Current Opinion in Neurology最新文献_第9页

Genetic predisposition to autoimmune encephalitis and paraneoplastic neurological syndromes. 自身免疫性脑炎和副肿瘤性神经综合征的遗传易感性。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2024-06-01 Epub Date: 2024-03-14 DOI: 10.1097/WCO.0000000000001263

Sergio Muñiz-Castrillo, Jérôme Honnorat

{"title":"Genetic predisposition to autoimmune encephalitis and paraneoplastic neurological syndromes.","authors":"Sergio Muñiz-Castrillo, Jérôme Honnorat","doi":"10.1097/WCO.0000000000001263","DOIUrl":"10.1097/WCO.0000000000001263","url":null,"abstract":"Purpose of review: We summarize the recent discoveries on genetic predisposition to autoimmune encephalitis and paraneoplastic neurological syndromes (PNS), emphasizing clinical and pathophysiological implications.Recent findings: The human leukocyte antigen (HLA) is the most studied genetic factor in autoimmune encephalitis and PNS. The HLA haplotype 8.1, which is widely known to be related to systemic autoimmunity, has been only weakly associated with a few types of autoimmune encephalitis and PNS. However, the strongest and most specific associations have been reported in a subgroup of autoimmune encephalitis that comprises antileucine-rich glioma-inactivated 1 (LGI1) limbic encephalitis, associated with DRB1∗07 : 01 , anticontactin-associated protein-like 2 (CASPR2) limbic encephalitis, associated with DRB1∗11 : 01 , and anti-IgLON5 disease, associated with DRB1∗10 : 01∼DQA1∗01∼DQB1∗05 . Non-HLA genes have been poorly investigated so far in autoimmune encephalitis, mainly in those lacking HLA associations such as anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis, with only a few genome-wide association studies (GWAS) reporting equivocal results principally limited by small sample size.Summary: Genetic predisposition seems to be driven mostly by HLA in a group of autoimmune encephalitis characterized by being nonparaneoplastic and having predominantly IgG4 autoantibodies. The contribution of non-HLA genes, especially in those diseases lacking known or strong HLA associations, will require large cohorts enabling GWAS to be powerful enough to render meaningful results.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"329-337"},"PeriodicalIF":4.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140119035","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

Neuronal antibodies in nonparaneoplastic autoimmune cerebellar ataxias. 非副肿瘤性自身免疫性小脑共济失调的神经元抗体

IF 4.8 2区医学

Current Opinion in Neurology Pub Date : 2024-06-01 Epub Date: 2024-03-14 DOI: 10.1097/WCO.0000000000001260

Albert Saiz, Francesc Graus

{"title":"Neuronal antibodies in nonparaneoplastic autoimmune cerebellar ataxias.","authors":"Albert Saiz, Francesc Graus","doi":"10.1097/WCO.0000000000001260","DOIUrl":"10.1097/WCO.0000000000001260","url":null,"abstract":"Purpose of review: To describe relevant advances in nonparaneoplastic autoimmune cerebellar ataxias (ACA) with neuronal antibodies.Recent findings: Apart from metabotropic glutamate receptor 1(mGluR1) antibodies, in recent years, the number of neuronal antibodies against surface antigens in ACA has increased with the description of glutamate kainate receptor subunit 2 (GluK2) antibodies in young patients with cerebellitis. Around 20% of patients with contactin-associated protein-like 2 (CASPR2) encephalitis also present prominent cerebellar ataxia. However, isolate cerebellar ataxia is unusual (<4%). Outcome in patients with neuronal antibodies against surface antigens remains suboptimal despite the cerebellar ataxia probably is antibody-mediated.Concerning neuronal antibodies against intracellular antigens, up to 25% of patients with glutamic acid decarboxylase (GAD) antibodies present transient episodes of vertigo or diplopia that antedate the development of the ACA. There is in-vitro evidence that septin-5 is partially exposed to the membrane and the antibodies may interfere with septin-5 function. The clinical significance of the remaining antibodies against intracellular antigens remains unclear.Summary: The number of antibodies against surface antigens is increasing in ACA, but the response to the immunotherapy remains suboptimal. More studies are needed to clarify the role of most of the antibodies against intracellular antigens described in these patients.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"322-328"},"PeriodicalIF":4.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140119036","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

Interest of rare autoantibodies in autoimmune encephalitis and paraneoplastic neurological syndromes: the utility (or futility) of rare antibody discovery. 自身免疫性脑炎和副肿瘤性神经综合征中罕见自身抗体的兴趣：罕见抗体发现的实用性（或徒劳性）。

IF 4.8 2区医学

Current Opinion in Neurology Pub Date : 2024-06-01 Epub Date: 2024-03-26 DOI: 10.1097/WCO.0000000000001261

Yahel Segal, Anastasia Zekeridou

引用次数: 0

Current opinion: Racial and ethnic health disparities in multiple sclerosis: considering the social determinants of health. 当前观点：多发性硬化症的种族和民族健康差异：考虑健康的社会决定因素。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2024-06-01 Epub Date: 2024-03-20 DOI: 10.1097/WCO.0000000000001264

Michael V Robers, Lilyana Amezcua

{"title":"Current opinion: Racial and ethnic health disparities in multiple sclerosis: considering the social determinants of health.","authors":"Michael V Robers, Lilyana Amezcua","doi":"10.1097/WCO.0000000000001264","DOIUrl":"10.1097/WCO.0000000000001264","url":null,"abstract":"Purpose of review: We discuss racial and ethnic disparities in multiple sclerosis (MS), outcomes, and social determinants of health (SDoH). We also provide essential considerations needed to bridge the gap in inequalities, including broader representation of racial and ethnic people in clinical trials and research in general and the inclusion of better measures of living conditions.Recent findings: The incidence and prevalence of MS have become more diverse in the USA. There is increased recognition that racial and ethnic health disparities and inequities exist due to adverse social conditions. Clinical trials have failed to be inclusive and diverse. Training in health disparity is an essential priority of funding sources, and designing clinical trials that consider the barriers these populations face can close significant gaps.Summary: The incidence, prevalence, and awareness of MS have seen an incline in diverse racial and ethnic populations. Health disparities exist in MS with Black, Hispanic, and indigenous populations appearing to have worse outcomes. SDoH play a significant role in causing these health disparities. Accessibility to clinical trials and treatment are barriers these populations face. Strategic and earnest interventions considering SDoH are critically needed to develop solutions that collectively improve health and MS care for all.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"245-251"},"PeriodicalIF":4.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140174102","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

Bruton tyrosine kinase inhibitors in multiple sclerosis: evidence and expectations. 布鲁顿酪氨酸激酶抑制剂在多发性硬化症中的应用：证据与期望。

IF 4.1 2区医学

Current Opinion in Neurology Pub Date : 2024-06-01 Epub Date: 2024-03-27 DOI: 10.1097/WCO.0000000000001269

Julia Krämer, Heinz Wiendl

{"title":"Bruton tyrosine kinase inhibitors in multiple sclerosis: evidence and expectations.","authors":"Julia Krämer, Heinz Wiendl","doi":"10.1097/WCO.0000000000001269","DOIUrl":"10.1097/WCO.0000000000001269","url":null,"abstract":"Purpose of review: Despite availability of high-efficacy therapies for multiple sclerosis (MS), many patients experience significant disability worsening due to limited effects of currently available drugs on central nervous system (CNS)-compartmentalized inflammation. Bruton tyrosine kinase (BTK) is an intracellular signaling molecule involved in regulation of maturation, survival, migration, and activation of B cells and microglia, which are central players in the immunopathogenesis of progressive MS. Therefore, CNS-penetrant BTK inhibitors may better prevent disease progression by targeting immune cells on both sides of the blood-brain barrier. This review gives an overview on the preliminary results of clinical trials.Recent findings: Currently, the efficacy and safety of six BTK inhibitors are being evaluated in clinical trials in patients with relapsing and progressive MS. Evobrutinib, tolebrutinib and fenebrutinib have shown efficacy and safety in relapsing MS in phase 2 studies, and evobrutinib and tolebrutinib in their extension studies up to 3-5 years. However, evobrutinib failed to distinguish itself from the comparator drug teriflunomide in reduction of relapse rate (primary end point) in two phase 3 studies in relapsing MS.Summary: Inhibition of BTK has emerged as a promising therapeutic approach to target the CNS-compartmentalized inflammation. Results from phase 3 clinical trials will shed light on differences in efficacy and safety of BTK inhibitors and its potential role in the future MS landscape.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"237-244"},"PeriodicalIF":4.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140293120","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

Vestibular migraine: an update. 前庭性偏头痛：最新进展。

IF 4.8 2区医学

Current Opinion in Neurology Pub Date : 2024-04-16 DOI: 10.1097/wco.0000000000001257

Maria D Villar-Martinez, Peter J Goadsby

引用次数: 0

Pregnancy and reproductive health in women with multiple sclerosis: an update. 多发性硬化症女性患者的妊娠和生殖健康：最新进展。

IF 4.8 2区医学

Current Opinion in Neurology Pub Date : 2024-04-09 DOI: 10.1097/wco.0000000000001275

Maria K Houtchens

引用次数: 0

Glymphatic system dysfunction in neurodegenerative diseases. 神经退行性疾病中的淋巴系统功能障碍。

IF 4.8 2区医学

Current Opinion in Neurology Pub Date : 2024-04-01 Epub Date: 2024-02-12 DOI: 10.1097/WCO.0000000000001252

Natalie Beschorner, Maiken Nedergaard

引用次数: 0

Recent advances in clinical electroencephalography. 临床脑电图的最新进展。

IF 4.8 2区医学

Current Opinion in Neurology Pub Date : 2024-04-01 Epub Date: 2024-01-17 DOI: 10.1097/WCO.0000000000001246

Birgit Frauscher, Andrea O Rossetti, Sándor Beniczky

{"title":"Recent advances in clinical electroencephalography.","authors":"Birgit Frauscher, Andrea O Rossetti, Sándor Beniczky","doi":"10.1097/WCO.0000000000001246","DOIUrl":"10.1097/WCO.0000000000001246","url":null,"abstract":"Purpose of review: Clinical electroencephalography (EEG) is a conservative medical field. This explains likely the significant gap between clinical practice and new research developments. This narrative review discusses possible causes of this discrepancy and how to circumvent them. More specifically, we summarize recent advances in three applications of clinical EEG: source imaging (ESI), high-frequency oscillations (HFOs) and EEG in critically ill patients.Recent findings: Recently published studies on ESI provide further evidence for the accuracy and clinical utility of this method in the multimodal presurgical evaluation of patients with drug-resistant focal epilepsy, and opened new possibilities for further improvement of the accuracy. HFOs have received much attention as a novel biomarker in epilepsy. However, recent studies questioned their clinical utility at the level of individual patients. We discuss the impediments, show up possible solutions and highlight the perspectives of future research in this field. EEG in the ICU has been one of the major driving forces in the development of clinical EEG. We review the achievements and the limitations in this field.Summary: This review will promote clinical implementation of recent advances in EEG, in the fields of ESI, HFOs and EEG in the intensive care.","PeriodicalId":11059,"journal":{"name":"Current Opinion in Neurology","volume":" ","pages":"134-140"},"PeriodicalIF":4.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139477529","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

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