Updates on management of headache in women and transgender women
Purpose of review
Gender differences exist in headache disorders. A greater understanding of the role of hormones in headache can help the clinician better approach and manage common primary headache disorders.
Recent findings
Recent studies highlight differences in how migraine and cluster headache present in women and men. Updates to the ongoing debate of how to manage the use of hormones in women with migraine, especially with aura, have been well reviewed in the last 18 months. A new meta-analysis evaluates gender differences in response to triptans.
Summary
This review will focus on recent updates ...
Source: Current Opinion in Neurology - May 11, 2021 Category: Neurology Tags: HEADACHE: Edited by Mark W. Green Source Type: research
Drug interactions and risks associated with the use of triptans, ditans and monoclonal antibodies in migraine
Purpose of review
The aim of this study was to review current evidence concerning potential risks and interactions associated with concomitant use of drugs indicated for the abortive treatment of migraine, namely triptans and ditans, and more recently developed drugs used for the preventive treatment. The latter drug class encompasses monoclonal antibodies (mAbs), which target either calcitonin gene-related peptide (CGRP) or its receptor.
Recent findings
To date, no pharmacokinetic interactions between these drug classes have been reported. However, patients who suffer from triptan- (or ditan-) induced medicatio...
Source: Current Opinion in Neurology - May 11, 2021 Category: Neurology Tags: HEADACHE: Edited by Mark W. Green Source Type: research
Editorial: A 2021 update on migraine
No abstract available (Source: Current Opinion in Neurology)
Source: Current Opinion in Neurology - May 11, 2021 Category: Neurology Tags: HEADACHE: Edited by Mark W. Green Source Type: research
Vaccinations in multiple sclerosis patients receiving disease-modifying drugs
Purpose of review
This review focuses on new evidence supporting the global immunization strategy for multiple sclerosis (MS) patients receiving disease-modifying drugs (DMDs), including the recently available vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
Recent findings
New data strengthen the evidence against a causal link between MS and vaccination. Recent consensus statements agree on the need to start vaccination early. Timings for vaccine administration should be adjusted to ensure safety and optimize vaccine responses, given the potential interference of DMDs. Pa...
Source: Current Opinion in Neurology - May 11, 2021 Category: Neurology Tags: MULTIPLE SCLEROSIS: Edited by Per S. Sørensen Source Type: research
Predicting disability worsening in relapsing and progressive multiple sclerosis
Purpose of review
Multiple sclerosis (MS) is a clinically heterogeneous disease, which complicates expectant management as well as treatment decisions. This review provides an overview of both well established and emerging predictors of disability worsening, including clinical factors, imaging factors, biomarkers and treatment strategies.
Recent findings
In addition to well known clinical predictors (age, male sex, clinical presentation, relapse behaviour), smoking, obesity, vascular and psychiatric comorbidities are associated with subsequent disability worsening in persons with MS. A number of imaging features...
Source: Current Opinion in Neurology - May 11, 2021 Category: Neurology Tags: MULTIPLE SCLEROSIS: Edited by Per S. Sørensen Source Type: research
Use of disease-modifying drugs during pregnancy and breastfeeding
Purpose of review
The fact that multiple sclerosis (MS) predominantly affects women has been recognized for many years. As the age at diagnosis is decreasing, and treatment options are becoming more complex, increasing numbers of women are facing decisions about the use of disease modifying therapy (DMT) in and around pregnancy.
Recent findings
New data are rapidly becoming available, particularly regarding the safety of therapies in both pregnancy and breastfeeding. Effective treatment and suppression of relapses is key to ensuring good outcomes in the longer term for the woman, however this must be balanced ag...
Source: Current Opinion in Neurology - May 11, 2021 Category: Neurology Tags: MULTIPLE SCLEROSIS: Edited by Per S. Sørensen Source Type: research
Targeting B cells in multiple sclerosis
Purpose of review
Treatments targeting B cells are increasingly used for patients with multiple sclerosis (MS). We review the mechanisms of action, clinical effectiveness and safety of treatment, with emphasis on recently published studies.
Recent findings
Several monoclonal antibodies targeting the surface molecule CD20 on B cells are approved or being developed for treatment of MS. Overall, they seem comparable in terms of strongly suppressing radiological disease activity and relapse biology. Novel approaches include anti-CD19 antibody therapy and treatment with oral drugs targeting Bruton's tyrosine kinase (...
Source: Current Opinion in Neurology - May 11, 2021 Category: Neurology Tags: MULTIPLE SCLEROSIS: Edited by Per S. Sørensen Source Type: research
Highly effective disease-modifying treatment as initial MS therapy
Purpose of review
Using highly effective (HE) compounds right from the beginning of disease-modifying immunotherapy (DMT) in people with multiple sclerosis (pwMS) has gained popularity among clinicians and pwMS alike. We discuss the most recent evidence supporting this approach, and whether any of the associated risks should stop us adopting it as a default strategy.
Recent findings
With the addition of injectable ofatumumab, and the two oral sphingosine one phosphate modulators siponimod and ozanimod, ten HE DMTs are now available for pwMS, though variation in licensing status and cost may limit their use in so...
Source: Current Opinion in Neurology - May 11, 2021 Category: Neurology Tags: MULTIPLE SCLEROSIS: Edited by Per S. Sørensen Source Type: research
Early multiple sclerosis: diagnostic challenges in clinically and radiologically isolated syndrome patients
Purpose of review
With the introduction of new diagnostic criteria, the sensibility for multiple sclerosis (MS) diagnosis increased and the number of cases with the clinically isolated syndrome (CIS) decreased. Nevertheless, a misdiagnosis might always be around the corner, and the exclusion of a ‘better explanation’ is mandatory.
There is a pressing need to provide an update on the main prognostic factors that increase the risk of conversion from CIS or from radiologically isolated syndrome (RIS) to MS, and on the potential ‘red flags’ to consider during the diagnostic workup.
Recent findings
We disc...
Source: Current Opinion in Neurology - May 11, 2021 Category: Neurology Tags: MULTIPLE SCLEROSIS: Edited by Per S. Sørensen Source Type: research
Editorial: Challenges in the diagnosis and treatment of multiple sclerosis
No abstract available (Source: Current Opinion in Neurology)
Source: Current Opinion in Neurology - May 11, 2021 Category: Neurology Tags: MULTIPLE SCLEROSIS: Edited by Per S. Sørensen Source Type: research
Editorial introductions
No abstract available (Source: Current Opinion in Neurology)
Source: Current Opinion in Neurology - May 11, 2021 Category: Neurology Tags: EDITORIAL INTRODUCTIONS Source Type: research
Current advances in plasma and cerebrospinal fluid biomarkers in Alzheimer's disease
Purpose of review
This review provides a concise overview of recent advances in cerebrospinal fluid (CSF) and blood-based biomarkers of Alzheimer's disease lesions.
Recent findings
Important recent advances for CSF Alzheimer's disease biomarkers include the introduction of fully automated assays, the development and implementation of certified reference materials for CSF Aβ42 and a unified protocol for handling of samples, which all support reliability and availability of CSF Alzheimer's disease biomarkers. Aβ deposition can be detected using Aβ42/Aβ40 ratio in both CSF and plasma, though a much more modest ...
Source: Current Opinion in Neurology - March 11, 2021 Category: Neurology Tags: DEGENERATIVE AND COGNITIVE DISEASES: Edited by Teresa Gomez-Isla Source Type: research
What have we learned from cognition in the oldest-old
Purpose of review
People over 90 are the fastest growing segment of the population with the highest rates of dementia. This review highlights recent findings that provide insight to our understanding of dementia and cognition at all ages.
Recent findings
Risk factors for Alzheimer's disease (AD) and dementia differ by age, with some factors, like the development of hypertension, actually becoming protective in the oldest-old. At least half of all dementia in this age group is due to non AD pathologies, including microinfarcts, hippocampal sclerosis and TDP-43. The number of pathologic changes found in the brain ...
Source: Current Opinion in Neurology - March 11, 2021 Category: Neurology Tags: DEGENERATIVE AND COGNITIVE DISEASES: Edited by Teresa Gomez-Isla Source Type: research
Cerebral small vessel disease and vascular cognitive impairment: from diagnosis to management
We present recent developments in the field of small vessel disease (SVD)-related vascular cognitive impairment, including pathological mechanisms, updated diagnostic criteria, cognitive profile, neuroimaging markers and risk factors. We further address available management and therapeutic strategies.
Recent findings
Vascular and neurodegenerative pathologies often co-occur and share similar risk factors. The updated consensus criteria aim to standardize vascular cognitive impairment (VCI) diagnosis, relying strongly on cognitive profile and MRI findings. Aggressive blood pressure control and multidomain lifestyle i...
Source: Current Opinion in Neurology - March 11, 2021 Category: Neurology Tags: DEGENERATIVE AND COGNITIVE DISEASES: Edited by Teresa Gomez-Isla Source Type: research
What is ‘Alzheimer's disease’? The neuropathological heterogeneity of clinically defined Alzheimer's dementia
Purpose of review
Beta-amyloid with paired helical filaments (PHF)-tau neurofibrillary tangles define hallmark Alzheimer's disease neuropathologic changes (AD-NC). Yet persons with Alzheimer's dementia, defined broadly as an amnestic multidomain progressive dementia, often exhibit postmortem evidence of other neuropathologies including other neurodegenerative (Lewy body disease and transactive response DNA-binding protein disease) and vascular-related brain lesions. Clinicopathologic and epidemiologic analyses demonstrate the significance of these substrates, as coinciding neuropathologies mitigate the threshold for di...
Source: Current Opinion in Neurology - March 11, 2021 Category: Neurology Tags: DEGENERATIVE AND COGNITIVE DISEASES: Edited by Teresa Gomez-Isla Source Type: research
