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CNS Summit 2017 Abstracts of Poster Presentations
Conclusion: This novel technology discriminates and quantifies subtle differences in behavior and neurological impairments in subjects afflicted with neurological injury/disease. KINARM assessments can be incorporated into multi-center trials (e.g., monitoring stroke motor recovery: NCT02928393). Further studies will determine if KINARM Labs can demonstrate a clinical effect with fewer subjects over a shorter trial period. Disclosures/funding: Dr. Stephen Scott is the inventor of KINARM and CSO of BKIN Technologies.   Multiplexed mass spectrometry assay identifies neurodegeneration biomarkers in CSF Presenter: Chelsky...
Source: Innovations in Clinical Neuroscience - November 1, 2017 Category: Neuroscience Authors: ICNS Online Editor Tags: Assessment Tools biomarkers Cognition Current Issue Drug Development General Genetics Medical Issues Neurology Patient Assessment Psychopharmacology Scales Special Issues Supplements Trial Methodology clinical trials CNS Su Source Type: research

July –August e-edition
Click here to access e-Edition PDFs can be downloaded and printed from the e-Editions. Click on the above issue issue, find the article, then click on the print command. For archived e-editions, click on the image above, then click on the folder icon at the top of the window.  The post July–August e-edition appeared first on Innovations in Clinical Neuroscience. (Source: Innovations in Clinical Neuroscience)
Source: Innovations in Clinical Neuroscience - July 1, 2017 Category: Neuroscience Authors: ICNS Online Editor Tags: Current Issue Drug Development e-Edition Neurology Psychiatry Psychiatry and Neurology Trial Methodology central nervous system CNS ICNS Innovations in Clinical Neuroscience psychotherapy Source Type: research

Immersive Virtual Reality Therapy with Myoelectric Control for Treatment-resistant Phantom Limb Pain: Case Report
Conclusions: Currently available immersive virtual reality technology with myolectric and motion tracking control may represent a possible therapy option for treatment-resistant phantom limb pain. Keywords: virtual reality, phantom limb pain, rehabilitation, amputation, therapy, pain Innov Clin Neurosci. 2017;14(7–8):3–7 Phantom limb pain (PLP), the sensation of pain in an absent limb, is a frequent complication after amputation, with reported prevalence rates ranging from 40 to 85 percent.1,2 While the exact mechanism of PLP remains to be elucidated, peripheral and central neural factors are thought to contrib...
Source: Innovations in Clinical Neuroscience - July 1, 2017 Category: Neuroscience Authors: ICNS Online Editor Tags: Case Report Current Issue amputation pain phantom limb pain rehabilitation therapy virtual reality Source Type: research

Methadone Treatment of Opiate Addiction: A Systematic Review of Comparative Studies
Conclusion and Recommendations More intervention-based clinical trials are needed to provide a strong alternative candidate therapy for management of opiate use disorder. Buprenorphine, although a promising candidate, should be researched more regarding treatment retention and patient satisfaction before any conclusions can be made regarding its standard use for opiate substitution maintenance treatment of pregnant patients with opiate use disorder. Heroin-assisted treatment still cannot be considered in opiate addicts refractory to MMT; more data should be collected regarding efficacy in larger participant populations un...
Source: Innovations in Clinical Neuroscience - July 1, 2017 Category: Neuroscience Authors: ICNS Online Editor Tags: Current Issue General Review buphernorphin heroin methadone opiate opiate addiction treatment withdrawal Source Type: research

Narcolepsy in Adolescence — A Missed Diagnosis: A Case Report
We report a case of an adolescent male who presented with all four cardinal symptoms of narcolepsy and had been misdiagnosed with epilepsy, psychosis, and depression. We discuss various issues regarding narcolepsy in children and adolescents. Keywords: narcolepsy, adolescence, misdiagnosis Innov Clin Neurosci. 2017;14(9–10):20–23 Introduction Narcolepsy is an uncommon sleep cycle disorder characterized by the tetrad of chronic excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, and sleep paralysis.1 The cardinal symptom of paroxysmal sleep is seen in all patients, whereas other symptoms such as ...
Source: Innovations in Clinical Neuroscience - July 1, 2017 Category: Neuroscience Authors: ICNS Online Editor Tags: Case Report Current Issue adolescence misdiagnosis narcolepsy Source Type: research

Trazodone for Insomnia: A Systematic Review
Conclusion. A review of the literature suggests that there are adequate data supporting the efficacy and general safety of the low-dose use of trazodone for the treatment of insomnia. keywords: insomnia, hypnotics, treatment, trazodone, sedative Keywords: insomnia, hypnotics, treatment, trazodone, sedative Innov Clin Neurosci. 2017;14(9–10):24–34 Introduction Insomnia is characterized by difficulty falling asleep, difficulty staying asleep, or waking too early1 and is associated with significant impairments in daytime activities, which might occur despite adequate opportunities for sleep.2–6 Primary insom...
Source: Innovations in Clinical Neuroscience - July 1, 2017 Category: Neuroscience Authors: ICNS Online Editor Tags: Current Issue Review hypnotics insomnia sedative trazodone treatment Source Type: research

Editorial Message and Issue Highlights, May –June 2017
Dear Colleagues: Welcome to the May-June 2017 issue of Innovations in Clinical Neuroscience. We start the issue with the review article, “The Role and Treatment Implications of Peripheral and Central Processing of Pain, Pruritus, and Nausea in Heightened Somatic Awareness: A Review,” by Spiegel et al. Here, the authors describe and discuss human studies that explore acute neural transmission processes of pain, pruritus, and nausea, including how cortical and subcortical networks are activated by these symptoms. Based on the discussed research, the authors then describe potential treatment options for patients w...
Source: Innovations in Clinical Neuroscience - June 1, 2017 Category: Neuroscience Authors: ICNS Online Editor Tags: Current Issue Editor's Message: Issue Highlights Amir H. Kalali Innovations in Clinical Neuroscience Source Type: research

The Role and Treatment Implications of Peripheral and Central Processing of Pain, Pruritus, and Nausea in Heightened Somatic Awareness: A Review
This article reviews the acute neural transmission of pain, pruritus, and nausea symptoms, which can begin in the periphery and/or viscera. The subsequent multiple pathways in the central nervous system that become involved in the processing of these symptoms are also discussed. The authors describe human brain imaging studies that have revealed consistent cortical and subcortical networks  activated by these symptoms, including sensory, limbic, and associative regions. In particular, the authors discuss information revealed by the studies regarding the primary somatosensory cortex, secondary somatosensory cortex, ant...
Source: Innovations in Clinical Neuroscience - June 1, 2017 Category: Neuroscience Authors: ICNS Online Editor Tags: Current Issue Neurologic Systems and Symptoms Neurology Pain Review central processing nausea pruritus Source Type: research

Single Nucleotide Polymorphisms and the Central Nervous System: Potential Biomarkers in Identifying Suicide Risk
Conclusion Point of care testing (POC) with immediately available results becomes more important, especially in young adults in whom an escalation in the number and severity of self-destructive behaviors is increasingly associated with fatal outcomes. Other populations of concern would be the active duty military and veterans where suicides are also steadily rising and warrant close monitoring and predictive testing when available. At the very least, it behooves us as clinicians and scientists to further explore and clearly establish the relationship between SNPs and suicidal behaviors. Disclaimer The views expressed here ...
Source: Innovations in Clinical Neuroscience - June 1, 2017 Category: Neuroscience Authors: ICNS Online Editor Tags: biomarkers Current Issue Drug Development Genetics Psychiatry Review Suicidality CNS CYP2C19 CYP2D6 pharmacogenomics Single nucleotide polymorphism Single nucleotide polymorphisms SNP SNPs suicide risk Source Type: research

When the Opioid Medications Go Missing: Confidentiality and Safety in Adolescents
Conclusion Clinicians should be aware of state laws regarding consent for alcohol and substance use treatment for minors. While family participation is the ideal strategy for treatment, minors can invoke the right of confidentiality to bar clinicians from sharing information regarding substance use with their families. Clinicians should obtain appropriate consent for communications and maintain confidentiality when possible, but above all ensure the safety of the adolescent while providing optimal care. Advice from peers, hospital ethical committees, and/or attorneys is recommended in these situations. Acknowledgment The a...
Source: Innovations in Clinical Neuroscience - June 1, 2017 Category: Neuroscience Authors: ICNS Online Editor Tags: Child Adol Mental Disorders Commentary Current Issue Ethics in Psychiatry Substance Use Disorders adolescents confidentiality diversion opioids safety Source Type: research

It ’s Time for Combination Therapies in Multiple Sclerosis
Conclusion In summary, MS?therapies that combine BBB-crossing molecules with peripherally acting MAbs should be a strategy of MS drug development. MS therapies that effectively limit or halt disease progression and improve overall treatment outcomes will need to address the disease mechanisms both inside and outside the CNS. It must also be recognized that the presence of lymphoid-follicle like structures are associated clinically with irreversible disability and, from a pathological perspective, show pronounced demyelination, microglial activation, and loss of neurites in the cerebral cortex.[14] Without addressing such f...
Source: Innovations in Clinical Neuroscience - June 1, 2017 Category: Neuroscience Authors: ICNS Online Editor Tags: Commentary Current Issue Drug Development Multiple Sclerosis Neurodegenerative Disease Neurology Neuromuscular Disease Psychopharmacology Update on Blood Brain Barrier combination therapies cyclophosphamide disability status laquin Source Type: research

What Can I Do About a Negative Online Review?
Conclusion While the vast majority of online reviews about healthcare professionals are positive, it can be very frustrating to see false, negative, and/or unfair comments posted about one’s professionalism and/or treatment practices or that of one’s clinic. Keep in mind that there are very few options in terms of response, and some responses, such as filing a lawsuit against the poster, will likely not benefit the healthcare professional, and will very likely generate more attention to the accusations in the post. References Attorney General Cuomo secures settlement with plastic surgery franchise that flooded...
Source: Innovations in Clinical Neuroscience - June 1, 2017 Category: Neuroscience Authors: ICNS Online Editor Tags: Current Issue Practice Management Risk Management clinician-patient interaction HIPAA online reviews patient relationship Source Type: research

Editor ’s Message—Issue Highlights, March–April 2017
Dear Colleagues: Welcome to the March–April 2017 issue of Innovations in Clinical Neuroscience. We start this issue with an interesting case series by Shroff titled, “Human Embryonic Stem Cells in the Treatment of Autism: A Case Series.” Here, investigators administered human embryonic stem cell therapy to three children with autism spectrum disorder (ASD) in an effort to improve blood perfusion in their brains, which theorectically improve motor, social, and cognition skills. After 3 to 4 treatment phases (each 4 to 6 weeks long) that were separated by 4- to 8-month gap phases, the authors report that th...
Source: Innovations in Clinical Neuroscience - April 1, 2017 Category: Neuroscience Authors: ICN Online Editor Tags: Current Issue Editor's Message: Issue Highlights Amir H. Kalali Innovations in Clinical Neuroscience Source Type: research

Human Embryonic Stem Cells in the Treatment of Autism: A Case Series
Conclusion: The use of human embryonic stem cell therapy may be a safe and effective treatment for patients with autism spectrum disorder. Studies with larger sample sizes are needed to support the use of human embryonic stem cell therapy in this patient population. Introduction Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social disconnection, incomplete verbal and nonverbal communication, severely restricted interests, and display of stereotyped and repetitive obsessive behaviors.[1,2] The current diagnosis of ASD is based on the revised criteria in the fifth edition of the Diagnostic ...
Source: Innovations in Clinical Neuroscience - April 1, 2017 Category: Neuroscience Authors: ICN Online Editor Tags: Autism Behavioral and Cognitive Neurology Case Review Current Issue Neurologic Systems and Symptoms Pervasive Developmental Disorders brain related disorder hESC human embryonic stem cell neurodevelopmental disorder stem cell therapy Source Type: research

Interactive Voice Response and Text-based Self-report Versions of the Electronic Columbia-Suicide Severity Rating Scale Are Equivalent
Conclusion: These results support the validity and reliability of the new tablet-based electronic Columbia-Suicide Severity Rating Scale. This will allow the inclusion of the electronic Columbia-Suicide Severity Rating Scale in a wider range of clinical studies, particularly where a tablet is also being used to collect other study data. Introduction Prospective assessment of suicidal ideation and behavior (SIB) is a critical step in many clinical trials. The United States Food and Drug Administration (FDA) mandates prospective SIB in “all clinical trials involving any drug being developed for any psychiatric indicati...
Source: Innovations in Clinical Neuroscience - April 1, 2017 Category: Neuroscience Authors: ICN Online Editor Tags: Assessment Tools Current Issue Depression Devices Drug Development Evaluations Original Research Patient Assessment Psychiatry Scales Suicidality Technology Trial Methodology C-SSR Columbia-Suicide Severity Rating Scale elect Source Type: research

Liothyronine for Depression: A Review and Guidance for Safety Monitoring
Conclusion: With appropriate baseline and follow-up safety monitoring, liothyronine augmentation can be a safe and effective treatment for unipolar depression. Larger studies of longer duration assessing liothyronine efficacy with serotonin norepinephrine reuptake inhibitors and multimodal antidepressants are needed. Introduction Major depressive disorder (MDD) has a 12-month prevalence of 6.7 percent and a lifetime prevalence of 16.9 percent.[1,2] Treatment-resistant depression is defined as lack of response after trials of two or more antidepressants with different mechanisms of action for sufficient duration.[3] Such an...
Source: Innovations in Clinical Neuroscience - April 1, 2017 Category: Neuroscience Authors: ICN Online Editor Tags: Current Issue Depression Mood Disorders Psychiatry Psychopharmacology Review augmentation enhancement liothyronine T3 treatment-resistant depression Triiodothyronine Source Type: research

Neuroendocrine, Autonomic, and Metabolic Responses to an Orexin Antagonist, Suvorexant, in Psychiatric Patients with Insomnia
Conclusion: Suvorexant treatment resulted in overall improvement in the quality of sleep and the severity of anxiety and depression. This dual orexin antagonist may be related to autonomic functions and neuroendocrine systems, especially in the hypothalamus-pituitary-adrenal axis in psychiatric subjects. Introduction The hypothalamus plays a critical role in the integrated control of sleep/wakefulness, thermogenesis, and energy homeostasis, and the lateral hypothalamus area (LHA) in this region has been regarded as an important center for arousal and feeding.[1] The neuropeptide orexin A and orexin B (also known as hypocre...
Source: Innovations in Clinical Neuroscience - April 1, 2017 Category: Neuroscience Authors: ICN Online Editor Tags: Anxiety Disorders Current Issue Depression Original Research Psychiatry Psychopharmacology Sleep Disorders Autonomic nervous insomnia neuroendocrine orexin antagonist suvorexant Source Type: research

Redefining Acute Relapses in Multiple Sclerosis: Implications for Phase 3 Clinical Trials and Treatment Algorithms
Conclusion A better definition of what constitutes a relapse in MS is urgently needed. From a treatment perspective, the management of relapses, particularly in the emergency department (ED), is highly variable. In general, it is possible that patients are treated with steroids based on symptomatology and an ED physician’s evaluation. It is often difficult in the ED to ascertain baseline status or a deviation from it, and an MRI may or may not be performed in the ED owing to cost and availability. However, if objective MRI data are not the singular surrogate biomarker to validate BBB breach, false-positive cases are ...
Source: Innovations in Clinical Neuroscience - April 1, 2017 Category: Neuroscience Authors: ICN Online Editor Tags: Commentary Current Issue Devices Evaluations Multiple Sclerosis Neurology Technology acute relapse big data blood brain barrier imaging magnetic resonance imaging MRI MS Source Type: research

Managing Your Aging Patient Population
by Ann L. McNary, JD Ms. McNary is Senior Risk Manager at PRMS, Inc. in Arlington, Virginia. Innov Clin Neurosci. 2017;14(3–4)41–44 This ongoing column is dedicated to providing information to our readers on managing legal risks associated with medical practice. We invite questions from our readers. The answers are provided by PRMS, Inc. (www.prms.com), a manager of medical professional liability insurance programs with services that include risk management consultation, education and onsite risk management audits, and other resources to healthcare providers to help improve patient outcomes and reduce professio...
Source: Innovations in Clinical Neuroscience - April 1, 2017 Category: Neuroscience Authors: ICN Online Editor Tags: Current Issue Practice Management Risk Management geriatrics professional liability Source Type: research

Letter to the editor: Modafinil Augmentation Therapy in Patient with Traumatic Brain Injury
Discussion. TBI results in a complex alteration of various brain regions. Recent advances in neuroimaging studies support the hypothesis that symptomatology of TBI-induced depression and cognitive deficits are directly related to the altered functional connectivity between different brain networks.[2] The default mode network represents one of them. It has been previously proposed that this functional network mainly consists of the ventromedial prefrontal cortex, posterior cingulate/retrosplenial cortex, and inferior parietal lobule. The neurochemical underprint of this network is modulated by a combined input from cortica...
Source: Innovations in Clinical Neuroscience - April 1, 2017 Category: Neuroscience Authors: ICN Online Editor Tags: Current Issue Depression Editor's Message: Issue Highlights Neurology Traumatic Brain Injury augmentation modafinil TBI Source Type: research

CNS Summit 2016 Abstracts of Poster Presentations
Conclusion: Subjects with acutely exacerbated schizophrenia who were eligible for discharge from the inpatient setting and who completed the study demonstrated high rates of adherence using the mobile AI application. Subjects were able to easily use the technology. Use of the platform did not appear to increase the dropout rate. This study demonstrates the feasibility of using AI platforms to ensure high adherence, provide reliable adherence data, and rapidly detect nonadherence in CNS trials. Disclosures/funding: Adam Hanina and Laura Shafner are employees of AiCure, New York, New York, and consultants to Takeda. Xinxin D...
Source: Innovations in Clinical Neuroscience - February 1, 2017 Category: Neuroscience Authors: ICN Online Editor Tags: Assessment Tools biomarkers Cognition Current Issue Devices Drug Development Evaluations Genetics Medical Issues Neurology Patient Assessment Proceedings Psychiatry Psychopharmacology Scales Supplements Technology Trial M Source Type: research

Editor ’s Message: Issue Highlights, January–February 2017
Dear Colleagues: Welcome to the January–February 2017 issue of Innovations in Clinical Neuroscience. We start our 14th year of publication strong with an interesting and diverse issue we hope you enjoy as much as we did putting it together. In the review article by Dascal et al, “Virtual Reality and Medical Inpatients: A Systematic Review of Randomized, Controlled Trials,” the researchers evaluate the evidence supporting the use of virtual reality among patients in acute inpatient medical settings. The authors found that virtual reality in the medical setting has demonstrated some efficacy, but they concl...
Source: Innovations in Clinical Neuroscience - February 1, 2017 Category: Neuroscience Authors: ICN Online Editor Tags: Current Issue Editor's Message: Issue Highlights Source Type: research

Behavioral and Stereological Analysis of the Effects of Intermittent Feeding Diet on the Orally Administrated MDMA ( “ecstasy”) in Mice
In this study, we investigated the behavioral and histological outcomes of the effect of intermittent feeding on the orally administered MDMA in mice. Methods—The animals (male albino mice) were divided into four groups: ad libitum (AL), intermittent feeding (IF) (food given every other day), and AL and IF control groups. After five weeks, AL and IF groups were given a single oral dose of 20 or 60mg/kg MDMA. Behavior was assessed with the elevated plus-maze and the open field tests. Each of the treatment groups were then divided in to two groups: AL-AL (AL diet throughout), AL-IF (IF after MDMA administration), IF-IF...
Source: Innovations in Clinical Neuroscience - February 1, 2017 Category: Neuroscience Authors: ICN Online Editor Tags: Anxiety Disorders Behavioral and Cognitive Neurology Current Issue Original Research Psychiatry Substance Use Disorders Elevated plus-maze hippocampus intermittent feeding MDMA neuronal numerical density open field Source Type: research

MicroRNAs as Biomarkers for Psychiatric Conditions: A Review of Current Research
Conclusion Neural miRNAs are responsive to environmental, synaptic, and pathological changes and are actively secreted by cells as exosomes from brain into blood. While serum miRs cannot cross the blood brain barrier (BBB), naturally occurring exosomes are capable of crossing the BBB. These exosomes bear cell-type specific surface markers. Using a neural-specific surface marker, neural-derived exosomes can be successfully isolated and can be used as diagnostic markers for many psychiatric conditions. For example, brain-derived exosomes are fused with neuron-specific RVG peptide (rabies virus glycoprotein, a peptide known t...
Source: Innovations in Clinical Neuroscience - February 1, 2017 Category: Neuroscience Authors: ICN Online Editor Tags: biomarkers Bipolar Disorder Current Issue Depression Psychiatry Review Schizophrenia hippocampus messengerRNA (mRNA) MicroRNA (miR/miRNA) neurogenesis neuronal plasticity Source Type: research

Ketamine Therapy for Treatment-resistant Depression in a Patient with Multiple Sclerosis: A Case Report
Conclusion—Ketamine may be an alternative treatment for resistant depression and may have a special use in patients with multiple sclerosis. Introduction Depression is a frequent finding in patients with multiple sclerosis (MS), with the lifetime prevalence rates for major depressive disorder (MDD) ranging from 36 to 54 percent, more than twice of that in the general population.[1] Even with advances in pharmacological options for treating depression, an estimated 33 to 66 percent of patients with MDD in the general population do not respond to the first antidepressant, and a reported 15 to 33 percent of patients do ...
Source: Innovations in Clinical Neuroscience - February 1, 2017 Category: Neuroscience Authors: ICN Online Editor Tags: Case Report Current Issue Depression Multiple Sclerosis Neurology Psychiatry Psychopharmacology Electroconvulsive therapy Ketamine major depressive disorder treatment-resistant depression Source Type: research

Risk Management Issues When Taking Locum Tenens Assignments
by Charles D. Cash, JD, LLM Mr. Cash is Assistant Vice President of Risk Management at PRMS, Inc., Arlington, Virginia. Innov Clin Neurosci. 2017;14(1–2)60–62 This ongoing column is dedicated to providing information to our readers on managing legal risks associated with medical practice. We invite questions from our readers. The answers are provided by PRMS, Inc. (www.prms.com), a manager of medical professional liability insurance programs with services that include risk management consultation, education and onsite risk management audits, and other resources to healthcare providers to help improve patient ou...
Source: Innovations in Clinical Neuroscience - February 1, 2017 Category: Neuroscience Authors: ICN Online Editor Tags: Current Issue Practice Management Psychiatry Risk Management liability Locum Tenens malpractice Source Type: research

Letters to the Editor: Discussing sexual health after traumatic brain injury: an unmet need!
In conclusion, taking into account the high prevalence of SD in men with TBI and its multifactorial etiology, we believe clinicians who treat patients with TBI should be properly trained in human sexuality in order to better meet the needs of these patients. Clinicians should be prepared to have frank, educated discussions on sexual functioning with all of their TBI patients so that they may provide valuable information to their patients on achieving healthy sexual functioning; this in turn will help their patients and their patients’ partners achieve a higher quality of life. References Bivona U, Antonucci G, Contr...
Source: Innovations in Clinical Neuroscience - February 1, 2017 Category: Neuroscience Authors: ICN Online Editor Tags: Behavioral and Cognitive Neurology Current Issue Evaluations Letters to the Editor Medical Issues Neurologic Systems and Symptoms Traumatic Brain Injury clinician-patient interaction sexual dysfunction TBI Source Type: research

The Neuroscience Report —Volume 47 (December 6, 2016): Psychology of Technology in Society
The latest in neuroscience—sorted and summarized for you Welcome to The Neuroscience Report where each week we will highlight a specific topic in neuroscience and provide you with links to 5 journal articles, 5 news articles, and 5 wildcard picks. Brought to you by Innovations in Clinical Neuroscience—your source for peer-reviewed, evidence-based information. This week’s topic: Psychology of Technology in Society Journal Articles Virtual Detox: Inpatient Therapy for Internet Addicts The Effect of Distance on Moral Engagement: Event Related Potentials and Alpha Power are Sensitive to Perspective i...
Source: Innovations in Clinical Neuroscience - December 6, 2016 Category: Neuroscience Authors: ICN Online Editor Tags: Devices Psychology Technology The Neuroscience Report society Source Type: research

Editors Message and Issue Highlights: November –December 2016
Dear Colleagues: Welcome to the November–December 2016 issue of Innovations in Clinical Neuroscience. We begin this issue with a thoughtful review and commentary by Calabró et al titled, “The Right to Die in Chronic Disorders of Consciousness: Can We Avoid the Slippery Slope Argument?” Here the authors review current opinions and ethical issues concerning end-of-life decisions in patients with disorders of consciousness (DOCs) (i.e., vegetative state, minimally conscious state), including the impact misdiagnoses of DOCs may have on end-of-life decisions, the concept of “dignity” and &ld...
Source: Innovations in Clinical Neuroscience - December 1, 2016 Category: Neuroscience Authors: ICN Online Editor Tags: Current Issue Editor's Message: Issue Highlights Source Type: research

Acute Hyperglycemia Associated with Psychotic Symptoms in a Patient with Type 1 Diabetes Mellitus: A Case Report
Conclusion Clinicians should consider inadequate glycemic control as a potential cause of acute-onset psychotic episodes in patients with diabetes. Our case highlights the importance of first stabilizing these patients’ glycemic levels before prescribing antipsychotics, especially atypical antipsychotics, which may exacerbate hyperglycemia and thus potentially worsen the psychosis. If other pathologies are ruled out and an association between hyperglycemia and psychotic symptoms is established, these patients may benefit from benzodiazepines, as these drugs will not exacerbate hyperglycemia and may help calm the pati...
Source: Innovations in Clinical Neuroscience - December 1, 2016 Category: Neuroscience Authors: ICN Online Editor Tags: Case Report Current Issue Medical Issues Primary Care Psychiatry Schizophrenia Acute psychosis diabetes mellitus hyperglycemia organic psychosis Source Type: research

Complete Recovery from Cardiac Arrest Caused by Risperidone-induced Hypothermia
Conclusion Our patient presented to the ER in a state of cardiac arrest. We were able to successfully resuscitate her without complication. Based on her very low body temperature and the presence of J-waves on her ECG, we speculated that hypothermia was the cause of the cardiac arrest. The patient did not have any medical conditions known to cause hypothermia nor had she been subjected to unusually cold temperatures; however, she was taking risperidone, an antipsychotic known to cause hypothermia. Thus, we deduced that our patient’s hypothermia was caused by risperidone. After being stabilized, our patient was switch...
Source: Innovations in Clinical Neuroscience - December 1, 2016 Category: Neuroscience Authors: ICN Online Editor Tags: Case Report Current Issue Medical Issues Psychiatry Schizophrenia Cardiac arrest hypothermia J-wave risperidone Source Type: research

Sympathetic Nerve Entrapment Point Injection as an Antireflux Procedure for Refractory Laryngopharyngeal Reflux: A First Case Report of Innovative Autonomic Regulation
Conclusion Hyperexcitability of T5 and T6 sympathetic preganglionic fibers appears to be the main etiology of LPR. SNEPI can reduce LES relaxation and improve blood flow to the mucosa, thereby increasing the stability of the vagus reflex and laryngopharyngeal mucosal defense factors. To the best of our knowledge, this case represents the first report of a patient with LPR refractory to PPIs who was successfully treated with SNEPI alone. SNEPI can be considered as an alternative to anti-reflux procedures. References 1. Vakil N, van Zanten SV, Kahrilas P, et al. Global Consensus Group. The Montreal definition and classificat...
Source: Innovations in Clinical Neuroscience - December 1, 2016 Category: Neuroscience Authors: ICN Online Editor Tags: Case Report Current Issue Medical Issues Neurologic Systems and Symptoms Neurology antireflux procedure autonomic regulation laryngopharyngeal reflux refractory Sympathetic nerve entrapment point injection Source Type: research

Ransomware: Minimizing the Risks
by Justin Pope, JD Mr. Pope is Associate Risk Manager at PRMS, Inc. in Arlington, Virginia. Innov Clin Neurosci. 2016;13(11–12)37–40 This ongoing column is dedicated to providing information to our readers on managing legal risks associated with medical practice. We invite questions from our readers. The answers are provided by PRMS, Inc. (www.prms.com), a manager of medical professional liability insurance programs with services that include risk management consultation, education and onsite risk management audits, and other resources to healthcare providers to help improve patient outcomes and reduce professi...
Source: Innovations in Clinical Neuroscience - December 1, 2016 Category: Neuroscience Authors: ICN Online Editor Tags: Current Issue Digital Medicine Practice Management Risk Management Technology computer system data security EHR electronic health record hacker HIIPA malware ransomware Source Type: research

Differential Diagnoses: Encephalopathy or Psychosis?
by Malathi Latha Perugula, MD, and Steven Lippmann, MD The authors are from the Department of Psychiatry and Behavioral Science, University of Louisville School of Medicine, Louisville, Kentucky. Innov Clin Neurosci. 2016;13(11–12):41–42 This column series compares neurological conditions that pose differential challenges in diagnoses. Funding: No funding was provided for the preparation of this article. Financial disclosures: The authors have no conflicts of interest relevant to the content of this article. Introduction Encephalopathy and psychosis are two separate mental states that are both characterized by ...
Source: Innovations in Clinical Neuroscience - December 1, 2016 Category: Neuroscience Authors: ICN Online Editor Tags: CNS Infections Current Issue Differential Diagnoses Medical Issues Mental Disorders Neuro oncology Neurologic Systems and Symptoms Neurology Psychiatry Schizophrenia Substance Use Disorders encephalopathy psychosis Source Type: research

The Neuroscience Report —Volume 46 (November 11, 2016): Accessibility of Mental Healthcare
The latest in neuroscience—sorted and summarized for you Welcome to The Neuroscience Report where each week we will highlight a specific topic in neuroscience and provide you with links to 5 journal articles, 5 news articles, and 5 wildcard picks. Brought to you by Innovations in Clinical Neuroscience—your source for peer-reviewed, evidence-based information.   This week’s topic: Accessibility of Mental Healthcare Journal Articles Moving Out of the Office: Removing Barriers to Access to Psychiatrists Factors for Success in Mental Health Advocacy Acceptance of Insurance by Psychiatr...
Source: Innovations in Clinical Neuroscience - November 11, 2016 Category: Neuroscience Authors: ICN Online Editor Tags: Medical Issues Practice Management Primary Care Psychiatry Psychotherapy The Neuroscience Report access to mental healthcare physician shortage Source Type: research

Editor ’ s Message: September –October 2016 Issue Highlights
Dear Colleagues: Welcome to the September-October 2016 issue of Innovations in Clinical Neuroscience (ICNS). As the official journal of the CNS Summit, the International Society for CNS Drug Development (ISCDD), and the International Society for CNS Clinical Trials and Methodology (ISCTM), an important part of our editorial mission is to accelerate and enhance of the development of cheaper, more effective treatments for our patients through technology, collaboration, and innovation—not just in neuroscience but in all disciplines of medicine and among all involved entities, including clinicians, researchers, and membe...
Source: Innovations in Clinical Neuroscience - October 9, 2016 Category: Neuroscience Authors: ICN Online Editor Tags: Current Issue Drug Development Editor's Message: Issue Highlights Neurology Psychiatry Trial Methodology Amir H. Kalali CNS Summit Innovations in Clinical Neuroscience ISCDD ISCTM Source Type: research

The Depression Inventory Development Workgroup: A Collaborative, Empirically Driven Initiative to Develop a New Assessment Tool for Major Depressive Disorder
We report here an overview of the Depression Inventory Development initiative, including results of the third iteration of items assessing symptoms related to anhedonia, cognition, fatigue, general malaise, motivation, anxiety, negative thinking, pain and appetite. The strategies adopted from the Depression Inventory Development program, as an empirically driven and collaborative process for scale development, have provided the foundation to develop and validate measurement tools in other therapeutic areas as well. Introduction The Hamilton Depression Rating Scale (HAMD)[1] and Montgomery–Åsberg Depression Rati...
Source: Innovations in Clinical Neuroscience - October 9, 2016 Category: Neuroscience Authors: ICN Online Editor Tags: Current Issue Depression Mood Disorders Patient Assessment Psychiatry Review Scales Trial Methodology depressive symptoms item response theory major depressive disorder rating scales Source Type: research

Eszopiclone-induced Parasomnia with Suicide Attempt: A Case Report
Conclusion The possibility for adverse effects, including life-threatening events, when taking eszopiclone should be considered by all prescribers. The pharmacological profile of eszopiclone suggests a potential for a greater risk of adverse events than with other benzodiazepine-like hypnotics such as zolpidem, which has a one-percent risk for sleep-related amnestic behaviors.[10] This risk increases further with concomitant administration of monoaminergic drugs like SSRIs. The risk for these behaviors among patients taking eszopiclone is yet to be quantified and presents an opportunity for future research endeavors. Regar...
Source: Innovations in Clinical Neuroscience - October 9, 2016 Category: Neuroscience Authors: ICN Online Editor Tags: Case Report Current Issue Depression Mood Disorders Psychiatry Psychopharmacology Sleep Disorders benzodiazepine-like drug reaction Eszopiclone hypnotic insomnia parasomnia sedative Source Type: research

Cariprazine for Schizophrenia and Bipolar Disorder
This article reviews mechanisms of action, efficacy, tolerability (including adverse effects), dosing, and contraindications of cariprazine. Introduction Schizophrenia is characterized by at least two of the following symptoms: delusions, hallucinations, disorganized speech, disorganized or catatonic behavior, or negative symptoms.[1] Bipolar disorder consists of manic, hypomanic, or mixed episodes alternating with depressive episodes.[2] Because second-generation or atypical antipsychotics reduce both positive and negative symptoms of schizophrenia as well as manic and mixed episodes of bipolar disorder, they are recommen...
Source: Innovations in Clinical Neuroscience - October 8, 2016 Category: Neuroscience Authors: ICN Online Editor Tags: Bipolar Disorder Current Issue Mood Disorders Psychiatry Psychopharmacology Review Schizophrenia antipsychotic cariprazine mania mixed episode Source Type: research

Consent to Treatment of Minors, Revisited
by Ann McNary, JD Ms. McNary is Senior Risk Manager at PRMS, Inc. in Arlington, Virginia. Innov Clin Neurosci. 2016;13(9–10)53–55 This ongoing column is dedicated to providing information to our readers on managing legal risks associated with medical practice. We invite questions from our readers. The answers are provided by PRMS, Inc. (www.prms.com), a manager of medical professional liability insurance programs with services that include risk management consultation, education and onsite risk management audits, and other resources to healthcare providers to help improve patient outcomes and reduce professiona...
Source: Innovations in Clinical Neuroscience - October 8, 2016 Category: Neuroscience Authors: ICN Online Editor Tags: Child Adol Mental Disorders Current Issue Practice Management Psychiatry Psychology Psychotherapy Risk Management child and adolescent psychiatry consent of minor patient assent patient consent Source Type: research

The Neuroscience Report —Volume 45 (September 15, 2016): Schizophrenia
The latest in neuroscience—sorted and summarized for you Welcome to The Neuroscience Report where each week we will highlight a specific topic in neuroscience and provide you with links to 5 journal articles, 5 news articles, and 5 wildcard picks. Brought to you by Innovations in Clinical Neuroscience—your source for peer-reviewed, evidence-based information. This week’s topic: Schizophrenia Journal Articles Brexpiprazole: A New Treatment Option for Schizophrenia Efficacy and Safety of Pharmacological and Psychological Interventions for the Treatment of Psychosis and Schizophrenia in Children, A...
Source: Innovations in Clinical Neuroscience - September 15, 2016 Category: Neuroscience Authors: ICN Online Editor Tags: Mental Disorders Psychiatry Schizophrenia The Neuroscience Report Source Type: research

Editor ’s Message—Issue Highlights, July–August 2016
Dear Colleagues: Welcome to the July–August 2016 issue of Innovations in Clinical Neuroscience. We start this issue with an interesting study by MacEwan et al titled, “Pharmaceutical Innovation in the Treatment of Schizophrenia and Mental Disorders Compared with Other Diseases.” Here, the authors assessed the level of private and public investment in research and development (R&D) of treatments for schizophrenia and other mental disorders and compared this to other diseases. They present their data on the economic burden and pharmaceutical innovation by disease area and compare the level of investment...
Source: Innovations in Clinical Neuroscience - August 1, 2016 Category: Neuroscience Authors: ICN Online Editor Tags: Current Issue Drug Development Editor's Message: Issue Highlights Neurology Psychiatry Amir Kalali Innovations in Clinical Neuroscience Source Type: research

Pharmaceutical Innovation in the Treatment of Schizophrenia and Mental Disorders Compared with Other Diseases
Conclusion: Despite the significant burden mental disorders impose on society, investment and pharmaceutical innovation in this disease area remains comparatively low. Policymakers should consider new strategies to stimulate public and private investment in the research and development of novel and effective therapies to treat schizophrenia and other mental disorders. Introduction Over the last two decades, there have been remarkable breakthroughs in healthcare. These breakthroughs include the development of novel pharmaceutical treatments that have significantly improved outcomes for patients suffering from various medica...
Source: Innovations in Clinical Neuroscience - August 1, 2016 Category: Neuroscience Authors: ICN Online Editor Tags: Bipolar Disorder Current Issue Drug Development Mental Disorders Mood Disorders Original Research Psychiatry Psychopharmacology disease burden expenditures major depressive disorder pharmaceutical innovation research and developmen Source Type: research

Brexpiprazole: A New Treatment Option for Schizophrenia
Conclusion Schizophrenia is a debilitating condition with significant morbidity and mortality. Many atypical antipsychotics improve functioning, but they carry risks for adverse effects. Brexpiprazole reduced symptoms of acute schizophrenia and prevented relapse with minimal adverse effects. It is an additional option for clinicians who treat patients with schizophrenia, and ongoing trials are assessing its efficacy as an adjunctive treatment for patients with posttraumatic stress disorder or behavioral disturbances associated with dementia. Disclaimer The views expressed in this article are those of the author and do not ...
Source: Innovations in Clinical Neuroscience - August 1, 2016 Category: Neuroscience Authors: ICN Online Editor Tags: Current Issue Drug Development Psychiatry Psychopharmacology Review Schizophrenia antipsychotic brexpiprazole Source Type: research

The Potential Role of T Helper Cell 22 and IL-22 in Immunopathogenesis of Multiple Sclerosis
Conclusion Recent evidence shows changes in frequency and function of Th22 and its cytokine IL-22 in patients with MS, which suggests a potential relationship between Th22 cells, IL-22 levels, and the development and disease course of MS and its response to treatment. How Th22 cells and IL-22 levels affect the disease course of MS requires further elucidation. Additional studies on the immunopathogenesis of MS, specifically the roles Th22 cells and IL-22 cytokines may play in disease progression, are warranted and may lead to the development of new therapeutic strategies for treating neuro-inflammatory diseases, such as MS...
Source: Innovations in Clinical Neuroscience - August 1, 2016 Category: Neuroscience Authors: ICN Online Editor Tags: Current Issue Demyelinating Disease Genetics Multiple Sclerosis Neurology Review interleukin-22 T helper 22 Source Type: research

A Case of Treatment-resistant Depression and Body Dysmorphic Disorder: The Role of Electroconvulsive Therapy Revisited
Conclusion and Recommendations ECT has an important place in the management of treatment-resistant depression associated with BDD and, in select patients such as ours, may be effective for dysmorphic symptoms as well. It is currently not possible to identify such patients. However, BDD is said to be underestimated,21 and useful indications for ECT may emerge as the ascertainment of BDD in depressed populations becomes more refined. Previous studies establishing the efficacy of ECT in MDD may have unknowingly included and successfully treated a significant number of patients with BDD, given the elevated comorbidity of these...
Source: Innovations in Clinical Neuroscience - August 1, 2016 Category: Neuroscience Authors: ICN Online Editor Tags: Case Report Current Issue ECT Mood Disorders Neurology Psychiatry Suicidality BDD body dysmorphic disorder depression Electroconvulsive therapy suicide attempt treatment-resistant Source Type: research

Professional Liability for Forensic Activities: Liability Without a Treatment Relationship
by Donna Vanderpool, MBA, JD Ms. Vanderpool is Vice President of Risk Management at PRMS, Inc., Arlington, Virginia. Innov Clin Neurosci. 2016;13(7–8):41–44 This ongoing column is dedicated to providing information to our readers on managing legal risks associated with medical practice. We invite questions from our readers. The answers are provided by PRMS, Inc. (www.prms.com), a manager of medical professional liability insurance programs with services that include risk management consultation, education and onsite risk management audits, and other resources to healthcare providers to help improve patient out...
Source: Innovations in Clinical Neuroscience - August 1, 2016 Category: Neuroscience Authors: ICN Online Editor Tags: Current Issue Evaluations Forensic Files Mental Disorders Practice Management Psychiatry Risk Management court of law expert testimony forensics liability psychiatric evaluation treatment relationship Source Type: research

Fahr ’ s Disease or Fahr ’ s Syndrome?
by Malathi Latha Perugula, MD, and Steven Lippmann, MD The authors are from the Department of Psychiatry and Behavioral Science, University of Louisville School of Medicine, Louisville, Kentucky. Innov Clin Neurosci. 2016;13(7–8):45–46 This column series compares neurological conditions that pose differential challenges in diagnoses. Funding: No funding was provided for the preparation of this article. Financial Disclosures: The authors have no conflicts of interest relevant to the content of this article. What’s Your Diagnosis? Fahr’s disease and Fahr’s syndrome are two conditions characte...
Source: Innovations in Clinical Neuroscience - August 1, 2016 Category: Neuroscience Authors: ICN Online Editor Tags: Current Issue Dementia Differential Diagnoses Neurodegenerative Disease Neurology autosomal dominant trait autosomal recessive trait basal ganglia calcification Fahr's Syndrome Fahr’s disease Source Type: research

Criminal Behavior and Borderline Personality: Correlations among Four Measures
Innov Clin Neurosci. 2016;13(7–8):15–16 Dear Editor: Borderline personality disorder (BPD) is over-represented in prison populations, with 25 to 50 percent of incarcerated individuals suffering from this disorder.[1] As an empirical illustration of this association, Sansone et al[2] reported correlations of 0.32 and 0.47 between 27 criminal behaviors and two measures of BPD. Given these evolving associations between criminal behavior and BPD, no study to date has compared the strength of these associations among more than two assessment measures for BPD in a less criminally inclined sample (e.g., psychiatric in...
Source: Innovations in Clinical Neuroscience - August 1, 2016 Category: Neuroscience Authors: ICN Online Editor Tags: Current Issue Letters to the Editor Personality Disorders Primary Care Psychiatry borderline personality disorder criminal behavior Source Type: research

Letter to the Editor: Gabapentin Abuse in a Patient with Comorbid Mood and Substance Use Disorders
Conclusion. Collectively, behavioral changes that include dose escalation and/or self-administration of gabapentin or withdrawal symptoms and/or indications of relapse into illicit drug use following the abrupt discontinuation of gabapentin are indicative of gabapentin misuse. Prescribing clinicians should take these factors into consideration when prescribing gabapentin and educate their patients about its risks. In particular, clinicians should closely monitor those patients with sigificant histories of comorbid mood and substance use disorders when prescribing gabapentin due to the increased risk of gabapentin’s m...
Source: Innovations in Clinical Neuroscience - August 1, 2016 Category: Neuroscience Authors: ICN Online Editor Tags: Bipolar Disorder Letters to the Editor Mental Disorders Mood Disorders Psychiatry Psychopharmacology Substance Use Disorders comorbidity gabapentin Source Type: research