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Sommaires des Revues - The Lancet Neurology

The Lancet Neurology


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[Editorial] WHO has a dementia plan, now we need action  Voir?

Dementia is a growing global challenge. Around 47 million people worldwide were estimated to be living with dementia in 2015, with 60% in low-income or middle-income countries; by 2030, the number of people with dementia is expected to reach 75 million, at a cost of US$2 trillion. Recognising the need for action, on May 29, 2017, delegates at the 70th World Health Assembly in Geneva, Switzerland, voted to adopt a Global Action Plan on the public health response to dementia. For this decision to be a useful step towards reducing the burden of dementia, meaningful action must now follow.

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[Comment] Simvastatin and cognition in multiple sclerosis  Voir?

Few treatment options are available for patients with progressive multiple sclerosis,1 in whom anti-inflammatory drugs have little effect and for whom clinical manifestations, such as cognitive impairment and neuropsychiatric dysfunction, have a dramatic effect on quality of life. Preservation of functional and social independence are perhaps the main therapeutic goals in these patients.

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[Comment] Potential biomarker breakthrough for Huntington's disease  Voir?

Huntington's disease, with a single genetic cause and correlation between age of onset and length of the CAG repeat in the huntingtin gene (HTT), has long served as a model for neurodegenerative diseases. Predictive genetic testing has made it possible to define the natural history of the disease and to show that regional brain atrophy, especially of the striatum, begins many years before diagnosable motor onset and progresses steadily through the premanifest and manifest periods.1–3 Structural neuroimaging enables excellent tracking of progressive atrophy; however, it requires an expensive apparatus and does not provide a direct chemical reflection of brain injury.

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[Comment] Deep brain stimulation in Tourette's syndrome: new insights  Voir?

Hallmarked by multiple motor and phonic tics, Tourette's syndrome is a remarkable neuropsychiatric disease. The syndrome often involves diverse psychiatric comorbidities and coexisting psychopathologies1 and seemingly relates to fronto-striato-thalamo-cortical dysfunction.2 Although deep brain stimulation (DBS) is well established as an effective therapy for other hyperkinetic movement disorders, it has so far been tested in only a few patients with severe Tourette's syndrome. Thus, most of the studies that have been reported have been small and uncontrolled trials, applying DBS to different structures within the fronto-striato-thalamo-cortical loop, and the effects on motor symptom relief have varied.

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[Comment] A new tool to identify patients with Parkinson's disease at increased risk of dementia  Voir?

Many patients with Parkinson's disease develop dementia; some patients develop dementia within the first 5 years after diagnosis of Parkinson's disease, whereas others remain free of dementia for more than 10–15 years after diagnosis.1 Identification of individuals at the highest risk of early dementia is important for the development of targeted intervention strategies for the primary prevention of dementia and for enabling future planning for patients, carers, and delivery of true personalised medicine.

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[Comment] Adding insight to injury: a new era in neurotrauma  Voir?

Traumatic brain injury (TBI) is an age-old disease, and core principles that still guide its management were identified centuries ago. The Edwin–Smith Papyrus describes the use of neurological examinations to classify injury severity, localise lesions, identify intracranial hypertension, triage patients, and predict outcome from as early as 3000–2500 BC.1 Progress in management came in 1744 with the first report of an external ventricular drain for CSF diversion,2 and shortly afterwards, the fundamental Monro–Kellie hypothesis was proposed, which described the pressure–volume association between intracranial pressure and the volumes of CSF, blood, and brain tissue in a fixed intracranial space.

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[Comment] Diagnostic biomarkers for Alzheimer's disease: a regulatory view  Voir?

Health-care systems worldwide face an unprecedented challenge in dealing with the unmet needs of dementia diagnosis. Dementia is a clinical concept, and the diagnosis of Alzheimer's disease remains essentially based on clinical symptoms, despite the neuropathological end state of the condition being known. Several potential diagnostic biomarkers for Alzheimer's disease have been assessed in cohort studies.1 However, for any disorder, the usefulness of biomarkers is only as good as the understanding of the disease process.

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[Comment] Genomic profiling and diagnostic biomarkers in Alzheimer's disease  Voir?

Biomarkers will be essential in identifying individuals with prodromal Alzheimer's disease and stratifying participants in clinical trials. In a Policy View in The Lancet Neurology, Giovanni Frisoni and colleagues1 set out the evidence on Alzheimer's disease diagnostic biomarkers, using a framework previously developed in oncology. Their comprehensive review of neuroimaging and CSF biomarkers draws attention to the lack of common standards and clinical validation across health systems, and the subsequent effects on diagnosis.

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[Comment] Thank you to our peer reviewers in 2016  Voir?

For the thirteenth consecutive year, The Lancet Neurology has maintained its position as the leading journal in the clinical neurology category, according to the 2016 Journal Citation Report released by Thomson Reuters. We owe this achievement to our authors for their outstanding Articles and Reviews, but also to our clinical and statistical reviewers for their tireless support in guiding the journal and its content.

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[Corrections] Corrections  Voir?

Bertini E, Dessaud E, Mercuri E, et al, for the Olesoxime SMA Phase 2 Study Investigators. Safety and efficacy of olesoxime in patients with type 2 or non-ambulatory type 3 spinal muscular atrophy:a randomised, double-blind, placebo-controlled phase 2 trial. Lancet Neurol 2017; 17: 513–22—In the methods section of the summary, the penultimate sentence should read “Safety was assessed in all patients who received one or more doses of the study drug.” The fifth sentence of the first paragraph of the Results section should say “Protocol violations occurred in 32 patients (21 [20%] receiving olesoxime…” and the sixth sentence should say “(olesoxime n=9 and placebo n=6)…” The penultimate column heading in table 2 has been corrected to “95% CI” and the following footnote has been added to the table “*=96% CI”.

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[Corrections] Corrections  Voir?

Charlier P, Saudamini D, Lippi D, Perciaccante A, Appenzeller O, Bianucci R. The cerebrovascular health of Thomas Aquinas. Lancet Neurol 2017; 16: 502—In this Focal point, the first sentence should be “On Dec 6, 1273, the theologian and philosopher Thomas Aquinas had visions and experienced a spiritual transformation that radically affected his subsequent behaviour.1–3” This correction has been made to the online version as of July 11, 2017.

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[Corrections] Corrections  Voir?

Lamberink HJ, Otte WM, Geerts AT, et al. Individualised prediction model of seizure recurrence and long-term outcomes after withdrawal of antiepileptic drugs in seizure-free patients: a systematic review and individual participant data meta-analysis. Lancet Neurology 2017; 16: 523–31—In the ‘Instructions’ box within figure 3A (Nomogram to predict seizure recurrence after antiepileptic drug withdrawal), point 3 should not refer to the 2-year and 5-year recurrence risk, but to the 10-year chance of seizure freedom.

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[Corrections] Corrections  Voir?

Aarsland D, Creese B, Chaudhuri KR. A new tool to identify patients with Parkinson's disease at increased risk of dementia. Lancet Neurol 2017; 16: 576–78—In this Comment (published online on June 16), Byron Creese's affiliation should have been University of Exeter Medical School, University of Exeter, Exeter, UK. This correction has been made to the online version as of July 11, 2017, and the printed comment is correct.

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[Correspondence] Lessons from the Multidomain Alzheimer Preventive Trial  Voir?

The Multidomain Alzheimer Preventive Trial (MAPT) investigators should be commended for their work on one of the larger and longer duration multicentre trials to investigate dementia prevention.1 The results of MAPT showed no significant effects with any of the three treatment interventions compared with placebo on the primary outcomes, the 15 secondary outcomes (except for one comparison of combined intervention with placebo on the ten item Mini-Mental State Examination, p=0·036), or on five of seven prespecified and exploratory subgroup analyses, which compared a multidomain intervention combined with omega 3 polyunsaturated fatty acids or placebo, or omega 3 capsules alone, against placebo capsules in old adults with memory complaints.

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[Correspondence] Lessons from the Multidomain Alzheimer Preventive Trial – Authors' reply  Voir?

We thank Hussein Yassine and Lon Schneider for their interest in the MAPT trial1 and their analysis of its contribution to research on the prevention of cognitive decline. Given the nature of the intervention, it would have been virtually impossible for the multidomain component of our intervention to be double-blind. We acknowledge that this is a limitation of our study, as underlined in the discussion section of the Article.1 However, we made every effort to make sure that the trial was at least single-blind by using blinded evaluators and asking participants not to disclose their multidomain group assignment to these evaluators.

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[In Context] A better, fairer, and safer world for people with dementia  Voir?

There are an estimated 50 million people with dementia worldwide. This number is projected to double every 20 years. Jules Morgan reports on initiatives to create dementia-inclusive communities, and changing attitudes towards people living with dementia.
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[In Context] Henrik Zetterberg: biomarking neurological disorders  Voir?

Henrik Zetterberg's steady outlook on life could date back to his tranquil upbringing close to the Gothenburg archipelago in Sweden. His parents inspired his love of nature, which would eventually translate into a love of science and a medical degree. Today, he is Professor of Neurochemistry, senior consultant of clinical chemistry, and head of the Department of Psychiatry and Neurochemistry at the University of Gothenburg (Gothenburg, Sweden), where he is also co-lead of the Clinical Neurochemistry Laboratory with long-time friend Kaj Blennow.

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[In Context] Juan Fortea  Voir?

Juan Fortea is a neurologist and dementia expert at the Hospital of Sant Pau and Catalan Down Syndrome Foundation, both in Barcelona, Spain. His main research interest is investigating the preclinical phase of sporadic and genetically determined Alzheimer's disease. He has received several awards, including the Best Young Neurologist in Dementia from the Spanish Neurological Society and the Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas award to the Best Young Neurologist.

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[In Context] Hildegard of Bingen's remedies for Parkinson's disease  Voir?

Hildegard of Bingen (1098–1179) was a German abbess who is considered to be the founder of the natural history field in Germany. Hildegard's medical writings were collected in two works called Physica (Natural History) and Causae et curae (Causes and Remedies). Physica is an inventory of natural therapies describing the healing properties of various plants, animals, and minerals. In the section devoted to zedoary (Curcuma zedoaria), the reader can find the following statements:

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[In Context] A new non-surgical approach for deep-brain stimulation  Voir?

Although deep brain stimulation (DBS) can provide meaningful improvement in appropriately selected patients with movement disorders, the procedure is not risk free, and highly trained comprehensive management teams are required for patient screening, surgery, and postoperative management. To date, non-invasive strategies to replicate the therapeutic benefits of DBS have been limited to ablative high-intensity focused ultrasound. Grossman and colleagues now describe a non-surgical method for DBS by use of oscillating electric fields and temporal interference.

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[Articles] Effect of high-dose simvastatin on cognitive, neuropsychiatric, and health-related quality-of-life measures in secondary progressive multiple sclerosis: secondary analyses from the MS-STAT randomised, placebo-controlled trial  Voir?

To our knowledge, this SPMS cohort is the largest studied to date with comprehensive longitudinal cognitive, neuropsychiatric, and HRQoL assessments. We found evidence of a positive effect of simvastatin on frontal lobe function and a physical quality-of-life measure. Although we found no effect of simvastatin on the other outcome measures, these potential effects warrant confirmation and underline the importance of fully assessing cognition and quality of life in progressive multiple sclerosis treatment trials.

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[Articles] Neurofilament light protein in blood as a potential biomarker of neurodegeneration in Huntington's disease: a retrospective cohort analysis  Voir?

NfL in plasma shows promise as a potential prognostic blood biomarker of disease onset and progression in Huntington's disease.
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[Articles] Anterior pallidal deep brain stimulation for Tourette's syndrome: a randomised, double-blind, controlled trial  Voir?

3 months of aGPi DBS is insufficient to decrease tic severity for patients with Tourette's syndrome. Future research is needed to investigate the efficacy of aGPi DBS for patients over longer periods with optimal stimulation parameters and to identify potential predictors of the therapeutic response.

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[Articles] Prediction of cognition in Parkinson's disease with a clinical–genetic score: a longitudinal analysis of nine cohorts  Voir?

Our predictive algorithm provides a potential test for future cognitive health or impairment in patients with Parkinson's disease. This model could improve trials of cognitive interventions and inform on prognosis.
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[Series] Coagulopathy and haemorrhagic progression in traumatic brain injury: advances in mechanisms, diagnosis, and management  Voir?

Normal haemostasis depends on an intricate balance between mechanisms of bleeding and mechanisms of thrombosis, and this balance can be altered after traumatic brain injury (TBI). Impaired haemostasis could exacerbate the primary insult with risk of initiation or aggravation of bleeding; anticoagulant use at the time of injury can also contribute to bleeding risk after TBI. Many patients with TBI have abnormalities on conventional coagulation tests at admission to the emergency department, and the presence of coagulopathy is associated with increased morbidity and mortality.

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[Review] Music-based interventions in neurological rehabilitation  Voir?

During the past ten years, an increasing number of controlled studies have assessed the potential rehabilitative effects of music-based interventions, such as music listening, singing, or playing an instrument, in several neurological diseases. Although the number of studies and extent of available evidence is greatest in stroke and dementia, there is also evidence for the effects of music-based interventions on supporting cognition, motor function, or emotional wellbeing in people with Parkinson's disease, epilepsy, or multiple sclerosis.

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[Policy View] Strategic roadmap for an early diagnosis of Alzheimer's disease based on biomarkers  Voir?

The diagnosis of Alzheimer's disease can be improved by the use of biological measures. Biomarkers of functional impairment, neuronal loss, and protein deposition that can be assessed by neuroimaging (ie, MRI and PET) or CSF analysis are increasingly being used to diagnose Alzheimer's disease in research studies and specialist clinical settings. However, the validation of the clinical usefulness of these biomarkers is incomplete, and that is hampering reimbursement for these tests by health insurance providers, their widespread clinical implementation, and improvements in quality of health care.

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Dernière mise à jour : 26/07/2017 : 21:20


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