[Comment] Subcutaneous IgG for chronic inflammatory demyelinating polyneuropathy
Chronic inflammatory demyelinating polyneuropathy (CIDP) is the most common chronic autoimmune neuropathy and often responds to corticosteroids, plasmapheresis, and intravenous immunoglobulin (IVIg).1 The only US Food and Drug Administration-approved, and the most commonly applied therapy, is IVIg, which, at 2 g/kg followed by 1 g/kg every 3 –4 weeks, has been shown to prevent relapses and maintain stability in 75% of patients.2 Subcutaneous immunoglobulin (SCIg), an alternative route of IgG administration, is approved for IgG replacement therapy in primary immunodeficiency,3 but whether or not it has an effect in balanc...
Source: Lancet Neurology - November 6, 2017 Category: Neurology Authors: Marinos C Dalakas Tags: Comment Source Type: research
[The Lancet Neurology Commission] Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research
A concerted effort to tackle the global health problem posed by traumatic brain injury (TBI) is long overdue. TBI is a public health challenge of vast, but insufficiently recognised, proportions. Worldwide, more than 50 million people have a TBI each year, and it is estimated that about half the world's population will have one or more TBIs over their lifetime. TBI is the leading cause of mortality in young adults and a major cause of death and disability across all ages in all countries, with a disproportionate burden of disability and death occurring in low-income and middle-income countries (LMICs). (Source: Lancet Neurology)
Source: Lancet Neurology - November 6, 2017 Category: Neurology Authors: Andrew I R Maas, David K Menon, P David Adelson, Nada Andelic, Michael J Bell, Antonio Belli, Peter Bragge, Alexandra Brazinova, Andr ás Büki, Randall M Chesnut, Giuseppe Citerio, Mark Coburn, D Jamie Cooper, A Tamara Crowder, Endre Czeiter, Marek Czosn Tags: The Lancet Neurology Commission Source Type: research
[In Context] The CENTER-TBI core study: The making-of
It's a veritable medical mega-production, with results coming soon to a computer screen near you! But only behind the scenes can you appreciate the massive effort to collect and curate the data involved in this vast study. Adrian Burton takes a peek. (Source: Lancet Neurology)
Source: Lancet Neurology - November 6, 2017 Category: Neurology Authors: Adrian Burton Tags: In Context Source Type: research
[Comment] Traumatic brain injury: a priority for public health policy
The Lancet Neurology Commission1 draws attention to the devastating impact of traumatic brain injury (TBI) on patients and their families, and the huge public health burden and economic cost of TBI globally. About 50 –60 million new TBI cases are estimated to occur annually, with 2·5 million occurring in the European Union.1 The burden of TBI is greatest in low-income and middle-income countries, where 90% of trauma-related deaths occur.2,3 The Commission sets priorities for prevention, clinical care, and res earch, calling for a combination of innovative research methods and global collaboration to address the huge but...
Source: Lancet Neurology - November 6, 2017 Category: Neurology Authors: Gianluca Quaglio, Maurizio Gallucci, Helmut Brand, Amr Dawood, Francesco Cobello Tags: Comment Source Type: research
[Comment] Traumatic brain injury: a global challenge
Traumatic brain injury (TBI) is a leading cause of death and disability worldwide, with enormous economic consequences. The Lancet Neurology Commission1 on TBI sets priorities and provides recommendations for future clinical practice, research, and policy to reduce this overwhelming burden. The Commission comes at a time when the global incidence of TBI is rising, access to care is severely lacking in many parts of the world, and methods of monitoring and diagnosis are frequently inadequate. (Source: Lancet Neurology)
Source: Lancet Neurology - November 6, 2017 Category: Neurology Authors: Walter D Johnson, Dylan P Griswold Tags: Comment Source Type: research
[Articles] 24-month intervention with a specific multinutrient in people with prodromal Alzheimer's disease (LipiDiDiet): a randomised, double-blind, controlled trial
The intervention had no significant effect on the NTB primary endpoint over 2 years in prodromal Alzheimer's disease. However, cognitive decline in this population was much lower than expected, rendering the primary endpoint inadequately powered. Group differences on secondary endpoints of disease progression measuring cognition and function and hippocampal atrophy were observed. Further study of nutritional approaches with larger sample sizes, longer duration, or a primary endpoint more sensitive in this pre-dementia population, is needed. (Source: Lancet Neurology)
Source: Lancet Neurology - October 30, 2017 Category: Neurology Authors: Hilkka Soininen, Alina Solomon, Pieter Jelle Visser, Suzanne B Hendrix, Kaj Blennow, Miia Kivipelto, Tobias Hartmann, LipiDiDiet clinical study group Tags: Articles Source Type: research
[Comment] Targeting prodromal Alzheimer's disease: too late for prevention?
Prodromal Alzheimer's disease is a novel area of research, with clinical research definitions still under development. The LipiDiDiet trial,1 published in The Lancet Neurology, was one of the first completed trials based on the International Working Group (IWG-1) criteria for prodromal Alzheimer's disease.2 The study was a non-pharmacological intervention (medical food Souvenaid) in prodromal Alzheimer's disease. (Source: Lancet Neurology)
Source: Lancet Neurology - October 30, 2017 Category: Neurology Authors: Hussein N Yassine Tags: Comment Source Type: research
[Comment] Neurodegeneration in histiocytoses might start in utero
Histiocytic disorders, such as Langerhans cell histiocytosis and Erdheim-Chester disease, are characterised by inflammation and accumulation of cells derived from the monocyte and macrophage lineages, resulting in tissue damage.1 Neurodegenerative lesions in Langerhans cell histiocytosis are a devastating type of CNS involvement —different from tumour infiltration—in which patients present with progressive symmetric cerebellar syndrome, tetrapyramidal syndrome with or without motor deficits, pseudobulbar palsy, or cognitive impairment. (Source: Lancet Neurology)
Source: Lancet Neurology - October 27, 2017 Category: Neurology Authors: Julien Haroche, Fleur Cohen-Aubart, Jean-Fran çois Emile, Jean Donadieu, Zahir Amoura Tags: Comment Source Type: research
[Comment] Eculizumab: a treatment option for myasthenia gravis?
Eculizumab is an expensive, humanised monoclonal antibody against the terminal complement protein C5. The drug was patented in 2007, and has since been used and approved for two rare diseases, paroxysmal nocturnal haemoglobulinuria and atypical haemolytic ureamic syndrome. Additionally, eculizumab has been used off-label, which constitutes up to a half of its use in some countries,1 for at least 25 different conditions. Refractory and generalised myasthenia gravis with anti-acetylcholine receptor antibodies is a rare disease that involves the complement system and for which eculizumab has a potential effect. (Source: Lancet Neurology)
Source: Lancet Neurology - October 20, 2017 Category: Neurology Authors: Nils Erik Gilhus Tags: Comment Source Type: research
[Articles] Safety and efficacy of eculizumab in anti-acetylcholine receptor antibody-positive refractory generalised myasthenia gravis (REGAIN): a phase 3, randomised, double-blind, placebo-controlled, multicentre study
The change in the MG-ADL score was not statistically significant between eculizumab and placebo, as measured by the worst-rank analysis. Eculizumab was well tolerated. The use of a worst-rank analytical approach proved to be an important limitation of this study since the secondary and sensitivity analyses results were inconsistent with the primary endpoint result; further research into the role of complement is needed. (Source: Lancet Neurology)
Source: Lancet Neurology - October 20, 2017 Category: Neurology Authors: James F Howard, Kimiaki Utsugisawa, Michael Benatar, Hiroyuki Murai, Richard J Barohn, Isabel Illa, Saiju Jacob, John Vissing, Ted M Burns, John T Kissel, Srikanth Muppidi, Richard J Nowak, Fanny O'Brien, Jing-Jing Wang, Renato Mantegazza, REGAIN Study Gr Tags: Articles Source Type: research
[Comment] Eculizumab: a treatment option for mysthenia gravis?
Eculizumab is an expensive, humanised monoclonal antibody against the terminal complement protein C5. The drug was patented in 2007, and has since been used and approved for two rare diseases, paroxysmal nocturnal haemoglobulinuria and atypical haemolytic ureamic syndrome. Additionally, eculizumab has been used off-label, which constitutes up to a half of its use in some countries,1 for at least 25 different conditions. Refractory and generalised myasthenia gravis with anti-acetylcholine receptor antibodies is a rare disease that involves the complement system and for which eculizumab has a potential effect. (Source: Lancet Neurology)
Source: Lancet Neurology - October 20, 2017 Category: Neurology Authors: Nils Erik Gilhus Tags: Comment Source Type: research
[In Context] The next generation of leaders advocating for brain health
A monologist, a musician, an event producer, and an animal behaviourist are working to change how society thinks about aging and dementia. These individuals are part of the first cohort of Atlantic Fellows at the Global Brain Health Institute and are using their talents to transform the way we think about and care for elders and people with dementia. Dana Smith investigates. (Source: Lancet Neurology)
Source: Lancet Neurology - October 16, 2017 Category: Neurology Authors: Dana Smith Tags: In Context Source Type: research
[Corrections] Corrections
Terkelsen A J, Karlsson P, Lauria G, Freeman R, Finnerup N B, Jensen T S. The diagnostic challenge of small fibre neuropathy: clinical presentations, evaluations, and causes. Lancet Neurol 2017; 16: 934 –44. The declaration of interests section of this article should have stated, “AJT has participated in an investigator-sponsored study provided by Sanofi Genzyme and Alynylam Pharmaceuticals.” This correction has been made to the online version as of Oct 16, 2017. (Source: Lancet Neurology)
Source: Lancet Neurology - October 16, 2017 Category: Neurology Tags: Corrections Source Type: research
[Review] The diagnostic challenge of small fibre neuropathy: clinical presentations, evaluations, and causes
Small fibre neuropathies are a heterogeneous group of disorders affecting thinly myelinated A δ-fibres and unmyelinated C-fibres. Although multiple causes of small nerve fibre degeneration have been reported, including via genetic mutations, the cause of small fibre neuropathy remains unknown in up to 50% of cases. The typical clinical presentation of small fibre neuropathy is that of a sym metrical, length-dependent polyneuropathy associated with sensory or autonomic symptoms. More rarely, the clinical presentation is characterised by non-length-dependent, focal, or multifocal symptoms. (Source: Lancet Neurology)
Source: Lancet Neurology - October 11, 2017 Category: Neurology Authors: Astrid J Terkelsen, P áll Karlsson, Giuseppe Lauria, Roy Freeman, Nanna B Finnerup, Troels S Jensen Tags: Review Source Type: research
[Articles] Identification of novel risk loci for restless legs syndrome in genome-wide association studies in individuals of European ancestry: a meta-analysis
Identification of new candidate genes and associated pathways will inform future functional research. Advances in understanding of the molecular mechanisms that underlie restless legs syndrome could lead to new treatment options. We focused on common variants; thus, additional studies are needed to dissect the roles of rare and structural variations. (Source: Lancet Neurology)
Source: Lancet Neurology - October 11, 2017 Category: Neurology Authors: Barbara Schormair, Chen Zhao, Steven Bell, Erik Tilch, Aaro V Salminen, Benno P ütz, Yves Dauvilliers, Ambra Stefani, Birgit Högl, Werner Poewe, David Kemlink, Karel Sonka, Cornelius G Bachmann, Walter Paulus, Claudia Trenkwalder, Wolfgang H Oertel, Mag Tags: Articles Source Type: research
