Pub Date : 2024-01-01Epub Date: 2023-11-06DOI: 10.47795/SQWE8437
Ruth Dobson, Nirandeep Rehill, Rimona S Weil
As the UK population ages, dementia affects an increasing proportion of the population. There is a drive to accelerate dementia research, however access to research is not equitably distributed. We examine access to dementia research and discuss some enabling factors and barriers. High recruitment is frequently driven by a person (or people) dedicated to improving research participation. Barriers are commonly structural, rather than lack of willingness or knowledge. A recurring issue was lack of time and/or resources. Leveraging existing infrastructure, such as streamlined and efficient governance frameworks, is a clear part of the solution. Research teams need to ensure inclusion/exclusion criteria serve the target population, and that any intervention is accessible to a range of patients. An injection of resources is crucial to support the recruitment process on the ground.
{"title":"Democratising access to dementia research.","authors":"Ruth Dobson, Nirandeep Rehill, Rimona S Weil","doi":"10.47795/SQWE8437","DOIUrl":"10.47795/SQWE8437","url":null,"abstract":"<p><p>As the UK population ages, dementia affects an increasing proportion of the population. There is a drive to accelerate dementia research, however access to research is not equitably distributed. We examine access to dementia research and discuss some enabling factors and barriers. High recruitment is frequently driven by a person (or people) dedicated to improving research participation. Barriers are commonly structural, rather than lack of willingness or knowledge. A recurring issue was lack of time and/or resources. Leveraging existing infrastructure, such as streamlined and efficient governance frameworks, is a clear part of the solution. Research teams need to ensure inclusion/exclusion criteria serve the target population, and that any intervention is accessible to a range of patients. An injection of resources is crucial to support the recruitment process on the ground.</p>","PeriodicalId":34274,"journal":{"name":"Advances in Clinical Neuroscience Rehabilitation","volume":"22 3","pages":"12-15"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7615713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140040509","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}
Abigail Clynch, George E Richardson, Mohammad A Mustafa, Conor S Gillespie, Nitika Rathi, Ali Bakhsh, Rasheed Zakaria, Abdurrahman I Islim, Christopher P Millward, Michael D Jenkinson
Meningioma are the most common primary brain tumour. Classically, meningioma are phenotypically grouped using the World Health Organisation (WHO) classification system. However, it is now understood that the WHO approach overfits tumours into three grades, resulting in similarly graded tumours displaying phenotypically distinct behaviour. There is a growing body of research investigating the molecular biology of these tumours, including genomic, transcriptomic, metabolomic, proteomic, and methylomic profiling. Such advancements in molecular profiling of meningioma are providing greater accuracy in prognostication of tumours. Furthermore, a clearer understanding of tumour molecular biology highlights potential targets for pharmacotherapies. Currently, the routine application of in-depth tumour molecular analysis is limited, however as it becomes more widely available it will likely result in improved patient care. This review seeks to explore the important developments in meningioma molecular biology, discussed in the context of their clinical importance.
{"title":"Beyond the WHO classification of meningioma: using molecular diagnostics to guide management.","authors":"Abigail Clynch, George E Richardson, Mohammad A Mustafa, Conor S Gillespie, Nitika Rathi, Ali Bakhsh, Rasheed Zakaria, Abdurrahman I Islim, Christopher P Millward, Michael D Jenkinson","doi":"10.47795/WVJZ9783","DOIUrl":"10.47795/WVJZ9783","url":null,"abstract":"<p><p>Meningioma are the most common primary brain tumour. Classically, meningioma are phenotypically grouped using the World Health Organisation (WHO) classification system. However, it is now understood that the WHO approach overfits tumours into three grades, resulting in similarly graded tumours displaying phenotypically distinct behaviour. There is a growing body of research investigating the molecular biology of these tumours, including genomic, transcriptomic, metabolomic, proteomic, and methylomic profiling. Such advancements in molecular profiling of meningioma are providing greater accuracy in prognostication of tumours. Furthermore, a clearer understanding of tumour molecular biology highlights potential targets for pharmacotherapies. Currently, the routine application of in-depth tumour molecular analysis is limited, however as it becomes more widely available it will likely result in improved patient care. This review seeks to explore the important developments in meningioma molecular biology, discussed in the context of their clinical importance.</p>","PeriodicalId":34274,"journal":{"name":"Advances in Clinical Neuroscience Rehabilitation","volume":"22 2","pages":"WVJZ9783"},"PeriodicalIF":0.0,"publicationDate":"2023-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7615222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49683063","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}
Transcranial MR guided Focused ultrasound (MRgFUS) is a recently approved treatment for patients with Essential Tremor (ET), the commonest movement disorder in clinical practice. In this review, we explain why thalamotomy has returned, how it is performed, and outline the basic eligibility criteria and risks of this procedure. The aim of this article is to provide a practical guide to clinicians seeing ET patients as to what they should consider before referring for this treatment.
{"title":"Update on MR guided focused ultrasound for tremor","authors":"Tom Gilbertson, Sadaquate Khan","doi":"10.47795/nwmg7581","DOIUrl":"https://doi.org/10.47795/nwmg7581","url":null,"abstract":"Transcranial MR guided Focused ultrasound (MRgFUS) is a recently approved treatment for patients with Essential Tremor (ET), the commonest movement disorder in clinical practice. In this review, we explain why thalamotomy has returned, how it is performed, and outline the basic eligibility criteria and risks of this procedure. The aim of this article is to provide a practical guide to clinicians seeing ET patients as to what they should consider before referring for this treatment. ","PeriodicalId":34274,"journal":{"name":"Advances in Clinical Neuroscience Rehabilitation","volume":"223 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80021979","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}
Ben Beare, F. Brander, R. Farrell, C. Lakra, R. Higgins, N. Ward
Frozen shoulder is more common in the weakened hemiparetic shoulder post stroke than in the general population. Increasing age, micro-vascular co-morbidities and the presence of subluxation make the soft tissue of the hemiparetic shoulder more susceptible to injury and inflammation. Inflammation can trigger fibrosis of the shoulder ligamentous capsule due to a disruption of joint homeostasis. It is this fibrosis that results in the common presenting features of frozen shoulder, namely restriction of passive shoulder external rotation, abduction and internal rotation. Spasticity of shoulder adductors and internal rotators is also common in hemiparesis and is hard to differentiate from frozen shoulder. Diagnostic lateral pectoralis nerve blocks (DNBs) may help to differentiate between the two. However, several muscles often contribute to shoulder adductor and internal rotator spasticity, so there is a risk of false positives with DNBs. Frozen shoulder is still largely a clinical diagnosis after assessment and exclusion of other possibilities. In cases of Frozen shoulder, daily movements of the shoulder joint within tolerable pain limits can help to restore joint homeostasis and lead to reduced pain. Steroid injection (either alone or as part of a hydrodilatation injection) when inflammation is present can also reduce pain and improve range when used in combination with physiotherapy.
{"title":"Understanding frozen shoulder in the hemiparetic arm after stroke","authors":"Ben Beare, F. Brander, R. Farrell, C. Lakra, R. Higgins, N. Ward","doi":"10.47795/ivsc5970","DOIUrl":"https://doi.org/10.47795/ivsc5970","url":null,"abstract":"Frozen shoulder is more common in the weakened hemiparetic shoulder post stroke than in the general population. Increasing age, micro-vascular co-morbidities and the presence of subluxation make the soft tissue of the hemiparetic shoulder more susceptible to injury and inflammation. Inflammation can trigger fibrosis of the shoulder ligamentous capsule due to a disruption of joint homeostasis. It is this fibrosis that results in the common presenting features of frozen shoulder, namely restriction of passive shoulder external rotation, abduction and internal rotation. Spasticity of shoulder adductors and internal rotators is also common in hemiparesis and is hard to differentiate from frozen shoulder. Diagnostic lateral pectoralis nerve blocks (DNBs) may help to differentiate between the two. However, several muscles often contribute to shoulder adductor and internal rotator spasticity, so there is a risk of false positives with DNBs. Frozen shoulder is still largely a clinical diagnosis after assessment and exclusion of other possibilities. In cases of Frozen shoulder, daily movements of the shoulder joint within tolerable pain limits can help to restore joint homeostasis and lead to reduced pain. Steroid injection (either alone or as part of a hydrodilatation injection) when inflammation is present can also reduce pain and improve range when used in combination with physiotherapy.","PeriodicalId":34274,"journal":{"name":"Advances in Clinical Neuroscience Rehabilitation","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83272033","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}
A new era in migraine prophylaxis has begun with the launch of antibodies blocking the Calcitonin-Gene Related Peptide (CGRP) pathway. These substances act across the entire frequency spectrum of migraine and have a tolerability superior to any other class of migraine preventatives based on our clinical and experimental knowledge of a 5- year period of use. Their superior tolerability profile may be due to their specificity. New questions have also arrived with these drugs ranging from the duration of therapy and treatment pause to the question which monoclonal antibodies (mAb) for which patient - a question which we cannot answer at this stage. Nevertheless, CGRP – ® mAbs offer a class of migraine prophylactics with significant advantages over older medications.
{"title":"Monoclonal CGRP- (R) antibodies for the prevention of migraine","authors":"U. Reuter","doi":"10.47795/vkej7377","DOIUrl":"https://doi.org/10.47795/vkej7377","url":null,"abstract":"A new era in migraine prophylaxis has begun with the launch of antibodies blocking the Calcitonin-Gene Related Peptide (CGRP) pathway. These substances act across the entire frequency spectrum of migraine and have a tolerability superior to any other class of migraine preventatives based on our clinical and experimental knowledge of a 5- year period of use. Their superior tolerability profile may be due to their specificity. New questions have also arrived with these drugs ranging from the duration of therapy and treatment pause to the question which monoclonal antibodies (mAb) for which patient - a question which we cannot answer at this stage. Nevertheless, CGRP – ® mAbs offer a class of migraine prophylactics with significant advantages over older medications.","PeriodicalId":34274,"journal":{"name":"Advances in Clinical Neuroscience Rehabilitation","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74797494","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}
Oliver Kleinig, Christopher Ovenden, A. Abou‐Hamden, T. Kleinig
{"title":"An update on the Acute Surgical Management of Intracerebral Haemorrhage","authors":"Oliver Kleinig, Christopher Ovenden, A. Abou‐Hamden, T. Kleinig","doi":"10.47795/iort4059","DOIUrl":"https://doi.org/10.47795/iort4059","url":null,"abstract":"","PeriodicalId":34274,"journal":{"name":"Advances in Clinical Neuroscience Rehabilitation","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74278008","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}
Introduction However great their achievements in clinical neurology and investigative neuroscience, however loud their acclamation by their peers, few if any neurologists become sufficiently famous (or infamous) to impinge on the wider public consciousness, certainly not to the point of becoming subjects for comment in popular fiction. The only example that initially springs to my mind is the “Penfield mood organ” described in Philip K. Dick’s (1968) novel Do androids dream of electric sheep? (on which the 1982 film Blade Runner, a very different cultural artefact, was based), which is surely a reference to Wilder Penfield (1891-1976), whose work stimulating the cortex of awake epilepsy patients undergoing surgery allowed him to map the functions of various regions of the brain [1]. In contrast, I am aware of three literary works which either mention by name [2], or respond to the experimental work of [3], David Ferrier (1843-1928), perhaps Penfield’s ultimate precursor in the field of brain stimulation studies.
无论他们在临床神经病学和调查神经科学方面取得了多么伟大的成就，无论他们在同行中获得了多么响亮的赞誉，很少有神经学家能够足够出名(或臭名昭著)，从而影响到更广泛的公众意识，当然也不会成为通俗小说中评论的对象。我最初想到的唯一一个例子是菲利普·k·迪克(Philip K. Dick, 1968)的小说《机器人会梦见电子羊吗?》中描述的“彭菲尔德情绪器官”。(1982年的电影《银翼杀手》是一个非常不同的文化产物)，这肯定是对怀尔德·彭菲尔德(1891-1976)的参考，他的工作刺激正在接受手术的清醒癫痫患者的皮层，使他能够绘制大脑各个区域的功能[1]。相比之下，我知道有三部文学作品要么提到了名字[2]，要么回应了大卫·费里尔(1843-1928)的实验工作[3]，他可能是彭菲尔德在脑刺激研究领域的终极先驱。
{"title":"Neuroliterature: David Ferrier (1843-1928)","authors":"A. Larner","doi":"10.47795/afyi1968","DOIUrl":"https://doi.org/10.47795/afyi1968","url":null,"abstract":"Introduction However great their achievements in clinical neurology and investigative neuroscience, however loud their acclamation by their peers, few if any neurologists become sufficiently famous (or infamous) to impinge on the wider public consciousness, certainly not to the point of becoming subjects for comment in popular fiction. The only example that initially springs to my mind is the “Penfield mood organ” described in Philip K. Dick’s (1968) novel Do androids dream of electric sheep? (on which the 1982 film Blade Runner, a very different cultural artefact, was based), which is surely a reference to Wilder Penfield (1891-1976), whose work stimulating the cortex of awake epilepsy patients undergoing surgery allowed him to map the functions of various regions of the brain [1]. In contrast, I am aware of three literary works which either mention by name [2], or respond to the experimental work of [3], David Ferrier (1843-1928), perhaps Penfield’s ultimate precursor in the field of brain stimulation studies.","PeriodicalId":34274,"journal":{"name":"Advances in Clinical Neuroscience Rehabilitation","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83678283","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}
Intracerebral haemorrhage (ICH) is caused by spontaneous, non-traumatic haemorrhage within the brain parenchyma. ICH has poor outcomes, with a 30-40% 1-month case fatality and most survivors remaining dependent. Current management of ICH is aimed at providing appropriate supportive care and reducing the risk of haematoma expansion, which affects up to 20-30% of patients in the first 24 hours. Rapid and intensive blood pressure lowering to a pre-specified target and reversal of anticoagulants in the 20% of patients who are taking them may reduce the risk of expansion and improve outcome.
{"title":"Hyperacute Medical Management of Intracerebral Haemorrhage","authors":"Allan Paterson, A. Parry-Jones","doi":"10.47795/ziui6736","DOIUrl":"https://doi.org/10.47795/ziui6736","url":null,"abstract":"Intracerebral haemorrhage (ICH) is caused by spontaneous, non-traumatic haemorrhage within the brain parenchyma. ICH has poor outcomes, with a 30-40% 1-month case fatality and most survivors remaining dependent. Current management of ICH is aimed at providing appropriate supportive care and reducing the risk of haematoma expansion, which affects up to 20-30% of patients in the first 24 hours. Rapid and intensive blood pressure lowering to a pre-specified target and reversal of anticoagulants in the 20% of patients who are taking them may reduce the risk of expansion and improve outcome.","PeriodicalId":34274,"journal":{"name":"Advances in Clinical Neuroscience Rehabilitation","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77564843","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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