Members of the Duke Neurology Department advanced the fields of clinical, translational, and basic neuroscience this April with 14 new peer-reviewed studies. Nicole Calakos, MD, PhD, was the senior author of a new study in Science that expands our understanding of the integrated stress response in the brain and how it influences learning and memory. Other studies include an analysis of demographic disparities in use of emergency medical services for stroke, the discovery that some skin cells can act as “pre-neurons,” and a national survey of clinical neurophysiology fellowships. Read about these studies and more, and find links to the original journal articles in the paragraphs below.
Epilepsy, Sleep, and Clinical Neurophysiology
- A new national survey of directors of accredited clinical neurophysiology fellowship programs found great variety in the number of CNP positions and CNP tracks offered. Saurabh Sinha, MD, PhD, was the senior author of the study, which appears in the Journal of Clinical Neurophysiology. Read that study here.
- Senior authors Brad Kolls, MD, PhD, and Brian Mace outline a practical method for determining automated EEG interpretation software performance on continuous Video-EEG monitoring data in the latest issue of Informatics in Medicine Unlocked. Their approach offers a potentially better method for performance assessment than traditional metrics of sensitivity and specificity. Read more about it here.
Neurodegeneration and Neurotherapeutics
- A new study found striking sex differences in monocyte gene expression in patients with early Parkinson’s disease. The results of this study have important implications for how inflammation may contribute to the development of this disease. Andrew West, PhD, contributed to the study, which appears in NPJ Parkinson’s disease. Read more.
Stroke and Vascular Neurology
- A new study in the Journal of Thrombosis and Thrombolysis examined the emergency attendance rate for heart attacks and stroke in Beijing from 2018 through the first half of 2020, providing insight into how the pandemic shaped individuals’ use of these much-needed services. Analysis by Wuwei “Wayne” Feng, MD, MS, and colleagues found that emergency attendance for stroke and heart attacks fell by 50% in the beginning of the pandemic, and then gradually increased afterwards. Read that study here.
- The New England Journal of Medicine’s THALES trial recently found that ticagrelor and aspirin were better at reducing recurrent stroke than aspirin alone. Senior author Ying Xian, MD, PhD, and colleagues put that trial in context with a new article that examines the past, present and future of antiplatelet therapy trials for ischemic stroke patients. Read that article in the Neuroscience Bulletin.
- A new analysis identifies several disparities in use of emergency medical services (EMS) for stroke. Senior authors Matthew Ehrlich, MD, MPH, and Carmen Graffagnino, MD, found that EMS use was lower in stroke patients who were younger, had higher income, were married, more educated, and who identified as Hispanic, with EMS use also correlated with faster arrival to code, imaging, and thrombolytic treatment times. Michael Lutz, PhD, Shreyansh Shah, MD, and Brad Kolls, MD, PhD, also contributed to the study, which appears in the Neurohospitalist.
- The carotid web is an important and under recognized etiology for recurrent cryptogenic strokes. A team including Brian Mac Grory, MB BCh, MRCP, describes the technical nuances involved in successfully performing a carotid endarterectomy for resection of a carotid web. Read that article in Acta Neurochirurgica.
Headache and Facial Pain
- Wolfgang Liedtke, MD, PhD, wrote a commentary paper for Neuroscience Bulletin discussing a recent Nature paper, "STING controls nociception via type-I interferon signaling in sensory neurons" by Ru-Rong Ji, PhD, and colleagues at Duke. Read that analysis here.
Neurocritical Care
- Extracranial organ dysfunction following traumatic brain injury remains an under-addressed public health problem. A team including Daniel Laskowitz, MD, MHS, Michael “Luke” James,” MD, and colleagues used a sensitive marker of myocardial injury—high sensitivity troponin (hsTn)—to examine the incidence of early myocardial injury following TBI and explored its association with neurological outcomes following moderate-severe TBI. Read what they found in the Journal of Neurosurgical Anesthesiology.
Parkinson’s Disease and Movement Disorders
- Mindfulness-based stress reduction (MBSR) offers the potential to alleviate at least some of the harmful symptoms experienced by people with Parkinson’s disease and their care partners. Senior author Sneha Mantri, MD, MS, Allison Allen, MSW, Lacy Rardin, MSW, Jeffrey Cooney, MD, Margaret Ivancic, and former Duke Neurology resident Deepal Shah-Zamora, MD, examined the effects of a nine-week MSBR on both of these groups. The team found that the MBSR improved mindful awareness in care partners and improved health-related quality of life in people with Parkinson’s. Read the full study in Complementary Therapies in Clinical Practice.
- A devastating itching of the skin driven by severe liver disease turns out to have a surprising cause. The study found that the keratinocyte cells of the skin surface are acting as "pre-neurons." Senior authors Yong Chen, PhD, and Wolfgang Liedtke, MD, PhD, as well as Carlene Moore, PhD, contributed to the study, which appears in Gastroenterology. Read it here.
Translational Brain Sciences
- A new article in Science expands our understanding of the integrated stress response (ISR) in the brain and how it influences learning and memory. Lead authors Nicole Calakos, MD, PhD, and former Movement Disorders Fellow Ashley Helseth, MD, PhD, and colleagues found a class of neurons in the mouse brain, known as striatal cholinergic interneurons (CINs), in which the ISR was activated at steady state. Genetic and pharmacological manipulations revealed that ISR signaling was necessary in CINs for normal type 2 dopamine receptor (D2R) modulation and that Inhibiting the ISR inverted the sign of D2R modulation of CIN firing and evoked dopamine release and altered skill learning. Calakos lab manager Miranda Shipman, lab analyst Zachary Caffall, postdoctoral associate Brandon Turner, research technician Connor King also contributed to the study, which is available here.
- A devastating itching of the skin driven by severe liver disease turns out to have a surprising cause. The study found that the keratinocyte cells of the skin surface are acting as ‘pre-neurons.’ Senior authors Yong Chen, PhD, and Wolfgang Liedtke, MD, PhD, as well as Carlene Moore, PhD, contributed to the study, which appears in Gastroenterology. Read it here.
- Wolfgang Liedtke, MD, PhD, wrote a commentary paper for Neuroscience Bulletin discussing a recent Nature paper, "STING controls nociception via type-I interferon signaling in sensory neurons" by Ru-Rong Ji, PhD, and colleagues at Duke. Read that analysis here.
Other
- Chromosomal instability and neuroendocrine CTC phenotypeare associated with worse survival in men with metastatic castration resistant prostate cancer who are being treated with abiraterone or enzalutamide, according to a new study in Clinical Cancer Research. Simon Gregory, PhD, contributed to that study. Read it here.