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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Neurological Prognostication After Cardiac Arrest in the Era of Target Temperature Management
AbstractPurpose of ReviewThe purpose of this study is to provide an updated review on neurological prognostication in comatose patients after cardiac arrest in light of current targeted temperature management (TTM) strategies.Recent FindingsWith improved pre-hospital and hospital care, death due to cardiac arrest is decreasing. Yet, most survivors have poor neurological outcomes. While TTM has demonstrated to improve neurological outcomes, it may cloud our prognostic accuracy. A multimodal approach is currently used to diminish prognostic uncertainty.SummaryThe neurological examination remains the mainstay for prognosis af...
Source: Current Neurology and Neuroscience Reports - February 9, 2019 Category: Neuroscience Source Type: research

Movement Disorders in Metabolic Disorders
AbstractPurpose of ReviewWe provide a review of the movement disorders that complicate selected metabolic disorders, including the abnormal movements that may appear during or after their treatment.Recent FindingsMovement disorders may be underrecognized when arising in the context of a broad range of metabolic disorders.SummaryAbnormal movements may occur as the initial manifestation of a systemic disease, at any time during its course, or as a result of the medical interventions required for its management. Ascertaining movement phenomenology in acute and subacute presentations may assist in the determination of the spec...
Source: Current Neurology and Neuroscience Reports - February 9, 2019 Category: Neuroscience Source Type: research

Sleep Complaints, Sleep and Breathing Disorders in Myotonic Dystrophy Type 2
AbstractPurpose of ReviewTo update the current knowledge concerning sleep complaints and breathing disorders in myotonic dystrophy type 2 (DM2) and to better understand if sleep and breathing symptoms may add a further clinical definition of DM2.Recent FindingsAlthough DM2 has been poorly evaluated, the most relevant sleep disorders are sleep-disordered breathing (SDB) (37.5 –66.7%) and restless legs syndrome (RLS) (50–60%). Excessive daytime somnolence (EDS) is not consistent with SDB, and a large percentage of patients with sleep complaints (58–69%) report pain. In addition, respiratory dysfunctions are...
Source: Current Neurology and Neuroscience Reports - February 9, 2019 Category: Neuroscience Source Type: research

Promoting Brain Repair and Regeneration After Stroke: a Plea for Cell-Based Therapies
AbstractPurpose of ReviewAfter decades of hype, cell-based therapies are emerging into the clinical arena for the purposes of promoting recovery after stroke. In this review, we discuss the most recent science behind the role of cell-based therapies in ischemic stroke and the efforts to translate these therapies into human clinical trials.Recent FindingsPreclinical data support numerous beneficial effects of cell-based therapies in both small and large animal models of ischemic stroke. These benefits are driven by multifaceted mechanisms promoting brain repair through immunomodulation, trophic support, circuit reorganizati...
Source: Current Neurology and Neuroscience Reports - February 2, 2019 Category: Neuroscience Source Type: research

Research in the Acute Rehabilitation Setting: a Bridge Too Far?
AbstractPurpose of ReviewThe goal of this paper is to critically examine the challenges to clinical practice in acute neurorehabilitation settings to provide evidence-based recommendations for conducting research on neurologic recovery.Recent FindingsRecent changes in health care have dramatically challenged post-acute care by reducing the length of stay and increasing transitions in care with resulting loss of continuity of care and follow-up. These challenges hinder research and undermine progress in neurorehabilitation.SummaryBased on recent evidence, a hub and spoke model is proposed to bridge and facilitate continuity...
Source: Current Neurology and Neuroscience Reports - January 16, 2019 Category: Neuroscience Source Type: research

Therapeutic Hypothermia in Neonatal Hypoxic-Ischemic Encephalopathy
In conclusion, recent studies suggest that current protocols for therapeutic hypothermia are near-optimal, and that the key to better neurodevelopmental outcomes is earlier diagnosis and initiation of hypothermia after birth. Further research is essential to find and evaluate ways to further improve outcomes after hypoxic-ischemic encephalopathy, including add-on therapies for therapeutic hypothermia and preventing pyrexia during labor and delivery. (Source: Current Neurology and Neuroscience Reports)
Source: Current Neurology and Neuroscience Reports - January 14, 2019 Category: Neuroscience Source Type: research

CSF Biomarkers for Early Diagnosis of Synucleinopathies: Focus on Idiopathic RBD
AbstractPurpose of ReviewIdiopathic REM sleep behavior disorder (iRBD) is one of the most significant prodromal manifestations of synucleinopathies. Different predictive biomarkers for iRBD conversion have been investigated, but scarce data are present in literature about the predictive role of cerebrospinal fluid (CSF) biomarkers. In this review, we focus on CSF biomarkers in patients with both iRBD and RBD associated with synucleinopathies to explore their potential predictive power.Recent FindingsRecent studies revealed that CSF α-synuclein levels are higher in Parkinson’s disease (PD) patients with RBD comp...
Source: Current Neurology and Neuroscience Reports - January 14, 2019 Category: Neuroscience Source Type: research

Defining Cognitive Reserve and Implications for Cognitive Aging
AbstractPurpose of ReviewThe aim of this review is to summarize current conceptual models of cognitive reserve (CR) and related concepts and to discuss evidence for these concepts within the context of aging and Alzheimer ’s disease.Recent FindingsEvidence to date supports the notion that higher levels of CR, as measured by proxy variables reflective of lifetime experiences, are associated with better cognitive performance, and with a reduced risk of incident mild cognitive impairment/dementia. However, the impact of CR on longitudinal cognitive trajectories is unclear and may be influenced by a number of factors. Al...
Source: Current Neurology and Neuroscience Reports - January 9, 2019 Category: Neuroscience Source Type: research

Untangling PTSD and TBI: Challenges and Strategies in Clinical Care and Research
AbstractPurpose of ReviewTraumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) can result from similar injuries and can result in similar symptoms, such as problems with sleep, concentration, memory, and mood. Although PTSD and persistent sequelae due to a TBI (PST) have generally been viewed as pragmatically confounded but conceptually separable entities, we examine emerging evidence emphasizing the breadth of overlap in both clinical presentation and underlying pathophysiology between PST and PTSD.Recent FindingsNew evidence underscores the poor specificity of symptoms to etiology and emphasizes the pote...
Source: Current Neurology and Neuroscience Reports - November 8, 2018 Category: Neuroscience Source Type: research

Relation Between Stress Granules and Cytoplasmic Protein Aggregates Linked to Neurodegenerative Diseases
Abstractá…źA hallmark of neurodegenerative diseases is the accumulation of cytoplasmic protein aggregates in neurons of affected subjects. Among recently identified elements of these aggregates are RNA-binding proteins (RBPs) involved in RNA metabolism and alternative splicing and have in common the presence of low complexity domains (LCD) that are prone to self-assemble and form aggregates. The mechanism of cytoplasmic protein aggregation remains elusive. Stress granules (SGs) that are micrometric RNA-protein assemblies located in the cytoplasm of cells exposed to environmental stress are suspected to play the role of see...
Source: Current Neurology and Neuroscience Reports - November 8, 2018 Category: Neuroscience Source Type: research

A Precision Medicine Approach to Cerebral Edema and Intracranial Hypertension after Severe Traumatic Brain Injury: Quo Vadis?
AbstractPurpose of ReviewStandard clinical protocols for treating cerebral edema and intracranial hypertension after severe TBI have remained remarkably similar over decades. Cerebral edema and intracranial hypertension are treated interchangeably when in fact intracranial pressure (ICP) is a proxy for cerebral edema but also other processes such as extent of mass lesions, hydrocephalus, or cerebral blood volume. A complex interplay of multiple molecular mechanisms results in cerebral edema after severe TBI, and these are not measured or targeted by current clinically available tools. Addressing these underpinnings may be ...
Source: Current Neurology and Neuroscience Reports - November 7, 2018 Category: Neuroscience Source Type: research

Prognostic Factors in Pediatric Sport-Related Concussion
AbstractPurpose of ReviewSport-related concussion (SRC) and mild traumatic brain injury (mTBI) have been thrust into the national spotlight, with youth athletes bearing the burden of this public health problem. The current review aims to provide a practical summary of pediatric SRC, including key terminology, return to play/school, and risk factors for post-concussion syndrome (PCS).Recent FindingsWhile the majority of youth athletes recover within 2 to 4  weeks, approximately 10% of athletes experience a protracted recovery with symptoms lasting months, impacting social, scholastic, and sporting activities.SummaryIn ...
Source: Current Neurology and Neuroscience Reports - November 5, 2018 Category: Neuroscience Source Type: research

Comparative Sleep Disturbances in Myotonic Dystrophy Types 1 and 2
AbstractPurpose of ReviewTo update current knowledge regarding sleep disturbances and myotonic dystrophies so as to better understand if sleep symptoms may help in the early recognition of the two genetic subtypes: myotonic dystrophy type 1 (DM1) and myotonic dystrophy type 2 (DM2).Recent FindingsSleep-disordered breathing (SDB), restless legs syndrome, periodic limb movements in sleep, hypersomnia, and REM sleep dysregulation are frequently described in DM1 patients. SDB does not always explain hypersomnia, but a central dysregulation of sleep –wake modulation is reported mainly in DM1. Sleep apnea, restless legs sy...
Source: Current Neurology and Neuroscience Reports - October 31, 2018 Category: Neuroscience Source Type: research

Management of Episodic Migraine in Children and Adolescents: a Practical Approach
AbstractPurpose of ReviewEpisodic migraine is very common in children and adolescents, seen by primary care and specialists. In kids, this can greatly affect quality of life, including significant disability, specifically in terms of missed school and other activities. The goal of this paper is to give an overview of the most up-to-date thoughts on episodic migraine in the pediatric population.Recent FindingsCurrent options for both abortive and preventative treatments in kids, as well as specific non-pharmacological and lifestyle management recommendations for children, will be reviewed, as well as options for status migr...
Source: Current Neurology and Neuroscience Reports - October 31, 2018 Category: Neuroscience Source Type: research

Serotonin Selective Reuptake Inhibitors (SSRIs) and Stroke
AbstractPurpose of ReviewThe interest in SSRIs after stroke has increased in the past few years, with better knowledge of post-stroke depression and with the demonstrated capacity of some SSRIs to act on the functional recovery of non-depressed subjects.Recent FindingsArguments for the action of SSRIs in favour of post-stroke neurological function recovery have improved through new elements: basic science and preclinical data, positive clinical trials and repeated series of stroke patient meta-analysis, and confirmation of favourable safety conditions in post-stroke patients.SummaryGlobal coherence is appearing, showing th...
Source: Current Neurology and Neuroscience Reports - October 23, 2018 Category: Neuroscience Source Type: research

Management of Blunt Cerebrovascular Injury
AbstractPurpose of ReviewThis review provides an updated summary of blunt cerebrovascular injury (BCVI) to guide clinicians in its early diagnosis and prevention and treatment of stroke associated with such injury.Recent FindingsUntreated BCVI causes stroke in 10 –40% of patients, but more than half will not present with stroke symptoms initially. Risk of stroke is highest in the first 7 days, with a peak in the first 24 h. Computed tomography (CT) angiography is currently the screening modality of choice, although digital subtraction angiography may sti ll be required in some cases. Antithrombotic therapy ...
Source: Current Neurology and Neuroscience Reports - October 23, 2018 Category: Neuroscience Source Type: research

Cerebral Microdialysis in Neurocritical Care
AbstractPurpose of ReviewA major goal in neurocritical care is to monitor for and prevent secondary brain injuries. However, injuries occurring at the cellular and molecular levels evade detection by conventional hemodynamic monitoring and the neurological exam. Cerebral microdialysis (CMD) is an invasive means of providing nearly continuous measurements of cerebral metabolism and is a promising tool that can detect signs of cellular distress before systemic manifestations of intracranial catastrophe.Recent FindingsIn this review, we describe the technique of CMD and the common biomarkers used to monitor cerebral energy me...
Source: Current Neurology and Neuroscience Reports - October 23, 2018 Category: Neuroscience Source Type: research