Handbook of clinical neurology最新文献_第3页

Glaucoma. 青光眼。

Handbook of clinical neurology Pub Date : 2026-01-01 DOI: 10.1016/B978-0-443-22212-2.00010-0

Henry Bair, Mak Djulbegovic, Joel S Schuman

{"title":"Glaucoma.","authors":"Henry Bair, Mak Djulbegovic, Joel S Schuman","doi":"10.1016/B978-0-443-22212-2.00010-0","DOIUrl":"10.1016/B978-0-443-22212-2.00010-0","url":null,"abstract":"Glaucoma, a prevalent cause of blindness, refers to a group of optic neuropathies that result in the degeneration of retinal ganglion cells. Glaucoma can be broadly classified based on the anatomy of the anterior chamber angle (open vs closed), though each group can be further subdivided by underlying etiology and chronicity. Given that chronic glaucoma is the most common type and usually progresses insidiously, periodic eye exams are critical to assess both anatomic integrity and visual function. The most important modalities for screening and monitoring at-risk patients or those with a diagnosis are ophthalmoscopy for appraising the appearance of the optic nerve head, gonioscopy for examining the anterior chamber angle, tonometry for measuring intraocular pressure, optical coherence tomography for evaluating structural damage to the optic nerve head, macula, and retinal nerve fiber layer, and perimetry for assessing visual function. Since most cases of glaucoma involve elevated intraocular pressure due to an abnormality in the drainage of aqueous humor out of the eye, current treatments, including medications, laser therapies, and surgeries, focus on lowering intraocular pressure. This chapter additionally includes a summary of significant clinical trials that have helped establish current standard practices, and concludes with an overview of promising emerging research, including stem cell therapies, gene therapies, visual prosthesis, and artificial intelligence/computer vision. Neurologists should be familiar with the diagnosis and management of glaucoma, given its similarities in pathophysiology with other neurodegenerative conditions as well as the fact that glaucoma affects both the eye and the brain.","PeriodicalId":12907,"journal":{"name":"Handbook of clinical neurology","volume":"218 ","pages":"219-239"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148101452","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

Insights into retinal remodeling in retinal degenerative disease. 视网膜退行性疾病中视网膜重塑的研究进展。

Handbook of clinical neurology Pub Date : 2026-01-01 DOI: 10.1016/B978-0-443-22212-2.00015-X

Bryan William Jones

{"title":"Insights into retinal remodeling in retinal degenerative disease.","authors":"Bryan William Jones","doi":"10.1016/B978-0-443-22212-2.00015-X","DOIUrl":"10.1016/B978-0-443-22212-2.00015-X","url":null,"abstract":"The retina is a highly organized sensory structure responsible for capturing and processing visual information. Visual computation begins at the first synapse between photoreceptors, bipolar cells, and horizontal cells, before involving amacrine and ganglion cells to generate vision. Retinal degeneration disrupts the precise neural architecture required for vision, initiating a maladaptive process known as retinal remodeling. Photoreceptor degeneration in diseases, like retinitis pigmentosa (RP) and age-related macular degeneration, induces retinal remodeling, but good evidence shows glaucoma and diabetic retinopathy do as well, expanding the clinical significance. Historically, studies relied on histologic measures that assumed photoreceptor degeneration marked disease endpoints. However, retinal remodeling involves extensive structural and functional reorganization across all retinal cell classes, driven by the interdependence between neurons, glia, and the retinal pigment epithelium. Retinal plasticity corrupts normal retinal computations, and recent evidence suggests therapeutic windows close after ∼50% photoreceptor loss. Understanding remodeling mechanisms is critical for effective therapies, as current treatments fail to address the ongoing negative plasticity. Insights from retinal remodeling offer broader implications for neurodegeneration, highlighting the retina as a model for understanding central nervous system diseases like Alzheimer and Parkinson. Advancing knowledge of these processes will be pivotal for developing interventions to preserve vision.","PeriodicalId":12907,"journal":{"name":"Handbook of clinical neurology","volume":"218 ","pages":"327-339"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148101503","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

The evolution and current status of anti-B-cell therapies in autoimmune neurologic diseases. 自身免疫性神经疾病中抗b细胞疗法的发展与现状

Handbook of clinical neurology Pub Date : 2026-01-01 DOI: 10.1016/B978-0-323-90887-0.00010-9

Albert Aboseif, Eoin P Flanagan

{"title":"The evolution and current status of anti-B-cell therapies in autoimmune neurologic diseases.","authors":"Albert Aboseif, Eoin P Flanagan","doi":"10.1016/B978-0-323-90887-0.00010-9","DOIUrl":"10.1016/B978-0-323-90887-0.00010-9","url":null,"abstract":"B lymphocytes are essential to the adaptive immune system with several key functions involving antibody production, pro- and anti-inflammatory cytokine production, and antigen presentation to CD4+ T cells. These functions are critical in promoting downstream effector mechanisms underlying the pathogenesis of many autoimmune neurologic disorders. Inhibiting B cells with monoclonal antibodies has been successful in a variety of autoimmune neurologic disorders, including diseases thought to be primarily T-cell mediated. B-cell depletion is now commonly utilized in clinical practice with approved medications for multiple sclerosis and aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder. Moreover, clinical trials are underway involving several other disorders including autoimmune encephalitis. Their effectiveness has led to the development of a variety of B-cell targeting treatments that differ by antigenic target, form (humanized or chimeric), route of administration, and dosing frequency. Additionally, there has been an increase in their affordability via biosimilars, allowing for increased accessibility globally. With their increasing use, it is important to be aware of their side-effect profile, associated risk of infection, and their use in special populations. Anti-B-cell therapies have revolutionized our therapeutic approach to autoimmune disorders of the central nervous system and their high efficacy has led to an overall benefit in patients afflicted by these conditions.","PeriodicalId":12907,"journal":{"name":"Handbook of clinical neurology","volume":"214 ","pages":"107-123"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959262","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

The history of paraneoplastic neurologic disorders of the CNS, PNS, and autonomic nervous systems: Perspective on the past toward a brighter future. 中枢神经系统、PNS和自主神经系统的副肿瘤神经系统疾病的历史：展望未来。

Handbook of clinical neurology Pub Date : 2026-01-01 DOI: 10.1016/B978-0-323-90887-0.00005-5

Aditi Sharma, Tammy L Smith, John E Greenlee, Stacey L Clardy

引用次数: 0

Immunotherapies in autoimmune inflammatory myopathies: Rationale and therapeutic updates. 自身免疫性炎症性肌病的免疫治疗：基本原理和治疗进展

Handbook of clinical neurology Pub Date : 2026-01-01 DOI: 10.1016/B978-0-323-90887-0.00008-0

Goran Rakocevic, Marinos C Dalakas

{"title":"Immunotherapies in autoimmune inflammatory myopathies: Rationale and therapeutic updates.","authors":"Goran Rakocevic, Marinos C Dalakas","doi":"10.1016/B978-0-323-90887-0.00008-0","DOIUrl":"10.1016/B978-0-323-90887-0.00008-0","url":null,"abstract":"Autoimmune inflammatory myopathies (AIM) constitute a heterogeneous group of acquired myopathies with endomysial inflammation as a shared feature highlighting a potentially autoimmune inflammatory process amenable to immunotherapies. The disorders can be best classified as dermatomyositis, necrotizing autoimmune myositis, antisynthetase syndrome-overlap myositis, and inclusion body myositis. Because of clinical and immunohistologic heterogeneity but often overlapping pathophysiologic features among all major subsets, a correct diagnosis is critical from the outset to apply the most suitable and subset-specific immunotherapy. Advances in the immunopathologic characterization of autoimmune inflammatory myopathies have identified potentially mechanism-specific disease subsets that promise the application of targeted immunotherapies for better clinical outcomes. A number of recent clinical trials with biologic agents and monoclonal antibodies, regardless of the clinical outcome considering that several were negative, have collectively expanded our knowledge on the main pathogenic markers of autoimmunity associated with each AIM subset including the role of T-cell or B-cell factors, key cytokines, complement and various associated antibodies, or innate immunity factors. The paper summarizes the main clinical and histopathologic features of each myositis subtype, including overlapping or unique concepts of their immunopathogenic mechanisms, being mainly focused on applied immunotherapies and relevant controlled clinical trials discussing evidence-based efficacy according to the currently evolved therapeutic algorithm. The ongoing trials are also discussed highlighting those with promising future, if applied early in the disease, and the new immunotherapeutic interventions for the refractory AIM subsets.","PeriodicalId":12907,"journal":{"name":"Handbook of clinical neurology","volume":"214 ","pages":"417-436"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959191","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

Hematopoietic stem cell transplantation for multiple sclerosis: Improving understanding and addressing misconceptions. 多发性硬化症的造血干细胞移植：增进理解和解决误解。

Handbook of clinical neurology Pub Date : 2026-01-01 DOI: 10.1016/B978-0-323-90887-0.00020-1

Richard K Burt, Tobias Alexander

{"title":"Hematopoietic stem cell transplantation for multiple sclerosis: Improving understanding and addressing misconceptions.","authors":"Richard K Burt, Tobias Alexander","doi":"10.1016/B978-0-323-90887-0.00020-1","DOIUrl":"10.1016/B978-0-323-90887-0.00020-1","url":null,"abstract":"Autologous hematopoietic stem cell transplantation (HSCT) for multiple sclerosis (MS) is the technique of administrating a short immunosuppressive regimen over 4-6 days (depending on the drug regimen) followed by intravenous infusion of one's own hematopoietic stem cells to hasten hematopoietic recovery. The toxicity and efficacy of the procedure depend on the regimen and on patient selection and, to a lesser extent, on center experience. MS-specific nonmyeloablative regimens are less toxic and safer than myeloablative regimens that were initially developed for cancer. To date, there have been no randomized trials comparing the different regimens. HSCT like all immune-based therapy is more effective for the inflammatory phase of MS. It is effective for relapsing-remitting MS, less effective for active secondary progressive MS (SPMS), and almost ineffective for nonactive SPMS and primary progressive MS. Effectiveness and superiority of HSCT have been reported in a phase III randomized trial against the best available disease-modifying therapies at that time (mostly natalizumab) and in large meta-analyses. Compared to disease-modifying therapies, HSCT demonstrates posttransplant drug-free meaningful improvement of neurologic disability and quality of life for prolonged long-term follow-up in most patients.","PeriodicalId":12907,"journal":{"name":"Handbook of clinical neurology","volume":"214 ","pages":"191-216"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959174","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

Overview of support associations and other useful resources. 支持协会和其他有用资源的概述。

Handbook of clinical neurology Pub Date : 2026-01-01 DOI: 10.1016/B978-0-443-13554-5.00028-6

Seonaid Anderson

引用次数: 0

Behavioral interventions for tic disorders. 抽动障碍的行为干预。

Handbook of clinical neurology Pub Date : 2026-01-01 DOI: 10.1016/B978-0-443-13554-5.00030-4

Michael B Himle, Marika Marklin, Brianna Wellen

{"title":"Behavioral interventions for tic disorders.","authors":"Michael B Himle, Marika Marklin, Brianna Wellen","doi":"10.1016/B978-0-443-13554-5.00030-4","DOIUrl":"10.1016/B978-0-443-13554-5.00030-4","url":null,"abstract":"Behavioral interventions are now recommended within evidence-based treatment guidelines as an alternative or adjunct to medication for the management of tic disorders (TD). The behavioral model of TD conceptualizes tics as neurologic based yet modifiable behaviors that are influenced by internal and external contextual antecedents and tic-contingent consequences. The behavioral interventions with the strongest empirical support are habit reversal training (HRT), an expanded version of HRT referred to as comprehensive behavioral intervention for tics (CBIT), and a version of exposure and response prevention (ERP) adapted from an evidence-based cognitive-behavioral intervention for obsessive-compulsive disorder. Each of these interventions involves teaching volitional tic suppression and environmental modifications aimed at reducing contextual worsening of tics. In this chapter, we review the behavioral model of TD, the core components of HRT, CBIT, and ERP, and discuss their supporting evidence base. We then briefly review several persistent and unfounded concerns and misunderstandings regarding behavior interventions for TD that inhibit adoption among some professionals and patients. Finally, despite evidence supporting their efficacy, access to behavior therapies for TD remains limited. We conclude with a review of existing and emerging approaches aimed at increasing dissemination and implementation and future directions for research.","PeriodicalId":12907,"journal":{"name":"Handbook of clinical neurology","volume":"215 ","pages":"263-271"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113097","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

Genetics of Tourette syndrome and tic disorders. 图雷特综合征和抽动障碍的遗传学。

Handbook of clinical neurology Pub Date : 2026-01-01 DOI: 10.1016/B978-0-443-13554-5.00020-1

Pritesh Jain, Peristera Paschou, Apostolia Topaloudi

引用次数: 0

Epigenetic factors in eating disorders: Clinical correlates and diagnostic specificity. 饮食失调的表观遗传因素：临床相关性和诊断特异性。

Handbook of clinical neurology Pub Date : 2026-01-01 DOI: 10.1016/B978-0-443-19043-8.00011-6

Linda Booij, Édith Breton, Lea Thaler, Howard Steiger

{"title":"Epigenetic factors in eating disorders: Clinical correlates and diagnostic specificity.","authors":"Linda Booij, Édith Breton, Lea Thaler, Howard Steiger","doi":"10.1016/B978-0-443-19043-8.00011-6","DOIUrl":"https://doi.org/10.1016/B978-0-443-19043-8.00011-6","url":null,"abstract":"In this chapter, we discuss epigenetic factors in eating disorders. Following a brief introduction to eating disorders, we review research on how different environmental factors - gestational, psychosocial, nutritional, and metabolic - could impact the epigenome and eating-disorder development. We review the literature providing evidence for DNA methylation alterations in eating disorders in genes regulating mental health, metabolism, and immune function. We also review researchthat has suggested that DNA methylation patterns in anorexia nervosa may be reversible upon remission. Although most epigenetic research in eating disorders focuses on anorexia nervosa, there is some evidence of epigenetic overlap between eating disorders, on the one hand, and other psychiatric metabolic and autoimmune disorders, on the other. Shared epigenetic alterations may contribute to comorbidity patterns. Overall, results of epigenetic genome-wide research in eating disorders mirror the findings from genome-wide association studies, and underscore the importance of incorporating metabolic, psychiatric, and immune components in etiologic models of eating disorders. We conclude our chapter with an integrated etiologic epigenetic model, provide avenues for future research, and discuss the clinical potentials, for eating disorders, of epigenetic markers.","PeriodicalId":12907,"journal":{"name":"Handbook of clinical neurology","volume":"219 ","pages":"269-285"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192907","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