Neurology—the next 10 years

Baron, Ralf; Ferriero, Donna M.; Frisoni, Giovanni B.; Bettegowda, Chetan; Gokaslan, Ziya L.; Kessler, John A.; Vezzani, Annamaria; Waxman, Stephen G.; Jarius, Sven; Wildemann, Brigitte; Weller, Michael

doi:10.1038/nrneurol.2015.196

Cited by 7 publications

(3 citation statements)

References 78 publications

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“…Many of the class I evidence results in our study reaffirm previous opinions on implementation science (for a discussion on geopolitical factors affecting implementation of policies on chronic diseases, see [10]). As previously supported [164], scientists should stop advocating the need for yet another clinical trial on the cognitive benefits of healthy lifestyles and lobby decision-makers to implement societal polices to actively promote propitious lifestyles. This approach will substantially produce benefit not only for the brain but for the society at large.…”

Section: Implications For Target Groupsmentioning

confidence: 99%

Non-genetic risk and protective factors and biomarkers for neurological disorders: a meta-umbrella systematic review of umbrella reviews

Mentis

Dardiotis

Efthymiou

et al. 2021

BMC Med

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Background The etiologies of chronic neurological diseases, which heavily contribute to global disease burden, remain far from elucidated. Despite available umbrella reviews on single contributing factors or diseases, no study has systematically captured non-purely genetic risk and/or protective factors for chronic neurological diseases. Methods We performed a systematic analysis of umbrella reviews (meta-umbrella) published until September 20th, 2018, using broad search terms in MEDLINE, SCOPUS, Web of Science, Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health Literature, ProQuest Dissertations & Theses, JBI Database of Systematic Reviews and Implementation Reports, DARE, and PROSPERO. The PRISMA guidelines were followed for this study. Reference lists of the identified umbrella reviews were also screened, and the methodological details were assessed using the AMSTAR tool. For each non-purely genetic factor association, random effects summary effect size, 95% confidence and prediction intervals, and significance and heterogeneity levels facilitated the assessment of the credibility of the epidemiological evidence identified. Results We identified 2797 potentially relevant reviews, and 14 umbrella reviews (203 unique meta-analyses) were eligible. The median number of primary studies per meta-analysis was 7 (interquartile range (IQR) 7) and that of participants was 8873 (IQR 36,394). The search yielded 115 distinctly named non-genetic risk and protective factors with a significant association, with various strengths of evidence. Mediterranean diet was associated with lower risk of dementia, Alzheimer disease (AD), cognitive impairment, stroke, and neurodegenerative diseases in general. In Parkinson disease (PD) and AD/dementia, coffee consumption, and physical activity were protective factors. Low serum uric acid levels were associated with increased risk of PD. Smoking was associated with elevated risk of multiple sclerosis and dementia but lower risk of PD, while hypertension was associated with lower risk of PD but higher risk of dementia. Chronic occupational exposure to lead was associated with higher risk of amyotrophic lateral sclerosis. Late-life depression was associated with higher risk of AD and any form of dementia. Conclusions We identified several non-genetic risk and protective factors for various neurological diseases relevant to preventive clinical neurology, health policy, and lifestyle counseling. Our findings could offer new perspectives in secondary research (meta-research).

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Section: Implications For Target Groupsmentioning

confidence: 99%

Non-genetic risk and protective factors and biomarkers for neurological disorders: a meta-umbrella systematic review of umbrella reviews

Mentis

Dardiotis

Efthymiou

et al. 2021

BMC Med

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“…The keys of neural repairing have not been revealed to us by progress, despite many efforts, many clear-sighted and dedicated clinicians, and many brilliant and exceptional researchers. Those keys for neuroregeneration appear to be deadlocked despite the colossal knowledge acquired in ontogenics and multi-omics (genomics, transcriptomics, proteomics, functional lipidomics and metabolomics) and the development of powerful advanced methods of bioinformatics and big data mining [ 140 , 141 ].…”

Section: Discussionmentioning

confidence: 99%

After 55 Years of Neurorehabilitation, What Is the Plan?

Viruega¹,

Gaviria²

2022

Brain Sciences

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Neurological disorders often cause severe long-term disabilities with substantial activity limitations and participation restrictions such as community integration, family functioning, employment, social interaction and participation. Increasing understanding of brain functioning has opened new perspectives for more integrative interventions, boosting the intrinsic central nervous system neuroplastic capabilities in order to achieve efficient behavioral restitution. Neurorehabilitation must take into account the many aspects of the individual through a comprehensive analysis of actual and potential cognitive, behavioral, emotional and physical skills, while increasing awareness and understanding of the new self of the person being dealt with. The exclusive adoption by the rehabilitator of objective functional measures often overlooks the values and goals of the disabled person. Indeed, each individual has their own rhythm, unique life history and personality construct. In this challenging context, it is essential to deepen the assessment through subjective measures, which more adequately reflect the patient’s perspective in order to shape genuinely tailored instead of standardized neurorehabilitation approaches. In this overly complex panorama, where confounding and prognostic factors also strongly influence potential functional recovery, the healthcare community needs to rethink neurorehabilitation formats.

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“…Anyway, providing individualised psychosocial support for patients and their caregivers is very important for improving symptoms and quality of life. 10 CONCLUSION Some of PNFAs are due to the underlying pathology of AD, which is more common in EOAD. In the present case, neither clinical examination nor MRI could definitively differentiate FTLD from EOAD.…”

Section: Discussionmentioning

confidence: 99%

Case of early-onset Alzheimer’s disease with atypical manifestation

Zhu

Sun

et al. 2021

Gen Psych

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Short-term memory decline is the typical clinical manifestation of Alzheimer’s disease (AD). However, early-onset AD usually has atypical symptoms and may get misdiagnosed. In the present case study, we reported a patient who experienced symptoms of memory loss with progressive non-fluent aphasia accompanied by gradual social withdrawal. He did not meet the diagnostic criteria of AD based on the clinical manifestation and brain MRI. However, his cerebrospinal fluid examination showed a decreased level of beta-amyloid 42, and increased total tau and phosphorylated tau. Massive amyloid β-protein deposition by 11C-Pittsburgh positron emission tomography confirmed the diagnosis of frontal variant AD. This case indicated that early-onset AD may have progressive non-fluent aphasia as the core manifestation. The combination of individual and precision diagnosis would be beneficial for similar cases.

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Neurology—the next 10 years

Cited by 7 publications

References 78 publications

Non-genetic risk and protective factors and biomarkers for neurological disorders: a meta-umbrella systematic review of umbrella reviews

Non-genetic risk and protective factors and biomarkers for neurological disorders: a meta-umbrella systematic review of umbrella reviews

After 55 Years of Neurorehabilitation, What Is the Plan?

Case of early-onset Alzheimer’s disease with atypical manifestation

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