Neurodegenerative disease management最新文献

{"title":"The AT(N) system for describing biological changes in Alzheimer's disease: a plain language summary.","authors":"Harald Hampel, Aya Elhage, Jeffrey Cummings, Kaj Blennow, Peng Gao, Clifford R Jack, Andrea Vergallo","doi":"10.2217/nmt-2022-0013","DOIUrl":"10.2217/nmt-2022-0013","url":null,"abstract":"<p><strong>What is this summary about?: </strong>This is a plain language summary of an article published in <i>Nature Reviews Neurology</i>. It explains how Alzheimer's disease is diagnosed. It also looks at whether a newer way to assess people with Alzheimer's disease could help improve how the condition is diagnosed, monitored, and treated.</p><p><strong>Why is this important?: </strong>Alzheimer's disease is a long-term progressive brain disease that leads to difficulties with thinking and memory. It is a progressive condition, which means it gets worse over time. Biological changes occur in the brain of people with Alzheimer's disease. This includes a build-up of toxic protein clusters called amyloid plaques and tau tangles, gradual damage to the brain cells (neurodegeneration), and brain shrinkage due to loss of neurons. It is often due to multiple factors and doctors usually diagnose Alzheimer's disease by looking at a person's symptoms and ruling out other causes of dementia. However, research shows that people diagnosed in this way do not always have the biological changes in the brain that are related to Alzheimer's disease. This means that some people may be misdiagnosed. Additionally, there may be a delay in the appearance of Alzheimer's symptoms, by which point changes in the brain may be severe. For example, people with Alzheimer's disease show biological changes in the brain, years before symptoms appear.</p><p><strong>What are the key takeaways?: </strong>An assessment of biological changes in the brain, by measuring substances that indicate disease progress (biomarkers), may offer a fuller picture of a person's Alzheimer's disease, how advanced it is, and which treatments are likely to work best. A recently developed classification scheme known as the AT(N) system provides a way to assess and describe the biological changes in amyloid (A), tau (T), and neurodegeneration (N) that occur in people with Alzheimer's disease. The goal is to include biomarker testing in clinical practice to help physicians and practitioners diagnose, monitor, and treat people with Alzheimer's disease more effectively. The AT(N) system is being used for various purposes in clinical studies, and has the potential to assist physicians and practitioners in early detection, accurate diagnosis, staging, and treatment selection for people with Alzheimer's disease.</p>","PeriodicalId":19114,"journal":{"name":"Neurodegenerative disease management","volume":"12 5","pages":"231-239"},"PeriodicalIF":2.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40616842","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}

{"title":"Off-Adherence Keeping (OAK) observational study: intentional off-adherence immunomodulatory multiple sclerosis treatment.","authors":"Marco Peresson,&nbsp;Salvatore Cottone,&nbsp;Vincenzo Brescia Morra,&nbsp;Giuseppe Salemi,&nbsp;Antonio Gallo,&nbsp;Paola Valentino,&nbsp;Luca Prosperini","doi":"10.2217/nmt-2021-0016","DOIUrl":"https://doi.org/10.2217/nmt-2021-0016","url":null,"abstract":"<p><p><b>Aims:</b> To evaluate how improved treatment adherence with a lower-frequency regimen/treatment of intramuscular (IM) IFNβ-1a impacts therapeutic effectiveness in relapsing-remitting multiple sclerosis (MS) patients switching from a higher-frequency injectable regimen/treatment. <b>Patients & methods:</b> Italian patients with relapsing-remitting MS and prior poor adherence to high-frequency injectable treatments (n = 181) were followed for 24 months after starting IM IFNβ-1a. <b>Results:</b> During the study, 97.4% of patients were treatment adherent; 22.1% of patients reported a relapse. The estimated probability of remaining relapse-free after 2 years was 78%. A high dropout rate (52.5%) led to small sample size and reduced statistical power. <b>Conclusion:</b> Intramuscular IFNβ-1a treatment was associated with high adherence and a low relapse rate. Unfortunately, low patient retention limited the generalizability of these findings.</p>","PeriodicalId":19114,"journal":{"name":"Neurodegenerative disease management","volume":"12 5","pages":"241-251"},"PeriodicalIF":2.6,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40355669","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}

{"title":"The 5-Cog paradigm to improve detection of cognitive impairment and dementia: clinical trial protocol.","authors":"Rachel Chalmer, Emmeline Ayers, Erica F Weiss, Rubina Malik, Amy Ehrlich, Cuiling Wang, Jessica Zwerling, Asif Ansari, Katherine L Possin, Joe Verghese","doi":"10.2217/nmt-2021-0043","DOIUrl":"10.2217/nmt-2021-0043","url":null,"abstract":"<p><p>Cognitive impairment related to dementia is under-diagnosed in primary care despite availability of numerous cognitive assessment tools; under-diagnosis is more prevalent for members of racial and ethnic minority groups. Clinical decision-support systems may improve rates of primary care providers responding to positive cognitive assessments with appropriate follow-up. The 5-Cog study is a randomized controlled trial in 1200 predominantly Black and Hispanic older adults from an urban underserved community who are presenting to primary care with cognitive concerns. The study will validate a novel 5-minute cognitive assessment coupled with an electronic medical record-embedded decision tree to overcome the barriers of current cognitive assessment paradigms in primary care and facilitate improved dementia care.</p>","PeriodicalId":19114,"journal":{"name":"Neurodegenerative disease management","volume":"12 4","pages":"171-184"},"PeriodicalIF":2.6,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9245592/pdf/nmt-12-171.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9913965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An overview of the active clinical trials for Parkinson's disease psychosis.","authors":"Cynthia Kwan, Philippe Huot","doi":"10.2217/nmt-2022-0020","DOIUrl":"10.2217/nmt-2022-0020","url":null,"abstract":"<p><p>Tweetable abstract An overview of the active clinical trials for Parkinson's disease psychosis. In this article, we review the drugs currently undergoing clinical testing for Parkinson's disease psychosis and offer some perspectives on the treatment of the condition.</p>","PeriodicalId":19114,"journal":{"name":"Neurodegenerative disease management","volume":"1 1","pages":"165-170"},"PeriodicalIF":2.3,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41432215","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}

{"title":"Usability of an application device for nabiximols oromucosal spray in patients with upper limb impaired multiple sclerosis.","authors":"Armando Creta, Luana Gilio, D. Centonze, R. Fantozzi","doi":"10.2217/nmt-2022-0014","DOIUrl":"https://doi.org/10.2217/nmt-2022-0014","url":null,"abstract":"Aim: This study aimed to assess the usability of a specific EU-available application device for Sativex® (USA adopted name: nabiximols) cannabinoid-based oromucosal spray in patients with multiple sclerosis (MS) and spasticity-related upper limb and hand impairment in routine daily practice. Methods: MS patients with upper limb and hand impairment evaluated the usability of the device using an ad hoc 18-item questionnaire. Results: 60 patients were included. The comprehensibility of the instructions for use, practical handling and ergonomics of the device were rated as optimal (mean scores ≥8.9/10 across questions). Assisting trained nurses also rated the device as easy to use and helpful for drug administration (mean scores 10/10). Conclusion: The application device may assist MS patients with upper limb impairment self-administer nabiximols oromucosal spray.","PeriodicalId":19114,"journal":{"name":"Neurodegenerative disease management","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2022-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48976677","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}

{"title":"Prodromal depression and subsequent risk of developing Parkinson's disease: a systematic review with meta-analysis.","authors":"Syeda Beenish Bareeqa, Syeda Sana Samar, Sufiyan Kamal, Yasir Masood, Allahyar, Syed Ijlal Ahmed, Ghazala Hayat","doi":"10.2217/nmt-2022-0001","DOIUrl":"10.2217/nmt-2022-0001","url":null,"abstract":"<p><p><b>Aim:</b> Parkinson's disease (PD) is a progressive neurological disorder that predominately affects dopaminergic neurons. We believe that this pooling of data will help to better understand the prodromal nature of depression in PD. <b>Materials & methods:</b> We conducted this study in accordance with PRISMA guidelines 2020. Fifteen eligible articles were shortlisted for final analysis. Risk of bias assessment was also conducted <b>Results:</b> The random-effect model revealed that the risk of subsequent PD in patients with prodromal depression was twice as likely (odds ratio, 2.04; 95% CI, 1.02-4.08) as compared with a healthy population. <b>Conclusion:</b> Our meta-analysis concluded that the subsequent risk of PD is significantly higher in patients with depression as compared with healthy individuals.</p>","PeriodicalId":19114,"journal":{"name":"Neurodegenerative disease management","volume":" ","pages":"155-164"},"PeriodicalIF":2.3,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47219628","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}

{"title":"Healthcare resource utilization and costs for extended interval dosing of natalizumab in multiple sclerosis.","authors":"Marcello Moccia,&nbsp;Ilaria Loperto,&nbsp;Laura Santoni,&nbsp;Silvia Masera,&nbsp;Giuseppina Affinito,&nbsp;Antonio Carotenuto,&nbsp;Roberta Lanzillo,&nbsp;Maria Triassi,&nbsp;Vincenzo Brescia Morra,&nbsp;Raffaele Palladino","doi":"10.2217/nmt-2021-0038","DOIUrl":"https://doi.org/10.2217/nmt-2021-0038","url":null,"abstract":"<p><p><b>Aims:</b> Natalizumab is approved as an infusion every 4 weeks (standard-interval dosing [SID]) in relapsing-remitting multiple sclerosis (MS). Extended-interval dosing (EID) reduces risk of progressive multifocal leukoencephalopathy (PML) compared with SID, but the impact on healthcare resources and costs remains unknown. <b>Methods:</b> In this population-based study, we included 208 natalizumab-treated MS patients who were classified into EID (≤15 infusions in the previous 18 months; n = 51; age = 33.7 ± 11.1 years; female = 72.5%) and SID (>15 infusions in the previous 18 months; n = 157; age = 36.5 ± 10.8 years; female = 68.1%) groups. <b>Results:</b> Natalizumab EID had fewer MS outpatient visits (p = 0.01) and related costs (p = 0.03), and lower natalizumab costs (p < 0.01) compared with SID, without changes in other healthcare resources and costs. <b>Conclusion:</b> Natalizumab EID is associated with reduced direct treatment costs, apparently without additional healthcare burden.</p>","PeriodicalId":19114,"journal":{"name":"Neurodegenerative disease management","volume":"12 3","pages":"109-116"},"PeriodicalIF":2.6,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10806664","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}

{"title":"Glutamate modulation for the treatment of levodopa induced dyskinesia: a brief review of the drugs tested in the clinic.","authors":"Imane Frouni, P. Huot","doi":"10.2217/nmt-2021-0055","DOIUrl":"https://doi.org/10.2217/nmt-2021-0055","url":null,"abstract":"Levodopa is the standard treatment for Parkinson's disease, but its use is marred by the emergence of dyskinesia, for which treatment options remain limited. Here, we review the glutamatergic modulators that were assessed for their antidyskinetic potential in clinical trials, including N-methyl-D-aspartate (NMDA) antagonists, agonists at the glycine-binding site on NMDA receptors, metabotropic glutamate (mGlu) 4 agonists, mGlu5 antagonists, α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) antagonists and glutamate release inhibitors. Several agents that were investigated are not selective for their targets, raising uncertainty about the extent to which glutamatergic modulation contributed to their effects. Except for amantadine, the use of glutamatergic modulators for the treatment of dyskinesia in Parkinson's disease remains largely investigational, with promising results obtained with mGlu5 negative allosteric modulation.","PeriodicalId":19114,"journal":{"name":"Neurodegenerative disease management","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47403834","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}

{"title":"A qualitative examination of apathy and physical activity in Huntington's and Parkinson's disease.","authors":"K. Atkins, C. Friel, Sophie C Andrews, T. Chong, J. Stout, L. Quinn","doi":"10.2217/nmt-2021-0047","DOIUrl":"https://doi.org/10.2217/nmt-2021-0047","url":null,"abstract":"Aim: In Huntington's disease (HD) and Parkinson's disease (PD), apathy is a frequently cited barrier to participation in physical activity. Current diagnostic criteria emphasize dissociable variants of apathy that differentially affect goal-directed behavior. How these dimensions present and affect physical activity in HD and PD is unknown. Methods: Using a qualitative approach, we examined the experience of apathy and its impact on physical activity in 20 people with early-manifest HD or idiopathic PD. Results: Two major themes emerged: the multidimensionality of apathy, including initiation or goal-identification difficulties, and the interplay of apathy and fatigue; and facilitators of physical activity, including routines, safe environments and education. Conclusion: Physical activity interventions tailored to apathy phenotypes may maximize participant engagement.","PeriodicalId":19114,"journal":{"name":"Neurodegenerative disease management","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2022-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49329481","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}

{"title":"Evidence-based management of multiple sclerosis spasticity with nabiximols oromucosal spray in clinical practice: a 10-year recap.","authors":"A. Chan, C. Silván","doi":"10.2217/nmt-2022-0002","DOIUrl":"https://doi.org/10.2217/nmt-2022-0002","url":null,"abstract":"Effective symptomatic management of multiple sclerosis (MS) spasticity remains an unmet need for many patients. The second-line option nabiximols is the most widely investigated of the noninvasive antispasticity medications in this patient population. Clinical evidence accumulated with nabiximols since it was first approved in Europe in 2010 suggests that about 40% of initial responders (i.e., those with ≥20% improvement in their baseline 0-10 Numerical Rating Scale score) may expect to achieve clinically meaningful (≥30% Numerical Rating Scale response) and durable symptomatic improvement in MS spasticity. During 10 years' routine use of nabiximols, no new safety signals have emerged. Nabiximols-associated improvement in MS spasticity-related symptoms such as pain and sleep disruption suggests a need to track possible therapeutic effects beyond muscle tone control.","PeriodicalId":19114,"journal":{"name":"Neurodegenerative disease management","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2022-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45184496","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}