Diabetes Therapies for Dementia
AbstractPurpose of reviewType 2 diabetes (T2D) is a well-established risk factor for the development of dementia. Dementia and T2D share some underlying pathophysiology that has led to interest in the potential to repurpose drugs used in the management of T2D to benefit brain health. This review describes the scientific data available on the use of T2D medications for the risk reduction or management of dementia, in people with and without T2D.Recent findingsResults from basic laboratory research support the potential for commonly-used medications for T2D, including those with direct glucose-lowering properties, to have a ...
Source: Current Neurology and Neuroscience Reports - July 12, 2019 Category: Neuroscience Source Type: research

Imaging After Thrombolysis and Thrombectomy: Rationale, Modalities and Management Implications
AbstractPurpose of ReviewUrgent reperfusion treatment with intravenous thrombolysis or mechanical thrombectomy reduces disability after ischaemic stroke. Imaging plays an important role in identifying patients who benefit, particularly in extended time windows. However, the role of post-treatment neuroimaging is less well established. We review recent advances in neuroimaging after reperfusion treatment and provide a practical guide to the options and management implications.Recent FindingsPost-treatment imaging is critical to identify patients with reperfusion-related haemorrhage and oedema requiring intervention. It also...
Source: Current Neurology and Neuroscience Reports - July 6, 2019 Category: Neuroscience Source Type: research

Recent Advancement and Clinical Implications of 18FDG-PET in Parkinson ’s Disease, Atypical Parkinsonisms, and Other Movement Disorders
This article reviews FDG-PET studies in Parkinson ’s disease (PD), atypical parkinsonism (AP), Huntington’s disease (HD), and dystonia.Recent FindingsThe metabolic pattern of PD, disease progression, non-motor symptoms such as fatigue, depression, apathy, impulse control disorders, and cognitive impairment, and the risk of progression to dementia have been identified with FDG-PET studies. In prodromal PD, the REM sleep behavior disorder-related covariance pattern has been described. In AP, FDG-PET studies have demonstrated to be superior to D2/D3 SPECT in differentiating PD from AP. The metabolic patterns of HD...
Source: Current Neurology and Neuroscience Reports - June 29, 2019 Category: Neuroscience Source Type: research

Update on Restless Legs Syndrome: from Mechanisms to Treatment
AbstractPurpose of ReviewTo provide an overview of the molecular pathways and recent genetic risk loci associated with restless legs syndrome/Willis-Ekbom disease (RLS/WED) and describe the most recent treatment guidelines.Recent FindingsDiagnostic criteria for RLS/WED now include a fifth criterion to differentiate from RLS/WED mimics. Our understanding of disease pathophysiology has improved, specifically regarding iron regulation in the brain and the role of other pathways such as opioid signaling and brain and spinal cord circuitry may play. Finally, several genetic risk loci have been described, includingMEIS1 which is...
Source: Current Neurology and Neuroscience Reports - June 27, 2019 Category: Neuroscience Source Type: research

Multivariate Approaches to Understanding Aphasia and its Neural Substrates
AbstractPurpose of ReviewAphasia is often characterized in terms of subtype and severity, yet these constructs have limited explanatory power, because aphasia is inherently multifactorial both in its neural substrates and in its symptomatology. The purpose of this review is to survey current and emerging multivariate approaches to understanding aphasia.Recent FindingsTechniques such as factor analysis and principal component analysis have been used to define latent underlying factors that can account for performance on batteries of speech and language tests, and for characteristics of spontaneous speech production. Multiva...
Source: Current Neurology and Neuroscience Reports - June 27, 2019 Category: Neuroscience Source Type: research

Delusional Misidentification of the Mirror Image
AbstractPurpose of ReviewDelusional misidentification syndromes (DMS) include conditions in which a false belief about the identity of a person, place, or object occurs in the context of psychiatric or neurological disorders. One form of DMS involves the delusion that the patient ’s mirror image is a separate individual. This review of reported cases characterizes the psychiatric, neuropathological, and neuropsychological aspects of DMS for the mirror image. An individual case presentation highlights the patient’s subjective experience. Finally, the impact of this syndro me on the sense of self is considered.Re...
Source: Current Neurology and Neuroscience Reports - June 27, 2019 Category: Neuroscience Source Type: research

Hereditary Sensory and Autonomic Neuropathies: Adding More to the Classification
AbstractPurpose of ReviewHereditary sensory and autonomic neuropathies (HSANs) are a clinically heterogeneous group of inherited neuropathies featuring prominent sensory and autonomic involvement. Classification of HSAN is based on mode of inheritance, genetic mutation, and phenotype. In this review, we discuss the recent additions to this classification and the important updates on management with a special focus on the recently investigated disease-modifying agents.Recent FindingsIn this past decade, three more HSAN types were added to the classification creating even more diversity in the genotype –phenotype. Clin...
Source: Current Neurology and Neuroscience Reports - June 20, 2019 Category: Neuroscience Source Type: research

Role of Cerebral Microbleeds for Intracerebral Haemorrhage and Dementia
AbstractPurpose of ReviewCerebral microbleeds (CMB) —small round or ovoid lesions detected in hyposignal on blood-sensitive MRI sequences—are promising radiological biomarkers of cerebral small vessel disease. Their relations with ischaemic or haemorragic stroke and their potential contribution to dementia have been extensively addressed. This ar ticle reviews recent research on the clinical significance of CMB that remains to be determined.Recent FindingsThe presence, burden and location of CMB allow to obtain a more accurate estimate of intracerebral haemorrhage and ischaemic stroke risk. Most studies evaluat...
Source: Current Neurology and Neuroscience Reports - June 19, 2019 Category: Neuroscience Source Type: research

Functional MRI to Study Gait Impairment in Parkinson ’s Disease: a Systematic Review and Exploratory ALE Meta-Analysis
AbstractPurpose of ReviewWhilst gait impairment is a main cause for disability in Parkinson ’s disease (PD), its neural control remains poorly understood. We performed a systematic review and meta-analysis of neuroimaging studies of surrogate features of gait in PD.FindingsAssessing the results from PET or SPECT scans after a period of actual walking as well as fMRI during mental imagery or virtual reality (VR) gait paradigms, we found a varying pattern of gait-related brain activity. Overall, a decrease in activation of the SMA during gait was found in PD compared to elderly controls. In addition, the meta-analysis ...
Source: Current Neurology and Neuroscience Reports - June 18, 2019 Category: Neuroscience Source Type: research

Structural Imaging in Parkinson ’s Disease: New Developments
AbstractPurpose of ReviewTo review the advances in structural imaging for the diagnosis, prognosis, and treatment of Parkinson ’s disease (PD) during the last 5 years.Recent FindingsStructural imaging using high-field MRI ( ≥ 3 T) and new MR sequences sensitive to iron and nigral pigments have achieved to assess in vivo pathological surrogates useful for PD diagnosis (notably decreased nigral neuromelanin and loss of dorsal nigral hyperintensity, increased nigral iron content, diffusivity, and free-water), prodrom al diagnosis (decreased neuromelanin signal in the locus coeruleus), and PD progress...
Source: Current Neurology and Neuroscience Reports - June 18, 2019 Category: Neuroscience Source Type: research

Paroxysmal Movement Disorders: Recent Advances
AbstractPurpose of ReviewRecent advancements in next-generation sequencing (NGS) have enabled techniques such as whole exome sequencing (WES) and whole genome sequencing (WGS) to be used to study paroxysmal movement disorders (PMDs). This review summarizes how the recent genetic advances have altered our understanding of the pathophysiology and treatment of the PMDs. Recently described disease entities are also discussed.Recent FindingsWith the recognition of the phenotypic and genotypic heterogeneity that occurs amongst the PMDs, an increasing number of gene mutations are now implicated to cause the disorders. PMDs can al...
Source: Current Neurology and Neuroscience Reports - June 11, 2019 Category: Neuroscience Source Type: research

Primary Stabbing Headache
AbstractPurpose of ReviewTo provide a comprehensive and updated review of the literature on primary stabbing headache.Recent FindingsChanges to theICHD-3 criteria have resulted in increased sensitivity to capture primary stabbing headache (PSH). According to theICHD-3, the sharp stabbing pain is no longer restricted to the first division of the trigeminal nerve. Age, gender, and co-morbidities such as migraine seem to influence the prevalence of PSH. Subclassification into monophasic, intermittent, and chronic forms have been proposed in a recent prospective study and may be helpful from a prognostication perspective; howe...
Source: Current Neurology and Neuroscience Reports - June 8, 2019 Category: Neuroscience Source Type: research

Cold Stimulus Headache
AbstractPurpose of ReviewTo provide an updated review on cold stimulus headache.Recent FindingsAge, type of stimulus, comorbidities, and study design but not necessarily gender appear to influence the reported prevalence of cold stimulus headache (CSH). Different cold stimuli appear to provoke different types of CSH. Ice water appears to provoke more frequent and higher pain intensity with a shorter latency compared to CSH provoked by ice cubes.SummaryCold stimulus headache is very common unusual headache with limited literature. The severity, frequency, and latency appear to be influenced by the speed and size of the expo...
Source: Current Neurology and Neuroscience Reports - June 6, 2019 Category: Neuroscience Source Type: research

Tau Imaging in Neurodegenerative Diseases Using Positron Emission Tomography
AbstractPurpose of ReviewAbnormal accumulation of tau protein is the main hallmark of tauopathies and is closely associated with neurodegeneration and cognitive impairment, whereas the advance in PET imaging provides a non-invasive detection of tau inclusions in the brain. In this review, we discuss the potential of PET imaging as a biomarker in tauopathies, the latest development of novel tau tracers with new clinical information that has been disclosed, and the opportunities for improving diagnosis and designing clinical trials in the future.Recent FindingsIn recent years, several first-generation tau PET tracers includi...
Source: Current Neurology and Neuroscience Reports - June 6, 2019 Category: Neuroscience Source Type: research

Neuroimaging Technological Advancements for Targeting in Functional Neurosurgery
This article reviews recent neuroimaging advancements for targeting in movement disorders.Recent FindingsDedicated MRI sequences can often visualize to some degree anatomical structures commonly targeted during DBS surgery, including at 1.5-T field strengths. Due to recent technological advancements, MR images using ultra-high magnetic field strengths and new acquisition parameters allow for markedly improved visualization of common movement disorder targets. In addition, novel neuroimaging techniques have enabled group-level analysis of DBS patients and delineation of areas associated with clinical benefits. These areas m...
Source: Current Neurology and Neuroscience Reports - May 30, 2019 Category: Neuroscience Source Type: research

Pharmacological Enhancement of Stroke Recovery
AbstractPurpose of ReviewThis review aims to discuss the recent literature relating to drugs for stroke recovery and to identify some of the challenges in conducting translational research for stroke recovery.Recent FindingsAdvances in our understanding of neural repair mechanisms in pre-clinical stroke models have provided insights into potential targets for drugs that enhance the repair/recovery process. Few drugs that act on serotonergic and dopaminergic systems have been tested in humans with mixed results. The FOCUS trial, a phase III study of early administration of fluoxetine for stroke recovery, failed to replicate...
Source: Current Neurology and Neuroscience Reports - May 30, 2019 Category: Neuroscience Source Type: research

Face Recognition
AbstractPurpose of ReviewFunctional imaging studies, intracranial recordings, and lesion-deficit correlations in neurological patients have produced unique insights into the cognitive mechanisms and neural substrates of face recognition. In this review, we highlight recent advances in the field and integrate data from these complementary lines of research to propose a functional neuroanatomical model of face identity recognition.Recent FindingsRather than being localized to a single specialized cortical region, face recognition is supported by a distributed neural network. Core components of the network include face-select...
Source: Current Neurology and Neuroscience Reports - May 30, 2019 Category: Neuroscience Source Type: research

Sleep and Tension-Type Headache
AbstractPurpose of ReviewTension-type headache (TTH) is a common neurological condition that is related to sleep dysfunction. This review discusses recent evidence for the association between TTH and sleep disturbances.Recent FindingsThere is an increasing evidence for the association of TTH with sleep disturbances including insomnia, poor sleep quality, excessive daytime sleepiness, insufficient sleep, and shift working. Most studies have reported that sleep disturbances are more prevalent among subjects with TTH than among subjects without headaches. Clinical presentations of TTH are more exacerbated in TTH subjects with...
Source: Current Neurology and Neuroscience Reports - May 30, 2019 Category: Neuroscience Source Type: research

Sleep-Disordered Breathing and Idiopathic Normal-Pressure Hydrocephalus: Recent Pathophysiological Advances
This article reviews recent advances in the pathophysiology of iNPH concerning sleep-disordered breathing (SDB) and glymphatic circulation during deep sleep.Recent FindingsThe authors found iNPH frequently associated with obstructive sleep apnea (OSA). A critical factor in iNPH is intracranial venous hypertension delaying drainage of cerebrospinal fluid (CSF) into the cerebral venous sinuses. CSF-venous blood circulates in the jugular veins and finally drains into the heart. During SDB, repeated reflex attempts to breathe induce strong respiratory efforts against a closed glottis thereby increasing the negative intrathorac...
Source: Current Neurology and Neuroscience Reports - May 29, 2019 Category: Neuroscience Source Type: research

Patients on NOACs in the Emergency Room
AbstractPurpose of ReviewDespite the increasing use of NOACs, there is still uncertainty on how to treat NOAC patients presenting with neurological emergencies. Initial assessment of coagulation status is challenging but essential in these patients to provide best-possible treatment in case of ischemic or hemorrhagic stroke. Meanwhile, anticoagulation reversal strategies have been suggested; yet, the optimal management is still unestablished. The current review aims to provide up-to-date information on (i) how to identify patients with NOAC intake, (ii) which therapies are feasible in the setting of ischemic and hemorrhagi...
Source: Current Neurology and Neuroscience Reports - May 29, 2019 Category: Neuroscience Source Type: research

PET Evaluation of Microglial Activation in Non-neurodegenerative Brain Diseases
AbstractPurpose of the ReviewMicroglial cell activation is an important component of neuroinflammation, and it is generally well accepted that chronic microglial activation is indicative of accumulating tissue damage in neurodegenerative conditions, particularly in the earlier stages of disease. Until recently, there has been less focus on the role of neuroinflammation in other forms of neurological and neuropsychiatric conditions. Through this review, we hope to demonstrate the important role TSPO PET imaging has played in illuminating the pivotal role of neuroinflammation and microglial activation underpinning these cond...
Source: Current Neurology and Neuroscience Reports - May 28, 2019 Category: Neuroscience Source Type: research

Incidence, Implications, and Management of Seizures Following Ischemic and Hemorrhagic Stroke
AbstractPurpose of ReviewIn this review, we summarize the recent literature regarding the incidence and treatment of seizures arising after ischemic and hemorrhagic strokes. Additionally, we identify open questions in guidelines and standard clinical care to aid future studies aiming to improve management of seizures in post-stroke patients.Recent FindingsStudies demonstrate an increasing prevalence of seizures following strokes, probably a consequence of advances in post-stroke management and expanding use of continuous EEG monitoring. Post-stroke seizures are associated with longer hospitalization and increased mortality...
Source: Current Neurology and Neuroscience Reports - May 27, 2019 Category: Neuroscience Source Type: research

Correction to: Management of Blood Pressure after Acute Ischemic Stroke
The original version of this article unfortunately contained a mistake. (Source: Current Neurology and Neuroscience Reports)
Source: Current Neurology and Neuroscience Reports - May 25, 2019 Category: Neuroscience Source Type: research

Epilepsy Education: Recent Advances and Future Directions
AbstractPurpose of ReviewThe goal of this review is to survey the current literature on education in epilepsy and provide the most up-to-date information for physicians involved in the training of future doctors on this topic. We intended to review what opportunities exist to enhance our current teaching practices that may not be well-known or widely used, but may be adapted to a broader audience.Recent FindingsMany new techniques adopting principles of education (e.g., retrieval practice and spaced learning) or new technologies (e.g., pre-recorded lectures, computer-enhanced modules, and simulation practice) have been tri...
Source: Current Neurology and Neuroscience Reports - May 23, 2019 Category: Neuroscience Source Type: research

Genetic Disorders of Manganese Metabolism
This article provides an overview of the pathogenesis, clinical presentation and treatment of inherited manganese transporter defects.Recent FindingsIdentification of a new group of manganese transportopathies has greatly advanced our understanding of how manganese homeostasis is regulatedin vivo. While the manganese efflux transporter SLC30A10 and the uptake transporter SLC39A14 work synergistically to reduce the manganese load, SLC39A8 has an opposing function facilitating manganese uptake into the organism. Bi-allelic mutations in any of these transporter proteins disrupt the manganese equilibrium and lead to neurologic...
Source: Current Neurology and Neuroscience Reports - May 14, 2019 Category: Neuroscience Source Type: research

The Use of Caffeine by People with Epilepsy: the Myths and the Evidence
AbstractPurpose of ReviewCaffeine is the most widely consumed central nervous stimulant. For people with epilepsy, it is often unclear whether drinking coffee carries a risk of triggering seizures.Recent FindingsThe relationship between caffeine, seizures, epilepsy, and anti-seizure drugs is not fully understood. Clinical studies are scarce. In animal models, caffeine can increase seizure susceptibility but can also protect from seizures. Effects seem dose-dependent and are influenced by the duration of intake and the developmental stage at which caffeine exposure started. Caffeine reduces the efficacy of several anti-seiz...
Source: Current Neurology and Neuroscience Reports - May 14, 2019 Category: Neuroscience Source Type: research

Early Secondary Prevention in Transient Ischemic Attack (TIA) and Minor Stroke
AbstractPurpose of ReviewThe purpose of this study was to review recent literature on the early secondary prevention in transient ischemic attack (TIA) and minor stroke.Recent FindingsThe result of Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events and the secondary analysis of Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke (POINT) have shown that treatment with clopidogrel and aspirin for 21  days reduced the risk of recurrent stroke with no significant increase in bleeding risk. Triple antiplatelet therapy with aspirin, clopidogrel, and dipyridamole resulted in a sign...
Source: Current Neurology and Neuroscience Reports - May 14, 2019 Category: Neuroscience Source Type: research

Comparing the Wada Test and Functional MRI for the Presurgical Evaluation of Memory in Temporal Lobe Epilepsy
AbstractPurpose of ReviewThe usefulness of the Wada test (WT) predicting memory impairment from temporal lobe epilepsy (TLE) surgery has been debated, and it has progressively been replaced by functional MRI (fMRI). We review the current role of WT and fMRI in the presurgical assessment of TLE, and how novel surgical techniques might improve cognitive outcomes.Recent FindingsfMRI ’s ability to predict global amnesia has not been assessed. Although WT can produce false-positive results, it is still indicated in patients at risk for developing global amnesia: those with significant bilateral or contralateral memory def...
Source: Current Neurology and Neuroscience Reports - May 1, 2019 Category: Neuroscience Source Type: research

Global Health and Epilepsy: Update and Future Directions
AbstractPurpose of ReviewEfforts to improve epilepsy care outcomes in low- and middle-income countries (LMICs) are occurring through global health work. Despite an increase in these efforts, several barriers exist and a significant epilepsy treatment gap remains. This paper will review barriers to epilepsy care in LMICs and summarize recent published and unpublished data about global health projects which aimed to improve epilepsy care in these regions, focusing on work in the past 5  years.Recent FindingsThere are multiple recent and ongoing projects including clinical, research, education, and advocacy programs.Summ...
Source: Current Neurology and Neuroscience Reports - May 1, 2019 Category: Neuroscience Source Type: research

Management of Blood Pressure After Acute Ischemic Stroke
AbstractPurpose of ReviewThe present manuscript examines the significance of blood pressure elevation in patients with acute ischemic stroke, the physiologic principles worthy of consideration during its treatment, and the recent empirical evidence that should guide management protocols. It also provides a sound and practical approach to treatment along the time continuum, with particular relevance to reperfusion strategies.Recent FindingsThe existing evidence shows that both insufficient and excessive blood pressures are detrimental to the outcome of patients with acute ischemic stroke. This “U-shaped” relatio...
Source: Current Neurology and Neuroscience Reports - April 29, 2019 Category: Neuroscience Source Type: research

Secondary Headaches During Pregnancy: When to Worry
This article reviews recent research into distinguishing worrisome vs non-worrisome headache presentations during pregnancy.Recent FindingsRecent research suggests that secondary causes of headache are highly prevalent during pregnancy, in between 25 and 42.4% of women seeking medical attention. Secondary causes of headache in pregnancy are most commonly homeostatic disturbances and hypertensive disorders of pregnancy, vascular problems, space-occupying lesions, and infections. Migraine itself also increases the risk of hypertensive disorders of pregnancy. Specific red flags for a secondary cause of headache in pregnancy i...
Source: Current Neurology and Neuroscience Reports - April 22, 2019 Category: Neuroscience Source Type: research

The Impact of Physical Activity Before and After Stroke on Stroke Risk and Recovery: a Narrative Review
AbstractPurpose of the ReviewSummarising the evidence for pre- and post-stroke physical activity (PA) and exercise to reduce stroke risk, and improve recovery and brain health.Recent FindingsPre-stroke PA reduces the risk of stroke, and post-stroke PA and exercise reduce cardiovascular risk factors, which can moderate the risk of recurrent strokes. Pre-clinical evidence indicates that exercise enhances neuroplasticity. The results from clinical studies showed that exercise changes brain activity patterns in stroke survivors, which can be a signal neuroplasticity. The intensity of pre- and post-stroke PA and exercise is a k...
Source: Current Neurology and Neuroscience Reports - April 22, 2019 Category: Neuroscience Source Type: research

Nummular Headache
This article reviews nummular headache (NH), including the latest literature on the epidemiological and clinical features, the most recent proposed pathophysiology, and novel management.Recent FindingsNH is characterized by continuous or intermittent head pain confined to a focal circumscribed area (1 –6 cm in diameter). It is usually of mild to moderate intensity, although some patients have severe continuous pain or disabling exacerbations. NH is a primary headache, though many secondary cases have been described. Evaluation requires exclusion of systemic and structural diseases. Gabapentin can be recommended ...
Source: Current Neurology and Neuroscience Reports - April 17, 2019 Category: Neuroscience Source Type: research

Update on the Clinical Approach to Spatial Neglect
This article addresses the implementation gap in identifying and treating spatial neglect, to reduce disability and improve healthcare costs and burden.Recent FindingsProfessional organizations published recommendations to implement spatial neglect care. Physicians can lead an interdisciplinary team: functionally relevant spatial neglect assessment, evidence-based spatial retraining, and integrated spatial and vision interventions can optimize outcomes. Research also strongly suggests spatial neglect adversely affects motor systems. Spatial neglect therapy might thus “kick-start” rehabilitation and improve para...
Source: Current Neurology and Neuroscience Reports - April 4, 2019 Category: Neuroscience Source Type: research

New and Old TSPO PET Radioligands for Imaging Brain Microglial Activation in Neurodegenerative Disease
AbstractPurpose of ReviewWe will discuss the developments in TSPO PET imaging and the contribution this technique has had to understanding neuroinflammation in vivo, as well as the limitations inherent to the currently available radioligands and the potential future direction.Recent FindingsPositron emission tomography (PET) imaging targeting the translocator protein 18  kDa (TSPO) has led to major advances in understanding the pathological role played by microglia activation and neuroinflammation in a diverse range of neurodegenerative conditions.SummaryThe first-generation radioligand11[C](R)-PK11195 has been the mo...
Source: Current Neurology and Neuroscience Reports - April 2, 2019 Category: Neuroscience Source Type: research

Neurological Complications of Infective Endocarditis
AbstractPurpose of ReviewThe purpose of this narrative review and update is to summarize the current knowledge and provide recent advances on the neurologic complications of infective endocarditis.Recent FindingsNeurological complications occur in about one-fourth of patients with infective endocarditis. Brain MRI represents a major tool for the identification of asymptomatic lesions, which occur in most of the patients with infective endocarditis. The usefulness of systematic brain imaging and the preferred treatment of patients with infective endocarditis and silent brain lesions remains uncertain. The basis of treatment...
Source: Current Neurology and Neuroscience Reports - March 30, 2019 Category: Neuroscience Source Type: research

New Daily Persistent Headache: a Diagnostic and Therapeutic Odyssey
AbstractPurpose of ReviewNew daily persistent headache (NDPH) is a rare primary headache disorder, which often has a refractory clinical course. This narrative review seeks to highlight what is known about the development of NDPH, to outline a diagnostic approach to a patient with new daily headache, and to explore management considerations and potential future therapies for patients diagnosed with NDPH.Recent FindingsInterval work at the level of case series and cohort studies has identified novel triggering factors (e.g., Valsalva), subgroups with unique temporal profiles (e.g., thunderclap onset), psychophysical profile...
Source: Current Neurology and Neuroscience Reports - March 19, 2019 Category: Neuroscience Source Type: research

A Review of Spontaneous Intracranial Hypotension
AbstractPurpose of ReviewSpontaneous intracranial hypotension (SIH) is an underdiagnosed phenomenon predominantly presenting with low cerebrospinal fluid (CSF) pressure and postural headache in setting of CSF leak. The goal of this paper is to provide updates on the pathology, diagnosis, and management of SIH. The utility of multiple imaging modalities and the use of epidural blood patches and fibrin glue polymers are explored.Recent FindingsIn regard to diagnosis, new non-invasive modalities in detection of SIH including transorbital ultrasound and serum biomarkers are found. In addition, increased efficacy of large volum...
Source: Current Neurology and Neuroscience Reports - March 19, 2019 Category: Neuroscience Source Type: research

Occipital Neuralgia and Cervicogenic Headache: Diagnosis and Management
This article reviews the anatomy, clinical features, unique diagnostic considerations, and management approaches relating to ON and CGH.Recent FindingsConservative therapeutic approaches are considered first-line. Anesthetic nerve blocks may have a dual role in both supporting diagnosis and providing pain relief. Newer minimally invasive procedures, such as pulsed radiofrequency (PRF) and occipital nerve stimulation (ONS), represent an exciting therapeutic avenue for severe/refractory cases. Surgical interventions should be reserved for select patient populations who have failed all other conservative and minimally invasiv...
Source: Current Neurology and Neuroscience Reports - March 19, 2019 Category: Neuroscience Source Type: research

Perceptual Postural Imbalance and Visual Vertigo
AbstractPurpose of ReviewDisorders of posture and balance cause significant patient morbidity, with reduction of quality of life as patients refrain from critical activities of daily living such as walking outside the home and driving. This review describes recent efforts to characterize visual disorders that interact with the neural integrators of positional maintenance and emerging therapies for these disorders.Recent FindingsAbnormalities of gait and body position sense may be unrecognized by patients but are correlated with focal neurological injury (stroke). Patients with traumatic brain injury can exhibit visual vert...
Source: Current Neurology and Neuroscience Reports - March 16, 2019 Category: Neuroscience Source Type: research

Update on the Genetics of Spastic Paraplegias
AbstractPurpose of ReviewHereditary spastic paraplegias are a genetically heterogeneous group of neurological disorders. Patients present lower limb weakness and spasticity, complicated in complex forms by additional neurological signs. We review here the major steps toward understanding the molecular basis of these diseases made over the last 10  years.Recent FindingsOur perception of the intricate connections between clinical, genetic, and molecular aspects of neurodegenerative disorders has radically changed in recent years, thanks to improvements in genetic approaches. This is particularly true for hereditary spas...
Source: Current Neurology and Neuroscience Reports - February 28, 2019 Category: Neuroscience Source Type: research

Neurologic Complications of Sickle Cell Disease
AbstractPurpose of ReviewSickle cell anemia is a multiorgan disease with acute and chronic complications. Involvement of the central nervous system (CNS) is associated with increased mortality and morbidity. This review highlights the broad spectrum of neurological complications seen in patients with sickle cell disease.Recent FindingsIncreasing recognition of neurological complications has led to improved diagnostic and treatment options throughout the years. Neurologic complications in sickle cell disease include silent cerebral ischemia, ischemic/hemorrhagic stroke, moyamoya syndrome, posterior reversible encephalopathy...
Source: Current Neurology and Neuroscience Reports - February 28, 2019 Category: Neuroscience Source Type: research

Intractable Generalized Epilepsy: Therapeutic Approaches
AbstractPurpose of ReviewTo summarize recent developments in therapeutic options, both medical and surgical, for patients with drug-resistant generalized epilepsy syndromes, which continue to be a multifaceted challenge for patients and physicians.Recent FindingsNewer generation pharmaceutical options are now available, such as brivaracetam, rufinamide, lacosamide, perampanel, and cannabidiol. Less restrictive dietary options appear to be nearly as effective as classic ketogenic diet for amelioration of seizures. The latest implantable devices include responsive neurostimulation and deep brain stimulation. Corpus callosoto...
Source: Current Neurology and Neuroscience Reports - February 26, 2019 Category: Neuroscience Source Type: research

Neurological Complications of Cardiac Tumors
This article reviews recent literature regarding the neurological manifestations of cardiac tumors, including diagnosis, pathophysiology, and treatment.Recent FindingsClinical cases of patients with acute ischemic stroke due to cardiac tumors who were treated with intravenous alteplase show a favorable safety profile. Mechanical thrombectomy seems to be a reasonable treatment alternative for these patients, when there is a large vessel occlusion. Histopathology analysis of mechanical thrombectomy specimens may allow the diagnosis of a cardiac tumor. Prolonged time interval between stroke and tumor excision surgery is signi...
Source: Current Neurology and Neuroscience Reports - February 26, 2019 Category: Neuroscience Source Type: research

Should We Care About Early Post-Stroke Rehabilitation? Not Yet, but Soon
AbstractPurpose of ReviewStudies in humans and animal models show that most recovery from impairment occurs in the first 1 –3 months after stroke as a result of both spontaneous recovery as well as increased responsiveness to enriched environments and training. Improvement from impairment is attributable to a short-lived “sensitive period” of post-stroke plasticity defined by unique genetic, physiological, and st ructural events. Unfortunately, rehabilitative interventions in humans have not been able to exploit this sensitive period similar to that seen in animal models. Here, we review these data a...
Source: Current Neurology and Neuroscience Reports - February 20, 2019 Category: Neuroscience Source Type: research

Neurologic Complications of Fat Embolism Syndrome
This article reviews the history, pathophysiology, clinical features, diagnosis, and treatment of FES with a focus on its neurologic aspects.Recent FindingsThe neurologic complications of FES are more commonly recognized with current diagnostic testing and increase awareness of the disorder. FES may present initially with neurologic manifestations. Prompt diagnosis of FES and of its neurologic manifestations could be lifesaving. This includes respiratory support and management of neurological complications.SummaryThe classic clinical triad of pulmonary insufficiency, neurologic disturbances, and petechial skin rash typical...
Source: Current Neurology and Neuroscience Reports - February 20, 2019 Category: Neuroscience Source Type: research

Protean Neurologic Manifestations of Two Rare Dermatologic Disorders: Sweet Disease and Localized Craniofacial Scleroderma
AbstractPurpose of ReviewTo describe diverse neurologic and neuroradiologic presentations of two rare, immunologically mediated skin conditions: Sweet disease and localized scleroderma (morphea).Recent FindingsCore syndromes of neuro-Sweet disease (NSD) are steroid responsiveness, recurrent meningitis, and encephalitis. Focal neurologic, neuro-vascular, and neuro-ophthalmologic syndromes have been reported recently in NSD. A variety of steroid-sparing treatments and biologics have been used for relapsing NSD. Localized craniofacial scleroderma is associated with seizures, headaches, and, less commonly, focal deficits and c...
Source: Current Neurology and Neuroscience Reports - February 12, 2019 Category: Neuroscience Source Type: research

Neuroimaging in Functional Movement Disorders
AbstractPurpose of ReviewFunctional movement disorders are common and disabling causes of abnormal movement control. Here, we review the current state of the evidence on the use of neuroimaging in Functional movement disorders, particularly its role in helping to unravel the pathophysiology of this enigmatic condition.Recent FindingsIn recent years, there has been a shift in thinking about functional movement disorder, away from a focus on high-level psychological precipitants as in Freudian conversion theories, or even an implicit belief they are ‘put-on’ for secondary gain. New research has emphasised novel n...
Source: Current Neurology and Neuroscience Reports - February 12, 2019 Category: Neuroscience Source Type: research

Neurological Complications of Cardiological Interventions
AbstractPurpose of ReviewNeurological complications are common during cardiac procedures. The type of procedure influences the profile of neurological complications and their management. In this article, we review the different neurological complications encountered following cardiac procedures, and treatment strategies for managing those complications.Recent FindingsRecent clinical trials have expanded the time window of eligibility for mechanical thrombectomy and intravenous thrombolysis. As a result, more options are now available for the treatment of periprocedural strokes.SummaryEarly recognition of neurological compl...
Source: Current Neurology and Neuroscience Reports - February 9, 2019 Category: Neuroscience Source Type: research

Unbiased Screens for Modifiers of Alpha-Synuclein Toxicity
AbstractPurpose of ReviewWe provide an overview about unbiased screens to identify modifiers of alpha-synuclein ( αSyn)-induced toxicity, present the models and the libraries that have been used for screening, and describe how hits from primary screens were selected and validated.Recent FindingsScreens can be classified as either genetic or chemical compound modifier screens, but a few screens do not fit this classification. Most screens addressing αSyn-induced toxicity, including genome-wide overexpressing and deletion, were performed in yeast. More recently, newer methods such as CRISPR-Cas9 became available ...
Source: Current Neurology and Neuroscience Reports - February 9, 2019 Category: Neuroscience Source Type: research