Current Treatment Options in Neurology最新文献

{"title":"Cerebrovascular Manifestations of SARS-CoV-2: A Comprehensive Review.","authors":"Eleni Stefanou, Nikolaos Karvelas, Samuel Bennett, Christo Kole","doi":"10.1007/s11940-023-00747-6","DOIUrl":"10.1007/s11940-023-00747-6","url":null,"abstract":"<p><strong>Purpose of review: </strong>The risks of cerebrovascular manifestations due to SARS-CoV-2 infection are significantly increased within the first 6 months of the infection. Our work aims to give an update on current clinical aspects of diagnosis and treatment of cerebrovascular manifestations during acute and long-term SARS-CoV-2 infection.</p><p><strong>Recent findings: </strong>The incidence of acute ischemic stroke and haemorrhagic stroke during acute SARS-CoV-2 patients is estimated at 0.9 to 4.6% and 0.5-0.9%, respectively, and were associated with increased mortality. The majority presented with hemiparesis, dysarthria, sensory deficits, and a NIHSS score within 5-15. In addition, beyond the first 30 days of infection people with COVID-19 exhibited increased risk of stroke. During acute phase, age, hypertension, diabetes, and medical history of vascular disease were increased in patients with COVID-19 with new onset of cerebrovascular manifestations, while during long-COVID-19, the risk of cerebrovascular manifestations were found increased regardless of these factors. The management of patients with large-vessel ischemic stroke fulfilling the intravenous thrombolysis criteria are successfully treated according to the guidelines, while hyperosmolar therapy is typically administered in 4- to 6-h intervals. In addition, prophylaxis of anticoagulation therapy is associated with a better prognosis and low mortality during acute and post hospital discharge of patients with COVID-19.</p><p><strong>Summary: </strong>In this work, we provide a comprehensive review of the current literature on acute and post-acute COVID-19 cerebrovascular sequelae, symptomatology, and its pathophysiology mechanisms. Moreover, we discuss therapeutic strategies for these patients during acute and long-term care and point populations at risk. Our findings suggest that older patients with risk factors such as hypertension, diabetes, and medical history of vascular disease are more likely to develop cerebrovascular complications.</p>","PeriodicalId":10975,"journal":{"name":"Current Treatment Options in Neurology","volume":"25 4","pages":"71-92"},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9984763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9166578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mass Spectrometry-Based Approaches for Clinical Biomarker Discovery in Traumatic Brain Injury.","authors":"Matthew Creech, Lindsey Carvalho, Heather McCoy, Jon Jacobs, H E Hinson","doi":"10.1007/s11940-022-00742-3","DOIUrl":"10.1007/s11940-022-00742-3","url":null,"abstract":"<p><strong>Purpose of review: </strong>Precision treatments to address the multifaceted pathophysiology of traumatic brain injury (TBI) are desperately needed, which has led to the intense study of fluid-based protein biomarkers in TBI. Mass Spectrometry (MS) is increasingly being applied to biomarker discovery and quantification in neurological disease to explore the proteome, allowing for more flexibility in biomarker discovery than commonly encountered antibody-based assays. In this narrative review, we will provide specific examples of how MS technology has advanced translational research in traumatic brain injury (TBI) focusing on clinical studies, and looking ahead to promising emerging applications of MS to the field of Neurocritical Care.</p><p><strong>Recent findings: </strong>Proteomic biomarker discovery using MS technology in human subjects has included the full range of injury severity in TBI, though critically ill patients can offer more options to biofluids given the need for invasive monitoring. Blood, urine, cerebrospinal fluid, brain specimens, and cerebral extracellular fluid have all been sources for analysis. Emerging evidence suggests there are distinct proteomic profiles in radiographic TBI subtypes, and that biomarkers may be used to distinguish patients sustaining TBI from healthy controls. Metabolomics may offer a window into the perturbations of ongoing cerebral insults in critically ill patients after severe TBI.</p><p><strong>Summary: </strong>Emerging MS technologies may offer biomarker discovery and validation opportunities not afforded by conventional means due to its ability to handle the complexities associated with the proteome. While MS techniques are relatively early in development in the neurosciences space, the potential applications to TBI and neurocritical care are likely to accelerate in the coming decade.</p>","PeriodicalId":10975,"journal":{"name":"Current Treatment Options in Neurology","volume":"24 12","pages":"605-618"},"PeriodicalIF":2.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10072855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9276728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and Treatment of Poststroke Epilepsy: Where Do We Stand?","authors":"M. Mauritz, Kai-Nicolas Poppert, E. Trinka, S. Mutzenbach","doi":"10.1007/s11940-022-00744-1","DOIUrl":"https://doi.org/10.1007/s11940-022-00744-1","url":null,"abstract":"","PeriodicalId":10975,"journal":{"name":"Current Treatment Options in Neurology","volume":"25 1","pages":"1 - 21"},"PeriodicalIF":2.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47059325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pompe Disease: a Clinical, Diagnostic, and Therapeutic Overview.","authors":"David Stevens,&nbsp;Shadi Milani-Nejad,&nbsp;Tahseen Mozaffar","doi":"10.1007/s11940-022-00736-1","DOIUrl":"https://doi.org/10.1007/s11940-022-00736-1","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review summarizes the clinical presentation and provides an update on the current strategies for diagnosis of Pompe disease. We will review the available treatment options. We examine newly approved treatments as well as upcoming therapies in this condition. We also provide commentary on the unmet needs in clinical management and research for this disease.</p><p><strong>Recent findings: </strong>In March 2015, Pompe disease was added to the Recommended Uniform Screening Panel (RUSP) and since then a number of states have added Pompe disease to their slate of diseases for their Newborn Screening (NBS) program. Data emerging from these programs is revising our knowledge of incidence of Pompe disease. In 2021, two randomized controlled trials involving new forms of enzyme replacement therapy (ERT) were completed and one new product is already FDA-approved and on the market, whereas the other product will come up for FDA review in the fall. Neither of the new ERT were shown to be superior to the standard of care product, <i>alglucosidase</i>. The long-term effectiveness of these newer forms of ERT is unclear. Newer versions of the ERT are in development in addition to multiple different strategies of gene therapy to deliver GAA, the gene responsible for producing acid alpha-glucosidase, the defective protein in Pompe Disease. Glycogen substrate reduction is also in development in Pompe disease and other glycogen storage disorders.</p><p><strong>Summary: </strong>There are significant unmet needs as it relates to clinical care and therapeutics in Pompe disease as well as in research. The currently available treatments lose effectiveness over the long run and do not have penetration into neuronal tissues and inconsistent penetration in certain muscles. More definitive gene therapy and enzyme replacement strategies are currently in development and testing.</p>","PeriodicalId":10975,"journal":{"name":"Current Treatment Options in Neurology","volume":"24 11","pages":"573-588"},"PeriodicalIF":2.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10035871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9552138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-care and Epilepsy","authors":"Stephen E. Rostad, Gena R. Ghearing","doi":"10.1007/s11940-022-00743-2","DOIUrl":"https://doi.org/10.1007/s11940-022-00743-2","url":null,"abstract":"","PeriodicalId":10975,"journal":{"name":"Current Treatment Options in Neurology","volume":"24 1","pages":"641 - 654"},"PeriodicalIF":2.0,"publicationDate":"2022-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48200875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fenfluramine for the Treatment of Dravet Syndrome and Lennox Gastaut Syndrome: A Review","authors":"D. Nordli, Fernando N. Galan","doi":"10.1007/s11940-022-00741-4","DOIUrl":"https://doi.org/10.1007/s11940-022-00741-4","url":null,"abstract":"","PeriodicalId":10975,"journal":{"name":"Current Treatment Options in Neurology","volume":"24 1","pages":"631 - 640"},"PeriodicalIF":2.0,"publicationDate":"2022-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42749909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Epilepsy in the Setting of Cognitive Decline in Older Adults","authors":"Jamie N. Mayo, S. Panahi, A. Roghani, A. V. Van Cott, M. Pugh","doi":"10.1007/s11940-022-00740-5","DOIUrl":"https://doi.org/10.1007/s11940-022-00740-5","url":null,"abstract":"","PeriodicalId":10975,"journal":{"name":"Current Treatment Options in Neurology","volume":"24 1","pages":"619 - 630"},"PeriodicalIF":2.0,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42786004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Intracerebral Vascular Malformations: When to Intervene","authors":"R. Abbas, Fadi Al-Saiegh, E. Atallah, K. Naamani, S. Tjoumakaris, M. Gooch, N. Herial, P. Jabbour, R. Rosenwasser","doi":"10.1007/s11940-022-00739-y","DOIUrl":"https://doi.org/10.1007/s11940-022-00739-y","url":null,"abstract":"","PeriodicalId":10975,"journal":{"name":"Current Treatment Options in Neurology","volume":"24 1","pages":"655 - 671"},"PeriodicalIF":2.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44839822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temperature Control in Hypoxic-Ischemic Brain Injury—a Focused Update","authors":"Nicholas J. Nelson, Briana Wasserstrom, C. Maciel","doi":"10.1007/s11940-022-00738-z","DOIUrl":"https://doi.org/10.1007/s11940-022-00738-z","url":null,"abstract":"","PeriodicalId":10975,"journal":{"name":"Current Treatment Options in Neurology","volume":"24 1","pages":"551 - 572"},"PeriodicalIF":2.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42289210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting and Treating Post-traumatic Epilepsy","authors":"C. Rubinos, Brandon Waters, L. Hirsch","doi":"10.1007/s11940-022-00727-2","DOIUrl":"https://doi.org/10.1007/s11940-022-00727-2","url":null,"abstract":"","PeriodicalId":10975,"journal":{"name":"Current Treatment Options in Neurology","volume":"24 1","pages":"365 - 381"},"PeriodicalIF":2.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46948313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}