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01-04-2020 | Spinocerebellar Degeneration | Neurological Update

The neurological update: therapies for cerebellar ataxias in 2020

Authors: J. Gandini, Mario Manto, T. Bremova-Ertl, K. Feil, M. Strupp

Published in: Journal of Neurology | Issue 4/2020

Abstract

Cerebellar ataxias (CAs) represent a heterogeneous group of sporadic or inherited disorders. The clinical spectrum of CAs is continuously expanding. Our understanding of the mechanisms leading to the clinical deficits has improved over these last decades, in particular thanks to progress in genetics, neuroimaging and the advent of relevant animal models allowing the identification of the pathophysiological pathways leading to CAs. The rationale behind treatments is now established for most of the CAs encountered during daily practice worldwide. In this update, we will discuss the symptomatic, physical and occupational therapies now being trialled along with individualized exercises, and present key emerging issues on immune-mediated cerebellar ataxias, hereditary cerebellar ataxias. Finally, we will discuss novel therapeutic approaches, including cerebellar non-invasive stimulation and treatments acting on RNA/proteins. So far, no state-of-the art randomized placebo-controlled clinical trial has shown a convincing clinically relevant efficacy of any drug, with the exception of 4-aminopyridine for the symptomatic treatment of episodic ataxia type 2 and downbeat nystagmus (placebo-controlled trials).

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Title: The neurological update: therapies for cerebellar ataxias in 2020
Authors: J. Gandini
Mario Manto
T. Bremova-Ertl
K. Feil
M. Strupp
Publication date: 01-04-2020
Publisher: Springer Berlin Heidelberg
Keywords: Spinocerebellar Degeneration
Downbeat Nystagmus
Spinocerebellar Ataxia
Published in: Journal of Neurology / Issue 4/2020
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-020-09717-3

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The neurological update: therapies for cerebellar ataxias in 2020

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