Duke Neurology Research Round Up, December 2020

By William Alexander

This November, research from members of the Duke Department of Neurology examined how different types of seizures feel to the person experiencing them, discovered genes associated with longevity and health cognition, analyzed how the COVID-19 outbreak impacted stroke care, and more. Our faculty, trainees, and staff contributed to 15 studies published in the past 30 days. Read about each of them, and find links to the original articles below. 


Multiple Sclerosis and Neuroimmunology

  • Patients who have both COVID-19 and Guillain-Barre syndrome (GBS) are at an increased risk likelihood of neuromuscular respiratory failure, autonomic dysfunction, and other life-threatening symptoms. However, little is known about the underlying mechanisms, clinical course, and prognostic implications of comorbid COVID-19 in patients with GBS. Senior author Daniel Laskowitz, MD, MHS, Brad Kolls, MD, PhD, MMCI, and Deborah Koltai, PhD, reviewed more than 51 case reports of  COVID-19-associated GBS case reports published since the outbreak of the pandemic. Read what they found in the latest issue of SN Comprehensive Clinical Medicine.

Memory Disorders

  • A form of artificial intelligence designed to interpret a combination of retinal images was able to successfully identify a group of patients who were known to have Alzheimer’s disease, suggesting the approach could one day be used as a predictive tool, according to an interdisciplinary study by Andy Liu, MD, James Burke, MD, PhD, and colleagues from across Duke. Read the full study in the British Journal of Ophthalmology.


  • Advances in our understanding of the molecular underpinnings of the central nervous system has helped us improve our classification of brain tumors and led the path forward for the development of new therapeutics. A team including Katy Peters, MD, PhD, discusses these and other developments in the field of neuro-oncology for Neurologic Clinics. Read that article here.

Translational Brain Sciences

  • A new genome-wide association study establishes a phenotype of exceptional longevity and normal cognition versus cognitive impairment. Michael Lutz, PhD, was the senior author of the article, which identified significant genetic variants and biological pathways associated with cognitive impairments from 2156 individuals from the Chinese Longitudinal Healthy Longevity Survey. Read that article in Scientific Reports. 
  • Tatiana Segura, PhD, was part of a team that found that the generation of an adaptive immune response from a biomaterial induced cutaneous regenerative healing, a finding with important implications for the use of microporous annealed particle scaffolds. Read the full article in Nature Materials.


  • The COVID-19 pandemic has introduced a host of challenges in providing effective medical care, especially for stroke, where a minute’s delay in treatment can result in the death of a million brain cells. Wuwei “Wayne” Feng, MD, MS was part of a new Frontiers in Neurology study that examined data from 77 stroke centers in Beijing during the first-level response to the pandemic this spring, comparing stroke admissions from the lockdown period and a parallel time in 2019, finding a reduction of 69% for hemorrhagic stroke and 42.9% for ischemic stroke. Read the full article here.
  • Stroke patients who are female, abuse drugs, or have diabetes are more likely to experience delays between symptom onset and arrival at the emergency department, according to a new study by first author Scott Le, DO, and colleagues. For the study, Le and colleagues examined demographic and clinical data from nearly 2,000 patients presenting to a large tertiary care center. The results were published in the latest issue of eNeurologicalSciRead them here.
  • A retrospective analysis of more than 40,000 Medicare beneficiaries validates the use of the ABCD score for long-term risk assessment after transient ischaemic attack. Shreyansh Shah, MD, was the first author of the Stroke and Vascular Neurology study, which found that patients with ABCD scores of 4 or higher had higher mortality at one year, and higher adjuster risk for ischemic stroke, all-cause readmission and mortality, and other outcomes related to ischemic stroke. Read that article here.

Neuromuscular Disease

  • The Duke Myasthenia Gravis (MG) Clinic Registry is a disease-specific database containing physician-derived data from patients seen in the Duke MG Clinic since 1980. Senior authors Don Sanders, MD, and Janice Massey, MD, as well as Shruti Raja, MD, Jeffrey Guptill, MD, MHS, and Lisa Hobson-Webb, MD, reviewed the demographics and other details of more than 1,000 patients seen between 1980 and 2008. Read their analysis in Muscle and Nerve.
  • An international team of experts has updated its guidelines for the management of myasthenia gravis for 2020. Don Sanders, MD, and Janice Massey, MD contributed to those guidelines, which were recently published in Neurology. Read about them here.
  • Jeffrey Guptill, MD, MHS, contributed to a new correspondence on COVID-19-associated risks and effects in myasthenia gravis published in The Lancet Neurology. Read that letter here.
  • Neuromuscular fellow Yohei Harada, MD, was the first author of a small but important retrospective study examining combination therapy for patients with spinal muscular atrophy type 1. The Muscle and Nerve study found improvement without adverse effects in the five children studied. Read the full results here.

Epilepsy, Sleep, and Neurophysiology

  • A patient’s subjective experience of a seizure depends on the type and origin of that seizure, according to a new study by senior author Aatif Husain, MD, lead author Julie Uchitel, Charles McDade, Marika Matthew, Deborah Jenson, and Sneha Mantri, MD, MS. The team interviewed 13  patients with epilepsy and used conversational analysis to analyze how they described the experience, finding specific types of seizures were associated with different levels of consciousness or memory loss. Read the full study in Epilepsy and Behavior.
  • A team including Saurabh Sinha, MD, PhD, conducted a randomized, double-blind placebo-controlled trial on midazolam nasal spray for epilepsy. Read the results of that study in the latest issue of Epilepsia.

Neurocritical Care

  • Machine learning-based early warning systems (EWSs) can detect clinical deterioration more accurately than point-score tools, but the best use of EWS alerts in patients with sepsis. Xiao Hu, PhD, was part of a team that evaluated the timing and frequency of fluid bolus therapy, new antibiotics, and do not resuscitate status relative to the time of an advanced EWS alert. Read that article in Nursing Adminstration Quarterly.