Neuromodulation - science and practice in epilepsy: Vagus nerve stimulation, thalamic deep brain stimulation, and responsive neurostimulation.
Authors: Markert MS, Fisher RS Abstract INTRODUCTION: Neuromodulation devices can be safe and effective for the treatment of drug-resistant epilepsy. A body of scientific work supports peripheral, subcortical and cortical targets, each with different fundamental methods of action. Areas covered: High-quality evidence is available for vagal nerve stimulation (VNS), deep brain stimulation (DBS), and responsive neurostimulation (RNS). Mechanistic research in animals and human studies are reviewed, along with key data from VNS, DBS, and RNS clinical trials. Specifically, the authors review some of the science behind the m...
Source: Expert Review of Neurotherapeutics - December 12, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Treatment of psychiatric disturbances in common hyperkinetic movement disorders.
Authors: Berardelli I, Pasquini M, Conte A, Bologna M, Berardelli A, Fabbrini G Abstract INTRODUCTION: This paper reviews studies that have assessed the treatment of psychiatric disturbances in dystonia, tic disorders, Tourette syndrome, Huntington's disease and essential tremor. Areas covered: We searched for papers in English in Pubmed using the following keywords: blepharospasm, cervical dystonia, arm dystonia, laryngeal dystonia, spasmodic dysphonia, tic disorders, Tourette syndrome, Huntington's chorea, essential tremor, depression, anxiety, obsessive compulsive disorders, attention deficit hyperactivity disorder...
Source: Expert Review of Neurotherapeutics - December 7, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Microbial monotherapy with Prevotella histicola for patients with multiple sclerosis.
Authors: Mangalam A, Murray J Abstract INTRODUCTION: The gut microbiome helps to maintain a person's healthy state while perturbations in its function often leading to the development of inflammatory diseases including multiple sclerosis (MS). Consequently, gut-commensals which restore homeostasis have the potential to become novel therapeutic options for treating MS. MS patients have presented gut microbial dysbiosis with a reduction in bacteria belonging to the Prevotella genus. Notably, increased levels of Prevotella are observed when disease-modifying therapies are used. Additionally, Prevotella histicola, an anae...
Source: Expert Review of Neurotherapeutics - December 5, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

An update on ketamine and its two enantiomers as rapid-acting antidepressants.
Authors: Zhang K, Hashimoto K Abstract INTRODUCTION: Depression is one of the most disabling diseases worldwide. Approximately one-third of depressed patients are treatment-resistant to the currently available antidepressants and there is a significant therapeutic time lag of weeks to months. There is a clear unmet need for rapid-acting and more efficacious treatments. (R,S)-ketamine, an old anesthetic drug, appears now to be going through a renaissance. Areas covered: This paper reviews recent literature describing the antidepressant effects of ketamine and its enantiomer (S)-ketamine in patients with major depressiv...
Source: Expert Review of Neurotherapeutics - December 5, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Application of advanced MRI techniques to monitor pharmacologic and rehabilitative treatment in multiple sclerosis: current status and future perspectives.
Authors: Rocca MA, Preziosa P, Filippi M Abstract INTRODUCTION: Advances in magnetic resonance imaging (MRI) technology and analyses are improving our understanding of the pathophysiology of multiple sclerosis (MS). Due to their ability to grade the presence of irreversible tissue loss, microstructural tissue abnormalities, metabolic changes and functional plasticity, the application of these techniques is also expanding our knowledge on the efficacy and mechanisms of action of different pharmacological and rehabilitative treatments. Areas covered. This review discusses recent findings derived from the application of ...
Source: Expert Review of Neurotherapeutics - December 4, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

An update on diagnosis and therapy of metabolic myopathies.
Authors: Finsterer J Abstract INTRODUCTION: Metabolic myopathies are a heterogeneous group of disorders characterized by inherited defects of enzymatic pathways involved in muscle fiber energetics. Diagnosing metabolic myopathies requires a thoroughly taken individual and family history, a meticulous neurologic exam, exercise tests, blood and urine tests, needle-electromyography, nerve-conduction studies, muscle biopsy, targeted genetic tests, or next-generation sequencing. There is limited evidence from the literature to guide treatment of metabolic myopathies. Treatment is largely limited to non-invasive/invasive sy...
Source: Expert Review of Neurotherapeutics - November 28, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Preventing suicidal behaviour in patients with multiple sclerosis: a scoping review.
Authors: Mellentin A, Stenager E, Stenager E Abstract INTRODUCTION: Suicidal behavior is a relatively rare occurrence among patients with multiple sclerosis (MS). Nonetheless, it is important to identify and be aware of the constituting risk factors to prevent suicidal behavior among vulnerable patients. Areas covered: This scoped review will shortly outline well-known biological and psycho-social risk factors for suicidal behavior among MS patients and suggest preventive initiatives. The preventive strategies should include a close monitoring of MS pharmacotherapy to prevent progression, and awareness and early ident...
Source: Expert Review of Neurotherapeutics - November 20, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Biomarkers for bipolar disorder: current status and challenges ahead.
Authors: Teixeira AL, Colpo GD, Fries GR, Bauer IE, Selvaraj S Abstract INTRODUCTION: Bipolar disorder (BD) is a chronic psychiatric disorder marked by clinical and pathophysiological heterogeneity. There is a high expectation that personalized approaches can improve the management of patients with BD. For that, identification and validation of potential biomarkers are fundamental. Areas covered: This manuscript will critically review the current status of different biomarkers for BD, including peripheral, genetic, neuroimaging and neurophysiological candidates, discussing the challenges to move the field forward. Exp...
Source: Expert Review of Neurotherapeutics - November 20, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Pharmacotherapy of postpartum obsessive-compulsive disorder: a systematic review.
Authors: Sharma V Abstract INTRODUCTION: Despite the common occurrence of obsessive-compulsive disorder (OCD) after childbirth, the role of pharmacotherapy in its management is unclear. Areas covered: This systematic review aims to determine the role of drugs in the acute and preventative treatment of postpartum OCD. Using PRISMA guidelines, four electronic databases including Medline/PubMed, PsycINFO, the Cochrane Database of Systematic Reviews, and Google Scholar were searched. A total of 10 articles - one randomized controlled trial, two open-label trials, one case series, and six case reports were selected for rev...
Source: Expert Review of Neurotherapeutics - November 20, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Autoimmune autonomic ganglionopathy: an update on diagnosis and treatment.
Authors: Nakane S, Mukaino A, Higuchi O, Watari M, Maeda Y, Yamakawa M, Nakahara K, Takamatsu K, Matsuo H, Ando Y Abstract INTRODUCTION: Autoimmune autonomic ganglionopathy (AAG) is an acquired immune-mediated disorder that leads to autonomic failure. The disorder is associated with autoantibodies to the ganglionic nicotinic acetylcholine receptor (gAChR). We subsequently reported that AAG is associated with an overrepresentation of psychiatric symptoms, sensory disturbance, autoimmune diseases and endocrine disorders. Area covered: The aim of this review was to describe AAG, and highlight its pivotal pathophysiologic...
Source: Expert Review of Neurotherapeutics - October 26, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Therapeutic potential of rescuing protein O-GlcNAcylation in tau-related pathologies.
Authors: Di Domenico F, Lanzillotta C, Tramutola A PMID: 30354776 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - October 26, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Is deep brain stimulation therapy underutilized for movement disorders?
Authors: Shukla AW, Deeb W, Patel B, Ramirez-Zamora A PMID: 30350730 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - October 24, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

rTMS for the treatment of Alzheimer's disease: where should we be stimulating?
Authors: Heath A, Taylor JL, McNerney MW PMID: 30350733 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - October 24, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Thunderclap headache: An update.
Authors: Yang CW, Fuh JL Abstract INTRODUCTION: Thunderclap headache (TCH) is an excruciating headache that reaches maximal intensity within a minute. It has numerous potential etiologies, the most concerning of which is subarachnoid hemorrhage (SAH) due to high morbidity and mortality. Thus, patients with TCH must be evaluated urgently to identify the underlying cause and initiate prompt therapy. Areas covered: This paper reviews PubMed-listed research articles and presents an update of the clinical features, diagnostic evaluation, and possible causes of TCH. Expert commentary: In addition to SAH, TCH has been associ...
Source: Expert Review of Neurotherapeutics - October 20, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Remediation of depression-related cognitive impairment: Cognitive Control Training as treatment augmentation.
Authors: Van den Bergh N, Hoorelbeke K, De Raedt R, Koster EHW Abstract INTRODUCTION: Despite several available evidence-based interventions for major depression relapse rates remain high and relapse prevention programs are still scarce. In order to increase effectiveness, novel techniques that target underlying vulnerability factors may be a promising avenue. Depression is associated with impairments in executive functioning, which is in turn associated with poor psychosocial outcomes and more Repetitive Negative Thinking (RNT), a key vulnerability factor for relapse. This paper examines deficits in cognitive control...
Source: Expert Review of Neurotherapeutics - October 20, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Rationale and patient selection for interventional therapies in Parkinson's disease.
This article attempts to identify different patient profiles and matches them with suggested advanced therapies for PD. There is limited literature providing guidance to a busy neurologist to match the most appropriate advanced therapy to the right patient profile. This article attempts to fill that void. Expert commentary: When matching patient profiles to therapy, several features must be considered: age, frailty, cognitive status, phenotype (predominant tremor vs. akinetic rigid), side effect or complication profile (dyskinesia, hallucinations, dysautonomia), and patient's comfort with invasive therapy options. PMID:...
Source: Expert Review of Neurotherapeutics - October 18, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Novel technology for mobility and balance tracking in patients with multiple sclerosis: a systematic review.
Authors: Sun R, McGinnis R, Sosnoff JJ Abstract INTRODUCTION: Mobility and balance impairments in patients with multiple sclerosis (MS) are major factors for decreased quality of life. Novel sensing technologies have great potential to efficiently capture subtle changes in mobility and balance performance, and thus improve current practices by providing an easy-to-implement, objective, and continuous functional tracking in MS population. Areas covered: This review details the collective findings of novel technology utilization in mobility and balance tracking in patients with MS. Thirty-three were systematically ident...
Source: Expert Review of Neurotherapeutics - October 12, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

The influence of language and culture on cognitive assessment tools in the diagnosis of early cognitive impairment and dementia.
Authors: Ng KP, Chiew HJ, Lim L, Rosa-Neto P, Kandiah N, Gauthier S Abstract INTRODUCTION: Cognitive assessment tools measure cognitive impairment and complement biomarkers to link cognitive symptoms with pathophysiological processes underlying dementia. However, language and cultural differences in multilingual populations can influence the interpretation of cognitive assessment tools when applied in cross-cultural and multinational studies. Areas covered: This paper examines the influence of culture and language on the interpretation of the Mini-Mental State Examination, Montreal Cognitive Assessment and Alzheimer's...
Source: Expert Review of Neurotherapeutics - October 6, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Childhood-onset craniopharyngioma: latest insights into pathology, diagnostics, treatment, and follow-up.
Authors: Bogusz A, Müller HL Abstract INTRODUCTION: Childhood-onset craniopharyngiomas are rare embryonic tumors of low-grade histological malignancy. Severe obesity, physical fatigue, and psychosocial deficits due to hypothalamic tumor involvement have negative impact on quality of life. Initial pretreatment involvement of hypothalamic structures and/or treatment-related lesions result in sequelae clinically associated with impaired social and physical functionality and severe neuroendocrine deficiencies. Overall and progression-free survival rates are not associated with the degree of surgical resection. Howeve...
Source: Expert Review of Neurotherapeutics - October 5, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Technology-based assessment of motor and non-motor phenomena in Parkinson disease.
Authors: Merola A, Sturchio A, Hacker S, Serna S, Vizcarra JA, Marsili L, Fasano A, Espay AJ Abstract INTRODUCTION: The increasing development and availability of portable and wearable technologies is rapidly expanding the field of technology-based objective measures (TOMs) in neurological disorders, including Parkinson disease (PD). Substantial challenges remain in the recognition of disease phenomena relevant to patients and clinicians, as well as in the identification of the most appropriate devices to carry out these measurements. Areas Covered: The authors systematically reviewed PubMed for studies employing tech...
Source: Expert Review of Neurotherapeutics - October 5, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Current and emerging ALS biomarkers: utility and potential in clinical trials.
Authors: Taga A, Maragakis NJ Abstract INTRODUCTION: Amyotrophic Lateral Sclerosis (ALS) is a neurodegenerative disorder which results in progressive muscle weakness as a prominent feature. However, clinical and pathogenic heterogeneity with regard to anatomical sites of disease onset and progression over time are important features of the disease which have frustrated attempts to inform patients about their prognosis as well as limited the potential successes of therapeutic studies. Areas covered: This paper discusses: clinical biomarkers which can be measured by history, physical examination, and clinical scales of ...
Source: Expert Review of Neurotherapeutics - October 5, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Challenges and importance of measuring neurobehavioural disability in acquired brain injury: the 'St Andrew's Swansea - Neurobehavioural Outcomes Scale' (SASNOS).
Authors: Alderman N PMID: 30277093 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - October 5, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

BACE inhibitors in clinical development for the treatment of Alzheimer's disease.
Authors: Panza F, Lozupone M, Solfrizzi V, Sardone R, Piccininni C, Dibello V, Stallone R, Giannelli G, Bellomo A, Greco A, Daniele A, Seripa D, Logroscino G, Imbimbo BP Abstract INTRODUCTION: The amyloid hypothesis of Alzheimer's disease (AD) affirms that brain accumulation of amyloid-β (Aβ) oligomers and soluble aggregates represents the major pathological event of the disease. Several anti-Aβ small organic molecules, monoclonal antibodies and antigens were developed to interfere with Aβ production and clearance, including β-site amyloid precursor protein cleaving enzyme (BACE) inhibitors, b...
Source: Expert Review of Neurotherapeutics - October 5, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

A review of the effects of baclofen and of THC:CBD oromucosal spray on spasticity-related walking impairment in multiple sclerosis.
Authors: Arroyo González R Abstract INTRODUCTION: Multiple sclerosis (MS) is a complex disease with a heterogeneous and unpredictable clinical course. Mobility impairment after progressive paralyses and muscle tone spasticity is common. Areas covered: The prevalence, assessment, and pharmacological management of gait impairment and spasticity in MS and their effects on health-related quality of life (HRQoL) are discussed. The roles of oral and intrathecal baclofen and of delta-9-tetrahydrocannabinol/cannabidiol (THC:CBD) oromucosal spray in treating MS spasticity-related gait impairment are reviewed. Expert com...
Source: Expert Review of Neurotherapeutics - September 22, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Going meta on metacognitive interventions.
Authors: Moritz S, Lysaker PH, Hofmann SG, Hautzinger M PMID: 30232920 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - September 21, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Deep brain stimulation for childhood dystonia: current evidence and emerging practice.
Authors: Elkaim LM, De Vloo P, Kalia SK, Lozano AM, Ibrahim GM Abstract INTRODUCTION: Dystonia, one of the most common childhood movement disorders, is often medically refractory and can lead to profound impacts on the child and their caretakers' quality of life. Limited efficacy of pharmacological treatments has fueled enthusiasm for innovative neurosurgical approaches, notably deep brain stimulation (DBS) as a treatment for refractory dystonia. Areas covered: DBS is increasingly applied to successfully treat childhood dystonia. While generally safe and effective, results vary widely depending on underlying dystonia ...
Source: Expert Review of Neurotherapeutics - September 18, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Select hyperacute complications of ischemic stroke: cerebral edema, hemorrhagic transformation, and orolingual angioedema secondary to intravenous altepase.
Authors: Bar B, Biller J Abstract INTRODUCTION: Remarkable advances have occurred in the management of acute ischemic stroke especially in regards to reperfusion treatments. With advances in reperfusion treatments come the risk of complications associated with these treatments. Areas covered: The paper focuses on three acute complications that can occur in the setting of acute ischemic stroke: cerebral edema, hemorrhagic transformation, and orolingual angioedema following administration of alteplase, a recombinant tissue plasminogen activator. Predictors of the development of these complications are reviewed. The mana...
Source: Expert Review of Neurotherapeutics - September 15, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

New guidelines for the diagnosis and treatment of neurocysticercosis: a difficult proposal for patients in endemic countries.
Authors: Carpio A, Fleury A, Kelvin EA, Romo ML, Abraham R, Tellez-Zenteno J Abstract INTRODUCTION: Recent guidelines for the diagnosis and treatment for neurocysticercosis (NC) from the Infectious Disease Society of America/American Society of Tropical Medicine and Hygiene were developed to be used in the United States and Canada, where only a small fraction of NC cases occur. Areas covered: The paper discusses the strengths and weakness of the proposed guidelines. Expert commentary: Although these new guidelines bring much needed attention to a neglected parasitic disease, some of the recommendations made are based ...
Source: Expert Review of Neurotherapeutics - September 7, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Diagnostic challenges in rapidly progressive dementia.
Authors: Zerr I, Hermann P Abstract INTRODUCTION: Rapidly progressive dementia is a syndrome caused by numerous disease entities. Accurate diagnosis is crucial as substantial proportion of these diseases is highly treatable. Others might implicate specific hygienic problems. Still, differential diagnosis remains challenging because of a huge overlap of clinical presentations. Areas covered: The paper reviews PubMed-listed research articles with a focus on diagnosis and treatment of diseases showing rapid cognitive decline such as inflammatory diseases, rapid progressive neurodegenerative diseases, toxic-metabolic ence...
Source: Expert Review of Neurotherapeutics - September 4, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Interactions between tumor associated macrophages and tumor cells in glioblastoma: unraveling promising targeted therapies.
Authors: Morisse MC, Jouannet S, Dominguez-Villar M, Sanson M, Idbaih A Abstract INTRODUCTION: Glioblastoma (GBM) is the deadliest primary malignant central nervous system tumor with a median overall survival of 15 months despite a very intensive therapeutic regimen including maximal safe surgery, radiotherapy and chemotherapy. Therefore, GBM treatment still raises major biological and therapeutic challenges. Areas covered: One of the hallmarks of the GBM is its tumor microenvironment including tumor-associated macrophages (TAM). TAM, accounting for approximately 30% of the GBM bulk cell population, may explain, at le...
Source: Expert Review of Neurotherapeutics - August 14, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Reminiscence therapy for dementia: an abridged Cochrane systematic review of the evidence from randomized controlled trials.
Authors: O' Philbin L, Woods B, Farrell EM, Spector AE, Orrell M Abstract INTRODUCTION: Reminiscence therapy (RT) is a popular psychosocial intervention widely used in dementia care. It involves discussion of past events and experiences, using tangible prompts to evoke memories or stimulate conversation. Areas covered: The aim of this review is to evaluate the effectiveness of RT for people with dementia. It includes studies from the specialized register of the Cochrane Dementia and Cognitive Improvement Group (ALOIS). Searches yielded 185 records of which 22 (n=1972) were eligible for inclusion. The meta-analysis com...
Source: Expert Review of Neurotherapeutics - August 11, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

An update on the treatment of restless legs syndrome/Willis-Ekbom disease: prospects and challenges.
Authors: Zucconi M, Galbiati A, Rinaldi F, Casoni F, Ferini-Strambi L Abstract INTRODUCTION: Restless Legs Syndrome/Willis-Ekbom Disease (RLS/WED) is a sleep disorder characterized by an urge to move the legs, frequently associated or triggered by unpleasant sensations in the lower limbs that affects approximately 2.5% of adults. Therapy and management of RLS/WED require long term interventions, since the typical manifestation of this disorder is chronic. Areas covered: In this review, we provide an update regarding the treatment of RLS/WED with particular attention to future challenges for its management. We reviewed...
Source: Expert Review of Neurotherapeutics - August 11, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

How would we combat menopause as an Alzheimer's risk factor?
Authors: Mosconi L, Brinton RD PMID: 30091648 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - August 10, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Controlled-release pregabalin in the treatment of fibromyalgia.
Authors: Alciati A, Atzeni F, Masala IF, Cirillo M, Sciortino D, Perna G, Sarzi-Puttini P Abstract INTRODUCTION: Fibromyalgia (FM) is a chronic disorder whose symptoms of musculo-skeletal pain, fatigue, sleep disturbances and cognitive impairment pervade the personal, occupational and social aspects of a patient's life. Together with the antidepressants duloxetine and milnacipram, the anticonvulsant pregabalin (PGB) is one of the three drugs approved by the Food and Drug Administration (FDA) for the treatment of FM. The aim of this narrative review is to summarise the data relating to the efficacy and safety of the co...
Source: Expert Review of Neurotherapeutics - August 10, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

An update on diagnostic options and considerations in limb girdle dystrophies.
Authors: Angelini C, Giaretta L, Marozzo R Abstract INTRODUCTION: Limb Girdle Muscular Dystrophies (LGMD) encompasses a clinically heterogeneous group of rare, genetic progressive muscle disorders presenting with weakness and atrophy of predominant pelvic and shoulder muscles. The spectrum of disease severity ranges from severe childhood-onset muscular dystrophy to adult-onset dystrophy. Areas covered: The review presents an update of the clinical phenotypes and diagnostic options for LGMD including both dominant and recessive LGMD and consider their differential clinical and histopathological features. An overview of...
Source: Expert Review of Neurotherapeutics - August 8, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

New discoveries in progressive myoclonus epilepsies: a clinical outlook.
Authors: Bhat S, Ganesh S Abstract INTRODUCTION: Progressive myoclonus epilepsies (PMEs) constitute a rare and heterogeneous group of genetic disorders with a distinctive triad of myoclonus, seizures and progressive neurological deterioration. PMEs, even though rare, are arguably the severest form of epilepsies accounting for
Source: Expert Review of Neurotherapeutics - July 24, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Clinical and pre-clinical utility of genomics in medulloblastoma.
Authors: Nör C, Ramaswamy V Abstract INTRODUCTION: Integrated genomics has significantly advanced our understanding of medulloblastoma heterogeneity. It is now clear that it is actually comprised of at least four distinct molecular subgroups termed WNT, SHH, Group 3 and Group 4 with stark clinical and biological differences. Areas Covered: This paper reviews advances in the classification and risk stratification of medulloblastoma, specifically integrating subgroup with clinical and cytogenetic risk factors, with a summary of the potential to lead to more precise therapies. Moreover, the current state of pre-clin...
Source: Expert Review of Neurotherapeutics - July 24, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Role of the Personal KinetiGraph in the routine clinical assessment of Parkinson's disease: Recommendations from an Expert Panel.
Authors: Pahwa R, Isaacson SH, Torres-Russotto D, Nahab FB, Lynch PM, Kotschet KE Abstract INTRODUCTION: Evaluation of people with Parkinson's disease (PD) is often complex due to heterogeneity of symptoms and disease course, including the variability of motor fluctuations and dyskinesia. Routine clinical evaluations may be incomplete, may not accurately capture important symptoms, and may not reflect day-to-day variability. While significant advances have been made in wearable ambulatory continuous objective monitoring (COM) technologies, many clinicians remain uncertain of how to incorporate them in clinical practic...
Source: Expert Review of Neurotherapeutics - July 24, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Cerebrolysin: a multi-target drug for recovery after stroke.
Authors: Brainin M Abstract INTRODUCTION: Cerebrolysin is a neuropeptide preparation with neurotrophic factor-like effects and promotes recovery after brain injury. Its preclinical profile promises wide applications due to multi-target effects. Currently, Cerebrolysin is used for treatment of cerebral ischemia and neurodegeneration. Areas covered: In stroke, early clinical trials with Cerebrolysin were performed mostly in mildly affected stroke populations, which usually have a favourable prognosis. Due to this selection, a likely floor or ceiling effect of recovery measures in the mild cases may have prevented to sho...
Source: Expert Review of Neurotherapeutics - July 14, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Deutetrabenazine for the treatment of Huntington's chorea.
Authors: Bashir H, Jankovic J Abstract INTRODUCTION: Huntington's disease (HD) is an inherited neurodegenerative disorder for which no disease-modifying treatment is currently available. Only symptomatic treatment can be offered. Chorea is the most common motor manifestation of HD and may interfere with daily activities, reduce quality of life and cause injury. Areas covered: Deutetrabenazine is the first deuterated drug and second drug after tetrabenazine, the classic vesicular monoamine transporter type 2 (VMAT2) inhibitor, to receive approval for the treatment of chorea associated with HD. This review, based largel...
Source: Expert Review of Neurotherapeutics - July 12, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

An update on intracerebral stem cell grafts.
Authors: Neal EG, Liska MG, Lippert T, Lin R, Gonzalez M, Russo E, Xu K, Ji X, Vale F, van Loveren H, Borlongan CV Abstract INTRODUCTION: Primary neurological disorders are notoriously debilitating and deadly, and over the past four decades stem cell therapy has emerged as a promising treatment. Translation of stem cell therapies from the bench to the clinic requires a better understanding of delivery protocols, safety profile, and efficacy in each disease. Areas Covered: In this review, benefits and risks of intracerebral stem cell transplantation are presented for consideration. Milestone discoveries in stem cell ap...
Source: Expert Review of Neurotherapeutics - July 3, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Advances in autoimmune myasthenia gravis management.
Authors: Wang S, Breskovska I, Gandhy S, Punga AR, Guptill JT, Kaminski HJ Abstract INTRODUCTION: Myasthenia gravis (MG) is an autoimmune neuromuscular disorder with no cure and conventional treatments limited by significant adverse effects and variable benefit. In the last decade, therapeutic development has expanded based on improved understanding of autoimmunity and financial incentives for drug development in rare disease. Clinical subtypes exist based on age, gender, thymic pathology, autoantibody profile, and other poorly defined factors, such as genetics, complicate development of specific therapies. Areas cove...
Source: Expert Review of Neurotherapeutics - June 24, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Value of nerve biopsy in the management of peripheral neuropathies.
Authors: Mathis S, Magy L, Le Masson G, Richard L, Soulages A, Solé G, Duval F, Ghorab K, Vallat JM, Duchesne M Abstract INTRODUCTION: Peripheral neuropathy is a common symptom throughout the population, with numerous possible etiologies. The diagnosis of peripheral neuropathies (and their causes) is mainly based on clinical, electrophysiological, biological and imaging features. Areas covered: This paper reviews the main causes of neuropathy and discuss the usefulness of nerve biopsy (NB) in such cases. Expert Commentary: In most cases, NB is not mandatory in the diagnostic work-up of a peripheral neuropathy. ...
Source: Expert Review of Neurotherapeutics - June 21, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

The diagnosis of progressive supranuclear palsy: current opinions and challenges.
Authors: Ali F, Josephs K Abstract INTRODUCTION: Progressive supranuclear palsy (PSP) is associated with microtubule associated protein tau dysfunction. Originally thought to result in a syndrome of atypical parkinsonism, vertical supranuclear gaze palsy and cognitive impairment, several additional phenotypic manifestations of PSP pathology have been described over the last 20 years. Furthermore, prototypical PSP features may develop late, making early diagnosis challenging. Areas covered: An in-depth view of emerging knowledge in the field of PSP. Advances in clinicopathologic correlation, blood, cerebrospinal, and m...
Source: Expert Review of Neurotherapeutics - June 15, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Sleep disorders and the risk of stroke.
Authors: McDermott M, Brown DL, Chervin RD Abstract INTRODUCTION: Stroke is a major cause of disability and death in the United States and across the world, and the incidence and prevalence of stroke are expected to rise significantly due to an aging population. Obstructive sleep apnea, an established independent risk factor for stroke, is a highly prevalent disease that is estimated to double the risk of stroke. It remains uncertain whether non-apnea sleep disorders increase the risk of stroke. Areas covered: This paper reviews the literature describing the association between incident stroke and sleep apnea, REM sle...
Source: Expert Review of Neurotherapeutics - June 15, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Efficacy and mode of action of external trigeminal neurostimulation in migraine.
Authors: Schoenen J, Coppola G Abstract INTRODUCTION: Available preventive drug treatments for migraine lack complete efficacy and often have unpleasant adverse effects. Hence their clinical utility and therapeutic adherence are limited. Hence, non-invasive neurostimulation methods applied over various peripheral sites (forehead, mastoid, upper arm, cervical vagus nerve) have raised great interest because of their excellent efficacy/tolerance profile. Amongst them external trigeminal nerve stimulation (eTNS) was first to obtain FDA approval for migraine therapy. Areas covered: All clinical trials of eTNS as preventive...
Source: Expert Review of Neurotherapeutics - June 14, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Advances in migraine neuroimaging and clinical utility: from the MRI to the bedside.
This article aims to review the recent advances in functional neuroimaging, the consequent progress in the knowledge of migraine pathophysiology and their putative application and impact in the clinical setting. A comprehensive review was conducted of PubMed citations by entering the key word "MRI" combined with "migraine" AND/OR "headache." Other key words included "grey matter" OR "white matter", "structural" OR "functional". The only restriction was English-language publication. The abstracts of all articles meeting these criteria were reviewed, and f...
Source: Expert Review of Neurotherapeutics - June 9, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Testosterone and estrogen in multiple sclerosis: from pathophysiology to therapeutics.
Authors: Collongues N, Patte-Mensah C, de Seze J, Mensah-Nyagan AG, Derfuss T Abstract INTRODUCTION: Neuroprotection and remyelination are two unmet needs in the treatment of multiple sclerosis (MS). Therapeutic potential has been identified with sexual hormones, supported in women by a decrease in MS activity during the pregnancy, in men by a greater severity of symptoms and a faster progression than in women. Areas covered: The therapeutic effect of testosterone and estrogens is reviewed. Both hormones have demonstrated an anti-inflammatory effect. Testosterone has an effect in protecting neurons in culture against ...
Source: Expert Review of Neurotherapeutics - May 29, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Epigenetic regulatory modifications in genetic and sporadic frontotemporal dementia.
Authors: Fenoglio C, Scarpini E, Galimberti D Abstract INTRODUCTION: Epigenetic modifications have recently been linked to neurodegenerative diseases such as frontotemporal dementia (FTD), which represents the second most common form of dementia in adulthood after Alzheimer's disease (AD). Epigenetic regulation occurs at different cellular levels and serve as a way to alter genetic information not only in aging but also following environmental signals. Thus, epigenetics mechanisms could exert their function at early stage of the disease, especially in sporadic cases. Areas covered: Herein, the available evidence suppo...
Source: Expert Review of Neurotherapeutics - May 29, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Cerebral amyloid angiopathy: diagnosis and potential therapies.
Authors: Weber SA, Patel RK, Lutsep HL Abstract INTRODUCTION: Cerebral amyloid angiopathy (CAA) is characterized by the pathologic deposition of amyloid-beta within cortical and leptomeningeal arteries, arterioles, capillaries and, in rare cases, the venules of the brain. It is often associated with the development of lobar intracerebral hemorrhages but may cause other neurologic symptoms or be asymptomatic. Magnetic resonance imaging characteristics, such as lobar microbleeds, support a diagnosis of CAA and assist with hemorrhage risk assessments. Immunosuppressants are used to treat rarer inflammatory forms of CAA. ...
Source: Expert Review of Neurotherapeutics - May 25, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research