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Cerebellar Involvement in Attacks of Aquaporin-4-IgG Positive Neuromyelitis Optica Spectrum Disorder.
Neurol Neuroimmunol Neuroinflamm
January 2025
From the Department of Neurology and Center for Multiple Sclerosis and Autoimmune Neurology (A.D., L.C., J.J.-W.C., B.G.W., S.A.B., S.J.P., E.P.F.), Mayo Clinic College of Medicine, Rochester, MN; Department of Neurosciences (A.D.), Biomedicine, and Movement Sciences, University of Verona, Italy; Department of Radiology (K.N.K.), Mayo Clinic; Department of Ophthalmology (J.J.-W.C.), Mayo Clinic College of Medicine, Rochester, MN; Department of Neurology (D.M.W., C.V.-S.), Mayo Clinic, Scottsdale, AZ; Department of Neurology (B.G.W.), University of Virginia, Charlottesville; Department of Neurology (A.S.L.-C.), Mayo Clinic College of Medicine, Jacksonville, FL; Neurology Unit (E.S.), University Hospital of Sassari, Italy; and Department of Laboratory Medicine and Pathology (S.J.P., E.P.F.), Mayo Clinic College of Medicine, Rochester, MN.
Objectives: To characterize the frequency and clinicoradiologic phenotype of cerebellar involvement in attacks of aquaporin-4-IgG positive neuromyelitis optica spectrum disorder (AQP4+NMOSD) which are incompletely captured in current diagnostic criteria.
Methods: Brain MRI scans from patients with AQP4+NMOSD in the Mayo Clinic database were reviewed, and those with cerebellar T2-hyperintense lesions ≤30 days from attack onset were included for clinical and radiologic characterization.
Results: From 432 patients with AQP4+NMOSD, we identified 17 (4%) with cerebellar attacks.
Disease-modifying treatment and disability progression in subclasses of patients with primary progressive MS: results from the Big MS Data Network.
J Neurol Neurosurg Psychiatry
December 2024
Department of Neurology, The Alfred Hospital, Melbourne, Victoria, Australia.
Background: Effectiveness of disease-modifying treatment (DMT) in people affected by primary progressive multiple sclerosis (PPMS) is limited. Whether specific subgroups may benefit more from DMT in a real-world setting remains unclear. Our aim was to investigate the potential effect of DMT on disability worsening among patients with PPMS stratified by different disability trajectories.
View Article and Find Full Text PDFMitochondrial disorders are associated with morphological neuromuscular junction defects.
Neuromuscul Disord
December 2024
INMG-PGNM, UMR CNRS 5261 - INSERM U1315, Université Lyon 1, Lyon, France; Centre de Biotechnologie Cellulaire, Hospices Civils De Lyon, Lyon, France.
Article Synopsis
- The study assessed the link between inherited mitochondrial dysfunction and neuromuscular junction (NMJ) remodeling in patients with mitochondrial disorders, analyzing muscle biopsies from 15 patients and 10 controls.
- Results showed that patients with mitochondrial disorders had significantly more remodeled and neoformed NMJ endplates, with a trend towards increased Schwann cell extensions, indicating NMJ alterations even without muscle weakness.
- The findings suggest that mitochondrial disorders may lead to NMJ remodeling as a primary issue, separate from structural muscle damage, though the exact mechanisms and clinical indicators warrant further investigation.
Building research capacity and capability to enhance the quality of living and dying addressing advancing frailty through integrated care: the ALLIANCE partnership.
Public Health Res (Southampt)
October 2024
University of Surrey, Guildford, UK.
Background: Frailty affects around 10% of people aged over 65 years, increasing to 65% of those over 90 years. This number is increasing. Older people with frailty are projected to become the largest future users of care services as they near end of life.
View Article and Find Full Text PDFDistributed Opioids in Morphine Equivalent: A Global Measure of Availability for Palliative Care.
J Pain Symptom Manage
October 2024
International Association of Hospice and Palliative Care (IAHPC) (L.D.L.), Houston, TX, USA; Department of Palliative Medicine (V.V.E.L.R.), University Hospital Bonn, Bonn, Germany.
Article Synopsis
- Estimates show a significant need for palliative care in low- and middle-income countries, particularly regarding access to essential opioids for pain relief.
- The DOME (Distributed Opioids in Morphine Equivalents) methodology quantifies this need by converting procured opioid quantities into morphine equivalents, allowing for a clearer assessment of unmet pain relief requirements.
- By using DOME and its metrics, countries can evaluate their health systems' capacity for palliative care and address gaps, ultimately improving health coverage and access to necessary treatments.
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