What do a speech prosthetic that translates brain signals into speech, retinal scans that detect cognitive impairment, and a promising new form of genetic therapy for Parkinson’s and some forms of dementia have in common? They’re all examples of the 21 peer-reviewed journal articles authored members of the Duke Neurology Department published this November.
Other highlights include insights into how the brain codes different types of memory, recommendations for ending daylight savings time to improve health, and discussions the potential to use modulation to improve recovery from stroke. Read the paragraphs below to find brief summaries of all of these articles and more, as well as links to the original research.
Epilepsy, Clinical Neurophysiology, and Sleep
- Senior authors Rahul Gaini, MD, and Elijah Lackey, MD, as well as Duke medical student Julia Denniss and Ashley Lengel, MS, PA-C, wrote a new case report exploring the clinical presentation and genetic findings of a 44-year-old male with a history of pediatric epilepsy. The case report also discusses a novel gene variant shared by the patient and his daughter and how that variant influenced his neurologic symptoms. Read it here in Cureus.
- Gregory Cogan, PhD, led a collaborative team of Duke neuroscientists, neurosurgeons, and engineers that developed a speech prosthetic that can translate a person’s brain signals into what they’re trying to say. The new technology might one day help people unable to talk due to neurological disorders regain the ability to communicate through a brain-computer interface. Read that article in Nature Communications.
- When daylight savings time ended this year on November 5, the American Academy of Sleep Medicine issued a position statement arguing that permanent standard time is the optimal choice for both health and safety. Andrew Spector, MD, contributed to that statement. Read it here.
- Shruti Agashe, MD, was the first author on a paper that provided a comprehensive review of intracranial hemorrhage in sEEG regardless of clinical symptoms. She also identified electrographic correlates of hemorrhage to help in early detection. Read that article in the Journal of Clinical Neurophysiology.
Memory Disorders
- A novel artificial intelligence model utilizes retinal scans from widely available imaging technology to distinguish individuals with mild cognitive impairment (MCI) from those with normal cognition, thanks to a collaborative study with the Duke Department of Ophthalmology. Senior author Sharon Fekrat, MD FASRS, along with Andrew Liu, MD, MS, Kim Johnson, MD, and other Duke colleagues in the iMIND Study Group, developed a multimodal convolutional neural network (CNN) that was trained, validated, and tested using these multimodal retinal images along with quantitative data to identify those with MCI. Read that article in Ophthalmology Science.
- Senior author Sharon Fekrat, MD, and Kim Johnson, MD, were part of a team that examined differences in retinal and choroidal microvasculature and structure in individuals with dementia with Lewy bodies (DLB) and individuals with normal cognition. Fekrat’s team used optical coherence tomography (OCT) and OCT angiography to analyze images from patients with DLB and patients with normal cognition, finding that patients with DLB had an increased peripapillary CPD, decreased peripapillary CFI, and attenuated GC-IPL thickness. Read the full article in the Journal of VitreoRetinal Diseases.
- Effective, accurate clinical trials are needed to develop new therapies for Alzheimer’s disease, but the slow, varied progression of this condition makes these trials difficult. Kathleen Welsh-Bohmer, PhD, was the first author of a new article that addresses these challenges as well as new directions and actionable steps to improve future trial designs. Read that article in Alzheimer’s & Dementia.
Neurocritical Care
- A new article in Critical Care Medicine examines associations of early sedation patterns, as well as the association of dexmedetomidine exposure, with clinical and functional outcomes among mechanically ventilated patients with moderate-severe traumatic brain injury (msTBI). Katharine Colton, MD, Daniel Laskowitz, MD, MHS,and M. Luke James, MD, contributed to that article, which found variation in early sedation choice among mechanically ventilated patients and a lack of improved 6-month functional outcomes among patients with early dexmedetomidine exposure. Read that article here.
Neuro-Oncology
- Tumors of the central nervous system are the most common pediatric cancer in the United States, but most physicians caring for these patients are not formally certified in this subspecialty. Katherine Peters, MD, PhD, was part of a team that examined physician, patient, and caregiver support for formal certification in neuro-oncology. Read what they found in Neuro-Oncology Advances.
- Suma Shah, MD, was part of a randomized controlled trial investigating the effects of cryocompression therapy on chemotherapy-induced peripheral neuropathy. Shah and colleagues enrolled 91 gynecologic cancer patients planned for five to six cycles of neurotoxic chemotherapy and assigned them to receive cryocompression on their dominant hand or foot, and no cryocompression on the opposite limb. The therapy decreased the odds of patients’ sensory neuropathy by 46% at their final visit. Read the full article in Obstetrics & Gynecology.
Neuromuscular Disease
- Senior author Rick Bedlack, MD, PhD, Xiaoyan Li, MD, and Tasnim Mushannen, MD, contributed to the 72nd entry in the ALSUntangled series, which reviews alternative and off-label treatments for people living with amyotrophic lateral sclerosis (ALS). In this entry, Bedlack and colleagues examine plausible mechanisms, and existing data for the use of insulin in slowing ALS progression. Read their article in Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration.
- A new case review in the Journal of Neuromuscular Disease provides insights into the course of double-seronegative myasthenia gravis (DSNMG) during and after pregnancy. Senior author Donald Sanders, MD, Janice Massey, MD, Vern Juel, MD, and colleagues performed a retrospective cohort study of women with DSNMG seen in the Duke Myasthenia Gravis Clinic over the past 20 years. Their analysis found women with DSNMG had increased MG symptoms during pregnancy and within 6 months postpartum, similar to seropositive MG. Read that article here.
Stroke and Vascular Neurology
- Shreyansh Shah, MD, was part of a team that sheds light on current patterns associated with the use of antithrombotic and statin therapies after intracerebral hemorrhage (ICH). The team’s analysis of nearly 500,000 patients with ICH found about 10% were prescribed antiplatelet medications, 35% were prescription statins, and 5% were prescribed anticoagulation therapy at discharge. Read the full article in Stroke.
- Each year, more than 600,000 people suffer serious, often permanent disabilities due to stroke. Adjunctive neuromodulation is an emerging therapy that offers the potential to help reduce these disabilities and improve stroke survivors’ quality of life. A new review article summarizes and discusses various neuromodulation techniques, including existing clinical evidence and their future potential. Senior author Wuwei “Wayne” Feng, MD, MS, and Shashank Shekhar, MD, contributed to that article, which appears in Current Neurology and Neuroscience Reports.
- Senior author Wuwei “Wayne” Feng, MD, MS, Sara Hassani, MD, Dylan Ryan, MD and colleagues performed a systematic review and meta analysis examining the use of propranolol or beta blockers for cerebral cavernous malformation. Read that study in Translational Stroke Research.
- Scott Le, DO, and Rahul Gaini, MD, wrote a case report detailing an elderly woman who was found to have caseous calcification of the papillary muscle (CCPM) after a possible central retinal artery occlusion or eye stroke. Their article provides more details on her diagnosis and treatment as well as how CCPM may act as a risk factor for cardioembolic stroke. Read the full article in BMJ Case Reports.
Translational Brain Sciences
- New research offers a promising new therapeutic avenue for treating Parkinson’s disease and dementia with Lewy bodies. Senior author Ornit Chiba-Falek, PhD, Duke Neurobiology’s Boris Kantor, PhD, and Zhigou Sun, PhD, describe a novel neuronal-type specific epigenome therapy that reduces overexpression of SNCA, the gene whose overexpression leads to the development of these conditions. The team also demonstrated in vitro proof-of-concept using human based disease models. Future research will examine the potential for this therapy in preclinical animal models and, eventually, clinical trials. Read the article in Molecular Therapy Nucleic Acids.
- Tatiana Segura, PhD, led the development of two novel biomaterial formulations of granular hydrogels for tissue regeneration after stroke: highly porous microgels and microgels loaded with heparin-norbornene nanoparticles with covalently bound SDF-1α. These hydrogels may improve our ability to deliver stem cells, growth factors, or other therapies to improve tissue repair and outcomes for stroke survivors. Read more about them in Advanced Healthcare Materials.
- Extended reality (XR) technologies have shown promise to help people living with autism spectrum disorders, but there gaps in our understanding of the neurobiology of autism, particularly relating to sex-based differences, have limited this potential. Estate Sokhadze, PhD, was the senior author of a new review article synthesizing the current research on brain activity patterns in autism spectrum disorder, emphasizing the implications for XR interventions and neurofeedback therapy. Read that article here.
- Simon Davis, PhD, was the senior author of a new study that provides fresh insights into how our brains remember. Davis and colleagues used functional MRI to observe 19 study participants as they tried to memorize images of real-world objects like pizza, birds, and clothing. They later tested the participants on their memory of both the concept of the objects and the specific details.They found that certain brain regions exhibited a heightened sensitivity to visual characteristics, while others were more attuned to semantic, or meaning-related, information. Read the full article in the Journal of Clinical Neuroscience.
Other Topics
- Sneha Mantri, MD, MS, contributed to a new article examining the psychological impact of the COVID-19 epidemic on the prevalence of moral injury, burnout, depression, and anxiety in the healthcare workforce. Mantri and colleagues administered a series of surveys to 17,000 employees of a large academic medical between December 2021 and February 2022. Across all roles, the prevalence of moral injury, burnout, depression, and anxiety were 41%, 35%-61%, 25%, and 25%, respectively. Read the full article in the Journal of Nervous and Mental Disease.