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Charlotte E Teunissen, Markus Otto, Sebastiaan Engelborghs, Sanna-Kaisa Herukka, Sylvain Lehmann, Piotr Lewczuk, Alberto Lleó, Armand Perret-Liaudet, Hayrettin Tumani, Martin R Turner, Marcel M Verbeek, Jens Wiltfang, Henrik Zetterberg, Lucilla Parnetti, Kaj Blennow
Body fluid biomarkers have great potential for different clinical purposes, including diagnosis, prognosis, patient stratification and treatment effect monitoring. This is exemplified by current use of several excellent biomarkers, such as the Alzheimer's disease cerebrospinal fluid (CSF) biomarkers, anti-neuromyelitis optica antibodies and blood neurofilament light. We still, however, have a strong need for additional biomarkers and several gaps in their development and implementation should be filled. Examples of such gaps are i) limited knowledge of the causes of neurological diseases, and thus hypotheses about the best biomarkers to detect subclinical stages of these diseases; ii) the limited success translating discoveries obtained by e...
March 15, 2018: Alzheimer's Research & Therapy
Xiaoqing Gong, Shenghui Mei, Xindi Li, Xingang Li, Heng Zhou, Yonghong Liu, Anna Zhou, Li Yang, Zhigang Zhao, Xinghu Zhang
Thiopurines (TPRs) are effective drugs in treating neuromyelitis optica spectrum disorders (NMOSD) and other diseases. TPRs' toxicity is mainly imputed to thiopurine S-methyltransferase (TPMT) activity. In Chinese population, the most common and important variation of TPMT is TPMT*3C (rs1142345). This study aims to reveal the association between TPMT activity and genetic polymorphisms of TPMT in patients with NMOSD in China. An LC-MS/MS method was used to evaluate the TPMT activity by using 6-mercapthioprine as substrate in human erythrocyte hemolysate via 1 h incubation at 37 °C to form its methylated product 6-methylmercaptopurine (6-MMP)...
March 10, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
X F You, H T Hu, J Ye
Objective: To evaluate the clinical characteristics and the corresponding MRI and laboratory findings in patients with neuromyelitis optica spectrum disorder (NMOSD) associated with area postrema (AP). Methods: The study was a retrospective analysis of data from 120 NMOSD patients, and 18 cases were with AP out of these patients, The clinical presentation, MRI changes, serological markers and treatment outcome were reported. Results: AP occurred in 18 patients (15%, 18/120). AP was the onset symptom in 14 (14/18) patients and 3 days to 7 months (median 40 days) later, optic neuritis or myelitis was involved...
March 6, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Carolina Candeias da Silva, Denis Bernardi Bichuetti, Sonia Maria Cesar de Azevedo Silva, Henrique Ballalai Ferraz, Enedina Maria Lobato de Oliveira, Vanderci Borges
INTRODUCTION: Movement disorders are not rare in demyelinating diseases but there are few studies comparing their frequency between multiple sclerosis and neuromyelitis optica spectrum disorder. Our aim was to determine the frequency and the related features of movement disorders in a cohort of patients with multiple sclerosis and neuromyelitis optica spectrum disorder. METHODS: It is a cross-sectional study of patients with multiple sclerosis and neuromyelitis optica spectrum disorder...
March 3, 2018: Parkinsonism & related Disorders
Bruna Garbugio Dutra, Antônio José da Rocha, Renato Hoffmann Nunes, Antônio Carlos Martins Maia Júnior
No abstract text is available yet for this article.
March 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
L Monge Galindo, A L Martínez de Morentín, V Pueyo Royo, J P García Iñiguez, S Sánchez Marco, J López-Pisón, J L Peña-Segura
INTRODUCTION AND OBJECTIVE: In this article, we present our experience on optic neuritis (ON) and provide a diagnostic/therapeutic protocol, intended to rule out other aetiologies (particularly infection), and a fact sheet for parents. MATERIAL AND METHODS: We conducted a descriptive, retrospective study of patients with ON over a 27-year period (1990-2017). A review of the available scientific evidence was performed in order to draft the protocol and fact sheet...
March 8, 2018: Neurología: Publicación Oficial de la Sociedad Española de Neurología
Raed Alroughani, Alexey Boyko
BACKGROUND: Pediatric-onset multiple sclerosis (POMS) prevalence and incidence rates are increasing globally. No disease-modifying therapy are approved for MS pediatric population. Hence, we aim to review the literature on POMS to guide treating physicians on the current understanding of diagnosis and management of pediatric MS. METHODS: The authors performed a literature search and reviewed the current understanding on risk factors and disease parameters in order to discuss the challenges in assessing and implementing diagnosis and therapy in clinical practice...
March 9, 2018: BMC Neurology
Ruth Geraldes, Olga Ciccarelli, Frederik Barkhof, Nicola De Stefano, Christian Enzinger, Massimo Filippi, Monika Hofer, Friedemann Paul, Paolo Preziosa, Alex Rovira, Gabriele C DeLuca, Ludwig Kappos, Tarek Yousry, Franz Fazekas, Jette Frederiksen, Claudio Gasperini, Jaume Sastre-Garriga, Nikos Evangelou, Jacqueline Palace
MRI red flags proposed over a decade ago by the European Magnetic Resonance Network in MS (MAGNIMS) have guided clinicians in the diagnosis of multiple sclerosis (MS). However, the past 10 years have seen increased recognition that vascular disease can coexist and possibly interact with MS, improvements in the reliability of ways to differentiate MS from novel antibody-mediated CNS disorders (such as anti-aquaporin-4 antibody and myelin-oligodendrocyte glycoprotein antibody-associated diseases) and advances in MRI techniques...
March 9, 2018: Nature Reviews. Neurology
Marco Bo, Magdalena Niegowska, Giannina Arru, Elia Sechi, Sara Mariotto, Chiara Mancinelli, Alessia Farinazzo, Daniela Alberti, Alberto Gajofatto, Sergio Ferrari, Ruggero Capra, Salvatore Monaco, GianPietro Sechi, Leonardo A Sechi
Epstein-Barr virus (EBV) is the main environmental agent associated to neuromyelitis optica spectrum disorder (NMOSD). Following to studies reporting an increased prevalence of antibodies against peptides derived from Mycobacterium avium subsp. paratuberculosis (MAP) homologous to EBV and human epitopes (MBP85-98 , IRF5424-434 ) in multiple sclerosis (MS), we investigated whether seroreactivity to these antigens display a NMOSD-specific pattern. The sera of 34 NMOSD patients showed elevated levels of antibodies against MAP and MBP compared to healthy controls (44% vs...
February 28, 2018: Journal of Neuroimmunology
Lu-Mei Chi, Yu Gao, Guang-Xian Nan
RATIONALE: Neuromyelitis optica spectrum disorders (NMOSDs) represent recurrent autoimmune diseases, generally beginning with optic nerve neuritis or acute transverse myelitis. PATIENT CONCERNS: A 57-year-old male with long-term alcohol intake was hospitalized because of limb numbness. EMG examination showed the peripheral sensory nerve was in demyelination and an axonal injury was found. His symptoms could not be improved by vitamin B injection but were later significantly attenuated by dexamethasone treatment...
March 2018: Medicine (Baltimore)
Frederike C Oertel, Hanna Zimmermann, Friedemann Paul, Alexander U Brandt
Neuromyelitis optica spectrum disorders (NMOSD) are mostly relapsing inflammatory disorders of the central nervous system (CNS). Optic neuritis (ON) is the first NMOSD-related clinical event in 55% of the patients, which causes damage to the optic nerve and leads to visual impairment. Retinal optical coherence tomography (OCT) has emerged as a promising method for diagnosis of NMOSD and potential individual monitoring of disease course and severity. OCT not only detects damage to the afferent visual system caused by ON but potentially also NMOSD-specific intraretinal pathology, i...
March 2018: EPMA Journal
Christopher Hollen, Omer Suhaib, Aaron Farrow, Evgeny Sidorov
We present a case of an 82-year-old man with new-onset neuromyelitis optica (NMO) spectrum disorder, the treatment of which was complicated by a severe pre-existing prednisone allergy. His age caused much initial doubt about his diagnosis, and his corticosteroid allergy altered our management as we attempted to minimize risk to the patient. Our patient was a healthy 82-year-old, right-handed man who presented with sensory loss of the bilateral lower extremities and progressive, painless vision loss. MRI showed bilateral pre-chiasmatic optic nerve and optic chiasm enhancement, along with enhancement within the thoracic spinal cord from T3 to T7...
January 2018: Case Reports in Neurology
Rosa Cortese, Lise Magnollay, Carmen Tur, Khaled Abdel-Aziz, Anu Jacob, Floriana De Angelis, Marios C Yiannakas, Ferran Prados, Sebastien Ourselin, Tarek A Yousry, Frederik Barkhof, Olga Ciccarelli
OBJECTIVE: To assess the value of the central vein sign (CVS) on a clinical 3T scanner to distinguish between multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). METHODS: Eighteen aquaporin-4-antibody-positive patients with NMOSD, 18 patients with relapsing-remitting MS, and 25 healthy controls underwent 3T MRI. The presence of a central vein in white matter lesions on susceptibility-weighted imaging, defined as a thin hypointense line or a small dot, was recorded...
March 7, 2018: Neurology
Jae-Won Hyun, So-Young Huh, Hyun-June Shin, Mark Woodhall, Su-Hyun Kim, Sarosh R Irani, Sang Hyun Lee, Patrick Waters, Ho Jin Kim
OBJECTIVES: We aimed to evaluate the utility of the recently described brain lesion distribution criteria to differentiate multiple sclerosis (MS) from aquaporin-4 immunoglobulin G-positive neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein immunoglobulin G-associated encephalomyelitis (MOG-EM) at disease onset in an Asian cohort. METHODS: A total of 214 patients who fulfilled the published criteria for MS, NMOSD, or MOG-EM and underwent brain magnetic resonance imaging (MRI) within 3 months of disease onset were enrolled...
March 1, 2018: Multiple Sclerosis: Clinical and Laboratory Research
E C Tallantyre, D H Whittam, S Jolles, D Paling, C Constantinesecu, N P Robertson, A Jacob
B-cell depleting anti-CD20 monoclonal antibody therapies are being increasingly used as long-term maintenance therapy for neuroinflammatory disease compared to many non-neurological diseases where they are used as remission-inducing agents. While hypogammaglobulinaemia is known to occur in over half of patients treated with medium to long-term B-cell-depleting therapy (in our cohort IgG 38, IgM 56 and IgA 18%), the risk of infections it poses seems to be under-recognised. Here, we report five cases of serious infections associated with hypogammaglobulinaemia occurring in patients receiving rituximab for neuromyelitis optica spectrum disorders...
March 6, 2018: Journal of Neurology
Ami Schattner, Shilo Voichanski, Livnat Uliel
A healthy 38-year-old woman developed sudden unilateral vision loss due to retrobulbar optic neuritis in the wake of varicella-zoster virus infection. She had no further central nervous system (CNS) lesions. Antinuclear antibodies (ANA) and anti-aquaporin 4 antibodies were found, consistent with neuromyelitis optica (NMO). Later, serial MRIs showed dynamic short-segment and long-segment myelitis lesions, ANA titre increased and additional autoantibodies were found including anti-dsDNA, anti-chromatin/nucleosome and antiphospholipid antibodies...
March 5, 2018: BMJ Case Reports
Yu Zhang, Mingqin Zhu, Lifang Wang, Miao Shi, Hui Deng
RATIONALE: Longitudinally extensive transverse myelitis (LETM) is characterized by contiguous inflammatory lesions of spinal cord extending to ≥3 vertebral segments. The etiology of LETM is complicated, including various infection, autoimmune disease, and so on. Neuromyelitis optic spectrum disorder (NMOSD) is the most common cause of LETM. Several case reports have suggested the associations between NMOSD and pulmonary tuberculosis (PTB). PATIENT CONCERNS: Patient 1, a 20-year-old woman who had a past history of PTB, presented with weakness, numbness, and pain in the limbs...
January 2018: Medicine (Baltimore)
Nam Hee Kim, Ho Jin Kim, Cheol Yong Park, Kyoung Sook Jeong, Joong Yang Cho
BACKGROUND AND PURPOSE: Optical coherence tomography (OCT) and visual evoked potentials (VEPs) can be used to detect optic neuritis (ON). However, the comparative sensitivities of OCT and VEPs for detecting ON in neuromyelitis optica spectrum disorder (NMOSD) are unclear, and so we assessed these sensitivities. METHODS: This cross-sectional study included 73 patients with aquaporin-4 antibody-seropositive NMOSD, and 101 eyes with ON. The clinical characteristics, visual acuity (VA), Expanded Disability Status Scale (EDSS) scores, OCT peripapillary retinal nerve fiber layer (RNFL) thickness, and VEPs of the patients were evaluated...
February 28, 2018: Journal of Clinical Neurology
Jie Lin, Xiang Li, Binbin Xue, Qiuling Tong, Zhibo Chen, Weiqian Zhu, Jia Li, Junhui Xia
Rituximab has been effectively used for treating neuromyelitis optica spectrum disorder (NMOSD) for several years. However those regimens exert a heavy burden on Chinese patients. The aim of our study was to investigate an effectiveness, economic alternatives of RTX. The enrolled patients received different immunosuppressant drugs. Annual relapse rate (ARR), neurological disability (Expanded Disability Status Scale, EDSS), time to the next relapse were evaluated after treatments. Fourteen patients treated with RTX and 37 relapse events from 23 patients treated with traditional immunosuppressant drugs (ISDs) were analyzed in our study...
April 15, 2018: Journal of Neuroimmunology
Sharareh Eskandarieh, Saharnaz Nedjat, Ibrahim Abdollahpour, Amir Reza Azimi, Abdorreza Naser Moghadasi, Nasrin Asgari, Mohammad Ali Sahraian
Neuromyelitis optica spectrum disorder (NMOSD) has unknown risk factors. The aim of this study was to identify the environmental risk factors for NMOSD. A case-control study was conducted in Tehran from 2015 to 2016 among 100 patients with NMOSD. Sex-matched healthy controls (n = 400) were selected through random digit dialing (RDD). Logistic regression was used to estimate unadjusted and adjusted ORs (odds ratio) at 95% confidence intervals (CI) via SPSS. Compared with the control population, in NMOSD patients, the adjusted OR for low dairy consumption per week was (OR = 18...
March 2, 2018: Acta Neurologica Belgica
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