Articles related to Neurology

Diving into intensive systolic BP treatment unveils intriguing cognitive benefits according to a secondary analysis of the SPRINT trial. The SPRINT trial has shed fresh light on the impact of intensive systolic blood pressure (SBP) treatment on cognitive health. Out of 7,918 participants, a significant majority with higher baseline risk of dementia or mild cognitive impairment (MCI) revealed marked cognitive improvements with intensive SBP treatment. This marks a leap forward in understanding SBP treatment’s role in cognitive function preservation. In the comprehensive secondary analysis, patients were meticulously followed up over a median of four years. To streamline the study, two SBP treatment targets were identified: intensive, set at less than 120 mm Hg, and standard, at less than 140 mm Hg. The data collected showcased 765 and 828 primary outcome events in intensive and standard treatment groups, respectively. Consequently, it confirmed intensive SBP treatment’s potential in reducing the risk of MCI or dementia. Digging deeper into the data, certain trends emerged. Older age, Medicare enrollment, and higher baseline serum creatinine levels correlated with a higher risk of the primary outcome. Conversely, enhanced baseline cognitive functioning and active employment status signified lower risk. Interestingly, higher baseline risk connected directly with greater […]

Dive into the intriguing findings from the PEACH trial on prophylactic levetiracetam for seizure prevention in intracerebral haemorrhage patients. The PEACH trial aimed to test prophylactic levetiracetam for seizure prevention in acute intracerebral haemorrhage (ICH) patients. Early seizures within seven days of stroke onset occur in almost 30% of patients. However, current guidelines lack strategies to manage this issue. Despite being prematurely stopped, the trial showed promise. In this double-blind, randomised, placebo-controlled trial, 50 patients received either levetiracetam or a placebo. Clinical or electrographic seizures were seen in 16% of levetiracetam patients and 43% of placebo patients within 72 hours. Interestingly, these seizures were only electrographic. Adverse events included headaches and pain, but no treatment-related deaths were reported. The findings suggest levetiracetam may prevent acute seizures in ICH patients, but larger studies are needed. Acute seizures can lead to increased morbidity and mortality. The trial found fewer seizures within 72 hours of study inclusion in the levetiracetam group. This is promising, but more research is required. This study opens avenues for further investigation. It raises questions about early detection of interictal epileptiform activity and the need for prophylactic levetiracetam. It also underscores the need to understand which factors influence seizure […]

FDA’s New Approval of Atogepant for Chronic Migraine Prevention is a Breakthrough in Migraine Management A promising breakthrough in migraine management, the FDA’s new approval of atogepant tablets, brings renewed hope for chronic migraine sufferers. According to AbbVie, this endorsement allows the use of atogepant (Qulipta) in the prevention of chronic migraines in adults. Atogepant stands out as the first oral calcitonin gene-related peptide (CGRP) receptor antagonist to receive dual approval for episodic and chronic migraines. It works by blocking CGRP, a molecule involved in transmitting pain signals. Chronic migraines, to clarify, involve enduring headaches for at least 15 days a month, with eight of those days associated with migraines. Before this, in September 2021, the FDA approved atogepant for treating episodic migraines. Patients can take the drug in 10 mg, 30 mg, and 60 mg dosages. The FDA recommends the 60 mg dose for chronic migraine patients. Peter McAllister, MD, from the New England Center for Neurology and Headache, noted that the FDA’s endorsement offers a new, convenient daily treatment for chronic migraine patients. The demonstrated efficacy and functional improvement of atogepant make it an appealing option for neurologists and headache specialists when devising treatment plans for patients. The […]

A study has found that the protein Mfsd2a, responsible for transporting molecules containing omega-3 fatty acids, plays a crucial role in regulating the development of cells that produce the myelin sheath, which is damaged in multiple sclerosis (MS). The absence of Mfsd2a in mice resulted in immature myelin-producing cells and reduced levels of omega-3 fatty acids, leading to a decline in myelination. The study suggests that omega-3 molecules play a critical role in directing the development of oligodendrocytes, and this discovery may pave the way for therapies and dietary supplements based on omega-3 to retain myelin in the aging brain and treat neurological disorders arising from reduced myelination. MS involves immune-mediated damage to the myelin sheath, which is predominantly composed of lipids and specialized proteins. The study’s authors emphasize the importance of developing therapies to improve myelination in both normal aging and neurological diseases like MS and Alzheimer’s disease. By elucidating the role of Mfsd2a in myelination, the researchers hope to explore the potential of dietary supplements containing omega-3 fatty acids to enhance brain myelination and cognitive function in aging individuals and those with neurodegenerative diseases.

Researchers presented findings from the AB10015 Phase 2/3 clinical trial, demonstrating that masitinib, an oral add-on therapy to Rilutek, offers significant benefits for patients with mild to moderate amyotrophic lateral sclerosis (ALS). Although the entire study population did not experience improved survival with masitinib, patients with moderate ALS who received masitinib in addition to Rilutek had significantly longer survival compared to those who received a placebo. The combined treatment also slowed disease progression, improved lung function, and enhanced quality of life in these patients. Masitinib works by blocking specific tyrosine kinase enzymes that regulate immune cell activity and inflammation, aiming to slow disease progression and alleviate symptoms. The analysis focused on normally progressing participants with moderate ALS at the study’s start, and in this subgroup, masitinib combined with Rilutek significantly slowed disease progression by 42% compared to Rilutek alone. Additionally, patients with moderate ALS experienced a median survival of 69 months with masitinib, representing a 44% reduction in mortality risk compared to placebo-treated patients. The combination therapy also showed positive effects on quality of life and lung function in patients progressing normally. These findings suggest that initiating masitinib at an earlier stage of the disease could lead to substantial reductions […]

This case study applies the newly revised CDC Clinical Practice Guideline for Prescribing Opioids for Pain to a patient with chronic neck pain. The patient, Joanna, is a 78-year-old woman who has undergone two neck surgeries and experiences worsening pain. Her pain ranges from 6 to 7 on average and can increase up to 8. She has tried various non-pharmacologic modalities, such as heat, ice, TENS, physical therapy, and massage therapy, but insurance limitations and cost have hindered her access to these treatments. Considering Joanna’s medical history, physical therapy and topical analgesics are identified as potential options. However, due to limitations and contraindications with other medications, the only feasible options for her are low-dose acetaminophen and topical analgesics. As a result, initiating a low-dose opioid therapy is considered appropriate, in addition to low-dose acetaminophen, OTC menthol and methyl salicylate cream, and a referral to physical medicine and rehabilitation. Before initiating opioids, the patient’s risk of side effects, including overdose, addiction, constipation, and hypogonadal axis suppression, should be discussed. Joanna’s Risk Index for Overdose or Serious Opioid-Induced Respiratory Depression (RIOSORD) score indicates a risk class of 4 out of 7, with a 15% estimated probability of an opioid-induced respiratory depression event […]