The Hanger Reflex: An Inexpensive and Non-invasive Therapeutic Modality for Dystonia and Neurological Disorders

Takashi ASAHI; Takuto NAKAMURA; Michi SATO; Yuki KON; Hiroyuki KAJIMOTO; Shuji SATO

doi:10.2176/nmc.ra.2020-0156

Botulinum Toxin in Movement Disorders: An Update

Toxins ◽

10.3390/toxins13010042 ◽

2021 ◽

Vol 13 (1) ◽

pp. 42

Author(s):

Charenya Anandan ◽

Joseph Jankovic

Keyword(s):

Botulinum Toxin ◽

Movement Disorders ◽

Neurological Disorders ◽

Active Drug ◽

Therapeutic Agents ◽

Therapeutic Modality ◽

Review Of The Literature ◽

Pilot Studies ◽

The Us ◽

Novel Applications

Since its initial approval in 1989 by the US Food and Drug Administration for the treatment of blepharospasm and other facial spasms, botulinum toxin (BoNT) has evolved into a therapeutic modality for a variety of neurological and non-neurological disorders. With respect to neurologic movement disorders, BoNT has been reported to be effective for the treatment of dystonia, bruxism, tremors, tics, myoclonus, restless legs syndrome, tardive dyskinesia, and a variety of symptoms associated with Parkinson’s disease. More recently, research with BoNT has expanded beyond its use as a powerful muscle relaxant and a peripherally active drug to its potential central nervous system applications in the treatment of neurodegenerative disorders. Although BoNT is the most potent biologic toxin, when it is administered by knowledgeable and experienced clinicians, it is one of the safest therapeutic agents in clinical use. The primary aim of this article is to provide an update on recent advances in BoNT research with a focus on novel applications in the treatment of movement disorders. This comprehensive review of the literature provides a critical review of evidence-based clinical trials and highlights recent innovative pilot studies.

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Non-invasive brain stimulation and psychiatric symptoms in neurological disorders

Journal of the Neurological Sciences ◽

10.1016/j.jns.2021.117962 ◽

2021 ◽

Vol 429 ◽

pp. 117962

Author(s):

Sarah Lisanby

Keyword(s):

Brain Stimulation ◽

Neurological Disorders ◽

Psychiatric Symptoms ◽

Non Invasive

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P04.22 Tumor treating fields in high-grade glioma patients: A retrospective single-center study

Neuro-Oncology ◽

10.1093/neuonc/noab180.075 ◽

2021 ◽

Vol 23 (Supplement_2) ◽

pp. ii23-ii23

Author(s):

R Lucaciu ◽

B Suchorska ◽

M Wettig ◽

S Jung ◽

M Scholz

Keyword(s):

Promoter Methylation ◽

Daily Life ◽

Methylation Status ◽

Mgmt Promoter Methylation ◽

Therapeutic Modality ◽

High Grade ◽

Newly Diagnosed ◽

Non Invasive ◽

Tumor Treating Fields ◽

Mgmt Promoter

Abstract BACKGROUND Tumor-treating fields (TTFields) are a modern anti-mitotic, non-invasive therapy for the treatment of patients with recurrent and newly diagnosed glioblastoma multiforme (GBM). In Europe, Optune® recieved in 2015 the CE certification. TTFields are a low-intensity (1–3 V/cm) approved therapeutic modality using a non-invasive application of intermediate frequency (200 kHz) alternating electric fields through four transducer arrays directly applied to the skin. The EF-14 study has shown that the addition of TTFields to temozolomide chemotherapy in patients with newly diagnosed GBM significantly improved overall survival (OS) and progression-free survival (PFS) without additional adverse events, apart from mild to moderate skin irritations (Stupp et al., JAMA 2017). MATERIAL We retrospectively analyzed data from TTFields-treated patients (2015–2020) that were treated at our department. Patient characteristics such as MGMT promoter methylation status, age, and diagnosis, as well as treatment duration and TTFields therapy usage, were evaluated for this study. RESULTS 29 patients were treated with TTFields therapy between 2015 and 2020 at our hospital. Most patients received TTFields as primary treatment together with temozolomide maintenance therapy. In detail, 48% of patients were diagnosed with newly diagnosed GBM, 41% received TTFields therapy after tumor recurrence and 10% were diagnosed with other high-grade gliomas. In summary, patients could integrate TTFields therapy into their daily life and showed high adherence to the therapy.Particularly, one of our patients (with MGMT-promoter methylation positive) receives TTFields therapy now for almost 1229 days (approx. 41 months) and is still on therapy. Additionally, this patient shows a high usage rate of 86% indicating well integration of the therapy into daily life. CONCLUSION Taken together, our data provided the outcomes of using TTFields together with chemotherapy in the treatment of recurrent and newly diagnosed GBM in our department. Therapy with TTFields has been showing to provide significant clinical benefit for GBM patients.

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Pulmonary Delivery of Biological Drugs

Pharmaceutics ◽

10.3390/pharmaceutics12111025 ◽

2020 ◽

Vol 12 (11) ◽

pp. 1025

Author(s):

Wanling Liang ◽

Harry W. Pan ◽

Driton Vllasaliu ◽

Jenny K. W. Lam

Keyword(s):

Pulmonary Delivery ◽

High Specificity ◽

Therapeutic Modality ◽

Systemic Delivery ◽

Biological Drugs ◽

Onset Of Action ◽

Non Invasive ◽

Inhalation Devices ◽

Rapid Absorption ◽

Immense Potential

In the last decade, biological drugs have rapidly proliferated and have now become an important therapeutic modality. This is because of their high potency, high specificity and desirable safety profile. The majority of biological drugs are peptide- and protein-based therapeutics with poor oral bioavailability. They are normally administered by parenteral injection (with a very few exceptions). Pulmonary delivery is an attractive non-invasive alternative route of administration for local and systemic delivery of biologics with immense potential to treat various diseases, including diabetes, cystic fibrosis, respiratory viral infection and asthma, etc. The massive surface area and extensive vascularisation in the lungs enable rapid absorption and fast onset of action. Despite the benefits of pulmonary delivery, development of inhalable biological drug is a challenging task. There are various anatomical, physiological and immunological barriers that affect the therapeutic efficacy of inhaled formulations. This review assesses the characteristics of biological drugs and the barriers to pulmonary drug delivery. The main challenges in the formulation and inhalation devices are discussed, together with the possible strategies that can be applied to address these challenges. Current clinical developments in inhaled biological drugs for both local and systemic applications are also discussed to provide an insight for further research.

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Nanotechnology Based Point-of-Care Diagnostics and Therapeutics for Neurological Disorders

ASME 2010 First Global Congress on NanoEngineering for Medicine and Biology ◽

10.1115/nemb2010-13014 ◽

2010 ◽

Author(s):

Vijay K. Varadan

Keyword(s):

Health Care Professionals ◽

Neurological Disorders ◽

Point Of Care ◽

Diagnostic Testing ◽

Preventive Therapy ◽

Accurate Diagnosis ◽

Wireless Sensor ◽

Non Invasive ◽

Point Of Care Diagnostics ◽

Fundamental Research

This talk is aimed at presenting novel solutions developed recently by the author’s group for many neurological disorders including Parkinson’s disease, Alzheimer’s disease, depression, anxiety, sleep apnea and sleep disorders using the fundamental research and developments in nanotechnologies and wireless sensor network. Point-of-care (POC) diagnostics promises to bring diagnostic testing out of the laboratory directly to patients and the general public wherever they may be. The key to POC diagnostics is capable of bringing immediate answers so that health care professionals can make rapid and accurate diagnosis of disease so as to ensure the effectiveness of therapy and early detection for preventive therapy. Selected movies illustrating the applications of both invasive and non-invasive wireless nanosensor systems to patients and surgical procedures will be shown at the talk.

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Evaluation of Spontaneous Swallow Frequency in Healthy People and Those With, or at Risk of Developing, Dysphagia: A Review

Gerontology and Geriatric Medicine ◽

10.1177/23337214211041801 ◽

2021 ◽

Vol 7 ◽

pp. 233372142110418

Author(s):

Joseph M. Bulmer ◽

Caroline Ewers ◽

Michael J. Drinnan ◽

Victoria C. Ewan

Keyword(s):

At Risk ◽

Neurological Disorders ◽

Quality Criteria ◽

Clinical Variable ◽

Normative Values ◽

Healthy Population ◽

Cochrane Central Register ◽

Non Invasive ◽

Cochrane Database ◽

Central Register

Dysphagia is a common and frequently undetected complication of many neurological disorders and of sarcopoenia in ageing persons. Spontaneous swallowing frequency (SSF) has been mooted as a possible tool to classify dysphagia risk. We conducted a review of the literature to describe SSF in both the healthy population and in disease-specific populations, in order to consider its utility as a screening tool to identify dysphagia. We searched Medline, Embase, Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials databases. Metadata were extracted, collated and analysed to give quantitative insight. Three hundred and twelve articles were retrieved, with 19 meeting inclusion and quality criteria. Heterogeneity between studies was high (I2 = 99%). Mean SSF in healthy younger sub-groups was 0.98/min [CI: 0.67; 1.42]. In the Parkinson’s sub-group, mean SSF was 0.59/min [0.40; 0.87]. Mean SSF in healthy older, higher risk and dysphagic populations were similar (0.21/min [0.09; 0.52], 0.26/min [0.10; 0.72] and 0.30/min [0.16; 0.54], respectively). SSF is a novel, non-invasive clinical variable which warrants further exploration as to its potential to identify persons at risk of dysphagia. Larger, well-conducted studies are needed to develop objective, standardised methods for detecting SSF, and develop normative values in healthy populations.

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Design and Implementation of Wireless Rehabilitation Aid for Tongue Disorders

International Journal of Pharmacy and Biomedical Engineering ◽

10.14445/23942576/ijpbe-v4i1p102 ◽

2017 ◽

Vol 4 (1) ◽

pp. 4-7

Author(s):

Farhana Siddique ◽

Saranya M ◽

Saranya Christabell M ◽

Prema S

Keyword(s):

Oral Cavity ◽

Neurological Disorders ◽

Short Interval ◽

Tongue Pressure ◽

Therapeutic Tool ◽

Non Invasive ◽

Design And Implementation ◽

Color Detection ◽

Impaired Speech ◽

Tongue Color

The tongue is a muscular hydrostat which is a part of oral cavity. The interaction of tongue with palate is essential for articulation of speech and swallowing of food. Patients with neurological disorders have impaired speech and swallowing problem. In this work, a device is envisioned to provide a non-invasive rehabilitation aid for speech and swallowing disorders. The proposed device serves as both diagnostic and therapeutic tool. The parameters of the proposed device are tongue pressure measurement and tongue color detection along with neuromodulation stimulator (tongue stimulator – therapeutic aid). The output, which is a waveform (tongue pressure) and an image (tongue color) are transmitted wirelessly outside the oral cavity to the computer. This device is used to investigate and quantify the degree of tongue disorder. Periodic rehabilitation therapies along with the proposed device, increases the chances of recovery of functional tongue disorders by 50% within a short interval of time.

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Modulated focused ultrasound for treatment of de-myelinating axons in multiple sclerosis lesions – pilot animal studies

10.31225/osf.io/vqbef ◽

2018 ◽

Author(s):

Pierre D. Mourad

Keyword(s):

Multiple Sclerosis ◽

Mouse Model ◽

Brain Tissue ◽

Neurological Disorders ◽

Animal Studies ◽

Focused Ultrasound ◽

Neural Circuits ◽

Laser Light ◽

Non Invasive ◽

Pulsed Focused Ultrasound

Multiple sclerosis is a debilitating disease whose symptoms arise from de-myelination of axons within brain tissue with an attendant loss of central and peripheral function. We among others have shown that transcranial delivery of pulsed focused ultrasound (pFU) can non-destructively activate central neural circuits. Others have shown enhanced myelin remodeling of axons activated by laser light in an optogenetic mouse model. We hypothesize that pFU activation of axons within MS lesions in a rodent model will decrease their de-myelination and increase their re-myelination. If successful, this non-invasive therapy may lead to rapid advancements in the treatment of MS and other de-myelinating neurological disorders.

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