Neurology Alert
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Treatment of Psychotic Symptoms in Alzheimer’s Disease
In a meta-analysis of several large treatment trials of patients with Alzheimer’s disease, Parkinson’s disease, and dementia with Lewy bodies, cholinesterase inhibitors demonstrated a small but statistically significant benefit in reducing psychotic symptoms.
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Antidepressants for Chronic Pain: Do They Work?
Antidepressant medications have been widely used for treating a variety of chronic pain disorders but strong evidence to support their efficacy is lacking. Some patients may respond, but available data do not help us to determine which agents may be helpful in a specific type of chronic pain condition.
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Celery Seed-Derived Compound: A Legitimate Neuroprotectant for Acute Ischemic Stroke?
A Phase III double-blind, placebo-controlled, randomized controlled trial suggests that early administration of DL-3-n-butylphthalide, when given adjunctively to thrombolysis or endovascular therapy, improves functional outcomes in patients with acute ischemic stroke. Statistically significant results of well-designed analyses are tantalizing, but confidence in the findings is tempered by a lack of generalizability, an unclear mechanism of action, and trial design irregularities.
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Brain Atrophy and Type 1 Diabetes
In a long-term longitudinal study of people with type 1 diabetes, excessive brain atrophy and cognitive dysfunction were noted compared to healthy controls. The investigators calculated that type 1 diabetes resulted in six years of accelerated brain aging and brain atrophy that was separate and distinct from Alzheimer’s disease.
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New Research Suggests Treating Traumatic Brain Injury as a Chronic Illness
The road to recovery might be longer than initially thought.
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Glycoprotein IIb/IIIa Receptor Inhibitor Tirofiban for Ischemic Stroke
Glycoprotein IIb/IIIa receptor inhibitors are potent, rapidly acting antiplatelet agents that have been tried in pilot studies to treat acute ischemic stroke, without significant benefit. Tirofiban is fast-acting, highly selective, and has a short half-life that allows bleeding time to return to normal within three hours after administration is stopped. The investigators proposed that this medication may be of benefit in patients with acute ischemic stroke who arrived within 24 hours after stroke onset but are not eligible for thrombolysis or thrombectomy or have progression of stroke symptoms after receiving thrombolysis.
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Endovascular Thrombectomy for Large Ischemic Core Strokes
Endovascular thrombectomy has been rapidly adopted throughout the world for the treatment of patients with acute ischemic stroke and large vessel occlusion. This approach has achieved strong recommendations in stroke guidelines. However, the trials that form the basis of the recommendations have strict imaging recruitment criteria.
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Is Dexamethasone Effective in the Treatment of Chronic Subdural Hematomas?
Chronic subdural hematomas are common disorders and may occur after minor trauma or no trauma. For decades, nonsurgical therapies have been tried and proposed, including the use of corticosteroids. Various case series and nonrandomized trials of treatment with corticosteroids have been reported to show benefit, but efficacy of steroid therapy has been uncertain.
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Decompressive Craniectomy for Acute Subdural Hematoma
There has been longstanding discussion about whether craniectomy results in better outcomes than craniotomy with preservation of the skull for treatment of patients with acute subdural hematomas. This multicenter, international clinical trial was designed to compare the long-term results, benefits, and complications of decompressive craniectomy vs. craniotomy in patients with acute subdural hematomas.
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Gene Therapy for Leber’s Hereditary Optic Neuropathy Patients: The REFLECT Trial
Gene therapy for Leber’s hereditary optic neuropathy, a mitochondrial genetic disorder, using nuclear deoxyribonucleic acid that is transported into mitochondria, shows promising benefits in the treatment of this disease.