Introduction: Comorbidities affect diagnosis and treatments in cancer patients. This study explores the prevalence and patterns of comorbidities in non-small cell lung cancer (NSCLC) patients and their association with survival. Materials and Methods: This retrospective population-based cohort study included 1674 incident NSCLC patients. Comorbidities were classified based on the ICD-9-CM system, with 13 disease categories analyzed. Patients with more than two comorbidities were classified into three mutually exclusive and exhaustive latent classes (Latent Class Analysis [LCA]). The optimal number of latent classes was determined by applying the Akaike Information Criterion. Cox regression models were run to assess overall and cancer-specific mortality, adjusting for the comorbidity groups, sex, age, and stage at diagnosis. Results: In 1674 NSCLC patients, the most prevalent medical conditions were respiratory (35.8%) and cardiovascular (33.5%). The Cox regression showed that even one comorbidity is associated with an increased hazard of overall mortality (HR = 1.33, 95%CI: 1.11–1.59, p = 0.002). LCA-derived Class-1 (cardiovascular-respiratory and endocrine) reported HR = 1.74 (95%CI: 1.39–2.17, p < 0.001), Class-2 (multi-organ) HR = 1.44 (95%CI: 1.18–1.77, p < 0.001), and Class-3 (socio-multifactorial-neuro) HR = 1.62 (95%CI: 1.36–1.93, p < 0.001). Instead, in patients with one comorbidity, NSCLC-specific mortality showed no significant trend towards increased risk (HR = 1.17, 95%CI: 1.00–1.43, p = 0.114). Significant associations emerged between NSCLC-specific mortality and LCA-classes: Class-1: HR = 1.49 (95%CI: 1.20–1.91, p = 0.001); Class-2 HR = 1.25 (95%CI: 1.0–1.57 p = 0.048); and Class-3: HR = 1.23 (95%CI: 1.00–1.48, p = 0.035). Conclusions: The adverse impact of comorbidities on NSCLC-specific mortality requires their inclusion as risk factors in cancer treatment and prognosis.

Impulse control and related behavioral disorders (ICBDs) commonly complicate Parkinson's disease (PD) course. The ICBDs spectrum encompasses two groups of conditions, with distinct pathophysiology: proper 'impulse control disorders (ICDs)' (e.g. gambling) and the 'ICDs related disorders (ICDs-RD)' (e.g. punding). Behavioral disturbances are associated with dopamine replacement therapies. ICBDs significantly affect the quality of life of patients and caregivers, making their management essential for reducing the overall burden of PD. This article reviews the current management strategies for ICBDs in PD. The authors highlight their strengths and limitations of these strategies, and explore the potential role of emerging treatment options, giving particular focus to new compounds and invasive therapies. Prevention, close monitoring and caregiver involvement are essential in managing ICBDs in PD. Treatment approaches should be tailored to ICBDs' functional impact and aimed to reduce the pulsatile stimulation of dopamine receptors, especially D2. Dopamine agonist (DA) tapering remains the primary therapeutic approach for ICDs, alongside psychotherapy and second-line agents, like atypical antipsychotics and serotonin-noradrenaline reuptake inhibitors. Insights into ICDs pathophysiology and DA-specific pharmacodynamics indicate safer profiles for certain preparations (e.g. rotigotine patches) and possibly for D1/D5 agonists like tavapadon. Invasive treatments, including deep brain stimulation and infusion therapies, should be prioritized in advanced-stage PD complicated by ICBDs.

Introduction: Lung cancer imposes a substantial economic burden on patients, healthcare systems, and societies due to its high prevalence and costs associated with diagnosis, treatment, and palliative care. Comorbidities in lung cancer patients can further complicate clinical management and increase healthcare utilization. This study investigated the impact of comorbidity patterns on healthcare costs in patients with lung cancer. Methods: A cohort of 1540 lung cancer patients in the Veneto region of Italy was divided into five groups based on comorbidity burden using latent class analysis: no comorbidities, only one comorbidity, and specific comorbidity classes (Class 1: cardiovascular, respiratory, and endocrine diseases; Class 2: multiorgan diseases; Class 3: socio-multifactorial neuro conditions). Using administrative data, both overall healthcare costs and lung cancer-specific costs were analyzed over three years. Results: Patients with one comorbidity class had the highest overall costs over three years from diagnosis (USD 52,039) and the highest lung-specific costs (USD 47,804). In contrast, patients in the Cardiovascular-Respiratory and Endocrine class incurred the lowest overall costs (USD 38,447). Additionally, they had the lowest lung case-specific costs (USD 33,425) over the same three-year period from diagnosis. Higher costs for inpatient medications were observed in patients without any comorbidities or with at most one. Conclusions: The findings emphasize the significant effect of comorbidity patterns on resource use in lung cancer patients. Considering comorbidity profiles is essential for economic assessments and healthcare planning, as it allows for better resource allocation and supports personalized treatment strategies.

Background: Advances in STN-DBS technology, among which directional stimulation, improved Parkinson's disease (PD) treatment efficacy, while increasing the clinical programming complexity. Lead localization software may aid the stimulation contact selection process. Objective: We aimed to assess the concordance between imaging-suggested (IGP) and conventional-programming (CP) selected stimulation contacts one year after surgery and its impact on motor outcomes. Methods: Sixty-four PD patients with bilateral STN-DBS were enrolled. Lead localization was reconstructed with Brainlab ^TM software. For each electrode, the vertical contact level and, when applicable, the directionality predicted by the lead reconstruction software to be the most effective were established and compared to the stimulation parameters clinically activated one-year post-surgery. IGP/CP concordance ratio was calculated for both stimulation level and directional contacts. Post-operative modifications of PD motor symptoms severity were compared among groups of concordant and discordant IGP/CP programming. Results: One-year post-surgery, IGP/CP concordance was 80% for active stimulation vertical contact level and 51% for directionality. No significant difference in motor outcomes was found between IGP/CP concordant and discordant patients for contact level activation, whereas patients with concordant IGP/CP active directional stimulation (c-Direction) showed superior motor outcomes at one-year follow-up than those discordant (d-Direction) (UPDRS-III stimulation-induced improvement: c-Direction = −25.66 ± 13.74 vs. d-Direction = −12.54 ± 11.86; p = 0.011). Conclusions: Visual reconstruction software correctly predicted the most clinically effective stimulation contact levels in most patients. Imaging therefore facilitates classic STN-DBS clinical programming while assuring similar outcomes. Moreover, better motor outcomes were reached by patients with concordant IGP/CP directional parameters, suggesting that visualization can represent an added value in particular for directional stimulation programming.

Oral dopaminergic treatment is the cornerstone of Parkinson's disease (PD) management. However, progressive shortening of oral levodopa's effect, along with the limited efficacy of enzyme inhibitors and dopamine agonists, does not allow to adequately control motor and non-motor complications characterizing advanced PD. At this stage, device-aided therapies (DATs), including infusion treatments, are warranted to guarantee an adequate quality of life. We review current and upcoming infusion therapies for PD, with a particular focus on their efficacy and safety data. Moreover, we provide an overview of current knowledge and open issues on patient selection and specific DAT choice. Recent EAN/MDS-ES guidelines suggest infusion therapies for advanced PD, yet several challenges remain, including limited access, delayed referrals, and patients' hesitancy. The'5-2-1' criteria and tools like MANAGE-PD aid early identification of eligible candidates, but treatment decisions often do not account for patients' preferences. Current trends favor early DATs implementation, as soon as motor fluctuations appear and before the disability onset. Emerging infusion therapies (e.g. foslevodopa-foscarbidopa) will boost this tendency. Enhancing DATs accessibility and inclusivity in clinical trials are key priorities. Finally, regenerative therapies including putaminal infusion of neurotrophic factors and dopaminergic neuron precursors may transform advanced PD care.

Introduction: Brain-derived neurotrophic factor (BDNF) is a neurotrophin expressed in the central nervous system, where it supports synaptic plasticity, neuronal survival, and dendritic remodeling. Reduced circulating BDNF levels have been reported in several neurological and psychiatric disorders, increasing evidence links BDNF to post-stroke recovery. However, because BDNF is also produced and stored in platelets- the main peripheral reservoir- its measurement is highly sensitive to preanalytical handling. Improper sample preparation may trigger platelet degranulation and cause substantial variability in serum and plasma BDNF levels. Content: This scoping review examined preanalytical procedures used for BDNF quantification in clinical studies involving adult stroke patients. Following PRISMA-ScR guidelines, we systematically searched Pubmed, Embase, Web of Science, and the Cochrane Library for English-language clinical trials, randomized controlled trials, and observational studies measuring BDNF in blood derivatives. The search was completed on February 3rd, 2025. Summary: From 11,030 records identified, 8,696 underwent screening after removing duplicates and excluding records concerning populations other than stroke, 49 studies met inclusion criteria. 74.4 % reported associations between circulating BDNF levels and clinical features or outcomes, though significant heterogeneity across study designs limited comparability. Serum was used in 36 studies, but key preanalytical parameters (such as clotting time, transport temperature) were frequently unreported. Similar inconsistencies emerged for plasma preparation, including anticoagulant type and management of platelet content. Outlook: These findings reveal major gaps in the reporting of preanalytical methods for BDNF measurement in stroke research and emphasize the need for standardized procedures to ensure reliable and comparable biomarker data.