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Duke Neurology Research Round Up, August 2018

Tuesday, September 4, 2018
Image courtesy NIH

What do the first major study of the effectiveness of medications to treat seizures for patients in neurointensive care, an analysis of Alzheimer’s disease at the national “systems” level, and an examination of how brain stimulating technologies may improve memory have in common? They’re all topics of major peer-reviewed journals written or co-written by members of the Duke Neurology Department that were published this August. Here’s a summary of those studies and others written by our housestaff and faculty during that time.

Neurocritical Care

  • Nonconvulsive seizures are a common complication in critically ill patients receiving intensive care. However, there is no uniformly accepted treatment regimen for these seizures. A team including lead author Aatif Husain, MD, Brad Kolls, MD, PhD, Christa Swisher, MD, Saurabh Sinha, MD, Keith Dombrowski, MD, William Gallentine and colleagues tested two antiseizure medications for nonconvulsive seizures, lacosamide and fosphenytoin. This study is the first major clinical study to use continuous electroencephalography (cEEG) to monitor responses. Read the results of their study here.

General and Community Neurology

  • Immune checkpoint inhibitors have improved outcomes for many patients with advanced cancers; however, these same treatments can also cause immune-related adverse effects. Lead authors Christopher Eckstein, MD, and Suma Shah, MD, as well as Matthew Luedke, MD, Joel Morgenlander, MD, and Mark Skeen, MD discuss two rare cases where those adverse effects emerged and effected the central nervous system. Read their case reports and discussion of the literature here.

Memory Disorders

  • Alzheimer’s disease is a gradual, incredibly complex process rather than a simple disease. Myriad factors, each of them complicated in themselves, have a direct effect and influence each other in how Alzheimer’s begins and develops. Senior author Ying Xian, MD, PhD, Michael Lutz, PhD, and Bejing’s Yin Tang, MD, argue that a systems-based model, which helps to take these complexities into account, would improve research and treatment for the condition. Read their commentary in Alzheimer’s and Dementia here.
  • Brain stimulating technologies hold potential to improve memory and other aspects of brain function. Senior author Simon Davis, PhD, and colleagues investigated the effects of one such technology, repetitive transcranial magnetic stimulation (rTMS), at two different frequencies in a group of older adults. Read what they found about rTMS and memory formation here.

Neuromuscular Disease

  • Myasthenia gravis frequently causes visual symptoms, such as double vision and drooping eyelids, which can be persistent, disabling and frustrating for patients. Senior author Lisa Hobson-Webb, MD, and Amanda Guidon, MD, wrote an editorial in Muscle and Nerve discussing this problem, as well as a recent study that examined early immunotherapy as treatment. Read what they wrote here.

Child Neurology

Neurodegeneration and Neurotherapeutics

  • Audrey Dickey, PhD, contributed to a new Journal of Neuroscience study that found a potential protective mechanism for stroke at the subcellular level: inhibiting mitochondrial fission by the protein drp1. This study increases our knowledge of the role mitochondrial fission plays in neuronal injury and offers potential new therapeutic avenues to improve stroke outcomes. Read the full study here.