Katy Gallop, Ngan Pham, Grant Maclaine, Emma Saunders, Bonnie Black, Lena Hubig, Sarah Acaster
Aim: This study explores the burden of caring for an individual with neurogenic orthostatic hypotension (nOH) and an underlying neurodegenerative disease (Parkinson's disease, multiple system atrophy, pure autonomic failure or dementia with Lewy bodies). Materials & methods: A survey including several validated instruments was conducted with informal caregivers of individuals with Parkinson's disease, multiple system atrophy, pure autonomic failure or dementia with Lewy bodies. Results: Caregivers of patients with nOH (n = 60) reported greater burden across all outcomes compared with those without nOH (n = 60). Receiving pharmacological treatment for nOH was the variable most consistently associated with significantly better caregiver health-related quality-of-life (p < 0.05). Conclusion: This study demonstrates the burden of nOH on informal caregivers and highlights the potential benefit of pharmacological treatment not only for patients but also indirectly, their caregivers.
{"title":"Health-related quality-of-life and burden for caregivers of individuals with neurogenic orthostatic hypotension.","authors":"Katy Gallop, Ngan Pham, Grant Maclaine, Emma Saunders, Bonnie Black, Lena Hubig, Sarah Acaster","doi":"10.2217/nmt-2022-0015","DOIUrl":"https://doi.org/10.2217/nmt-2022-0015","url":null,"abstract":"<p><p><b>Aim:</b> This study explores the burden of caring for an individual with neurogenic orthostatic hypotension (nOH) and an underlying neurodegenerative disease (Parkinson's disease, multiple system atrophy, pure autonomic failure or dementia with Lewy bodies). <b>Materials & methods:</b> A survey including several validated instruments was conducted with informal caregivers of individuals with Parkinson's disease, multiple system atrophy, pure autonomic failure or dementia with Lewy bodies. <b>Results:</b> Caregivers of patients with nOH (n = 60) reported greater burden across all outcomes compared with those without nOH (n = 60). Receiving pharmacological treatment for nOH was the variable most consistently associated with significantly better caregiver health-related quality-of-life (p < 0.05). <b>Conclusion:</b> This study demonstrates the burden of nOH on informal caregivers and highlights the potential benefit of pharmacological treatment not only for patients but also indirectly, their caregivers.</p>","PeriodicalId":19114,"journal":{"name":"Neurodegenerative disease management","volume":"13 1","pages":"35-45"},"PeriodicalIF":2.6,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10793820","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 : 2022-12-01Epub Date: 2022-08-26DOI: 10.2217/nmt-2022-0018
Gavin Giovannoni, Giancarlo Comi, Kottil Rammohan, Peter Rieckmann, Fernando Dangond, Dominic Jack, Patrick Vermersch
What is this summary about?: This is a summary of an article originally published in the journal Advances in Therapy. Cladribine tablets are approved for treating people with relapsing multiple sclerosis (shortened to MS). People with MS take cladribine tablets for 2 periods of 4 to 5 days per year. This analysis looks at the results from 2 studies called the CLARITY and CLARITY Extension studies. These studies looked at what effect a 2-year course of treatment with cladribine tablets had on disability over 5 years in people with MS.
How was the analysis carried out?: In this analysis, researchers measured disability worsening at regular intervals during the 2-year treatment period in the CLARITY study and thereafter in the 2-year CLARITY Extension study. As many patients had a bridging interval between CLARITY and CLARITY extension, the researchers were able to assess disability over a 5-year timeframe.
What were the results?: When measurements were taken at Year 5 of the study, disability remained stable in more than half of participants. Over the 5-year period, 70% of participants did not experience persistent disease worsening that lasted more than 6 months.
What do the results mean?: Researchers concluded that a 2-year course of cladribine tablets may provide long-term benefits on disability for up to 5 years. Clinical Trial Registration: NCT00213135 (ClinicalTrials.gov) Clinical Trial Registration: NCT00641537 (ClinicalTrials.gov).
{"title":"Disease stability over five years in people with multiple sclerosis treated with cladribine tablets: a plain language summary.","authors":"Gavin Giovannoni, Giancarlo Comi, Kottil Rammohan, Peter Rieckmann, Fernando Dangond, Dominic Jack, Patrick Vermersch","doi":"10.2217/nmt-2022-0018","DOIUrl":"https://doi.org/10.2217/nmt-2022-0018","url":null,"abstract":"<p><strong>What is this summary about?: </strong>This is a summary of an article originally published in the journal <i>Advances in Therapy</i>. Cladribine tablets are approved for treating people with relapsing multiple sclerosis (shortened to MS). People with MS take cladribine tablets for 2 periods of 4 to 5 days per year. This analysis looks at the results from 2 studies called the CLARITY and CLARITY Extension studies. These studies looked at what effect a 2-year course of treatment with cladribine tablets had on disability over 5 years in people with MS.</p><p><strong>How was the analysis carried out?: </strong>In this analysis, researchers measured disability worsening at regular intervals during the 2-year treatment period in the CLARITY study and thereafter in the 2-year CLARITY Extension study. As many patients had a bridging interval between CLARITY and CLARITY extension, the researchers were able to assess disability over a 5-year timeframe.</p><p><strong>What were the results?: </strong>When measurements were taken at Year 5 of the study, disability remained stable in more than half of participants. Over the 5-year period, 70% of participants did not experience persistent disease worsening that lasted more than 6 months.</p><p><strong>What do the results mean?: </strong>Researchers concluded that a 2-year course of cladribine tablets may provide long-term benefits on disability for up to 5 years. <b>Clinical Trial Registration</b>: NCT00213135 (ClinicalTrials.gov) <b>Clinical Trial Registration</b>: NCT00641537 (ClinicalTrials.gov).</p>","PeriodicalId":19114,"journal":{"name":"Neurodegenerative disease management","volume":"12 6","pages":"295-301"},"PeriodicalIF":2.6,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33439153","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 : 2022-12-01Epub Date: 2022-08-26DOI: 10.2217/nmt-2022-0019
Nicola De Stefano, Maria Pia Sormani, Gavin Giovannoni, Kottil Rammohan, Thomas P Leist, Patricia K Coyle, Fernando Dangond, Nektaria Alexandri, Andrew Galazka
What is this summary about?: This is a summary of an article originally published in the Multiple Sclerosis Journal. The article presents the results from the CLARITY and CLARITY Extension studies, which looked at how well cladribine tablets work in treating people with multiple sclerosis (shortened to MS). Cladribine tablets are a medication approved for treating relapsing forms of MS. This study looked at how treatment with cladribine tablets affects the frequency and severity of relapses in people with MS. A relapse is when new symptoms develop or old symptoms return or get worse after a period of stability or improvement.
What happened in the studies?: In the CLARITY study, 870 people received either cladribine tablets (3.5 mg/kg, the approved dose) or placebo (a dummy pill). After the CLARITY study ended, some participants who received cladribine tablets chose to take part in a second study called the CLARITY Extension study. Of these participants, 98 were given placebo for 2 more years following an interval period of up to 10 months between participating in each study.
What were the results?: People with MS who were treated with cladribine tablets for 2 years in the CLARITY study had lower risks of any relapse compared with those given placebo. Participants taking placebo (after cladribine tablets) in the CLARITY Extension study experienced these same benefits, which continued for up to 3 more years after having received cladribine tablets in the CLARITY study.
What do the results mean?: Researchers concluded the recommended 2-year dosing of cladribine tablets may reduce the number and severity of relapses in people with MS for up to 5 years. Clinical Trial Registration: NCT00213135 (ClinicalTrials.gov) Clinical Trial Registration: NCT00641537 (ClinicalTrials.gov).
{"title":"Relapses in people with multiple sclerosis treated with cladribine tablets followed for up to 5 years: a plain language summary.","authors":"Nicola De Stefano, Maria Pia Sormani, Gavin Giovannoni, Kottil Rammohan, Thomas P Leist, Patricia K Coyle, Fernando Dangond, Nektaria Alexandri, Andrew Galazka","doi":"10.2217/nmt-2022-0019","DOIUrl":"https://doi.org/10.2217/nmt-2022-0019","url":null,"abstract":"<p><strong>What is this summary about?: </strong>This is a summary of an article originally published in the <i>Multiple Sclerosis Journal</i>. The article presents the results from the CLARITY and CLARITY Extension studies, which looked at how well cladribine tablets work in treating people with multiple sclerosis (shortened to MS). Cladribine tablets are a medication approved for treating relapsing forms of MS. This study looked at how treatment with cladribine tablets affects the frequency and severity of relapses in people with MS. A relapse is when new symptoms develop or old symptoms return or get worse after a period of stability or improvement.</p><p><strong>What happened in the studies?: </strong>In the CLARITY study, 870 people received either cladribine tablets (3.5 mg/kg, the approved dose) or placebo (a dummy pill). After the CLARITY study ended, some participants who received cladribine tablets chose to take part in a second study called the CLARITY Extension study. Of these participants, 98 were given placebo for 2 more years following an interval period of up to 10 months between participating in each study.</p><p><strong>What were the results?: </strong>People with MS who were treated with cladribine tablets for 2 years in the CLARITY study had lower risks of any relapse compared with those given placebo. Participants taking placebo (after cladribine tablets) in the CLARITY Extension study experienced these same benefits, which continued for up to 3 more years after having received cladribine tablets in the CLARITY study.</p><p><strong>What do the results mean?: </strong>Researchers concluded the recommended 2-year dosing of cladribine tablets may reduce the number and severity of relapses in people with MS for up to 5 years. <b>Clinical Trial Registration</b>: NCT00213135 (ClinicalTrials.gov) <b>Clinical Trial Registration</b>: NCT00641537 (ClinicalTrials.gov).</p>","PeriodicalId":19114,"journal":{"name":"Neurodegenerative disease management","volume":"12 6","pages":"303-310"},"PeriodicalIF":2.6,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33438207","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 : 2022-10-01Epub Date: 2022-07-22DOI: 10.2217/nmt-2022-0012
Harald Hampel, Aya Elhage, Leslie M Shaw, Paul Aisen, Christopher Chen, Alberto Lleó, Takeshi Iwatsubo, Atsushi Iwata, Masahito Yamada, Takeshi Ikeuchi, Jianping Jia, Huali Wang, Charlotte E Teunissen, Elaine Peskind, Kaj Blennow, Jeffrey Cummings, Andrea Vergallo
What is this summary about?: This is a plain language summary of an article published in Alzheimer's & Dementia. It looks at a type of test called a lumbar puncture (also known as spinal tap) used in people suspected of having Alzheimer's disease or some other form of dementia. This summary focuses on how to do a lumbar puncture safely.
Why is this important?: Alzheimer's disease is a progressive condition, which means it gets worse over time. This leads to difficulties with thinking and memory. People with Alzheimer's disease show a build up of proteins called amyloid-β and tau in the brain. This is followed by a gradual loss of brain cells and brain function. The changes in the brain are thought to occur years before symptoms appear. Lumbar puncture is a medical procedure during which samples of cerebrospinal fluid are collected. In Alzheimer's disease, it is used to examine cerebrospinal fluid biomarkers that can help diagnose disease. Lumbar puncture is traditionally considered as a painful and invasive procedure with frequent side effects. However, multiple studies indicate that a lumbar puncture can be performed safely. Side effects are typically mild and do not require specialist intervention.
What are the key takeaways?: Despite the low risk of serious complications associated with a lumbar puncture, physicians and their patients may be reluctant to recommend or undergo this procedure. Patient education, specialist training, as well as new methods concerning patient safety are important factors to support the widespread use of lumbar puncture in Alzheimer's disease.
{"title":"The use of lumbar puncture and safety recommendations in Alzheimer's disease: a plain language summary.","authors":"Harald Hampel, Aya Elhage, Leslie M Shaw, Paul Aisen, Christopher Chen, Alberto Lleó, Takeshi Iwatsubo, Atsushi Iwata, Masahito Yamada, Takeshi Ikeuchi, Jianping Jia, Huali Wang, Charlotte E Teunissen, Elaine Peskind, Kaj Blennow, Jeffrey Cummings, Andrea Vergallo","doi":"10.2217/nmt-2022-0012","DOIUrl":"https://doi.org/10.2217/nmt-2022-0012","url":null,"abstract":"<p><strong>What is this summary about?: </strong>This is a plain language summary of an article published in <i>Alzheimer's & Dementia</i>. It looks at a type of test called a lumbar puncture (also known as spinal tap) used in people suspected of having Alzheimer's disease or some other form of dementia. This summary focuses on how to do a lumbar puncture safely.</p><p><strong>Why is this important?: </strong>Alzheimer's disease is a progressive condition, which means it gets worse over time. This leads to difficulties with thinking and memory. People with Alzheimer's disease show a build up of proteins called amyloid-β and tau in the brain. This is followed by a gradual loss of brain cells and brain function. The changes in the brain are thought to occur years before symptoms appear. Lumbar puncture is a medical procedure during which samples of cerebrospinal fluid are collected. In Alzheimer's disease, it is used to examine cerebrospinal fluid biomarkers that can help diagnose disease. Lumbar puncture is traditionally considered as a painful and invasive procedure with frequent side effects. However, multiple studies indicate that a lumbar puncture can be performed safely. Side effects are typically mild and do not require specialist intervention.</p><p><strong>What are the key takeaways?: </strong>Despite the low risk of serious complications associated with a lumbar puncture, physicians and their patients may be reluctant to recommend or undergo this procedure. Patient education, specialist training, as well as new methods concerning patient safety are important factors to support the widespread use of lumbar puncture in Alzheimer's disease.</p>","PeriodicalId":19114,"journal":{"name":"Neurodegenerative disease management","volume":"12 5","pages":"221-229"},"PeriodicalIF":2.6,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40545160","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 : 2022-10-01Epub Date: 2022-06-29DOI: 10.2217/nmt-2022-0011
Medina Keita, Kellie McIntyre, Layne N Rodden, Kim Schadt, David R Lynch
Friedreich's ataxia (FRDA), a neurodegenerative disease characterized by ataxia and other neurological features, affects 1 in 50,000-100,000 individuals in the USA. However, FRDA also includes cardiac, orthopedic and endocrine dysfunction, giving rise to many secondary disease characteristics. The multifaceted approach for clinical care has necessitated the development of disease-specific clinical care guidelines. New developments in FRDA include the advancement of clinical drug trials targeting the NRF2 pathway and frataxin restoration. Additionally, a novel understanding of gene silencing in FRDA, reflecting a variegated silencing pattern, will have applications to current and future therapeutic interventions. Finally, new perspectives on the neuroanatomy of FRDA and its developmental features will refine the time course and anatomical targeting of novel approaches.
{"title":"Friedreich ataxia: clinical features and new developments.","authors":"Medina Keita, Kellie McIntyre, Layne N Rodden, Kim Schadt, David R Lynch","doi":"10.2217/nmt-2022-0011","DOIUrl":"10.2217/nmt-2022-0011","url":null,"abstract":"<p><p>Friedreich's ataxia (FRDA), a neurodegenerative disease characterized by ataxia and other neurological features, affects 1 in 50,000-100,000 individuals in the USA. However, FRDA also includes cardiac, orthopedic and endocrine dysfunction, giving rise to many secondary disease characteristics. The multifaceted approach for clinical care has necessitated the development of disease-specific clinical care guidelines. New developments in FRDA include the advancement of clinical drug trials targeting the NRF2 pathway and frataxin restoration. Additionally, a novel understanding of gene silencing in FRDA, reflecting a variegated silencing pattern, will have applications to current and future therapeutic interventions. Finally, new perspectives on the neuroanatomy of FRDA and its developmental features will refine the time course and anatomical targeting of novel approaches.</p>","PeriodicalId":19114,"journal":{"name":"Neurodegenerative disease management","volume":"12 5","pages":"267-283"},"PeriodicalIF":2.6,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9517959/pdf/nmt-12-267.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40408649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-01Epub Date: 2022-06-30DOI: 10.2217/nmt-2021-0056
Raj Rawal, Joy Read, Elizabeth Chesterman, Kate Walters, Anette Schrag, Gareth Ambler, Megan Armstrong
Many neurodegenerative conditions are chronic disorders and result in a range of debilitating symptoms, with many people turning to complementary therapies. A systematic review and meta-analysis were conducted to investigate the evidence on effectiveness of aromatherapy and reflexology on all neurodegenerative conditions. We identified nine eligible studies (total sample n = 504 participants) all of which were on multiple sclerosis only. A meta-analysis was conducted including data from six studies, which demonstrated no significant benefit of aromatherapy/reflexology; however, the sample sizes were small and of low quality. This systematic review confirmed that it is not possible to draw conclusions regarding the effectiveness of reflexology and aromatherapy in multiple sclerosis. Larger high-quality studies are required to test these widely used therapies.
{"title":"The effectiveness of aromatherapy and reflexology in neurodegenerative disorders: a systematic review and meta-analysis.","authors":"Raj Rawal, Joy Read, Elizabeth Chesterman, Kate Walters, Anette Schrag, Gareth Ambler, Megan Armstrong","doi":"10.2217/nmt-2021-0056","DOIUrl":"https://doi.org/10.2217/nmt-2021-0056","url":null,"abstract":"<p><p>Many neurodegenerative conditions are chronic disorders and result in a range of debilitating symptoms, with many people turning to complementary therapies. A systematic review and meta-analysis were conducted to investigate the evidence on effectiveness of aromatherapy and reflexology on all neurodegenerative conditions. We identified nine eligible studies (total sample n = 504 participants) all of which were on multiple sclerosis only. A meta-analysis was conducted including data from six studies, which demonstrated no significant benefit of aromatherapy/reflexology; however, the sample sizes were small and of low quality. This systematic review confirmed that it is not possible to draw conclusions regarding the effectiveness of reflexology and aromatherapy in multiple sclerosis. Larger high-quality studies are required to test these widely used therapies.</p>","PeriodicalId":19114,"journal":{"name":"Neurodegenerative disease management","volume":"12 5","pages":"253-265"},"PeriodicalIF":2.6,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40410289","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 : 2022-10-01Epub Date: 2022-07-14DOI: 10.2217/nmt-2022-0025
Martin Knapp, Xheni Shehaj, Gloria Wong
{"title":"Digital interventions for people with dementia and carers: effective, cost-effective and equitable?","authors":"Martin Knapp, Xheni Shehaj, Gloria Wong","doi":"10.2217/nmt-2022-0025","DOIUrl":"10.2217/nmt-2022-0025","url":null,"abstract":"","PeriodicalId":19114,"journal":{"name":"Neurodegenerative disease management","volume":"12 5","pages":"215-219"},"PeriodicalIF":2.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9517957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40592266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-01Epub Date: 2022-07-22DOI: 10.2217/nmt-2022-0013
Harald Hampel, Aya Elhage, Jeffrey Cummings, Kaj Blennow, Peng Gao, Clifford R Jack, Andrea Vergallo
What is this summary about?: This is a plain language summary of an article published in Nature Reviews Neurology. It explains how Alzheimer's disease is diagnosed. It also looks at whether a newer way to assess people with Alzheimer's disease could help improve how the condition is diagnosed, monitored, and treated.
Why is this important?: Alzheimer's disease is a long-term progressive brain disease that leads to difficulties with thinking and memory. It is a progressive condition, which means it gets worse over time. Biological changes occur in the brain of people with Alzheimer's disease. This includes a build-up of toxic protein clusters called amyloid plaques and tau tangles, gradual damage to the brain cells (neurodegeneration), and brain shrinkage due to loss of neurons. It is often due to multiple factors and doctors usually diagnose Alzheimer's disease by looking at a person's symptoms and ruling out other causes of dementia. However, research shows that people diagnosed in this way do not always have the biological changes in the brain that are related to Alzheimer's disease. This means that some people may be misdiagnosed. Additionally, there may be a delay in the appearance of Alzheimer's symptoms, by which point changes in the brain may be severe. For example, people with Alzheimer's disease show biological changes in the brain, years before symptoms appear.
What are the key takeaways?: An assessment of biological changes in the brain, by measuring substances that indicate disease progress (biomarkers), may offer a fuller picture of a person's Alzheimer's disease, how advanced it is, and which treatments are likely to work best. A recently developed classification scheme known as the AT(N) system provides a way to assess and describe the biological changes in amyloid (A), tau (T), and neurodegeneration (N) that occur in people with Alzheimer's disease. The goal is to include biomarker testing in clinical practice to help physicians and practitioners diagnose, monitor, and treat people with Alzheimer's disease more effectively. The AT(N) system is being used for various purposes in clinical studies, and has the potential to assist physicians and practitioners in early detection, accurate diagnosis, staging, and treatment selection for people with Alzheimer's disease.
这个总结是关于什么的?这是一篇发表在《自然评论神经学》上的文章的简明扼要的总结。它解释了阿尔茨海默病的诊断方法。它还研究了一种评估阿尔茨海默病患者的新方法是否有助于改善这种疾病的诊断、监测和治疗方式。为什么这很重要?阿尔茨海默病是一种长期的进行性脑部疾病,会导致思考和记忆困难。这是一种进行性疾病,这意味着它会随着时间的推移而恶化。阿尔茨海默病患者的大脑会发生生物学变化。这包括被称为淀粉样斑块和tau蛋白缠结的有毒蛋白质簇的积累,对脑细胞的逐渐损伤(神经变性),以及由于神经元丧失而导致的大脑萎缩。它通常是由多种因素引起的,医生通常通过观察一个人的症状来诊断阿尔茨海默病,并排除痴呆症的其他原因。然而,研究表明,以这种方式诊断的人并不总是有与阿尔茨海默病相关的大脑生物学变化。这意味着有些人可能会被误诊。此外,阿尔茨海默病的症状可能会延迟出现,到那时大脑的变化可能会很严重。例如,患有阿尔茨海默病的人在症状出现前几年就表现出大脑的生物学变化。关键的收获是什么?通过测量指示疾病进展的物质(生物标志物)来评估大脑的生物变化,可以更全面地了解一个人的阿尔茨海默病,了解病情的进展程度,以及哪种治疗方法可能最有效。最近开发的分类方案称为AT(N)系统提供了一种评估和描述发生在阿尔茨海默病患者的淀粉样蛋白(A), tau (T)和神经变性(N)的生物学变化的方法。目标是将生物标志物测试纳入临床实践,以帮助医生和从业人员更有效地诊断、监测和治疗阿尔茨海默病患者。AT(N)系统在临床研究中被用于各种目的,并有可能帮助医生和从业人员对阿尔茨海默病患者进行早期发现、准确诊断、分期和治疗选择。
{"title":"The AT(N) system for describing biological changes in Alzheimer's disease: a plain language summary.","authors":"Harald Hampel, Aya Elhage, Jeffrey Cummings, Kaj Blennow, Peng Gao, Clifford R Jack, Andrea Vergallo","doi":"10.2217/nmt-2022-0013","DOIUrl":"https://doi.org/10.2217/nmt-2022-0013","url":null,"abstract":"<p><strong>What is this summary about?: </strong>This is a plain language summary of an article published in <i>Nature Reviews Neurology</i>. It explains how Alzheimer's disease is diagnosed. It also looks at whether a newer way to assess people with Alzheimer's disease could help improve how the condition is diagnosed, monitored, and treated.</p><p><strong>Why is this important?: </strong>Alzheimer's disease is a long-term progressive brain disease that leads to difficulties with thinking and memory. It is a progressive condition, which means it gets worse over time. Biological changes occur in the brain of people with Alzheimer's disease. This includes a build-up of toxic protein clusters called amyloid plaques and tau tangles, gradual damage to the brain cells (neurodegeneration), and brain shrinkage due to loss of neurons. It is often due to multiple factors and doctors usually diagnose Alzheimer's disease by looking at a person's symptoms and ruling out other causes of dementia. However, research shows that people diagnosed in this way do not always have the biological changes in the brain that are related to Alzheimer's disease. This means that some people may be misdiagnosed. Additionally, there may be a delay in the appearance of Alzheimer's symptoms, by which point changes in the brain may be severe. For example, people with Alzheimer's disease show biological changes in the brain, years before symptoms appear.</p><p><strong>What are the key takeaways?: </strong>An assessment of biological changes in the brain, by measuring substances that indicate disease progress (biomarkers), may offer a fuller picture of a person's Alzheimer's disease, how advanced it is, and which treatments are likely to work best. A recently developed classification scheme known as the AT(N) system provides a way to assess and describe the biological changes in amyloid (A), tau (T), and neurodegeneration (N) that occur in people with Alzheimer's disease. The goal is to include biomarker testing in clinical practice to help physicians and practitioners diagnose, monitor, and treat people with Alzheimer's disease more effectively. The AT(N) system is being used for various purposes in clinical studies, and has the potential to assist physicians and practitioners in early detection, accurate diagnosis, staging, and treatment selection for people with Alzheimer's disease.</p>","PeriodicalId":19114,"journal":{"name":"Neurodegenerative disease management","volume":"12 5","pages":"231-239"},"PeriodicalIF":2.6,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40616842","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 : 2022-10-01Epub Date: 2022-09-07DOI: 10.2217/nmt-2021-0016
Marco Peresson, Salvatore Cottone, Vincenzo Brescia Morra, Giuseppe Salemi, Antonio Gallo, Paola Valentino, Luca Prosperini
Aims: To evaluate how improved treatment adherence with a lower-frequency regimen/treatment of intramuscular (IM) IFNβ-1a impacts therapeutic effectiveness in relapsing-remitting multiple sclerosis (MS) patients switching from a higher-frequency injectable regimen/treatment. Patients & methods: Italian patients with relapsing-remitting MS and prior poor adherence to high-frequency injectable treatments (n = 181) were followed for 24 months after starting IM IFNβ-1a. Results: During the study, 97.4% of patients were treatment adherent; 22.1% of patients reported a relapse. The estimated probability of remaining relapse-free after 2 years was 78%. A high dropout rate (52.5%) led to small sample size and reduced statistical power. Conclusion: Intramuscular IFNβ-1a treatment was associated with high adherence and a low relapse rate. Unfortunately, low patient retention limited the generalizability of these findings.
{"title":"Off-Adherence Keeping (OAK) observational study: intentional off-adherence immunomodulatory multiple sclerosis treatment.","authors":"Marco Peresson, Salvatore Cottone, Vincenzo Brescia Morra, Giuseppe Salemi, Antonio Gallo, Paola Valentino, Luca Prosperini","doi":"10.2217/nmt-2021-0016","DOIUrl":"https://doi.org/10.2217/nmt-2021-0016","url":null,"abstract":"<p><p><b>Aims:</b> To evaluate how improved treatment adherence with a lower-frequency regimen/treatment of intramuscular (IM) IFNβ-1a impacts therapeutic effectiveness in relapsing-remitting multiple sclerosis (MS) patients switching from a higher-frequency injectable regimen/treatment. <b>Patients & methods:</b> Italian patients with relapsing-remitting MS and prior poor adherence to high-frequency injectable treatments (n = 181) were followed for 24 months after starting IM IFNβ-1a. <b>Results:</b> During the study, 97.4% of patients were treatment adherent; 22.1% of patients reported a relapse. The estimated probability of remaining relapse-free after 2 years was 78%. A high dropout rate (52.5%) led to small sample size and reduced statistical power. <b>Conclusion:</b> Intramuscular IFNβ-1a treatment was associated with high adherence and a low relapse rate. Unfortunately, low patient retention limited the generalizability of these findings.</p>","PeriodicalId":19114,"journal":{"name":"Neurodegenerative disease management","volume":"12 5","pages":"241-251"},"PeriodicalIF":2.6,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40355669","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 : 2022-08-01Epub Date: 2022-05-23DOI: 10.2217/nmt-2021-0043
Rachel Chalmer, Emmeline Ayers, Erica F Weiss, Rubina Malik, Amy Ehrlich, Cuiling Wang, Jessica Zwerling, Asif Ansari, Katherine L Possin, Joe Verghese
Cognitive impairment related to dementia is under-diagnosed in primary care despite availability of numerous cognitive assessment tools; under-diagnosis is more prevalent for members of racial and ethnic minority groups. Clinical decision-support systems may improve rates of primary care providers responding to positive cognitive assessments with appropriate follow-up. The 5-Cog study is a randomized controlled trial in 1200 predominantly Black and Hispanic older adults from an urban underserved community who are presenting to primary care with cognitive concerns. The study will validate a novel 5-minute cognitive assessment coupled with an electronic medical record-embedded decision tree to overcome the barriers of current cognitive assessment paradigms in primary care and facilitate improved dementia care.
{"title":"The 5-Cog paradigm to improve detection of cognitive impairment and dementia: clinical trial protocol.","authors":"Rachel Chalmer, Emmeline Ayers, Erica F Weiss, Rubina Malik, Amy Ehrlich, Cuiling Wang, Jessica Zwerling, Asif Ansari, Katherine L Possin, Joe Verghese","doi":"10.2217/nmt-2021-0043","DOIUrl":"10.2217/nmt-2021-0043","url":null,"abstract":"<p><p>Cognitive impairment related to dementia is under-diagnosed in primary care despite availability of numerous cognitive assessment tools; under-diagnosis is more prevalent for members of racial and ethnic minority groups. Clinical decision-support systems may improve rates of primary care providers responding to positive cognitive assessments with appropriate follow-up. The 5-Cog study is a randomized controlled trial in 1200 predominantly Black and Hispanic older adults from an urban underserved community who are presenting to primary care with cognitive concerns. The study will validate a novel 5-minute cognitive assessment coupled with an electronic medical record-embedded decision tree to overcome the barriers of current cognitive assessment paradigms in primary care and facilitate improved dementia care.</p>","PeriodicalId":19114,"journal":{"name":"Neurodegenerative disease management","volume":"12 4","pages":"171-184"},"PeriodicalIF":2.6,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9245592/pdf/nmt-12-171.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9913965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}