394 results match your criteria: "and The National Hospital for Neurology[Affiliation]"

Background: ATX-FGF/SCA27A has been exclusively associated with heterozygous variants in the FGF14 gene, presenting with postural tremor, slowly progressive cerebellar ataxia, and psychiatric and behavioral disturbances.

Objectives: This study describes the first case of ATX-FGF/SCA27A linked to a biallelic frameshift variant in the FGF14 gene.

Methods: Whole-exome sequencing (WES) was conducted using the Illumina NovaSeq 6000 platform, and the identified variant was confirmed using Sanger sequencing.

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Over the past two decades there has been increased interest in orphan drug development for rare diseases. However, hurdles to clinical trial design for these disorders remain. This phase 1a/1b study addressed several challenges, while evaluating the safety and tolerability of the novel oral molecule KL1333 in healthy volunteers and subjects with primary mitochondrial disease.

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Diagnosis and management of status epilepticus: improving the status quo.

Lancet Neurol

January 2025

Division of Epilepsy and Clinical Neurophysiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.

Status epilepticus is a common neurological emergency that is characterised by prolonged or recurrent seizures without recovery between episodes and associated with substantial morbidity and mortality. Prompt recognition and targeted therapy can reduce the risk of complications and death associated with status epilepticus, thereby improving outcomes. The most recent International League Against Epilepsy definition considers two important timepoints in status epilepticus: first, when the seizure does not self-terminate; and second, when the seizure can have long-term consequences, including neuronal injury.

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Extra-articular symptoms, including headaches, are frequently encountered in patients with Ehlers-Danlos syndrome (EDS) and hypermobility spectrum disorders (HSD), and may be the presenting complaint. Migraine is reported in up to three quarters of patients with symptomatic joint hypermobility, have a higher headache frequency, and an earlier age of onset compared to the general population. Orthostatic headache is an important presentation, and should raise suspicion of an underlying spinal cerebrospinal fluid leak, dysautonomia, and craniocervical pathology, which are all associated with heritable connective tissue disorders (HCTD) including EDS.

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Assessment of the Clinical Interactions of GAA Repeat Expansions in and .

Neurol Genet

December 2024

From the Department of Neurology (B.J.G., J.S.N., M.N.), O'Donnell Brain Institute, University of Texas Southwestern Medical Center, Dallas; Department of Neurology and Neurosurgery (D.P., B.B.), Montreal Neurological Hospital and Institute, McGill University, Montreal, Quebec, Canada; Department of Neuromuscular Diseases (D.P.), UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, University College London, United Kingdom; Dr. John T. Macdonald Foundation Department of Human Genetics and John P. Hussman Institute for Human Genomics (M.C.D., S.Z.), University of Miami Miller School of Medicine, FL; Department of Human Genetics (B.B.), McGill University, Montreal, Quebec, Canada; Laboratory of Genome Integrity (G.M.-R., A.N.), National Cancer Institute, NIH; Laboratory of Cell and Molecular Biology (K.U.), National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD; and Department of Pediatrics and Neurology (C.C.P., D.R.L.), The Children's Hospital of Philadelphia, PA.

Article Synopsis
  • - This study aimed to investigate if the length of GAA repeat tracts in certain genes impacts the age of onset and clinical symptoms in patients with Friedreich ataxia (FRDA).
  • - Researchers analyzed 221 FRDA patients, focusing on the relationship between GAA repeat lengths and clinical presentation but found no significant correlations.
  • - Despite some similarities between FRDA and SCA27B, the GAA repeat lengths in the genes studied did not influence how FRDA manifests in patients.
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Objective: Late-onset cerebellar ataxia (LOCA) is a slowly progressive cerebellar disorder with symptom onset ≥30years of age. Intronic tandem repeat expansions (TREs) in RFC1 and FGF14 have recently emerged as common causes of LOCA. The relative contribution of classic vs.

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Article Synopsis
  • Cerebral small vessel disease (SVD) can lead to various cerebrovascular issues, but research on sex differences in SVD is limited.
  • This study analyzed data from over 20,000 patients with acute ischemic stroke to examine whether the presence and severity of cerebral microbleeds (CMB) and other SVD markers differ between males and females.
  • Results showed that males had more frequent CMB while females had fewer lacunes but higher severe white matter hyperintensities, indicating distinct SVD characteristics based on sex.
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Physical therapy in patients with Parkinson's disease treated with Deep Brain Stimulation: a Delphi panel study.

medRxiv

September 2024

"Aldo Ravelli" Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Via Antonio di Rudinì 8, 20142 Milan, Italy.

Article Synopsis
  • Deep brain stimulation of the subthalamic nucleus (STN-DBS) offers motor benefits for Parkinson's disease patients, but its effectiveness on postural and gait issues remains uncertain.
  • Physical therapy (PT) has shown effectiveness in improving mobility and stability in non-surgically treated Parkinson's patients, but its role after STN-DBS is less explored.
  • A study involving 21 experts highlighted that while PT could enhance motor function and quality of life post-STN-DBS, there’s a preference for conventional therapies over massage or manual techniques.
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Somatic instability of the FGF14-SCA27B GAA•TTC repeat reveals a marked expansion bias in the cerebellum.

Brain

October 2024

Department of Neurology and Neurosurgery, Montreal Neurological Hospital and Institute, McGill University, Montreal, QC H3A 2B4, Canada.

Article Synopsis
  • Spinocerebellar ataxia 27B (SCA27B) is a disease that affects balance and coordination, caused by a genetic change in a specific part of a gene called FGF14.
  • Research shows that most brain damage from this disease happens mainly in the cerebellum, which controls movement.
  • In a study of blood samples and brain tissue, scientists found that the genetic change was mostly stable over time, but it exhibited more growth in the cerebellum than in other brain areas, helping to explain why SCA27B mainly affects that part of the brain.
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Article Synopsis
  • Cerebrovascular events (CVEs) can happen during or after a procedure called TAVR, which replaces a heart valve, and can lead to serious health problems.
  • Even though strokes have become less common since TAVR started, they’re still a major concern because TAVR is being used more often.
  • New devices and treatments are being tested to help prevent CVEs, but current options may not reduce stroke risk enough, and there are concerns about bleeding from the medication used.
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Collagen VI-related dystrophies (COL6-RD) display a wide spectrum of disease severity and genetic variability ranging from mild Bethlem myopathy (BM) to severe Ullrich congenital muscular dystrophy (UCMD) and the intermediate severities in between with dual modes of inheritance, dominant and recessive. In the current study, next-generation sequencing demonstrated potential variants in the genes coding for the three alpha chains of collagen VI (COL6A1, COL6A2, or COL6A3) in a cohort of Egyptian patients with progressive muscle weakness (n = 23). Based on the age of disease onset and the patient clinical course, subjects were diagnosed as follows: 12 with UCMD, 8 with BM, and 3 with intermediate disease form.

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Article Synopsis
  • Chronic migraine affects 2-4% of adults globally and recent advances in expensive medications have prompted a review of their clinical and cost-effectiveness.
  • The study analyzed data from randomised controlled trials involving 7352 adults and compared six different medications, including calcitonin gene-related peptide monoclonal antibodies, Botox, and topiramate, against placebo.
  • Results showed that calcitonin gene-related peptide monoclonal antibodies ranked highest in reducing headache days and improving quality of life, while topiramate was less effective compared to these newer treatments.
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Adaptive Deep Brain Stimulation in Parkinson's Disease: A Delphi Consensus Study.

medRxiv

August 2024

"Aldo Ravelli" Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Via Antonio di Rudinì 8, 20142 Milan, Italy.

Article Synopsis
  • The evolution of Deep Brain Stimulation (DBS) is shifting from conventional methods to adaptive techniques (aDBS), which are expected to become standard practice in the next decade, similar to past advancements in cardiac pacing.
  • Research involving 21 experts highlighted the challenges and potential of aDBS, showing consensus on its safety and effectiveness compared to conventional DBS, particularly for Parkinson's Disease patients with motor fluctuations and dyskinesias.
  • Further studies are necessary to refine the algorithms used in aDBS, ensuring its widespread and effective use in clinical settings.
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Reduced Age-Dependent Penetrance of a Large FGF14 GAA Repeat Expansion in a 74-Year-Old Woman from a German Family with SCA27B.

Mov Disord

October 2024

Division Translational Genomics of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany.

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A common flanking variant is associated with enhanced stability of the FGF14-SCA27B repeat locus.

Nat Genet

July 2024

Dr. John T. Macdonald Foundation Department of Human Genetics and John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA.

Article Synopsis
  • The study investigates the factors affecting the expansion of tandem repeats, focusing on the FGF14 (GAA)·(TTC) repeat locus in a large sample of 2,530 individuals through advanced sequencing techniques.
  • Researchers discovered a prevalent 5'-flanking variant present in over 70% of alleles, which is linked to nonpathogenic alleles and the ancestral lineage of this genetic marker.
  • This common variant is associated with greater stability of the tandem repeat during inheritance and improved accessibility of chromatin, suggesting a role in preventing pathological expansion.
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Neurological disorders caused by novel non-coding repeat expansions: clinical features and differential diagnosis.

Lancet Neurol

July 2024

Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy. Electronic address:

Nucleotide repeat expansions in the human genome are a well-known cause of neurological disease. In the past decade, advances in DNA sequencing technologies have led to a better understanding of the role of non-coding DNA, that is, the DNA that is not transcribed into proteins. These techniques have also enabled the identification of pathogenic non-coding repeat expansions that cause neurological disorders.

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Pathogenic variants in are one of the most common genetic risk factors for Parkinson's disease (PD). Recently, the lesser-known p.L1795F variant was proposed as a strong genetic risk factor for PD, however, further families are currently lacking in literature.

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Article Synopsis
  • - The study investigates cardiovascular autonomic dysfunction in individuals with hereditary transthyretin amyloidosis, revealing that 27% reported symptoms at disease onset, increasing to 78% at the first evaluation (T1) after 4.5 years.
  • - A total of 124 individuals participated, with cardiovascular autonomic failure found in 75% of symptomatic patients and 64% of asymptomatic TTR variant carriers, highlighting a significant underestimate of autonomic issues in early stages.
  • - The findings suggest that autonomic dysfunction can be an early indicator of disease progression, with a faster progression rate observed in individuals reporting autonomic symptoms, emphasizing the need for routine autonomic function testing for better diagnosis and monitoring.
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Increasing appreciation of the phenotypic and biological overlap between amyotrophic lateral sclerosis (ALS) and frontotemporal dementia, alongside evolving biomarker evidence for a pre-symptomatic stage of disease and observations that this stage of disease might not always be clinically silent, is challenging traditional views of these disorders. These advances have highlighted the need to adapt ingrained notions of these clinical syndromes to include both the full phenotypic continuum - from clinically silent, to prodromal, to clinically manifest - and the expanded phenotypic spectrum that includes ALS, frontotemporal dementia and some movement disorders. The updated clinical paradigms should also align with our understanding of the biology of these disorders, reflected in measurable biomarkers.

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Climate change and disorders of the nervous system.

Lancet Neurol

June 2024

Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, University College London, London, UK; MRC International Centre for Genomic Medicine in Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, University College London, London, UK.

Anthropogenic climate change is affecting people's health, including those with neurological and psychiatric diseases. Currently, making inferences about the effect of climate change on neurological and psychiatric diseases is challenging because of an overall sparsity of data, differing study methods, paucity of detail regarding disease subtypes, little consideration of the effect of individual and population genetics, and widely differing geographical locations with the potential for regional influences. However, evidence suggests that the incidence, prevalence, and severity of many nervous system conditions (eg, stroke, neurological infections, and some mental health disorders) can be affected by climate change.

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Background: Migraine is the second most common prevalent disorder worldwide and is a top cause of disability with a substantial economic burden. Many preventive migraine medications have notable side effects that affect different body organs.

Method: We systematically searched for published randomised controlled trials (RCTs) using terms for migraine/headache and preventive medications.

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Baseline perihematomal edema, C-reactive protein, and 30-day mortality are not associated in intracerebral hemorrhage.

Front Neurol

April 2024

Division of Cardiovascular Sciences, School of Medical Sciences, Manchester Academic Health Science Center, University of Manchester, Manchester, United Kingdom.

Background: The relationship between baseline perihematomal edema (PHE) and inflammation, and their impact on survival after intracerebral hemorrhage (ICH) are not well understood.

Objective: Assess the association between baseline PHE, baseline C-reactive protein (CRP), and early death after ICH.

Methods: Analysis of pooled data from multicenter ICH registries.

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The genetic landscape and phenotypic spectrum of GAA-FGF14 ataxia in China: a large cohort study.

EBioMedicine

April 2024

Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China; Department of Neurology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, 410008, China; Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, Hunan, 410008, China; Bioinformatics Center & National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China; Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China; National International Collaborative Research Center for Medical Metabolomics, Central South University, Changsha, Hunan, China; Furong Laboratory, Central South University, Changsha, Hunan, 410008, China; Brain Research Center, Central South University, Changsha, Hunan, 410008, China. Electronic address:

Background: An intronic GAA repeat expansion in FGF14 was recently identified as a cause of GAA-FGF14 ataxia. We aimed to characterise the frequency and phenotypic profile of GAA-FGF14 ataxia in a large Chinese ataxia cohort.

Methods: A total of 1216 patients that included 399 typical late-onset cerebellar ataxia (LOCA), 290 early-onset cerebellar ataxia (EOCA), and 527 multiple system atrophy with predominant cerebellar ataxia (MSA-c) were enrolled.

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