Current Opinion in Neurology最新文献_第8页

An update on psychogenic nonepileptic seizures. 精神性非癫痫发作的最新进展。

IF 4.8 2区医学

Current Opinion in Neurology Pub Date : 2024-04-01 Epub Date: 2024-01-18 DOI: 10.1097/WCO.0000000000001245

Mithila Vijay, Markus Reuber

{"title":"An update on psychogenic nonepileptic seizures.","authors":"Mithila Vijay, Markus Reuber","doi":"10.1097/WCO.0000000000001245","DOIUrl":"10.1097/WCO.0000000000001245","url":null,"abstract":"Purpose of review: The understanding of psychogenic nonepileptic seizures (PNES) has advanced steadily over recent decades. This update summarizes new insights from the last three years.Recent findings: The process of diagnosing PNES has shifted from the exclusion of epilepsy to one based on the recognition of typical clinical features. While the diagnosis cannot rely on any single feature in isolation, a range of semiological features characterising PNES are now recognised and a number of studies hint at the potential for machine learning and AI to improve the diagnostic process. Advances in data processing and analysis may also help to make sense of the heterogeneity of PNES populations demonstrated by recent studies focussing on aetiology and patient subgroups. It is now clear that PNES are associated with high rates of mental and physical comorbidities and premature death, highlighting that they are only one manifestation of a complex disorder extending beyond the nervous system and the seizures themselves.Summary: PNES are now understood as a manifestation of dysfunction in interacting brain networks. This understanding provides an explanation for the psychopathological and semiological heterogeneity of PNES patient populations. New insights into medical comorbidities and increased rates of premature death call for more research into associated pathological processes outside the nervous system.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"121-126"},"PeriodicalIF":4.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139484615","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

Evidence based noninvasive presurgical evaluation for patients with drug resistant epilepsies. 对耐药性癫痫患者进行循证无创手术前评估。

IF 4.8 2区医学

Current Opinion in Neurology Pub Date : 2024-04-01 Epub Date: 2024-02-14 DOI: 10.1097/WCO.0000000000001253

Eugen Trinka, Matthias Koepp, Gudrun Kalss, Teia Kobulashvili

{"title":"Evidence based noninvasive presurgical evaluation for patients with drug resistant epilepsies.","authors":"Eugen Trinka, Matthias Koepp, Gudrun Kalss, Teia Kobulashvili","doi":"10.1097/WCO.0000000000001253","DOIUrl":"10.1097/WCO.0000000000001253","url":null,"abstract":"Purpose of review: To review the current practices and evidence for the diagnostic accuracy and the benefits of presurgical evaluation.Recent findings: Preoperative evaluation of patients with drug-resistant focal epilepsies and subsequent epilepsy surgery leads to a significant proportion of seizure-free patients. Even those who are not completely seizure free postoperatively often experience improved quality of life with better social integration. Systematic reviews and meta-analysis on the diagnostic accuracy are available for Video-electroencephalographic (EEG) monitoring, magnetic resonance imaging (MRI), electric and magnetic source imaging, and functional MRI for lateralization of language and memory. There are currently no evidence-based international guidelines for presurgical evaluation and epilepsy surgery.Summary: Presurgical evaluation is a complex multidisciplinary and multiprofessional clinical pathway. We rely on limited consensus-based recommendations regarding the required staffing or methodological expertise in epilepsy centers.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"141-151"},"PeriodicalIF":4.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139706355","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

Ambulatory seizure detection. 移动式癫痫发作检测。

IF 4.8 2区医学

Current Opinion in Neurology Pub Date : 2024-04-01 Epub Date: 2024-02-07 DOI: 10.1097/WCO.0000000000001248

Adriano Bernini, Jonathan Dan, Philippe Ryvlin

{"title":"Ambulatory seizure detection.","authors":"Adriano Bernini, Jonathan Dan, Philippe Ryvlin","doi":"10.1097/WCO.0000000000001248","DOIUrl":"10.1097/WCO.0000000000001248","url":null,"abstract":"Purpose of review: To review recent advances in the field of seizure detection in ambulatory patients with epilepsy.Recent findings: Recent studies have shown that wrist or arm wearable sensors, using 3D-accelerometry, electrodermal activity or photoplethysmography, in isolation or in combination, can reliably detect focal-to-bilateral and generalized tonic-clonic seizures (GTCS), with a sensitivity over 90%, and false alarm rates varying from 0.1 to 1.2 per day. A headband EEG has also demonstrated a high sensitivity for detecting and help monitoring generalized absence seizures. In contrast, no appropriate solution is yet available to detect focal seizures, though some promising findings were reported using ECG-based heart rate variability biomarkers and subcutaneous EEG.Summary: Several FDA and/or EU-certified solutions are available to detect GTCS and trigger an alarm with acceptable rates of false alarms. However, data are still missing regarding the impact of such intervention on patients' safety. Noninvasive solutions to reliably detect focal seizures in ambulatory patients, based on either EEG or non-EEG biosignals, remain to be developed. To this end, a number of challenges need to be addressed, including the performance, but also the transparency and interpretability of machine learning algorithms.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"99-104"},"PeriodicalIF":4.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139702014","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

Recent advances in Alzheimer disease genetics. 阿尔茨海默病遗传学的最新进展。

IF 4.8 2区医学

Current Opinion in Neurology Pub Date : 2024-04-01 Epub Date: 2024-01-19 DOI: 10.1097/WCO.0000000000001242

Gaël Nicolas

{"title":"Recent advances in Alzheimer disease genetics.","authors":"Gaël Nicolas","doi":"10.1097/WCO.0000000000001242","DOIUrl":"10.1097/WCO.0000000000001242","url":null,"abstract":"Purpose of review: Genetics studies provide important insights into Alzheimer disease (AD) etiology and mechanisms. Critical advances have been made recently, mainly thanks to the access to novel techniques and larger studies.Recent findings: In monogenic AD, progress has been made with a better understanding of the mechanisms associated with pathogenic variants and the input of clinical studies in presymptomatic individuals. In complex AD, increasing sample sizes in both DNA chip-based (genome-wide association studies, GWAS) and exome/genome sequencing case-control studies unveiled novel common and rare risk factors, while the understanding of their combined effect starts to suggest the existence of rare families with oligogenic inheritance of early-onset, nonmonogenic, AD.Summary: Most genetic risk factors with a known consequence designate the aggregation of the Aβ peptide as a core etiological factor in complex AD thus confirming that the research based on monogenic AD - where the amyloid cascade seems more straightforward - is relevant to complex AD as well. Novel mechanistic insights and risk factor studies unveiling novel factors and attempting to combine the effect of common and rare variants will offer promising perspectives for future AD prevention, at least regarding early-onset AD, and probably in case of later onset as well.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"154-165"},"PeriodicalIF":4.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139484625","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

Update on modifiable risk factors for Alzheimer's disease and related dementias. 阿尔茨海默病及相关痴呆症可改变风险因素的最新进展。

IF 4.8 2区医学

Current Opinion in Neurology Pub Date : 2024-04-01 Epub Date: 2024-01-24 DOI: 10.1097/WCO.0000000000001243

Methasit Jaisa-Aad, Clara Muñoz-Castro, Alberto Serrano-Pozo

{"title":"Update on modifiable risk factors for Alzheimer's disease and related dementias.","authors":"Methasit Jaisa-Aad, Clara Muñoz-Castro, Alberto Serrano-Pozo","doi":"10.1097/WCO.0000000000001243","DOIUrl":"10.1097/WCO.0000000000001243","url":null,"abstract":"Purpose of review: All human beings undergo a lifelong cumulative exposure to potentially preventable adverse factors such as toxins, infections, traumatisms, and cardiovascular risk factors, collectively termed exposome. The interplay between the individual's genetics and exposome is thought to have a large impact in health outcomes such as cancer and cardiovascular disease. Likewise, a growing body of evidence is supporting the idea that preventable factors explain a sizable proportion of Alzheimer's disease and related dementia (ADRD) cases.Recent findings: Here, we will review the most recent epidemiological, experimental preclinical, and interventional clinical studies examining some of these potentially modifiable risk factors for ADRD. We will focus on new evidence regarding cardiovascular risk factors, air pollution, viral and other infectious agents, traumatic brain injury, and hearing loss.Summary: While greater and higher quality epidemiological and experimental evidence is needed to unequivocally confirm their causal link with ADRD and/or unravel the underlying mechanisms, these modifiable risk factors may represent a window of opportunity to reduce ADRD incidence and prevalence at the population level via health screenings, and education and health policies.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"166-181"},"PeriodicalIF":4.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10932854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139540875","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: Epilepsy advances in 2023. 社论：2023 年的癫痫进展。

IF 4.8 2区医学

Current Opinion in Neurology Pub Date : 2024-04-01 Epub Date: 2024-03-07 DOI: 10.1097/WCO.0000000000001251

Philippe Ryvlin

引用次数: 0

Somatic mosaicism in focal epilepsies. 局灶性癫痫的体细胞镶嵌。

IF 4.8 2区医学

Current Opinion in Neurology Pub Date : 2024-04-01 Epub Date: 2024-01-18 DOI: 10.1097/WCO.0000000000001244

Samuel Gooley, Piero Perucca, Caitlin Tubb, Michael S Hildebrand, Samuel F Berkovic

{"title":"Somatic mosaicism in focal epilepsies.","authors":"Samuel Gooley, Piero Perucca, Caitlin Tubb, Michael S Hildebrand, Samuel F Berkovic","doi":"10.1097/WCO.0000000000001244","DOIUrl":"10.1097/WCO.0000000000001244","url":null,"abstract":"Purpose of review: Over the past decade, it has become clear that brain somatic mosaicism is an important contributor to many focal epilepsies. The number of cases and the range of underlying pathologies with somatic mosaicism are rapidly increasing. This growth in somatic variant discovery is revealing dysfunction in distinct molecular pathways in different focal epilepsies.Recent findings: We briefly summarize the current diagnostic yield of pathogenic somatic variants across all types of focal epilepsy where somatic mosaicism has been implicated and outline the specific molecular pathways affected by these variants. We will highlight the recent findings that have increased diagnostic yields such as the discovery of pathogenic somatic variants in novel genes, and new techniques that allow the discovery of somatic variants at much lower variant allele fractions.Summary: A major focus will be on the emerging evidence that somatic mosaicism may contribute to some of the more common focal epilepsies such as temporal lobe epilepsy with hippocampal sclerosis, which could lead to it being re-conceptualized as a genetic disorder.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"105-114"},"PeriodicalIF":4.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139484720","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

Predictive models of epilepsy outcomes. 癫痫预后预测模型。

IF 4.8 2区医学

Current Opinion in Neurology Pub Date : 2024-04-01 Epub Date: 2024-01-15 DOI: 10.1097/WCO.0000000000001241

Shehryar Sheikh, Lara Jehi

{"title":"Predictive models of epilepsy outcomes.","authors":"Shehryar Sheikh, Lara Jehi","doi":"10.1097/WCO.0000000000001241","DOIUrl":"10.1097/WCO.0000000000001241","url":null,"abstract":"Purpose of review: Multiple complex medical decisions are necessary in the course of a chronic disease like epilepsy. Predictive tools to assist physicians and patients in navigating this complexity have emerged as a necessity and are summarized in this review.Recent findings: Nomograms and online risk calculators are user-friendly and offer individualized predictions for outcomes ranging from safety of antiseizure medication withdrawal (accuracy 65-73%) to seizure-freedom, naming, mood, and language outcomes of resective epilepsy surgery (accuracy 72-81%). Improving their predictive performance is limited by the nomograms' inability to ingest complex data inputs. Conversely, machine learning offers the potential of multimodal and expansive model inputs achieving human-expert level accuracy in automated scalp electroencephalogram (EEG) interpretation but lagging in predictive performance or requiring validation for other applications.Summary: Good to excellent predictive models are now available to guide medical and surgical epilepsy decision-making with nomograms offering individualized predictions and user-friendly tools, and machine learning approaches offering the potential of improved performance. Future research is necessary to bridge the two approaches for optimal translation to clinical care.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"115-120"},"PeriodicalIF":4.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139466216","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: Degenerative and cognitive diseases. 社论：退化性疾病和认知疾病。

IF 4.8 2区医学

Current Opinion in Neurology Pub Date : 2024-04-01 Epub Date: 2024-03-07 DOI: 10.1097/WCO.0000000000001250

David Wallon

引用次数: 0

Prevention of epileptogenesis - are we there yet? 预防癫痫发生--我们做到了吗？

IF 4.8 2区医学

Current Opinion in Neurology Pub Date : 2024-02-13 DOI: 10.1097/WCO.0000000000001256

Matthias Koepp, Eugen Trinka, Wolfgang Löscher, Pavel Klein

引用次数: 0