{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T03:44:09Z","timestamp":1775619849361,"version":"3.50.1"},"reference-count":43,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T00:00:00Z","timestamp":1747094400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T00:00:00Z","timestamp":1747094400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","award":["Ministero della Salute"],"award-info":[{"award-number":["Ministero della Salute"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neurol Sci"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>The aim of this study is to describe the results of a comprehensive neurological assessment conducted on a cohort of 70 adults with Down syndrome (DS), aged 21 to 74 years, recruited in Bologna, Italy. Neurocognitive disorder (NcD) was identified in 28.6% of participants and showed a significant association with psychiatric disorders (<jats:italic>p<\/jats:italic>=0.03). Psychiatric conditions were present in 40% of the cohort, while Down Syndrome Regression Disorder (DSRD) was diagnosed in 7.1%. Transient loss of consciousness affected 28.6% of individuals. Epilepsy, observed in 7.1%, was significantly associated with NcD (<jats:italic>p<\/jats:italic>=0.02). Neurological examination revealed that stereotypic movements correlated with DSRD (<jats:italic>p<\/jats:italic>&lt;0.01), tics with obsessive-compulsive disorders (<jats:italic>p<\/jats:italic>=0.01), and hypokinetic movement disorders with psychotic conditions (<jats:italic>p<\/jats:italic>=0.03). Additionally, nystagmus and cerebellar signs were significantly associated with elevated serum bilirubin levels (<jats:italic>p<\/jats:italic>&lt;0.01). These findings underscore the high prevalence and complexity of neurological comorbidities in adults with DS, emphasizing the need for specialized, multidisciplinary care.<\/jats:p>","DOI":"10.1007\/s10072-025-08195-7","type":"journal-article","created":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T02:30:43Z","timestamp":1747103443000},"page":"3639-3649","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Neurological findings in a cohort of adults with down syndrome"],"prefix":"10.1007","volume":"46","author":[{"given":"Nicola","family":"Grotteschi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magali Jane","family":"Rochat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Virginia","family":"Pollarini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Ghezzo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camilla","family":"Pellegrini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanna","family":"Calandra-Buonaura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raffaele","family":"Lodi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caterina","family":"Tonon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pietro","family":"Cortelli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Giulia","family":"Bacalini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gian Luca","family":"Pirazzoli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5939-7933","authenticated-orcid":false,"given":"Luisa","family":"Sambati","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,5,13]]},"reference":[{"issue":"1","key":"8195_CR1","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1038\/s41572-019-0143-7","volume":"6","author":"SE Antonarakis","year":"2020","unstructured":"Antonarakis SE, Skotko BG, Rafii MS et al (2020) Down syndrome. Nat Rev Dis Primer 6(1):9. https:\/\/doi.org\/10.1038\/s41572-019-0143-7","journal-title":"Nat Rev Dis Primer"},{"issue":"7","key":"8195_CR2","doi-asserted-by":"publisher","first-page":"1735","DOI":"10.1002\/ajmg.a.61636","volume":"182","author":"A Carf\u00ec","year":"2020","unstructured":"Carf\u00ec A, Romano A, Zaccaria G et al (2020) The burden of chronic disease, Multimorbidity, and polypharmacy in adults with down syndrome. Am J Med Genet A 182(7):1735\u20131743. https:\/\/doi.org\/10.1002\/ajmg.a.61636","journal-title":"Am J Med Genet A"},{"key":"8195_CR3","doi-asserted-by":"publisher","unstructured":"Lott IT (2012) Neurological phenotypes for down syndrome across the life span. Progress in brain research, vol 197. Elsevier, pp 101\u2013121. https:\/\/doi.org\/10.1016\/B978-0-444-54299-1.00006-6","DOI":"10.1016\/B978-0-444-54299-1.00006-6"},{"issue":"12","key":"8195_CR4","doi-asserted-by":"publisher","first-page":"4495","DOI":"10.1007\/s00415-020-10179-w","volume":"268","author":"JD Santoro","year":"2021","unstructured":"Santoro JD, Pagarkar D, Chu DT et al (2021) Neurologic complications of down syndrome: a systematic review. J Neurol 268(12):4495\u20134509. https:\/\/doi.org\/10.1007\/s00415-020-10179-w","journal-title":"J Neurol"},{"issue":"6","key":"8195_CR5","doi-asserted-by":"publisher","first-page":"623","DOI":"10.1016\/S1474-4422(10)70112-5","volume":"9","author":"IT Lott","year":"2010","unstructured":"Lott IT, Dierssen M (2010) Cognitive deficits and associated neurological complications in individuals with Down\u2019s syndrome. Lancet Neurol 9(6):623\u2013633. https:\/\/doi.org\/10.1016\/S1474-4422(10)70112-5","journal-title":"Lancet Neurol"},{"key":"8195_CR6","unstructured":"Newton RW, Puri S, Marder L (eds) (2015) Down syndrome: current perspectives. Mac Keith"},{"key":"8195_CR7","doi-asserted-by":"publisher","first-page":"903729","DOI":"10.3389\/fncel.2022.903729","volume":"16","author":"F Stagni","year":"2022","unstructured":"Stagni F, Bartesaghi R (2022) The challenging pathway of treatment for neurogenesis impairment in down syndrome: achievements and perspectives. Front Cell Neurosci 16:903729. https:\/\/doi.org\/10.3389\/fncel.2022.903729. PMID: 35634470; PMCID: PMC9130961","journal-title":"Front Cell Neurosci"},{"issue":"6","key":"8195_CR8","doi-asserted-by":"publisher","first-page":"622","DOI":"10.1016\/S1474-4422(16)00063-6","volume":"15","author":"C Ballard","year":"2016","unstructured":"Ballard C, Mobley W, Hardy J, Williams G, Corbett A (2016) Dementia in Down\u2019s syndrome. Lancet Neurol 15(6):622\u2013636. https:\/\/doi.org\/10.1016\/S1474-4422(16)00063-6","journal-title":"Lancet Neurol"},{"issue":"Pt 2","key":"8195_CR9","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1046\/j.1365-2788.2000.00263.x","volume":"44","author":"AJ Holland","year":"2000","unstructured":"Holland AJ, Hon J, Huppert FA, Stevens F (2000) Incidence and course of dementia in people with Down\u2019s syndrome: findings from a population-based study. J Intellect Disabil Res JIDR 44(Pt 2):138\u2013146. https:\/\/doi.org\/10.1046\/j.1365-2788.2000.00263.x","journal-title":"J Intellect Disabil Res JIDR"},{"key":"8195_CR10","doi-asserted-by":"publisher","first-page":"940175","DOI":"10.3389\/fneur.2022.940175","volume":"13","author":"JD Santoro","year":"2022","unstructured":"Santoro JD, Patel L, Kammeyer R et al (2022) Assessment and diagnosis of down syndrome regression disorder: international expert consensus. Front Neurol 13:940175. https:\/\/doi.org\/10.3389\/fneur.2022.940175","journal-title":"Front Neurol"},{"issue":"3","key":"8195_CR11","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1002\/mrdd.20159","volume":"13","author":"EM Dykens","year":"2007","unstructured":"Dykens EM (2007) Psychiatric and behavioral disorders in persons with down syndrome. Ment Retard Dev Disabil Res Rev 13(3):272\u2013278. https:\/\/doi.org\/10.1002\/mrdd.20159","journal-title":"Ment Retard Dev Disabil Res Rev"},{"key":"8195_CR12","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1192\/bjp.157.1.131","volume":"157","author":"TG Dinan","year":"1990","unstructured":"Dinan TG, Golden T (1990) Orofacial dyskinesia in Down\u2019s syndrome. Br J Psychiatry J Ment Sci 157:131\u2013132. https:\/\/doi.org\/10.1192\/bjp.157.1.131","journal-title":"Br J Psychiatry J Ment Sci"},{"issue":"4","key":"8195_CR13","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1002\/mds.870110408","volume":"11","author":"CM Haw","year":"1996","unstructured":"Haw CM, Barnes TR, Clark K, Crichton P, Kohen D (1996) Movement disorder in Down\u2019s syndrome: a possible marker of the severity of mental handicap. Mov Disord Off J Mov Disord Soc 11(4):395\u2013403. https:\/\/doi.org\/10.1002\/mds.870110408","journal-title":"Mov Disord Off J Mov Disord Soc"},{"issue":"1","key":"8195_CR14","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1177\/0333102410375628","volume":"31","author":"J Olesen","year":"2011","unstructured":"Olesen J, Third International Headache Classification Committee of the International Headache Society (2011) New plans for headache classification: ICHD-3. Cephalalgia Int J Headache 31(1):4\u20135. https:\/\/doi.org\/10.1177\/0333102410375628","journal-title":"Cephalalgia Int J Headache"},{"issue":"4","key":"8195_CR15","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1111\/epi.13709","volume":"58","author":"IE Scheffer","year":"2017","unstructured":"Scheffer IE, Berkovic S, Capovilla G et al (2017) ILAE classification of the epilepsies: position paper of the ILAE commission for classification and terminology. Epilepsia 58(4):512\u2013521. https:\/\/doi.org\/10.1111\/epi.13709","journal-title":"Epilepsia"},{"issue":"21","key":"8195_CR16","doi-asserted-by":"publisher","first-page":"1883","DOI":"10.1093\/eurheartj\/ehy037","volume":"39","author":"M Brignole","year":"2018","unstructured":"Brignole M, Moya A, De Lange FJ et al (2018) 2018 ESC guidelines for the diagnosis and management of syncope. Eur Heart J 39(21):1883\u20131948. https:\/\/doi.org\/10.1093\/eurheartj\/ehy037","journal-title":"Eur Heart J"},{"key":"8195_CR17","unstructured":"American Academy of Sleep Medicine, ed (2014) International classification of sleep disorders, 3 edn. American Acad. of Sleep Medicine"},{"issue":"1","key":"8195_CR18","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/j.jphys.2013.12.01","volume":"60","author":"LK Kwah","year":"2014","unstructured":"Kwah LK, Diong J (2014) National institutes of health stroke scale (NIHSS). J Physiother 60(1):61. https:\/\/doi.org\/10.1016\/j.jphys.2013.12.01","journal-title":"J Physiother"},{"issue":"1","key":"8195_CR19","doi-asserted-by":"publisher","first-page":"177","DOI":"10.3233\/JAD-2012-111613","volume":"29","author":"IT Lott","year":"2012","unstructured":"Lott IT, Doran E, Nguyen VQ, Tournay A, Movsesyan N, Gillen DL (2012) Down syndrome and dementia: seizures and cognitive decline. J Alzheimers Dis 29(1):177\u2013185. https:\/\/doi.org\/10.3233\/JAD-2012-111613","journal-title":"J Alzheimers Dis"},{"issue":"10452","key":"8195_CR20","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1016\/S0140-6736(24)01296-0","volume":"404","author":"G Livingston","year":"2024","unstructured":"Livingston G, Huntley J, Liu KY, Costafreda SG, Selb\u00e6k G, Alladi S, Ames D, Banerjee S, Burns A, Brayne C, Fox NC, Ferri CP, Gitlin LN, Howard R, Kales HC, Kivim\u00e4ki M, Larson EB, Nakasujja N, Rockwood K, Samus Q, Shirai K, Singh-Manoux A, Schneider LS, Walsh S, Yao Y, Sommerlad A, Mukadam N (2024) Dementia prevention, intervention, and care: 2024 report of the lancet standing commission. Lancet 404(10452):572\u2013628. https:\/\/doi.org\/10.1016\/S0140-6736(24)01296-0. Epub 2024 Jul 31. PMID: 39096926","journal-title":"Lancet"},{"issue":"9","key":"8195_CR21","doi-asserted-by":"publisher","first-page":"1197","DOI":"10.3390\/brainsci11091197","volume":"11","author":"M Walpert","year":"2021","unstructured":"Walpert M, Zaman S, Holland A (2021) A systematic review of unexplained early regression in adolescents and adults with down syndrome. Brain Sci 11(9):1197. https:\/\/doi.org\/10.3390\/brainsci11091197","journal-title":"Brain Sci"},{"issue":"1","key":"8195_CR22","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1186\/s11689-022-09446-w","volume":"14","author":"JD Santoro","year":"2022","unstructured":"Santoro JD, Partridge R, Tanna R et al (2022) Evidence of neuroinflammation and immunotherapy responsiveness in individuals with down syndrome regression disorder. J Neurodev Disord 14(1):35. https:\/\/doi.org\/10.1186\/s11689-022-09446-w","journal-title":"J Neurodev Disord"},{"key":"8195_CR23","doi-asserted-by":"publisher","first-page":"769","DOI":"10.1016\/j.psychres.2018.10.039","volume":"270","author":"L Baudewijns","year":"2018","unstructured":"Baudewijns L, Ronsse E, Verstraete V, Sabbe B, Morrens M, Bertelli MO (2018) Problem behaviours and major depressive disorder in adults with intellectual disability and autism. Psychiatry Res 270:769\u2013774. https:\/\/doi.org\/10.1016\/j.psychres.2018.10.039","journal-title":"Psychiatry Res"},{"issue":"2","key":"8195_CR24","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1177\/17446295231154119","volume":"28","author":"AN Kildahl","year":"2024","unstructured":"Kildahl AN, Oddli HW, Helverschou SB (2024) Bias in assessment of co-occurring mental disorder in individuals with intellectual disabilities: theoretical perspectives and implications for clinical practice. J Intellect Disabil JOID 28(2):393\u2013414. https:\/\/doi.org\/10.1177\/17446295231154119","journal-title":"J Intellect Disabil JOID"},{"issue":"4","key":"8195_CR25","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1007\/s10286-016-0361-y","volume":"26","author":"K Bunsawat","year":"2016","unstructured":"Bunsawat K, Baynard T (2016) Cardiac autonomic modulation and blood pressure responses to isometric handgrip and submaximal cycling exercise in individuals with down syndrome. Clin Auton Res Off J Clin Auton Res Soc 26(4):253\u2013260. https:\/\/doi.org\/10.1007\/s10286-016-0361-y","journal-title":"Clin Auton Res Off J Clin Auton Res Soc"},{"issue":"3","key":"8195_CR26","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1097\/JES.0b013e318292f408","volume":"41","author":"B Fernhall","year":"2013","unstructured":"Fernhall B, Mendonca GV, Baynard T (2013) Reduced work capacity in individuals with down syndrome: a consequence of autonomic dysfunction? Exerc Sport Sci Rev 41(3):138\u2013147. https:\/\/doi.org\/10.1097\/JES.0b013e318292f408","journal-title":"Exerc Sport Sci Rev"},{"issue":"3","key":"8195_CR27","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1161\/HYPERTENSIONAHA.119.14416","volume":"75","author":"JD Santoro","year":"2020","unstructured":"Santoro JD, Lee S, Mlynash M, Mayne EW, Rafii MS, Skotko BG (2020) Diminished blood pressure profiles in children with down syndrome. Hypertension 75(3):819\u2013825. https:\/\/doi.org\/10.1161\/HYPERTENSIONAHA.119.14416","journal-title":"Hypertension"},{"issue":"13","key":"8195_CR28","doi-asserted-by":"publisher","first-page":"2776","DOI":"10.3390\/jcm10132776","volume":"10","author":"M Altuna","year":"2021","unstructured":"Altuna M, Gim\u00e9nez S, Fortea J (2021) Epilepsy in down syndrome: A highly prevalent comorbidity. J Clin Med 10(13):2776. https:\/\/doi.org\/10.3390\/jcm10132776","journal-title":"J Clin Med"},{"key":"8195_CR29","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1016\/j.eplepsyres.2016.08.027","volume":"127","author":"Y Yamamoto","year":"2016","unstructured":"Yamamoto Y, Terada K, Takahashi Y, Imai K, Kagawa Y, Inoue Y (2016) Influence of antiepileptic drugs on serum lipid levels in adult epilepsy patients. Epilepsy Res 127:101\u2013106. https:\/\/doi.org\/10.1016\/j.eplepsyres.2016.08.027","journal-title":"Epilepsy Res"},{"issue":"1","key":"8195_CR30","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/S0278-2626(02)00019-2","volume":"50","author":"G Andreou","year":"2002","unstructured":"Andreou G, Galanopoulou C, Gourgoulianis K, Karapetsas A, Molyvdas P (2002) Cognitive status in down syndrome individuals with sleep disordered breathing deficits (SDB). Brain Cogn 50(1):145\u2013149. https:\/\/doi.org\/10.1016\/S0278-2626(02)00019-2","journal-title":"Brain Cogn"},{"key":"8195_CR31","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1016\/j.jns.2017.02.014","volume":"375","author":"JP Marto","year":"2017","unstructured":"Marto JP, Dias M, Alves JN et al (2017) Stroke in adults with down syndrome. J Neurol Sci 375:279\u2013280. https:\/\/doi.org\/10.1016\/j.jns.2017.02.014","journal-title":"J Neurol Sci"},{"issue":"9","key":"8195_CR32","doi-asserted-by":"publisher","first-page":"e0137093","DOI":"10.1371\/journal.pone.0137093","volume":"10","author":"CG Sobey","year":"2015","unstructured":"Sobey CG, Judkins CP, Sundararajan V, Phan TG, Drummond GR, Srikanth VK (2015) Risk of major cardiovascular events in people with down syndrome. PLoS ONE 10(9):e0137093. https:\/\/doi.org\/10.1371\/journal.pone.0137093","journal-title":"PLoS ONE"},{"issue":"1","key":"8195_CR33","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1136\/jnnp.48.1.61","volume":"48","author":"S Takashima","year":"1985","unstructured":"Takashima S, Becker LE (1985) Basal ganglia calcification in Down\u2019s syndrome. J Neurol Neurosurg Psychiatry 48(1):61\u201364. https:\/\/doi.org\/10.1136\/jnnp.48.1.61. PMID: 3156213; PMCID: PMC1028184","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"8195_CR34","doi-asserted-by":"publisher","unstructured":"Ieshima A, Kisa T, Yoshino K, Takashima S, Takeshita K (1984) A morphometric CT study of Down\u2019s syndrome showing small posterior fossa and calcification of basal ganglia. Neuroradiology.;26(6):493-8. https:\/\/doi.org\/10.1007\/BF00342687. PMID: 6239108","DOI":"10.1007\/BF00342687"},{"key":"8195_CR35","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1016\/j.nicl.2018.01.024","volume":"18","author":"J Pujol","year":"2018","unstructured":"Pujol J, Fenoll R, Ribas-Vidal N, Mart\u00ednez-Vilavella G, Blanco-Hinojo L, Garc\u00eda-Alba J, Deus J, Novell R, Esteba-Castillo S (2018) A longitudinal study of brain anatomy changes preceding dementia in down syndrome. Neuroimage Clin 18:160\u2013166 PMID: 29868444; PMCID: PMC5984600","journal-title":"Neuroimage Clin"},{"issue":"6","key":"8195_CR36","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1097\/00004583-200106000-00014","volume":"40","author":"BS Peterson","year":"2001","unstructured":"Peterson BS, Pine DS, Cohen P, Brook JS, Prospective (2001) Longitudinal study of tic, Obsessive-Compulsive, and Attention-Deficit\/Hyperactivity disorders in an epidemiological sample. J Am Acad Child Adolesc Psychiatry 40(6):685\u2013695. https:\/\/doi.org\/10.1097\/00004583-200106000-00014","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"4","key":"8195_CR37","doi-asserted-by":"publisher","first-page":"e32068","DOI":"10.1002\/ajmg.c.32068","volume":"193","author":"A Jain","year":"2023","unstructured":"Jain A, Boyd NK, Paulsen KC, Vogel BN, Nguyen L, Santoro JD (2023) Ophthalmologic and neuro-ophthalmologic findings in children with down syndrome. Am J Med Genet C Semin Med Genet 193(4):e32068. https:\/\/doi.org\/10.1002\/ajmg.c.32068","journal-title":"Am J Med Genet C Semin Med Genet"},{"issue":"11","key":"8195_CR38","doi-asserted-by":"publisher","first-page":"1439","DOI":"10.1016\/S0161-6420(90)32399-0","volume":"97","author":"RS Wagner","year":"1990","unstructured":"Wagner RS, Caputo AR, Reynolds RD (1990) Nystagmus in down syndrome. Ophthalmology 97(11):1439\u20131444. https:\/\/doi.org\/10.1016\/S0161-6420(90)32399-0","journal-title":"Ophthalmology"},{"issue":"12","key":"8195_CR39","doi-asserted-by":"publisher","first-page":"1367","DOI":"10.1136\/bjo.86.12.1367","volume":"86","author":"NR Bromham","year":"2002","unstructured":"Bromham NR, Woodhouse JM, Cregg M, Webb E, Fraser WI (2002) Heart defects and ocular anomalies in children with Down\u2019s syndrome. Br J Ophthalmol 86(12):1367. https:\/\/doi.org\/10.1136\/bjo.86.12.1367","journal-title":"Br J Ophthalmol"},{"issue":"2","key":"8195_CR40","doi-asserted-by":"publisher","first-page":"123","DOI":"10.3109\/09286586.2015.1017652","volume":"22","author":"A Ljubic","year":"2015","unstructured":"Ljubic A, Trajkovski V, Tesic M, Tojtovska B, Stankovic B (2015) Ophthalmic manifestations in children and young adults with down syndrome and congenital heart defects. Ophthalmic Epidemiol 22(2):123\u2013129. https:\/\/doi.org\/10.3109\/09286586.2015.1017652","journal-title":"Ophthalmic Epidemiol"},{"issue":"5","key":"8195_CR41","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1016\/j.pediatrneurol.2003.09.011","volume":"29","author":"SM Shapiro","year":"2003","unstructured":"Shapiro SM (2003) Bilirubin toxicity in the developing nervous system. Pediatr Neurol 29(5):410\u2013421. https:\/\/doi.org\/10.1016\/j.pediatrneurol.2003.09.011","journal-title":"Pediatr Neurol"},{"key":"8195_CR42","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1016\/j.jpeds.2019.12.039","volume":"219","author":"TM Bahr","year":"2020","unstructured":"Bahr TM, Henry E, Hulse W et al (2020) Early hyperbilirubinemia in neonates with down syndrome. J Pediatr 219:140\u2013145. https:\/\/doi.org\/10.1016\/j.jpeds.2019.12.039","journal-title":"J Pediatr"},{"issue":"3","key":"8195_CR43","doi-asserted-by":"publisher","first-page":"1301","DOI":"10.1167\/iovs.15-18532","volume":"57","author":"AH Weiss","year":"2016","unstructured":"Weiss AH, Kelly JP, Phillips JO (2016) Infantile nystagmus and abnormalities of conjugate eye movements in down syndrome. Invest Ophthalmol Vis Sci 57(3):1301\u20131309. https:\/\/doi.org\/10.1167\/iovs.15-18532","journal-title":"Invest Ophthalmol Vis Sci"}],"container-title":["Neurological Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10072-025-08195-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10072-025-08195-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10072-025-08195-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,6]],"date-time":"2025-09-06T14:22:22Z","timestamp":1757168542000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10072-025-08195-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,13]]},"references-count":43,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["8195"],"URL":"https:\/\/doi.org\/10.1007\/s10072-025-08195-7","relation":{},"ISSN":["1590-1874","1590-3478"],"issn-type":[{"value":"1590-1874","type":"print"},{"value":"1590-3478","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,13]]},"assertion":[{"value":"30 September 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 April 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have no conflict of interests related to this publication. The authors have no financial or non-financial interests to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"The research involves human participants.All the participants gave their written informed consent to study participation. In case participants were unable to make decisions or presented a significant cognitive impairment, the consents were signed by a surrogate legal representative.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Research involving human participants and\/or animals"}},{"value":"Study protocols were approved by the Local Ethics Committee of the local health service of Bologna, Italy (1070-2021-SUPER-AUSLBO). All the participants gave their written informed consent to study participation. In case participants were unable to make decisions or presented a significant cognitive impairment, the consents were signed by a surrogate legal representative.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Research involving human participants and\/or animals"}}]}}