Current Opinion in Neurology最新文献_第10页

Low-field MRI for use in neurological diseases. 用于神经系统疾病的低场磁共振成像。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2024-08-01 Epub Date: 2024-05-30 DOI: 10.1097/WCO.0000000000001282

Sharada Balaji, Neale Wiley, Megan E Poorman, Shannon H Kolind

{"title":"Low-field MRI for use in neurological diseases.","authors":"Sharada Balaji, Neale Wiley, Megan E Poorman, Shannon H Kolind","doi":"10.1097/WCO.0000000000001282","DOIUrl":"10.1097/WCO.0000000000001282","url":null,"abstract":"Purpose of review: To review recent clinical uses of low-field magnetic resonance imaging (MRI) to guide incorporation into neurological practice.Recent findings: Use of low-field MRI has been demonstrated in applications including tumours, vascular pathologies, multiple sclerosis, brain injury, and paediatrics. Safety, workflow, and image quality have also been evaluated.Summary: Low-field MRI has the potential to increase access to critical brain imaging for patients who otherwise may not obtain imaging in a timely manner. This includes areas such as the intensive care unit and emergency room, where patients could be imaged at the point of care rather than be transported to the MRI scanner. Such systems are often more affordable than conventional systems, allowing them to be more easily deployed in resource constrained settings. A variety of systems are available on the market or in a research setting and are currently being used to determine clinical uses for these devices. The utility of such devices must be fully evaluated in clinical scenarios before adoption into standard practice can be achieved. This review summarizes recent clinical uses of low-field MR as well as safety, workflows, and image quality to aid practitioners in assessing this new technology.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"381-391"},"PeriodicalIF":4.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141175105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Advances in functional and structural imaging of the brainstem: implications for disease. 脑干功能和结构成像的进展：对疾病的影响。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2024-08-01 Epub Date: 2024-06-17 DOI: 10.1097/WCO.0000000000001284

Jiayue Cai, Yuheng Wang, Martin J McKeown

{"title":"Advances in functional and structural imaging of the brainstem: implications for disease.","authors":"Jiayue Cai, Yuheng Wang, Martin J McKeown","doi":"10.1097/WCO.0000000000001284","DOIUrl":"10.1097/WCO.0000000000001284","url":null,"abstract":"Purpose of review: The brainstem's complex anatomy and relatively small size means that structural and functional assessment of this structure is done less frequently compared to other brain areas. However, recent years have seen substantial progress in brainstem imaging, enabling more detailed investigations into its structure and function, as well as its role in neuropathology.Recent findings: Advancements in ultrahigh field MRI technology have allowed for unprecedented spatial resolution in brainstem imaging, facilitating the new creation of detailed brainstem-specific atlases. Methodological improvements have significantly enhanced the accuracy of physiological (cardiac and respiratory) noise correction within brainstem imaging studies. These technological and methodological advancements have allowed for in-depth analyses of the brainstem's anatomy, including quantitative assessments and examinations of structural connectivity within both gray and white matter. Furthermore, functional studies, including assessments of activation patterns and functional connectivity, have revealed the brainstem's roles in both specialized functions and broader neural integration. Notably, these investigations have identified alterations in brainstem structure and function associated with various neurological disorders.Summary: The aforementioned developments have allowed for a greater appreciation of the importance of the brainstem in the wider context of neuroscience and clinical neurology.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"361-368"},"PeriodicalIF":4.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141330542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An update on multiple system atrophy. 多系统萎缩的最新进展

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2024-08-01 Epub Date: 2024-06-03 DOI: 10.1097/WCO.0000000000001285

Iva Stankovic, Mechteld Kuijpers, Horacio Kaufmann

{"title":"An update on multiple system atrophy.","authors":"Iva Stankovic, Mechteld Kuijpers, Horacio Kaufmann","doi":"10.1097/WCO.0000000000001285","DOIUrl":"10.1097/WCO.0000000000001285","url":null,"abstract":"Purpose of review: Multiple system atrophy (MSA) is a rapidly progressive synucleinopathy characterized by autonomic failure, parkinsonism, and cerebellar ataxia. Here, we provide an update on α-synuclein's role in MSA pathophysiology and review the new Movement Disorders Society (MDS) diagnostic criteria and the utility of α-synuclein-based biomarkers. We also highlight ongoing efforts toward clinical trial readiness and review potential disease-modifying therapies undergoing clinical trials.Recent findings: A role of urinary tract infections in triggering α-synuclein aggregation and contribution of genes implicated in oligodendroglial development have been suggested in the MSA pathophysiology. The clinically probable MSA category of the new diagnostic criteria shows improved accuracy in early disease stages. Predictors of phenoconversion from pure autonomic failure to MSA are now better defined. Alpha-synuclein strains in CSF and serum, phosphorylated α-synuclein deposits in the skin, and brain α-synuclein pathology visualized using PET ligand [18F]ACI-12589 are emerging as valuable diagnostic tools. Clinical trials in MSA investigate drugs targeting α-synuclein aggregation or preventing α-synuclein expression, along with stem cell and gene therapies to halt disease progression.Summary: New MSA diagnostic criteria and α-synuclein-based biomarkers may enhance diagnostic accuracy while promising therapies are in development to address disease progression.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"400-408"},"PeriodicalIF":4.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11219253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Editorial: Update on movement disorders. 社论：运动障碍的最新进展。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2024-08-01 Epub Date: 2024-07-04 DOI: 10.1097/WCO.0000000000001281

Per Svenningsson

引用次数: 0

Levodopa infusion therapies for Parkinson disease. 帕金森病的左旋多巴输注疗法。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2024-08-01 Epub Date: 2024-05-23 DOI: 10.1097/WCO.0000000000001277

Marissa N Dean, David G Standaert

{"title":"Levodopa infusion therapies for Parkinson disease.","authors":"Marissa N Dean, David G Standaert","doi":"10.1097/WCO.0000000000001277","DOIUrl":"10.1097/WCO.0000000000001277","url":null,"abstract":"Purpose of review: to review recent progress in the development and use of continuous levodopa therapies in Parkinson disease (PD).Recent findings: Levodopa/Carbidopa intestinal gel (LCIG) is a continuous levodopa therapy which is widely used in the United States, Europe and other countries and is effective at reducing 'off' time. Recent work has shown that LCIG can be useful in managing dyskinesias and can improve nonmotor symptoms and quality of life. Several studies have shown good long-term effectiveness of LCIG. Recent data support the cost-effectiveness of this treatment strategy. Subcutaneous (SC) delivery of levodopa is a newer strategy that avoids the need for a surgically placed gastric tube. Two different products enabling SC delivery of levodopa are in development: ND0612 and foslevodopa/foscarbidopa. Both have recently been shown to reduce 'off' time in randomized, double-blind trials. Adverse effects of SC levodopa are primarily related to skin reactions at the infusion site.Summary: Continuous levodopa therapies can be used to treat Parkinson disease motor fluctuations that cannot be managed with standard oral therapies. They may also improve nonmotor symptoms, and improve overall quality of life in patients with advanced PD.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"409-413"},"PeriodicalIF":4.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

fMRI-based spatio-temporal parcellations of the human brain. 基于 fMRI 的人脑时空细分。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2024-08-01 Epub Date: 2024-05-27 DOI: 10.1097/WCO.0000000000001280

Qinrui Ling, Aiping Liu, Yu Li, Martin J McKeown, Xun Chen

{"title":"fMRI-based spatio-temporal parcellations of the human brain.","authors":"Qinrui Ling, Aiping Liu, Yu Li, Martin J McKeown, Xun Chen","doi":"10.1097/WCO.0000000000001280","DOIUrl":"10.1097/WCO.0000000000001280","url":null,"abstract":"Purpose of review: Human brain parcellation based on functional magnetic resonance imaging (fMRI) plays an essential role in neuroscience research. By segmenting vast and intricate fMRI data into functionally similar units, researchers can better decipher the brain's structure in both healthy and diseased states. This article reviews current methodologies and ideas in this field, while also outlining the obstacles and directions for future research.Recent findings: Traditional brain parcellation techniques, which often rely on cytoarchitectonic criteria, overlook the functional and temporal information accessible through fMRI. The adoption of machine learning techniques, notably deep learning, offers the potential to harness both spatial and temporal information for more nuanced brain segmentation. However, the search for a one-size-fits-all solution to brain segmentation is impractical, with the choice between group-level or individual-level models and the intended downstream analysis influencing the optimal parcellation strategy. Additionally, evaluating these models is complicated by our incomplete understanding of brain function and the absence of a definitive \"ground truth\".Summary: While recent methodological advancements have significantly enhanced our grasp of the brain's spatial and temporal dynamics, challenges persist in advancing fMRI-based spatio-temporal representations. Future efforts will likely focus on refining model evaluation and selection as well as developing methods that offer clear interpretability for clinical usage, thereby facilitating further breakthroughs in our comprehension of the brain.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"369-380"},"PeriodicalIF":4.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The role of caffeine in headache disorders. 咖啡因在头痛疾病中的作用。

IF 4.8 2区医学

Current Opinion in Neurology Pub Date : 2024-06-01 Epub Date: 2024-02-07 DOI: 10.1097/WCO.0000000000001249

Andrew Charles

{"title":"The role of caffeine in headache disorders.","authors":"Andrew Charles","doi":"10.1097/WCO.0000000000001249","DOIUrl":"10.1097/WCO.0000000000001249","url":null,"abstract":"Purpose of review: Caffeine is known to have both beneficial and adverse effects in individuals with headache disorders. This review describes recent findings regarding caffeine that are relevant to headache disorders and puts these findings into the context of clinical management.Recent findings: Preclinical studies show that caffeine has complex effects on sleep, brain blood flow, and intracranial pressure that may depend on the timing of caffeine intake relative to the sleep-wake cycle. Caffeine metabolism may have significant inter-individual variation that influences its therapeutic and/or adverse effects. Caffeine has acute therapeutic benefit for some primary headache disorders. For migraine, this benefit is predominantly in milder headache without cutaneous allodynia. High levels of caffeine intake may contribute to progression of headache disorders. Caffeine-containing combination analgesics commonly cause medication overuse headache. Abrupt reduction in caffeine consumption is a trigger for migraine that may be important in situations including the hospital setting, religious and cultural fasting, and pregnancy.Summary: There is not sufficient evidence to support universal guidelines for the use of dietary and medicinal caffeine in headache disorders. A sensible approach based upon available evidence is to limit dietary caffeine intake to moderate amounts with consistent timing before noon, and to use caffeine-containing combination analgesics infrequently for milder headache.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"289-294"},"PeriodicalIF":4.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139702015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Shifting our attention earlier in the multiple sclerosis disease course. 在多发性硬化症病程的早期转移我们的注意力。

IF 4.8 2区医学

Current Opinion in Neurology Pub Date : 2024-06-01 Epub Date: 2024-03-28 DOI: 10.1097/WCO.0000000000001268

Samantha E Epstein, Erin E Longbrake

{"title":"Shifting our attention earlier in the multiple sclerosis disease course.","authors":"Samantha E Epstein, Erin E Longbrake","doi":"10.1097/WCO.0000000000001268","DOIUrl":"10.1097/WCO.0000000000001268","url":null,"abstract":"Purpose of review: Revisions of multiple sclerosis (MS) diagnostic criteria enable clinicians to diagnose patients earlier in the biologic disease course. Prompt initiation of therapy correlates with improved clinical outcomes. This has led to increased attention on the earliest stages of MS, including the MS prodrome and radiologically isolated syndrome (RIS). Here, we review current understanding and approach to patients with preclinical MS.Recent findings: MS disease biology often begins well before the onset of typical MS symptoms, and we are increasingly able to recognize preclinical and prodromal stages of MS. RIS represents the best characterized aspect of preclinical MS, and its diagnostic criteria were recently revised to better capture patients at highest risk of conversion to clinical MS. The first two randomized control trials evaluating disease modifying therapy use in RIS also found that treatment could delay or prevent onset of clinical disease.Summary: Despite progress in our understanding of the earliest stages of the MS disease course, additional research is needed to systematically identify patients with preclinical MS as well as capture those at risk for developing clinical disease. Recent data suggests that preventive immunomodulatory therapies may be beneficial for high-risk patients with RIS; though management remains controversial.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"212-219"},"PeriodicalIF":4.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140305157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

New knowledge on anti-IgLON5 disease. 抗 IgLON5 疾病的新知识。

IF 4.8 2区医学

Current Opinion in Neurology Pub Date : 2024-06-01 Epub Date: 2024-04-01 DOI: 10.1097/WCO.0000000000001271

Carles Gaig, Lidia Sabater

{"title":"New knowledge on anti-IgLON5 disease.","authors":"Carles Gaig, Lidia Sabater","doi":"10.1097/WCO.0000000000001271","DOIUrl":"10.1097/WCO.0000000000001271","url":null,"abstract":"Purpose of review: Anti-IgLON5 disease is characterized by a distinctive sleep disorder, associated with a heterogeneous spectrum of neurological symptoms. Initial autopsies showed a novel neuronal tauopathy predominantly located in the tegmentum of the brainstem. Recently, new diagnostic red flags, biomarkers predictors of response to immunotherapy, and novel insights into the autoimmune pathogenesis of the disease have been reported.Recent findings: Patients with diagnosis of neurodegenerative dementia, progressive supranuclear palsy (PSP) or with motor-neuron disease (MND)-like syndrome have been reported to have IgLON5 antibodies, which are the hallmark of anti-IgLON5 disease. Second, low levels of neurofilament light chain in serum and cerebrospinal fluid of patients at disease onset could be a predictor of immunotherapy response. Recent neuropathological studies indicate that the neuronal tau deposits occur late in the course of the disease. Moreover, IgLON5 antibodies induce cytoskeletal changes in cultured hippocampal neurons suggesting that the tauopathy could be secondary of the IgLON5 antibody effects.Summary: Anti-IgLON5 disease can mimic and should be considered in atypical presentations of MND, neurodegenerative dementia and PSP. Neurofilament light chain levels seem promising biomarker for disease prognosis. Finally, the neuropathological and in vitro experimental studies strengthen the autoimmune hypothesis of the disease.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"316-321"},"PeriodicalIF":4.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11064895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140335112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Understanding multiple sclerosis as a disease spectrum: above and below the clinical threshold. 将多发性硬化症视为一种疾病谱：高于和低于临床阈值。

IF 4.8 2区医学

Current Opinion in Neurology Pub Date : 2024-06-01 Epub Date: 2024-04-09 DOI: 10.1097/WCO.0000000000001262

Stephen Krieger, Karin Cook, Carrie M Hersh

{"title":"Understanding multiple sclerosis as a disease spectrum: above and below the clinical threshold.","authors":"Stephen Krieger, Karin Cook, Carrie M Hersh","doi":"10.1097/WCO.0000000000001262","DOIUrl":"10.1097/WCO.0000000000001262","url":null,"abstract":"Purpose of review: Research in multiple sclerosis (MS) has long been predicated on clinical groupings that do not reflect the underlying biologic heterogeneity apparent within patient populations. This review explicates the various levels of explanation through which the spectrum of disease is described and investigated both above and below the clinical threshold of detection, as framed by the topographical model of MS, to help advance a cogent mechanistic framework.Recent findings: Contemporary evidence has amended the view of MS as consisting of sequential disease phases in favor of a spectrum of disease with an admixture of interdependent and dynamic pathobiological axes driving tissue injury and progression. Recent studies have shown the presence of acute and compartmentalized inflammation and mechanisms of neurodegeneration beginning early and evolving throughout the disease continuum. Still, the gap between the understanding of immunopathologic processes in MS and the tools used to measure relevant molecular, laboratory, radiologic, and clinical metrics needs attention to enable better prognostication of disease and monitoring for changes along specific pathologic axes and variable treatment outcomes.Summary: Aligning on a consistently-applied mechanistic framework at distinct levels of explanation will enable greater precision across bench and clinical research, and inform discourse on drivers of disability progression and delivery of care for individuals with MS.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"189-201"},"PeriodicalIF":4.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11064902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140293122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0