Members of the Duke Neurology Department contributed to 13 new peer-reviewed journal articles this May, advancing our understanding of how viruses that kill cancer cells may be used against brain tumors, the optimal treatments for various types of stroke, the origins of Parkinson’s disease, and more. Read the paragraphs below for summaries of our research from the past 31 days, as well as links to the complete articles themselves.
- Therapeutic cooling for neuroprotection is a standard of care during cardiac arrest, but the concept of temperature dose, or the duration spent at a given depth of hypothermia, is not as well explored. In a new retrospective study, senior authors Matthew Luedke, MD, and Brad Kolls, MD, PhD, MCii, as well as Carmen Graffangino, MD, examined 66 patients undergoing therapeutic hypothermia for cardiac arrest to assess the relationship of temperature dose with outcomes. After controlling for old age, they found that longer durations between >35°C, ≤36.5°C during therapeutic hypothermia for cardiac arrest were significantly associated with good clinical outcomes. Read the full article in BMJ Neurology Open.
- Daniel Laskowitz, MD, MHS, and Michael “Luke” James, MD, contributed to an analysis of risk factors and neurological outcomes associated with circulatory shock after moderate to severe traumatic brain injury (TBI). In addition to identifying several potential risk factors for circulatory shock after moderate-severe TBI, their study also suggests that developing circulatory shock after moderate-severe TBI is associated with poor long-term functional outcomes. Read the full article in Neurosurgery.
- Oncolytic viruses--viruses that infect and kill cancer cells while leaving healthy cells in the body unaffected--have shown potential as a tool to treat cancer. In the newest issue of Advances in Oncology, Katherine Peters, MD, PhD, and neuro-oncology fellow Madison Shoaf, MD, MS, discuss the current status, safety, and clinical trial data for the use of oncolytic viruses as a treatment for glioblastoma. Read that article here.
- First author Jerry Shih-Hsiu “Jerry” Wang, John Ervin, Jay Lusk, and colleagues compared the neuropathological associations of a condition known as LATE-NC and its contributions to cognitive impairment in populations 90 years or older and younger but still elderly patients. They found that LATE-NC is associated with other neurodegenerative pathologies, in “younger-old” patients, while in patients 90 or more years old, LATE-NC can exist independent of significant ADNC. Read that article in Acta Neuropathologica.
Stroke and Vascular Neurology
- A new study by first author Shreyansh Shah, MD, Michael “Luke” James, MD, and colleagues sheds light on the effects of mechanical thrombectomy for ischemic stroke patients who have had elective inpatient surgery. Shah and colleagues examined data from more than 12,507 patients who underwent elective inpatient surgery and suffered from a perioperative ischemic stroke. They found that despite an increase in mechanical thrombectomy, utilization rates were low, especially in non-teaching hospitals. Read the full article in the Journal of Clinical Neuroscience.
- Hypereosinophilic syndrome is a rare disorder characterized by excessive peripheral eosinophilia and eosinophil associated end-organ damage. In a series of two case reports, senior authors Wuwei “Wayne” Feng, MD, MS and Dylan Ryan, MD, as well as Nada El-Husseini, MD, and colleagues discuss how this condition can contribute to myocarditis and cardioembolic strokes. Read that article in the American Journal of the Medical Sciences.
- Wuwei “Wayne” Feng, MD, MS, was part of a team that investigated the associations between non‐lesioned hippocampal volume and upper limb sensorimotor impairment in people with chronic stroke. Their analysis identifies novel associations between chronic poststroke sensorimotor impairment and ipsilesional hippocampal volume that are not caused by lesion size and may be stronger in women. Read the full study in the Journal of the American Heart Association.
- A new study from JAMA Cardiology provides important insights into the benefits of apixaban compared with vitamin K antagonists for patients with prior stroke. The post hoc analysis of the AUGUSTUS trial found that patients with prior stroke, transient ischemic attack or thromboembolism who were treated with apixaban had less bleeding, death, or hospitalization than those treated with vitamin K antagonists and that patients treated with aspirin had a higher bleeding risk than those receiving placebo. Dedrick Jordan, MD, PhD, and Brad Kolls, MD, PhD, MCii, contributed to the study, which is available here.
- Brian Mac Grory, MB BCh, MRCP, contributed to a new study examining the global disability status of patients who had a mild ischaemic stroke at 30 and 90 days poststroke. Their analysis of more than 1300 patients found that one in four mild ischaemic stroke participants exhibited functional changes between 30 and 90 days, suggesting that the 30-day outcome may insufficiently represent long-term recovery in mild stroke. Read the full article in Stroke and Vascular Neurology.
- Brian Mac Grory, MB BCh, MRCP, was also part of a team that provided insights into the risk and causes of recurrent ischemic events for patients with atrial fibrillation who have had ischemic stroke while being treatment with nonvitamin K antagonist oral anticoagulants. Read about the RENO-EXTEND study in the latest issue of Stroke.
Translational Brain Sciences
- Laurie Sanders, PhD, was part of a team that found a sex-biased impact of limbic α-synucleinopathy on the expression and function of the APE1 enyzme suggestions that APE1 overexpression attenuates α-synucleinopathy in both sexes. Read that article in the FASEB Journal.
- Simon Gregory, PhD, was part of a team that performed single-cell RNA sequencing analysis on the transcriptional heterogeneity of red blood cells from three adult healthy adults stored in a blood bank at day 1 and day 15. Their results indicate the power of single RBC RNA-Seq to capture and discover known and unexpected heterogeneity of RBC population. Read the full study in Frontiers in Physiology.
- Katherine Peters, MD, PhD, was part of a team that created and tested a modified geriatric assessment to examine candidates for hematopoietic stem cell transplantation (HCT). Their study shows that this assessment can identify functional impairments in patients of all ages, which in turn could facilitate referrals to supportive care and resolution of impairments before HCT. Read the full article in Transplantation and Cellular Therapy.