Duke Neurology Research Round Up, April 2019

What do studies examining interactions between neighborhood and cognitive decline, how the huntingtin protein causes Huntington’s disease, and the development of simple tests to measure muscle health have in common? They’re all part of new research authored by Duke Neurology faculty members that was published this April. Learn about these studies and more, or read the original articles themselves, in the paragraphs and links below.

General Neurology

  • Advanced biophysical models like neurite orientation dispersion and density imaging (NODDI) hold promise for helping us better understand the brain microstructure; however these techniques have been too time-consuming to bring into general use. Leonard White, PhD, contributed to a study that lays the groundwork for bringing this technique into general use for basic research. Read that Brain Structure Function article here.

Neuromuscular Disease

  • Developing accessible, reliable, and inexpensive methods to measure muscle health holds enormous potential for assessing the well-being and functionality of older adults. Lead author Lisa Hobson-Webb, MD, Paul Zwelling, Ashley Pifer, and colleagues investigated the use of quantitative muscle ultrasound and electrical impedance myography techniques for this purpose. Read what they found here in the latest issue of Geriatrics.

Epilepsy, Sleep and Clinical Neurophysiology

  • Saurabh Sinha, MD, PhD, was part of a team that conducted a study to examine the long-term safety and efficacy of eslicarbazepine acetate (ESL) for adults with focal seizures. Their study, which followed about 400 patients for more than five years found that ESL was effective and well tolerated, both as a monotherapy and in combination with other antiepileptic drugs. Read their full study in Epilepsy Research here.

Stroke

  • A team of researchers including Ellen Bennett, PhD, performed a comprehensive analysis of the existing studies analyzing the relationship between haptoglobin genotype and aneurysmal subarachnoid hemorrhage. Their analysis of 11 studies featuring individual patient level data found no significant relationship between these two factors. Read their full article in Neurology.
  • Lead author Shreyansh Shah, MD, and Ying Xian, MD examine the variable of home time, or the total amount of time a patient spends living at home after discharge from stroke, in the latest issue of the Journal of Neuroscience Nursing. Their article discusses how home time is a simple variable that reflects overall health, quality of life, cost, complications while being a patient-centric variable. Read their article here.
  • Stroke patients who have previously had ischemic stroke and who have diabetes are a growing population--and one that is especially vulnerable to additional strokes. However, these patients have been excluded from studies examining the effects of intravenous tissue-type plasminogen activator out of concerns for their safety. A new study by lead authors Matthew Ehrlich, MD, Ying Xian, MD, PhD, and colleagues examined data from more than 2,000 patients with those conditions, comparing them to nearly 17,000 patients without prior stroke or diabetes. They found this treatment was not associated with increased risk for intracerebral hemorrhage or mortality for patients with diabetes and prior stroke. Read the full results of their study in Stroke.
  • Many factors may influence the effectiveness for dual antiplatelet treatment for stroke. Daniel Laskowitz, MD, MHS contributed to a study that compared the effects of clopidogrel and aspirin versus aspirin alone for recurrent stroke as well as admission activated partial thromboplastin time (aPTT). They found that dual antiplatelet therapy was better than single antiplatelet therapy for the high and medium aPTT, but not the low aPTT groups. Read the full study here.

Memory Disorders

  • Alzheimer’s is a complex, multifactorial disease, and our mouse models of this condition often fail to take this complexity into account. A new Magnetic Resonance Imaging article by senior authors Carol Colton, PhD, and Alexandra Badea, PhD discusses a new in vivo approach using enhanced MRI that offer significant improvements in predicting cognitive dysfunction in mose models of Alzheimer’s. Read that article here.
  • A small but growing body of evidence has linked lower neighborhood socioeconomic status (NSES) with cognitive decline. Michael Lutz, PhD, and Brenda Plassman, PhD were part of a team that attempted to analyze this relationship and control for confounding factors, such as genetics, heart disease, stroke, and diabetes. Their study found that a relationship between lower NSES and cognitive decline persisted even in after accounting for other variables. Read that study here.

Neurodegeneration

  • While it is known that the protein huntingtin triggers neurotoxicity in Huntington's disease, the exact manner in which this happens is uncertain. A new eLife article co-written by Audrey Dickey, PhD, and Al La Spada, MD, PhD sheds light on this subject by showing how mutant huntingtin disrupts DNA repair and transcription. Read that article here.

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