, related to reproductive issues in MS was "I do not know". Over two-thirds of PwMS did not have an answer to the question related to the benefits of breastfeeding. The primary source of information for the PwMS group were neurologists (82.7%) and for persons without MS the Internet (54.4%). Persons with MS additionally received information from MS nurses. Both PwMS and persons without MS subjectively evaluated their level of knowledge as an inadequate (49.3% vs. 77.5%). People with MS still have a low level of information concerning reproductive issues while a considerable number of respondents recognized a deficit of adequate information regarding MS. Availability and validity of information are key aspects to consider in the future. Improvements in access to verified information is needed with an emphasis on reproductive issues.

Surgical resection of ventricular brain tumors is traditionally performed via microsurgery, which requires open craniotomy and can result in significant complications. Endoscopic approaches have emerged as minimally invasive alternatives. There is a lack of consensus regarding the preferred surgical strategy for ventricular tumor resection; the technique with the optimal rates of recurrence, mortality, and complications is debatable. This article aims to evaluate the efficacy of endoscopic resection in comparison to microsurgical resection, focusing on identifying the approach with superior clinical outcomes. To determine surgical outcomes, we performed a meta-analysis of the existing original studies across PubMed, SCOPUS, Cochrane, and Web of Science medical databases from inception to 20 February 2024, per PRISMA guidelines that discussed microsurgery and endoscopic resection in ventricular tumors. Eligible studies (n = 47) were included, which contained data describing clinical outcomes, postoperative complications, and mortality rates that were extracted and analyzed. A total of 47 studies, encompassing 3,059 patients (1,121 microsurgery, 1,938 endoscopy), were included. The mean age was 37.4 years (range 6-64), with 66.62% male (1,701/3,059). Colloid cysts were present in 67% (1,629/3,059), predominantly located in the third ventricle (55%, 715/1,301). Headache (96.15%, 2,700/2,808) was the most common symptom, followed by nausea/vomiting (12.5%, 351/2,808) and visual field deficits (11.26%, 316/2,808). The pooled gross-total resection (GTR) rate was 81.5% (95% CI, 75-88.1%; I²=66.66%), with endoscopic and microsurgery subgroups yielding GTR rates of 80% and 84.4%, respectively. Recurrence occurred in 4.7% (95% CI, 2.8-6.6%; I²=72.74%), with endoscopic and microsurgery rates of 3.9% and 6.6%. The mortality rate was 1.7% (95% CI, 0.9-2.5%; I²=29.1%), lower in endoscopic (0.6%) than microsurgery (5.2%). Postoperative hydrocephalus was noted in 4.8% (95% CI, 1.5-8.1%; I²=49.7%), cognitive deficits in 4.9% (95% CI, 3-6.9%; I²=33.57%), and cerebrospinal fluid leakage in 4.7% (95% CI, 1.8-7.6%; I²=53.81%). Seizures occurred in 3.6% (95% CI, 2-5.2%; I²=5.08%), neurological deficits in 5.5% (95% CI, 3-8%; I²=72.64%), visual field defects in 4.3% (95% CI, 2.6-6%; I²=35%), and wound infections in 2.5% (95% CI, 1-4%; I²=0%). Subgroup analyses generally showed lower complication rates for endoscopic surgery compared to microsurgery. Endoscopic resection offers favorable trends in the management of ventricular tumors. These include improved neurological outcomes, postoperative complications such as visual field defects and seizure rates, and lower mortality rates. Despite the need for further research to fully elucidate its benefits, Endoscopic resection stands out as a valuable technique in advancing neurosurgical care for ventricular tumor patients.