Category Archives: Neurology

Its been documented that patients with preexisting conditions may have greater risks when it comes to COVID-19. Now, according to research, patients with neurological symptoms and COVID-19 may be at risk for not only more severe COVID-19 symptomsbut exacerbated neurological symptoms as well.

The authors of the study queried the MEDLINE and medRxiv databases for relevant studies that reported on patients with preexisting neurological disorders and COVID-19 that reported the severity of the latter and/or changes in symptoms of the former. Severe COVID-19 was defined as having severe/critical pneumonia or admission to the intensive care unit.

Of 1,702 total studies identified (866 from MEDLINE, 836 from medRxiv), 26 studies encompassing 2,278 total patients were included in the final analysis. The disorders represented in the studies included cerebrovascular disease, Parkinsons disease, multiple sclerosis and related disorders, aquaporin-4 (AQP-4)-positive neuromyelitis optica spectrum disorder (NMOSD), dementia and cognitive disorder, epilepsy, spinal cord injury, systemic atrophy, myelopathy, intracranial mass, and unspecified disorders.

Not every study discussed both outcomes (the exacerbation of neurological symptoms and COVID-19 severity), so patients were stratified by those with preexisting neurological disorders and COVID-19 for where exacerbation of neurological symptoms was available (n=232) and where the severe COVID-19 course was available (n=2,618).

Among the patients whose neurological symptoms exacerbation was reported, 74 (31.9%) presented exacerbated preexisting neurological symptoms. This was observed in more than half of the patients with dementia (n=55/92; 59.5%) and Parkinsons disease (n=10/17; 58.8%).

Among the patients whose COVID-19 severity course was reported, 478 (22%) presented worsening COVID-19 severity. This was observed in about one-fifth of patients with cerebrovascular disease (n=86/445; 19.3%) and dementia (n=70/316; 22.2%) and two in five patients with multiple sclerosis (n=28/71; 39.4%); it was also seen in patients Parkinsons disease (25/214; 11.7%), epilepsy (10/98; 10.2%), spinal cord injury (5/7; 71.1%), and unspecified neurological disorders (254/1011; 25%).

The study was published in Clinical Neurology and Neurosurgery.

Clinicians should be aware of the risks of an exacerbation of neurological symptoms and an increase in COVID-19 severity in patients with preexisting neurological diseases, and should focus on the prevention and early care of COVID-19, the researchers concluded.

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Neurological Symptoms Mixed with COVID-19 May Mean Double the Worse Outcomes - DocWire News

Researchers from Penn Medicine have developed a new targeted approach that modifies viral vectors and inhibits toxicities in the sensory neurons of dorsal root ganglia (DRG) that commonly occur following the use of gene therapy for neurological diseases.

This strategy will likely have several important research and clinical implications, as investigators in the field have worked tirelessly for years to develop safer and more effective gene therapies for neurological disorders. We believe that this new approach could improve safety in gene therapy universally, said lead author Juliette Hordeaux, DVM, Ph.D., senior director of Translational Research in Penns Gene Therapy Program, in a statement.

Many gene therapies use viral vectors, but these vectors can have adverse neurological effects. While these toxicities have not yet been observed in humans, nonhuman primate studies using adeno-associated viral (AAV) vectors to deliver corrected genes via the spinal cord fluid have shown issues of axonal degeneration in spinal cord and peripheral nerve tracts. In these studies, the cause of the issues led back to the DRG, comprising a cluster of neural cells found on the outside of the spinal cord that are responsible for delivering sensory messages.

In a recent paper published in Science Translational Medicine, Dr. Hordeaux and colleagues found a way of modifying these vectors so they ultimately avoid these dangerous side effects. They first found that the toxicities appear to come from overexpression of a transgene in cells in the DRG.

The researchers altered a transgene with a microRNA target that was designed to reduce transgene expression levels in the DRG. Ultimately, this modification eliminated over 80% of the transgene expression and resulted in drastic toxicity reduction in the studied primates

We believe it is a safe, straightforward way to ameliorate the safety of AAV therapy for the central nervous system, said Hordeaux about the studied modification. This approach could be used to design other gene therapy vectors to repress transgene expression in the cell types that are affected by the toxicity and not others, which is critical, because you need the expression everywhere else to effectively treat the disorder.

Senior author of the paper was gene transfer expert James M. Wilson, MD, Ph.D., professor of Medicine and Pediatrics in Penns Perelman School of Medicine. Dr. Wilson, who left Solid Biosciences two years ago. Dr. Wilson has been discussing the potential adverse neurological effects of AAV vectors for several years.

Drs. Hordeaux and Wilson injected vectors with and without a microRNA target miRNA183 in mice and primates in the new study. The administration of unaltered AAV vectors led to robust delivery of the gene into target tissue as well as toxicities in DRG neurons. These effects occurred without impacting transduction in elsewhere in the brain, according to histological analyses conducted up to 90 days later.

The authors of the study suggest the toxicity of DRGs likely occur in a gene therapy relying on high vector doses or direct vector delivery into the fluid of the spinal cord. We were concerned about the DRG pathology that was observed in most of our nonhuman primate studies, noted Wilson. This modified vector shows great promise to reduce DRG toxicity and should facilitate the development of safer AAV-based gene therapies for many central nervous system diseases.

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New Targeted Approach Could Prevent Toxicities Associated with Neurological Gene Therapies - BioSpace

Transparency Market Research (TMR) has published a new report on the neurovascular embolization devices (neurology) market for the forecast period of 20192027. According to the report, the global neurovascular embolization devices (neurology) market was valued at ~US$ 1.2 Bn in 2018, and is projected to expand at a CAGR of ~3% from 2019 to 2027.

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Rise in Prevalence of Stroke to Drive Neurovascular Embolization Devices (Neurology) Market

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This article was originally published here

Clin Neurol Neurosurg. 2020 Nov 1:106349. doi: 10.1016/j.clineuro.2020.106349. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with chronic diseases likely develop severe 2019 coronavirus disease (COVID-19). However, little is known about the effects of COVID-19 on patients with neurological disorders. We conducted a systematic review to evaluate the severity of COVID-19 and its effect on neurological symptoms in patients with preexisting neurological disorder and COVID-19.

METHODS: We searched the MEDLINE (PubMed) and medRxiv databases for reports of patients with both preexisting neurological disorders and COVID-19. Studies reporting data on changes in the symptoms of preexisting neurological disorders and/or the severity of COVID-19 were included.

RESULTS: Twenty-six articles with 2278 patients with preexisting neurological disorder and COVID-19 were identified. Of 232 patients, 74 (31.9 %) showed exacerbation of preexisting neurological symptoms of dementia (55/92; 59.5 %), Parkinsons disease (10/17; 58.8 %), epilepsy (1/1; 100 %), and unspecified neurological disorders (8/106; 7.5 %). Of 2168 patients, 478 (22.0 %) showed severe COVID-19 course. These included patients with cerebrovascular disease (86/445; 19.3 %), dementia (70/316; 22.2 %), Parkinsons disease (25/214; 11.7 %), multiple sclerosis (28/71; 39.4 %), spinal cord injury (5/7; 71.4 %), epilepsy (10/98; 10.2 %) and unspecified neurological disorders (254/1011; 25 %).

CONCLUSIONS: Patients with preexisting neurological disorders and COVID-19 may develop exacerbation of neurological symptoms and severe COVID-19. Clinicians should be aware of the risk of symptom exacerbation and severe COVID-19 in patients with preexisting neurological disease and should focus on the prevention and early care of COVID-19.

PMID:33172719 | DOI:10.1016/j.clineuro.2020.106349

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Exacerbation of neurological symptoms and COVID-19 severity in patients with preexisting neurological disorders and COVID-19: A systematic review -...

Overview Of Interventional Neurology Device Industry 2020-2025:

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Interventional Neurology Device Market competition by top manufacturers as follow:MedtronicJohnson and JohnsonTerumo CorporationPenumbra, Inc.Merit Medical Systems, IncW.L. Gore & AssociatesMicroport Scientific CorporationMedikit Co., Ltd.Stryker

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The Type Coverage in the Market are: Embolization & coilingNeurothrombectomy Devices

Market Segment by Applications, covers:Treatment of Cerebral AneurysmsTreatment of Cerebral VasospasmVertebroplasty

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Global Minimally Invasive Neurology Device Market Is Anticipated To Witness Major Revenue Uplift During The Forecast Period 2020-2026| Reportspedia -...