Current opinion in neurology
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Myasthenic syndromes are distinct disorders at the neuromuscular junction, most often with well characterized autoimmune or genetic pathology. New aspects of the dysfunctions give insight into the normal neuromuscular function in addition to giving therapeutic clues and tailoring the therapy to the pathophysiology in individual patients. ⋯ Myasthenic syndromes and myasthenia gravis are well characterized disorders. The prognosis is generally good, apart from paraneoplastic Lambert-Eaton myasthenic syndrome. However, patients need long-term symptomatic and immunoactive treatment, this treatment to be balanced against present and potential side effects. New and more selective treatment is needed, especially for severe generalized disease. Well controlled long-term studies of sufficient power are much wanted, but new therapy has often to be tried in patients before high-class evidence of effect on myasthenia gravis has been published.
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This review focuses on recent advances in functional connectivity MRI and renewed interest in studying the large-scale functional network assemblies in the brain. We also consider some methodological aspects of graph theoretical analysis. ⋯ Functional connectivity MRI and corresponding analytical tools continue to reveal novel properties of the functional organization of the brain, which will in turn be key for understanding pathologies in neurology.
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Curr. Opin. Neurol. · Aug 2012
ReviewFunctional brain networks in movement disorders: recent advances.
Different neuroimaging techniques have been used to identify disease-specific functional brain networks in Parkinson's disease, atypical parkinsonian syndromes, and other movement disorders. This review highlights recent advances in network imaging and its clinical applications in movement disorders. ⋯ Although in most movement disorders the predominant histopathology involves the basal ganglia, including the substantia nigra, functional changes in relevant neural circuits are not limited to these structures. The current advances in functional brain imaging have contributed to a better pathophysiological understanding of movement disorders as complex alterations of widespread functional brain networks. The promising findings from recent studies may help to establish new and reliable biomarkers to monitor disease progression and treatment effects in future clinical trials.
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Curr. Opin. Neurol. · Aug 2012
ReviewMRI in multiple sclerosis: a review of the current literature.
This review summarizes the recent data pertaining to the use of magnetic resonance imaging (MRI) in assessing brain and spinal cord involvement in multiple sclerosis (MS). ⋯ MRI continues to play a pivotal role in the investigation of MS. Ongoing advances in MRI technology should further expand the current understanding of pathologic disease mechanisms and improve diagnostic, prognostic, and monitoring ability in patients with MS.
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This review article is focused upon the most recent biomarker studies of Parkinson's disease. It provides an update on promising areas of biomarker research in a rapidly expanding field, and discusses future directions that might lead to successful development of Parkinson's disease biomarkers. ⋯ The search for effective biomarkers for diagnosis and surveillance of Parkinson's disease continues. A battery of biomarkers comprising different modalities might be required to address clinical needs in this complex disorder. Critically, collaborative efforts including centralized tissue repository and clinical research infrastructure that are being organized will advance this field further.