Cranioplasty Following Severe Traumatic Brain Injury: Role in Neurorecovery
This article reviews recent studies on the effect of cranioplasty on neurological recovery in severe TBI.Recent FindingsRecent findings suggested that cranioplasty has the potential to enhance neurological recovery after severe TBI. Cranioplasty may alleviate cognitive and functional deficits by reinstating the regular cerebrospinal fluid dynamics and improving brain perfusion. Analyses on the effects of cranioplasty timing on neurological recovery likely favor early cranioplasty. Also, materials used during cranioplasty, autologous and exogenous, were suggested to have similar effects in recovery.SummaryAlthough neurologi...
Source: Current Neurology and Neuroscience Reports - October 21, 2021 Category: Neuroscience Source Type: research

COVID-19 and Aphasia
AbstractPurpose of Review Aphasia is an acquired neurological language disorder after brain damages. Persons with aphasia (PWA) are more susceptible to behavioral and emotional implications due to inherent communication and/or cognitive difficulties. Currently, little is known regarding the impact of COVID-19 on PWA.Recent FindingsThere are now growing reports with evidence of neurological and dysexecutive syndromes subsequent to interference of brain functions in acute patients with COVID-19, leading to variable aphasia-like symptoms. COVID-19 affected chronic PWA more in terms of disrupted communication and daily routi...
Source: Current Neurology and Neuroscience Reports - October 21, 2021 Category: Neuroscience Source Type: research

Aphasia in Multilingual Patients
AbstractPurpose of ReviewWe summarize recent published work concerning assessment and treatment of aphasia in bilingual and multilingual people and review current related models of treatment outcomes. As well, we discuss studies that address the recently debated topic of cognitive processes in bilingual individuals with aphasia, with a focus on the effects of bilingualism on aphasia recovery and its potential protective effects.Recent FindingsProviding assessment and treatment tools that best serve multilingual individuals with aphasia and unpacking the variables and mechanisms that underlie response to treatment have emer...
Source: Current Neurology and Neuroscience Reports - October 21, 2021 Category: Neuroscience Source Type: research

Neurological Complications of Pulmonary Embolism: a Literature Review
AbstractPurpose of ReviewThe present review discusses in-depth about neurological complications following acute venous thromboembolism (VTE).Recent FindingsIntracranial hemorrhage, acute ischemic cerebrovascular events, and VTE in brain tumors are described as central nervous system (CNS) complications of PE, while peripheral neuropathy and neuropathic pain are reported as peripheral nervous system (PNS) sequelae of PE. Syncope and seizure are illustrated as atypical neurological presentations of PE.SummaryMounting evidence suggests higher risk of venous thromboembolism (VTE) in patients with neurological diseases, but dat...
Source: Current Neurology and Neuroscience Reports - October 20, 2021 Category: Neuroscience Source Type: research

Color Vision Deficits
AbstractPurpose of ReviewColor provides important information about the identity of the objects we encounter. After early processing stages in the retinal cones, thalamus, and occipital cortex, retinal signals reach the ventral temporal cortex for high-level color and object processing, which links color perception with top-down expectations and knowledge. In the language-dominant hemisphere, some of these regions communicate with the language systems; by assigning verbal labels to percepts, these circuits speed up stimulus categorization, and permit fast and accurate inter-individual communication. This paper provides a r...
Source: Current Neurology and Neuroscience Reports - October 4, 2021 Category: Neuroscience Source Type: research

Current Understanding of the Pathophysiology and Approach to Tension-Type Headache
AbstractPurpose of ReviewDescription of headache dates back thousands of years, and to date, tension-type headache (TTH) remains the most common form of headache. We will review the history and current understanding of the pathophysiology of TTH and discuss the recommended clinical evaluation and management for this syndrome.Recent FindingsDespite being the most prevalent headache disorder, TTH pathophysiology remains poorly understood. Patients with TTH tend to have muscles that are harder, more tender to palpation, and may have more frequent trigger points of tenderness than patients without headache. However, cause and ...
Source: Current Neurology and Neuroscience Reports - October 2, 2021 Category: Neuroscience Source Type: research

Management of Intracerebral Hemorrhage: Update and Future Therapies
AbstractPurpose of ReviewIntracerebral hemorrhage (ICH) represents about 15% of all strokes in the USA, but almost 50% of fatal strokes. There are many causes of ICH, but the most common are hypertension and cerebral amyloid angiopathy. This review will discuss new advances in the treatment of intracerebral hemorrhage.Recent FindingsThe treatment of ICH focuses on management of edema, aggressive blood pressure reduction, and correction of coagulopathy. Early initiation of supportive medical therapies, including blood pressure management, in a neurological intensive care unit reduces mortality, but at present there is no de...
Source: Current Neurology and Neuroscience Reports - October 2, 2021 Category: Neuroscience Source Type: research

The Ties that Bind: Agnosia, Neglect and Selective Attention to Visual Scale
AbstractPurpose of ReviewHistorical and contemporary treatments of visual agnosia and neglect regard these disorders as largely unrelated. It is thought that damage to different neural processes leads directly to one or the other condition, yet apperceptive variants of agnosia and object-centered variants of neglect share remarkably similar deficits in the quality of conscious experience. Here we argue for a closer association between “apperceptive” variants of visual agnosia and “object-centered” variants of visual neglect. We introduce a theoretical framework for understanding these conditions bas...
Source: Current Neurology and Neuroscience Reports - September 29, 2021 Category: Neuroscience Source Type: research

Dietary Insights in Neurological Diseases
This article describes the most common and impactful dietary regimens for commonly encountered neurological disorders.Recent FindingsPlant-based, low-fat, high-fiber diets, rich in antioxidants and other lifestyle interventions may reduce the burden and disability of common neurological disorders. The ketogenic diet, the diet of choice for the treatment of refractory epilepsy, is such an example.SummaryDiverse neurological disorders demonstrate several common pathophysiological mechanisms including increased oxidative stress, neuroinflammation, and disrupted metabolism. Dietary interventions can potentially influence these...
Source: Current Neurology and Neuroscience Reports - September 29, 2021 Category: Neuroscience Source Type: research

Molecular Imaging of the Cholinergic System in Alzheimer and Lewy Body Dementias: Expanding Views
AbstractPurpose of ReviewBrain cholinergic denervation is a major feature of Alzheimer ’s disease (AD) and dementia with Lewy bodies (DLB). We reviewed the topography assessed by a cholinergic molecular imaging study in these two major types of dementia. A small meta-analysis directly comparing vesicular acetylcholine transporter (VAChT) PET scans of AD vs. DLB patients is presented .Recent FindingsVAChT PET studies showed evidence of extensive cortical cholinergic denervation in both forms of dementia, while multiple subcortical structures were also in DLB. Novel analysis revealed evidence of metathalamic denervatio...
Source: Current Neurology and Neuroscience Reports - September 20, 2021 Category: Neuroscience Source Type: research

Medical and Neurological Management of Brain Tumor Complications
This article reviews the medical and neurological conditions that commonly complicate the disease course of brain tumors patients.Recent FindingsVarious mechanisms have been newly identified to be involved in the pathophysiology of seizures and brain edema and can help advance the treatment of such complications. There have also been new developments in the management of thromboembolic disease and cognitive impairment.SummaryMedical and neurological complications are being identified more often in brain tumor patients with the improved survival provided by therapeutic advances. Early and proper identification and managemen...
Source: Current Neurology and Neuroscience Reports - September 20, 2021 Category: Neuroscience Source Type: research

Cerebrovascular Complications of Anemia
AbstractPurpose of the ReviewAnemia has been called the fifth cardiovascular risk factor. It is one of the most prevalent pathologies worldwide. In this article, we aimed to perform a narrative review of the main cerebrovascular complications of anemia and its influence on stroke prognosis.Recent FindingsBoth hypoproliferative anemia (thalassemia, iron deficiency anemia, etc.) and hyperproliferative anemia (sickle cell disease, paroxysmal nocturnal hemoglobinuria, hereditary spherocytosis, etc.) are associated to cerebrovascular disease ranging from transient ischemic attack to ischemic stroke and hemorrhagic stroke with b...
Source: Current Neurology and Neuroscience Reports - September 3, 2021 Category: Neuroscience Source Type: research

Aneurysmal Subarachnoid Hemorrhage: Review of the Pathophysiology and Management Strategies
AbstractPurpose of ReviewAneurysmal subarachnoid hemorrhage remains a devastating disease process despite medical advances made over the past 3 decades. Much of the focus was on prevention and treatment of vasospasm to reduce delayed cerebral ischemia and improve outcome. In recent years, there has been a shift of focus onto early brain injury as the precursor to delayed cerebral ischemia. This review will focus on the most recent data surrounding the pathophysiology of aneurysmal subarachnoid hemorrhage and current management strategies.Recent FindingsThere is a paucity of successful trials in the management of subarachno...
Source: Current Neurology and Neuroscience Reports - July 26, 2021 Category: Neuroscience Source Type: research

Improving Diagnostic Workup Following Traumatic Spinal Cord Injury: Advances in Biomarkers
AbstractPurpose of ReviewTraumatic spinal cord injury (SCI) is a life-changing event with drastic implications for patients due to sensorimotor impairment and autonomous dysfunction. Current clinical evaluations focus on the assessment of injury level and severity using standardized neurological examinations. However, they fail to predict individual trajectories of recovery, which highlights the need for the development of advanced diagnostics. This narrative review identifies recent advances in the search of clinically relevant biomarkers in the field of SCI.Recent FindingsAdvanced neuroimaging and molecular biomarkers se...
Source: Current Neurology and Neuroscience Reports - July 15, 2021 Category: Neuroscience Source Type: research

Tremor in Primary Monogenic Dystonia
This article reviews research articles reporting tremor in primary monogenic dystonia.Recent FindingsWe searched the MDS gene data and selected all research articles reporting tremor in primary monogenic dystonia. Tremor was reported in nine dystonia genes, namelyDYT-HPCA,DYT-ANO3,DYT-KCTD17,DYT-THAP1,DYT-PRKRA,DYT-GNAL,DYT-TOR1A,DYT-KMT2B, andDYT-SGCE in the descending order of its frequency. HPCA gene mutation is rare, but all reported patients had tremor. Similarly, tremor was reported in eight genes associated with dystonia parkinsonism, namelyDYT-SLC6A3,DYT-TH,DYT-SPR,DYT-PTS,DYT-GCH1,DYT-TAF1,DYT-QDPR, andDYT-SCL30A1...
Source: Current Neurology and Neuroscience Reports - July 15, 2021 Category: Neuroscience Source Type: research

Civilian Firearm-Inflicted Brain Injury: Coagulopathy, Vascular Injuries, and Triage
AbstractPurpose of ReviewCivilian firearm-inflicted penetrating brain injury (PBI) carries high morbidity and mortality. Concurrently, the evidence base guiding management decisions remains limited. Faced with large volume of PBI patients, we have made observations in relation to coagulopathy and cerebrovascular injuries. We here review this literature in addition to the question about early prognostication as it may inform neurosurgical decision-making.Recent FindingsThe triad of coagulopathy, low motor score, and radiographic compression of basal cisterns comprises a phenotype of injury with exceedingly high mortality. P...
Source: Current Neurology and Neuroscience Reports - July 10, 2021 Category: Neuroscience Source Type: research

A Lifecourse Perspective on Female Sex-Specific Risk Factors for Later Life Cognition
AbstractPurpose of ReviewThe prevalence of Alzheimer ’s disease and related dementias is greater in women compared to men. We provide a review of female sex-specific risk factors across the lifecourse for cognition in older adulthood, highlighting areas that need further study.Recent FindingsPregnancy may affect late-life cognition, with adverse pregnancy outcomes associated with an increased risk of cognitive decline but parity providing a protective effect. Cumulative estrogen exposure, influenced by age of menarche, menopause, and exogenous estrogen use, may modify a woman ’s risk for dementia. Menopause tra...
Source: Current Neurology and Neuroscience Reports - July 6, 2021 Category: Neuroscience Source Type: research

The More, the Better: High-Dose Omega-3 Fatty Acids Improve Behavioural and Molecular Outcomes in Preclinical Models in Mild Brain Injury
AbstractPurpose of ReviewMild traumatic brain injury (mTBI) is a continuing healthcare concern worldwide contributing to significant cognitive and neurological impairment, consequently affecting activities of daily living. While mTBI recovery is becoming well studied, there are no interventions to reduce the known impairments of mTBI. Omega-3 fatty acids (N-3FA) are safe and beneficial for brain health; however, their potential effects in a pathophysiological environment such as that seen post-mTBI are unknown.Recent FindingsPreclinical studies using rodent models are key to understanding molecular mechanisms underlying im...
Source: Current Neurology and Neuroscience Reports - July 6, 2021 Category: Neuroscience Source Type: research

The Neurological Manifestations of Post-Acute Sequelae of SARS-CoV-2 infection
AbstractPurpose of ReviewCoronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a global health challenge. This review aims to summarize the incidence, risk factors, possible pathophysiology, and proposed management of neurological manifestations of post-acute sequelae of SARS-CoV-2 infection (PASC) or neuro-PASC based on the published literature.Recent FindingsThe National Institutes of Health has noted that PASC is a multi-organ disorder ranging from mild symptoms to an incapacitating state that can last for weeks or longer following recovery from initial infec...
Source: Current Neurology and Neuroscience Reports - June 28, 2021 Category: Neuroscience Source Type: research

Correction to: Neurologic Complications of Poverty: the Associations between Poverty as a Social Determinant of Health and Adverse Neurologic Outcomes
A Correction to this paper has been published:https://doi.org/10.1007/s11910-021-01129-8 (Source: Current Neurology and Neuroscience Reports)
Source: Current Neurology and Neuroscience Reports - June 24, 2021 Category: Neuroscience Source Type: research

Debunking Myths: Sinus Headache
AbstractPurpose of ReviewAlthough sinus headache has been extensively reviewed and described, misdiagnosis remains common. This paper discusses the myths and truths about sinus headaches.Recent FindingsSinus headache is used colloquially to attribute facial pain to allergies or a sinus infection; however, most sinus headaches are migraine. Sinus-region pain from sinusitis and migraine share the same origins in the trigeminovascular system, but their causes are very different. After reviewing sinus anatomy and sinogenic pain, we provide information to assist clinicians in correctly diagnosing patients with the additional go...
Source: Current Neurology and Neuroscience Reports - June 20, 2021 Category: Neuroscience Source Type: research

Neurologic Manifestations of the Antiphospholipid Syndrome — an Update
AbstractPurpose of ReviewIn recent years, the spectrum of neurological manifestations of antiphospholipid syndrome (APS) has been growing. We provide a critical review of the literature with special emphasis on presentation, proposed mechanisms of disease, and treatment of neurological involvement in APS.Recent FindingsAlthough stroke is the most common cause of neurological manifestations in patients with APS, other neurological disorders have been increasingly associated with the disease, including cognitive dysfunction, headache, and epilepsy. Direct oral anticoagulants have failed to show non-inferiority compared to vi...
Source: Current Neurology and Neuroscience Reports - June 14, 2021 Category: Neuroscience Source Type: research

The History of Amnesia —a Review
AbstractPurpose of ReviewThis review traces amnesia ’s history from its earliest eighteenth century classification as a medical disorder to the present. Sophisticated depictions in the nineteenth century literature containing elaborate compilations of causal factors, including neurologic, consider pathogenesis, course, duration, durability, and tem poral features.Recent FindingsSevere amnesia, especially anterograde involving new learning, found archetypal expression in the twentieth century, in the case of H.M. The “pure” amnesia confirmed an independent memory disorder distinct from other cognitive dist...
Source: Current Neurology and Neuroscience Reports - June 10, 2021 Category: Neuroscience Source Type: research

Critical Appraisal of Amyloid Lowering Agents in AD
AbstractPurpose of ReviewAccording to the amyloid cascade hypothesis, removing amyloid beta (A β) should cure Alzheimer’s disease (AD). In the past three decades, many agents have been tested to try to lower Aβ production, prevent Aβ aggregation, and dissolve Aβ deposits. However, the paucity in definitive preventative or curative properties of these agents in clinical trials has result ed in more avant-garde approaches to therapeutic investigations. Immunotherapy has become an area of focus for research on disease-modifying therapies for neurodegenerative diseases. In this review, we highlight th...
Source: Current Neurology and Neuroscience Reports - June 10, 2021 Category: Neuroscience Source Type: research

Approach to Pediatric Intractable Migraine
AbstractPurpose of ReviewIntractable migraine in children and adolescents is a significant cause of disability and decreased quality of life (QoL) in this population. Challenges include lack of unifying definition for intractable migraine, and limited data on best-practice management in this age group, with most current treatment pathways extrapolated from adult studies or expert consensus.Recent FindingsA comprehensive approach in the evaluation and management of intractable migraine in this age group encompasses excluding secondary causes of headache; making an accurate diagnosis; identifying and appropriately managing m...
Source: Current Neurology and Neuroscience Reports - June 4, 2021 Category: Neuroscience Source Type: research

Central Nervous System Infections in Immunocompromised Patients
This article reviews current epidemiologic trends, clinical presentations, and diagnostic strategies for central nervous system (CNS) infections in human immunodeficiency virus-negative (HIV) patients immunocompromised by their underlying disease or by receipt of immunosuppressive or immunomodulating therapies. Three patient groups are considered: (1) cancer patients; (2) hematopoietic or solid organ transplantation recipients; and (3) patients with autoimmune or inflammatory conditions requiring therapies that alter the host immune response.Recent FindingsClinical presentations, associated neuroimaging, and cerebrospinal ...
Source: Current Neurology and Neuroscience Reports - May 26, 2021 Category: Neuroscience Source Type: research

Infection Mitigation Strategies for Multiple Sclerosis Patients on Oral and Monoclonal Disease-Modifying Therapies
AbstractPurpose of ReviewThe newer, higher-efficacy disease-modifying therapies (DMTs) for multiple sclerosis (MS) —orals and monoclonals—have more profound immunomodulatory and immunosuppressive properties than the older, injectable therapies and require risk mitigation strategies to reduce the risk of serious infections. This review will provide a systematic framework for infectious risk mitigation strateg ies relevant to these therapies.Recent FindingsWe classify risk mitigation strategies according to the following framework: (1) screening and patient selection, (2) vaccinations, (3) antibiotic prophylaxis,...
Source: Current Neurology and Neuroscience Reports - May 19, 2021 Category: Neuroscience Source Type: research

Retinal Migraine: Evaluation and Management
AbstractPurpose of ReviewThis review aims to summarize the last 15 years of literature and case reports detailing retinal migraine —an uncommon and somewhat poorly understood migraine variant.Recent FindingsIn the last 15 years, only 12 cases of retinal migraine have been outlined. Similar to other migraine statistics, retinal migraine appears to affect women more so than men and presents with unilateral headache which tends to be ipsilateral to the side of vision loss. The pathophysiology may relate to vasoconstriction of retinal vessels, as evidenced by ictal fundus photography in the past few years.SummaryRetinal ...
Source: Current Neurology and Neuroscience Reports - May 11, 2021 Category: Neuroscience Source Type: research

Nutraceuticals and Behavioral Therapy for Headache
AbstractPurpose of ReviewHeadache affects and disables at least 1 billion people worldwide. Patients and providers seek new therapies to relieve headache without the side effects and financial burden of current treatments. This narrative review highlights recent treatment advances in integrative headache medicine: nutraceuticals and behavioral therapies.Recent FindingsGrowing use of complementary and alternative medicine (CAM) therapies for headache (riboflavin, coenzyme Q10, magnesium, vitamin D, melatonin) alongside mainstream treatments is increasing with improving evidence of quality, safety, and tolerability. Increasi...
Source: Current Neurology and Neuroscience Reports - May 10, 2021 Category: Neuroscience Source Type: research

Effects of the Menstrual Cycle on Neurological Disorders
AbstractPurpose of ReviewThe menstrual cycle involves recurrent fluctuations in hormone levels and temperature via neuroendocrine feedback loops. This paper reviews the impact of the menstrual cycle on several common neurological conditions, including migraine, seizures, multiple sclerosis, stroke, and Parkinson ’s disease.Recent FindingsThe ovarian steroid hormones, estrogen and progesterone, have protean effects on central nervous system functioning that can impact the likelihood, severity, and presentation of many neurological diseases. Hormonal therapies have been explored as a potential treatment for many neurol...
Source: Current Neurology and Neuroscience Reports - May 10, 2021 Category: Neuroscience Source Type: research

Effects of Obstructive Sleep Apnea and CPAP on Cognitive Function
AbstractPurpose of ReviewObstructive sleep apnea (OSA) is characterized by repetitive episodes of complete or partial upper airway obstruction during sleep. Studies indicate that OSA is an independent risk factor for cognitive decline in older patients. The purpose of this paper is to critically review the recent literature on the cognitive effects of untreated OSA and the benefits of treatment across cognitive domains.Recent FindingsOSA ’s greatest impact appears to be on attention, vigilance, and information processing speed. Furthermore, the presence of OSA seems to have a significant impact on development and pro...
Source: Current Neurology and Neuroscience Reports - May 6, 2021 Category: Neuroscience Source Type: research

Sleep Disorders in Mitochondrial Diseases
AbstractPurpose of ReviewWe aim to summarize the sleep disorders reported in patients affected by primary mitochondrial dysfunctions and describe the association with their clinical and molecular characteristics.Recent FindingsSleep complaints are prevalent in mitochondrial disorders. Sleep-disordered breathing is the main sleep disorder reported in mitochondrial diseases. OSA and CSA are, respectively, more frequently associated with patients characterized by the prevalent involvement of the skeletal muscle and the predominant involvement of the central nervous system. Other sleep disorders, such as restless legs syndrome...
Source: Current Neurology and Neuroscience Reports - May 5, 2021 Category: Neuroscience Source Type: research

Cluster Headache: A Review and Update in Treatment
AbstractPurpose of ReviewThe treatment of cluster headache has evolved to include a handheld neuromodulation device and a monoclonal antibody in addition to more traditional agents.Recent FindingsGalcanezumab is an approved treatment for episodic cluster headache. The non-invasive vagal nerve stimulator has been shown to be effective as a treatment for episodic cluster headache. Dedicated pituitary imaging may not be necessary with a normal MRI of the brain.SummaryCluster headache is the most common trigeminal-autonomic cephalalgia, characterized by unilateral, frequent, debilitating attacks associated with ipsilateral aut...
Source: Current Neurology and Neuroscience Reports - May 5, 2021 Category: Neuroscience Source Type: research

Neurologic Complications of Poverty: the Associations Between Poverty as a Social Determinant of Health and Adverse Neurologic Outcomes
This study summarizes the recent literature on poverty as it contributes to neurological disease.Recent FindingsChildren growing up in poverty have increased risk for cognitive deficits and behavioral disorders as reported by Noble et al. (Dev Sci. 9(6):642 –54, 2006) and Farah et al. (Brain Res. 1110(1):166–74, 2006) as well as worse outcomes when it comes to epilepsy management and disease course as discussed by Camfield et al. (Epilepsia. 57(11):1826–33, 2016). In adulthood, as the number of social determinants of health increases, the inciden ce of stroke and severe stroke increases significantly as r...
Source: Current Neurology and Neuroscience Reports - May 5, 2021 Category: Neuroscience Source Type: research

Economics of Multiple Sclerosis Disease-Modifying Therapies in the USA
AbstractPurpose of ReviewMultiple sclerosis (MS) is a prevalent and debilitating neuroinflammatory disease associated with a significant economic burden. Direct healthcare costs, which can average $70,000 a year, have risen rapidly over the last decade and are driven by the escalating cost of disease-modifying therapies (DMTs). Despite a growing number of DMTs, annual increases in price for most DMTs have commonly exceeded 10% over the last 15 years. The high cost of MS DMTs has created economic hardships for patients in terms of high out-of-pocket costs and insurance company-induced barriers. Although generic versions of ...
Source: Current Neurology and Neuroscience Reports - May 5, 2021 Category: Neuroscience Source Type: research

Telemedicine in Pediatric Headache: A Review and Practical Implementation
AbstractPurpose of ReviewThe purpose of this review was to summarize the current literature about telemedicine in pediatric headache and to provide practical guidance for its implementation.Recent FindingsThere are few studies dedicated to telemedicine in pediatric headache, and existing studies are small. Patients and families report high levels of satisfaction with telemedicine, and most are willing to continue telemedicine visits in the future. Telemedicine demonstrated similar reductions in headache frequency, severity, and duration as patients treated in-person. Remotely delivered psychologic interventions have some u...
Source: Current Neurology and Neuroscience Reports - April 12, 2021 Category: Neuroscience Source Type: research

Chronic Demyelination and Axonal Degeneration in Multiple Sclerosis: Pathogenesis and Therapeutic Implications
AbstractPurpose of ReviewMultiple sclerosis (MS) is the most common demyelinating disease of the central nervous system (CNS). Inflammatory attacks in MS lead to both demyelination and axonal damage. However, due to incomplete remyelination most MS lesions remain chronically demyelinated. In parallel, there is axonal degeneration in the CNS of MS patients, contributing to progressive disability. There are currently no approved therapies that adequately restore myelin or protect axons from degeneration. In this review, we will discuss the pathophysiology of axonal loss and chronic demyelination in MS and how understanding t...
Source: Current Neurology and Neuroscience Reports - April 9, 2021 Category: Neuroscience Source Type: research

Cerebrovascular Complications Associated with Marijuana Use
AbstractPurpose of reviewIn the last few years, the attitude toward marijuana in many parts of the world has shifted from illicit to legalized for medical use and to decriminalized. In parallel, there has been a gradual increase in the consumption of this product in the general population, particularly among adolescents and young adults. Marijuana is generally perceived as a harmless drug. However, data obtained in observational studies and preclinical models have established associations between cannabis use and cardiovascular events. In addition, there is emerging evidence linking marijuana use to cerebrovascular complic...
Source: Current Neurology and Neuroscience Reports - April 7, 2021 Category: Neuroscience Source Type: research

Functional Connectome in Parkinson ’s Disease and Parkinsonism
AbstractPurpose of ReviewThere has been an exponential growth in functional connectomics research in neurodegenerative disorders. This review summarizes the recent findings and limitations of the field in Parkinson ’s disease (PD) and atypical parkinsonian syndromes.Recent FindingsIncreasingly more sophisticated methods ranging from seed-based to network and whole-brain dynamic functional connectivity have been used. Results regarding the disruption in the functional connectome vary considerably based on disease severity and phenotypes, and treatment status in PD. Non-motor symptoms of PD also link to the dysfunction...
Source: Current Neurology and Neuroscience Reports - April 4, 2021 Category: Neuroscience Source Type: research

Sleep Disorders in Patients with Essential Tremor
AbstractPurpose of the ReviewPatients diagnosed with essential tremor (ET) report frequent sleep complaints. This review focuses on the main findings of studies addressing sleep features in patients diagnosed with ET, updating previously reported information.Recent Findings and SummaryBad quality of sleep and excessive daytime somnolence are very frequent in patients with ET, although the effects of the drugs used for the therapy of ET could contribute to these complaints. REM sleep behavior disorder, restless legs, insomnia, and nocturia are frequent complaints as well. There is a lack of studies addressing polysomnograph...
Source: Current Neurology and Neuroscience Reports - March 22, 2021 Category: Neuroscience Source Type: research

Computed Tomography Imaging Predictors of Intracerebral Hemorrhage Expansion
AbstractPurpose of ReviewHematoma expansion (HE) is strongly associated with poor clinical outcome and is a compelling target for improving outcome after intracerebral hemorrhage (ICH). Non-contrast computed tomography (NCCT) is widely used in clinical practice due to its faster acquisition at the presence of acute stroke. Recently, imaging markers on NCCT are increasingly used for predicting HE. We comprehensively review the current evidence on HE prediction using NCCT and provide a summary for assessment of these markers in future research studies.Recent FindingsPredictors of HE on NCCT have been described in reports of ...
Source: Current Neurology and Neuroscience Reports - March 12, 2021 Category: Neuroscience Source Type: research

Neurological Complications of Endocrine Emergencies
AbstractPurpose of ReviewEndocrine disorders are the result of insufficient or excessive hormonal production. The clinical course is long, and the manifestations are nonspecific due to the systemic effect of hormones across many organs and systems including the nervous system. This is a narrative review of the recent evidence of the diagnosis and treatment approach of these medical and neurological emergencies.Recent FindingsWith the possible exception of diabetic ketoacidosis, hyperosmolar hyperglycemic state, and hypoglycemia, endocrinological emergencies are complex, uncommon yet life-threatening conditions with protean...
Source: Current Neurology and Neuroscience Reports - March 11, 2021 Category: Neuroscience Source Type: research

Neurocritical Care of Mechanical Circulatory Support Devices
AbstractPurpose of ReviewMechanical circulatory support (MCS) devices have demonstrated improved survival outcomes in otherwise refractory cardiopulmonary failure but are associated with significant neurologic morbidity and mortality. This review aims to characterize MCS-associated brain injury and discuss the neurocritical care of this population.Recent FindingsWe found no practice guidelines or specific management strategies for the neurocritical care of patients with MCS devices. Acute brain injury was commonly observed in short-term and durable MCS devices. There is emerging evidence that a standardized neurological mo...
Source: Current Neurology and Neuroscience Reports - March 10, 2021 Category: Neuroscience Source Type: research

Genetic Variation and Impact on Outcome in Traumatic Brain Injury: an Overview of Recent Discoveries
AbstractPurpose of ReviewTraumatic brain injury (TBI) has a significant burden of disease worldwide and outcomes vary widely. Current prognostic tools fail to fully account for this variability despite incorporating clinical, radiographic, and biochemical data. This variance could possibly be explained by genotypic differences in the patient population. In this review, we explore single nucleotide polymorphism (SNP) TBI outcome association studies.Recent FindingsIn recent years, SNP association studies in TBI have focused on global, neurocognitive/neuropsychiatric, and physiologic outcomes. While the APOE gene has been the...
Source: Current Neurology and Neuroscience Reports - March 10, 2021 Category: Neuroscience Source Type: research

Management Strategies for Comorbid Supine Hypertension in Patients with Neurogenic Orthostatic Hypotension
This article reviews the pathophysiology and clinical characteristics of nOH and nSH, and describes the management of patients with both nOH and nSH.Recent FindingsPressor medications required to treat the symptoms of nOH also increase the risk of nSH. Because nOH and nSH are hemodynamically opposed, therapies to treat one condition may exacerbate the other. The management of patients with nOH who also have nSH can be challenging and requires an individualized approach to balance the short- and long-term risks associated with these conditions.SummaryApproaches to manage neurogenic BP dysregulation include nonpharmacologic ...
Source: Current Neurology and Neuroscience Reports - March 9, 2021 Category: Neuroscience Source Type: research

The Role of Genetic Testing for Parkinson ’s Disease
AbstractPurpose of ReviewTo describe current practices and attitudes about genetic testing for Parkinson ’s disease (PD) among neurologists, highlight the changing scene of genetic testing for PD, and provide guidance on facilitating PD genetic testing in a clinical practice.Recent FindingsSince the 1990s, researchers have discovered several major gene variants contributing to PD etiology. A large body of literature now exists supporting the frequency of these variants in different populations and their effects on phenotype and clinical course. Recently, clinical trials have emerged with therapies targeting genetic f...
Source: Current Neurology and Neuroscience Reports - March 8, 2021 Category: Neuroscience Source Type: research

Digital Technology in Movement Disorders: Updates, Applications, and Challenges
This article reviews recent literature on the application of digital technology in movement disorders, with a focus on Parkinson ’s disease (PD) and Huntington’s disease.Recent FindingsRecent research has demonstrated the ability for digital technology to discriminate between individuals with and without PD, identify those at high risk for PD, quantify specific motor features, predict clinical events in PD, inform clinical management, and generate novel insights.SummaryDigital technology has enormous potential to transform clinical research and care in movement disorders. However, more work is needed to better ...
Source: Current Neurology and Neuroscience Reports - March 3, 2021 Category: Neuroscience Source Type: research

Challenges and Controversies in the Genetic Diagnosis of Hereditary Spastic Paraplegia
AbstractPurpose of ReviewThe hereditary spastic paraplegias (HSPs) are a group of disorders characterised by progressive lower limb weakness and spasticity. We address the challenges and controversies involved in the genetic diagnosis of HSP.Recent FindingsThere is a large and rapidly expanding list of genes implicated in HSP, making it difficult to keep gene testing panels updated. There is also a high degree of phenotypic overlap between HSP and other disorders, leading to problems in choosing the right panel to analyse. We discuss genetic testing strategies for overcoming these diagnostic hurdles, including the use of t...
Source: Current Neurology and Neuroscience Reports - February 28, 2021 Category: Neuroscience Source Type: research

Telehealth in Multiple Sclerosis Clinical Care and Research
AbstractPurpose of ReviewThe COVID-19 pandemic has provided us with a unique opportunity to experiment with telehealth and evaluate its benefits and limitations. This review discusses the impact of telehealth on multiple sclerosis (MS) care and research in adults and children.Recent FindingsTelehealth visits for MS patients have been shown to reduce missed workdays and costs for patients. Brief telephone-based counseling may be associated with better adherence to disease-modifying therapy, although results of multiple home-based tele-rehabilitation for people with MS have been equivocal. Overall, patients and providers hav...
Source: Current Neurology and Neuroscience Reports - February 28, 2021 Category: Neuroscience Source Type: research

Genetic ataxias: update on classification and diagnostic approaches
AbstractAtaxia encompasses a large group of rare disorders characterized by irregular movements, decreased coordination, imbalance, kinetic tremor, wide-based stance, and dysarthria. Evaluating ataxia can be challenging considering the volume of disorders and their complex pathologies involving diverse genetic and clinical factors. This is a comprehensive review of the genetic ataxia literature, presenting updated guidelines for differential diagnosis. Age, time course, and family history provide initial guidance for evaluation of ataxia. As genetic testing is increasingly utilized, new genes are discovered and phenotypes ...
Source: Current Neurology and Neuroscience Reports - February 26, 2021 Category: Neuroscience Source Type: research