Research

Vansteensel et al. reported a new technique for communication that could be applied to oral-disabled patients. By implanting electrodes to read brain activity in the sensorimotor cortex, and an interface with a subcutaneous transmitter in the thorax, a patient with ALS was able to communicate wireless controlling a computer typing program.

For December 2016 we have selected: Gonzales-Bermejo J, Morélot-Panzini C, Tanguy M-L, et al.  Early diaphragm pacing in patients with amyotrophic lateral sclerosis (RespiStimALS): a randomized controlled triple-blind trial. Lancet Neurol 2016:15;1217-1227. The main cause of death in patients with amyotrophic lateral sclerosis (ALS) is related to respiratory failure. It has been hypothesized that diaphragm pacing (a technique that induces diaphragm contraction through the stimulation of the phrenic nerve) could slow the progression of respiratory muscle weakness, and increase alveolar ventilation and lung compliance in ALS patients.

The authors developed a sensor molecule to detect serotonin, injected it into rat striatum and scanned the rodents for 2 hours in a 9.4T magnet with 200 micron in-plane resolution to track the dynamics of reuptake of serotonin and the influence of drugs.

For November 2016 we have selected: Cree BAC, Gourraud P-A, Oksenberg JR, et al. Long-term evolution of multiple sclerosis disability in the treatment era. Ann Neurol 2016:80;499-510. Studies describing the natural history of multiple sclerosis (MS) before the availability of disease-modifying treatments have reported a progression of the disease from the relapsing-remitting form to the secondary progressive form in about 50% of patients at 19 years after the onset.

For October 2016 we have selected: Sevigny J, Chiao P, Bussiere T, et al. The antibody aducanumab reduces Aβ plaques in Alzheimer’s disease. Nature 2016;537:50-56. Alzheimer’s disease (AD) is the most frequent neurodegenerative disorder. It is also extremely disabling with severe impact of the quality of life of patients and caregivers. The main pathological process is related to the toxic deposition of amyloid-β plaques and neurofibrillary tangles. No effective treatment is currently available to slow down the disease progression.

For September 2016 we have selected: Mattle HP, Evers S, Hildick-Smith D, et al. Percutaneous closure of patent foramen ovale in migraine with aura, a randomized controlled trial. Eur Heart J 2016:37;2029-2036. There are about 50 million people suffering from migraine in Europe. About one third of the cases has migraine with aura, that has been found more prevalent in patients with patent foramen ovale (PFO).

For August 2016 we have selected: Gormley P, Anttila V, Winsvold BS, et al. Meta-analysis of 375,000 individuals identifies 38 susceptibility loci for migraine. Nature Genetics 2016 June 20;doi: 10.1038/ng.3598. Migraine is a worldwide common, disabling, and costly disease. Its pathophysiology has been related to either a primary vascular dysfunction or a primary neuronal dysfunction with secondary vascular involvement.

For July 2016 we have selected: Effects of aspirin on risk and severity of early recurrent stroke after transient ischaemic attack and ischaemic stroke: time-course analysis of randomized trials. Rothwell PM, Algra A, Chen Z, Diener H-C, Norrving B, Mehta Z. Lancet Neurol 2016 May 18. doi: 10.1016/S0140-6736(16)30468-8. Whereas there is robust evidence encouraging the use of aspirin for long-term secondary prevention after transient ischaemic attack (TIA) or ischaemic stroke, data supporting aspirin treatment to reduce early recurrence of ischæmic events is weak. Moreover, even less information is available concerning the early aspirin effects on risk or severity recurrence after minor strokes.

For June 2016 we have selected: Safety and efficacy of repeated injections of botulinum toxin A in peripheral neuropathic pain (BOTNEP): a randomised, double-blind, placebo-controlled trial. Attal N, et al. Lancet Neurol 2016;15:555-565. The treatment of neuropathic pain is very challenging for neurologists and pain specialists since pain medications often have important adverse events or are partially effective. Botulinum toxin type A has been successfully used for many years to treat dystonia, spasticity, and other disorders with muscle hyperactivity.

For May 2016 we have selected: Meinzer M, Darkow R, Lindenberg R, Flöel A. Electrical stimulation of the motor cortex enhances treatment outcome in post-stroke aphasia. Brain 2016:139;1152-1163. Language deficits after a stroke can be devastating and have a remarkable impact on the quality of life. Rehabilitation strategies can improve aphasia also in the chronic phases, but there is the overall need of more efficacious and focused treatment strategies. Transcranial direct current stimulation (tDCS) has been shown to change cortical excitability and induce synaptic plasticity without side effects.

or April 2016 we have selected: Lublin F, Miller DH, Freedman MS, et al., on behalf of the INFORMS study investigators. Oral fingolimod in primary progressive multiple sclerosis (INFORMS): a phase 3, randomized, double-blind, placebo-controlled trial. Lancet Neurol, 27 Jan 2016; pii: S0140-6736(15)01314-8. doi: 10.1016/S0140-6736(15)01314-8. Primary progressive multiple sclerosis (PPMS) represents around 10-15% of the clinical forms of MS. Several characteristics differentiate PPMS from the relapse-onset MS, the classical more frequent form: older age at onset, equal prevalence between sexes, less inflammatory component at the MRI, and quicker progression of disability.