Articles related to Neurology

Many drugs of abuse increase orexin production in both animal and human brains. Blocking the orexin system reverses addiction in animals. Orexin levels normally cycle in a circadian rhythm, with additional activation when under stress. Opioids, cocaine, alcohol, and other substances activate the cells that produce orexin, but don’t deactivate them. They stay on constantly, producing high levels of orexin that drive the desire for another hit. Anti-orexin insomnia medications might be of benefit in treating addiction.

In this case report, two Massachusetts psychiatrists, together with a radiologist and gerontologist, walk through the diagnosis and management of new onset neuropsychiatric symptoms following COVID infection.

The findings of this study are similar to results from in small human post-mortem study and could provide a pathological explanation for the subjective complaint of long-COVID “brain fog.” Using a mouse model to explore how mild respiratory infections with COVID could lead to neuroinflammation and subsequent brain damage, investigators found signs of central neuroinflammation after clearance of the virus. There is an accompanying case presentation.

This meta analysis of antidepressants in MDD included 34 double-blind, randomized, placebo-controlled studies covering 20 antidepressants. Outcomes were 6-month relapse rates and tolerability measures. Fourteen of the agents had better relapse rates than placebo. Four — desvenlafaxine, paroxetine, venlafaxine, and vortioxetine — displayed the best efficacy and tolerability.

The 8-week treatment with mindfulness-based stress reduction was a well-tolerated treatment option with comparable effectiveness to a first-line medication for patients with anxiety disorders in this randomized clinical trial of 276 adults with anxiety disorders.

Relapsing MS treatment remains difficult, and new therapeutic targets have been investigated. S1P, a bioactive lysophospholipid signaling molecule present in several organs, including the central nervous system, is one such target. S1P plays a role in a variety of physiologic and pathophysiologic processes. S1P levels have been linked to disease progression in the brain parenchyma and cerebrospinal fluid of MS patients. There are 5 recognized S1PR subtypes, and depending on the receptor being targeted, their expression patterns and outcomes change. S1PRMs are a more recent class of RMS treatments, and the FDA has currently approved 4 of these treatments: fingolimod, siponimod, ozanimod, and ponesimod.