Cerebellar ataxias: an update
Purpose of review Providing an update on the pathophysiology, cause, diagnosis and treatment of cerebellar ataxias. This is a group of sporadic or inherited disorders with heterogeneous clinical presentation and notorious impact on activities of daily life in many cases. Patients may exhibit a pure cerebellar phenotype or various combinations of cerebellar deficits and extracerebellar deficits affecting the central/peripheral nervous system. Relevant animal models have paved the way for rationale therapies of numerous disorders affecting the cerebellum. Recent findings Clinically, the cerebellar syndrome is now divide...
Source: Current Opinion in Neurology - January 17, 2020 Category: Neurology Tags: NEURO-OTOLOGY: Edited by Marianne Dieterich Source Type: research

Differential diagnosis of acute vascular vertigo
Purpose of review The current review covers recent advances in vascular vertigo in terms of diagnostic strategies, clinical/laboratory features, pathophysiology, and differential diagnosis. Recent findings Acute strokes presenting with isolated dizziness/vertigo without other obvious symptoms or signs of central nervous system involvements may be easily mistaken as peripheral vestibulopathy. For correct diagnosis of vascular vertigo, the importance of clinical history (timing and triggers) and targeted bedside examination cannot be overemphasized. In addition to Head Impulse-Nystagmus-Test of Skew, several differentia...
Source: Current Opinion in Neurology - January 17, 2020 Category: Neurology Tags: NEURO-OTOLOGY: Edited by Marianne Dieterich Source Type: research

‘Excess anxiety’ and ‘less anxiety’: both depend on vestibular function
Purpose of review To present evidence of a functional interrelation between the vestibular and the anxiety systems based on a complex reciprocally organized network. The review focuses on the differential effects of various vestibular disorders, on psychiatric comorbidity, and on anxiety related to vertigo. Recent findings Episodic vertigo syndromes such as vestibular migraine, vestibular paroxysmia, and Menière's disease are associated with a significant increase of psychiatric comorbidity, in particular anxiety/phobic disorders and depression. Chronic unilateral and bilateral vestibulopathy (BVP) do not exhib...
Source: Current Opinion in Neurology - January 17, 2020 Category: Neurology Tags: NEURO-OTOLOGY: Edited by Marianne Dieterich Source Type: research

Physiology, clinical evidence and diagnostic relevance of sound-induced and vibration-induced vestibular stimulation
Purpose of review To examine the recent literature concerning the neural basis and clinical evidence for the response of the labyrinth to sound and vibration: vestibular-evoked myogenic potentials (VEMPs) and vibration-induced nystagmus (VIN). Recent findings There are two streams of information from each otolith – a sustained stream (afferents with regular resting activity, signalling gravity and low-frequency linear accelerations) and a transient stream (afferents with irregular resting activity) signalling onset of linear acceleration, and sound and vibration. These irregular neurons are synchronized to each ...
Source: Current Opinion in Neurology - January 17, 2020 Category: Neurology Tags: NEURO-OTOLOGY: Edited by Marianne Dieterich Source Type: research

Vertigo and dizziness in the emergency room
Purpose of review To provide an update on diagnostic algorithms for differential diagnosis of acute vertigo and dizziness and swift identification of potentially harmful causes. Recent findings About 25% of patients with acute vertigo and dizziness have a potentially life-threatening diagnosis, including stroke in 4–15%. Diagnostic work-up relies on the combination of symptom features (triggers, duration, history of vertigo/dizziness, accompanying symptoms) and a comprehensive vestibular, ocular motor, and balance exam. The latter includes head impulse, head-shaking nystagmus, positional nystagmus, gaze-holding,...
Source: Current Opinion in Neurology - January 17, 2020 Category: Neurology Tags: NEURO-OTOLOGY: Edited by Marianne Dieterich Source Type: research

Eye movements in demyelinating, autoimmune and metabolic disorders
Purpose of review In the last three decades, the use of eye movements and vestibular testing in many neurological disorders has accelerated, primarily because of practical technologic developments. Although the acute vestibular syndrome is a prime example of this progress, more chronic neurologic and systemic disorders have received less attention. We focus here on recent contributions relating vestibular and ocular motor abnormalities in inflammatory, demyelinating, metabolic, and peripheral nervous system disorders Recent findings Vestibular abnormalities have been identified in acute demyelinating neuropathies (AID...
Source: Current Opinion in Neurology - January 17, 2020 Category: Neurology Tags: NEURO-OTOLOGY: Edited by Marianne Dieterich Source Type: research

Artificial intelligence for detection of optic disc abnormalities
Purpose of review The aim of this review is to highlight novel artificial intelligence-based methods for the detection of optic disc abnormalities, with particular focus on neurology and neuro-ophthalmology. Recent findings Methods for detection of optic disc abnormalities on retinal fundus images have evolved considerably over the last few years, from classical ophthalmoscopy to artificial intelligence-based identification methods being applied to retinal imaging with the aim of predicting sight and life-threatening complications of underlying brain or optic nerve conditions. Summary Artificial intelligence and in...
Source: Current Opinion in Neurology - January 17, 2020 Category: Neurology Tags: NEURO-OPHTHALMOLOGY: Edited by Heather E. Moss Source Type: research

Neuro-protection and neuro-regeneration of the optic nerve: recent advances and future directions
Purpose of review Optic neuropathies refer to a collection of diseases in which retinal ganglion cells (RGCs), the specialized neuron of the retina whose axons make up the optic nerve, are selectively damaged. Blindness secondary to optic neuropathies is irreversible as RGCs do not have the capacity for self-renewal and have a limited capacity for self-repair. Numerous strategies are being developed to either prevent further RGC degeneration or replace the cells that have degenerated. In this review, we aim to discuss known limitations to regeneration in central nervous system (CNS), followed by a discussion of previous,...
Source: Current Opinion in Neurology - January 17, 2020 Category: Neurology Tags: NEURO-OPHTHALMOLOGY: Edited by Heather E. Moss Source Type: research

Retinal vessel changes in cerebrovascular disease
Purpose of review The retina is growingly recognized as a window into cerebrovascular and systemic vascular conditions. The utility of noninvasive retinal vessel biomarkers in cerebrovascular risk assessment has expanded due to advances in retinal imaging techniques and machine learning-based digital analysis. The purpose of this review is to underscore the latest evidence linking retinal vascular abnormalities with stroke and vascular-related cognitive disorders; to highlight modern developments in retinal vascular imaging modalities and software-based vasculopathy quantification. Recent findings Longitudinal studies...
Source: Current Opinion in Neurology - January 17, 2020 Category: Neurology Tags: NEURO-OPHTHALMOLOGY: Edited by Heather E. Moss Source Type: research

Current opinion neurology: visual pathway biomarkers in Alzheimer's disease
Purpose of review The incidence of Alzheimer's disease is increasing. Premortem diagnosis of Alzheimer's disease is now possible but require invasive and expensive testing such as PET amyloid beta binding and/or spinal fluid amyloid beta levels. There is a great need for minimally invasive and inexpensive biomarkers to allow for early diagnosis and intervention. Recent findings There has been a large volume of literature assessing ocular biomarkers for Alzheimer's disease. Much of the research to date has significant limitations, including sample size, variable diagnostic criteria for Alzheimer's disease, lack of biom...
Source: Current Opinion in Neurology - January 17, 2020 Category: Neurology Tags: NEURO-OPHTHALMOLOGY: Edited by Heather E. Moss Source Type: research

Visual snow syndrome: a review on diagnosis, pathophysiology, and treatment
Purpose of review Visual snow is considered a disorder of central visual processing resulting in a perturbed perception of constant bilateral whole-visual field flickering or pixelation. When associated with additional visual symptoms, it is referred to as visual snow syndrome. Its pathophysiology remains elusive. This review highlights the visual snow literature focusing on recent clinical studies that add to our understanding of its clinical picture, pathophysiology, and treatment. Recent findings Clinical characterization of visual snow syndrome is evolving, including a suggested modification of diagnostic criteria...
Source: Current Opinion in Neurology - January 17, 2020 Category: Neurology Tags: NEURO-OPHTHALMOLOGY: Edited by Heather E. Moss Source Type: research

Update on posterior cortical atrophy
Purpose of review Non-amnestic (or atypical) presentations of neurodegenerative dementias are underrecognized and underdiagnosed, including posterior cortical atrophy (PCA) syndrome, which is characterized by prominent visuospatial and visuoperceptual dysfunction at presentation. It is most commonly due to Alzheimer's disease pathology, while Lewy body disease, corticobasal degeneration, and prion disease are neuropathological entities that are less frequently associated with PCA. The diagnosis of PCA is often delayed, to the detriment of the patient, and awareness and understanding of PCA will improve detection, prognos...
Source: Current Opinion in Neurology - January 17, 2020 Category: Neurology Tags: NEURO-OPHTHALMOLOGY: Edited by Heather E. Moss Source Type: research

Spaceflight associated neuro-ocular syndrome
Purpose of review Several decades of long duration space flight missions by the National Aeronautics and Space Administration has revealed an interesting and unique constellation of neuro-ophthalmic findings now called spaceflight associated neuro-ocular syndrome (SANS). The unique space environment of microgravity produces novel physiological changes and derangements that present a challenge to astronauts in current and future long duration space missions. Although the precise mechanism of SANS is not fully understood, in this review, we examine recent developments that may to help explain possible causes and potential ...
Source: Current Opinion in Neurology - January 17, 2020 Category: Neurology Tags: NEURO-OPHTHALMOLOGY: Edited by Heather E. Moss Source Type: research

Ocular myasthenia gravis: updates on an elusive target
Purpose of review Ocular myasthenia gravis (OMG) is a complex condition with heterogenous phenotypes and ill-defined diagnostic criteria. Understanding concomitant risk factors and autoimmune serology can help inform prognosis for generalization and guide treatment. Recent findings Although antibodies to acetylcholine receptors or muscle-specific kinase likely increase risk of generalization, they are less frequent in OMG. Patients without either antibody tend to have a milder disease process and often have variable antibodies to other end-plate proteins such as LRP4, agrin, or cortactin. The treatment of OMG begins w...
Source: Current Opinion in Neurology - January 17, 2020 Category: Neurology Tags: NEURO-OPHTHALMOLOGY: Edited by Heather E. Moss Source Type: research

Clinical phenotype, radiological features, and treatment of myelin oligodendrocyte glycoprotein-immunoglobulin G (MOG-IgG) optic neuritis
Purpose of review To review the clinical characteristics, radiological manifestations and treatment of myelin oligodendrocyte glycoprotein (MOG)-immunoglobulin G (IgG) optic neuritis. Recent findings Serum antibodies to MOG have recently been found to be a biomarker of MOG-IgG-associated disorder (MOGAD), a demyelinating disease distinct from both multiple sclerosis (MS) and aquaporin-4-IgG neuromyelitis optica spectrum disorder (AQP4-IgG-positive NMOSD). The phenotype of MOGAD is broad and includes optic neuritis, transverse myelitis, and acute demyelinating encephalomyelitis (ADEM). Optic neuritis is the most common...
Source: Current Opinion in Neurology - January 17, 2020 Category: Neurology Tags: NEURO-OPHTHALMOLOGY: Edited by Heather E. Moss Source Type: research

Focal cerebral arteriopathy and childhood stroke
Purpose of review Focal cerebral arteriopathy (FCA) is one of the most common causes of arterial ischaemic stroke in a previously healthy child. Distinguishing between different subtypes of arteriopathy is challenging and has significant management implications. Recent findings Recent studies have helped to define the subtypes of focal cerebral arteriopathies and improved understanding of their clinical and radiological features. In addition, they have reported new evidence for the association between viral infection and inflammation in the pathogenesis of FCA and proposed new radiological, serum and cerebrospinal flu...
Source: Current Opinion in Neurology - January 17, 2020 Category: Neurology Tags: CEREBROVASCULAR DISEASE: Edited by Mitchell S.V. Elkind Source Type: research

Immunological mechanisms in poststroke dementia
Purpose of review To review new evidence on links between poststroke dementia and inflammation. Recent findings Although there are still no treatments for poststroke dementia, recent evidence has improved our understanding that stroke increases the risk of incident dementia and worsens cognitive trajectory for at least a decade afterwards. Within approximately the first year dementia onset is associated with stroke severity and location, whereas later absolute risk is associated with more traditional dementia risk factors, such as age and imaging findings. The molecular mechanisms that underlie increased risk of incid...
Source: Current Opinion in Neurology - January 17, 2020 Category: Neurology Tags: CEREBROVASCULAR DISEASE: Edited by Mitchell S.V. Elkind Source Type: research

RNA expression studies in stroke: what can they tell us about stroke mechanism?
Purpose of review Diagnosis of stroke and understanding the mechanism of stroke is critical to implement optimal treatment. RNA expressed in peripheral blood cells is emerging as a precision biomarker to aid in stroke diagnosis and prediction of stroke cause. In this review, we summarize available data regarding the role of RNA to predict stroke, the rationale for these changes, and a discussion of novel mechanistic insight and clinical applications. Recent findings Differences in RNA gene expression in blood have been identified in patients with stroke, including differences to distinguish ischemic from hemorrhagic s...
Source: Current Opinion in Neurology - January 17, 2020 Category: Neurology Tags: CEREBROVASCULAR DISEASE: Edited by Mitchell S.V. Elkind Source Type: research

Atrial fibrillation and stroke: how much atrial fibrillation is enough to cause a stroke?
Purpose of review The association between atrial fibrillation and stroke is firmly established, and anticoagulation reduces stroke risk in patients with atrial fibrillation. However, the role of anticoagulation in very brief durations of atrial fibrillation (subclinical atrial fibrillation) is an area of controversy. Recent findings Stroke risk increases alongside burden of atrial fibrillation. Ongoing trials will clarify if 24 h or less of atrial fibrillation on extended monitoring necessitates lifelong anticoagulation. Trials examining empiric anticoagulation for individuals with ESUS did not demonstrate benefit o...
Source: Current Opinion in Neurology - January 17, 2020 Category: Neurology Tags: CEREBROVASCULAR DISEASE: Edited by Mitchell S.V. Elkind Source Type: research

Patent foramen ovale and stroke: current evidence and treatment options
Purpose of review Recent data have changed the landscape of patent foramen ovale (PFO) closure for secondary stroke prevention. This review synthesizes the data and provides a framework for optimal management of stroke patients with PFO. Recent findings The cumulative evidence indicates that PFO closure reduces the risk of recurrent stroke in carefully selected young cryptogenic stroke patients, with an annualized risk reduction of ∼0.6%. The benefit of PFO closure is particularly evident in patients with embolic appearing strokes, large right-to-left shunt, or an associated atrial septal aneurysm. There may be li...
Source: Current Opinion in Neurology - January 17, 2020 Category: Neurology Tags: CEREBROVASCULAR DISEASE: Edited by Mitchell S.V. Elkind Source Type: research

Sleep apnea and stroke
Purpose of review Stroke and sleep apnea are highly prevalent conditions with a physiologically plausible bidirectional relationship. This review addresses prestroke sleep apnea, wake-up stroke and sleep apnea, and poststroke sleep apnea, with an attempt to highlight research published in the last 18 months. Recent findings Sleep apnea is highly prevalent poststroke. Poststroke sleep apnea is associated with worse poststroke functional and cognitive outcomes and a higher risk of recurrent stroke. Physiologic tests are needed to diagnose sleep apnea in poststroke patients as sleep apnea questionnaires do not perform we...
Source: Current Opinion in Neurology - January 17, 2020 Category: Neurology Tags: CEREBROVASCULAR DISEASE: Edited by Mitchell S.V. Elkind Source Type: research

Editorial: Advances in understanding causes and outcomes in stroke
No abstract available (Source: Current Opinion in Neurology)
Source: Current Opinion in Neurology - January 17, 2020 Category: Neurology Tags: CEREBROVASCULAR DISEASE: Edited by Mitchell S.V. Elkind Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Neurology)
Source: Current Opinion in Neurology - January 17, 2020 Category: Neurology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Complications associated with immunotherapy for brain metastases
Purpose of review Median survival after the diagnosis of brain metastases has historically been on the order of months. With the recent development of immune checkpoint inhibitors, intracranial activity and durable responses have been observed in brain metastases on multiple phase 2 clinical trials, which have primarily been conducted in patients with melanoma. Immune-related adverse events related to checkpoint inhibitor therapy of brain metastasis can present unique challenges for the clinician and underscore the need for a multidisciplinary team in the care of these patients. The goal of this review is to address the ...
Source: Current Opinion in Neurology - November 5, 2019 Category: Neurology Tags: NEOPLASMS: Edited by Antonio Omuro Source Type: research

Progress in rare central nervous system tumors
Purpose of review Although all primary central nervous system (CNS) tumors are rare, certain tumor types each represent less than 2% of the total and an annual incidence of about 1000 patients or less. Most of them are disproportionally diagnosed in children and young adults, but older adults can also be affected and are rarely recruited to clinical trials. Recent new molecular techniques have led to reclassification of some of these tumors and discovery of actionable molecular alterations. Recent findings We review recent progress in the molecular understanding and therapeutic options of selected rare CNS tumors, wit...
Source: Current Opinion in Neurology - November 5, 2019 Category: Neurology Tags: NEOPLASMS: Edited by Antonio Omuro Source Type: research

Molecular profiling of primary central nervous system lymphomas – predictive and prognostic value?
This article reviews multiple markers that could potentially serve as future diagnostic tools and predictors of treatment response. Recent findings Many studies have attempted to classify DLBCL into different subtypes for prognostic purposes using methods such as immunohistochemistry. PCNSL often falls under the activated B-cell-like subgroup, and further genomic sequencing has identified alterations in genes within the B-cell receptor signaling axis at increased frequencies. Two such genes, MYD88 and CD79B, implicate the involvement of the NF-kB (nuclear factor kappa-light-chain enhancer of activated B cells) pathway, ...
Source: Current Opinion in Neurology - November 5, 2019 Category: Neurology Tags: NEOPLASMS: Edited by Antonio Omuro Source Type: research

Targeting DNA repair in gliomas
Purpose of review Gliomas represent a disparate group of malignancies with varying clinical outcomes despite a tremendous amount of time, effort, and resources dedicated to their management and understanding. The most aggressive entity, glioblastoma, has a dismal prognosis with poor local control despite intense local and systemic treatment, including radiation therapy. Recent findings Given the heterogeneity in genotype, phenotype, and patient outcomes, researchers and clinicians have turned their attention toward attacking DNA damage response and repair mechanisms in gliomas in an effort to develop novel chemo and r...
Source: Current Opinion in Neurology - November 5, 2019 Category: Neurology Tags: NEOPLASMS: Edited by Antonio Omuro Source Type: research

New metabolic imaging tools in neuro-oncology
Purpose of review The current treatment of gliomas dovetails results of decades-old clinical trials with modern trends in chemotherapy. Molecular characterization now plays a pivotal role, and IDH mutations are key characteristics and the subject of active debate. IDH-mutant tumors produce the ‘onco-metabolite’, 2-hydroxyglutarate. Metabolic changes have become central to the understanding of tumor biology, and tumors display a fundamental metabolic change called the Warburg Effect. The Warburg Effect represents a preference for glycolysis, as opposed to oxidative phosphorylation. The present review details t...
Source: Current Opinion in Neurology - November 5, 2019 Category: Neurology Tags: NEOPLASMS: Edited by Antonio Omuro Source Type: research

The path forward for anti-programmed cell death-1 therapy in gliomas
Purpose of review Checkpoint inhibitors (CPIs) represent the forefront of novel immunotherapeutic approaches for the treatment of solid cancers. However, the clinical development of CPIs in glioblastoma (GBM) has been challenging owing to an immunosuppressive tumor microenvironment and, possibly, low tumor mutation burden. Here, we review possible mechanisms responsible for the success of programmed cell death-1 (PD-1) blockade in patients with hypermutated GBM, recent clinical trials of anti-PD-1 monotherapy, trials incorporating neoadjuvant strategies, and trials of immunotherapy combination approaches in GBM. Mechanis...
Source: Current Opinion in Neurology - November 5, 2019 Category: Neurology Tags: NEOPLASMS: Edited by Antonio Omuro Source Type: research

Tumor treating fields for glioblastoma: should it or will it ever be adopted?
Purpose of review The purpose of this review is to discuss how a new treatment modality, tumor treating fields, may be incorporated into the oncologic care for patients with glioblastoma. Recent findings Tumor treating fields are a new treatment modality available to patients with newly diagnosed and recurrent glioblastoma. Alternating electric fields are delivered via a wearable, removable device affixed to the scalp of patients with supratentorial glioblastoma. With continuous use, the application of tumor treating fields combined with temozolomide chemotherapy has been shown to improve overall survival compared wit...
Source: Current Opinion in Neurology - November 5, 2019 Category: Neurology Tags: NEOPLASMS: Edited by Antonio Omuro Source Type: research

Applications of artificial intelligence in neuro-oncology
Purpose of review To discuss recent applications of artificial intelligence within the field of neuro-oncology and highlight emerging challenges in integrating artificial intelligence within clinical practice. Recent findings In the field of image analysis, artificial intelligence has shown promise in aiding clinicians with incorporating an increasing amount of data in genomics, detection, diagnosis, classification, risk stratification, prognosis, and treatment response. Artificial intelligence has also been applied in epigenetics, pathology, and natural language processing. Summary Although nascent, applications o...
Source: Current Opinion in Neurology - November 5, 2019 Category: Neurology Tags: NEOPLASMS: Edited by Antonio Omuro Source Type: research

Novel sensory paradigms for neuromodulation in disorders of consciousness in traumatic brain injury
Purpose of review Traumatic brain injury (TBI) represents a major cause of mortality and disability worldwide. In cases of severe TBI, disorders of consciousness (DoC) can occur and therapeutic options for these conditions are few and of limited efficacy. Sensory stimulation, an instrument to improve arousal and awareness, is frequently applied in the neurorehabilitation of DoC, but scientific evidence supporting its efficacy is limited. Our aim is to review the recent literature concerning novel sensory paradigms used in sensory stimulation protocols in DoC following TBI. Recent findings Recent studies on sensory sti...
Source: Current Opinion in Neurology - November 5, 2019 Category: Neurology Tags: TRAUMA AND REHABILITATION: Edited by Rajiv R. Ratan and Yutaka Yoshida Source Type: research

Alternative routes for recovery of hand functions after corticospinal tract injury in primates and rodents
Purpose of review Recent studies on various corticospinal tract (CST) lesions have shown the plastic changes at a variety of motor systems after the lesion. This review provides the alternative routes associated with the motor functional recovery after the CST lesions at various levels in nonhuman primates and rodents. Recent findings In the case of the motor cortical lesions, the perilesional area compensates for the lesion. In contrast, sprouting of the corticoreticular tracts was observed after the lesions involving sensorimotor cortical areas. After the internal capsule lesion, sprouting in the cortico-rubral path...
Source: Current Opinion in Neurology - November 5, 2019 Category: Neurology Tags: TRAUMA AND REHABILITATION: Edited by Rajiv R. Ratan and Yutaka Yoshida Source Type: research

Enhancing rehabilitation and functional recovery after brain and spinal cord trauma with electrical neuromodulation
Purpose of review This review discusses recent advances in the rehabilitation of motor deficits after traumatic brain injury (TBI) and spinal cord injury (SCI) using neuromodulatory techniques. Recent findings Neurorehabilitation is currently the only treatment option for long-term improvement of motor functions that can be offered to patients with TBI or SCI. Major advances have been made in recent years in both preclinical and clinical rehabilitation. Activity-dependent plasticity of neuronal connections and circuits is considered key for successful recovery of motor functions, and great therapeutic potential is att...
Source: Current Opinion in Neurology - November 5, 2019 Category: Neurology Tags: TRAUMA AND REHABILITATION: Edited by Rajiv R. Ratan and Yutaka Yoshida Source Type: research

Novel synaptic plasticity enhancer drug to augment functional recovery with rehabilitation
Purpose of review Stroke is a devastating illness which severely attenuates quality of life because of paralysis. Despite recent advances in therapies during acute phase such as thrombolytic therapy, clinical option to intervene the process of rehabilitation is limited. No pharmacological intervention that could enhance the effect of rehabilitation has not been established. Recent articles, which are summarized in the review article, reported novel small compound which accelerates training-dependent motor function recovery after brain damage. Recent findings A novel small compound, edonerpic maleate, binds to collapsi...
Source: Current Opinion in Neurology - November 5, 2019 Category: Neurology Tags: TRAUMA AND REHABILITATION: Edited by Rajiv R. Ratan and Yutaka Yoshida Source Type: research

Sugar as a therapeutic target for the cognitive restoration following traumatic brain injury
Purpose of review This review aims to discuss examples of changes in glucose (sugar) metabolism after traumatic brain injury (TBI). It will attempt to provide an understanding of what changes in glucose metabolism mean for the injured brain. It will further identify potential therapeutic target(s) emanating from our growing understanding of glucose pathways and their roles in TBI. Recent findings Although a significant fraction of glucose is utilized for the energy production in the brain, a small fraction is utilized in other, often ignored pathways. Recent studies have unraveled unexpected biological effects of gluc...
Source: Current Opinion in Neurology - November 5, 2019 Category: Neurology Tags: TRAUMA AND REHABILITATION: Edited by Rajiv R. Ratan and Yutaka Yoshida Source Type: research

Exercise factors as potential mediators of cognitive rehabilitation following traumatic brain injury
Purpose of review To summarize what is known about how exercise mediates cognitive rehabilitation post traumatic brain injury (TBI). Recent findings TBI is a devastating condition that leads to cognitive, motor and social deficits with significant social and economic burdens. Physical exercise has been shown to mediate cognitive rehabilitation post-TBI. The therapeutic effects of exercise are related in part to its ability to increase brain-derived neurotrophic factor (Bdnf) expression in the hippocampus. However, we have only recently begun to understand how exercise induces Bdnf expression in the brain through the i...
Source: Current Opinion in Neurology - November 5, 2019 Category: Neurology Tags: TRAUMA AND REHABILITATION: Edited by Rajiv R. Ratan and Yutaka Yoshida Source Type: research

Autonomic dysfunction following mild traumatic brain injury
This article aims to review recent research on the topic, emphasizing the role of the autonomic nervous system (ANS) in concussion. Current data suggests that ANS dysfunction is often evident following mTBI and accounts for many of the symptoms commonly seen in concussed patients. This link suggests several objective biomarkers that could be used to diagnose and monitor recovery following mTBI. Contrary to conventional wisdom, symptoms and biomarkers of ANS function improve when individuals are exposed to a program of graded exercise as treatment within the first week following concussion. Summary ANS dysfunction contri...
Source: Current Opinion in Neurology - November 5, 2019 Category: Neurology Tags: TRAUMA AND REHABILITATION: Edited by Rajiv R. Ratan and Yutaka Yoshida Source Type: research

Transglutaminases, neuronal cell death and neural repair: implications for traumatic brain injury and therapeutics
Purpose of review Traumatic brain injury (TBI) is one of the leading causes of death in the developed world. Despite advances at the bedside, pharmacological interventions have yet to be successful likely because of the need for a better understanding of disease mechanisms as potential targets for intervention. Recent evidence implicates a family of enzymes, namely transglutaminases, in the pathological mechanisms of TBI. Recent findings Transglutaminases are multifunctional, calcium-dependent enzymes that are significantly upregulated in TBI. They are known for their transamidase activity that consists of the covalen...
Source: Current Opinion in Neurology - November 5, 2019 Category: Neurology Tags: TRAUMA AND REHABILITATION: Edited by Rajiv R. Ratan and Yutaka Yoshida Source Type: research

Wallerian degeneration as a therapeutic target in traumatic brain injury
Purpose of review Diffuse or traumatic axonal injury is one of the principal pathologies encountered in traumatic brain injury (TBI) and the resulting axonal loss, disconnection, and brain atrophy contribute significantly to clinical morbidity and disability. The seminal discovery of the slow Wallerian degeneration mice (Wlds) in which transected axons do not degenerate but survive and function independently for weeks has transformed concepts on axonal biology and raised hopes that axonopathies may be amenable to specific therapeutic interventions. Here we review mechanisms of axonal degeneration and also describe how th...
Source: Current Opinion in Neurology - November 5, 2019 Category: Neurology Tags: TRAUMA AND REHABILITATION: Edited by Rajiv R. Ratan and Yutaka Yoshida Source Type: research

Editorial: The voluminous axon as an organizing principle for traumatic brain injury therapeutics: novel molecular, metabolic, and circuit strategies
No abstract available (Source: Current Opinion in Neurology)
Source: Current Opinion in Neurology - November 5, 2019 Category: Neurology Tags: TRAUMA AND REHABILITATION: Edited by Rajiv R. Ratan and Yutaka Yoshida Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Neurology)
Source: Current Opinion in Neurology - November 5, 2019 Category: Neurology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Current therapeutic landscape in multiple sclerosis: an evolving treatment paradigm: Erratum
No abstract available (Source: Current Opinion in Neurology)
Source: Current Opinion in Neurology - August 29, 2019 Category: Neurology Tags: ERRATUM Source Type: research

Therapeutic advances in SMA
Purpose of review To review the advent of novel therapies and their impact on the field of chromosome 5q-associated spinal muscular atrophy (SMA). Recent findings Antisense oligonucleotides (ASOs) enhancing SMN2 function are delivered intrathecally and small molecules will also be available soon delivered by the oral route; alternatively, systemic injection of viral vectors in order to replace the SMN gene are likely to be available in the future. In summer 2019, it remains the core finding that intrathecally delivered ASOs convincingly change the natural history of the disease in children and that the treatment effec...
Source: Current Opinion in Neurology - August 29, 2019 Category: Neurology Tags: MOTOR NEURON DISEASE: Edited by Albert C. Ludolph Source Type: research

Epidemiology of amyotrophic lateral sclerosis: an update of recent literature
Purpose of review The cause of amyotrophic lateral sclerosis (ALS) remains unknown for most of the patients with the disease. Epidemiologic studies can help describe disease burden and examine its potential risk factors, providing thereby evidence base for future mechanistic studies. With this review, we aimed to provide a summary of epidemiologic studies published during the past 18 months, which studied the incidence and risk factors for ALS. Recent findings An increasing incidence and prevalence of ALS continue to be reported from different parts of the world. Several previously studied risk factors are confirmed a...
Source: Current Opinion in Neurology - August 29, 2019 Category: Neurology Tags: MOTOR NEURON DISEASE: Edited by Albert C. Ludolph Source Type: research

New insights on the disease contribution of neuroinflammation in amyotrophic lateral sclerosis
Purpose of review Amyotrophic lateral sclerosis (ALS) is a degenerative motor neuron disease with a strong neuroinflammatory component. This review summarizes how the connection between neurodegeneration and the immune system is strengthened by new discoveries from ALS genetics and the analysis of subpopulations of immune cells in ALS. Recent findings Recent genes identified in ALS encode for proteins with direct immune roles, which when mutated lead to deregulation of immune functions, potentially influencing the disease. Although neuroinflammation in the central nervous system (CNS) of ALS patients has been well doc...
Source: Current Opinion in Neurology - August 29, 2019 Category: Neurology Tags: MOTOR NEURON DISEASE: Edited by Albert C. Ludolph Source Type: research

Clinical trials in amyotrophic lateral sclerosis
Purpose of review To review new developments in the field of amyotrophic lateral sclerosis (ALS) clinical trial design and to review the implications of the latest ALS clinical trials. Recent findings There has been substantial reflection on how clinical trials in ALS are best conducted. The revised Airlie House recommendations are an important milestone and should guide trial design. In addition, innovations using individualized risk-based eligibility criteria, adaptive designs, joint modelling, patient-centred approaches, and remote collection of data show real promise. Edaravone was shown to have benefit on functio...
Source: Current Opinion in Neurology - August 29, 2019 Category: Neurology Tags: MOTOR NEURON DISEASE: Edited by Albert C. Ludolph Source Type: research

Neurochemical biomarkers in amyotrophic lateral sclerosis
Purpose of review The diagnosis of amyotrophic lateral sclerosis (ALS) still relies mainly on clinical criteria. In present review we will provide an overview of neurochemical ALS biomarkers, which are in the most advanced position on the way towards inclusion into the clinical work-up. Recent findings The field of ALS neurology still lacks a neurochemical marker for routine clinical use. However, this is urgently needed, because it would help in diagnosis, prognostic stratification, and monitoring of drug response. Despite this lack of a routinely used biomarker, in the last decade significant progress has been made ...
Source: Current Opinion in Neurology - August 29, 2019 Category: Neurology Tags: MOTOR NEURON DISEASE: Edited by Albert C. Ludolph Source Type: research

Imaging in amyotrophic lateral sclerosis: MRI and PET
Purpose of review Neuroimaging with MRI and PET has become a well-established technical tool for amyotrophic lateral sclerosis (ALS). This review summarizes current developments in the advanced neuroimaging assessment of ALS and explores their potential in a clinical and neuroscientific setting. Recent findings With a focus on diffusion-weighted imaging, MRI-based neuroimaging has shown to provide reliable measures for monitoring disease progression and should be included in the clinical workup of ALS. There have been efforts to improve the clinical utility of fluorodesoxyglucose (FDG)-PET, and multivariate analysis h...
Source: Current Opinion in Neurology - August 29, 2019 Category: Neurology Tags: MOTOR NEURON DISEASE: Edited by Albert C. Ludolph Source Type: research

Update on amyotrophic lateral sclerosis genetics
Purpose of review The fatal motoneuron disease amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder with a high contribution of genetic factors to pathogenesis, in probably both familial and sporadic ALS cases. State-of-the art sequencing techniques continue to reveal novel monogenic causes for ALS, risk factors and modifiers. This leads to an improved genotype/phenotype correlation and is becoming increasingly relevant for genetic diagnosis, counseling and therapy. The first gene-specific therapies are being tested in ongoing clinical trials. Consequently, this review aims to summarize the most important ...
Source: Current Opinion in Neurology - August 29, 2019 Category: Neurology Tags: MOTOR NEURON DISEASE: Edited by Albert C. Ludolph Source Type: research