Massimo Filippi, Alma Ghirelli, Edoardo Gioele Spinelli, Federica Agosta
{"title":"A comprehensive update on neuroimaging endpoints in amyotrophic lateral sclerosis.","authors":"Massimo Filippi, Alma Ghirelli, Edoardo Gioele Spinelli, Federica Agosta","doi":"10.1080/14737175.2025.2470324","DOIUrl":"10.1080/14737175.2025.2470324","url":null,"abstract":"<p><strong>Introduction: </strong>There are currently few treatments approved for amyotrophic lateral sclerosis (ALS). Additionally, there remains a significant unmet need for reliable, standardized biomarkers to assess endpoints in clinical trials. Magnetic resonance imaging (MRI)- and positron emission tomography (PET)-derived metrics could help in patient selection and stratification, shortening trial duration and reducing costs.</p><p><strong>Areas covered: </strong>This review focuses on the potential use of neuroimaging endpoints in the context of ALS therapeutic trials, providing insights on structural and functional neuroimaging, plexus and muscle alterations, glial involvement and neuroinflammation, envisioning how these surrogates of disease progression could be implemented in clinical trials. A PubMed search covering the past 15 years was performed.</p><p><strong>Expert opinion: </strong>Neuroimaging is essential in understanding ALS pathophysiology, aiding in disease progression tracking and evaluating therapeutic interventions. High costs, limited accessibility, lack of standardization, and patient tolerability limit their use in routine ALS care. Addressing these obstacles is essential for fully harnessing neuroimaging potential in improving diagnostics and treatment in ALS.</p>","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":"1-17"},"PeriodicalIF":3.4,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476479","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}
Luis Arturo Sanchez Trujillo, Martha Eugenia Pastrana, Javier Andres Galnares Olalde, Alejandro Marfil, Luis Roberto Partida Medina, Manuel Gudiño Castelazo, Mariana Osorio-Hernandez, Nohemi Caballero, Guilherme Silva Julian
{"title":"The burden of migraine in Mexico: a database analysis of migraine-related visits to emergency departments in Mexico's ministry of health (MMoH) hospitals.","authors":"Luis Arturo Sanchez Trujillo, Martha Eugenia Pastrana, Javier Andres Galnares Olalde, Alejandro Marfil, Luis Roberto Partida Medina, Manuel Gudiño Castelazo, Mariana Osorio-Hernandez, Nohemi Caballero, Guilherme Silva Julian","doi":"10.1080/14737175.2025.2474557","DOIUrl":"https://doi.org/10.1080/14737175.2025.2474557","url":null,"abstract":"<p><strong>Background: </strong>The burden of migraine in Mexican Emergency Department (ED) settings remains understudied. This study aimed to determine the frequency of migraine-related ED visits within the ED Mexican Ministry of Health's (MMoH) database and analyze their demographics and treatment patterns.</p><p><strong>Research design and methods: </strong>This retrospective study analyzed MMoH database of ED visits between 2013 and 2022. Visits with migraine diagnosis were selected using ICD-10 codes. Demographic characteristics, geographical location, and time of consultation were described, medication use patterns were analyzed.</p><p><strong>Results: </strong>Between 2013 and 2022, there were 1,022,450 reported ED visits related to primary headache (0.6% of all ED visits), there were 179,618 migraine-related ED visits (19% of all headache visits). Females represented 78% of visits. Visits peaked in 2014 (20,066) and were the lowest in 2019 (8,273). Medication was used in 21% of visits, NSAIDs being the most frequent (15%). Triptan use was low (0.04% of all migraine visits).</p><p><strong>Conclusion: </strong>Our results highlight the significant burden of migraines on Mexico's healthcare system and the importance of considering age and sex in the approach to migraine ED visits. An update in therapeutic strategies for migraine in Mexico is needed to improve patient outcomes.</p>","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604442","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}
{"title":"Charcot-Marie-Tooth disease: a review of clinical developments and its management - What's new in 2025?","authors":"Amedeo De Grado, Marina Serio, Paola Saveri, Chiara Pisciotta, Davide Pareyson","doi":"10.1080/14737175.2025.2470980","DOIUrl":"10.1080/14737175.2025.2470980","url":null,"abstract":"<p><strong>Introduction: </strong>Charcot-Marie-Tooth disease (CMT) understanding and diagnostic rates are improving. Symptomatic management is still the only option, but many therapeutic approaches are under investigation, some in the clinical trial phase.</p><p><strong>Areas covered: </strong>Through a comprehensive search in PubMed, the ClinicalTrials.gov website, and the latest abstracts on the topic, the authors review the diagnostic advances and promising treatments, focusing on pharmacological and gene therapy/silencing approaches, and on clinical trial challenges. They also review current CMT management, including rehabilitation, orthotics, and associated symptoms and comorbidities.</p><p><strong>Expert opinion: </strong>The CMT field is evolving rapidly, with significant advances in genetic diagnosis and disease recognition. International networks and patient organization partnerships are vital for progress, enabling collaboration and large-scale studies. Metabolic neuropathies are relatively easier to target, and interim analysis results from the CMT-SORD trial suggest govorestat may become the first approved CMT drug. Gene therapy shows promise but currently faces safety and targeting challenges; PMP22 silencers for CMT1A are close to being tested in patients. New drugs, such as HDAC6 inhibitors, are also approaching the clinical trial phase, despite existing hurdles. Supportive care, including rehabilitation and orthotics, continues to improve quality of life. There is optimism that within the next decade, approved therapies will reduce disease burden.</p>","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":"1-16"},"PeriodicalIF":3.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523037","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}
{"title":"Treating subependymal giant cell astrocytoma in patients with tuberous sclerosis complex: an update of the literature.","authors":"David M Ritter, Sara Twardowski, David N Franz","doi":"10.1080/14737175.2025.2472922","DOIUrl":"https://doi.org/10.1080/14737175.2025.2472922","url":null,"abstract":"<p><strong>Introduction: </strong>Subependymal giant cell astrocytomas (SEGAs) are one of the predominant features of the tuberous sclerosis complex (TSC). Before the use of mTOR inhibitors (mTORi; everolimus and sirolimus) in TSC, many patients had to undergo surgical operations (both preemptively and emergently). However, with mTORis gaining increased use, the role of medical and surgical therapy in SEGA is unclear.</p><p><strong>Areas covered: </strong>The authors have based this review on publications listed in PubMed that delve into the role of surgery and mTORi in the treatment of SEGAs.</p><p><strong>Expert opinion: </strong>There is no sizable head-to-head comparison of surgery and medical therapy in treating SEGA. Factors that reduce the ability to do these types of studies are the lack of uniform diagnosis of SEGA, provider preference for treatment, and variability in each treatment group (dosing of mTORis and various surgical providers). However, with the safety of mTORi, the authors recommend starting mTORi therapy for any growth in a nodule on serial scans and relying on surgery only for failed mTORi therapy.</p>","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":"1-8"},"PeriodicalIF":3.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572546","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}
Filippo Migliorini, Marco Pilone, Jörg Eschweiler, Dragana Katusic, Michael Kurt Memminger, Nicola Maffulli
{"title":"Therapeutic strategies that modulate the acute phase of secondary spinal cord injury scarring and inflammation and improve injury outcomes.","authors":"Filippo Migliorini, Marco Pilone, Jörg Eschweiler, Dragana Katusic, Michael Kurt Memminger, Nicola Maffulli","doi":"10.1080/14737175.2025.2470326","DOIUrl":"https://doi.org/10.1080/14737175.2025.2470326","url":null,"abstract":"<p><strong>Introduction: </strong>The acute phase of secondary spinal cord injury (SCI) is a crucial therapeutic window to mitigate ongoing damage and promote tissue repair. The present systematic review critically evaluates the efficacy and safety of current management modalities for this phase, identifying gaps in knowledge and providing insights for future research directions.</p><p><strong>Methods: </strong>In December 2024, PubMed, Web of Science, Google Scholar, and Embase were accessed with no time constraints. All the clinical studies investigating the pharmacological management of secondary SCI were accessed.</p><p><strong>Results: </strong>Data from 3017 patients (385 women) were collected. The mean length of the follow-up was 6 ± 3.4 months, and the mean age of the patients was 43.3 ± 10.3 years.</p><p><strong>Conclusion: </strong>Erythropoietin (EPO) improves motor function, reduces impairment in secondary spinal cord injury, modulates antioxidation and neurogenesis, and minimizes apoptosis and inflammation. Although commonly administered, methylprednisolone shows uncertain efficacy. The rho-GTPases inhibitor VX-210 and levetiracetam did not demonstrate effectiveness in treatment. Monosialotetrahexosylganglioside Sodium Salt (GM-1) and riluzole are associated with favorable neurological outcomes. Granulocyte Colony-Stimulating Factor (G-CSF) and Hepatocyte Growth Factor (HGF) offer improved motor scores with fewer side effects.</p>","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556372","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}
Gianluca D'Onofrio, Gianmichele Villano, Giovanni Dell'isola, Alberto Verrotti, Pasquale Striano
{"title":"Neuromodulation as a treatment strategy in Lennox-Gastaut syndrome: evidence and future directions.","authors":"Gianluca D'Onofrio, Gianmichele Villano, Giovanni Dell'isola, Alberto Verrotti, Pasquale Striano","doi":"10.1080/14737175.2025.2474560","DOIUrl":"10.1080/14737175.2025.2474560","url":null,"abstract":"","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":"1-4"},"PeriodicalIF":3.4,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531569","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}
{"title":"Advances in the early diagnosis of amyotrophic lateral sclerosis.","authors":"Pilar H García-Casanova, Juan F Vázquez-Costa","doi":"10.1080/14737175.2025.2471556","DOIUrl":"10.1080/14737175.2025.2471556","url":null,"abstract":"<p><strong>Introduction: </strong>Amyotrophic lateral sclerosis (ALS) is a rapidly progressing neurodegenerative disease. Despite rapid disease progression, diagnostic delay of 10-16 months persists, influenced by disease-specific factors and healthcare systems. Reducing it is crucial for early intervention, multidisciplinary care planning, and patient participation in clinical trials.</p><p><strong>Areas covered: </strong>The authors review relevant studies identified through PubMed from 1990 to 2024. The article explores factors contributing to diagnostic delay, the importance of early diagnosis, and strategies for improvement, including the role of diagnostic criteria and biomarkers.</p><p><strong>Expert opinion: </strong>Diagnosis of ALS remains clinical, with clinical expertise as the main modifiable factor in the diagnostic delay. Some biomarkers may be useful to speed up diagnosis at an earlier stage of the disease and in patients with atypical presentations or co-morbidities. However, the use of biomarkers for ALS diagnosis in clinical practice is far from being established and poses considerable challenges, including the lack of disease-specific biomarkers and the potential for delayed results. Until disease-specific biomarkers become available, early referral to ALS specialists, together with physician education programs, will remain the main tools to reduce diagnostic delay in the next years.</p>","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":"1-11"},"PeriodicalIF":3.4,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143500098","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}
Timoteo Almeida, Jheremy S Reyes, Sydney E Scanlon, Stephen C Frederico, Sakibul Huq, Costas G Hadjipanayis
{"title":"Laser interstitial thermal therapy for recurrent brain metastases following stereotactic radiosurgery: a systematic review.","authors":"Timoteo Almeida, Jheremy S Reyes, Sydney E Scanlon, Stephen C Frederico, Sakibul Huq, Costas G Hadjipanayis","doi":"10.1080/14737175.2025.2471551","DOIUrl":"10.1080/14737175.2025.2471551","url":null,"abstract":"<p><strong>Introduction: </strong>Laser Interstitial Thermal Therapy (LITT) has emerged as a promising minimally invasive treatment option for recurrent brain metastases, especially for patients who have previously undergone Stereotactic Radiosurgery (SRS). Despite its growing use, additional research is needed to explore its utility and safety in this population.</p><p><strong>Methods: </strong>This systematic review evaluates the literature on LITT for recurrent brain metastases post-SRS, including patient selection, treatment protocols, outcomes, and complications. The review was registered with PROSPERO (CRD42024577899) and followed the PRISMA 2020 guidelines.</p><p><strong>Results: </strong>Seventeen studies, encompassing 694 patients, met our inclusion criteria. The median overall survival (OS) across these studies was 14.4 months with an average 12-month OS of 60.1%. Notably, median OS was 5.9 months after LITT alone and 12.7 months when LITT was followed by adjuvant SRS. The pooled local control rate was 75.6% at 6 months and 72.2% at 12 months.</p><p><strong>Conclusion: </strong>LITT is a minimally invasive treatment option that has shown potential in managing recurrent brain metastases after prior SRS, particularly when biopsy is required to differentiate between tumor recurrence and radiation necrosis. However, data on the comparative efficacy and cost-effectiveness of LITT versus alternative treatments such as repeat SRS or craniotomy remain limited.</p>","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":"1-11"},"PeriodicalIF":3.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482568","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}
Stefania Chiappini, Gaia Sampogna, Antonio Ventriglio, Giulia Menculini, Valerio Ricci, Mauro Pettorruso, Umberto Volpe, Giovanni Martinotti
{"title":"Emerging strategies and clinical recommendations for the management of novel depression subtypes.","authors":"Stefania Chiappini, Gaia Sampogna, Antonio Ventriglio, Giulia Menculini, Valerio Ricci, Mauro Pettorruso, Umberto Volpe, Giovanni Martinotti","doi":"10.1080/14737175.2025.2470973","DOIUrl":"https://doi.org/10.1080/14737175.2025.2470973","url":null,"abstract":"<p><strong>Introduction: </strong>The phenomenology of depression is characterized by a wide array of emotional, cognitive, and physical symptoms that significantly disrupt an individual's life. Societal changes, driven by technological advancements, economic pressures, environmental concerns including climate change, and shifting cultural norms, have influenced how depression manifests and is understood. These developments have led to the identification of new depression subtypes, highlighting the need for personalized treatment approaches based on individual symptoms and underlying causes.</p><p><strong>Areas covered: </strong>The authors provide a comprehensive narrative review of the literature on managing novel depression subtypes, focusing on both pharmacological and non-pharmacological treatments. Specifically, scenarios recorded were related to i) depression in adolescents and young adults; ii) depression and social disconnection; iii) depression and alcohol/substance use disorder; iv) depression and gender dysphoria; v) depression, stressful events, and other environmental factors.</p><p><strong>Expert opinion: </strong>In the novel depression subtypes discussed, individualized treatment approaches tailored to the individual's specific circumstances are necessary. While selective serotonin reuptake inhibitors (SSRIs) and serotonin and noradrenaline reuptake inhibitors (SNRIs) remain the cornerstone of treatment for many forms of depression, atypical antidepressants such as trazodone, and emerging therapies like ketamine, neuromodulation techniques, and personalized psychotherapy offer hope for those with complex or treatment-resistant presentations.</p>","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":"1-21"},"PeriodicalIF":3.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515212","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}
{"title":"The effectiveness of electroconvulsive therapy (ECT) for people with bipolar disorder: is there a specific role?","authors":"Giulio Emilio Brancati, Pierpaolo Medda, Giulio Perugi","doi":"10.1080/14737175.2025.2470979","DOIUrl":"https://doi.org/10.1080/14737175.2025.2470979","url":null,"abstract":"<p><strong>Introduction: </strong>Electroconvulsive therapy (ECT) has been used for over 80 years to treat various neuropsychiatric conditions, including mood and psychotic disorders. Despite its proven efficacy, ECT remains underutilized and underexplored in patients with bipolar disorder (BD).</p><p><strong>Areas covered: </strong>This perspective examines the role of ECT in BD, highlighting its effectiveness across depressive, manic, and mixed phases, including those characterized by catatonic or delirious features. Based on these findings, the authors propose a comprehensive transdiagnostic framework to conceptualize ECT-responsive syndromes based on psychomotor, psychotic, and cognitive disturbances. The potential long-term effectiveness of ECT as a mood stabilizer is also suggested, despite the limited amount of literature. Finally, safety issues and alternative options are discussed.</p><p><strong>Expert opinion: </strong>The shift in ECT usage, from being a first-line treatment for severe affective episodes to a 'last-resort' option for treatment-resistant depression, may have contributed to increased relapse rates and chronicity. Considering ECT at an early stage, potentially even before any medication trials, is recommended for specific clinical conditions associated with BD and marked by objective psychomotor disturbances, acute psychotic symptoms, and severe cognitive alterations.</p>","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143500100","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}