The month of September saw 20 new peer-reviewed journal articles articles and one book chapter from members of the Duke Neurology Department. Highlights from this month’s research include four articles advancing our understanding of epilepsy and sleep from incoming Professor of Neurology Birgit Frauscher, MD, PhD, and members of her Anphy Lab, a comparison of the accuracy of electronic health record and medicare data for various neurodegenerative diseases, and a pilot test for a less invasive, but still effective treatment for some brain tumors. Read the paragraphs below for brief summaries of these and other articles as well as links to the original research articles themselves.
Epilepsy, Sleep, and Clinical Neurophysiology
- Birgit Frauscher, MD, PhD, and Alyssa Ho were the senior authors of a new Epilepsia article that provides new insights into the interactions between REM sleep and epilepsy. Frauscher, Ho, and colleagues used polysomnography combined with direct cortical recordings to investigate the influences of anatomical locations and the time of night on the suppressive effect of REM sleep on interictal epileptiform discharges (IEDs). They found spatiotemporal effect of IED suppression by REM sleep relative to wakefulness in neocortical, but not mesiotemporal regions, and in late versus early sleep. Tamir Avigdor, MSc, also contributed to the article. Read it here.
- Shruti Agashe, MD, contributed to a new article in the Journal of Clinical Neurophysiology that may guide surgical decision-making for drug-resistant temporal lobe epilepsy. Agashe and colleagues localized EEGs, finding that scalp EEG localize near encephaloceles, but typically not in the encephalocele itself. They also observed surprisingly increased source localization to encephalocele distances in patients with excellent surgical outcomes. Read their full study here.
- Epileptic spikes, high-frequency oscillations (HFOs), and connectivity measures are valuable biomarkers of epileptogenicity. Questions remain, however, whether they could also be used for preresective differentiation of the underlying brain pathology. Birgit Frauscher, MD, PhD, contributed to a new article describing a powerful new predictive model with the potential to identify the nature of the underlying lesion prior to resection. Read that article in Epilepsia.
- Tamir Avigdor, MSc, and Birgit Frauscher, MD, PhD, were the senior authors of a new article in Sleep examining the interactions between sleep oscillations and general episodic memory abilities in 26 adults with drug-resistant temporal lobe epilepsy. Her team’s results corroborate the role of scalp spindles in memory processes in patients with drug-resistant temporal lobe epilepsy, but do not provide support for a role of sleep ripples as trait-like characteristics of general memory abilities in epilepsy. Read that article here.
- A new Annals of Neurology article offers valuable insights into neural network dynamics in epilepsy and has important clinical implications for localizing seizure foci. Senior authors Birgit Frauscher, MD, PhD, and Alyssa Ho, Tamir Avigdor, MS, and colleagues evaluated the influences of non-rapid eye movement REM sleep on ictal spatiotemporal dynamics and compared these with interictal network dynamics. In contrast to its effects on focal interictal epileptiform discharges, NREM sleep does not affect ictal spatiotemporal dynamics. This suggests that once the brain surpasses the seizure threshold, it will follow the underlying epileptic network irrespective of the vigilance state. Read the full article here.
- Epilepsy is one of the most burdensome neurologic diseases in sub-Saharan Africa, but few studies have investigated the epidemiology of idiopathic epilepsy in this region, especially among older populations. Deborah Koltai, PhD, and colleagues at Duke Neurosurgery examined epidemiological data from the Global Burden of Disease database, finding a greater disease burden and mortality for this population. Read the full article in Epilepsy & Behavior.
Headache and Pain
- Sweta Sengupta, MD, and Jaskiran Vidwan, MD, wrote a new article discussing the overlap in migraine and idiopathic intracranial hypertension as well as differences between those two conditions. Read their analysis in Current Pain and Headache Reports.
Memory Disorders
- Brenda Plassman, PhD, was the senior author of a new study that examined associations between traumatic brain injuries (TBI) received over the lifetime and cognitive decline. Plassman and colleagues analyzed patterns of TBI and later cognitive decline among identical twins over time, finding that individuals who had suffered TBI were substantially more likely to have poorer cognitive outcomes later in life. Read the full article in Neurology.
- A new BMC Neurology study provides insights into both the specificity and the sensitivity of electronic health record claims for neurodegenerative diseases. Senior authors Jay Lusk, MD, and Emily O’Brien, PhD, as well as Margarethe Goetz, PA-C, PhD, Kim Johnson, MD, and Richard O’Brien, MD, PhD, and colleagues examined electronic health record and medicare data from more than 100,000 patients, finding high specificity (99%) but only moderate sensitivity (61.3%) for dementia and Parkinson’s. Read the full study here.
Multiple Sclerosis and Neuroimmunology
- People living with multiple sclerosis (MS) often require complex medication regimens to help with their symptoms, modifying the course of their MS, and managing any other conditions they may have. Jenelle Montgomery, PharmD, was the senior author of a new literature review examining the role neurology clinical pharmacists play in managing these medications and optimizing patient care and quality of life. Read that article in the International Journal of MS Care.
Neurocritical Care
- The lack of targeted therapies for traumatic brain injury (TBI) remains a compelling clinical unmet need. Daniel Laskowitz, MD, MS, and David Van Wyck, DO, wrote an article discussing ApoE mimetic peptides as a potential therapy for this condition and outlining the reverse translational approach that has allowed for the development of this promising therapeutic approach. Read that article in Neurotherapeutics.
- A new article in Critical Care Explorations examines patterns of beta-blocker use among critically ill patients after traumatic brain injury as well as association of early beta-blocker exposure with functional and clinical outcomes after injury. The retrospective cohort study found that 13% of patients received early beta blockers, and that early exposure was not associated with clinical and functional outcomes. Daniel Laskowitz, MD, MHS, Michael “Luke” James, MD, and Katharine Colton, MD, contributed to the article. Read it here.
Neuromuscular Disease
- Lisa Hobson Webb, MD, contributed to a new study that evaluated the effectiveness of muscle ultrasound measuring echointensity (EI) to identify late-onset Pompe disease in infants. Their analysis identified several regions where muscle EI was elevated and found EI had potential as a reliable, non-invasive tool for identifying this chronic condition. Read the full article in Molecular Genetics and Metabolism Reports.
- Parsonage-Turner syndrome is characterized by severe, acute upper extremity pain and subsequent paresis; it most commonly involves the long thoracic nerve. Jonathan Morena, DO, was the first author of a new article that used quantitative muscle MRI (qMRI) to observe serratus anterior muscle neurogenic changes in the long thoracic nerve among patients with this condition. Read the full article in the Journal of Magnetic Resonance Imaging.
- Jonathan Morena, DO, was the first author of a combined case report and literature review discussing intraneural ganglion cysts that develop from the peroneal nerve at the lateral knee, the multimodal diagnostic approach, and surgical techniques to prevent recurrence. Read that article in RRNMF Neuromuscular Journal.
Neuro-Oncology
- Katherine Peters, MD, PhD, contributed to a pilot study that examined a new potential treatment modality for primary central nervous system lymphoma (PCNSL). Peters and colleagues reviewed data from PCNSL patients who received reduced-dose whole-brain radiotherapy followed by a stereotactic radiosurgery boost received durable intracranial control with fewer neurotoxic side effects. Read the full study in Neuro-Oncology Advances.
Neurosurgery
- Traumatic lateral spondyloptosis, or lateraloptosis, the complete lateral dislocation of the spine, is a surgery that presents unique challenges and risks. Resident Felix Nwajei, MD, PhD, contributed to a new article discussing a new on-table closed reduction technique that offers several advantages to traditional approaches. Read more about this technique in Operative Neurosurgery.
Parkinson’s and Movement Disorders
- Noreen Bukhari-Parlakturk, MD, PhD, co-authored a new chapter in the Handbook of Clinical Neurology reviewing the symptoms, development, and molecular mechanisms of isolated and combined dystonias. The chapter also examines the current state of clinical trials and therapeutic strategies to treat these related conditions. Read that chapter here.
Stroke and Vascular Neurology
- Senior author Wuwei “Wayne” Feng, MD, MS, Nada El-Husseini, MD, Swaroop Pawar, MD, and colleagues wrote a new entry in Neurology’s “Teaching NeuroImages” series discussing diffuse midline glioma mimicking edema in cerebral venous thrombosis. Read that entry here.
- Brian Mac Grory, MB Bch, MRCP, contributed to a new study that examined the association of hospital procedural volumes with outcomes among acute ischemic stroke (AIS) patients undergoing endovascular therapy (EVT). Their analysis found that EVT at hospitals with higher procedural volumes was associated with faster treatment times, better discharge outcomes, and lower rates of in-hospital mortality. Read the full study in Annals of Neurology.
Translational Brain Sciences
- Microporous annealed particle (MAP) scaffolds are injectable granular materials that offer the potential to enhance wound healing from a variety of sources. Tatiana Segura, PhD, was the senior author of a new study examining how microgels of three sizes (40, 70, and 130 μm) affected healing and immune cell recruitment within skin wounds. Read what her team discovered in Advanced Materials.