eNeurologicalSciThe June issue of the eNeurologicalSci (eNS)  Vol 8  is available online.

 

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Issue Highlights

Can suitable candidates for levodopa/carbidopa intestinal gel therapy be identified using current evidence?

Advanced Parkinson's disease (APD) is characterized by increased functional disability, caused by motor complications, the presence of axial symptoms, and emergent disease- and drug-related non-motor symptoms. One of the advanced therapies available is intrajejunal infusion of levodopa/carbidopa intestinal gel (LCIG); however, patient selection for this treatment is sometimes difficult, particularly because of overlapping indications with other alternatives.

In recent years, strong evidence has supported the use of LCIG in treating motor fluctuations associated with APD, and several clinical studies provide emerging evidence for additional benefits of LCIG treatment in certain patients. This article provides an overview of the published literature on the benefits, limitations, and drawbacks of LCIG in relation to PD symptoms, the psychosocial impact of the disease, and the quality of life of patients, with the aim of determining candidates for whom treatment with LCIG would be beneficial. According to current evidence, patients with APD (defined as inability to achieve optimal control of the disease with conventional oral treatment), a relatively well-preserved cognitive-behavioral status, and good family/caregiver would count as suitable candidates for LCIG treatment. Contraindications in the opinion of the authors are severe dementia and active psychosis.

Does cerebral large-artery disease contribute to cognitive impairment? 

Along with the increasingly elderly population in Japan, both vascular dementia and Alzheimer's disease are important issues to be tackled. Studies have investigated whether cerebral large-artery disease (CLAD) and atherosclerotic risk factors contribute to mild cognitive decline or vascular dementia. These findings are important because they allow us to decide which patients with CLAD should be treated by strictly controlling their atherosclerotic risk factors or should be considered for intervention.

Although many patients with cerebral large-artery disease (CLAD) show impaired cognitive performance, the risk factors remain unclear in this population.  CLAD might induce cognitive decline because of the risk of ischemic stroke, cerebral hypoperfusion, white matter lesions, and microembolization. It also remains uncertain which of these factors modifies which cognitive function.

The purpose of the current study was to elucidate the prevalence and characteristics of impaired cognitive performance in patients with CLAD. 

A structural MRI study of cholinergic pathways and cognition in multiple sclerosis

Multiple sclerosis (MS) is a common autoimmune disease of the central nervous system. Its most common symptoms are sensory and motor dysfunctions, but cognitive impairment is also seen in about 40% to 65% of MS patients.

This study aimed to evaluate the relationship between the volume reduction of cholinergic pathways and cognitive function in patients with multiple sclerosis (MS). The study examines the relationships among cognitive scores, CHIPS scores, and the WMH lesion load using an automated lesion segmentation tool in MS patients using a 3-tesla MR system. We also examined the relationships between cognitive scores and the regional volumes measured by FreeSurfer 

  


Original Articles


About eNS

eNeurologicalSci (eNS) is an Open Access journal that provides high-quality manuscripts across a broad research spectrum of Neuroscience and Neurology, with the potential for grasping mechanisms and informing management of diseases of the human nervous system.

The journal especially accepts contributions from basic laboratory research all the way through to community studies in neurology-related fields of interest submitted by researchers from around the world. eNS also welcomes papers of major relevance to neurologic education and accommodates submissions from trainees in neurology (e.g. residents, fellows, post-doctorate scholars, and medical students).