Handbook of clinical neurology最新文献

Evolving targeted biologics against T cells, cytokines, and intracellular immune targets for multiple sclerosis with implications in other autoimmune neurologic diseases. 发展针对T细胞、细胞因子和细胞内免疫靶点的靶向生物制剂对多发性硬化症和其他自身免疫性神经系统疾病的影响。

Handbook of clinical neurology Pub Date : 2026-01-01 DOI: 10.1016/B978-0-323-90887-0.00016-X

Bernhard Hemmer

{"title":"Evolving targeted biologics against T cells, cytokines, and intracellular immune targets for multiple sclerosis with implications in other autoimmune neurologic diseases.","authors":"Bernhard Hemmer","doi":"10.1016/B978-0-323-90887-0.00016-X","DOIUrl":"10.1016/B978-0-323-90887-0.00016-X","url":null,"abstract":"Over the last three decades, immunotherapies targeting T cells, cytokines, and intracellular molecules have been explored extensively in clinical trials in multiple sclerosis (MS). These studies resulted in the approval of several therapies for the treatment of relapsing-remitting MS, and secondary and primary progressive MS. However, many treatment approaches were unsuccessful but provided important insights into pathomechanisms driving disease activity and progression in MS. Additional treatment strategies are currently evaluated in phase II and III trials in MS and are likely to improve the treatment of relapsing and progressive MS in the future. Some of the established treatment strategies in MS paved the way for the development of treatment strategies in other autoimmune diseases of the central nervous system, in particular neuromyelitis optica spectrum disorders (NMOSD) and myelin-oligodendrocyte glycoprotein-associated disorders. As a result, the first drugs for the treatment of NMOSD were recently approved and are now available to alter the course of this disease. Overall, T cell and cytokine-targeting treatment approaches have proven less successful in neuroinflammatory diseases than strategies targeting B cells. A better understanding of the pathomechanisms underlying MS and related diseases will facilitate the successful development of specific therapies targeting T cells, cytokines, and intracellular molecules in the future.","PeriodicalId":12907,"journal":{"name":"Handbook of clinical neurology","volume":"214 ","pages":"125-142"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Beneath the tip of the iceberg: treatment of neuropsychiatric comorbidities in tic disorders. 冰山一角之下：抽动障碍中神经精神合并症的治疗。

Handbook of clinical neurology Pub Date : 2026-01-01 DOI: 10.1016/B978-0-443-13554-5.00008-0

Elia Abi-Jaoude, Daniel A Gorman, Paul Sandor

{"title":"Beneath the tip of the iceberg: treatment of neuropsychiatric comorbidities in tic disorders.","authors":"Elia Abi-Jaoude, Daniel A Gorman, Paul Sandor","doi":"10.1016/B978-0-443-13554-5.00008-0","DOIUrl":"10.1016/B978-0-443-13554-5.00008-0","url":null,"abstract":"While Tourette syndrome (TS) is defined by tics, comorbidities are very much part of the clinical presentation - 90% of patients having a least one associated condition, most prominently obsessive-compulsive disorder (OCD) and attention-deficit/hyperactivity disorder (ADHD), but also learning disabilities, anxiety, depression, rage outbursts, autism spectrum disorder, sensory hypersensitivities, and sleep difficulties. Moreover, the associated symptoms often are more problematic than tics, or interact with the tics such that the different symptoms exacerbate each other, adding complexity to the clinical picture. Thus, to provide optimal care to patients with TS, it is essential that clinicians consider and address associated symptoms as part of their management. In this chapter, we review the treatment of the common neuropsychiatric comorbidities in TS, focusing especially on OCD and ADHD. We describe cognitive, behavioral, and pharmacologic interventions, with the aim of making these clear and applicable for the nonspecialist clinician. The goal is for clinicians to provide holistic care that includes understanding the impact of various symptoms and collaboratively prioritizing targets for intervention while favoring conservative approaches, in order to improve the quality of life of patients with TS.","PeriodicalId":12907,"journal":{"name":"Handbook of clinical neurology","volume":"215 ","pages":"311-326"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Deep brain stimulation for Gilles de la Tourette syndrome. 脑深部电刺激治疗妥瑞氏症。

Handbook of clinical neurology Pub Date : 2026-01-01 DOI: 10.1016/B978-0-443-13554-5.00002-X

Kara A Johnson, Aysegul Gunduz, Michael S Okun

{"title":"Deep brain stimulation for Gilles de la Tourette syndrome.","authors":"Kara A Johnson, Aysegul Gunduz, Michael S Okun","doi":"10.1016/B978-0-443-13554-5.00002-X","DOIUrl":"10.1016/B978-0-443-13554-5.00002-X","url":null,"abstract":"Gilles de la Tourette syndrome (GTS) is a childhood-onset neurodevelopmental disorder characterized by motor and vocal tics and commonly associated with comorbid psychiatric and behavioral symptoms. Medication or behavioral therapies are effective for treating GTS in most cases; however, a proportion of individuals experience treatment-refractory tics. Deep brain stimulation (DBS) is an invasive surgical therapy reserved for select individuals with severe, treatment-refractory GTS. DBS has been targeted to several brain regions involved in the basal ganglia-thalamo-cortical networks implicated in GTS pathophysiology, including medial thalamic regions, the anteromedial (limbic) globus pallidus internus, and the posteroventrolateral (sensorimotor) globus pallidus internus, among others. Evidence from case studies, open-label studies, randomized controlled trials, and multicenter retrospective studies has suggested that DBS can be effective for improving tics, comorbidities, and quality of life. However, outcomes have been variable across individuals, and challenges remain regarding selecting individuals who are most likely to benefit from DBS, identifying effective target(s) for each individual, and determining optimal postoperative stimulation strategies. Progress has been made toward addressing these challenges through multicenter collaborations, neuroimaging, and neurophysiology; however, further prospective studies, clinical trials, and regulatory approvals will be needed to advance DBS as a more widely adopted therapy for treatment-refractory GTS.","PeriodicalId":12907,"journal":{"name":"Handbook of clinical neurology","volume":"215 ","pages":"283-297"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Explosive outbursts in Tourette syndrome and chronic tic disorders. 图雷特综合症和慢性抽动障碍的爆炸性爆发。

Handbook of clinical neurology Pub Date : 2026-01-01 DOI: 10.1016/B978-0-443-13554-5.00014-6

Erica Greenberg, Florentina Lazaroaie, Cathy Budman

{"title":"Explosive outbursts in Tourette syndrome and chronic tic disorders.","authors":"Erica Greenberg, Florentina Lazaroaie, Cathy Budman","doi":"10.1016/B978-0-443-13554-5.00014-6","DOIUrl":"10.1016/B978-0-443-13554-5.00014-6","url":null,"abstract":"Explosive outbursts, often referred to as \"rage attacks,\" affect a significant number of individuals with Tourette syndrome (TS) and chronic tic disorders (CTDs), and are associated with increased disorder-related morbidity and psychosocial impairment. Tic severity, psychiatric comorbidity, psychosocial and other factors appear relevant. This chapter provides an overview of the phenomenology, possible neurobiologic and environmental underpinnings, and evaluation and treatment of explosive outbursts in TS. Existing literature on explosive outbursts, rage attacks, impulsive anger and aggression, and episodic dyscontrol in TS/CTD was reviewed and summarized. Explosive outbursts are common transdiagnostic symptoms and occur with increased frequency in individuals with TS/CTD. The etiology of these symptoms in TS/CTD is still unknown, appears multifactorial, and may reflect factors that are intrinsic to tic disorders, associated with their common neuropsychiatric comorbidities, and/or extrinsic influences. At present, evidence-based treatments for explosive outbursts in TS/CTD are limited. There remains an urgent need to advance the investigation of these disabling symptoms in TS/CTD. Use of consistent terminology and standardized assessment tools for studying and treating explosive outbursts in TS and CTDs are much needed.","PeriodicalId":12907,"journal":{"name":"Handbook of clinical neurology","volume":"215 ","pages":"97-109"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146111953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Attention-deficit/hyperactivity disorder in individuals with primary tic disorders and Tourette syndrome. 原发性抽动障碍和图雷特综合征患者的注意缺陷/多动障碍

Handbook of clinical neurology Pub Date : 2026-01-01 DOI: 10.1016/B978-0-443-13554-5.00003-1

Valerie Brandt, Nader A Perroud, Kerstin Jessica Plessen

{"title":"Attention-deficit/hyperactivity disorder in individuals with primary tic disorders and Tourette syndrome.","authors":"Valerie Brandt, Nader A Perroud, Kerstin Jessica Plessen","doi":"10.1016/B978-0-443-13554-5.00003-1","DOIUrl":"10.1016/B978-0-443-13554-5.00003-1","url":null,"abstract":"The co-occurrence of tic disorders and ADHD (attention-deficit/hyperactivity disorder) is common; however, the significant overlap in their symptoms and underlying mechanisms frequently poses questions for diagnosis and treatment. The interaction between tic disorders and ADHD involves intricate genetic and neurobiologic factors, particularly related to inhibitory processes and cortico-striato-thalamic pathways in the brain. While both conditions present shared and specific challenges, studies suggest that ADHD symptoms often pose a greater burden on patients than tics. Therefore addressing ADHD symptoms alongside tics is essential for achieving optimal outcomes and those may differ with respect to the developmental stage and/or age of the individual. Psychoeducation, as well as behavioral and psychopharmacologic treatment strategies, have evolved during the last decade, demonstrating that managing both conditions concurrently can be done safely and effectively. This approach involves comprehensive evaluations and prioritizing treatments that target both tic symptoms and those of ADHD. By focusing on therapies that address these overlapping issues, individuals may experience improved overall outcomes.","PeriodicalId":12907,"journal":{"name":"Handbook of clinical neurology","volume":"215 ","pages":"85-96"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Repetitive and restricted behaviors, habits, body-focused repetitive behaviors, and motor stereotypies. 重复性和限制性行为，习惯，以身体为中心的重复性行为和运动刻板印象。

Handbook of clinical neurology Pub Date : 2026-01-01 DOI: 10.1016/B978-0-443-13554-5.00001-8

Harvey S Singer, Sahar Mahate, Christina Morris-Berry

{"title":"Repetitive and restricted behaviors, habits, body-focused repetitive behaviors, and motor stereotypies.","authors":"Harvey S Singer, Sahar Mahate, Christina Morris-Berry","doi":"10.1016/B978-0-443-13554-5.00001-8","DOIUrl":"10.1016/B978-0-443-13554-5.00001-8","url":null,"abstract":"Movement disorder definitions that include the clinical characteristics \"sudden, rapid, repetitive, brief, and involuntary\" are not limited to motor tic disorders. Hence, it is essential that caregivers be aware of other relatively common conditions that could be confused with the diagnosis of tics. Included in this differential are entities such as repetitive and restricted behaviors (RRBs), habits, body-focused repetitive behaviors (BFRBs), and motor stereotypies. The importance of separation of these individual conditions is further emphasized by the recognition that they can be coexisting problems in individuals with tic disorders, and thus therapeutic approaches may differ. For example, some individuals diagnosed with Tourette syndrome have co-occurring complex motor stereotypies or recurring skin picking, nail biting, and hair pulling. This chapter reviews the definition of a movement disorder and the evolving entity labeled as RRBs. It also contains a more in-depth review of our knowledge regarding the clinical features, etiology, pathophysiology, and therapeutic approaches for the more specific diagnoses including habits, BFRBs, and stereotypies.","PeriodicalId":12907,"journal":{"name":"Handbook of clinical neurology","volume":"215 ","pages":"63-71"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Georges Gilles de la Tourette in the history of tics. 抽搐史上的乔治·吉尔斯·德拉·图雷特。

Handbook of clinical neurology Pub Date : 2026-01-01 DOI: 10.1016/B978-0-443-13554-5.00009-2

Olivier Walusinski

{"title":"Georges Gilles de la Tourette in the history of tics.","authors":"Olivier Walusinski","doi":"10.1016/B978-0-443-13554-5.00009-2","DOIUrl":"10.1016/B978-0-443-13554-5.00009-2","url":null,"abstract":"After a year spent working for Jean-Martin Charcot, Georges Gilles de la Tourette published an article in 1885 that would become a seminal work, reporting on nine cases of tic disease. However, only four observations meet the current criteria of the eponym, including echolalia and coprolalia, the latter term coined by Gilles de la Tourette. In 1886, Charcot asked Georges Guinon to complete the clinical picture by adding obsessional disorders temporary control of tics, and the premonitory sensation leading to their occurrence. In 1888, Charcot presided over the jury for Grégoire Breitman's thesis, then in 1890 for Jacques Catrou's thesis; both theses covered Gilles de la Tourette disease and were prepared with the namesake's help. Gilles de la Tourette put the finishing touch on the disease's description in 1900, which implicitly credited Guinon with completing the clinical picture and naming the disease at the time: \"la maladie des tics convulsifs\" (convulsive tic disease). That said, Gilles de la Tourette did not give much importance to his own nosographic contribution to neurology. After having been nearly forgotten, it was not until the 1960s that this pathology was definitively resurrected and validated by Arthur and Elaine Shapiro under the name of Gilles de la Tourette syndrome. This was a testament to its significant prevalence and its treatment possibilities.","PeriodicalId":12907,"journal":{"name":"Handbook of clinical neurology","volume":"215 ","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Animal models of Gilles de la Tourette Syndrome and other tic disorders. 抽动症及其他抽动障碍的动物模型。

Handbook of clinical neurology Pub Date : 2026-01-01 DOI: 10.1016/B978-0-443-13554-5.00015-8

Yocheved Loewenstern, Orel Tahary, Izhar Bar-Gad, Katya Belelovsky

{"title":"Animal models of Gilles de la Tourette Syndrome and other tic disorders.","authors":"Yocheved Loewenstern, Orel Tahary, Izhar Bar-Gad, Katya Belelovsky","doi":"10.1016/B978-0-443-13554-5.00015-8","DOIUrl":"10.1016/B978-0-443-13554-5.00015-8","url":null,"abstract":"Tic disorders (TD) present considerable challenges in research due to their intricate and multifaceted nature. Their primary symptoms, tics, often co-occur with other comorbid conditions that overlap with other psychiatric and movement disorders. Tic development and expression are associated with alterations in different neurotransmitter systems, genetic factors, and environmental influences. However, the current understanding regarding the underlying causes and mechanism remains limited, with the available treatments lacking specificity and efficacy. To address these complexities, numerous animal models have been developed using diverse approaches. Some models focus on studying the neural mechanisms underlying tic expression, while others are designed to investigate the therapeutic effects on the various comorbid symptoms. The objective of this chapter is to systematically review the animal models for TD. We will discuss the commonly used criteria for assessing the experimental model validity and evaluate the unique properties of each model based on its ability to address specific aspects of the disorder. Thus, the diverse spectrum of animal models will be established in a complementary form to enable the utilization of these models for the wide range of therapeutic and scientific purposes presented by tic disorders.","PeriodicalId":12907,"journal":{"name":"Handbook of clinical neurology","volume":"215 ","pages":"183-200"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ultrasound studies of brainstem. 脑干超声研究。

Handbook of clinical neurology Pub Date : 2026-01-01 DOI: 10.1016/B978-0-443-15736-3.00006-8

Binnur Çelik, Rezzak Yilmaz

引用次数: 0

The vestibular system: Unsteadiness, dizziness, and vertigo. 前庭系统：不稳定、头晕和眩晕。

Handbook of clinical neurology Pub Date : 2026-01-01 DOI: 10.1016/B978-0-443-15736-3.00016-0

Diego Kaski

{"title":"The vestibular system: Unsteadiness, dizziness, and vertigo.","authors":"Diego Kaski","doi":"10.1016/B978-0-443-15736-3.00016-0","DOIUrl":"10.1016/B978-0-443-15736-3.00016-0","url":null,"abstract":"This chapter provides a detailed overview of the vestibular system's anatomy, physiology, and clinical relevance, emphasizing how inner-ear sensory structures and brainstem pathways interact to maintain balance, gaze stability, and spatial orientation. It begins with the peripheral vestibular apparatus, describing the semicircular canals and otolith organs in detecting angular and linear accelerations. These signals are transmitted via the vestibulocochlear nerve to the vestibular nuclei at the pontomedullary junction, where they integrate with visual and somatosensory inputs to drive coordinated reflexes - most notably the vestibulo-ocular (VOR) and vestibulo-spinal reflexes - that stabilize vision and posture. We then examine central vestibular pathways, including reciprocal connections between the brainstem, cerebellum, and cortex. These circuits enable adaptive mechanisms like VOR gain recalibration and support functions such as self-motion perception. A range of common vestibular disorders is discussed - benign paroxysmal positional vertigo (BPPV), vestibular neuritis, Ménière's disease, vestibular migraine, and persistent postural-perceptual dizziness - covering their pathophysiology and clinical features. Diagnostic tools include bedside exams (e.g., head impulse test), imaging, and objective measures like caloric testing, video head impulse testing, and vestibular-evoked myogenic potentials. Treatment strategies are reviewed, highlighting the effectiveness of repositioning maneuvers for BPPV and vestibular rehabilitation for compensation after vestibular loss. The chapter concludes with emerging advances, including vestibular prosthetics and high-resolution imaging, which are redefining diagnosis and treatment. These innovations underscore the vestibular system's vital role in equilibrium and point to promising therapies for chronic dizziness and imbalance.","PeriodicalId":12907,"journal":{"name":"Handbook of clinical neurology","volume":"216 ","pages":"105-121"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147528379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0