Neurodegenerative disease management最新文献

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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 CLINICAL NEUROLOGY

Neurodegenerative disease management

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。

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 CLINICAL NEUROLOGY

Neurodegenerative disease management

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 CLINICAL NEUROLOGY

Neurodegenerative disease management

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。

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 CLINICAL NEUROLOGY

Neurodegenerative disease management

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。

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 CLINICAL NEUROLOGY

Neurodegenerative disease management

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。

引用次数: 4

A qualitative examination of apathy and physical activity in Huntington's and Parkinson's disease. 亨廷顿舞蹈症和帕金森病患者冷漠和体力活动的定性检查。

IF 2.6 Q3 CLINICAL NEUROLOGY

Neurodegenerative disease management

Pub Date : 2022-04-12 DOI: 10.2217/nmt-2021-0047

K. Atkins, C. Friel, Sophie C Andrews, T. Chong, J. Stout, L. Quinn

Aim: In Huntington's disease (HD) and Parkinson's disease (PD), apathy is a frequently cited barrier to participation in physical activity. Current diagnostic criteria emphasize dissociable variants of apathy that differentially affect goal-directed behavior. How these dimensions present and affect physical activity in HD and PD is unknown. Methods: Using a qualitative approach, we examined the experience of apathy and its impact on physical activity in 20 people with early-manifest HD or idiopathic PD. Results: Two major themes emerged: the multidimensionality of apathy, including initiation or goal-identification difficulties, and the interplay of apathy and fatigue; and facilitators of physical activity, including routines, safe environments and education. Conclusion: Physical activity interventions tailored to apathy phenotypes may maximize participant engagement.

目的：在亨廷顿舞蹈症（HD）和帕金森病（PD）中，冷漠是参与体育活动的常见障碍。目前的诊断标准强调冷漠的可分离变体，这些变体对目标导向的行为有不同的影响。这些维度如何在HD和PD中表现和影响身体活动尚不清楚。方法：采用定性方法，我们调查了20名早期明显HD或特发性PD患者的冷漠体验及其对体育活动的影响。结果：出现了两个主要主题：冷漠的多维性，包括启动或目标识别困难，以及冷漠和疲劳的相互作用；以及体育活动的促进者，包括日常活动、安全环境和教育。结论：针对冷漠表型的体育活动干预可以最大限度地提高参与者的参与度。

引用次数: 2

Evidence-based management of multiple sclerosis spasticity with nabiximols oromucosal spray in clinical practice: a 10-year recap. 纳比昔醇口腔喷雾剂治疗多发性硬化症痉挛的临床实践:10年回顾

IF 2.6 Q3 CLINICAL NEUROLOGY

Neurodegenerative disease management

Pub Date : 2022-04-04 DOI: 10.2217/nmt-2022-0002

A. Chan, C. Silván

Effective symptomatic management of multiple sclerosis (MS) spasticity remains an unmet need for many patients. The second-line option nabiximols is the most widely investigated of the noninvasive antispasticity medications in this patient population. Clinical evidence accumulated with nabiximols since it was first approved in Europe in 2010 suggests that about 40% of initial responders (i.e., those with ≥20% improvement in their baseline 0-10 Numerical Rating Scale score) may expect to achieve clinically meaningful (≥30% Numerical Rating Scale response) and durable symptomatic improvement in MS spasticity. During 10 years' routine use of nabiximols, no new safety signals have emerged. Nabiximols-associated improvement in MS spasticity-related symptoms such as pain and sleep disruption suggests a need to track possible therapeutic effects beyond muscle tone control.

多发性硬化症（MS）痉挛的有效症状管理仍然是许多患者未满足的需求。在这一患者群体中，二线选择的那必昔单抗是研究最广泛的非侵入性抗痉挛药物。自2010年在欧洲首次获得批准以来，纳比西莫司积累的临床证据表明，约40%的初始反应者（即基线0-10数值评定量表评分改善≥20%的患者）可能有望在多发性硬化症痉挛中实现有临床意义的（≥30%数值评量表反应）和持久的症状改善。在纳比西摩尔的10年常规使用过程中，没有出现新的安全信号。纳比西摩尔对多发性硬化症痉挛相关症状（如疼痛和睡眠中断）的改善表明，需要追踪肌肉张力控制之外的可能治疗效果。

引用次数: 2

Recruitment of participants for dementia research: interprofessional perspectives from primary care-based memory clinics. 痴呆症研究参与者的招募：基于初级保健的记忆诊所的跨专业视角。

IF 2.6 Q3 CLINICAL NEUROLOGY

Neurodegenerative disease management

Pub Date : 2022-04-04 DOI: 10.2217/nmt-2021-0053

Linda Lee, J. Locklin, Tejal Patel, Stephanie K Lu, L. Hillier

Aim: To understand clinician attitudes and the barriers that impede research recruitment from specialized primary care-based memory clinics. Materials & methods: Clinicians completed a survey on attitudes and barriers to research recruitment from memory clinics. Results: Comfort and willingness to recruit for research were low to moderate and were lower for drug trials than for observational and non-drug trials. Respondents believed that it is important to have a standardized recruitment process. Identified barriers provide some insights into the factors that contribute to discomfort and lack of willingness to recruit research participants. Discussion: Findings can inform future efforts to develop a recruitment process that addresses identified barriers, while also providing an opportunity to increase participant recruitment in dementia research.

目的：了解临床医生的态度以及阻碍从专门的初级保健记忆诊所招募研究人员的障碍。材料与方法：临床医生完成了一项关于记忆诊所招募研究人员的态度和障碍的调查。结果：招募研究人员的舒适度和意愿从低到中等，药物试验低于观察性和非药物试验。受访者认为，有一个标准化的招聘流程很重要。已确定的障碍为导致不适和缺乏招募研究参与者意愿的因素提供了一些见解。讨论：研究结果可以为未来制定招聘流程提供信息，以解决已发现的障碍，同时也为增加痴呆症研究参与者的招聘提供了机会。

引用次数: 1

Real-world patient characteristics, treatment patterns and costs in relapsing multiple sclerosis patients treated with glatiramer acetate, dimethyl fumarate or teriflunomide in Germany. 在德国使用醋酸格拉替默、富马酸二甲酯或特立氟米特治疗的多发性硬化症复发患者的真实世界患者特征、治疗模式和成本

IF 2.6 Q3 CLINICAL NEUROLOGY

Neurodegenerative disease management

Pub Date : 2022-04-01 Epub Date: 2021-12-21 DOI: 10.2217/nmt-2021-0031

Tjalf Ziemssen, Anna Kurzeja, Bogdan Muresan, Jennifer S Haas, Jessica Alexander, Maurice T Driessen

Aim: To evaluate adherence, healthcare resource utilization (HRU) and costs for glatiramer acetate (GA; injectable), dimethyl fumarate (oral) and teriflunomide (oral) in relapsing multiple sclerosis. Patients & methods: Retrospective analyses of a claims database. Results: Teriflunomide patients were older with more co-morbidities and fewer relapses versus GA and dimethyl fumarate. GA patients were mostly disease-modifying therapies (DMTs)-treatment naive. Treatment adherence was 61-70%. All DMTs reduced HRU versus pre-index. Costs were comparable across cohorts. High adherence reduced hospitalizations and several costs versus low adherers. Conclusion: Adherence rates were high and comparable with all DMTs. Similar (and high) reductions in HRU and costs occurred with all DMTs. High adherence improved economic outcomes versus low adherence. Thus, investing in adherence improvement is beneficial to improve outcomes in relapsing multiple sclerosis.

目的:评价醋酸格拉替默(GA)的依从性、医疗资源利用率(HRU)和成本;可注射)，富马酸二甲酯(口服)和特立氟米特(口服)复发多发性硬化症。患者与方法:回顾性分析索赔数据库。结果:与GA和富马酸二甲酯相比，特立氟米特患者年龄更大，合并症更多，复发更少。GA患者大多采用疾病修饰疗法(dmt)-初始治疗。治疗依从性为61-70%。与索引前相比，所有dmt均降低了HRU。不同队列的成本具有可比性。与低依从者相比，高依从性降低了住院率和多项费用。结论:依从率高，与所有dmt相当。在所有的dmt中，HRU和成本都出现了类似的(并且很高的)降低。与低依从性相比，高依从性改善了经济结果。因此，投资于依从性改善有利于改善复发性多发性硬化症的预后。

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引用次数: 1

Accuracy of cognitive screening instruments reconsidered: overall, balanced or unbiased accuracy? 重新考虑认知筛查工具的准确性:总体、平衡还是无偏准确性?

IF 2.6 Q3 CLINICAL NEUROLOGY

Neurodegenerative disease management

Pub Date : 2022-04-01 Epub Date: 2022-02-18 DOI: 10.2217/nmt-2021-0049

Andrew J Larner

Aim: To examine three different accuracy metrics for evaluation of cognitive screening instruments: overall correct classification accuracy (Acc), the sum of true positives and negatives divided by the total number tested; balanced accuracy (balanced Acc), half of the sum of sensitivity and specificity; and unbiased accuracy (unbiased Acc), removing biasing effects of random associations between test results and disease prevalence. Materials & methods: Data from a prospective test accuracy study of Mini-Addenbrooke's Cognitive Examination were used to calculate and plot the Acc measures. Results: Each Acc metric resulted in a similar pattern of results across the range of Mini-Addenbrooke's Cognitive Examination cut-offs for diagnosis of both dementia and mild cognitive impairment. Acc and balanced Acc gave more optimistic outcomes (closer to possible maximum value of 1) than unbiased Acc. Conclusion: Unbiased Acc may have advantages over Acc and balanced Acc by removing biasing effects of random associations between test result and disease prevalence.

目的:探讨认知筛查工具评估的三种不同准确性指标:总正确分类准确率(Acc)，真阳性和阴性的总和除以测试总数;平衡准确度(balanced Acc)，敏感性和特异性之和的一半;和无偏准确性(unbiased Acc)，消除了测试结果和疾病流行之间随机关联的偏倚效应。材料与方法:数据来自Mini-Addenbrooke认知测验的前瞻性测试准确性研究，用于计算和绘制Acc测量值。结果:每个Acc指标在Mini-Addenbrooke认知检查的范围内诊断痴呆和轻度认知障碍的结果模式相似。Acc和平衡Acc比无偏Acc给出更乐观的结果(更接近可能的最大值1)。结论:通过消除检测结果与疾病患病率之间随机关联的偏倚效应，无偏Acc可能比Acc和平衡Acc具有优势。

引用次数: 7

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Neurodegenerative disease management

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