To find out if the brain development of a newborn baby is normal, doctors usually look at among other things a small reflex action, triggered by exerting a tiny amount of pressure on the palm of the hand or the sole of the foot. This little movement in the first months of life provides invaluable information.

Llus Barraquer Roviralta considered the father of neurology in Spain first utilized this technique over a century ago at Sant Pau Hospital in Barcelona. A full 140 years of scientific advances (and three generations of Barraquers) have now passed in the neurology clinics of Sant Pau. Today, specialized services in this area of medicine have taken giant leaps, thanks to the development of imaging technology.

This is the decade of neurology, proclaims Albert Lle, the current director of the department that Barraquer created. The 50-year-old neurologist recently received a lot of media attention after his team successfully treated the 92-year-old former premier of Catalonia, Jordi Pujol, after he suffered a stroke. Pujol was released from hospital last weekend.

This interview has been translated and edited for clarity and brevity.

Question. How has the field of neurology changed in 140 years?

Answer. Neurological disorders are becoming more frequent. Many of these are age-related diseases this is to be expected, given that people are living longer. Its projected that the prevalence of degenerative diseases could triple within the next 30 years.

Q. How has the prognosis of these diseases evolved?

A. Thirty years ago, there were very few diseases that had effective treatment. In most cases, the causes and mechanisms were not well understood. For strokes, there were only antiaggregants, such as aspirin. Practically nothing was known about degenerative diseases. As for neuromuscular diseases, only cortisone or very broad-acting immunosuppressants were available. What has happened in recent years is that more knowledge about the causes has resulted in more effective treatments.

Q. It used to be said that neurologists know all about the diseases, but they cant cure any of them

A. This belief is totally obsolete. There are effective treatments for cerebral vascular diseases, for stopping blood clots from growing or causing problems there are very effective treatments for migraines, theres gene therapy treatment being carried out for spinal muscular atrophy. Perhaps the most difficult diseases to treat are Alzheimers and Parkinsons.

Q. These are good times for neurology, then?

A. We are in a fantastic era, because of the therapeutic tools we have access to. But the rise of neurological diseases is also, in turn, a time bomb, because it can squeeze health services. We have aging populations, a greater prevalence of chronic diseases all of this comes at a very high cost, the treatments arent cheap. This is why its very important to have adequate plans for Alzheimers, for example, or for other neurodegenerative diseases, to prioritize where were going to put the money do we put it into long-term care homes or do we put it in research?

Q. Last week, former Catalan premier Jordi Pujol was proof that strokes can be reversible, even at an advanced age.

A. Today, more and more work is being done on biological age rather than on chronological age. That is, you can be 60 years old, but have the brain of an 80-year-old, because youve had an unhealthy lifestyle.

The rise of neurological diseases is a time bomb, because it can squeeze health services

Q. Mar Castellanos, the head of neurology at A Corua Hospital, said in an interview with EL PAS that strokes dont just take place among the elderly more and more often, they are affecting the working age population. Why is this happening?

A. A stroke is highly influenced by lifestyle: smoking, diabetes, high cholesterol, a sedentary lifestyle, high stress levels age is not the only factor.

Q. Speaking of lifestyle even though were living longer, are we living worse? Are we harming our brain with our habits?

A. I think there is still a lack of awareness regarding the prevention and early detection of neurological diseases. In the case of a stroke, for example, there are people who still think that its not necessary to go to the emergency room, that you can wait and see if it goes away. We see this every day. And why is this happening? Because cardiovascular or cancer prevention campaigns began in the 1970s, but in neurology, they started much later weve been repeating this message for less time. In the case of a stroke, time is brain: the longer it takes to get to the hospital, the more brain damage there will be. Neurological diseases have been largely neglected from the point of view of awareness campaigns and funding.

Q. Theres a kind of knowledge black hole when it comes to neurodegenerative diseases, which still have no treatment. Why?

A. Alzheimers, Parkinsons these are very difficult diseases to study and treat. Sometimes, many years may pass before a person notices the first symptoms. By the time they begin to notice and seek help, there is already significant brain damage. When someone has a tumor, oncologists do a biopsy of the tissue, analyze it and look for viable treatment options. But you cant do a biopsy in the brain: we depend on imaging techniques, which dont have microscopic resolution. We arent able to examine these diseases in detail in the early stages not knowing whats happening during these critical years makes it difficult to find treatments.

In Alzheimers, there are more than 50 genes involved its very difficult to know what the sequence of events is. Even so, I would say that much progress has been made. And its also very clear that the greatest advances have been made in the degenerative diseases that have received the most funding, like Alzheimers and MS. The common thread of all chronic diseases except for strokes is to understand the immune system in our brain, about which very little is known. This will be essential research over the coming decades.

Q. How can the healthcare system remain sustainable?

A. Its necessary to carry out a cost-effectiveness analysis. If we manage to reduce or postpone the onset of Alzheimers for five years with effective treatments, we can reduce the number of total cases and, most importantly, improve peoples quality of life. This has a very high cost, but maybe it will buy patients a few extra years of life outside of long-term care.

Originally posted here:
Time is brain: The longer you take to go to the hospital after a stroke, the worse the damage - EL PAS USA

The NFL Players Association's investigation into why Tua Tagovailoa was allowed to return in Week 3 after appearing to suffer a head injury took a drastic turn Saturday afternoon.

The union fired the independent neurotrauma doctor who was "involved" in the situation at the game between the Miami Dolphins and the Buffalo Bills, according to Pro Football Talk. Tagovailoa suffered what the team announced was a "head injury" after being knocked to the ground, standing up and stumbling before leaving the game. The hit appeared to end Tagovailoa's day, but he ended up returning to the game for the second half to lead the Dolphins to a 21-19 win.

That decision raised a lot of eyebrows and prompted the NFLPA to officially open up an investigation into the incident.

Tagovailoa was reportedly checked for a concussion all week and passed all the necessary tests leading to the Dolphins' Week 4 game against the Cincinnati Bengals just four days later. Tagovailoa suffered another scary-looking injury Thursday night, though, after being slammed to the ground before he was stretchered off the field and taken to a hospital. He was discharged that night and flew home with the team.

The investigation is still ongoing, but the independent doctor and the Dolphins team physician were reportedly interviewed on Friday as part of the investigation, according to NFL Network's Tom Pelissero. The NFLPA reportedly found that the doctor made "several mistakes" during the game.

Tua Tagovailoa is at the center of a major NLFPA investigation. (Photo by Megan Briggs/Getty Images)

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NFLPA reportedly fires independent neurologist who was at Week 3 game where Tua Tagovailoa returned after head injury - Yahoo Sports

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Nathan Carberry, M.D., has joined the University of Miami Health System's Neuromuscular Division as an assistant professor of clinical neurology.

Dr. Carberry studied bioengineering at the University of Pennsylvania and earned his medical degree at New York Medical College, with AOA honors society distinction. He completed his medical internship, neurology residency, and fellowship in clinical neurophysiology (EMG/Neuromuscular Medicine) at Columbia University College of Physicians and Surgeons. Dr. Carberry's clinical and research interests are electrodiagnostic medicine, motor neuron disease, and neuropathy.

Name:Nathan Carberry, M.D.

Title:Assistant Professor of Clinical Neurology, Neuromuscular Division

Clinical Specialties:Neuromuscular medicine (motor neuron disease and neuropathy) and general neurology

Research Interests: Electrodiagnostic medicine, motor neuron disease, and neuropathy

Education:

Certifications:

Languages Spoken:English

Practice Locations:

1150 NW 14th Street- Suite 609

Appointments: 305-243-3100

See the article here:
Dr. Nathan Carberry Joins the Department of Neurology - InventUM | University of Miami Miller School of Medicine

Background

Medical comorbidities and neurological manifestations are commonly associated with COVID-19, though specific relationships remain unclear.

The aim of this study is to investigate the relationship between medical comorbidities and neurological manifestations in patients with COVID-19.

We reviewed medical comorbidities and COVID-19-related central nervous system (CNS) and peripheral nervous system (PNS) manifestations in 484 consecutive patients with COVID-19.

Neurological manifestations were seen in 345 (71%) of 484 COVID-19 patients. CNS manifestations included headaches (22%), altered mental status (19%), dizziness (8%), gait imbalance (5%), strokes (four patients, <1%), and seizures (two patients, <1%). PNS manifestations included myalgia (31%), hypogeusia (8%), hyposmia (6%), critical illness myopathy (nine patients, 2%), visual disturbance (six patients, 1%), rhabdomyolysis (four patients, <1%), and nerve pain (one patient, <1%). There were 153 (32%) patients with CNS manifestations, 98 (20%) patients with PNS manifestations, and 94 (19%) patients with combined CNS and PNS manifestations. Comorbidities such as cardiac disease (22%), dementia (17%), hypertension (16%), and chronic obstructive pulmonary disease (COPD; 13%) were significantly associated with CNS manifestations. No comorbidities were associated with PNS manifestations.

Neurological manifestations were common in our sample of 484 COVID-19 patients, with headache and altered mental status being the most common CNS manifestations and myalgia being the most common PNS manifestation. Cardiac disease, dementia, hypertension, and COPD were more common in patients with CNS manifestations. Providers should be vigilant about the possible emergence of CNS manifestations in COVID-19 patients with these comorbid conditions.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the disease it causes, coronavirus disease 2019 (COVID-19), can present with a range of manifestations such as fever, cough, shortness of breath, fatigue, nausea, vomiting, and diarrhea. Multiple medical comorbidities have been linked to severe disease and mortality, including cardiovascular diseases, cancer, chronic kidney disease, chronic lung diseases, dementia, diabetes mellitus, and obesity. Research has also documented a diverse constellation of central nervous system (CNS) and peripheral nervous system (PNS) manifestations including altered mental status, dizziness, gait imbalance, headache, hyposmia, hypogeusia, seizure, and stroke [1-3]. These neurological signs and symptoms have been reported in more than half of hospitalized patients with COVID-19 and are associated with an increased risk of mortality [1,4,5]. Interestingly, involvement of the CNS and PNS is independent of the severity of the respiratory disease, presenting a challenge for treating neurologists.

While medical comorbidities and neurological manifestations have well-documented associations with COVID-19, there remains much to learn about the specific nature of these relationships. As such, it is important to understand which medical comorbidities increase the risk of neurological manifestations in patients with COVID-19 and whether specific comorbidities increase the risk for CNS or PNS manifestations. This study investigates the association between medical comorbidities and CNS and PNS manifestations in patients with COVID-19 to further elucidate the nature of these relationships.

Data were collected through a clinical chart review of 484 consecutive patients with SARS-CoV-2 infection seen in outpatient clinics and the hospital between February 20, 2020, and July 4, 2020, at EvergreenHealth Medical Center in Kirkland, WA, the first hospital with reported cases in the United States. All patients had SARS-CoV-2 infection confirmed by polymerase chain reaction testing of a nasopharyngeal sample. The study was approved by Western Institutional Review Board, which is our institutional review board and ethics committee.

Data included demographic characteristics, medical history, and presenting manifestations. Only new-onset neurological manifestations were analyzed. Chart notes were independently reviewed by a neurologist and neuropsychologist, and data were cross-referenced for accuracy. Presenting signs and symptoms were reported by patients, family members, care partners, nursing staff, emergency responders, and physicians.

Descriptive statistics (mean [M], standard deviation [SD], percentage) were computed for relevant variables. Categorical variables were presented as absolute values along with percentages and compared using the Pearson 2 test. All tests were two-sided, with a p-value less than 0.05 considered statistically significant. All 345 patients displaying neurological signs and symptoms were divided into three groups: (1) patients with only CNS manifestations, (2) patients with only PNS manifestations, and (3) patients with both CNS and PNS manifestations. Chi-square tests were carried out using Excel functions and null hypothesis. The critical 2 value for comparison of three groups was calculated using two degrees of freedom with a p-value of 0.05. The problem 2 was calculated for each comorbid condition by summing the values calculated using the formula (O-E)2/E for each CNS, PNS, and CNS/PNS groups, where O = observed frequency of CNS, PNS, or CNS/PNS group, and E = expected frequency of the comorbid condition of each of the CNS, PNS, or CNS/PNS group. If the problem 2 value for the comorbid condition is greater than the calculated 2 value of the comorbid condition group, the null hypothesis was rejected, indicating that the difference between observed frequencies and expected frequencies is large enough to be considered statistically significant.

Clinical characteristics and preadmission comorbidities of patients with nervous system involvement are presented in Table 1. Neurological manifestations were seen in 345 (71%) of 484 COVID-19 patients. The average age of patients with neurological manifestations was 59 years (M = 58.8, SD = 20.6). The majority were Caucasian/white (79.4%), with slightly more females (51%). In our sample of 484 COVID-19 patients, there were 153 (32%) patients with CNS manifestations, 98 (20%) patients with PNS manifestations, and 94 (19%) patients with combined CNS and PNS manifestations. CNS manifestations included headaches (107 patients, 22%), altered mental status (92 patients, 19%), dizziness (40 patients, 8%), gait imbalance (23 patients, 5%), strokes (four patients, <1%), and seizures (two patients, <1%). PNS manifestations included myalgia (151 patients, 31%), hypogeusia (38 patients, 8%), hyposmia (27 patients, 6%), critical illness myopathy (nine patients, 2%), visual disturbance (six patients, 1%), rhabdomyolysis (four patients, <1%), and nerve pain (one patient, <1%). The most common comorbid condition associated with CNS manifestations was cardiac disease. Comorbidities such as cardiac disease (108 patients, 22%), dementia (83 patients, 17%), hypertension (76 patients, 16%), and COPD (61 patients, 13%) were significantly associated with CNS manifestations. No comorbidities were associated with PNS manifestations.

In our review of 484 patients with COVID-19 presenting to outpatient clinics and the emergency department, 345 (71%) had neurological manifestations. Of the 345 patients with neurological manifestations, 153 (32%) had CNS manifestations, 98 (20%) had PNS manifestations, and 94 (19%) had both CNS and PNS manifestations. Several comorbid conditions were associated with CNS manifestations (cardiac disease, dementia, hypertension, and COPD), though no comorbidities were associated with PNS manifestations. Our results are largely consistent with those of prior studies and suggest that neurological signs and symptoms are common presenting features of COVID-19 [6-8].

The pathophysiology of neurological manifestations in COVID-19 is mechanistically diverse and includes direct neuroinvasion, immune dysregulation and systemic inflammation, hypoxic-ischemic processes, endothelial damage and microvascular injury, maladaptation of the angiotensin-converting enzyme (ACE2) pathway, and the unique psychosocial impacts of this infection and related pandemic [5,9]. Several studies have reported the presence of SARS-CoV-2 in the cerebral spinal fluid and postmortem brain tissue of COVID-19 patients with encephalitis [10,11]. Early reports suggested that SARS-CoV-2 may gain access through nasal epithelial cells, infiltrating the bloodstream and lymph to reach other tissues [12-15]. However, while the neurotrophic properties of the virus represent one potential route to neurological dysfunction, research indicates that neurological complications are more commonly the result of severe systemic inflammation rather than direct neuroinvasion [16]. Immune-mediated mechanisms influence function of macrophages, microglia, and astrocytes, and are closely related to the development of a systemic inflammatory response. The neurovirulence of COVID-19 correlates with its ability to induce proinflammatory cytokine signals from astrocytes and microglia. SARS-CoV-2 can promote a proinflammatory state by activating glial cells [17]. Virus proliferation in lung tissue may precipitate cerebral hypoxia and anaerobic metabolism, leading to manifestations such as altered mental status, dizziness, gait imbalance, and stroke. This is particularly true for vulnerable individuals such as those with cardiac disease, hypertension, dementia, and COPD [4]. Strokes have been documented extensively in COVID-19 patients, though less than 1% of our patients experienced stroke.

Early research demonstrated that SARS-CoV-2 attaches to ACE2 receptors in the capillary endothelium [18,19], which, in turn, may cause abnormally elevated blood pressure, acute cerebral infarction or hemorrhage, and/or cerebral sinus venous thrombosis. ACE2 is expressed in various organs including the brain, lung, and blood vessels, and plays a role in regulation of a potent vasoactive peptide hormone, angiotensin II. ACE2 also acts as anti-inflammatory, and inhibition of ACE2 results in overactivation of inflammatory pathways. Additionally, psychosocial stressors caused by COVID-19 may also contribute to autonomic dysfunction. Autonomic dysfunction is characterized by elevated sympathetic activity and withdrawal of parasympathetic activity and is a common pathophysiological condition in patients with heart disease, hypertension, and diabetes [20].

Hyposmia is a well-known neurological manifestation of COVID-19. However, hyposmia occurred in only 27 (6%) of our patients, likely due to the older age and high rate of dementia in our sample. Hyposmia may be due to infection of olfactory epithelium and trigeminal nerves by SARS-CoV-2 [21,22]. Altered mental status is another commonly documented CNS manifestation of COVID-19 and occurred in 92 (19%) of our patients. Prior research suggests that altered mental status is a particularly lethal manifestation of COVID-19, specifically in older adults presenting to the emergency department, in most cases causing acute on chronic neurocognitive dysfunction strongly influenced by systemic inflammation and hypoxic-ischemic mechanisms [5].

Our study identified myalgia and headache as the most common neurological manifestations. Limited information exists regarding the mechanisms and timing of headache in patients with COVID-19. Direct viral invasion of the nervous system as well as the cytokine release syndrome can cause headache. Headache may be due to infection of nasal cavity trigeminal nerve endings and/or endothelial cells in the trigeminovascular system, and/or irritation of trigeminal nerve endings due to increased proinflammatory cytokines [23].

The association of comorbid conditions with neurological manifestations has been reported previously; however, the specific association of comorbid conditions with CNS manifestations, PNS manifestations, and combined CNS/PNS manifestations was unclear. Our study finds that several comorbid conditions were associated with CNS manifestations, though no comorbidities were associated with PNS manifestations. It is unclear whether cardiac disease, hypertension, dementia, and/or COPD made these patients more prone to CNS manifestations or whether systemic inflammation and/or other mechanisms led to CNS involvement.

There are limitations of our study that are worth mentioning. As a retrospective study focused on acute neurological manifestations, we lack information regarding persisting problems and outcomes. Furthermore, we lack data on the results of diagnostic studies that could enhance the results of our findings such as results of serology, electroencephalography, and neuroimaging. We also lack data on patient medications, which could also influence treatment options for COVID-19 manifestations.

Medical comorbidities and neurological manifestations are common in COVID-19 patients. The most common CNS manifestations in our sample were headache and altered mental status. The most common PNS manifestation was myalgia. Comorbid conditions such as cardiac disease, dementia, hypertension, and COPD were more prevalent in patients with CNS manifestations. Future research may further investigate CNS and PNS manifestations and their relationships with laboratory studies, electroencephalography, neuroimaging, medications, and patient outcomes.

Our study provides further evidence of neurological involvement in COVID-19. To our knowledge, there are few studies specifically analyzing the association between medical comorbidities and CNS or PNS manifestations in COVID-19. Providers should be vigilant about the possible emergence of CNS manifestations in COVID-19 patients with cardiac disease, hypertension, dementia, and COPD. Proper management of comorbid disease conditions in patients with COVID-19 may minimize CNS manifestations leading to improved outcomes.

Read this article:
A Study on the Correlations Between Comorbid Disease Conditions and Central and Peripheral Neurological Manifestations of COVID-19 - Cureus

Arthur M. Blank Family Residences. (Photo provided by Shepherd Center)

Shepherd Center a private, not-for-profit hospital in Buckhead has announced the launch of a new campaign that will allow it to serve more of its patients who are suffering from neurological illnesses and injuries.

The $350 million campaign, titled Pursuing Possible: The Campaign for Shepherd Center, will go towards funding capital and programmatic projects that will benefit patients who are experiencing neurological illnesses/injuries such as brain injuries, spinal cord injuries, multiple sclerosis, etc.

Shepherd Center says that one of the ways it will be assisting more patients with neurological illnesses/injuries is by expanding the capacity of its inpatient and outpatient programs.

According to the Atlanta hospital, every year it runs into the issue of not having enough available beds for patients.

In an effort to address this, Shepherd Center says it will be adding 48 more beds to serve more patients on an inpatient basis. As well, Shepherd Center will be expanding its outpatient programs to more effectively assist patients who do not need to be admitted to the hospital.

The hospital says it is able to expand its inpatient and outpatient programs thanks to an $80 million grant from the Marcus Foundation.

In addition to expanding patient care, Shepherd Center also says that the grant will help support the launch of the Marcus Center for Advanced Rehabilitation.

Included in the Marcus Center launch is the addition of a 30,000-square-foot Innovation Institute, a dedicated clinical lab for testing new treatment ideas, an accelerator fund, as well as the hospitals implementation of predictive analytics and artificial intelligence.

Shepherd Center also plans on assisting the families of its patients by doubling the hospitals housing capacity.

Through a capital grant from the Arthur M. Blank Foundation worth $50 million, the grant will allow the hospital to add 160 new accessible units. Through this expansion, more families will be able to stay in housing close by to loved ones who are staying in the hospital, according to Shepherd Center.

When we considered how Shepherd Center needed to grow to fully meet the needs of our patients, their families, our staff, and the community, it was clear that we should expand access to our services, said Sarah Morrison, PT, MBA, MHA, CEO of Shepherd Center.

And we also want to provide a world-class experience with an unparalleled level of recovery for our patients and families as they navigate rehabilitation and achieve their goals for life beyond injury and illness. This expansion will transform the way we provide care to our patients.

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Shepherd Center to assist more patients with neurological illnesses and injuries - Reporter Newspapers

WATCH TIME: 4 minutes

For patients with stroke and those with neurological conditions, developing arm weakness can be a common occurrence. Traditionally, physical therapy-related approaches have been the standard of care; however, with the expansion of technology in recent years, options like portable powered braces and functional electrical stimulation have shown benefits in restoring functional arm movement for these individuals. A new modality for this aspect of care, the NuroSleeve powered brace and stimulation system, is currently being evaluated by researchers at the Jefferson Center for Neurorestoration at Thomas Jefferson University.

The overall objective of the study is to establish that children and adults with chronic, stable neurological motor impairment can achieve voluntary control over the NuroSleeve upper extremity orthosis and functional electrical stimulation system, and that they can use this voluntary control to perform functionally beneficial tasks. Currently ongoing, the trial features patients with a range of neurological diseases, including stroke, amyotrophic lateral sclerosis, spinal muscular atrophy, cerebral palsy, and several others.

To learn more about the function of NuroSleeve, how it operates, and why it is effective, NeurologyLive reached out to Joe Kardine, MS, OTR, CBIS, clinical program manager, Jefferson Center for Neurorestoration. Kardine discussed the multifaceted use of the system across several neurologic conditions and how it can be personally customized for each individual.

See the article here:
Multifaceted Use of NuroSleeve to Restore Arm Function in Neurological Diseases: Joe Kardine, MS, OTR, CBIS - Neurology Live

Recently published findings in Lancet Neurology from a placebo-controlled study (NCT02940912)showed that night-time subcutaneous apomorphine infusion (Orkyn; Aguettant Pharma) for up to 5 mg/h is safe and improves Parkinson disease (PD)-related insomnia, as demonstrated by scores on Parkinsons Disease Sleep Scale (PDSS) scores.1

"Night-time administration could render apomorphine infusion more acceptable (compared with a 24-h infusion) because patients will not have to deal with the device-related constraints during the daytime," lead investigator Valeria Cochen De Cock, MD, professor of sleep and neurology, Beau Soleil Clinic, and colleagues wrote. "Our study supports the concept of continuous dop-aminergic stimulation, not only during the day but also at night, in patients with advanced Parkinsons disease."

The study, which spanned 11 expert centers in France, enrolled 46 patients aged 35 to 80 years with fluctuating PD and moderate to severe insomnia, defined by scores of at least 15 on Insomnia Severity Index (ISI). There were 2 treatment periods separated by a washout period, then crossover to the other intervention. Each treatment period consisted of a 10-night titration phase followed by a 7-night fixed-dose phase. During the washout period, the dose was gradually reduced over 3 nights, and patients remained free of medication for the following 14 nights.

Among the cohort, 91% (n = 42) completed the 2 medication periods. Between the 2 treatment groups, change in PDSS score was greater in those on night-time apomorphine infusion than placebo (treatment effect, 9.95; 95% CI, 0.88-19.03; P = .041). In terms of individual PDSS grouped-item scores, apomorphine outperformed placebo for the items "overall quality of nights sleep" (1.63; 95% CI, 0.49-2.77; P = .0063) and "sleep onset and maintenance insomnia" (1.51; 95% CI, 0.01 to 2.70; P = .024).

The apomorphine treatment period was also associated with greater change in ISI score (treatment effect, 2.23; 95% CI, 3.83 to 0.64; P = .011) and self-estimated clinical global impression of sleep quality (change in CGI score, 1.40; 95% CI, 0.62-2.19; P = .0007). On morning awakening, compared with the placebo period, the apomorphine period was associated with an improvement in motor condition, as demonstrated by change in Likert scale score (0.57; 95% CI, 0.98 to 0.16; P = .012) but without change in pain (0.20; 95% CI, 0.59 to 0.19; P = .36).

Apomorphine infusion was also found to be safe, as 54% (n = 25) of those on active therapy reported adverse events (AEs) vs 37% (n = 17) of those on placebo. Apomorphine was associated with more frequent dizziness, found in 7 (15%) participants compared with none in the placebo group.

Additional findings from the study showed that night-time apomorphine led to greater increase in percentage of sleep stage N2 (6.59%; 95% CI, 0.96-12.23; P = .021) and reduction in percentage of non-REM sleep stage N3 (5.08%; 95% CI, 9.67 to 0.50; P = .040) and percentage of REM sleep (3.57%;95% CI, 6.70 to 0.44; P = .031). Notably, the duration of non-REM stage N3 was unchangeded (7.91 min; 95% CI, 24.89 to 9.07; P = .037).

Compared with placebo, apomorphine infusion was associated with a greater increase in the arousal index (488 events per h; 95% CI, 1.03-8.73; P = .021), and reduction in the periodic leg movement index during sleep (574 events per h; 95% CI, 10.72 to 0.75; P = .050), whereas the apnea and hypopnea index and the percentage of enhanced submental tonic and phasic EMG activity remained unchanged. Between the two treatment periods, the mean sleep latency on the MSLT was unchained during daytime; however, the number of sleep-onset REM periods was higher with apomorphine (0.19; 95% CI, 0.00-0.38; P = .061).

Read more:
Night-Time Only Apomorphine Infusion Shows Benefit to Treating Parkinson Disease Insomnia - Neurology Live

image:This study was conducted using the latest neuroimaging techniques at the Ortenzio Center, which is dedicated solely to rehabilitation research, view more

Credit: Kessler Foundation

East Hanover, NJ. September 30, 2022. Using advanced diffusion neuroimaging technology, Kessler Foundation researchers investigated the relationship between the rate of cognitive fatigue to microstructural changes in the brain in persons with multiple sclerosis. Their findings help fill a gap in the current understanding of how brain pathology influences the development of fatigue over time.

Their findings were reported in Frontiers in Neurology on July 04, 2022, in the open access article Associations of White Matter and Basal Ganglia Microstructure to Cognitive Fatigue Rate in Multiple Sclerosis, (doi: 10.3389/fneur.2022.911012). The authors are Cristina Almeida Flores Romn, PhD, Glenn Wylie, DPhil, John DeLuca, PhD, and Bing Yao, PhD, and of Kessler Foundation.

The study was conducted at the Rocco Ortenzio Neuroimaging Center at Kessler Foundation, which is dedicated solely to rehabilitation research. Participants were 62 individuals with relapsing-remitting MS. All completed questionnaires measuring depression, state and trait anxiety, and trait fatigue. While in the scanner, participants underwent a cognitively fatiguing task. In addition to measuring rate of cognitive fatigue, researchers measured whole brain lesion volume and performance during the fatigue-inducing task.

We found that the cognitive rate related to white matter tracts, many with associations with the basal ganglia or what we have proposed as the fatigue network, said lead author Dr. Romn, National MS Society postdoctoral fellow at Kessler Foundation. These findings bring us closer to understanding how brain pathology impacts the experience in the moment. This is fundamental to developing effective interventions for managing the disabling fatigue of MS and other neurological conditions.

Funding: Kessler Foundation, National Multiple Sclerosis Society (RG-1701-26930)

Learn more about ongoing studies at Kessler Foundation at Join Our Research Studies | Kessler Foundation

About Kessler Foundation

Kessler Foundation, a major nonprofit organization in the field of disability, is a global leader in rehabilitation research that improves cognition, mobility, and long-term outcomes, including employment, for people with neurological disabilities caused by diseases and injuries of the brain and spinal cord. Kessler Foundation leads the nation in funding innovative programs that expand opportunities for employment for people with disabilities. Learn more by visiting http://www.KesslerFoundation.org

Stay Connected

Twitter |http://Twitter.com/KesslerFdnFacebook |http://Facebook.com/KesslerFoundationYouTube |http://Youtube.com/user/KesslerFoundationInstagram |http://Instagram.com/kesslerfdn

iTunes & SoundCloud |http://Soundcloud.com/kesslerfoundation

To interview an expert, contact:

Deborah Hauss, DHauss@kesslerfoundation.org

Carolann Murphy, CMurphy@KesslerFoundation.org

Frontiers in Neurology

Imaging analysis

People

Associations of White Matter and Basal Ganglia Microstructure to Cognitive Fatigue Rate in Multiple Sclerosis

4-Jul-2022

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

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Kessler Foundation study advances knowledge of role of brain pathology and cognitive fatigue in multiple sclerosis - EurekAlert

Newswise Could artificial intelligence help solve the mental health crisis? What if an algorithm allowed neurologists to know the area affected by a brain seizure?

These are just a few of the questions thatMaryamRavan, Ph.D., assistant professor of electrical and computer engineering at New York Institute of Technology, aims to address in new research studies published this fall. The studies, which have been featured in journals and conferences of the Institute of Electrical and Electronics Engineers (IEEE), propose cutting-edge algorithms and techniques that could provide non-invasive solutions for clinicians to more effectively treat neurological and psychiatric conditions.

Normal brain activity, including mood and thinking processes, relies on a balance of fast and slow brain waves. Imbalanced brain wave activity is associated with neurological issues, such as epilepsy, and psychiatric conditions like bipolar disorder and major depressive disorder.

One technique that clinicians use to detect brain wave imbalances is electroencephalography (EEG). This diagnostic test uses sensors to measure the electrical activity on a patients scalp, which is representative of the brain wave activity taking place underneath. Given this, brain wave data collected through EEG holds valuable information regarding an individuals neurological and mental health.

Now, Ravan has partnered with physicians from prestigious institutions, including Stanford University and McMaster University (Canada), to propose new, non-invasive diagnostic techniquesfounded on algorithms and engineering principlesthat could improve how physicians use EEG brain wave data to treat the brain.

Locating the Source of a Seizure

Approximatelythree million adults and 470,000 childrenin the United States have epilepsy, a neurological condition that causes seizures. During a seizure, the brains normal electrical pattern is disrupted and sudden bursts of electrical energy can affect consciousness, movements, and sensations.

However, precisely identifying the region of the brain where a seizure originated (brain source) is challenging. Existing software models that process EEG brain wave data use a mathematical technique calledexact low-resolution brain electromagnetic tomography (eLORETA). While these models can provide a brain source estimate, they have a high margin of error and do not account for many variables, including individual head shape, which impacts the distribution of electrodes, or the brains electricity producers. While magneticresonance imaging (MRI), which does account for head shape, can be used to identify the brain source, these systems are costly, and not every patient can undergo an MRI scan.

Now, in a study published in IEEE Transactions on Biomedical Engineering,Ravanand her fellow co-authors, including renowned Stanford University physicians Robert Fisher, M.D., Ph.D., andBabak Razavi, M.D., Ph.D., as well as Amin Noroozi, a Ph.D. candidate from Staffordshire University (United Kingdom), propose a more precise and robust brain mapping technique to pinpoint the brain source.

Using AI to Improve Mental Health Diagnoses and Treatments

In collaboration with prominent McMaster University psychiatrist Gary M. Hasey, M.D.,Ravanhas co-authored two studies that leverage machine learning, a form of artificial intelligence (AI), to improve the treatment of mental health conditions.

In one study, which was presented at this years 44thAnnual International Conference of the IEEE Engineering in Medicine and Biology Society, Ravan helped to develop a machine learning algorithm to analyze patients brain waves and categorize their patterns as biomarkers for bipolar disorder or major depressive disorder.

The second study, which was published inIEEE Transactions on Biomedical Engineering, explores how brain wave data could be used to predict how patients with major depressive disorder will respond to the antidepressant sertraline (sold under the brand name Zoloft) vs. a placebo treatment.

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Engineering Research Provides Non-Invasive Solutions for Diagnosing and Treating Neurological and Psychiatric Conditions - Newswise

HARTFORD, Conn. (WTNH) A Hartford Healthcare neurologist is cautiously excited about a new treatments ability to prevent memory loss in patients with Alzheimers disease.

Dr. Amy Sanders has been watching research indicating that the drug lecanemab can either slow or altogether stop cognitive decline.

The results, she said, werent surprising.

That has been the Holy Grail of Alzheimers disease pharmaceutical research for decades, so this is the first time my heart went pitty pat, when I read these announcements, Sanders said.

Lecanemab clears amyloid plaques, which are protein deposits linked to dementia.

Weve had agents that could clear amyloid plaques in the past, but we have not had the one-two punch, Sanders said. And its possible that we now have it.

The 1,800 people in the clinical trial had either a mild form of Alzheimers disease, or a pre-Alzheimers condition that is considered to be a mild cognitive impairment.

While the data wont be released until the end of November, the Alzheimers Association has called the study a major development, and said that more drugs are in the pipeline.

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Hartford Healthcare neurologist excited about possible new Alzheimers disease treatment - WTNH.com

Patients misdiagnosed in the Neurology scandal must get access to the truth about what happened to them, Sinn Fin MLA Carl N Chuiln has said.

Speaking after the Belfast Trust appeared before the Neurology APG, the North Belfast MLA said: "It is unacceptable that patients and families impacted by the neurology scandal are still waiting for truth and accountability.

"The Independent Inquiry report is nothing short of damming and has cataloged missed opportunities to address their treatment.

"The RQIA report on governance in outpatients - published in Feb 2020 - made 26 recommendations for improvements in Neurology services, and for many families, they feel that very little progress has been made since then.

"Former patients have had their confidence rocked and the Belfast Trust need to do more to support all those failed by Michael Watt.

"Sinn Fin will continue to support the victims and their families in their campaign for truth and accountability."

Continue reading here:
Neurology Scandal Patients 'Must Get Access To The Truth' - 4ni.co.uk

The Department of Work and Pensions offers extra support to people with a range of neurological conditions. Illnesses such as epilepsy, motor neurone disease and multiple sclerosis are all covered by the Personal Independent Payment (PIP).

According to the DWP nearly 3 million people in the UK are claiming extra support and over 300,000 claim it for a neurological condition. The PIP benefit is available to over 70 conditions and can help families struggling under the cost of living crisis, The Daily Record reports.

You could be entitled to 156 per week if you have any of these 70 neurological conditions. The PIP can be claimed as long as the following applies:

Read more: DWP: Benefits may not rise with the rate of inflation warns treasury

Cerebrovascular disease

Epilepsy

Non epileptic disturbance of consciousness

Movement disorders

Multiple sclerosis

Benign tumours

Hydrocephalus

Headache

Head injury

Spinal cord compression

Degenerative neuronal diseases

Cerebral palsy

Spina bifida

Ataxia

Neuropathy

Peripheral nerve injury

Disease of muscle

Muscular dystrophy

READ NEXT:

DWP warns pensioners claiming Attendance Allowance could risk going to court

DWP issues urgent warning over cost of living scammers who offer fake energy bill discounts

Argos' 25 electric blanket costing pennies to run sells out across Cambridgeshire: alternatives and where it's still available

DWP announces millions could receive an extra 600 with Winter Fuel Payment

Read more:
DWP: You could be entitled to 156 per week if you have any of these 70 neurological conditions - Cambridgeshire Live

Pune, Maharashtra, September 29 2022 (Wiredrelease) Market.Biz :Discover the game-changing elements and trends that are impacting Gene Therapy in Neurological Diseases Market With Market.biz, you can navigate the complexities of Gene Therapy in the Neurological Diseases industry.

Global Gene Therapy on Neurological Diseases Market Analysis:

The Gene Therapy on Neurological Diseases reports overview is a compilation of the most recent trends and figures that reveal a broad analysis of the market drivers, revenue share, segmentation, and geographical markets. It investigates a wide range of topics, including regional market scope, product-market various applications, market size according to a specific product, sales and revenue by region, production cost analysis, supply chain, market influencing factors analysis, market size estimates, and more. This market analysis includes an overview of Gene Therapy in the Neurological Diseases industry, a look at the target market, a competition analysis, business projections, and regulations. The following are the main points discussed:

Description and forecast for the industry:

First and foremost, this is where youll discover information about the present situation of the Gene Therapy in Neurological Diseases business and where its heading. This section includes industry indicators such as size, trends, life cycle, and predicted growth. This report includes statistics to back up your company concept. The worldwide Gene Therapy on Neurological Diseases market is divided into North America; Europe; Asia Pacific; Latin America; The Middle East & Africa.

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Market Segmentation Analysis

This studys target market segment contains the following:

Demographics such as age, income, and geography are included in the user persona and attributes. It informs you of their hobbies and purchasing habits, as well as the greatest position to suit their demands.

Market size: What is the potential size of the Gene Therapy on Neurological Diseases market for your company? It reveals the consumption in the Gene Therapy on Neurological Diseases business according on Type and application. With respect to Type, segmentation is carried out under Viral Gene Therapy; Non-viral Gene Therapy. And concerning the applications, segmentation Hospital; Clinic

Analysis of competitors: Learn about Gene Therapy on Neurological Diseases competitors. The study not only informs you about your competition, but it also identifies their flaws. Is there a client base that is underserved? What do you have to offer that other companies dont? The competitive analysis includes the following elements:

Direct competitors include: What other businesses provide comparable goods and services? Which firms are your genuine rivals? All of these issues are addressed in the paper. This section also provides Biogen; Novartis; Sarepta Therapeutics analysis.

Indirect competitors: Similarly, this report informs you that you are not competing with Gene Therapy on Neurological Diseases firms, but rather report Cat companies.

What are the strengths and shortcomings of your competition? Where are they falling short? Learn how to discover opportunities to flourish when others are failing.

What are the possible drawbacks of joining the Gene Therapy on Neurological Diseases market? What is the entrance fee? Is it unreasonably expensive or simple to enter? This is where you look at your flaws.

The opportunity window: Finally, do you plan to enter the Gene Therapy on Neurological Diseases sector using time-sensitive technology? Is it necessary to enter early to capitalise on an emerging market? As a result, the study addresses all of these concerns.

So, what will the reality be in 2023? Inquire, learn, and get https://market.biz/report/global-gene-therapy-on-neurological-diseases-market-gm/#inquiry

Projections: Similarly, We provided deliberate forecasting rather than hockey-stick forecasting. Market share We have also provided consumer consumption behaviour. Only you will comprehend how much of the Gene Therapy on Neurological Diseases sector you have a chance to capture once you know how much your prospective clients can pay. And this is where we came up with actual statistics and data. Bottom-up predictions will show how your marketing and sales activities will allow you to capture a specific share of the market.

Pricing and gross margin: We also design a pricing structure. The difference between your Gene Therapy on Neurological Diseases expenditures and the Gene Therapy on Neurological Diseases sales price is your gross margin. These positive estimates might not only serve as a guide, but also as an incentive.

Regulations: Is there any special governmental rules or limits on the Global Gene Therapy on Neurological Diseases Market? If thats the case, it brought them up here and spoke about how to comply with them.

Success Factors: Above all, what criteria distinguish success from failure? We identified key parameters based on Gene Therapy on Neurological Diseases categories, which include pricing, value, availability, features, financing, upgrades or return policies, and customer service.

Most importantly, this market study can assist you in identifying market blind spots.

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Thank you for reading it all the way to this point.

Contact number: +1 (857)4450045, +91 9130855334.Email: inquiry@market.biz

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Gene Therapy on Neurological Diseases Market Size, Share, Segmentation, And Forecast 2030 - PharmiWeb.com

The Brainy Insights

Global precision surgery device market growth would be driven by the increasing incidence of accidents, sports injuries, and other diseases that require surgical intervention. The growing research and development of innovative wound closure devices are gaining traction in the medical industry. The North American region emerged as the largest market for the global precision surgery device market, with a 37.66% share of the market revenue in 2021.

Newark, Sept. 30, 2022 (GLOBE NEWSWIRE) -- As per the report published by The Brainy Insights, the globalprecision surgery device market is expected to grow from USD 5.14 billion in 2021 to USD 18.99 billion by 2030, at a CAGR of 15.63% during the forecast period 2022-2030.

A sedentary lifestyle, lack of exercise, bad eating habits, and a rise in the number of hours spent in front of laptops and smartphone displays have all contributed to an increase in the number of people with acute and chronic diseases. Cardiovascular, respiratory, and orthopedic diseases are becoming more common among the aging population. Precision surgery devices are increasingly used in surgical procedures due to their minimally invasive nature and quicker healing times. The global market is driven during the forecast period by the rising usage of precision surgery equipment and the rising prevalence of disorders.

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Accidents are also among the leading causes of death worldwide, which will drive the market's growth. Major players have invested capital into research and system development to meet the growing need for precision surgery technologies. Robust technological advancements and developments in precision surgery equipment will boost industry efficiency and competitiveness, fostering the sector's expansion and creating profitable prospects for market participants. However, the high cost of precision surgery devices can hamper the market's growth. Stringent government guidelines and regulations will also challenge the market forecast period. The lack of skilled professionals to operate these devices will also limit the market's growth. Innovations and comprehensive approval mechanisms can help overcome these challenges and provide an impetus to the global precision surgery device market.

Story continues

Competitive Strategy

To enhance their market position in the global precision surgery device market, the key players are now focusing on adopting the strategies such as product innovations, mergers & acquisitions, recent developments, joint ventures, collaborations, and partnerships.

In August 2022, Edwards Lifesciences' Pascal Precision system, its newest treatment for mitral and tricuspid regurgitation patients, received a CE mark. With the regulatory nod, Edwards will be able to launch the surgical device in the European market. According to a statement offered by the company's CEO, the firm is scheduled to receive approval from the FDA before year-end.

Market Growth & Trends

The rise in accidents, sports injuries, and other conditions requiring surgical intervention will fuel the market for precision surgery devices. The medical sector is witnessing an increase in the study, research, and development of novel wound closure devices, which is anticipated to drive product innovations in the market. Precision surgery devices are becoming more widely used in healthcare due to their minimally invasive design and improved post-operative healing. Precision surgery gadgets are less painful than open operations, so the aging population will drive the market for them. Additionally, it lessens discomfort and enables the patient to reduce scarring. The dangers of open surgery, such as harm to internal organs, are minimized. Medical experts can also use precision surgery tools to repair the little anomalies that were previously impossible to fix. Advances in artificial intelligence and machine learning are creating lucrative opportunities in the market. Precision surgery equipment is becoming more widely used due to the use of robotics and the internet of things (IoT) in medicine to increase hospital success or survival rates.

If you have any questions, please feel free to contact our analyst at: https://www.thebrainyinsights.com/enquiry/speak-to-analyst/12935

Key Findings

In 2021, the cardiovascular segment dominated the market with the largest market share of 45% and market revenue of 2.31 billion.

The application segment is divided into orthopedic, neurosurgery, cardiovascular, wound closure, and others. In 2021, the cardiovascular segment dominated the market with the largest market share of 45% and market revenue of 2.31 billion.

The handheld surgical devices segment is expected to grow at the fastest CAGR of 17.15% over the forecast period.

The type segment is divided into handheld surgical devices, electrosurgical devices, and others. Over the forecast period, the handheld surgical devices segment is expected to grow at the fastest CAGR of 17.15%.

In 2021, the hospitals' segment accounted for the largest share of the market, with 53% and a market revenue of 2.72 billion.

The end-user segment is divided into hospitals, specialty clinics, ambulatory settings, long-term care centers, and others. In 2021, the hospitals' segment accounted for the largest share of the market, with 53% and a market revenue of 2.72 billion.

Regional Segment Analysis of the Precision Surgery Device Market

North America (U.S., Canada, Mexico) Europe (Germany, France, U.K., Italy, Spain, Rest of Europe) Asia-Pacific (China, Japan, India, Rest of APAC) South America (Brazil and the Rest of South America) The Middle East and Africa (UAE, South Africa, Rest of MEA)

Among all regions, the North American region emerged as the largest market for the global precision surgery device market, with a market share of around 37.66% and 1.93 billion of the market revenue in 2021. Healthcare is more readily available and more reasonably priced for the populace due to the high per capita income and the established insurance market with favorable reimbursement policies in the region. The growing elderly population also fuels the growing need for surgery. The market for precision surgery devices has benefited from the growing need for reconstructive, plastic, and other procedures to enhance body aesthetics. Furthermore, the rising government spending on healthcare infrastructure will influence the market's growth in the upcoming years.

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Key players operating in the global precision surgery device market are:

Alcon Aspen Surgical B. Braun SE Baxter Boston Scientific Johnson & Johnson Medtronic PLC Siemens Healthcare GmbH Stryker Corporation Zimmer Biomet

This study forecasts global, regional, and country revenue from 2019 to 2030. The Brainy Insights has segmented the global precision surgery device market based on the below-mentioned segments:

Global Precision Surgery Device Market by Application:

Orthopedic Neurosurgery Cardiovascular Wound Closure Others

Global Precision Surgery Device Market by Type:

Handheld Surgical Devices Electrosurgical Devices Others

Global Precision Surgery Device Market by End User:

Hospitals Specialty Clinics Ambulatory Settings Long-Term Care Centers Others

About the report:

The global precision surgery device market is analyzed based on value (USD Billion). All the segments have been analyzed on a worldwide, regional, and country basis. The study includes the analysis of more than 30 countries for each part. The report offers an in-depth analysis of driving factors, opportunities, restraints, and challenges for gaining critical insight into the market. The study includes porter's five forces model, attractiveness analysis, raw material analysis, supply, and demand analysis, competitor position grid analysis, distribution, and marketing channels analysis.

About The Brainy Insights:

The Brainy Insights is a market research company, aimed at providing actionable insights through data analytics to companies to improve their business acumen. We have a robust forecasting and estimation model to meet the clients' objectives of high-quality output within a short span of time. We provide both customized (clients' specific) and syndicate reports. Our repository of syndicate reports is diverse across all the categories and sub-categories across domains. Our customized solutions are tailored to meet the clients' requirement whether they are looking to expand or planning to launch a new product in the global market.

Contact Us

Avinash DHead of Business DevelopmentPhone: +1-315-215-1633Email: sales@thebrainyinsights.comWeb: http://www.thebrainyinsights.com

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Precision Surgery Device Market Size to Hit USD 18.99 Billion by 2030 | Rising Demand in Neurological Surgical Procedures & High Investment by Top...