[2017 Round-up] High priority publications on Parkinson's disease in 2017
Understanding how dopaminergic neurons die in Parkinson's disease is crucial to identify which cellular pathways and molecular targets are amenable to therapeutic intervention. Using neurons from patients with Parkinson's disease, Burbulla and colleagues1 identified a toxic cascade of mitochondrial and lysosomal dysfunction mediated by the accumulation of oxidised dopamine and α-synuclein. However, this pathogenic cascade was not found in mouse models of Parkinson's disease because of species-specific differences in dopamine metabolism that allow the survival of mouse dopaminergic neurons. (Source: Lancet Neurology)
Source: Lancet Neurology - December 16, 2017 Category: Neurology Authors: Tanya Simuni, Dimitri Krainc Tags: 2017 Round-up Source Type: research
[2017 Round-up] A new classification and class 1 evidence transform clinical practice in epilepsy
Despite great strides in the past decade in understanding the heterogeneous causes and mechanisms underlying epilepsies, their classification and class 1 evidence for therapies have lagged well behind. 2017 saw a leap forward with an updated epilepsy classification and the first class 1 evidence for the efficacy of cannabidiol. Less surprising, but nevertheless important, was class 1 evidence showing that epilepsy surgery in children works. Finally, the burgeoning of gene discovery in epilepsy has had untold success in the severe developmental and epileptic encephalopathies, however, the hardest genetic puzzle to solve has...
Source: Lancet Neurology - December 16, 2017 Category: Neurology Authors: Ingrid E Scheffer Tags: 2017 Round-up Source Type: research
[2017 Round-up] Headache advances in 2017: a new horizon in migraine therapy
There is a great unmet need for effective and tolerable treatments for migraine. This primary headache disorder is the leading cause of neurological disability worldwide and is one of the five leading causes of long-term disability.1 The success of available antimigraine treatments is limited by inadequate effectiveness, adverse effects, and poor patient adherence. Furthermore, the drugs available for prophylaxis are not specific for migraine, but include antiepileptic drugs, β-blockers, and antidepressants. (Source: Lancet Neurology)
Source: Lancet Neurology - December 16, 2017 Category: Neurology Authors: Lars Edvinsson Tags: 2017 Round-up Source Type: research
[2017 Round-up] Neurodegeneration: the first mechanistic therapy and other progress in 2017
The news about mechanistic therapies in neurodegeneration has been generally rather glum, particularly with the disappointing results of trials targeting β-secretase for Alzheimer's disease. However, in my view, the most important development in neurodegeneration research in 2017 has been the introduction of successful gene-based therapies for spinal muscular atrophy, which is caused by mutations in the SMN1 gene.1,2 One phase 1–2 trial1 assessed the effect of injection of adeno-associated virus carrying SMN1 cDNA, and a phase 3 trial2 assessed intrathecal injection of an antisense oligonucleotide (nusinersen) that corr...
Source: Lancet Neurology - December 16, 2017 Category: Neurology Authors: John Hardy Tags: 2017 Round-up Source Type: research
[2017 Round-up] Stroke research in 2017: surgical progress and stem-cell advances
To show that progress has been made in stroke intervention, it is possible to cite several substantial advances over the past year. Beginning with a clinical highlight: three randomised trials1 –3 that tested the safety and efficacy of patent foramen ovale (PFO) closure after a cryptogenic stroke reported their results simultaneously. The CLOSE trial1 enrolled patients who had a recent PFO-attributed stroke associated with either an atrial septal aneurysm or a large, right-to-left intera trial shunt. (Source: Lancet Neurology)
Source: Lancet Neurology - December 16, 2017 Category: Neurology Authors: Yilong Wang, Yongjun Wang Tags: 2017 Round-up Source Type: research
[Editorial] A neuroethics round up
In every January issue, The Lancet Neurology celebrates the best neurological research of the year that we leave behind. The 2017 Round-up, with comments on the advances on eleven major subspecialties, highlights findings that bear testimony to the remarkable progress of the neurological community in understanding brain function, and improving brain dysfunction. The knowledge on how the human brain works, and how physicians can affect its function, is not purely theoretical, but has very real ethical consequences. (Source: Lancet Neurology)
Source: Lancet Neurology - December 16, 2017 Category: Neurology Authors: The Lancet Neurology Tags: Editorial Source Type: research
[In Context] Music lives on: fine tuning the memory
“Music is part of being human.”Oliver Sacks (Source: Lancet Neurology)
Source: Lancet Neurology - December 15, 2017 Category: Neurology Authors: Jules Morgan Tags: In Context Source Type: research
[Articles] Effectiveness and costs of specialised physiotherapy given via ParkinsonNet: a retrospective analysis of medical claims data
These results confirm the findings from controlled trials, and offer evidence that specialised physiotherapy as delivered through ParkinsonNet is associated with fewer Parkinson's disease-related complications and lower costs in real-world practice. Neurologists can facilitate specialised physiotherapy by specific referral to such experts. (Source: Lancet Neurology)
Source: Lancet Neurology - December 12, 2017 Category: Neurology Authors: Jan H L Ypinga, Nienke M de Vries, Lieke H H M Boonen, Xander Koolman, Marten Munneke, Aeilko H Zwinderman, Bastiaan R Bloem Tags: Articles Source Type: research
[Comment] Parkinson's disease physiotherapy: specialisation adds value
In an era of evidence-based medicine, the value of rehabilitative therapies in Parkinson's disease has been difficult to establish. Although experts in movement disorders routinely aver the merits of, and recommend, such interventions to their patients, randomised trials have often yielded contradictory, few, or non-generalisable results (eg, as evident in the systematic review1 of the effectiveness of Nordic walking in Parkinson's disease). The reasons for such heterogeneity of conclusions have been extensively discussed,2 but the remedies are not self-evident. (Source: Lancet Neurology)
Source: Lancet Neurology - December 12, 2017 Category: Neurology Authors: Sotirios A Parashos Tags: Comment Source Type: research
[Series] The pathophysiology of migraine: implications for clinical management
The understanding of migraine pathophysiology is advancing rapidly. Improved characterisation and diagnosis of its clinical features have led to the view of migraine as a complex, variable disorder of nervous system function rather than simply a vascular headache. Recent studies have provided important new insights into its genetic causes, anatomical and physiological features, and pharmacological mechanisms. The identification of new migraine-associated genes, the visualisation of brain regions that are activated at the earliest stages of a migraine attack, a greater appreciation of the potential role of the cervical nerv...
Source: Lancet Neurology - December 8, 2017 Category: Neurology Authors: Andrew Charles Tags: Series Source Type: research
[Comment] Genetic therapies for spinal muscular atrophy type 1
Spinal muscular atrophy (SMA) type 1 —the leading genetic cause of infant mortality—results from an absence of functional copies of the SMN1 gene, which encodes survival motor neuron protein (SMN). The course of this disease might soon change, however, as outlined by two publications on successful trials with SMA therapies.1,2 (Source: Lancet Neurology)
Source: Lancet Neurology - December 8, 2017 Category: Neurology Authors: Annemieke Aartsma-Rus Tags: Comment Source Type: research
[Articles] Focused ultrasound subthalamotomy in patients with asymmetric Parkinson's disease: a pilot study
MRI-guided focused ultrasound unilateral subthalamotomy was well tolerated and seemed to improve motor features of Parkinson's disease in patients with noticeably asymmetric parkinsonism. Large randomised controlled trials are necessary to corroborate these preliminary findings and to assess the potential of such an approach to treat Parkinson's disease. (Source: Lancet Neurology)
Source: Lancet Neurology - December 1, 2017 Category: Neurology Authors: Raul Mart ínez-Fernández, Rafael Rodríguez-Rojas, Marta del Álamo, Frida Hernández-Fernández, Jose A Pineda-Pardo, Michele Dileone, Fernando Alonso-Frech, Guglielmo Foffani, Ignacio Obeso, Carmen Gasca-Salas, Esther de Luis-Pastor, Lydia Vela, José Tags: Articles Source Type: research
[Comment] Subthalamotomy for Parkinson's disease: back to the future?
MRI-guided focused ultrasound is a novel method for creating thermic ablations in the thalamus or basal ganglia without opening the skull. The method uses focused sonic energy and real-time MRI thermography of brain temperature to control lesion size and location precisely. This is a principle advantage over gamma-knife radiosurgery, which is another incision-free lesioning technique but induces radionecrosis that is difficult to control and develops within months of the procedure. In July, 2016, the US Food and Drug Administration approved MRI-guided focused ultrasound for unilateral thalamotomy for treatment of medically...
Source: Lancet Neurology - December 1, 2017 Category: Neurology Authors: Jens Volkmann Tags: Comment Source Type: research
[Comment] The evolving landscape of epilepsy neuropathology
The neuropathological findings from brain tissue specimens taken from 9523 adults and children with treatment-resistant focal epilepsy who had resective surgery were recently published in the New England Journal of Medicine.1 These specimens were taken from a collaborative brain tissue registry involving 27 European centres, which is possibly the largest database of surgically resected neuropathology in epilepsy compiled to date. The most common pathologies were hippocampal sclerosis (36%), developmental tumours (gangliogliomas and dysembryonic neuroepithelial tumours, 16%), focal cortical dysplasias (14%), cavernous angio...
Source: Lancet Neurology - November 29, 2017 Category: Neurology Authors: Jacqueline French, Daniel Friedman Tags: Comment Source Type: research
[In Context] Telestroke: India's solution to a public health-care crisis
Stroke is a leading cause of morbidity and mortality in India. Yet much of the country is composed of rural, low-income and middle-income communities that lack access to essential neurological care. Telemedicine is helping to tackle this important problem. Jacquelyn Corley investigates. (Source: Lancet Neurology)
Source: Lancet Neurology - November 29, 2017 Category: Neurology Authors: Jacquelyn Corley Tags: In Context Source Type: research
