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Volpe SG, Ahmad J, Patel RA, Rosendale N. Neurological care for LGBT+ people. Nat Rev Neurol 2024; 20:288-297. [PMID: 38499761 DOI: 10.1038/s41582-024-00944-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2024] [Indexed: 03/20/2024]
Abstract
Sexual and gender minority (LGBT+) people face unique health disparities that must be considered by health-care providers to ensure equitable and inclusive care. Although traditionally LGBT+ health has not been integrated into neurology training, sexual orientation and gender identity have direct relevance to neurological health, driven by both systemic and interpersonal factors. In this Review, we summarize the evidence for associations between sexual orientation and gender identity with the prevalence and outcomes of various neurological conditions, including neurodegenerative diseases, epilepsy, stroke and neurodevelopmental disorders, among others. We describe important clinical considerations pertaining to LGBT+ people and recommend language and practices to promote inclusive care, as well as highlight gaps in need of further research and possible strategies to minimize these, including systematic collection of sexual orientation and gender identity and use of inclusive language.
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Affiliation(s)
| | - Joya Ahmad
- College of Medicine, SUNY Downstate Health Sciences University, New York City, NY, USA
| | - Roshni Abee Patel
- Neurology Service, Jesse Brown VA Medical Center, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Nicole Rosendale
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA.
- Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA.
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Trabacca A. Children, neurology, and "the metaverse": is this the road map? Neurol Sci 2023; 44:3719-3720. [PMID: 37351677 DOI: 10.1007/s10072-023-06921-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 06/19/2023] [Indexed: 06/24/2023]
Affiliation(s)
- Antonio Trabacca
- Head of Unit for Severe Disabilities in Developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Scientific Institute IRCCS "E. Medea", Brindisi, Italy.
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3
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Owolabi MO, Leonardi M, Bassetti C, Jaarsma J, Hawrot T, Makanjuola AI, Dhamija RK, Feng W, Straub V, Camaradou J, Dodick DW, Sunna R, Menon B, Wright C, Lynch C, Chadha AS, Ferretti MT, Dé A, Catsman-Berrevoets CE, Gichu M, Tassorelli C, Oliver D, Paulus W, Mohammed RK, Charway-Felli A, Rostasy K, Feigin V, Craven A, Cunningham E, Galvin O, Perry AH, Fink EL, Baneke P, Helme A, Laurson-Doube J, Medina MT, Roa JD, Hogl B, O'Bryan A, Trenkwalder C, Wilmshurst J, Akinyemi RO, Yaria JO, Good DC, Hoemberg V, Boon P, Wiebe S, Cross JH, Haas M, Jabalpurwala I, Mojasevic M, DiLuca M, Barbarino P, Clarke S, Zuberi SM, Olowoyo P, Owolabi A, Oyesiku N, Maly-Sundgren PC, Norrving B, Soekadar SR, van Doorn PA, Lewis R, Solomon T, Servadei F. Global synergistic actions to improve brain health for human development. Nat Rev Neurol 2023; 19:371-383. [PMID: 37208496 PMCID: PMC10197060 DOI: 10.1038/s41582-023-00808-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2023] [Indexed: 05/21/2023]
Abstract
The global burden of neurological disorders is substantial and increasing, especially in low-resource settings. The current increased global interest in brain health and its impact on population wellbeing and economic growth, highlighted in the World Health Organization's new Intersectoral Global Action Plan on Epilepsy and other Neurological Disorders 2022-2031, presents an opportunity to rethink the delivery of neurological services. In this Perspective, we highlight the global burden of neurological disorders and propose pragmatic solutions to enhance neurological health, with an emphasis on building global synergies and fostering a 'neurological revolution' across four key pillars - surveillance, prevention, acute care and rehabilitation - termed the neurological quadrangle. Innovative strategies for achieving this transformation include the recognition and promotion of holistic, spiritual and planetary health. These strategies can be deployed through co-design and co-implementation to create equitable and inclusive access to services for the promotion, protection and recovery of neurological health in all human populations across the life course.
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Affiliation(s)
- Mayowa O Owolabi
- Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria.
- Neurology Unit, Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria.
- African Stroke Organization, Ibadan, Nigeria.
- World Federation for Neurorehabilitation, North Shields, UK.
- Lebanese American University of Beirut, Beirut, Lebanon.
- Blossom Specialist Medical Center, Ibadan, Nigeria.
| | - Matilde Leonardi
- Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Claudio Bassetti
- Neurology Department Inselspital - University of Bern, Bern, Switzerland
- European Academy of Neurology, Vienna, Austria
| | - Joke Jaarsma
- European Federation of Neurological Associations, Brussels, Belgium
| | - Tadeusz Hawrot
- European Federation of Neurological Associations, Brussels, Belgium
| | | | | | - Wuwei Feng
- Department of Neurology, Duke University School of Medicine, Durham, NC, USA
| | - Volker Straub
- John Walton Muscular Dystrophy Research Center, Newcastle University, Newcastle, UK
| | - Jennifer Camaradou
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
- One Neurology Initiative, Brussels, Belgium
| | - David W Dodick
- Department of Neurology, Mayo Clinic, Phoenix, AZ, USA
- Atria Academy of Science and Medicine, New York, NY, USA
- American Brain Foundation, Minneapolis, MN, USA
| | - Rosita Sunna
- Tics and Tourette Across the Globe, Hannover, Germany
- Australian Clinical Psychology Association, Sydney, New South Wales, Australia
| | - Bindu Menon
- Department of Neurology, Apollo Specialty Hospitals, Nellore, India
| | | | - Chris Lynch
- Alzheimer's Disease International, London, UK
| | | | | | - Anna Dé
- Women's Brain Project, Guntershausen, Switzerland
| | - Coriene E Catsman-Berrevoets
- Department of Paediatric Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- European Paediatric Neurology Society, Bolton, UK
| | - Muthoni Gichu
- Department of Non-Communicable Diseases, Ministry of Health, Nairobi, Kenya
- Global Brain Health Institute, San Francisco, CA, USA
| | - Cristina Tassorelli
- Department of Brain and Behavioral Sciences of the University of Pavia, Pavia, Italy
- IRCCS C. Mondino Foundation Neurological Institute, Pavia, Italy
- International Headache Society, London, UK
| | - David Oliver
- University of Kent, Canterbury, UK
- International Neuro-Palliative Care Society, Roseville, MN, USA
| | - Walter Paulus
- Department of Neurology, Ludwig-Maximilians University Munich, Klinikum Großhadern, Munich, Germany
- International Federation of Clinical Neurophysiology, Milwaukee, WI, USA
| | - Ramla K Mohammed
- Amal Neuro Developmental Centres, Gudalur, India
- Al Ameen Educational Trust, Gudalur, India
| | | | - Kevin Rostasy
- European Paediatric Neurology Society, Bolton, UK
- Department of Paediatric Neurology, Children's Hospital Datteln, University Witten/Herdecke, Witten, Germany
| | - Valery Feigin
- National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand
| | | | | | - Orla Galvin
- European Federation of Neurological Associations, Brussels, Belgium
| | | | - Ericka L Fink
- Department of Paediatric Neurology and Critical Care, University of Pittsburgh Medical Centre Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
- Safar Center for Resuscitation Research, University of Pittsburgh Medical Centre Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Peer Baneke
- Multiple Sclerosis International Federation, London, UK
| | - Anne Helme
- Multiple Sclerosis International Federation, London, UK
| | | | - Marco T Medina
- National Autonomous University of Honduras, Tegucigalpa, Honduras
- Pan-American Federation of Neurological Societies, Santiago de Chile, Chile
| | - Juan David Roa
- HOMI Fundacion Hospital Paediatrico la Misericordia, Bogota, Colombia
| | - Birgit Hogl
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
- World Sleep Society, Rochester, MN, USA
| | | | - Claudia Trenkwalder
- Paracelsus-Elena Hospital, Kassel, Department of Neurosurgery, University Medical Centre, Goettingen, Germany
| | - Jo Wilmshurst
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- International Child Neurology Association, London, UK
| | - Rufus O Akinyemi
- African Stroke Organization, Ibadan, Nigeria
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Joseph O Yaria
- Department of Neurology, University College Hospital, Ibadan, Nigeria
| | - David C Good
- World Federation for Neurorehabilitation, North Shields, UK
- Department of Neurology, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Volker Hoemberg
- World Federation for Neurorehabilitation, North Shields, UK
- SRH Neurorehabilitation Hospital Bad Wimpfen, Bad Wimpfen, Germany
| | - Paul Boon
- European Academy of Neurology, Vienna, Austria
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Samuel Wiebe
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Alberta, Canada
- International League Against Epilepsy, Flower Mound, TX, USA
| | - J Helen Cross
- International League Against Epilepsy, Flower Mound, TX, USA
- Clinical Neurosciences Section, UCL Institute of Child Health, University College London, London, UK
| | - Magali Haas
- Cohen Veterans Bioscience, New York, NY, USA
| | | | | | - Monica DiLuca
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
- European Brain Council, Brussels, Belgium
| | | | - Stephanie Clarke
- World Federation for Neurorehabilitation, North Shields, UK
- Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Sameer M Zuberi
- European Paediatric Neurology Society, Bolton, UK
- Paediatric Neurosciences Research Group, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Paul Olowoyo
- Department of Medicine, Afe Babalola University, Ado-Ekiti, Nigeria
- Federal Teaching Hospital, Ido-Ekiti, Nigeria
| | | | - Nelson Oyesiku
- Department of Neurosurgery, University of North Carolina at Chapel Hill, North Carolina, NC, USA
- World Federation of Neurosurgical Societies, Prague, Czech Republic
| | - Pia C Maly-Sundgren
- Department of Clinical Sciences/Diagnostic Radiology, Lund University, Lund, Sweden
| | - Bo Norrving
- Department of Clinical Sciences/Neurology, Lund University, Lund, Sweden
| | - Surjo R Soekadar
- Clinical Neurotechnology Laboratory, Department of Psychiatry and Neurosciences, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Pieter A van Doorn
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Peripheral Nerve Society, Roseville, MN, USA
| | - Richard Lewis
- Peripheral Nerve Society, Roseville, MN, USA
- Department of Neurology, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Tom Solomon
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
- Encephalitis Society, Malton, North Yorkshire, UK
| | - Franco Servadei
- World Federation of Neurosurgical Societies, Prague, Czech Republic
- Department of Neurosurgery, Humanitas Clinical and Research Center - IRCCS, Humanitas University, Milan, Italy
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4
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Fujii T. [Current Situation and Issues in Transitional Medicine: A Pediatric Neurology Viewpoint]. Brain Nerve 2022; 74:747-751. [PMID: 35676206 DOI: 10.11477/mf.1416202113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The transition from pediatric neurology to adult neurology is not easy for patients with childhood-onset neurological or muscular diseases. The reasons can be broadly categorized into patient-related and transition system issues. To resolve these issues, the following are important: 1)promoting awareness of the necessity of future transition among patients and their families during childhood, 2)establishing a transition support team to coordinate the transitions and collect information about medical institutions for adults that can accept patients who need transition, and above all, 3)facilitating close communication and information sharing between the concerned adult and pediatric neurologists.
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Affiliation(s)
- Tatsuya Fujii
- Department of Pediatrics, Shiga Medical Center for Children
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5
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Szepanowski F, Warnke C, Meyer Zu Hörste G, Mausberg AK, Hartung HP, Kleinschnitz C, Stettner M. Secondary Immunodeficiency and Risk of Infection Following Immune Therapies in Neurology. CNS Drugs 2021; 35:1173-1188. [PMID: 34657228 PMCID: PMC8520462 DOI: 10.1007/s40263-021-00863-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/13/2021] [Indexed: 12/13/2022]
Abstract
Secondary immunodeficiencies (SIDs) are acquired conditions that may occur as sequelae of immune therapy. In recent years a number of disease-modifying therapies (DMTs) has been approved for multiple sclerosis and related disorders such as neuromyelitis optica spectrum disorders, some of which are frequently also used in- or off-label to treat conditions such as chronic inflammatory demyelinating polyneuropathy (CIDP), myasthenia gravis, myositis, and encephalitis. In this review, we focus on currently available immune therapeutics in neurology to explore their specific modes of action that might contribute to SID, with particular emphasis on their potential to induce secondary antibody deficiency. Considering evidence from clinical trials as well as long-term observational studies related to the patients' immune status and risks of severe infections, we delineate long-term anti-CD20 therapy, with the greatest data availability for rituximab, as a major risk factor for the development of SID, particularly through secondary antibody deficiency. Alemtuzumab and cladribine have relevant effects on circulating B-cell counts; however, evidence for SID mediated by antibody deficiency appears limited and urgently warrants further systematic evaluation. To date, there has been no evidence suggesting that treatment with fingolimod, dimethyl fumarate, or natalizumab leads to antibody deficiency. Risk factors predisposing to development of SID include duration of therapy, increasing age, and pre-existing low immunoglobulin (Ig) levels. Prevention strategies of SID comprise awareness of risk factors, individualized treatment protocols, and vaccination concepts. Immune supplementation employing Ig replacement therapy might reduce morbidity and mortality associated with SIDs in neurological conditions. In light of the broad range of existing and emerging therapies, the potential for SID warrants urgent consideration among neurologists and other healthcare professionals.
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Affiliation(s)
- Fabian Szepanowski
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Medicine Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany
| | - Clemens Warnke
- Department of Neurology, University of Cologne, Cologne, Germany
| | | | - Anne K Mausberg
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Medicine Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany
| | - Hans-Peter Hartung
- Department of Neurology, Medical Faculty, University of Duesseldorf, Duesseldorf, Germany
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
- Medical University Vienna, Vienna, Austria
- Department of Neurology, Palacky University, Olomouc, Czech Republic
| | - Christoph Kleinschnitz
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Medicine Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany
| | - Mark Stettner
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Medicine Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany.
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6
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Snider BJ, Holtzman DM. Effects of COVID-19 on preclinical and clinical research in neurology: Examples from research on neurodegeneration and Alzheimer's disease. Neuron 2021; 109:3199-3202. [PMID: 34525328 DOI: 10.1016/j.neuron.2021.08.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 08/14/2021] [Accepted: 08/18/2021] [Indexed: 11/17/2022]
Abstract
The COVID-19 pandemic has had a profound impact on neuroscientists, including those involved in translational research. In this NeuroView, we discuss the positive and negative effects of the pandemic on preclinical research and clinical studies in humans.
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Affiliation(s)
- B Joy Snider
- Department of Neurology, Hope Center for Neurological Disorders, Knight Alzheimer's Disease Research Center, Washington University in St. Louis, 660 S. Euclid Ave., Box 8111, St. Louis, MO 63110, USA
| | - David M Holtzman
- Department of Neurology, Hope Center for Neurological Disorders, Knight Alzheimer's Disease Research Center, Washington University in St. Louis, 660 S. Euclid Ave., Box 8111, St. Louis, MO 63110, USA.
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Abstract
Despite years of basic research and pioneering clinical work, ischemic stroke remains a major public health concern. Prior STAIR (Stroke Treatment Academic Industry Roundtable) conferences identified both failures of clinical trial design and failures in preclinical assessment in developing putative ischemic stroke treatments. At STAIR XI, participants in workshop no. 1 Top Priorities for Neuroprotection sought to redefine the neuroprotection paradigm and given the paucity of evidence underlying preclinical assessment, offer consensus-based recommendations. STAIR proposes the term brain cytoprotection or cerebroprotection to replace the term neuroprotection when the intention of an investigation is to demonstrate that a new, candidate treatment benefits the entire brain. Although "time is still brain," tissue imaging techniques have been developed to identify patients with both predicted core injury and penumbral, salvageable brain tissue, regardless of time after stroke symptom onset. STAIR XI workshop participants called this imaging approach a tissue window to select patients for recanalization. Elements of the neurovascular unit show differential vulnerability evolving over differing time scales in different brain regions. STAIR proposes the term target window to suggest therapies that target the different elements of the neurovascular unit at different times. Based on contemporary principles of rigor and transparency, the workshop updated, revised, and enhanced the STAIR preclinical recommendations for developing new treatments in 2 phases: an exploratory qualification phase and a definitive validation phase. For new, putative treatments, investigators should carefully characterize the mechanism of action, the pharmacokinetics/pharmacodynamics, demonstrate target engagement, and confirm penetration through the blood-brain barrier. Before clinical trials, testing of candidate molecules in stroke models could proceed in a comprehensive manner using animals of both sexes and to include significant variables such as age and comorbid conditions. Comprehensive preclinical assessment might include multicenter, collaborative testing, for example, network trials. In the absence of a proven cerebroprotective agent to use as a gold standard, however, it remains speculative whether such comprehensive preclinical assessment can effectively predict clinical outcome.
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Affiliation(s)
- Patrick Lyden
- Department of Physiology and Neuroscience, Department of Neurology, Keck School of Medicine, Los Angeles (P.L.)
| | - Alastair Buchan
- Radcliffe Department of Medicine, University of Oxford, Oxford (A.B.)
| | - Johannes Boltze
- School of Life Sciences, University of Warwick, Coventry (J.B.)
| | - Marc Fisher
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston (M.F.)
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Wijeratne T, Grisold W, Baneke P, Helme A, King R, Carroll W. World Brain Day 2021: a call to stop multiple sclerosis. Lancet Neurol 2021; 20:597-598. [PMID: 34166643 DOI: 10.1016/s1474-4422(21)00200-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 06/09/2021] [Accepted: 06/11/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Tissa Wijeratne
- Department of Neurology & Medicine, AIMSS, Melbourne Medical School, Western Health, St Albans, VIC, Australia.
| | - Wolfgang Grisold
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Vienna, Austria
| | - Peer Baneke
- Multiple Sclerosis International Federation, London, UK
| | - Anne Helme
- Multiple Sclerosis International Federation, London, UK
| | - Rachel King
- Multiple Sclerosis International Federation, London, UK
| | - William Carroll
- Department of Neurology, Sir Charles Gairdner Hospital, Perth, WA, Australia
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Kiliçaslan ÖF, Nabi V, Yardibi F, Tokgöz MA, Köse Ö. Research Tendency in Lumbar Spinal Stenosis over the Past Decade: A Bibliometric Analysis. World Neurosurg 2021; 149:e71-e84. [PMID: 33662607 DOI: 10.1016/j.wneu.2021.02.086] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The purpose of this bibliometric analysis was to identify trends and hot topics in research on lumbar spinal stenosis (LSS) over the past decade, for helping researchers explore new directions for future research in that area. METHODS All research articles on LSS, written in English and indexed in the Web of Science database (WoS) between 2010 and 2020, were used. The visualization of network and in-depth bibliometric analysis including the number of publications, countries, institutions, journals, authors, cited references, and key words was carried out with the help of CiteSpace. RESULTS A total of 4033 papers (3577 original articles and 476 reviews) were identified and included in the study. The most productive year was in 2019. The Spine was the journal that published the highest number of articles and received the most citations. The most productive country and institutions in this field were the United States and Seoul National University, respectively. Kim HJ was the most prolific author, and Deyo RA ranked the first in the cited authors. The most cited article was published in 2010 by Deyo et al. and described the complications and charges index for LSS. From the coword cluster analysis, there were 3 frontiers in lumbar spinal stenosis: intervention, outcomes, and pathogenesis. CONCLUSIONS We have summarized the literature on LSS in the past decade including publication information, country, institution, authors, and journal. Research on minimally invasive surgery, outcomes, and gene therapies in LSS will be hot topics in the future.
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Affiliation(s)
- Ömer Faruk Kiliçaslan
- Antalya Training and Research Hospital, Department of Orthopedics and Traumatology, Antalya, Turkey
| | - Vugar Nabi
- Antalya Training and Research Hospital, Department of Orthopedics and Traumatology, Antalya, Turkey
| | - Fatma Yardibi
- Akdeniz University, Agricultural Engineering Faculty, Department of Zootechnology, Antalya, Turkey.
| | - Mehmet Ali Tokgöz
- Ankara Keçiören Training and Research Hospital-Department of Orthopaedics and Traumatology, Ankara, Turkey
| | - Özkan Köse
- Antalya Training and Research Hospital, Department of Orthopedics and Traumatology, Antalya, Turkey
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11
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Tauscher RG, Simon SS, Volpe NJ. Retinal disease in the neurology clinic. Curr Opin Neurol 2021; 34:122-132. [PMID: 33278143 DOI: 10.1097/wco.0000000000000883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Retinal disease can manifest with visual symptoms similar to those which result from central nervous system disorders. We provide a framework for considering retinal causes of common visual complaints presenting to a neurology clinic. RECENT FINDINGS Technological advances have afforded quicker detection and a more thorough understanding of these retinal entities and are crucial to consider when evaluating visual complaints in the neurology clinic. SUMMARY It is essential to maintain a working knowledge of common retinal conditions that symptomatically overlap with common neurologic conditions. Furthermore, the ophthalmoscopic exam and retinal imaging modalities can both aid in the diagnosis and workup of visual complaints and neurologic disease.
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Affiliation(s)
| | - Shira S Simon
- Department of Ophthalmology
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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Rajan S, Bebawy J, Avitsian R, Lee CZ, Rath G, Luoma A, Bilotta F, Pierce JT, Kofke WA. The Impact of the Global SARS-CoV-2 (COVID-19) Pandemic on Neuroanesthesiology Fellowship Programs Worldwide and the Potential Future Role for ICPNT Accreditation. J Neurosurg Anesthesiol 2021; 33:82-86. [PMID: 33075035 DOI: 10.1097/ana.0000000000000738] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The COVID-19 pandemic is an international crisis placing tremendous strain on medical systems around the world. Like other specialties, neuroanesthesiology has been adversely affected and training programs have had to quickly adapt to the constantly changing environment. METHODS An email-based survey was used to evaluate the effects of the pandemic on clinical workflow, clinical training, education, and trainee well-being. The impact of the International Council on Perioperative Neuroscience Training (ICPNT) accreditation was also assessed. RESULTS Responses were received from 14 program directors (88% response rate) in 10 countries and from 36 fellows in these programs. Clinical training was adversely affected because of the cancellation of elective neurosurgery and other changes in case workflow, the introduction of modified airway and other protocols, and redeployment of trainees to other sites. To address educational demands, most programs utilized online platforms to organize clinical discussions, journal clubs, and provide safety training modules. Several initiatives were introduced to support trainee well-being during the pandemic. Feelings of isolation and despair among trainees varied from 2 to 8 (on a scale of 1 to 10). Fellows all reported concerns that their clinical training had been adversely affected by the coronavirus disease 2019 (COVID-19) pandemic because of decreased exposure to elective subspecialty cases and limited opportunities to complete workplace-based assessments and training portfolio requirements. Cancellation of examination preparation courses and delayed examinations were cited as common sources of stress. Programs accredited by the ICPNT reported that international networking and collaboration was beneficial to reduce feelings of isolation during the pandemic. CONCLUSION Neuroanesthesia fellowship training program directors introduced innovative ways to maintain clinical training, educational activity and trainee well-being during the COVID-19 pandemic.
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Affiliation(s)
| | - John Bebawy
- Department of Anesthesiology & Neurological Surgery, Northwestern University Feinberg School of Medicine
| | - Rafi Avitsian
- General Anesthesiology, Cleveland Clinic, Cleveland, OH
| | - Chanhung Z Lee
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA
| | - Girija Rath
- Department of Neuroanaesthesiology & Critical Care, All India Institute of Medical Sciences (AIIMS), New Delhi, Delhi, India
| | - Astri Luoma
- Department of Neuroanaesthesia and Neurocritical Care, National Hospital for Neurology and Neurosurgery, UCLH NHS Foundation Trust, London, UK
| | - Federico Bilotta
- Department of Anesthesiology and Critical Care, Sapienza University of Rome, Rome, Italy
| | - John T Pierce
- Department of Anesthesiology, Chicago Medical School, North Chicago, IL
| | - William A Kofke
- Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, PA
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14
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Collins RA, Chan MCW. Editorial. Hong Kong Med J 2020; 26 Suppl 7:3. [PMID: 33229607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023] Open
Affiliation(s)
- R A Collins
- Chief Scientific Reviewer (Research Office), Food and Health Bureau
| | - M C W Chan
- Senior Scientific Reviewer (Research Office), Food and Health Bureau
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15
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Prasad VMN, Remacle M. Future Advances in Neurolaryngology. Adv Otorhinolaryngol 2020; 85:170-174. [PMID: 33166983 DOI: 10.1159/000486567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Neurolaryngology as a subspecialty of laryngology has developed considerably in the last four decades with more laryngologists, neurologists, speech and swallow therapists, and neurophysiologists taking interest in the field. The North American and Japanese laryngology societies have increasingly focused on conditions which are mainly concerned with aberrations of the nervous system affecting the larynx directly or indirectly. In the last few years, societies in Europe and the Asia-Pacific have also recognized the need to collaborate both within their organizations and with other societies globally. Cross-border pollination of ideas has increasingly become easier and with the aid of technology - almost seamless with real-time capacity to share operating experience, lectures, and panel discussions. The future advances in neurolaryngology will require incremental improvements in processes of diagnostics, objectivization (where possible) of pathology, standardization of treatments with comparison of results using accepted patient-based tests, investigations and imaging where possible. Ultimately, from the contributions in the previous chapters, it is fairly obvious that many conditions are still poorly understood and therefore management becomes more symptom based rather than dealing with the root cause of the problem. An understanding of the physiology of vocalization, swallow, and breathing beyond a rudimentary acceptance of many towards the vagus nerve and other neural factors may help understand what has otherwise been a rather simplistic approach to one of the most complex parts of the human body, essential to life and equally important - the quality of life. In this chapter, we aim to look at where advances in neurolaryngology may and perhaps will take place. We will look at the potential of better imaging modalities, neurophysiological testing and physiology of the brain. Tests and treatments currently in use may require some refinements or be possibly abandoned and replaced with more effective ones that can demonstrate a difference in the management of various patient groups. The future is hard to predict, and the rate of advancement equally so, but given the rate at which information technology, artificial intelligence, and basic science research are progressing, neurolaryngology may indeed have its welcome boost in the not too distant future.
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Affiliation(s)
- Vyas M N Prasad
- Singapore Medical Specialist Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore,
| | - Marc Remacle
- Department of Otolaryngology, Centre Hospitalier Luxembourg, Luxemburg, Luxembourg
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16
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Asnafi S, Duszak R, Hemingway JM, Hughes DR, Allen JW. Evolving Use of fMRI in Medicare Beneficiaries. AJNR Am J Neuroradiol 2020; 41:1996-2000. [PMID: 33033048 DOI: 10.3174/ajnr.a6845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 06/22/2020] [Indexed: 11/07/2022]
Abstract
Using the Medicare Physician-Supplier Procedure Summary Master File, we evaluated the evolving use of fMRI in Medicare fee-for-service beneficiaries from 2007 through 2017. Annual use rates (per 1,000,000 enrollees) increased from 17.7 to 32.8 through 2014 and have remained static since. Radiologists have remained the dominant specialty group from 2007 to 2017 (86.4% and 88.6% of all services, respectively), and the outpatient setting has remained the dominant place of service (65.4% and 65.4%, respectively).
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Affiliation(s)
- S Asnafi
- From the Department of Radiology and Imaging Sciences (S.A., R.D., J.W.A.)
| | - R Duszak
- From the Department of Radiology and Imaging Sciences (S.A., R.D., J.W.A.)
| | - J M Hemingway
- Harvey L. Neiman Health Policy Institute (J.M.H., D.R.H.), Reston, Virginia
| | - D R Hughes
- Harvey L. Neiman Health Policy Institute (J.M.H., D.R.H.), Reston, Virginia
- School of Economics (D.R.H.), Georgia Institute of Technology, Atlanta, Georgia
| | - J W Allen
- From the Department of Radiology and Imaging Sciences (S.A., R.D., J.W.A.)
- Neurology (J.W.A.), Emory University School of Medicine, Atlanta, Georgia
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Abstract
Liping Liu and colleagues discuss the challenges of global collaboration for brain health research and promising future opportunities for improvement of brain health worldwide
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Affiliation(s)
- Liping Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Valery Feigin
- National Institute for Stroke and Applied Neurosciences, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Ralph L Sacco
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Walter J Koroshetz
- National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD, USA
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Abstract
Yongjun Wang and colleagues discuss the definition of brain health and the opportunities and challenges of future research
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Affiliation(s)
- Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yuesong Pan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Hao Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
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Affiliation(s)
- David Z Wang
- Neurovascular Division, Department of Neurology, Barrow Neurological Institute, St Joseph Hospital and Medical Center, Phoenix, AZ, USA
| | - Lee H Schwamm
- Comprehensive Stroke Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Tianyi Qian
- Department of Public Health, School of Medicine, Tsinghua University, Beijing
- Tencent Healthcare, Tencent AIMIS, Shenzhen, China
| | - Qionghai Dai
- Tencent Healthcare, Tencent AIMIS, Shenzhen, China
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Affiliation(s)
- Christopher P Cifarelli
- Departments of Neurosurgery & Radiation Oncology, West Virginia University, Morgantown, WV, USA.
| | - Jason P Sheehan
- Department of Neurosurgery, University of Virginia, Charlottesville, VA, USA
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Abstract
BACKGROUND Telehealth provides health care to a patient from a provider at a distant location. Before the COVID-19 pandemic, adoption of telehealth modalities was increasing slowly but steadily. During the public health emergency, rapid widespread telehealth implementation has been encouraged to promote patient and provider safety and preserve access to health care. EVIDENCE ACQUISITION Evidence was acquired from English language Internet searches of the medical and business literature and following breaking news on the COVID-19 pandemic and responses from health care stakeholders, including policymakers, payers, physicians, health care organizations, and patients. We also had extensive discussions with colleagues who are developing telehealth techniques relevant to neuro-ophthalmology. RESULTS Regulatory, legal, reimbursement, and cultural barriers impeded the widespread adoption of telehealth before the COVID-19 pandemic. With the increased use of telehealth in response to the public health emergency, we are rapidly accumulating experience and an evidence base identifying opportunities and challenges related to the widespread adoption of tele-neuro-ophthalmology. One of the major challenges is the current inability to adequately perform funduscopy remotely. CONCLUSIONS Telehealth is an increasingly recognized means of health care delivery. Tele-Neuro-Ophthalmology adoption is necessary for the sake of our patients, the survival of our subspecialty, and the education of our trainees and students. Telehealth does not supplant but supplements and complements in-person neuro-ophthalmologic care. Innovations in digital optical fundus photography, mobile vision testing applications, artificial intelligence, and principles of channel management will facilitate further adoption of tele-neuro-ophthalmology and bring the specialty to the leading edge of health care delivery.
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Mariotto S, Beatrice G, Carta S, Bozzetti S, Mantovani A. Gender disparity in editorial boards of journals in neurology. Neurology 2020; 95:489-491. [PMID: 32753445 DOI: 10.1212/wnl.0000000000010500] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 06/22/2020] [Indexed: 11/15/2022] Open
Affiliation(s)
- Sara Mariotto
- From the Neurology Unit (S.M., S.C., S.B.), Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona; and Section of Endocrinology (G.B., A.M.), Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Italy
| | - Giorgia Beatrice
- From the Neurology Unit (S.M., S.C., S.B.), Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona; and Section of Endocrinology (G.B., A.M.), Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Italy
| | - Sara Carta
- From the Neurology Unit (S.M., S.C., S.B.), Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona; and Section of Endocrinology (G.B., A.M.), Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Italy
| | - Silvia Bozzetti
- From the Neurology Unit (S.M., S.C., S.B.), Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona; and Section of Endocrinology (G.B., A.M.), Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Italy
| | - Alessandro Mantovani
- From the Neurology Unit (S.M., S.C., S.B.), Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona; and Section of Endocrinology (G.B., A.M.), Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Italy.
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23
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Lui YW, Chang PD, Zaharchuk G, Barboriak DP, Flanders AE, Wintermark M, Hess CP, Filippi CG. Artificial Intelligence in Neuroradiology: Current Status and Future Directions. AJNR Am J Neuroradiol 2020; 41:E52-E59. [PMID: 32732276 PMCID: PMC7658873 DOI: 10.3174/ajnr.a6681] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Fueled by new techniques, computational tools, and broader availability of imaging data, artificial intelligence has the potential to transform the practice of neuroradiology. The recent exponential increase in publications related to artificial intelligence and the central focus on artificial intelligence at recent professional and scientific radiology meetings underscores the importance. There is growing momentum behind leveraging artificial intelligence techniques to improve workflow and diagnosis and treatment and to enhance the value of quantitative imaging techniques. This article explores the reasons why neuroradiologists should care about the investments in new artificial intelligence applications, highlights current activities and the roles neuroradiologists are playing, and renders a few predictions regarding the near future of artificial intelligence in neuroradiology.
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Affiliation(s)
- Y W Lui
- From the Department of Radiology (Y.W.L.), New York University Langone Medical Center, New York, New York
| | - P D Chang
- Department of Radiology (P.D.C.), University of California Irvine Health Medical Center, Orange, California
| | - G Zaharchuk
- Department of Neuroradiology (G.Z., M.W.), Stanford University, Stanford, California
| | - D P Barboriak
- Department of Radiology (D.P.B.), Duke University Medical Center, Durham, North Carolina
| | - A E Flanders
- Department of Radiology (A.E.F.), Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - M Wintermark
- Department of Neuroradiology (G.Z., M.W.), Stanford University, Stanford, California
| | - C P Hess
- Department of Radiology and Biomedical Imaging (C.P.H.), University of California, San Francisco, San Francisco, California
| | - C G Filippi
- Department of Radiology (C.G.F.), Northwell Health, New York, New York.
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24
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Roy B, Nowak RJ, Roda R, Khokhar B, Patwa HS, Lloyd T, Rutkove SB. Teleneurology during the COVID-19 pandemic: A step forward in modernizing medical care. J Neurol Sci 2020; 414:116930. [PMID: 32460041 PMCID: PMC7241381 DOI: 10.1016/j.jns.2020.116930] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 05/17/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND The COVID-19 pandemic mandated rapid transition from face-to-face encounters to teleneurology visits. While teleneurology is regularly used in acute stroke care, its application in other branches of neurology was limited. Here we review how the recent pandemic has created a paradigm shift in caring for patients with chronic neurological disorders and how academic institutions have responded to the present need. METHOD Literature review was performed to examine the recent changes in health policies. Number of outpatient visits and televisits in the Department of Neurology was reviewed from Yale University School of Medicine and Johns Hopkins School of Medicine to examine the road to transition to televisit. RESULTS The federal government and the insurance providers extended their supports during the COVID-19 pandemic. Several rules and regulations regarding teleneurology were revised and relaxed to address the current need. New technologies for video conferencing were incorporated. The transition to televisits went smoothly in both the institutions and number of face-to-face encounters decreased dramatically along with a rapid rise in televisits within 2 weeks of the declaration of national emergency. CONCLUSION AND RELEVANCE The need for "social distancing" during the COVID-19 pandemic has created a major surge in the number of teleneurology visits, which will probably continue for the next few months. It may have initiated a more permanent transition to virtual technology incorporated medical care.
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Affiliation(s)
- Bhaskar Roy
- Yale University School of Medicine, Department of Neurology, 15 York Street, LCI 9, P.O. Box 208108, New Haven 06519, CT, USA.
| | - Richard J Nowak
- Yale University School of Medicine, Department of Neurology, 15 York Street, LCI 9, P.O. Box 208108, New Haven 06519, CT, USA.
| | - Ricardo Roda
- Johns Hopkins School of Medicine, Department of Neurology, 600 N. Wolfe Street, Baltimore, MD 21287, USA
| | - Babar Khokhar
- Yale University School of Medicine, Department of Neurology, 15 York Street, LCI 9, P.O. Box 208108, New Haven 06519, CT, USA
| | - Huned S Patwa
- Yale University School of Medicine, Department of Neurology, 15 York Street, LCI 9, P.O. Box 208108, New Haven 06519, CT, USA
| | - Thomas Lloyd
- Johns Hopkins School of Medicine, Department of Neurology, 600 N. Wolfe Street, Baltimore, MD 21287, USA
| | - Seward B Rutkove
- Beth Israel Deaconess Medical Center, Department of Neurology, 330 Brookline Ave, Boston 02215, MA, USA
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26
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Rexach J, Lee H, Martinez-Agosto JA, Németh AH, Fogel BL. Clinical application of next-generation sequencing to the practice of neurology. Lancet Neurol 2020; 18:492-503. [PMID: 30981321 DOI: 10.1016/s1474-4422(19)30033-x] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 12/21/2018] [Accepted: 01/02/2019] [Indexed: 01/05/2023]
Abstract
Next-generation sequencing technologies allow for rapid and inexpensive large-scale genomic analysis, creating unprecedented opportunities to integrate genomic data into the clinical diagnosis and management of neurological disorders. However, the scale and complexity of these data make them difficult to interpret and require the use of sophisticated bioinformatics applied to extensive datasets, including whole exome and genome sequences. Detailed analysis of genetic data has shown that accurate phenotype information is essential for correct interpretation of genetic variants and might necessitate re-evaluation of the patient in some cases. A multidisciplinary approach that incorporates bioinformatics, clinical evaluation, and human genetics can help to address these challenges. However, despite numerous studies that show the efficacy of next-generation sequencing in establishing molecular diagnoses, pathogenic mutations are generally identified in fewer than half of all patients with genetic neurological disorders, exposing considerable gaps in the understanding of the human genome and providing opportunities to focus research on improving the usefulness of genomics in clinical practice. Looking forward, the emergence of precision health in neurological care will increasingly apply genomic data analysis to pharmacogenetics, preventive medicine, and patient-targeted therapies.
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Affiliation(s)
- Jessica Rexach
- Program in Neurogenetics, Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Hane Lee
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA; Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Julian A Martinez-Agosto
- Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, CA, USA; Division of Medical Genetics, Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Andrea H Németh
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK; Oxford Centre for Genomic Medicine, Oxford University Hospitals National Health Service Foundation Trust, Oxford, UK
| | - Brent L Fogel
- Program in Neurogenetics, Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA; Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, CA, USA; Clinical Neurogenomics Research Center, Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
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Affiliation(s)
- S Emamzadehfard
- Department of RadiologyUniversity of Texas Health Science CenterSan Antonio, Texas
| | - A Taree
- Icahn School of Medicine at Mount SinaiNew York, New York
| | - D M Yousem
- Johns Hopkins Medical InstitutionBaltimore, Maryland
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28
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Acosta JN, Brown SC, Falcone GJ. Genetic Variation and Response to Neurocritical Illness: a Powerful Approach to Identify Novel Pathophysiological Mechanisms and Therapeutic Targets. Neurotherapeutics 2020; 17:581-592. [PMID: 31975153 PMCID: PMC7283396 DOI: 10.1007/s13311-020-00837-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Disease-specific therapeutic options for critically ill neurological patients are limited. The identification of new preventive, therapeutic, and rehabilitation strategies is of the utmost importance in the field of neurocritical care research. Population genetics offers powerful tools to identify and prioritize biological pathways to be targeted by novel interventions. New treatments with supportive genetic evidence have twice the chances of obtaining final FDA approval compared to those without this support. Large collaborations, public access to data, reproducible science, and innovative analytical methods have exponentially increased the pace of discoveries related to neurocritical care genetics.
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Affiliation(s)
- Julián N Acosta
- Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Yale School of Medicine, New Haven, Connecticut, 06520, USA
| | - Stacy C Brown
- Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Yale School of Medicine, New Haven, Connecticut, 06520, USA
| | - Guido J Falcone
- Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Yale School of Medicine, New Haven, Connecticut, 06520, USA.
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29
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Hemphill JC, James ML. Translational Neurocritical Care Research: Advancing Understanding and Developing Therapeutics. Neurotherapeutics 2020; 17:389-391. [PMID: 32424631 PMCID: PMC7283417 DOI: 10.1007/s13311-020-00867-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- J Claude Hemphill
- Departments of Neurology and Neurological Surgery, University of California, San Francisco, CA, USA.
- Department of Neurology, Zuckerberg San Francisco General Hospital, Building 1, Room 101, 1001 Potrero Avenue, San Francisco, CA, 94110, USA.
| | - Michael L James
- Departments of Anesthesiology and Neurology, Duke University, Durham, USA
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30
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Kuzuhara S. [Lessons from the 116 years (1902-2018) of history of the Japanese Society of Neurology in establishing its identity]. Rinsho Shinkeigaku 2020; 60:1-19. [PMID: 31852875 DOI: 10.5692/clinicalneurol.cn-001353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The Japanese Society of Neurology and Psychiatry was founded in 1902 as a joint society of Neurology and Psychiatry, but was renamed the Japanese Society of Psychiatry and Neurology in 1935 because of the stagnation of activities of Neurology and the rise of those of Psychiatry. After World War II, activities of Neurology were restored and the Japanese Society of Neurology (JSN) independent from the Societies of Internal Medicine and Psychiatry was established in 1960 after overcoming many difficulties. In 1975, neurology was approved by law as one of the specialized fields of medicine. After that, neurology and JSN developed dramatically, both in research and medical practices. As of 2018, JSN had 9,000 members and more than 5,500 board-certified neurology specialists. JSN successfully hosted the World Congress of Neurology twice in 1981 and 2017. In 2002, JSN accepted the offer to join the Japanese Board of Medical Specialties as one of the subspecialties of Internal Medicine. In 2018 JSN enacted a new policy to upgrade the neurology specialist from a subspecialty of Internal Medicine to an independent major medical field. Lessons of the 116 years of history of the Society would teach us a sensible way to achieve the goals.
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Affiliation(s)
- Shigeki Kuzuhara
- Graduate School of Health Science, Suzuka University of Medical Science
- School of Nursing, Suzuka University of Medical Science
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31
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Perrenoud M, Pantazou V, Michel P, Hirt L, Ryvlin P, Theaudin M, Rouaud O, Benninger D, Novy J, Rossetti AO, Kuntzer T, Diserens K, Pasquier RD. [Neurology 2019]. Rev Med Suisse 2020; 16:68-71. [PMID: 31961088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
New studies confirm the possibility of late thrombolysis. Meta-analyses have confirmed that CGRP inhibitors are efficacious for migraines. Cladribine is a new oral treatment for relapsing-remitting multiple sclerosis. Limbic-predominant age-related TDP-43 encephalopathy (LATE) is a new clinical entity accounting for cognitive decline in old patients. The timing of levodopa introduction has no effect on the long-term course of idiopathic Parkinson's disease. Hypophosphatemia helps distinguish between seizures and syncopes in the emergency department. A second course of intravenous immunoglobulins provides no benefit for severe Guillain Barre syndrome. Outdoor therapy improves clinical scales in patients with disorder of consciousness. Ultrasound guided lumbar puncture improves the yield of the procedure.
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Affiliation(s)
- Matthieu Perrenoud
- Département des neurosciences cliniques, CHUV et Université de Lausanne, 1011 Lausanne
| | - Vasiliki Pantazou
- Département des neurosciences cliniques, CHUV et Université de Lausanne, 1011 Lausanne
| | - Patrik Michel
- Département des neurosciences cliniques, CHUV et Université de Lausanne, 1011 Lausanne
| | - Lorenz Hirt
- Département des neurosciences cliniques, CHUV et Université de Lausanne, 1011 Lausanne
| | - Philippe Ryvlin
- Département des neurosciences cliniques, CHUV et Université de Lausanne, 1011 Lausanne
| | - Marie Theaudin
- Département des neurosciences cliniques, CHUV et Université de Lausanne, 1011 Lausanne
| | - Olivier Rouaud
- Département des neurosciences cliniques, CHUV et Université de Lausanne, 1011 Lausanne
| | - David Benninger
- Département des neurosciences cliniques, CHUV et Université de Lausanne, 1011 Lausanne
| | - Jan Novy
- Département des neurosciences cliniques, CHUV et Université de Lausanne, 1011 Lausanne
| | - Andrea O Rossetti
- Département des neurosciences cliniques, CHUV et Université de Lausanne, 1011 Lausanne
| | - Thierry Kuntzer
- Département des neurosciences cliniques, CHUV et Université de Lausanne, 1011 Lausanne
| | - Karin Diserens
- Département des neurosciences cliniques, CHUV et Université de Lausanne, 1011 Lausanne
| | - Renaud Du Pasquier
- Département des neurosciences cliniques, CHUV et Université de Lausanne, 1011 Lausanne
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Kreitmair KV. Response to Open Peer Commentaries on "Ethical Dimensions of Direct-to-Consumer Neurotechnologies". AJOB Neurosci 2019; 10:W1-W3. [PMID: 31663829 DOI: 10.1080/21507740.2019.1675798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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Wexler A. Direct-to-Consumer Neurotechnology: A Grounded Appraisal. AJOB Neurosci 2019; 10:172-174. [PMID: 31642764 PMCID: PMC6814257 DOI: 10.1080/21507740.2019.1665138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Anna Wexler
- University of Pennsylvania Perelman School of Medicine
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34
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Forlini C, Lipworth W, Carter A, Kerridge I. Beyond Flourishing: Intersecting Uses and Interests in the Neurotechnology Marketplace. AJOB Neurosci 2019; 10:178-180. [PMID: 31642760 DOI: 10.1080/21507740.2019.1665128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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Abstract
Neuroimmunology as a separate discipline has its roots in the fields of neurology, neuroscience and immunology. Early studies of the brain by Golgi and Cajal, the detailed clinical and neuropathology studies of Charcot and Thompson's seminal paper on graft acceptance in the central nervous system, kindled a now rapidly expanding research area, with the aim of understanding pathological mechanisms of inflammatory components of neurological disorders. While neuroimmunologists originally focused on classical neuroinflammatory disorders, such as multiple sclerosis and infections, there is strong evidence to suggest that the immune response contributes to genetic white matter disorders, epilepsy, neurodegenerative diseases, neuropsychiatric disorders, peripheral nervous system and neuro-oncological conditions, as well as ageing. Technological advances have greatly aided our knowledge of how the immune system influences the nervous system during development and ageing, and how such responses contribute to disease as well as regeneration and repair. Here, we highlight historical aspects and milestones in the field of neuroimmunology and discuss the paradigm shifts that have helped provide novel insights into disease mechanisms. We propose future perspectives including molecular biological studies and experimental models that may have the potential to push many areas of neuroimmunology. Such an understanding of neuroimmunology will open up new avenues for therapeutic approaches to manipulate neuroinflammation.
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Affiliation(s)
- E. Nutma
- Department of PathologyAmsterdam UMC, VUmc siteAmsterdamthe Netherlands
| | - H. Willison
- University of Glasgow, Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life SciencesGlasgowUK
| | - G. Martino
- Neuroimmunology Unit, Division of NeuroscienceInstitute of Experimental Neurology (INSpe), San Raffaele Scientific Institute and Vita‐Salute San Raffaele UniversityMilanItaly
| | - S. Amor
- Department of PathologyAmsterdam UMC, VUmc siteAmsterdamthe Netherlands
- Centre for Neuroscience and TraumaThe Blizard Institute, Barts and The London School of Medicine and DentistryLondonUK
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36
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Abstract
Transsynaptic viral tracers are an invaluable neuroanatomical tool to define neuronal circuit connectivity across single or multiple synapses. There are variants that label either inputs or outputs of defined starter populations, most of which are based on the herpes and rabies viruses. However, we still have an incomplete understanding of the factors influencing specificity of neuron-neuron transmission and labeling of inputs vs. outputs. This article will touch on three topics: First, how specific are the directional transmission patterns of these viruses? Second, what are the properties that confer synaptic specificity of viral transmission? Lastly, what can we learn from this specificity, and can we use it to devise better transsynaptic tracers?
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Affiliation(s)
- Kevin T Beier
- Department of Physiology and Biophysics, Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, CA, 92697, United States.
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37
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Gasser T, Lerche H, Ziemann U. [Personalized diagnostics and treatment in neurology : Prospect and challenge]. Nervenarzt 2019; 90:765-766. [PMID: 31399757 DOI: 10.1007/s00115-019-0757-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Thomas Gasser
- Neurologische Klinik und Hertie-Institut für Klinische Hirnforschung, Universität Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Deutschland.
| | - Holger Lerche
- Neurologische Klinik und Hertie-Institut für Klinische Hirnforschung, Universität Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Deutschland
| | - Ulf Ziemann
- Neurologische Klinik und Hertie-Institut für Klinische Hirnforschung, Universität Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Deutschland
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38
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Paz R. [POTENTIAL CLINICAL APPLICATIONS OF RESTING-STATE-FMRI IN NEUROLOGY]. Harefuah 2019; 158:378-382. [PMID: 31215190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Resting-state functional Magnetic Resonance Imaging (rs-fMRI) is a non-invasive technique allowing to characterize brain functional connectivity. Blood oxygenation, the basis of the fMRI signal, fluctuates in the resting brain. These fluctuations have been shown to correlate between anatomically connected regions, thus allowing to examine functional connectivity between local and distal brain regions. The ability to identify functional networks, and to characterize their inter- and intra-connectivity is the basis for the development of useful clinical applications, which are especially relevant for neurological and neuropsychiatric diseases and disorders, in which network organization is altered. In this article, I will describe this method, review results obtained with it and demonstrate its potential through the consideration of findings from Alzheimer's disease research.
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Affiliation(s)
- Rotem Paz
- The Cognitive Neurology Institute, Rambam Health Care Center, Haifa
- The Laboratory for Brain Systems Organization in Health and Disease, Department of Neuroscience, Ruth and Bruce Rappaport Faculty of Medicine, The Technion Israel Institute of Technology
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39
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Milligan TA. The Importance of Neurology for the Non-Neurologist. Med Clin North Am 2019; 103:xv-xvi. [PMID: 30704691 DOI: 10.1016/j.mcna.2018.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Tracey A Milligan
- Harvard Medical School, Brigham and Women's Hospital, 60 Fenwood Road, Boston, MA 02115, USA.
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40
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Rietschel M, Winkelmann J. [Genetics in neurology and psychiatry]. Nervenarzt 2019; 90:97-98. [PMID: 30758638 DOI: 10.1007/s00115-019-0672-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Marcella Rietschel
- Genetische Epidemiologie in der Psychiatrie, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, J 5, 68159, Mannheim, Deutschland.
| | - Juliane Winkelmann
- Institut für Neurogenomik, Helmholtz Zentrum München, München, Deutschland.
- Institut für Humangenetik und Neurologische Klinik, Technische Universität München, München, Deutschland.
- Munich Cluster for Systems Neurology (SyNergy), München, Deutschland.
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41
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Eskioglou E, Benninger D, Di Virgilio G, Hirt L, Kuntzer T, Michel P, Novy J, Rossetti AO, Rouaud O, Ryvlin P, Theaudin M, Du Pasquier R. [Neurology]. Rev Med Suisse 2019; 15:74-77. [PMID: 30629375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Thrombolysis and late thrombectomy can be performed in case of compatible radiological imaging. Anti-CGRP monoclonal antibodies seem more effective for the treatment of migraine. Siponimod can reduce significantly disability progression in secondarily progressive MS. Brand-to-generic levetiracetam switching does not cause recrudescence of epileptic seizures. A new definition of Alzheimer's disease using biomarkers of cerebrospinal fluid (CSF) and imaging provides a better understanding of the underlying mechanisms. The use of levodopa-carbidopa intestinal gel and a subcutaneous apomorphine infusion allow a reduction of motor fluctuations in Parkinson's disease. Eculizumab appears as an alternative treatment in severe forms of myasthenia gravis.
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Affiliation(s)
- Elissavet Eskioglou
- Service de neurologie, Département des neurosciences cliniques, CHUV, 1011 Lausanne
| | - David Benninger
- Service de neurologie, Département des neurosciences cliniques, CHUV, 1011 Lausanne
| | | | - Lorenz Hirt
- Service de neurologie, Département des neurosciences cliniques, CHUV, 1011 Lausanne
| | - Thierry Kuntzer
- Service de neurologie, Département des neurosciences cliniques, CHUV, 1011 Lausanne
| | - Patrik Michel
- Service de neurologie, Département des neurosciences cliniques, CHUV, 1011 Lausanne
| | - Jan Novy
- Service de neurologie, Département des neurosciences cliniques, CHUV, 1011 Lausanne
| | - Andrea O Rossetti
- Service de neurologie, Département des neurosciences cliniques, CHUV, 1011 Lausanne
| | - Olivier Rouaud
- Service de neurologie, Département des neurosciences cliniques, CHUV, 1011 Lausanne
| | - Philippe Ryvlin
- Service de neurologie, Département des neurosciences cliniques, CHUV, 1011 Lausanne
| | - Marie Theaudin
- Service de neurologie, Département des neurosciences cliniques, CHUV, 1011 Lausanne
| | - Renaud Du Pasquier
- Service de neurologie, Département des neurosciences cliniques, CHUV, 1011 Lausanne
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42
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Boldery C. Kathleen Mears Memorial Lecture: How We Can Solidify the Future of Neurodiagnostic Technology. Neurodiagn J 2019; 59:194-211. [PMID: 31825735 DOI: 10.1080/21646821.2019.1690359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 11/05/2019] [Indexed: 06/10/2023]
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44
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Abstract
Five decades ago, Henry Knowles Beecher, a renowned professor of research anesthesiology, sought to solve a problem created by modern medicine. The solution proposed by Beecher and his colleagues on the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death proved very influential.1 Indeed, other contemporaneous medical developments magnified its significance yet also made the solution it offered somewhat problematic. As we mark this fiftieth anniversary, at a time when concerns about the conceptual model on which its recommendations rested are being voiced by critics from medicine as well as philosophy, it is worthwhile to view the committee's report in relation to the problem that prompted its existence as well as the one to which it was quickly applied.
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Abstract
Deep learning is a form of machine learning using a convolutional neural network architecture that shows tremendous promise for imaging applications. It is increasingly being adapted from its original demonstration in computer vision applications to medical imaging. Because of the high volume and wealth of multimodal imaging information acquired in typical studies, neuroradiology is poised to be an early adopter of deep learning. Compelling deep learning research applications have been demonstrated, and their use is likely to grow rapidly. This review article describes the reasons, outlines the basic methods used to train and test deep learning models, and presents a brief overview of current and potential clinical applications with an emphasis on how they are likely to change future neuroradiology practice. Facility with these methods among neuroimaging researchers and clinicians will be important to channel and harness the vast potential of this new method.
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Affiliation(s)
- G Zaharchuk
- From the Departments of Radiology (G.Z., M.W., D.R., C.P.L.)
| | - E Gong
- Electrical Engineering (E.G.), Stanford University and Stanford University Medical Center, Stanford, California
| | - M Wintermark
- From the Departments of Radiology (G.Z., M.W., D.R., C.P.L.)
| | - D Rubin
- From the Departments of Radiology (G.Z., M.W., D.R., C.P.L.)
| | - C P Langlotz
- From the Departments of Radiology (G.Z., M.W., D.R., C.P.L.)
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46
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Sjöström C, Lundin A. [Not Available]. Lakartidningen 2018; 115:EY9U. [PMID: 29381179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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47
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Chopard I, Benninger D, Demonet JF, Du Pasquier R, Hirt L, Kuntzer T, Michel P, Nater B, Novy J, Rossetti A, Rouaud O, Ryvlin P, Schluep M, Theaudin M. [Neurology]. Rev Med Suisse 2018; 14:58-61. [PMID: 29337452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Ocrelizumab (Ocrevus), an anti-CD20 monoclonal antibody, has been approved for the treatment of multiple sclerosis. Eculizumab (Soliris) has been approved in several countries for refractory forms of generalized seropositive severe myasthenia gravis. A form of gene therapy, patisiran, has shown positive results in transthyretin familial amyloidosis. In the treatment of headaches, particularly migraines, non-pharmacological approaches have shown some interesting results. The criteria for Lewy body dementia have been revised. Generic use of lamotrigine does not result in recrudescence of epileptic seizures or adverse effects.
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Affiliation(s)
- Isabelle Chopard
- Service de neurologie, Département des neurosciences cliniques, CHUV, 1011 Lausanne
| | - David Benninger
- Service de neurologie, Département des neurosciences cliniques, CHUV, 1011 Lausanne
| | | | - Renaud Du Pasquier
- Service de neurologie, Département des neurosciences cliniques, CHUV, 1011 Lausanne
| | - Lorenz Hirt
- Service de neurologie, Département des neurosciences cliniques, CHUV, 1011 Lausanne
| | - Thierry Kuntzer
- Service de neurologie, Département des neurosciences cliniques, CHUV, 1011 Lausanne
| | - Patrik Michel
- Service de neurologie, Département des neurosciences cliniques, CHUV, 1011 Lausanne
| | - Bernard Nater
- Service de neurologie, Département des neurosciences cliniques, CHUV, 1011 Lausanne
| | - Jan Novy
- Service de neurologie, Département des neurosciences cliniques, CHUV, 1011 Lausanne
| | - Andrea Rossetti
- Service de neurologie, Département des neurosciences cliniques, CHUV, 1011 Lausanne
| | - Olivier Rouaud
- Service de neurologie, Département des neurosciences cliniques, CHUV, 1011 Lausanne
| | - Philippe Ryvlin
- Service de neurologie, Département des neurosciences cliniques, CHUV, 1011 Lausanne
| | - Myriam Schluep
- Service de neurologie, Département des neurosciences cliniques, CHUV, 1011 Lausanne
| | - Marie Theaudin
- Service de neurologie, Département des neurosciences cliniques, CHUV, 1011 Lausanne
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48
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Editorial: Advancements in Neurodiagnostic Technologies and Their Impact on Technologists. Neurodiagn J 2018; 58:139. [PMID: 30257176 DOI: 10.1080/21646821.2018.1508982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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49
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Abstract
Mental, neurological, and neurodevelopmental (MNN) disorders impose an enormous burden of disease globally. Many MNN disorders follow a developmental trajectory. Thus, defining symptoms of MNN disorders may be conceived as the end product of a long developmental process. Many pharmaceutical therapies are aimed at the end symptoms, essentially attempting to reverse pathological brain function that has developed over a long time. A new paradigm is needed to leverage the developmental trajectory of MNN disorders, based on measuring brain function through the life span. Electroencephalography (EEG) is ideally suited for this task. New developments in several fields, including consumer EEG hardware, ubiquitous access to the Internet and electronic health records, and nonlinear mathematics to extract information from physiological signals have converged to enable new approaches to integrating EEG into routine health care. Research continues to demonstrate that EEG analysis can be used to discover digital biomarkers for a wide range of MNN disorders, including autism, attention-deficit/hyperactivity disorder (ADHD), schizophrenia and dementias, and likely many others. When EEG-derived information about brain function is stored with an electronic health record, clinical decision support software may use these data to detect atypical brain development in the earliest stages, thus opening a potential window for early intervention. These developments create an opportunity for neurodiagnostics to merge with biomedical informatics to create clinical tools for monitoring brain function through the life span. Advanced professionals with neurodiagnostics and biomedical informatics skills and training are needed to lead the way in this emerging field.
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Affiliation(s)
- William J Bosl
- a Health Informatics and Clinical Psychology Programs University of San Francisco , San Francisco , California
- b Computational Health Informatics Program Boston Children's Hospital , Boston , Massachusetts
- c Department of Pediatrics Harvard Medical School , Boston , Massachusetts
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50
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Hainline B, Stern RA. Future directions. Handb Clin Neurol 2018; 158:473-480. [PMID: 30482374 DOI: 10.1016/b978-0-444-63954-7.00043-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Brian Hainline
- National Collegiate Athletic Association, Indianapolis, IN, United States.
| | - Robert A Stern
- Departments of Neurology, Neurosurgery, and Anatomy and Neurobiology, and Boston University Alzheimer's Disease Center and CTE Center, Boston University School of Medicine, Boston, MA, United States
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