US neurology最新文献

{"title":"Proton Pump Inhibitor Use and Risk of Dementia in Older Adults: A Systematic Review","authors":"Xiaoyi Gao, Z. Shao, N. Grysman, G. Grossberg","doi":"10.17925/usn.2023.19.1.21","DOIUrl":"https://doi.org/10.17925/usn.2023.19.1.21","url":null,"abstract":"Proton pump inhibitors (PPIs) are commonly used for gastroesophageal reflux disease. Previous studies have raised concerns about the impact of PPIs on cognition in older adults, but the evidence supporting this concern is lacking. This article aims to analyse the available data regarding the impact of long-term PPI use on cognition in older adults. We searched PubMed for relevant studies conducted between 2015 and 2022. Seventeen such studies were identified. Limitations to available research data include the fact that studies are mainly observational, use heterogeneous study methods and do not account for confounding variables such as B12 deficiency, Helicobacter pylori infection, and thyroid dysfunction. Overall, this search did not find a compelling association between PPI use and cognitive decline.","PeriodicalId":90076,"journal":{"name":"US neurology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67614166","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":"History of Frameless Radiosurgery","authors":"Eric B. Hintz, A. Goenka, M. Schulder","doi":"10.17925/usn.2023.19.1.30","DOIUrl":"https://doi.org/10.17925/usn.2023.19.1.30","url":null,"abstract":"Radiosurgical methods have made significant advancements in the past 50 years. From the patient’s perspective, the transition from invasive to non-invasive frames has been the most meaningful change. In this review article, we provide an overview of the stepwise evolution of frame technology and discuss the external pressures that prompted modifications.","PeriodicalId":90076,"journal":{"name":"US neurology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67614177","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":"Exploring the Impact of Coronavirus Disease 2019 on Dementia: A Review","authors":"Michael Axenhus, B. Winblad","doi":"10.17925/usn.2023.19.1.16","DOIUrl":"https://doi.org/10.17925/usn.2023.19.1.16","url":null,"abstract":"The coronavirus disease 2019 (COVID-19) pandemic has caused significant disruptions to almost every healthcare system worldwide. Older adults have been hit disproportionately hard by the pandemic, with most deaths occurring among people aged 75 or older. Dementia researchers have noted the increased dementia-related mortality among older adults and fewer dementia diagnoses during the pandemic. Questions have therefore been raised regarding the effects of the COVID-19 virus on dementia prevalence and mortality. As a groundbreaking dementia treatment is about to hit the market, proper diagnoses of dementia are now more important than ever. There are also concerns that the COVID-19 virus could precipitate dementia and worsen dementia symptoms. This short review examines the current scientific evidence on the impact of COVID-19 on dementia mortality and prevalence, as well as describing the pathophysiological mechanisms by which COVID-19 might cause dementia and worsen dementia symptoms. Lastly, this review speculates on how dementia epidemiology might change during the next years as a result of the pandemic and provide suggestions for clinicians on how to respond to the coming changes.","PeriodicalId":90076,"journal":{"name":"US neurology","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67613839","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":"LGMDR1 with Prominent Limb–Joint Contractures and Inflammatory Changes Misdiagnosed as Scleromyositis with a Novel CAPN3 Mutation: A Case Report","authors":"Y. Abida, H. Benrhouma, Emna Farhat, T. B. Younes, I. Habibi, H. Klaa, A. Reymond, I. Kraoua, I. Youssef‐Turki","doi":"10.17925/usn.2023.19.1.46","DOIUrl":"https://doi.org/10.17925/usn.2023.19.1.46","url":null,"abstract":"Muscle diseases with prominent limb–joint contractures (LJCs) are a subgroup of rare neuromuscular disorders. Prominent LJCs are not specific to genetic myopathies. Myositis can also induce severe contractures, especially in the late stages. We report the case of a 12-year-old girl with a 3-year history of painful muscular weakness with generalized LJCs. The inflammatory pattern associated with positive anti-PM/ Scl antibodies on muscle biopsy allowed us to initially retain the diagnosis of scleromyositis. After 12 months of corticosteroids and immunosuppressive treatment, there was no clinical improvement, and creatine kinase levels remained high (over 10 times the normal value). A second muscle biopsy showed persistent inflammatory infiltrate with the appearance of dystrophic features. Immunohistochemical analysis showed the absence of class 1 major histocompatibility complex expression on muscle fibres, raising the possibility of the diagnosis of muscular dystrophy. Whole-exome sequencing revealed a missense homozygous novel mutation c.386G>T (p.Arg129Ile) on the calpain 3 gene, finally confirming the diagnosis of autosomal recessive limb–girdle muscular dystrophy recessive type 1 (or calpainopathy). This case report highlights the diagnostic challenges and the importance of a comprehensive evaluation in cases of muscle diseases with prominent LJCs.","PeriodicalId":90076,"journal":{"name":"US neurology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67614242","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":"Pridopidine: Topline Results from the Phase III Trial, PROOF-HD, for the Treatment of Huntington’s Disease","authors":"R. Reilmann","doi":"10.17925/usn.2023.19.2.3","DOIUrl":"https://doi.org/10.17925/usn.2023.19.2.3","url":null,"abstract":"<p />","PeriodicalId":90076,"journal":{"name":"US neurology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67614413","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":"Treatment for Spinal Muscular Atrophy Using Onasemnogene Abeparvovec","authors":"C. Bekircan-Kurt, M. Waldrop, A. Connolly, J. Mendell","doi":"10.17925/usn.2022.18.2.133","DOIUrl":"https://doi.org/10.17925/usn.2022.18.2.133","url":null,"abstract":"Spinal muscular atrophy (SMA) is the most common cause of death in infancy. Recently introduced molecular-based approaches have changed the poor prognosis, saved lives and improved the quality of life for those affected with SMA. Gene therapy uses an adeno-associated virus (AAV) to deliver and replace the mutant survival of motor neuron (SMN ) genes, SMN1 and SMN2. This review describes the development, relative safety and efficacy of intravenously delivered AAV for SMA type 1 and the intrathecal delivery for SMA type 2. For SMA, viral immunosuppressive treatment and AAV doses never used in clinical research or practice were required for success. As a prototype, the approach has greatly influenced the development of treatment for other childhood and adult diseases. Two additional pharmacologic agents, nusinersen and risdiplam, are clinically approved as alternative treatments. Both use antisense oligonucleotides and are briefly described in this review.","PeriodicalId":90076,"journal":{"name":"US neurology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67613982","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":"Computed Tomography Perfusion Deficit as an Indicator for Reperfusion in Large-vessel Occlusions with Low National Institutes of Health Stroke Scale Scores in Acute Ischaemic Stroke: A Retrospective Review","authors":"S. Kothari, Uttam Verma, Michael I Nahhas, J. Waller, S. Rahimi, J. Switzer, D. Giurgiutiu","doi":"10.17925/usn.2022.18.2.147","DOIUrl":"https://doi.org/10.17925/usn.2022.18.2.147","url":null,"abstract":"Background: Endovascular thrombectomy (EVT) has proven to be successful in acute ischaemic stroke (AIS) with a National Institutes of Health Stroke Scale (NIHSS) score of >8, but remains controversial in AIS with an NIHSS score of <8. This study evaluated computed tomography (CT) perfusion indicators for EVT in large-vessel occlusion (LVO) ischaemic strokes with low NIHSS scores. Methods: We retrospectively reviewed data from 49 patients with AIS, LVO and an NIHSS score of <8 who received medical therapy (n=27), or rescue (n=10) or urgent (n=12) thrombectomy. Therapy decision was made from clinical course and perfusion imaging. The urgent group underwent EVT in <6 hours. The rescue group underwent EVT in >6 hours due to increasing NIHSS scores; this included patients who presented after 6 hours and underwent urgent EVT. Modified Rankin scores were obtained at 3 months to assess outcomes. Results: More patients in the urgent group (91.7%) had a discharge NIHSS improvement (>1) compared with the rescue (50.0%) and medical (51.9%) groups (p=0.02). The urgent group displayed thrombolysis in cerebral infarction (TICI) scores of 2b/3 in 100% of patients, whereas the rescue group displayed TICI scores of 2b/3 in 80% and 1/2a in 20% (p=0.076). The perfusion core (cerebral blood flow [CBF] <30%) was not different between the groups (2.1 cm3, 1.0 cm3 and 9.2 cm3, for urgent, rescue and medical groups, respectively). The perfusion penumbra (time to max [Tmax] >6 s) and mismatch (Tmax minus CBF) were significantly larger for the urgent and rescue groups. Penumbra volume was 80.1 cm3, 107.5 cm3 versus 50.6 cm3 (p=0.011), and mismatch was 78.0 cm3, 106.5 cm3 versus 41.5 cm3 (p=0.002) for urgent and rescue thrombectomy versus medical therapy, respectively. Conclusion: The biggest driver of urgent reperfusion was a larger penumbra seen on CT perfusion, which appeared to show better outcomes in NIHSS scores at discharge without any difference in 3-month outcomes graded by modified Rankin scores. Our data suggest that larger perfusion deficits on CT imaging may serve as a tool for patient selection for EVT in LVO with an NIHSS score of <8 and should be investigated further.","PeriodicalId":90076,"journal":{"name":"US neurology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67614019","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":"Neurological Manifestations of SARS-CoV-2 Infection and the Role of Complement Activation","authors":"M. Jaffry, Iqra Faiz, K. Jaffry, N. Souayah","doi":"10.17925/usn.2022.18.2.86","DOIUrl":"https://doi.org/10.17925/usn.2022.18.2.86","url":null,"abstract":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, while considered a respiratory illness, is associated with a wide range of neurological manifestations, with severity ranging from transient deficit to permanent disability and death. These neurological manifestations can be divided into central nervous system complications, which include cerebrovascular disease and encephalopathies, and peripheral nervous system complications, which involve the muscle (i.e. muscle injuries, myositis, and peripheral and cranial neuropathies). Complement overactivation has been observed clinically in many studies and is hypothesized to be involved in a variety of pathogenic mechanisms of SARS-CoV-2 infection. These include endothelial damage, thrombosis and hyperinflammation, all of which are completely interconnected and integrated. This article broadly describes the diverse neurological effects of coronavirus disease 2019 and delves into the current literature available on complement in this context.","PeriodicalId":90076,"journal":{"name":"US neurology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67613711","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":"Neuromodulation for Prevention and Treatment of Headache Disorders","authors":"Risako Shirane, E. Kim, Daniela Riveros, Huma U. Sheikh","doi":"10.17925/usn.2022.18.2.103","DOIUrl":"https://doi.org/10.17925/usn.2022.18.2.103","url":null,"abstract":"Neuromodulation is a treatment modality that can be used in the abortive and preventive treatment of migraine and other primary headache disorders. The basic concept of neurostimulation is to manipulate peripheral or central pain pathways with either magnetic or electrical impulses. Common neuromodulation techniques include occipital nerve stimulation, which is the oldest technique, and trigeminal nerve stimulation, combined occipital and trigeminal nerve stimulation, sphenopalatine ganglion stimulation, vagus nerve stimulation and transcranial magnetic stimulation, which were introduced soon after. The two newest modalities are remote electrical neuromodulation and caloric vestibular stimulation, the last of which is still in the experimental phases.","PeriodicalId":90076,"journal":{"name":"US neurology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67613888","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":"Lifestyle Measures in Multiple Sclerosis","authors":"C. Fernandez-Carbonell, Natasha Hameed, A. Harel","doi":"10.17925/usn.2022.18.2.122","DOIUrl":"https://doi.org/10.17925/usn.2022.18.2.122","url":null,"abstract":"Despite substantial breakthroughs in pharmacological therapies for multiple sclerosis (MS) over the past two decades, lifestyle modification remains an important strategy in managing symptoms and potentially preventing disability for people with MS. There is growing evidence that certain dietary factors may influence MS incidence, symptoms and disease course. Obesity, which is closely linked to diet, has been shown to be a risk factor for the development and increased severity of MS. Although the precise mechanisms by which the above factors exert their effects on MS are unknown, it is important for physicians to consider how these factors can influence the management of patients with MS. For example, sleep interventions and regular exercise may help with the common symptoms of MS, such as fatigue, cognitive dysfunction and mood disorders. Other important interventions include avoidance of tobacco smoke and adequate vitamin D intake. This review summarizes existing knowledge regarding the abovementioned factors with respect to MS incidence and severity.","PeriodicalId":90076,"journal":{"name":"US neurology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67613963","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}