Wilson disease
Purpose of review The aim of this article is to review recent developments in the areas of the disease features and treatment of Wilson disease, and survey disorders that share its pathophysiology or clinical symptoms. Recent findings Knowledge of the clinical spectrum of Wilson disease has expanded with recognition of patients who present in atypical age groups – patients with very early onset ( (Source: Current Opinion in Neurology)
Source: Current Opinion in Neurology - July 30, 2020 Category: Neurology Tags: MOVEMENT DISORDERS: Edited by Nutan Sharma Source Type: research

Immunotherapy in progressive supranuclear palsy
Purpose of review Progressive supranuclear palsy (PSP) is a progressive adult-onset neurodegenerative disease. Abnormally, phosphorylated forms of the microtubule-associated protein tau containing four repeat domains (4R-tau) aggregate in neurons. Additionally, increasing evidence suggests that secretion and uptake of fragments of abnormal 4R-tau may play a role in disease progression. This extracellular tau is a natural target for immunotherapy. Recent findings Three monoclonal antibodies targeting extracellular tau are in clinical stages of development. ABBV-8E12 and BIIB092 were safe in Phase 1, but both Phase two ...
Source: Current Opinion in Neurology - July 30, 2020 Category: Neurology Tags: MOVEMENT DISORDERS: Edited by Nutan Sharma Source Type: research

Recent therapeutic prospects for Machado–Joseph disease
Purpose of review Machado–Joseph disease (MJD), also known as spinocerebellar ataxia type 3 (SCA3), is a fatal, dominantly inherited, neurodegenerative disease caused by expansion of a CAG repeat in the coding region of the ATXN3 gene. No disease-modifying treatment is yet available for MJD/SCA3. This review discusses recently developed therapeutic strategies that hold promise as future effective treatments for this incurable disease. Recent findings As a result of the exploration of multiple therapeutic approaches over the last decade, the MJD/SCA3 field is finally starting to see options for disease-modifying ...
Source: Current Opinion in Neurology - July 30, 2020 Category: Neurology Tags: MOVEMENT DISORDERS: Edited by Nutan Sharma Source Type: research

Therapeutic strategies for Huntington's disease
Purpose of review Huntington's disease is a fatal autosomal dominant neurodegenerative disorder caused by a trinucleotide expansion in the HTT gene, and current therapies focus on symptomatic treatment. This review explores therapeutic approaches that directly target the pathogenic mutation, disrupt HTT mRNA or its translation. Recent findings Zinc-finger transcription repressors and CRISPR-Cas9 therapies target HTT DNA, thereby preventing all downstream pathogenic mechanisms. These therapies, together with RNA interference (RNAi), require intraparenchymal delivery to the brain in viral vectors, with only a single del...
Source: Current Opinion in Neurology - July 30, 2020 Category: Neurology Tags: MOVEMENT DISORDERS: Edited by Nutan Sharma Source Type: research

Recent genetic advances in early-onset dystonia
Purpose of review The discovery of new disease-causing genes and availability of next-generation sequencing platforms have both progressed rapidly over the last few years. For the practicing neurologist, this presents an increasingly bewildering array both of potential diagnoses and of means to investigate them. We review the latest newly described genetic conditions associated with dystonia, and also address how the changing landscape of gene discovery and genetic testing can best be approached, from both a research and a clinical perspective. Recent findings Several new genetic causes for disorders in which dystonia...
Source: Current Opinion in Neurology - July 30, 2020 Category: Neurology Tags: MOVEMENT DISORDERS: Edited by Nutan Sharma Source Type: research

Editorial: Advances in rare movement disorders
No abstract available (Source: Current Opinion in Neurology)
Source: Current Opinion in Neurology - July 30, 2020 Category: Neurology Tags: MOVEMENT DISORDERS: Edited by Nutan Sharma Source Type: research

Magnetic resonance-guided focused ultrasound for movement disorders: clinical and neuroimaging advances
Purpose of review To describe the path of technological developments that have led to the actual application of MRI-guided focused ultrasound in multiple neurological disorders and to update the more recent technical advances in the field. An insight into the latest clinical achievements in movement disorders will be provided, together with the neuroimaging advances for the screening, planning, and outcome evaluation. Recent findings Developments, such as phased array transducers and MRI guidance have allowed the use of focused ultrasound to successfully perform incisionless therapeutic ablation in deep brain structur...
Source: Current Opinion in Neurology - July 30, 2020 Category: Neurology Tags: NEUROIMAGING: Edited by Stéphane Lehéricy Source Type: research

Prediction of motor recovery after stroke: being pragmatic or innovative?
Purpose of review This review considers both pragmatic and cutting-edge approaches for predicting motor stroke recovery over the period 2017–2019. It focuses on the predictive value of clinical scores and biomarkers including Transcranial Magnetic Stimulation (TMS) and MRI as well as more innovative alternatives. Recent findings Clinical scores combined with corticospinal tract (CST) integrity as assessed by both TMS-induced motor-evoked potential (MEP) and MRI predict motor recovery with an accuracy of about 75%. Therefore, research on novel biomarkers is still needed to improve the accuracy of these models. S...
Source: Current Opinion in Neurology - July 30, 2020 Category: Neurology Tags: NEUROIMAGING: Edited by Stéphane Lehéricy Source Type: research

Tremor pathophysiology: lessons from neuroimaging
Purpose of review We discuss the latest neuroimaging studies investigating the pathophysiology of Parkinson's tremor, essential tremor, dystonic tremor and Holmes tremor. Recent findings Parkinson's tremor is associated with increased activity in the cerebello-thalamo-cortical circuit, with interindividual differences depending on the clinical dopamine response of the tremor. Although dopamine-resistant Parkinson's tremor arises from a larger contribution of the (dopamine-insensitive) cerebellum, dopamine-responsive tremor may be explained by thalamic dopamine depletion. In essential tremor, deep brain stimulation nor...
Source: Current Opinion in Neurology - July 30, 2020 Category: Neurology Tags: NEUROIMAGING: Edited by Stéphane Lehéricy Source Type: research

MRI of neurodegeneration with brain iron accumulation
This article details the contribution of MRI in the diagnosis by summarizing and comparing MRI patterns of the various NBIA subtypes. Recent findings MRI almost always shows characteristic changes combining iron accumulation and additional neuroimaging abnormalities. Iron-sensitive MRI shows iron deposition in the basal ganglia, particularly in bilateral globus pallidus and substantia nigra. Other regions may be affected depending on the NBIA subtypes including the cerebellum and dentate nucleus, the midbrain, the striatum, the thalamus, and the cortex. Atrophy of the cerebellum, brainstem, corpus callosum and cortex, a...
Source: Current Opinion in Neurology - July 30, 2020 Category: Neurology Tags: NEUROIMAGING: Edited by Stéphane Lehéricy Source Type: research

MR imaging and spectroscopy in degenerative ataxias: toward multimodal, multisite, multistage monitoring of neurodegeneration
Purpose of review Degenerative ataxias are rare and currently untreatable movement disorders, primarily characterized by neurodegeneration in the cerebellum and brainstem. We highlight MRI studies with the most potential for utility in pending ataxia trials and underscore advances in disease characterization and diagnostics in the field. Recent findings With availability of advanced MRI acquisition methods and specialized software dedicated to the analysis of MRI of the cerebellum, patterns of cerebellar atrophy in different degenerative ataxias are increasingly well defined. The field further embraced rigorous multim...
Source: Current Opinion in Neurology - July 30, 2020 Category: Neurology Tags: NEUROIMAGING: Edited by Stéphane Lehéricy Source Type: research

Machine learning for classification and prediction of brain diseases: recent advances and upcoming challenges
Purpose of review Machine learning is an artificial intelligence technique that allows computers to perform a task without being explicitly programmed. Machine learning can be used to assist diagnosis and prognosis of brain disorders. Although the earliest articles date from more than ten years ago, research increases at a very fast pace. Recent findings Recent works using machine learning for diagnosis have moved from classification of a given disease versus controls to differential diagnosis. Intense research has been devoted to the prediction of the future patient state. Although a lot of earlier works focused on n...
Source: Current Opinion in Neurology - July 30, 2020 Category: Neurology Tags: NEUROIMAGING: Edited by Stéphane Lehéricy Source Type: research

Contribution of PET-MRI in brain diseases in clinical practice
Purpose of review Hybrid PET- MRI is a technique that has the ability to improve diagnostic accuracy in many applications, whereas PET and MRI performed separately often fail to provide accurate responses to clinical questions. Here, we review recent studies and current developments in PET-MRI, focusing on clinical applications. Recent findings The combination of PET and MRI imaging methods aims at increasing the potential of each individual modality. Combined methods of image reconstruction and correction of PET-MRI attenuation are being developed, and a number of applications are being introduced into clinical pract...
Source: Current Opinion in Neurology - July 30, 2020 Category: Neurology Tags: NEUROIMAGING: Edited by Stéphane Lehéricy Source Type: research

Ultra-high field 7 T imaging in multiple sclerosis
Purpose of review Ultra-high field 7 T MRI has multiple applications for the in vivo characterization of the heterogeneous aspects underlying multiple sclerosis including the identification of cortical lesions, characterization of the different types of white matter plaques, evaluation of structures difficult to assess with conventional MRI (thalamus, cerebellum, spinal cord, meninges). Recent findings The sensitivity of cortical lesion detection at 7 T is twice than at lower field MRI, especially for subpial lesions, the most common cortical lesion type in multiple sclerosis. Cortical lesion load accrual is indep...
Source: Current Opinion in Neurology - July 30, 2020 Category: Neurology Tags: NEUROIMAGING: Edited by Stéphane Lehéricy Source Type: research

Magnetic resonance spectroscopy of isocitrate dehydrogenase mutated gliomas: current knowledge on the neurochemical profile
Purpose of review Magnetic resonance spectroscopy (MRS) may play a key role for the management of patients with glioma. We highlighted the utility of MRS in the noninvasive diagnosis of gliomas with mutations in isocitrate dehydrogenase (IDH) genes, by providing an overview of the neurochemical alterations observed in different glioma subtypes, as well as during treatment and progression, both in vivo and ex vivo. Recent findings D-2-hydroxyglutarate (2HG) decrease during anticancer treatments was recently shown to be associated with altered levels of other metabolites, including lactate, glutamate and glutathione, su...
Source: Current Opinion in Neurology - July 30, 2020 Category: Neurology Tags: NEUROIMAGING: Edited by Stéphane Lehéricy Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Neurology)
Source: Current Opinion in Neurology - July 30, 2020 Category: Neurology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Update on T cells in the virally infected brain: friends and foes
Purpose of review The present review will outline neuroprotective and neurotoxic effects of central nervous system (CNS) infiltrating T cells during viral infections. Evidence demonstrating differential roles for antiviral effector and resident memory T-cell subsets in virologic control and immunopathology in the CNS will be discussed. Potential therapeutic targets emanating from a growing understanding of T-cell-initiated neuropathology that impacts learning and memory will also be delineated. Recent findings The critical role for T cells in preventing and clearing CNS infections became incontrovertible during the er...
Source: Current Opinion in Neurology - May 6, 2020 Category: Neurology Tags: CNS INFLAMMATORY DISORDERS OUTSIDE MULTIPLE SCLEROSIS: Edited by Bruce T. Volpe Source Type: research

Chronic inflammation mediates brain injury in HIV infection: relevance for cure strategies
Purpose of review Chronic inflammation is a major component of HIV infection, the effects of which can be devastating in the central nervous system (CNS). Protecting the brain is, therefore, critical as efforts proceed to cure HIV infection by reactivating latent viral reservoirs and driving immune responses. We review the clinical presentation and pathology findings of inflammatory processes in the CNS in patients managed with ART and the drivers of these processes. Recent findings Chronic inflammation is associated with increased mortality and morbidity and HIV infection increases the risk for chronic diseases, espe...
Source: Current Opinion in Neurology - May 6, 2020 Category: Neurology Tags: CNS INFLAMMATORY DISORDERS OUTSIDE MULTIPLE SCLEROSIS: Edited by Bruce T. Volpe Source Type: research

The biological basis of chronic fatigue: neuroinflammation and innate immunity
Purpose of review Chronic fatigue is common in cancer, neurodegenerative, and chronic inflammatory diseases and is regarded by many patients as their absolutely worst problem. Lately, fatigue is increasingly understood to have a genetic and molecular basis. Recent findings Biologically, fatigue occurs as part of the sickness behavior response, a complex and automated behavior triggered by the activation of innate immunity and neuroinflammation. IL-1β causes neuronal activation in the brain and subsequent fatigue. In addition to proinflammatory molecules, potential partners in the complex brain signaling of fatigu...
Source: Current Opinion in Neurology - May 6, 2020 Category: Neurology Tags: CNS INFLAMMATORY DISORDERS OUTSIDE MULTIPLE SCLEROSIS: Edited by Bruce T. Volpe Source Type: research

Galectins in the brain: advances in neuroinflammation, neuroprotection and therapeutic opportunities
Purpose of review Galectin interactions with glycoproteins and glycolipids modulate a variety of cellular responses that are now increasingly explored to better understand neuroinflammation processes and eventually find new therapeutic opportunities for neurological diseases. Recent findings Gal-1 confirmed its indirect neuroprotective roles through anti-inflammatory properties whereas Gal-3 remains elusive, showing anti-inflammatory or pro-inflammatory roles depending on damaging conditions and genetic background of mice models. Interestingly, microglial intracellular rather than extracellular overexpression of Gal-3...
Source: Current Opinion in Neurology - May 6, 2020 Category: Neurology Tags: CNS INFLAMMATORY DISORDERS OUTSIDE MULTIPLE SCLEROSIS: Edited by Bruce T. Volpe Source Type: research

Anti-gamma-aminobutyric acid receptor type A encephalitis: a review
Purpose of review To systematically review the clinical features, diagnosis, and management of anti-gamma-aminobutyric acid receptor Type A (GABAA) autoimmune encephalitis with a focus on recent data. Recent findings In a review of published reports, we identified 50 cases of anti-GABAA receptor encephalitis with clinical features reported. The median age at presentation was 47 years old (range, 2.5 months–88 years old), 64% were adults, 36% were children and it occurred in both males and females. Eight-two percent (41/50) presented with seizures, 72% (36/50) with encephalopathy, and 58% (29/50) with both. Of th...
Source: Current Opinion in Neurology - May 6, 2020 Category: Neurology Tags: CNS INFLAMMATORY DISORDERS OUTSIDE MULTIPLE SCLEROSIS: Edited by Bruce T. Volpe Source Type: research

Novel insights into pathophysiology and therapeutic possibilities reveal further differences between AQP4-IgG- and MOG-IgG-associated diseases
Purpose of review This review summarizes recent insights into the pathogenesis and therapeutic options for patients with MOG- or AQP4-antibodies. Recent findings Although AQP4-IgG are linked to NMOSD, MOG-IgG-associated diseases (MOGAD) include a broader clinical spectrum of autoimmune diseases of the central nervous system (CNS). Details of membrane assembly of AQP4-IgG required for complement activation have been uncovered. Affinity-purified MOG-IgG from patients were shown to be pathogenic by induction of demyelination when the blood--brain barrier (BBB) was breached and by enhancement of activation of cognate T ce...
Source: Current Opinion in Neurology - May 6, 2020 Category: Neurology Tags: CNS INFLAMMATORY DISORDERS OUTSIDE MULTIPLE SCLEROSIS: Edited by Bruce T. Volpe Source Type: research

Advanced neuroimaging in neuropsychiatric systemic lupus erythematosus
Purpose of review Neuropsychiatric lupus (NPSLE) comprises a disparate collection of syndromes affecting the central and peripheral nervous systems. Progress in the attribution of neuropsychiatric syndromes to SLE-related mechanisms and development of targeted treatment strategies has been impeded by a lack of objective imaging biomarkers that reflect specific neuropsychiatric syndromes and/or pathologic mechanisms. The present review addresses recent publications of neuroimaging techniques in NPSLE. Recent findings Imaging studies grouping all NPSLE syndromes together are unable to differentiate between NPSLE and non...
Source: Current Opinion in Neurology - May 6, 2020 Category: Neurology Tags: CNS INFLAMMATORY DISORDERS OUTSIDE MULTIPLE SCLEROSIS: Edited by Bruce T. Volpe Source Type: research

What are the latest clinical findings regarding the association of neurotoxic brain antibodies found in the cerebrospinal fluid in patients with autoimmune disorders?
Purpose of review Recently, experiments show that the autoantibodies with direct access to neurons following blood brain barrier (BBB) disruption destroy neurons and lead to remodeling in damaged neurons. These are critical steps in autoantibody-mediated central nervous system disorder called neuropsychiatric syndromes in systemic lupus erythematosus (NPSLE). The purpose of this review is to examine therapeutic opportunities to repress neuronal remodeling by microglia after acute neuronal injury by autoantibodies. Recent findings Recent studies have demonstrated that BBB disruption is a critical step for developing NP...
Source: Current Opinion in Neurology - May 6, 2020 Category: Neurology Tags: CNS INFLAMMATORY DISORDERS OUTSIDE MULTIPLE SCLEROSIS: Edited by Bruce T. Volpe Source Type: research

Persistent inflammatory states and their implications in brain disease
Purpose of review Apart from mental, motor and sensory functions, the human central nervous system (CNS) regulates a plethora of homeostatic (autonomic and hormonal) bodily functions. These functions are dependent on specialized neuronal networks. To ensure connectivity of these networks, they are continuously refined and supported by glial cells that outnumber neurons by, according to some accounts, an order of magnitude. Among glial cells, microglia – the brain resident macrophages – plays a crucial role in maintaining neuronal networks. However, in their concomitant role as brain immune cells microglia als...
Source: Current Opinion in Neurology - May 6, 2020 Category: Neurology Tags: CNS INFLAMMATORY DISORDERS OUTSIDE MULTIPLE SCLEROSIS: Edited by Bruce T. Volpe Source Type: research

Editorial: Immune mechanisms and brain dysfunction
No abstract available (Source: Current Opinion in Neurology)
Source: Current Opinion in Neurology - May 6, 2020 Category: Neurology Tags: CNS INFLAMMATORY DISORDERS OUTSIDE MULTIPLE SCLEROSIS: Edited by Bruce T. Volpe Source Type: research

Neuromodulation in primary headaches: current evidence and integration into clinical practice
Purpose of review Neuromodulatory approaches add to our armamentarium of therapeutic tools for the treatment of primary headaches. This review provides a comprehensive overview of current controlled studies on the different neuromodulation techniques and recommendations for clinical practice. Recent findings Evidence for efficacy of transcutaneous vagal nerve stimulation (tVNS) is limited to acute use in migraine with ambiguous results and episodic cluster headache as well as chronic cluster headache if applied in addition to conventional treatment. Transcutaneous stimulation of the supraorbital and supratrochlear ner...
Source: Current Opinion in Neurology - May 6, 2020 Category: Neurology Tags: HEADACHE: Edited by Peter J. Goadsby Source Type: research

Evolving options for the treatment of cluster headache
Purpose of review Cluster headache is a neurological disorder that patients consider the most severe pain they experience. Recognizing new treatments provides opportunities to advance current management. Recent findings In contrast to the classic treatments, new options narrow in on the therapeutic target and are better tolerated. Calcitonin gene-related peptide (CGRP) pathway blockade with monoclonal antibodies (MABs), specifically the CGRP MAB galcanezumab, represents an important advance for episodic cluster headache, reducing the number of attacks during a bout. Neuromodulation strategies aimed at anatomical struc...
Source: Current Opinion in Neurology - May 6, 2020 Category: Neurology Tags: HEADACHE: Edited by Peter J. Goadsby Source Type: research

Posttraumatic headache: recent progress
Purpose of review Posttraumatic headache (PTH) attributed to mild traumatic brain injury is common and debilitating. In up to one-half of those with acute PTH, the PTH becomes persistent (PTH), enduring for longer than 3 months. The high incidence and persistence of PTH necessitate research into PTH pathophysiology and treatment. In this review, recent developments regarding the diagnostic criteria for PTH, the pathophysiology of PTH, and PTH treatment are discussed. Recent findings International Classification of Headache Disorders 3 diagnostic criteria for PTH attributed to head trauma require that ‘a headache...
Source: Current Opinion in Neurology - May 6, 2020 Category: Neurology Tags: HEADACHE: Edited by Peter J. Goadsby Source Type: research

Gepants, calcitonin-gene-related peptide receptor antagonists: what could be their role in migraine treatment?
Purpose of review Migraine is the second leading cause of years lived with disability after back pain. Poor tolerability, contraindications, drug–drug interactions and efficacy limited to a subpopulation make new approaches necessary for the acute and preventive treatment of migraine. The study of the calcitonin-gene-related peptide (CGRP) pathway over the last decades is a good example of translational medicine leading to directed therapies for patients. Recent findings After some of the first-generation CGRP receptor antagonists, gepants, were not fully developed because of hepatotoxicity, the second generatio...
Source: Current Opinion in Neurology - May 6, 2020 Category: Neurology Tags: HEADACHE: Edited by Peter J. Goadsby Source Type: research

Neuromyelitis optica spectrum disorders and myelin oligodendrocyte glycoprotein antibody-associated disease: current topics
Purpose of review We reviewed present topics on neuromyelitis optica spectrum disorders (NMOSD) and myelin oligodendrocyte glycoprotein (MOG)-antibody-associated disease (MOGAD). Recent findings The number of NMOSD-related publications have increased year by year after the discovery of aquaporin 4 (AQP4)-antibody, and those on MOGAD started to surge since 2012–2013. Recent clinic-epidemiological surveys in NMOSD suggest that some racial differences in the prevalence and the clinical course. At present, experts feel the 2015 diagnostic criteria of AQP4-antibody-seronegative NMOSD should be revised. Randomized con...
Source: Current Opinion in Neurology - May 6, 2020 Category: Neurology Tags: MULTIPLE SCLEROSIS: Edited by Giancarlo Comi Source Type: research

Measuring outcomes that matter most to people with multiple sclerosis: the role of patient-reported outcomes
Purpose of review Patient-reported outcome (PRO) represents a unique opportunity to measure the impact of health research, and care on outcomes that matter most to people with multiple sclerosis (PwMS). Recent findings How to incorporate PROs in MS clinical trials and, practice remains a matter of debate. The variety of measures available for use in MS has some benefits, but the lack of a set of standard measures has significant disadvantages. To help meeting the challenge, different PROs standard sets have been developed (PROMIS) for use across a broad range of chronic health conditions, and SymptoMScreen, specifical...
Source: Current Opinion in Neurology - May 6, 2020 Category: Neurology Tags: MULTIPLE SCLEROSIS: Edited by Giancarlo Comi Source Type: research

Prevention and management of adverse effects of disease modifying treatments in multiple sclerosis
Purpose of review To summarize the currently known side effects of the approved therapies of multiple sclerosis and to suggest monitoring procedures. Recent findings The progress in the treatment of multiple sclerosis with new very effective therapies is accompanied by a number of side effects. Some of these have already been described in the approval studies, but some only after approval in a real world situation. The reason for this is the short duration of the clinical studies, the very heterogeneous patient profile in the real world setting with a number of comorbidities, pretherapies, and wider age range. The sid...
Source: Current Opinion in Neurology - May 6, 2020 Category: Neurology Tags: MULTIPLE SCLEROSIS: Edited by Giancarlo Comi Source Type: research

Mechanisms underlying progression in multiple sclerosis
Purpose of review In multiple sclerosis, currently approved disease-modifying treatments are effective in modulating peripheral immunity, and coherently, in reducing clinical/radiological relapses, but still, they perform poorly in preventing disease progression and overall disability accrual. This review provides an up-to-date overview of the neuropathology of progressive multiple sclerosis, including a summary of the main mechanisms of disease progression. Recent findings Clinical progression in multiple sclerosis is likely related to the accumulation of neuro-axonal loss in a lifelong inflammatory CNS environment (...
Source: Current Opinion in Neurology - May 6, 2020 Category: Neurology Tags: MULTIPLE SCLEROSIS: Edited by Giancarlo Comi Source Type: research

E-health and multiple sclerosis
Purpose of review To outline recent applications of e-health data and digital tools for improving the care and management of healthcare for people with multiple sclerosis. Recent findings The digitization of most clinical data, along with developments in communication technologies, miniaturization of sensors and computational advances are enabling aggregation and clinically meaningful analyses of real-world data from patient registries, digital patient-reported outcomes and electronic health records (EHR). These data are allowing more confident descriptions of prognoses for multiple sclerosis patients and the long-ter...
Source: Current Opinion in Neurology - May 6, 2020 Category: Neurology Tags: MULTIPLE SCLEROSIS: Edited by Giancarlo Comi Source Type: research

The window of opportunity for treatment of progressive multiple sclerosis
Purpose of review Based on the knowledge of disease mechanisms in the progressive course of multiple sclerosis and the experience from randomized clinical trials, we assessed the timing of disease-modifying therapy in patients with progressive multiple sclerosis to define the optimal window of opportunity for treatment of progressive multiple sclerosis. Recent findings In progressive multiple sclerosis both small molecules that cross the blood--brain barrier (siponimod) and monoclonal antibodies (ocrelizumab) have shown therapeutic efficacy and have been approved for treatment of progressive multiple sclerosis. Howeve...
Source: Current Opinion in Neurology - May 6, 2020 Category: Neurology Tags: MULTIPLE SCLEROSIS: Edited by Giancarlo Comi Source Type: research

Advances in physical rehabilitation of multiple sclerosis
Purpose of review Multiple sclerosis (MS) is a neurological disorder that heavily affects quality of life (QoL) and demands a multidisciplinary therapeutic approach. This includes multiple protocols and techniques of physical rehabilitation, ranging from conventional exercise paradigms to noninvasive brain stimulation (NIBS). Recently, studies showing the clinical efficacy of physical rehabilitation have remarkably increased, suggesting its disease-modifying potential. Recent findings Studies in animal models of MS have shown that physical exercise ameliorates the main disease pathological hallmarks, acting as a pro-m...
Source: Current Opinion in Neurology - May 6, 2020 Category: Neurology Tags: MULTIPLE SCLEROSIS: Edited by Giancarlo Comi Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Neurology)
Source: Current Opinion in Neurology - May 6, 2020 Category: Neurology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Data science in neurodegenerative disease: its capabilities, limitations, and perspectives
Purpose of review With the advancement of computational approaches and abundance of biomedical data, a broad range of neurodegenerative disease models have been developed. In this review, we argue that computational models can be both relevant and useful in neurodegenerative disease research and although the current established models have limitations in clinical practice, artificial intelligence has the potential to overcome deficiencies encountered by these models, which in turn can improve our understanding of disease. Recent findings In recent years, diverse computational approaches have been used to shed light on...
Source: Current Opinion in Neurology - March 6, 2020 Category: Neurology Tags: DEGENERATIVE AND COGNITIVE DISEASES: Edited by Jean-Jean-François Demonet Source Type: research

Serious video games and virtual reality for prevention and neurorehabilitation of cognitive decline because of aging and neurodegeneration
Purpose of review Cognitive decline because of aging and neurodegeneration has become increasingly prevalent. This calls for the implementation of efficacious, motivating, standardized and widely available cognitive interventions for the elderly. In this context, serious video games and virtual reality may represent promising approaches. Here, we review recent research on their potential for cognitive prevention and neurorehabilitation of age-related cognitive decline and mild cognitive impairment (MCI). Recent findings The majority of currently available data in this evolving domain lacks the methodological quality t...
Source: Current Opinion in Neurology - March 6, 2020 Category: Neurology Tags: DEGENERATIVE AND COGNITIVE DISEASES: Edited by Jean-Jean-François Demonet Source Type: research

Linking mechanisms of periodontitis to Alzheimer's disease
Purpose of review The review article discusses the association between periodontal disease and the development of dementia. Recent findings In the last decade, increasing evidence has pointed to a microbial and inflammatory origin for Alzheimer's disease with the discovery of oral and airway bacteria, viruses, and fungal species in the brain of patients with Alzheimer's disease. Furthermore, recognized as the culprit of neural network dysfunction, β-amyloid oligomeric species have antimicrobial properties reinforcing the idea that dysbiosis in the host–microbiota interaction can be at the origin of dementia...
Source: Current Opinion in Neurology - March 6, 2020 Category: Neurology Tags: DEGENERATIVE AND COGNITIVE DISEASES: Edited by Jean-Jean-François Demonet Source Type: research

Quantitative MRI markers in Parkinson's disease and parkinsonian syndromes
Purpose of review In Parkinson's disease and parkinsonian disorders, the differential diagnosis is still challenging. We aim to review current developments in MRI quantitative markers and their potential in a clinical and neuroscientific setting. Recent findings There have been efforts to improve MRI acquisition methods and to explore new promising biomarkers. In parallel, technological advances in data analysis (i.e. deep learning) open new ways to use these biomarkers. The MRI markers may differ according to the brain structure investigated. Even if the newly adopted acquisition protocols served mainly the developme...
Source: Current Opinion in Neurology - March 6, 2020 Category: Neurology Tags: DEGENERATIVE AND COGNITIVE DISEASES: Edited by Jean-Jean-François Demonet Source Type: research

Frontotemporal dementias: main syndromes and underlying brain changes
Purpose of review Frontotemporal dementia (FTD) is a rare dementia, that accounts for about 15% of all dementia cases. Despite consensus diagnostic criteria, FTD remains difficult to diagnose in life because of its complex and variable clinical phenomenology and heterogeneous disorders. This review provides an update on the current knowledge of the main FTD syndromes -- the behavioural variant, semantic variant, and nonfluent/agrammatic variant-- their brain abnormalities and genetic profiles. Recent findings The complexity of the clinical features in FTD has become increasingly apparent, particularly in the domain of...
Source: Current Opinion in Neurology - March 6, 2020 Category: Neurology Tags: DEGENERATIVE AND COGNITIVE DISEASES: Edited by Jean-Jean-François Demonet Source Type: research

The dialog between cognitive neurology and digitized technologies
No abstract available (Source: Current Opinion in Neurology)
Source: Current Opinion in Neurology - March 6, 2020 Category: Neurology Tags: DEGENERATIVE AND COGNITIVE DISEASES: Edited by Jean-Jean-François Demonet Source Type: research

The cognitive costs, contraindications and complications of epilepsy surgery in adults
Purpose of review Access to epilepsy surgery is rapidly growing throughout the world. While it is an established and effective treatment for seizures, epilepsy surgery has the potential to exacerbate cognitive comorbidities of the condition. Recent findings Not all surgical patients experience a postoperative decline in cognitive function. Postoperative cognitive function depends upon the functional integrity of the tissue to be removed and the functional reserve of the structures that remain in situ. While developments in surgical technique can reduce the cognitive morbidity of epilepsy surgery, the same procedure ma...
Source: Current Opinion in Neurology - March 6, 2020 Category: Neurology Tags: SEIZURE DISORDERS: Edited by Matthew C. Walker Source Type: research

Localizing the epileptogenic zone
This article reviews the latest neurophysiological advances for EZ localization with emphasis on ictal EZ identification, interictal EZ markers, and noninvasive neurophysiological mapping procedures. Recent findings We will review methods for computerized EZ assessment, summarize computational network approaches for outcome prediction and individualized surgical planning. We will discuss electrical stimulation as an option to reduce the time needed for presurgical work-up. We will summarize recent research regarding high-frequency oscillations, connectivity measures, and combinations of multiple markers using machine le...
Source: Current Opinion in Neurology - March 6, 2020 Category: Neurology Tags: SEIZURE DISORDERS: Edited by Matthew C. Walker Source Type: research

Epilepsy, antiepileptic drugs and dementia
Purpose of review To illustrate the frequency and trends of the comorbidity of epilepsy and dementia and the effects of antiepileptic drugs (AEDs) on cognitive functions. Recent findings Although the mortality and incidence of epilepsy are decreasing overall, they are increasing in the elderly as a result of population growth and increased life expectancy. Alzheimer's disease and other dementias are among the commonest causes of seizures and epilepsy. Epilepsy can be also complicated by cognitive impairment, suggesting a bidirectional association. Although epilepsy with onset in the elderly can be the manifestation of...
Source: Current Opinion in Neurology - March 6, 2020 Category: Neurology Tags: SEIZURE DISORDERS: Edited by Matthew C. Walker Source Type: research

What has been the impact of new drug treatments on epilepsy?
Purpose of review Nearly two dozen antiseizure medications (ASMs) with different mechanisms of action have been introduced over the past three decades with the aim of providing better efficacy or safety profile than the previous drugs. Several new ASMs with improvement on a classic drug family or have novel mechanisms of action have been recently approved for epilepsy. The present review explored recent studies or guidelines on new agents and discussed the potential impact of these novel treatments on epilepsy management and future directions of research. Recent findings Long-term cohort studies showed that, collectiv...
Source: Current Opinion in Neurology - March 6, 2020 Category: Neurology Tags: SEIZURE DISORDERS: Edited by Matthew C. Walker Source Type: research

What are the epileptic encephalopathies?
Purpose of review To review the evolution of the concept of epileptic encephalopathy during the course of past years and analyze how the current definition might impact on both clinical practice and research. Recent findings Developmental delay in children with epilepsy could be the expression of the cause, consequence of intense epileptiform activity (seizures and EEG abnormalities), or because of the combination of both factors. Therefore, the current International League Against Epilepsy classification identified three electroclinical entities that are those of developmental encephalopathy, epileptic encephalopathy...
Source: Current Opinion in Neurology - March 6, 2020 Category: Neurology Tags: SEIZURE DISORDERS: Edited by Matthew C. Walker Source Type: research

Why do seizures impair consciousness and how can we reverse this?
Purpose of review Consciousness disorders occurring during seizures are a major source of disability in people with epilepsy. The purpose of this review is to show recent developments in the assessment and understanding of consciousness disorders in epilepsy. Recent findings The most frequent alterations in consciousness are alterations in the level of awareness. They are linked to disruptions on a large-scale network of fronto-parietal associative systems in different forms of focal seizures or in absences. Different theories account for these alterations. Summary Although there is no specific treatment for &lsquo...
Source: Current Opinion in Neurology - March 6, 2020 Category: Neurology Tags: SEIZURE DISORDERS: Edited by Matthew C. Walker Source Type: research