Dextromethorphan/Quinidine for Pseudobulbar Affect Following Stroke: Safety and Effectiveness in the PRISM II Trial

Publication date: Available online 30 June 2018Source: PM&RAuthor(s): Richard D. Zorowitz, David N. Alexander, Andrea E. Formella, Fred Ledon, Charles Davis, Joao SiffertAbstractBackgroundDextromethorphan (DM)/quinidine (Q) was approved for pseudobulbar affect (PBA) treatment based upon efficacy and safety trials in patients with PBA secondary to amyotrophic lateral sclerosis or multiple sclerosis. The PRISM II trial evaluated DM/Q as PBA treatment in patients with stroke, dementia or traumatic brain injury.ObjectiveTo report results from the stroke cohort of PRISM II, including the Stroke Impact Scale (SIS).DesignOpen-label trial evaluating twice daily DM/Q over 90 daysStudy participantsAdults (n=113) with a clinical diagnosis of PBA secondary to stroke; stable psychiatric medications were allowed.MethodsPRISM II was an open-label, 12-week trial enrolling adults with PBA secondary to dementia, stroke (reported here), or TBI. All study participants received DM/Q 20/10 mg twice daily. Study visits occurred at baseline and at day 30 and day 90.Setting150 US centers.Main Outcome MeasurementsPrimary efficacy measure was change from baseline to day 90 in Center for Neurologic Study-Lability Scale (CNS-LS) scores. Secondary outcomes included PBA episodes (estimated over 7 days), Clinical and Patient/Caregiver Global Impression of Change (CGI-C and PGI-C), Quality of Life-Visual Analog Scale (QOL-VAS), SIS, Patient Health Questionnaire (PHQ-9), and Mini-Mental State Examination (MMS...
Source: PMandR - Category: Rehabilitation Source Type: research

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Conclusion: The presence of headache, mood disorders, psychosis, depression, and other neuropsychological manifestations in a patient with JSLE should prompt investigations into diagnosis of the primary nervous system involvement in order to reduce mortality and morbidity. PMID: 30002929 [PubMed]
Source: Neurology Research International - Category: Neurology Tags: Neurol Res Int Source Type: research
Publication date: Available online 30 May 2018Source: Nutrition, Metabolism and Cardiovascular DiseasesAuthor(s): A. Deng, S. Pattanaik, A. Bhattacharya, J. Yin, L. Ross, C. Liu, J. ZhangAbstractBackgroundThere is a paucity of studies examining the beneficial effects of fish consumption on cardiovascular diseases (CVDs) among adults with diabetes, who experience a substantially high risk of CVDs.Methods and resultsWe analyzed the data of 1136 adults with diabetes mellitus aged 18 years and older who participated in the National Health and Nutrition Examination Survey, 1988–1994, and were followed up through December ...
Source: Nutrition, Metabolism and Cardiovascular Diseases - Category: Nutrition Source Type: research
Dear Carol: I’ve lived 900 miles away from my parents for years. My husband and I were tied down with caring for his parents, so we didn’t see my family as often as we’d like, but they always seemed fine when we talked or visited. Now, his parents have both passed and we’ve been traveling to visit my parents more often. These last few visits have highlighted my mom’s decline. It’s obvious that she’s got dementia but she ignores the symptoms and hasn't been diagnosed. Dad is in denial and covers for her, as does my only sibling. How do I even begin to help with this? – NY...
Source: Minding Our Elders - Category: Geriatrics Authors: Source Type: blogs
AbstractThe exact mechanism of the migraine pathophysiology remained unclear. Although there are some reports showing low-grade inflammation in migraineurs, further studies are needed in this field. Thus, we designed a study to evaluate the serum levels of two main proinflammatory markers in migraine patients. In this case-control research, 43 migraine patients (23 chronic and 20 episodic migraineurs) and 40 age-sex-matched headache-free controls were studied. Demographic, dietary, and anthropometric data, headache characteristics, and serum C-reactive proteins (CRP) and tumor necrosis factor-alpha (TNF- α) assessmen...
Source: Neurological Sciences - Category: Neurology Source Type: research
Conclusion: Leptospirosis is a common cause of undifferentiated tropical febrile illness in Colombia; it is important to establish ongoing and accurate surveillance for acute febrile illness to facilitate the detection of cases of leptospirosis. PMID: 30003104 [PubMed - in process]
Source: Biomed Res - Category: Research Authors: Tags: Biomed Res Int Source Type: research
Conclusions: The present study strongly showed that lower GFR is an independently predictor of HT; in addition, large infarct volume, AF, and HA are also important risks of HT for AIS patients without TT, which offered a practical information that risk factors should be paid attention or eliminated to prevent HT for stroke patients though the level of evidence seems to be unstable. PMID: 29998881 [PubMed - in process]
Source: Chinese Medical Journal - Category: General Medicine Authors: Tags: Chin Med J (Engl) Source Type: research
CONCLUSIONS: The main findings of fMRI applied to MS are strongly related to the demyelinating nature of the disease and provide an adequate insight into the mechanisms that underlie functional alterations reported in this disease. fMRI also appears to be useful for studying disease evolution and response to treatment in MS and other disorders. PMID: 29999173 [PubMed - in process]
Source: Revista de Neurologia - Category: Neurology Authors: Tags: Rev Neurol Source Type: research
HEADACHES can be agonising and affect our ability to focus, concentrate or just relax. It could be possible to get rid of them through these five natural remedies.
Source: Daily Express - Health - Category: Consumer Health News Source Type: news
Abstract Neuroimaging studies have demonstrated that major depressive disorder increases the risk of dementia in older individuals with mild cognitive impairment. We used resting-state functional magnetic resonance imaging to explore the intrinsic coupling patterns between the amplitude and synchronisation of low-frequency brain fluctuations using the amplitude of low-frequency fluctuations (ALFF) and the functional connectivity density (FCD) in 16 patients who had mild cognitive impairment with depressive symptoms (D-MCI) (mean age: 69.6 ± 6.2 years) and 18 patients with nondepressed mild cog...
Source: Neural Plasticity - Category: Neurology Authors: Tags: Neural Plast Source Type: research
Conclusions: These findings suggest that action observation is lateralized to the dominant, rather than ipsilesional, hemisphere, which may reflect an interaction between the lesioned hemisphere and the dominant hemisphere in driving lateralization of brain activity after stroke. Hemispheric dominance and laterality should be carefully considered when characterizing poststroke neural activity. PMID: 29997648 [PubMed - in process]
Source: Neural Plasticity - Category: Neurology Authors: Tags: Neural Plast Source Type: research
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