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Masitinib for the treatment of Alzheimer's disease. 马西替尼用于治疗阿尔茨海默病。
IF 2.6 Q3 CLINICAL NEUROLOGY Pub Date : 2021-08-01 Epub Date: 2021-08-20 DOI: 10.2217/nmt-2021-0019
Miren Ettcheto, Amanda Cano, Elena Sanchez-López, Ester Verdaguer, Jaume Folch, Carme Auladell, Antoni Camins

The actual standard treatment for mild-to-moderately severe Alzheimer's disease only attacks its symptoms. Masitinib is a potent and selective phenylaminothiazole-type tyrosine kinase inhibitor which is currently in Phase III studies for the treatment of Alzheimer's disease (AD) with the aim of modifying its evolution and with multiple pharmacological targets such as inhibition of mast cells activity, inhibition of microglia activation, modulation of Aβ and Tau protein signaling pathway and prevention of synaptic damage. Here, we review the preclinical and clinical studies that investigated the administration of masitinib treatment in monotherapy in AD. All research studies revealed positive effects concerning the cognitive functions in AD and generally with good safety and tolerability.

对轻度至中度阿尔茨海默病的实际标准治疗只针对其症状。Masitinib是一种有效的选择性苯氨基噻唑型酪氨酸激酶抑制剂,目前正在进行治疗阿尔茨海默病(AD)的III期研究,目的是改变其进化,并具有多种药理靶点,如抑制肥大细胞活性,抑制小胶质细胞活化,调节a β和Tau蛋白信号通路以及预防突触损伤。在这里,我们回顾了研究马西替尼单药治疗AD的临床前和临床研究。所有的研究都表明,该药对阿尔茨海默病患者的认知功能有积极的影响,总体上具有良好的安全性和耐受性。
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引用次数: 10
A survey on patients' disease perception and the impact of the COVID-19 pandemic on persons living with amyotrophic lateral sclerosis in Malaysia. 马来西亚肌萎缩性侧索硬化症患者疾病认知及新冠肺炎疫情对患者影响调查
IF 2.6 Q3 CLINICAL NEUROLOGY Pub Date : 2021-08-01 Epub Date: 2021-07-21 DOI: 10.2217/nmt-2021-0004
Suzanna Edgar, Nur Adilah Abdul-Aziz, Ee Chin Loh, David Capelle, Khean-Jin Goh, Lydia Abdul Latif, Nortina Shahrizaila, Azlina Ahmad-Annuar

Aim: To investigate the patients' perception of their disease, its management and the impact of the COVID-19 pandemic on persons living with amyotrophic lateral sclerosis (ALS) in Malaysia. Patients & methods: An online survey comprising 42 questions was conducted on ALS patients during the peak of the COVID-19 pandemic. Results: Responses were received from 37/60 (62%) participants with ALS directly or through their caregivers. During the COVID-19 pandemic, two-thirds of patients were negatively impacted by the sudden disruption to their hospital appointments, rehabilitation sessions and reduced social interactions. Conclusion: This study provided insight into patients' perception of their care and management of ALS in Malaysia which will facilitate in implementing changes that can improve care to persons living with this devastating illness.

目的:了解马来西亚肌萎缩性侧索硬化症(ALS)患者对疾病的认知、管理以及2019冠状病毒病大流行对ALS患者的影响。患者和方法:在COVID-19大流行高峰期对ALS患者进行了一项包含42个问题的在线调查。结果:60名ALS患者中有37名(62%)直接或通过他们的照顾者回复。在2019冠状病毒病大流行期间,三分之二的患者受到医院预约、康复疗程突然中断和社交活动减少的负面影响。结论:这项研究提供了洞察患者的看法,他们的护理和管理的ALS在马来西亚,这将有助于实施变化,可以改善护理的人生活与这种毁灭性的疾病。
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引用次数: 3
Neurophysiological biomarkers to optimize deep brain stimulation in movement disorders. 优化运动障碍深部脑刺激的神经生理生物标志物。
IF 2.6 Q3 CLINICAL NEUROLOGY Pub Date : 2021-08-01 Epub Date: 2021-07-15 DOI: 10.2217/nmt-2021-0002
Daniel Sirica, Angela L Hewitt, Christopher G Tarolli, Miriam T Weber, Carol Zimmerman, Aida Santiago, Andrew Wensel, Jonathan W Mink, Karlo J Lizárraga

Intraoperative neurophysiological information could increase accuracy of surgical deep brain stimulation (DBS) lead placement. Subsequently, DBS therapy could be optimized by specifically targeting pathological activity. In Parkinson's disease, local field potentials (LFPs) excessively synchronized in the beta band (13-35 Hz) correlate with akinetic-rigid symptoms and their response to DBS therapy, particularly low beta band suppression (13-20 Hz) and high frequency gamma facilitation (35-250 Hz). In dystonia, LFPs abnormally synchronize in the theta/alpha (4-13 Hz), beta and gamma (60-90 Hz) bands. Phasic dystonic symptoms and their response to DBS correlate with changes in theta/alpha synchronization. In essential tremor, LFPs excessively synchronize in the theta/alpha and beta bands. Adaptive DBS systems will individualize pathological characteristics of neurophysiological signals to automatically deliver therapeutic DBS pulses of specific spatial and temporal parameters.

术中神经生理信息可提高脑深部电刺激(DBS)导联定位的准确性。随后,DBS治疗可以通过特异性靶向病理活性来优化。在帕金森病中,β带(13-35 Hz)过度同步的局部场电位(LFPs)与动力学刚性症状及其对DBS治疗的反应相关,特别是低β带抑制(13-20 Hz)和高频γ促进(35-250 Hz)。在肌张力障碍中,lfp在theta/alpha (4- 13hz)、beta和gamma (60- 90hz)波段异常同步。相性肌张力障碍症状及其对DBS的反应与θ / α同步变化相关。在特发性震颤中,lfp在θ / α和β波段过度同步。自适应DBS系统将个性化神经生理信号的病理特征,自动传递特定时空参数的治疗性DBS脉冲。
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引用次数: 11
Disease biomarkers in multiple sclerosis: current serum neurofilament light chain perspectives. 多发性硬化症的疾病生物标志物:当前血清神经丝轻链的观点。
IF 2.6 Q3 CLINICAL NEUROLOGY Pub Date : 2021-08-01 Epub Date: 2021-07-01 DOI: 10.2217/nmt-2020-0058
Dejan Jakimovski, Michael G Dwyer, Niels Bergsland, Bianca Weinstock-Guttman, Robert Zivadinov

The continuous neuroinflammatory and neurodegenerative pathology in multiple sclerosis (MS) results in irreversible accumulation of physical and cognitive disability. Reliable early detection of MS disease processes can aid in the diagnosis, monitoring and treatment management of MS patients. Recent assay technological advancements now allow reliable quantification of serum-based neurofilament light chain (sNfL) levels, which provide temporal information regarding the degree of neuroaxonal damage. The relationship and predictive value of sNfL with clinical and cognitive outcomes, other paraclinical measures and treatment response is reviewed. sNfL measurement is an emerging, noninvasive and disease-responsive MS biomarker that is currently utilized in research and clinical trial settings. Understanding sNfL confounders and further assay standardization will allow clinical implementation of this biomarker.

多发性硬化症(MS)持续的神经炎症和神经退行性病理导致身体和认知障碍的不可逆积累。可靠的MS疾病过程早期检测有助于MS患者的诊断、监测和治疗管理。最近的分析技术进步现在允许可靠的定量血清为基础的神经丝轻链(sNfL)水平,它提供了关于神经轴突损伤程度的时间信息。本文综述了sNfL与临床和认知结局、其他临床旁措施和治疗反应的关系和预测价值。sNfL测量是一种新兴的、无创的和疾病反应性的MS生物标志物,目前用于研究和临床试验环境。了解sNfL混杂因素和进一步的检测标准化将允许该生物标志物的临床应用。
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引用次数: 4
Neurostimulation for cognitive enhancement in Alzheimer's disease (the NICE-AD study): a randomized clinical trial. 阿尔茨海默病认知增强的神经刺激(NICE-AD研究):一项随机临床试验
IF 2.6 Q3 CLINICAL NEUROLOGY Pub Date : 2021-08-01 Epub Date: 2021-07-09 DOI: 10.2217/nmt-2020-0061
Emma Gulley, Joe Verghese, Helena M Blumen, Emmeline Ayers, Cuiling Wang, Russell K Portenoy, Jessica L Zwerling, Erica Weiss, Helena Knotkova

New therapies for symptoms in Alzheimer's disease (AD) are urgently needed. Prior studies suggest that transcranial direct current stimulation (tDCS), a noninvasive neuromodulatory method, may be a safe and potentially effective treatment, but conclusions have been limited by small-sample sizes and brief stimulation protocols. This double-blind randomized trial involving 100 older adults with mild-to-moderate AD examines effects of 6 months of at-home active tDCS or sham delivered over the dorsolateral prefrontal cortex. The primary outcome is global cognitive performance. Secondary outcomes include executive-control/spatial selective attention, functional neuroplasticity, depressive symptoms, quality of life and the durability of effects 3 months after the stimulation period. The results will provide evidence on the efficacy of multimonth at-home tDCS in the AD treatment. =Clinical trial identifier NCT04404153 (Clinicaltrials.gov).

迫切需要新的治疗阿尔茨海默病(AD)症状的方法。先前的研究表明,经颅直流电刺激(tDCS)是一种无创的神经调节方法,可能是一种安全且潜在有效的治疗方法,但结论受到小样本量和短暂刺激方案的限制。这项双盲随机试验涉及100名患有轻度至中度AD的老年人,研究了6个月的在家活动tDCS或在背外侧前额叶皮质上进行假手术的效果。主要结果是整体认知表现。次要结果包括执行控制/空间选择性注意、功能性神经可塑性、抑郁症状、生活质量和刺激期后3个月效果的持久性。该结果将为数月在家tDCS治疗AD的有效性提供证据。=临床试验标识符NCT04404153 (Clinicaltrials.gov)。
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引用次数: 4
Adjusting the Thai version of the Addenbrooke's Cognitive Examination III for education to screen for dementia. 调整泰国版本的阿登布鲁克认知考试III教育筛查痴呆症。
IF 2.6 Q3 CLINICAL NEUROLOGY Pub Date : 2021-08-01 Epub Date: 2021-07-07 DOI: 10.2217/nmt-2021-0001
Thammanard Charernboon

Aim: To examine whether education adjusted cut-off points of the Thai version of the ACE-III improve diagnostic accuracy in the detection of mild cognitive impairment (MCI) and dementia. Materials & methods: There were 172 participants consisting of 70 normal controls, 49 people with MCI and 53 patients with dementia. Results: To screen for MCI, the adjusted for education method yielded greater accuracy for the area under the receiver operating characteristic curve (AuROC) than the unadjusted method (0.9-0.92 vs 0.86). For the detection of dementia, when applying the education correction, AuROC increased from 0.87 (unadjusted) to 0.91 for the education >6 group, but there was no improvement for education ≤6 group (AuROC 0.86). Conclusion: The use of adjusted cut-off score for education level could increase the diagnostic accuracy of the test.

目的:探讨泰国版ACE-III的教育调整截断点是否能提高轻度认知障碍(MCI)和痴呆的诊断准确性。材料与方法:172名参与者,其中70名正常对照,49名轻度认知障碍患者和53名痴呆患者。结果:为了筛查MCI,调整教育方法的受试者工作特征曲线下面积(AuROC)比未调整方法的准确度更高(0.9-0.92 vs 0.86)。对于痴呆的检测,应用教育矫正时,教育程度>6组的AuROC从0.87(未经调整)增加到0.91,而教育程度≤6组的AuROC无改善(AuROC为0.86)。结论:教育程度调整分界点可提高该测试的诊断准确性。
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引用次数: 0
NM101 Phase III study of NE3107 in Alzheimer's disease: rationale, design and therapeutic modulation of neuroinflammation and insulin resistance. NM101 NE3107治疗阿尔茨海默病的III期研究:原理、设计和对神经炎症和胰岛素抵抗的治疗调节。
IF 2.6 Q3 CLINICAL NEUROLOGY Pub Date : 2021-08-01 Epub Date: 2021-07-12 DOI: 10.2217/nmt-2021-0022
Christopher L Reading, Clarence N Ahlem, Michael F Murphy

Recently, the roles of inflammation and insulin resistance in neurodegeneration have become better appreciated. NE3107, an oral small molecule, blood-brain permeable anti-inflammatory insulin sensitizer that binds extracellular signal-regulated kinase, has been shown to selectively inhibit inflammation-driven ERK- and NF-κB-stimulated inflammatory mediators, including TNF-α, without inhibiting their homeostatic functions. We describe the rationale and design of NM101, the first randomized, multicenter Phase III clinical study to examine the safety and efficacy of 30 week treatment with NE3107 versus placebo in elderly adults with mild-to-moderate Alzheimer's disease. Patients (316) will be randomized in a 1:1 ratio. The co-primary end points measure cognitive function (ADAS Cog12), and functional and behavioral characteristics (ADCS CGIC). Trial registration number: NCT04669028 (Clinicaltrials.gov).

最近,人们对炎症和胰岛素抵抗在神经退行性变中的作用有了更深入的认识。NE3107是一种口服小分子、血脑屏障抗炎胰岛素增敏剂,能与细胞外信号调节激酶结合,已被证明能选择性地抑制炎症驱动的ERK和NF-κB刺激的炎症介质,包括TNF-α,而不抑制其平衡功能。我们介绍了 NM101 的原理和设计,这是首个随机、多中心 III 期临床研究,目的是考察 NE3107 与安慰剂相比,在轻度至中度阿尔茨海默病老年患者中治疗 30 周的安全性和有效性。患者(316人)将按1:1的比例随机分组。共同主要终点测量认知功能(ADAS Cog12)以及功能和行为特征(ADCS CGIC)。试验注册号NCT04669028(Clinicaltrials.gov)。
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引用次数: 0
The Remote Assessment of Parkinsonism Supporting Ongoing Development of Interventions in Gaucher Disease - Study Protocol 支持戈谢病干预措施持续发展的帕金森病远程评估-研究方案
IF 2.6 Q3 CLINICAL NEUROLOGY Pub Date : 2021-07-22 DOI: 10.1101/2021.07.21.21260533
A. Higgins, M. Toffoli, Stephen Mullin, Chiao Lee, S. Koletsi, M. Avenali, Fabio Blandini, Anthony H V Schapira
Mutations in GBA which are causative of Gaucher disease in their biallelic form, are the most common genetic risk factor for Parkinson disease. The diagnosis of Parkinson disease relies upon clinically defined motor features which appear after irreversible neurodegeneration. Prodromal symptoms of Parkinson disease may provide a means to predict latent pathology, years before the onset of motor features. Previous work has reported prodromal features of Parkinson disease in GBA mutation carriers, however this has been insufficiently sensitive to identify those that will develop Parkinson disease. The Remote Assessment of Parkinsonism Supporting Ongoing Development of Interventions in Gaucher Disease (RAPSODI) study assesses a large cohort of GBA mutation carriers, to aid development of procedures for earlier diagnosis of Parkinson disease.
GBA突变以双等位基因形式导致戈谢病,是帕金森病最常见的遗传危险因素。帕金森病的诊断依赖于不可逆神经变性后出现的临床定义的运动特征。帕金森病的前驱症状可能提供了一种预测潜伏病理的手段,在运动特征发作前几年。先前的研究报道了GBA突变携带者帕金森病的前驱症状特征,然而,这对于识别那些将发展为帕金森病的人还不够敏感。支持戈谢病干预措施持续发展的帕金森远程评估(RAPSODI)研究评估了一大群GBA突变携带者,以帮助开发早期诊断帕金森病的程序。
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引用次数: 0
Neurodegenerative diseases, art and creativity: therapeutic implications. 神经退行性疾病、艺术和创造力:治疗意义。
IF 2.6 Q3 CLINICAL NEUROLOGY Pub Date : 2021-06-01 Epub Date: 2021-06-03 DOI: 10.2217/nmt-2021-0012
Julio Alberto Perez Matos, Alby Richard, Blanca Tm Spee, Matthew Pelowski
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引用次数: 4
Ozanimod for the treatment of relapsing forms of multiple sclerosis. Ozanimod用于治疗复发型多发性硬化症。
IF 2.6 Q3 CLINICAL NEUROLOGY Pub Date : 2021-06-01 Epub Date: 2021-05-20 DOI: 10.2217/nmt-2021-0005
Andrea M Kuczynski, Jiwon Oh

Multiple sclerosis (MS) is an inflammatory disease that causes chronic neurological disability in young adults. Modulation of sphingosine 1-phosphate (S1P) receptors, a group of receptors that, among other things, regulate egression of lymphocytes from lymph nodes, has proven to be effective in treating relapsing MS. Fingolimod, the first oral S1P receptor modulator, has demonstrated potent efficacy and tolerability, but can cause undesirable side effects due to its interaction with a wide range of S1P receptor subtypes. This review will focus on ozanimod, a more selective S1P receptor modulator, which has recently received approval for relapsing MS. We summarize ozanimod's mechanism of action, and efficacy and safety from clinical trials that demonstrate its utility as another treatment option for relapsing MS.

多发性硬化症(MS)是一种炎症性疾病,可导致年轻人慢性神经功能障碍。sphingosine 1-phosphate (S1P)受体是一组调节淋巴细胞从淋巴结分泌的受体,已被证明对治疗复发性多发性硬化症有效。Fingolimod是第一种口服S1P受体调节剂,已被证明具有强大的疗效和耐受性,但由于其与广泛的S1P受体亚型相互作用,可能引起不良的副作用。ozanimod是一种选择性更强的S1P受体调节剂,最近被批准用于治疗复发性多发性硬化症。我们总结了ozanimod的作用机制、临床试验的有效性和安全性,这些试验证明了ozanimod作为复发性多发性硬化症的另一种治疗选择。
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引用次数: 3
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Neurodegenerative disease management
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