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The effectiveness of aromatherapy and reflexology in neurodegenerative disorders: a systematic review and meta-analysis. 芳香疗法和反射疗法在神经退行性疾病中的有效性:系统回顾和荟萃分析。
IF 2.6 Q3 Medicine Pub Date : 2022-10-01 Epub Date: 2022-06-30 DOI: 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.

许多神经退行性疾病是慢性疾病,并导致一系列衰弱症状,许多人转向补充疗法。我们进行了系统回顾和荟萃分析,以调查芳香疗法和反射疗法对所有神经退行性疾病有效的证据。我们确定了9项符合条件的研究(总样本n = 504名参与者),所有这些研究均仅针对多发性硬化症。我们对六项研究的数据进行了荟萃分析,结果显示芳香疗法/反射疗法没有显著的益处;然而,样本量小,质量低。本系统综述证实,不可能得出关于反射疗法和芳香疗法在多发性硬化症中的有效性的结论。需要更大规模的高质量研究来测试这些广泛使用的疗法。
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引用次数: 2
Digital interventions for people with dementia and carers: effective, cost-effective and equitable? 针对痴呆症患者和照护者的数字化干预措施:有效、具有成本效益且公平吗?
IF 2.3 Q3 CLINICAL NEUROLOGY Pub Date : 2022-10-01 Epub Date: 2022-07-14 DOI: 10.2217/nmt-2022-0025
Martin Knapp, Xheni Shehaj, Gloria Wong
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引用次数: 0
The AT(N) system for describing biological changes in Alzheimer's disease: a plain language summary. 描述阿尔茨海默病生物学变化的AT(N)系统:简单的语言总结。
IF 2.6 Q3 Medicine Pub Date : 2022-10-01 Epub Date: 2022-07-22 DOI: 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。
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引用次数: 2
Off-Adherence Keeping (OAK) observational study: intentional off-adherence immunomodulatory multiple sclerosis treatment. 非依从性保持(OAK)观察性研究:有意的非依从性免疫调节多发性硬化治疗。
IF 2.6 Q3 Medicine Pub Date : 2022-10-01 Epub Date: 2022-09-07 DOI: 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.

目的:评估低频方案/肌注(IM) IFNβ-1a治疗依从性的改善如何影响复发-缓解型多发性硬化症(MS)患者从高频注射方案/治疗转换的治疗效果。患者和方法:意大利复发-缓解型MS患者,既往对高频注射治疗依从性差(n = 181),在开始IM IFNβ-1a后随访24个月。结果:研究期间,97.4%的患者坚持治疗;22.1%的患者复发。估计2年后无复发的概率为78%。高辍学率(52.5%)导致样本量小,统计效力降低。结论:肌肉注射IFNβ-1a治疗具有高依从性和低复发率。不幸的是,低患者保留率限制了这些发现的普遍性。
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引用次数: 0
The 5-Cog paradigm to improve detection of cognitive impairment and dementia: clinical trial protocol. 改善认知障碍和痴呆症检测的 5-Cog 范式:临床试验方案。
IF 2.6 Q3 Medicine Pub Date : 2022-08-01 Epub Date: 2022-05-23 DOI: 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.

尽管有许多认知评估工具,但在初级保健中与痴呆症有关的认知障碍诊断不足;少数种族和少数族裔群体成员的诊断不足现象更为普遍。临床决策支持系统可提高初级保健提供者对认知评估结果做出积极回应并进行适当随访的比率。5-Cog 研究是一项随机对照试验,对象是来自城市服务不足社区的 1200 名主要是黑人和西班牙裔的老年人,他们因认知问题向初级保健机构求诊。该研究将验证一种新颖的 5 分钟认知评估方法,并将其与嵌入电子病历的决策树相结合,以克服初级保健中现有认知评估范例的障碍,促进痴呆症护理的改善。
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引用次数: 0
Usability of an application device for nabiximols oromucosal spray in patients with upper limb impaired multiple sclerosis. 纳比昔醇口腔粘膜喷雾剂在上肢受损多发性硬化症患者中的应用装置的可用性。
IF 2.6 Q3 Medicine Pub Date : 2022-06-16 DOI: 10.2217/nmt-2022-0014
Armando Creta, Luana Gilio, D. Centonze, R. Fantozzi
Aim: This study aimed to assess the usability of a specific EU-available application device for Sativex® (USA adopted name: nabiximols) cannabinoid-based oromucosal spray in patients with multiple sclerosis (MS) and spasticity-related upper limb and hand impairment in routine daily practice. Methods: MS patients with upper limb and hand impairment evaluated the usability of the device using an ad hoc 18-item questionnaire. Results: 60 patients were included. The comprehensibility of the instructions for use, practical handling and ergonomics of the device were rated as optimal (mean scores ≥8.9/10 across questions). Assisting trained nurses also rated the device as easy to use and helpful for drug administration (mean scores 10/10). Conclusion: The application device may assist MS patients with upper limb impairment self-administer nabiximols oromucosal spray.
目的:本研究旨在评估基于大麻素的Sativex®(美国采用名称:nabiximols)口腔粘膜喷雾剂在多发性硬化症(MS)和痉挛相关上肢和手部损伤患者日常应用中的可用性。方法:有上肢和手部损伤的多发性硬化症患者使用一份特设的18项问卷来评估该装置的可用性。结果:共纳入60例患者。使用说明的可理解性、实际操作和设备的人体工程学被评为最佳(各题平均得分≥8.9/10)。辅助培训护士也认为该装置易于使用,有助于给药(平均得分10/10)。结论:该应用装置可帮助多发性硬化症上肢损伤患者自行给药纳比昔莫尔或粘膜喷雾剂。
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引用次数: 0
Healthcare resource utilization and costs for extended interval dosing of natalizumab in multiple sclerosis. 在多发性硬化症中延长纳他珠单抗间隔给药的医疗资源利用和成本。
IF 2.6 Q3 Medicine Pub Date : 2022-06-01 DOI: 10.2217/nmt-2021-0038
Marcello Moccia, Ilaria Loperto, Laura Santoni, Silvia Masera, Giuseppina Affinito, Antonio Carotenuto, Roberta Lanzillo, Maria Triassi, Vincenzo Brescia Morra, Raffaele Palladino

Aims: Natalizumab is approved as an infusion every 4 weeks (standard-interval dosing [SID]) in relapsing-remitting multiple sclerosis (MS). Extended-interval dosing (EID) reduces risk of progressive multifocal leukoencephalopathy (PML) compared with SID, but the impact on healthcare resources and costs remains unknown. Methods: In this population-based study, we included 208 natalizumab-treated MS patients who were classified into EID (≤15 infusions in the previous 18 months; n = 51; age = 33.7 ± 11.1 years; female = 72.5%) and SID (>15 infusions in the previous 18 months; n = 157; age = 36.5 ± 10.8 years; female = 68.1%) groups. Results: Natalizumab EID had fewer MS outpatient visits (p = 0.01) and related costs (p = 0.03), and lower natalizumab costs (p < 0.01) compared with SID, without changes in other healthcare resources and costs. Conclusion: Natalizumab EID is associated with reduced direct treatment costs, apparently without additional healthcare burden.

目的:Natalizumab被批准为每4周输注一次(标准间隔剂量[SID])治疗复发-缓解型多发性硬化症(MS)。与SID相比,延长间隔给药(EID)可降低进行性多灶性白质脑病(PML)的风险,但对医疗资源和成本的影响尚不清楚。方法:在这项基于人群的研究中,我们纳入了208名接受那他单抗治疗的MS患者,这些患者被分为EID(过去18个月内≤15次输注;n = 51;年龄= 33.7±11.1岁;女性= 72.5%)和SID(18个月内>15次输注);n = 157;年龄= 36.5±10.8岁;女性= 68.1%)组。结果:Natalizumab EID减少MS门诊就诊(p = 0.01)和相关费用(p = 0.03),降低Natalizumab成本(p)。结论:Natalizumab EID与降低直接治疗费用相关,显然没有额外的医疗负担。
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引用次数: 4
An overview of the active clinical trials for Parkinson's disease psychosis. 帕金森病精神病的临床试验综述。
IF 2.6 Q3 Medicine Pub Date : 2022-05-20 DOI: 10.2217/nmt-2022-0020
Cynthia Kwan, P. Huot
Tweetable abstract An overview of the active clinical trials for Parkinson's disease psychosis. In this article, we review the drugs currently undergoing clinical testing for Parkinson's disease psychosis and offer some perspectives on the treatment of the condition.
推特摘要帕金森病精神病临床试验综述。在这篇文章中,我们回顾了目前正在进行帕金森病精神病临床试验的药物,并对该疾病的治疗提供了一些看法。
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引用次数: 0
Glutamate modulation for the treatment of levodopa induced dyskinesia: a brief review of the drugs tested in the clinic. 谷氨酸调节治疗左旋多巴诱导的运动障碍:临床试验药物综述。
IF 2.6 Q3 Medicine Pub Date : 2022-05-19 DOI: 10.2217/nmt-2021-0055
Imane Frouni, P. Huot
Levodopa is the standard treatment for Parkinson's disease, but its use is marred by the emergence of dyskinesia, for which treatment options remain limited. Here, we review the glutamatergic modulators that were assessed for their antidyskinetic potential in clinical trials, including N-methyl-D-aspartate (NMDA) antagonists, agonists at the glycine-binding site on NMDA receptors, metabotropic glutamate (mGlu) 4 agonists, mGlu5 antagonists, α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) antagonists and glutamate release inhibitors. Several agents that were investigated are not selective for their targets, raising uncertainty about the extent to which glutamatergic modulation contributed to their effects. Except for amantadine, the use of glutamatergic modulators for the treatment of dyskinesia in Parkinson's disease remains largely investigational, with promising results obtained with mGlu5 negative allosteric modulation.
左旋多巴是帕金森病的标准治疗方法,但其使用因运动障碍的出现而受到影响,治疗选择仍然有限。在此,我们综述了在临床试验中评估其抗代谢动力学潜力的谷氨酸能调节剂,包括N-甲基-D-天冬氨酸(NMDA)拮抗剂、NMDA受体甘氨酸结合位点的激动剂、代谢型谷氨酸(mGlu)4激动剂、mGlu5拮抗剂、α-氨基-3-羟基-5-甲基-4-异恶唑丙酸(AMPA)拮抗剂和谷氨酸释放抑制剂。研究的几种药剂对其靶标没有选择性,这增加了谷氨酸能调节对其作用的影响程度的不确定性。除金刚烷胺外,谷氨酸能调节剂用于治疗帕金森病的运动障碍仍在大量研究中,mGlu5阴性变构调节获得了有希望的结果。
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引用次数: 4
Prodromal depression and subsequent risk of developing Parkinson's disease: a systematic review with meta-analysis. 原发性抑郁症和随后发展为帕金森病的风险:一项荟萃分析系统综述。
IF 2.6 Q3 Medicine Pub Date : 2022-05-05 DOI: 10.2217/nmt-2022-0001
Syeda Beenish Bareeqa, Syeda Sana Samar, Sufiyan Kamal, Y. Masood, Allahyar, S. I. Ahmed, G. Hayat
Aim: Parkinson's disease (PD) is a progressive neurological disorder that predominately affects dopaminergic neurons. We believe that this pooling of data will help to better understand the prodromal nature of depression in PD. Materials & methods: We conducted this study in accordance with PRISMA guidelines 2020. Fifteen eligible articles were shortlisted for final analysis. Risk of bias assessment was also conducted Results: The random-effect model revealed that the risk of subsequent Parkinson's disease in patients with prodromal depression was twice as likely (OR, 2.04; 95% CI, 1.02-4.08) as compared with a healthy population. Conclusion: Our meta-analysis concluded that the subsequent risk of PD is significantly higher in patients with depression as compared with healthy individuals.
目的:帕金森病(PD)是一种进展性神经系统疾病,主要影响多巴胺能神经元。我们相信,这些数据的汇集将有助于更好地了解帕金森病患者抑郁症的前驱性质。材料和方法:我们根据2020年PRISMA指南进行了这项研究。15篇符合条件的文章入围最终分析。还进行了偏倚风险评估结果:随机效应模型显示,与健康人群相比,前驱抑郁症患者患帕金森病的风险是健康人群的两倍(OR,2.04;95%CI,1.02-4.08)。结论:我们的荟萃分析得出结论,与健康人相比,抑郁症患者患帕金森病的后续风险显著更高。
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引用次数: 4
期刊
Neurodegenerative disease management
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