Nature reviews. Neurology
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Nature reviews. Neurology · Dec 2012
ReviewNeural interfaces for the brain and spinal cord--restoring motor function.
Regaining motor function is of high priority to patients with spinal cord injury (SCI). A variety of electronic devices that interface with the brain or spinal cord, which have applications in neural prosthetics and neurorehabilitation, are in development. Owing to our advancing understanding of activity-dependent synaptic plasticity, new technologies to monitor, decode and manipulate neural activity are being translated to patient populations, and have demonstrated clinical efficacy. ⋯ Next-generation interfaces that combine recording and stimulating capabilities in so-called closed-loop devices will further extend the potential for neuroelectronic augmentation of injured motor circuits. Emerging evidence suggests that integration of closed-loop interfaces into intentional motor behaviours has therapeutic benefits that outlast the use of these devices as prostheses. In this Review, we summarize this evidence and propose that several known plasticity mechanisms, operating in a complementary manner, might underlie the therapeutic effects that are achieved by closing the loop between electronic devices and the nervous system.
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Nature reviews. Neurology · Dec 2012
ReviewHigh-pressure headaches: idiopathic intracranial hypertension and its mimics.
Idiopathic intracranial hypertension (IIH) is a rare disorder that typically affects obese women of childbearing age, but can also occur in paediatric populations. Patients usually present with diffuse, daily headache and visual disturbances, but either symptom can occur in isolation. Patients with IIH often have papilloedema; however, IIH without papilloedema is fairly common in patients with chronic daily headache. ⋯ Prevention of visual loss (which can be substantial) is the main goal of treatment. Residual headache and IIH recurrence are not uncommon after treatment, and regular follow-up is, therefore, warranted even in patients who achieve remission. This Review provides an update of current knowledge of the aetiology, pathophysiology and treatment of IIH.