Lithium Aspartate for Long COVID Fatigue and Cognitive Dysfunction: A Randomized Clinical Trial.

Importance: Neurologic post-COVID-19 condition (PCC), or long COVID, symptoms of fatigue and cognitive dysfunction continue to affect millions of people who have been infected with SARS-CoV-2. There currently are no effective evidence-based therapies available for treating neurologic PCC.

Objective: To assess the effects of lithium aspartate therapy on PCC fatigue and cognitive dysfunction.

Lithium's effects on therapeutic targets and MRI biomarkers in Parkinson's disease: A pilot clinical trial.

Background: Lithium has a wide range of neuroprotective actions, has been effective in Parkinson's disease (PD) animal models and may account for the decreased risk of PD in smokers.

Methods: This open-label pilot clinical trial randomized 16 PD patients to "high-dose" ( = 5, lithium carbonate titrated to achieve serum level of 0.4-0.

Thalamic Dorsomedial Nucleus Free Water Correlates with Cognitive Decline in Parkinson's Disease.

Background: Brain diffusion tensor imaging (DTI) has been shown to reflect cognitive changes in early Parkinson's disease (PD) but the diffusion-based measure free water (FW) has not been previously assessed.

Objectives: To assess if FW in the thalamic nuclei primarily involved with cognition (ie, the dorsomedial [DMN] and anterior [AN] nuclei), the nucleus basalis of Meynert (nbM), and the hippocampus correlates with and is associated with longitudinal cognitive decline and distinguishes cognitive status at baseline in early PD. Also, to explore how FW compares with conventional DTI, FW-corrected DTI, and volumetric assessments for these outcomes.

Diffusion Magnetic Resonance Imaging Detects Progression in Parkinson's Disease: A Placebo-Controlled Trial of Rasagiline.

Background: Rasagiline has received attention as a potential disease-modifying therapy for Parkinson's disease (PD). Whether rasagiline is disease modifying remains in question.

Objective: The main objective of this study was to determine whether rasagiline has disease-modifying effects in PD over 1 year.

Molecular Features of Parkinson's Disease in Patient-Derived Midbrain Dopaminergic Neurons.

Background: Despite intense efforts to develop an objective diagnostic test for Parkinson's disease, there is still no consensus on biomarkers that can accurately diagnose the disease.

Objective: Identification of biomarkers for idiopathic Parkinson's disease (PD) may enable accurate diagnosis of the disease. We tried to find molecular and cellular differences in dopaminergic (DA) neurons derived from healthy subjects and idiopathic PD patients with or without rest tremor at onset.

Effect of gabapentin on hyperemesis gravidarum: a double-blind, randomized controlled trial.

Background: Hyperemesis gravidarum is a disabling disease of nausea, vomiting, and undernutrition in early pregnancy for which there are no effective outpatient therapies. Poor weight gain in hyperemesis gravidarum is associated with several adverse fetal outcomes including preterm delivery, low birthweight, small for gestational age, low 5-minute Apgar scores, and neurodevelopmental delay. Gabapentin is most commonly used clinically for treating neuropathic pain but also substantially reduces chemotherapy-induced and postoperative nausea and vomiting.

Long-standing multiple sclerosis neurodegeneration: volumetric magnetic resonance imaging comparison to Parkinson's disease, mild cognitive impairment, Alzheimer's disease, and elderly healthy controls.

Multiple sclerosis (MS) exhibits neurodegeneration driven disability progression. We compared the extent of neurodegeneration among 112 long-standing MS patients, 37 Parkinson's disease (PD) patients, 34 amnestic mild cognitive impairment (aMCI) patients, 37 Alzheimer's disease (AD) patients, and 184 healthy controls. 3T MRI volumes of whole brain (WBV), white matter (WMV), gray matter (GMV), cortical (CV), deep gray matter (DGM), and nuclei-specific volumes of thalamus, caudate, putamen, globus pallidus, and hippocampus were derived with SIENAX and FIRST software.

High lithium levels in tobacco may account for reduced incidences of both Parkinson's disease and melanoma in smokers through enhanced β-catenin-mediated activity.

Parkinson's disease (PD) patients have higher rates of melanoma and vice versa, observations suggesting that the two conditions may share common pathogenic pathways. β-Catenin is a transcriptional cofactor that, when concentrated in the nucleus, upregulates the expression of canonical Wnt target genes, such as Nurr1, many of which are important for neuronal survival. β-Catenin-mediated activity is decreased in sporadic PD as well as in leucine-rich repeat kinase 2 (LRRK2) and β-glucosidase (GBA) mutation cellular models of PD, which is the most common genetic cause of and risk for PD, respectively.

Ventral posterior substantia nigra iron increases over 3 years in Parkinson's disease.

Background: Parkinson's disease (PD) is characterized in part by the progressive accumulation of iron within the substantia nigra (SN); however, its spatial and temporal dynamics remain relatively poorly understood.

Objectives: The objective of this study was to investigate spatial patterns and temporal evolution of SN iron accumulation in PD.

Methods: A total of 18 PD patients (mean disease duration = 6.

Targeting kinases in Parkinson's disease: A mechanism shared by LRRK2, neurotrophins, exenatide, urate, nilotinib and lithium.

Several kinases have been implicated in the pathogenesis of Parkinson's disease (PD), most notably leucine-rich repeat kinase 2 (LRRK2), as LRRK2 mutations are the most common genetic cause of a late-onset parkinsonism that is clinically indistinguishable from sporadic PD. More recently, several other kinases have emerged as promising disease-modifying targets in PD based on both preclinical studies and clinical reports on exenatide, the urate precursor inosine, nilotinib and lithium use in PD patients. These kinases include protein kinase B (Akt), glycogen synthase kinases-3β and -3α (GSK-3β and GSK-3α), c-Abelson kinase (c-Abl) and cyclin-dependent kinase 5 (cdk5).

Treatment of chronic insomnia disorder in menopause: evaluation of literature.

Objective: Insomnia both as a symptom and as part of chronic insomnia disorder is quite common in menopause. Comorbid conditions, such as restless legs syndrome and obstructive sleep apnea, occur with high prevalence among perimenopausal women with insomnia. Insomnia in this population group is associated with adverse health outcomes, and there are no clear standards on how to treat it.

Potential maternal symptomatic benefit of gabapentin and review of its safety in pregnancy.

Restless legs syndrome (RLS) and nausea and vomiting of pregnancy (NVP) are both common maternal conditions affecting quality of life. Gabapentin is currently FDA-approved for treating RLS and preliminary results have shown it may be effective for treating the most severe form of NVP, hyperemesis gravidarum (HG). Because NVP and HG symptoms peak early in pregnancy, the potential teratogenicity of gabapentin needs to be considered.

Gabapentin's anti-nausea and anti-emetic effects: a review.

Gabapentin's main clinical use is in the treatment of neuropathic pain where its binding to neuronal alpha-2/delta subunits of voltage-gated calcium channels (VGCCs) is critical to its mechanism of action. Over the past 10 years, there have been several reports of gabapentin also having anti-nausea and anti-emetic effects in conditions including postoperative nausea and vomiting (PONV), chemotherapy-induced nausea and vomiting (CINV), and hyperemesis gravidarum (HG). In this report, a MEDLINE electronic search was performed, and relevant citations were reviewed and classified by level of evidence; a grade of recommendation was then assigned for gabapentin's use for each studied indication.

Stellate ganglion block for treating hot flashes: a viable treatment option or sham procedure?

Stellate ganglion block (SGB) has been used for over 70 years to treat various cervical pain syndromes. Over the past 8 years, 4 different groups have reported on SGB's effects on hot flashes from unblinded, open-label trials. Review of these studies has shown markedly disparate results in terms of the magnitude of hot flash reduction from Baseline with one trial showing a 90% reduction in hot flashes and 3 other trials showing 28-44% reductions in hot flashes.

Nighttime awakenings responding to gabapentin therapy in late premenopausal women: a case series.

Insomnia related to nighttime awakenings is known to be more prevalent in women than men. Three cases are presented here of late premenopausal women experiencing frequent nighttime awakenings that responded well to bedtime treatment with gabapentin. In one case, what started as isolated nighttime awakenings slowly progressed to awakenings accompanied by typical menopausal night sweats.

Effective and clinically meaningful non-hormonal hot flash therapies.

Although many non-hormonal compounds have shown statistically significant benefit over placebo in hot flash randomized controlled trials (RCTs), these studies have varied considerably in basic methodology making it challenging to deduce which compounds have the greatest potential to provide clinically meaningful benefit. This review used evidence-based methodology closely mirroring the FDA and EMEA guidelines as a template to identify "well-designed" RCTs from which effective and clinically meaningful non-hormonal hot flash therapies could be identified. In addition, pertinent safety information was reviewed.

Review of hot flash diaries.

Currently, there is only 1 published hot flash diary. This diary rates hot flash severity according to 4 categories: mild, moderate, severe, and very severe. The descriptions of these 4 severity categories are located on a separate form from the main data form.

Minimum trial duration to reasonably assess long-term efficacy of nonhormonal hot flash therapies.

Background: Because hot flashes usually persist for years after menopause, a clinically meaningful hot flash therapy needs to have long-term efficacy; however, it is unclear for how long a therapy needs to be compared with a placebo before long-term efficacy can be reasonably deduced. The Food and Drug Administration (FDA) requires a 12-week treatment period for industry-initiated hot flash trials, whereas most academic-initiated trials have ranged from 4 to 12 weeks. We have focused on reviewing nonhormonal hot flash trials to identify inadequate trial durations as a guide toward deducing adequate trial duration to reasonably assess for long-term efficacy.

Gabapentin use in hyperemesis gravidarum: a pilot study.

Among 7 subjects with hyperemesis gravidarum (HG), we found gabapentin therapy to be associated with mean reductions in nausea and emesis from Baseline to Days 12-14 of 80% and 94%, respectively. There have been 2 congenital defects among 7 exposed infants. Gabapentin may be effective in the treatment of HG.

Effects of gabapentin on sleep in menopausal women with hot flashes as measured by a Pittsburgh Sleep Quality Index factor scoring model.

Objective: The aim of this research was to analyze gabapentin's effect on Pittsburgh Sleep Quality Index (PSQI) scores in menopausal women.

Methods: Secondary analysis of data from a cohort of menopausal women participating in a randomized, double-blind, placebo-controlled trial of gabapentin 300 mg three times daily (TID) for hot flashes. The outcomes of interest were PSQI global and factor scores at weeks 4 and 12.

Effect of L-methionine on hot flashes in postmenopausal women: a randomized controlled trial.

Objective: Based on a common mechanism of action with gabapentin, we investigated the effects of L-methionine on hot flashes in postmenopausal women.

Methods: After a 1-week baseline period, 51 postmenopausal women experiencing at least five moderate-severe hot flashes per day were randomized to one of three groups in a 13:13:25 ratio: placebo/placebo, placebo/L-methionine, or L-methionine/L-methionine, respectively (phase 1/phase 2). Phase 1 was 12 weeks long, and phase 2 was 8 weeks long.

Newer antidepressants and gabapentin for hot flashes: an individual patient pooled analysis.

Purpose: Nonhormonal treatment options have been investigated as treatments for hot flashes, a major clinical problem in many women. Starting in 2000, a series of 10 individual double-blind placebo-controlled studies has evaluated newer antidepressants and gabapentin for treating hot flashes. This current project was developed to conduct an individual patient pooled analysis of the data from these published clinical trials.