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Sommaires des Revues - The Lancet Neurology

The Lancet Neurology


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[Editorial] Alzheimer's disease: evolution of research diagnostic criteria  Voir?

The diagnosis of Alzheimer's disease in research settings has evolved rapidly over the past decade, with both the International Working Group (IWG) and the US National Institute on Aging and Alzheimer's Association (NIA-AA) contributing to endeavours to integrate biomarkers into research diagnostic criteria. These efforts have been important to distinguish the range of disease stages, from asymptomatic to severe dementia. The NIA-AA work group is now proposing a draft research framework that builds upon the 2011 NIA-AA and 2014 IWG criteria to include biomarkers more comprehensively than previously.

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[Comment] Targeting prodromal Alzheimer's disease: too late for prevention?  Voir?

Prodromal Alzheimer's disease is a novel area of research, with clinical research definitions still under development. The LipiDiDiet trial,1 published in The Lancet Neurology, was one of the first completed trials based on the International Working Group (IWG-1) criteria for prodromal Alzheimer's disease.2 The study was a non-pharmacological intervention (medical food Souvenaid) in prodromal Alzheimer's disease.

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[Comment] Eculizumab: a treatment option for mysthenia gravis?  Voir?

Eculizumab is an expensive, humanised monoclonal antibody against the terminal complement protein C5. The drug was patented in 2007, and has since been used and approved for two rare diseases, paroxysmal nocturnal haemoglobulinuria and atypical haemolytic ureamic syndrome. Additionally, eculizumab has been used off-label, which constitutes up to a half of its use in some countries,1 for at least 25 different conditions. Refractory and generalised myasthenia gravis with anti-acetylcholine receptor antibodies is a rare disease that involves the complement system and for which eculizumab has a potential effect.

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[Comment] Traumatic brain injury: a global challenge  Voir?

Traumatic brain injury (TBI) is a leading cause of death and disability worldwide, with enormous economic consequences. The Lancet Neurology Commission1 on TBI sets priorities and provides recommendations for future clinical practice, research, and policy to reduce this overwhelming burden. The Commission comes at a time when the global incidence of TBI is rising, access to care is severely lacking in many parts of the world, and methods of monitoring and diagnosis are frequently inadequate.

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[Comment] Traumatic brain injury: a priority for public health policy  Voir?

The Lancet Neurology Commission1 draws attention to the devastating impact of traumatic brain injury (TBI) on patients and their families, and the huge public health burden and economic cost of TBI globally. About 50–60 million new TBI cases are estimated to occur annually, with 2·5 million occurring in the European Union.1 The burden of TBI is greatest in low-income and middle-income countries, where 90% of trauma-related deaths occur.2,3 The Commission sets priorities for prevention, clinical care, and research, calling for a combination of innovative research methods and global collaboration to address the huge but poorly recognised public health challenge of TBI, with steps to ensure that developments in care and progress in research are effectively translated into clinical practice and public health policy.

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[Comment] Neurodegeneration in histiocytoses might start in utero  Voir?

Histiocytic disorders, such as Langerhans cell histiocytosis and Erdheim-Chester disease, are characterised by inflammation and accumulation of cells derived from the monocyte and macrophage lineages, resulting in tissue damage.1 Neurodegenerative lesions in Langerhans cell histiocytosis are a devastating type of CNS involvement—different from tumour infiltration—in which patients present with progressive symmetric cerebellar syndrome, tetrapyramidal syndrome with or without motor deficits, pseudobulbar palsy, or cognitive impairment.

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[Corrections] Corrections  Voir?

Terkelsen A J, Karlsson P, Lauria G, Freeman R, Finnerup N B, Jensen T S. The diagnostic challenge of small fibre neuropathy: clinical presentations, evaluations, and causes. Lancet Neurol 2017; 16: 934–44. The declaration of interests section of this article should have stated, “AJT has participated in an investigator-sponsored study provided by Sanofi Genzyme and Alynylam Pharmaceuticals.” This correction has been made to the online version as of Oct 16, 2017.

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[Corrections] Corrections  Voir?

Howard J F Jr, Utsugisawa K, Benatar M, et al. Safety and efficacy of eculizumab in anti-acetylcholine receptor antibody-positive refractory generalised myasthenia gravis (REGAIN): a phase 3, randomised, double-blind, placebo-controlled, multicentre study. Lancet Neurol 2017; 16: 976–86—In this Article, (published online Oct 20), the p value for one of the datapoints in figure 2 should be 0·0007. Additionally, in the sentence ‘Half of all patients reported their worst MGFA classification since diagnosis as class IV or V’ on page 6, the citation at the end of the sentence should be ‘appendix’.

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[Corrections] Corrections  Voir?

Wild E J, Tabrizi S J. Therapies targeting DNA and RNA in Huntington's disease. Lancet Neurol 2017; 16: 837–47—In table 1, the final row and footnote have been updated to reflect that CHDI Foundation's small-molecule huntingtin-lowering programme is currently at the screening stage and that the mechanisms of action, route of delivery, and advantages and disadvantages of the small molecules being investigated remain to be determined. This correction has been made to the online version as of Nov 14, 2017.

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[Corrections] Corrections  Voir?

Kathrin Reetz, Imis Dogan, Ralf-Dieter Hilgers, et al, for the EFACTS Study Group. Progression characteristics of the European Friedreich's Ataxia Consortium for Translational Studies (EFACTS): a 2 year cohort study. Lancet Neurol 2016; 15: 1346–54—This Article has been updated so that the members of the EFACTS Study Group are now indexed as authors. This correction has been made to the online version as of Nov 14, 2017.

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[Correspondence] Chelated or dechelated gadolinium deposition  Voir?

Although Vikas Gulani and colleagues1 cite most of the recent literature on gadolinium deposition in their Personal View, we believe that pharmacokinetic evidence obtained from recently published studies2–4 in rats should have also been discussed.
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[Correspondence] Chelated or dechelated gadolinium deposition – Authors' reply  Voir?

We thank Alexander Radbruch and colleagues for their comments regarding our and more recent publications. They highlight an experiment comparing gadolinium retention in the rat brain after high doses of linear or macrocyclic gadolinium-based contrast agents (GBCAs),1 demonstrating retention of tiny amounts of soluble gadolinium in brain tissue for all agents, but higher concentrations of the insoluble fraction for linear than for macrocyclic agents. Of note, another paper2 by the same group reported that brain tissue of rats with proven gadolinium deposition showed no histopathological changes with either linear or macrocyclic agents.

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[Correspondence] Portrayal of progressive supranuclear palsy in the 16th century  Voir?

A stolid face stares outwards from an oak panel, painted five centuries ago by Cornelis Anthonisz (figure). Skin creases in his neck suggest that the man in this portrait was middle-aged or older. The portrait's most intriguing element, however, is what the artist has captured in his patron's face. Unlike an expressive mien that Dutch artists of this period were so skilled at portraying, this man's face seems oddly lacking in emotion. My impression is that this portrait speaks across the centuries to convey something wrong with the health of the sitter.

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[In Context] The CENTER-TBI core study: The making-of  Voir?

It's a veritable medical mega-production, with results coming soon to a computer screen near you! But only behind the scenes can you appreciate the massive effort to collect and curate the data involved in this vast study. Adrian Burton takes a peek.
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[In Context] Eric Reiman: aiming to prevent Alzheimer's disease  Voir?

What will it take to prevent Alzheimer's disease by 2025? Eric Reiman, Executive Director of the Banner Alzheimer's Institute in Phoenix (Arizona, USA), has an answer. “It will take the right prevention trials, methods, and enrolment strategies to rapidly test, find and approve prevention therapies in people at genetic or biomarker risk. It will take shared urgency, courage and commitment, new collaborative models, and extensive data sharing. It will take a multi-faceted approach to optimise availability, affordability, and appropriate use of treatments.

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[In Context] Sonja Scholz  Voir?

Sonja Scholz is a neurologist–scientist specialised in neurodegenerative diseases. She obtained her medical doctorate from the Medical University Innsbruck, Austria and her PhD in neurogenomics from University College London, UK. She trained as a postdoctoral fellow in neurogenetics before completing an internship and neurology residency training at Johns Hopkins University, USA. In 2015, she joined the National Institute of Neurological Disorders and Stroke (Bethesda, USA) as an Assistant Clinical Investigator to study neurodegenerative diseases using modern genomic technologies.

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[In Context] The longest sleep  Voir?

Why should I fear death? If I am, death is not. If death is, I am not. Why should I fear that which cannot exist when I do?Epicurus
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[In Context] Keeping an open mind about autism  Voir?

There is a common goal shared between science and art—to educate and captivate—and the meeting of these two fields can increase the public's awareness and understanding of medical conditions that are often difficult to comprehend. Expression of the effects of autism through an artistic medium is an excellent way for the wider population to appreciate how an autistic person may view the world, as it allows the artist to portray the condition in a multitude of ways. The Open Minds exhibition at the London School of Economics featured interactive installations that brought together stories collected from one community in Hull (East Yorkshire, UK).

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[In Context] The mind's secrets brought to life  Voir?

It cannot be denied that for many a layperson, myself included, something as simple as self-seeking curiosity is enough motivation to delve into the field of neuroscience and to contemplate or query the way in which our lives are shaped by the development of our minds. It was with great joy and satisfaction then that I devoured Mariano Sigman's book, The Secret Life of the Mind, a wide-ranging and comprehensive exploration of how our brains think, feel, and make decisions.

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[Articles] 24-month intervention with a specific multinutrient in people with prodromal Alzheimer's disease (LipiDiDiet): a randomised, double-blind, controlled trial  Voir?

The intervention had no significant effect on the NTB primary endpoint over 2 years in prodromal Alzheimer's disease. However, cognitive decline in this population was much lower than expected, rendering the primary endpoint inadequately powered. Group differences on secondary endpoints of disease progression measuring cognition and function and hippocampal atrophy were observed. Further study of nutritional approaches with larger sample sizes, longer duration, or a primary endpoint more sensitive in this pre-dementia population, is needed.

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[Articles] Safety and efficacy of eculizumab in anti-acetylcholine receptor antibody-positive refractory generalised myasthenia gravis (REGAIN): a phase 3, randomised, double-blind, placebo-controlled, multicentre study  Voir?

The change in the MG-ADL score was not statistically significant between eculizumab and placebo, as measured by the worst-rank analysis. Eculizumab was well tolerated. The use of a worst-rank analytical approach proved to be an important limitation of this study since the secondary and sensitivity analyses results were inconsistent with the primary endpoint result; further research into the role of complement is needed.

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[The Lancet Neurology Commission] Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research  Voir?

A concerted effort to tackle the global health problem posed by traumatic brain injury (TBI) is long overdue. TBI is a public health challenge of vast, but insufficiently recognised, proportions. Worldwide, more than 50 million people have a TBI each year, and it is estimated that about half the world's population will have one or more TBIs over their lifetime. TBI is the leading cause of mortality in young adults and a major cause of death and disability across all ages in all countries, with a disproportionate burden of disability and death occurring in low-income and middle-income countries (LMICs).

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Dernière mise à jour : 13/12/2017 : 16:58


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