Transcutaneous Electrical Nerve Stimulation as a Treatment for Neuropathic Cough: A Tolerability and Feasibility Study
This study explored the tolerability and feasibility of using TENS as a treatment for neuropathic cough. Laryngeal TENS was administered to five subjects with neuropathic cough. One electrode was placed ove r the lateral thyrohyoid membrane, and a second over the cricothyroid space. A frequency of 120 Hz was applied for 30 min. Participants rated symptoms pre-, during, and post-TENS treatment using a Likert scale. Laryngeal TENS was well tolerated by all subjects. Adverse effects included brief neck discomfort when increasing TENS intensity and an event of mild post-treatment hoarseness. The self-reported scores ...
Source: Neurology and Therapy - May 18, 2021 Category: Neurology Source Type: research
Pharmacokinetics and Comparative Bioavailability of Apomorphine Sublingual Film and Subcutaneous Apomorphine Formulations in Patients with Parkinson ’s Disease and “OFF” Episodes: Results of a Randomized, Three-Way Crossover, Open-Label Study
ConclusionIn patients with PD and “OFF” episodes, APL demonstrated lowerCmax and relative bioavailability but similar exposures (AUCs) versus SC apomorphine within the approved dose range.Trial RegistrationClinicalTrials.gov, NCT03292016. (Source: Neurology and Therapy)
Source: Neurology and Therapy - May 15, 2021 Category: Neurology Source Type: research
Pregnancy and the Control of Epileptic Seizures: A Review
AbstractOver the past 50 years, published studies have provided quantitative data on the control of epileptic seizures during pregnancy. The studies have varied in quality, and particularly in the ways in which seizure control has been assessed. However, most studies have shown that seizure occurrence rates are more likel y to worsen than improve during pregnancy, though in most pregnancies the rates have been unaltered. Nearly all of the studies have involved women with antiseizure medication-treated epilepsy, but there is a little evidence that seizure control also tends to worsen in pregnancies of women with untre...
Source: Neurology and Therapy - May 14, 2021 Category: Neurology Source Type: research
The Association Between Dietary Acid Load and Odds of Migraine: A Case –Control Survey
ConclusionIn this study, high dietary acid load was associated with higher odds of migraine. It is therefore possible that restricting dietary acid load could reduce the odds of migraine in susceptible subjects. However, due to the preliminary nature of the current evidence, caution is advised in drawing a definitive conclusion. More well-designed studies are required for a better understanding of this important issue. (Source: Neurology and Therapy)
Source: Neurology and Therapy - April 24, 2021 Category: Neurology Source Type: research
Position of Cladribine Tablets in the Management of Relapsing-Remitting Multiple Sclerosis: An Expert Narrative Review From the United Arab Emirates
AbstractThe use of immune reconstitution therapies (IRT) in patients with relapsing-remitting multiple sclerosis (RRMS) is associated with a prolonged period of freedom from relapses in the absence of continuously applied therapy. Cladribine tablets is a disease-modifying treatment (DMT) indicated for highly active relapsing multiple sclerosis (MS) as defined by clinical or imaging features. Treatment with cladribine tablets is effective and well tolerated in patients with active MS disease and have a low burden of monitoring during and following treatment. In this article, an expert group of specialist neurologists involv...
Source: Neurology and Therapy - April 23, 2021 Category: Neurology Source Type: research
STO: Stroke Ontology for Accelerating Translational Stroke Research
ConclusionsThe stroke ontology is the first, multiple-view ontology in the domain of brain stroke that can be used as a tool for representation, formalization, and standardization of the heterogeneous data related to the stroke domain. Since this is a draft version of the ontology, the contribution of the stroke scientific community can help to improve the usability of the current version. (Source: Neurology and Therapy)
Source: Neurology and Therapy - April 22, 2021 Category: Neurology Source Type: research
Comprehensive Approach to Management of Multiple Sclerosis: Addressing Invisible Symptoms —A Narrative Review
AbstractMultiple sclerosis (MS) is a chronic autoimmune inflammatory disease of the central nervous system, leading to neurodegeneration and manifesting as a variety of symptoms. These can include “invisible” symptoms, not externally evident to others, such as fatigue, mood disorders, cognitive impairments, pain, bladder/bowel dysfunction, sexual dysfunction, and vision changes. Invisible symptoms are highly prevalent in people living with MS, with multifactorial etiology and potential to impact the disease course. Patient experiences of these symptoms include both physical and psychosocial elements, which when...
Source: Neurology and Therapy - April 20, 2021 Category: Neurology Source Type: research
Patient and Provider Insights into the Impact of Multiple Sclerosis on Mental Health: A Narrative Review
AbstractMultiple sclerosis (MS) is a chronic disease in which the immune system attacks the central nervous system, causing inflammation and neurodegeneration. People living with MS may experience a variety of symptoms as a consequence of this process, including many “invisible” symptoms that are internally manifested and not seen by others. Of the invisible symptoms of MS, which we have reviewed in a companion article, mood and mental health disorders are of particular concern due to their high prevalence and significant impact on patient quality of life. I n this review, we showcase the experiences of patient...
Source: Neurology and Therapy - April 20, 2021 Category: Neurology Source Type: research
Effects of Gocovri (Amantadine) Extended Release Capsules on Non-Motor Symptoms in Patients with Parkinson ’s Disease and Dyskinesia
We report treatment-related effects on non-motor symptoms (NMS) assessed as secondary outcomes in two trials using the Movement Disorder Society–Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Part I.MethodsEASE LID and EASE LID 3 enrolled levodopa-treated patients with PD and ≥ 1 h/day ON time with troublesome dyskinesia. Patients were randomized to Gocovri (274 mg) or placebo taken daily at bedtime. Treatment differences from baseline to week 12 in MDS-UPDRS Part I were evaluated for the pooled population (N = 196) from both trials. Correlation analyses of NMS (M...
Source: Neurology and Therapy - April 17, 2021 Category: Neurology Source Type: research
Real-World Treatment Profiles, Clinical Outcomes, and Healthcare Resource Utilization of Patients with Migraine Prescribed Erenumab: A Multicenter Chart-Review Study of US Headache Centers
ConclusionIn this predominantly refractory chronic migraine population treated in select headache centers, patients had fewer headache/migraine days per month and outpatient visits after initiating erenumab. However, patients largely continued to be managed via a polypharmacy approach after erenumab initiation. (Source: Neurology and Therapy)
Source: Neurology and Therapy - April 15, 2021 Category: Neurology Source Type: research
The COVID-19 Pandemic Experience in Multiple Sclerosis: The Good, the Bad and the Neutral
ConclusionThese findings suggest that younger people, those with progressive types of MS, and those with psychological symptoms are particularly vulnerable to the negative effects of a COVID-19 pandemic induced lockdown. Coping strategies provide further insight into these findings with those reporting active problem-focused approaches seemingly faring better than those who do not state any coping strategies. These results also have implications for understanding other like neurological conditions that share many similarities with MS and how best to direct support. (Source: Neurology and Therapy)
Source: Neurology and Therapy - April 15, 2021 Category: Neurology Source Type: research
Multiple Sclerosis Patients Treated With Diroximel Fumarate in the Real-World Setting Have High Rates of Persistence and Adherence
ConclusionThis real-world analysis of DRF-treated patients showed high overall persistence, low discontinuation rate due to GI AEs, and high adherence to therapy, aligning with expectations based on DRF clinical trials. Data were consistent in the DMF-to-DRF subgroup.Infographic (Source: Neurology and Therapy)
Source: Neurology and Therapy - April 12, 2021 Category: Neurology Source Type: research
Treatment Satisfaction of Galcanezumab in Japanese Patients with Episodic Migraine: A Phase 2 Randomized Controlled Study
AbstractIntroductionThis analysis evaluated the treatment satisfaction of Japanese patients receiving galcanezumab (GMB) as a preventive medication for episodic migraine (4 –14 monthly migraine headache days).MethodsThis phase 2, randomized, double-blind, placebo-controlled study enrolled patients aged 18–65 years at 40 centers in Japan. Patients were randomized 2:1:1 to receive monthly subcutaneous injections of placebo (PBO,n = 230), GMB 120 mg (n = 115), or GMB 240 mg (n = 114) for 6 months. Patients’ experience with treatment was meas...
Source: Neurology and Therapy - April 9, 2021 Category: Neurology Source Type: research
Healthcare Resource Utilization Among Patients with Focal Seizure Treated with Eslicarbazepine Acetate in the US Long-Term Care Setting: A Retrospective Claims Database Analysis
AbstractIntroductionThe aim of this study was to compare healthcare resource utilization (HCRU) before and after initiation of eslicarbazepine acetate (ESL) in the long-term care (LTC) setting (rehabilitation center, mental health center, LTC non-skilled nursing facility/assisted-living facility, home health, assisted living, nursing home, other/unknown).MethodsThis retrospective analysis used IQVIA ’s New Data Warehouse, which includes deterministically linked LTC, prescription, and professional fee claims data and IQVIA Hospital Charge Data Master database. The study period was 1 April 2013 to 31 December 2019. The...
Source: Neurology and Therapy - April 7, 2021 Category: Neurology Source Type: research
Global Peginterferon Beta-1a Tolerability Management Best Practices: A Nurse-Focused Delphi Approach
ConclusionDelphi respondents reached consensus on ISR and FLS management strategies, which can help to inform treatment decisions. The results of this global Delphi analysis indicate that management of ISRs and FLS could be improved with more frequent follow-up visits and individualized training and education. (Source: Neurology and Therapy)
Source: Neurology and Therapy - March 24, 2021 Category: Neurology Source Type: research
Evidence-Based Recommendations for the Oral Health of Patients with Parkinson ’s Disease
ConclusionPatients with PD present poor oral health with conditions that are mostly preventable. (Source: Neurology and Therapy)
Source: Neurology and Therapy - March 18, 2021 Category: Neurology Source Type: research
Design and Rationale of the Global Phase 3 NEURO-TTRansform Study of Antisense Oligonucleotide AKCEA-TTR-L Rx (ION-682884-CS3) in Hereditary Transthyretin-Mediated Amyloid Polyneuropathy
ConclusionNEURO-TTRansform is designed to determine whether targeted delivery of AKCEA-TTR-LRx to hepatocytes with lower and less frequent doses will translate into clinical and quality-of-life benefits for patients with hATTR-PN.Trial RegistrationThe study is registered at ClinicalTrials.gov (NCT04136184) and EudraCT (2019-001698-10). (Source: Neurology and Therapy)
Source: Neurology and Therapy - February 26, 2021 Category: Neurology Source Type: research
Ubrogepant for the Acute Treatment of Migraine: Pooled Efficacy, Safety, and Tolerability From the ACHIEVE I and ACHIEVE II Phase 3 Randomized Trials
AbstractIntroductionUbrogepant is an oral, small-molecule calcitonin gene –related peptide receptor antagonist approved for the acute treatment of migraine. The efficacy and safety of ubrogepant were demonstrated in two pivotal phase 3, single-attack, randomized, placebo-controlled trials (ACHIEVE I and ACHIEVE II).MethodsWe conducted a post hoc analysis of pooled data from the ACHIEVE trials to evaluate the efficacy, safety, and tolerability of ubrogepant 50 mg (the only dose evaluated in both trials) versus placebo across a large population of participants with migraine. The coprimary efficacy outcomes were p...
Source: Neurology and Therapy - February 20, 2021 Category: Neurology Source Type: research
Targeting of the Subthalamic Nucleus in Patients with Parkinson ’s Disease Undergoing Deep Brain Stimulation Surgery
AbstractPrecise stereotactic targeting of the dorsolateral motor part of the subthalamic nucleus (STN) is paramount for maximizing clinical effectiveness and preventing side effects of deep brain stimulation (DBS) in patients with advanced Parkinson ’s disease. With recent developments in magnetic resonance imaging (MRI) techniques, direct targeting of the dorsolateral part of the STN is now feasible, together with visualization of the motor fibers in the nearby internal capsule. However, clinically relevant discrepancies were reported when c omparing STN borders on MRI to electrophysiological STN borders during micr...
Source: Neurology and Therapy - February 9, 2021 Category: Neurology Source Type: research
Recognition of Facial Emotion Expressions in Patients with Depressive Disorders: A Prospective, Observational Study
AbstractIntroductionProcessing of emotional stimuli is altered in patients with depression. The present feasibility study investigated the features of emotional information recognition in people with depressive disorders and how these differ from individuals without depression to determine whether response times could potentially be used as a diagnostic marker to identify individuals at high risk of depression and as an indicator of antidepressant medication response.MethodsThe study recruited 32 individuals, 16 with single or recurrent depressive episodes and 16 control subjects without depression. Patients with depressio...
Source: Neurology and Therapy - February 8, 2021 Category: Neurology Source Type: research
Rivaroxaban in Recurrent Ischemic Stroke Due to Protein S Deficiency: A Case Report
In this study our patient was treated with rivaroxaban. Protein S deficiency may be a predisposing factor in recurrent ischemic stroke, and rivaroxaban can be a safe and effective treatment option. Further studies are needed to confirm our findings. (Source: Neurology and Therapy)
Source: Neurology and Therapy - January 30, 2021 Category: Neurology Source Type: research
Quantifying Knowledge of Alzheimer ’s Disease: An Analysis of the Psychometric Properties of the Alzheimer’s Disease Knowledge Scale
ConclusionAlthough the ADKS does not present a unidimensional structure, its independent items together provide a comprehensive spectrum of information regarding AD knowledge. (Source: Neurology and Therapy)
Source: Neurology and Therapy - January 29, 2021 Category: Neurology Source Type: research
Correction to: A Review of Patisiran (ONPATTRO ®) for the Treatment of Polyneuropathy in People with Hereditary Transthyretin Amyloidosis
The middle initial of one of the authors, Alan Kaye, was missed in the original publication. (Source: Neurology and Therapy)
Source: Neurology and Therapy - January 12, 2021 Category: Neurology Source Type: research
Design of a Non-Interventional Study to Validate a Set of Patient- and Caregiver-Oriented Measurements to Assess Health Outcomes in Spinal Muscular Atrophy (SMA-TOOL Study)
This study will provide us with a comprehensive set of tools to better capture the course of the disease and the response to treatments. (Source: Neurology and Therapy)
Source: Neurology and Therapy - January 9, 2021 Category: Neurology Source Type: research
Potential Neuroregenerative and Neuroprotective Effects of Uridine/Choline-Enriched Multinutrient Dietary Intervention for Mild Cognitive Impairment: A Narrative Review
AbstractIn mild cognitive impairment (MCI) due to Alzheimer disease (AD), also known as prodromal AD, there is evidence for a pathologic shortage of uridine, choline, and docosahexaenoic acid [DHA]), which are key nutrients needed by the brain. Preclinical and clinical evidence shows the importance of nutrient bioavailability to support the development and maintenance of brain structure and function in MCI and AD. Availability of key nutrients is limited in MCI, creating a distinct nutritional need for uridine, choline, and DHA. Evidence suggests that metabolic derangements associated with ageing and disease-related pathol...
Source: Neurology and Therapy - December 26, 2020 Category: Neurology Source Type: research
Parent Experiences of Sanfilippo Syndrome Impact and Unmet Treatment Needs: A Qualitative Assessment
ConclusionEven modest treatment benefits for Sanfilippo syndrome were shown to be highly valued. Despite high caregiver burden, most parents expressed a willingness to “try anything,” including treatments with potentially high risk profiles, to maintain their child’s current state. (Source: Neurology and Therapy)
Source: Neurology and Therapy - December 2, 2020 Category: Neurology Source Type: research
Lennox –Gastaut Syndrome: Perspective of a Parent and a Physician
This article is co-authored by a parent of a 32-year-old male patient with Lennox –Gastaut syndrome (LGS) and his epileptologist. It discusses the parent’s experience of having a child with LGS from diagnosis through living day-to-day with the disease and the physician’s perspective when treating this devastating epilepsy syndrome. The patient’s mother, who is his legal r epresentative, provided written consent for publication of this article. (Source: Neurology and Therapy)
Source: Neurology and Therapy - October 28, 2020 Category: Neurology Source Type: research
Long-Term Assessment of Lurasidone in Schizophrenia: Post Hoc Analysis of a 12-Month, Double Blind, Active-Controlled Trial and 6-Month Open-Label Extension Study
ConclusionLurasidone was generally well tolerated and effective in clinically stable schizophrenia patients over the long term. Lurasidone was also generally well tolerated and maintained effectiveness over 6 months in patients switching from risperidone. Patients switching from risperidone experienced improvements in metabolic parameters and prolactin levels. These findings confirm lurasidone’s long-term effectiveness and favourable metabolic profile in patients with schizophrenia.Trial RegistrationClinicalTrials.gov identifier NCT00641745. (Source: Neurology and Therapy)
Source: Neurology and Therapy - October 24, 2020 Category: Neurology Source Type: research
Immunomagnetic Reduction Detects Plasma A β 1–42 Levels as a Potential Dominant Indicator Predicting Cognitive Decline
AbstractAlthough the concentrations of Alzheimer ’s disease (AD) biomarkers Aβ1 –40, A β1 –42 and tau protein are very low in human plasma, ultrasensitive assays such as immunomagnetic reduction (IMR) are able to precisely quantify them. Review articles have described the detailed working mechanism of IMR and revealed the feasibility of detecting early-stage AD by assaying these plasma biomarkers with IMR. In this review, we aimed to compare the significance of these plasma biomarkers in predicting cognitive decline in patients with Down syndrome, stroke, or amnestic mild cognitive impairment ba...
Source: Neurology and Therapy - October 22, 2020 Category: Neurology Source Type: research
CRISPR-Cas9: A Promising Genome Editing Therapeutic Tool for Alzheimer ’s Disease—A Narrative Review
AbstractAlzheimer ’s disease (AD) is a chronic and irreversible neurodegenerative disorder characterized by cognitive deficiency and development of amyloid-β (Aβ) plaques and neurofibrillary tangles, comprising hyperphosphorylated tau. The number of patients with AD is alarmingly increasing worldwide; currently, at least 50 million people are thought to be living with AD. The mutations or alterations in amyloid-β precursor protein (APP), presenilin-1 (PSEN1), or presenilin-2 (PSEN2) genes are known to be associated with the pathophysiology of AD. Effective medication for AD is still elusive and ma...
Source: Neurology and Therapy - October 21, 2020 Category: Neurology Source Type: research
An Evidence-Based Review of Galcanezumab for the Treatment of Migraine
AbstractPurpose of ReviewThis is a comprehensive review of the current literature on the usage of galcanezumab for migraine treatment. It reviews the biology, pathophysiology, epidemiology, diagnosis, and conventional treatment of migraines, then compares the literature available for galcanezumab with historical treatment options.Recent FindingsMigraine is a common headache disorder and constitutes a significant source of distress from both a personal and societal perspective. Conventional treatment includes abortive and preventive treatment. Treatment options are limited and may be only partially or minimally effective in...
Source: Neurology and Therapy - October 2, 2020 Category: Neurology Source Type: research
A Narrative Review of the Role of Transthyretin in Health and Disease
AbstractTransthyretin (TTR) is a tetrameric transport protein highly conserved through vertebrate evolution and synthesized in the liver, choroid plexus, and retinal pigment epithelium. TTR transports the thyroid hormone thyroxine and the retinol-binding protein (RBP) bound to retinol (vitamin A). Mutations in TTR are associated with inherited transthyretin amyloidosis (ATTRv), a progressive, debilitating disease that is ultimately fatal and is characterized by misfolding of TTR and aggregation as amyloid fibrils, predominantly leading to cardiomyopathy or polyneuropathy depending on the particular TTR mutation. Transthyre...
Source: Neurology and Therapy - September 30, 2020 Category: Neurology Source Type: research
Acupuncture and Its Role in the Treatment of Migraine Headaches
AbstractAcupuncture is a form of traditional Chinese medicine that is performed by placing needles or pressure in specific locations on a patient ’s skin to achieve a therapeutic effect. Although used to treat a variety of disorders, one of the most common applications of acupuncture is to treat chronic pain, especially headache and migraine pain. Migraines are difficult to treat, and pharmacotherapies are often the first line of treatment, although these options have many unwanted side effects, such as exacerbation of headache pain in those with chronic migraine. Many complimentary and integrative therapies are avai...
Source: Neurology and Therapy - September 30, 2020 Category: Neurology Source Type: research
A Systematic Review and Mixed Treatment Comparison of Pharmaceutical Interventions for Multiple Sclerosis
ConclusionsMeta-analyses confirmed the benefit of all DMTs in terms of relapse rate compared with placebo with a comparable rate of SAEs for the DMTs that could be included in the network. The rigor and transparency of reporting in this study provide a benchmark for comparisons with future new agents. (Source: Neurology and Therapy)
Source: Neurology and Therapy - September 27, 2020 Category: Neurology Source Type: research
Overview of Differences and Similarities of Published Mixed Treatment Comparisons on Pharmaceutical Interventions for Multiple Sclerosis
ConclusionGiven the importance of MTCs for healthcare decision-making, it is imperative that reporting of methods, results and assumptions is clear and transparent to allow accurate interpretation of findings. For MTCs to be relevant, the choice of outcome measures should reflect clinical practice. Combination of treatments or of outcomes measured at different points of time should be avoided, as should imputation without justification. Furthermore, all approved treatment options should be included and updates of MTCs should be conducted when data for new treatments are published. (Source: Neurology and Therapy)
Source: Neurology and Therapy - September 24, 2020 Category: Neurology Source Type: research
Impact of Early Initiation of Eslicarbazepine Acetate on Economic Outcomes Among Patients with Focal Seizure: Results from Retrospective Database Analyses
This study assessed the association between early initiation of eslicarbazepine acetate (ESL) as first-line therapy (1L cohort) or as first adjunctive regimen to either levetiracetam (LEV) or lamotrigine (LTG) (add-on cohort), and healthcare resource utilization (HCRU) and charges among adults with treated focal seizures (FS).MethodsThis retrospective, longitudinal cohort analysis used Symphony Health ’s Integrated Dataverse (IDV®) claims data to identify patients aged ≥ 18 years with a diagnosis of FS who had a new prescription for ESL between April 2015 and June 2018. Baseline was the 90-d...
Source: Neurology and Therapy - September 18, 2020 Category: Neurology Source Type: research
Transthyretin Amyloidosis: Update on the Clinical Spectrum, Pathogenesis, and Disease-Modifying Therapies
AbstractATTR amyloidosis is caused by systemic deposition of transthyretin (TTR) and comprises ATTRwt (wt for wild-type) amyloidosis, ATTRv (v for variant) amyloidosis, and acquired ATTR amyloidosis after domino liver transplantation. ATTRwt amyloidosis has classically been regarded as cardiomyopathy found in the elderly, whereas carpal tunnel syndrome has also become a major initial manifestation. The phenotypes of ATTRv amyloidosis are diverse and include neuropathy, cardiomyopathy, and oculoleptomeningeal involvement as the predominant features, depending on the mutation and age of onset. In addition to variant TTR, the...
Source: Neurology and Therapy - September 17, 2020 Category: Neurology Source Type: research
Validity and Reliability of the 32-Item Motor Function Measure in 2- to 5-Year-Olds with Neuromuscular Disorders and 2- to 25-Year-Olds with Spinal Muscular Atrophy
AbstractIntroductionTo investigate the validity and reliability of the 32-item Motor Function Measure (MFM32) in individuals with neuromuscular disorders (NMD), including spinal muscular atrophy (SMA), aged 2 –5 years, and in non-ambulant individuals with Types 2 or 3 SMA, aged 2–25 years.MethodsTest –retest reliability (intraclass correlation coefficient [ICC]), internal consistency (Cronbach’s alpha [α]), convergent validity (Spearman rank-order correlations), and known-groups validity (analysis of covariance comparing groups defined by the Clinical Global Impression of&...
Source: Neurology and Therapy - August 26, 2020 Category: Neurology Source Type: research
Reliability and Validity of the Persian Version of the Mini-Balance Evaluation Systems Test in Patients with Stroke
AbstractBackgroundStroke can cause balance disorders, which often lead to falls and fall-related injuries. The Mini-Balance Evaluation Systems Test (Mini-BESTest) is a balance test that has been recently translated into Persian. The reliability and validity of the Persian version of Mini-BESTest have not been assessed in patients with stroke.ObjectivesTo assess the reliability and validity of the Persian version of the Mini-BESTest in patients with stroke.MethodsA cross-sectional study was designed. Thirty patients with stroke participated in this study. Patients were tested using the Mini-BESTest according to the Persian ...
Source: Neurology and Therapy - August 13, 2020 Category: Neurology Source Type: research
A Review of Patisiran (ONPATTRO ®) for the Treatment of Polyneuropathy in People with Hereditary Transthyretin Amyloidosis
AbstractHereditary variant transthyretin amyloidosis (ATTRv) is a rare genetic defect that affects about 5000 –10,000 people worldwide, causing amyloidosis secondary to misfolding of mutant transthyretin (TTR) protein fibrils. TTR mutations can cause protein deposits in many extracellular regions of organs, but those deposits in cardiac and axonal cells are the primary cause of this clinical syndrome. Tre atment options are limited, but new drugs are being developed. Patisiran, a novel drug, is a liposomal siRNA against TTR that specifically targets this protein, reducing the accumulation of TTR in tissues, with subs...
Source: Neurology and Therapy - August 11, 2020 Category: Neurology Source Type: research
Maintenance Intravenous Immunoglobulin Treatment for Multiple Sclerosis Coexisting with Ehlers-Danlos Syndrome and Muir-Torre Syndrome: A Case Study
We report the case of a female patient with RRMS who was diagnosed with Ehlers-Danlos syndrome (EDS) and Muir-Torre syndrome (MTS) soon after the diagnosis of active RRMS was made. The coexisting conditions precluded the use of available dise ase-modifying treatments. She benefited from monthly and then bi-monthly IVIg, with a single mild relapse over 10 years. Discontinuation of IVIg due to reduced availability with a brief aborted course of subcutaneous PEGylated interferon-beta was followed by significant relapses. Five months after the first ocrelizumab infusion, she developed caecal cancer requiring colectomy. Re...
Source: Neurology and Therapy - August 10, 2020 Category: Neurology Source Type: research
Management of Migraine and the Accessibility of Specialist Care: Findings from an Extended Multinational Survey (My Migraine Center Survey)
ConclusionThis study confirmed differences across treatment center archetypes in terms of patients, waiting lists, level of delegation to nurse, and patient education and compliance, and provides support for the potential benefit of dedicated clinical settings for headache patients. The survey highlighted the potential role of nurses in patient education and waiting list prioritization, consequently benefiting headache centers. (Source: Neurology and Therapy)
Source: Neurology and Therapy - August 6, 2020 Category: Neurology Source Type: research
A Call to Action: The Role of Healthcare Providers in Reducing the Burden Associated with Neurogenic Orthostatic Hypotension
AbstractNeurogenic orthostatic hypotension (nOH) is a sustained fall in blood pressure upon standing that frequently affects patients with neurodegenerative diseases (e.g., Parkinson disease) and manifests with symptoms such as lightheadedness and dizziness upon standing. nOH can severely affect patients by increasing the risk of falls and injuries and by decreasing functionality, independence, and quality of life. However, the condition is often under-recognized because of many factors, including the nonspecific nature of the symptoms, patient comorbidities, and patients ’ reluctance to discuss their symptoms with t...
Source: Neurology and Therapy - July 26, 2020 Category: Neurology Source Type: research
Effects on Melanoma Cell Lines Suggest No Significant Risk of Melanoma Under Cladribine Treatment
AbstractCladribine is an oral synthetic purine analog that depletes lymphocytes and induces a dose-dependent reduction of T and B cells. It was approved for the therapy of highly active relapsing-remitting multiple sclerosis. Given cladribine ’s mechanism of action, an increased risk of malignancies was suspected from the number of cancers that occurred in the 3.5 mg/kg-treated arm (CLARITY study). We showed that cladribine inhibits cell proliferation on three melanoma cell lines tested, irrespectively of their mutational oncogenic s tatus and invasive/metastatic potential. Aggregated safety data demonstrat...
Source: Neurology and Therapy - July 24, 2020 Category: Neurology Source Type: research
State of the Art and Future Challenges in Multiple Sclerosis Research and Medical Management: An Insight into the 5th International Porto Congress of Multiple Sclerosis
AbstractThe 5th International Porto Congress of Multiple Sclerosis took place between the 14th and 16th of February 2019 in Porto, Portugal. Its intensive programme covered a wide-range of themes —including many of the hot topics, challenges, pitfalls and yet unmet needs in the field of multiple sclerosis (MS)—led by a number of well-acknowledged world experts. This meeting review summarizes the talks that took place during the congress, which focussed on issues in MS as diverse as the d evelopment and challenges of progressive MS, epidemiology, differential diagnosis, medical management, molecular research and...
Source: Neurology and Therapy - July 13, 2020 Category: Neurology Source Type: research
Disease-Modifying Drugs and Family Planning in People with Multiple Sclerosis: A Consensus Narrative Review from the Gulf Region
AbstractMost disease-modifying drugs (DMDs) are contraindicated in pregnancy. Management of MS is especially challenging for pregnant patients, as withdrawal of DMDs leave the patient at risk of increased disease activity. We, a group of experts in MS care from countries in the Arab Gulf, present our consensus recommendations on the management of MS in these patients. Where possible, a patient planning pregnancy can be switched to a DMD considered safe in this setting. Interferon β now can be used during pregnancy, where there is a clinical need to maintain treatment, in addition to glatiramer acetate. Natalizumab (us...
Source: Neurology and Therapy - June 19, 2020 Category: Neurology Source Type: research
Autologous Hematopoietic Stem Cell Transplantation (AHSCT): Standard of Care for Relapsing –Remitting Multiple Sclerosis Patients
AbstractAutologous hematopoietic stem cell transplantation (AHSCT) has been used in the treatment of highly active multiple sclerosis (MS) for over two decades. It has been demonstrated to be highly efficacious in relapsing –remitting (RR) MS patients failing to respond to disease-modifying drugs (DMDs). AHSCT guarantees higher rates of no evidence of disease activity (NEDA) than those achieved with any other DMDs, but it is also associated with greater short-term risks which have limited its use. In the 2019 updated EBMT and ASBMT guidelines, which review the clinical evidence of AHSCT in MS, AHSCT indication for hi...
Source: Neurology and Therapy - June 15, 2020 Category: Neurology Source Type: research
The Humanistic and Economic Burden of Migraine in Europe: A Cross-Sectional Survey in Five Countries
AbstractIntroductionPrior studies have estimated the burden of migraine in patients suffering from ≥ 4 monthly headache days (MHDs), but the burden experienced by migraineurs suffering from one to three (1–3) MHDs is unknown. The aim of this study was to examine the incremental burden of migraine in terms of health-related quality of life (HRQoL), impairments to work and daily activities, and healthcare resource utilization (HRU) in five European countries (France, Germany, Italy, Spain, and the UK (EU5]), by comparing migraineurs with ≥ 4 MHDs and migraineurs with 1–3 MHDs.MethodsThe s...
Source: Neurology and Therapy - June 14, 2020 Category: Neurology Source Type: research
Could Early Identification of Changes in Olfactory Function Be an Indicator of Preclinical Neurodegenerative Disease? A Systematic Review
ConclusionDespite improvements in olfactory testing needing to be implemented, OI is clearly impaired in neurodegenerative disease across a multitude of ages and cultures, offering an early marker of future cognitive decline. As a result of the heterogenous nature of the included studies, there is a further need for future research to ensure the sensitivity, validity and reliability of implementing olfactory testing as an early marker of future cognitive decline. (Source: Neurology and Therapy)
Source: Neurology and Therapy - June 10, 2020 Category: Neurology Source Type: research
Treatment Options for Dementia with Lewy Bodies: A Network Meta-Analysis of Randomised Control Trials
ConclusionDespite the lack of statistical significance, when assessing the efficacy and safety outcomes for each drug in the evidence network, donepezil appeared to have a more favourable overall benefit/risk profile for patients with DLB. Further comparative trials are required to improve understanding of the true difference between existing and potential future treatment options. (Source: Neurology and Therapy)
Source: Neurology and Therapy - June 2, 2020 Category: Neurology Source Type: research