The effectiveness and safety of endovascular thrombectomy for the treatment of large vessel occlusion (LVO) have been demonstrated in landmark randomized controlled trials. However, patients in these studies were pre-selected and recruited using stringent inclusion and exclusion criteria. The STRATIS registry has evaluated almost 1,000 US patients, with acute stroke, who received endovascular thrombectomy treatment […]
Selecting Patients for Endovascular Therapy and recent Developments and Clinical Experience with Medtronic Devices
This article summarizes Medtronic-sponsored symposia presented at the World Federation of Interventional and Therapeutic Neuroradiology (WFITN) 14th Congress held October 16-19, 2017, in Budapest, Hungary. The topics included: the definition and analysis of optimal neuroimaging criteria for selecting patients for endovascular treatment using perfusion and diffusion neuroimaging (iSchema View RAPID). This review was presented by…
Leaving A Legacy Of Stroke In Europe: A Community Of Dedicated Professionals Is Changing The Face Of Stroke In Europe
Time is of the essence in the treatment of acute stroke; however, there are wide variations, across and within countries, in the ability to hospitalize, scan, diagnose, and treat acute stroke patients rapidly within the accepted time window of 4.5 hours. Door-to-needle (DTN) time is an important performance indicator that illustrates the speed and operational […]
This symposium acknowledged considerable variation across European in-hospital stroke services in their level of expertise, facilities available for rapid neuroimaging, and access to treatment interventions for acute stroke patients. Stroke neurologists face the dilemma of deciding whether to dispatch acute stroke patients to a highly specialised comprehensive stroke centre, or to the nearest available centre. […]
The Pipeline Embolization Device (PED) has become a routine first-line interventional option for treatment of intracranial aneurysms; however, thromboembolic complications are the main adverse events with flow diversion interventional procedures. A new, third generation version of the PED, the Pipeline Flex™ Embolization Device with Shield Technology™ (PFEDST), is now available with…
Intro: Cerebral cavernous malformations are benign lesions composed of abnormally stretched-out, thin-walled blood vessels clustered together and filled with blood. This paper reports a case of cerebral cavernous malformation located in the left subcortical nuclei region with additional venous angioma, and reviews the…
“Time is brain” is a concept that perfectly encapsulates the need for swift action when stroke strikes. The sooner stroke symptoms are realised, the sooner the person gets the care they need, the greater the chances for survival and life with fewer disabilities. What happens in Europe is that a person who has a stroke […]
Rating scales aid Parkinson’s evaluation and are an important assessment tool for healthcare professionals. However, existing scales have their limitations, which is why the European Parkinson’s Disease Association (EPDA) has developed the new Parkinson’s Disease…
The causes of dystonia are not fully understood and although currently available treatments can provide effective symptomatic relief, they cannot provide curative disease modification. Botulinum neurotoxin type A injections are well established for the symptomatic treatment of focal dystonias and post-stroke spasticity. Three proprietary injectable formulations of botulinum neurotoxin type A are currently available: Botox® […]
Cardiovascular diseases, including stroke, are the leading cause of death in the European Union (EU), responsible for more than 4 million deaths in 2013 and accounting for 45% of all deaths. Coronary heart disease (CHD) and stroke account for the majority CVD-related deaths, with 1.8 million deaths from CHD and 1 million from stroke annually. […]
Infantile Spasms is a rare disorder consisting of epileptic spasms that occur before the age of one year. This severe epilepsy affects about 0.31 in 1000 births with an average age at onset of 6 months. Treatment usually consists of hormonal therapies (adrenocorticotropic hormone or corticosteroids) or vigabatrin. Decisions about choice of therapy are…
Novel Stroke Prophylaxis Strategies: When Should Device-Based Cardiac Occlusion Therapies Be Considered?
Oral anticoagulation (OAC) is the established therapy to prevent ischemic stroke in high-risk patients with atrial fibrillation (AF) and it reduces the threat of recurrence in those who had a cardioembolic stroke. However, OAC is associated with a substantial risk of major bleeding. Therefore, device-based occlusion therapies including left atrial appendage occlusion (LAAO) and patent […]
The development and application of neuromelanin sensitive MR imaging has allowed the detection of significant changes in the substantia nigra (SN) of Parkinson’s disease (PD) patients, with high sensitivity and specificity in differentiating PD patients from non-PD aged controls, even in early disease stages, namely…
Introduction Home based objective measures of bradykinesia and dyskinesia will be important in managing Parkinsons Disease (PD). The Aim of this paper was to further validate the Parkinsons Kinetigraph system as a tool for measuring bradykinesia and dyskinesia by examining its capacity capture the effect of therapeutic interventions, detect bradykinesia and asymmetry in a newly […]
Dear Colleagues, On behalf of the Czech chapter and the Commission on European affairs (CEA) of the International League Against Epilepsy (ILAE) as well as the International Scientific and Organising Committee (ISOC), it is our pleasure to invite you to Prague for the 12th European Congress on Epileptology (ECE), taking place from 11th to 15th […]
A clinical scale that takes a broader, deeper view of PD symptoms is the latest milestone in a collaborative effort to resolve multiple challenges to timely, comprehensive and individualised management of Parkinson’s disease across Europe. Project leaders Professor Fabrizio Stocchi and Professor Pablo Martinez-Martin presented the aims and…
Acute Ischaemic Stroke (AIS) is the second cause of death and disability in Europe. Mechanical thrombectomy has proven efficacy in the management of patients with large vessel occlusions. It brings hope to the treatment of AIS, but the development of this technique is still ongoing. Technological developments, especially thromboaspiration, offer promising results. The need for the timely identification, transfer, and treatment of […]
The Angels (Acute-Networks StrivinG For ExceLlence In Stroke) Initiative: Solving A Problem By Giving Physicians The Tools They Need To Create A Solution
Stroke can be a devastating event, not only for the victims, but also for their families, friends, work colleagues, and carers. The burden of stroke in terms of absolute numbers and number of disability adjusted life years (DALYs) is increasing worldwide and is impacting health services on a global scale. Despite an earlier reluctance to […]
New EANS President Andre Grotenhuis discusses technical advances in neurosurgery, the role of the EANS, and why sports are important! The theme of EANS2015, our recent Annual Meeting in Madrid, was “Technical Advances in Neurosurgery” and it is undeniable that the specialty is evolving extremely rapidly. To name but a few of these advances: 1. functional preservation in glioma surgery using…
Multiple sclerosis (MS) is a chronic autoimmune and disabling disease affecting the central nervous system (CNS) of unknown etiology. As a diagnostic marker for MS does not exist, prognostic biomarkers of disease severity become clinically relevant. Several CSF biomarkers related to the pathogenesis of brain lesions of MS are displayed. Neurofilament light protein, glial fibrillary […]
A new and innovative magazine-style website has been launched to inspire and inform the international Parkinson’s community. Parkinson’s Life, developed by the European Parkinson’s Disease Association (EPDA), aims to connect everyone touched by the disease – wherever they are in the world – from people with Parkinson’s and their families, to healthcare professionals, carers and decision makers. Unlike many other Parkinson’s-related […]
MS Nurse PROfessional is a ground-breaking online educational tool for nurses and healthcare professionals caring for those with multiple sclerosis (MS). It is a program designed to standardize care for people with MS across Europe and support nurses to develop the knowledge and skills they need. What is Multiple Sclerosis? MS is a complex, chronic, […]
Alzheimer Europe (AE) is an NGO and has been raising awareness of all forms of dementia since 1996. It operates a common European platform through cooperation among its 36 members, which are all active…
Optogenetic Manipulation Of The Cholinergic System: Potential Implications For The Treatment Of Memory Deficits In Alzheimer’s Disease
Successful treatment of psychiatric disorders and neurodegenerative diseases depends crucially on our fundamental knowledge of how information is processed and stored by the brain. Understanding the interaction between neuromodulation and signal encoding would essentially aid the progress of…
Success in treating patients with atypical parkinsonisms remains exceedingly low. This finding probably relates to the widespread distribution of the pathological changes that account for the varied and complex spectrum of clinical manifestations. Dopaminergic drugs are regularly used for…
Stroke is a sudden loss of brain function due to disturbance in the cerebral blood supply with symptoms lasting at least 24 hours or leading to death with vascular background as its only cause. Stroke can be caused either by rupture of a blood vessel or…
Minimizing The Risk Of Hemorrhagic Stroke During Oral Anticoagulant Therapy For Atrial Fibrillation: The Neurologist’s Perspective
Until recently, warfarin has been the gold standard for reducing stroke risk and mortality in patients with atrial fibrillation (AF). The key goals of antithrombotic treatment are the primary and secondary prevention of ischemic stroke and systemic embolism while minimizing…
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2014 Joint ACTRIMS-ECTRIMS Meeting EMSP Highlights Report For us at the European Multiple Sclerosis Platform (EMSP), medical congresses are one of the highlights of our calendar and this year’s joint ACTRIMS-ECTRIMS congress held in Boston was no exception. Congresses enable healthcare professionals and researchers to share the latest clinical updates and scientific breakthroughs; […]
The Role Of Apomorphine In The Effective Management Of Parkinson’S Disease – Highlights From Cony 2014
The 8th World Congress on Controversies in Neurology (CONy) held in Berlin in May 2014 provided a forum for neurologists and other healthcare professionals to debate some of the most significant and controversial topics facing clinicians in the field of neurology. The Britannia-sponsored debate session on Parkinson’s Disease Treatment tackled some key questions about the […]
Daniel Prefasi Gomar MD; Patricia Martínez-Sánchez , MD, PhD; Exuperio Díez-Tejedor, MD, PhD, FAHA, FESO, FANA. Department of Neurology and Stroke Centre La Paz University Hospital. Autonoma of Madrid University. IdiPAZ Health Research Institute Paseo de la Castellana 261, 28046, Madrid, Spain. Telephone number: +34 91 7277444 Fax number: +34 913581403 e-mail: email@example.com; firstname.lastname@example.org […]
João Massano, MD Department of Neurology, Hospital Pedro Hispano/ULS Matosinhos, Portugal Department of Clinical Neurosciences and Mental Health, Faculty of Medicine University of Porto, Portugal email@example.com Parkinson’s disease (PD) is a common
New research out of the University of Maryland School of Public Health shows that exercise may improve
Dr Clare Walton, Research Communications Officer at The Stroke Association Stroke is the leading cause of complex adult disability in the
A protein secreted with insulin travels through the bloodstream and accumulates in the brains of individuals with type 2 diabetes and dementia, in the same manner as the amyloid beta (Αβ) plaques that are associated with Alzheimer’s disease, a study by researchers with the UC Davis Alzheimer’s Disease Center has found. The study is the […]
Scientists hope the pharmaceuticals could lead to the development of a silver bullet for combatting the neurodegenerative disease. Researchers at USC have found that a class of pharmaceuticals can both prevent and treat Alzheimer’s Disease in mice. The drugs, known as “TSPO ligands,” are currently used for certain types of neuroimaging.
A study in the journal, JAMA Neurology suggests that controlling or preventing risk factors such as hypertension earlier in life may limit or delay the brain changes associated with Alzheimer’s disease and other age-related neurological deterioration.
Buphenyl, an FDA-approved medication for hyperammonemia, may protect memory and prevent the progression of Alzheimer’s disease. Hyperammonemia is a life-threatening condition that can affect patients at any age. It is caused by abnormal, high levels of ammonia in the blood.
In the weeks, months and years after a severe head injury, patients often experience epileptic seizures that are difficult to control. A new study in rats suggests that gently cooling the brain after injury may prevent these seizures.
Patients who become depressed after having had a stroke are four times more likely to die than those who have not had a stroke and who are not depressed. Results of a large 21-year follow-up study stress the importance of depression screening in poststroke care, according to Dr. Amytis Towfighi, who will present her data […]
A majority of pediatricians and family practitioners in a central Texas survey were unsure when pediatric epilepsy should be considered refractory and children should be referred for possible surgery. Researchers from the epilepsy program at the Dell Children’s Medical Center in Austin surveyed 84 pediatricians, 44 family practitioners, and 18 neurologists or neurosurgeons to gauge […]
The majority of a Food and Drug Administration advisory panel voted against approval of an extended-release, single-ingredient capsule formulation of hydrocodone for the treatment of chronic pain, citing the need for a tamper-proof formulation and a stronger risk mitigation strategy to address the high potential for abuse and misuse of the product.
PET/CT scans routinely used in the care of oncology patients may prove useful in pinpointing physiological changes associated with chemo brain.
Bilateral stimulation of the anterior nuclei of the thalamus led to a median reduction in partial-onset seizure frequency of 69% after a follow-up period of 5 years in the ongoing multicenter, double-blind, randomized SANTE trial.
Dr. Mohamed Salama Head of Experimental Neurology Unit MERC, Mansoura University, Egypt
While febrile seizures are common in early childhood and generally benign, prolonged febrile seizures of 30 minutes or longer have been associated with a greatly increased risk of later epilepsy, particularly temporal lobe epilepsy.
In addition to raising the risk of Alzheimer’s disease, the apolipoprotein E e4 allele appears to confer strong risks for Lewy body and Parkinson’s dementia – diseases that do not exhibit Alzheimer’s characteristic beta-amyloid plaques.
Young adult carriers of the presenilin gene mutation that invariably induces Alzheimer’s disease around the age of 45 years already show distinctive changes on functional and structural brain MRI and in amyloid-beta biomarkers when they are in their 20s and are still asymptomatic. However, amyloid-beta deposition in the grey matter of the brain does not […]
More than two-thirds of patients with medically refractory chronic cluster headache responded to on-demand, self-administered sphenopalatine ganglion stimulation with acute pain relief, less frequent attacks, or both. The prophylactic effect – a reduction in cluster attack frequency, but in most cases without acute pain relief – came as a surprise to investigators in the prospective, […]
Adults in Norway with diffuse low-grade gliomas who were treated at a hospital advocating early surgical resection had better overall survival than those treated at a hospital advocating “watchful waiting,” according to a report published online Oct. 30 in JAMA.
Epilepsy increased the risk for sudden cardiac death threefold in a case-control study involving 1,019 cases of sudden cardiac death.
Plain old aspirin proved far and away the most effective of the various agents used for prophylaxis of migraine with aura in an Italian study, with 86% of aspirin-treated patients reporting at least a 50% reduction in frequency of attacks. “We found the probability of treatment success with acetylsalicylic acid at 300 mg once daily […]
Frovatriptan may be the triptan of choice for the acute treatment of menstrual migraine attacks, according to reanalyses of data from double-blind, randomized crossover trials involving the drug. Frovatriptan’s lengthy half-life – the longest of all the triptans – and prolonged duration of clinical effect make it a particularly attractive option for the treatment of […]
Patients whose epilepsy was uncontrolled had more injuries, spent more time in the hospital, received more prescriptions, and incurred greater health care resource usage and costs than did patients whose epilepsy was under control in a retrospective, longitudinal matched-cohort study.
Occipital nerve blocks are an effective, safe, and well-tolerated therapy in patients with exacerbation of chronic or episodic cluster headache, according to two observational studies presented at the European Headache and Migraine Trust International Congress. “It’s a treatment that can suppress attacks temporarily or reduce pain intensity in a high percentage of patients. From the […]
The use of any form of acute antimigraine medication by patients with episodic migraine – be it single analgesics, combination analgesics, or triptans – exerted a protective effect against developing chronic migraine in a large, prospective, population-based study. “This effect seems to be stronger for single analgesics and triptans than for combination analgesics,” Dr. Zaza […]
Mixed results in phase II and III clinical trials leave open the question of whether lapatinib can prevent brain metastases in women with HER2-positive breast cancer.
The medical illustration is provided courtesy of Alzheimer’s Disease Research, a program of BrightFocus Foundation. Among patients with Alzheimer’s disease who develop psychosis or agitation-aggression that responds to risperidone, discontinuing the drug as advised after 3-6 months is associated with a doubling of the rate of relapse, according to a […]
The imaging agent florbetapir F 18 injection (Amyvid), used to exclude a diagnosis of Alzheimer’s disease, is being evaluated for Medicare reimbursement, the Centers for Medicare and Medicaid Services has announced. The agency stated on Oct. 9 that it expected a preliminary decision by July 2013, and a final decision by October 2013.
Headache medicine specialists have used onabotulinumtoxinA off label as an efficacious treatment for headache prophylaxis for a number of years. The pooled results from the double-blind, randomized, placebo-controlled, Phase III Research Evaluating Migraine Prophylaxis Therapy (PREEMPT) 1 and 2 trials (Headache 2010;50:921-36) demonstrated that onabotulinumtoxinA (Botox) is an effective prophylactic treatment for chronic migraine (CM). […]
Twenty-five percent of chronic migraine patients experience at least a 75% reduction in headache days per month after 6 months of treatment with onabotulinumtoxinA, according to a new analysis of data from the landmark PREEMPT trials. “That’s what I tell my patients to expect: If they go on Botox [onabotulinumtoxinA], they have a 1 in […]
Roughly 40% of the cost of 6 months of onabotulinumtoxinA for the treatment of chronic migraine is offset by resultant decreased use of emergency departments, urgent care facilities, and migraine-related hospitalizations, according to a prospective, real-world, cost-benefit study conducted in clinical practice. “The associated savings offset a reasonable proportion of the cost of treatment for […]
Prof.Dr.C.Dettmers Kliniken Schmieder Konstanz, Konstanz, Germany; Faculty of Psychology, University Konstanz, Konstanz, Germany.
Dr. Maria Pia Sormani Department of Health Sciences, University of Genova, Italy
Chronic musculoskeletal complaints and chronic daily headache share a bidirectional causal relationship in which patients with either condition are predisposed over time to develop the other one.
Physicians in five countries agree: Those who diagnose and treat patients with Alzheimer’s disease need more – and better – tools to handle the job.
Prof. Peter Rieckmann Department of Neurology, Sozialstiftung Bamberg Hospital, Bamberg, Germany
Rare cases of chemical burns caused by over-the-counter topical muscle and joint pain relievers has prompted the Food and Drug Administration to issue an advisory about the use of the products, with recommendations for both consumers and health professionals. The single- or combination-ingredient products contain menthol, methyl salicylate, or capsaicin. The products included in the […]
Marc Fisher, MD (pictured below) Department of Neurology, University of Massachusetts School of Medicine Gregory W. Albers, MD Stanford University School of Medicine
The Food and Drug Administration has approved the latest oral therapy for relapsing multiple sclerosis, teriflunomide (Aubagio), but it will carry a strong warning that it increases the risk of fetal harm.
Glatiramer acetate and interferon beta-1a used in combination were no more effective for patients with relapsing-remitting multiple sclerosis than were either agent alone in a 3-year, randomized trial.
Is there A Multiple Sclerosis Epidemic And Is It The Result Of A Plethora Of Etiological Factors Or Of An As Yet Unknown Or Emergent Latent Risk Factor?
Bernd Krone, Institute of Virology, University Göttingen, Göttingen, Germany, and Laboratory Medicine Institute Kassel, Druseltalstrasse 61, 34131 Kassel, Germany, Email firstname.lastname@example.org
Why some Multiple Sclerosis- Patients stop Disease Modifying Treatment in MS and why some Don’t start at all
Nina Grytten Torkildsen National Multiple Sclerosis Competence Centre, Dept. of Neurology, Haukeland University Hospital Norway
The development and resolution of impulse control disorders in patients with Parkinson’s disease appears to be largely reliant on gender, daily dose of dopamine agonists, and the presence of depressive symptoms, according to a prospective study.
Secondary headaches in pregnant women are likely to be associated with an additional medical complaint, according to a retrospective study of patients who presented to a tertiary-care center.
Oral relaxin therapy resulted in significantly improved cognitive and functional recovery in poststroke patients participating in a randomized controlled trial.
Nocturnal sleep enhances working memory training in patients with Parkinson’s disease but not in those with Lewy body dementia, results from a novel study demonstrated.
The vast majority of patients with Alzheimer’s disease will show agitation, delusion, and other disruptive behaviors during the course of their illnesses. These behaviors cause suffering and distress for patients and for caregivers and families, often diminishing quality of life and making care more difficult.
Major Finding: Functional magnetic resonance imaging correlated with EEG in children with absence epilepsy and matched healthy controls.
Existing data support the use of physiotherapy in the treatment of Parkinson’s disease in the short term, but larger, randomized controlled trials of longer duration are needed to better define the benefit of the intervention.
Measurements of five protein biomarkers in the cerebrospinal fluid helped to differentiate Alzheimer’s disease from Parkinson’s disease with dementia and from dementia with Lewy bodies in a cross-sectional study of individuals at Swedish neurology and memory disorder clinics.
The impact of acetyl-l-carnitine on chemotherapy-induced peripheral neuropathy may depend largely on the clinical context and patient population, a pair of phase III trials suggests.
Pediatric stroke survivors had an absolute risk of 39% for developing epilepsy in the 10 years following their stroke in a review of 371 patients in Northern California.
Eli Lilly’s experimental Alzheimer’s drug solanezumab failed to have statistically significant benefits in the primary end points of two phase III trials but showed possible early cognitive benefits in secondary analyses, the company announced Aug. 24. The two 18-month trials, called EXPEDITION 1 and 2, randomized more than 2,050 patients with mild-to-moderate Alzheimer’s disease to […]
The total defined daily dose of antiepileptic drugs was the best predictor of medication side effects in a clinical prediction rule developed from a single-center, cross-sectional study of 801 patients with epilepsy.
Sometimes the only relief for a patient who presents with chronic and recalcitrant pain comes from a course of spinal cord stimulation.
Interferon-beta therapy did not slow the long-term progression of disability in adults with relapsing-remitting multiple sclerosis in a retrospective cohort study based on prospectively collected data.
Researchers have discovered that one or more substances produced by a certain type of immune cell may be involved in the progression of multiple sclerosis (MS), an autoimmune disease affecting the brain and spinal cord, may be involved caused by. The finding might lead to new, targeted treatments for those suffering from MS.
A “one-size-fits-all” new class of drugs that targets a particular type of brain inflammation is showing early promise for the treatment of Alzheimer’s disease, Parkinson’s disease, multiple sclerosis and traumatic brain injury.
Numerous muscles are involved and use coordination just to perform simple actions like picking up a pen. For instance, the eyes and head need to turn towards the object, the hand needs to reach towards the pen and the fingers need to pick it up.
Long-term coffee consumption may protect against dementia in the elderly, according to an Italian study presented at the Alzheimer’s Association International Conference 2012. In the prospective population-based cohort study of adults aged 80 years or older, about three-fourths drank coffee, having started on average at the age of 19 years. Among those who were dementia-free […]
When used as a first-line choice for the treatment of acute ischemic stroke secondary to large artery occlusion, the Solitaire FR revascularization device was safe and offered good recanalization rates and clinical outcomes, a multicenter study showed. The Solitaire FR device, which mechanically removes blood clots from blocked vessels, received CE Mark approval in Europe […]
The first human trial of bexarotene, the skin cancer drug shown to clear beta-amyloid brain plaques in mice with Alzheimer’s-like pathology, will commence sometime in September. The phase Ib trial will randomize 12 healthy subjects to placebo or bexarotene (Targretin), Gary E. Landreth, Ph.D., said in an interview.
Of the many scales at a clinician’s disposal to measure acute pain, the three most commonly used are the Numerical Rating Scale, the Verbal Rating Scale, and the Visual Analog Scale, Dr. Jeffrey A. Stone said at the annual meeting of the Society of Neurointerventional Surgery. “All of these scales have been shown to be […]
Potentially modifiable environmental factors protect against Alzheimer’s disease in older adults carrying the apolipoprotein E e4 allele, a major susceptibility gene for the late-onset form of the disease and also a risk factor for other types of dementia.
A study indirectly comparing three oral anticoagulant drugs – dabigatran, rivaroxaban, and apixaban – has revealed potential differences among the agents in their relative efficacy and safety when used for stroke prevention in atrial fibrillation.
A proposal for a new way to classify seizures would modify the way they have been discussed and organized since 1989.
A thrombus retrieval device for use in patients experiencing an acute ischemic stroke has been cleared for marketing in the United States by the Food and Drug Administration, the manufacturer announced on Aug. 13. The device will be marketed as the “Trevo Pro Retriever,” according to the statement issued by Stryker Neurovascular. Courtesy Stryker Neurovascular
The first evidence of emerging Alzheimer’s disease surfaces at least 1 decade before the onset of the disorder, based on new neuropsychological data reported at the Alzheimer’s Association International Conference 2012. So far, though, there is no single test or battery of tests that can be performed at baseline to predict preclinical Alzheimer’s disease, acknowledged […]
Nonpharmacologic interventions bestow clinically meaningful benefits on patients with dementia, a literature review has concluded. But these aren’t one-size-fits-all activities, Dr. Clive Ballard said at the Alzheimer’s Association International Conference. Different activities improve different problems, leading to the possibility of targeted treatment.
When Alzheimer’s disease patients who took risperidone for psychoses discontinued the drug, they were more than four times more likely to relapse than were those who continued treatment in a randomized, placebo-controlled trial.
Interim results from an ongoing study demonstrated that that a higher pretreatment Alberta Stroke Program Early CT Score on computed tomography angiogram images is associated with better outcome following endovascular therapy. “There is no standard imaging approach for endovascular therapy patient selection,” Dr. Donald Frei said at the annual meeting of the Society of Neurointerventional […]
A family member with Parkinson’s disease confers the strongest risk for developing the disease, according to findings from the largest and most comprehensive systematic review and meta-analysis of Parkinson’s disease risk factors suitable for screening in primary care.
As the men and women who graciously serve our country return home, often times we can easily recognize the associated morbidity that resulted from their service. The physical injuries that can occur are obvious. But people have become more sensitive toward the injuries that are not so easily apparent, such as traumatic brain injury and […]
Are a few animal studies and a handful of human case reports enough to let physicians skirt institutional review boards? Two neurosurgeons in California did just that when they used Enterobacter aerogenes to infect the surgical wounds of three terminally ill glioblastoma patients. Two of the patients died from the infections. Dr. J. Paul Muizelaar […]
Evidence that voice disturbances might be an additional clue to making a diagnosis of Parkinson’s disease was recently supported by a study conducted by a mathematician and collaborators from Intel Corp. Max Little, Ph.D., a mathematician now at the Massachusetts Institute of Technology in Cambridge, Mass., was approached by the company to use voice recordings […]
Neurosurgeons can now follow a glowing road map that points the way to cancerous brain tissue, leading thereby to a more effective surgical excision.
Full results of the second phase III trial of dimethyl fumarate in patients with relapsing-remitting multiple sclerosis show that the investigational drug significantly reduces annualized relapse rates and MRI lesions over the course of 2 years
Parkinson’s disease patients with mild cognitive impairment have dysfunctional circuitry in brain networks involving the right dorsal caudate nucleus and the bilateral anterior cingulate cortex, compared with unaffected Parkinson’s patients, according to a prospective cohort study.
Metformin was associated with more modest reports of pain among patients with lumbar radiculopathy. In a retrospective case-control study presented at the annual meeting of the Endocrine Society, 46 patients who were taking metformin and sought care for lumbar radiculopathy pain averaged a 1.85-point lower score on a 0-10 point “having pain now,” scale as […]
Intravenous immunoglobulin continues to slow the decline in cognitive and other functions seen in Alzheimer’s disease for at least 3 years, suggest data from an extended phase II randomized trial among 21 patients with mild to moderate disease. Compared with their counterparts who started on a placebo and crossed over to intravenous immunoglobulin (IVIG) in […]
An investigational gene-based blood test identified prodromal Alzheimer’s disease with an accuracy of 81%. The test is based on a panel of 25 genes active in biological processes associated with Alzheimer’s, Dr. Magnus Sjögren said at the Alzheimer’s Association International Conference 2012. Michele G. Sullivan/IMNG Medical Media Dr. Magnus Sjögren
Rankings of hospital performance in treating acute ischemic stroke must take into consideration the severity of each case, or the rankings will be extremely inaccurate, researchers say in the July 18 issue of JAMA. Unfortunately, the rankings that are currently used by accreditation organizations, the Centers for Medicare and Medicaid Services (CMS), and other payers […]
Maternal hypertension and intrapartum fever increase the risk for ischemic stroke in infants, a large retrospective analysis suggests. Gestational diabetes, a known risk factor for maternal hypertension and neonatal hypoglycemia, does not increase stroke risk. “Additional research is needed to determine the mechanism underlying these associations and to develop effective preventive methods for high-risk infants,” […]
Tetrahydrocannabinol, the main active ingredient in marijuana, did not slow the progression of multiple sclerosis in a 3-year, randomized trial of 493 British patients with primary or secondary progressive forms of the disease. Some patients with lower baseline EDSS (Expanded Disability Status Scale) scores appeared to have delayed progression, but the trial did not have […]
Chronic migraineurs reported a greater number of stressful major life events than did those with episodic migraines in a large, cross-sectional analysis of the American Migraine Prevalence and Prevention Study. In the study, 551 chronic migraineurs were 25% more likely report to a higher number of stressful major life events in the past year than […]
The largest-ever genome sequencing project is the newest weapon in the Alzheimer’s battle. This new project will examine the genetic codes of more than 800 people, generating more than 165 terabytes – 165,000 gigabytes – of new information about Alzheimer’s disease and its genetic roots. “This is the biggest single whole-genome scan that has ever […]
Although it is rare and the prognosis for patients is often poor, the presence of central nervous system involvement at the time of diagnosis of mantle cell lymphoma is not always immediately fatal, according to findings from an international study.
NATIONAL HARBOR, MD. – Percutaneous balloon angioplasty improved flow dynamics in multiple sclerosis patients with chronic cerebrospinal venous insufficiency in a pilot study. An association has been made recently between multiple sclerosis and chronic cerebrospinal venous insufficiency (CCSVI) that is characterized by stenosis and reflux of the principal extracranial venous drainage, including the internal jugular […]
A PET imaging protocol using an amino acid analog radiotracer in patients with recurrent high-grade gliomas identified responses to treatment with bevacizumab as early as 2 weeks after starting therapy in a prospective study.
An emergency department at an academic medical institution with a multiple sclerosis center missed diagnosing multiple sclerosis in nearly 40% of patients who were later diagnosed with the disease, calling into question what the rate of missed cases might be at smaller centers staffed by fewer specialists. The retrospective study analyzed assessments for neurologic symptoms […]
Statins are beneficial in women for the secondary prevention of some cardiovascular events, but they don’t appear to be any better than placebo at preventing stroke or all-cause mortality, according to a meta-analysis reported in the June 25 issue of Archives of Internal Medicine.
Cancer survivors with chemotherapy-induced peripheral neuropathy may be headed for a fall, researchers cautioned at the annual meeting of the American Society of Clinical Oncology.
Approximately one in eight Alzheimer’s disease patients who develop delirium while hospitalized will suffer at least one adverse outcome, based on data from 771 adults. The findings were published in Annals of Internal Medicine on June 18. Previous studies have shown that delirium can increase the rate of cognitive decline in AD patients, but the […]
Oral contraceptives containing low- or very low-dose estradiol raised the risks of thrombotic stroke and myocardial infarction by a factor of 1 to 2 in a large Danish cohort study. The results were published in the June 14 issue of the New England Journal of Medicine.
The risk of developing progressive multifocal leukoencephalopathy from natalizumab therapy appears to be greater than previously thought, being greatest in multiple sclerosis patients with certain risk factors, according to an updated analysis. The analysis provides an algorithm that might help clinicians hone in on which patients are least or most likely to develop PML, and […]
Dopamine agonist–induced impulse control disorders may be more likely in Parkinson’s disease patients who smoke, drink, or consume caffeine, according to the first prospective cohort study of the problem.
Higher vitamin D levels are associated with slightly less disability and greater preservation of gray matter in patients with multiple sclerosis, according to a 5-year observational study. The researchers assessed 25-hydroxyvitamin D levels, clinical disability, and MRI brain volumes annually in 469 patients with relapsing-remitting multiple sclerosis (MS) or clinically isolated syndrome, all members of […]
A reformulated version of the previously withdrawn Neupro rotigotine patch had favorable results in separate studies of patients with advanced idiopathic Parkinson’s disease and restless legs syndrome, according to reports given prior to the planned return of the patch to the U.S. market in July.
Recurrent depression from midlife through late life increases the risk of vascular dementia, suggesting a progressive etiologic association with vascular disease, a large, long-term retrospective cohort study has shown. When depression begins only in late life, it might be part of the Alzheimer’s disease prodrome, the researchers found. Whether treatment of depression could help prevent […]
Women with epilepsy appear to have a significantly greater number of unintended pregnancies than does the general population and cite a wide variety of reasons for discontinuing different contraceptive methods, according to preliminary results from the Epilepsy Birth Control Registry.
A new plan marshals the forces of funding, research, and education to fight the battle against Alzheimer’s. The National Plan to Address Alzheimer’s Disease has an ambitious, overarching goal: to prevent and effectively treat Alzheimer’s by 2025. But while focusing on the future, it does not neglect the present. The plan calls for the resources […]
Every patient should get an electrocardiogram prior to and 6 hours after the first dose of fingolimod, and hourly blood pressure and heart rate measurements in between, to assess for bradycardia, according to revised labeling released by the Food and Drug Administration on May 9.
Noninvasive transcranial direct current stimulation of the pain-modulating areas of the cerebral cortex markedly reduced postoperative pain and opioid use in a randomized trial involving total knee arthroplasty recipients. Transcranial direct current stimulation (tDCS), a novel and apparently safe form of neurostimulation for analgesia, also is in planned or ongoing clinical trials for various forms […]
Patients with an apparent first demyelinating event who are treated early with subcutaneous interferon beta-1a experience a significantly longer time until progression to multiple sclerosis, compared with those whose treatment is initiated after diagnosis with clinically definite MS, according to 3-year results from the ongoing phase III, double-blind REFLEX extension trial.
The Food and Drug Administration’s approval of the first amyloid plaque-imaging agent, florbetapir F18, may usher in a “new age” in the diagnosis of Alzheimer’s disease, according to Dr. Daniel Skovronsky. “We are entering a new age in which we can evaluate patients [with cognitive decline] based on the molecular pathology in the brain,” rather […]
Ocular fixation instability, also known as ocular tremor, is a pervasive and highly specific feature among patients with Parkinson’s disease, according to findings from a study involving 112 patients and 60 controls.
Nearly half of elderly patients who have an ischemic stroke also have atrial fibrillation, based on a review of 527 stroke patients aged 75 or older at a single U.S. center.
A new report released by the Institute of Medicine offers a unified public health plan for the epilepsies that focuses on public health surveillance and data collection, population and public health research, health policy and human services, and education.
Immunotherapy with peptide vaccines may offer a much-needed therapeutic option for gliomas in children, which carry a poor prognosis despite current treatments. In a pilot trial of subcutaneous vaccinations with peptides for glioma-associated antigen (GAA) epitopes in children who have been newly diagnosed with brain stem gliomas, cerebral high-grade gliomas, or recurrent gliomas, the immunotherapy […]
The American Stroke Association is developing a host of new guidelines and statements, including a consensus statement on the definition of stroke and a scientific review of new anticoagulants. The first new guideline – on the Management of Aneurysmal Subarachnoid Hemorrhage (SAH) – is complete and has been submitted for publication, said Dr. Colin Derdeyn, […]
Monitoring for metabolic side effects proved to be infrequent for outpatients with dementia or delirium who had been prescribed antipsychotic medications at 32 Veterans Affairs medical centers. Antipsychotic medications are approved by the Food and Drug Administration for use in patients with psychotic disorders, not for those with dementia and delirium. However, they are widely […]
Electrocutaneous direct nerve stimulation via a device that scrambles “pain” and “no pain” signals reduced pain scores in preliminary studies involving patients with refractory chemotherapy-induced peripheral neuropathy, post-herpetic neuralgia, and other forms of chronic, disabling neuropathic pain. “What I saw in our pilot study in patients with chemotherapy-induced peripheral neuropathy was about a 60% reduction […]
Levels of air pollution that fall within the amounts deemed safe in current U.S. standards for air quality were associated with a significant increase the risk for acute ischemic stroke after short-term exposure and accelerated cognitive decline after long-term exposure in two separate studies. Previous studies of the effects of ambient fine particulate matter air […]
Two new risk assessment scores predicted the likelihood of a symptomatic intracranial hemorrhage after ischemic stroke treatment with more than 70% accuracy.
A granulocyte colony-stimulating drug did not protect brain tissue or improve functional outcomes after ischemic stroke.
The potential advantages of tenecteplase, a modified form of tissue plasminogen activator engineered to outperform the native molecule, finally shone through for treating patients with acute ischemic stroke. A head-to-head comparison of tenecteplase against recombinant tissue plasminogen activator (TPA; alteplase) showed that the modified molecule produced better reperfusion and better clinical recovery 24 hours after […]
Regular users of statins had a “marginally significant” lower risk of developing Parkinson’s disease than did nonusers in a prospective, observational analysis of two large, ongoing study cohorts.
An investigative, minimally invasive surgery for reducing intracranial clot volume following an intracerebral hemorrhage showed promise in results from a phase II study. In the controlled study, 54 patients who underwent clot removal by minimally-invasive surgery (MIS) had a 10% increased rate of achieving a modified Rankin Scale (mRS) score of 1-3 at 180 days, […]
When results from a major trial with more than 900 patients failed to show that closure of a patent foramen ovale in patients who had a cryptogenic stroke worked better than medical therapy for preventing a future stroke, some experts suggested that the problem was patient selection. Researchers now have evidence that this explanation was […]
Pediatric stroke survivors had an absolute risk of 39% for developing epilepsy in the 10 years following their stroke in a review of 371 patients in Northern California. Two factors significantly boosted a child’s risk of developing epilepsy following a stroke: A seizure at the time of stroke, and a neurologic deficit at the time […]
Patients with moderate or severe Alzheimer’s disease who continued to worsen despite treatment with donepezil appeared to retain a small but significant benefit over those who added or switched to memantine or stopped taking medication for Alzheimer’s altogether in a randomized trial. The patients in the 1-year study, DOMINO (Donepezil and Memantine in Moderate to […]
Surgery was clearly superior to pharmacotherapy at relieving seizures in a study of patients with intractable mesial temporal lobe epilepsy who were no more than 2 years beyond the point where they failed to respond to adequate trials of two brand-name antiepileptic drugs.
Surgery was clearly superior to pharmacotherapy at relieving seizures in a study of patients with intractable mesial temporal lobe epilepsy who were no more than 2 years beyond the point where they failed to respond to adequate trials of two brand-name antiepileptic drugs.
An elevated Framingham Risk Score identified recent ischemic stroke patients at high risk for a myocardial infarction or vascular death over the next 2 years, in a retrospective analysis of data from more than 2,500 stroke survivors without documented coronary heart disease. If prospective study results confirm this finding, it could establish the Framingham Risk […]
“Drip and ship” is a safe way to manage patients with acute ischemic stroke, according to results from two separate studies. A review of 145 ischemic stroke patients who began receiving an intravenous infusion of tissue plasminogen activator (TPA) at a community hospital, followed by transport to a regional primary stroke center, showed a 63% […]
An investigational clot-retrieval device completely recanalized blocked cerebral arteries, improved neurologic outcomes, and significantly reduced mortality from acute ischemic stroke more often than did the widely used Merci device in a randomized, open-label trial. The SWIFT (SOLITAIRE-FR With the Intention for Thrombectomy) study intended to randomize 200 patients with ischemic stroke to treatment with either […]
The extra time needed for CT perfusion imaging in patients with an acute ischemic stroke may not be warranted, based on a retrospective analysis of 418 patients treated at nine U.S. tertiary stroke centers. The analysis showed that the outcomes in patients assessed using CT perfusion (CTP) were very similar to those in patients worked […]
A 2-year weight-lifting program improved physical symptoms of Parkinson’s disease – including tremor – and seemed to slow their progression.
A pharmacotherapeutic approach that harnesses the amyloid-beta clearing effects of the apolipoprotein E gene while also activating microglia to clear amyloid plaques from the brains of mouse models of Alzheimer’s disease could become a new treatment strategy to test clinically. The protein product of the APOE gene – the most influential genetic risk factor for […]
There may be a correlation between infection and stroke in children, according to research presented at the International Stroke Conference. Acute infection is considered to be a risk factor for stroke in adults, so researchers from the University of California, San Francisco, decided to study whether it might also be a potential risk in children, […]
Tai chi improved postural stability and other functional outcomes in patients with mild to moderate Parkinson’s disease to a significantly greater extent than did resistance training over the course of a 6-month period in a randomized, controlled trial.
A novel implantable device has demonstrated potential for predicting seizure onset in a preliminary analysis of 15 adult patients with medically refractory complex partial seizures.
The multiple sclerosis drug laquinimod did not reduce the risk of relapse in the BRAVO phase III trial, yet the investigational agent delayed the progression of disability to a greater extent than did placebo. The BRAVO trial also included an open comparator arm against interferon beta-1a (IFNB-1a, Avonex), which proved to reduce brain lesions on […]
Women with multiple sclerosis can be reassured that should they choose to become pregnant, they are generally not at any greater risk of adverse pregnancy or birth outcomes than are similar women without the disease, according to a retrospective cohort study.
Tick, tick, tick. It’s a familiar sound to neurologists, who have grown accustomed to watching the clock as they hurry to get tissue plasminogen activator on board in ischemic stroke patients. If Dr. Steven Cramer proves correct, a second timer may soon be ticking, this one measuring in days or weeks a limited “golden” period […]
Disparities Seen in Care of Parkinson’s Patients : Better Clinical care Associated with Neurologists was often Unavailable to women or Minorities.
Major Finding: Women and blacks with Parkinson’s disease both had 23% lower odds of receiving care from a neurologist than did men and whites, after adjustment for covariates.
Major Finding: Significantly more individuals with hyposmia had DAT levels of 65% or lower, compared with normosmic individuals (11% vs. 1%).
Almost half the patients who undergo surgery for epilepsy remain seizure free 10 years postop, but further improvements in presurgical assessment and surgical treatment of people with chronic epilepsy are needed to improve success rates, according to findings from a prospective study.
Major Finding: Monthly infusion with 200 mg gantenerumab, a monoclonal antibody to amyloid-beta, resulted in an average 15% decline in the amount of brain amyloid-beta in patients with mild to moderate Alzheimer’s disease. Data Source: Randomized trial of 16 patients with mild to moderate Alzheimer’s disease given monthly infusions with 60 or 200 mg gantenerumab […]
Serum levels of interleukin-7 helped determine which patients with relapsing-remitting multiple sclerosis would benefit from treatment with interferon-beta in a series of experiments involving human sera and mice with experimental autoimmune encephalo-myelitis.
New Drugs, Devices Edge Toward Clinical Use : New Antiepileptic drugs in the Pipeline may Provide Enhanced Safety, Tolerability, or Potency.
Several new antiepileptic drugs and devices aimed at preventing or suppressing seizure have achieved results with better management of side effects than is seen with existing therapeutic agents, according to Dr. Jacqueline A. French.
Major Finding: Exercise and medication use significantly improved cognitive function in patients with Parkinson’s disease based on results of the Stroop Color and Word Test. Exercise improved performance on the Brief Test of Attention and the Digit Span Forward and Backward Task when patients were off medication but not when they were on medication.
New evidence suggests that excessive glutamate released from glioma cells causes epileptic activity in peritumoral neurons, which may be stopped by a drug that blocks the release of glutamate from tumor cells.
A cardiac rehabilitation program can help cerebrovascular-disease patients as much as it helps patients with cardiac disease, based on results from 89 patients treated in a Canadian pilot program. “Patients suffering a nondisabling stroke or TIA [transient ischemic attack] gain the same, if not better, outcomes from being part of a multifactorial, risk-reduction program traditionally […]
An international panel has revised the McDonald criteria for the diagnosis of multiple sclerosis to simplify the use of imaging in determining the dissemination of central nervous system lesions both in space and time, while preserving sensitivity and specificity.