How Relevant Are Imaging Findings in Animal Models of Movement Disorders to Human Disease?
Abstract The combination of novel imaging techniques with the use of small animal models of disease is often used in attempt to understand disease mechanisms, design potential clinical biomarkers and therapeutic interventions, and develop novel methods with translatability to human clinical conditions. However, it is clear that most animal models are deficient when compared to the complexity of human diseases: they cannot sufficiently replicate all the features of multisystem disorders. Furthermore, some practical differences may affect the use or interpretation of animal imaging to model human conditions such as...
Source: Current Neurology and Neuroscience Reports - June 21, 2015 Category: Neuroscience Source Type: research

TMS as a Tool for Examining Cognitive Processing
Abstract Transcranial magnetic stimulation (TMS) is a non-invasive method where an externally placed, rapidly changing magnetic field causes induction of weak electric currents that lead to changes in neuronal polarization and activity. TMS is a modality that has emerged as a unique tool in the study of functional neuroscience for several reasons. TMS can be used to selectively activate or inhibit specific cortical structures, leading to transient perturbations in their function. Systematic study of these perturbations has been employed to determine the function of specific cortical structures and to investigate ...
Source: Current Neurology and Neuroscience Reports - June 20, 2015 Category: Neuroscience Source Type: research

Neural Mechanisms Underlying Musical Pitch Perception and Clinical Applications Including Developmental Dyslexia
Abstract Music production and perception invoke a complex set of cognitive functions that rely on the integration of sensorimotor, cognitive, and emotional pathways. Pitch is a fundamental perceptual attribute of sound and a building block for both music and speech. Although the cerebral processing of pitch is not completely understood, recent advances in imaging and electrophysiology have provided insight into the functional and anatomical pathways of pitch processing. This review examines the current understanding of pitch processing and behavioral and neural variations that give rise to difficulties in pitch p...
Source: Current Neurology and Neuroscience Reports - June 20, 2015 Category: Neuroscience Source Type: research

Neurologic Complications of Chronic Kidney Disease
Abstract Chronic kidney disease (CKD) is an increasing problem worldwide and is now being recognized as a global health burden particularly for cardiovascular and cerebrovascular events. The incidence of stroke increases in the presence of CKD with a 3-fold increased rate reported in ESRD. Atrial fibrillation (AF) increases the risk of stroke in CKD. There is conflicting observational evidence regarding benefit of anticoagulation in CKD for prevention of stroke in AF as risk of bleeding is high. Overall, anticoagulant in CKD may be beneficial in appropriate patients with meticulous monitoring of international nor...
Source: Current Neurology and Neuroscience Reports - June 18, 2015 Category: Neuroscience Source Type: research

Update in Aphasia Research
Abstract The sequelae of post-stroke aphasia are considerable, with implications at the societal and personal levels. An understanding of the mechanisms of recovery of cognitive and language processes after stroke and the factors associated with increased risk of post-stroke language and cognitive deficits is vital in providing optimal care of individuals with aphasia and in counseling to their families and caregivers. Advances in neuroimaging facilitate the identification of dysfunctional or damaged brain tissue responsible for these cognitive/language deficits and contribute insights regarding the functional ne...
Source: Current Neurology and Neuroscience Reports - June 16, 2015 Category: Neuroscience Source Type: research

Treatment of Chronic Inflammatory Demyelinating Polyneuropathy
Abstract Chronic inflammatory demyelinating polyneuropathy (CIDP) is one of the acquired demyelinating neuropathies and is considered to be immune mediated. Diagnosis is typically based on clinical history, neurologic examination, electrophysiologic studies, CSF studies, and pathologic examination. Early diagnosis and treatment is important to prevent irreversible axonal loss and optimize improvement in function. The first-line agents for treatment are intravenous immunoglobulin (IVIg), corticosteroids, and plasmapheresis, which have all been demonstrated to be effective in controlled studies. Studies have not sh...
Source: Current Neurology and Neuroscience Reports - May 26, 2015 Category: Neuroscience Source Type: research

What Does Imaging Reveal About the Pathology of Amyotrophic Lateral Sclerosis?
Abstract Amyotrophic lateral sclerosis (ALS) is now recognised to be a heterogeneous neurodegenerative syndrome of the motor system and its frontotemporal cortical connections. The development and application of structural and functional imaging over the last three decades, in particular magnetic resonance imaging (MRI), has allowed traditional post mortem histopathological and emerging molecular findings in ALS to be placed in a clinical context. Cerebral grey and white matter structural MRI changes are increasingly being understood in terms of brain connectivity, providing insights into the advancing degenerati...
Source: Current Neurology and Neuroscience Reports - May 26, 2015 Category: Neuroscience Source Type: research

Neuromuscular Issues in Systemic Disease
Abstract The neuromuscular system can be involved in several systemic conditions. Clinical manifestations can appear at onset or throughout the course of the disease process. New investigational methods, including imaging of peripheral nerves, new laboratory tests, and antibodies, are available. In addition to symptomatic therapies, specific treatment options, such as for familial amyloid neuropathy and Fabry’s disease, are becoming increasingly available. Pathomechanisms vary depending on the underlying disease process. In addition to metabolic, hormonal, immune, and antibody-mediated mechanisms, in some g...
Source: Current Neurology and Neuroscience Reports - May 26, 2015 Category: Neuroscience Source Type: research

Developments in the Role of Transcranial Sonography for the Differential Diagnosis of Parkinsonism
Abstract In the last two decades transcranial sonography (TCS) has developed as a valuable, supplementary tool in the diagnosis and differential diagnosis of movement disorders. In this review, we highlight recent evidence supporting TCS as a reliable method in the differential diagnosis of parkinsonism, combining substantia nigra (SN), basal ganglia and ventricular system findings. Moreover, several studies support SN hyperechogenicity as one of most important risk factors for Parkinson’s disease (PD). The advantages of TCS include short investigation time, low cost and lack of radiation. Principal limitat...
Source: Current Neurology and Neuroscience Reports - May 26, 2015 Category: Neuroscience Source Type: research

The Neurology of Solid Organ Transplantation
Abstract Transplantation is the rescue treatment for end-stage organ failure with more than 110,000 solid organs transplantations performed worldwide annually. Recent advances in transplantation procedures and posttransplantation management have improved long-term survival and quality of life of transplant recipients, shifting the focus from acute perioperative critical care needs toward long-term chronic medical problems. Neurologic complications affect up to 30–60 % of solid organ transplant recipients. Common etiologies include opportunistic infections and toxicities of antirejection medications, an...
Source: Current Neurology and Neuroscience Reports - May 26, 2015 Category: Neuroscience Source Type: research

The Genetics of the Epilepsies
Abstract While genetic causes of epilepsy have been hypothesized from the time of Hippocrates, the advent of new genetic technologies has played a tremendous role in elucidating a growing number of specific genetic causes for the epilepsies. This progress has contributed vastly to our recognition of the epilepsies as a diverse group of disorders, the genetic mechanisms of which are heterogeneous. Genotype-phenotype correlation, however, is not always clear. Nonetheless, the developments in genetic diagnosis raise the promise of a future of personalized medicine. Multiple genetic tests are now available, but there...
Source: Current Neurology and Neuroscience Reports - May 26, 2015 Category: Neuroscience Source Type: research

The Relationship Between Atrophy and Hypometabolism: Is It Regionally Dependent in Dementias?
Abstract Neuronal failure leading to dementia in neurodegenerative diseases is evidenced in vivo by functional and structural changes in the brain such as reductions of glucose consumption and volume of grey matter. The earliest phase of cognitive decline and presymptomatic stages of these diseases are heralded by specific patterns of hypometabolism, even in the absence of atrophy, which are currently considered as diagnostic biomarkers. Atrophy is less consistently found as an initial marker of these diseases and is invariably present in moderate to severe stages with a disease-related topography. The relationsh...
Source: Current Neurology and Neuroscience Reports - May 26, 2015 Category: Neuroscience Source Type: research

LRRK2 Pathways Leading to Neurodegeneration
Abstract Mutations in LRRK2 are associated with inherited Parkinson’s disease (PD) in a large number of families, and the genetic locus containing the LRRK2 gene contains a risk factor for sporadic PD. The LRRK2 protein contains several domains that suggest a role in cellular signaling, including a kinase domain. It is also clear that LRRK2 interacts, either physically or genetically, with several other important proteins implicated in PD, suggesting that LRRK2 may be a central player in the pathways that underlie parkinsonism. As such, LRRK2 has been proposed to be a plausible target for therapeutic interv...
Source: Current Neurology and Neuroscience Reports - May 26, 2015 Category: Neuroscience Source Type: research

Psychotic Symptoms in Frontotemporal Dementia
Abstract Although psychotic features have long been recognized in association with frontotemporal dementia (FTD), recent genetic discoveries enabling further subtyping of FTD have revealed that psychotic symptoms are frequent in some forms of FTD. Hallucinations and delusions can even precede onset of other cognitive or behavioural symptoms in patients with FTD. In this review, we explore the frequency and types of psychotic symptoms reported in patients with FTD, as well as in other neuropsychiatric disorders, to aid practitioners’ consideration of these features in the diagnosis of FTD and related disorde...
Source: Current Neurology and Neuroscience Reports - May 26, 2015 Category: Neuroscience Source Type: research

Retinal Vascular Changes are a Marker for Cerebral Vascular Diseases
Abstract The retinal circulation is a potential marker of cerebral vascular disease because it shares origin and drainage with the intracranial circulation and because it can be directly visualized using ophthalmoscopy. Cross-sectional and cohort studies have demonstrated associations between chronic retinal and cerebral vascular disease, acute retinal and cerebral vascular disease, and chronic retinal vascular disease and acute cerebral vascular disease. In particular, certain qualitative features of retinopathy, retinal artery occlusion, and increased retinal vein caliber are associated with concurrent and futu...
Source: Current Neurology and Neuroscience Reports - May 26, 2015 Category: Neuroscience Source Type: research

Neuroscience of Aphasia Recovery: the Concept of Neural Multifunctionality
Abstract Aphasia therapy, while demonstrably successful, has been limited by its primary focus on language, with relatively less attention paid to nonlinguistic factors (cognitive, affective, praxic) that play a major role in recovery from aphasia. Neuroscientific studies of the past 15–20 years have opened a breach in the wall of traditional clinico-anatomical teachings on aphasia. It is not an exaggeration to talk of a paradigm shift. The term “neural multifunctionality” denotes a complex web of neural networks supporting both linguistic and nonlinguistic functions in constant and dynamic...
Source: Current Neurology and Neuroscience Reports - May 26, 2015 Category: Neuroscience Source Type: research

Capillary Dysfunction: Its Detection and Causative Role in Dementias and Stroke
Abstract In acute ischemic stroke, critical hypoperfusion is a frequent cause of hypoxic tissue injury: As cerebral blood flow (CBF) falls below the ischemic threshold of 20 mL/100 mL/min, neurological symptoms develop and hypoxic tissue injury evolves within minutes or hours unless the oxygen supply is restored. But is ischemia the only hemodynamic source of hypoxic tissue injury? Reanalyses of the equations we traditionally use to describe the relation between CBF and tissue oxygenation suggest that capillary flow patterns are crucial for the efficient extraction of oxygen: without close cap...
Source: Current Neurology and Neuroscience Reports - May 9, 2015 Category: Neuroscience Source Type: research

Recent Advances in the Genetics of Autism Spectrum Disorder
Abstract Autism spectrum disorder (ASD) is a devastating neurodevelopmental disorder with high prevalence in the population and a pronounced male preponderance. ASD has a strong genetic basis, but until recently, a large fraction of the genetic factors contributing to liability was still unknown. Over the past 3 years, high-throughput next-generation sequencing on large cohorts has exposed a heterogeneous and complex genetic landscape and has revealed novel risk genes. Here, we provide an overview of the recent advances on the ASD genetic architecture, with an emphasis on the estimates of heritability, the c...
Source: Current Neurology and Neuroscience Reports - May 8, 2015 Category: Neuroscience Source Type: research

New Genes for Focal Epilepsies with Speech and Language Disorders
Abstract The last 2 years have seen exciting advances in the genetics of Landau-Kleffner syndrome and related disorders, encompassed within the epilepsy-aphasia spectrum (EAS). The striking finding of mutations in the N-methyl-d-aspartate (NMDA) receptor subunit gene GRIN2A as the first monogenic cause in up to 20 % of patients with EAS suggests that excitatory glutamate receptors play a key role in these disorders. Patients with GRIN2A mutations have a recognizable speech and language phenotype that may assist with diagnosis. Other molecules involved in RNA binding and cell adhesion have been implicate...
Source: Current Neurology and Neuroscience Reports - April 29, 2015 Category: Neuroscience Source Type: research

Pediatric Migraine Variants: a Review of Epidemiology, Diagnosis, Treatment, and Outcome
This article aims to review the pathophysiology, evaluation, and management of the pediatric migraine variants including abdominal migraine, benign paroxysmal vertigo, cyclic vomiting syndrome, and benign paroxysmal torticollis as well as the episodic syndromes that may lead to migraine, infantile colic, alternating hemiplegia of childhood, and vestibular migraine. (Source: Current Neurology and Neuroscience Reports)
Source: Current Neurology and Neuroscience Reports - April 23, 2015 Category: Neuroscience Source Type: research

Phenotype-Specific Diagnosis of Functional (Psychogenic) Movement Disorders
Abstract Published diagnostic criteria for functional (psychogenic) movement disorders (FMDs) include psychiatric symptoms and some historical variables to affect the threshold between categories of diagnostic certainty. Clinically probable and possible categories, however, do not suffice to rule in FMD or rule out complex organic movement disorders and therefore are of little practical help. In contrast, a handful of unequivocal and reliably incongruent or inconsistent clinical features in each functional movement phenotype, when present, allow a clinically definite diagnosis of FMD, regardless of any psychiatri...
Source: Current Neurology and Neuroscience Reports - April 23, 2015 Category: Neuroscience Source Type: research

New Zebrafish Models of Neurodegeneration
Abstract In modern biomedicine, the increasing need to develop experimental models to further our understanding of disease conditions and delineate innovative treatments has found in the zebrafish (Danio rerio) an experimental model, and indeed a valuable asset, to close the gap between in vitro and in vivo assays. Translation of ideas at a faster pace is vital in the field of neurodegeneration, with the attempt to slow or prevent the dramatic impact on the society’s welfare being an essential priority. Our research group has pioneered the use of zebrafish to contribute to the quest for faster and improved ...
Source: Current Neurology and Neuroscience Reports - April 23, 2015 Category: Neuroscience Source Type: research

Pediatric Epilepsy Surgery
This article reviews the process of selecting appropriate patients using the latest advances in neuroimaging and electrophysiologic techniques. It also discusses the various surgical techniques currently available, including recent advances in minimally invasive approaches. (Source: Current Neurology and Neuroscience Reports)
Source: Current Neurology and Neuroscience Reports - April 20, 2015 Category: Neuroscience Source Type: research

Headaches of the Elderly
Abstract The prevalence of headache decreases in elderly age groups; however, headache remains a significant issue with unique diagnostic and therapeutic considerations in this population. While primary headache disorders such as migraine and tension-type headache still occur in the majority of cases, secondary headaches are more common with advancing age. Additionally, several rare primary headache disorders, such as hypnic headache and primary cough headache, occur more frequently in an elderly population and have distinct treatments. In this review, we provide an updated overview of the common, concerning, and...
Source: Current Neurology and Neuroscience Reports - April 16, 2015 Category: Neuroscience Source Type: research

Current Neurological Observations and Complications of Dengue Virus Infection
Abstract Dengue, a mosquito-borne flavivirus and fastest growing tropical disease in the world, has experienced an explosion of neurologic case reports and series in recent years. Now dengue is a frequent or leading cause of encephalitis in some endemic regions, is estimated to infect one in six tourists returning from the tropics, and has been proven to have local transmission within the continental USA. High documentation of neurologic disease in recent years reflects increases in overall cases, enhanced clinical awareness and advances in diagnostics. Neurological aspects of dengue virus, along with epidemiolog...
Source: Current Neurology and Neuroscience Reports - April 16, 2015 Category: Neuroscience Source Type: research

The Prion Hypothesis of Parkinson’s Disease
Abstract The discovery of alpha-synuclein’s prion-like behaviors in mammals, as well as a non-Mendelian type of inheritance, has led to a new concept in biology, the “prion hypothesis” of Parkinson’s disease. The misfolding and aggregation of alpha-synuclein (α-syn) within the nervous system occur in many neurodegenerative diseases including Parkinson’s disease (PD), Lewy body dementia (LBD), and multiple system atrophy (MSA). The molecular basis of synucleinopathies appears to be tightly coupled to α-syn’s conformational conversion and fibril formation. The patholo...
Source: Current Neurology and Neuroscience Reports - April 14, 2015 Category: Neuroscience Source Type: research

Glutamate and GABA Imbalance Following Traumatic Brain Injury
Abstract Traumatic brain injury (TBI) leads to multiple short- and long-term changes in neuronal circuits that ultimately conclude with an imbalance of cortical excitation and inhibition. Changes in neurotransmitter concentrations, receptor populations, and specific cell survival are important contributing factors. Many of these changes occur gradually, which may explain the vulnerability of the brain to multiple mild impacts, alterations in neuroplasticity, and delays in the presentation of posttraumatic epilepsy. In this review, we provide an overview of normal glutamate and GABA homeostasis and describe acute,...
Source: Current Neurology and Neuroscience Reports - March 22, 2015 Category: Neuroscience Source Type: research

Palliative Care for Parkinson’s Disease: Has the Time Come?
Abstract Although Parkinson’s disease (PD) is traditionally viewed as a movement disorder which affects quality of life, recent literature has revealed an increased mortality, a high burden of difficult-to-manage non-motor symptoms (e.g., pain, fatigue), high caregiver distress, and a high utilization of medical services especially in the last year of life. Current medical systems have yet to adequately respond to this mounting evidence through the adoption of palliative care practices and through the provision of palliative care services to both PD patients and to affected families. This holistic, interdis...
Source: Current Neurology and Neuroscience Reports - March 22, 2015 Category: Neuroscience Source Type: research

CGRP Mechanism Antagonists and Migraine Management
Abstract Migraine is a complex disorder of the brain that is common and highly disabling. As understanding of the neural pathways has advanced, and it has become clear that the vascular hypothesis does not explain the disorder, new therapeutic avenues have arisen. One such target is calcitonin gene-related peptide (CGRP)-based mechanisms. CGRP is found within the trigeminovascular nociceptive system widely from the trigeminal ganglion to second-order and third-order neurons and in regulatory areas in the brainstem. Studies have shown CGRP is released during severe migraine attacks and the reversal of the attack w...
Source: Current Neurology and Neuroscience Reports - March 19, 2015 Category: Neuroscience Source Type: research

Infantile-Onset Saccade Initiation Delay (Congenital Ocular Motor Apraxia)
Abstract Infantile-onset saccade initiation delay, also known as congenital ocular motor apraxia, typically presents in early infancy with horizontal head thrusts once head control is achieved. Defective initiation of horizontal saccades and saccade hypometria with normal saccadic velocity are characteristic findings. Isolated impairment of vertical saccades is rare. Impaired smooth ocular pursuit may be seen. Other relatively common features include developmental delay, hypotonia, ataxia, or clumsiness. Brain MRI may be normal or show a diverse range of abnormalities, most commonly involving the cerebellum. Defe...
Source: Current Neurology and Neuroscience Reports - March 19, 2015 Category: Neuroscience Source Type: research

Sleep Disorders in Multiple Sclerosis. Review
Abstract Sleep disorders are common in patients with multiple sclerosis (MS) and play a crucial role in health and quality of life; however, they are often overlooked. The most important sleep disorders in this context are as follows: insomnia, restless legs syndrome, periodic limb movement disorders, and sleep-related breathing disorders (SRBD). It is unclear if MS-related processes (lesions, brain atrophy) can cause symptomatic forms of sleep apnea. MS-related narcolepsy-like symptoms are described in the literature and, in some cases, have resolved with methylprednisolone pulse therapy. Similarly, REM sleep be...
Source: Current Neurology and Neuroscience Reports - March 15, 2015 Category: Neuroscience Source Type: research

The Clinical Presentation of Chronic Traumatic Encephalopathy
Abstract Chronic traumatic encephalopathy (CTE) is a progressive neurodegenerative disorder attributed to repetitive mild traumatic brain injury. The diagnosis in a living individual can be challenging and can be made definitively only at autopsy. The symptoms are often nonspecific and overlap with neurodegenerative disorders such as Alzheimer’s disease (AD) and frontotemporal dementia (FTD). Higher exposure to repetitive head trauma increases the risk of CTE. Genetic risk factors such as presence of an apolipoprotein E ε4 allele may be important. Individuals have varying degrees of cognitive, behav...
Source: Current Neurology and Neuroscience Reports - March 15, 2015 Category: Neuroscience Source Type: research

Clinical Utility of Ocular Vestibular-Evoked Myogenic Potentials (oVEMPs)
Abstract Over the last years, vestibular-evoked myogenic potentials (VEMPs) have been established as clinical tests of otolith function. Complementary to the cervical VEMPs, which assess mainly saccular function, ocular VEMPs (oVEMPs) test predominantly utricular otolith function. oVEMPs are elicited either with air-conducted (AC) sound or bone-conducted (BC) skull vibration and are recorded from beneath the eyes during up-gaze. They assess the vestibulo-ocular reflex and are a crossed excitatory response originating from the inferior oblique eye muscle. Enlarged oVEMPs have proven to be sensitive for screening o...
Source: Current Neurology and Neuroscience Reports - March 15, 2015 Category: Neuroscience Source Type: research

Migraine Management in Children
Abstract Migraine management in children relies on understanding the difference between adult and childhood migraine, being able to identify childhood migraine variants and knowledge of both the pediatric and adult literature regarding treatment. (Source: Current Neurology and Neuroscience Reports)
Source: Current Neurology and Neuroscience Reports - March 14, 2015 Category: Neuroscience Source Type: research

Development of Regional Stroke Programs
Abstract The organization of stroke care has undergone a dramatic evolution in the USA over the last two decades. Beginning with the recommendation for Primary Stroke Centers (PSCs) in 1994, there has been a concerted effort by physicians, the American Heart Association/American Stroke Association (AHA/ASA), National Institutes of Health (NIH), and state legislatures to advance an evidence-based system of care with several tiers of stroke centers. At the apex of this structure are Regional Stroke Centers (RSCs), which do not have official recognition like PSCs and Comprehensive Stroke Centers (CSCs), but their ex...
Source: Current Neurology and Neuroscience Reports - March 13, 2015 Category: Neuroscience Source Type: research

Neurological Counterparts of Hyponatremia: Pathological Mechanisms and Clinical Manifestations
Abstract Hyponatremia, defined as a serum sodium concentration
Source: Current Neurology and Neuroscience Reports - February 28, 2015 Category: Neuroscience Source Type: research

The Role of Neuroinflammation in Dementias
Abstract The molecular mechanism of neuronal loss and synaptic damage in Alzheimer’s disease (AD), Parkinson’s disease dementia (PDD), frontotemporal dementia (FTD) and Lewy body dementia (LBD) is poorly understood and could differ among different types of neurodegenerative processes. However, the presence of neuroinflammation is a common feature of dementia. In this setting, reactive microgliosis, oxidative damage and mitochondrial dysfunction are associated with the pathogenesis of all types of neurodegenerative dementia. Moreover, an increased body of evidence suggests that microglia may play a cen...
Source: Current Neurology and Neuroscience Reports - February 26, 2015 Category: Neuroscience Source Type: research

The Relationship Between Herpes Zoster and Stroke
Abstract Varicella zoster virus (VZV) infects>95 % of the world population. Typically, varicella (chickenpox) results from primary infection. The virus then becomes latent in ganglionic neurons along the entire neuraxis. In immunocompromised individuals, VZV reactivates and causes herpes zoster (shingles), pain, and rash in 1–2 dermatomes. Multiple case reports showed a link between stroke and zoster, and recent studies have emerged which reveal that VZV infection of the cerebral arteries directly causes pathological vascular remodeling and stroke (VZV vasculopathy). In the past few years, several l...
Source: Current Neurology and Neuroscience Reports - February 25, 2015 Category: Neuroscience Source Type: research

Behavioral Treatments for Migraine Management: Useful at Each Step of Migraine Care
Abstract Migraine is a disabling and prevalent disorder. Migraine is most effectively treated with a stepped care approach, where patients initially receive a broad level of care (primary care) and proceed to receive increasingly specialized care throughout the course of treatment. Behavioral treatments for migraine modify behaviors of people with migraine with the intention to prevent migraine episodes and secondary consequence of migraine. Behavioral treatments can be incorporated into each level of the stepped care approach for migraine treatment. In this article, we provide a rationale for including behaviora...
Source: Current Neurology and Neuroscience Reports - February 24, 2015 Category: Neuroscience Source Type: research

Dietary Interventions to Lower the Risk of Stroke
Abstract Stroke is a major cause of death and permanent disability in the USA; primary prevention and risk reduction are a critical health concern. A wealth of research investigated stroke risk factors, including primary hypertension, diabetes, and atrial fibrillation. Research has expanded to examine lifestyle factors, such as diet/dietary patterns, physical activity, cigarette smoking, and obesity distribution, as critical modifiable risk factors. Emerging evidence suggests diet/dietary patterns may lead to heightened risk of stroke. Despite a growing literature, research has yet to implement dietary interventi...
Source: Current Neurology and Neuroscience Reports - February 24, 2015 Category: Neuroscience Source Type: research

Inpatient Management of Migraine
Abstract Migraine is a frequently disabling disorder which may require inpatient treatment. Admission criteria for migraine include intractable migraine, nausea and/or vomiting, severe disability, and dependence on opioids or barbiturates. The inpatient treatment of migraine is based on observational studies and expert opinion rather than placebo-controlled trials. Well-established inpatient treatments for migraine include dihydroergotamine, neuroleptics/antiemetics, lidocaine, intravenous aspirin, and non-pharmacologic treatment such as cognitive–behavioral therapy. Short-acting treatments possibly associa...
Source: Current Neurology and Neuroscience Reports - February 23, 2015 Category: Neuroscience Source Type: research

Neurogenic Changes in the Upper Airway of Obstructive Sleep Apnoea
Abstract Obstructive sleep apnoea (OSA) is linked to local neural injury that evokes airway muscle remodelling. The upper airway muscles of patients with OSA are exposed to intermittent hypoxia as well as vibration induced by snoring. A range of electrophysiological and other studies have established altered motor and sensory function of the airway in OSA. The extent to which these changes impair upper airway muscle function and their relationship to the progression of OSA remains undefined. This review will collate the evidence for upper airway remodelling in OSA, particularly the electromyographic changes in up...
Source: Current Neurology and Neuroscience Reports - February 23, 2015 Category: Neuroscience Source Type: research

Concussion and Football: a Review and Editorial
Abstract The issue of concussion in football is of substantial interest to players, coaches, fans, and physicians. In this article, we review specific cultural hindrances to diagnosis and treatment of concussion in football. We review current trends in management and identify areas for improvement. We also discuss the obligations that physicians, particularly neurosurgeons and neurologists, have toward brain-injured football players and the larger societal role they may play in helping to minimize football-associated brain injury. (Source: Current Neurology and Neuroscience Reports)
Source: Current Neurology and Neuroscience Reports - February 22, 2015 Category: Neuroscience Source Type: research

Molecular Biology of Pediatric Brain Tumors and Impact on Novel Therapies
Abstract Brain tumors are the leading cause of cancer-related death in children. For the past several decades, therapeutic strategies have centered on cytotoxic chemotherapy and radiation therapy due, in part, to limited understanding of genetic events that underlie tumor initiation and maintenance. Significant improvement in high-throughput genomic methods, such as next-generation sequencing, methylation array, and copy number array, in recent years has propelled the knowledge base from which novel therapies are derived. Translation of recent genomic findings into more effective therapies remains the most formid...
Source: Current Neurology and Neuroscience Reports - February 18, 2015 Category: Neuroscience Source Type: research

Parkinson’s Disease and Sleep/Wake Disturbances
Abstract Sleep disturbances are a common non-motor feature in patients with Parkinson’s disease (PD). Early diagnosis and appropriate management are imperative for enhancing patient quality of life. Sleep disturbances can be caused by multiple factors in addition to age-related changes in sleep, such as nocturnal motor symptoms (rigidity, resting tremor, akinesia, tardive dyskinesia, and the “wearing off” phenomenon), non-motor symptoms (pain, hallucination, and psychosis), nocturia, and medication. Disease-related pathology involving the brainstem and changes in the neurotransmitter systems (no...
Source: Current Neurology and Neuroscience Reports - February 17, 2015 Category: Neuroscience Source Type: research

Neuroimaging Insights into Insomnia
Abstract Insomnia is one of the most prevalent health complaints afflicting approximately 10 % of the population in Western industrialized countries at a clinical level. Despite the proposition that both biological and psychological factors play a role in the experience of insomnia, the field continues to puzzle over so-called “discrepancies” between objective and subjective measurements of sleep and daytime functioning. The promise of neuroimaging is to uncover physiological processes that may readily explain patient reports. However, while there has been an explosion in the number of studies in...
Source: Current Neurology and Neuroscience Reports - February 17, 2015 Category: Neuroscience Source Type: research

Brain Imaging in Acute Ischemic Stroke—MRI or CT?
Abstract In acute stroke, imaging provides different technologies to demonstrate stroke subtype, tissue perfusion and vessel patency. In this review, we highlight recent clinical studies that are likely to guide therapeutic decisions. Clot length in computed tomography (CT) and clot burden in MR, imaging of leptomeningeal collaterals and indicators for active bleeding are illustrated. Imaging-based concepts for treatment of stroke at awakening and pre-hospital treatment in specialized ambulances offer new potentials to improve patient outcome. (Source: Current Neurology and Neuroscience Reports)
Source: Current Neurology and Neuroscience Reports - February 10, 2015 Category: Neuroscience Source Type: research

Sleep-Disordered Breathing in Dementia with Lewy Bodies
Abstract Dementia with Lewy bodies (DLB) is the second most common form of dementia, and it is very frequently associated with changes in sleep patterns. To date, the literature has focused mainly on REM sleep behavior as the most prominent sleep disorder in DLB while little is known about the prevalence and the impact of sleep-disordered breathing (SDB) in DLB. Clinicians should be aware that the clinical diagnosis of SDB in DLB is difficult to establish and that the risk of overlooking SDB in patients with DLB is substantial. Polysomnographic sleep investigations may therefore be advisable in patients with DLB ...
Source: Current Neurology and Neuroscience Reports - February 10, 2015 Category: Neuroscience Source Type: research

Dissecting the Association Between Migraine and Stroke
Abstract Migraine is a common disabling neurological disorder resulting from excessive cortical excitation and trigeminovascular afferent sensitization. In addition to aberrant neuronal processing, migraineurs are also at significant risk of vascular disease. Consequently, the impact of migraine extends well beyond the ictal headache and includes a well-documented association with acute ischemic stroke, particularly in young women with a history of migraine with aura. The association between migraine and stroke has been acknowledged for 40 years or more. However, examining the pathobiology of this associatio...
Source: Current Neurology and Neuroscience Reports - February 5, 2015 Category: Neuroscience Source Type: research

Autoimmune Encephalitis and Its Relation to Infection
Abstract Encephalitis, an inflammatory condition of the brain that results in substantial morbidity and mortality, has numerous causes. Over the past decade, it has become increasingly recognized that autoimmune conditions contribute significantly to the spectrum of encephalitis causes. Clinical suspicion and early diagnosis of autoimmune etiologies are of particular importance due to the need for early institution of immune suppressive therapies to improve outcome. Emerging clinical observations suggest that the most commonly recognized cause of antibody-mediated autoimmune encephalitis, anti-N-methyl-d-aspartat...
Source: Current Neurology and Neuroscience Reports - January 31, 2015 Category: Neuroscience Source Type: research