Current Opinion in Neurology最新文献_第9页

Gauging and controlling excitability in cortical disorders. 皮质紊乱中兴奋性的测量和控制。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2025-04-01 Epub Date: 2025-02-17 DOI: 10.1097/WCO.0000000000001345

Cecilia Friedrichs-Maeder, Grégory Lepeu, Maxime O Baud

{"title":"Gauging and controlling excitability in cortical disorders.","authors":"Cecilia Friedrichs-Maeder, Grégory Lepeu, Maxime O Baud","doi":"10.1097/WCO.0000000000001345","DOIUrl":"10.1097/WCO.0000000000001345","url":null,"abstract":"Purpose of review: Cortical excitability, defined as the cortex's responsiveness to incoming stimuli, is a fundamental concept in neuroscience and a targetable mechanism for controlling brain dysfunctions such as epilepsy, as well as other neurological and psychiatric disorders. In this review, we delineate the boundaries between physiological and pathological excitability, highlighting recent theoretical, experimental, and translational advances relevant to human brain disorders. Specifically, we describe the dynamic regulation of cortical excitability and propose practical means to monitor its known fluctuations as to guide therapeutic interventions.Recent findings: From a conceptual standpoint, the last decade of research on cortical excitability has benefited from dynamical systems theory, which studies the behavior of nonlinear systems (here, the cortex) and their resilience to perturbations in different conditions (here, variable excitability). We review how fundamental relationships between excitability and resilience were verified in the brain in a series of recent studies. We also review natural fluctuations in cortical excitability, and how these may open windows of vulnerability for the expression of cortical dysfunctions. We then turn to the practicalities of measuring and monitoring cortical excitability, a latent variable that must be actively probed.Summary: Practical means for gauging cortical excitability likely have broad applicability. To enable new developments in clinical practice, a principled design of pharmacological and neurostimulation therapies must leverage current understanding of cortical dynamics.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"140-150"},"PeriodicalIF":4.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440164","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

Seizure prediction and forecasting: a scoping review. 癫痫发作预测与预报：范围综述。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2025-04-01 Epub Date: 2025-01-20 DOI: 10.1097/WCO.0000000000001344

Joshua C Cheng, Daniel M Goldenholz

{"title":"Seizure prediction and forecasting: a scoping review.","authors":"Joshua C Cheng, Daniel M Goldenholz","doi":"10.1097/WCO.0000000000001344","DOIUrl":"10.1097/WCO.0000000000001344","url":null,"abstract":"Purpose of review: This scoping review summarizes key developments in the field of seizure forecasting.Recent findings: Developments have been made along several modalities of seizure forecasting, including long term intracranial and subcutaneous encephalogram, wearable physiologic monitoring, and seizure diaries. However, clinical translation of these tools is limited by various factors. One is the lack of validation of these tools on an external dataset. Moreover, the widespread practice of comparing models to a chance forecaster may be inadequate. Instead, the model should be able to at least surpass a moving average forecaster, which serves as a 'napkin test' (i.e., can be computed on the back of a napkin). The impact of seizure frequency on model performance should also be accounted for when comparing performance across studies. Surprisingly, despite the potential for poor quality forecasts, some individuals with epilepsy still want access to imprecise forecasts and some even alter their behavior based upon them.Summary: Promising advances have been made in the development of tools for seizure forecasting, but current tools have not yet overcome clinical translation hurdles. Future studies will need to address potentially dangerous patient behaviors as well as account for external validation, the napkin test, seizure frequency dependent metrics.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"135-139"},"PeriodicalIF":4.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001795","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 trend in air pollution exposure and stroke. 空气污染暴露与中风的当前趋势。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2025-02-01 Epub Date: 2024-12-02 DOI: 10.1097/WCO.0000000000001331

Stephan Gabet, Laurent Puy

{"title":"Current trend in air pollution exposure and stroke.","authors":"Stephan Gabet, Laurent Puy","doi":"10.1097/WCO.0000000000001331","DOIUrl":"10.1097/WCO.0000000000001331","url":null,"abstract":"Purpose of review: Stroke is the second leading cause of death worldwide, and exposure to particulate air pollution is now recognized as one of the major modifiable risk factors. However, air pollution can vary in terms of physicochemical composition and exposition specificities. Therefore, its relationships with stroke outcomes remain under intense investigation.Recent findings: This review highlights, alongside particles, that short-term and long-term exposure to nitrogen dioxide (NO 2 ) and ozone is likely to be also linked to stroke-related morbidity and mortality. Moreover, air pollution may increase the risk of transitioning from a healthy status to incident stroke and morbimortality after stroke. Additionally, relationships may vary depending on the air pollution mixture (e.g., particle-related components, pollutant interactions), pollutant sources (e.g., traffic-related or not), stroke etiology (ischemic or hemorrhagic), or exposed individual's characteristics (e.g., age, sex, genetic predisposition, weight status). Nonlinear dose-response functions and short-term effect lags have been reported, but these features need further refinement.Summary: The relationship between stroke and air pollution is now well established. Nonetheless, future research should further consider the physicochemical properties of air pollutants, multiple exposures, and individual vulnerabilities. Moreover, advanced statistical methods should be more commonly used to better describe the relationship shapes.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"54-61"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602684","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

Optical coherence tomography: implications for neurology. 光学相干断层扫描：对神经学的影响。

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.0000000000001340

Abdullah Al-Ani, Étienne Benard-Seguin, Fiona Costello

{"title":"Optical coherence tomography: implications for neurology.","authors":"Abdullah Al-Ani, Étienne Benard-Seguin, Fiona Costello","doi":"10.1097/WCO.0000000000001340","DOIUrl":"10.1097/WCO.0000000000001340","url":null,"abstract":"Purpose of review: This article explores the role of optical coherence tomography (OCT) in neurology practice, particularly in diagnosing and monitoring conditions such as papilledema, optic neuritis, and retinal artery occlusion. OCT has been increasingly utilized as a noninvasive and effective tool for detecting and monitoring neuroaxonal damage in the visual pathway, which is important for early intervention and improved patient outcomes across a variety of neurologic conditions.Recent findings: OCT as an imaging modality continues to demonstrate its utility in quantifying optic nerve and retinal changes reflecting neuroaxonal injury, including, peripapillary retinal nerve fiber layer (pRNFL) thickness and macular ganglion cell layer thickness (or volume). This review focuses on recent evidence regarding the utilization of this modality in diagnosing, monitoring, and quantifying treatment responses in patients with papilledema, optic neuritis, and retinal artery occlusion. Advances in OCT technology, including deep learning algorithms, continue to enhance the diagnostic accuracy and predictive capabilities in the field of neuro-ophthalmology.Summary: In recent years, OCT has become an essential tool in neuro-ophthalmic assessment, offering precise structural and anatomical assessments that support diagnosis, treatment planning, and monitoring of conditions affecting the visual pathway. Ongoing advances in OCT technology are expected to further enhance its clinical utility.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"62-70"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863539","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 portable, low-field magnetic resonance imaging in cerebrovascular disease. 便携式低场磁共振成像在脑血管疾病中的最新进展。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2025-02-01 Epub Date: 2024-12-02 DOI: 10.1097/WCO.0000000000001338

Julia Zabinska, Adam de Havenon, Kevin N Sheth

{"title":"Recent advances in portable, low-field magnetic resonance imaging in cerebrovascular disease.","authors":"Julia Zabinska, Adam de Havenon, Kevin N Sheth","doi":"10.1097/WCO.0000000000001338","DOIUrl":"10.1097/WCO.0000000000001338","url":null,"abstract":"Purpose of review: This review aims to describe recent advances in low-field (0.064 T) magnetic resonance imaging (LF-MRI) of cerebrovascular disease, including ischemic and hemorrhagic stroke and white matter hyperintensities.Recent findings: Since 2023, several studies have highlighted the rapidly changing landscape of portable, low-field MRI (LF-MRI) and its applications in stroke and cerebrovascular disease. The advantages of using LF-MRI in these settings are multifold: cheaper and dynamic imaging of this patient population confers closer observation during the acute and chronic stages of cerebrovascular disease. Initial deployments of the device span a variety of acute and emergency settings, including imaging around thrombolytic administration, endovascular reperfusion, intracerebral hemorrhage management, and cardiovascular intensive care. LF-MRI also has an important role in cerebrovascular disease monitoring and prevention, namely white matter hyperintensity (WMH) progression and vascular and Alzheimer's dementia. Early studies suggest reliable sensitivity and specificity for these pathologies. With further improvements to LF-MRI hardware, software and postprocessing on the horizon, we anticipate the device's ability to provide inexpensive and flexible neuroimaging to a wide array of healthcare settings that treat, prevent, and manage cerebrovascular disease.Summary: Recent studies indicate that LF-MRI promotes rapid, cost-effective, and clinically useful neuroimaging at various clinical timepoints throughout stroke and cerebrovascular disease progression and management.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"35-39"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767360","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

Cerebral amyloid angiopathy: one single entity? 脑淀粉样血管病：一个单一的实体？

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2025-02-01 Epub Date: 2024-11-11 DOI: 10.1097/WCO.0000000000001330

Emma A Koemans, Ellis S van Etten

{"title":"Cerebral amyloid angiopathy: one single entity?","authors":"Emma A Koemans, Ellis S van Etten","doi":"10.1097/WCO.0000000000001330","DOIUrl":"https://doi.org/10.1097/WCO.0000000000001330","url":null,"abstract":"Purpose of review: Cerebral amyloid angiopathy (CAA) is a common brain disorder among the elderly and individuals with Alzheimer's disease, where accumulation of amyloid-ß can lead to intracerebral hemorrhage and dementia. This review discusses recent developments in understanding the pathophysiology and phenotypes of CAA.Recent findings: CAA has a long preclinical phase starting decades before symptoms emerge. Its pathophysiology follows consecutive stages of amyloid-ß deposition, decreased vascular reactivity, nonhemorrhagic changes, and ultimately hemorrhages. Although impaired perivascular clearance is the leading hypothesis underlying CAA, several lines of evidence suggest that glymphatic dysfunction also plays a significant role in the disease process. Despite its common pathway, the disease course is variable. Some patients develop more microbleeds, while others develop larger hemorrhages, suggesting a differentiation in vascular remodeling. Some patients with CAA develop a symptomatic immune response, and inflammation could be an important contributor to vascular damage in CAA in general. Furthermore, the prion-like transmission of amyloid-β has been identified as a cause of iatrogenic CAA occurring decades after neurosurgical procedures involving cadaveric dura mater.Summary: Emerging evidence of sporadic, hereditary, inflammatory, and iatrogenic CAA suggests a complex interplay between brain clearance, inflammation and vascular remodeling leading to a diverse clinical phenotype.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":"38 1","pages":"29-34"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930107","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

The optic nerve in spaceflight: novel concepts in the pathogenesis of optic disc edema in microgravity. 太空飞行中的视神经：微重力下视盘水肿发病机制的新概念。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2025-02-01 Epub Date: 2024-12-04 DOI: 10.1097/WCO.0000000000001334

Cihan M Kadipasaoglu, Virginia A Lee, Joshua Ong, Andrew G Lee

{"title":"The optic nerve in spaceflight: novel concepts in the pathogenesis of optic disc edema in microgravity.","authors":"Cihan M Kadipasaoglu, Virginia A Lee, Joshua Ong, Andrew G Lee","doi":"10.1097/WCO.0000000000001334","DOIUrl":"10.1097/WCO.0000000000001334","url":null,"abstract":"Purpose of review: Spaceflight-associated neuro-ocular syndrome (SANS) encompasses a unique constellation of neuro-ocular findings in astronauts, including optic disc edema (ODE), globe flattening, chorioretinal folds, and hyperopic refractive shift. Although there are numerous neuro-ocular findings in SANS, the purpose of this review is to describe the novel, emerging concepts of the pathogenesis for the ODE specifically in SANS.Recent findings: While the initial hypotheses on the pathogenesis of ODE in SANS focused on possible elevated intracranial pressures (i.e., papilledema), the most prominent current hypothesis is microgravity-induced cephalad fluid shift. More recent studies however suggest that the pathogenesis of the ODE in SANS is likely multifactorial including possible underlying metabolic and genetic components.Summary: We review the literature on ODE in SANS including recent work integrating the complex physiologic interactions of microgravity-induced disruption in intracerebral and intraocular fluid dynamics, vascular congestion, cellular stress responses, and genetic predisposition. We believe that the development of ODE in SANS is likely multifactorial in origin, and further understanding of the mechanical, cellular, metabolic, and genetic components is of utmost importance to develop future countermeasures in preparation for possible future crewed missions to the moon, the asteroid belt, and Mars.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"87-95"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767363","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

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