[Correspondence] Intravenous versus subcutaneous immunoglobulin
We read with interest the Article by Ivo van Schaik and colleagues1 about the use of weekly subcutaneous immunoglobulin (SCIg) in patients with chronic inflammatory demyelinating polyneuropathy (CIDP). After an IgG dependency test, the investigators randomly assigned 172 patients to low-dose SCIg (0 ·2 g/kg), high-dose SCIg (0·4 g/kg), or placebo. Relapse or withdrawal rate was significantly higher in the placebo group (63%) than in the high-dose SCIg group (33%) or low-dose SCIg group (39%). (Source: Lancet Neurology)
Source: Lancet Neurology - April 13, 2018 Category: Neurology Authors: Ravi Uniyal, Ravindra Kumar Garg, Hardeep Singh Malhotra, Neeraj Kumar, Shweta Pandey Tags: Correspondence Source Type: research
[Comment] Understanding risk of PML through multiple sclerosis
Progressive multifocal leukoencephalopathy (PML), first described in 1959, is an often-fatal disease caused by an opportunistic infection by JC virus (JCV), which most human beings carry throughout life without consequences.1,2 PML was a major cause of death in patients with AIDS, but its prevalence decreased sharply with the introduction of retroviral therapy. PML is now mostly seen in patients during chemotherapy or immunosuppression. The first PML cases in patients with multiple sclerosis who were treated with natalizumab came as a surprise in 20053,4 because PML had not been observed with other drugs for multiple scler...
Source: Lancet Neurology - April 13, 2018 Category: Neurology Authors: Roland Martin Tags: Comment Source Type: research
[Comment] Evidence-based care in Duchenne muscular dystrophy
Duchenne muscular dystrophy (DMD) is a severely progressive X-linked recessive neuromuscular disorder. It is caused by mutations in the dystrophin gene that result in absent or insufficient functional dystrophin protein, and manifests as progressive muscle degeneration and weakness with symptom onset between ages 3 and 5 years. The disease primarily affects boys and men, but in rare cases it can affect girls and women. Prevalence of DMD has been reported as one case per 5000 –6000 live male births. (Source: Lancet Neurology)
Source: Lancet Neurology - April 13, 2018 Category: Neurology Authors: Craig M McDonald, Eugenio Mercuri Tags: Comment Source Type: research
[Comment] Prediction to prevention in Alzheimer's disease and dementia
Risks of dementia and Alzheimer's disease reflect the combined effects of age, genetic variants, and social and behavioural determinants.1 In The Lancet Neurology, Sven van der Lee and colleagues2 use data from the Rotterdam Study to address the important task of predicting whether an individual is likely to develop Alzheimer's disease or dementia in his or her lifetime. In this cohort, a genetic risk score (GRS) of 23 genetic variants modified the risk of late-onset Alzheimer's disease or dementia above and beyond the effect of the gene for apolipoprotein E (APOE). (Source: Lancet Neurology)
Source: Lancet Neurology - April 13, 2018 Category: Neurology Authors: Carole Dufouil, M Maria Glymour Tags: Comment Source Type: research
[Editorial] Hope and foresight for your patients with ALS
The astrophysicist Stephen Hawking, arguably the most famous patient with amyotrophic lateral sclerosis (ALS) to date, died on March 14, 2018. He was exceptional in many respects, and so was his disease. Hawking's long survival after an ALS diagnosis (over 50 years) gave hope to other patients, and his case helped ALS specialists illustrate disease variability and prognostic uncertainty. When caring for people with a neurodegenerative disease that usually progresses rapidly, like ALS, prognosis is key to plan medical care and future needs. (Source: Lancet Neurology)
Source: Lancet Neurology - April 13, 2018 Category: Neurology Authors: The Lancet Neurology Tags: Editorial Source Type: research
[Corrections] Corrections
Nonnekes J, Post B, Tetrud JW, Langston JW, Bloem BR. MPTP-induced parkinsonism: an historical case series. Lancet Neurol 2018; 17: 300 –01—The appendix of this Correspondence has been corrected as of March 27, 2018. (Source: Lancet Neurology)
Source: Lancet Neurology - March 27, 2018 Category: Neurology Tags: Corrections Source Type: research
[Review] Diagnosis and assessment of neuropathic pain through questionnaires
Neuropathic pain —pain caused by a lesion or disease of the somatosensory nervous system—is underdiagnosed and difficult to treat. However, development of easy-to-use questionnaires based mainly on self-reports of symptoms has improved diagnosis and management. Two types of questionnaires (screening and assessme nt) have been validated, and rapidly translated and revalidated in several languages, probably because of their simplicity. Screening questionnaires help clinicians to identify neuropathic pain easily, particularly in patients with complex medical conditions (eg, spinal cord injury). (Source: Lancet Neurology)
Source: Lancet Neurology - March 26, 2018 Category: Neurology Authors: Nadine Attal, Didier Bouhassira, Ralf Baron Tags: Review Source Type: research
[Articles] Prognosis for patients with amyotrophic lateral sclerosis: development and validation of a personalised prediction model
We have developed an externally validated model to predict survival without tracheostomy and non-invasive ventilation for more than 23 h per day in European patients with ALS. This model could be applied to individualised patient management, counselling, and future trial design, but to maximise the benefit and prevent harm it is intended to be used by medical doctors only. (Source: Lancet Neurology)
Source: Lancet Neurology - March 26, 2018 Category: Neurology Authors: Henk-Jan Westeneng, Thomas P A Debray, Anne E Visser, Ruben P A van Eijk, James P K Rooney, Andrea Calvo, Sarah Martin, Christopher J McDermott, Alexander G Thompson, Susana Pinto, Xenia Kobeleva, Angela Rosenbohm, Beatrice Stubendorff, Helma Sommer, Bas Tags: Articles Source Type: research
[Comment] What if you knew the prognosis of your patients with ALS?
More than 60 years ago, Karl Jaspers1 stated that when patients plead for the truth, most of them just want assurance. Forbes Norris, one of the most respected American experts on amyotrophic lateral sclerosis (ALS), used to tell his patients: “I think you have ALS, but I might be wrong”. His intention was to try to convey some uncertainty regarding the diagnosis, which could provide hope for some patients. After so many years, have we made any progress in relaying diagnoses and prognoses to patients with ALS? In The Lancet Neurology, a research team led by Leonard van den Berg and colleagues now reports on a comprehen...
Source: Lancet Neurology - March 26, 2018 Category: Neurology Authors: Hiroshi Mitsumoto Tags: Comment Source Type: research
[Review] Diagnosis and assessment of neuropathic pain through questionnaires
Neuropathic pain —pain caused by a lesion or disease of the somatosensory nervous system—is underdiagnosed and difficult to treat. However, development of easy-to-use questionnaires based mainly on self-reports of symptoms has improved diagnosis and management. Two types of questionnaires (screening and assessme nt) have been validated, and rapidly translated and revalidated in several languages, probably because of their simplicity. Screening questionnaires help clinicians to identify neuropathic pain easily, particularly in patients with complex medical conditions (eg, spinal cord injury). (Source: Lancet Neurology)
Source: Lancet Neurology - March 26, 2018 Category: Neurology Authors: Nadine Attal, Didier Bouhassira, Ralf Baron Tags: Review Source Type: research
[Articles] Prognosis for patients with amyotrophic lateral sclerosis: development and validation of a personalised prediction model
We have developed an externally validated model to predict survival without tracheostomy and non-invasive ventilation for more than 23 h per day in European patients with ALS. This model could be applied to individualised patient management, counselling, and future trial design, but to maximise the benefit and prevent harm it is intended to be used by medical doctors only. (Source: Lancet Neurology)
Source: Lancet Neurology - March 26, 2018 Category: Neurology Authors: Henk-Jan Westeneng, Thomas P A Debray, Anne E Visser, Ruben P A van Eijk, James P K Rooney, Andrea Calvo, Sarah Martin, Christopher J McDermott, Alexander G Thompson, Susana Pinto, Xenia Kobeleva, Angela Rosenbohm, Beatrice Stubendorff, Helma Sommer, Bas Tags: Articles Source Type: research
[Comment] What if you knew the prognosis of your patients with ALS?
More than 60 years ago, Karl Jaspers1 stated that when patients plead for the truth, most of them just want assurance. Forbes Norris, one of the most respected American experts on amyotrophic lateral sclerosis (ALS), used to tell his patients: “I think you have ALS, but I might be wrong”. His intention was to try to convey some uncertainty regarding the diagnosis, which could provide hope for some patients. After so many years, have we made any progress in relaying diagnoses and prognoses to patients with ALS? In The Lancet Neurology, a research team led by Leonard van den Berg and colleagues now reports on a comprehen...
Source: Lancet Neurology - March 26, 2018 Category: Neurology Authors: Hiroshi Mitsumoto Tags: Comment Source Type: research
[In Context] Frederik Barkhof: building bridges between disciplines
The early academic journey of Frederik Barkhof was a winding one. As a child he was fascinated by the engineering of buildings and bridges, but then crossed over to study dentistry —“which was a mistake” (a bridge too far, presumably). He next stopped to study at the intersection between philosophy and medicine, until he landed at VU University (Amsterdam, the Netherlands) where he received his MD in 1988. Combining his love of engineering and medicine, Barkhof is now a neuroradiology professor who shares his expertise with both VU University Medical Centre and University College London (UCL, London, UK) and brings d...
Source: Lancet Neurology - March 22, 2018 Category: Neurology Authors: Jules Morgan Tags: In Context Source Type: research
[Correspondence] Accelerated long-term forgetting in asymptomatic APOE ε4 carriers
In The Lancet Neurology, Philip Weston and colleagues report that presymptomatic individuals carrying familial Alzheimer's disease gene mutations demonstrate accelerated long-term forgetting over an extended 1 week retention interval compared with gene-negative controls.1 These findings raise the question of whether accelerated long-term forgetting is also detectable in presymptomatic individuals at genetic risk of the much more common sporadic form of Alzheimer's disease. (Source: Lancet Neurology)
Source: Lancet Neurology - March 22, 2018 Category: Neurology Authors: Jacqueline F Zimmermann, Christopher R Butler Tags: Correspondence Source Type: research
