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Therapeutic Advances in Neurological Disorders

Elena H Martinez-Lapiscina, Maria Sepulveda, Ruben Torres-Torres, Salut Alba-Arbalat, Sara Llufriu, Yolanda Blanco, Ana M Guerrero-Zamora, Nuria Sola-Valls, Santiago Ortiz-Perez, Pablo Villoslada, Bernardo Sanchez-Dalmau, Albert Saiz
No abstract text is available yet for this article.
September 2016: Therapeutic Advances in Neurological Disorders
Johan Zelano
Stroke is among the most common causes of epilepsy after middle age. Patients with poststroke epilepsy (PSE) differ in several respects from patients with other forms of structural-metabolic epilepsy; not least in age, age-related sensitivity to side effects of antiepileptic drugs (AEDs), and specific drug-drug interaction issues related to secondary-stroke prophylaxis. Encouragingly, there has lately been remarkable activity in the study of PSE. Three developments in PSE research deserve particular focus. First, large prospective trials have established the incidence and risk factors of PSE in the setting of modern stroke care...
September 2016: Therapeutic Advances in Neurological Disorders
Matilde Capi, Martina Curto, Luana Lionetto, Fernando de Andrés, Giovanna Gentile, Andrea Negro, Paolo Martelletti
Migraine is a multifactorial, neurological and disabling disorder, also characterized by several autonomic symptoms. Triptans, selective serotonin 5-HT1B/1D agonists, are the first-line treatment option for moderate-to-severe headache attacks. In this paper, we review the recent data on eletriptan clinical efficacy, safety, and tolerability, and potential clinically relevant interactions with other drugs. Among triptans, eletriptan shows a consistent and significant clinical efficacy and a good tolerability profile in the treatment of migraine, especially for patients with cardiovascular risk factors without coronary artery disease...
September 2016: Therapeutic Advances in Neurological Disorders
Hiroshi Mitoma, Mario Manto
Cerebellar ataxias represent a group of heterogeneous disorders impacting on activities of daily living and quality of life. Various therapies have been proposed to improve symptoms in cerebellar ataxias. This review examines the physiological background of the various treatments currently administered worldwide. We analyze the mechanisms of action of drugs with a focus on aminopyridines and other antiataxic medications, of noninvasive cerebellar stimulation, and of motor rehabilitation. Considering the cerebellum as a controller, we propose the novel concept of 'restorable stage'...
September 2016: Therapeutic Advances in Neurological Disorders
Klaus Rose, Thomas Müller
BACKGROUND: Both the United States (US) Food and Drug Administration (FDA) and the European Union (EU) European Medicines Agency (EMA) order pediatric clinical trials as a condition for approval of new compounds. We evaluate clinical value and likelihood of sufficient recruitment for pediatric multiple sclerosis (pMS) studies and discuss US and EU pediatric legislation with pMS as a paradigm. METHODS: We analyzed pMS clinical trials requested by the FDA and the EMA and industry-sponsored pMS studies registered on www...
September 2016: Therapeutic Advances in Neurological Disorders
Antonios Bayas, Katrin Schuh, Monika Baier, Stefan Viktor Vormfelde
OBJECTIVES: Approximately one in two patients with multiple sclerosis (MS) suffer from comorbid depression. The primary objective of this study was to evaluate the safety and tolerability of fingolimod and antidepressant combination in relapsing-remitting MS patients with mild-to-moderate depression. Efficacy outcome variables were quality of life (QoL), fatigue, disability and depression. METHODS: Patients received open-label fingolimod 0.5 mg over 2 weeks, followed by fingolimod plus citalopram (40 mg), fluoxetine (40 mg) or venlafaxine (150 mg) over 16 weeks...
September 2016: Therapeutic Advances in Neurological Disorders
Divyanshu Dubey, Zehra Farzal, Ryan Hays, L Steven Brown, Steven Vernino
BACKGROUND: The objective of this study was to analyze published literature on autoimmune epilepsy and assess predictors of seizure outcome. METHODS: From PubMed and EMBASE databases, two reviewers independently identified publications reporting clinical presentations, management and outcomes of patients with autoimmune epilepsy. A meta-analysis of 46 selected studies was performed. Demographic/clinical variables (sex, age, clinical presentation, epilepsy focus, magnetic resonance imaging [MRI] characteristics, time to diagnosis and initiation of immunomodulatory therapy, and type of immunomodulatory therapy) were compared between two outcome groups (responders and nonresponders)...
September 2016: Therapeutic Advances in Neurological Disorders
Aristeidis H Katsanos, Dimitris Mavridis, John Parissis, Spyridon Deftereos, Alexandra Frogoudaki, Agathi-Rosa Vrettou, Ignatios Ikonomidis, Maria Chondrogianni, Apostolos Safouris, Angeliki Filippatou, Konstantinos Voumvourakis, Nikos Triantafyllou, John Ellul, Theodore Karapanayiotides, Sotirios Giannopoulos, Anne W Alexandrov, Andrei V Alexandrov, Georgios Tsivgoulis
BACKGROUND: Novel oral anticoagulants (NOACs) have shown to be both safe and effective for ischemic stroke prevention in patients with nonvalvular atrial fibrillation (NVAF). We conducted a network meta-analysis (NMA) using published data from secondary prevention subgroups of different phase III randomized clinical trials (RCTs) comparing individual NOACs with warfarin. METHODS: Eligible studies were identified by searching MEDLINE and SCOPUS and the Cochrane Central Register of Controlled Trials databases...
September 2016: Therapeutic Advances in Neurological Disorders
Georgios Tsivgoulis, Aristeidis H Katsanos, Georgios Magoufis, Odysseas Kargiotis, Georgios Papadimitropoulos, Konstantinos Vadikolias, Theodoros Karapanayiotides, John Ellul, Anne W Alexandrov, Panayiotis D Mitsias, Andrei V Alexandrov
OBJECTIVES: The cumulative safety and efficacy measures of percutaneous transluminal angioplasty and stenting (PTAS) for secondary stroke prevention in patients with symptomatic intracranial arterial stenosis (sICAS) have not previously been evaluated using a meta-analytical approach. METHODS: We conducted a systematic review and random effects meta-analysis of all available randomized controlled trials (RCTs) evaluating the safety and efficacy of PTAS (in comparison with medical therapy) for sICAS...
September 2016: Therapeutic Advances in Neurological Disorders
Domenico Plantone, Floriana De Angelis, Anisha Doshi, Jeremy Chataway
No abstract text is available yet for this article.
July 2016: Therapeutic Advances in Neurological Disorders
Verena I Leussink, Hans-Peter Hartung, Bernd C Kieseier, Mark Stettner
Intravenous immunoglobulins represent an established therapy for the treatment of chronic immune-mediated neuropathies, specifically chronic inflammatory demyelinating polyradiculoneuropathies (CIDPs) as well as multifocal motor neuropathies (MMNs). For the treatment of antibody deficiency syndromes, subcutaneous immunoglobulins (SCIgs) have represented a mainstay for decades. An emerging body of evidence suggests that SCIg might also exhibit clinical efficacy in CIDP and MMN. This article reviews the current evidence for clinical effectiveness, as well as safety of SCIg for the treatment of immune-mediated neuropathies, and addresses remaining open questions in this context...
July 2016: Therapeutic Advances in Neurological Disorders
Alexander Tallner, Klaus Pfeifer, Mathias Mäurer
The World Wide Web is increasingly used in therapeutic settings. In this regard, internet-based interventions have proven effective in ameliorating several health behaviors, amongst them physical activity behavior. Internet-delivered interventions have shown positive effects on physical activity and physical function in persons with MS (pwMS). In this review we give an overview on several online exercise programs for pwMS and discuss the advantages and drawbacks of web-based interventions. Although participants of online exercise programs reported a high acceptance and satisfaction with the intervention, decreasing compliance was a major issue...
July 2016: Therapeutic Advances in Neurological Disorders
Rigmor Højland Jensen, Aleksandra Radojicic, Hanne Yri
Idiopathic intracranial hypertension (IIH) is a challenging disorder with a rapid increasing incidence due to a close relation to obesity. The onset of symptoms is often insidious and patients may see many different specialists before the IIH diagnosis is settled. A summary of diagnosis, symptoms, headache characteristics and course, as well as existing evidence of treatment strategies is presented and strategies for investigations and management are proposed.
July 2016: Therapeutic Advances in Neurological Disorders
Dingbang Chen, Xiangxue Zhou, Haiman Hou, Li Feng, JunXiu Liu, Yinyin Liang, Xiaopu Lin, Jiwei Zhang, Chao Wu, Xiuling Liang, Zhong Pei, Xunhua Li
OBJECTIVES: There are limited pharmacological treatments for patients with neurological Wilson's disease (WD) and a history of copper-chelating treatment failure. METHODS: We retrospectively evaluated the clinical records of 38 patients with WD who were treated with sodium dimercaptopropanesulfonate (DMPS) and zinc (group 1) or zinc alone (group 2). All patients had a history of neurological deterioration during their previous treatment with D-penicillamine (DPA)...
July 2016: Therapeutic Advances in Neurological Disorders
Anne W Alexandrov, Kisha C Coleman, Paola Palazzo, Reza Bavarsad Shahripour, Andrei V Alexandrov
BACKGROUND: In the USA, stable intravenous tissue plasminogen activator (IV tPA) patients have traditionally been cared for in an intensive care unit (ICU). We examined the safety of using an acuity-adaptable stroke unit (SU) to manage IV tPA patients. METHODS: We conducted an observational study of consecutive patients admitted to our acuity-adaptable SU over the first 3 years of operation. Safety was assessed by symptomatic intracerebral hemorrhage (sICH) rates, systemic hemorrhage (SH) rates, tPA-related deaths, and transfers from SU to ICU; cost savings and length of stay (LOS) were determined...
July 2016: Therapeutic Advances in Neurological Disorders
Christiane Schneider-Gold, Marco Krenzer, Erdmute Klinker, Behrouz Mansouri-Thalegani, Wolfgang Müllges, Klaus V Toyka, Ralf Gold
OBJECTIVES: The goal of this study was to analyze safety and assess the efficacy of standard plasma exchange (PE) compared with immunoadsorption (IA) alone, or an alternating combination of both in deteriorating myasthenia gravis (MG). METHODS: A total of 72 patients with MG who had received PE procedures for treatment of severe deterioration were retrospectively analyzed. They received either five cycles of PE (1-1.5 plasma volumes), or five cycles of IA in line with plasma separation, or a sequential alternating procedure of one cycle of PE followed by two cycles of IA, which was repeated once or more if needed...
July 2016: Therapeutic Advances in Neurological Disorders
Larry D Lynd, Anthony Traboulsee, Carlo A Marra, Nicole Mittmann, Charity Evans, Kathy H Li, Melanie Carter, Celestin Hategekimana
BACKGROUND: With recent developments in drug therapy for multiple sclerosis (MS), new treatment options have become available presenting patients with complex treatment decisions. OBJECTIVES: The objective of this study was to elicit patients' preferences for different attributes of MS drug therapy. METHODS: A representative sample of patients with MS across Canada (n=189) participated in a best-worst scaling study to quantify preferences for different attributes of MS drug therapy, including delaying progression, improving symptoms, preventing relapse, minor side effects, rare but serious adverse events (SAEs), and route of administration...
July 2016: Therapeutic Advances in Neurological Disorders
Simon Faissner, Johanna Nikolayczik, Andrew Chan, Ralf Gold, Min-Suk Yoon, Aiden Haghikia
INTRODUCTION: Neuromyelitis optica spectrum disorder (NMOSD) is a neuroinflammatory disorder of the central nervous system, distinct from multiple sclerosis by affecting predominantly the optic nerve and the spinal cord, and mediated by antibodies directed against aquaporin 4 (AQP4-ab) as a possible pathomechanistic hallmark of NMOSD. Therapeutic options include immunosuppression with steroids or B-cell-depleting agents as baseline therapies, as well as plasma exchange (PLEX) and/or immunoadsorption (IA) during relapses...
July 2016: Therapeutic Advances in Neurological Disorders
Kathrin S Utz, De-Hyung Lee, Alexandra Lämmer, Anne Waschbisch, Ralf A Linker, Thomas Schenk
OBJECTIVES: Disease-modifying therapies (DMTs) are applied to delay or prevent disease progression in multiple sclerosis (MS). While this has mostly been proven for physical symptoms, available studies regarding long-term effects of DMTs on cognitive functions are rare and sometimes inconsistent due to methodological shortcomings. Particularly in the case of fingolimod, comprehensive data on cognitive functions are not yet available. Therefore, we set out to reliably assess cognitive functions in patients with relapsing-remitting MS (RRMS) treated with DMTs over 1 year...
July 2016: Therapeutic Advances in Neurological Disorders
Thomas Müller, Thomas Herrling, Sven Lütge, Lutz Lohse, Gabi Öhm, Katinka Jung
INTRODUCTION: Cerebrospinal fluid analysis may provide insight into the interplay between chronic inflammation and response to treatment. OBJECTIVES: To demonstrate the impact of one intrathecal triamcinolone injection on the redox potential and on ascorbyl radical appearance in the cerebrospinal fluid of chronic progressive multiple sclerosis patients. METHODS: A total of 16 patients received 40 mg triamcinolone. Electron-spin resonance spectroscopy measured the oxidation range after copper ion [Cu (II)] addition and ascorbyl-radical bioavailability...
July 2016: Therapeutic Advances in Neurological Disorders
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