JNS.jpgThe October issue of the Journal of the Neurological Sciences Vol 393 is now available online.

 

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Issue highlights

The role of LP in NDs where there is no neuroimaging

A lumbar puncture (LP) and cerebrospinal fluid (CSF) examination is often the only available investigation in Africa that can confirm or exclude a treatable neurological disorder (ND). NDs are common in Africa accounting for up to 20% of adult hospital admissions with an overall lesser burden in children. The main treatable causes are infections which include, acute bacterial meningitis (ABM), cryptococcal meningitis (CM), tuberculous meningitis (TBM), toxoplasmosis and malaria. Other neurological disorders where an LP may be diagnostic include encephalitis, inflammation, vasculitis, strokes, subarachnoid haemorrhage, paraplegia and polyneuropathies.


Consensus recommendations for the diagnosis and treatment of primary progressive multiple sclerosis in Latin America

Despite the availability of a large amount of information regarding the management and care of relapsing remitting multiple sclerosis (RRMS) patients, there is scant information about recommendations on how to care for primary progressive MS (PPMS) patients. The objective of this study was to review how PPMS patients should be assessed and cared for in Latin America (LATAM). 17 experts from LATAM carry out a consensus recommendation on the diagnosis and treatment of PPMS patients in LATAM.

 

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Pharmacological treatment for REM sleep behavior disorder in Parkinson disease and related conditions: A scoping review

Rapid eye movement (REM) sleep behaviour disorder (RBD) is a parasomnia characterized by the presence of a complex of signals resulting from the loss of REM sleep atony and manifested by vigorous and sometimes violent motor jerks and nocturnal vocalizations associated with dream enactment. RBD might be a clinical predictor of severity for Parkinson's disease (PD) and one of its most important non-motor manifestations, preceding the emergence of synucleinopathy by several years or even decades. The detection of RBD may represent a therapeutic window for research regarding the development of new neuroprotective therapies with the potential to modify the natural course of synucleinopathies, such as PD.

We performed a scoping review of studies indexed in MEDLINE and LILACS focusing on pharmacological interventions for RBD associated with PD.

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Repetitive transcranial magnetic stimulation of the dorsolateral prefrontal cortex to alleviate depression and cognitive impairment associated with Parkinson's disease: A review and clinical implications

The rapid methodological development and growing availability of neuromodulation techniques have spurred myriad studies investigating their clinical effectiveness. Repetitive transcranial magnetic stimulation (rTMS) of the dorsolateral prefrontal cortex (DLPFC) has in many instances been proven to exert antidepressant-like effects superior to placebo and equivalent to standard psychopharmacological treatment. Due to the similar neuroanatomy and neurophysiology of executive and affective control processes, rTMS to the DLPFC may be able to address multiple issues simultaneously.

This review pools available literature on the therapeutic usage of rTMS on non-motor symptoms of Parkinson's disease associated with the DLPFC (i.e. mood disturbance and cognitive impairment). To the best of the author's knowledge, it is one of the few available of its' kind, up to this date.

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