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Sommaires des Revues - The Lancet Neurology

The Lancet Neurology


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[Editorial] Global analysis of neurological disease: burden and benefit  Voir?

Neurological diseases take a large toll on both individuals and health-care systems, and new analyses from The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study indicate that the burden from neurological disorders is even greater than previously thought. The GBD Study describes mortality and morbidity at global, national, and regional levels, and provides tools to quantify health loss, enabling better understanding of changing health challenges. With the publication of a large set of analyses using data collected between 1990 and 2016, now is an appropriate time to reflect on the past successes and future challenges of applying the GBD data to neurological health issues.

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[Comment] Global burden of neurological disease: what's in a name?  Voir?

We are living in a rapidly changing landscape in terms of global public health. On one hand, the immense increase in and ageing of the world's population, mass migration of people from rural to urban areas, and unhealthy lifestyles—either by choice or by circumstance—are negatively affecting the overall health of the planet. On the other hand, medical advances such as vaccines, antibiotics, and new medications, and renewed emphasis on workplace safety, have benefitted global health. These balancing influences perhaps have the most effect on neurological diseases, which affect many different daily functions and therefore have a disproportionately large effect on global health.

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[Comment] Restless legs syndrome: is it all in the genes?  Voir?

Restless legs syndrome is a common movement disorder that presents with unpleasant sensations in the lower extremities and results in an irresistible urge to move the legs, particularly at night-time and during quiet wakefulness. Although not fatal, restless legs syndrome can cause disabling fragmentation of sleep, leading to cognitive and mood symptoms and decreased quality of life.1–3 Despite a prevalence of about 10% in the elderly population, the pathophysiology is not well understood.

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[Comment] Predicting progression in patients with Parkinson's disease  Voir?

A major challenge to patients, clinicians, family members, and scientists is the unpredictable future that accompanies a diagnosis of Parkinson's disease. When met with the question “what does my future hold?” it is difficult to give predictions that are likely to be useful to the patient. Some individuals will face features that rapidly and adversely affect their quality of life; others will experience a prolonged and fairly benign course, initially well managed by drugs and lifestyle changes. Variability between patients in core features of this multisystem disease—eg, motor decline, neuropsychiatric changes, mood disorders, dysautonomic signs, and fatigue—is the rule.

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[Comment] Pathology and hippocampal atrophy in Alzheimer's disease  Voir?

Over time, reduced hippocampal volume results in an amnestic syndrome, a core feature of Alzheimer's disease.1 Damage to the hippocampus is incorporated into the pathological criteria for Alzheimer's disease, with two regionally separable pathological features required: at least some neurofibrillary tangles in the hippocampus, and β-amyloid deposition and moderate neuritic infiltrate in association cortices.2 The severity of hippocampal tangle formation at clinical onset can be very variable (from some neurons to nearly all neurons involved).

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[Comment] PML risk and natalizumab: the elephant in the room  Voir?

Natalizumab is one of the most effective therapies currently available for relapsing-remitting multiple sclerosis.1 With the exception of rare hypersensitivity reactions, monthly intravenous infusions are well tolerated and, for most patients, treatment is not associated with an increase in infections.2 But, for unknown reasons, progressive multifocal leukoencephalopathy (PML), an opportunistic, disabling, and life-threatening disease caused by the John Cunningham virus (JCV), is associated with natalizumab treatment.

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[Comment] Challenges and unfulfilled promises in Parkinson's disease  Voir?

Neurodegenerative disorders take a heavy toll on individuals who have a diagnosis and their family and loved ones, and place an enormous economic burden on the health-care system. Parkinson's disease is amenable to reasonably, albeit incompletely, effective therapies to manage symptoms, but to date, no treatment has been found to slow its progression. Therefore, any potentially disease-modifying treatment is met with great enthusiasm.

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[Corrections] Corrections  Voir?

Lai C. Flashing lights and poor funding: more than a headache. Lancet Neurol 2017; published online Aug 16. http://dx.doi.org/10.1016/S1474-4422(17)30285-5—In this Radio review, the affiliation for Peter Goadsby should have been King's College London. This correction has been made to the online version as of Aug 23, 2017.

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[Correspondence] Palliative care in neurology  Voir?

A recent Editorial in The Lancet Neurology1 highlighted the importance of palliative care for patients with progressive neurological diseases and the requirement for increased funding and research. Because data on prevalence, incidence, and stage of disease in many low-income and middle-income countries is scarce, proxy data is used to estimate palliative care needs. One method of estimation proposed by WHO and the World Palliative Care Alliance relies on mortality data.2 The number of patients with a progressive neurological disease who require palliative care is estimated by the number of deaths attributable to a particular cause and multiplied by the prevalence of pain in that patient group.

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[Correspondence] Palliative care in neurology  Voir?

We congratulate the editors of The Lancet Neurology for highlighting the topic of palliative care in neurology in their Editorial,1 which was prompted by the European Association for Neuro-Oncology guideline2 on palliative care in glioblastoma. As the coordinators of the earlier consensus review3 on the development of palliative care for patients with chronic and progressive neurological disease, developed by the European Academy of Neurology and the European Association for Palliative Care, we would like to suggest that there is a need for further development of disease-specific guidelines, in neurology and other fields, and consideration of the collaboration of these specialties.

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[In Context] Trying to change the stroke landscape in Nigeria  Voir?

The dearth of stroke awareness and specialised medical services in Nigeria leaves plenty for new NGOs to do. But the problems they face, including their own capacity building, are many. Can their efforts turn the tide? Adrian Burton investigates.
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[In Context] Andrew Maas (and the bird on his shoulder)  Voir?

“I am probably not an easy person to work with. By nature I am critical. I set the bar high for myself and others, and I have a knack for identifying errors. Give me a page of text and I will pinpoint the single typo within a glance—a most infuriating trait for everyone I work with”, says Andrew Maas, Emeritus Professor of Neurosurgery at the Antwerp University Hospital and University of Antwerp (Belgium). It's the kind of opener that simultaneously enthuses (help with mistakes) and terrifies (make no mistakes!) profiling journalists.

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[In Context] The Rhythms of Thought  Voir?

The question of consciousness—how subjective experience can arise from activity in the brain—is arguably the greatest question in science, so much so that it's become well known simply as “the hard problem”, a term introduced by the philosopher David Chalmers. Attempts to answer the question of consciousness draw on many disciplines—not just neuroscience and psychology, but physics, mathematics, and philosophy as well. Making explorations of this question accessible to a general audience is a hard problem in itself, but Paul Nunez manages to do just that in The New Science of Consciousness.

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[In Context] Conversations with a neuroscientist  Voir?

In an era in which fake news is permeating mainstream journalism, it is becoming particularly important that scientific facts are separated from untruths. Coupled with the public's increasing appetite for using different types of media, there are now more ways than ever for those engaged in science research to communicate their work to the general public. After 15 years working in neuroscience research, a position at the Wellcome Trust as part of their science engagement team, participating as a judge for the Man Booker Prize in 2014, and most recently becoming the Director of the Science Gallery, expected to open in London in 2018, Daniel Glaser is no stranger to science communication.

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[In Context] Moving in the right direction?  Voir?

“We should consider every day lost on which we have not danced at least once”, Friedrich Nietzsche wrote in his philosophical novel Thus Spoke Zarathustra. Sean Cross, Clinical Director of King's Health Partners Mind and Body Programme, South London and Maudsley National Health Service (NHS) Foundation Trusts (SLaM, London, UK), has this quote on his Facebook profile. Cross was one of the speakers at the Moving Bodies, Moving Minds event organised by Performing Medicine in London, UK. Under the banner The Art of Healthcare, Performing Medicine is an award-winning programme created by theatre company Clod Ensemble.

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[In Context] Flashing lights and poor funding: more than a headache  Voir?

For many migraineurs, daily life can be a carefully choreographed routine of avoiding triggers. So to intentionally induce a migraine seems not only ill-advised, but also foolish. Yet, that is precisely what author A L Kennedy did for the BBC Radio 4 production AL Kennedy's Migraine. At the start of the programme, Kennedy thoughtfully advises listeners for whom simply hearing about symptoms of migraines might trigger an attack, “Please, don't soldier on, the way we sometimes do, switch this off.

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[Global Health Metrics] Global, regional, and national burden of neurological disorders during 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015  Voir?

Neurological disorders are an important cause of disability and death worldwide. Globally, the burden of neurological disorders has increased substantially over the past 25 years because of expanding population numbers and ageing, despite substantial decreases in mortality rates from stroke and communicable neurological disorders. The number of patients who will need care by clinicians with expertise in neurological conditions will continue to grow in coming decades. Policy makers and health-care providers should be aware of these trends to provide adequate services.

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[Articles] Identification of novel risk loci for restless legs syndrome in genome-wide association studies in individuals of European ancestry: a meta-analysis  Voir?

Identification of new candidate genes and associated pathways will inform future functional research. Advances in understanding of the molecular mechanisms that underlie restless legs syndrome could lead to new treatment options. We focused on common variants; thus, additional studies are needed to dissect the roles of rare and structural variations.

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[Articles] Large-scale identification of clinical and genetic predictors of motor progression in patients with newly diagnosed Parkinson's disease: a longitudinal cohort study and validation  Voir?

Our model ensemble confirmed established and identified novel predictors of Parkinson's disease motor progression. Improvement of existing prognostic models through machine-learning approaches should benefit trial design and evaluation, as well as clinical disease monitoring and treatment.
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[Articles] Rates of hippocampal atrophy and presence of post-mortem TDP-43 in patients with Alzheimer's disease: a longitudinal retrospective study  Voir?

TDP-43 should be considered as a potential factor related to increased rates of hippocampal atrophy in patients with Alzheimer's disease. Given the importance of hippocampal atrophy in Alzheimer's disease, it is imperative that techniques are developed for detection of TDP-43 in vivo.
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[Articles] Risk of natalizumab-associated progressive multifocal leukoencephalopathy in patients with multiple sclerosis: a retrospective analysis of data from four clinical studies  Voir?

Our risk estimates calculated from patient-level clinical data allow individualised annual prediction of risk of PML in patients receiving natalizumab for multiple sclerosis, supporting yearly benefit–risk re-evaluation in clinical practice. Further, our estimates are generally consistent with previously calculated estimates. Incorporating anti-JCV antibody index allows further risk stratification for anti-JCV antibody-positive patients who have not previously taken immunosuppressants.

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[Review] The diagnostic challenge of small fibre neuropathy: clinical presentations, evaluations, and causes  Voir?

Small fibre neuropathies are a heterogeneous group of disorders affecting thinly myelinated Aδ-fibres and unmyelinated C-fibres. Although multiple causes of small nerve fibre degeneration have been reported, including via genetic mutations, the cause of small fibre neuropathy remains unknown in up to 50% of cases. The typical clinical presentation of small fibre neuropathy is that of a symmetrical, length-dependent polyneuropathy associated with sensory or autonomic symptoms. More rarely, the clinical presentation is characterised by non-length-dependent, focal, or multifocal symptoms.

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Dernière mise à jour : 17/10/2017 : 06:02


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