Category Archives: Neurology

WATCH TIME: 4 minutes

For patients with stroke and those with neurological conditions, developing arm weakness can be a common occurrence. Traditionally, physical therapy-related approaches have been the standard of care; however, with the expansion of technology in recent years, options like portable powered braces and functional electrical stimulation have shown benefits in restoring functional arm movement for these individuals. A new modality for this aspect of care, the NuroSleeve powered brace and stimulation system, is currently being evaluated by researchers at the Jefferson Center for Neurorestoration at Thomas Jefferson University.

The overall objective of the study is to establish that children and adults with chronic, stable neurological motor impairment can achieve voluntary control over the NuroSleeve upper extremity orthosis and functional electrical stimulation system, and that they can use this voluntary control to perform functionally beneficial tasks. Currently ongoing, the trial features patients with a range of neurological diseases, including stroke, amyotrophic lateral sclerosis, spinal muscular atrophy, cerebral palsy, and several others.

To learn more about the function of NuroSleeve, how it operates, and why it is effective, NeurologyLive reached out to Joe Kardine, MS, OTR, CBIS, clinical program manager, Jefferson Center for Neurorestoration. Kardine discussed the multifaceted use of the system across several neurologic conditions and how it can be personally customized for each individual.

See the article here:
Multifaceted Use of NuroSleeve to Restore Arm Function in Neurological Diseases: Joe Kardine, MS, OTR, CBIS - Neurology Live

Recently published findings in Lancet Neurology from a placebo-controlled study (NCT02940912)showed that night-time subcutaneous apomorphine infusion (Orkyn; Aguettant Pharma) for up to 5 mg/h is safe and improves Parkinson disease (PD)-related insomnia, as demonstrated by scores on Parkinsons Disease Sleep Scale (PDSS) scores.1

"Night-time administration could render apomorphine infusion more acceptable (compared with a 24-h infusion) because patients will not have to deal with the device-related constraints during the daytime," lead investigator Valeria Cochen De Cock, MD, professor of sleep and neurology, Beau Soleil Clinic, and colleagues wrote. "Our study supports the concept of continuous dop-aminergic stimulation, not only during the day but also at night, in patients with advanced Parkinsons disease."

The study, which spanned 11 expert centers in France, enrolled 46 patients aged 35 to 80 years with fluctuating PD and moderate to severe insomnia, defined by scores of at least 15 on Insomnia Severity Index (ISI). There were 2 treatment periods separated by a washout period, then crossover to the other intervention. Each treatment period consisted of a 10-night titration phase followed by a 7-night fixed-dose phase. During the washout period, the dose was gradually reduced over 3 nights, and patients remained free of medication for the following 14 nights.

Among the cohort, 91% (n = 42) completed the 2 medication periods. Between the 2 treatment groups, change in PDSS score was greater in those on night-time apomorphine infusion than placebo (treatment effect, 9.95; 95% CI, 0.88-19.03; P = .041). In terms of individual PDSS grouped-item scores, apomorphine outperformed placebo for the items "overall quality of nights sleep" (1.63; 95% CI, 0.49-2.77; P = .0063) and "sleep onset and maintenance insomnia" (1.51; 95% CI, 0.01 to 2.70; P = .024).

The apomorphine treatment period was also associated with greater change in ISI score (treatment effect, 2.23; 95% CI, 3.83 to 0.64; P = .011) and self-estimated clinical global impression of sleep quality (change in CGI score, 1.40; 95% CI, 0.62-2.19; P = .0007). On morning awakening, compared with the placebo period, the apomorphine period was associated with an improvement in motor condition, as demonstrated by change in Likert scale score (0.57; 95% CI, 0.98 to 0.16; P = .012) but without change in pain (0.20; 95% CI, 0.59 to 0.19; P = .36).

Apomorphine infusion was also found to be safe, as 54% (n = 25) of those on active therapy reported adverse events (AEs) vs 37% (n = 17) of those on placebo. Apomorphine was associated with more frequent dizziness, found in 7 (15%) participants compared with none in the placebo group.

Additional findings from the study showed that night-time apomorphine led to greater increase in percentage of sleep stage N2 (6.59%; 95% CI, 0.96-12.23; P = .021) and reduction in percentage of non-REM sleep stage N3 (5.08%; 95% CI, 9.67 to 0.50; P = .040) and percentage of REM sleep (3.57%;95% CI, 6.70 to 0.44; P = .031). Notably, the duration of non-REM stage N3 was unchangeded (7.91 min; 95% CI, 24.89 to 9.07; P = .037).

Compared with placebo, apomorphine infusion was associated with a greater increase in the arousal index (488 events per h; 95% CI, 1.03-8.73; P = .021), and reduction in the periodic leg movement index during sleep (574 events per h; 95% CI, 10.72 to 0.75; P = .050), whereas the apnea and hypopnea index and the percentage of enhanced submental tonic and phasic EMG activity remained unchanged. Between the two treatment periods, the mean sleep latency on the MSLT was unchained during daytime; however, the number of sleep-onset REM periods was higher with apomorphine (0.19; 95% CI, 0.00-0.38; P = .061).

Read more:
Night-Time Only Apomorphine Infusion Shows Benefit to Treating Parkinson Disease Insomnia - Neurology Live

image:This study was conducted using the latest neuroimaging techniques at the Ortenzio Center, which is dedicated solely to rehabilitation research, view more

Credit: Kessler Foundation

East Hanover, NJ. September 30, 2022. Using advanced diffusion neuroimaging technology, Kessler Foundation researchers investigated the relationship between the rate of cognitive fatigue to microstructural changes in the brain in persons with multiple sclerosis. Their findings help fill a gap in the current understanding of how brain pathology influences the development of fatigue over time.

Their findings were reported in Frontiers in Neurology on July 04, 2022, in the open access article Associations of White Matter and Basal Ganglia Microstructure to Cognitive Fatigue Rate in Multiple Sclerosis, (doi: 10.3389/fneur.2022.911012). The authors are Cristina Almeida Flores Romn, PhD, Glenn Wylie, DPhil, John DeLuca, PhD, and Bing Yao, PhD, and of Kessler Foundation.

The study was conducted at the Rocco Ortenzio Neuroimaging Center at Kessler Foundation, which is dedicated solely to rehabilitation research. Participants were 62 individuals with relapsing-remitting MS. All completed questionnaires measuring depression, state and trait anxiety, and trait fatigue. While in the scanner, participants underwent a cognitively fatiguing task. In addition to measuring rate of cognitive fatigue, researchers measured whole brain lesion volume and performance during the fatigue-inducing task.

We found that the cognitive rate related to white matter tracts, many with associations with the basal ganglia or what we have proposed as the fatigue network, said lead author Dr. Romn, National MS Society postdoctoral fellow at Kessler Foundation. These findings bring us closer to understanding how brain pathology impacts the experience in the moment. This is fundamental to developing effective interventions for managing the disabling fatigue of MS and other neurological conditions.

Funding: Kessler Foundation, National Multiple Sclerosis Society (RG-1701-26930)

Learn more about ongoing studies at Kessler Foundation at Join Our Research Studies | Kessler Foundation

About Kessler Foundation

Kessler Foundation, a major nonprofit organization in the field of disability, is a global leader in rehabilitation research that improves cognition, mobility, and long-term outcomes, including employment, for people with neurological disabilities caused by diseases and injuries of the brain and spinal cord. Kessler Foundation leads the nation in funding innovative programs that expand opportunities for employment for people with disabilities. Learn more by visiting http://www.KesslerFoundation.org

Stay Connected

Twitter |http://Twitter.com/KesslerFdnFacebook |http://Facebook.com/KesslerFoundationYouTube |http://Youtube.com/user/KesslerFoundationInstagram |http://Instagram.com/kesslerfdn

iTunes & SoundCloud |http://Soundcloud.com/kesslerfoundation

To interview an expert, contact:

Deborah Hauss, DHauss@kesslerfoundation.org

Carolann Murphy, CMurphy@KesslerFoundation.org

Frontiers in Neurology

Imaging analysis

People

Associations of White Matter and Basal Ganglia Microstructure to Cognitive Fatigue Rate in Multiple Sclerosis

4-Jul-2022

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

Read more here:
Kessler Foundation study advances knowledge of role of brain pathology and cognitive fatigue in multiple sclerosis - EurekAlert

Newswise Could artificial intelligence help solve the mental health crisis? What if an algorithm allowed neurologists to know the area affected by a brain seizure?

These are just a few of the questions thatMaryamRavan, Ph.D., assistant professor of electrical and computer engineering at New York Institute of Technology, aims to address in new research studies published this fall. The studies, which have been featured in journals and conferences of the Institute of Electrical and Electronics Engineers (IEEE), propose cutting-edge algorithms and techniques that could provide non-invasive solutions for clinicians to more effectively treat neurological and psychiatric conditions.

Normal brain activity, including mood and thinking processes, relies on a balance of fast and slow brain waves. Imbalanced brain wave activity is associated with neurological issues, such as epilepsy, and psychiatric conditions like bipolar disorder and major depressive disorder.

One technique that clinicians use to detect brain wave imbalances is electroencephalography (EEG). This diagnostic test uses sensors to measure the electrical activity on a patients scalp, which is representative of the brain wave activity taking place underneath. Given this, brain wave data collected through EEG holds valuable information regarding an individuals neurological and mental health.

Now, Ravan has partnered with physicians from prestigious institutions, including Stanford University and McMaster University (Canada), to propose new, non-invasive diagnostic techniquesfounded on algorithms and engineering principlesthat could improve how physicians use EEG brain wave data to treat the brain.

Locating the Source of a Seizure

Approximatelythree million adults and 470,000 childrenin the United States have epilepsy, a neurological condition that causes seizures. During a seizure, the brains normal electrical pattern is disrupted and sudden bursts of electrical energy can affect consciousness, movements, and sensations.

However, precisely identifying the region of the brain where a seizure originated (brain source) is challenging. Existing software models that process EEG brain wave data use a mathematical technique calledexact low-resolution brain electromagnetic tomography (eLORETA). While these models can provide a brain source estimate, they have a high margin of error and do not account for many variables, including individual head shape, which impacts the distribution of electrodes, or the brains electricity producers. While magneticresonance imaging (MRI), which does account for head shape, can be used to identify the brain source, these systems are costly, and not every patient can undergo an MRI scan.

Now, in a study published in IEEE Transactions on Biomedical Engineering,Ravanand her fellow co-authors, including renowned Stanford University physicians Robert Fisher, M.D., Ph.D., andBabak Razavi, M.D., Ph.D., as well as Amin Noroozi, a Ph.D. candidate from Staffordshire University (United Kingdom), propose a more precise and robust brain mapping technique to pinpoint the brain source.

Using AI to Improve Mental Health Diagnoses and Treatments

In collaboration with prominent McMaster University psychiatrist Gary M. Hasey, M.D.,Ravanhas co-authored two studies that leverage machine learning, a form of artificial intelligence (AI), to improve the treatment of mental health conditions.

In one study, which was presented at this years 44thAnnual International Conference of the IEEE Engineering in Medicine and Biology Society, Ravan helped to develop a machine learning algorithm to analyze patients brain waves and categorize their patterns as biomarkers for bipolar disorder or major depressive disorder.

The second study, which was published inIEEE Transactions on Biomedical Engineering, explores how brain wave data could be used to predict how patients with major depressive disorder will respond to the antidepressant sertraline (sold under the brand name Zoloft) vs. a placebo treatment.

See original here:
Engineering Research Provides Non-Invasive Solutions for Diagnosing and Treating Neurological and Psychiatric Conditions - Newswise

Patients misdiagnosed in the Neurology scandal must get access to the truth about what happened to them, Sinn Fin MLA Carl N Chuiln has said.

Speaking after the Belfast Trust appeared before the Neurology APG, the North Belfast MLA said: "It is unacceptable that patients and families impacted by the neurology scandal are still waiting for truth and accountability.

"The Independent Inquiry report is nothing short of damming and has cataloged missed opportunities to address their treatment.

"The RQIA report on governance in outpatients - published in Feb 2020 - made 26 recommendations for improvements in Neurology services, and for many families, they feel that very little progress has been made since then.

"Former patients have had their confidence rocked and the Belfast Trust need to do more to support all those failed by Michael Watt.

"Sinn Fin will continue to support the victims and their families in their campaign for truth and accountability."

Continue reading here:
Neurology Scandal Patients 'Must Get Access To The Truth' - 4ni.co.uk

HARTFORD, Conn. (WTNH) A Hartford Healthcare neurologist is cautiously excited about a new treatments ability to prevent memory loss in patients with Alzheimers disease.

Dr. Amy Sanders has been watching research indicating that the drug lecanemab can either slow or altogether stop cognitive decline.

The results, she said, werent surprising.

That has been the Holy Grail of Alzheimers disease pharmaceutical research for decades, so this is the first time my heart went pitty pat, when I read these announcements, Sanders said.

Lecanemab clears amyloid plaques, which are protein deposits linked to dementia.

Weve had agents that could clear amyloid plaques in the past, but we have not had the one-two punch, Sanders said. And its possible that we now have it.

The 1,800 people in the clinical trial had either a mild form of Alzheimers disease, or a pre-Alzheimers condition that is considered to be a mild cognitive impairment.

While the data wont be released until the end of November, the Alzheimers Association has called the study a major development, and said that more drugs are in the pipeline.

See the rest here:
Hartford Healthcare neurologist excited about possible new Alzheimers disease treatment - WTNH.com