Current Opinion in Neurology最新文献_第3页

Leprous neuropathy. 鳞状神经病

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2024-10-01 Epub Date: 2024-07-25 DOI: 10.1097/WCO.0000000000001304

Wilson Marques

引用次数: 0

Blood and cerebrospinal fluid biomarkers in neuro-oncology. 神经肿瘤学中的血液和脑脊液生物标记物。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2024-09-30 DOI: 10.1097/WCO.0000000000001317

Roberta Rudà, Alessia Pellerino, Riccardo Soffietti

{"title":"Blood and cerebrospinal fluid biomarkers in neuro-oncology.","authors":"Roberta Rudà, Alessia Pellerino, Riccardo Soffietti","doi":"10.1097/WCO.0000000000001317","DOIUrl":"https://doi.org/10.1097/WCO.0000000000001317","url":null,"abstract":"Purpose of review: The purpose of this review is to discuss the value of blood and CSF biomarkers in primary CNS tumors.Recent findings: Several analytes can be assessed with liquid biopsy techniques, including circulating tumor cells, circulating cell-free tumor DNA, circulating cell-free RNA, circulating proteins and metabolites, extracellular vesicles and tumor-educated platelets. Among diffuse gliomas of the adult, ctDNA in blood or CSF has represented the most used analyte, with the detection of molecular alterations such as MGMT promoter, PTEN, EGFRVIII, TERT promoter mutation and IDH R132H mutation. In general, CSF is enriched for ctDNA as compared with plasma. The use of MRI-guided focused ultrasounds to disrupt the blood-brain barrier could enhance the level of biomarkers in both blood and CSF. The detection of MYD88 L265P mutation with digital droplet PCR and the detection of ctDNA with next generation sequencing represent the best tools to diagnose and monitoring CNS lymphomas under treatment. In meningiomas, the low concentration of ctDNA is a limiting factor for the detection of driver mutations, such as NF2, AKTs, SMO, KLF4, TRAF7, SMARCB1, SMARCE1, PTEN, and TERT; an alternative approach could be the isolation of ctDNA through circulating extracellular vesicles. Liquid biopsies are being used extensively for diagnosis and surveillance of diffuse midline gliomas, in particular with the detection of the driver mutation H3K27M. Last, specific methylome patterns in CSF may allow the distinction of glioblastomas from CNS lymphomas or meningiomas.Summary: This review summarizes the current knowledge and future perspectives of liquid biopsy of blood and CSF for diagnosis and monitoring of primary CNS tumors.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343355","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

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 : 2024-09-27 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":"https://doi.org/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":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-09-27","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

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 : 2024-09-26 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":"https://doi.org/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":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Updates for newly diagnosed and recurrent glioblastoma: a review of recent clinical trials. 新诊断和复发胶质母细胞瘤的最新治疗方法：近期临床试验综述。

IF 4.8 2区医学

Current Opinion in Neurology Pub Date : 2024-09-13 DOI: 10.1097/wco.0000000000001320

Corinna M Fukushima,John de Groot

{"title":"Updates for newly diagnosed and recurrent glioblastoma: a review of recent clinical trials.","authors":"Corinna M Fukushima,John de Groot","doi":"10.1097/wco.0000000000001320","DOIUrl":"https://doi.org/10.1097/wco.0000000000001320","url":null,"abstract":"PURPOSE OF REVIEWGlioblastoma (GBM) is the most common and devastating primary malignant brain tumor. We summarize recent advances in radiotherapy, immunotherapy, and targeted therapy approaches for the treatment of newly diagnosed and recurrent glioblastoma. We also introduce ongoing clinical trials.RECENT FINDINGSRecent clinical trials have explored multiple novel strategies to treat GBM including the use of oncoviruses, chimeric antigen receptor (CAR) T cell therapy, vaccines, radiotherapy, and novel drug delivery techniques to improves drug penetrance across the blood brain barrier. Approaches to improve drug delivery to brain tumors have the potential to expand treatment options of existing therapies that otherwise have poor brain tumor penetrance. Immunotherapy has been of keen interest in both newly diagnosed and recurrent glioblastoma. Vaccines SurVaxM and DCVax-L have shown initial promise in phase II and III trials, respectively. CAR T cell therapy trials are in their early phases but hold promise in both newly diagnosed and recurrent glioblastoma.SUMMARYAlthough progress to improve outcomes for GBM patients has been modest, multiple novel strategies utilizing combination therapies, focused ultrasound to improve drug delivery, and novel immunotherapies are underway.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142216534","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 the treatment of IDH-mutant gliomas. 治疗 IDH 突变胶质瘤的进展。

IF 4.8 2区医学

Current Opinion in Neurology Pub Date : 2024-09-12 DOI: 10.1097/wco.0000000000001316

Chooyoung Baek,Alice Laurenge,Mehdi Touat

引用次数: 0

Perception and control of a virtual body in immersive virtual reality for rehabilitation. 在用于康复的沉浸式虚拟现实中感知和控制虚拟人体。

IF 4.8 2区医学

Current Opinion in Neurology Pub Date : 2024-09-10 DOI: 10.1097/wco.0000000000001321

Tony Donegan,Maria V Sanchez-Vives

{"title":"Perception and control of a virtual body in immersive virtual reality for rehabilitation.","authors":"Tony Donegan,Maria V Sanchez-Vives","doi":"10.1097/wco.0000000000001321","DOIUrl":"https://doi.org/10.1097/wco.0000000000001321","url":null,"abstract":"PURPOSE OF REVIEWThis review explores recent advances in using immersive virtual reality to improve bodily perception and motor control in rehabilitation across musculoskeletal and neurological conditions, examining how virtual reality's unique capabilities can address the challenges of traditional approaches. The potential in this area of the emerging metaverse and the integration of artificial intelligence in virtual reality are discussed.RECENT FINDINGSIn musculoskeletal rehabilitation, virtual reality shows promise in enhancing motivation, adherence, improving range of motion, and reducing kinesiophobia, particularly postsurgery. For neurological conditions like stroke and spinal cord injury, virtual reality's ability to manipulate bodily perceptions offers significant therapeutic potential, with reported improvements in upper limb function and gait performance. Balance and gait rehabilitation, especially in older adults, have also seen positive outcomes. The integration of virtual reality with brain-computer interfaces presents exciting possibilities for severe speech and motor impairments.SUMMARYCurrent research is limited by small sample sizes, short intervention durations, and variability in virtual reality systems. Future studies should focus on larger, long-term trials to confirm findings and explore underlying mechanisms. As virtual reality technology advances, its integration into rehabilitation programs could revolutionize treatment approaches, personalizing treatments, facilitating home training, and potentially improving patient outcomes across a wide variety of conditions.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142216536","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 4.1 2区医学

Current Opinion in Neurology Pub Date : 2024-09-03 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":"https://doi.org/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":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-09-03","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

Noninvasive brain stimulation to improve motor outcomes after stroke. 无创脑部刺激改善中风后的运动效果。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2024-09-03 DOI: 10.1097/WCO.0000000000001313

Emma C J Savelon, Harry T Jordan, Cathy M Stinear, Winston D Byblow

{"title":"Noninvasive brain stimulation to improve motor outcomes after stroke.","authors":"Emma C J Savelon, Harry T Jordan, Cathy M Stinear, Winston D Byblow","doi":"10.1097/WCO.0000000000001313","DOIUrl":"https://doi.org/10.1097/WCO.0000000000001313","url":null,"abstract":"Purpose of review: This review highlights recent developments in noninvasive brain stimulation (NIBS) techniques and applications for improving motor outcomes after stroke. Two promising areas of development relate to deep brain neuromodulation and the use of single-pulse transcranial magnetic stimulation (TMS) within a prediction tool for predicting upper limb outcome for individual patients.Recent findings: Systematic reviews highlight the inconsistent effect sizes of interventional NIBS for motor outcome after stroke, as well as limited evidence supporting the interhemispheric competition model. To improve the therapeutic efficacy of NIBS, studies have leveraged metaplasticity and priming approaches. Transcranial temporal interference stimulation (tTIS) and low-intensity focused ultrasound stimulation (LIFUS) are emerging NIBS techniques with potential for modulating deeper brain structures, which may hold promise for stroke neurorehabilitation. Additionally, motor evoked potential (MEP) status obtained with single-pulse TMS is a prognostic biomarker that could be used to tailor NIBS for individual patients.Summary: Trials of interventional NIBS to improve stroke outcomes may be improved by applying NIBS in a more targeted manner. This could be achieved by taking advantage of NIBS techniques that can be targeted to deeper brain structures, using biomarkers of structural and functional reserve to stratify patients, and recruiting patients in more homogeneous time windows.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105138","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

PET-based brain molecular connectivity in neurodegenerative disease. 神经退行性疾病中基于 PET 的大脑分子连接。

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.0000000000001283

Jordan U Hanania, Erik Reimers, Connor W J Bevington, Vesna Sossi

{"title":"PET-based brain molecular connectivity in neurodegenerative disease.","authors":"Jordan U Hanania, Erik Reimers, Connor W J Bevington, Vesna Sossi","doi":"10.1097/WCO.0000000000001283","DOIUrl":"10.1097/WCO.0000000000001283","url":null,"abstract":"Purpose of review: Molecular imaging has traditionally been used and interpreted primarily in the context of localized and relatively static neurochemical processes. New understanding of brain function and development of novel molecular imaging protocols and analysis methods highlights the relevance of molecular networks that co-exist and interact with functional and structural networks. Although the concept and evidence of disease-specific metabolic brain patterns has existed for some time, only recently has such an approach been applied in the neurotransmitter domain and in the context of multitracer and multimodal studies. This review briefly summarizes initial findings and highlights emerging applications enabled by this new approach.Recent findings: Connectivity based approaches applied to molecular and multimodal imaging have uncovered molecular networks with neurodegeneration-related alterations to metabolism and neurotransmission that uniquely relate to clinical findings; better disease stratification paradigms; an improved understanding of the relationships between neurochemical and functional networks and their related alterations, although the directionality of these relationships are still unresolved; and a new understanding of the molecular underpinning of disease-related alteration in resting-state brain activity.Summary: Connectivity approaches are poised to greatly enhance the information that can be extracted from molecular imaging. While currently mostly contributing to enhancing understanding of brain function, they are highly likely to contribute to the identification of specific biomarkers that will improve disease management and clinical care.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141175194","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