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Neurodegenerative Disease Management

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October 2016: Neurodegenerative Disease Management
Seyed-Mohammad Fereshtehnejad
Among chronic neurodegenerative disorders, Parkinson's disease (PD) is one of the most difficult and challenging to tackle as several motor and nonmotor features influence the patients' quality of life (QoL) and daily activities. Assessing patients QoL with valid instruments and gathering knowledge about the determinants that affect QoL in individuals with PD are the basis of an efficient caring strategy. In addition to the known motor symptoms, nonmotor disorders must also be comprehensively tracked and targeted for treatment to enhance QoL...
October 2016: Neurodegenerative Disease Management
Stephanie M Schindler, Andis Klegeris
Increased worldwide longevity through medical interventions, although beneficial, has allowed the age-related Alzheimer's disease (AD) to become an epidemic of the 21st century. AD pathology involves adverse activation of microglia, the immune cells of the brain and resulting chronic neuroinflammation. Certain diets, physical inactivity and Type 2 diabetes mellitus have been identified as the risk factors for developing AD, which may increase the risk of AD by neuroimmune mechanisms primarily through the overactivation of microglia...
October 2016: Neurodegenerative Disease Management
Thomas Müller
Patients with Parkinson's disease suffer from impaired motor behavior due to the dopaminergic striatal deficit and nonmotor symptoms, which also result from nondopaminergic neuronal death. This review provides a personal opinion on treatment strategies for symptoms, resulting at least partially from nondopaminergic neurodegeneration, and on therapeutic modulation of dopaminergic neurotransmission. Patient-tailored treatment regimes on the basis of an individual risk benefit ratio as essential precondition try to balance all these symptoms...
October 2016: Neurodegenerative Disease Management
Virginia Meca-Lallana, Rafael Arroyo-González, José Meca-Lallana, Javier Martín-Hernández, Rainel Sánchez-de la Rosa
AIM: To create a national consensus checklist to assess newly diagnosed multiple sclerosis patients when considering treatment initiation in Spain. MATERIALS & METHODS: The Delphi consensus method was used. A scientific committee drafted items/domains, 52 experts evaluated their inclusion in the project checklist and 47 experts assessed checklist use in clinical practice. RESULTS: Forty-eight items from seven dimensions were selected: sociodemographics, n = 3; medical history, n = 10; multiple sclerosis clinical factors, n = 14; laboratory/MRI, n = 8; multiple sclerosis signs affecting treatment, n = 4; multiple sclerosis signs affecting management, n = 1; treatment-related features, n = 8...
October 2016: Neurodegenerative Disease Management
Margherita Fabbri, Mario M Rosa, Joaquim J Ferreira
Two catechol-O-methyl transferase inhibitors are currently used as add-on therapy to levodopa for the amelioration of end-of-dose motor fluctuations in Parkinson's disease patients: entacapone, which has moderate efficacy and requires multiple dosing, and tolcapone, which has a poor safety profile. Opicapone (OPC) is a novel, long-acting, peripherally selective, once daily, third-generation catechol-O-methyl transferase inhibitor. Two Phase III clinical trials demonstrated OPC efficacy in reducing OFF-time by an average of about 60 min daily compared with placebo, without increasing ON-time with troublesome dyskinesias, with a good drug safety profile...
October 2016: Neurodegenerative Disease Management
Alberto Cucca, Milton C Biagioni, Jori E Fleisher, Shashank Agarwal, Andre Son, Pawan Kumar, Miroslaw Brys, Alessandro Di Rocco
Freezing of gait (FOG) is 'an episodic inability to generate effective stepping in the absence of any known cause other than parkinsonism or high level gait disorders'. FOG is one of the most disabling symptoms in Parkinson's disease, especially in its more advanced stages. Early recognition is important as FOG is related to higher fall risk and poorer prognosis. Although specific treatments are still elusive, there have been recent advances in the development of new therapeutic approaches. The aim of this review is to present the latest knowledge regarding the phenomenology, pathogenesis, diagnostic assessment and conventional treatment of FOG in Parkinson's disease...
October 2016: Neurodegenerative Disease Management
Kristen Dams-O'Connor, Gabrielle Guetta, Amanda E Hahn-Ketter, Andrew Fedor
There is growing concern about the late effects of traumatic brain injury (TBI). This scoping review summarizes clinical research from the past 10 years that evaluates the relationship between TBI and Alzheimer's disease. This review identified five studies that found increased risk for dementia after TBI, two studies that found no increased risk and four studies that found a relationship only under certain conditions or in specified subsamples. Methodological differences across studies preclude direct comparison of results, and discrepant findings elucidate the complex course of post-TBI neurodegeneration...
October 2016: Neurodegenerative Disease Management
Deepak Kumar Vijaya Kumar, William A Eimer, Rudolph E Tanzi, Robert D Moir
No abstract text is available yet for this article.
October 2016: Neurodegenerative Disease Management
Sheharyar Sajjad Baig, Mark Strong, Oliver Wj Quarrell
The ascertained prevalence of Huntington's disease (HD) increased significantly following the provision of diagnostic testing. A systematic review was conducted to estimate the prevalence of HD in the post-diagnostic testing era. 22 studies with original data pertaining to the prevalence of HD (1993-2015) were included and analyzed. A global meta-analysis was not performed due to heterogeneity in study methods and geographical variation. The prevalence of HD is significantly lower in Asian populations compared with western Europe, North America and Australia...
August 2016: Neurodegenerative Disease Management
José Meca-Lallana, Mar Mendibe, Rocío Hernández-Clares, Ana Belén Caminero, Javier Mallada-Frechin, Pablo Dávila-Gonzalez, Moisés Garcés-Redondo, Montserrat Gómez, Jorge Millán-Pascual, Gerardo Soriano-Hernández, María Del Campo Amigo-Jorrín
AIM: To assess potential predictors for burden and depression among caregivers of relapsing-remitting multiple sclerosis patients in Spain. Family functioning and social support were also assessed. PATIENTS & METHODS: Multicenter and cross-sectional study in relapsing-remitting multiple sclerosis adult patients and their respective informal caregivers (n = 180). Assessment performed: Zarit Scale (Burden), Center for Epidemiologic Studies Depression-7 Scale (depression), Family APGAR (Adaptation, Partnership, Growth, Affection, Resolve) Questionnaire (family functioning) and Duke UNC-11 Functional Social Support Questionnaire (social support)...
August 2016: Neurodegenerative Disease Management
Francesc Valldeoriola, Francisco Grandas, Diego Santos-García, Ignacio Regidor, María José Catalán, José Matías Arbelo, Víctor Puente, Pablo Mir, Juan Carlos Parra
AIM: To assess long-term effectiveness and tolerability of levodopa-carbidopa intestinal gel (LCIG) in Spanish patients with advanced Parkinson's disease. PATIENTS & METHODS: This was an observational, multicenter, cross-sectional, retrospective study. RESULTS: Data of 177 patients were analyzed. LCIG treatment led to a reduction in the percentage of daily 'off' time (16.2 vs 47.6% before LCIG), an increase in the percentage of daily 'on' time without disabling dyskinesia (55...
August 2016: Neurodegenerative Disease Management
Paul Cannon, Andrew J Larner
AIM: To measure the frequency of scoring and reporting errors in cognitive screening instruments administered in the primary care setting in consecutive referrals to a dedicated secondary care memory clinic. METHODS: Using a simple ad hoc classification, referral letters from primary care mentioning cognitive screening instrument use were classified as: unequivocal, incorrect/ambiguous or incomplete. RESULTS: Overall, reported test scores were either ambiguous/incorrect or incomplete in 23% of cases, with higher individual frequencies for two screening instruments recommended for use in primary care, the Six-item Cognitive Impairment Test (26%) and the General Practitioner Assessment of Cognition (32%)...
August 2016: Neurodegenerative Disease Management
Kyle A Smith, Rajesh Pahwa, Kelly E Lyons, Jules M Nazzaro
Parkinson's disease is a neurodegenerative condition secondary to loss of dopaminergic neurons in the substantia nigra pars compacta. Surgical therapy serves as an adjunct when unwanted medication side effects become apparent or additional therapy is needed. Deep brain stimulation emerged into the forefront in the 1990s. Studies have demonstrated improvement in all of the cardinal parkinsonian signs with stimulation. Frameless and 'mini-frame' stereotactic systems, improved MRI for anatomic visualization, and intraoperative MRI-guided placement are a few of the surgical advances in deep brain stimulation...
August 2016: Neurodegenerative Disease Management
Daniel Martinez-Ramirez, Michael S Okun, Michael S Jaffee
Parkinson's disease (PD) is a chronic and complex neurodegenerative disorder resulting in a mixture of motor and nonmotor symptoms. Psychosis develops in around 60% of PD patients during and can be one of the most challenging nonmotor symptoms. PD psychosis is considered the single greatest precipitant for nursing home placement. PD psychosis is an independent predictor of increased mortality, and there is no 'ideal' or universal treatment strategy. The treatment approach to PD psychosis should be tailored and individualized for each patient...
August 2016: Neurodegenerative Disease Management
Christian Johannes Hartmann, Stefan Jun Groiss, Jan Vesper, Alfons Schnitzler, Lars Wojtecki
Huntington's disease (HD) is a hereditary neurodegenerative disorder which is associated with severe disturbances of motor function, especially choreatic movements, cognitive decline and psychiatric symptoms. Various brain stimulation methods have been used to study brain function in patients with HD. Moreover, brain stimulation has evolved as an alternative or additive treatment option, besides current symptomatic medical treatment. This article summarizes the results of brain stimulation to better understand the characteristics of cortical excitability and plasticity in HD and gives a perspective on the therapeutic role for noninvasive and invasive neuromodulatory brain stimulation methods...
June 2016: Neurodegenerative Disease Management
Maria Eliza Freitas, Susan H Fox
Parkinson's disease is primarily caused by dysfunction of dopaminergic neurons, however, nondopaminergic (ND) systems are also involved. ND targets are potentially useful to reduce doses of levodopa or to treat nonlevodopa-responsive symptoms. Recent studies have investigated the role of ND drugs for motor and nonmotor symptoms. Adenosine A2A receptor antagonists, mixed inhibitors of sodium/calcium channels and monoamine oxidase-B have recently been found to improve motor fluctuations. N-methyl-d-aspartate receptor antagonists and serotonin 5HT1B receptor agonists demonstrated benefit in levodopa-induced dyskinesia...
June 2016: Neurodegenerative Disease Management
Jeffrey A Allen, Vera Bril
This article considers several issues of current interest relating to the management of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), including diagnostic pitfalls, differences between CIDP patients with and without concurrent diabetes mellitus and how to best measure treatment response in daily practice. Despite the availability of diagnostic criteria, many patients diagnosed with CIDP do not meet these criteria; reasons for misdiagnosis are discussed. There are no definitive predictors of treatment response in CIDP; however, certain clinical and electrophysiological characteristics may be helpful...
June 2016: Neurodegenerative Disease Management
Alberto Costa, Carlo Caltagirone
The risk of alexithymia in individuals with Parkinson's disease (PD) is about double compared with that observed in the general population. This finding indicates that alexithymia may be a relevant phenomenon in PD. However, several issues have to be clarified. The review here proposed outlines two main points. First, available data do not allow the clarification of whether alexithymia is independently associated with PD or if it is secondary to other mood and/or cognitive disorders. Second, it is not well understood how PD-related neurobiological changes may account for alexithymic expression...
June 2016: Neurodegenerative Disease Management
Jofre Güell-Bosch, Laia Montoliu-Gaya, Gisela Esquerda-Canals, Sandra Villegas
No abstract text is available yet for this article.
June 2016: Neurodegenerative Disease Management
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