Expert opinion: use of valproate in girls and women of childbearing potential with epilepsy: recommendations and alternatives based on a review of the literature and clinical experience —a European perspective
AbstractValproate is a broad-spectrum antiepileptic drug (AED) of particular interest in pediatric epilepsy syndromes and idiopathic generalized epilepsy, as it is relatively more effective in these syndromes than other AEDs. In 2018, the European Medicines Agency introduced new restrictions on the use of valproate in girls and women of childbearing potential to avoid exposure during pregnancy. The strengthening of existing restrictions sparked controversy and debate among patients and the medical community. The high prevalence of epilepsy syndromes amenable to valproate treatment in women of childbearing age and the littl...
Source: Journal of Neurology - April 1, 2020 Category: Neurology Source Type: research

Effects of immunotherapies and prognostic predictors in neuromyelitis optica spectrum disorder: a prospective cohort study
This study aimed to evaluate the long-term effects of the first-line immunotherapies on relapse and disability, and identify the prognostic predictors in NMOSD.MethodsIn this prospective cohort study, we enrolled patients with NMOSD from Southwest China and performed a long-term follow-up. We compared no immunotherapies (NIT) versus treatment of mycophenolate mofetil (MMF), azathioprine (AZA), or only corticosteroid (CS). Cox proportional-hazards model was used to explore the prognostic predictors in NMOSD.ResultsUltimately, 281 patients were enrolled during 2009 to 2017. The proportions of relapse, motor disability, and m...
Source: Journal of Neurology - April 1, 2020 Category: Neurology Source Type: research

The neurological update: therapies for cerebellar ataxias in 2020
AbstractCerebellar 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 occupatio...
Source: Journal of Neurology - April 1, 2020 Category: Neurology Source Type: research

MRI patterns of muscle involvement in type 2 and 3 spinal muscular atrophy patients
AbstractOnly few studies have reported muscle involvement in spinal muscular atrophy using muscle MRI but this has not been systematically investigated in a large cohort of both pediatric and adult patients with type 2 and type 3 spinal muscular atrophy. The aim of the present study was to define possible patterns of muscle involvement on MRI, assessing both fatty replacement and muscle atrophy, in a cohort of type 2 and type 3 spinal muscular atrophy children and adults (age range 2 –45 years), including both ambulant and non-ambulant patients. Muscle MRI protocol consisted in T1-weighted sequences acquired on ...
Source: Journal of Neurology - April 1, 2020 Category: Neurology Source Type: research

Max Lewandowsky (1876 –1918)
(Source: Journal of Neurology)
Source: Journal of Neurology - April 1, 2020 Category: Neurology Source Type: research

Lack of effects of a single session of cerebellar transcranial direct current stimulation (tDCS) in a dynamic balance task
(Source: Journal of Neurology)
Source: Journal of Neurology - April 1, 2020 Category: Neurology Source Type: research

Retinal axonal degeneration in Niemann –Pick type C disease
We examined NPC1-patients (NPC1-P), clinically asymptomatic NPC1-mutation carriers (NPC1-MC), and healthy controls (HC) to (1) identify retinal degeneration in NPC1-disease and (2) to investigate possible subclinical retinal degeneration in NPC1-MC.MethodsFourteen NPC1-P, 17 NPC1-MC, and 31 age-matched HC were examined using spectral-domain OCT. Neurological examinations, clinical scales [modified Disability Rating Scale (mDRS); Scale for the Rating and Assessment of Ataxia (SARA); Spinocerebellar Ataxia Functional Index (SCAFI)], and video-oculography (VOG) were correlated with OCT data.ResultsMacular retinal nerve fiber ...
Source: Journal of Neurology - March 28, 2020 Category: Neurology Source Type: research

Mental health and coping strategies in families of children and young adults with muscular dystrophies
ConclusionsPsychosocial interventions should address problems of anxiety and depression that people with MDs frequently experience, even through fostering parents ’ and childrens’ engagement coping over disengagement coping. (Source: Journal of Neurology)
Source: Journal of Neurology - March 28, 2020 Category: Neurology Source Type: research

Long-term outcomes in temporal lobe epilepsy with glutamate decarboxylase antibodies
ConclusionMost patients with temporal lobe epilepsy and CSF GAD65-Abs develop a chronic disease with progressive cognitive impairment and refractory epilepsy regardless of the presence of additional limbic symptoms at onset. (Source: Journal of Neurology)
Source: Journal of Neurology - March 28, 2020 Category: Neurology Source Type: research

Correction to: Gait variability as digital biomarker of disease severity in Huntington ’s disease
The original version of this article unfortunately contained a mistake. The name of one author is not presented correctly in the author group. (Source: Journal of Neurology)
Source: Journal of Neurology - March 27, 2020 Category: Neurology Source Type: research

Impaired connectivity within neuromodulatory networks in multiple sclerosis and clinical implications
AbstractThere is mounting evidence regarding the role of impairment in neuromodulatory networks for neurodegenerative diseases, such as Parkinson ’s and Alzheimer’s disease. However, the role of neuromodulatory networks in multiple sclerosis (MS) has not been assessed. We applied resting-state functional connectivity and graph theory to investigate the changes in the functional connectivity within neuromodulatory networks including the se rotonergic, noradrenergic, cholinergic, and dopaminergic systems in MS. Twenty-nine MS patients and twenty-four age- and gender-matched healthy controls performed clinical and...
Source: Journal of Neurology - March 26, 2020 Category: Neurology Source Type: research

Efficacy and safety of incobotulinumtoxinA in post-stroke upper-limb spasticity in Japanese subjects: results from a randomized, double-blind, placebo-controlled study (J-PURE)
AbstractBackgroundUpper-limb spasticity frequently occurs after stroke and there is a clinical need for more effective therapies. The Phase III J-PURE study assessed the efficacy and safety of incobotulinumtoxinA up to 400 U for post-stroke upper-limb spasticity in Japan.MethodsIn the 12-week main period (MP) of this double-blind, placebo-controlled study, Japanese subjects with upper-limb spasticity received one injection cycle of incobotulinumtoxinA 400 U, 250 U, or matching placebo. Eligible subjects enrolled in an open-label extension (OLEX) period of three injection cycles of incobotulinumtoxinA 400 U (32 –40&nb...
Source: Journal of Neurology - March 26, 2020 Category: Neurology Source Type: research

Correction to: Cognitive profiles discriminate between genetic variants of behavioral frontotemporal dementia
The original version of this article unfortunately contained a mistake. (Source: Journal of Neurology)
Source: Journal of Neurology - March 26, 2020 Category: Neurology Source Type: research

Prediction contribution of the cranial collateral circulation to the clinical and radiological outcome of ischemic stroke
ConclusionThe whole brain collateral vasculature status is clearly associated with clinical and radiological outcome but in a multivariate model seems not sufficiently predictive for FIV, mRS and NIHSS outcome at discharge in non-preselected patients admitted to the emergency department with ischemic stroke. (Source: Journal of Neurology)
Source: Journal of Neurology - March 23, 2020 Category: Neurology Source Type: research

Ischemic stroke and dose adjustment of oral Factor Xa inhibitors in patients with atrial fibrillation
AbstractBackgroundOral Factor Xa inhibitors for the prevention of stroke in atrial fibrillation require dose adjustment based on certain clinical criteria, but the off-label use of the reduced doses is common.MethodsData from an observational registry including patients admitted with acute cerebral ischemia while taking oral Factor Xa inhibitors for atrial fibrillation between April 2016 and December 2018 were investigated. The dose regimen of the Xa inhibitor was classified as “appropriate”, “underdosed” and “overdosed” in conformity with the European Medicines Agency labelling. The eff...
Source: Journal of Neurology - March 23, 2020 Category: Neurology Source Type: research

Does lysing make life better? A trial sequential analysis
(Source: Journal of Neurology)
Source: Journal of Neurology - March 23, 2020 Category: Neurology Source Type: research

Factors delaying intravenous thrombolytic therapy in acute ischaemic stroke: a systematic review of the literature
ConclusionFurther integrated processes are required to maximise patient benefit from thrombolysis. Expansion of community education to incorporate less common symptoms and provision of alert pagers for patients may provide further reduction in thrombolysis times. (Source: Journal of Neurology)
Source: Journal of Neurology - March 21, 2020 Category: Neurology Source Type: research

Normalized grip strength is a sensitive outcome measure through all stages of Duchenne muscular dystrophy
AbstractObjectiveThe main aim was to explore the changes in hand-grip strength in patients with Duchenne muscular dystrophy (DMD) aged 5 –29 years. Secondary aims were to test the effect of mutation, ambulatory status and glucocorticoid use on grip strength and its changes over time and to compute the number of subjects needed for a clinical trial to stabilize grip strength.MethodsThe analysis was performed on data collected during five international natural history studies on a cohort of DMD patients. Two hundred and two patients with genetically proven DMD were pooled from five different natural history studie...
Source: Journal of Neurology - March 21, 2020 Category: Neurology Source Type: research

A protocol to reduce self-reported pain scores and adverse events following lumbar punctures in older adults
ConclusionsThe LP protocol described herein may reduce adverse event rates and improve patient comfort in future studies. (Source: Journal of Neurology)
Source: Journal of Neurology - March 20, 2020 Category: Neurology Source Type: research

Correction to: Minimally conscious state “plus”: diagnostic criteria and relation to functional recovery
Following electronic publication of the above-referenced manuscript, we discovered that one of the three criteria we proposed to establish command-following in the MCS+  syndrome was inadvertently omitted in some parts of the manuscript. (Source: Journal of Neurology)
Source: Journal of Neurology - March 19, 2020 Category: Neurology Source Type: research

Management of functional neurological disorder
AbstractFunctional neurological disorder (FND) is a common cause of persistent and disabling neurological symptoms. These symptoms are varied and include abnormal control of movement, episodes of altered awareness resembling epileptic seizures and abnormal sensation and are often comorbid with chronic pain, fatigue and cognitive symptoms. There is increasing evidence for the role of neurologists in both the assessment and management of FND. The aim of this review is to discuss strategies for the management of FND by focusing on the diagnostic discussion and general principles, as well as specific treatment strategies for v...
Source: Journal of Neurology - March 19, 2020 Category: Neurology Source Type: research

‘Minimal symptom expression’ in patients with acetylcholine receptor antibody-positive refractory generalized myasthenia gravis treated with eculizumab
ConclusionsPatients with AChR+ refractory gMG who receive eculizumab can achieve sustained ‘minimal symptom expression’ based on patient-reported outcomes. ‘Minimal symptom expression’ may be a useful tool in measuring therapy effectiveness in gMG.Trial registrationClinicalTrials.gov NCT01997229, NCT02301624. (Source: Journal of Neurology)
Source: Journal of Neurology - March 18, 2020 Category: Neurology Source Type: research

Retraction Note to: Meni ère’s disease: combined pharmacotherapy with betahistine and the MAO-B inhibitor selegiline—an observational study
The authors have retracted this article. (Source: Journal of Neurology)
Source: Journal of Neurology - March 18, 2020 Category: Neurology Source Type: research

Liliana Lubi ńska (1904–1990)
(Source: Journal of Neurology)
Source: Journal of Neurology - March 16, 2020 Category: Neurology Source Type: research

Genetic correlations and causal inferences in ischemic stroke
ConclusionsShared genetic overlaps might exist between ischemic stroke and physical activity, cardiometabolic factors, smoking, and lung function. We provided suggestive evidence for a potential causal role of LDL.P and LDL.C in ischemic stroke, particularly in large artery stroke. Future researches are required to confirm these findings. (Source: Journal of Neurology)
Source: Journal of Neurology - March 14, 2020 Category: Neurology Source Type: research

Concussion-related deficits in the general population predict impairments in varsity footballers
AbstractObjectiveWe investigated the long-term cognitive effects of concussion in 19,261 members of the general population and a cohort of varsity American football players with a history of frequent head impacts, using tests that are known to be sensitive to small changes in performance.MethodsWe asked 19,261 participants to complete a demographic questionnaire and 12 cognitive tests measuring aspects of executive function, including inhibitory control. We compared the performance of those reporting a history of concussion (post-concussion) to those reporting no history of concussion (non-concussed) on the cognitive batte...
Source: Journal of Neurology - March 14, 2020 Category: Neurology Source Type: research

Spatial metabolic profiles to discriminate dementia with Lewy bodies from Alzheimer disease
ConclusionsSpatial metabolic profile that could discriminate DLB from AD emphasized different imaging features and eliminated common findings between DLB and AD. Neither cognitive function nor core features were associated with the profile. (Source: Journal of Neurology)
Source: Journal of Neurology - March 13, 2020 Category: Neurology Source Type: research

GCH-1 genetic variant may cause Parkinsonism by unmasking the subclinical nigral pathology
ConclusionOur case suggests that GCH-1 variant causes Parkinsonism by unmasking the subclinical nigral pathology, not by causing the nigral neurodegeneration. (Source: Journal of Neurology)
Source: Journal of Neurology - March 13, 2020 Category: Neurology Source Type: research

Laparoscopic sleeve gastrectomy improves brain connectivity in obese patients
ConclusionLSG might induce weight loss in part by increasing SC and FC between DLPFC and ACC, and thus strengthening top-down control over food intake. (Source: Journal of Neurology)
Source: Journal of Neurology - March 13, 2020 Category: Neurology Source Type: research

Autonomic dysfunction is associated with neuropsychological impairment in Lewy body disease
This study aimed to analyze the association of autonomic dysfunction with cognition, depression, apathy, and fatigue in Lewy body disease (LBD).MethodsWe included 61 patients [49 with idiopathic Parkinson ’s disease, 7 with dementia with Lewy bodies, and 5 E46K-SNCA mutation carriers] and 22 healthy controls. All participants underwent a comprehensive battery of neuropsychological and clinical measures, autonomic symptom assessment with the SCOPA-AUT, analysis of non-invasive hemodynamic parameters during deep breathing, the Valsalva maneuver, and a 20-min tilt test, and electrochemical skin conductance measurement a...
Source: Journal of Neurology - March 13, 2020 Category: Neurology Source Type: research

A wearable sensor identifies alterations in community ambulation in multiple sclerosis: contributors to real-world gait quality and physical activity
AbstractPeople with multiple sclerosis (pwMS) often suffer from gait impairments. These changes in gait have been well studied in laboratory and clinical settings. A thorough investigation of gait alterations during community ambulation and their contributing factors, however, is lacking. The aim of the present study was to evaluate community ambulation and physical activity in pwMS and healthy controls and to compare in-lab gait to community ambulation. To this end, 104 subjects were studied: 44 pwMS and 60 healthy controls (whose age was similar to the controls). The subjects wore a tri-axial, lower back accelerometer du...
Source: Journal of Neurology - March 12, 2020 Category: Neurology Source Type: research

Predictors of cognitive impairment in Parkinson ’s disease: a systematic review and meta-analysis of prospective cohort studies
AbstractIntroductionCognitive impairment is a debilitating manifestation in Parkinson ’s disease (PD). We sought to investigate predictors of PD-CI (PD with cognitive impairment).MethodsWe systematically searched PubMed and Cochrane Library for prospective cohort studies and pooled estimates via random-effects models. Primary analyses for all types of cognitive impairments and subgroup analyses by separate outcomes were conducted.ResultsA total of 28,009 studies were identified, of which 57 studies with 31 factors were included in the meta-analysis. In the primary analysis, 13 factors were associated with PD-CI, comp...
Source: Journal of Neurology - March 12, 2020 Category: Neurology Source Type: research

Autonomic failure in Parkinson ’s disease is associated with striatal dopamine deficiencies
AbstractAutonomic dysfunction is a common non-motor symptom in Parkinson ’s disease (PD). Dopamine and serotonin are known to play a role in autonomic regulation, and, therefore, PD-related degeneration of serotonergic and dopaminergic neurons in these regions may be associated with autonomic dysfunction. We sought to clarify the association between extrastriatal serot onergic and striatal dopaminergic degeneration and the severity of autonomic symptoms, including gastrointestinal, pupillomotor, thermoregulatory, cardiovascular, and urinary dysfunction. We performed hierarchical multiple regression analyses to determ...
Source: Journal of Neurology - March 12, 2020 Category: Neurology Source Type: research

Diagnostic utility of fluid biomarkers in multiple system atrophy: a systematic review and meta-analysis
ConclusionThe findings of our meta-analysis demonstrated diagnostic biomarkers for MSA. Moreover, three biomarkers could be used in differential diagnosis of MSA and PD. The results could be helpful for the early diagnosis of MSA and the accuracy of MSA diagnosis. (Source: Journal of Neurology)
Source: Journal of Neurology - March 11, 2020 Category: Neurology Source Type: research

Pediatric ischemic stroke
(Source: Journal of Neurology)
Source: Journal of Neurology - March 11, 2020 Category: Neurology Source Type: research

Primary DQ effect in the association between HLA and neurological syndromes with anti-GAD65 antibodies
AbstractThe primary cause of neurological syndromes with antibodies against glutamic acid decarboxylase 65 (GAD65-Ab) is unknown, but genetic predisposition may exist as it is suggested by the co-occurrence in patients and their relatives of other organ-specific autoimmune diseases, notably type 1 diabetes mellitus (T1DM), and by the reports of a few familial cases. We analyzed the human leukocyte antigen (HLA) in 32 unrelated patients and compared them to an ethnically matched sample of 137 healthy controls. Four-digit resolution HLA alleles were imputed from available Genome Wide Association data, and full HLA next-gener...
Source: Journal of Neurology - March 9, 2020 Category: Neurology Source Type: research

Beneficial effect of 24-month bilateral subthalamic stimulation on quality of sleep in Parkinson ’s disease
ConclusionsIn this multicenter study with a 24  months follow-up, we report significant sustained improvements after bilateral STN-DBS using a PD-specific sleep scale and a significant relationship between sleep and QoL improvements. This highlights the importance of sleep in holistic assessments of DBS outcomes. (Source: Journal of Neurology)
Source: Journal of Neurology - March 9, 2020 Category: Neurology Source Type: research

CT angiography vs echocardiography for detection of cardiac thrombi in ischemic stroke: a systematic review and meta-analysis
AbstractBackground and purpose Cardiac thrombi are an important cause of embolic stroke. We studied the diagnostic yield and diagnostic accuracy of cardiac CT angiography (CTA) compared to echocardiography for detection of cardiac thrombi in ischemic stroke patients.MethodsWe performed a systematic review and meta-analysis of the literature on cardiac CTA versus echocardiography for detection of cardiac thrombi in ischemic stroke patients. We included studies (N ≥ 20) in which both cardiac CTA (index test) and echocardiography (reference test) were performed and data on cardiac thrombi were reported. Resul...
Source: Journal of Neurology - March 5, 2020 Category: Neurology Source Type: research

Axonal variants of Guillain –Barré syndrome: an update
AbstractAxonal variants of Guillain –Barré syndrome (GBS) mainly include acute motor axonal neuropathy, acute motor and sensory axonal neuropathy, and pharyngeal-cervical-brachial weakness. Molecular mimicry of human gangliosides by a pathogen's lipooligosaccharides is a well-established mechanism forCampylobacter jejuni-associated GBS. New triggers of the axonal variants of GBS (axonal GBS), such as Zika virus, hepatitis viruses, intravenous administration of ganglioside, vaccination, and surgery, are being identified. However, the pathogenetic mechanisms of axonal GBS related to antecedent bacterial or viral...
Source: Journal of Neurology - March 5, 2020 Category: Neurology Source Type: research

Predictive factors of outcome in cervical dystonia following deep brain stimulation: an individual patient data meta-analysis
AbstractBackgroundDeep brain stimulation (DBS) therapy has been suggested to be a beneficial alternative in cervical dystonia (CD) for patients who failed nonsurgical treatments. This individual patient data meta-analysis compared the efficacy of DBS in the globus pallidus internus (GPi) versus subthalamic nucleus (STN) and identified possible predictive factors for CD.MethodsThree electronic databases (PubMed, Embase and Web of Science) were searched for studies with no publication date restrictions. The primary outcomes were normalized by calculating the relative change in TWSTRS total scores and subscale scores at the l...
Source: Journal of Neurology - March 5, 2020 Category: Neurology Source Type: research

Depression in myasthenia gravis: a heterogeneous and intriguing entity
ConclusionsDepression and fatigue are highly prevalent and largely overlapping comorbidities in MG, but only fatigue increased with disease severity, and only depression was milder in thymectomized patients. Comparative use of BDI subscales in MG reveals distinct depression phenotypes with distinct correlations to other disease features. (Source: Journal of Neurology)
Source: Journal of Neurology - March 5, 2020 Category: Neurology Source Type: research

Cerebellar gray matter lesions are common in pediatric multiple sclerosis at clinical onset
ConclusionAt clinical onset, cerebellar GML are common in pedMS, are very often asymptomatic, do not correlate with physical and cognitive disability, and more frequently affect the posterior lobe. (Source: Journal of Neurology)
Source: Journal of Neurology - March 5, 2020 Category: Neurology Source Type: research

Administration of subcutaneous interferon beta 1a in the evening: data from RELIEF study
ConclusionIFN- β1a evening injections in the first 8 weeks of treatment led to an improvement in FLS; when continuing therapy, time of administration could be decided according to patient’s lifestyle and preference. (Source: Journal of Neurology)
Source: Journal of Neurology - March 5, 2020 Category: Neurology Source Type: research

Outcomes of mechanical thrombectomy with pre-intravenous thrombolysis: a systematic review and meta-analysis
AbstractBackground and purposeWhether pre-intravenous thrombolysis (IVT) provides any extra benefits to mechanical thrombectomy (MT) remains controversial. We conducted a systematic review and meta-analysis to compare MT with pre-IVT (IVT  + MT) and MT without pre-IVT (MT) for acute ischemic stroke of large vessel occlusion.MethodsWe systematically searched PubMed, EMBASE and Cochrane Library to identify studies comparing outcomes between IVT  + MT and MT from inception to Jan 24, 2019. Random effects mode was used to pool relative risk (RR) with confidence intervals (CI) to compare functional i...
Source: Journal of Neurology - March 5, 2020 Category: Neurology Source Type: research

Altered cerebral blood flow in patients with anti-NMDAR encephalitis
This study aimed to identify to resting-state cerebral blood flow (CBF) connectivity alterations in patients with anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis.MethodsThree-dimensional pseudo-continuous arterial spin labeling (pcASL) imaging was performed to measure the resting-state CBF in 23 patients with anti-NMDAR encephalitis at the peak stage of the disease and 32 healthy subjects. CBF was normalized to reduce variations among subjects. CBF was compared between the groups, and the correlations between the CBF alterations and clinical parameters were assessed. Differences in CBF connectivity in specific...
Source: Journal of Neurology - March 4, 2020 Category: Neurology Source Type: research

Neurological update: dizziness
AbstractThe diagnosis and management of vertigo remains a challenge for clinicians, including general neurology. In recent years there have been advances in the understanding of established vestibular  syndromes, and the development of treatments for existing vestibular diagnoses. In this ‘update’ I will review how our understanding of previously “unexplained” dizziness in the elderly is changing, explore novel insights into the pathophysiology of vestibular migraine, and its relationshi p to the newly coined term ‘persistent postural perceptual dizziness’, and finally discuss how a...
Source: Journal of Neurology - March 4, 2020 Category: Neurology Source Type: research

Impact of anti-epileptic drug choice on discharge in acute traumatic brain injury patients
ConclusionIn this cohort, using Phenytoin for acute TBI, seizure prophylaxis was associated with longer length of stay and more dizziness compared to Levetiracetam. Given their equivalent AED efficacy in acute TBI seizure prophylaxis, our data suggest that Levetiracetam is preferable to Phenytoin for early seizure prophylaxis in TBI. This requires evaluation in larger, prospective studies. (Source: Journal of Neurology)
Source: Journal of Neurology - March 4, 2020 Category: Neurology Source Type: research

Other primary headaches —thunderclap-, cough-, exertional-, and sexual headache
This article reviews the disorders of thunderclap, cough, exertional and sexual headache. These are a group of paroxysmal and precipitated headaches, which often occur in bouts with prolonged remissions. Indometacin seems to be the most effective preventative. Each can occur in primary and secondary form. Thunderclap headache is the most frequently reported headache syndrome associated with a secondary pathology. Discussed are the complexities of whether all patients with thunderclap headache should have further investigation if timely computerised tomography is normal and, the relevance of abnormal imaging in these disord...
Source: Journal of Neurology - March 4, 2020 Category: Neurology Source Type: research

Patient reported outcome measures (PROMs) in amyotrophic lateral sclerosis
The objective of this study was to examine the feasibility of PROM collection in an academic ALS clinic and to measure correlations between PROMs and standard ALS clinical outcome measures.MethodsPROMs were gathered from tablet-based surveys offered to adult patients in the waiting room, prior to ALS outpatient clinic visits. They included a demographic section and two validated surveys: the patient reported outcome measurement information system (PROMIS-10), which generates physical health and mental health subscores, and the quality of life in neurological disorders-fatigue subscale (NeuroQoL-fatigue). The ALS functional...
Source: Journal of Neurology - March 3, 2020 Category: Neurology Source Type: research

A review of anticoagulation in patients with central nervous system malignancy: between a rock and a hard place
AbstractThe incidence and prevalence of patients who develop primary and secondary metastatic central nervous system cancer (CNS) is increasing. This is a consequence of advancements in the sensitivity and availability of diagnostic imaging, and improved therapeutic options, leading to increased detection of CNS malignancies and improved survival. These patients are at very high risk of thrombosis as well as haemorrhage, and the optimum management of anticoagulation can be challenging for treating clinicians, particularly as robust prospective evidence is sparse. In this focused review, we discuss (1) risk factors for thro...
Source: Journal of Neurology - March 2, 2020 Category: Neurology Source Type: research