Patients with a rare type of Alzheimer's disease do not show the memory loss characteristic of the condition even over the long term, new research suggests. They also show some differences in neuropathology to typical Alzheimer's patients, raising hopes of discovering novel mechanisms that might protect against memory loss in typical forms of the disease.

Dr Marsel Mesulam

"We are discovering that Alzheimer's disease has more than one form. While the typical Alzheimer's patient will have impaired memory, patients with primary progressive aphasia linked to Alzheimer's disease are quite different. They have problems with language they know what they want to say but can't find the words but their memory is intact," lead author Marsel Mesulam, MD, told Medscape Medical News.

"We have found that these patients still show the same levels of neurofibrillary tangles which destroy neurons in the memory part of the brain as typical Alzheimer's patients, but in patients with primary progressive aphasia Alzheimer's the nondominant side of this part of the brain showed less atrophy," added Mesulam, who is director of the Mesulam Center for Cognitive Neurology and Alzheimer's Disease at Northwestern University Feinberg School of Medicine, Chicago, Illinois. "It appears that these patients are more resilient to the effects of the neurofibrillary tangles."

The researchers also found that two biomarkers that are established risk factors in typical Alzheimer's disease do not appear to be risk factors for the primary progressive aphasia (PPA) form of the condition.

"These observations suggest that there are mechanisms that may protect the brain from Alzheimer's-type damage. Studying these patients with this primary progressive aphasia form of Alzheimer's may give us clues as to where to look for these mechanisms that may lead to new treatments for the memory loss associated with typical Alzheimer's disease," Mesulam commented.

The study was published online in the January 13 issue of Neurology.

PPA is diagnosed when language impairment emerges on a background of preserved memory and behavior, with about 40% of cases representing atypical manifestations of Alzheimer's disease, the researchers explain.

"While we knew that the memories of people with primary progressive aphasia were not affected at first, we did not know if they maintained their memory functioning over years," Mesulam noted.

The current study aimed to investigate whether the memory preservation in PPA linked to Alzheimer's is a consistent core feature or a transient finding confined to initial presentation, and to explore the underlying pathology of the condition.

The researchers searched their database to identify patients with PPA with autopsy or biomarker evidence of Alzheimer's, who also had at least two consecutive visits during which language and memory assessment had been obtained with the same tests.

The study included 17 patients with the PPA-type Alzheimer's disease. They were compared with 14 patients who had typical Alzheimer's disease with memory loss.

The authors point out that characterization of memory in patients with PPA is challenging because most tests use word lists, and thus patients may fail the test because of their language impairments. To address this issue, they included patients with PPA who had had memory tests involving recalling pictures of common objects.

Patients with typical Alzheimer's disease underwent similar tests but used a list of common words.

A second round of tests was conducted in the primary progressive aphasia group an average of 2.4 years later and in the typical Alzheimer's group an average of 1.7 years later.

Brain scans were also available for the patients with PPA, as well as postmortem evaluations for eight of the PPA cases and all the typical Alzheimer's cases.

Results showed that patients with PPA had no decline in their memory skills when they took the tests a second time. At that point, they had been showing symptoms of the disorder for an average of 6 years. In contrast, their language skills declined significantly during the same period. For typical Alzheimer's patients, verbal memory and language skills declined with equal severity during the study.

Postmortem results showed that the two groups had comparable degrees of Alzheimer's pathology in the medial temporal lobe the main area of the brain affected in dementia.

However, MRI scans showed that patients with PPA had an asymmetrical atrophy of the dominant (left) hemisphere with sparing of the right sided medial temporal lobe, indicating a lack of neurodegeneration in the nondominant hemisphere, despite the presence of Alzheimer's pathology.

It was also found that the patients with PPA had significantly lower prevalence of two factors strongly linked to Alzheimer's TDP-43 pathology and APOE 4 positivity than the typical Alzheimer's patients.

The authors conclude that: "Primary progressive aphasia Alzheimer's syndrome offers unique opportunities for exploring the biological foundations of these phenomena that interactively modulate the impact of Alzheimer's neuropathology on cognitive function."

In an accompanying editorial, Seyed Ahmad Sajjadi, MD, University of California, Irvine; Sharon Ash, PhD, University of Pennsylvania, Philadelphia; and Stefano Cappa, MD, University School for Advanced Studies, Pavia, Italy, say these findings have important implications, "as ultimately, preservation of cognition is the holy grail of research in this area."

They point out that the current observations imply "an uncoupling of neurodegeneration and pathology" in patients with PPA-type Alzheimer's, adding that "it seems reasonable to conclude that neurodegeneration, and not mere presence of pathology, is what correlates with clinical presentation in these patients."

The editorialists note that the study has some limitations: the sample size is relatively small; not all patients with PPA-type Alzheimer's underwent autopsy; MRI was only available for the aphasia group; and the two groups had different memory tests for comparison of their recognition memory.

But they conclude that this study "provides important insights about the potential reasons for differential vulnerability of the neural substrate of memory in those with different clinical presentations of Alzheimers pathology."

The study was supported by the National Institute on Deafness and Communication Disorders, the National Institute of Neurological Disorders and Stroke, the National Institute on Aging, the Davee Foundation, and the Jeanine Jones Fund.

Neurol. Published online January 13, 2021. Abstract, Editorial

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Type of Alzheimer's With Intact Memory Offers New Research Paths - Medscape

Chronic pain affects 1 in every 4 adults in the United States, many of whom are resistant to pharmacotherapy.1 It is a significant burden to both individuals and healthcare systems, affecting mental health, cognitive function, and promoting opioid dependency.2 However, researchers are hot on the heels of discovering new ways to treat the condition including via deep brain stimulation (DBS).

What is DBS?

DBS has the potential to treat a variety of neurological diseases by the implantation of electrical leads into specific areas of the brains cortex or subcortex, linking the leads to an implanted electrical stimulator.3 The appropriate areas of the brain are then stimulated with electrical current to ease or eliminate certain symptoms. While this treatment strategy is approved for motor diseases like essential tremors, dystonia, and Parkinsons disease, it is gaining increasing interest for pain relief in therapy-resistant individuals.4

DBS for the treatment of chronic pain

Since the 1950s, researchers have investigated DBS for the treatment of individuals with incurable, pain-inducing disorders.5 These investigations involved a variety of intractable pain syndromes, ranging from brachial plexopathy, injury of the spinal cord, and thalamic pain syndrome, to accident-related pain and mechanical lower back pain.6 Success has also been reported for incurable facial pain, although subsequent studies targeting different chronic pain disorders demonstrated inconsistent efficacy.5,6 Consequently, DBS is still considered investigational and off-label for chronic pain treatment today.

This off-label status has not hindered research, however. One study reported the results of 59 patients with a diverse range of chronic pain syndromes, who received DBS in the periventricular grey (PVG) area of the brain and/or the thalamus.7 In comparison to pre-operative levels, results indicated a drastic improvement, with more than half of patients, regardless of pain etiology, reporting pain relief by 50 percent.

Another study involved performing DBS on the periaqueductal grey (PAG) or PVG area, along with the sensory region of the thalamus or internal capsule, on patients with a variety of pain etiologies. Pain reduction exceeded 50 percent.8

Interestingly, some patients who fail to meet the 50 percent pain reduction criteria so often used in research testify to being greatly satisfied with any amount of pain reduction as it significantly improves their quality of life.9 This means that many patients are documented to have failed DBS treatment regardless of a partial, but notable, improvement.

Identifying novel target sites for chronic pain therapy

According to Prasad Shirvalkar, pain physician and Assistant Professor at the University of California, Historically, DBS has overwhelmingly targeted two brain regions: the ventral thalamus and the PAG areas. Thalamic DBS was hypothesized to work consistent with the Gate Control Theory of pain. It is believed that stimulating the thalamus produces tingling or other paraesthesia that effectively block pain-related transmission from fibers that provide input from the periphery and spinal cord. The Gate Control Theory posits that ascending fibers/inputs to the brain have limited bandwidth, and that providing some additional input may interfere with pain signal transmission. The PAG DBS may help by boosting the bodys endogenous opioid system, but there is some controversy over this.3

According to research, a low frequency below 50 Hz is presumed to have an analgesic effect upon thalamus and PAG stimulation, while higher frequencies above 70 Hz are presumed to increase pain sensitivity. Additionally, stimulation of the ventral posterolateral (VPL) and ventral posteromedial (VPM) nuclei causes a pleasant sensation that overrides pain, while stimulation of PVG and PAG areas triggers analgesia and a warm sensation over the painful region.9

More recently, a team at Oxford has introduced DBS of the anterior cingulate cortex (ACC), which may dampen the unpleasantness or bothersomeness of pain without affecting the somatosensory component of pain, says Shirvalkar. Patients have reported that even though pain was not totally relieved, it was less irritating or felt distant from them, demonstrating the emotional or affective aspect of the ACC.9

Overcoming barriers to the effective use of DBS

DBS currently involves a constant flow of electrical current and does not adjust to changes in brain activity.1 According to Shirvalkar, One of the biggest obstacles with DBS for pain is that no matter which target is stimulated, DBS often loses effect in the long term over 1-2 years for many patients. That is, the brain seems to adapt to the stimulation and ignores it. We are trying to figure out how to overcome such adaptation.3

It is more likely that multiple brain regions conspire over a network to produce and perpetuate chronic pain states, Shirvalkar explains. We are conducting a clinical trial that incorporates a novel trial period, where patients temporarily have electrodes placed in their brain for a period of 10 days. We then work very hard over 10 days to record brain activity and stimulate multiple regions that we believe are important for chronic pain. This way, we can determine which sites or nodes are most pain-relieving when stimulated for that individual person. By performing a comprehensive trial period, Shirvalkar and his team can learn more about the network behavior of chronic pain in the brain and maximize the probability of finding an efficacious therapy for each patient. Importantly, Shirvalkar says, This way, patients are not implanted with a permanent device when there is a low chance of long-term benefit.

Any emerging research findings could advance treatment for other conditions too. Other brain diseases that are treated with brain stimulation such as epilepsy, Parkinsons disease, and depression (although experimentally) could also benefit from developing technology where stimulation responds to ongoing neural activity, says Shirvalkar. Many of my colleagues are working on developing adaptive DBS for these other medical conditions.

The future of DBS for chronic pain

Going forward, Shirvalkar believes that there is the need for advancement in two key scientific areas. The first is understanding basic brain mechanisms that underlie these diseases so that we can better understand what effect stimulation is actually having on the disease itself, he says. The second is figuring out how we can modulate the key brain circuits non-invasively, using transcranial magnetic stimulation or scalp stimulation. I think the future is moving away from stimulating single brain regions and towards networks, ultimately with the goal of doing this without invasive implants.

References

1. Miller, JA. Tailoring deep brain stimulation to treat chronic pain. UC San Francisco. Published February 3, 2020. Accessed December 20, 2020. https://www.ucsf.edu/news/2020/02/416601/tailoring-deep-brain-stimulation-treat-chronic-pain.

2. Dydyk AM, Yarrarapu SNS, Conermann T. Chronic Pain. StatPearls; 2020. Updated November 8, 2020. https://www.ncbi.nlm.nih.gov/books/NBK553030/

3. Shirvalkar P, Sellers KK, Schmitgen A, et al. A Deep Brain Stimulation Trial Period for Treating Chronic Pain. J Clin Med. 2020;9(10):3155. doi:10.3390/jcm9103155

4. Lozano AM, Lipsman N, Bergman H, et al. Deep brain stimulation: current challenges and future directions. Nat Rev Neurol. 2019;15(3):148-160. doi:10.1038/s41582-018-0128-2

5. Frizon LA, Yamamoto EA, Nagel SJ, Simonson MT, Hogue O, Machado AG. Deep Brain Stimulation for Pain in the Modern Era: A Systematic Review. Neurosurgery. 2020;86(2):191-202. doi:10.1093/neuros/nyy552

6. Ben-Haim S, Mirzadeh Z, Rosenberg WS. Deep brain stimulation for intractable neuropathic facial pain. Neurosurg Focus. 2018;45(2): E15. doi:10.3171/2018.5.FOCUS18160

7. Boccard SGJ, Pereira EAC, Moir L, Aziz TZ, Green AL Long-term outcomes of deep brain stimulation for neuropathic pain. Neurosurgery. 2013; 72:221-230. doi:10.1227/NEU.0b013e31827b97d6

8. Kumar K, Toth C, Nath RK Deep brain stimulation for intractable pain: A 15-year experience. Neurosurgery. 1997; 40:736-746. doi:10.1097/00006123-199704000-00015

9. Farrell SM, Green A, Aziz T. The Current State of Deep Brain Stimulation for Chronic Pain and Its Context in Other Forms of Neuromodulation. Brain Sci. 2018;8(8):158. doi:10.3390/brainsci8080158

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Deep Brain Stimulation: The Answer to Chronic Pain? - Neurology Advisor

TOKYO and CAMBRIDGE, England, Feb. 1, 2021 /PRNewswire/ -- Sosei Group Corporation ("the Company"; TSE: 4565) announces it will apply its world-leading structure-based drug design (SBDD) expertise and platform to ion channels for the first time through a new strategic collaboration with Metrion Biosciences Limited ("Metrion"), the specialist ion channel CRO and drug discovery company.

Ion channels are a class of integral membrane proteins that regulate the flow of ions across the cell membrane as a means of conducting signals between cells and their environment. They are well established drug targets, particularly in neurological and cardiovascular diseases, but many remain undrugged or poorly drugged, and may be tractable to structure-based approaches.

The collaboration aims to demonstrate the potential of Sosei Heptares' SBDD technologies to address disease-associated ion channels and work towards establishing a leadership position in this area, in a similar way that it has done for G protein-coupled receptors (GPCRs).

As a first step, Sosei Heptares and Metrion will combine their respective capabilities in a drug discovery program to identify novel, highly specific drug leads for further development against a single ion channel associated with neurological diseases.

Metrion will contribute intellectual property, know-how and use of screening models for the nominated ion channel target. Sosei Heptares will apply its technologies for structure determination studies and SBDD. Sosei Heptares will have exclusive, full global rights to all molecules identified and directed to the targets for development by Sosei Heptares. No further financial details are disclosed.

Rob Cooke, Chief Technology Officer of Sosei Heptares, commented: "We are extremely pleased to enter this collaboration with Metrion in the hugely exciting area of ion channels. Their experience enables us to extend our world-leading expertise in Structure-Based Drug Discovery for GPCRs to other membrane proteins where structural input to drug discovery has been more limited. This strategic technology collaboration is the latest in a series we have made with highly innovative companies in recent months designed to strengthen our platform and enhance our discovery and partnering opportunities. In addition to Metrion, these collaborations with Captor Therapeutics in targeted protein degradation and with PharmEnable to access proprietary artificial intelligence-enabled and medicinal chemistry technologies are a key factor to drive our future growth ambitions."

Andrew Southan, Chief Executive Officer of Metrion Biosciences, added: "Resolving the 3D structure of ion channel proteins has great potential to accelerate the discovery of potent, selective new drugs targeting this highly important class of human proteins. This opportunity to combine Metrion Biosciences' depth of target class knowledge and assay expertise with Sosei Heptares' Structure-Based Drug Discovery capabilities has considerable potential to achieve scientific and commercial breakthroughs in this field. On behalf of the entire Metrion team I would like to thank Sosei Heptares for selecting Metrion Biosciences for this work and we look forward to a successful alliance."

About Sosei Heptares

We are an international biopharmaceutical group focused on the discovery and early development of new medicines originating from our proprietary GPCR-targeted StaR technology and structure-based drug design platform capabilities. We are advancing a broad and deep pipeline of novel medicines across multiple therapeutic areas, including neurology, immunology, gastroenterology and inflammatory diseases.

We have established partnerships with some of the world's leading pharmaceutical companies, including AbbVie, AstraZeneca, Biohaven, Genentech (Roche), GSK, Novartis, Pfizer and Takeda and additionally with multiple emerging technology companies. Sosei Heptares is headquartered in Tokyo, Japan with corporate and R&D facilities in Cambridge, UK.

"Sosei Heptares" is the corporate brand and trademark of Sosei Group Corporation, which is listed on the Tokyo Stock Exchange (ticker: 4565). Sosei, Heptares, the logo and StaR are trademarks of Sosei Group companies.

For more information, please visit https://www.soseiheptares.com/

LinkedIn: @soseiheptaresco | Twitter: @soseiheptaresco | YouTube: @soseiheptaresco

About Metrion Biosciences

Metrion Biosciences is a specialist ion-channel contract research organization and drug discovery business. The Company provides customers with access to a range of high-quality ion channel assays on a fee-for-service or collaboration basis. Metrion Biosciences' ion channel expertise includes an industry leading panel of in vitro cardiac ion channel safety assays, translational native cell and phenotypic assays for neurological and cardiotoxicity testing, and a range of other ion channel screening services such as cell line development and optimization. Metrion Biosciences is able to provide tailored assay formats, data analysis and reporting solutions, effective project management and quality assured data packages.

For more information, please visit http://www.metrionbiosciences.com

LinkedIn: @metrion-biosciences | Twitter: @metrion_biosci

Enquiries:

Sosei Heptares Media and Investor RelationsHironoshin Nomura, SVP Investor Relations and Corporate Strategy+81 (0)3 6679 2178 | Hironoshin.Nomura@SoseiHeptares.com

Shinichiro Nishishita, VP Investor Relations, Head of Regulatory Disclosures+81 (0)3 5210 3399 | IR@SoseiHeptares.com

Citigate Dewe Rogerson (for Sosei Heptares)Yas Fukuda Japanese Media+81 (0)3 4360 9234 | Yas.Fukuda@citigatedewerogerson.com

Mark Swallow, David Dible International Media+44 (0)20 7638 9571 | SoseiHeptares@citigatedewerogerson.com

Metrion BiosciencesKatie Odgaard Zyme Communications+44 (0)7787 502 947 | katie.odgaard@zymecommunications.com

Forward-looking statements

This press release contains forward-looking statements, including statements about the discovery, development and commercialization of products. Various risks may cause Sosei Group Corporation's actual results to differ materially from those expressed or implied by the forward-looking statements, including: adverse results in clinical development programs; failure to obtain patent protection for inventions; commercial limitations imposed by patents owned or controlled by third parties; dependence upon strategic alliance partners to develop and commercialize products and services; difficulties or delays in obtaining regulatory approvals to market products and services resulting from development efforts; the requirement for substantial funding to conduct research and development and to expand commercialization activities; and product initiatives by competitors. As a result of these factors, prospective investors are cautioned not to rely on any forward-looking statements. We disclaim any intention or obligation to update or revise any forward-looking statements, whether as a result of new information, future events or otherwise.

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SOURCE Sosei Heptares

Company Codes: Berlin:JSS, OTC-PINK:SOLTF, Tokyo:4565, Frankfurt:JSS, Munich:JSS, OtherOTC:SOLTF, Stuttgart:JSS

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Sosei Heptares to Explore Structure-based Drug Discovery (SBDD) Approaches to Ion Channels through Strategic Technology Collaboration with Metrion...

This article was originally published on Diagnostic Imaging.

According to a new study, coronavirus disease 2019 (COVID-19) positive patients who had hypertension and type 2 diabetes were more likely to experience the neurological complications, including bleeding in the brain and stroke, that come with the virus.

Based on CT and MRI images, investigators from the Perelman School of Medicine at the University of Pennsylvania determined that these chronic conditions could play a role in which patients are impacted by more than just the hallmark lung inflammation that comes with viral infection.

COVID-19s effects extend far beyond the chest, said lead study author Colbey W. Freeman, M.D., chief resident in the Penn Medicine radiology department. While complications in the brain are rare, they are an increasingly reported and potentially devastating consequence of COVID-19 infection.

Freemans team will present their findings during this years Radiological Society of North America (RSNA) annual meeting.

In an effort to better understand how COVID-19 impacts the body, they examined head CT and/or MRI images for patients positive for the virus who presented to the University of Pennsylvania health system from January 2020-April 2020.

A total of 81 of the 1,357 COVID-19-positive patients who were admitted underwent a brain scan prompted by either altered mental state or focal neurological deficits, including speech and vision problems.

Based on the teams analysis, 18 patients slightly over 20% had findings that were considered critical, such as strokes, brain bleeds, or blocked blood vessels. And, of that group, at least half also had a pre-existing history of high blood pressure or type 2 diabetes.

COVID-19 is associated with neurological manifestations, and hypertension and type 2 diabetes mellitus are common in individuals who develop these manifestations, Freeman said. These populations may be at higher risk for neurologic complications and should be monitored closely.

The team also found that two-thirds of the patients who had critical findings were African American, indicating COVID-19 positive patients in that minority group should be monitored more closely. And, among the entire group of 18 with emergent findings, three died while in the hospital, the team said.

Although this study revealed a role for high blood pressure and type 2 diabetes in the neurological impact of the virus, investigators still do not know exactly what causes those complications.

The mechanisms could be multi-factorial, and the generally accepted belief is that infection-associated inflammation is responsible, they said. In this study, in particular, they reported blood markers for inflammation were high in patients who had critical results.

When your body is in an inflammatory state, it produces all these molecules called cytokines to help recruit the immune system to perform its function, Freeman said. Unfortunately, if cytokines are over-produced, the immune response actually starts doing damage.

Using data from this study, the team is also looking at the how frequently COVID-19-positive patients on extracorporeal membrane oxygenation (ECMO) a pump system that circulates and replenishes oxygen in the blood experience neurological complications. Many patients included in this study required ECMO during hospitalization.

Future plans include a larger prospective study to investigate delayed, long-term, and chronic neurologic manifestations that have not currently been identified, but that might manifest later.

The study, "Diabetes, Hypertension May Increase Risk of COVID-19 Brain Complications," was published online by RSNA.

Original post:
Diabetes, Hypertension Linked to COVID-19-Related Neurological Complications - MD Magazine

BERLIN & FRANKFURT, Germany--(BUSINESS WIRE)--Tilray, Inc. (Tilray or the Company) (Nasdaq: TLRY), a leading company in the manufacture, research and distribution of medical cannabis, announced that it has entered into a co-promotion agreement with Hormosan for its full-spectrum cannabis extracts in Germany effective 1 January 2021.

Hormosan is primarily focused on pain therapy and neurology and is part of the Lupin Group, an international entity that sells innovative drugs and generics. Hormosan will support Tilray in its marketing and sales activities of full spectrum cannabis extract in Germany. Through this strategic partnership, the expertise of both Tilray and Hormosan will be leveraged to expand Tilrays presence in the German market.

Tilray launched its full-spectrum cannabis extracts in October 2017 and last expanded the range in May 2020. The range includes an extract with a balanced THC-CBD ratio, a CBD-dominant extract with a low THC content and a pure THC full-spectrum extract. According to the legal regulation, the use of cannabis full-spectrum extracts is not restricted to a specific indication, but the treating doctor decides at their own discretion whether a treatment is suitable. The Tilray extracts are used for chronic pain, spasticity, sleep disorders and a variety of other indications.

"With Hormosan we have gained a partner that has excellent expertise and contacts in the field of pain therapy and neurology and will thus significantly increase the visibility of Tilray's full-spectrum cannabis extracts in the future," explains Sascha Mielcarek, Managing Director Europe at Tilray. This will give physicians and patients even better access to our medical cannabis extracts while supporting our goal of contributing to improved care for patients with medical cannabis."

As one of the leading providers of full-spectrum cannabis extracts, Tilray is an ideal partner for Hormosan. With the co-promotion of medical cannabis extracts, we are expanding our competence and our therapeutic range in the field of pain therapy and neurology, comments Anjan Selz, Managing Director of Hormosan. "It is precisely the complementarity of medical cannabis with existing therapies that opens up promising options for doctors and their patients."

About Tilray

Tilray is one of the world's leading companies in the research, manufacture and distribution of medicinal cannabis and cannabinoids. Tilray has a broad product portfolio and can draw on experience with over 25,000 treated patients in fifteen countries on five continents. Further information can also be found at tilray.de.

About Hormosan

Hormosan Pharma GmbH was founded in Germany over 50 years ago and has been part of the international Lupin Group since 2008. With innovative and generic drugs, Hormosan supports the best possible treatment in the areas of neurology, pain therapy, as well as sexual health and HIV. In doing so, it focuses primarily on the medical needs of patients that have not yet been met, increasing patient benefits and the availability of alternative therapy options. Further information can also be found information at http://www.hormosan.de.

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Tilray, Inc. and Hormosan Sign a Cooperation Agreement for the Promotion of Medical Cannabis Extracts in Germany - Business Wire

Global Rare Neurological Disease Treatment Market Overview

Rare neurological diseases are vastly underdiagnosed and most of them go untreated. Additionally, until recently there has been no specific treatments for such disorders. However, the landscape of the market is changing slowly. It is expected that the global rare neurological disease treatment market will have a great potential in the coming years of the forecast period ranging from 2020 to 2030. Increasing awareness about these diseases, advancing healthcare and neurobiological technologies, and fast track approvals of new treatment methods are some of the key factors that will help in pushing up the growth of the global market.

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Global Rare Neurological Disease Treatment Market Notable Developments

In terms of competitive landscape of the global neurological disease treatment market, there are several key players operating in the market space. This makes the competitive landscape a highly fragmented one. The companies in the market are mainly focusing on developing new and innovative therapeutics to diagnose and treat these neurological diseases. The market consists of a few significant players who dominate the market. Some of the leading market players include CSL Ltd, Kedrion Biopharma Inc., US WorldMeds LLC (Solstice Neurosciences LLC), Merz Pharma GmbH & Co. KGaA, Aquestive Therapeutics Inc., Bayer AG, Pfizer Inc., Novartis AG, Merck & Co. Inc. (EMD Serono Inc.), and Jazz Pharmaceuticals PLC.

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Global Rare Neurological Disease Treatment Market Driver and Restraints

There are several factors that are responsible for the overall development of the global rare neurological disease treatment market. One of the key driving factor for the growth of the global market has been the increasing activities of research and development to find cures for such disorders. In recent years, there has been a growing prevalence of rare neurological diseases across the globe. Most of them go unnoticed or are underdiagnosed. A lack of effective treatment is the most prominent driving factor for the key players in the market that will help it grow in the coming years of the forecast period. Another important factor for the growth of the market is growth focus on fast-track approvals for new and upcoming therapies to treat such disorders. Furthermore, recent technological advancements in the field of neurology and neuro-biology has also fueled the development of the global neurological disease treatment market. Also, increasing awareness about early diagnosis of these disorders might help the market growth in coming years.

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One key restraining factor for the growth of the global neurological disease treatment market has been lack of standard treatment to cure these disorders.

Global Rare Neurological Disease Treatment Market Geographical Outlook

Based on the geographical segmentation, the global rare neurological disease treatment market is divided into five key regions. These regions are North America, Latin America, Europe, Asia Pacific, and the Middle East and Africa. Of these currently, the global neurological disease treatment market is expected to be dominated by the regional segment of North America. The region is expected to account for a larger chunk of the global market in coming years of the forecast period ranging from 2020 to 2030. One of the key reasons of the growth of the North America market has been the increasing prevalence of such rare neurological diseases across the region. According to the Center for Rare Neurological Disease Research report, rare neurological diseases have an impact on around 200,000 individuals in the US alone. In addition to this, growing healthcare spending and availability of a matured and well-established nature of healthcare infrastructure is expected to fuel the development of the North America region.

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Rare Neurological Disease Treatment Market: Growing prevalence of rare neurological diseases across the globe to drive the market - BioSpace

This article was originally published here

Sichuan Da Xue Xue Bao Yi Xue Ban. 2020 Nov;51(6):873-877. doi: 10.12182/20201160108.

ABSTRACT

OBJECTIVE: To retrospectively analyze the symptoms and characteristics of nervous system damage in severe/critically severe patients with coronavirus disease 2019 (COVID-19) in Sichuan province, with a view to providing basic references for the prevention and treatment of COVID-19.

METHODS: A total of 90 patients with severe/critically severe COVID-19 were included, who were diagnosed and treated in COVID-19 designated hospital of Sichuan province from 11 January 2020 to 20 March 2020. Clinical features, test results, treatment options and clinical outcomes were analyzed retrospectively.

RESULTS: Of 90 patients, there were 54 males and 36 females, with an average age of (53.9016.92) years. In addition to the classic symptoms such as fever and/or respiratory symptoms, 53 patients also had various degrees of neurologic manifestations, including 33 cases of fatigue, 21 muscle soreness, 12 dizziness, 8 headaches, 3 mental disorders, and 1 consciousness disorders and 1 case of neck pain. Compared with the patients without neurologic manifestations, those with neurologic manifestations took a longer time from admission to diagnosis of COVID-19 ( P<0.05), and received more antifungal treatment ( P<0.05).

CONCLUSIONS: Neurological symptoms are not uncommon in severe/critically severe patients with COVID-19, and its relatively difficult in the treatment. It should be paid attention in order to avoid misdiagnosis.

PMID:33236615 | DOI:10.12182/20201160108

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Retrospective Analysis of Neurological Symptoms of Severe/Critical COVID-19 Patients in Sichuan Province - DocWire News

TOKYO & CAMBRIDGE, England--(BUSINESS WIRE)--Eisai Co., Ltd. (Headquarters: Tokyo, CEO: Haruo Naito, Eisai) and Wren Therapeutics Ltd. (Headquarters: Cambridge, UK, Wren) today announced that the companies have entered into an exclusive research collaboration agreement aiming to advance the discovery of novel small molecules that target -synuclein for the potential treatment of synucleinopathies including Parkinsons disease and dementia with Lewy bodies.

Wren possesses a novel network kinetics drug discovery platform that precisely quantifies the effects of small molecules on the protein misfolding and aggregation pathway that causes neurodegenerative diseases. Wrens approach to synucleinopathies is focused on identifying novel small molecules that selectively control the aggregation process of -synuclein, which is associated with the onset and progression of these diseases. The collaboration will use Wrens network kinetics drug discovery platform, alongside Eisais extensive experience in drug discovery for neurodegenerative disorders, to accelerate the development of clinical candidates.

Dr. Samuel Cohen, Chief Executive Officer of Wren, commented: We are delighted to have formed this collaboration with Eisai, a company with a distinguished track record and company-wide commitment to providing innovative treatments for patients suffering from neurodegenerative diseases. We believe that by combining our unique, predictive and quantitatively driven platform with Eisais deep expertise in neurology, we can together advance highly differentiated small molecules targeting -synuclein for the treatment of debilitating protein misfolding disorders such as Parkinsons disease.

Dr. Teiji Kimura, Vice President, Chief Discovery Officer of the Eisai Neurology Business Group, commented: Synucleinopathies such as dementia with Lewy bodies and Parkinsons disease represent a significant unmet medical need due to the lack of any effective disease-modifying treatments. The accumulation of -synuclein oligomers with protein misfolding is an important hallmark of these diseases. The Wren team, with its world-renowned founding scientists, is pioneering a new and fundamentally different approach to addressing protein misfolding diseases. By integrating capabilities across both companies we expect this exciting collaboration to be uniquely successful in identifying novel disease-modifying therapeutics for patients suffering from dementia with Lewy bodies, Parkinsons disease and related disorders.

About Wrens novel network kinetics drug discovery platformWrens proprietary network kinetics drug discovery platform enables an entirely new approach to drug discovery, designed specifically to address the unique challenges associated with protein misfolding diseases. The kinetics-based approach solves for the distinct molecular reaction network that underlies each misfolding disease and produces a fully predictive, quantitative map of the network and its dynamics. The platform identifies the optimum intervention points in the network to reduce the populations of toxic misfolded and aggregated species, and subsequently makes it possible to identify and optimise molecules with the desired kinetic inhibitory activity.

About SynucleinopathiesSynucleinopathies are neurodegenerative diseases characterised by the aberrant misfolding and aggregation of -synuclein in neurons and glial cells. Synucleinopathies include Parkinson's disease (PD), dementia with Lewy bodies (DLB), and multiple system atrophy (MSA).

About Eisai Co., Ltd.Eisai Co., Ltd. is a leading global research and development-based pharmaceutical company headquartered in Japan. We define our corporate mission as giving first thought to patients and their families and to increasing the benefits health care provides, which we call our human health care (hhc) philosophy. With approximately 10,000 employees working across our global network of R&D facilities, manufacturing sites and marketing subsidiaries, we strive to realize our hhc philosophy by delivering innovative products to address unmet medical needs, with a particular focus in our strategic areas of Neurology and Oncology. As a global pharmaceutical company, our mission extends to patients around the world through working with key stakeholders to improve access to medicines in developing and emerging countries.For further information on Eisai Co., Ltd., please visit https://www.eisai.com.

About Wren Therapeutics Ltd.Wren is a spin-off company from the University of Cambridge (UK) and Lund University (Sweden), focused on drug discovery and development for protein misfolding diseases. Wren is advancing an entirely novel approach to address this class of diseases, based on more than a decade of research from its scientific founders focused on the chemical kinetics of the protein misfolding process. Wren's predictive, quantitative platform is built on concepts from the physical sciences and is a fundamental shift from the descriptive, qualitative methods of traditional biology, which have failed to successfully address these complex systems. Wren is using its unique approach to develop a broad pipeline of therapeutics for protein misfolding diseases.For further information on Wren, please visit http://www.wrentherapeutics.com

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Eisai and Wren Therapeutics Enter Into Research Collaboration Agreement for Drug Discovery for Synucleinopathies - Business Wire

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

Football clubs may be required to add neurologists to their medical teams as part of plans to confront concussion in the sport.

Trials of concussion substitutes are expected to be authorised by the games rule-making body, Ifab, next month as the authorities attempt to get to grips with the risk of brain injuries.

But the complexities of implementing a plan, including the possible recruitment of extra medical staff and the logistical and legal challenges around the trials, may mean they are not implemented until the 2021-22 season.

The recent diagnosis of dementia in Sir Bobby Charlton, the death of Nobby Stiles and campaigning by families of former players with dementia have returned focus to the risks of neurodegenerative disease.

On Wednesday the Professional Footballers Association announced it would launch a working group including relatives of former players to help refine its support provisions for former players with neurodegenerative conditions.

There remains great uncertainty over how to best limit the risk in contemporary generations of players, however. Action was taken this year in England, Scotland and Northern Ireland to ban heading in training for under-12s, with some limitations for older children too.

But adults face no limitations on heading practice, with Gary Lineker coming out in favour of restrictions. Theres absolutely no reason to head the ball in training, the former England striker tweeted.

Players face further risks during matches and in December Ifab plans to confirm a protocol that would allow teams extra substitutes in the event of an apparent concussion. If the protocol is approved at Ifabs annual business meeting, competitions will be invited to apply to trial the protocols with campaigners hoping these could begin this season.

Under the protocol, club doctors would have three minutes to evaluate a player on the field before deciding whether to substitute them, though that period could be longer if the player were to leave the pitch.

There are concerns that would be too short a time to properly evaluate the player and it is understood such considerations have meant the Premier League and Football Association are reluctant to commit to implementing the protocol immediately after it is agreed.

The recruitment of a specialist concussion team could be one of the solutions, according to the Ifab secretary, Lukas Brud. Before the protocols can be implemented, logistical and legal frameworks need to be put in place, amendments to the regulations need to be agreed then approved, he said, describing the hurdles to clear before trials can begin.

We are not encouraging the introduction mid-season, only allowing it. It will be down to individual competitions. Will it require a concussion team, a neurologist on hand? These are the questions competitions will ask and they will be required to feed back on challenges.

The announcement of the PFAs neurodegenerative disease working group will also bring extra focus on the plight of former players and their families with these conditions.

After receiving criticism over a perceived lack of support for members with dementia, including from Stiless son John, the players union said the group would help guide the PFA with decisions regarding the support and protection of former and current footballers.

Previously our support has predominantly been based on financial assistance and advice, it said. Now, with the guidance of our working group, we want to ensure a more holistic support system is available for former footballers and their families.

In another development lawyers have called for former players to come forward with their stories before potential legal action. The personal injury specialists John Foy and James Byrne, alongside Nick De Marco QC, are representing a group of players and hope to establish whether clubs and governing bodies have taken timely and proper steps to prevent the injuries we are seeing, according to De Marco.

The litigation is still in its early stages and we still want to hear from professional sports players, De Marco said. By bringing this case we hope not only to provide our clients with adequate compensation to pay for the future medical treatment and care they will inevitably need but also to bring about much-needed reform.

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Clubs may need to hire neurologists as part of plans to combat concussion - The Guardian

As many as 62 people diagnosed with COVID-19 suffered a stroke in the city during the infection between June and August. Of these 16% died in hospital, a study by doctors from St Johns Medical College Hospital has revealed.

The multi-centre retrospective study from 13 hospitals has been accepted for publication in the International Journal of Stroke, the official publication of the World Stroke Organization.

A stroke is the sudden onset of neurological deficit due to vascular causes.

Thomas Mathew, Professor and Head of the department of Neurology at St. Johns Medical College Hospital, who is the principal investigator of the study, told The Hindu that COVID-19 related strokes (CORS) are associated with increased mortality and morbidity.

We found that mortality among the 62 CORS was high compared to the non-COVID-19 strokes diagnosed during the corresponding period last year. While 111 suffered a stroke from June to August last year according to St. Johns Stroke Registry, no death was reported, he said.

Of the 62 CORS, 60 (97%) patients had ischemic strokes while two (3%) had haemorrhagic strokes. A majority of them (59.7%) had a bad stroke wherein the large artery was blocked.

The mean age of patients was 55.66 with a standard deviation of 13.20 years. While 34 (77.4%) were male patients, 26 % (16/62) of patients did not have any conventional risk factors for stroke.

Attributing CORS in those without risk factors to inflammation triggered thrombosis and damage to endothelium due to COVID-19, Dr. Mathew said: However, in the remaining 46 patients, 54.8% had diabetes, 61.3% had hypertension, 8% had coronary artery disease, and 4.8% had atrial fibrillation.

City-based neurologists said they were seeing various neurological manifestations of COVID-19.

Amit Kulkarni, consultant neurologist at SPASRH Hospital, said with COVID-19 the problem was not just the sequelae of lung involvement but also varied other aspects like clotting occurring in the arteries of the lung, arteries of the brain, veins in the leg and venous sinuses in the brain, causing deep vein thrombosis, pulmonary embolism, arterial and venous strokes in the brain.

What is also unusual about this disease is the varied immunological manifestations like limp paralysis of arms and legs (Guillian Barre syndrome), facial paralysis with asymmetry, cranial nerve palsies causing double vision, drooping of the eye and muscle involvement (myositis). We have noted quite a few peripheral nerve palsies presenting with foot drop in patients recently affected or recovering from COVID (inability to extend the foot) where the other routine blood work is negative for any connective tissue disease and there is no spinal/peripheral cause of nerve compression, he said.

G.T. Subhas, former president of Bangalore Stroke Support Group and former director of Bangalore Medical College and Research Institute said the common symptoms of stroke can be remembered by Facial Drooping, Arm Weakness, Speech Difficulties and Time to reach a stroke ready hospital abbreviated as FAST.

Both during and post COVID-19, people should not ignore warning signs such as dizziness, sudden weakness in limbs and difficulty in speaking or understanding words. Patients should reach the hospital within three or four hours of the stroke. The earlier the patient is rushed to a hospital, the better the outcome, he added.

Hospitals that were part of the study included St. Johns, Bengaluru Medical College and Research Institute, Manipal Hospitals, Sakra, Apollo, M.S. Ramaiah, Satya Sai Institute of Higher Medical Sciences, and Narayana Health.

Originally posted here:
62 persons had COVID-related stroke in Bengaluru from June to August - The Hindu

When John Abraham began to lose his mind in late 2019, his family immediately feared the worst. Abraham had enjoyed robust health throughout retirement, but now at 80 he suddenly found himself struggling to finish sentences.

I would be talking to people, and all of a sudden the final word wouldnt come to mind, he remembers. I assumed this was simply a feature of ageing, and I was finding ways of getting around it.

But within weeks, further erratic behaviours started to develop. Abrahams family recall him often falling asleep mid-conversation, he would sometimes shout out bizarre comments in public, and during the night he would wake up every 15 minutes, sometimes hallucinating.

Patients can go from being in a nursing home, unable to communicate, to returning to work

To his son Steve, the diagnosis seemed inevitable, one which all families dread. I was convinced my dad had dementia, he says. What I couldnt believe was the speed at which it was all happening. It was like dementia on steroids.

Dementia is not just one disease it has more than 200 different subtypes. Over the past decade neurologists have become increasingly interested in one particular subtype, known as autoimmune dementia. In this condition, the symptoms of memory loss and confusion are the result of brain inflammation caused by rogue antibodies known as autoantibodies binding to the neuronal tissue, rather than an underlying neurodegenerative disease. Crucially this means that unlike almost all other forms of dementia, in some cases it can be cured, andspecialist neurologists have become increasingly adept at both spotting and treating it.

At the John Radcliffe hospital, University of Oxford, neurologist Sarosh Irani is one of the worlds leading experts in treating neurological conditions caused by a malfunctioning immune system. When Abraham was admitted under his care in early January 2020 following a seizure, Irani soon realised that the source of his problems was an autoantibody which targeted a protein in the brain named LGI1.

The main telltale clue was the speed of onset, one of the key distinguishing features of autoimmune dementia. The symptoms usually come on very quickly, Irani says. Over a few weeks or months, patients develop memory problems, and change their behaviour and personality. Patients with neurodegenerative forms of dementia can develop movement disorders or seizures, but this typically happens later in the illness once degeneration has set in. In autoimmune dementia, these are early problems.

Abraham underwent a treatment called plasma exchange, which aims to wash the blood of the disease-causing antibodies. The impact was almost instant. For me it caused a complete transformation, in one or two days, he says. My family came in to see me in the hospital, and they just looked at each other in amazement.

Such dramatic improvements are often reported as soon as treatment which can also include steroids and other immunotherapies begins. Patients can go from being in a nursing home, unable to communicate, to returning to work, being able to drive again, says Eoin Flanagan, a neurologist at the Mayo Clinic in Rochester, Minnesota, one of a handful of centres in the world along with Iranis research group, that is actively studying autoimmune dementia.

This is one reason why the condition, though rare Mayo Clinic neurologist Sean Pittock estimates that it makes up less than 5% of all dementia cases is so important to identify. The data available suggests that it is often missed. Among autoimmune dementia patients who were successfully treated at the Mayo Clinic between 2002 and 2009, 35% had been initially misdiagnosed with either Alzheimers or Creutzfeldt-Jakob disease.

A lot of patients over 60 are misdiagnosed, says Flanagan. Thats a concern because if you miss these cases, youre committing them to a presumed neurodegenerative course when they could respond to immunotherapy, and their symptoms resolve.

But autoimmune dementia is also an illustration of a broader trend. Over the past 15 years, treatable diseases have been identified across an entire spectrum of neurological illnesses from epilepsy to multiple sclerosis and psychiatry, all caused by autoantibodies binding to different parts of the brain and central nervous system.

Its become one of the most exciting areas of neurology, says Irani. There are subgroups within all these illness groups that have very treatable diseases. If youre a dementia doctor, a small percentage of your patients will have this condition, the same if youre a psychiatrist or a multiple sclerosis doctor. And with these patients you can actually directly treat the underlying cause by suppressing the immune system.

In October 2019, another patient was admitted to the John Radcliffe hospital.Pippa Carter, aged 19, had just begun an English literature degree at the University of Leeds when she noticed that her vision seemed to be strangely distorted.

I would be in lectures and I was really struggling to focus with my eyesight and with concentration in general, she says. I was trying to audition for a university play, and I had to stop because I couldnt really read at all. Initially, I thought it was just nerves because I was starting a new chapter in life.

Within weeks, she found herself unable to get her words out properly, before she was taken to hospital after suffering a large seizure. Just like Abraham, it was the speed of her decline which alerted doctors to a potential autoimmune cause. Within a week she was hallucinating, shouting things, remembers Irani. In her hospital room, which she was in for several weeks, she drew these bizarre childlike pictures on the wall, like the sorts of things a four-year-old would draw. It was like something was causing her to regress in her behaviour.

Carter was suffering from a neuropsychiatric syndrome caused by an autoantibody binding to the brains NMDA receptors, proteins which play a key role in learning and memory formation. Soon after she began treatment, first with steroids, and then an immunotherapy called rituximab, she began to improve. Now more than a year on, she is hoping to resume her university studies soon.

Since 2004, scientists have been steadily discovering the autoantibodies behind these various neurological conditions, making it possible for clinics to test for them. Irani says that so far they have discovered approximately 25, with one or two new autoantibodies detected every year. There are probably many more out there still, he says. Were not at the tip of the iceberg, but I think were probably nowhere near the base either.

Precisely what stimulates the body to produce these autoantibodies remains unclear, but it is thought that there can be a variety of environmental triggers ranging from viral infections to tumours, along with an underlying genetic susceptibility.

Due to the number of patients who can be successfully treated, specialists are looking to raise awareness of the importance of keeping an eye out for them. Its really a not-to-miss set of conditions, says Irani. Our clinic runs a diagnostics lab where we receive UK-wide samples for many of these diseases. One in 100 are positive, and these patients clearly get better with steroids and similar medications.

There are signs that the interest is growing. In November 2019, data was published from the first clinical trial looking at the effectiveness of different treatments for patients with a type of epilepsy caused by LGI1 autoantibodies. Two more trials are under way looking at new experimental therapies aimed at trying to stop the body from producing these damaging antibodies.

Irani is hoping that this will yield many benefits in years to come. Theres definitely an under-recognition of these conditions, he says. But as the field continues to expand, there will be more and more of these patients who get picked up. Im sure that if you look hard enough in acute psychiatry wards, and in nursing homes, there are patients out there with treatable conditions who are being missed.

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The dementia that can be cured - The Guardian

Precisionbusinessinsights Research offers an overarching research and analysis-based study on the globalInterventional Neurology Devices market, covering growth prospects, market development potential, profitability, supply and demand, and other important subjects. The report presented here comes out as a highly reliable source of information and data on the global Interventional Neurology Devices market. The researchers and analysts who have prepared the report used an advanced research methodology and authentic primary and secondary sources of market information and data. Readers are provided with clear understanding on the current and future situations of the global Interventional Neurology Devices market based on revenue, volume, production, trends, technology, innovation, and other critical factors.

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Interventional Neurology Devices Market Competition

Medtronic plc) (Ireland), Stryker Corporation (U.S.), Depuy Synthes (Johnson and Johnson Services Inc.) (U.S.),Abbott Laboratories (U.S.), Terumo Corporation (Japan),Bayer AG (Germany), Boston Scientific, Corporation (U.S.), and Penumbra, Inc. (U.S.)

Based on the product type, Global Marketsegmented into the following:

Based on the technology type, Global Marketsegmented into the following:

Based on the indication, Global Marketis segmented into the following:

Based on the end user, Global Market segmented into the following:

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Interventional Neurology Devices Market to 2020 Review With Current Demand and Forecasts | COVID-19 Analysis - PRnews Leader

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Neurology Software Market to 2025: Growth Analysis by Manufacturers, Regions, Types and Applications - AlgosOnline

From sleep to neurologic conditions, to better food allergy care and worse respiratory outcomes, coronavirus 2019 (COVID-19) has been more impactful to every field of medicine this year than any disease in recent memory.

Courtesy of sister publicationHCPLive, here is some new research from this last week which illuminates COVID-19s effect on patients across non-infectious disease specialties.

COPD Linked to Three-Fold Greater Mortality Risk in Severe COVID-19 Patients

The prevalence of comorbid chronic obstructive pulmonary disease (COPD) among patients hospitalized with COVID-19 is actually lower than its presence in the general population, according to a new observational cohort analysis presented at the CHEST 2020 Annual Meeting this weekend.

A pair of investigators reported that just 5% of observed patients hospitalized with COVID-19 suffered from COPDversus significantly greater rates of cardiometabolic disease among the most severely ill patients.

Their analyses included 22 studies from 8 countries including 11,000-plus patients hospitalized with COVID-19.

Patients with COPD faced a three-fold greater risk of mortality (odds ratio [OR], 3.23; 95% CI, 1.59 6.57;P<.05) than those without.

Investigators also found that smoking was present in 37% of COVID-19 patientsyet patients who smoked faced only a 52% worsened risk of disease severity (OR, 1.52; 95% CI, 0.81 2.87;P= .20).

Virtually Supported Home Peanut Introduction is Viable Option

A new report detailed the first known use of a virtually-supported home peanut introduction in infant patients at risk of developing peanut allergy. The program, conducted in April, could provide means to continue crucial, timely peanut allergy care during the pandemic.

Investigators noted that no reactions were reported during the assessed virtual food introduction process, which they considered to be consistent with the current evidence that anaphylaxis is rare and non-threatening with first ingestion in infancy.

Thus, they emphasized that mild reactions can generally be managed with antihistamine and/or observation.

Even before COVID-19, lack of allergist resources presented significant barriers to the introduction of peanut to at-risk patients where there was hesitance, they wrote. Virtually supported introduction may represent a future option after COVID-19 to improve access for patients who live in remote areas, or otherwise have limited access to allergists, or for clinicians with overburdened clinics.

COVID-19 Linked to Several Neurological Disorders

Data from a prospective study conducted by investigators from the NYU Langone Grossman School of Medicine showed patients with COVID-19 may be at risk for developing new neurologic disorders.

The study observed that 13.5% of patients hospitalized with COVID-19 during the study timeframe developed a new neurologic disorder in a median of 2 days from COVID-19 symptom onset.

Among those newly diagnosed, the most commonly observed neurologic disorders were toxic/metabolic encephalopathy (6.8%), seizure (1.6%), stroke (1.9%), and hypoxic/ischemic injury (1.4%). Among patients with seizure, 34 of 74 (46%) had no prior history of seizure or epilepsy.

No patients reported with meningitis/encephalitis or myelopathy/myelitis referable to SARS-CoV-2 infection and 18 of 18 patients that underwent cerebrospinal fluid analyses were reverse transcription polymerase chain reaction negative for SARS-CoV-2.

In contrast to prior retrospective studies that focused on the conglomerate prevalence of non-specific neurologic symptoms (agitation, dysexecutive function, myalgia, dizziness, headache) along with neurologic diagnoses (e.g. stroke, seizures, Guillian-Barre syndrome etc.), we applied rigorous, standardized diagnostic criteria to identify the prevalence of specific neurologic diagnoses in a prospective fashion, the authors wrote.

Patients who were diagnosed with neurologic disorders after admission were significantly older, and more severely ill based on Sequential Organ Failure Assessment scores, intubation rates and acute renal failure rates. Additionally, patients who had neurologic disorders post-admission were more often diagnosed with stroke, hypoxic/ischemic brain injury, seizure, neuropathy, and myopathy.

New Study Shows Connection Between COVID-19 and Sleep Issues

Investigators from a web-based study conducted 4 weeks into national lockdowns in Israel found a high frequency of maternal clinical insomnia in recent months: 23% during the pandemic, compared to 11% in the 1-2 months prior to the pandemic.

They also found approximately 80% of mothers reported no change in their childs sleep quality, duration, and sleeping arrangement during the COVID-19 pandemic.

On the other hand, approximately 30% of these mothers reported a negative change in their childs sleep quality, as well as a decrease in sleep duration. There were also mothers who reported a positive change.

These findings suggest that the changes in sleep patterns during the COVID19 pandemic are varied and that no unified change for the worse should be expected, the authors wrote. Further consideration of changes in sleep within the family context during this ongoing crisis is needed.

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How COVID-19 Influences Allergies, Neurology, and Sleep - Contagionlive.com

You wouldnt expect a scientist, teacher or business leaders work to improve following a traumatic brain injury or the onset of a neurological disorder, but, oddly, that does sometimes seem to be the case for artists at least if youre willing to accept expert opinions on art. In this interview with Robert Lawrence Kuhn for the PBS series Closer to Truth, Anjan Chatterjee, professor of neurology at the University of Pennsylvania, explains how artistic proclivities and production can change and even improve with neurological disorder. Because of the brains complexity, there are myriad ways in which this phenomenon can potentially be made manifest, but, as Chatterjee elucidates, the answer lies in different constellations of brain systems becoming more prominent as others become subdued. And, as Kuhn and Chatterjee discuss, these experiences in both artists and observers raise intriguing questions at the frontiers of neurology and aesthetics.

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Artists can flourish after brain damage. What does this say about neurology and aesthetics? - aeon.co

Testing someone for nerve damage is done manually by a clinician who determines what a patient can detect on their skin, most often using a specialized set of monofilaments or a tuning fork. It can be a long and uncomfortable process for the patient and the clinician. But using wearable technologies, Dr. Ryan Peters, PhD, in the Faculty of Kinesiology and member of the Hotchkiss Brain Institute at the Cumming School of Medicine, is developing new ways for performing neurological testing anytime, anywhere, and with greater accuracy.

Peters is a co-founder and chief science officer of Vibratus Inc., which is bringing these new neurological wearable technologies to market. You can think of Vibratus as your wearable neurologist, says Peters. He is pictured above, right, with members of his team.

Ryan Peters.

Adrian Shellard

Peters is creating a suite of devices and a software application, or app, to remotely monitor sensory and motor function of the foot sole, hand and other parts of the body. Vibratus technology uses vibration-emitting wearable devices, such as smartphones and watches, to measure a patients neural responses. This biometric data can be tracked and exchanged between the patient and their health-care provider at chosen intervals, enabling the worlds first virtual neurology clinic. The COVID-19 pandemic provides an ideal proving ground for such technologies, when in-person access to the neurologist can be more restrictive.

Patients with nerve damage have increased risk of injuries and falls, and yet months can go by before they can visit a neurologist to have their condition re-assessed. With this app, both the doctor and patient will quickly know if personalized treatment strategies are working or if they need to be adjusted, says Peters.

Peters says the technology is useful for nerve disorders such as peripheral neuropathy (nerve damage caused by conditions such as Type 2 diabetes or chemotherapy), peripheral nerve or spinal cord injuries, cerebral palsy, Parkinsons disease and stroke. The clinical tests that Vibratus is looking to improve upon are part of the standard neurological exam, making them useful for a broad range of neurological disorders.

Though still in the testing phase now, Peters plans to launch the app within the next year and has filed U.S. provisional patents for these technologies. It would be great to see our devices in the hands of everyone who does neurological testing. We have the potential to improve outcomes for people with neurological disorders while saving time and money for the health-care industry.

Vibratus will be the first startup business to come out of the Faculty of Kinesiologys new specialization in wearable technology, referred to as We-TRAC. Dr. Reed Ferber, PhD, who leads the We-TRAC program,says Peters has been a fantastic addition to the collaborative group.

He has shown success in obtaining grants, working with companies, and now as the first startup company to come out of We-TRAC, says Ferber. Peters says Ferber has been a tremendous mentor to him, and that it was Ferber who suggested he apply for the grants that are now supporting this endeavour.

As well as receiving a $101,500 grant from the National Sciences and Engineering Research Council of Canada, or NSERC, Peters received a $200,000 Life Science Fellowship from Innovate Calgary. These grants are for research and development funding, and the creation, entrepreneurship and talent development for emerging life science-based companies.

Innovate Calgary has supported our device prototyping activities and helped guide the business development for Vibratus which has been invaluable to us, says Peters.I appreciate the incredible support Im receiving from everyone.

Peters also collaborates closely with Drs. Tyler Cluff, Art Kuo and Nicole Culos-Reed in the Faculty of Kinesiology, along with his incoming students and the Vibratus team, includingco-foundersRaied Aburashed, who is the chief executive office and holds a Bachelor of Science degree from the Schulich School of Engineering at UCalgary, and Dr. Osman Darici, PhD, who is the chief technology officer and a postdoctoral scholar in the Faculty of Kinesiology at UCalgary.

For more information about the program, contact Dr. Ryan Peters, PhD.

We-TRACis developing the next generation of wearable tech experts and focusing on using wearable technology to revolutionize sport performance, health care and health research.

The University of Calgarys Faculty of Kinesiology is theNo. 1 ranked sport science school in North America and No. 7 globally, according to ShanghaiRanking.

Led by theHotchkiss Brain Institute,Brain and Mental Healthis one of six research strategies guiding the University of Calgary toward itsEyes Highgoals. The strategy provides a unifying direction for brain and mental health research at the university.

The University of Calgarys multidisciplinaryEngineering Solutions for Health: Biomedical Engineeringresearch strategy drives solutions to our most pressing health challenges in disease and injury prevention, diagnosis, and treatments. Our biomedical engineering researchers make a significant impact in our communities by extending lives, improving quality of life, promoting independence, and continuously improving the health system.

(Photos were taken prior to COVID-19)

Ryan Peters lab group in the Faculty of Kinesiology at the University of Calgary

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Kinesiology researcher creates smart way to assess and track neurological function - UCalgary News

EMERYVILLE, Calif., Dec. 02, 2020 (GLOBE NEWSWIRE) -- Adamas Pharmaceuticals, Inc., Inc. (Nasdaq: ADMS), a company dedicated to developing and delivering medicines that make a meaningful difference to people affected by neurological diseases, todayannouncedit hassigned an agreement tosettle its ongoing patent litigation with OsmoticaPharmaceutical US LLC, a subsidiary of OsmoticaPharmaceuticals plc.As a result of this agreement,both partieswilldrop their respective claims relating to thepatentlitigation,and Adamaswillacquire the global rightstoOSMOLEXERfor $7.5 million.The agreement is expected to closeearly in2021.

Adamas current portfolio consists of GOCOVRI (amantadine) extended-release capsules for the treatment of dyskinesia in patients with Parkinsons disease receiving levodopa-based therapy. OSMOLEX ER (amantadine) extended-release tablets is FDA-approved for the treatment for Parkinsons disease and drug-induced extrapyramidal reactions in adult patients.

This settlement agreement removes any further litigation costs and related distraction for Adamas. The acquisition of OSMOLEX ER also expands our presence in Neurology which is part of our long-term growth strategy, said Neil F. McFarlane, Chief Executive Officer. The different FDA-approved indications and pharmacokinetic profiles for GOCOVRI and OSMOLEX ER allow for the treatment of distinct patient populations. We intend to leverage our commercial expertise to unlock the full potential of both products and serve more patients in the wider neurology community.

As part of the acquisition, Adamas will receiveexisting inventory and allrightstoOSMOLEX ER.Parties also entered a supply agreementin whichOsmoticawillbe the sole manufacturer ofOSMOLEXER.Both parties are working together toensurecontinuity ofproductsupplytopatients.

About GOCOVRI

GOCOVRI (amantadine) extended-release capsulesisthe first and only FDA-approved medicine indicated for the treatment of dyskinesia in patients with Parkinsons disease receiving levodopa-based therapy, with or without concomitant dopaminergic medications. It is also the only medicine clinically proven to reduce both dyskinesia and OFF.

Taken once daily at bedtime, GOCOVRI provides an initial lag and a slow rise in amantadine concentration during the night, resulting in a high concentration from the morning and throughout the waking day. Additionally, in the clinical trials, the adjunctive use of GOCOVRI did not require dose changes to dopaminergic therapies. Themost commonly observedadverse reactions with GOCOVRI were hallucinations, dizziness, dry mouth, peripheral edema, constipation, falls and orthostatic hypotension.

For more information about GOCOVRI, please visitwww.GOCOVRI.com.

About OSMOLEXER

OSMOLEX ER,(amantadine)extended-releasetablets, is FDA-approved for the treatment of Parkinsons disease and drug-induced extrapyramidal reactions in adult patients.OSMOLEX ER is contraindicated in patients with end-stage renal disease (i.e., creatinine clearance below 15 mL/min/1.73 m2). The most common adverse reactions reported in 5% of patients at the recommended dosage of immediate-release amantadine were nausea, dizziness/lightheadedness, and insomnia.

For more information about OSMOLEX ER, including the full Prescribing Information, please visit http://www.OSMOLEX.com

About Adamas

At Adamas our vision is clear - to deliver innovative medicines that reduce the burden of neurological diseases on patients, caregivers and society. We are a fully integrated company focused on growing a portfolio of therapies to address a range of neurological diseases. For more information, please visitwww.adamaspharma.com.

Forward-looking statements

Statements contained in this press release regarding matters that may occur in the future are forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995, including but not limited to, statements contained in this press release regarding Adamas expectationsregarding the expected timing of the closing of the transaction with Osmotica. Such statements are subject to risks and uncertainties, and actual results may differ materially from those expressed or implied by such forward-looking statements. Forexample, the completion of the transaction is subject to closing conditions, which if not met or waived, would cause the transaction not to close. Other risks relating to Adamas may be found inAdamas Quarterly Report on Form 10-Q filed with the Securities and Exchange Commission on November 5, 2020, particularly under the caption Risk Factors. Investors are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date of this release. Adamas undertakes no obligation to update any forward-looking statement in this press release, except as required by law.

Contact:

MediaSarah MathiesonVice President of Corporate Communications510-450-3528smathieson@adamaspharma.com

InvestorsPeter VozzoManaging Director, Westwicke443-213-0505peter.vozzo@westwicke.com

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Adamas Announces Agreement to Settle Patent Litigation with OsmoticaAs part of this agreement Adamas will acquire the global rights to OSMOLEX ER -...

This article was originally published here

Assist Technol. 2021 Jan 22. doi: 10.1080/10400435.2021.1880494. Online ahead of print.

ABSTRACT

Severe neurodegenerative diseases such as Parkinsons disease or multiple sclerosis and acute events like stroke, spinal cord injuries or other related pathologies have been shown to negatively impact the central and peripheral nervous systems, thus causing severe impairments to mobility. The development and utilisation of exoskeletons as rehabilitation devices has shown good potential for improving patients gait function. Ten older adults (age: 68.9 9.2 yrs; height: 1.65 0.08 m. mass: 71.6 11.0 kg) affected by neurological diseases impacting their gait function completed a 10-session gait training protocol where they walked for 10 minutes wearing a passive exoskeleton assisting hip flexion, namely Exoband. Results showed that participants walked a significantly longer distance in the last session of training with respect to the first session (453.1178.8m vs 392.4135.1m; respectively). This study indicates the potential of Exoband as an effective tool for gait rehabilitation in patients with neurological diseases. Wearable, lightweight and low-cost devices such as the one involved in this work have the potential to improve walking distance in patients.

PMID:33481693 | DOI:10.1080/10400435.2021.1880494

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Effect of a passive hip exoskeleton on walking distance in neurological patients - DocWire News

EXTON, Pa., Jan. 29, 2021 /PRNewswire/ --Spherix Global Insights, a leading market intelligence firm specializing in select dermatology, gastroenterology, nephrology, neurology, and rheumatology markets, announces the inaugural publications of their newest service offering, Launch Dynamix. This innovative, independent service provides monthly benchmarking of newly launched products for the first eighteen months of commercial availability.

This is augmented by a quarterly deep dive into promotional activity, messaging, drivers of use, barriers to uptake, patient types, market access landscape, and degree of disruption surrounding the newly launched product including a mix of both quantitative and qualitative feedback. Clients subscribed to this service received their first monthly pulse on January 15, 2021, including data benchmarking the current launch to relevant historical market entrants at similar post-entry timings.

In rheumatology, Spherix is currently tracking the entry of both Novartis' Cosentyx and Eli Lilly's Taltz in non-radiographic axial spondylarthritis (nr-axSpA), which were approved within weeks of each other in June of last year. Data on the key performance indicators (KPIs), provided in the January publication, are compared to the performance of UCB's Cimzia, which was the first biologic/advanced systemic agent to gain FDA approval for nr-axSpA in March of 2019.

With regard to psoriatic arthritis (PsA), Spherix's new service is available for Janssen's Tremfya, with KPIs benchmarked to Cosentyx, Taltz, Amgen's Otezla, and Pfizer's Xeljanz. Pending FDA approval, Spherix also plans to cover AbbVie's Rinvoq in both ankylosing spondylitis (AS) and PsA, Xeljanz for the treatment of AS, and AstraZeneca's anifrolumab for the treatment of systemic lupus erythematosus.

Inaugural Launch Dynamix coverage in gastroenterology includes tracking and trending of Janssen's Stelara for the treatment of ulcerative colitis (UC), benchmarking the entry of the IL-12/23 inhibitor to the respective Crohn's disease launch, as well as the launch of Xeljanz for the treatment of UC.

In neurology, Spherix is currently covering the launches of Novartis' Kesimpta and BMS' Zeposia, with appropriate benchmarked KPIs to Genentech's Ocrevus, Novartis' Mayzent, EMD Serono's Mavenclad, and Biogen's Vumerity. Pending approval, Spherix will also cover the launch of Janssen's ponesimod, which is expected to be available in the Spring of 2021.

In an area of significant unmet need, the lupus nephritis market is poised for a massive shift with recent drug approvals for GSK's Benlysta (also approved for systemic lupus erythematosus) and Aurinia Pharmaceuticals' Lupkynis. The study will include responses from both nephrologists and rheumatologists, with the first pulse available in February.

Other launches on Spherix's radar with planned 2021 coverage (pending approval) include:

"We are really excited to be able to bring this level of launch detail to our clients," says Lynn Price, Vice President of Strategy and Innovation at Spherix. "The rapid turn-around from fielding to publication and the monthly cadence coupled with quarterly deep-dives provides those with assets in this market or with near-term plans to enter it the perfect tool to keep their finger on the pulse."

About Launch Dynamix

Launch Dynamix is an independent service providing monthly benchmarking of newly launched products for the first eighteen months of commercial availability, augmented by a quarterly deep dive into patient types initiated, brand perceptions, promotional activity, and drivers and barriers to uptake. The service is offered on a brand-by-brand basis.

Learn more about our services here.

About Spherix Global Insights

Spherix Global Insights is a hyper-focused market intelligence firm that leverages our own independent data and expertise to provide strategic guidance, so biopharma stakeholders make decisions with confidence. We specialize in select dermatology, gastroenterology, nephrology, neurology, and rheumatology markets.

All company, brand or product names in this document are trademarks of their respective holders.

For more information contact:

Kristen Henn, Business Development Manager

Email:info@spherixglobalinsights.com

http://www.spherixglobalinsights.com

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SOURCE Spherix Global Insights

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Spherix Global Insights Introduces New Service Focusing on Recent Launches in Expanding Immunology, Nephrology, and Neurology Markets - Daily Local...