"paper"

This month’s selected paper addresses the risk of neurological deficits in people with cavernomas treated with antithrombotic medication. Perhaps counter-intuitively, the authors report a lower risk of intracerebral haemorrhage in patients taking antithrombotic medication (mostly antiplatelet therapy). The study therefore provides reassurance for clinicians managing patients with this relatively common, and often incidental, vascular finding that antithrombotic therapy does not appear harmful; conversely, there could be some benefit, but this requires further evaluation in a randomised controlled trial.

This month’s selected paper is a working group report that addresses a recently described disorder, limbic-predominant age-related TDP-43 encephalopathy (LATE), which is emerging as an important cause of cognitive impairment in the elderly. The group make recommendations for standardised neuropathological evaluation and identify research avenues to better understand this evolving new disease phenotype.

For September 2019, we have selected two scientific papers with a common theme: Goadsby et al., Trial of galcanezumab in prevention of episodic cluster headache NEJM 2019; 381: 132-41, and Lipton et al., Rimegepant, an oral calcitonin gene-related peptide receptor antagonist, for migraine NEJM 2019; 381: 142-9.

For August 2019, we have selected Wilson, Sample et al. Clinical metagenomic sequencing for diagnosis of meningitis and encephalitis. N Eng J Med 2019; 380:24;2327-2340

For July 2019, we have selected a scientific paper: RESTART Collaboration. Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage: a randomised open label trial. Lancet 2019; May 21 [Epub ahead of print]

For June 2019, we have selected a scientific paper: Moreno-Jimenez, Garcia, Roncal et al. Adult hippocampal neurogenesis is abundant in neurologically healthy subjects and drops sharply in patients with Alzheimer’s disease Nature Medicine 2019; 25: 554–560.

For May 2019, we have selected: Fancourt D & Steptoe A. Television viewing and cognitive decline in older age: findings from the English Longitudinal Study of Ageing. Scientific Reports 2019;9:2851.

For April 2019, we have selected: Kellinghaus C, Rossetti AO, Trinka E, et al.  Factors predicting cessation of status epilepticus in clinical practice: Data from a prospective observational registry (SENSE). Ann Neurol 2019;85:421-432.

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.

For January 2019, we have selected: Killinger BA, Madaj Z, Sikora JW, et al. The vermiform appendix impacts the risk of developing Parkinson’s disease. Sci Transl Med 2018,10:1-15.

For December 2018, we have selected: Reuter U, Goadsby PJ, Lanteri-Minet M, et al. Efficacy and tolerability of erenumab in patients with episodic migraine in whom two-to-four previous preventive treatments were unsuccessful: a randomized, double-blind, placebo-controlled, phase 3b study. Lancet Neurol 22 October, 2018.

For November 2018, we have selected: Oh KW, Noh MY, Kwon NS, et al. Repeated intrathecal stem cells for amyotrophic lateral sclerosis. Ann Neurol 2018;84:361-373. Stem cell research is a hot topic in motor neuron disease/amyotrophic lateral sclerosis (MND/ALS) both for clinicians and patients. Whilst recognized as an important area of promise for developing future therapeutics in neurodegenerative disease, it has been much hyped in the media, and dissecting the scientific research on the subject from the many unproven approaches advertised to patients by commercially motivated companies can be challenging.

For September 2018, we have selected:  Katzenschlager R, Poewe W, Rascol O, et al. Apomorphine subcutaneous infusion in patients with Parkinson’s disease with persisten motor fluctuations (TOLEDO): a multicenter, double-blind, randomized, placebo-controlled trial. Lancet Neurol July 25, 2018. doi:10.1016/S1474-4422(18)30284-4. Subcutaneous infusion of apomorphine, a potent dopamine receptor agonist, is widely used in patients with Parkinson’s disease (PD) with motor fluctuations not optimally controlled with oral medication, but the previous evidence base to support this approach was weak, derived from open label studies.