Current Opinion in Neurology最新文献_第3页

The atypical faces of optic neuritis: neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein antibody-associated disease. 视神经炎的非典型表现：视神经炎谱系障碍和髓鞘少突胶质细胞糖蛋白抗体相关疾病。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2025-02-01 Epub Date: 2024-11-20 DOI: 10.1097/WCO.0000000000001335

Sabrina Poonja, Natthapon Rattanathamsakul, John J Chen

{"title":"The atypical faces of optic neuritis: neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein antibody-associated disease.","authors":"Sabrina Poonja, Natthapon Rattanathamsakul, John J Chen","doi":"10.1097/WCO.0000000000001335","DOIUrl":"10.1097/WCO.0000000000001335","url":null,"abstract":"Purpose of review: The purpose of this article is to provide a review of neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), with a focus on what renders optic neuritis \"atypical\" in these two conditions. Clinical features, diagnostic criteria, and epidemiology are outlined. Acute treatments for optic neuritis, as well as immunotherapy for NMOSD and MOGAD are discussed.Recent findings: Updates in NMOSD and MOGAD are highlighted, with an emphasis on novel work including the new 2023 MOGAD diagnostic criteria, our evolving understanding on the epidemiology of these conditions, and recently FDA-approved NMOSD treatments. Pipeline therapies are also discussed.Summary: A thorough history and examination, supported by ancillary testing, continues to be the mainstay of optic neuritis diagnosis. Stratifying typical versus atypical optic neuritis is paramount. Within the atypical category, NMOSD and MOGAD are important considerations. Clues can point towards these diagnoses and guide steps for treatment, which is increasingly becoming targeted to individual diseases, as the pathophysiology is different for these disorders.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"96-104"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675365","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

Thyroid eye disease and ocular myasthenia gravis. 甲状腺眼病和眼肌萎缩症。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2025-02-01 Epub Date: 2024-11-27 DOI: 10.1097/WCO.0000000000001339

Julie M Shabto, Shanlee Stevens, Michael Kazim

引用次数: 0

Acute stroke care in low and middle-income countries. 中低收入国家的急性中风护理。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2025-02-01 Epub Date: 2024-11-07 DOI: 10.1097/WCO.0000000000001332

Sheila Cristina Ouriques Martins, Sarah Shali Matuja

{"title":"Acute stroke care in low and middle-income countries.","authors":"Sheila Cristina Ouriques Martins, Sarah Shali Matuja","doi":"10.1097/WCO.0000000000001332","DOIUrl":"10.1097/WCO.0000000000001332","url":null,"abstract":"Purpose of review: The purpose of this article is to discuss the global impact of stroke, the disparities and barriers to implement stroke care, and the global efforts to improve access to acute treatments in low and middle-income countries (LMICs).Recent findings: Disparities in access to stroke care are influenced by socioeconomic inequalities, geographic disparities, and limited healthcare infrastructure, particularly in LMICs. Effective stroke care requires a coordinated approach involving emergency services, rapid diagnosis, timely treatment, and early rehabilitation. However, there are significant delays in implementing evidence-based practices, particularly in areas where stroke care resources are scarce.Key barriers include geographic disparities, economic constraints, insufficient healthcare infrastructure, low public awareness, and weak policy frameworks. Addressing these challenges requires strengthening health systems, promoting universal health coverage, enhancing public and healthcare provider education, leveraging technology like telemedicine, and fostering international collaboration. Global efforts, including initiatives by the World Stroke Organization, focus on improving stroke care through infrastructure development, workforce training, and policy advocacy.Summary: These recommended strategies aim to make stroke care accessible and effective for everyone, regardless of location or socioeconomic status, ultimately helping to reduce the global burden of stroke.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"47-53"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602682","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

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

Headache in infections.

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2025-01-30 DOI: 10.1097/WCO.0000000000001348

Rithvik Ramesh, Lakshmi Narasimhan Ranganathan

{"title":"Headache in infections.","authors":"Rithvik Ramesh, Lakshmi Narasimhan Ranganathan","doi":"10.1097/WCO.0000000000001348","DOIUrl":"https://doi.org/10.1097/WCO.0000000000001348","url":null,"abstract":"Purpose of review: This review explores the phenomenology, pathogenesis, and nosology of headaches associated with infections, an often-overlooked yet clinically significant symptom. With the increasing recognition of secondary headaches in infections, understanding their clinical patterns, mechanisms, and classifications is crucial for accurate diagnosis and management.Recent findings: Headaches in infections are ubiquitous but vary in presentation, severity, and underlying mechanisms depending on the causative pathogen. Elevated intracranial pressure, meningeal irritation, and activation of the trigeminovascular system are key contributors to headache generation, which varies depending on each pathogen. Pathogen-specific predilection for one of these mechanisms may subtly alter the clinical phenotype of the headache, which can be used to guide management. Emerging evidence highlights postinfectious headache syndromes, particularly following bacterial meningitis and SARS-CoV-2 infection, underscoring the need for long-term follow-up in these patients.Summary: The diverse presentations of infection-related headaches necessitate a systematic approach to evaluation and management. While the pathophysiology is complex and multifaceted, understanding these mechanisms aids in differentiating primary headaches from those secondary to infections.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058068","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