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Clinical Trial AND Neurology

Anastasia N L Newman, Janelle Gravesande, Stephanie Rotella, Stephen S Wu, Nam Topp-Nguyen, Michelle E Kho, Jocelyn E Harris, Alison Fox-Robichaud, Patricia Solomon
PURPOSE: This scoping review summarizes the literature on the safety and effectiveness of physiotherapy interventions in patients with neurological and/or traumatic injuries in the intensive care unit (ICU), identifies literature gaps and provides recommendations for future research. MATERIALS AND METHODS: We searched five databases from inception to June 2, 2018. We included published retrospective studies, case studies, observation and randomized controlled trials describing physiotherapy interventions in ICU patients with neurotrauma injuries...
October 3, 2018: Journal of Critical Care
David Michelson, Emma Ciafaloni, Stephen Ashwal, Elliot Lewis, Pushpa Narayanaswami, Maryam Oskoui, Melissa J Armstrong
OBJECTIVE: To identify the level of evidence for use of nusinersen to treat spinal muscular atrophy (SMA) and review clinical considerations regarding use. METHODS: The author panel systematically reviewed nusinersen clinical trials for patients with SMA and assigned level of evidence statements based on the American Academy of Neurology's 2017 therapeutic classification of evidence scheme. Safety information, regulatory decisions, and clinical context were also reviewed...
October 12, 2018: Neurology
Alipio Pinto, Clara Berdasco, David Arenas-Mosquera, Adriana Cangelosi, Patricia A Geoghegan, Myriam C Nuñez, Jorge Goldstein
Infections by Enterohemorrhagic Escherichia coli may cause in addition to hemolytic uremic syndrome neurological disorders which may lead to fatal outcomes in patients. The brain striatum is usually affected during this outcome. The aim of this study was to determine in this area the role of the microglia in pro-inflammatory events that may occur during Shiga toxin 2 intoxication and consequently to this, whether oligodendrocytes were being affected. In the present paper we demonstrated that anti-inflammatory treatments reduced deleterious effects in brain striatal cells exposed to Shiga toxin 2 and LPS...
October 4, 2018: International Journal of Medical Microbiology: IJMM
Sarah Michiels, Annemarie Christien van der Wal, Evelien Nieste, Paul Van de Heyning, Marc Braem, Corine Visscher, Vedat Topsakal, Annick Gilles, Laure Jacquemin, Marianne Hesters, Willem De Hertogh
BACKGROUND: Tinnitus is a highly prevalent symptom affecting 10-15% of the adult population. It often affects patient quality of life and frequently causes distress. When subjective tinnitus can be elicited by the somatosensory system of the cervical spine or temporomandibular area it is termed somatic tinnitus. The first aim of the current study is to investigate the effect of the best evidence conservative temporomandibular disorder (TMD) treatment on tinnitus in patients with co-existence of tinnitus and TMD or oral parafunctions compared to no treatment...
October 12, 2018: Trials
Thirimon Moe-Byrne, Jennifer Valeska Elli Brown, William McGuire
BACKGROUND: Naloxone, a specific opioid antagonist, is available for the treatment of newborn infants with cardiorespiratory or neurological depression that may be due to intrauterine exposure to opioid. It is unclear whether newborn infants may benefit from this therapy and whether naloxone has any harmful effects. OBJECTIVES: To determine the effect of naloxone on the need for and duration of neonatal unit stay in infants of mothers who received opioid analgesia prior to delivery or of mothers who have used a prescribed or non-prescribed opioid during pregnancy...
October 12, 2018: Cochrane Database of Systematic Reviews
Vaclav Kremen, Benjamin H Brinkmann, Inyong Kim, Hari Guragain, Mona Nasseri, Abigail L Magee, Tal Pal Attia, Petr Nejedly, Vladimir Sladky, Nathanial Nelson, Su-Youne Chang, Jeffrey A Herron, Tom Adamski, Steven Baldassano, Jan Cimbalnik, Vince Vasoli, Elizabeth Fehrmann, Tom Chouinard, Edward E Patterson, Brian Litt, Matt Stead, Jamie Van Gompel, Beverly K Sturges, Hang Joon Jo, Chelsea M Crowe, Timothy Denison, Gregory A Worrell
Brain stimulation has emerged as an effective treatment for a wide range of neurological and psychiatric diseases. Parkinson's disease, epilepsy, and essential tremor have FDA indications for electrical brain stimulation using intracranially implanted electrodes. Interfacing implantable brain devices with local and cloud computing resources have the potential to improve electrical stimulation efficacy, disease tracking, and management. Epilepsy, in particular, is a neurological disease that might benefit from the integration of brain implants with off-the-body computing for tracking disease and therapy...
2018: IEEE Journal of Translational Engineering in Health and Medicine
Courtney R Sparks, Angela Gorney, Kim Williams, Emily H Griffith, Sofia Cerda-Gonzalez, B Duncan X Lascelles, Natasha J Olby
BACKGROUND: Cavalier King Charles Spaniels (CKCS) suffer pain associated with Chiari-like malformation and syringomyelia (CMSM). People suffer from a similar condition and describe numerous sensory abnormalities. Sensory changes have not been quantified in affected CKCS. OBJECTIVES: To use quantitative sensory testing (QST) to quantify thermal and mechanical thresholds in CKCS and to compare QST in dogs with and without syringomyelia (SM). ANIMALS: Forty-four CKCS...
October 11, 2018: Journal of Veterinary Internal Medicine
Ingrid Faber, Alberto Rolim Muro Martinez, Carlos Roberto Martins, Maidane Luise Maia, Juliana Pasquotto Souza, Charles Marques Lourenço, Wilson Marques, Celeste Montecchiani, Antonio Orlacchio, Jose Luiz Pedroso, Orlando Graziani Povoas Barsottini, Celso Darío Ramos, Íscia Lopes-Cendes, Joseph H Friedman, Bárbara Juarez Amorim, Marcondes Cavalcante França
BACKGROUND: Molecular imaging has proven to be a powerful tool to elucidate degenerated paths in a wide variety of neurological diseases and has not been systematically studied in hereditary spastic paraplegias. OBJECTIVES: To investigate dopaminergic degeneration in a cohort of 22 patients with hereditary spastic paraplegia attributed to SPG11 mutations and evaluate treatment response to l-dopa. METHODS: Patients and controls underwent single-photon emission computed tomography imaging utilizing 99m Tc-TRODAT-1 tracer...
October 10, 2018: Movement Disorders: Official Journal of the Movement Disorder Society
Danica B Stanimirovic, Jagdeep K Sandhu, Will J Costain
Antibody, immuno- and gene therapies developed for neurological indications face a delivery challenge posed by various anatomical and physiological barriers within the central nervous system (CNS); most notably, the blood-brain barrier (BBB). Emerging delivery technologies for biotherapeutics have focused on trans-cellular pathways across the BBB utilizing receptor-mediated transcytosis (RMT). 'Traditionally' targeted RMT receptors, transferrin receptor (TfR) and insulin receptor (IR), are ubiquitously expressed and pose numerous translational challenges during development, including species differences and safety risks...
October 10, 2018: BioDrugs: Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy
Jack J Miller, James T Grist, Sébastien Serres, James R Larkin, Angus Z Lau, Kevin Ray, Katherine R Fisher, Esben Hansen, Rasmus Stilling Tougaard, Per Mose Nielsen, Jakob Lindhardt, Christoffer Laustsen, Ferdia A Gallagher, Damian J Tyler, Nicola Sibson
Hyperpolarised MRI with Dynamic Nuclear Polarisation overcomes the fundamental thermodynamic limitations of conventional magnetic resonance, and is translating to human studies with several early-phase clinical trials in progress including early reports that demonstrate the utility of the technique to observe lactate production in human brain cancer patients. Owing to the fundamental coupling of metabolism and tissue function, metabolic neuroimaging with hyperpolarised [1-13 C]pyruvate has the potential to be revolutionary in numerous neurological disorders (e...
October 10, 2018: Scientific Reports
Eric Albrecht, Leon Vorobeichik, Alain Jacot-Guillarmod, Nicolas Fournier, Faraj W Abdallah
BACKGROUND: Both dexamethasone and dexmedetomidine are effective peripheral nerve block (PNB) perineural adjuncts that prolong block duration. However, each is associated with side effects. With paucity of head-to-head comparisons of these adjuncts, the question of the best adjunct to mix with local anesthetics (LA) for PNB is unanswered. This meta-analysis aims to inform current practice and future research by identifying the superior adjunct by comparing dexamethasone and dexmedetomidine...
October 9, 2018: Anesthesia and Analgesia
Ann Monahan, Joanne Guay, John Hajduk, Santhanam Suresh
BACKGROUND: The aim of this systematic review was to compare the effects of regional analgesic (RA) techniques with systemic analgesia on postoperative pain, nausea and vomiting, resources utilization, reoperation, death, and complications of the analgesic techniques in children undergoing cardiac surgery. METHODS: A search was done in May 2018 in PubMed, Embase, and the Cochrane Central Register of Controlled Trials for randomized controlled trials comparing RA techniques with systemic analgesia...
October 8, 2018: Anesthesia and Analgesia
Patricia B Mills, Kaila A Holtz, Elena Szefer, Vanessa K Noonan, Brian K Kwon
OBJECTIVE: To identify early predictors and develop reliable, validated prediction models for development of problematic spasticity after traumatic spinal cord injury (SCI). DESIGN: Prospective cohort study of the Rick Hansen Spinal Cord Injury Registry (RHSCIR), retrospective review of inpatient medical charts. SETTING: Quaternary trauma center, rehabilitation center, community settings. PARTICIPANTS: Individuals with traumatic SCI between March 1, 2005, and March 31, 2014, prospectively enrolled in the Vancouver site RHSCIR...
October 9, 2018: Journal of Spinal Cord Medicine
David Fiorella, Alan Boulos, Aquilla S Turk, Adnan H Siddiqui, Adam S Arthur, Orlando Diaz, Demetrius K Lopes
INTRODUCTION: The LVIS stent system (LVIS and LVIS Junior) is a self-expanding, retrievable, microstent system indicated for the treatment of wide-necked cerebral aneurysms (WNAs). The present pivotal study was performed to evaluate the safety and effectiveness of this device. METHODS: The US LVIS pivotal trial was a prospective, multicenter, single-arm, interventional study conducted at 21 US centers. The study enrolled 153 adults with WNAs of the anterior and posterior circulations...
October 8, 2018: Journal of Neurointerventional Surgery
Katinka R van Kranendonk, Kilian M Treurniet, Anna M M Boers, Olvert A Berkhemer, Lucie A van den Berg, Vicky Chalos, Hester F Lingsma, Wim H van Zwam, Aad van der Lugt, Robert J van Oostenbrugge, Diederik W J Dippel, Yvo B W E M Roos, Henk A Marquering, Charles B L M Majoie
BACKGROUND AND PURPOSE: Hemorrhagic transformation (HT) is a complication that may cause neurological deterioration in patients with acute ischemic stroke. Various radiological subtypes of HT can be distinguished. Their influence on functional outcome is currently unclear. The purpose of this study was to assess the associations between HT subtypes and functional outcome in acute ischemic stroke patients with proven large vessel occlusion included in the MR CLEAN trial (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic stroke in The Netherlands)...
October 8, 2018: Journal of Neurointerventional Surgery
Artur Jan Kiepura, Andrzej Kochański
Charcot‑Marie‑Tooth type 1A (CMT1A) is a dysmyelinating disease of the peripheral nervous system that results in a slow progressive weakening and wasting of the distal muscles of the upper and lower limbs. Despite extensive research and clinical trials there is still no treatment for CMT1A that results in complete neurological improvement. Recent studies investigating various pharmacological modulators of adenylyl cyclase activity, including ascorbic acid and ligands of G protein‑coupled receptors (GPCRs), provide hope for future treatments of this type of hereditary motor and sensory neuropathy...
2018: Acta Neurobiologiae Experimentalis
Marcus Yu Bin Pai, Thais Tavares Terranova, Marcel Simis, Felipe Fregni, Linamara Rizzo Battistella
Neurologic disorders such as stroke and cerebral palsy are leading causes of long-term disability and can lead to severe incapacity and restriction of daily activities due to lower and upper limb impairments. Intensive physical and occupational therapy are still considered main treatments, but new adjunct therapies to standard rehabilitation that may optimize functional outcomes are being studied. Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that polarizes underlying brain regions through the application of weak direct currents through electrodes on the scalp, modulating cortical excitability...
September 23, 2018: Journal of Visualized Experiments: JoVE
Saravanan S Karuppagounder, Lauren Alin, Yingxin Chen, David Brand, Megan W Bourassa, Kristen Dietrich, Cassandra M Wilkinson, Colby A Nadeau, Amit Kumar, Steve Perry, John T Pinto, Victor Darley-Usmar, Stephanie Sanchez, Ginger L Milne, Domenico Pratico, Theodore R Holman, S Thomas Carmichael, Giovanni Coppola, Frederick Colbourne, Rajiv R Ratan
OBJECTIVES: N-acetylcysteine (NAC) is a clinically approved thiol-containing redox modulatory compound currently in trials for many neurological and psychiatric disorders. Although generically labeled as an "antioxidant", poor understanding of its site(s) of action is a barrier to its use in neurological practice. Here, we examined the efficacy and mechanism of action of NAC in rodent models of hemorrhagic stroke. METHODS: Hemin was used to model ferroptosis and hemorrhagic stroke in cultured neurons...
October 7, 2018: Annals of Neurology
Peter Witters, Tomas Honzik, Eric Bauchart, Ruqaiah Altassan, Tiffany Pascreau, Arnaud Bruneel, Sandrine Vuillaumier, Nathalie Seta, Delphine Borgel, Gert Matthijs, Jaak Jaeken, Wouter Meersseman, David Cassiman, Lonlay Pascale de, Eva Morava
PURPOSE: PMM2-CDG is the most common congenital disorder of glycosylation (CDG), which presents with either a neurologic or multisystem phenotype. Little is known about the longitudinal evolution. METHODS: We performed data analysis on PMM2-CDG patients' clinical features according to the Nijmegen CDG severity score and laboratory data. Seventy-five patients (28 males) were followed up from 11.0 ± 6.91 years for an average of 7.4 ± 4.5 years. RESULTS: On a group level, there was no significant evolution in overall clinical severity...
October 8, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
Pedro D'Orléans-Juste, Oscar B Akide Ndunge, Louisane Desbiens, Herbert B Tanowitz, Mahalia S Desruisseaux
Endothelins were discovered more than thirty years ago as potent vasoactive compounds. Beyond their well-documented cardiovascular properties, however, the contributions of the endothelin pathway have been demonstrated in several neuroinflammatory processes and the peptides have been reported as clinically relevant biomarkers in neurodegenerative diseases. Several studies report that endothelin-1 significantly contributes to the progression of neuroinflammatory processes, particularly during infections in the central nervous system (CNS), and is associated with a loss of endothelial integrity at the blood brain barrier level...
October 3, 2018: Pharmacology & Therapeutics
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