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Duke Neurology Research Round Up, February 2017

Wednesday, March 1, 2017
Image courtesy NIH

Research published in the past 28 days by members of the Duke Neurology Department advanced our understanding of disease and offered better ways to improve patient care, from new providing new guidelines on rehabilitating patients with multiple sclerosis, to reviewing a decade of research on late-onset Pompe disease. Here’s a summary of the research members of our Department have contributed to published in February, 2017.

Multiple Sclerosis

  • Treating multiple sclerosis is a complex process, with many symptoms requiring both drug-based and rehabilitation approaches from a variety of health-care providers. Bryan Walker, PA-C, MHS, was part of a multidisciplinary group of clinicians and researchers that wrote a new series of guidelines that reviews symptoms such as mobility impairment, fatigue, bladder and bowel dysfunction, and mental health issues, as well as the best ways to treat these symptoms to improve patient quality of life. Read these guidelines, the second part of a two-part series, here. Or, read the first part, which focuses on treating different phenotypes of MS, here.

Epilepsy and Sleep

  • Olinda Pineda, MD, wrote two short educational articles reviewing sleep disordered breathing (SDB) for the latest issue of Neurology: a review of a recent study that examined potential connections between SDB and cognitive decline, and a discussion of obstructive sleep apnea, the most common type of SDB, its signs, risk factors, and treatments. Both articles provide background and context designed to bring the reader up to speed on these subjects. Read them here.

Neuromuscular Disease

  • For patients with refractory myasthenia gravis, eculizumab may offer therapeutic benefits for symptoms and clinical outcomes. In the latest issue of Muscle & Nerve lead author Vern Juel, MD, as well as Don Sanders, MD, Lisa Hobson-Webb, MD, Janice Massey, MD, Jeffrey Guptill, MD, MHS, and colleagues discuss a case study in which eculizumab provided these benefits, offering additional evidence for this therapy. Read their article here.
  • Neuromuscular ultrasound has potential as a diagnostic tool evaluating neuromuscular disorders, but research in this field has been inconsistent. In the same issue of Muscle & Nerve, lead author Lisa Hobson-Webb, MD and Wake Forest’s Michael Cartwright, MD, MS, discuss current shortcomings in this area of research and offer suggestions to improve the literature in this field. Read their article here.
  • A new technique called median nerve ultrasound offers potential as a diagnostic tool for diagnosing carpal tunnel syndrome for patients who have had strokes. In the Journal of Clinical Neuroscience, senior author Lisa Hobson-Webb, MD along with lead author (and former Duke Neurology resident) Chen Lin, MD, Chief Resident Aaron Loochtan, MD, Brian Dresser, Jianhong Chang, and colleagues, compared this technique to a physical examination and the Boston Carpal Tunnel Questionnaire in a group of 24 patients, finding the tool to be an effective diagnostic method in this group. Read their study here.
  • The appearance and symptoms of late-onset Pompe disease varies dramatically, often leading to mistaken or missed diagnoses. To reduce confusion in this area, Lisa Hobson-Webb, MD, and colleagues performed a systematic literature review of the evolving phenotype of this condition, helping to increase knowledge of this multisystematic disease. Read their article here.
  • Don Sanders, MD, wrote a chapter in the Oxford Textbook of Neurophysiology titled “Clinical aspects of neuromuscular junction disorders.” This comprehensive textbook summarizes the basic science underlying neurophysiological techniques, describes the techniques themselves, including normal values, and describes the techniques in clinical situations. Read more about this book here.
  • The Lancet Neurology conducted an interview with Rick Bedlack, MD, PhD, about his work at Duke, the profession he’d be if he wasn’t a neurologist (rock star), and what he’s planning on calling his autobiography. The full interview is available here.

Neurobiology

  • In the latest issue of PNAS, Wolfgang Liedtke, MD, PhD, discusses how thermoregulation was a critical evolutionary development for mammals, and describes how a new study identifying a neural circuit that controls core temperature and thermogenesis advances our understanding of this important area. Read Liedtke’s commentary here and the article he describes here.

Stroke and Neurocritical Care

  • Spontaneous intracerebral hemorrhage kills nearly half the people who experience it and causes substantial disability for most survivors. In a new short review article, Neurocritical Care Fellow Marc-Alain Babi, MD, and Michael “Luke” James, MD, FAHA, discuss the biology of this condition as well as the advantages and disadvantages of current treatment strategies. Read their article from Frontiers in Neurology here.