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Neurology and Therapy

Yara Dadalti Fragoso, Tarso Adoni, Joseph B Bidin Brooks, Alessandro Finkelsztejn, Paulo Diniz da Gama, Anderson K Grzesiuk, Vanessa Daccach Marques, Monica Fiuza K Parolin, Henry K Sato, Daniel Lima Varela, Claudia Cristina F Vasconcelos
Multiple sclerosis (MS) management presently aims to reach a state of no (or minimal) evidence of disease activity. The development and commercialization of new drugs has led to a renewed interest in family planning, since patients with MS may face a future with reduced (or no) disease-related neurological disability. The advice of neurologists is often sought by patients who want to have children and need to know more about disease control at conception and during pregnancy and the puerperium. When MS is well controlled, the simple withdrawal of drugs for patients who intend to conceive is not an option...
August 30, 2018: Neurology and Therapy
Hiroyuki Todo, Hiroshi Yamasaki, Go Ogawa, Katsuya Nishida, Naonobu Futamura, Itaru Funakawa
INTRODUCTION: Camptocormia (severe bending of the spine) is a debilitating complication of Parkinson's disease (PD) without established treatment. Botulinum toxin (BT) may be beneficial, but data is scarce regarding the efficacy of administration of BT into the bilateral external oblique (EO) muscle for treatment of camptocormia in PD. METHODS: Six patients with PD and camptocormia, with flexion of the thoracic spine, were enrolled in the study. BT (75 or 90 units, onabotulinum toxin A) were injected into each EO bilaterally under sonographic guidance...
August 9, 2018: Neurology and Therapy
Lori Hendin Travis, Annette Okai, Steve Cavalier, Darren Stam, Lisa Farnett, Keith R Edwards
INTRODUCTION: Hair thinning occurred in 10-14% of teriflunomide-treated patients in the teriflunomide multiple sclerosis clinical development program, compared with 5% of placebo-treated patients. Our objective was to examine the clinical course of hair thinning in patients in an observational real-world project. METHODS: Patients with relapsing-remitting multiple sclerosis who reported hair thinning to healthcare professionals (HCPs) during treatment with teriflunomide were eligible for inclusion...
August 6, 2018: Neurology and Therapy
Michelle Stewart, Shannon Shaffer, Brian Murphy, Jane Loftus, Jose Alvir, Michael Cicchetti, William R Lenderking
INTRODUCTION: Transthyretin amyloidosis (ATTR amyloidosis), whether manifesting as familial amyloid polyneuropathy (ATTR-PN) or cardiomyopathy (ATTR-CM), is a progressive, debilitating, and often fatal, rare disease requiring significant caregiver support. This study aims to better characterize the burden of disease for ATTR amyloidosis patients and caregivers. METHODS: Patients and caregivers in the USA and Spain were recruited through patient advocacy groups to complete a cross-sectional survey...
August 2, 2018: Neurology and Therapy
Kristen M Ward, Leslie Citrome
INTRODUCTION: Drug-induced parkinsonism (DIP) and tardive dyskinesia (TD) are stigmatizing movement disorders associated with exposure to dopamine receptor blocking agents such as antipsychotics, but they differ in their pathophysiology and clinical management. Treatment for one may worsen the other, and there are important diagnostic clues that assist in making an accurate assessment and instituting a rational treatment plan. METHODS: A literature review was executed to identify articles relating to the presentation, pathophysiology, epidemiology, and management of DIP and TD...
July 19, 2018: Neurology and Therapy
Samuel D Capouch, Martin R Farlow, Jared R Brosch
Dementia with Lewy bodies is one of the most common causes of dementia. It is not as common as Alzheimer's disease; the general public's awareness of the disease is poor in comparison. Its effects on caregivers and patients alike are not well known to the general population. There are currently no FDA-approved medications specifically for the treatment of DLB. Many of the medications that are approved for Alzheimer's disease are widely used in the treatment of DLB with varying degrees of success. Treatment of DLB is life long and requires a dedicated team of physicians and caregivers to minimize the degree of morbidity and mortality experienced by the patients suffering from the disease as it progresses...
July 9, 2018: Neurology and Therapy
Maria Petracca, Monica Margoni, Giulia Bommarito, Matilde Inglese
Imaging markers for monitoring disease progression in progressive multiple sclerosis (PMS) are scarce, thereby limiting the possibility to monitor disease evolution and to test effective treatments in clinical trials. Advanced imaging techniques that have the advantage of metrics with increased sensitivity to short-term tissue changes and increased specificity to the structural abnormalities characteristic of PMS have recently been applied in clinical trials of PMS. In this review, we (1) provide an overview of the pathological features of PMS, (2) summarize the findings of research and clinical trials conducted in PMS which have applied conventional and advanced magnetic resonance imaging techniques and (3) discuss recent advancements and future perspectives in monitoring PMS with imaging techniques...
June 28, 2018: Neurology and Therapy
Freya Corfield, Dawn Langdon
Multiple sclerosis (MS) is a neurological disease of the central nervous system which can lead to a range of severe physical disabilities. A large proportion of those affected will experience cognitive impairment, which is associated with a worse prognosis. Effective assessment of cognition in MS has been problematic due to a lack of suitable scales. The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) was developed in 2010 as part of an international endeavour to facilitate cognitive assessment...
June 19, 2018: Neurology and Therapy
Christine Lebrun, Mikael Cohen, Maria Alessandra Rosenthal-Allieri, Saskia Bresch, Sylvia Benzaken, Romain Marignier, Barbara Seitz-Polski, Michel Ticchioni
INTRODUCTION: Neuromyelitis optica spectrum disorders (NMOSD) are identified as a spectrum of inflammatory demyelinating disorders involving the brain, spinal cord and optic nerves. These disorders require early diagnosis and highly active immunosuppressive treatment. Rituximab (RTX) has demonstrated efficacy in limiting relapse in NMOSD when using several administration schedules. We questioned if the CD19+ CD27+ memory B cell count was a more reliable marker to monitor RTX administration than the RTX plasma level and CD19+ B cell count...
June 7, 2018: Neurology and Therapy
Megan Andrews, Babak Tousi, Marwan N Sabbagh
Alzheimer's disease is an important condition with a considerable and unmet disease burden in large need of continued research and more treatment options. The 5HT6 antagonists are a new class of medications to be offered. Because they are pro-cholinergic, these medications are to be used as adjuncts to acetylcholinesterase inhibitors (such as donepezil), further increasing acetylcholine in the central nervous system (CNS). Early trials of the 5HT6 antagonists showed improvements in cognition and activities of daily living when used as adjuncts to current therapies for Alzheimer's dementia...
June 2018: Neurology and Therapy
Elisabet Londos
No abstract text is available yet for this article.
June 2018: Neurology and Therapy
Thomas Müller
No abstract text is available yet for this article.
June 2018: Neurology and Therapy
Maksymilian Aleksander Brzezicki, Matthew David Kobetić
No abstract text is available yet for this article.
June 2018: Neurology and Therapy
Rajiv Mundayat, Michelle Stewart, Jose Alvir, Sarah Short, Moh-Lim Ong, Denis Keohane, Denise Rill, Marla B Sultan
INTRODUCTION: The effectiveness of tafamidis for the treatment of transthyretin familial amyloid polyneuropathy (TTR-FAP) was evaluated using data from the Transthyretin Amyloidosis Outcomes Survey (THAOS) registry. METHODS: Subjects receiving tafamidis (n = 252) were compared with untreated subjects in a non-randomized, matched cohort analysis. Subjects were matched with up to four untreated controls by genetic mutation, region of birth, and mean treatment propensity score...
June 2018: Neurology and Therapy
Daniel Serrano, Christopher B Atzinger, Marc F Botteman
INTRODUCTION: Hereditary transthyretin (TTR) amyloidosis with polyneuropathy (hATTR-PN) is a rare, autosomal dominant amyloidosis characterized primarily by progressive ascending sensorimotor neuropathy often associated with  autonomic involvement. hATTR-PN is caused by a mutation in the TTR gene leading to protein misfolding and amyloid accumulation in peripheral nerves and vital organs. The latest global prevalence estimates point to 10,000 cases worldwide, with an upper end of about 40,000...
June 2018: Neurology and Therapy
Adriano Luís Soares De Souza, Stefan Rudin, Rui Chang, Keith Mitchell, Timothy Crandall, Shuning Huang, Ji-Kyung Choi, Shinji L Okitsu, Danielle L Graham, Blake Tomkinson, Tammy Dellovade
INTRODUCTION: Antigen-specific immunotherapy could provide a targeted approach for the treatment of multiple sclerosis that removes the need for broad-acting immunomodulatory drugs. ATX-MS-1467 is a mixture of four peptides identified as the main immune-dominant disease-associated T-cell epitopes in myelin basic protein (MBP), an autoimmune target for activated autoreactive T cells in multiple sclerosis. Previous animal studies have shown that ATX-MS-1467 treatment prevented the worsening of signs of disease in experimental autoimmune encephalitis (EAE) in the humanized (DR2 × Ob1)F1 mouse in a dose-dependent fashion...
June 2018: Neurology and Therapy
Michael Dennis, Laura Shine, Ann John, Amanda Marchant, Joanna McGregor, Ronan A Lyons, Sinead Brophy
This article was originally published under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0), but has now been made available under a Creative Commons Attribution 4.0 International License ( ), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made...
June 2018: Neurology and Therapy
Jacobo Lester, Gerardo Esteban Alvarez-Resendiz, Enrique Klériga, Fernando Videgaray, Gerardo Zambito
INTRODUCTION: Brain and spinal cord injuries may cause very severe spasticity that occasionally may be associated with persistent fever. CASE SERIES: We present 14 patients with spasticity and persistent fever, treated with botulinum toxin type A. Their spasticity improved and the fever resolved within a period no greater than 48 h. In all cases, infectious and other non-infectious causes were ruled out. CONCLUSIONS: When sustained tonic muscular activity is associated with a significant increase in body temperature and is refractory to the usual drugs used for hyperpyrexia, type A botulinum toxin may be an effective treatment option to control both spasticity and fever...
June 2018: Neurology and Therapy
Mortimer Mamelak
The high energy demands of the substantia nigra pars compacta dopaminergic (DASNc) neurons render these neurons vulnerable to degeneration. These energy demands are a function of their long and extensively arborized axons and very large number of transmitter release sites, and are further augmented by their natural pacemaking activity. Pacemaking is driven by the rhythmic entry of Ca2+ into the cell and, while the entry of Ca2+ into the neuron stimulates energy (ATP) production, the extrusion of Ca2+ conversely saps the energy that is generated...
June 2018: Neurology and Therapy
Elisabet Londos
This article describes the practical considerations in the clinical medical treatment in dementia with Lewy body (DLB) patients. It is illustrated with the voice of a DLB sufferer and his wife. According to our experience, emanating from a 15 year collaboration between a doctor and a nurse at a memory clinic, there are several possible therapeutical entrances. However, the order in which the medication is introduced is of great importance to avoid aggravation of other DLB symptoms. We start the treatment with cholinesterase inhibitor and memantine, and; thereafter, we treat the most disturbing symptom...
June 2018: Neurology and Therapy
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