Handbook of clinical neurology最新文献_第7页

Insights into age-related macular degeneration. 洞察年龄相关性黄斑变性。

Handbook of clinical neurology Pub Date : 2026-01-01 DOI: 10.1016/B978-0-443-22212-2.00020-3

Polina Lankry, Anat Loewenstein, Omer Trivizki

{"title":"Insights into age-related macular degeneration.","authors":"Polina Lankry, Anat Loewenstein, Omer Trivizki","doi":"10.1016/B978-0-443-22212-2.00020-3","DOIUrl":"10.1016/B978-0-443-22212-2.00020-3","url":null,"abstract":"Age-related macular degeneration (AMD) is a complex and prevalent ocular condition with significant implications for vision and quality of life in the aging population. This chapter provides a comprehensive exploration of AMD, encompassing its multifactorial pathophysiology, epidemiologic trends, and associated risk factors. A detailed examination of the distinct features and symptoms characterizing neovascular and dry AMD enhances our understanding of the clinical spectrum. Special emphasis is placed on geographic atrophy (GA), an advanced stage of AMD, highlighting its significant impact on visual outcomes. Apart from examining the present diagnostic methods and criteria for AMD, this chapter assesses current therapeutic approaches, with a specific emphasis on antivascular endothelial growth factor (anti-VEGF) treatments. Additionally, the discussion extends to emerging therapies and potential avenues for future research in AMD. Preventative strategies and lifestyle modifications that may influence disease progressions are also reviewed. By consolidating current knowledge, clinical insights, and future prospects, this chapter aims to serve as a valuable resource for clinicians, researchers, and students engaged in the study and management of age-related macular degeneration.","PeriodicalId":12907,"journal":{"name":"Handbook of clinical neurology","volume":"218 ","pages":"165-190"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148101530","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

Optical coherence tomography and OCT-angiography in neurologic and neuro-ophthalmologic diseases: Current applications and future perspectives. 光学相干断层扫描和oct血管造影在神经和神经眼科疾病中的应用现状和未来展望。

Handbook of clinical neurology Pub Date : 2026-01-01 DOI: 10.1016/B978-0-443-22212-2.00022-7

Caterina Toma, Stela Vujosevic

{"title":"Optical coherence tomography and OCT-angiography in neurologic and neuro-ophthalmologic diseases: Current applications and future perspectives.","authors":"Caterina Toma, Stela Vujosevic","doi":"10.1016/B978-0-443-22212-2.00022-7","DOIUrl":"10.1016/B978-0-443-22212-2.00022-7","url":null,"abstract":"Optical coherence tomography (OCT) and OCT-angiography (OCTA) have emerged as useful tools for noninvasive imaging in the neurologic field. This chapter elucidates their utility in detecting biomarkers for the diagnosis and monitoring of progression and response to treatment in different prevalent neurologic conditions. The retina, an extension of the central nervous system, presents a unique opportunity for monitoring brain pathology due to its accessibility. Through highly resolved scans of the retina and optic nerve, OCT and OCTA facilitate the identification of subtle clinical changes occurring during neuroinflammatory, neurodegenerative, and ischemic processes in disorders like multiple sclerosis, Alzheimer and Parkinson disease, anterior ischemic optic neuropathies, and papilledema. Peripapillary nerve fiber layer and macular internal retinal layer thickness on OCT, and vessel density in the superficial retina on OCTA seem to be the most sensitive parameters in detecting axonal injury and neurodegeneration. These metrics hold promise as surrogate markers for cerebral alterations. While OCT and OCTA show considerable potential, continued research is necessary to validate their reliability and clinical significance, considering potential confounding factors such as concurrent ophthalmic pathologies. Nonetheless, these advancements represent significant progress toward enhancing the diagnosis, management, and prediction of outcomes in various neuro-ophthalmic disorders.","PeriodicalId":12907,"journal":{"name":"Handbook of clinical neurology","volume":"218 ","pages":"13-32"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148101558","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

Optoretinography - Mechanisms and applications. 视网膜造影-机制和应用。

Handbook of clinical neurology Pub Date : 2026-01-01 DOI: 10.1016/B978-0-443-22212-2.00006-9

Vimal Prabhu Pandiyan, Pawan Kumar, Teng Liu, Ramkumar Sabesan

{"title":"Optoretinography - Mechanisms and applications.","authors":"Vimal Prabhu Pandiyan, Pawan Kumar, Teng Liu, Ramkumar Sabesan","doi":"10.1016/B978-0-443-22212-2.00006-9","DOIUrl":"10.1016/B978-0-443-22212-2.00006-9","url":null,"abstract":"Optoretinography (ORG) refers to the optical imaging of light-evoked neural activity, specifically in the retina. The general protocol involves using an imaging instrument, such as a scanning laser ophthalmoscope (SLO) or optical coherence tomography (OCT), to monitor the retinal response evoked by a visual stimulus. Advances in imaging technology, such as adaptive optics, high-speed and parallel recordings, and phase-resolved detection with SLO and OCT, have together enabled the recording of stimulus-evoked retinal events across a range of spatiotemporal resolution, from individual to collection cells, from milliseconds to minutes. The slow responses are attributed to changes in osmotic pressure and water movement, creating a shape change. The fast responses are attributed to shape changes due to voltage-dependent membrane tension that accompanies cell signaling via hyper- or depolarization. The cone ORG includes a rapid contraction followed by two slower elongation phases of the outer segment, each linked to specific stages of phototransduction. ORG has enabled classification of the cone types with high efficiency and precision, providing a detailed view of their spectral composition in the human macula. In patients with inherited retinal disease, ORG provides early detection of dysfunction in photoreceptors, evident even in clinically-defined healthy retinal areas. As a noninvasive, sensitive, and objective assay of retinal health, ORG holds promise for detecting disease progression and evaluating therapies.","PeriodicalId":12907,"journal":{"name":"Handbook of clinical neurology","volume":"218 ","pages":"131-149"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148101587","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

Brainstem in pain control. 脑干控制疼痛。

Handbook of clinical neurology Pub Date : 2026-01-01 DOI: 10.1016/B978-0-443-15736-3.00003-2

Luke A Henderson, Lewis S Crawford, Kevin A Keay

{"title":"Brainstem in pain control.","authors":"Luke A Henderson, Lewis S Crawford, Kevin A Keay","doi":"10.1016/B978-0-443-15736-3.00003-2","DOIUrl":"10.1016/B978-0-443-15736-3.00003-2","url":null,"abstract":"One of the most powerful systems in the brain is that which alters the processing of noxious information. The processing of noxious stimuli into the experience of pain is important for survival, as it warns an individual of danger and motivates them to either escape the source of pain, or to confront and control it, that is, fight/flight. While pain is important for survival, it can be powerfully modulated in a range of situations, such as intense emotional state changes, stress, during shifts in attention and expectation, and after confrontational responses where it aids in rest and recuperation. Given its biologic importance, the circuits responsible for pain modulation are located in regions of the brainstem considered phylogenetically primitive. While in many situations, higher cortical regions can drive the modulation of pain, these higher regions are thought to contact the brainstem which in turn modulates incoming noxious information from the spinal cord and caudal brainstem. Understanding the brainstem circuits that control noxious information is vital for our understanding of how the brain modulates pain in various situations. The following is a review of the brainstem circuits that control noxious inputs and considers how higher brain regions can drive these brainstem sites to modulate overall intensity of pain.","PeriodicalId":12907,"journal":{"name":"Handbook of clinical neurology","volume":"216 ","pages":"75-90"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147528365","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

Intrinsic pontine tumors: Pathology of brainstem tumors and exploration of diffuse intrinsic pontine glioma. 脑干肿瘤病理及弥漫性脑桥内胶质瘤的探讨。

Handbook of clinical neurology Pub Date : 2026-01-01 DOI: 10.1016/B978-0-443-15736-3.00020-2

Ryan Moon, Sabine Mueller, Pascale Varlet

引用次数: 0

Brain death and the brainstem. 脑死亡和脑干

Handbook of clinical neurology Pub Date : 2026-01-01 DOI: 10.1016/B978-0-443-15736-3.00013-5

Calixto Machado

{"title":"Brain death and the brainstem.","authors":"Calixto Machado","doi":"10.1016/B978-0-443-15736-3.00013-5","DOIUrl":"10.1016/B978-0-443-15736-3.00013-5","url":null,"abstract":"Brain death/death by neurologic criteria (BD/DNC) represents a distinct state after a catastrophic brain injury. In the 19th century, anatomists and physiologists progressively began to sustain the conception of the brainstem as a mediator of vital physiologic functions. A primary supratentorial brain lesion usually provokes a rostrocaudal transtentorial brain herniation syndrome, resulting in brain function impairment in both cerebral hemispheres and the brainstem. When a secondary brain lesion (i.e., cerebral hypoxia) is present, the brainstem, like the forebrain, is also affected. Nevertheless, some patients with a primary infratentorial brain lesion may retain cerebral blood flow and electroencephalographic (EEG) activity without a significant increment of intracranial pressure. Jahi McMath was declared brain-dead, leading to a legal controversy about keeping life-support despite the BD/DNC diagnosis. She presented a huge lesion in the brainstem, but ancillary tests, performed nine months after the initial brain insult, showed conservation of intracranial structures, EEG activity, and autonomic reactivity to the \"Mother Talks\" stimulus, rejecting the BD/DNC diagnosis. Jahi represented a new state of disorder of consciousness, nonpreviously described, termed \"responsive unawakefulness syndrome.\"","PeriodicalId":12907,"journal":{"name":"Handbook of clinical neurology","volume":"216 ","pages":"345-359"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147528137","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 brainstem in neurodegenerative diseases. 神经退行性疾病中的脑干

Handbook of clinical neurology Pub Date : 2026-01-01 DOI: 10.1016/B978-0-443-15736-3.00017-2

Lea Tenenholz Grinberg

{"title":"The brainstem in neurodegenerative diseases.","authors":"Lea Tenenholz Grinberg","doi":"10.1016/B978-0-443-15736-3.00017-2","DOIUrl":"10.1016/B978-0-443-15736-3.00017-2","url":null,"abstract":"The brainstem, despite its modest size relative to the cerebral cortex, is critically involved in the pathology and clinical manifestations of numerous neurodegenerative diseases (NDDs). Historically, research on NDDs such as Alzheimer disease, Lewy body disease, and frontotemporal lobar degeneration predominantly adopted a cortico-centric perspective. However, emerging neuropathologic evidence underscores the brainstem's essential role, with early pathologic changes often predating cortical involvement. This chapter highlights salient points regarding the pathology and clinicopathologic correlations of brainstem involvement across major NDDs, emphasizing the chronology of disease progression. Key mechanisms, including protein misfolding and aggregation, selective neuronal vulnerability, and neurotransmitter dysfunction, are explored. Clinical correlations illustrate how early brainstem pathology significantly contributes to prodromal symptoms and helps define distinct clinical phenotypes, such as autonomic dysfunction, sleep disturbances, and mood disorders. Recognizing the chronologic order and specific nuclei affected in the brainstem broadens our understanding of disease progression, highlighting opportunities for targeted interventions at earlier disease stages.","PeriodicalId":12907,"journal":{"name":"Handbook of clinical neurology","volume":"216 ","pages":"201-212"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147528461","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

DNA methylation in motor neuron biology and epigeneticopathy in amyotrophic lateral sclerosis. 运动神经元生物学中的DNA甲基化和肌萎缩侧索硬化症的表观遗传病。

Handbook of clinical neurology Pub Date : 2026-01-01 DOI: 10.1016/B978-0-443-19043-8.00014-1

Lee J Martin

{"title":"DNA methylation in motor neuron biology and epigeneticopathy in amyotrophic lateral sclerosis.","authors":"Lee J Martin","doi":"10.1016/B978-0-443-19043-8.00014-1","DOIUrl":"https://doi.org/10.1016/B978-0-443-19043-8.00014-1","url":null,"abstract":"Amyotrophic lateral sclerosis (ALS), the 3rd most frequent neurodegenerative disease, is fatal. Skeletal muscles, neuromuscular junctions, and motor neurons in the cerebral cortex, brainstem, and spinal cord that control swallowing, breathing, and movement degenerate, causing paralysis, respiratory arrest, and death. Clinically meaningful disease mechanisms are unknown, and no effective therapies are available. ALS is a polygenic heterogeneous disease seen in 5%-10% of patients as inherited, but most patients have no inheritance pattern. ALS appears to manifest as a complex interplay between many genes in multiple tissues, individual lifestyle, the environment, and metabolism. Monozygotic twin and triplet studies of ALS suggest that epigenetic mechanisms could be involved in the pathogenesis because discordance is seen. Epigenetic anomalies involving DNA and RNA methylation occur in human ALS. Cell and animal models show that motor neuron development and degeneration can be regulated by DNA methylation. This chapter summarizes the DNA and RNA epigenetic anomalies that are prominent in human ALS and models of ALS, concluding with the suggestion that they are promising therapeutic targets with small molecules.","PeriodicalId":12907,"journal":{"name":"Handbook of clinical neurology","volume":"219 ","pages":"381-397"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192901","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

Human-induced pluripotent stem cell-derived neural cells to model epigenetic regulations in the nervous system and brain disorders in vitro. 人类诱导的多能干细胞衍生的神经细胞在体外模拟神经系统和大脑疾病的表观遗传调控。

Handbook of clinical neurology Pub Date : 2026-01-01 DOI: 10.1016/B978-0-443-19043-8.00002-5

Yan Hong, Guo-Li Ming, Hongjun Song

{"title":"Human-induced pluripotent stem cell-derived neural cells to model epigenetic regulations in the nervous system and brain disorders in vitro.","authors":"Yan Hong, Guo-Li Ming, Hongjun Song","doi":"10.1016/B978-0-443-19043-8.00002-5","DOIUrl":"https://doi.org/10.1016/B978-0-443-19043-8.00002-5","url":null,"abstract":"Epigenetic regulations, including DNA methylation, histone modification, and noncoding RNA regulation, play essential roles in human diseases but our understanding of their involvement in central nervous system disorders has been hampered by the complexity of the human brain and the inaccessibility of targeted cells. Previously, disease-relevant neural cell types were only available from postmortem tissues after many years of disease progression and potential exposure to many different medications. Human-induced pluripotent stem cells (iPSCs) generated by cellular reprogramming of somatic cells have provided promising in vitro disease models to enable the study of brain disorders at molecular and cellular levels that were previously impossible. Recent methodological advances in molecular biology and genomics technologies enable researchers to investigate epigenetic regulations using iPSC-derived neural models, which is expected to have a great impact on understanding the pathophysiology of neurodevelopmental and neurodegenerative disorders and expand future therapeutic possibilities. In this chapter, we review the current understanding of epigenetic regulation in neurodevelopmental and neurodegenerative disorders, focusing on the potential of human iPSC-derived neural models as promising tools for the epigenetic study of these disorders.","PeriodicalId":12907,"journal":{"name":"Handbook of clinical neurology","volume":"219 ","pages":"569-589"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193025","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

Neuroimaging of tic disorders. 抽动障碍的神经影像学。

Handbook of clinical neurology Pub Date : 2026-01-01 DOI: 10.1016/B978-0-443-13554-5.00004-3

Yulia Worbe, Bassam Al-Fatly

{"title":"Neuroimaging of tic disorders.","authors":"Yulia Worbe, Bassam Al-Fatly","doi":"10.1016/B978-0-443-13554-5.00004-3","DOIUrl":"10.1016/B978-0-443-13554-5.00004-3","url":null,"abstract":"Gilles de la Tourette syndrome (GTS) is increasingly conceptualized as a neurodevelopmental network disorder. In this chapter, we have synthesized two decades of neuroimaging findings spanning gray- and white-matter morphology, structural connectivity, and functional network dynamics in GTS across childhood and adulthood. Structural MRI studies using voxel-based morphometry (VBM) have reported heterogeneous volume differences-both decreases and increases-across cortico-striatal-thalamo-cortical regions, motivating the use of meta-analytic approaches to identify more consistent loci, including cingulate, sensorimotor, thalamic, striatal, and insular regions. In contrast, cortical thickness studies more consistently indicate cortical thinning in motor/premotor and prefrontal areas, with links to tic phenomenology and premonitory urges. Diffusion and volumetric white-matter measures further implicate interhemispheric pathways and fronto-striatal projections, with some indices relating to tic severity. At the circuit level, tractography and structural covariance studies support altered connectivity within the cortico-striato-pallido-thalamo-cortical loop and highlight a complementary contribution of cerebello-cortical pathways. Functional MRI studies converge on temporally structured node engagement during tic generation-preceding activity in supplementary motor, cingulate, insular, and opercular regions, followed by sensorimotor, thalamic, and cerebellar involvement-and reveal large-scale reconfiguration of cortico-basal ganglia networks associated with tic severity and comorbid symptoms. Finally, lesion-network mapping and coordinate-based network mapping studies in secondary tics and GTS-related atrophy converge on a common tic-associated network, providing a translational framework to guide neuromodulation and to derive clinically meaningful network biomarkers for treatment targeting.","PeriodicalId":12907,"journal":{"name":"Handbook of clinical neurology","volume":"215 ","pages":"215-223"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112747","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