Kinesiophobia is defined as an excessive and irrational fear of movement and physical activity. Individuals living with Parkinson’s disease (PD) can be at risk of developing this phobia, due to the debilitating nature of the disease’s motor symptoms such as impaired balance, bradykinesia, rigidity and tremor. This is particularly problematic, as exercise is crucial for people with PD, especially considering its potential to slow down disease progression. The Tampa Scale of Kinesiophobia for Parkinson’s disease (TSK-PD) is a valid and reliable instrument for measuring kinesiophobia in PD. However, no French translation of this scale existed prior to this study.

The English TSK-PD was translated, cross-culturally adapted into Canadian French, and administered to 102 ambulatory French-speaking Canadians living with PD, aged 46–83. Statistical analyses were then conducted to examine the psychometric properties of the translated scale.

Results confirmed the construct validity of the translated version and revealed high internal consistency (Cronbach’s alpha = 0.90), good test-retest reliability (ICC = 0.84), with no evidence of floor or ceiling effects. Exploratory and confirmatory factor analyses supported a two-factor structure consisting of “Activity Avoidance” and “Harm.”

The French-Canadian TSK-PD can be recommended for use in research and in clinical settings to better identify fear of movement in French-speaking PD patients and promote physical activity.

Emerging evidence suggests that metabolic and hormonal disturbances in polycystic ovary syndrome (PCOS) may increase vulnerability to neurodegenerative disorders. However, the link between PCOS and Alzheimer’s disease (AD)-related pathology remains unclear.

In this cross-sectional study, plasma levels of β-amyloid (Aβ40, Aβ42), phosphorylated tau (p-tau181), neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) were quantified in women with PCOS and age-matched controls. Homeostasis model assessment of insulin resistance (HOMA-IR), inflammatory cytokines (IL-6, TNF-α) and hormonal parameters were assessed. Mediation and moderation analyses were conducted to explore metabolic and hormonal pathways underlying biomarker alterations.

Among 400 women (200 PCOS, 200 controls), age and BMI were comparable (P > 0.05). Compared with controls, PCOS participants had increased Aβ40, p-tau181, NfL and GFAP, a slightly higher Aβ42, and a lower Aβ42/40 ratio (all P < 0.05). p-tau181 correlated positively with HOMA-IR (r = 0.41) and IL-6 (r = 0.36), while Aβ42/40 ratio correlated negatively with HOMA-IR (r = –0.27). In multivariable analysis, p-tau181 (aOR = 1.34, 95% CI 1.05–1.71), IL-6 (aOR = 1.19) and TNF-α (aOR = 1.14) were independent predictors of insulin resistance. Mediation analysis indicated that HOMA-IR, IL-6 and TNF-α jointly mediated ∼ 71% of the PCOS–p-tau181 association, suggesting a metabolic–inflammatory pathway linking PCOS to AD-related tau pathology.

PCOS is linked to peripheral markers of early Alzheimer’s pathology, largely mediated by insulin resistance and inflammation. PCOS may provide a clinical context to explore metabolic–inflammatory contributors to early neurodegenerative changes.

Timely access to endovascular treatment (EVT) for ischaemic stroke patients is critical for optimal outcomes, but Canada’s size and population distribution create barriers to access. EVT is mostly available in tertiary centres located in large urban cities, and patients that arrive at intravenous thrombolysis (IVT)-only stroke centres need to be transferred for EVT.

Geographic modelling of access to an IVT-only centre and an EVT-capable centre was conducted for Canada. Canada was divided into small grid sections. Drive times from the centre of each grid section to the closest stroke centres and the population of each grid section were obtained. The onset to paramedic arrival time and on-scene time were assumed to be 30 and 30 minutes, respectively. In the suboptimal and optimal scenarios, the door-in-door-out (DIDO) times were 150 minutes and 45 minutes, respectively. The poor access regions and population were calculated for onset to thrombolysis at 4.5 hours and to EVT-capable centre arrival for EVT within 6 and 3 hours.

The results show 99.37% of the population having access to thrombolysis within 4.5 hours. However, with a suboptimal DIDO time, 13.6% (5.2 million people) and 42.7% (16.2 million people) do not have access to EVT within 6 and 3 hours, respectively. With an efficient DIDO time, an additional 5.6% (2.1 million people) and 15.7% (6.0 million people) have access to EVT within 6 and 3 hours, respectively.

There is an imperative to reduce DIDO times to an ambitious median of 45 minutes to ensure optimal access to EVT across Canada.

The aim of this study was to investigate the effects of central vestibular dysfunction on physical functionality and cognitive function in individuals with multiple sclerosis (MS).

Fifty-two fully ambulatory individuals with MS (Expanded Disability Status Scale [EDSS] ≤ 4) were included and divided into two groups: those with central vestibular involvement (Group 1; n = 25) and those without (Group 2; n = 27). Central vestibular involvement was assessed using videonystagmography. Physical and cognitive functions were evaluated in all participants using the Glittre Activities of Daily Living (ADL) test, Godin Leisure-Time Exercise Questionnaire (GLTEQ), and the physical dimension of the MSQoL-54 for physical functionality, and the BICAMS, Trail Making Test (TMT), Word List Generation test and the cognitive dimension of the MSQoL-54 for cognitive function.

According to the physical functionality assessment results, the time required to complete the Glittre ADL test was longer in group 1 than in group 2 (p = 0.01). The score for the physical dimension of the MSQoL-54 was lower in group 1 (p = 0.045). In the BICAMS Symbol Digit Modalities Test, Group 1 scored lower than Group 2 (p = 0.013). A significant difference between the groups was also observed in the time taken to complete the TMT (p = 0.017). Additionally, Group 1 exhibited lower scores on the cognitive dimension of the MSQoL-54 (p = 0.012).

Physical functionality and specific cognitive domains differed between MS participants with and without central vestibular involvement. It should be considered that vestibular dysfunction may adversely impact cognitive and physical functionality, even in low-moderate disability level.

A better understanding of calcitonin gene-related peptide (CGRP) inhibitor use is in migraine treatment needed.

A retrospective, observational, population-based cohort study was conducted using administrative data. Adults (≥18 years) who received ≥1 prophylactic CGRP inhibitor in Canada (six provinces) between 2018 (first approved) and 2023 were identified. CGRP inhibitor use was described; migraine-related acute medication and healthcare use were compared pre–post CGRP inhibitor initiation (independent and paired t-tests).

12,851 adults were identified. CGRP inhibitor use increased from 11.8 (incident/prevalent) to 22.4 (incident) and 57.3 (prevalent) per 100,000 adults. Erenumab use decreased over time, as use of newer agents increased. During the 1-year period after CGRP inhibitor initiation, 57.4% had concomitant use with a different prophylactic migraine medication class (onabotulinumtoxinA injection: 23.2%; oral non-CGRP inhibitor: 34.2%), and 30.4% stopped use (21.3% switched to a different prophylactic migraine medication class; 9.1% discontinued all prophylactic migraine medication). During the 1-year period after CGRP inhibitor initiation (versus before), days of supply for migraine-related acute medication was lower (mean [standard deviation]: 129 [191] versus 145 [197] days; mean difference [95% confidence interval]: −16: [−22, −11] days), as were the number of healthcare visits (7.36 [8.70] versus 9.18 [10.10]; −1.82 [−2.06, −1.58]).

CGRP inhibitor use increased from 2018 to 2023. After CGRP inhibitor initiation, most patients had concomitant use with a different prophylactic migraine medication class, and some stopped use; migraine-related acute medication and healthcare use were lower (versus before). Findings provide a real-world description of the evolving landscape of CGRP inhibitor use in Canada.

Stroke remains a major public health issue globally. Tele-rehabilitation, incorporating internet-based interventions and wearable devices, offers an accessible strategy for post-discharge rehabilitation. This study evaluates their effectiveness in stroke patients.

A total of 160 subacute stroke patients hospitalized between November 2022 and September 2023 were enrolled and randomly allocated to four groups at discharge (n = 40 per group): a control group receiving conventional rehabilitation, an internet-based tele-rehabilitation (ITR) group, a wearable-device-assisted (WDA) group and a combined intervention (IWT) group, which received both ITR and WDA training. The primary outcome was assessed by the Modified Barthel Index (MBI) at discharge, 4 weeks and 12 weeks post-discharge, with the 12-week score prespecified as the primary endpoint. Secondary outcomes included Berg Balance Scale (BBS), simplified Fugl-Meyer Assessment (sFMA), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Mini-Mental State Examination (MMSE) and Zarit Burden Interview (ZBI), all assessed at discharge, 4 weeks and 12 weeks post-discharge.

At baseline, no significant differences were observed among groups (P > 0.05). Over 12 weeks, all intervention groups demonstrated significant improvements in MBI, BBS and sFMA compared to the control group (P < 0.05), with the IWT group achieving the greatest gains (P < 0.01). Anxiety, depression and caregiver burden significantly decreased across intervention groups, with the IWT group showing the most pronounced reductions (P < 0.01). Cognitive function also improved significantly, particularly in the IWT group (P < 0.01).

ITR and WDA training enhances functional and psychological recovery in stroke patients, highlighting its potential clinical significance in managing stroke recovery.

Parkinson’s disease (PD) is a neurodegenerative disorder whose diagnostic motor symptoms appear only after significant progression of neurodegeneration. Identification of preclinical markers is essential. Idiopathic rapid eye movement sleep behavior disorder (iRBD) has a high risk of conversion to PD. Olfactory impairment (hyposmia) is present in both PD and iRBD; hyposmia in iRBD may be an additional clue indicating the development of PD. The processes underlying hyposmia in iRBD are unknown. Using resting-state functional connectivity (rsFC), a “sensory olfactory subnetwork” (SOS) has been identified that is thought to represent the processing of basic sensory olfactory information. We investigated whether changes in the SOS are seen in both PD and iRBD and whether changes are associated with hyposmia in both conditions.

The University of Pennsylvania Smell Identification Test (UPSIT) and a seed-based approach to analyze SOS region rsFC in early PD, iRBD and healthy controls (HC) were employed. Our SOS regions included (right hemisphere) anterior piriform cortex, dorsal insula (INSd), ventral insula (INSv), posterior insula (INSp) and ventral posterior thalamus (THLvp).

Compared to HC, idiopathic iRBD and PD participants performed significantly worse on UPSIT and exhibited lower FC between INSd and INSv and higher FC between INSd and THLvp and INSv and THLvp. UPSIT scores were negatively correlated with FC between INSv and THLvp and INSp and THLvp.

Idiopathic iRBD may be associated with similar functional and perceptual olfactory alterations and potential compensatory changes as early PD, which may show promise as additional preclinical biomarkers of PD.