Research from members of the Duke Neurology Department advanced the fields of clinical, translational, and basic neurology in February. Over the past 28 days, our faculty, staff, and trainees contributed to journal articles answering questions about the use of mobile phones for stroke care, modifiable risk factors associated with cognitive decline in Parkinson’s, the genetics of Alzheimer’s disease, and more. The paragraphs below contain short summaries of each of the 13 articles published in February featuring members of our Department, along with links to the original articles themselves.
Stroke
- A new analysis of data from more than 20,000 stroke patients treated for depression answers important questions about complications and outcomes associated for patients with both these conditions. The study found that stroke patients treated for depression had higher rates of mortality, readmission to the hospital, major cardiac events and other poorer outcomes, showing the need for further research and interventions for this vulnerable population. Shreyansh Shah, MD, Ying Xian, MD, PhD, contributed to this study, which was published in Stroke and Vascular Neurology.
- Mobile phones offer enormous potential to improve the speed of thromboyltic therapy for ischemic stroke, but effective, reliable platforms that that work throughout the first aid process still need to be built and tested. Wuwei “Wayne” Feng, MD, MS, helped test one potential platform in a new observational study. Feng and colleagues examined the utility and use of a new platform in the management of ischemic stroke and in reporting door-to-needle time over a two-year period. They found sustained improvement in door-to-needle time overall observed months and across all facilities observed. Read the full study in JMIR Mhealth UHealth.
- Direct factor Xa inhibitors have been developed as alternatives to warfarin for stroke prevention in atrial fibrillation. Some patients may experience intracerebral hemorrhage while taking these drugs. Because these adverse events are rare, there are limited data of these complications. Ying Xian, MD, PhD, was the first author of a new study that examined more than 200,000 patients with intracerebral hemorrhage. The analysis suggest that factor Xa inhibitors are a better choice than warfarin. Read that study in JAMA Open Network.
- A new analysis by Brian Mac Grory, MB BCh, MRCP, and colleagues found that baseline hyperglycemia was associated with brain infarction growth in ischemic stroke patients. Finding ways to establish glycemic control before and after reperfusion in patients could be a way to improve outcomes and reduce complications for patients at risk of stroke. Read the full study in the Journal of Stroke and Cerebrovascular Disease.
Translational Brain Sciences
- The APOE gene is one of the strongest, most reproducible genetic risk factors for Alzheimer’s disease. It may also hold the key to developing the first effective therapies for the condition. Senior author Ornit Chiba-Falek, PhD, first author Anna Yang, and Duke Neurobiology’s Boris Kantor, PhD wrote an article discussing how precision medicine may allow APOE to be a new frontier in developing therapies for Alzheimer’s disease. Read that article in the International Journal of Molecular Sciences.
- A new review article from the lab of Yong Chen, PhD, sheds important light on the molecular underpinnings of orofacial pain. The review article examines the experimental evidence involving TRP ion channels and the possible cellular and molecular mechanisms behind them, in orofacial pain. Senior author Yong Chen, first author Yuhi Luo, PhD, Qiaojuan Zhang, PhD, Peng Wang, MS, and Abbie Suttle, MSc, contributed to the article in Molecular Neurobiology. Read it here.
- Michael Lutz, PhD, contributed to a new Alzheimer’s and Dementia investigating genes associated with cognitive decline in Black Americans without Alzheimer’s disease. The team investigated the effects of the ‘523-short variant within the apolipoprotein E (APOE) genotype, finding the variants had different effects among non-demented Blacks depending on the APOE allele. This finding helps to explain previous mixed findings and cognitive decline observed in this population. Read the study in Alzheimer’s & Dementia.
- Alzheimer’s disease is a growing national crisis, with more than 5 million Americans living with the condition, a number that will more than double by 2050. Michael Vitek, PhD, recently met with other Alzheimer's experts as part of the Alzheimer's Association Business Consortium Think Tank to address the massive unmet need to improve the discovery and successful development of Alzheimer's therapies. Read what that group proposed in Alzheimer’s & Dementia: Translational Research and Clinical Interventions.
Neuro-Oncology
- Among other challenges, reaching a culture of equity, inclusion and diversity in academic medicine will require a thorough evaluation of bias and evidence-based strategies to mitigate that bias. Katy Peters, MD, PhD, was a co-author of a new article providing a broad perspective on evaluating bias in the neuro-oncology workplace. Read that article here.
Neurodegeneration and Neurotherapeutics
- Senior author Andrew West, PhD, Kaela Kelly, Allison Chang, Lindsay Hastings, and colleagues evaluated how the LRKK2 gene’s upregulation of Rab phosphorylation was influenced by genetic background. Read what they found in the latest issue of Brain Research.
Movement Disorders
- Cognitive impairment is one of the most feared, debilitating complications of Parkinson’s disease, and no therapies can slow or prevent this condition. Sneha Mantri, MD, MS, was part of a team that was able to identify modifiable behaviors or comorbidities including higher body mass index, anxiety, depression, and poor sleep associated with faster decline. These associations offer opportunities for early intervention to delay or reduce cognitive impairment. Read the full study in Movement Disorders Clinical Practice.
- Mantri contributed to another study examining possible triggers and alleviating factors of fatigue in Parkinson’s disease. A sample of more than 1,000 individuals with Parkinson’s disease conducted by Mantri and colleagues identified several behavioral and environmental triggers and alleviating strategies for fatigue. Their study may inform future developments of treatments of coping strategies for this complication. Read it in PLoS One.
Other Topics
- A team including Wolfgang Liedtke, MD, PhD, has developed a mechanically responsive bioartificial tissue that responds to mechanical loading to produce a preprogrammed therapeutic biologic drug. This engineered, living tissue constructed for coordinated drug delivery obviates many of the traditional limitations of “smart” materials, such as long-term integration, rapid dynamic responses, and extended drug delivery without the need for replacement or reimplantation of the drug delivery system. Read the full study in Science Advances.