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 18, 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 27, 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 14, 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 12, 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 11, 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 7, 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 27, 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 25, 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 14, 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 20, 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 16, 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 15, 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 11, 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 3, 2020 Category: Neurology Source Type: research

A Review of the Recent Findings in Minimally Invasive Treatment Options for the Management of Occipital Neuralgia
AbstractOccipital neuralgia (ON) is unilateral or bilateral neuralgia in the dermatomal nerve distribution of the greater, lesser or third occipital nerves and is a very common presentation of neuropathic pain. ON, although common and well defined, is still a poorly understood pain syndrome. It often requires invasive treatment for long term and significant pain alleviation; however, the evidence supporting different options is still limited. Several minimally invasive techniques have proven to be efficacious and safe, and the selection depends mostly on response to nerve blocks, patient choice and provider preference. Thi...
Source: Neurology and Therapy - June 2, 2020 Category: Neurology Source Type: research

Impact of Formulary Restrictions on Antiepileptic Drug Dispensation Outcomes
This study included two patient populations: the overall patient population (N = 54,097) and a pediatric population (
Source: Neurology and Therapy - May 30, 2020 Category: Neurology Source Type: research

Real-World Safety and Effectiveness of Dimethyl Fumarate in Black or African American Patients with Multiple Sclerosis: 3-Year Results from ESTEEM
AbstractIntroductionBlack or African American (black/AA) patients with multiple sclerosis (MS) are reported to exhibit greater disease severity compared with non-black or non-AA patients. Whether differences exist in response to MS disease-modifying therapies remains uncertain, as MS clinical trials have included low numbers of non-white patients. We evaluated real-world safety and effectiveness of dimethyl fumarate (DMF) on MS disease activity in black/AA patients.MethodsESTEEM is an ongoing, 5-year, multinational, prospective study evaluating long-term safety and effectiveness of DMF in patients with MS. This interim ana...
Source: Neurology and Therapy - May 29, 2020 Category: Neurology Source Type: research

Real-World Safety and Effectiveness of Dimethyl Fumarate in Hispanic or Latino Patients with Multiple Sclerosis: 3-Year Results from ESTEEM
AbstractIntroductionCompared with the non-Hispanic/non-Latino population, Hispanic/Latino patients with multiple sclerosis (MS) are reported to exhibit greater disease severity. Geographical location and genetics play a role in differences observed across Hispanic/Latino subpopulations. We evaluated real-world safety and effectiveness of dimethyl fumarate (DMF) on MS disease activity in Hispanic/Latino patients.MethodsESTEEM is an ongoing, 5-year, multinational, prospective study evaluating long-term safety and effectiveness of DMF in patients with MS. This interim analysis included patients newly prescribed DMF in routine...
Source: Neurology and Therapy - May 29, 2020 Category: Neurology Source Type: research

The Clinical and Economic Burden of Newly Diagnosed Hereditary Transthyretin (ATTRv) Amyloidosis: A Retrospective Analysis of Claims Data
ConclusionPatients newly diagnosed with ATTRv amyloidosis have substantial healthcare utilization and costs in the first year, primarily the initial months, post-diagnosis. Further research should examine later costs associated with disease progression and end-of-life care. (Source: Neurology and Therapy)
Source: Neurology and Therapy - May 25, 2020 Category: Neurology Source Type: research

Improvement in Function after Lasmiditan Treatment: Post Hoc Analysis of Data from Phase 3 Studies
AbstractIntroductionMigraine is associated with substantial functional impairment and affects many aspects of daily life.MethodsUsing data from SAMURAI and SPARTAN (double-blind, placebo-controlled, phase 3 studies) and GLADIATOR (an open-label, phase 3 study enrolling patients who had completed SAMURAI or SPARTAN), we assessed the effects of lasmiditan on migraine-related functional disability at multiple time points from 0.5 to 48  h post dose by asking patients to rate how much the migraine was interfering with normal activities. Pooled data from SAMURAI and SPARTAN (SAMURAI + SPARTAN) and data from G...
Source: Neurology and Therapy - May 23, 2020 Category: Neurology Source Type: research

Knowledge Is Power, but Is Ignorance Bliss? Optimising Conversations About Disease Progression in Multiple Sclerosis
This article reports on a symposium at the European Charcot Foundation, 2018, led by a panel of leading clinicians and patient experts from MS in the 21st Century, who debated the benefits, drawbacks, and challenges of communicating about disease progression, for both HCPs and PwMS, and potential ways to optimise these discussions. PwMS' preferences and priorities regarding conversations about disease progression vary widely. While the majority want to have these conversations, some will be reluctant and/or emotionally unready. Communication therefore needs to be personalised, and HCPs should always be prepared to have suc...
Source: Neurology and Therapy - May 15, 2020 Category: Neurology Source Type: research

Quality of Life Improves with Alemtuzumab Over 6  Years in Relapsing-Remitting Multiple Sclerosis Patients with or without Autoimmune Thyroid Adverse Events: Post Hoc Analysis of the CARE-MS Studies
ConclusionAutoimmune thyroid AEs (serious and nonserious) had minimal impact on HRQL in alemtuzumab-treated patients. These data may aid therapeutic decisions in patients with relapsing MS. (Source: Neurology and Therapy)
Source: Neurology and Therapy - May 14, 2020 Category: Neurology Source Type: research

Pathophysiology of Chronic Inflammatory Demyelinating Polyneuropathy: Insights into Classification and Therapeutic Strategy
AbstractChronic inflammatory demyelinating polyneuropathy (CIDP) is classically defined as polyneuropathy with symmetric involvement of the proximal and distal portions of the limbs. In addition to this “typical CIDP”, the currently prevailing diagnostic criteria proposed by the European Federation of Neurological Societies and Peripheral Nerve Society (EFNS/PNS) define “atypical CIDP” as encompassing the multifocal acquired demyelinating sensory and motor (MADSAM), distal acquired demyelin ating symmetric (DADS), pure sensory, pure motor, and focal subtypes. Although macrophage-induced demyelinatio...
Source: Neurology and Therapy - May 14, 2020 Category: Neurology Source Type: research

Pathway Analysis for Plasma β-Amyloid, Tau and Neurofilament Light (ATN) in World Trade Center Responders at Midlife
ConclusionsThe current ATN model of AD does not specify the subtype of β-amyloid to be considered, which may be overlooking the differential roles that these two subtypes serve in the pathogenesis of AD. (Source: Neurology and Therapy)
Source: Neurology and Therapy - April 30, 2020 Category: Neurology Source Type: research

Potentially Inappropriate Medications in a Psychogeriatric Inpatient Ward: An Audit Based on Beers Criteria
ConclusionOlder adults suffering from severe psychiatric disorders are frequently prescribed PIMs. However, clinical decision-making for this vulnerable population needs to take into account safety as reflected by the Beers Criteria, but also the complexity of managing psychogeriatric problems. (Source: Neurology and Therapy)
Source: Neurology and Therapy - April 17, 2020 Category: Neurology Source Type: research

Immune Reconstitution Therapy or Continuous Immunosuppression for the Management of Active Relapsing –Remitting Multiple Sclerosis Patients? A Narrative Review
AbstractThe majority of disease-modifying drugs (DMDs) available for the management of active relapsing –remitting multiple sclerosis (RMS) depend on continuous drug intake for maintained efficacy, with escalation to a more active drug when an unacceptable level of disease activity returns. Among continuously applied regimens, interferons and glatiramer acetate act as immunomodulators, while dimeth yl fumarate, fingolimod, ocrelizumab, natalizumab and teriflunomide are associated with continuous immunosuppression. By contrast, immune reconstitution therapy (IRT) provides efficacy that outlasts a short course of treat...
Source: Neurology and Therapy - April 15, 2020 Category: Neurology Source Type: research

A Case Report of Myoclonus-Dystonia with Isolated Myoclonus Phenotype and Novel Mutation Successfully Treated with Deep Brain Stimulation
ConclusionOur case confirms the poor response to oral medications and supports the use of GPi DBS for patients with genetically confirmed myoclonus-dystonia and isolated-myoclonus phenotype. In addition, our case represents familial myoclonus-dystonia due to a novel SGCE mutation. (Source: Neurology and Therapy)
Source: Neurology and Therapy - April 9, 2020 Category: Neurology Source Type: research

Impact of Non-Cardiac Clinicopathologic Characteristics on Survival in Transthyretin Amyloid Polyneuropathy
ConclusionSurvival in patients with ATTR-PN is highly variable and affected by non-cardiac baseline characteristics, such as autonomic dysfunction, large fiber involvement, late-onset disease, and non-Val30Met mutation. Careful interpretation of these findings is warranted given that this synthesis did not control for differences between studies. Survival in patients with ATTR-PN remains poor among those who are untreated or with delayed diagnosis. (Source: Neurology and Therapy)
Source: Neurology and Therapy - March 31, 2020 Category: Neurology Source Type: research

The Misdiagnosis of CIDP: A Review
AbstractThere is a growing realization that many patients are incorrectly diagnosed with chronic inflammatory demyelinating polyneuropathy (CIDP), with at least half of patients that carry a diagnosis of CIDP in the USA possibly having a different explanation for their neuropathy or having no neuropathy at all. Many misdiagnosed patients go on to receive costly and potentially harmful treatments for a disease that they do not have, while at the same time missing an opportunity to treat their true ailment. The cost of misdiagnosis on patients and society is not trivial. Many factors contribute to misdiagnosis. Particular po...
Source: Neurology and Therapy - March 26, 2020 Category: Neurology Source Type: research

Cost-Effectiveness of IncobotulinumtoxinA in the Treatment of Sialorrhea in Patients with Various Neurological Conditions
ConclusionsThe quality of life (QoL) of patients with sialorrhea caused by neurological conditions was considerably compromised. IncobotulinumtoxinA was shown to successfully alleviate sialorrhea and it was demonstrated to be a cost-effective intervention when compared with SoC alone. (Source: Neurology and Therapy)
Source: Neurology and Therapy - March 12, 2020 Category: Neurology Source Type: research

Current Directions in Deep Brain Stimulation for Parkinson ’s Disease—Directing Current to Maximize Clinical Benefit
AbstractSeveral single-center studies and one large multicenter clinical trial demonstrated that directional deep brain stimulation (DBS) could optimize the volume of tissue activated (VTA) based on the individual placement of the lead in relation to the target. The ability to generate axially asymmetric fields of stimulation translates into a broader therapeutic window (TW) compared to conventional DBS. However, changing the shape and surface of stimulating electrodes (directional segmented vs. conventional ring-shaped) also demands a revision of the programming strategies employed for DBS programming. Model-based approac...
Source: Neurology and Therapy - March 9, 2020 Category: Neurology Source Type: research

Evaluation of Mortality During Long-Term Treatment with Tafamidis for Transthyretin Amyloidosis with Polyneuropathy: Clinical Trial Results up to 8.5  Years
ConclusionLong-term tafamidis treatment may confer survival benefit in patients with ATTR-PN.Trial registrationClinicalTrials.gov identifier: NCT00409175, NCT00791492, NCT00630864, and NCT00925002. (Source: Neurology and Therapy)
Source: Neurology and Therapy - February 27, 2020 Category: Neurology Source Type: research

Care Among Migraine Patients in a Commercially Insured Population
ConclusionNewly diagnosed migraine patients are not being properly treated, as indicated by their excessive use of acute therapies and short time on preventive treatment before discontinuation of that treatment. Further study of the reasons why patients discontinue preventive therapy (adverse events, no response, etc.) and continue to excessively use acute treatments once their treatment regimen has been established is needed. (Source: Neurology and Therapy)
Source: Neurology and Therapy - February 15, 2020 Category: Neurology Source Type: research

Correction to: Long-Term Effect of Immediate Versus Delayed Fingolimod Treatment in Young Adult Patients with Relapsing –Remitting Multiple Sclerosis: Pooled Analysis from the FREEDOMS/FREEDOMSII Trials
Figures  1a, 1b and 3 were published incorrectly in the original version. The corrected images are given as follows. (Source: Neurology and Therapy)
Source: Neurology and Therapy - February 14, 2020 Category: Neurology Source Type: research

Cladribine Tablets and Relapsing –Remitting Multiple Sclerosis: A Pragmatic, Narrative Review of What Physicians Need to Know
AbstractImmune reconstitution therapy (IRT) is an emerging management concept for multiple sclerosis, whereby a short course of treatment provides long-lasting suppression of disease activity. “Cladribine tablets 10 mg” refers to a total cumulative dose of cladribine given over 2 years (henceforth referred to as cladribine tablets 3.5 mg/kg); it is a relatively new treatment option that is hypothesised to act as an IRT acting preferentially on the adaptive immune system. A randomis ed, 2-year, placebo-controlled trial (CLARITY) showed that treatment with cladribine tablets reduced indices of dise...
Source: Neurology and Therapy - February 13, 2020 Category: Neurology Source Type: research

Psychometric Properties of the SymptoMScreen Questionnaire in a Mild Disability Population of Patients with Relapsing –Remitting Multiple Sclerosis: Quantifying the Patient’s Perspective
AbstractCrucial elements for achieving optimal long-term outcomes in multiple sclerosis (MS) are patient confidence and effective physician –patient communication. Patient-reported instruments may provide the means to fill the gap in currently available clinician-rated measures. The SymptoMScreen (SMSS) is a brief self-assessment tool for measuring symptom severity in 12 neurologic domains commonly affected by MS. We conducted a non-i nterventional study to assess the dimensional structure and item characteristics of the SMSS. A total of 218 patients with relapsing–remitting MS and mild disability (median Expan...
Source: Neurology and Therapy - January 18, 2020 Category: Neurology Source Type: research

Tardive Reactivation of Progressive Multiple Sclerosis During Treatment with Biotin
We report the case of a 41-year-old patient suffering from primary progressive (PP) MS who presented after 16  months of treatment with high doses of biotin (QIZENDAY) with worsening of his Expanding Disability Status Scale (EDSS) score and the appearance of a symptomatic new T2 pseudo-tumoural lesion on brain magnetic resonance imaging (MRI), suggestive of tardive inflammatory reactivation possibly due to the biotin. The newer and more effective therapies for MS are, however, associated with risks that necessitate an active management strategy and continuous vigilance. Physicians should be aware of iatrogenic neurolo...
Source: Neurology and Therapy - December 19, 2019 Category: Neurology Source Type: research

A Retrospective Analysis of Real-World Discontinuation Rates with Delayed-Release Dimethyl Fumarate in Patients with Relapsing –Remitting Multiple Sclerosis
ConclusionThis study, conducted shortly after the approval of DMF in Australia when first-hand clinical experience was still limited, demonstrated that DMF has an acceptable tolerability profile in the real-world setting that is similar to that demonstrated in clinical trials. (Source: Neurology and Therapy)
Source: Neurology and Therapy - December 13, 2019 Category: Neurology Source Type: research

Real-World Treatment of Patients with Multiple Sclerosis per MS Subtype and Associated Healthcare Resource Use: An Analysis Based on 13,333 Patients in Germany
ConclusionAmong the four MS subtypes, RRMS patients most often received a disease-modifying immunomodulatory treatment. Consequently, healthcare costs were highest for patients with this MS subtype. Contrary to the treatment guideline, a substantial percentage of patients with CIS, RRMS, and SPMS did not receive any disease-modifying immunomodulatory treatment. (Source: Neurology and Therapy)
Source: Neurology and Therapy - December 12, 2019 Category: Neurology Source Type: research

Case Report of a Novel Technique for Repair of the Vertebral Artery During Cranial Surgery
AbstractSurgery of complex cranial base lesions carries a high risk of damage to main vessels, often resulting in life-changing or even life-threatening injuries. We describe a rapid, effective, and noninvasive application of a collagen-based hemostatic patch to repair the vertebral artery during cranial surgery. A 61-year-old male patient underwent retrosigmoid craniotomy to remove a foramen magnum meningioma that encased the vertebral artery. A linear incision was made behind the ear and standard retrosigmoid craniotomy was performed with preservation of the transverse and sigmoid sinuses. The dura was open...
Source: Neurology and Therapy - December 1, 2019 Category: Neurology Source Type: research

Neurophysiological Markers of Alzheimer ’s Disease: Quantitative EEG Approach
AbstractCurrently established and employed biomarkers of Alzheimer's disease (AD) predominantly mirror AD-associated molecular and structural brain changes. While they are necessary for identifying disease-specific neuropathology, they lack a clear and robust relationship with the clinical presentation of dementia; they can be altered in healthy individuals, while they often inadequately mirror the degree of cognitive and functional deficits in affected subjects. There is growing evidence that synaptic loss and dysfunction are early events during the trajectory of AD pathogenesis that best correlate with the clinical sympt...
Source: Neurology and Therapy - December 1, 2019 Category: Neurology Source Type: research

Reflections on the Utility of the Retina as a Biomarker for Alzheimer ’s Disease: A Literature Review
AbstractAs a part of the central nervous system, the retina may reflect both physiologic processes and abnormalities related to diseases of the brain. Indeed, a concerted effort has been put forth to understand how Alzheimer ’s disease (AD) pathology may manifest in the retina as a means to assess the state of the AD brain. The development and refinement of ophthalmologic techniques for studying the retina in vivo have produced evidence of retinal degeneration in AD diagnosed patients. In this review, we will discuss retinal imaging techniques implemented to study the changes in AD retina as well as highlight the rec...
Source: Neurology and Therapy - December 1, 2019 Category: Neurology Source Type: research

Critical Steps to be Taken into Consideration Before Quantification of β-Amyloid and Tau Isoforms in Blood can be Implemented in a Clinical Environment
AbstractThis review aims to document difficulties, limitations, and pitfalls when considering protein analysis in blood samples. It proposes an improved workflow for design, development, and validation of (immuno)assays for blood proteins, without providing reflections on a potential hypothesis of the origin of protein mismetabolism and deposition. There is a special focus on assay development for quantification of β-amyloid (Aβ) and tau in blood for diagnostic use or for integration in clinical trials in the field of Alzheimer’s disease (AD). (Source: Neurology and Therapy)
Source: Neurology and Therapy - December 1, 2019 Category: Neurology Source Type: research

Salivary Biomarkers for Alzheimer ’s Disease and Related Disorders
AbstractThe search for accessible and cost-effective biomarkers to complement current cerebrospinal fluid (CSF) and imaging biomarkers in the accurate detection of Alzheimer disease (AD) and other common neurodegenerative disorders remains a challenging task. The advances in ultra-sensitive detection methods has highlighted blood biomarkers (e.g. amyloid- β and neurofilament light) as a valuable and realistic tool in a diagnostic or screening process. Saliva, however, is also a rich source of potential biomarkers for disease detection and offers several practical advantages over biofluids that are currently examined f...
Source: Neurology and Therapy - December 1, 2019 Category: Neurology Source Type: research

Peripheral Biomarkers for Alzheimer ’s Disease: Update and Progress
(Source: Neurology and Therapy)
Source: Neurology and Therapy - December 1, 2019 Category: Neurology Source Type: research

Neurogenic Orthostatic Hypotension in Parkinson Disease: A Primer
AbstractAbstractParkinson disease (PD) is associated with a variety of motor and non-motor clinical manifestations, including cardiovascular autonomic dysfunction. Neurogenic orthostatic hypotension (nOH) is a potentially serious manifestation of cardiovascular sympathetic failure that occurs in approximately 30% of patients with PD. Here we review the pathophysiology and effects of the condition as well as treatment considerations for patients with PD and nOH. Screening for nOH using orthostatic symptom questionnaires, orthostatic blood pressure measurements, and specialized autonomic testing is beneficial f...
Source: Neurology and Therapy - December 1, 2019 Category: Neurology Source Type: research

Acknowledgement to Authors, Referees and Readers 2019
(Source: Neurology and Therapy)
Source: Neurology and Therapy - November 7, 2019 Category: Neurology Source Type: research

Fingolimod Immune Effects Beyond Its Sequestration Ability
AbstractFingolimod is the first orally administered drug approved for the treatment of relapsing –remitting multiple sclerosis (MS). This drug, modulating sphingosine receptors, regulates the trafficking of lymphocytes between primary and secondary lymphoid organs, trapping naïve T cells and central memory T cells in secondary lymphoid organs, without affecting effector memory T cells and th erefore without compromising immunosurveillance. Additionally, fingolimod inhibits expression of Th1 and Th17 cytokines and enhances regulatory T-cell differentiation. It also acts on the B arm of immunity through an increas...
Source: Neurology and Therapy - November 6, 2019 Category: Neurology Source Type: research

Correction to: Abstracts from the 5th International Porto Congress of Multiple Sclerosis
The given name of one of the authors was incorrectly published as Vera in abstract EPIII028 “Anti-MOG Antibody-Positive Isolated Longitudinally Extensive Transverse Myelitis”. The correct name should read as follows: (Source: Neurology and Therapy)
Source: Neurology and Therapy - November 4, 2019 Category: Neurology Source Type: research

Fingolimod Rebound: A Review of the Clinical Experience and Management Considerations
AbstractBecause the treatment of multiple sclerosis (MS) may span decades, the need often arises to make changes to the treatment plan in order to accommodate changing circumstances. Switching drugs, or the discontinuation of immunomodulatory agents altogether, may leave patients vulnerable to relapse or disease progression. In some cases, severe MS disease activity is noted clinically and on MRI after treatment withdrawal. When this disease activity is disproportionate to the pattern observed prior to treatment initiation, patients are said to have experiencedrebound. Of the US Food and Drug Administration (FDA)-approved ...
Source: Neurology and Therapy - November 1, 2019 Category: Neurology Source Type: research