Current Opinion in Neurology最新文献_第2页

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

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

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

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

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

IF 4.1 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":4.1,"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

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 4.1 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":4.1,"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

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 4.1 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":4.1,"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 4.1 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

Novel therapies for pediatric low grade glioma. 治疗小儿低级别胶质瘤的新疗法。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2024-12-01 Epub Date: 2024-09-26 DOI: 10.1097/WCO.0000000000001319

Dardan Demaliaj, Sharon L Gardner

{"title":"Novel therapies for pediatric low grade glioma.","authors":"Dardan Demaliaj, Sharon L Gardner","doi":"10.1097/WCO.0000000000001319","DOIUrl":"10.1097/WCO.0000000000001319","url":null,"abstract":"Purpose of review: Current biological findings provide new insights into the genetics driving growth of low-grade gliomas in pediatric patients. This has provided new targets for novel therapies. The purpose of this paper is to review novel therapies for pediatric low-grade gliomas that have been published in the past 24 months.Recent findings: Low-grade gliomas are often driven by mitogen activated protein kinase (MAPK) alterations either with BRAF V600E point mutations or BRAF fusions. Current advances have also highlighted novel fusions of fibroblast growth factor receptor (FGFR), myeloblastosis family of transcription factors (MYB), meningioma 1 tumor suppressor (MN1), neurotrophic receptor kinase family of receptors (NTRK), Kristen RAS (Rat Sarcoma Virus) oncogene homolog in mammals (KRAS), Receptor tyrosine kinase ROS proto oncogene 1 (ROS1), protein kinase C alpha (PRKCA), and platelet derive growth factor receptor (PDGFR) amplification. Novel therapies have been employed and are showing encouraging results in pediatric low-grade gliomas. Current trials are underway with newer generation pan RAF inhibitors and mitogen activated protein kinase - kinase (MEK) inhibitors. Other early phase clinical trials have provided safety data in pediatric patients targeting FGFR fusion, NTRK fusion, PDGFR amplification and ROS1 mutations.Summary: Historical treatment options in pediatric low-grade gliomas have utilized surgery, radiation therapy and conventional chemotherapy. Recently greater insight into their biology has found that alterations in MAPK driven pathways are often the hallmark of tumorigenesis. Targeting these novel pathways has led to tumor control and shrinkage without the use of conventional chemotherapy. Caution should be taken however, since these treatment options are still novel, and we do not fully appreciate the long-term effects. Nonetheless a new era of targeted medicine is here.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"702-707"},"PeriodicalIF":4.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343357","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

CAR T-cell therapy for gliomas. 胶质瘤的 CAR T 细胞疗法。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2024-12-01 Epub Date: 2024-10-09 DOI: 10.1097/WCO.0000000000001318

Kun-Wei Song, Brian J Scott

{"title":"CAR T-cell therapy for gliomas.","authors":"Kun-Wei Song, Brian J Scott","doi":"10.1097/WCO.0000000000001318","DOIUrl":"https://doi.org/10.1097/WCO.0000000000001318","url":null,"abstract":"Purpose of review: To review the landscape of chimeric antigen receptor T-cell (CAR T) therapy for gliomas as seen in recently published trials and discuss on-going challenges with new cancer immunotherapy treatments.Recent findings: Given how CAR T therapy has revolutionized the treatment of several hematologic malignancies, there has been increasing interest in using immunotherapy, and particularly CAR T therapy for gliomas. Within the past decade, several first in human trials have published early patient experiences showing treatment is generally well tolerated but with limited efficacy, which may be improving with newer evolutions in CAR T design to overcome known resistance mechanisms in glioma treatment.Summary: CAR T therapy is a promising avenue of treatment for high-grade gliomas, which have a universally poor prognosis as well as limited therapeutics. There are a growing number of CAR T clinical trials for CNS tumors and thus, an understanding of their treatment strategies, toxicity management, and overcoming resistance mechanisms will be important for both clinical practice and to identify areas for future research.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":"37 6","pages":"672-681"},"PeriodicalIF":4.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582490","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