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The Current of Consciousness: Neural Correlates and Clinical Aspects
AbstractPurpose of ReviewIn this review, we summarize the current understanding of consciousness including its neuroanatomic basis. We discuss major theories of consciousness, physical exam-based and electroencephalographic metrics used to stratify levels of consciousness, and tools used to shed light on the neural correlates of the conscious experience. Lastly, we review an expanded category of ‘disorders of consciousness,’ which includes disorders that impact either the level or experience of consciousness.Recent FindingsRecent studies have revealed many of the requisite EEG, ERP, and fMRI signals to predict aspects ...
Source: Current Neurology and Neuroscience Reports - June 12, 2023 Category: Neuroscience Source Type: research

Medication Overuse Headache: an Updated Review and Clinical Recommendations on Management
AbstractOverviewMedication overuse headache (MOH) is highly prevalent among individuals with primary headache disorders.Purpose of Review(1) Provide an update on epidemiology, risk factors, and treatment strategies of MOH and (2) provide recommendations on the management of MOH.Recent FindingsThe prevalence of MOH ranges from 0.5 to 7.2%. Risk factors for MOH include female sex, lower socioeconomic status, some psychiatric conditions, and substance use disorders, among others. Recent large clinical trials support preventative therapy as an integral component of MOH management. Emerging clinical trial evidence supports anti...
Source: Current Neurology and Neuroscience Reports - June 5, 2023 Category: Neuroscience Source Type: research

Supporting Post-Stroke Language and Cognition with Pharmacotherapy: Tools for Each Phase of Care
AbstractPurpose of ReviewThere is enormous enthusiasm for the possibility of pharmacotherapies to treat language deficits that can arise after stroke. Speech language therapy remains the most frequently utilized and most strongly evidenced treatment, but the numerous barriers to patients receiving the therapy necessary to recover have motivated the creation of a relatively modest, yet highly cited, body of evidence to support the use of pharmacotherapy to treat post-stroke aphasia directly or to augment traditional post-stroke aphasia treatment. In this review, we survey the use of pharmacotherapy to preserve and support l...
Source: Current Neurology and Neuroscience Reports - June 5, 2023 Category: Neuroscience Source Type: research

An Update on Apraxia of Speech
This article reviews recent findings regarding the clinic phenotypes of AOS, neuroimaging correlates, and the underlying disease processes.Recent FindingsTwo clinical subtypes of AOS map onto two underlying 4-repeat tauopathies. New imaging techniques have recently been applied to the study of progressive AOS. There is no data on the impact of behavioral intervention, although studies of nonfluent/agrammatic primary progressive aphasia that include patients with AOS suggest some benefit in speech intelligibility and maintenance.SummaryWhile recent findings suggest subtypes of AOS exist that are linked to molecular patholog...
Source: Current Neurology and Neuroscience Reports - June 3, 2023 Category: Neuroscience Source Type: research

Sleep Disorders in Patients with Choreic Syndromes
AbstractPurpose of ReviewPatients with different types of choreic syndromes, specially those with Huntington ’s (HD) and Wilson’s (WD) diseases, report frequent sleep complaints. This review focuses on the main findings of studies addressing the sleep features in these diseases, and other less frequent causes of chorea associated with sleep disorders, including a new syndrome described in the last deca de associated with IgLON5 antibodies.Recent FindingsPatients with HD and WD showed a bad quality of sleep and high frequency of insomnia and excessive daytime somnolence. WD patients also showed high scores on a specific...
Source: Current Neurology and Neuroscience Reports - June 3, 2023 Category: Neuroscience Source Type: research

Hemiplegic Migraine
AbstractPurpose of ReviewIn this article, we review recent updates to the epidemiology, diagnostic testing, genetics, pathophysiology, and management of hemiplegic migraine.Recent FindingsWhile three genes have been historically associated with hemiplegic migraine, recent studies suggest two additional genes may also be implicated includingPPRT2 andSLC1A3.SummaryHemiplegic migraine is a severe subset of migraine with aura with symptoms including reversible hemiparesis in addition to other aura symptoms such as visual, sensory, or speech. The exact pathophysiology of hemiplegic migraine is not clear, but it is thought that ...
Source: Current Neurology and Neuroscience Reports - May 29, 2023 Category: Neuroscience Source Type: research

Advances in Management of the Stroke Etiology One-Percenters
AbstractPurpose of ReviewUncommon causes of stroke merit specific attention; when clinicians have less common etiologies of stoke in mind, the diagnosis may come more easily. This is key, as optimal management will in many cases differs significantly from “standard” care.Recent FindingsRandomized controlled trials (RCT) on the best medical therapy in the treatment of cervical artery dissection (CeAD) have demonstrated low rates of ischemia with both antiplatelet and vitamin K antagonism. RCT evidence supports the use of anticoagulation with vitamin K antagonism in “high-risk” patients with antiphospholipid antibody...
Source: Current Neurology and Neuroscience Reports - May 29, 2023 Category: Neuroscience Source Type: research

Neurological Manifestations of Histiocytic Disorders
AbstractPurpose of ReviewHistiocytic disorders, including Erdheim-Chester disease (ECD), Langerhans cell histiocytosis (LCH), and Rosai-Dorfman disease (RDD), are rare neoplasms that may present with a spectrum of neurologic involvement. Diagnostic delay is common due to heterogeneity in presentation and challenging pathology.Recent FindingsRecent advances in the treatment of these diseases targeted towards mutations in the MAP kinase pathway have led to an improved prognosis in these patients with neurologic involvement.SummaryIt is critical for clinicians to have a high index of suspicion to allow for early targeted trea...
Source: Current Neurology and Neuroscience Reports - May 20, 2023 Category: Neuroscience Source Type: research

Advances in Treatment of Isocitrate Dehydrogenase (IDH)-Wildtype Glioblastomas
AbstractPurpose of ReviewThe management of isocitrate dehydrogenase (IDH)-wildtype glioblastomas is an area of unmet need. Despite multimodal therapy incorporating maximal safe resection, radiotherapy, and temozolomide, clinical outcomes remain poor. At disease progression or relapse, available systemic agents such as temozolomide, lomustine, and bevacizumab have limited efficacy. We review the recent advances in the treatment of IDH-wildtype glioblastomas.Recent FindingsA broad repertoire of systemic agents is in the early stages of development, encompassing the areas of precision medicine, immunotherapy, and repurposed m...
Source: Current Neurology and Neuroscience Reports - May 8, 2023 Category: Neuroscience Source Type: research

Neuroendocrine Disruptions Following Head Injury
This article reviews hypopituitarism after TBI, the importance of pituitary hormones, and related controversies, concluding with a suggested patient approach.Recent FindingsWhile earlier studies focused on increased pituitary deficiencies after moderate-severe TBI, recent studies have focused on deficiencies after mild TBI. There has been increasing focus on the role of growth hormone after injury; growth hormone is the most frequent reported deficiency at 1  year post-TBI, and an area with unresolved questions. While more research is needed to quantify the risk of deficiencies in special populations, and establish the na...
Source: Current Neurology and Neuroscience Reports - May 6, 2023 Category: Neuroscience Source Type: research

Apperceptive and Associative Forms of Phonagnosia
This article reviews recent research on the neuropsychological and anatomo-clinical aspects of this condition.Recent FindingsData obtained in group studies or single case reports of phonagnosic patients suggest that apperceptive phonagnosia might be due to disruption of the core temporal voice areas, bilaterally located in the posterior parts of the superior temporal gyrus, whereas associative phonagnosia might result from impaired access to structures where voice representations are stored, due to a disconnection of these areas from structures of the voice extended system.SummaryAlthough these results must be confirmed by...
Source: Current Neurology and Neuroscience Reports - May 3, 2023 Category: Neuroscience Source Type: research

Structural and Functional Imaging Correlates of Visual Hallucinations in Parkinson ’s Disease
AbstractPurpose of ReviewTo review recent structural and functional MRI studies of visual hallucinations in Parkinson ’s disease.Recent FindingsPreviously, neuroimaging had shown inconsistent findings in patients with Parkinson ’s hallucinations, especially in studies examining grey matter volume. However, recent advances in structural and functional MRI techniques allow better estimates of structural connections, as well as the direction of connectivity in functional MRI. These provide more sensitive measures of changes in structural connectivity and allow models of the changes in directional functional connectivity t...
Source: Current Neurology and Neuroscience Reports - May 1, 2023 Category: Neuroscience Source Type: research

Therapies for IDH-Mutant Gliomas
This article provides a review of standard of care treatment options and innovative, therapeutic approaches that are currently under investigation for these tumors.Recent FindingsExtensive pre-clinical data and a variety of clinical studies support targetingIDH mutations in glioma using different mechanisms, which include direct inhibition and immunotherapies that target metabolic and epigenomic vulnerabilities caused by these mutations.SummaryIDH mutations have been recognized as an oncogenic driver in gliomas for more than a decade and as a positive prognostic factor influencing the research for new therapeutic methods i...
Source: Current Neurology and Neuroscience Reports - April 15, 2023 Category: Neuroscience Source Type: research

Contemporary Antiplatelet and Anticoagulant Therapies for Secondary Stroke Prevention: A Narrative Review of Current Literature and Guidelines
AbstractPurpose of ReviewStroke is a leading cause of death and disability worldwide. The annual incidence of new or recurrent stroke is approximately 795,000 cases per year in the United States, of which 87% are ischemic in nature. In addition to the management of modifiable high-risk factors to reduce the risk of recurrent stroke, antithrombotic agents (antiplatelets and anticoagulants) play an important role in secondary stroke prevention. This review will discuss the published literature on the use of antiplatelets and anticoagulants in secondary prevention of acute ischemic stroke and transient ischemic attack (TIA), ...
Source: Current Neurology and Neuroscience Reports - April 11, 2023 Category: Neuroscience Source Type: research

Middle Meningeal Artery Embolization in the Management of Chronic Subdural Hematoma: a Comprehensive Review of Current Literature
AbstractPurpose of ReviewChronic subdural hematoma (cSDH) is a common intracranial hemorrhagic disorder with a high incidence rate among the elderly. While small, asymptomatic cSDH may resolve spontaneously, surgical intervention has been the treatment of choice for larger, symptomatic cases. Surgical evacuation of cSDH may be associated with high rates of recurrence, and even asymptomatic cSDH cases tend to progress. Over the last few years, middle meningeal artery (MMA) embolization has proven to be a safe non-invasive treatment of choice with favorable outcomes and a low recurrence rate. The ensuing paper discusses curr...
Source: Current Neurology and Neuroscience Reports - April 11, 2023 Category: Neuroscience Source Type: research