Open access. Functional non-epileptic attacks (FNEA) are seizure-like events occurring in the absence of epilepsy. Having had many different names over the years including dissociative convulsions and pseudo-seizures, they now fall in the borderland between neurology and psychiatry, often not accepted by either specialty. However, there is evidence that there is a high rate of psychiatric comorbidity in these patients and therefore it is likely that psychiatrists will come across patients with FNEA and they should know the broad principles of assessment and management.
Sexuality and intimacy are poorly researched in both people living with Parkinson's and in older people. Triggers for discussion usually centre on sexual dysfunction and hypersexuality in relation to Parkinson's. However, there are many more factors that impact on physical and emotional connectedness. Despite highlighting this unmet need there are limited tools or comprehensive assessments available to help improve quality of life. To read the full article, log in using your MPFT NHS OpenAthens details.
Neuro Patience presents the findings of the 2018/19 National Neurology Patient Experience Survey. The report covers three main themes – accessible, personalised and holistic care and support (which includes social care, mental health and financial security). Overall the 2018/19 results show that people’s experiences remain poor.
As a precautionary measure, patients taking certain types of prescription-only medicines for Parkinson’s (Neupro), epilepsy (Vimpat) and blood clots (Clexane) are asked to check to see if they have products from batches of medicines which are being recalled.
This narrative review describes a range of techniques invented by patients with Parkinson disease to mitigate gait disorders, including freezing of gait.. Please contact the library to request a copy of this article - http://bit.ly/2HjNDf3
Letter. Mutations in the l eucine-rich repeat kinase 2 (LRRK2) gene are an important monogenic cause of Parkinson’s disease (PD). Reported non-motor features of LRRK2 PD include depression, anxiety and bipolar disorder,1 but suicide has not been systematically investigated. As part of our LRRK2 Ashkenazi Jewish Consortium study we assessed the history of death by suicide in probands and first-degree relatives with and without LRRK2 G2019S mutations.. To read the full article, log in using your NHS OpenAthens details.
At the interface between mind and body, psychiatry and neurology, functional neurological disorder (FND) remains poorly understood. Formerly dominant stress-related aetiological models have been increasingly challenged, in part due to cases without any history of past or recent trauma. In this perspective article, we review current evidence for such models, and how research into the role of traumatic stress in other disorders and the neurobiology of the stress response can inform our mechanistic understanding of FND.. 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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.