Duke Neurology Research Round-Up, October 2017
This October saw 13 new peer-reviewed journals from members of the Duke Neurology Department. These studies advanced science from the molecular level--such as finding genetic links to the development of Parkinson’s and traumatic brain injury--to the bedside--such as an analysis of how cvEEG monitoring systems can improve care while reducing health-care costs--to the population level--such as health outcomes of stroke at the national level. Read more about all of these studies below.
- Adoption of continuous video-electroencephalography (cvEEG) monitoring offers the potential to improve health-care in intensive care units while reducing health-care costs. However, adoption of this method has been slow outside of major academic centers. In the most recent issue of Neurocritical Care, lead authors Brad Kolls, MD, PhD, and Keith Dombrowski, MD, as well as Brian Mace, report on their experience and lessons learned implementing a cvEEG monitoring program in a local community hospital. Read that article here.
- Higher levels of glucose in the brain, as well as poorer brain glucose regulation, are both associated with Alzheimer’s disease, according to a new study in Alzheimer’s & Dementia co-authored by Rich O’Brien, MD, PhD. Both of these factors were also associated with progression of Alzheimer’s as well as severity of symptoms. Read the full article here.
- Over the past several years, neuromuscular ultrasound has become more and more important for clinicians caring for patients with peripheral nerve and muscle disease, yet too many neuromuscular specialists lack training on this subject. Lisa Hobson Webb, MD was the lead author of editorial in Muscle and Nerve calling for greater training of housestaff on this technique, as well as the adoption of a formal curriculum on the subject. Read that editorial here.
- Hobson-Webb also contributed to a study in Molecular Genetics and Metabolism that used neuroimaging techniques to follow patients with infantile Pompe disease who were treated with enzyme replacement therapy. Read what they found here.
While concentric needle electrodes offer promise as a way to measure jitter, there are artefacts or errors that can reduce the accuracy of these readings. Don Sanders, MD, co-authored a review article that discusses pitfalls and errors in measuring jitter as well as ways these errors can sometimes be avoided. Read that article here.
Neuro-opthamology and Neuro-oncology
- Over the past 20 years, there have been many new advances in molecularly targeted therapies for cancer; however these advances have brought with them a variety of side effects, toxicity reactions, and other health concerns. M. Tariq Bhatti, MD, was the lead author of a review article examining these advances as well as the main neuro-opthalmic health concerns associated with them. Read that article in Eye here.
- Annick Desjardins, MD, was part of a team that examined the safety and efficacy of cabozantinib in patients with glioblastoma. Read the results of their study in Neuro-Oncology here.
- While post-stroke hypertension has in general been associated with poor short-term outcomes, the specifics of these associations have often been conflicting. Ying Xian, MD, PhD, and colleagues examined data from patients in the Get with the Guidelines-Stroke registry, finding increased risk of death (and a variety of other unfavorable outcomes) associated with both high and low systolic blood pressure levels. Read the full extent of their findings here.
- At the end of 2014, a series of trials found that endovascular thrombectomy greatly improved outcomes in patients with stroke. However, few data since then have examined how often EVT has been used. Xian and colleagues examined patterns in the use of endovascular thrombectomy (EVT) in more than two million ischemic stroke patients over the past 13 years. They found that EVT use has rapidly increased but also identified opportunities to treat additional patients. Read the full study in Circulation here.
- Get with the Guidelines-Stroke data provided the basis for a third recent article co-authored by Xian--an analysis of risk-standardized in-hospital stroke mortality of more than 500,000 ischemic stroke patients from nearly 1,500 hospitals. Xian and colleagues found that a composite outcome of in-hospital mortality and discharge to hospice together could serve as a proxy for 30-day mortality when used to identify high- or low-performing hospitals. Read their complete findings here.
- The extent of recovery from brain injury often depends on genetics--specifically genes associated with inflammatory response and cytostructural integrity. Senior author Michael “Luke” James, MD, FAHA, Ellen Bennett, PhD, Daniel Laskowitz, MD, MHS, and colleagues explored one area of this phenomenon, examining single nucleotide polymorphisms associated with patient outcomes of intracerebral hemorrhage. Their early analysis identified one SNP associated with improved patient outcomes. Read the full Journal of Stroke and Cerebrovascular Diseases study here.
- Senior author Ornit Chiba-Falek, PhD, Lidia Tagliafierro, and colleagues, tested the effect of the single nucleotide polymorphism (SNP) rs356168, a SNP associated with Parkinson’s disease, on total mRNA levels in brain tissues of healthy control donors. Read what they discovered in Frontiers in Genetics here.
- A growing body of evidence is linking mitochondrial DNA (mtDNA) damage with Parkinson’s disease, but the exact mechanism of this link is unknown. Senior author Laurie Sanders, however, found an explanation for one form of mtDNA damage: LRRK2 kinase. Sanders and colleagues found that a type of mtDNA damage associated with some forms of Parkinson’s was LRRK2-kinase dependent, and that inhibiting the kinase restored mtDNA damage to control levels. Read the full story in Human Molecular Genetics here.
Thanks to the National Institutes of Health for the image from their photo library.