Pub Date : 2017-01-01DOI: 10.17925/ENR.2017.12.02.92
K. Cook, R. Suresh, K. Lou, J. Kesslak, D. Fredericks
O ver half of patients with Parkinson’s disease (PD) develop symptoms of psychosis during the course of their disease. Existing guidelines include recommendations for managing symptoms of psychosis in patients with PD. However, the extent to which such recommendations translate to clinical practice in major European nations is unclear. The current study describes trends in the clinical management of patients diagnosed with PD psychosis (PDP) based on survey responses and patient chart reviews from 437 neurologists across France, Germany, Italy, Spain, and the UK (collectively, the EU-5). Surveyed neurologists reported that PDP typically manifests four or more years after the diagnosis of PD, with the most commonly reported initial symptoms being moderately disruptive visual hallucinations, agitation, and illusions/false sense of presence. PD medications adjustment was the most common first-line intervention, applicable to an estimated 59–79% of patients for the initial management of PDP depending on country. Responses from surveyed neurologists suggest PD medications adjustment is a temporary solution for many patients with PDP and that there is considerable variability in subsequent lines of intervention. The current report provides a resource for understanding the patterns of care and treatment for PDP across these major European nations.
{"title":"Parkinson’s Disease Psychosis – Patterns of Care and Treatment in the EU-5 from Neurologists’ Perspective","authors":"K. Cook, R. Suresh, K. Lou, J. Kesslak, D. Fredericks","doi":"10.17925/ENR.2017.12.02.92","DOIUrl":"https://doi.org/10.17925/ENR.2017.12.02.92","url":null,"abstract":"O ver half of patients with Parkinson’s disease (PD) develop symptoms of psychosis during the course of their disease. Existing guidelines include recommendations for managing symptoms of psychosis in patients with PD. However, the extent to which such recommendations translate to clinical practice in major European nations is unclear. The current study describes trends in the clinical management of patients diagnosed with PD psychosis (PDP) based on survey responses and patient chart reviews from 437 neurologists across France, Germany, Italy, Spain, and the UK (collectively, the EU-5). Surveyed neurologists reported that PDP typically manifests four or more years after the diagnosis of PD, with the most commonly reported initial symptoms being moderately disruptive visual hallucinations, agitation, and illusions/false sense of presence. PD medications adjustment was the most common first-line intervention, applicable to an estimated 59–79% of patients for the initial management of PDP depending on country. Responses from surveyed neurologists suggest PD medications adjustment is a temporary solution for many patients with PDP and that there is considerable variability in subsequent lines of intervention. The current report provides a resource for understanding the patterns of care and treatment for PDP across these major European nations.","PeriodicalId":12047,"journal":{"name":"European neurological review","volume":"12 1","pages":"92"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67592444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.17925/USN.2017.13.02.82
Lisa M. Gallagher, F. Bethoux
{"title":"Therapeutic use of the Arts for Patients with Multiple Sclerosis","authors":"Lisa M. Gallagher, F. Bethoux","doi":"10.17925/USN.2017.13.02.82","DOIUrl":"https://doi.org/10.17925/USN.2017.13.02.82","url":null,"abstract":"","PeriodicalId":12047,"journal":{"name":"European neurological review","volume":"13 1","pages":"82-89"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67611798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.17925/USE.2017.13.02.67
J. Cummings, K. Zhong, D. Cordes
A lzheimer’s disease (AD) is rapidly becoming more common as the global population ages. New treatments are needed and new approaches to drug development are warranted. The phase II challenge for AD treatment development programs is how to provide proof-of-concept (POC) of the candidate agent without a large long trial equivalent to phase III. We propose that the available data support measures of the default mode network (DMN) using functional magnetic resonance imaging (fMRI) as demonstrating the effect of treatment on cognitive circuits critical to human cognition. Improved DMN function with symptomatic cognitive enhancing agents or decreased deterioration of DMN function compared to placebo in trials of disease-modifying agents would support POC and allow progression to phase III with greater confidence.
{"title":"Drug Development in Alzheimer’s Disease—The Role of Default Mode Network Assessment in Phase II","authors":"J. Cummings, K. Zhong, D. Cordes","doi":"10.17925/USE.2017.13.02.67","DOIUrl":"https://doi.org/10.17925/USE.2017.13.02.67","url":null,"abstract":"A lzheimer’s disease (AD) is rapidly becoming more common as the global population ages. New treatments are needed and new approaches to drug development are warranted. The phase II challenge for AD treatment development programs is how to provide proof-of-concept (POC) of the candidate agent without a large long trial equivalent to phase III. We propose that the available data support measures of the default mode network (DMN) using functional magnetic resonance imaging (fMRI) as demonstrating the effect of treatment on cognitive circuits critical to human cognition. Improved DMN function with symptomatic cognitive enhancing agents or decreased deterioration of DMN function compared to placebo in trials of disease-modifying agents would support POC and allow progression to phase III with greater confidence.","PeriodicalId":12047,"journal":{"name":"European neurological review","volume":"13 1","pages":"67-69"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67603588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.17925/ENR.2017.12.01.24
R. Silva-Néto, A. Soares
T here is an important relationship between odours and primary headaches. Patients may present osmophobia during headaches and odours may trigger headache attacks. This review aimed to describe the studies on osmophobia, odour-triggered headache, the main researchers and their research centres. Publications on the relationship between odours and primary headaches were searched in 193 sovereign countries and 48 dependent territories in all continents. We consulted the PubMed database and used the descriptors: “osmophobia in [name of the country or territory]”; “odours and headache in [name of the country or territory]” and “smell and headache in [name of the country or territory]”. A total of 254 articles were found, but only 31 articles were considered relevant and composed this review. Of the 31 articles, 90.3% were cross-sectional studies, 6.5% case reports and 3.2% systematic reviews. All studies were performed on three continents: Europe (45.2%), America (32.2%) and Asia (22.6%). For the purpose of this study, North America and South America have been classed as one continent. No research was developed in Africa or Australia. More than 50.0% of the studies were conducted in Italy and Brazil. Only five authors published 38.7% of the studies. Osmophobia during headache attacks was investigated in 67.7% of studies, and odour-triggered headache in 19.3%. Studies on osmophobia and/or odour-triggered headache were carried out in several countries. They were useful in differentiating between migraine and tension-type headache. This could improve the accuracy of diagnosis of migraine compared to the current criteria.
{"title":"Osmophobia and Odour-triggered Headaches – Review of the Literature and Main Research Centres","authors":"R. Silva-Néto, A. Soares","doi":"10.17925/ENR.2017.12.01.24","DOIUrl":"https://doi.org/10.17925/ENR.2017.12.01.24","url":null,"abstract":"T here is an important relationship between odours and primary headaches. Patients may present osmophobia during headaches and odours may trigger headache attacks. This review aimed to describe the studies on osmophobia, odour-triggered headache, the main researchers and their research centres. Publications on the relationship between odours and primary headaches were searched in 193 sovereign countries and 48 dependent territories in all continents. We consulted the PubMed database and used the descriptors: “osmophobia in [name of the country or territory]”; “odours and headache in [name of the country or territory]” and “smell and headache in [name of the country or territory]”. A total of 254 articles were found, but only 31 articles were considered relevant and composed this review. Of the 31 articles, 90.3% were cross-sectional studies, 6.5% case reports and 3.2% systematic reviews. All studies were performed on three continents: Europe (45.2%), America (32.2%) and Asia (22.6%). For the purpose of this study, North America and South America have been classed as one continent. No research was developed in Africa or Australia. More than 50.0% of the studies were conducted in Italy and Brazil. Only five authors published 38.7% of the studies. Osmophobia during headache attacks was investigated in 67.7% of studies, and odour-triggered headache in 19.3%. Studies on osmophobia and/or odour-triggered headache were carried out in several countries. They were useful in differentiating between migraine and tension-type headache. This could improve the accuracy of diagnosis of migraine compared to the current criteria.","PeriodicalId":12047,"journal":{"name":"European neurological review","volume":"12 1","pages":"24"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67592137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.17925/ENR.2017.12.01.37
P. Vermersch
T eriflunomide is an oral immunotherapy agent that acts primarily as an inhibitor of dihydroorotate-dehydrogenase (DHODH), a key mitochondrial enzyme involved in the synthesis of pyrimidines in rapidly proliferating cells such as T lymphocytes and B lymphocytes, thus attenuating the inflammatory response to auto-antigens. The TEMSO and TOWER phase III clinical studies have demonstrated the efficacy and safety of teriflunomide in the first-line treatment of patients with relapsing multiple sclerosis (MS), with long-term follow-up data available up to 9 years. Teriflunomide has also been shown to decrease the risk of conversion to clinically definite MS (CDMS) in patients with a first clinical sign of MS or risk of conversion to CDMS after a clinically isolated syndrome. In addition to reducing disability progression and relapse rate, teriflunomide has also been found to decrease imaging activity and is associated with significant reductions in brain volume loss. The convenience of administration of teriflunomide should establish its role within the growing number of treatment options for MS.
T eriflunomide是一种口服免疫治疗剂，主要作为二氢羟酸脱氢酶(DHODH)的抑制剂，DHODH是一种关键的线粒体酶，参与快速增殖细胞(如T淋巴细胞和B淋巴细胞)嘧啶的合成，从而减轻对自身抗原的炎症反应。TEMSO和TOWER III期临床研究证明了teriflunomide用于复发性多发性硬化症(MS)患者一线治疗的有效性和安全性，长期随访数据可达9年。特立氟米特也被证明可以降低首次出现多发性硬化症临床体征的患者转化为临床明确多发性硬化症(CDMS)的风险，或在临床孤立综合征后转化为CDMS的风险。除了减少残疾进展和复发率外，特立氟米特还被发现可以降低成像活动，并与显著减少脑容量损失有关。特立氟米特给药的便利性应该在越来越多的多发性硬化症治疗方案中确立其作用。
{"title":"New and Evolving Treatment Goals in Multiple Sclerosis – the Role of Teriflunomide","authors":"P. Vermersch","doi":"10.17925/ENR.2017.12.01.37","DOIUrl":"https://doi.org/10.17925/ENR.2017.12.01.37","url":null,"abstract":"T eriflunomide is an oral immunotherapy agent that acts primarily as an inhibitor of dihydroorotate-dehydrogenase (DHODH), a key mitochondrial enzyme involved in the synthesis of pyrimidines in rapidly proliferating cells such as T lymphocytes and B lymphocytes, thus attenuating the inflammatory response to auto-antigens. The TEMSO and TOWER phase III clinical studies have demonstrated the efficacy and safety of teriflunomide in the first-line treatment of patients with relapsing multiple sclerosis (MS), with long-term follow-up data available up to 9 years. Teriflunomide has also been shown to decrease the risk of conversion to clinically definite MS (CDMS) in patients with a first clinical sign of MS or risk of conversion to CDMS after a clinically isolated syndrome. In addition to reducing disability progression and relapse rate, teriflunomide has also been found to decrease imaging activity and is associated with significant reductions in brain volume loss. The convenience of administration of teriflunomide should establish its role within the growing number of treatment options for MS.","PeriodicalId":12047,"journal":{"name":"European neurological review","volume":"12 1","pages":"37"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67592155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.17925/ENR.2017.12.02.78
N. Grigoriadis
{"title":"Selective Targeting of T and B Cell Populations by Alemtuzumab in the Treatment of Multiple Sclerosis","authors":"N. Grigoriadis","doi":"10.17925/ENR.2017.12.02.78","DOIUrl":"https://doi.org/10.17925/ENR.2017.12.02.78","url":null,"abstract":"","PeriodicalId":12047,"journal":{"name":"European neurological review","volume":"12 1","pages":"78"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67592363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.17925/ENR.2017.12.02.68
J. Georges
T he objective of a new report, ‘European Dementia Monitor 2017: comparing and benchmarking national dementia strategies and policies’, is to provide a benchmark of national dementia policies in order to compare the responses of European countries to the dementia challenge in different domains. This benchmarking of national dementia policies is intended as a tool for national organisations to compare their situation to that of other European countries. For Alzheimer Europe as a European organisation it is key to understand what differences exist, why they exist and how to find better solutions.
{"title":"Alzheimer Europe Publication Highlights Inequalities in Access to Dementia Care and Treatment Across Europe","authors":"J. Georges","doi":"10.17925/ENR.2017.12.02.68","DOIUrl":"https://doi.org/10.17925/ENR.2017.12.02.68","url":null,"abstract":"T he objective of a new report, ‘European Dementia Monitor 2017: comparing and benchmarking national dementia strategies and policies’, is to provide a benchmark of national dementia policies in order to compare the responses of European countries to the dementia challenge in different domains. This benchmarking of national dementia policies is intended as a tool for national organisations to compare their situation to that of other European countries. For Alzheimer Europe as a European organisation it is key to understand what differences exist, why they exist and how to find better solutions.","PeriodicalId":12047,"journal":{"name":"European neurological review","volume":"12 1","pages":"68"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67591894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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