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Neuromyelitis optica spectrum disorder with radiological manifestation of multiple sclerosis in the first brain MRI: a case report 视神经脊髓炎谱系障碍伴多发性硬化症首次脑MRI影像学表现1例
IF 1.3 Q4 CLINICAL NEUROLOGY Pub Date : 2019-05-01 DOI: 10.2217/FNL-2018-0032
A. Moghadasi, S. Baghbanian
A small percentage of patients with neuromyelitis optica spectrum disorder (NMOSD) may have radiological manifestations that completely mimic MS. Accurate diagnosis in these patients requires paying attention to patients’ history and how they respond to treatment. Here, a patient with NMOSD is introduced, in the MRI scan of whom, the diagnostic criteria of Barkhof were outlined; however, since her blurred vision did not respond to treatment with corticosteroids, she was diagnosed with NMOSD.
一小部分视神经脊髓炎谱系障碍(NMOSD)患者的放射学表现可能与ms完全相似。对这些患者的准确诊断需要关注患者的病史及其对治疗的反应。本文介绍了一位NMOSD患者,在其MRI扫描中,概述了Barkhof的诊断标准;然而,由于她的视力模糊对皮质类固醇治疗没有反应,她被诊断为NMOSD。
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引用次数: 0
Clinical and demographic features in Iranian multiple sclerosis patients: a systematic review and meta-analysis 伊朗多发性硬化症患者的临床和人口统计学特征:一项系统回顾和荟萃分析
IF 1.3 Q4 CLINICAL NEUROLOGY Pub Date : 2019-05-01 DOI: 10.2217/FNL-2018-0025
L. Mahmudi, Moslem Moslemirad, Bafrin Dabestani, M. Shohani, M. Azami
Aim: This study was conducted to determine the clinical and demographic features in Iranian multiple sclerosis (MS) patients including clinical courses, positive MS family history, disability and age of disease onset. Materials & methods: All stages of the study were reported according to the PRISMA guidelines. A systematic review of published literature in Persian and English journals with a comprehensive search was conducted on English international databases including Scopus, PubMed/Medline, Cochrane Library, Science Direct, Web of Science, Embase, PsycINFO, as well as the Google Scholar search engine and national databases. Results: The prevalence of clinical courses of relapsing remitting, primary progressive, secondary progressive and relapsing progressive in Iranian patients with MS was 77.1% (95% CI: 72.2–81.3), 6.2% (95% CI: 4.1–9.2), 9.5% (95% CI: 6.8–13.1) and 0.4% (95% CI: 0.2–0.8), respectively. Positive family history of MS in Iranian MS patients was 8.9% (95% CI: 6.9–11.4). The mean age of disease onset was 28.9 years (95% CI: 27.8–30.1). Conclusion: The results of this meta-analysis in an Iranian population can provide useful information for neurologists and healthcare.
目的:本研究旨在确定伊朗多发性硬化症(MS)患者的临床和人口学特征,包括临床病程、阳性MS家族史、残疾和发病年龄。材料与方法:研究的所有阶段均按照PRISMA指南进行报告。对波斯语和英语期刊发表的文献进行了系统的综述,并对英文国际数据库进行了全面的检索,包括Scopus, PubMed/Medline, Cochrane Library, Science Direct, Web of Science, Embase, PsycINFO,以及谷歌Scholar搜索引擎和国家数据库。结果:伊朗多发性硬化患者复发缓解、原发性进展、继发性进展和复发进展的临床病程患病率分别为77.1% (95% CI: 72.2-81.3)、6.2% (95% CI: 4.1-9.2)、9.5% (95% CI: 6.8-13.1)和0.4% (95% CI: 0.2-0.8)。伊朗MS患者MS家族史阳性占8.9% (95% CI: 6.9-11.4)。平均发病年龄为28.9岁(95% CI: 27.8-30.1)。结论:伊朗人群的meta分析结果可以为神经科医生和医疗保健人员提供有用的信息。
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引用次数: 7
Gabapentin completely neutralized the acute morphine activation in the rat hypothalamus: a c-Fos study 加巴喷丁完全中和大鼠下丘脑急性吗啡激活:一项c-Fos研究
IF 1.3 Q4 CLINICAL NEUROLOGY Pub Date : 2019-05-01 DOI: 10.2217/FNL-2018-0037
J. Kazi, Rasdi Zatilfarihiah
Aim: The molecular mechanism of gabapentin (GBP)–morphine combinational function and its neuro-anatomical sites of action to prevent, to neutralize morphine side effects and also the enhancement its analgesic effect of morphine is unknown. Methods: Morphine (10 mg/kg), saline, co-injection: GBP (150 mg/kg) with morphine (10 mg/kg) were injected by intraperitoneal injection in rats under deep anaesthesia. C-Fos immunohistochemistry technique was used to locate c-Fos expression in rat hypothalamus. Results: Gabapentin in combination with morphine significantly (p < 0.01) attenuated the acute morphine induced c-Fos immunoreactive neuron in hypothalamus. Conclusion: GBP neutralized the morphine sensitization in rat hypothalamus. GBP might neuromodulate and or antagonize the receptor regulatory machinery of morphine sensitization circuit which might work for drug discovery of morphine abuse.
目的:加巴喷丁(GBP)-吗啡联合作用的分子机制及其预防、中和吗啡副作用和增强吗啡镇痛作用的神经解剖学部位尚不清楚。方法:在深度麻醉下,大鼠腹腔注射吗啡(10mg/kg)、生理盐水、GBP(150mg/kg)和吗啡(10mgg/kg)。应用C-Fos免疫组化技术定位大鼠下丘脑C-Fos的表达。结果:加巴喷丁联合吗啡对吗啡诱导的急性下丘脑c-Fos免疫反应神经元有明显的减毒作用(p<0.01)。结论:GBP可中和大鼠下丘脑吗啡致敏作用。GBP可能神经调节和/或拮抗吗啡致敏回路的受体调节机制,这可能有助于发现吗啡滥用的药物。
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引用次数: 1
The rise and rise of cerebral small vessel disease: implications for vascular cognitive impairment and dementia 脑小血管疾病的发病率和发病率:对血管认知障碍和痴呆的影响
IF 1.3 Q4 CLINICAL NEUROLOGY Pub Date : 2019-05-01 DOI: 10.2217/FNL-2019-0004
R. Kalaria, Y. Hase, M. Ihara
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引用次数: 1
Resting functional connectivity and mild cognitive impairment in Parkinson’s disease. An electroencephalogram study 帕金森病的静息功能连通性和轻度认知障碍。脑电图研究
IF 1.3 Q4 CLINICAL NEUROLOGY Pub Date : 2019-05-01 DOI: 10.2217/FNL-2018-0048
Jairo Alexander Carmona Arroyave, Carlos Andrés Tobón Quintero, Jasmín Jimena Suárez Revelo, J. F. Gómez, Yamile Bocanegra García, Leonardo Moreno Gómez, David Antonio Pineda Salazar
Objective: Parkinson’s disease (PD) is characterized by cognitive deficits. There is not clarity about electroencephalogram (EEG) connectivity related to the cognitive profile of patients. Our objective was to evaluate connectivity over resting EEG in nondemented PD. Methods: PD subjects with and without mild cognitive impairment (MCI) were assessed using coherence from resting EEG for local, intra and interhemispheric connectivity. Results: PD subjects without MCI (PD-nMCI) had lower intra and interhemispheric coherence in alpha2 compared with controls. PD with MCI (PD-MCI) showed higher intra and posterior interhemispheric coherence in alpha2 and beta1, respectively, in comparison to PD-nMCI. PD-MCI presented lower frontal coherence in beta frequencies compared with PD-nMCI. Conclusion: EEG coherence measures indicate distinct cortical activity in PD with and without MCI.
目的:帕金森病(PD)以认知缺陷为特征。目前尚不清楚与患者认知特征相关的脑电图(EEG)连接。我们的目的是评估非痴呆性帕金森病患者静息脑电图的连接性。方法:使用静息脑电图的局部、半球内和半球间连接性的一致性来评估患有和不患有轻度认知障碍(MCI)的帕金森病受试者。结果:与对照组相比,没有MCI(PD-nMCI)的PD受试者在alpha2中的脑内和脑间连贯性较低。与PD nMCI相比,具有MCI的PD(PD-MCI)在α2和β1中分别显示出更高的大脑半球内和后半球间一致性。与PD-nMCI相比,PD-MCI在β频率上表现出较低的额叶相干性。结论:脑电相干测量显示有无MCI的帕金森病患者的皮层活动不同。
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引用次数: 11
Electroencephalogram and somatosensory evoked potential evaluation for good and poor neurological prognosis after cardiac arrest: a prospective multicenter cohort trial (ProNeCA) 一项前瞻性多中心队列试验(ProNeCA):对心脏骤停后神经系统预后好坏的脑电图和体感诱发电位评估
IF 1.3 Q4 CLINICAL NEUROLOGY Pub Date : 2019-05-01 DOI: 10.2217/FNL-2018-0036
M. Scarpino, R. Carrai, F. Lolli, G. Lanzo, M. Spalletti, D. Audenino, C. Callegarin, M. Celani, M. Lombardi, A. Marrelli, O. Mecarelli, C. Minardi, F. Minicucci, L. Motti, L. Politini, F. Valzania, E. Vitelli, A. Peris, A. Amantini, A. Grippo
Aim: Hypoxic-ischemic-encephalopathy is a severe and frequent neurological complication of successful cardiopulmonary-resuscitation after cardiac arrest. Prognosticating neurological outcomes in patients with hypoxic-ischemic-encephalopathy is challenging and recent guidelines suggest a multimodal approach. Only few studies have analyzed the prognostic power of the association between instrumental tests and, in addition, most of them were monocentric, retrospective and evaluating only poor outcome. Methods/design: We designed a multicenter prospective cohort study to assessing the prognostic power of the association of electroencephalogram and somatosensory evoked potentials for the prediction of both poor and good neurological outcomes at different times after cardiac arrest. Discussion: The results of our study will provide a high level of evidence for the use of neurophysiological evaluation in the current clinical practice.
目的:缺氧缺血性脑病是心脏骤停后成功心肺复苏的一种严重且常见的神经系统并发症。缺氧缺血性脑病患者的神经系统预后具有挑战性,最近的指南建议采用多模式方法。只有少数研究分析了仪器测试之间相关性的预后能力,此外,大多数研究都是单中心的、回顾性的,仅评估较差的结果。方法/设计:我们设计了一项多中心前瞻性队列研究,评估脑电图和体感诱发电位在心脏骤停后不同时间预测不良和良好神经结果的预后能力。讨论:我们的研究结果将为神经生理学评估在当前临床实践中的应用提供高水平的证据。
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引用次数: 6
Funding for spinal muscular atrophy research must continue 必须继续为脊髓性肌萎缩症研究提供资金
IF 1.3 Q4 CLINICAL NEUROLOGY Pub Date : 2019-05-01 DOI: 10.2217/FNL-2019-0001
M. Bowerman
Spinal muscular atrophy (SMA) is a devastating neuromuscular disorder and is the leading genetic cause of infant mortality [1,2]. SMA is a monogenic disease caused by complete loss of the SMN1 gene and the full-length (FL) functional SMN protein it produces [3]. A recent duplication in the human genome, however, has resulted in a second almost identical copy of SMN1, called SMN2, which, due to a silent point mutation, mostly produces a truncated nonfunctional protein [4]. The SMN2 gene nevertheless retains the ability to generate a small amount of FL protein, thus allowing the survival of individuals born with homozygous deletions/mutations within SMN1 [4]. A total absence of SMN protein is indeed not compatible with life [5]. Furthermore, the number of SMN2 copies varies from person to person and there is a clear and accepted negative correlation between the number of SMN2 copies (i.e., FL SMN protein produced) and severity of disease manifestation [6]. The identification of SMN as the gene that causes SMA dates back to 1995 [3]. Since that seminal discovery, a series of fundamental, pre-clinical and clinical research endeavours have been aimed at identifying and developing pharmacological strategies that could increase SMN abundance, either by exogenously re-introducing the SMN1 gene or by promoting the production of FL SMN protein from the SMN2 gene [7]. This arduous and approximately 25-year journey, which was supported by the entire SMA community (fundamental researchers, clinicians, families, patients and funders), reached its intended goal in December 2016, when the first gene therapy for SMA was approved by the US FDA for all SMA patients. It was subsequently approved by the European Medicines Agency (EMA) in June 2017. The drug, an antisense oligonucleotide that promotes FL SMN expression from SMN2, is sold under the commercial name of SpinrazaTM by Ionis and Biogen [8]. Saying that the approval of SpinrazaTM has changed SMA research would be quite an understatement. It has in fact completely transformed both the SMA therapeutic landscape and the SMA patient population [7,8]. Indeed, in a blink of an eye, we went from having no available therapies to having one with the potential to completely alter the fate of SMA children. Newly diagnosed patients that typically could not expect to live beyond their second birthday, now not only live beyond that timeframe, but do so by reaching motor function milestones that surpass what was ever thought possible [9,10]. Our research and clinical priorities had to therefore naturally adapt and shift overnight [11]. Shift yes, but not stop. Spinraza is an incredible life-changing treatment but, unfortunately, not a cure [8]. Indeed, treated SMA patients can still display neuromuscular symptoms and decline, and for reasons still unknown, patients respond differently to the treatment, roughly dividing into groups of responders that improve, responders that plateau and non-responders [8,12–15]. While recen
脊髓性肌萎缩(SMA)是一种破坏性的神经肌肉疾病,是婴儿死亡的主要遗传原因[1,2]。SMA是一种由SMN1基因及其产生的全长(FL)功能性SMN蛋白完全缺失引起的单基因疾病[3]。然而,最近在人类基因组中的一次复制导致了SMN1的第二个几乎相同的拷贝,称为SMN2,由于沉默点突变,它主要产生一种截短的无功能蛋白[4]。然而,SMN2基因保留了产生少量FL蛋白的能力,从而使出生时SMN1内纯合缺失/突变的个体得以存活[4]。SMN蛋白的完全缺失确实与生命不相容[5]。此外,SMN2拷贝数因人而异,SMN2副本数(即产生的FL-SMN蛋白)与疾病表现的严重程度之间存在明显且公认的负相关性[6]。SMN作为导致SMA的基因的鉴定可以追溯到1995年[3]。自这一开创性发现以来,一系列基础、临床前和临床研究工作旨在确定和开发可以通过外源性重新引入SMN1基因或通过促进SMN2基因产生FL-SMN蛋白来增加SMN丰度的药理学策略[7]。在整个SMA社区(基础研究人员、临床医生、家庭、患者和资助者)的支持下,这段长达约25年的艰难旅程于2016年12月达到了预期目标,当时美国食品药品监督管理局批准了第一种SMA基因疗法,适用于所有SMA患者。随后于2017年6月获得欧洲药品管理局(EMA)的批准。该药物是一种从SMN2促进FL SMN表达的反义寡核苷酸,由Ionis和Biogen以SpinrazaTM的商业名称出售[8]。如果说SpinrazaTM的批准改变了SMA的研究,那就太轻描淡写了。事实上,它已经完全改变了SMA的治疗环境和SMA患者群体[7,8]。事实上,一眨眼之间,我们就从没有可用的疗法变成了有可能完全改变SMA儿童命运的疗法。新确诊的患者通常不能指望活到2岁以上,现在他们不仅能活到2岁,而且能达到超过人们想象的运动功能里程碑[9,10]。因此,我们的研究和临床重点必须在一夜之间自然适应和转变[11]。转换是的,但不能停止。Spinraza是一种令人难以置信的改变生命的治疗方法,但不幸的是,它并不能治愈[8]。事实上,接受治疗的SMA患者仍然可以表现出神经肌肉症状和衰退,由于尚不清楚的原因,患者对治疗的反应不同,大致分为改善的应答者、稳定的应答者和无应答者[8,12-15]。虽然最近的数据支持症状前治疗患者的获益增加,但“越早越好”的教条并不总是成立[8,16]。此外,尚不清楚Spinraza对老年患者的益处,因为老年患者已经发生了显著的神经肌肉衰退,而且很可能无法恢复[8,17]。因此,对影响Spinraza疗效的因素及其对不同患者群体的影响进行更多的研究是至关重要的[8]。虽然上面讨论的问题与Spinraza有关,但在监管机构批准其他SMN基因疗法(例如Avexis/Novartis AAV9-SMN1病毒疗法和罗氏和诺华的口服小分子疗法)后,很可能会出现类似的询问和调查
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引用次数: 3
Could novel diagnostic technology Cognetivity accelerate dementia research? An interview with Dr Sina Habibi 新的诊断技术认知能加速痴呆症的研究吗?采访Sina Habibi博士
IF 1.3 Q4 CLINICAL NEUROLOGY Pub Date : 2019-05-01 DOI: 10.2217/FNL-2019-0005
Sina Habibi, Rachel Jenkins
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引用次数: 0
Molecular genetics of medulloblastoma in children: diagnostic, therapeutic and prognostic implications 儿童髓母细胞瘤的分子遗传学:诊断、治疗和预后意义
IF 1.3 Q4 CLINICAL NEUROLOGY Pub Date : 2019-02-01 DOI: 10.2217/FNL-2018-0030
M. Doussouki, A. Gajjar, Omar Chamdine
Medulloblastoma is the most common embryonal tumor in children. The current standard of care comprises surgical resection, radiation and chemotherapy. Patients are stratified into standard and high risk based on the degree of resection, presence of metastatic disease and histopathology. Cure rates dramatically improved during the past decades reaching 70–80% (high and average risk, respectively). Infant medulloblastoma has a worse outcome as the use of radiation therapy is very limited, a group of patients still has dismal outcome despite appropriate therapy, and the unacceptable long-term therapy side effects in survivors. Advanced molecular techniques have allowed scientists to discover four distinct molecular subgroups and correlate them with multiple factors such as histopathology, clinical behavior and possible therapeutic targets.
髓母细胞瘤是儿童最常见的胚胎性肿瘤。目前的护理标准包括手术切除、放疗和化疗。根据切除程度、转移性疾病的存在和组织病理学,将患者分为标准和高危。在过去几十年中,治愈率显著提高,达到70-80%(分别为高风险和平均风险)。婴儿髓母细胞瘤的预后更差,因为放射治疗的使用非常有限,尽管进行了适当的治疗,但一组患者的预后仍然不佳,幸存者的长期治疗副作用也令人无法接受。先进的分子技术使科学家能够发现四个不同的分子亚群,并将它们与组织病理学、临床行为和可能的治疗靶点等多种因素联系起来。
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引用次数: 16
Welcome to the 14th Volume of Future Neurology 欢迎来到《未来神经学》第14卷
IF 1.3 Q4 CLINICAL NEUROLOGY Pub Date : 2019-02-01 DOI: 10.2217/FNL-2018-0035
Rachel Jenkins
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引用次数: 1
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Future Neurology
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