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Expert Review of Neurotherapeutics

Christine M Stahl, Steven J Frucht
Myoclonus is a hyperkinetic movement disorder characterized by sudden, brief, lightning-like involuntary jerks. There are many possible causes of myoclonus and both the etiology and characteristics of the myoclonus are important in securing the diagnosis and treatment. Myoclonus may be challenging to treat, as it frequently requires multiple medications for acceptable results. Few randomized controlled trials investigating the optimal treatment for myoclonus are available, and expert experience and case series guide treatment...
March 15, 2019: Expert Review of Neurotherapeutics
Pankhuree Vandana, Eugene Arnold
A "holy grail" of treatment options for attention-deficit hyperactivity disorder (ADHD) has been an agent with low abuse potential and peak-trough clinical effects, providing sustained therapeutic benefits throughout the day. One such agent, Dasotraline, a DA and NE reuptake inhibitor agent, was recently reviewed by the FDA. Areas covered: The authors completed a timely drug review using a Pub Med literature search using words "Dasotraline, ADHD" "stimulant, abuse" "atomoxetine, ADHD"...
March 14, 2019: Expert Review of Neurotherapeutics
Monica J Killen, Susan Giorgi-Coll, Adel Helmy, Peter Ja Hutchinson, Keri Lh Carpenter
Traumatic Brain Injury (TBI) is a leading cause of death and disability in young people, affecting 69 million people annually, worldwide. The initial trauma disrupts brain homeostasis resulting in metabolic dysfunction and an inflammatory cascade, which can then promote further neurodegenerative effects for months or years, as a 'secondary' injury. Effective targeting of the cerebral inflammatory system is challenging due to its complex, pleiotropic nature. Cell metabolism plays a key role in many diseases, and increased disturbance in the TBI metabolic state is associated with poorer patient outcomes...
March 8, 2019: Expert Review of Neurotherapeutics
Julio Pascual, Carlos Vila
Almotriptan, a serotonin 5-HT1B/1D agonist has been used in the acute treatment of migraine with or without aura for 20 years, accumulating data on more than 15,000 patients in studies and from an estimated >150 million treated migraine attacks in daily clinical practice. The last major review of almotriptan was written almost 10 years ago. The current narrative review provides an overview of the experience gained with almotriptan over that time, and highlights data published in the last decade. Areas covered: Randomized clinical trials, observational studies, postmarketing studies and meta-analyses involving almotriptan for the treatment of acute migraine identified through a systematic literature search...
March 8, 2019: Expert Review of Neurotherapeutics
Maria Pia Amato, Elio Prestipino, Angelo Bellinvia
Introduction Cognitive impairment (CI) in Multiple Sclerosis (MS) has progressively regained clinical and research interest and is currently recognized as a debilitating and burdensome problem for these patients. Studying risk and protecting factors that may influence the development and course of CI is currently an area of increasing interest, due to the potential for preventive strategies. Areas covered In this narrative review the authors briefly addressed the physiopathologic basis, assessment and management of CI in MS and then focused on articles identifying modifiable and not modifiable risk factors for CI in MS, providing an overview of the current knowledge in the field and indicating avenues for future research...
March 3, 2019: Expert Review of Neurotherapeutics
Hiide Yoshino
Amyotrophic lateral sclerosis (ALS) is a progressive fatal disorder that affects all skeletal muscles, leading to death, mostly within 2-4 years from onset. To date, the anti-glutamatergic drug riluzole is the only drug that has been approved for the treatment of this disease; however, its efficacy is modest. Oxidative stress is considered to be involved in the pathology of ALS, and in this regard, the free radical scavenger edaravone, which was originally developed for the treatment of acute ischemic stroke, has also been developed for the treatment of ALS...
February 27, 2019: Expert Review of Neurotherapeutics
Chao Sun, Baili Song, Chunlian Jiang, Jian-Jun Zou
BACKGROUND: About 40% of acute ischemic stroke patients are under antiplatelet pretreatment. Previous studies have shown conflicting results on the effect of prior antiplatelet agents on post thrombolytic clinical outcomes. METHODS: A systematic search using PubMed and EMBASE databases for eligible studies. Prior antiplatelet safety was measured by symptomatic intracerebral hemorrhage (sICH) and mortality. Efficacy was measured by functional independence and favorable functional outcome...
February 26, 2019: Expert Review of Neurotherapeutics
Marina de Tommaso
In the past few years, brain functional analysis has provided scientific evidence supporting the neuronal basis of migraine. The role of electroencephalography (EEG) in detecting subtle dysfunctions in sensory temporal processing has been fully re-evaluated, thanks to advances in methods of quantitative analysis. However, the diagnostic value of EEG in migraine is very low, and migraine diagnosis is completely based on clinical criteria, while the utility of EEG in migraine pathophysiology has only been confirmed in more recent applications...
February 26, 2019: Expert Review of Neurotherapeutics
Jan Hoffmann, Arne May
Introduction Neuromodulation techniques play an increasing role in the treatment of primary headaches. While initially reserved for refractory cases they are now increasingly taken into consideration in earlier treatment phases and in non-refractory situations. One of the main reasons of this paradigm shift is that most neuromodulation techniques are better tolerated as compared to the majority of pharmacological approaches. However, these techniques have their limitations that should be considered. Areas covered The review provides an overview of the available techniques and their therapeutic rationale as well as on the evidence for their efficacy and their limitations...
February 22, 2019: Expert Review of Neurotherapeutics
Ioanna Giotaki, Peter Lange, Martin S Weber
OBJECTIVES: The detection of cerebrospinal fluid (CSF)-specific oligoclonal bands (OCB) as well as an elevated antibody production directed against neurotrophic viruses remain hallmark findings in multiple sclerosis (MS). In general, individual patients show a unique pattern of OCB, which is believed to persist over time. Here, the authors revisited this assumption and investigated to what extent common anti-inflammatory MS medications can alter the level of immunoglobulins produced within the CSF...
February 21, 2019: Expert Review of Neurotherapeutics
Marco Mula
Depression is one of the most frequent comorbidities in epilepsy affecting between 17% and 22% of patients but it is still underdiagnosed and undertreated. Areas covered: This paper discusses recent advances about screening, diagnosis and treatment of depression in epilepsy taking into account the heterogeneity of clinical scenarios where depression can occur. Expert opinion: A number of screening instruments are now validated for adults with epilepsy and their psychometric properties are discussed but the NDDIE is the most practical and cost-effective...
February 20, 2019: Expert Review of Neurotherapeutics
Trisha Chakrabarty, Lakshmi N Yatham
Subthreshold presentations of bipolarity (BSPs) pose a diagnostic conundrum, in terms of whether they should be conceptualized and treated similarly as traditionally defined bipolar disorders (BD). While it has been argued that BSPs are on a pathophysiologic continuum with traditionally defined BDs, there has been limited examination of biological and objective markers in these presentations to validate this assertion. Areas covered: The authors review studies examining genetic, neurobiological, cognitive and peripheral markers in BSPs, encompassing clinical and non-clinical populations with subthreshold hypo/manic symptoms...
February 14, 2019: Expert Review of Neurotherapeutics
Pan Chen, Melissa Totten, Ziyan Zhang, Hana Bucinca, Keith Erikson, Abel Santamaría, Aaron B Bowman, Michael Aschner
Iron (Fe) and manganese (Mn) are essential nutrients for humans. They act as cofactors for a variety of enzymes. In the central nervous system (CNS), these two metals are involved in diverse neurological activities. Dyshomeostasis may interfere with the critical enzymatic activities, hence altering the neurophysiological status and resulting in neurological diseases. Areas covered: In this review, the authors cover the molecular mechanisms of Fe/Mn-induced toxicity and neurological diseases, as well as the diagnosis and potential treatment...
February 13, 2019: Expert Review of Neurotherapeutics
Renee-Marie Ragguett, Roger S McIntyre
Depressive symptoms and episodes dominate the course of bipolar disorder. The morbidity of bipolar disorder is disproportionately mediated by depressive symptoms; economic costs of bipolar disorder are also disproportionately due to unremitting depressive symptoms. Relatively few treatment options have established unequivocal efficacy in the treatment of bipolar depression. Herein we review evidence regarding the efficacy of the D3 preferring D2 /D3 partial agonist cariprazine in the treatment of adults with bipolar depression...
February 12, 2019: Expert Review of Neurotherapeutics
Clément Dondé, Marine Mondino, Jérôme Brunelin, Frédéric Haesebaert
Auditory and visual sensory dysfunctions are key pathophysiological features of schizophrenia (Sz). Therefore, remedial interventions that directly target such impairments could potentially drive gains in higher-order cognition (e.g., memory, executive functions, emotion processing), symptoms and functional outcome, in addition to improving sensory abilities in this population. Here, the authors review available sensory-targeted cognitive training (S-TCT) programs that were investigated so far in patients with Sz...
February 9, 2019: Expert Review of Neurotherapeutics
Jason Margolesky
No abstract text is available yet for this article.
January 14, 2019: Expert Review of Neurotherapeutics
Lucas Overeem, Lars Neeb, Uwe Reuter
This paper reviews placebo-controlled randomized double-blind studies with erenumab for the prevention of migraine. Erenumab is a fully human monoclonal antibody (mAb), which specifically blocks the calcitonin gene-related peptide (GGRP) receptor. Areas covered: This manuscript was based on articles written in English located on PubMed found using the following search terms:episodic & chronic migraine, migraine prophylaxis & prevention, CGRP, CGRP receptor, CGRP receptor antagonist, erenumab, treatment failures, trigeminal nerve...
January 7, 2019: Expert Review of Neurotherapeutics
Soumya Ghosh
Gait and balance impairments are common in many neurological disorders and among the elderly, are often difficult to treat, and have a significant effect on quality of life. Areas covered: Non-invasive brain stimulation (NIBS) technologies have been recognized for their therapeutic potential in various neurologic and psychiatric disorders. There is increasing interest in treatment of gait and balance impairment using newer modalities such as NIBS. Most therapeutic trials so far have been of small size and heterogenous in design and stimulus parameters...
January 2, 2019: Expert Review of Neurotherapeutics
Frederike C Oertel, Hanna G Zimmermann, Alexander U Brandt, Friedemann Paul
Multiple Sclerosis (MS) is the most common chronic autoimmune neuroinflammatory condition in young adults. It is often accompanied by optic neuritis (ON) and retinal neuro-axonal damage causing visual disturbances. Optical coherence tomography (OCT) is a sensitive non-invasive method for quantifying intraretinal layer volumes. Recently, OCT not only showed to be a reliable marker for ON-associated damage, but also proved its high prognostic value for functional outcome and disability accrual in patients with MS...
December 27, 2018: Expert Review of Neurotherapeutics
Beatriz Costa, Isadora Ferreira, Alisson Trevizol, Aurore Thibaut, Felipe Fregni
There has been great development in the testing of invasive and non-invasive neuromodulation for chronic pain. To date, it is known that central and peripheral stimulation targets, combined or not, may influence chronic pain sensation. Although most of the significant results of chronic pain studies come from motor cortex stimulation, novel targets are being explored to increase effect sizes and to induce pain relief in non-responders. Areas covered: In this article, we discuss three emerging targets of non-invasive neuromodulation for chronic pain: (i) a central target: prefrontal cortex stimulation; (ii) a peripheral target: vagal nerve stimulation (VNS); and (iii) a combined peripheral-central target: combination of central and peripheral neural stimulation...
February 2019: Expert Review of Neurotherapeutics
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