Expert Review of Neurotherapeutics最新文献

{"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":"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":"477-490"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","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}

{"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":"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":"389-396"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","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}

{"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":"415-425"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","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}

{"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":"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":"381-388"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","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}

{"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":"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":"443-463"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","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 relevance of cortical thickness in migraine sufferers and implications to therapy.","authors":"Marcello Silvestro, Valentina Dortucci, Ilaria Orologio, Mario Cirillo, Fabrizio Esposito, Alessandro Tessitore, Antonio Russo","doi":"10.1080/14737175.2025.2483924","DOIUrl":"https://doi.org/10.1080/14737175.2025.2483924","url":null,"abstract":"<p><strong>Introduction: </strong>Advanced neuroimaging studies have strongly contributed to clarify the gaps in the knowledge about migraine pathophysiology. Cortical thickness has garnered significant interest reflecting physiological processes such as gray matter neurogenesis and synaptic pruning, as well as pathophysiological mechanisms like neurodegeneration or plasticity changes associated with aging and disease. Evidence on cortical thickness highlights significant variability, likely due to migraine clinical complexity but also to methodological issues. Nevertheless, changes in the cortical thickness of areas involved in pain perception and modulation, as well as in cognitive and emotional attributes of pain experiences, have been consistently demonstrated reinforcing the concept of a dysfunctional neuro-limbic pain network in migraine.</p><p><strong>Areas covered: </strong>This review summarizes the available findings from advanced structural neuroimaging investigations, highlighting the most relevant findings and how they have contributed to the advancement in our understanding of migraine pathophysiology. This review is based on a literature search using PubMed along with the keyword 'migraine' combined with 'cortical thickness.'</p><p><strong>Expert opinion: </strong>Presently, it is challenging to ascertain whether the structural changes in migraine represent a primary phenomenon or the result of pain experience. Nevertheless, longitudinal neuroimaging studies have highlighted a role for treatments that, even if short-term, modulate cortical thickness, while also promoting the idea of structural changes as biomarkers.</p>","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":"1-12"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751811","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 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":"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":"491-500"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","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":"Current perspectives on the recognition and management of treatment-resistant schizophrenia: challenges and opportunities.","authors":"Myrto Samara, Georgios Alevizopoulos, Vasilis P Bozikas, Ioannis Chatzimanolis, Dimitris Dikeos, Theodoros Mougiakos, Anastasia Nikolaou, Dimitrios Sakellariou, Charalampos Touloumis, Christos Tsopelas, Ofer Agid","doi":"10.1080/14737175.2025.2484434","DOIUrl":"10.1080/14737175.2025.2484434","url":null,"abstract":"<p><strong>Introduction: </strong>Treatment-resistant schizophrenia (TRS) significantly impacts patients with schizophrenia, leading to a high disease burden, reduced quality of life, and functional impairment. Many patients fail to respond to standard antipsychotic treatments, requiring specialized therapeutic approaches. Clozapine remains the only approved treatment for patients with TRS, demonstrating effectiveness in reducing symptoms, hospitalizations, and risk of suicide. However, its use is often delayed due to concerns about adverse events, and the need for ongoing monitoring.</p><p><strong>Areas covered: </strong>This critical perspective incorporates insights from psychiatrists in Greece and a comprehensive literature analysis that includes clinical guidelines and systematic reviews. It highlights strategies for early diagnosis and timely initiation of clozapine, while emphasizing practical challenges in its use. Recommendations emphasize reducing treatment delays and overcoming barriers such as inadequate training and hesitancy among clinicians. A comprehensive literature search was conducted on PubMed, Google Scholar, and Cochrane Library without any date restrictions to ensure a thorough review of available evidence. The initial literature search was carried out in September 2024, with a subsequent search conducted in March 2025.</p><p><strong>Expert opinion: </strong>International guidelines consistently recommend clozapine as the first-line treatment for patients with TRS; nevertheless, the authors advocate enhanced awareness to optimize use. Most adverse events can be effectively managed with proper oversight, and early initiation is crucial to improving remission rates and the quality of life of patients with TRS. There is a need for systemic improvements in clinical practice, which requires evidence-based guidance to better address treatment efficacy in this challenging patient population.</p>","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":"1-15"},"PeriodicalIF":3.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751810","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":"Current and emerging therapies for autoimmune encephalitis.","authors":"Darina Dinov, Linda Nguyen, Kyle Blackburn, Steven Vernino","doi":"10.1080/14737175.2025.2483925","DOIUrl":"10.1080/14737175.2025.2483925","url":null,"abstract":"<p><strong>Introduction: </strong>Autoimmune encephalitis (AIE) is an inflammatory neurological disorder often associated with autoantibodies targeting neural or glial antigens. Patients with AIE are often treated with immunotherapy, but multiple questions remain about the optimal treatment strategy for common AIE subtypes.</p><p><strong>Areas covered: </strong>The authors conducted a literature search of PubMed articles and Google Scholar articles using keywords 'autoimmune encephalitis,' 'anti-NMDA receptor encephalitis, 'LG1 encephalitis' from 2005 to 2024. This review briefly outlines the proposed pathophysiology of AIE with autoantibodies toward cell surface vs intracellular antigens. Next, the authors discuss treatments commonly used for AIE, and provide guidance on side effects and monitoring, and the evidence for treatment approaches for anti-NMDAr and LGI1 encephalitis is reviewed. In the final section, an overview of ongoing clinical trials and future therapies for AIE is provided.</p><p><strong>Expert opinion: </strong>Patients with AIE benefit from treatment with immunotherapy, but the evidence supporting specific treatment strategies is limited to observational studies. Successful clinical trials for AIE will provide new therapy options for patients, and the next generation of therapies may provide more targeted approaches to treating the condition.</p>","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":"1-11"},"PeriodicalIF":3.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691356","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":"Cenobamate add-on therapy for drug-resistant focal seizures: a systematic review and meta-analysis.","authors":"Felipe Alves de Paiva, Artur Menegaz de Almeida, Aminah Abrão Fauaz Ritter Lima, Théo Jacovani Tozzo, Larissa Emi Tanimoto, Hamilton Roberto Moreira de Oliveira Carriço, Danilo Monteiro Ribeiro","doi":"10.1080/14737175.2025.2484439","DOIUrl":"10.1080/14737175.2025.2484439","url":null,"abstract":"<p><strong>Introduction: </strong>Cenobamate (CNB) is an anti-seizure medication (ASM) utilized for drug-resistant focal-onset seizures, which are difficult to manage with usual agents. Previous studies demonstrated that it can be effective in patients with refractory epilepsy.</p><p><strong>Methods: </strong>The MEDLINE, Cochrane, and Scopus databases were systematically searched up to 24 October 2024. A Random-effects model was employed to compute the Mean Difference (MD) and the Risk Ratio (RR) with 95% Confidence Intervals (CI). Statistical Analyses were performed utilizing RStudio 4.4.2.</p><p><strong>Results: </strong>Four studies were included, comprising 906 patients; 527 (59%) received CNB as add-on therapy. The results indicated that the 50% responder rate (RR 1.77; 95% CI: 1.28 to 2.44, <i>p</i> = 0.000551, I² = 70.3%) and seizure freedom (RR of 3.09; 95% CI: 1.91 to 5.00, <i>p</i> = 0.000004, I² = 8.7%) were significantly higher in this group.</p><p><strong>Conclusions: </strong>In this meta-analysis of four studies, CNB as an add-on therapy significantly reduced seizure frequency in patients with uncontrolled focal seizures, making it a promising option for improved seizure control and quality of life.</p>","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":"1-7"},"PeriodicalIF":3.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700112","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}