Stroke in the Young: a Global Update
AbstractPurpose of ReviewWe aim to evaluate the epidemiology, racial and gender disparity, etiology, and treatment of stroke in the younger population.Recent FindingsThe younger age group without vascular risk factors exhibits an increased prevalence of cardio-embolism in context of patent foramen ovale/atrial septal aneurysm strokes, from other determined etiology of non-atherosclerotic vasculopathy including dissection, inherited or acquired thrombophilia, and other unusual causes of stroke. Ethnic disparities also exist in certain populations.SummaryThe prevalence of stroke in the young is increasing due to several fact...
Source: Current Neurology and Neuroscience Reports - November 25, 2019 Category: Neuroscience Source Type: research

Neurogenic Stunned Myocardium in Severe Neurological Injury
AbstractPurpose of ReviewNeurogenic stunned myocardium (NSM) is a poorly recognized cardiac manifestation of neurological illness. This review addresses the contemporary understanding of NSM pathophysiology, epidemiology, diagnosis, and clinical management.Recent FindingsWhile the precise pathophysiology and diagnosis remain unclear, NSM is phenotypically atypical stress cardiomyopathy that can be partially attributed to excess catecholaminergic toxicity. NSM is a diagnosis of exclusion where electrocardiography, echocardiography, and cardiac biomarkers are frequently abnormal. Clinical expertise is crucial to evaluate and...
Source: Current Neurology and Neuroscience Reports - November 13, 2019 Category: Neuroscience Source Type: research

Gray Matter Changes in Parkinson ’s and Alzheimer’s Disease and Relation to Cognition
AbstractPurpose of ReviewWe summarize structural (s)MRI findings of gray matter (GM) atrophy related to cognitive impairment in Alzheimer ’s disease (AD) and Parkinson’s disease (PD) in light of new analytical approaches and recent longitudinal studies results.Recent FindingsThe hippocampus-to-cortex ratio seems to be the best sMRI biomarker to discriminate between various AD subtypes, following the spatial distribution of tau pathology, and predict rate of cognitive decline. PD is clinically far more variable than AD, with heterogeneous underlying brain pathology. Novel multivariate approaches have been used t...
Source: Current Neurology and Neuroscience Reports - November 13, 2019 Category: Neuroscience Source Type: research

Updates in the Treatment of Post-Stroke Pain
AbstractPurpose of ReviewTo provide an overview of the current treatment strategies for common subtypes of post-stroke pain.Recent FindingsThere is growing research interest in non-pharmacological treatment approaches for chronic pain, including neurostimulation as well as lifestyle and psychosocial interventions. Newer pharmacotherapy research includes cannabinoids and NMDA-receptor antagonists as well as bee venom. Persistent post-stroke headache is an increasingly appreciated entity, though the role of novel chronic migraine treatments for post-stroke headache is not known.SummaryOverall, most treatment approaches to po...
Source: Current Neurology and Neuroscience Reports - November 13, 2019 Category: Neuroscience Source Type: research

Music Therapy and Music-Based Interventions for Movement Disorders
AbstractPurpose of ReviewThere is emerging evidence that music therapy and other methods using music and rhythm may meaningfully improve a broad range of symptoms in neurological and non-neurological disorders. This review highlights the findings of recent studies utilizing music and rhythm-based interventions for gait impairment, other motor symptoms, and non-motor symptoms in Parkinson disease (PD) and other movement disorders. Limitations of current studies as well as future research directions are discussed.Recent FindingsMultiple studies have demonstrated short-term benefits of rhythmic auditory stimulation on gait pa...
Source: Current Neurology and Neuroscience Reports - November 13, 2019 Category: Neuroscience Source Type: research

Exercise as Medicine in Multiple Sclerosis —Time for a Paradigm Shift: Preventive, Symptomatic, and Disease-Modifying Aspects and Perspectives
AbstractPurpose of ReviewFor many years, exercise was controversial in multiple sclerosis (MS) and thought to exacerbate symptoms and fatigue. However, having been found to be safe and effective, exercise has become a cornerstone of MS rehabilitation and may have even more fundamental benefits in MS, with the potential to change clinical practice again. The aim of this review is to summarize the existing knowledge of the effects of exercise as primary, secondary, and tertiary prevention in MS.Recent FindingsInitial studies established exercise as an effective symptomatic treatment (i.e., tertiary prevention), but recent st...
Source: Current Neurology and Neuroscience Reports - November 13, 2019 Category: Neuroscience Source Type: research

Sleep Disorders in Wilson ’s Disease
AbstractPurpose of ReviewWe aimed to review the sleep disorders described in Wilson ’s disease (WD), focusing on their mechanisms and treatments.Recent FindingsREM sleep behavior disorder or sleepiness can be warning signs of future WD. These early symptoms may significantly reduce the time to WD diagnosis. Early anti-copper therapies (chelators or zinc salts), reducing copper accumulation in the brain and though saving brain tissue, can allow the complete disappearance of these sleep disorders and of course improve the other symptoms of WD.SummaryInsomnia, restless legs syndrome (RLS), daytime sleepiness, cataplexy,...
Source: Current Neurology and Neuroscience Reports - November 13, 2019 Category: Neuroscience Source Type: research

Machine Learning and Artificial Intelligence in Neurocritical Care: a Specialty-Wide Disruptive Transformation or a Strategy for Success
AbstractPurpose of ReviewNeurocritical care combines the complexity of both medical and surgical disease states with the inherent limitations of assessing patients with neurologic injury. Artificial intelligence (AI) has garnered interest in the basic management of these complicated patients as data collection becomes increasingly automated.Recent FindingsIn this opinion article, we highlight the potential AI has in aiding the clinician in several aspects of neurocritical care, particularly in monitoring and managing intracranial pressure, seizures, hemodynamics, and ventilation. The model-based method and data-driven meth...
Source: Current Neurology and Neuroscience Reports - November 13, 2019 Category: Neuroscience Source Type: research

Clinical Characteristics of Multiple Sclerosis in African-Americans
AbstractPurpose of ReviewMultiple sclerosis (MS) is an autoimmune disease of the central nervous system that affects nearly 1 million people in the USA and has the potential to profoundly affect physical ability and income potential at a young age. Since a landmark paper was published in 2014, few studies have looked at differences in MS disease characteristics between African-American and Caucasian patients.Recent FindingsAfrican-American patients often have a more severe MS disease course, as well as biomarker data which can portend a worse prognosis. While the sample sizes are usually quite small, subgroup analyses of A...
Source: Current Neurology and Neuroscience Reports - November 13, 2019 Category: Neuroscience Source Type: research

Limb Apraxia: a Disorder of Learned Skilled Movement
AbstractPurpose of ReviewThis chapter focuses on limb apraxia, a cognitive-motor disorder of learned skilled movement, and the nature of the spatiotemporal errors that disrupt movement sequences.Recent FindingsA cognitive model that attempts to reconcile conceptual and preparatory aspects of the motor program with perceptual and kinematic features will be discussed. An update on the localization of the praxis network will be provided. In addition, a long-held view that limb apraxia does not have ecological relevance will be disputed in the context of studies that have shown that limb apraxia (i) is one of the most importan...
Source: Current Neurology and Neuroscience Reports - November 12, 2019 Category: Neuroscience Source Type: research

New Insights Into Cryptococcus Spp. Biology and Cryptococcal Meningitis
AbstractPurpose of ReviewDefective cell –mediated immunity is a major risk factor for cryptococcosis, a fatal disease if untreated. Cryptococcal meningitis (CM), the main presentation of disseminated disease, occurs through hematogenous spread to the brain from primary pulmonary foci, facilitated by yeast virulence factors. We revisit r emarkable recent improvements in the prevention, diagnosis and management of CM.Recent FindingsCryptococcal antigen (CrAg), main capsular polysaccharide ofCryptococcus spp. is detectable in blood and cerebrospinal fluid of infected patients with point of care lateral flow assays. Rece...
Source: Current Neurology and Neuroscience Reports - October 31, 2019 Category: Neuroscience Source Type: research

Next Steps in Wearable Technology and Community Ambulation in Multiple Sclerosis
AbstractPurpose of ReviewWalking impairments are highly prevalent in persons with multiple sclerosis (PwMS) and are associated with reduced quality of life. Walking is traditionally quantified with various measures, including patient self-reports, clinical rating scales, performance measures, and advanced lab-based movement analysis techniques. Yet, the majority of these measures do not fully characterize walking (i.e., gait quality) nor adequately reflect walking in the real world (i.e., community ambulation) and have limited timescale (only measure walking at a single point in time). We discuss the potential of wearable ...
Source: Current Neurology and Neuroscience Reports - September 4, 2019 Category: Neuroscience Source Type: research

Assessment and Measurement of Spasticity in MS: State of the Evidence
AbstractPurpose of ReviewThe purpose of this review is to familiarize the reader with assessments and measurement of spasticity in people with multiple sclerosis (MS). Spasticity affects 60 –84% of people with MS, worsening as disability worsens and impacting activity, participation, and quality of life. Spasticity manifests in many ways, including spasms, resistance to passive stretch, pain, and perception of tightness, and can affect muscles throughout the body, making assessment a nd quantification of spasticity challenging but important. Assessment tools include those quantified by clinicians, instrumentation, an...
Source: Current Neurology and Neuroscience Reports - August 30, 2019 Category: Neuroscience Source Type: research

Early Brain Injury After Poor-Grade Subarachnoid Hemorrhage
AbstractPurpose of ReviewOver the last years, the focus of clinical and animal research in subarachnoid hemorrhage (SAH) shifted towards the early phase after the bleeding based on the association of the early injury pattern (first 72  h) with secondary complications and poor outcome. This phase is commonly referenced as early brain injury (EBI). In this clinical review, we intended to overview commonly used definitions of EBI, underlying mechanisms, and potential treatment implications.Recent FindingsWe found a large heterogeneity in the definition used for EBI comprising clinical symptoms, neuroimaging parameters, a...
Source: Current Neurology and Neuroscience Reports - August 29, 2019 Category: Neuroscience Source Type: research

Depression and Suicidality in Multiple Sclerosis: Red Flags, Management Strategies, and Ethical Considerations
AbstractMultiple sclerosis (MS) causes physical, emotional, and cognitive changes that impact function and quality of life (QoL). Risk factors for suicidality in MS patients include a high incidence of depression, increased isolation, and reduced function/independence.Purpose of ReviewTo describe the epidemiology of depression and suicidality in this population, highlight warning signs for suicidal behavior, provide recommendations and resources for clinicians, and discuss ethical decisions related to patient safety vs. right to privacy.Recent FindingsFifty percent of MS patients will experience a major depression related ...
Source: Current Neurology and Neuroscience Reports - August 28, 2019 Category: Neuroscience Source Type: research

Healthcare-Associated Infections in the Neurocritical Care Unit
This article summarizes updated data and knowledge on healthcare-associated infections in the neurocritical care unit, with a focus on central nervous system infections and systemic infectious complications in patients with acute brain disease. It also reviews the concept of brain injury-induced immune modulation, an underlying mechanism to explain why the neuro-ICU population is particularly susceptible to infections.Recent FindingsHealthcare-associated infections in the neuro-ICU are common: up to 40  % of meningitides in the developed world are now healthcare-associated. The number of gram-negative infections is ri...
Source: Current Neurology and Neuroscience Reports - August 27, 2019 Category: Neuroscience Source Type: research

Technological Advancements in Magnetic Resonance Neurography
AbstractPurpose of ReviewMagnetic resonance neurography (MRN) is being increasingly used as a problem-solving tool for diagnosis and management of peripheral neuropathies. This review is aimed at summarizing important technological advances, including MR pulse sequence and surface coil developments, which have facilitated MRN ’s use in clinical practice.Recent FindingsThe most recent research in MRN focuses on its clinical applications, with concomitant development of three-dimensional, parallel imaging and vascular suppression techniques that facilitate higher spatial resolution and depiction of small nerve branches...
Source: Current Neurology and Neuroscience Reports - August 24, 2019 Category: Neuroscience Source Type: research

Epigenetics of the Synapse in Neurodegeneration
AbstractPurpose of ReviewIn the quest for understanding the pathophysiological processes underlying degeneration of nervous systems, synapses are emerging as sites of great interest as synaptic dysfunction is thought to play a role in the initiation and progression of neuronal loss. In particular, the synapse is an interesting target for the effects of epigenetic mechanisms in neurodegeneration. Here, we review the recent advances on epigenetic mechanisms driving synaptic compromise in major neurodegenerative disorders.Recent FindingsMajor developments in sequencing technologies enabled the mapping of transcriptomic patter...
Source: Current Neurology and Neuroscience Reports - August 23, 2019 Category: Neuroscience Source Type: research

Cerebral Venous Thrombosis: an Update
AbstractPurpose of ReviewThe purpose of this update is to summarize the recent advances on the management of cerebral venous thrombosis (CVT).Recent FindingsThere is a trend in declining frequency of CVT patients presenting with focal deficits or coma and a decrease in mortality over time. Anemia and obesity were identified as risk factors for CVT. During pregnancy and puerperium, the higher risk of CVT occurs in the first months post-delivery. With appropriate management, 1/3 of comatose CVT patients can have a full recovery.SummaryThe management of CVT patients includes treatment of associated conditions, anticoagulation...
Source: Current Neurology and Neuroscience Reports - August 23, 2019 Category: Neuroscience Source Type: research

Cancer and Cerebrovascular Disease
AbstractPurpose of ReviewTo review the latest information about the interactions between cancer and cerebrovascular disease.Recent FindingsAdditional data support the finding that both ischemic and hemorrhagic stroke are important complications of cancer or its treatment. Reperfusion therapy is being given successfully to patients with stroke complicating cancer.SummaryHemorrhagic stroke may occur with metastatic disease to the brain, coagulopathies from cancer, in particular leukemia, or as complications of chemotherapy. Ischemic stroke also may be a complication of metastatic disease with local invasion of vessels, a pro...
Source: Current Neurology and Neuroscience Reports - August 23, 2019 Category: Neuroscience Source Type: research

Automated Pupillometry in Neurocritical Care: Research and Practice
AbstractPurpose of ReviewThe purpose of this review is to examine the impact of pupillometer assessment on care and research of patients with neurological injury.Recent FindingsRecent studies demonstrate that automated pupillometry outperforms manual penlight pupil examination in neurocritical care populations. Further research has identified specific changes in the pupillary light reflex associated with pathologic conditions, and pupillometry has been used to successfully identify early changes in neurologic function, intracranial pressure, treatment response to osmotherapy, and prognosis after cardiac arrest.SummaryAutom...
Source: Current Neurology and Neuroscience Reports - August 23, 2019 Category: Neuroscience Source Type: research

MYORG Mutations: a Major Cause of Recessive Primary Familial Brain Calcification
AbstractPurpose of ReviewUntil recently, the gene associated with the recessive form of familial brain calcification (PFBC, Fahr disease) was unknown.MYORG, a gene that causes recessive PFBC was only recently discovered and is currently the only gene associated with a recessive form of this disease. Here, we review the radiological and clinical findings in adultMYORG mutation homozygous and heterozygous individuals.Recent FindingsMYORG was shown to be the cause of a large fraction of recessive cases of PFBC in patients of different ethnic populations. Pathogenic mutations include inframe insertions and deletions in additio...
Source: Current Neurology and Neuroscience Reports - August 23, 2019 Category: Neuroscience Source Type: research

Tardive Dyskinesia: Treatment Update
AbstractPurpose of ReviewTardive dyskinesia (TD) is caused by exposure to medications with dopamine antagonism, mainly antipsychotics. It often distresses individuals, physically and emotionally and affects their quality of life. We evaluated peer-reviewed recently published articles with a goal of providing a critically appraised update on the latest advancements in this field.Recent FindingsIn 2017, FDA approved VMAT2 inhibitors, deutetrabenazine and valbenazine. They have demonstrated efficacy in several class 1 studies. Also there have been update in the evidence-based guidelines for treatment for tardive dyskinesia.Su...
Source: Current Neurology and Neuroscience Reports - August 16, 2019 Category: Neuroscience Source Type: research

Updates in the Diagnosis and Management of Giant Cell Arteritis
AbstractPurpose of ReviewGiant cell arteritis is a systemic large vessel vasculitis that affects the older population and can cause progressive and at times, devastating complications including vision loss. While this has been commonly diagnosed and treated among vasculitides, the treatment options are limited and can have long-term adverse effects. The purpose of our review on GCA is to identify and discuss the pathophysiology and clinical aspects of GCA as they relate to the most recent data. The review will describe any new data on the diagnosis and treatment of this systemic large vessel vasculitis.Recent FindingsThe l...
Source: Current Neurology and Neuroscience Reports - August 8, 2019 Category: Neuroscience Source Type: research

Brain Imaging and Impulse Control Disorders in Parkinson ’s Disease
This article presents an update of recent findings from key neuroimaging studies in PD-related ICD, discusses results from controversial studies, and identifies areas for future research in the field. (Source: Current Neurology and Neuroscience Reports)
Source: Current Neurology and Neuroscience Reports - August 8, 2019 Category: Neuroscience Source Type: research

Focused Ultrasound and Other Lesioning Therapies in Movement Disorders
AbstractPurpose of ReviewLesioning therapies have been some of the earliest, most effective surgical treatments in movement disorders. This review summarizes recent studies, emerging modalities, and trends in lesioning procedures for movement disorders.Recent FindingsMagnetic resonance –guided high-intensity focused ultrasound (MRgFUS) is the newest incisionless technology for lesioning procedures in movement disorders. It has recent FDA approval for thalamotomy in essential tremor and tremor-dominant Parkinson disease. There are current studies exploring subthalamotomy and pall idotomy in PD. Gamma knife is another ...
Source: Current Neurology and Neuroscience Reports - August 3, 2019 Category: Neuroscience Source Type: research

Modern Medical Management of Spinal Cord Injury
AbstractPurpose of ReviewSpinal cord injury (SCI) shows an incidence of 10.4 –83 cases/million/year globally and remains a significant source of morbidity and cost to society. Despite greater understanding of the pathophysiology of SCI, neuroprotective and regenerative approaches to treatment have had limited clinical utility to date. Here, we review the key components of supportive care that are thus the mainstay of therapy and that have improved outcomes for victims of acute SCI in recent decades.Recent StudiesCurrent management strategies for acute SCI involve early surgical decompression and fixation, the use of ...
Source: Current Neurology and Neuroscience Reports - July 30, 2019 Category: Neuroscience Source Type: research

Antiplatelet Therapy in Cerebral Small Vessel Disease
AbstractPurpose of ReviewWe critically evaluate the evidence for the use of antiplatelet therapy for stroke prevention following lacunar stroke and in patients with hemorrhage-prone cerebral small vessel disease.Recent FindingsPooled lacunar stroke subgroup analyses of all relevant randomized controlled trials to date suggest a 22% relative risk reduction in recurrent stroke by single antiplatelet therapy (RR 0.77, 95% CI 0.62 –0.97) compared with placebo, no consistent suggestion of variable efficacy amongst specific antiplatelet agents, and the absence of clear benefit with dual over single antiplatelet therapy. Cu...
Source: Current Neurology and Neuroscience Reports - July 27, 2019 Category: Neuroscience Source Type: research

Semiology and Mechanisms of Near-Death Experiences
AbstractPurpose of ReviewNear-death experiences (NDEs) are conscious perceptual experiences, including self-related emotional, spiritual, and mystical experiences, occurring in close encounters with death or in non-life-threatening situations. The origin of NDEs remains unknown. Here, we review recent advances in the understanding of NDE semiology and pathophysiology.Recent FindingsRecent prospective studies confirm that NDEs reflect a spectrum of highly distinctive memories which are associated with negative or positive emotions and can be influenced by the nature of the causal event, but the temporal sequence with which ...
Source: Current Neurology and Neuroscience Reports - July 27, 2019 Category: Neuroscience Source Type: research

Multimodal CT in Acute Stroke
AbstractPurpose of ReviewMultimodal CT imaging (non-contrast CT, NCCT; CT angiography, CTA; and CT Perfusion, CTP) is central to acute ischemic stroke diagnosis and treatment. We reviewed the purpose and interpretation of each component of multimodal CT, as well as the evidence for use in routine care.Recent FindingsAcute stroke thrombolysis can be administered immediately following NCCT in acute ischemic stroke patients assessed within 4.5  h of symptom onset. Definitive identification of a large vessel occlusion (LVO) requires vascular imaging, which is easily achieved with CTA. This is critical, as the standard of ...
Source: Current Neurology and Neuroscience Reports - July 27, 2019 Category: Neuroscience Source Type: research

The Comorbidity of Migraine and Restless Legs Syndrome
AbstractPurpose of ReviewThe purpose of this review is to discuss migraine and RLS diseases and explain the comorbidity of migraine and RLS and possible mechanisms leading to this comorbidity in the light of recent studies.Recent FindingsMany clinical and epidemiological studies and recent meta-analyses of these studies have revealed a higher prevalence of RLS in patients with migraine compared to individuals without migraine.SummaryThere is an association between RLS and migraine in terms of some action mechanisms, especially the dopaminergic system, and some symptoms. They are associated concerning burden and economic co...
Source: Current Neurology and Neuroscience Reports - July 27, 2019 Category: Neuroscience Source Type: research

Atypical Clinical Manifestations of Cerebral Amyloid Angiopathy
AbstractPurposeCerebral amyloid angiopathy is a vasculopathy caused by β-amyloid deposition in cerebral arterioles and capillaries. It is closely linked to Alzheimer’s disease and predisposes elderly patients to intracerebral hemorrhage, transient focal neurological episodes, and cognitive impairment. Because of a predilection for symptomatic hemorrhage, particularl y in the frontal lobes, cerebral amyloid angiopathy may also cause a dysexecutive syndrome.Recent FindingsIn this case series, we describe presentations of classic clinical dementia syndromes which are not are widely thought to be associated with cer...
Source: Current Neurology and Neuroscience Reports - July 27, 2019 Category: Neuroscience Source Type: research

Sleep Disorders in Hereditary Ataxias
AbstractPurpose of ReviewIn this review, we aim to describe the main sleep disorders observed in patients with different forms of hereditary ataxias and discuss the main pathophysiological mechanisms.Recent FindingsSeveral pathological studies have demonstrated that the degenerative process in patients with hereditary ataxias may involve not only the cerebellum, but also other areas of the nervous system, and explain noncerebellar symptoms, such as sleep disorders.SummaryHereditary ataxias are neurodegenerative disorders with heterogeneous genetic and clinical presentation. This group of diseases usually affects other area...
Source: Current Neurology and Neuroscience Reports - July 25, 2019 Category: Neuroscience Source Type: research

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