Management of chronic traumatic encephalopathy.
Authors: Cantu R, Budson A Abstract Introduction Chronic Traumatic Encephalopathy (CTE) is a neuropathological disease defined by perivascular hyperphosphorylated tau protein depositions in a patchy distribution at the depths of cortical sulci in the brain. Presently, in living individuals, it cannot be precisely diagnosed or differentiated from other neurodegenerative diseases nor are there treatments for the underlying disease process. There are non-pharmacologic and pharmacologic treatments for the symptoms of CTE that improve the quality of daily life. That is the primary focus of this review article that used Pub...
Source: Expert Review of Neurotherapeutics - June 20, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Developing therapeutic strategies to promote myelin repair in multiple sclerosis.
Authors: Baldassari LE, Feng J, Clayton BLL, Oh SH, Sakaie K, Tesar PJ, Wang Y, Cohen JA Abstract Introduction: Approved disease modifying therapies for multiple sclerosis (MS) lessen inflammatory disease activity that causes relapses and MRI lesions. However, chronic inflammation and demyelination lead to axonal degeneration and neuronal loss, for which there currently is no effective treatment. There has been increasing interest in developing repair-promoting strategies, but there are important unanswered questions regarding the mechanisms and appropriate methods to evaluate these treatments. Areas covered: The rati...
Source: Expert Review of Neurotherapeutics - June 20, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Risk factors for intracranial hemorrhage after mechanical thrombectomy: A systematic review and meta-analysis.
Conclusion: Many predictors of ICH were identified, however, given the lack of robust evidence, larger cohort studies should be prioritized to confirm these predictors. PMID: 31200607 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - June 16, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Assessing the risk of multiple sclerosis disease-modifying therapies.
Authors: Ayrignac X, Bilodeau PA, Prat A, Girard M, Labauge P, Le Lorier J, Larochelle C, Duquette P Abstract Introduction: The number of immunomodulatory options approved for multiple sclerosis (MS) has increased over the past 24 years, resulting in a better control of the disease. Depending on disease activity, neurologists can now propose treatments with different levels of efficacy, from injectable and oral treatments with modest efficacy, to highly active immunosuppressants and monoclonal antibodies which can be used as induction therapies. Nevertheless, this gain in efficacy has come with an increase in the glob...
Source: Expert Review of Neurotherapeutics - June 15, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Brivaracetam efficacy and safety in focal epilepsy.
Authors: Makke Y, Abou-Khalil B Abstract Introduction Brivaracetam (BRV) is an analog of levetiracetam (LEV) with 15-30 times greater affinity to SV2A and greater brain permeability than LEV. These properties have stimulated interest in its clinical trial data and post marketing experience. Areas covered The authors provide a background on epilepsy and its treatment, discuss the racetam family of antiepileptic drugs to which BRV belongs, and then discuss BRV properties and its efficacy and tolerability in the treatment of epilepsy. Expert opinion While preclinical data suggest broad spectrum of efficacy, BRV is only a...
Source: Expert Review of Neurotherapeutics - June 15, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Intracerebral hemorrhage: an update on diagnosis and treatment.
We describe the causes, diagnosis (including new brain imaging biomarkers), classification, pathophysiological understanding, treatment (medical and surgical), and secondary prevention of ICH. Expert opinion: In recent years, significant advances have been made in deciphering causes, understanding pathophysiology, and improving acute treatment and prevention of ICH. However, the clinical outcome remains poor and many challenges remain. Acute interventions delivered rapidly (including medical therapies - targeting hematoma expansion, hemoglobin toxicity, inflammation, edema, anticoagulant reversal - and minimally invasive s...
Source: Expert Review of Neurotherapeutics - June 13, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Emerging therapies in Huntington's disease.
Authors: Bashir H Abstract Introduction Huntington's disease (HD) is an inherited neurodegenerative condition for which there are no disease-modifying treatments. The availability of early genetic diagnosis makes HD an ideal candidate for early intervention. Growing understanding of pathogenesis has led to identification of new therapeutic targets for which some compounds are now in clinical trials. Areas covered A detailed review of medical databases and clinical trial registries was performed. Recent clinical trials aimed to establish disease-modification were included. Focus was assigned to RNA and DNA-based therap...
Source: Expert Review of Neurotherapeutics - June 12, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Cognitive and behavioral assessment in Parkinson's disease.
Authors: Martinez-Horta S, Horta-Barba A, Kulisevsky J Abstract Introduction: Cognitive impairment and behavioral disturbances are common findings in Parkinson's disease (PD). Despite initially being considered late complications of the disease, it is currently accepted that almost all PD patients will exhibit cognitive and behavioral abnormalities from the early and even the premotor stages of the disease. Areas covered: The present review focuses on the cognitive profile of PD, the clinical picture of PD-MCI and dementia in PD (PDD) and the recommended methods for cognitive assessment in this population. The authors...
Source: Expert Review of Neurotherapeutics - June 11, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Beyond stimulants: a systematic review of randomised controlled trials assessing novel compounds for ADHD.
Authors: Nageye F, Cortese S Abstract Introduction Despite stimulants being highly efficacious in short-term randomised controlled trials (RCTs), not all patients respond or can successfully tolerate them. A number of novel non-stimulant options are currently in the pipeline for the treatment of ADHD. Areas covered The authors conducted a systematic review of RCTs registered in ClinicalTrials.gov in the past five years (January 2014 and February 2019), supplemented by searches in PubMed, Web of Science, and drug manufacturers websites to find recent RCTs on novel non-stimulant ADHD medications. Expert opinion The auth...
Source: Expert Review of Neurotherapeutics - June 7, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Parkinson's disease management and impulse control disorders: current state and future perspectives.
Authors: Vitale C, Amboni M, Erro R, Picillo M, Pellecchia MT, Barone P, Trojano L, Santangelo G Abstract Introduction: Impulse control disorders (ICDs) in Parkinson's disease (PD) are a group of impulsive behaviors most often associated, but not limited to, dopamine replacement therapy (DRT), particularly the use of dopamine agonists (DA). ICDs can impair activities of daily living and have a strong negative impact on quality of life of patients and their families. Areas covered: This review mainly focusses on the most common ICDs in the context of currently accepted management strategies for PD and emphasizes areas ...
Source: Expert Review of Neurotherapeutics - June 4, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Gut microbiota in ALS: possible role in pathogenesis?
Authors: McCombe PA, Henderson RD, Lee A, Lee JD, Woodruff TM, Restuadi R, McRae A, Wray NR, Ngo S, Steyn FJ Abstract INTRODUCTION: The gut microbiota has important roles in maintaining human health. The microbiota and its metabolic byproducts could play a role in the pathogenesis of neurodegenerative diseases, including amyotrophic lateral sclerosis (ALS). Areas covered: The authors evaluate the methods of assessing the gut microbiota, and also review how the gut microbiota affects the various physiological functions of the gut. The authors then consider how gut dysbiosis could theoretically affect the pathogenesis o...
Source: Expert Review of Neurotherapeutics - May 29, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Patient selection for migraine preventive treatment with anti-CGRP(r) monoclonal antibodies.
This article reviews current preventive treatments and their shortcomings and the road that, through the understanding of calcitonin gene-related peptide (CGRP) role in migraine pathophysiology, carried to the approval of the 3 first-in-class monoclonal antibodies (mAbs) acting on the CGRP pathway. Data from phase 2 and phase 3 clinical trials of erenumab, galcanezumab and fremanezumab, both for episodic and chronic migraine prevention, are consistent for safety and efficacy. Expert opinion: Anti-calcitonin gene-related peptide mAbs have potential advantages over conventional treatments such as ease of use, quick onset of ...
Source: Expert Review of Neurotherapeutics - May 22, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Challenges in the treatment of Alzheimer's disease: recent progress and treatment strategies of pharmaceuticals targeting notable pathological factors.
Authors: Kuo YC, Rajesh R Abstract INTRODUCTION: Alzheimer's disease (AD), a commonly encountered neurodegenerative disorder, causes cognitive decline and has a devastating effect on quality of life. AD occurs mainly through abnormal amyloid β peptide (Aβ) and tau protein (tau) activity around/in neurons. Aβ-based therapeutic techniques have been struggled to treat AD over the past few decades. In addition, the complexity in treating AD is due to diverse factors regulating its pathology. Areas covered: This review emphasizes recent advances regarding various pathological approaches and provides an overv...
Source: Expert Review of Neurotherapeutics - May 22, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Discriminating schizophrenia disease progression using a P50 sensory gating task with dense-array EEG, clinical assessments, and cognitive tests.
Authors: Luo Y, Zhang J, Wang C, Zhao X, Chang Q, Wang H, Wang C Abstract BACKGROUND: Schizophrenia affects approximately 10% of the world's population. Early detection of schizophrenia may significantly delay its progression. Although sensory gating deficits are reported in schizophrenia, it remains challenging how sensory gating deficits can be used with other metrics for risk detection and early diagnosis. RESEARCH DESIGN AND METHODS: Using EEG, the authors examined effects of sensory gating on the performance of 136 participants in a P50 sensory gating task, including patients with first-episode schizophrenia (...
Source: Expert Review of Neurotherapeutics - May 22, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Do BACE inhibitor failures in Alzheimer's patients challenge the amyloid hypothesis of the disease?
Authors: Panza F, Lozupone M, Watling M, Imbimbo BP PMID: 31112433 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - May 22, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

CVT-301 for the treatment of Parkinson's disease.
Authors: Shpiner DS, Bette S, Di Luca DG, Margolesky J Abstract INTRODUCTION: For patients with Parkinson's disease (PD), the treatment of motor and nonmotor fluctuations is tantamount to maintaining quality of life. Subcutaneous apomorphine has been the only commercially available rescue therapy for the treatment of OFF episodes. In December 2018, CVT-301 (Inbrija), an inhaled formulation of LD, was approved by the FDA for this indication. Areas covered: In this review the authors summarize the armamentarium available to address motor fluctuations in PD, including medications in development. The authors discuss the p...
Source: Expert Review of Neurotherapeutics - May 22, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Changing paradigms for targeted therapies against diffuse infiltrative gliomas: tackling a moving target.
Authors: Carpenter CD, Alnahhas I, Gonzalez J, Giglio P, Puduvalli VK Abstract INTRODUCTION: Gliomas are highly heterogeneous primary brain tumors which result in a disproportionately high degree of morbidity and mortality despite their locoregional occurrence. Advances in the understanding of the biological makeup of these malignancies have yielded a number of potential tumor-driving pathways which have been identified as rational targets for therapy. However, early trials of agents that target these pathways have uniformly failed to yield improvement in outcomes in patients with malignant gliomas. Areas covered: Thi...
Source: Expert Review of Neurotherapeutics - May 22, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Convergent neurobiological predictors of mood and anxiety symptoms and treatment response.
Authors: Jabbi M, Nemeroff CB Abstract INTRODUCTION: Mood and anxiety disorders are a leading contributor to the global burden of diseases. Comorbid mood and anxiety disorders have a lifetime prevalence of over 20% globally and increases the risk for suicide, one of the leading causes of death in Europe and North America. Areas covered: In this narrative review, the authors highlight recent advances in the understanding of multi-level neurobiological mechanisms for normal and pathological human affective functioning. The authors then address the complex interplay between environmental adversity and molecular-genetic m...
Source: Expert Review of Neurotherapeutics - May 19, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Neurodegenerative disease treatments by direct TNF reduction, SB623 cells, maraviroc and irisin and MCC950, from an inflammatory perspective - a Commentary.
Authors: Clark IA, Vissel B Abstract INTRODUCTION: The importance of excessive cerebral tumour necrosis factor (TNF) concentrations as one of the central tenets of the pathogenesis of the neurodegenerative diseases is now widely known, but variably accepted. Areas covered: Here we update the field by including material that is freely available on the large databases, particularly PubMed. We include the therapeutic outcomes with etanercept (a widely used specific anti-TNF biological), XPro1595 (a new double negative TNF inhibitor), 3,61-dithiothalidomide, implanted SB623 stem cells, maraviroc (a CCR5 inhibitor used to ...
Source: Expert Review of Neurotherapeutics - May 17, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Intravenous immunoglobulins for Alzheimer's disease and mild cognitive impairment due to Alzheimer's disease: a systematic review with meta-analysis.
Authors: Liu J, Wang LN Abstract INTRODUCTION: Alzheimer's disease (AD) is the most common phenotype of dementia. Mild cognitive impairment (MCI) due to AD is believed as a prodromal stage of AD. Intravenous immunoglobulin (IVIG) is a classical immunotherapy and potentially reduces AD-type pathology by anti-Aβ, anti-tau, anti-inflammatory effects and non-antibody-mediated effects. Areas covered: The authors aimed to determine the efficacy and safety of IVIG for AD and MCI due to AD patients. The electronic databases including PubMed, EMBASE, CINAHL, Cochrane Library and China National Knowledge Infrastructure wer...
Source: Expert Review of Neurotherapeutics - May 17, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

An update on Neurocritical Care for Intracerebral Hemorrhage.
Authors: Reyes R, Viswanathan M, Aiyagari V Abstract INTRODUCTION: Intracerebral hemorrhage remains one of the leading causes of death and disability worldwide with few established interventions that improve neurologic outcome. Research dedicated to better understanding and treating hemorrhagic strokes has multiplied in the past decade. Areas Covered: This review aims to discuss the current landscape of management of intracerebral hemorrhage in a critical care setting and provide updates regarding developments in therapeutic interventions and targets. PubMed was utilized to review recent literature, with a focus on la...
Source: Expert Review of Neurotherapeutics - May 17, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Potential effects of Nicotine on Glioblastoma and Chemoradiotherapy: A Review.
Authors: McConnell DD, Carr SB, Litofsky NS Abstract INTRODUCTION: Glioblastoma multiforme (GBM) has a poor prognosis despite maximal surgical resection with subsequent multi-modal radiation and chemotherapy. Use of tobacco products following diagnosis and during the period of treatment for non-neural tumors detrimentally affects treatment and prognosis. 16-28% of patients with glioblastoma continue to smoke after diagnosis and during treatment. The literature is sparse for information pertaining effects of smoking and nicotine on GBM treatment and prognosis. Areas covered: This review discusses cellular pathways invo...
Source: Expert Review of Neurotherapeutics - May 17, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Advances in preventing adverse events during monoclonal antibody management of multiple sclerosis.
Authors: De Giglio L, Grimaldi AE, Fubelli F, Marinelli F, Pozzilli C Abstract INTRODUCTION: Decades of pharmacological research in Multiple Sclerosis (MS) led to the development of therapeutic Monoclonal Antibodies (MAbs) with many different mechanisms of action (MoA), potentially able to improve disability outcome but also determining a more complex management of patients. Areas covered: When clinicians select MS treatments, they should consider adverse events (AEs) on individual basis to minimize patients' risks. Some AEs are common and can be easily handled, but rare complications should also be taken into account...
Source: Expert Review of Neurotherapeutics - May 17, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

The future role of robots in neuro-rehabilitation.
Authors: Fazekas G, Tavaszi I PMID: 31090484 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - May 16, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Autistic spectrum disorder and epilepsy: diagnostic challenges.
We report the current diagnostic criteria for both ASD and epilepsy. We describe the incidence, prevalence, and risk factors for epilepsy in patients with ASD. We then focus on the electro-clinical approach, including the clinical evaluation of cognitive regression. Expert Opinion: A diagnosis of epilepsy should be made based on the International League Against Epilepsy (ILAE) definition. A diagnosis of epilepsy should be established based on a single seizure with electroencephalography (EEG) abnormalities. Considering the high prevalence of EEG abnormalities in children with ASD without epilepsy, EEG should only be perfor...
Source: Expert Review of Neurotherapeutics - May 14, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Glial cells as therapeutic targets in progressive multiple sclerosis.
Authors: Wilbanks B, Maher LJ, Rodriguez M Abstract INTRODUCTION: Multiple sclerosis is a serious demyelinating disease of the central nervous system (CNS) with treatments generally restricted to immunosuppression to reduce attack rate and for symptom management. Glial cells may be useful targets for future CNS regenerative therapies to reverse disease. Areas covered: In this review, the authors cover currently available multiple sclerosis treatments and examine potential upcoming therapies targeting glial cells. The potential for new therapeutic approaches in the treatment of progressive multiple sclerosis is examine...
Source: Expert Review of Neurotherapeutics - May 14, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Therapeutic strategies that act on the peripheral nervous system in primary headache disorders.
Authors: Tajti J, Szok D, Nyári A, Vécsei L Abstract INTRODUCTION: Acute and preventive treatment of primary headache disorders is not completely resolved with regards to efficacy, safety, and tolerability. Hence peripheral and central neuromodulation can provide therapeutic alternatives in drug-resistant cases. Peripheral targets of neuromodulation include invasive and non-invasive neurostimulation and electrical and chemical nerve and ganglion blockades. Areas covered: A PubMed search of papers published from January 2012 to October 2018 was conducted. The goal of this review was to analyze the efficac...
Source: Expert Review of Neurotherapeutics - May 6, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Fremanezumab as a preventive treatment for episodic and chronic migraine.
Authors: Bigal ME, Walter S, Rapoport AM Abstract INTRODUCTION: The importance of calcitonin gene-related peptide (CGRP) in migraine pathogenesis is well established. Fremanezumab is a humanized IgG2a monoclonal antibody that binds to CGRP. Areas covered: In this paper we review the development of fremanezumab, from early development into approval. The authors focus on the efficacy and safety of fremanezumab in both migraine stages. The authors highlight studies conducted in special populations and focus on unique aspects of its development, as well as on clinical pearls supported by the data. Expert opinion: Fremanez...
Source: Expert Review of Neurotherapeutics - May 3, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Hereditary spastic paraplegias: time for an objective case definition and a new nosology for neurogenetic disorders to facilitate biomarker/therapeutic studies.
Authors: Elsayed LEO, Eltazi IZM, Ahmed AEM, Stevanin G Abstract INTRODUCTION: Hereditary spastic paraplegias (HSPs) are heterogeneous neurodegenerative disorders characterized by progressive lower limb weakness and spasticity as core symptoms of the degeneration of the corticospinal motor neurons. Even after exclusion of infectious and toxic mimickers of these disorders, the definitive diagnosis remains tricky, mainly in sporadic forms, as there is significant overlap with other disorders. Since their first description, various attempts failed to reach an appropriate classification. This was due to the constant expan...
Source: Expert Review of Neurotherapeutics - May 2, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Contemporary methods of improving cognitive dysfunction in clinical depression.
Authors: Knight MJ, Mills NT, Baune BT Abstract INTRODUCTION: Cognitive dysfunction is prevalent in patients with major depressive disorder (MDD), with deficits observed across several domains (e.g., executive function, memory, attention). While depression alone is disabling, patients with cognitive deficits typically experience greater functional impairments, poorer clinical recovery, and reduced quality of life. Consequently, it is imperative to elucidate recent advances in our understanding of the treatment of cognitive dysfunction in MDD. Areas covered: This review spans psychological, physical, and pharmacologica...
Source: Expert Review of Neurotherapeutics - April 26, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Vascular Aspects of Multiple Sclerosis: Emphasis on Perfusion and Cardiovascular Comorbidities.
Authors: Jakimovski D, Topolski M, Genovese AV, Weinstock-Guttman B, Zivadinov R Abstract INTRODUCTION: Multiple sclerosis (MS) is a chronic inflammatory, demyelinating, and neurodegenerative disease of the central nervous system. Over the last two decades, more favorable MS long-term outcomes have contributed towards increase in prevalence of the aged MS population. Emergence of age-associated pathology, such as cardiovascular diseases, may interact with the MS pathophysiology and further contribute to disease progression. Areas covered: This review summarizes the cardiovascular involvement in MS pathology, its disea...
Source: Expert Review of Neurotherapeutics - April 21, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Non-conventional compounds with potential therapeutic effects against Alzheimer's disease.
Authors: de Castro AA, Soares FV, Pereira AF, Polisel DA, Caetano MS, Leal DHS, da Cunha EFF, Nepovimova E, Kuca K, Ramalho TC Abstract INTRODUCTION: Alzheimer's disease (AD) is the most common cause of dementia. Clinical progress in this pathogenesis field has drawn the attention of researchers, stimulating the investigation of novel treatment methods. Current therapies that deal with cholinesterase inhibitors and/or NMDA antagonists have shown a modest symptomatic potential, increasing the need for research into more efficient therapeutics. The goal of this review is to summarize the advances in, and the potential o...
Source: Expert Review of Neurotherapeutics - April 20, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Disease-modifying therapies for tauopathies: agents in the pipeline.
Authors: Panza F, Imbimbo BP, Lozupone M, Greco A, Seripa D, Logroscino G, Daniele A, Colosimo C Abstract INTRODUCTION: Tauopathies are heterogeneous clinicopathological entities characterized by abnormal neuronal and/or glial inclusions of the microtubule-binding protein tau. Primary tauopathies considered to be diseases correspond to a major class of frontotemporal lobar degeneration (FTLD) neuropathology (FTLD-Tau), including several forms of frontotemporal dementia (FTD) clinical syndromes. Little progress has been made in the past 20 years in developing effective disease-modifying drugs for primary tauopathies an...
Source: Expert Review of Neurotherapeutics - April 12, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

An update on thymectomy in myasthenia gravis.
Authors: Evoli A, Meacci E Abstract INTRODUCTION: Myasthenia gravis (MG) is one of the best treatable autoimmune diseases. However, in most patients, treatment is necessarily long-term and related side effects are a serious burden. Thymectomy has a special place in the disease management as a non-pharmacological disease-modifying therapy. For several decades, its role has only been supported by observational studies. Despite the recently achieved class I evidence, many questions remain unaddressed. Areas covered: This review discusses the pathogenic role of the thymus and evidence and controversies concerning therapeu...
Source: Expert Review of Neurotherapeutics - March 29, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Stiripentol for the treatment of seizures associated with Dravet syndrome.
Authors: Chiron C Abstract Introduction Stiripentol is an orphan drug approved for the treatment of seizures associated with Dravet syndrome (since 2007 in Europe). Therapeutic options recently grew in this rare and severe early-onset epilepsy with the approval of stiripentol and cannabidiol in 2018 in the US and the positive trials just completed with fenfluramine. Areas covered First, the short-term efficacy of stiripentol as adjunctive therapy to clobazam and valproate, which was discovered by serendipity thanks to a basket study and then confirmed in 1998 despite the small number of samples in phase III trials. Se...
Source: Expert Review of Neurotherapeutics - March 23, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Cognitive remediation therapy of working memory in addictive disorders: An individualized, tailored, and recovery-oriented approach.
Authors: Rochat L, Khazaal Y PMID: 30892101 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - March 21, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Extended-Release Amantadine for Levodopa-Induced Dyskinesia.
Authors: Dashtipour K, Tafreshi AR, Pahwa R, Lyons KE Abstract INTRODUCTION: Levodopa-induced dyskinesia (LID) is a significant impediment to the long-term use of levodopa for Parkinson's disease (PD). Relatively few studies exist that have described safe and effective therapy for LID. There is thus a significant need for therapy that can control LID to allow for greater sustainability of levodopa therapy. Amantadine extended release (ER) is currently the only FDA-approved medication for the treatment of LID. While other medications have demonstrated efficacy in treating the motor symptoms of PD, amantadine ER is the ...
Source: Expert Review of Neurotherapeutics - March 21, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Taurine and GABA neurotransmitter receptors, a relationship with therapeutic potential?
Authors: Ochoa-de la Paz L, Zenteno E, Gulias-Cañizo R, Quiroz-Mercado H Abstract Taurine is a β-amino acid present in high concentrations in different areas of the mammalian central nervous system (CNS). It participates in different physiological processes such as osmoregulation, signal transduction, antioxidant activity, trophic factor activity, modulation of calcium movements and neurotransmission. It is known that taurine is an agonist of GABAA receptors, and their affinity depends of the subunits that conform this receptor. GABA is the main inhibitory neurotransmitter of the CNS and exerts its effect ...
Source: Expert Review of Neurotherapeutics - March 21, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Traditional Ayurvedic and herbal remedies for Alzheimer's disease: From Bench to Bedside.
Authors: Sharma R, Kuca K, Nepovimova E, Kabra A, Rao MM, Prajapati PK Abstract INTRODUCTION: Alzheimer's disease (AD) is a progressive, neurodegenerative disorder prevalent worldwide among elderly populations. Owing to limited efficacy, side effects and poor patient compliance for current rationally designed therapies, options are being searched from alternate therapies such as Indian (Ayurvedic), Chinese or other traditional systems. Areas covered: Following a comprehensive literature search, the authors provide a review encompassing: (i) pathophysiological changes involved in AD (ii) Ayurvedic holistic approach and...
Source: Expert Review of Neurotherapeutics - March 20, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Dasotraline in ADHD: novel or me too drug?
Authors: Vandana P, Arnold E Abstract INTRODUCTION: A "holy grail" of treatment options for attention-deficit hyperactivity disorder (ADHD) has been an agent with low abuse potential and peak-trough clinical effects, providing sustained therapeutic benefits throughout the day. One such agent, Dasotraline, a DA and NE reuptake inhibitor agent, was recently reviewed by the FDA. Areas covered: The authors completed a timely drug review using a Pub Med literature search using words "Dasotraline, ADHD" "stimulant, abuse" "atomoxetine, ADHD". FDA fact sheets of available medications w...
Source: Expert Review of Neurotherapeutics - March 16, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

An Update on Myoclonus Management.
Authors: Stahl CM, Frucht SJ Abstract INTRODUCTION: Myoclonus is a hyperkinetic movement disorder characterized by sudden, brief, lightning-like involuntary jerks. There are many possible causes of myoclonus and both the etiology and characteristics of the myoclonus are important in securing the diagnosis and treatment. Myoclonus may be challenging to treat, as it frequently requires multiple medications for acceptable results. Few randomized controlled trials investigating the optimal treatment for myoclonus are available, and expert experience and case series guide treatment. Areas Covered: In this article, the auth...
Source: Expert Review of Neurotherapeutics - March 16, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Almotriptan: a review of 20 years' clinical experience.
Authors: Pascual J, Vila C Abstract INTRODUCTION: Almotriptan, a serotonin 5-HT1B/1D agonist has been used in the acute treatment of migraine with or without aura for 20 years, accumulating data on more than 15,000 patients in studies and from an estimated>150 million treated migraine attacks in daily clinical practice. The last major review of almotriptan was written almost 10 years ago. The current narrative review provides an overview of the experience gained with almotriptan over that time, and highlights data published in the last decade. Areas covered: Randomized clinical trials, observational studies, postma...
Source: Expert Review of Neurotherapeutics - March 9, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Metabolism and inflammation: implications for traumatic brain injury therapeutics.
Authors: Killen MJ, Giorgi-Coll S, Helmy A, Hutchinson PJ, Carpenter KL Abstract INTRODUCTION: Traumatic Brain Injury (TBI) is a leading cause of death and disability in young people, affecting 69 million people annually, worldwide. The initial trauma disrupts brain homeostasis resulting in metabolic dysfunction and an inflammatory cascade, which can then promote further neurodegenerative effects for months or years, as a 'secondary' injury. Effective targeting of the cerebral inflammatory system is challenging due to its complex, pleiotropic nature. Cell metabolism plays a key role in many diseases, and increased dis...
Source: Expert Review of Neurotherapeutics - March 9, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Identifying risk factors for cognitive issues in Multiple Sclerosis.
Authors: Amato MP, Prestipino E, Bellinvia A Abstract Introduction Cognitive impairment (CI) in Multiple Sclerosis (MS) has progressively regained clinical and research interest and is currently recognized as a debilitating and burdensome problem for these patients. Studying risk and protecting factors that may influence the development and course of CI is currently an area of increasing interest, due to the potential for preventive strategies. Areas covered In this narrative review the authors briefly addressed the physiopathologic basis, assessment and management of CI in MS and then focused on articles identifying ...
Source: Expert Review of Neurotherapeutics - March 6, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Edaravone for the treatment of amyotrophic lateral sclerosis.
Authors: Yoshino H Abstract INTRODUCTION: Amyotrophic lateral sclerosis (ALS) is a progressive fatal disorder that affects all skeletal muscles, leading to death, mostly within 2-4 years from onset. To date, the anti-glutamatergic drug riluzole is the only drug that has been approved for the treatment of this disease; however, its efficacy is modest. Oxidative stress is considered to be involved in the pathology of ALS, and in this regard, the free radical scavenger edaravone, which was originally developed for the treatment of acute ischemic stroke, has also been developed for the treatment of ALS. Areas covered: Thi...
Source: Expert Review of Neurotherapeutics - February 28, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

An update on EEG in migraine.
Authors: de Tommaso M Abstract INTRODUCTION: In the past few years, brain functional analysis has provided scientific evidence supporting the neuronal basis of migraine. The role of electroencephalography (EEG) in detecting subtle dysfunctions in sensory temporal processing has been fully re-evaluated, thanks to advances in methods of quantitative analysis. However, the diagnostic value of EEG in migraine is very low, and migraine diagnosis is completely based on clinical criteria, while the utility of EEG in migraine pathophysiology has only been confirmed in more recent applications. Areas covered: The present revie...
Source: Expert Review of Neurotherapeutics - February 27, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Effect of antiplatelet pretreatment on safety and efficacy outcomes in acute ischemic stroke patients after intravenous thrombolysis: a systematic review and meta-analysis.
CONCLUSION: There was no significant difference in sICH and mortality between patients with and without antiplatelet pretreatment. Besides, antiplatelet pretreatment did not adversely affect the efficacy outcomes. The prevalence of sICH among Asians receiving antiplatelet pretreatment was relatively high. Additionally, it needs to be noticed that the effect of preexisting antiplatelet on clinical outcomes may be dependent on post thrombolytic antiplatelet regiments. PMID: 30807235 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - February 27, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Modification of CSF findings in multiple sclerosis in the era of rapidly expanding treatment options.
CONCLUSION: These observations suggest that inflammatory CSF findings are more accessible to immunomodulatory MS treatment than previously thought, and that accordingly, their significance may transition from a sole diagnostic finding to a valuable therapeutic biomarker which may help to assess effective targeting of CNS-established inflammation in MS. PMID: 30786785 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - February 23, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Neuromodulation for the treatment of primary headache syndromes.
Authors: Hoffmann J, May A Abstract Introduction Neuromodulation techniques play an increasing role in the treatment of primary headaches. While initially reserved for refractory cases they are now increasingly taken into consideration in earlier treatment phases and in non-refractory situations. One of the main reasons of this paradigm shift is that most neuromodulation techniques are better tolerated as compared to the majority of pharmacological approaches. However, these techniques have their limitations that should be considered. Areas covered The review provides an overview of the available techniques and their ...
Source: Expert Review of Neurotherapeutics - February 23, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Developments in depression in epilepsy: screening, diagnosis and treatment.
Authors: Mula M Abstract INTRODUCTION: Depression is one of the most frequent comorbidities in epilepsy affecting between 17% and 22% of patients but it is still underdiagnosed and undertreated. Areas covered: This paper discusses recent advances about screening, diagnosis and treatment of depression in epilepsy taking into account the heterogeneity of clinical scenarios where depression can occur. Expert opinion: A number of screening instruments are now validated for adults with epilepsy and their psychometric properties are discussed but the NDDIE is the most practical and cost-effective. Challenges in diagnosing d...
Source: Expert Review of Neurotherapeutics - February 21, 2019 Category: Neurology Tags: Expert Rev Neurother Source Type: research