eanpages
  • General interest
    • All Executive Page Paper of the Month EAN News EAN Congress news COVID-19 Interviews
      EAN News

      EAN endorsed meeting in September 2022

      August 12, 2022

      Executive Page

      Executive Page: New President-Elect outlines aims for EAN’s future agenda

      August 1, 2022

      Paper of the Month

      Research Paper of the Month: Thrombectomy alone versus intravenous alteplase plus thrombectomy in patients with stroke

      August 1, 2022

      EAN News

      Contribute to the EAN Neuro-Covid Registry (ENERGY) and be part of our growing global project

      July 29, 2022

      Executive Page

      Executive Page: New President-Elect outlines aims for EAN’s future agenda

      August 1, 2022

      Executive Page

      New EAN President, Prof. Paul Boon, identifies brain health, research agenda, and residents as key priorities

      July 8, 2022

      Executive Page

      Executive Page: packed programme for our happy reunion at EAN 2022 in Vienna

      June 3, 2022

      Executive Page Dear EAN members, dear friends, It is my pleasure to give you an update on behalf of the EAN Scientific Committee following a busy year since my appointment as chair. It has been a privilege to be so deeply involved in the scientific activities of the EAN and to work closely with an amazing community of people who are so dedicated to the advancement of neurology. One of the strongest threads within that community is the EAN’s group of Scientific Panels, which are often referred to as the organisation’s ‘scientific backbone’. The panels have a hand in everything the EAN does from a scientific point of view, including coordinating clinical research, disseminating good practice, assisting in planning the EAN annual congress, supporting the EAN’s educational efforts, and producing guidelines that assist neurologists in daily practice. All of this work requires a considerable amount of oversight, and this is why each panel is run by its own Management Group, elected by the panel members. Being a part of one of these Management Groups (PDF) is an opportunity to play a direct part in determining the direction of scientific progress within Europe, and I am excited to say that the call for applications to stand for election will be announced in September. All panel members and EAN individual members are eligible to apply to be candidates, with the vote being held among the existing panel members in autumn. I would like to urge every neurologist with a passion for the scientific future of their special area of interest to consider standing for election to the relevant Management Group and to look out for the call for applications later this month. I can tell you from personal experience that fulfilling a role such as this within the structure of the EAN is a fascinating and extremely rewarding experience. The chance to take on such a unique leadership position should not be missed! The most satisfying aspect of being involved in the EAN’s organisational structure is surely seeing all the hard work and planning come to fruition when a small idea evolves into a newly launched project. One such example is the 1st EAN Science School, taking place in Salzburg next March. The idea of the Science School is to offer early career neurologists with an interest in translational research a new avenue for learning about basic pathomechanisms of neurological disorders. Application for this very first edition, on ‘Pathophysiology of disorders of the nervous system’, closed last week and we have been delighted with the level of interest. It was a pleasure to be part of the task force in charge of planning this new project and I look forward to seeing it officially transferred to the hands of the Scientific Committee after a successful event and evaluation in spring. Of our ongoing activities, one of the most significant is the EAN Neuro-covid Registry, which aims to collate epidemiological data on neurological manifestations in patients with COVID-19 infection reported by neurologists in outpatient services, emergency rooms, and hospital departments. We currently have 1,542 patients entered in the database, from 35 centres across 23 countries. So far, 29 patients have been followed for 12 months and 387 have completed the 6-months follow up. This is a decent start, but I would like to strongly encourage EAN members and their institutions to get involved and contribute cases to what will become an invaluable resource for neurologists and clinicians to improve care for Covid-19 patients. Finally, I would like share a word on a forthcoming collaboration between EAN and the Human Brain Project in December, that I think will interest a lot of EAN members. The EAN-EBRAINS joint workshop on ‘The future of medical data sharing in clinical neurosciences’ will be a three-day virtual event that aims to discuss issues and challenges associated with data sharing in Europe, from ethics to data safety and privacy, including those specific to data federation, such as the development and validation of federated algorithms. The whole workshop is completely free of charge and registration is open until 25 November, so please check out the details and sign up! I wish you all a healthy and pleasant autumn and I look forward to updating you again. Best wishes Thomas Berger Chair of the EAN Scientific Committee

      Executive Page: Join the EAN Panels and reinforce our scientific backbone! (Plus ENERGY update, and our first Science School)

      May 1, 2022

      Paper of the Month

      Research Paper of the Month: Thrombectomy alone versus intravenous alteplase plus thrombectomy in patients with stroke

      August 1, 2022

      Paper of the Month

      Research Paper of the Month: Association of intraventricular fibrinolysis with clinical outcomes in ICH: an individual participant data meta-analysis

      July 8, 2022

      Paper of the Month

      Covid-19 Paper of the month: Widespread white matter oedema in subacute COVID-19 patients with neurological symptoms

      July 8, 2022

      Paper of the Month

      Research Paper of the Month: Healthy lifestyle and life expectancy with and without Alzheimer’s dementia: population based cohort study

      June 3, 2022

      EAN News

      EAN endorsed meeting in September 2022

      August 12, 2022

      EAN News

      Executive Page: New President-Elect outlines aims for EAN’s future agenda

      August 1, 2022

      EAN News

      Research Paper of the Month: Thrombectomy alone versus intravenous alteplase plus thrombectomy in patients with stroke

      August 1, 2022

      EAN News

      Contribute to the EAN Neuro-Covid Registry (ENERGY) and be part of our growing global project

      July 29, 2022

      EAN Congress news

      Video Interview: Sleep-Wake Panel Co-Chair, Dr. Evelina Pajediene

      July 28, 2022

      EAN Congress news

      Watch the full EAN 2022 Opening Session on our Vimeo channel!

      July 11, 2022

      EAN Congress news

      New EAN President, Prof. Paul Boon, identifies brain health, research agenda, and residents as key priorities

      July 8, 2022

      EAN Congress news

      Video Interview: WFN President, Prof. Wolfgang Grisold

      July 7, 2022

      COVID-19

      Contribute to the EAN Neuro-Covid Registry (ENERGY) and be part of our growing global project

      July 29, 2022

      COVID-19

      COVID-19 Breaking News: Case Series/Case Reports – July 2022

      July 18, 2022

      COVID-19

      COVID-19 Breaking News: Meta-analyses/systematic reviews – July 2022

      July 18, 2022

      COVID-19

      COVID-19 Breaking News: Cross-Sectional Case Control Studies – July 2022

      July 18, 2022

      Interviews

      Video Interview: Sleep-Wake Panel Co-Chair, Dr. Evelina Pajediene

      July 28, 2022

      Interviews

      Video: EAN supports World Brain Day

      July 19, 2022

      Interviews

      Video Interview: European Journal of Neurology Award winner, Dr. Jonathan Coutinho

      July 18, 2022

      Interviews

      Video Interview: WFN President, Prof. Wolfgang Grisold

      July 7, 2022

  • Academic/Scientific
    • All Breaking news Neurology updates Scientific committee reports Scientific panels reports Eur J Neurol Top 10 Articles Scientific Corner
      EAN News

      Contribute to the EAN Neuro-Covid Registry (ENERGY) and be part of our growing global project

      July 29, 2022

      Academic/Scientific

      2nd EAN Science School, 18-20 March 2023

      July 20, 2022

      Breaking news

      COVID-19 Breaking News: Case Series/Case Reports – July 2022

      July 18, 2022

      Breaking news

      COVID-19 Breaking News: Meta-analyses/systematic reviews – July 2022

      July 18, 2022

      Breaking news

      COVID-19 Breaking News: Case Series/Case Reports – July 2022

      July 18, 2022

      Breaking news

      COVID-19 Breaking News: Meta-analyses/systematic reviews – July 2022

      July 18, 2022

      Breaking news

      COVID-19 Breaking News: Cross-Sectional Case Control Studies – July 2022

      July 18, 2022

      Breaking news

      COVID-19 Breaking News: Observational studies – prospective longitudinal cohort – June 2022

      June 8, 2022

      Neurology updates

      Neurology Update: Palliative care

      July 6, 2021

      Neurology updates

      Neurology Update: Clinical Neurophysiology

      June 2, 2021

      Neurology updates Hannover Medical School

      Progressive multifocal leukoencephalopathy – promising therapeutic approach with allogeneic BK virus-specific T cells

      May 17, 2021

      Neurology updates

      Neurology Update: Neuroimmunology

      May 12, 2021

      Scientific committee reports

      Scientific Committee Snapshot: Didier Leys

      April 1, 2020

      Scientific committee reports

      Scientific Committee Snapshot: Rigmor Hojland

      February 26, 2020

      Scientific committee reports

      Scientific Committee Snapshot: Christian Enzinger

      December 1, 2019

      Scientific committee reports

      Scientific Committee Snapshot: Maurizio Leone

      November 1, 2019

      Scientific panels reports

      Coma and DOC Panel Update (May-June): news from the EAN Virtual Congress, personalized pain assessment, NIRS-EEG and machine learning to predict outcomes, prevalence of swallowing disorders and new multimodal predictive algorithms.

      August 11, 2020

      Scientific panels reports

      Statement of the EAN Sleep-Wake-Panel

      June 3, 2020

      Scientific panels reports

      Rare Neurological Diseases in the COVID-19 era: Suggestions for information to patients and caregivers

      May 13, 2020

      Scientific panels reports

      Scentific Panel of the Month: Higher Cortical Functions

      March 2, 2020

      Eur J Neurol

      Video Interview: European Journal of Neurology Award winner, Dr. Jonathan Coutinho

      July 18, 2022

      Eur J Neurol

      EAN NeuroCOVID-19 Task Force position paper on COVID-19 vaccination hesitancy among people with chronic neurological disorders

      May 2, 2022

      Eur J Neurol

      European Journal of Neurology welcomes new associate editors

      December 13, 2021

      Eur J Neurol

      New European guideline and expert statements on the management of narcolepsy in adults and children

      June 30, 2021

      Top 10 Articles

      EAN is proud to announce the 2020 Virtual Master Classes Christmas Special

      November 13, 2020

      Top 10 Articles

      EUROPEAN JOURNAL OF NEUROLOGY – TOP 15 ARTICLES 2018

      February 1, 2019

      Top 10 Articles

      Interview with Prof. Patrick Cras – UEMS Section of Neurology (SN)

      February 3, 2018

      Top 10 Articles

      Interview with Mr. Bertrand Daval and Mrs. Nathalie Paulus

      February 3, 2018

      Scientific Corner

      Join the EAN Guideline Workshop on 24 June!

      May 13, 2022

      Scientific Corner

      First EAN Science School proves a hit in Salzburg

      April 1, 2022

      Scientific Corner

      Invitation to the EAN-EBRAINS Joint Workshop on ‘The Future of Medical Data Sharing in Clinical Neurosciences’

      July 2, 2021

      Scientific Corner

      1st EAN Science School, 26-29 March 2022: “Pathophysiology of disorders of the nervous system”

      June 18, 2021

  • Educational
    • All eLearning Student Corner E-Brain Grand Rounds Resident and Research Fellows Fellowship reports Education corner
      Fellowship reports

      Clinical Fellowship Reports 2022 – Ulm, Oxford, London

      August 17, 2022

      Resident and Research Fellows

      Next matching round for EAN Mentorship Programme: 15 September

      August 16, 2022

      Fellowship reports

      Clinical Fellowship Reports 2022 – Oxford, Bern, London

      July 28, 2022

      Academic/Scientific

      2nd EAN Science School, 18-20 March 2023

      July 20, 2022

      eLearning

      Listen now to ‘eanCast: Weekly Neurology’ our latest eLearning resource

      July 14, 2022

      eLearning

      EAN Campus: Your source for online neurology education!

      June 24, 2022

      eLearning

      eanCast: Weekly Neurology

      June 24, 2022

      eLearning

      Meet our new eLearning Associate Editors

      August 12, 2021

      Student Corner

      EAN 2022 ‘Why Neurology?’ essay contest winners

      June 2, 2022

      Student Corner

      Students’ Corner: A day in the life of a medical student in your country

      May 20, 2022

      Student Corner

      Student Teaser Fellowship winners 2022

      May 11, 2022

      Student Corner

      ‘Why Neurology?’ student essay competition: win a travel grant for a future EAN Congress!

      March 14, 2022

      E-Brain

      ebrain May update: new website and podcast series

      May 1, 2021

      E-Brain

      EBRA launches 3rd call for clusters

      May 1, 2020

      E-Brain

      News from ebrain

      February 28, 2020

      E-Brain

      ebrain to host the 2019 Neurology Formative Test Questions, from 15 April to 26 May

      April 1, 2019

      Grand Rounds

      eBrain: virtual case report from Belgium

      October 2, 2017

      Grand Rounds

      Free access to Ebrain for EAN members

      July 1, 2016

      Grand Rounds

      Ebrain granted Royal College of Physicians (UK) CPD/CME accreditation

      July 1, 2016

      Grand Rounds

      ebrain session of the month: neuromuscular junction

      February 1, 2016

      Resident and Research Fellows

      Next matching round for EAN Mentorship Programme: 15 September

      August 16, 2022

      Resident and Research Fellows

      Workshop at EAN 2022 raises awareness of mentorship benefits

      July 5, 2022

      Resident and Research Fellows

      First ever UK Regional Teaching Course held in Liverpool, in person

      July 4, 2022

      Resident and Research Fellows

      RRFS Special Session – Unveiling research in Neurology: differences between basic, clinical and translational

      June 25, 2022

      Fellowship reports

      Clinical Fellowship Reports 2022 – Ulm, Oxford, London

      August 17, 2022

      Fellowship reports

      Clinical Fellowship Reports 2022 – Oxford, Bern, London

      July 28, 2022

      Fellowship reports

      Clinical Fellowship Reports 2021 – Bucharest & Padova

      July 15, 2022

      Fellowship reports

      Research Fellowship Report 2021 – Inselspital Bern, Switzerland

      July 15, 2022

      Education corner

      Clinical Fellowship Reports 2022 – Ulm, Oxford, London

      August 17, 2022

      Education corner

      Next matching round for EAN Mentorship Programme: 15 September

      August 16, 2022

      Education corner

      Clinical Fellowship Reports 2022 – Oxford, Bern, London

      July 28, 2022

      Education corner

      Clinical Fellowship Reports 2021 – Bucharest & Padova

      July 15, 2022

  • Other News
    • All EAN Staff Grant opportunities News from EAN member societies EBC EFNA News in general Patients societies reports Surveys Forum
      Other News

      The role of EAN in the European Medicine Agency

      August 2, 2022

      News from EAN member societies

      14 June: Special publication celebrates 10 years of the European Working Group of People with Dementia

      August 2, 2022

      News from EAN member societies

      14 June: Alzheimer Europe hosts European Parliament Lunch Debate examining EU and WHO policies on neurological conditions

      August 2, 2022

      News from EAN member societies

      22 June: Alzheimer Europe invites applications for its new Anti-Stigma Award

      August 2, 2022

      EAN Staff

      EAN Head Office Profiles: Patrycja & Martin

      July 28, 2022

      EAN Staff

      EAN Head Office Profiles: Anja S

      July 12, 2022

      EAN Staff

      EAN Head Office Profiles: Magda & Lindley

      June 7, 2022

      EAN Staff

      EAN Head Office Profiles: Julia & Maria

      April 4, 2022

      Grant opportunities

      1st EAN Science School, 26-29 March 2022: “Pathophysiology of disorders of the nervous system”

      June 18, 2021

      Grant opportunities

      European Commission: Innovation and novelty in medical devices and in vitro diagnostic devices; towards common concepts of innovation-related risk assessments

      November 1, 2019

      Grant opportunities

      GBS|CIDP Foundation International 2020 Research Grant Opportunity

      October 29, 2019

      Grant opportunities

      The Clinical Fellowship application deadline is approaching

      October 1, 2019

      News from EAN member societies

      14 June: Special publication celebrates 10 years of the European Working Group of People with Dementia

      August 2, 2022

      News from EAN member societies

      14 June: Alzheimer Europe hosts European Parliament Lunch Debate examining EU and WHO policies on neurological conditions

      August 2, 2022

      News from EAN member societies

      22 June: Alzheimer Europe invites applications for its new Anti-Stigma Award

      August 2, 2022

      News from EAN member societies

      Alzheimer Europe publishes new reports on ‘sex, gender and sexuality in the context of dementia’, and ‘dementia-inclusive initiatives and communities’

      April 5, 2022

      EBC

      Value of Treatment project releases results and calls to action

      March 29, 2022

      EBC

      Best practices for patient safety: An EU-wide view on the use of medicines off-label

      December 31, 2021

      EBC

      Creating synergies and showcasing innovation: Brain Innovation Days 2021

      November 30, 2021

      EBC

      Best practices for patient safety: Register now!

      October 28, 2021

      EFNA

      OneNeurology European Summit underlines urgent need to prioritise neurology and drive change

      December 31, 2021

      EFNA

      EFNA launch eLearning Platform for neurology advocates

      February 1, 2021

      EFNA

      ‘Me and My Brain’ – Art Competition winners announced!

      February 1, 2021

      EFNA

      Survey on the impact of COVID-19 on neurology service delivery

      November 1, 2020

      News in general

      EAN lecture at the International Neuro-Urology Society annual congress 2022

      May 25, 2022

      News in general

      EPA-EAN Joint Symposium: ‘Etiology and Treatment of the Long Covid-19 Syndrome’ and other highlights at the 30th European Congress of Psychiatry

      May 25, 2022

      News in general

      Organise an EAN-Day or EAN Regional Teaching Course in your Country!

      May 17, 2022

      News in general

      Value of Treatment project releases results and calls to action

      March 29, 2022

      Patients societies reports

      News from Alzheimer Europe

      March 2, 2020

      Patients societies reports

      News from the WHO

      January 9, 2020

      Patients societies reports

      News from EFIC and the European Pain Forum

      January 3, 2020

      Patients societies reports

      News from EFIC and the European Pain Forum

      January 2, 2020

      Surveys

      Survey: management of covert brain infarction

      October 29, 2021

      Surveys

      Driving with an intracranial tumor

      July 13, 2020

      Surveys

      SURVEY: Driving with an intracranial tumor

      June 25, 2020

      Surveys

      EAN SURVEY: Neurological Symptoms in COVID-19 Patients

      April 10, 2020

      Forum

      Call for Applications: e-Learning Platform Editor-in-Chief

      August 4, 2020

      Forum

      Neurological News from Denmark VI – the land of the 2nd EAN congress 2016: Pain Research in Denmark from a neurological perspective

      April 1, 2016

      Forum

      Neurological News from Denmark V – the land of the 2nd EAN congress 2016: Clinical Dementia Research in Denmark

      March 1, 2016

      Forum

      Updated recommendations to minimise the risk of the rare brain infection PML with Tysabri – Comment to EMA recommendation

      March 1, 2016

  • EAN
  • Congress 2022
  • EAN pages
  • Eur J Neurol
  • Virtual Congress

eanpages

  • General interest
    • All Executive Page Paper of the Month EAN News EAN Congress news COVID-19 Interviews
      EAN News

      EAN endorsed meeting in September 2022

      August 12, 2022

      Executive Page

      Executive Page: New President-Elect outlines aims for EAN’s future agenda

      August 1, 2022

      Paper of the Month

      Research Paper of the Month: Thrombectomy alone versus intravenous alteplase plus thrombectomy in patients with stroke

      August 1, 2022

      EAN News

      Contribute to the EAN Neuro-Covid Registry (ENERGY) and be part of our growing global project

      July 29, 2022

      Executive Page

      Executive Page: New President-Elect outlines aims for EAN’s future agenda

      August 1, 2022

      Executive Page

      New EAN President, Prof. Paul Boon, identifies brain health, research agenda, and residents as key priorities

      July 8, 2022

      Executive Page

      Executive Page: packed programme for our happy reunion at EAN 2022 in Vienna

      June 3, 2022

      Executive Page Dear EAN members, dear friends, It is my pleasure to give you an update on behalf of the EAN Scientific Committee following a busy year since my appointment as chair. It has been a privilege to be so deeply involved in the scientific activities of the EAN and to work closely with an amazing community of people who are so dedicated to the advancement of neurology. One of the strongest threads within that community is the EAN’s group of Scientific Panels, which are often referred to as the organisation’s ‘scientific backbone’. The panels have a hand in everything the EAN does from a scientific point of view, including coordinating clinical research, disseminating good practice, assisting in planning the EAN annual congress, supporting the EAN’s educational efforts, and producing guidelines that assist neurologists in daily practice. All of this work requires a considerable amount of oversight, and this is why each panel is run by its own Management Group, elected by the panel members. Being a part of one of these Management Groups (PDF) is an opportunity to play a direct part in determining the direction of scientific progress within Europe, and I am excited to say that the call for applications to stand for election will be announced in September. All panel members and EAN individual members are eligible to apply to be candidates, with the vote being held among the existing panel members in autumn. I would like to urge every neurologist with a passion for the scientific future of their special area of interest to consider standing for election to the relevant Management Group and to look out for the call for applications later this month. I can tell you from personal experience that fulfilling a role such as this within the structure of the EAN is a fascinating and extremely rewarding experience. The chance to take on such a unique leadership position should not be missed! The most satisfying aspect of being involved in the EAN’s organisational structure is surely seeing all the hard work and planning come to fruition when a small idea evolves into a newly launched project. One such example is the 1st EAN Science School, taking place in Salzburg next March. The idea of the Science School is to offer early career neurologists with an interest in translational research a new avenue for learning about basic pathomechanisms of neurological disorders. Application for this very first edition, on ‘Pathophysiology of disorders of the nervous system’, closed last week and we have been delighted with the level of interest. It was a pleasure to be part of the task force in charge of planning this new project and I look forward to seeing it officially transferred to the hands of the Scientific Committee after a successful event and evaluation in spring. Of our ongoing activities, one of the most significant is the EAN Neuro-covid Registry, which aims to collate epidemiological data on neurological manifestations in patients with COVID-19 infection reported by neurologists in outpatient services, emergency rooms, and hospital departments. We currently have 1,542 patients entered in the database, from 35 centres across 23 countries. So far, 29 patients have been followed for 12 months and 387 have completed the 6-months follow up. This is a decent start, but I would like to strongly encourage EAN members and their institutions to get involved and contribute cases to what will become an invaluable resource for neurologists and clinicians to improve care for Covid-19 patients. Finally, I would like share a word on a forthcoming collaboration between EAN and the Human Brain Project in December, that I think will interest a lot of EAN members. The EAN-EBRAINS joint workshop on ‘The future of medical data sharing in clinical neurosciences’ will be a three-day virtual event that aims to discuss issues and challenges associated with data sharing in Europe, from ethics to data safety and privacy, including those specific to data federation, such as the development and validation of federated algorithms. The whole workshop is completely free of charge and registration is open until 25 November, so please check out the details and sign up! I wish you all a healthy and pleasant autumn and I look forward to updating you again. Best wishes Thomas Berger Chair of the EAN Scientific Committee

      Executive Page: Join the EAN Panels and reinforce our scientific backbone! (Plus ENERGY update, and our first Science School)

      May 1, 2022

      Paper of the Month

      Research Paper of the Month: Thrombectomy alone versus intravenous alteplase plus thrombectomy in patients with stroke

      August 1, 2022

      Paper of the Month

      Research Paper of the Month: Association of intraventricular fibrinolysis with clinical outcomes in ICH: an individual participant data meta-analysis

      July 8, 2022

      Paper of the Month

      Covid-19 Paper of the month: Widespread white matter oedema in subacute COVID-19 patients with neurological symptoms

      July 8, 2022

      Paper of the Month

      Research Paper of the Month: Healthy lifestyle and life expectancy with and without Alzheimer’s dementia: population based cohort study

      June 3, 2022

      EAN News

      EAN endorsed meeting in September 2022

      August 12, 2022

      EAN News

      Executive Page: New President-Elect outlines aims for EAN’s future agenda

      August 1, 2022

      EAN News

      Research Paper of the Month: Thrombectomy alone versus intravenous alteplase plus thrombectomy in patients with stroke

      August 1, 2022

      EAN News

      Contribute to the EAN Neuro-Covid Registry (ENERGY) and be part of our growing global project

      July 29, 2022

      EAN Congress news

      Video Interview: Sleep-Wake Panel Co-Chair, Dr. Evelina Pajediene

      July 28, 2022

      EAN Congress news

      Watch the full EAN 2022 Opening Session on our Vimeo channel!

      July 11, 2022

      EAN Congress news

      New EAN President, Prof. Paul Boon, identifies brain health, research agenda, and residents as key priorities

      July 8, 2022

      EAN Congress news

      Video Interview: WFN President, Prof. Wolfgang Grisold

      July 7, 2022

      COVID-19

      Contribute to the EAN Neuro-Covid Registry (ENERGY) and be part of our growing global project

      July 29, 2022

      COVID-19

      COVID-19 Breaking News: Case Series/Case Reports – July 2022

      July 18, 2022

      COVID-19

      COVID-19 Breaking News: Meta-analyses/systematic reviews – July 2022

      July 18, 2022

      COVID-19

      COVID-19 Breaking News: Cross-Sectional Case Control Studies – July 2022

      July 18, 2022

      Interviews

      Video Interview: Sleep-Wake Panel Co-Chair, Dr. Evelina Pajediene

      July 28, 2022

      Interviews

      Video: EAN supports World Brain Day

      July 19, 2022

      Interviews

      Video Interview: European Journal of Neurology Award winner, Dr. Jonathan Coutinho

      July 18, 2022

      Interviews

      Video Interview: WFN President, Prof. Wolfgang Grisold

      July 7, 2022

  • Academic/Scientific
    • All Breaking news Neurology updates Scientific committee reports Scientific panels reports Eur J Neurol Top 10 Articles Scientific Corner
      EAN News

      Contribute to the EAN Neuro-Covid Registry (ENERGY) and be part of our growing global project

      July 29, 2022

      Academic/Scientific

      2nd EAN Science School, 18-20 March 2023

      July 20, 2022

      Breaking news

      COVID-19 Breaking News: Case Series/Case Reports – July 2022

      July 18, 2022

      Breaking news

      COVID-19 Breaking News: Meta-analyses/systematic reviews – July 2022

      July 18, 2022

      Breaking news

      COVID-19 Breaking News: Case Series/Case Reports – July 2022

      July 18, 2022

      Breaking news

      COVID-19 Breaking News: Meta-analyses/systematic reviews – July 2022

      July 18, 2022

      Breaking news

      COVID-19 Breaking News: Cross-Sectional Case Control Studies – July 2022

      July 18, 2022

      Breaking news

      COVID-19 Breaking News: Observational studies – prospective longitudinal cohort – June 2022

      June 8, 2022

      Neurology updates

      Neurology Update: Palliative care

      July 6, 2021

      Neurology updates

      Neurology Update: Clinical Neurophysiology

      June 2, 2021

      Neurology updates Hannover Medical School

      Progressive multifocal leukoencephalopathy – promising therapeutic approach with allogeneic BK virus-specific T cells

      May 17, 2021

      Neurology updates

      Neurology Update: Neuroimmunology

      May 12, 2021

      Scientific committee reports

      Scientific Committee Snapshot: Didier Leys

      April 1, 2020

      Scientific committee reports

      Scientific Committee Snapshot: Rigmor Hojland

      February 26, 2020

      Scientific committee reports

      Scientific Committee Snapshot: Christian Enzinger

      December 1, 2019

      Scientific committee reports

      Scientific Committee Snapshot: Maurizio Leone

      November 1, 2019

      Scientific panels reports

      Coma and DOC Panel Update (May-June): news from the EAN Virtual Congress, personalized pain assessment, NIRS-EEG and machine learning to predict outcomes, prevalence of swallowing disorders and new multimodal predictive algorithms.

      August 11, 2020

      Scientific panels reports

      Statement of the EAN Sleep-Wake-Panel

      June 3, 2020

      Scientific panels reports

      Rare Neurological Diseases in the COVID-19 era: Suggestions for information to patients and caregivers

      May 13, 2020

      Scientific panels reports

      Scentific Panel of the Month: Higher Cortical Functions

      March 2, 2020

      Eur J Neurol

      Video Interview: European Journal of Neurology Award winner, Dr. Jonathan Coutinho

      July 18, 2022

      Eur J Neurol

      EAN NeuroCOVID-19 Task Force position paper on COVID-19 vaccination hesitancy among people with chronic neurological disorders

      May 2, 2022

      Eur J Neurol

      European Journal of Neurology welcomes new associate editors

      December 13, 2021

      Eur J Neurol

      New European guideline and expert statements on the management of narcolepsy in adults and children

      June 30, 2021

      Top 10 Articles

      EAN is proud to announce the 2020 Virtual Master Classes Christmas Special

      November 13, 2020

      Top 10 Articles

      EUROPEAN JOURNAL OF NEUROLOGY – TOP 15 ARTICLES 2018

      February 1, 2019

      Top 10 Articles

      Interview with Prof. Patrick Cras – UEMS Section of Neurology (SN)

      February 3, 2018

      Top 10 Articles

      Interview with Mr. Bertrand Daval and Mrs. Nathalie Paulus

      February 3, 2018

      Scientific Corner

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Paper of the MonthGeneral interestFeatured Slider

Paper of the month: Stem cell transplantation vs continued disease-modifying therapy in patients with relapsing-remitting multiple sclerosis

March 1, 2019

 

 

by Tom Jenkins

 

 

 

For March 2019, we have selected: Burt RK Balabanov, MD Burman J, et al. Effect of nonmyeloablative haematopoietic stem cell transplantation vs continued disease-modifying therapy on disease progression in patients with relapsing-remitting multiple sclerosis. JAMA 2019;321(2):165-174.

Stem cells are a highly topical research area in clinical neurology. Approaches vary from attempts at nerve regeneration to exploitation of immunological effects. Our paper of the month reports an open label trial, assessing the effect of haematopoietic stem cell transplantation (HSCT), which seeks to harness the latter mechanism of action, in patients with relapsing-remitting multiple sclerosis (MS). Following cyclophosphamide induction, the authors propose that a “reset” of the immune system occurs after subsequent repopulation with autologous peripherally-harvested haematopoietic stem cells. Encouraging outcome data are presented.

The first author of this international multi-centre open label trial is based at Northwestern University in Chicago, USA, and the study was performed in collaboration with three other centres from Sheffield, UK, Uppsala, Sweden and Sao Paolo, Brazil. One hundred and ten patients with highly active relapsing-remitting MS and moderate disability scores were recruited over 11 years. Inclusion criteria were age 18-55 years, relapsing-remitting MS by standard McDonald criteria, with two or more clinical relapses (or one relapse and gadolinium enhancement at a separate timepoint) within 12 months despite treatment with an established disease-modifying therapy, and an Expanded Disability Status Score (EDSS) of 2-6 (mobile patients, at worst using one stick to walk). Exclusion criteria were progressive MS, hereditary neurological diseases, pregnancy, pulmonary, cardiac, renal or liver dysfunction, abnormal platelet or white cell counts, active infection, prior treatment with alemtuzumab (this was justified on the basis that persistent lymphopenia could increase risk in the setting of a HSCT) or mitoxantrone, use of natalizumab within the last 6 months, fingolimod within 3 months or persistent elevated teriflunomide levels despite cholestyramine treatment.

Patients were randomised either to HSCT or a disease-modifying therapy of higher efficacy or a different mechanism of action to their previous treatment, at the discretion of their treating neurologist. In this control group, additional treatment with steroids, rituximab, intravenous immunoglobulin or cyclophosphamide was allowed, but octrelizumab was not.  After a year of treatment, patients in the disease-modifying therapy group were allowed to cross over to HSCT if they had experienced progression of disability.

In the HSCT group, disease-modifying therapies were discontinued and there was a washout period of 6 months for natalizumab, 3 months for fingolimod, and dimethyl fumarate, 4 months for rituximab, and treatment with either cholestyramine or charcoal clearance for teriflunomide. Interferon and glatiramer acetate were continued until initiation of HSCT. No other immune-based therapies were given after HSCT unless the patients experienced clinical relapse, or new lesions on MRI (the numbers in whom this was necessary were not reported).

Peripheral blood stem cells were collected 10 days after intravenous cyclophosphamide (2g/m2) and 5 days after subcutaneous filgrastim (5-10 micrograms/kg). Immune ablation was achieved with intravenous cyclophosphamide 50mg/kg from days -5 to -2 and rabbit antithymocyte globulin from days -5 to -1 before stem cell infusion on day zero. An oral tail of steroids was given from day zero to day 11. The median hospital stay was 10 days. Oral acyclovir was given for a year and trimethoprim-sulphamethoxazole or nebulised pentamidine for 3 months.

The primary outcome was time to MS-related disease progression, defined as worsening of EDSS by at least one point on two evaluations by a blinded neurologist six months apart after at least one year of treatment. Evaluations were postponed in cases of intercurrent fever/infection. To avoid unblinding of assessors, all study participants wore wigs at these evaluations. Secondary outcomes were survival, relapses (defined as new neurological symptoms >24 hours in absence of infection and requiring treatment with steroids), neurologic rating scale scores, MRI T2-weighted lesion volume, SF-36 quality of life questionnaire and MS functional composite scores. No evidence of disease activity (NEDA), defined as no clinical progression, no relapses and no MRI activity was added as a post-hoc outcome. Adverse events were graded according to established criteria.

Nine hundred and thirty six patients were evaluated, of whom 110 met inclusion criteria. Fifty five patients were randomised to each group. Use of interferon-1a was more common in the control group; there were no other between-group differences at baseline. Three patients in the HSCT group and 4 in the control group withdrew. Therapies given in the control group were natalizumab (21), dimethyl fumarate (14), fingolimod (14), glatiramer (9), interferon beta-1a (7), mitoxantrone (6) and teriflunomide (1), steroids (38), rituximab (2), and one each received plasmapheresis, cyclophosphamide and intravenous immunoglobulin.

EDSS worsened by at least one point in 3 patients in the HSCT group and in 34 in the control group after median follow-up of 2 years (mean 2.8 years). Mean EDSS improved by 1.02 points at 1 year in the HSCT group and worsened by 0.67 points in the control group. Median time to progression was not calculable in the HSCT group because too few events occurred. There were no deaths in either group. Results of relapse rates, EDSS disability scores, neurologic rating scale scores, SF-36 quality of life, MS functional composite scores, T2 lesion volume and proportion of patients with NEDA all favoured the HSCT group at 1 year. For relapses and NEDA, improvements appeared maintained in the smaller numbers with available follow-up to 4-5 years.

Three inpatient infections (one C difficile diarrhoea, one E.coli urinary tract infection and one culture-negative pneumonia) were reported in the HSCT group. Thirty one post-transplant infections occurred in the HSCT group and 25 in the control group. Two cases of idiopathic thrombocytopenic purpura occurred in the HSCT group, one of whom had also received fingolimod, and there were three cases of thyroid dysfunction, all in patients who had been previously treated with interferon.

The authors concluded that their first randomised trial of HSCT in relapsing-remitting MS showed prolonged time to disease progression, and the degree of improvement is the largest seen to date. Limitations include the relatively small numbers, inability to assess longer-term outcomes in the control group given the crossover study design, the non-inclusion of alemtuzumab as an active comparator, and the lack of masking for relapse evaluators. The pragmatic open label study design is less robust than a fully blinded placebo-controlled trial but the nature of the intervention makes inclusion of a sham control group practically difficult. The findings now need to be replicated and longer term outcomes assessed.

“This is a very exciting therapy. The improvements in EDSS score and NEDA data are unprecedented”, said Prof Basil Sharrack, Department of Neurology, Sheffield Institute for Translational Neuroscience (SITraN) University of Sheffield, who was one of the Principal Investigators at the UK trial site. “In addition, HSCT using this regimen appears safe, which had been a concern with some of the previous studies. Further work is now needed to define the place of HSCT in the armamentarium of the neurologist treating patients with MS”

Prof David B. Vodusek, Division of Neurology, University Medical Center Ljubljana, Slovenia commented: “This is a most promising work. It will be important that these safety and efficacy data are replicated in other patient populations and that long term outcomes are evaluated. It would be interesting to see a direct comparison with patients treated with alemtuzumab, and further work to determine the relative contributions of cyclophosphamide conditioning and the stem cells themselves to the observed therapeutic effect.”

 

The other nominees for March 2019 Paper of the month are:

  • Verschuur CVM, Suwijn SR, Boel JA, et al, for the LEAP Study Group. Randomized delayed-start trial of levodopa in Parkinson’s disease. NEJM 2019;380:315-324. The potential effects of levodopa as disease-modifying drug was studied in this multicenter, double-blind, placebo controlled, delayed-start trial. A total of 445 patients with Parkinson’s disease were assigned to receive 100 mg levodopa TID as an early-start (222 patients followed for 80 weeks) or delayed-start (223 patients who had placebo for 40 weeks followed by levodopa for another 40 weeks). No differences were found between groups in the mean changes from baseline to week 80 in the UPDRS scores. Moreover, there were no differences in dyskinesia and motor fluctuations.
  • The RIGHT-2 Investigators. Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): an ambulance-based,randomised, sham-controlled, blinded, phase 3 trial. Lancet Neurology    February 6, 2019. Doi.org/S0140-6736(19)30194-1. In this multicenter, ambulance-based, randomized, sham-controlled study, the authors analyzed the effects of early administration of transdermal nitroglycerine on post-stroke functional outcome. A total of 1,149 patients were recruited in UK. No differences in outcome was found between the nitroglycerine group (568) and the sham group (581) at 90 days.
  • Hanley DF, Thompson RE, Rosenblum M, et al, for the MISTIE III Investigators. Efficacy and safety of minimally invasive surgery with thrombolysis in intracerebral haemorrhage evacuation (MISTIE III): a randomised, controlled, open-label, blinded endpoint phase 3 trial. Lancet Neurol February 7, 2019. doi.org/10.1016/S0140-6736(19)30195-3. Functional outcome after minimally invasive catheter evacuation of supratentorial intracerebral hematomas of moderate to large size followed by thrombolysis (MISTIE) was assessed in this open-label, phase 3, multicenter trial. No differences were found between the 255 patients allocated to MISTIE and the 251 who received standard medical care.
  • Connolly SJ, Crowther M, Eikelboom JW, et al., for the ANNEXA-4 Investigators. Full Study Report of Andexanet Alfa for Bleeding Associated with Factor Xa Inhibitors. NEJM February 7, doi: 10.1056/NEJMoa1814051. A total of 325 patients with acute major bleeding (intracranial or gastrointestinal) were assessed after administration of the factor Xa inhibitor andexanet. Treatment could reduce anti-factor Xa activity and provide satisfactory hemostatic effect at 12 hours.

 

 

Paper of the month: Stem cell transplantation vs continued disease-modifying therapy in patients with relapsing-remitting multiple sclerosis was last modified: March 5th, 2019 by Editor
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