Open access. Patients with Parkinson’s disease (PWP) have complex healthcare needs, and compared to the general population, are more likely to have an unplanned emergency department (ED) attendance to hospital, along with poorer outcomes. Innovative methods of notification, when patients have an ED attendance are needed to allow for earlier specialist team interventions. This study describes the introduction of an email alert (e-alert) for a specialist Parkinson’s team in Wales. In addition, the reason for admission, specialist team interventions, length of stay, frequency of readmission, discharge destination, mortality and the bed cost per ED attendance or admission episode will be explored.
This commentary is on the original article by Brenton et al.. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
To establish international expert recommendations on clinical features to prompt referral for diagnostic assessment of cerebral palsy (CP). . To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
In the context of the development of an International Classification of Functioning, Disability and Health (ICF) Core Set for adults with cerebral palsy (CP), this systematic review sought to identify the outcome measures used in studies on adults with CP, to examine their content using the ICF as a reference, and to demonstrate the most studied areas in this population.. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
To describe fatigue in Duchenne muscular dystrophy (DMD) from patients’ and parents’ perspectives and to explore risk factors for fatigue in children and adolescents with DMD.. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
To evaluate fatigue, depression, and quality of life (QoL) of children with multiple sclerosis and compare to other acute demyelinating syndromes (ADS).. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
To evaluate neuropsychiatric comorbidities in children and adolescents with hypothalamic hamartoma.. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
Parkinson's disease (PD) is a progressive neurodegenerative disease that often impedes activities of daily living (ADL) and social functioning. Impairment in these areas can alter social roles by interfering with employment status, household management, friendships and other relationships. Understanding how PD affects social functioning can help clinicians choose management strategies that mitigate these changes.. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
A clinical trial involving two leading children’s nurses is aiming to find the best treatment approaches for epilepsy. To read the full article, log in using your MPFT NHS OpenAthens details.
The neurodegenerative syndrome amyotrophic lateral sclerosis (ALS) is characterised by increased cortical excitability, thought to reflect pathological changes in the balance of local excitatory and inhibitory neuronal influences. Non-invasive brain stimulation (NIBS) has been shown to modulate cortical activity, with some protocols showing effects that outlast the stimulation by months. NIBS has been suggested as a potential therapeutic approach for disorders associated with changes in cortical neurophysiology, including ALS. This article reviews NIBS methodology, rationale for its application to ALS and progress to date.. To read the full article, log in using your NHS OpenAthens details.
Although not typical of Parkinson’s disease (PD), caudate dopaminergic dysfunction can occur in early stages of the disease. However, its frequency and longitudinal implications in large cohorts of recently diagnosed patients remain to be established. We investigated the occurrence of caudate dopaminergic dysfunction in the very early phases of PD (<2 years from diagnosis) using 123I-FP-CIT single photon emission CT and determined whether it was associated with the presence or subsequent development of cognitive impairment, depression, sleep and gait problems.. To read the full article, log in using your NHS OpenAthens details.
Unilateral radiofrequency subthalamotomy has been shown to improve the cardinal features of Parkinson’s disease (PD).1 However, this approach has not been widely employed because most surgical candidates require bilateral treatment such as deep brain stimulation. Here, we evaluated to what extent the therapeutic impact of unilateral radiofrequency subthalamotomy on the treated body side is maintained years after surgery. This is particularly relevant nowadays because of the newly developed technique of MRI-guided high-intensity focused ultrasound (MRIgFUS). This has been shown to effectively improve essential and parkinsonian tremor by thalamotomy2 and all cardinal features of PD in asymmetrical patients by . To read the full article, log in using your NHS OpenAthens details.
Natalizumab is a disease-modifying therapy (DMT) used in relapsing-remitting multiple sclerosis (RRMS), licenced for use in patients with highly-active disease. It is an α4-integrin receptor antagonist that decreases activated T cell migration across the blood-brain barrier.1 Natalizumab carries a risk of progressive multifocal leucoencephalopathy (PML)—a risk that increases with duration of treatment; John Cunningham Virus (JCV) seropositivity and higher index values; prior use of immunosuppression.1...... To read the full article, log in using your NHS OpenAthens details.
As new migraine prevention treatments are developed, the onset of a preventive effect, how long it is maintained and whether patients initially non-responsive develop clinically meaningful responses with continued treatment can be assessed.. To read the full article, log in using your NHS OpenAthens details.
Current guidelines from the American Heart Association/American Stroke Association advocate against the administration of intravenous thrombolysis (IVT) in patients with acute ischaemic stroke (AIS) with a prior ischaemic stroke (IS) within 3 months (Class III: Level of Evidence B).1 This concern is based on a presumed increased risk of symptomatic intracranial haemorrhage (sICH) and mortality2 and therefore led to the respective guideline recommendation. Thus, patients with a history of prior IS have been excluded in the majority of the pivotal randomised controlled clinical trials that have established IVT as a treatment for . To read the full article, log in using your NHS OpenAthens details.
To explore the barriers to and facilitators of physical activity for young people with cerebral palsy in specialist schools.. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
Common childhood mental health disorders are up to five times more frequent in children with neurological conditions than in those without a chronic illness, yet ‘contemporary standards of practice fail to integrate screening and treatment of the comorbidities into routine clinical care’1 and there is a high unmet need for treatment.2 This situation is not unique to neurological conditions; up to 80% of those with a chronic illness and symptoms of a mental health disorder are not in contact with child and adolescent mental health services.3–6 Left untreated, mental health disorders seriously impact social, occupational and educational functioning into adulthood.7 8..... To read the full article, log in using your NHS OpenAthens details.
Letter. Understanding the mechanism of psychogenic non-epileptic seizures (PNES) is challenging. A recent review grouped currently hypothesised psychological models into four: (1) traumatic dissociation, (2) hard-wired anxious-arousal responses, (3) conversion defences and (4) conditioned behaviours, but concluded that determining which of these was correct, if any, went far beyond the available evidence.1 . To read the full article, log in using your NHS OpenAthens details.
The association between allergy and multiple sclerosis (MS) is still unclear. In our study, we assessed the association between a self-reported history of allergic conditions with MS clinical and MRI disease activity.. To read the full article, log in using your NHS OpenAthens details.
Editorial commentary. The evidence on the association between allergies and multiple sclerosis (MS) disease activity is scarce. In this issue of JNNP , Fakih and colleagues report that patients with MS and food allergies have a higher disease activity compared with patients with no known allergies.
Both genetic and lifestyle/environmental factors are known to contribute to the development and the severity of MS.1 Previously, a series of studies addressed the relationship between food allergies and MS risk with conflicting results.2
In their JNNP article, Fakih et al 3 show that patients with MS and self-reported food allergies have more relapses and a higher likelihood of gadolinium-enhancing lesions compared with patients with no known allergies.. To read the full article, log in using your NHS OpenAthens details.
Open access. Fatigue is one of the most common symptoms in multiple sclerosis (MS), with a major impact on patients’ quality of life. Currently, treatment proceeds by trial and error with limited success, probably due to the presence of multiple different underlying mechanisms. Recent neuroscientific advances offer the potential to develop tools for differentiating these mechanisms in individual patients and ultimately provide a principled basis for treatment selection. However, development of these tools for differential diagnosis will require guidance by pathophysiological and cognitive theories that propose mechanisms which can be assessed in individual patients. This article provides an overview of contemporary pathophysiological theories of fatigue in MS and discusses how the mechanisms they propose may become measurable with emerging technologies and thus lay a foundation for future personalised treatments.
To assess the role of body mass index (BMI) and of the rate of weight loss as prognostic factors in amyotrophic lateral sclerosis (ALS) and to explore the clinical correlates of weight loss in the early phases of the disease.. To read the full article, log in using your NHS OpenAthens details.
Global hippocampal atrophy is a hallmark of Alzheimer’s dementia and has been similarly reported in Parkinson’s disease dementia (PDD). However, there is limited literature on the differential involvement of hippocampal subfields in predicting conversion to PDD. This study is an extension of previous findings on progression to mild cognitive impairment in Parkinson’s disease (PD).. To read the full article, log in using your NHS OpenAthens details.
Free access. Psychosis of epilepsy (POE) occurs more frequently in temporal lobe epilepsy, raising the question as to whether abnormalities of the hippocampus are aetiologically important. Despite decades of investigation, it is unclear whether hippocampal volume is reduced in POE, perhaps due to small sample sizes and methodological limitations of past research.
Several features of amyotrophic lateral sclerosis (ALS) impact on sexuality and intimate relationship; however, the issue has received poor attention so far. We performed a systematic literature review in order to provide an up-to-date account of sexuality in ALS.. To read the full article, log in using your NHS OpenAthens details.
NICE’s new guideline is the first to offer comprehensive information on neurological conditions to help non-specialist healthcare professionals to identify people who should be referred for specialist assessment and care.
Importance - Uncertainty remains about how aggressively to treat early multiple sclerosis. High-efficacy disease-modifying therapies (DMTs) are often reserved for individuals expressing poor prognostic features at baseline.
Objective To analyze long-term outcomes in a population-based cohort according to initial treatment strategy.. Please contact the library to request a copy of this article - http://bit.ly/2HjNDf3
Open access. Although not typical of Parkinson’s disease (PD), caudate dopaminergic dysfunction can occur in early stages of the disease. However, its frequency and longitudinal implications in large cohorts of recently diagnosed patients remain to be established. We investigated the occurrence of caudate dopaminergic dysfunction in the very early phases of PD (<2 years from diagnosis) using 123I-FP-CIT single photon emission CT and determined whether it was associated with the presence or subsequent development of cognitive impairment, depression, sleep and gait problems.
Experimental and Clinical Psychopharmacology (May 23, 2019). DOI:10.1037/pha0000281
Chronic pain states have resulted in an overreliance on opioid pain relievers, which can carry significant risks when used long term. As such, alternative pain treatments are increasingly desired. Although emerging research suggests that cannabinoids have therapeutic potential regarding pain, results from studies across pain populations have been inconsistent. To provide meta-analytic clarification regarding cannabis’s impact on subjective pain, we identified studies that assessed drug-induced pain modulations under cannabinoid and corresponding placebo conditions. To read the full article, log in using your NHS OpenAthens details.
Psychiatric Rehabilitation Journal (May 9, 2019). DOI:10.1037/prj0000361
Objective: A subset of military veterans who have experienced both traumatic brain injury and psychological trauma present with chronic neuropsychiatric symptoms and experience persistent obstacles to social reintegration. This project aimed to develop a novel treatment targeting the unmet social rehabilitation needs of these veterans.. To read the full article, log in using your NHS OpenAthens details.
Cerebral palsy (CP) is a complex disorder and children frequently have multiple impairments. Dystonia is a particularly frustrating impairment that interferes with rehabilitation and function and is difficult to treat. Of the available treatments, deep brain stimulation (DBS) has emerged as an option with the potential for large effect size in a subgroup of children. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
To develop an easily‐administered metric to quantify gait impairment in children and to assess its use in children with cerebral palsy (CP).. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
To evaluate short‐term (1y postoperatively; E1) and long‐term (at least 4y postoperatively; E2) changes in hamstring muscle‐tendon length (MTL) and lengthening velocity after hamstring lengthening in children with bilateral cerebral palsy (CP).. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
The research suggests that strobe lighting at festivals might increase the risk of seizures for people predisposed to photosensitive epilepsy.
For that reason it would be sensible for people who have photosensitive epilepsy to take precautions to avoid seizures by avoiding events with strobe lighting, being aware of early warning "aura" symptoms, and being ready to leave events if they start to feel unwell.
It's very hard to be sure of the exact level of risk that may be associated with any class or individual drug.
It's also worth considering that this study has looked at people prescribed anticholinergics in older age who were diagnosed with dementia at around 82 years. We cannot apply this data to give the risk for a younger adult taking one of these drugs.
This is a valuable study that furthers our understanding of the brain changes that may occur before any symptoms of Parkinson's disease develop. However, before concluding that measuring serotonin activity is a way of detecting who's likely to develop Parkinson's, it's important to set this finding in the right context.
For the vast majority of people who develop Parkinson's, the cause is unclear. Families with gene mutations that place them at strong hereditary risk of the condition are very rare.
To investigate long‐term development of hand function after repeated botulinum neurotoxin A (BoNT‐A) and occupational therapy at a young age.. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
To characterize fatigue in children with hemiparesis with perinatal stroke and explore associations with measures of motor performance and corticospinal excitability.. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
Free access. Persons with Parkinson’s disease (PwP) have many known risk factors for suicide and suicidal ideation (SI). Despite this, there is limited understanding of suicidality in this population. We conducted a systematic review to synthesise the available literature on suicidality in PwP and highlight areas for potential intervention and further research. We identified 116 articles discussing SI, suicidal behaviours, suicide attempts and/or fatal suicide in PwP. These articles describe prevalence, suicide methods, risk factors for suicide and SI and treatment of suicidality. In this review, we summarise the current literature and provide suggestions for how clinicians can identify and treat PwP who are at risk for suicide, for example, through aggressive treatment of depression and improved screening for access to lethal means.
Open access. Non-invasive neuromodulation therapies for migraine and cluster headache are a practical and safe alternative to pharmacologics. Comparisons of these therapies are difficult because of the heterogeneity in study designs. In this systematic review of clinical trials, the scientific rigour and clinical relevance of the available data were assessed to inform clinical decisions about non-invasive neuromodulation.
Open access. Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease of the motor system. The split hand sign in ALS refers to observed preferential weakness of the lateral hand muscles, which is unexplained. One possibility is larger cortical representation of the lateral hand compared with the medial. Biceps strength is usually preserved relative to triceps in neurological conditions, but biceps has a larger cortical representation and might be expected to show preferential weakness in ALS.
In 2017, the diagnostic criteria for cognitive and behavioural impairment in amyotrophic lateral sclerosis (ALS) with frontotemporal dementia (ALSFTD-1) have been modified (ALSFTD-2) with the inclusion of a novel category (ALS with combined cognitive and behavioural impairment, ALScbi) and with changes of operational criteria of the other categories (ALS with cognitive impairment (ALSci), ALS with behavioural impairment (ALSbi) and ALS with frontotemporal dementia (ALS-FTD)). We compared the two sets of criteria to assess the effect of the revised criteria on the cognitive classification of patients with ALS.. To read the full article, log in using your NHS OpenAthens details.
Free access. Sodium (23Na)-MRI is an emerging imaging technique to investigate in vivo changes in tissue viability, reflecting neuroaxonal integrity and metabolism. Using an optimised 23Na-MRI protocol with smaller voxel sizes and improved tissue contrast, we wanted to investigate whether brain total sodium concentration (TSC) is a biomarker for long-term disease outcomes in a cohort of patients with relapse-onset multiple sclerosis (MS), followed from disease onset.
Benign multiple sclerosis (BMS) is often defined by the Expanded Disability Status Scale (EDSS) score of ≤3.0 after ≥15 years of disease duration. This classification’s clinical relevance remains unclear as benign patients may suffer other impairments and advance towards a progressive course, prompting our objective to holistically investigate factors associated with BMS and its long-term prognosis.. To read the full article, log in using your NHS OpenAthens details.
Open access. The high degree of clinical overlap between atypical parkinsonian syndromes (APS) and Parkinson’s disease (PD) makes diagnosis challenging. We aimed to identify novel diagnostic protein biomarkers of APS using multiplex proximity extension assay (PEA) testing.