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

Surgical treatment of dystonia.
Authors: Cury RG, Kalia SK, Shah BB, Jimenez-Shahed J, Prashanth LK, Moro E Abstract INTRODUCTION: Treatment of dystonia should be individualized and tailored to the specific needs of patients. Surgical treatment is an important option in medically refractory cases. Several issues regarding type of the surgical intervention, targets, and predict factors of benefit are still under debate. Areas covered: To date, several clinical trials have proven the benefit and safety of deep brain stimulation (DBS) for inherited and idiopathic isolated dystonia, whereas there is still insufficient evidence in combined and acquired d...
Source: Expert Review of Neurotherapeutics - May 22, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Therapies for mobility disability in persons with multiple sclerosis.
Authors: Baird JF, Sandroff BM, Motl RW Abstract INTRODUCTION: Mobility disability is one of the most widespread and impactful consequences of multiple sclerosis (MS). Disease modifying drugs (DMDs) may delay the progression of disability over time; however, there is minimal evidence supporting the efficacy of DMDs for reversing mobility disability or restoring ambulatory function in persons with MS. Areas covered: This review outlines symptomatic pharmacologic and non-pharmacologic therapeutic approaches that target mobility disability with the goal of restoring and improving walking function. First, the efficacy of ...
Source: Expert Review of Neurotherapeutics - May 19, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

The modern role of antipsychotics for the treatment of agitation and psychosis in Alzheimer's disease.
Authors: Creese B, Da Silva MV, Johar I, Ballard C Abstract INTRODUCTION: Antipsychotics have long been the mainstay of treatment for agitation and psychosis in Alzheimer's disease. Despite their current use successive studies have shown that they only confer a modest benefit which must be balanced against their well-established serious side effects (extrapyramidal symptoms, stroke, accelerated cognitive decline and mortality). Areas covered: This review outlines the current guidance on antipsychotic usage and the evidence of their continued usage against a backdrop of emerging pharmacological treatments and an increa...
Source: Expert Review of Neurotherapeutics - May 17, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

The interactions between non-motor symptoms of Parkinson's disease.
Authors: Ehgoetz Martens KA, Shine JM PMID: 29722588 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - May 4, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Perispinal etanercept advances as a neurotherapeutic.
Authors: Tobinick E PMID: 29695205 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - April 27, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Deep brain stimulation for trigeminal autonomic cephalalgias.
Authors: Messina G, Broggi G, Levi V, Franzini A Abstract INTRODUCTION: Deep brain stimulation (DBS) of the posterior hypothalamic region (pHyr) has been shown to be efficacious for more than a half of patients suffering from trigeminal autonomic cephalalgias (TACs); nonetheless, controversies about the mechanisms of action and the actual site of stimulation have arisen in recent years. Areas covered: Firstly, a review of the most recent literature on the subject is presented, stressing the critical points that could, in the future, make a difference for optimal management of patients afflicted by these life-threating...
Source: Expert Review of Neurotherapeutics - April 20, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Transdermal buprenorphine for moderate chronic noncancer pain syndromes.
Authors: Pergolizzi JV, Coluzzi F, Taylor R Abstract INTRODUCTION: Chronic noncancer pain has remained a challenging clinical problem. Opioid analgesics are effective, but they are known to be associated with opioid use disorder and potentially treatment-limiting side effects. Buprenorphine is a Schedule III synthetic opioid in the USA with a chemical structure similar to that of morphine but with a longer duration of action, greater potency, and other unique pharmacological attributes. Its role in treatment of chronic noncancer pain may be broader than currently thought. Areas covered: The pharmacokinetics, pharmacod...
Source: Expert Review of Neurotherapeutics - April 19, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Implications of structural and functional brain changes in amyotrophic lateral sclerosis.
Authors: Dharmadasa T, Huynh W, Tsugawa J, Shimatani Y, Ma Y, Kiernan MC Abstract INTRODUCTION: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that causes progressive muscle weakness and disability, eventually leading to death. Heterogeneity of disease has become a major barrier to understanding key clinical questions such as prognosis and disease spread, and has disadvantaged clinical trials in search of therapeutic intervention. Patterns of disease have been explored through recent advances in neuroimaging, elucidating structural, molecular and functional changes. Unique brain signatures have eme...
Source: Expert Review of Neurotherapeutics - April 19, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Chronic subdural collection overlying an intra-axial hemorrhagic lesion in chronic myelomonocytic leukemia: special report and review of the literature.
Authors: Bernat AL, Priola SM, Elsawy A, Farrash F, Taslimi S, Gentili F Abstract INTRODUCTION: Chronic myelomonocytic leukaemia (CMML) is a clonal hematopoietic stem cell disorder characterized by the presence of an absolute monocytosis in the peripheral blood (>1 x 109/L) and the presence of myelodysplastic and myeloproliferative features in the bone marrow. Involvement of the central nervous system (CNS) is uncommon in CMML. Areas covered: Herein described is a case report of a CMML patient who presents with symptomatic chronic subdural collection overlying a haemorrhagic brain lesion, along with diffuse dural i...
Source: Expert Review of Neurotherapeutics - April 17, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Oxidative stress in epilepsy.
Authors: Geronzi U, Lotti F, Grosso S Abstract INTRODUCTION: The brain is particularly susceptible to oxidative stress being the most aerobically active organ in the body due to its high metabolic demands. There is evidence that neuronal hyperexcitability and oxidative injury produced by an excessive production of free radicals may play a role in the initiation and progression of epilepsy. Understanding the role of oxidative stress in epileptogenesis is essential to delineate appropriate therapeutic strategies. Neuroprotectant or antioxidant compounds may exert positive effects when associated with antiepileptic drugs...
Source: Expert Review of Neurotherapeutics - April 14, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

To diagnose or not to diagnose? Timing is the question: balancing early diagnosis of multiple sclerosis with misdiagnosis.
Authors: Dixon C, Robertson D PMID: 29641937 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - April 12, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Challenges and prospects in the diagnosis and treatment of primary central nervous system lymphoma.
Authors: Citterio G, Calimeri T, Ferreri AJM Abstract INTRODUCTION: Primary central nervous system lymphoma (PCNSL) retains peculiar biological and clinical characteristics and a worse prognosis with respect to other comparable lymphomas. The need for high doses of chemotherapy to achieve valid drug concentrations in cerebral tissues and/or radiotherapy results in severe treatment-related toxicities, mainly neurologic, which are frequently as disabling as the disease itself. Areas covered: Several emerging combined therapies are addressed that focus on treating PCNSL. The prognosis has improved in the last years but s...
Source: Expert Review of Neurotherapeutics - April 12, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Neuroimaging in amyotrophic lateral sclerosis: current and emerging uses.
Authors: Agosta F, Spinelli EG, Filippi M Abstract INTRODUCTION: Several neuroimaging techniques have been used to define in vivo markers of pathological alterations underlying amyotrophic lateral sclerosis (ALS). Growing evidence supports the use of magnetic resonance imaging (MRI) and positron emission tomography (PET) for the non-invasive detection of central nervous system involvement in patients with ALS. Areas covered: A comprehensive overview of structural and functional neuroimaging applications in ALS is provided, focusing on motor and extra-motor involvement in the brain and the spinal cord. Implications for...
Source: Expert Review of Neurotherapeutics - April 10, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Astroglial 5-HT2B receptor in mood disorders.
Authors: Peng L, Song D, Li B, Verkhratsky A Abstract INTRODUCTION: Astroglia represent the main cellular homeostatic system of the central nervous system (CNS). Astrocytes are intimately involved in regulation and maintenance of neurotransmission by regulating neurotransmitters removal and turnover and by supplying neurons with neurotransmitters precursors. Astroglial cells are fundamental elements of monoaminergic transmission in the brain and in the spinal cord. Astrocytes receive monoaminergic inputs and control catabolism of monoamines through dedicated transporters and intracellular enzymatic pathways. Areas cov...
Source: Expert Review of Neurotherapeutics - March 31, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Do pre-clinical multiple sclerosis models allow us to measure neurodegeneration and clinical progression?
Authors: Hochstrasser T, Jiangshan Z, Rühling S, Schmitz C, Kipp M PMID: 29589965 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - March 29, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Pediatric epilepsy surgery: the earlier the better.
Authors: Braun KPJ, Cross JH PMID: 29560752 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - March 24, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Precipitation and inhibition of seizures in focal epilepsies.
Authors: MameniškienÄ— R, Wolf P Abstract INTRODUCTION: There is growing awareness that reflex epileptic seizures offer unique insight into natural seizure generation in humans. In the last years, focus has mostly been on reflex seizures in generalized epilepsies whereas a comprehensive review of their role in focal epilepsies has been missing. Areas covered: This paper reviews reflex seizures strictly in focal epilepsies, not including focal reflex seizures in system epilepsies that also exist. They were categorized according to their triggers which can be sensory or cognitive, simple or complex. Numerous dive...
Source: Expert Review of Neurotherapeutics - March 24, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Tardive dyskinesia: placing vesicular monoamine transporter Type 2 (VMAT2) Inhibitors into Clinical Perspective.
Authors: Citrome L Abstract INTRODUCTION: Tardive dyskinesia (TD) is an iatrogenic movement disorder caused by exposure to dopamine receptor blocking agents. Two vesicular monoamine transporter type 2 (VMAT2) inhibitors for the treatment of TD were approved by the US Food and Drug Administration in 2017: valbenazine and deutetrabenazine. Areas covered: A brief review of TD and its identification, as well as a review of older treatment interventions is provided, followed by a detailed synthesis regarding the clinical utility of valbenazine and deutetrabenazine. Expert Commentary: As evidenced from well-designed clinica...
Source: Expert Review of Neurotherapeutics - March 21, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Low TT4 as a predictor of poor outcomes in severe encephalitis: a multivariate analysis of 94 patients.
Authors: Feng G, Tian X, Wang L, Zhao L, Wang X Abstract BACKGROUND: To investigate the prognostic value of acute thyroid function in patients with severe encephalitis. METHODS: We retrospectively analyzed information from patients with severe encephalitis from June 2012 to June 2017. Using multivariate logistic regression analysis, we examined predictors of poor outcomes in these patients after 6 months. RESULTS: A total of 94 patients with severe encephalitis were included in the study. Univariate analysis showed that patients with good or poor outcomes had significantly different total thyroxine (TT4) (P = 0....
Source: Expert Review of Neurotherapeutics - March 14, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Neurocysticercosis: the good, the bad, and the missing.
Authors: Carpio A, Fleury A, Romo ML, Abraham R Abstract INTRODUCTION: Neurocysticercosis (NC) is a neglected disease that contributes substantially to neurological morbidity/mortality in lower-income countries and increasingly among high-income countries due to migration. Many advances have been made in understanding NC, but unanswered questions remain Areas covered: This review discusses the epidemiology, pathophysiology, immunology, diagnosis, treatment, and eradication of NC. Expert commentary: The global NC prevalence remains unknown and needs proper ascertainment. Further understanding of the pathophysiology of ...
Source: Expert Review of Neurotherapeutics - March 10, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Improving surgical outcome for gliomas with intraoperative mapping.
Authors: Ferracci FX, Duffau H Abstract INTRODUCTION: Radical glioma resection improves overall survival, both in low-grade and high-grade glial tumors. However, preservation of the quality of life is also crucial. Areas covered: Due to the diffuse feature of gliomas, which invade the central nervous system, and due to considerable variations of brain organization among patients, an individual cerebral mapping is mandatory to solve the classical dilemma between the oncological and functional issues. Because functional neuroimaging is not reliable enough, intraoperative electrical stimulation, especially in awake patie...
Source: Expert Review of Neurotherapeutics - March 10, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

A novel scoring system to predict the outcomes of adult patients with hypoxic-ischemic encephalopathy.
Authors: Li F, Liu G, Tian X, Quan F, Li B, Feng G, Wang X, Hu Y Abstract OBJECTIVES: Adult patients with hypoxic-ischemic encephalopathy (HIE) often incur large costs, but their outcomes are poor. Currently, there is lack of a comprehensive quantitative approach to predict patient prognoses. METHODS: A total of 73 adult patients with HIE participated in this prospective, observational study. Clinical assessments, laboratory tests, and electrophysiological examinations were conducted within 3 days after HIE occurred. Logistic regression model was used to identify independent factors associated with patient outcomes...
Source: Expert Review of Neurotherapeutics - March 3, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Surgical treatments for essential tremor.
Authors: Elble RJ, Shih L, Cozzens JW Abstract INTRODUCTION: Essential tremor is the most common form of pathologic tremor. Surgical therapies disrupt tremorogenic oscillation in the cerebellothalamocortical pathway and are capable of abolishing severe tremor that is refractory to available pharmacotherapies. Surgical methods are rapidly improving and are the subject of this review. Areas covered: A PubMed search on January 18, 2018 using the query essential tremor AND surgery produced 839 abstracts. 379 papers were selected for review of the methods, efficacy, safety and expense of stereotactic deep brain stimulation...
Source: Expert Review of Neurotherapeutics - February 25, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Recent advances in the management of chronic migraine in children.
Authors: Arruda MA, Chevis CF, Bigal ME Abstract INTRODUCTION: Migraine is a chronic-recurrent disorder that progresses in some adults and also in many children. Chronic migraine (CM) is the clinical result of this process. Since migraine does not progress in most children, identifying the risk factors for progression is an important public health priority that should be matched by evidence-based treatment. Areas covered: Herein we conduct a systematic review on the comorbidities and treatment of CM in children and adolescents in the last ten years, summarizing evidence-based recommendations for disease management. Ex...
Source: Expert Review of Neurotherapeutics - February 14, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Identifying and mitigating Sudden Unexpected Death in Epilepsy (SUDEP) risk factors.
Authors: Watkins L, Shankar R, Sander JW Abstract INTRODUCTION: Sudden Unexpected Death in Epilepsy (SUDEP) is a significant cause of death for people with chronic epilepsy. Good practice guidance in the UK and the USA expect SUDEP to be discussed with the individual. The event rarity, methodological variance and lack of robust research into the pathological mechanisms, associated risk factors, and management strategies have created a challenge on how and what to discuss. There are some significant associations which allows for risk assessment and mitigation. Areas covered: The current understanding of static and modi...
Source: Expert Review of Neurotherapeutics - February 10, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Preservation of neuronal function as measured by clinical and MRI endpoints in relapsing-remitting multiple sclerosis: how effective are current treatment strategies?
Authors: Graetz C, Groppa S, Zipp F, Siller N Abstract INTRODUCTION: Approved medications for relapsing-remitting multiple sclerosis have shown to be effective in terms of their anti-inflammatory potential. However, it is also crucial to evaluate what long-term effects a patient can expect from current MS drugs in terms of preventing neurodegeneration. Here we aim to provide an overview of the current treatment strategies in MS with a specific focus on potential neuroprotective effects. Areas covered: Randomized, double-blind and placebo or referral-drug controlled phase 2a/b and phase 3 trials were examined; non-blin...
Source: Expert Review of Neurotherapeutics - February 8, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Clinical applications of ultra-high field magnetic resonance imaging in multiple sclerosis.
Authors: Inglese M, Fleysher L, Oesingmann N, Petracca M Abstract INTRODUCTION: Magnetic resonance imaging (MRI) is of paramount importance for the early diagnosis of multiple sclerosis (MS) and MRI findings are part of the MS diagnostic criteria. There is a growing interest in the use of ultra-high-field strength -7 Tesla- (7T) MRI to investigate, in vivo, the pathological substrate of the disease. Areas covered: An overview of 7T MRI applications in MS focusing on increased sensitivity for lesion detection, specificity of the central vein sign and better understanding of MS pathophysiology and discuss the implicatio...
Source: Expert Review of Neurotherapeutics - January 26, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Current treatment options for meningioma.
Authors: Apra C, Peyre M, Kalamarides M Abstract INTRODUCTION: With an annual incidence of 5/100,000, meningioma is the most frequent primary tumor of the central nervous system. Risk factors are radiotherapy and hormone intake. Most meningiomas are grade I benign tumors, but up to 15% are atypical and 2% anaplastic according to the WHO 2016 histological criteria. Areas covered: This review details the current standard therapy based on international guidelines and recent literature, and describes new approaches developed to treat refractory cases. First-line treatments are observation and surgery, but adjuvant radioth...
Source: Expert Review of Neurotherapeutics - January 18, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

mTOR dysregulation and tuberous sclerosis-related epilepsy.
Authors: Curatolo P, Moavero R, van Scheppingen J, Aronica E Abstract INTRODUCTION: The mammalian target of rapamycin (mTOR) pathway has emerged as a key player for proper neural network development, and it is involved in epileptogenesis triggered by both genetic or acquired factors. Areas covered. The robust mTOR signaling deregulation observed in a large spectrum of epileptogenic developmental pathologies, such as focal cortical dysplasias and tuberous sclerosis complex (TSC), has been linked to germline and somatic mutations in mTOR pathway regulatory genes, increasing the spectrum of "mTORopathies". The ...
Source: Expert Review of Neurotherapeutics - January 18, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Immunotherapy for brain tumors: understanding early successes and limitations.
Authors: Lieberman NAP, Vitanza NA, Crane CA Abstract INTRODUCTION: Adverse effects and toxicities related to standard treatments for brain tumors significantly reduce patients' quality of life. Although most immunotherapy approaches for solid tumors have not been successful, several early-phase clinical trials are beginning to reveal a potential role for immunotherapy in the treatment of brain tumors. In particular, methods that activate the innate immune system and induce a polyclonal anti-cancer response have demonstrated that brain tumors are susceptible to immune-mediated tumor destruction. Compared with conventi...
Source: Expert Review of Neurotherapeutics - January 13, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Do anti-epileptic drugs increase suicide in epilepsy? 10 years after the FDA alert.
Authors: Mula M PMID: 29319362 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - January 11, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

The ILAE Classification of Seizures and Epilepsies: Implications for the Clinic.
Authors: Beghi E, Sander JW Abstract INTRODUCTION: The classification of epileptic seizures and the epilepsies has recently been revised by the International League Against Epilepsy (ILAE) and a new classification scheme issued. Areas covered: The new classification scheme has been critically appraised in the light of the previous classifications and subsequent revisions. The purposes of the classification and its potential use have been extensively discussed. Expert Commentary: This ILAE classification scheme, the latest of a series of proposals published in the last thirty years, has made progress as it has a multi-...
Source: Expert Review of Neurotherapeutics - January 11, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Clinical implications of myelin regeneration in the central nervous system.
Authors: McMurran CE, Kodali S, Young A, Franklin RJ Abstract INTRODUCTION: Amongst strategies to repair the brain, myelin repair offers genuine cause for optimism. Myelin, which sheaths most axons in the central nervous system (CNS), is vital for normal neurological function, as demonstrated by the functional deficits that accrue when it is absent in a range of debilitating myelin diseases. Following demyelination, post-mortem and imaging studies have shown that extensive regeneration of myelin is possible in the human brain. Over recent decades preclinical research has given us a strong understanding of the biology ...
Source: Expert Review of Neurotherapeutics - December 30, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Optimizing the long-term management of chronic migraine with onabotulinumtoxinA in real life.
Authors: Tassorelli C, Tedeschi G, Sarchielli P, Pini LA, Grazzi L, Geppetti P, De Tommaso M, Aguggia M, Cortelli P, Martelletti P Abstract INTRODUCTION: Management of chronic migraine is challenging. OnabotulinumtoxinA (OBT-A) is the only medication licensed for prevention of chronic migraine, and has been widely adopted in clinical practice. Limited data is available on its long-term use. Areas covered: Data from controlled trials are combined with available data on the long-term use of OBT-A in real-life studies, with information obtained in a recent survey among Italian headache centers, and the clinical experienc...
Source: Expert Review of Neurotherapeutics - December 28, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Normobaric hyperoxia after stroke: a word of caution.
Authors: Taccone FS, Crippa IA, Vincent JL PMID: 29233067 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - December 14, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Tourette syndrome and other chronic tic disorders: an update on clinical management.
Authors: Martino D, Pringsheim TM Abstract INTRODUCTION: The management of Tourette syndrome (TS) and other chronic tic disorders occurs in multiple stages and begins with comprehensive assessment and complex psychoeducation. Behavioral and pharmacological interventions (second stage) are needed when tics cause physical or psychosocial impairment. Deep brain stimulation surgery or experimental therapies represent the third stage. Areas covered: Discussed are recent advances in assessment and therapy of chronic tic disorders, encompassing the three stages of intervention, with the addition of experimental, non-invasive...
Source: Expert Review of Neurotherapeutics - December 9, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Dysautonomia in the pathogenesis of migraine.
Authors: Gazerani P, Cairns BE Abstract INTRODUCTION: Migraine is a common complex neurological disorder involving multiple brain areas that regulate autonomic, affective, cognitive, and sensory functions. This review explores autonomic nervous system (ANS) dysfunction in migraine headache sufferers. Areas covered: Reference material for this review was obtained through PubMed searches. Migraine attacks can present with up to 4 phases (premonitory, aura, headache, postdrome) each with distinguishable signs and symptoms. Altered ANS tone can be found from the premonitory through the postdrome phases. Features of the mi...
Source: Expert Review of Neurotherapeutics - December 8, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Brain Circuits and Neurochemical Systems in Essential Tremor:Insights into Current and Future Pharmacotherapeutic Approaches.
Authors: Schaefer SM, Vives Rodriguez A, Louis ED Abstract INTRODUCTION: There are few medications that are available for the treatment of essential tremor (ET) and they are only moderately effective. Areas covered: Data were obtained from a PubMed search. Original articles, review articles, and clinical guidelines were included. Two disease models for ET have been proposed: 1) the olivary model, which attributes ET to a pathological pacemaker in the inferior olivary nucleus, and 2) the cerebellar degeneration model, which postulates that ET originates in the cerebellum and could be related to deficient or abnormal Pu...
Source: Expert Review of Neurotherapeutics - December 6, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

The role of electroencephalogram in neonatal seizure detection.
Authors: Pisani F, Pavlidis E Abstract INTRODUCTION: The role of EEG in neonatal seizure detection is well-established, being the multichannel video-EEG the gold standard. However, in the clinical practice often amplitude integrated EEG (aEEG) is used, in order to overcome the difficulties related to EEG use. Areas covered: An overview regarding neonatal seizures, current tools used to detect these (multichannel EEG versus aEEG) with respective strenghts and limitations, and some tools that can implement the use of multichannel EEG in the NICU. Expert commentary: Multichannel video-EEG is still a gold standard for sei...
Source: Expert Review of Neurotherapeutics - December 5, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Immune-based strategies for mood disorders: facts and challenges.
Authors: Colpo GD, Leboyer M, Dantzer R, Trivedi MH, Teixeira AL Abstract INTRODUCTION: Inflammation seems to play a role in the pathophysiology of mood disorders, including major depressive disorder (MDD) and bipolar disorder (BD). In the last years several studies have shown increased levels of inflammatory and/or immune markers in patients with mood disorders. Accordingly, the immune system has become a target of interest for the development of biomarkers and therapeutics for mood disorders. Areas covered: Here, we review the evidence showing low-grade inflammation in mood disorders and the studies evaluating immun...
Source: Expert Review of Neurotherapeutics - November 29, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Pharmacotherapy and motor recovery after stroke.
Authors: Viale L, Catoira NP, Di Girolamo G, González CD Abstract INTRODUCTION: Stroke is one of the most prevalent neurological diseases worldwide, especially among the elderly population. There are various mechanisms that enhance motor recovery after a stroke. In clinical practice, we have the opportunity to enhance plasticity by designing specific rehabilitation programs. Areas covered: There are a variety of drugs commonly administered to people after the acute phase of a stroke. These drugs may modify motor performance. Herein reviewed is the evidence concerning motor enhancement or decline in stroke patie...
Source: Expert Review of Neurotherapeutics - November 11, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Treatment options for chorea.
Authors: Bashir H, Jankovic J Abstract INTRODUCTION: Chorea is defined as jerk-like movements that move randomly from one body part to another. It is due to a variety of disorders and although current symptomatic therapy is quite effective there are few etiology- or pathogenesis-targeted therapies. The aim of this review is to summarize our own experience and published evidence in the treatment of chorea. Areas covered: After evaluating current guidelines and clinical practices for chorea of all etiologies, PubMed was searched for the most recent clinical trials and reviews using the term 'chorea' cross referenced wit...
Source: Expert Review of Neurotherapeutics - November 10, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Nummular headache: an update and future prospects.
This article reviews epidemiological and clinical features of NH, the most recently proposed pathophysiological mechanisms, and state-of-the-art management according to the literature. Expert commentary: Information regarding true incidence and prevalence is lacking, but NH is a fairly common disorder in patients attending a headache clinic. Diagnostic work-up requires the exclusion of systemic and structural disease by a thorough physical examination, blood tests including immunology screening, and neuroimaging. No clinical trials have been conducted for NH, so the level of evidence for any treatment is low. Gabapentin se...
Source: Expert Review of Neurotherapeutics - November 7, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Long-term effects of internet-supported cognitive behaviour therapy.
Authors: Andersson G, Rozental A, Shafran R, Carlbring P Abstract INTRODUCTION: Internet-supported and therapist-guided cognitive behaviour therapy (ICBT) is effective for a range of problems in the short run, but less is known about the long-term effects with follow-ups of two years or longer. Areas covered: This paper reviews studies in which the long-term effects of guided ICBT were investigated. Following literature searches in PubMed and other sources meta-analytic statistics were calculated for 14 studies involving a total of 902 participants, and an average follow-up period of three years. Studies were from Swe...
Source: Expert Review of Neurotherapeutics - November 3, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Protective Roles of Intestinal Microbiota derived Short Chain Fatty Acids in Alzheimer's Disease-type Beta-Amyloid Neuropathological Mechanisms.
CONCLUSION: Our studies support the hypothesis that intestinal microbiota may help protect against AD, in part, by supporting the generation of select SCFAs, which interfere with the formation of toxic soluble Aß aggregates. PMID: 29095058 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - November 3, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research