M. Podstawka, Andrzej Czajka, K. Zaczkowski, K. Wiśniewski, D. J. Jaskólski
The timing of suture closure and clinical implications of the metopic suture are still unknown. Premature fusion, causing craniosynostosis, happens rarely, but it may result in serious complications, such as craniofacial dysmorphology and neurodevelopmental problems. The clinical significance of metopism is still uncertain. The aim of this study was to review the literature and identify uncertain aspects associated with the formation and clinical implications of the metopic suture. The review showed significant variations in the typical age of metopic suture closure reported in the literature (from five months to seven years). Premature fusion of the suture, usually occurring before birth, may cause skull deformity and developmental disorders. Aetiology is probably multifactorial. Craniosynostosis may result in different phenotypes, ranging from mild changes to trigonocephaly. Diagnosis is achieved based on physical examination and computed tomography scans. Treatment is surgical and aims to achieve two goals: correction of craniofacial dysmorphology and prevention of further complications. Persistence of the metopic suture is diagnosed based on computed tomography scans and is considered to be an anatomical variant. The metopic suture is clinically significant if premature fusion occurs, causing craniofacial and neurodevelopmental disorders. The timing of the closure of the suture, and the aetiology of craniosynostosis and metopism require further research.
{"title":"Metopic suture: formation and clinical implications – a review","authors":"M. Podstawka, Andrzej Czajka, K. Zaczkowski, K. Wiśniewski, D. J. Jaskólski","doi":"10.15557/an.2024.0006","DOIUrl":"https://doi.org/10.15557/an.2024.0006","url":null,"abstract":"The timing of suture closure and clinical implications of the metopic suture are still unknown. Premature fusion, causing craniosynostosis, happens rarely, but it may result in serious complications, such as craniofacial dysmorphology and neurodevelopmental problems. The clinical significance of metopism is still uncertain. The aim of this study was to review the literature and identify uncertain aspects associated with the formation and clinical implications of the metopic suture. The review showed significant variations in the typical age of metopic suture closure reported in the literature (from five months to seven years). Premature fusion of the suture, usually occurring before birth, may cause skull deformity and developmental disorders. Aetiology is probably multifactorial. Craniosynostosis may result in different phenotypes, ranging from mild changes to trigonocephaly. Diagnosis is achieved based on physical examination and computed tomography scans. Treatment is surgical and aims to achieve two goals: correction of craniofacial dysmorphology and prevention of further complications. Persistence of the metopic suture is diagnosed based on computed tomography scans and is considered to be an anatomical variant. The metopic suture is clinically significant if premature fusion occurs, causing craniofacial and neurodevelopmental disorders. The timing of the closure of the suture, and the aetiology of craniosynostosis and metopism require further research.","PeriodicalId":276906,"journal":{"name":"Aktualności Neurologiczne","volume":" 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141824758","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}
Katarzyna Kapica-Topczewska, Paulina Matys, Elżbieta Jasińska, Maciej Huć, Ryszard Sędziak, Katarzyna Kubicka-Bączyk, Monika Adamczyk-Sowa, Alina Kułakowska
Natalizumab is a recombinant humanized monoclonal antibody, that binds to the integrin α4-subunit, inhibits the adhesion of lymphocytes to vascular endothelial cells and their infiltration into the central nervous system. In April 2021, a subcutaneous form of natalizumab, which until recently could only be administered intravenously, was registered in the European Union. Due to a shorter and simpler administration regimen, greater patient comfort and reduced healthcare costs, subcutaneous natalizumab is a highly convenient form of therapy, both for patients and healthcare professionals. The subcutaneous form is also an alternative for patients with difficult venous access. In this paper, we present four patients with relapsing-remitting multiple sclerosis of different duration, treated with natalizumab. The presented clinical cases are a summary of the first Polish experiences with subcutaneous natalizumab.
{"title":"The first Polish experiences with SC natalizumab","authors":"Katarzyna Kapica-Topczewska, Paulina Matys, Elżbieta Jasińska, Maciej Huć, Ryszard Sędziak, Katarzyna Kubicka-Bączyk, Monika Adamczyk-Sowa, Alina Kułakowska","doi":"10.15557/an.2022.0024","DOIUrl":"https://doi.org/10.15557/an.2022.0024","url":null,"abstract":"Natalizumab is a recombinant humanized monoclonal antibody, that binds to the integrin α4-subunit, inhibits the adhesion of lymphocytes to vascular endothelial cells and their infiltration into the central nervous system. In April 2021, a subcutaneous form of natalizumab, which until recently could only be administered intravenously, was registered in the European Union. Due to a shorter and simpler administration regimen, greater patient comfort and reduced healthcare costs, subcutaneous natalizumab is a highly convenient form of therapy, both for patients and healthcare professionals. The subcutaneous form is also an alternative for patients with difficult venous access. In this paper, we present four patients with relapsing-remitting multiple sclerosis of different duration, treated with natalizumab. The presented clinical cases are a summary of the first Polish experiences with subcutaneous natalizumab.","PeriodicalId":276906,"journal":{"name":"Aktualności Neurologiczne","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135792667","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}
The aim of this study was to review the literature on the topic of diversity of clinical symptoms of autoimmune encephalitis with the presence of antibodies against N-methyl-D-aspartate receptors (anti-NMDAR antibodies), the diagnostic process, and treatment. The incidence of the disease is approximately 4% of all reported cases of encephalitis. Autoimmune encephalitis with anti-NMDAR antibodies manifests as a rapidly progressive encephalopathy of acute or subacute onset. It usually develops over a period of six weeks. To diagnose the disease, it is necessary to confirm a minimum of four out of six symptoms, such as behavioural or cognitive impairment, speech impairment, epileptic seizures, movement disorders, disturbances of consciousness, and autonomic dysfunction. The diagnostic process is aided by additional examinations including electroencephalography, cerebrospinal fluid examination, magnetic resonance imaging, and laboratory tests (e.g. determination of titre of antineuronal antibodies). It is not uncommon for symptoms to indicate the possibility of co-occurrence of several psychiatric conditions at the same time, leading to a delay in making a correct diagnosis. Moreover, it should be remembered that anti-NMDAR encephalitis often displays the characteristics of a paraneoplastic syndrome, and particularly often coexists with ovarian teratoma. Consequently, this option should be included in the diagnostic process. Autoimmune encephalitis with anti-NMDAR antibodies can manifest itself in many ways, often with multiple neurological and psychiatric symptoms. Quick diagnosis, as well as early targeted treatment, increase the chance of success of the therapeutic process.
本研究的目的是回顾有关自身免疫性脑炎与n -甲基- d -天冬氨酸受体抗体(抗nmdar抗体)存在的临床症状多样性、诊断过程和治疗的文献。该病的发病率约占所有脑炎报告病例的4%。具有抗nmdar抗体的自身免疫性脑炎表现为急性或亚急性发作的快速进展性脑病。它通常在六周内发展。要诊断该疾病，必须确认六种症状中的至少四种，如行为或认知障碍、语言障碍、癫痫发作、运动障碍、意识障碍和自主神经功能障碍。辅助诊断过程的还有其他检查，包括脑电图、脑脊液检查、磁共振成像和实验室检查(如测定抗神经元抗体滴度)。这是不罕见的症状表明可能同时出现几种精神疾病，导致延误作出正确的诊断。此外，应该记住，抗nmdar脑炎经常表现出副肿瘤综合征的特征，特别是经常与卵巢畸胎瘤共存。因此，这个选项应该包含在诊断过程中。具有抗nmdar抗体的自身免疫性脑炎可以多种方式表现出来，通常伴有多种神经和精神症状。快速诊断，以及早期的靶向治疗，增加了治疗过程成功的机会。
{"title":"Autoimmune encephalitis with anti-NMDAR antibodies – variety of clinical manifestations","authors":"Alicja Sierakowska, Mateusz Roszak, Beata Łabuz-Roszak","doi":"10.15557/an.2023.0005","DOIUrl":"https://doi.org/10.15557/an.2023.0005","url":null,"abstract":"The aim of this study was to review the literature on the topic of diversity of clinical symptoms of autoimmune encephalitis with the presence of antibodies against N-methyl-D-aspartate receptors (anti-NMDAR antibodies), the diagnostic process, and treatment. The incidence of the disease is approximately 4% of all reported cases of encephalitis. Autoimmune encephalitis with anti-NMDAR antibodies manifests as a rapidly progressive encephalopathy of acute or subacute onset. It usually develops over a period of six weeks. To diagnose the disease, it is necessary to confirm a minimum of four out of six symptoms, such as behavioural or cognitive impairment, speech impairment, epileptic seizures, movement disorders, disturbances of consciousness, and autonomic dysfunction. The diagnostic process is aided by additional examinations including electroencephalography, cerebrospinal fluid examination, magnetic resonance imaging, and laboratory tests (e.g. determination of titre of antineuronal antibodies). It is not uncommon for symptoms to indicate the possibility of co-occurrence of several psychiatric conditions at the same time, leading to a delay in making a correct diagnosis. Moreover, it should be remembered that anti-NMDAR encephalitis often displays the characteristics of a paraneoplastic syndrome, and particularly often coexists with ovarian teratoma. Consequently, this option should be included in the diagnostic process. Autoimmune encephalitis with anti-NMDAR antibodies can manifest itself in many ways, often with multiple neurological and psychiatric symptoms. Quick diagnosis, as well as early targeted treatment, increase the chance of success of the therapeutic process.","PeriodicalId":276906,"journal":{"name":"Aktualności Neurologiczne","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135710029","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}
For years, there has been an ongoing myth that dementia diseases affect only elderly people. However, in recent years, with the development of medicine and growing awareness of “new” diseases, more and more cases of the so-called “young-onset dementia”, also known as “early-onset dementia” or even “working-age dementia” have been described. The disease can lead to job loss, changes in relationships with loved ones, and the necessity of providing constant care. The story of a 19-year-old boy from China who has been recently diagnosed with Alzheimer’s disease (Jia et al., 2023) inspired us to find out more about that condition, as there are still gaps in knowledge about that topic and a lot to discover, especially among people outside the medical environment. Despite claims that most of the information about this condition so far comprises theories, and there is still extensive research to be done, the authors decided to gather the key data and summarise them in this narrative review, with a view to raising awareness about this growing problem and about the lack of correct diagnosis, help for the patients, and the effects this condition has on the daily life of young people.
多年来，人们一直认为痴呆症只会影响老年人。然而，近年来，随着医学的发展和对“新”疾病认识的提高，越来越多的所谓“早发性痴呆”，也被称为“早发性痴呆”甚至“工作年龄痴呆”的病例被描述。这种疾病会导致失业，改变与亲人的关系，并且需要持续的护理。一个来自中国的19岁男孩最近被诊断患有阿尔茨海默病(Jia et al.， 2023)的故事激励我们去了解更多关于这种情况的信息，因为关于这个话题的知识仍然存在空白，还有很多需要发现，特别是在医疗环境之外的人群中。尽管声称迄今为止关于这种情况的大部分信息都是理论，还有大量的研究要做，但作者决定收集关键数据并在这篇叙述性综述中进行总结，以期提高人们对这一日益严重的问题的认识，以及对患者缺乏正确诊断和帮助，以及这种情况对年轻人日常生活的影响。
{"title":"Young-onset dementia – possible causes and effects on patients’ lives","authors":"Klaudia Karina Leś, Julia Lipska, Julia Lewtak","doi":"10.15557/an.2023.0003","DOIUrl":"https://doi.org/10.15557/an.2023.0003","url":null,"abstract":"For years, there has been an ongoing myth that dementia diseases affect only elderly people. However, in recent years, with the development of medicine and growing awareness of “new” diseases, more and more cases of the so-called “young-onset dementia”, also known as “early-onset dementia” or even “working-age dementia” have been described. The disease can lead to job loss, changes in relationships with loved ones, and the necessity of providing constant care. The story of a 19-year-old boy from China who has been recently diagnosed with Alzheimer’s disease (Jia et al., 2023) inspired us to find out more about that condition, as there are still gaps in knowledge about that topic and a lot to discover, especially among people outside the medical environment. Despite claims that most of the information about this condition so far comprises theories, and there is still extensive research to be done, the authors decided to gather the key data and summarise them in this narrative review, with a view to raising awareness about this growing problem and about the lack of correct diagnosis, help for the patients, and the effects this condition has on the daily life of young people.","PeriodicalId":276906,"journal":{"name":"Aktualności Neurologiczne","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135710023","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}
Grażyna Bugaj, Anna Mania, Magdalena Frydrychowicz, Agnieszka Górna, Karol Lubarski, Katarzyna Mazur-Melewska, Magdalena Figlerowicz
Introduction and objective: This study aimed to analyse the levels of selected pro-inflammatory cytokines in children with seizures during acute infection. Materials and methods: The study was conducted in the Department of Infectious Diseases and Child Neurology of the Poznan University of Medical Sciences from 19 January 2017 to 5 December 2020. Pro-inflammatory cytokines were measured in 64 patients with febrile seizures and 11 patients after an epileptic seizure in generalised epilepsy. The control group comprised 46 patients with delayed development. Serum pro-inflammatory cytokines were determined using the BioLegend’s ELISA MAX™ Deluxe Set. Pathogens were detected by standard diagnostic methods. Total white blood cell count, C-reactive protein and procalcitonin were determined using standard diagnostic methods. Results: Significantly higher levels of all analysed pro-inflammatory cytokines were found in patients with simple and simple plus febrile seizures; interleukin 6, CXCL-8 in those with complex febrile seizures; interleukin 6, CXCL-8, tumour necrosis factor α following epileptic seizure. The intensity of the inflammatory response in simple and simple plus febrile seizure patients corresponded to significantly higher levels of all pro-inflammatory cytokines and inflammatory markers. Pro-inflammatory profiles differed depending on the aetiology of the infection. Significantly higher levels interleukin 6, CXCL-8, tumour necrosis factor α were found in simple and simple plus febrile seizure patients infected with human herpesvirus-6 compared to the control group. Conclusions: In patients with febrile seizures and epileptic seizures, the involvement of interleukin 1β, interleukin 6, CXCL-8, and tumour necrosis factor α was confirmed in the inflammatory process, with a different distribution in the analysed groups. Pro-inflammatory cytokine profiles varied depending on the infectious aetiology.
{"title":"Analysis of selected pro-inflammatory cytokines: IL-1β, IL-6, CXCL-8, and TNF-α in children with seizure disorders during acute infection. Is there a specific pro-inflammatory cytokine profile in these patients?","authors":"Grażyna Bugaj, Anna Mania, Magdalena Frydrychowicz, Agnieszka Górna, Karol Lubarski, Katarzyna Mazur-Melewska, Magdalena Figlerowicz","doi":"10.15557/an.2023.0001","DOIUrl":"https://doi.org/10.15557/an.2023.0001","url":null,"abstract":"Introduction and objective: This study aimed to analyse the levels of selected pro-inflammatory cytokines in children with seizures during acute infection. Materials and methods: The study was conducted in the Department of Infectious Diseases and Child Neurology of the Poznan University of Medical Sciences from 19 January 2017 to 5 December 2020. Pro-inflammatory cytokines were measured in 64 patients with febrile seizures and 11 patients after an epileptic seizure in generalised epilepsy. The control group comprised 46 patients with delayed development. Serum pro-inflammatory cytokines were determined using the BioLegend’s ELISA MAX™ Deluxe Set. Pathogens were detected by standard diagnostic methods. Total white blood cell count, C-reactive protein and procalcitonin were determined using standard diagnostic methods. Results: Significantly higher levels of all analysed pro-inflammatory cytokines were found in patients with simple and simple plus febrile seizures; interleukin 6, CXCL-8 in those with complex febrile seizures; interleukin 6, CXCL-8, tumour necrosis factor α following epileptic seizure. The intensity of the inflammatory response in simple and simple plus febrile seizure patients corresponded to significantly higher levels of all pro-inflammatory cytokines and inflammatory markers. Pro-inflammatory profiles differed depending on the aetiology of the infection. Significantly higher levels interleukin 6, CXCL-8, tumour necrosis factor α were found in simple and simple plus febrile seizure patients infected with human herpesvirus-6 compared to the control group. Conclusions: In patients with febrile seizures and epileptic seizures, the involvement of interleukin 1β, interleukin 6, CXCL-8, and tumour necrosis factor α was confirmed in the inflammatory process, with a different distribution in the analysed groups. Pro-inflammatory cytokine profiles varied depending on the infectious aetiology.","PeriodicalId":276906,"journal":{"name":"Aktualności Neurologiczne","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135710024","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}
Piotr Jan Potyrała, Aleksandra Krawczuk, Jan Bieniasz, Igor Matkowski, Konrad Dendys, Paula Bigos, Wojciech Kuźnicki, Krzysztof Chmielak
Dyke–Davidoff–Mason syndrome is an extremely rare medical condition that results from brain damage occurring during foetal life or early childhood. The aetiology of the syndrome can be congenital or acquired. The clinical presentation of the syndrome is variable, and depends on the extent of damage to the central nervous system. It most commonly manifests as epileptic seizures, intellectual disability, and hemiparesis/hemiplegia, which is usually preceded by the first seizure. It is suspected that intellectual impairment is a consequence of epilepsy. The spectrum of symptoms also includes psychiatric conditions, particularly psychotic disorders and mood disorders. Radiological manifestations of the syndrome include midline cerebral shift, widening of the Sylvian fissure, hemispheric aplasia/hypoplasia of the brain, ipsilateral cranial bone thickening, lateral ventricle enlargement, as well as hyperpneumatisation of the frontal and sphenoid bones, and the mastoid process. Diagnosis is mainly based on imaging tests such as computed tomography and magnetic resonance imaging, as well as neurological examination and electroencephalography. During the patient’s history-taking, particular attention should be paid to pregnancy history and the childhood period in order to identify potential etiological factors. No characteristic changes in laboratory tests indicating Dyke–Davidoff–Mason syndrome have been found. Treatment is primarily symptomatic. The greatest challenge for physicians is the control of epileptic seizures. Conservative treatment is initially employed. If proven to be ineffective, surgical treatment should be considered.
{"title":"Dyke–Davidoff–Masson syndrome – a review of the literature","authors":"Piotr Jan Potyrała, Aleksandra Krawczuk, Jan Bieniasz, Igor Matkowski, Konrad Dendys, Paula Bigos, Wojciech Kuźnicki, Krzysztof Chmielak","doi":"10.15557/an.2023.0004","DOIUrl":"https://doi.org/10.15557/an.2023.0004","url":null,"abstract":"Dyke–Davidoff–Mason syndrome is an extremely rare medical condition that results from brain damage occurring during foetal life or early childhood. The aetiology of the syndrome can be congenital or acquired. The clinical presentation of the syndrome is variable, and depends on the extent of damage to the central nervous system. It most commonly manifests as epileptic seizures, intellectual disability, and hemiparesis/hemiplegia, which is usually preceded by the first seizure. It is suspected that intellectual impairment is a consequence of epilepsy. The spectrum of symptoms also includes psychiatric conditions, particularly psychotic disorders and mood disorders. Radiological manifestations of the syndrome include midline cerebral shift, widening of the Sylvian fissure, hemispheric aplasia/hypoplasia of the brain, ipsilateral cranial bone thickening, lateral ventricle enlargement, as well as hyperpneumatisation of the frontal and sphenoid bones, and the mastoid process. Diagnosis is mainly based on imaging tests such as computed tomography and magnetic resonance imaging, as well as neurological examination and electroencephalography. During the patient’s history-taking, particular attention should be paid to pregnancy history and the childhood period in order to identify potential etiological factors. No characteristic changes in laboratory tests indicating Dyke–Davidoff–Mason syndrome have been found. Treatment is primarily symptomatic. The greatest challenge for physicians is the control of epileptic seizures. Conservative treatment is initially employed. If proven to be ineffective, surgical treatment should be considered.","PeriodicalId":276906,"journal":{"name":"Aktualności Neurologiczne","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135710025","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}
Alzheimer’s disease is one of the major challenges of modern medicine. Despite strenuous research and numerous clinical trials, no registered causal treatment exists in Europe; however, such pharmacotherapy is already available in the United States (aducanumab and lecanemab). Positive results of immunotherapy clinical trials in Alzheimer’s disease, both completed and still ongoing, give hope for finding safe substances that would effectively inhibit the development of Alzheimer’s disease (donanemab pending registration or remternetug in the research phase). Failures in the registration of medicines in Europe have their roots in the lack of noticeable therapeutic benefits and, despite everything, relatively serious adverse effects. The high cost of this therapy as well as the lack of trained personnel and easily accessible centres, where the drug could be administered and patient’s condition could be monitored using magnetic resonance imaging, is another problem. Early diagnosis of patients with Alzheimer’s disease before the onset of symptoms of dementia is an old, still unsolved challenge as immunotherapy is designed only for these patients. Widely applicable diagnostic criteria and guidelines have still not solved the problem of late diagnosis in most patients. A large body of evidence indicates that the efficacy of preventive measures and the control of risk factors can significantly reduce the number of patients. Creating an integrated system to adequately care for the rapidly growing number of patients is crucial. Unfortunately, access to specialist diagnostic centres and support networks for the broadly understood post-diagnosis care for patients and their carers is still a matter of the distant future.
{"title":"Immunotherapy in Alzheimer’s disease – new treatment, old problems","authors":"Anna Barczak","doi":"10.15557/an.2023.0002","DOIUrl":"https://doi.org/10.15557/an.2023.0002","url":null,"abstract":"Alzheimer’s disease is one of the major challenges of modern medicine. Despite strenuous research and numerous clinical trials, no registered causal treatment exists in Europe; however, such pharmacotherapy is already available in the United States (aducanumab and lecanemab). Positive results of immunotherapy clinical trials in Alzheimer’s disease, both completed and still ongoing, give hope for finding safe substances that would effectively inhibit the development of Alzheimer’s disease (donanemab pending registration or remternetug in the research phase). Failures in the registration of medicines in Europe have their roots in the lack of noticeable therapeutic benefits and, despite everything, relatively serious adverse effects. The high cost of this therapy as well as the lack of trained personnel and easily accessible centres, where the drug could be administered and patient’s condition could be monitored using magnetic resonance imaging, is another problem. Early diagnosis of patients with Alzheimer’s disease before the onset of symptoms of dementia is an old, still unsolved challenge as immunotherapy is designed only for these patients. Widely applicable diagnostic criteria and guidelines have still not solved the problem of late diagnosis in most patients. A large body of evidence indicates that the efficacy of preventive measures and the control of risk factors can significantly reduce the number of patients. Creating an integrated system to adequately care for the rapidly growing number of patients is crucial. Unfortunately, access to specialist diagnostic centres and support networks for the broadly understood post-diagnosis care for patients and their carers is still a matter of the distant future.","PeriodicalId":276906,"journal":{"name":"Aktualności Neurologiczne","volume":"139 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135710026","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}
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