Current Opinion in Neurology最新文献_第10页

Artificial intelligence and stroke imaging. 人工智能和中风成像。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2025-02-01 Epub Date: 2024-11-14 DOI: 10.1097/WCO.0000000000001333

Jane Rondina, Parashkev Nachev

{"title":"Artificial intelligence and stroke imaging.","authors":"Jane Rondina, Parashkev Nachev","doi":"10.1097/WCO.0000000000001333","DOIUrl":"10.1097/WCO.0000000000001333","url":null,"abstract":"Purpose of review: Though simple in its fundamental mechanism - a critical disruption of local blood supply - stroke is complicated by the intricate nature of the neural substrate, the neurovascular architecture, and their complex interactions in generating its clinical manifestations. This complexity is adequately described by high-resolution imaging with sensitivity not only to parenchymal macrostructure but also microstructure and functional tissue properties, in conjunction with detailed characterization of vascular topology and dynamics. Such descriptive richness mandates models of commensurate complexity only artificial intelligence could plausibly deliver, if we are to achieve the goal of individually precise, personalized care.Recent findings: Advances in machine vision technology, especially deep learning, are delivering higher fidelity predictive, descriptive, and inferential tools, incorporating increasingly rich imaging information within ever more flexible models. Impact at the clinical front line remains modest, however, owing to the challenges of delivering models robust to the noisy, incomplete, biased, and comparatively small-scale data characteristic of real-world practice.Summary: The potential benefit of introducing AI to stroke, in imaging and elsewhere, is now unquestionable, but the optimal approach - and the path to real-world application - remain unsettled. Deep generative models offer a compelling solution to current obstacles and are predicted powerfully to catalyse innovation in the field.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":"38 1","pages":"40-46"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930040","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

Update on management of cerebral venous thrombosis. 脑静脉血栓治疗的最新进展。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2025-02-01 Epub Date: 2024-10-21 DOI: 10.1097/WCO.0000000000001329

Sara Rosa, Isabel Fragata, Diana Aguiar de Sousa

{"title":"Update on management of cerebral venous thrombosis.","authors":"Sara Rosa, Isabel Fragata, Diana Aguiar de Sousa","doi":"10.1097/WCO.0000000000001329","DOIUrl":"10.1097/WCO.0000000000001329","url":null,"abstract":"Purpose of review: This review intends to systematize the diagnostic and treatment approach to cerebral venous thrombosis (CVT), highlighting key studies that have been recently published.Recent findings: In light of the recent pandemic, new risk factors for CVT have emerged. Contrast-enhanced MRI and susceptibility-weighted imaging have been shown to offer increased sensitivity for detecting cortical vein thrombosis.Dabigatran seems to be as effective and well tolerated as warfarin for long-term anticoagulation. Partial venous recanalization often occurs in patients treated with anticoagulation only, as early as 8 days after treatment onset. For patients with CVT and impending brain herniation, two-thirds of those who undergo decompressive craniectomy survive, with one-third being functionally independent 6 months after diagnosis.Summary: CVT is an unusual type of cerebrovascular disease that mostly affects women of fertile age. Risk factors should be identified and addressed. Diagnosis relies on confirmation of venous sinus and/or vein thrombosis, usually by CT venography or MRI. Anticoagulation is the cornerstone of treatment. Despite the lack of high-quality evidence, endovascular treatment is often considered in severe cases. Special populations require tailored approaches. About 80% achieve mRS 0-1, but residual symptoms often affect quality of life and the ability to return to work.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"18-28"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521287","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 targets in spontaneous intracerebral hemorrhage. 自发性脑内出血的新目标。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2025-02-01 Epub Date: 2024-09-25 DOI: 10.1097/WCO.0000000000001325

Pu-Tien Chiang, Li-Kai Tsai, Hsin-Hsi Tsai

{"title":"New targets in spontaneous intracerebral hemorrhage.","authors":"Pu-Tien Chiang, Li-Kai Tsai, Hsin-Hsi Tsai","doi":"10.1097/WCO.0000000000001325","DOIUrl":"10.1097/WCO.0000000000001325","url":null,"abstract":"Purpose of review: Intracerebral hemorrhage (ICH) is a devastating stroke with limited medical treatments; thus, timely exploration of emerging therapeutic targets is essential. This review focuses on the latest strategies to mitigate secondary brain injury post-ICH other than targeting surgery or hemostasis, addressing a significant gap in clinical practice and highlighting potential improvements in patient outcomes.Recent findings: Promising therapeutic targets to reduce secondary brain injury following ICH have recently been identified, including attenuation of iron toxicity and inhibition of ferroptosis, enhancement of endogenous resorption of hematoma, and modulation of perihematomal inflammatory responses and edema. Additionally, novel insights suggest the lymphatic system of the brain may potentially play a role in hematoma clearance and edema management. Various experimental and early-phase clinical trials have demonstrated these approaches may potentially offer clinical benefits, though most research remains in the preliminary stages.Summary: Continued research is essential to identify multifaceted treatment strategies for ICH. Clinical translation of these emerging targets could significantly enhance the efficacy of therapeutic interventions and potentially reduce secondary brain damage and improve neurological recovery. Future efforts should focus on large-scale clinical trials to validate these approaches, to pave the way for more effective treatment protocols for spontaneous ICH.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"10-17"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343356","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

Current gaps in acute reperfusion therapies. 急性再灌注疗法目前存在的差距。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2025-02-01 Epub Date: 2024-11-28 DOI: 10.1097/WCO.0000000000001337

Thanh N Nguyen, Yunyun Xiong, Shuya Li, Mohamad Abdalkader, Hui-Sheng Chen

引用次数: 0

Clinical trials in Leber hereditary optic neuropathy: outcomes and opportunities. Leber 遗传性视神经病变的临床试验：成果与机遇。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2025-02-01 Epub Date: 2024-12-20 DOI: 10.1097/WCO.0000000000001343

Benson S Chen, Nancy J Newman

{"title":"Clinical trials in Leber hereditary optic neuropathy: outcomes and opportunities.","authors":"Benson S Chen, Nancy J Newman","doi":"10.1097/WCO.0000000000001343","DOIUrl":"10.1097/WCO.0000000000001343","url":null,"abstract":"Purpose of review: Leber hereditary optic neuropathy (LHON) is a mitochondrial DNA disease characterised by sequential bilateral vision loss due to loss of retinal ganglion cells. The purpose of this review is to provide an update on the results of recent clinical trials for LHON, focusing on studies of idebenone and lenadogene nolparvovec gene therapy.Recent findings: Evidence from three clinical studies (RHODOS, RHODOS-OFU, and LEROS) suggest that idebenone should be started early and continued for at least 24 months. Treatment effect varies according to the stage of LHON and the underlying mutation. Favourable outcomes are associated with the m.11778G>A mutation and chronic eyes with the m.14484T>C mutation. Caution should be taken in subacute/dynamic eyes with the m.3460G>A mutation, due to possible clinical worsening with idebenone. Compared to eyes from an external natural history cohort, pooled data from four clinical studies (RESCUE, REVERSE, RESTORE and REFLECT) show that a single intravitreal injection of lenadogene nolparvovec can result in sustained bilateral visual improvement in m.11778G>A LHON patients aged ≥15 years when treated within 1 year of onset. Although the treatment effect is modest, the final visual acuity of treated patients (∼1.2 logMAR) significantly differs from the published natural history of LHON and the treatment benefit is more pronounced than the effect of idebenone alone in patients with the m.11778G>A mutation.Summary: There is increasing evidence for the potential therapeutic benefit of idebenone and lenadogene nolparvovec gene therapy.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"79-86"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863536","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

Editorial introductions. 编辑介绍。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2024-12-01 Epub Date: 2024-11-07 DOI: 10.1097/WCO.0000000000001326

引用次数: 0

Towards multimodal cognition-based treatment for cognitive impairment in Parkinson's disease: drugs, exercise, non-invasive brain stimulation and technologies. 帕金森病认知障碍的多模式认知治疗：药物、运动、无创脑刺激和技术。

IF 4.4 2区医学

Current Opinion in Neurology Pub Date : 2024-12-01 Epub Date: 2024-07-30 DOI: 10.1097/WCO.0000000000001310

Elisa Mantovani, Miriana Maria Bressan, Michele Tinazzi, Stefano Tamburin

{"title":"Towards multimodal cognition-based treatment for cognitive impairment in Parkinson's disease: drugs, exercise, non-invasive brain stimulation and technologies.","authors":"Elisa Mantovani, Miriana Maria Bressan, Michele Tinazzi, Stefano Tamburin","doi":"10.1097/WCO.0000000000001310","DOIUrl":"10.1097/WCO.0000000000001310","url":null,"abstract":"Purpose of review: Cognitive impairment is one of the most challenging non-motor symptoms of Parkinson's disease (PD) and may occur during all PD stages. There are no established pharmacological treatments for PD-related cognitive impairment, which may be improved by cognition-based interventions (i.e., cognitive stimulation, cognitive training, cognitive rehabilitation). Multimodal cognition-based interventions by adjunctive drugs, exercise, non-invasive brain stimulation and technologies may be effective in PD.Recent findings: Exercise combined with cognitive training may enhance global, memory, visuospatial and executive functioning, transcranial direct current stimulation delivered alongside cognitive training may improve attention and executive functioning, and exergames, semi-immersive virtual reality (VR) and telerehabilitation plus non-immersive VR combined with cognitive training may ameliorate global and executive functioning in PD patients.Summary: The evidence reviewed here, despite preliminary, is very encouraging and suggests strong rationale for combining pharmacological and non-pharmacological interventions with cognition-based treatments in PD. To overcome limitations of current studies, we propose some recommendations for future trials on drugs, exercise, non-invasive brain stimulation and technologies combined with cognition-based treatments for cognitive impairment in PD.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"629-637"},"PeriodicalIF":4.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141916344","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

Medical and neurologic management of brain tumor patients. 脑肿瘤患者的内科和神经科治疗。

IF 4.4 2区医学

Current Opinion in Neurology Pub Date : 2024-12-01 Epub Date: 2024-09-02 DOI: 10.1097/WCO.0000000000001315

Juan Pablo Ospina, Patrick Y Wen

{"title":"Medical and neurologic management of brain tumor patients.","authors":"Juan Pablo Ospina, Patrick Y Wen","doi":"10.1097/WCO.0000000000001315","DOIUrl":"10.1097/WCO.0000000000001315","url":null,"abstract":"Purpose of review: This article discusses commonly encountered medical and neurological complications in patients with brain tumors and highlights recommendations for their management based on updated evidence.Recent findings: Use of dexamethasone is correlated with worse prognosis in patients with glioblastoma, and in brain metastases, high doses may lead to increased side effects without additional clinical benefit. There are multiple antiseizure medications (ASM) to choose from and possible interactions and toxicity must be considered when choosing an agent. Additionally, there is growing interest in the use of AMPA receptor blockers as ASM in patients with brain tumors. Nonpharmacological strategies for the management of fatigue remain paramount. Cognitive decline is common after whole brain radiation (WBRT) and hippocampal-sparing WBRT results in superior cognitive outcomes. Venous thromboembolism is a common complication and there is growing evidence on the use of direct oral anticoagulants (DOACs) in this population.Summary: There is evolving evidence on the management of medical and neurological complications in patients with brain tumors. These complications, require early identification and multidisciplinary collaboration and expertise.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"657-665"},"PeriodicalIF":4.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105137","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

Assessment of wearable robotics performance in patients with neurological conditions. 评估神经系统疾病患者的可穿戴机器人性能。

IF 4.4 2区医学

Current Opinion in Neurology Pub Date : 2024-12-01 Epub Date: 2024-10-04 DOI: 10.1097/WCO.0000000000001328

Lucas Gerez, Silvestro Micera, Richard Nuckols, Tommaso Proietti

{"title":"Assessment of wearable robotics performance in patients with neurological conditions.","authors":"Lucas Gerez, Silvestro Micera, Richard Nuckols, Tommaso Proietti","doi":"10.1097/WCO.0000000000001328","DOIUrl":"10.1097/WCO.0000000000001328","url":null,"abstract":"Purpose of review: While wearable robotics is expanding within clinical settings, particularly for neurological rehabilitation, there is still a lack of consensus on how to effectively assess the performance of these devices. This review focuses on the most common metrics, whose selection and design are crucial for optimizing treatment outcomes and potentially improve the standard care.Recent findings: The literature reveals that while wearable robots are equipped with various embedded sensors, most studies still rely on traditional, nontechnological methods for assessment. Recent studies have shown that, although quantitative data from embedded sensors are available (e.g., kinematics), these are underutilized in favor of qualitative assessments. A trend toward integrating automatic assessments from the devices themselves is emerging, with a few notable studies pioneering this approach.Summary: Our analysis suggests a critical need for developing standardized metrics that leverage the data from embedded sensors in wearable robots. This shift could enhance the accuracy of patient assessments and the effectiveness of rehabilitation strategies, ultimately leading to better patient outcomes in neurological rehabilitation.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"645-654"},"PeriodicalIF":4.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380179","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

Medical technologies, telemedicine and artificial intelligence for neurotrauma and neurorehabilitation. 用于神经创伤和神经康复的医疗技术、远程医疗和人工智能。

IF 4.4 2区医学

Current Opinion in Neurology Pub Date : 2024-12-01 Epub Date: 2024-11-07 DOI: 10.1097/WCO.0000000000001323

Stefano Tamburin

引用次数: 0