Psychotherapeutic Tools to Enhance the Neurologist-Patient Interaction
Semin Neurol DOI: 10.1055/s-0042-1742288Despite providing care for patients with “disturbances of the same organ,” the brain, the therapeutic approaches used by neurologists and psychiatrists are, to some extent, distinct. With recognition of the closely coupled relationship between physical health and mental health, there is increased awareness of the need to provide an integrated, neuropsychiatric approach to the care of patients in neurology. In this review article, we provide a broad overview of how neurologists can use psychotherapeutic principles to enhance patient–physician interactions in the neurological set...
Source: Seminars in Neurology - March 10, 2022 Category: Neurology Authors: DeGrush, Elizabeth LaFrance, W. Curt Tags: Review Article Source Type: research
Non-Pharmacological Treatments of Neuropsychiatric Symptoms in Mild Cognitive Impairment (MCI)
This article summarizes the literature on non-pharmacological treatments for NPS in MCI. The limited number of studies specific to individuals with MCI and its various etiologies, as well as the overall heterogeneity of research design and methodologies, make the evidence base inconclusive. Nevertheless, some studies support psychosocial interventions aimed at individuals with MCI and their caregivers. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents | Abstract | Full text (Source: Seminars in Neurology)
Source: Seminars in Neurology - March 4, 2022 Category: Neurology Authors: Thurin, Kristina Daffner, Kirk Gale, Seth Donovan, Nancy J. Urizar, Juan Carlos Tags: Review Article Source Type: research
Neuropsychiatric Treatments for Epilepsy: Nonpharmacological Approaches
Semin Neurol DOI: 10.1055/s-0042-1742582Neuropsychiatric conditions are frequently found in patients with epilepsy (PWE). These entities can be as disabling as epilepsy resulting in a significant negative impact on the quality of life of this population if not addressed and treated appropriately. In this article, we provide an overview of non-pharmacological treatments currently available to these patients—and review their effect on mood and anxiety disorders as well as epilepsy. These treatment strategies will allow the practitioner to optimize clinical care during the initial evaluation, which begins with the recogniti...
Source: Seminars in Neurology - February 25, 2022 Category: Neurology Authors: Lopez, Maria Raquel Kanner, Andres M. Tags: Review Article Source Type: research
Transcranial Magnetic Stimulation for the Neurological Patient: Scientific Principles and Applications
Semin Neurol DOI: 10.1055/s-0041-1742265Non-invasive brain stimulation has been increasingly recognized for its potential as an investigational, diagnostic and therapeutic tool across the clinical neurosciences. Transcranial magnetic stimulation (TMS) is a non-invasive method of focal neuromodulation. Diagnostically, TMS can be used to probe cortical excitability and plasticity, as well as for functional mapping. Therapeutically, depending on the pattern employed, TMS can either facilitate or inhibit stimulated cortex potentially modulating maladaptive physiology through its effects on neuroplasticity. Despite this potenti...
Source: Seminars in Neurology - February 25, 2022 Category: Neurology Authors: Eldaief, Mark C. Dickerson, Bradford C. Camprodon, Joan A. Tags: Review Article Source Type: research
Neuropsychiatric Treatment Approaches for Functional Neurological Disorder: A How to Guide
Semin Neurol DOI: 10.1055/s-0042-1742773There is a growing body of knowledge regarding management of functional neurological disorder (FND). The aim of this article is to guide the clinician through FND clinical management, from delivery of the diagnosis, to creation of a biopsychosocially-informed treatment plan, to troubleshooting common issues that arise throughout longitudinal care. We review the evidence and core principles of both rehabilitative therapies (physical therapy, occupational therapy, and speech and language therapy) and psychological therapies for the treatment of FND, and discuss the benefits of engaging...
Source: Seminars in Neurology - February 21, 2022 Category: Neurology Authors: Finkelstein, Sara A. Adams, Caitlin Tuttle, Margaret Saxena, Aneeta Perez, David L. Tags: Review Article Source Type: research
Meditative and Mindfulness-Focused Interventions in Neurology: Principles, Science, and Patient Selection
Semin Neurol DOI: 10.1055/s-0042-1742287A growing body of research suggests that meditative- and mindfulness-focused interventions may improve neuropsychiatric symptoms that commonly occur in a range of neurological disorders. In this article, the principles of meditation and mindfulness are first defined, as well as briefly describing the neurobiological mechanisms implicated in these interventions. Thereafter, a range of meditative- and mindfulness-focused interventions are detailed, along with their supporting evidence to treat neuropsychiatric symptoms in neurological conditions (e.g., headache, movement disorders, chr...
Source: Seminars in Neurology - February 9, 2022 Category: Neurology Authors: Kraemer, Kristen M. Jain, Felipe A. Mehta, Darshan H. Fricchione, Gregory L. Tags: Review Article Source Type: research
Medication Management of Neuropsychiatric Symptoms in Neurological Conditions: A Dimensional Transdiagnostic Approach
Semin Neurol DOI: 10.1055/s-0041-1742144Neuropsychiatric symptoms are prevalent in neurologic practice, but their complexity makes them challenging to manage. Many cognitive, affective, behavioral, and perceptual symptoms span multiple neurologic diagnoses—and there is prominent variability in neuropsychiatric symptom burden for a given condition. There is also a relative lack of robust controlled clinical trial evidence and expert consensus recommendations for a range of neuropsychiatric symptom presentations. Thus, the categorical approach (e.g., a discrete diagnosis equals a specific set of medication interventions) u...
Source: Seminars in Neurology - February 9, 2022 Category: Neurology Authors: Anderson, Jordan R. Schrift, Michael Tags: Review Article Source Type: research
Using the Biopsychosocial Model to Guide Patient-Centered Neurological Treatments
Semin Neurol DOI: 10.1055/s-0041-1742145The biopsychosocial model was defined by George L. Engel to propose a holistic approach to patient care. Through this model, physicians can understand patients in their context to aid the development of tailored, individualized treatment plans that consider relevant biological, psychological, and social–cultural–spiritual factors impacting health and longitudinal care. In this article, we advocate for the use of the biopsychosocial model in neurology practice across outpatient and inpatient clinical settings. To do so, we first present the history of the biopsychosocial model, an...
Source: Seminars in Neurology - February 3, 2022 Category: Neurology Authors: Saxena, Aneeta Paredes-Echeverri, Sara Michaelis, Rosa Popkirov, Stoyan Perez, David L. Tags: Review Article Source Type: research
Neuropsychiatric Treatment for Mild Traumatic Brain Injury: Nonpharmacological Approaches
This article presents an overview of current nonpharmacological strategies for postconcussive symptoms including psychoeducation; psychotherapy; vestibular, visual, and physical therapies; cognitive rehabilitation; as well as more novel approaches, such as neuromodulation. Ultimately, treatment and management of mTBI should begin early with appropriate psychoeducation/counseling, and be tailored based on core symptoms and individual goals. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents | Abstract | Full text (Source: Seminars in Neurology)
Source: Seminars in Neurology - February 3, 2022 Category: Neurology Authors: Mollica, Adriano Dey, Ayan Cairncross, Molly Silverberg, Noah Burke, Matthew J. Tags: Review Article Source Type: research
Neuropsychiatric Treatments for Parkinson's Disease: Nonpharmacological Approaches
Semin Neurol DOI: 10.1055/s-0041-1742266Although diagnosed by characteristic motor features, Parkinson's disease and other movement disorders are frequently accompanied by a wide range of neuropsychiatric symptoms that require a multidisciplinary approach for treatment. Neuropsychiatric symptoms such as depression, anxiety and cognitive symptoms strongly influence quality of life, motor symptoms, and non-motor bodily symptoms. This review summarizes our current understanding of the neuropsychiatric symptoms in movement disorders and discusses the evidence base for treatments focusing on rehabilitation and nonpharmacologica...
Source: Seminars in Neurology - February 3, 2022 Category: Neurology Authors: Mathur, Neha Bhatt, Haseel Lidstone, Sarah C. Tags: Review Article Source Type: research
TeleNeuroICU: Expanding the Reach of Subspecialty Neurocritical Care
Semin Neurol DOI: 10.1055/s-0041-1742093Telemedicine is a rapidly growing field of medicine due to a combination of high-speed global telecommunication systems and accessibility of small, fast mobile computing platforms with bidirectional audiovisual camera capabilities. Teleneurology is a subset of telemedicine. TeleNeuroICU, one form of teleneurology, is the practice of virtually consulting on patients in the ICU setting with neurological and neurosurgical conditions. Given the current and future shortage of neurologists and neurointensivists, there is a high demand for TeleNeuroICU services around the globe and this is ...
Source: Seminars in Neurology - January 24, 2022 Category: Neurology Authors: Freeman, W. David Rogers, Ashley Rabinstein, Alejandro Tags: Review Article Source Type: research
Neuroethics in the Era of Teleneurology
Semin Neurol DOI: 10.1055/s-0041-1741496The accelerating integration of telehealth technologies in neurology practice has transformed traditional interactions between neurologists and patients, allied clinicians and society. Despite the immense promise of these technologies to improve systems of neurological care, the infusion of telehealth technologies into neurology practice introduces a host of unique ethical challenges. Proactive consideration of the ethical dimensions of teleneurology and of the impact of these innovations on the field of neurology more generally can help to ensure responsible development and deployme...
Source: Seminars in Neurology - January 11, 2022 Category: Neurology Authors: Young, Michael J. Tags: Review Article Source Type: research
Digital Phenotyping in Clinical Neurology
Semin Neurol DOI: 10.1055/s-0041-1741495Internet-connected devices, including personal computers, smartphones, smartwatches, and voice assistants, have evolved into powerful multisensor technologies that billions of people interact with daily to connect with friends and colleagues, access and share information, purchase goods, play games, and navigate their environment. Digital phenotyping taps into the data streams captured by these devices to characterize and understand health and disease. The purpose of this article is to summarize opportunities for digital phenotyping in neurology, review studies using everyday technol...
Source: Seminars in Neurology - January 11, 2022 Category: Neurology Authors: Gupta, Anoopum S. Tags: Review Article Source Type: research
Approach to Common Sleep Disorders
Semin Neurol 2021; 41: 781-794 DOI: 10.1055/s-0041-1726364Sleep disorders are highly relevant in clinical practice given their prevalence as well as their impact on health outcomes and quality of life. The most common concerns are excessive daytime sleepiness, insomnia, disordered breathing, and abnormal movements or behaviors during sleep. A detailed but targeted history is vital, particularly from the sleep partner/witness. In-laboratory sleep testing (polysomnography and multiple sleep latency test) remains vital in the diagnosis of certain sleep disorders (such as sleep-disordered breathing and central hypersomnia) and...
Source: Seminars in Neurology - November 26, 2021 Category: Neurology Authors: Wang, Yujie Salas, Rachel Marie E. Tags: Review Article Source Type: research
The Outpatient Approach to Dizziness
Semin Neurol 2021; 41: 771-780 DOI: 10.1055/s-0041-1726369The evaluation of the dizzy patient is complicated by many common pitfalls. The patient's description of symptoms and the standard neurologic examination are often nonspecific or unrevealing, and neuroimaging is most often normal. Over the past several years, research has demonstrated that a refocusing of history taking results in more reliable and diagnostically helpful information. This can guide a targeted expansion of the exam, often with an emphasis on eye movements. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAAr...
Source: Seminars in Neurology - November 26, 2021 Category: Neurology Authors: Brune, Anthony J. Eggenberger, Eric R. Tags: Review Article Source Type: research
