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Neurodegenerative Disease Management

Andrea Stoccoro, Fabio Coppedè
Advances in molecular biology technologies have allowed uncovering the role of epigenetic regulation in several complex diseases, such as cancer and neurodegenerative disorders. Although the role of epigenetic mechanisms in Alzheimer's disease is still little understood, recent findings clearly show that such mechanisms are dysregulated during disease progression, already in its early stages. However, it is not clear if the observed epigenetic changes represent a cause or a consequence of the disease. Promising results are emerging from studies performed in peripheral blood DNA that could provide early biomarkers of the pathology...
June 11, 2018: Neurodegenerative Disease Management
Hikmat Hadoush, Saleem A Banihani, Hanan Khalil, Yasir Al-Qaisi, Alham Al-Sharman, Muhammed Al-Jarrah
AIM: To examine BDNF, dopamine, and motor function changes after bilateral anodal transcranial direct current stimulation (tDCS) in patients with Parkinson's disease. METHODS: 20 patients undertook ten sessions of bilateral anodal tDCS stimulation applied simultaneously over FC1/FC2, targeting left and right prefrontal and motor areas. Dopamine and BDNF serum levels, and Movement Disorders Society - Unified Parkinson's Disease Rating Scale part three (MDS-UPDRS-III) total score and disability sub-scores were examined pre/post-tDCS stimulation...
June 11, 2018: Neurodegenerative Disease Management
Christen F Kutz, Amy L Dix
Relapse management is a crucial component of multiple sclerosis care. Acute relapses are defined as new neurological symptoms or worsening of existing symptoms persisting for >24 h that are not attributable to heat, overexertion, or infection. The most commonly used treatment for multiple sclerosis relapse is a 3-5-day course of corticosteroids, primarily intravenous methylprednisolone with or without oral steroid taper. Repository corticotropin injection is also the US FDA-approved option for managing acute relapse, particularly in the patients with inadequate response, intolerability or allergy to corticosteroid treatment; poor venous access; or limited ability to receive home or clinic infusions...
June 5, 2018: Neurodegenerative Disease Management
Javier Mallada Frechín
AIM: To examine evolution in activities of daily living (ADL) in patients with multiple sclerosis spasticity during long-term use of tetrahydrocannabinol (THC):cannabidiol (CBD) oromucosal spray. METHODS: Functional impairment was assessed retrospectively (prior to start of treatment) and at the present moment using a 16-item ADL survey; results were compared. A control group without add-on THC:CBD oromucosal spray was included to investigate possible recall bias...
May 31, 2018: Neurodegenerative Disease Management
Angelo Antonini, Weining Z Robieson, Lars Bergmann, Ashley Yegin, Werner Poewe
AIM: To determine if age and Parkinson's disease duration at therapy initiation influence the efficacy of levodopa-carbidopa intestinal gel (LCIG) on quality of life and activities of daily living. PATIENTS & METHODS: This post hoc analysis assessed subgroups of patients stratified by baseline age, disease duration, hours/day of 'off' time and levodopa equivalent dose. Patients' data were collected from the GLORIA study, a 24-month observational registry evaluating long-term effectiveness of LCIG...
April 10, 2018: Neurodegenerative Disease Management
Mieko Ogino, Aki Shiozawa, Hiroyuki Ota, Shuichi Okamoto, Shinzo Hiroi, Izumi Kawachi
AIM: Use real-world data to investigate the treatment, comorbidities and prevalence of multiple sclerosis (MS) in an employed Japanese population. METHODS: Data from the Japanese Medical Data Center health insurance claims database were analyzed (January 2005-November 2014). Patients with claims associated with an MS diagnosis were identified (n = 494) and comorbidities and prescribed treatments were investigated. MS prevalence within the database was calculated for each calendar year (2011-2013) Results: IFN-β and prednisolone were the most commonly prescribed treatments...
April 2018: Neurodegenerative Disease Management
Ameer Mohammed, Richard Bayford, Andreas Demosthenous
Clinical deep brain stimulation (DBS) is now regarded as the therapeutic intervention of choice at the advanced stages of Parkinson's disease. However, some major challenges of DBS are stimulation induced side effects and limited pacemaker battery life. Side effects and shortening of pacemaker battery life are mainly as a result of continuous stimulation and poor stimulation focus. These drawbacks can be mitigated using adaptive DBS (aDBS) schemes. Side effects resulting from continuous stimulation can be reduced through adaptive control using closed-loop feedback, while those due to poor stimulation focus can be mitigated through spatial adaptation...
April 2018: Neurodegenerative Disease Management
Giacomo Lus, Roberto Cantello, Maura Chiara Danni, Agusto Rini, Paola Sarchielli, Tiziana Tassinari, Elisabetta Signoriello
AIM: Complaints about Δ9 -tetrahydrocannabinol (THC):cannabidiol (CBD) oromucosal spray (Sativex® ; GW Pharma Ltd, Salisbury, UK) in the management of multiple sclerosis spasticity include unpleasant taste and oral mucosal anomalies. This pilot study assessed the use of sugar-free chewing gum and/or a refrigerated bottle of THC:CBD oromucosal spray to mitigate these effects. MATERIALS & METHODS: Patients with multiple sclerosis spasticity (n = 52) at six sites in Italy who were receiving THC:CBD oromucosal spray and had associated oral mucosal effects were randomized into Group A (chewing gum; n = 15); Group B (cold bottle; n = 20); and Group C (cold bottle + chewing gum; n = 17)...
April 2018: Neurodegenerative Disease Management
Mazen T Elkurd, Laxman B Bahroo, Rajesh Pahwa
Levodopa is the most efficacious treatment for Parkinson's disease (PD). Long-term treatment with levodopa is limited due to dyskinesia. Dyskinesia in PD can be socially and functionally disabling. Extended-release amantadine (amantadine ER) is the first approved medication for the treatment of dyskinesia. When it is given at bedtime, it reaches plasma concentration approximately twice the level achieved by amantadine immediate release. Amantadine ER reduces the severity and duration of dyskinesia during the day, reduces OFF time and increases ON time without troublesome dyskinesia...
April 2018: Neurodegenerative Disease Management
Luciano Rossetti
Luciano Rossetti, MD, Executive Vice President, Global Head of R&D at Merck KGaA, Darmstadt, Germany speaks to Laura Dormer, Commissioning Editor Luciano Rossetti, MD, is Executive Vice President, Global Head of R&D at Merck KGaA, Darmstadt, Germany, and a member of the Healthcare Executive Committee. As Global Head of R&D, Rossetti leads the strategy for Merck KGaA, Darmstadt, Germany's discovery and development efforts in healthcare. He joined Merck KGaA in July 2014, and has since led the acceleration of several key programs through the pipeline and advanced the innovation of Merck KGaA's discovery teams into development...
April 2018: Neurodegenerative Disease Management
Elena Ripamonti, Grazia D'Angelo
AIM: In Duchenne muscular dystrophy (DMD), little attention has been paid to severity of respiratory function decline (RFD) based on disease progression. We performed a conjoint analysis among 123 Italian clinicians to generate a scale for RFD in DMD patients. METHODS: Before the interview, 11 attributes were selected by discussion among experts. 32 'patient profiles' were generated. Each physician assessed the severity of RFD for each profile. Each level/attribute was assigned an estimated usefulness to understand its impact on RFD...
April 2018: Neurodegenerative Disease Management
Jennifer Wiener Hartzell, Richard Geary, Kymberly Gyure, Venkata Ravi Chivukula, Marc W Haut
We report a case of a 57-year-old male with clinically diagnosed and autopsy-confirmed early onset Alzheimer's disease who completed suicide by gunshot wound to the chest. This case has several unique aspects that have not been discussed in previous case reports of completed suicide in Alzheimer's disease. In particular, our patient's death was highly planned with successful compensation for his cognitive deficits. After all firearms had been removed from the home as a safety precaution, he obtained a new weapon, hid it and left himself cues to find and use it...
April 2018: Neurodegenerative Disease Management
Stefan Wietek
AIM: To present data from three studies of a Post-Authorization Safety Surveillance (PASS) program for the subset of patients receiving octagam® 5% or 10% for chronic inflammatory demyelinating polyneuropathy (CIDP). METHODS: Data on patients with CIDP treated with octagam were analyzed to assess its safety and tolerability. RESULTS: Of 2314 patients included in the studies, 58 patients (mean age: 64.6 years) received octagam for CIDP, mean dose of which was 0...
March 8, 2018: Neurodegenerative Disease Management
Laura Dormer
Welcome to the eighth volume of Neurodegenerative Disease Management. At the start of a new volume, it is interesting to look back at which content proved most popular in 2017, and also to take a look forward to the content of this issue and beyond.
February 2018: Neurodegenerative Disease Management
Sarah I Sheikh
Sarah Isabel Sheikh speaks to Laura Dormer, Commissioning Editor: Sarah I Sheikh, MD, MSc, MRCP, is a Senior Medical Director in Late Stage Clinical Development at Biogen. Her current focus is on developing therapies for multiple sclerosis/neuroinflammation, remyelination and neuro-repair. Prior to Biogen, Dr Sheikh was an attending in Neurology at Brigham and Women's Hospital. She completed her internship at Massachusetts General Hospital and residency in Neurology and Neuromuscular fellowship at Massachusetts General Hospital and Brigham and Women's Hospital...
February 2018: Neurodegenerative Disease Management
John H Spreadbury, Christopher M Kipps
AIM: Psychosocial research on the lived experiences of young-onset dementia patients and caregivers has identified salient issues about their care, however, views on care from the perspective of young-onset dementia healthcare professionals is less well known. The aim of this study was to investigate and identify important issues in young-onset dementia care provision from a healthcare provider perspective. METHODS: The design was an exploratory qualitative interview study...
February 2018: Neurodegenerative Disease Management
Victoria S Pelak, William Hills
Visual dysfunction has long been recognized as a manifestation of Alzheimer's disease (AD), particularly in the form of visuospatial impairment during all stages of disease. However, investigations have revealed findings within the anterior (i.e., pregeniculate) afferent visual pathways that rely on retinal imaging and electrophysiologic methodologies for detection. Here we focus on the anterior afferent visual pathways in AD and the measures used for assessment, including optical coherence tomography, electrophysiology, color vision testing and threshold visual field perimetry...
February 2018: Neurodegenerative Disease Management
Ramnath Santosh Ramanathan, Sandeep Rana
AIM: Primary lateral sclerosis (PLS) is a form of motor neuron disease involving only upper motor neurons. In some patients presenting as PLS, the disease progresses to involve lower motor neurons and thereby converting to amyotrophic lateral sclerosis (ALS). However, pure forms of PLS do exist. Our aim was to study epidemiological and clinical characteristics of pure PLS patients treated at our neuromuscular clinic. METHODS: We retrospectively reviewed 15 patients from July 2011 to October 2014 with PLS treated at the neuromuscular disorder clinic at our hospital...
February 2018: Neurodegenerative Disease Management
Joseph O Fadare, Taofiki A Sunmonu, Idowu A Bankole, Kehinde A Adekeye, Sani A Abubakar
AIM: Medication adherence remains a major challenge among patients with epilepsy (PWE) with the adverse effect profile of antiepileptic drugs (AEDs) as one of its main drivers. METHODS: This was a cross-sectional questionnaire-based study among PWE in selected Nigerian tertiary healthcare facilities using the Morisky Medication Adherence Scale and the Liverpool Adverse Effect Profile (LAEP). RESULTS: 126 PWE from four tertiary healthcare facilities were included in this study comprising of 59 (46...
February 2018: Neurodegenerative Disease Management
Shibeshih Belachew
Shibeshih Belachew speaks to Laura Dormer, Commissioning Editor: Dr Shibeshih Belachew, MD, PhD, is a Senior Medical Director for Multiple Sclerosis (MS) Disease Area in Global Product Development Medical Affairs at Roche (Basel, Switzerland). Prior to joining Roche in January 2016, he was Director of MS Franchise and Head of Medical Director's office for Biogen Region Europe and Canada. Previously at Biogen he also served as a Director in Global Neurology for the natalizumab program in Cambridge (MA, USA)...
February 2018: Neurodegenerative Disease Management
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