Search Immortality Topics:

Page 4«..3456..1020..»


Category Archives: Neurology

Nutritional and Wellness Strategies for Neurological and Psychiatric Recovery From Post-COVID Syndrome and Post … – Cureus

Specialty

Please choose I'm not a medical professional. Allergy and Immunology Anatomy Anesthesiology Cardiac/Thoracic/Vascular Surgery Cardiology Critical Care Dentistry Dermatology Diabetes and Endocrinology Emergency Medicine Epidemiology and Public Health Family Medicine Forensic Medicine Gastroenterology General Practice Genetics Geriatrics Health Policy Hematology HIV/AIDS Hospital-based Medicine I'm not a medical professional. Infectious Disease Integrative/Complementary Medicine Internal Medicine Internal Medicine-Pediatrics Medical Education and Simulation Medical Physics Medical Student Nephrology Neurological Surgery Neurology Nuclear Medicine Nutrition Obstetrics and Gynecology Occupational Health Oncology Ophthalmology Optometry Oral Medicine Orthopaedics Osteopathic Medicine Otolaryngology Pain Management Palliative Care Pathology Pediatrics Pediatric Surgery Physical Medicine and Rehabilitation Plastic Surgery Podiatry Preventive Medicine Psychiatry Psychology Pulmonology Radiation Oncology Radiology Rheumatology Substance Use and Addiction Surgery Therapeutics Trauma Urology Miscellaneous

Read the original:
Nutritional and Wellness Strategies for Neurological and Psychiatric Recovery From Post-COVID Syndrome and Post ... - Cureus

Posted in Neurology | Comments Off on Nutritional and Wellness Strategies for Neurological and Psychiatric Recovery From Post-COVID Syndrome and Post … – Cureus

This Week on NeurologyLive December 25, 2023 – Neurology Live

Every week, the NeurologyLive staff prepares this preview of what to expect from our coverage. This week on NeurologyLive, there are a number of hot topics that we will be posting on the website. As always, our weekly coverage extends beyond just these topics, so make sure to check out the rest of the site!

Click through the slides below to see what you can expect from our team this week. Click any slide to check out the content.

View original post here:
This Week on NeurologyLive December 25, 2023 - Neurology Live

Posted in Neurology | Comments Off on This Week on NeurologyLive December 25, 2023 – Neurology Live

NeurologyLive Year in Review 2023: Top Stories in Headache and Migraine – Neurology Live

In 2023, the NeurologyLive staff was kept on its toes while covering clinical news and data readouts from around the world across a number of key neurology subspecialty areas. Between major study publications and FDA decisions, and from societal conference sessions and expert interviews, the team spent all year bringing the latest updates to the website's front page.

Among our key focus areas is headache and migraine, two of the most common neurological diseases worldwide. Treatments for headaches have advanced over the years; however, providing lasting and effective treatment for all headache types has proven to be difficult for all practitioners. The field has been advanced significantly by the introduction of calcitonin gene-related peptide (CGRP)-targeting inhibitors, a class of highly effective and safe agents. Whatever the reason for the attention these stories got, their place here helps provide an understanding of the themes in this field over the course of 2023.

Here, we'll highlight some of the most-read content on NeurologyLive this year. Click the buttons to read further into these stories.

Earlier this year, the FDA approved IntelGenx/Gensco'srizatriptan benzoate (Rizafilm VersaFilm) oral thin film for acute migraine treatment through the 505(b)(2) new drug application (NDA) pathway. This newly approved treatment is an orally disintegrating film formulation of the 5-HT1 receptor agonist designed to be bioequivalent to Mercks Maxalt-MLT, an orally disintegrating rizatriptan treatment.

The FDA has expanded the indication for atogepant (Qulipta; AbbVie) to include the prevention of chronic migraine in adults, adding to its existing indication for episodic migraine, according to an announcement from AbbVie.1 The approval was granted based on data from the phase 3 PROGRESS trial (NCT03855137) that showed that 60-mg atogepant resulted in a significant reduction in mean monthly migraine days (MMDs) compared with placebo across 12 weeks of treatment.

Using a cohort of medically-insured individuals in Arizona, findings from a recently conducted analysis showed specific factors associated with receiving a migraine diagnosis vs a headache diagnosis. Those in the migraine cohort tended to be middle aged, female, White race, non-Hispanic ethnicity, and have English as their primary language. All told, issues within the social determinants of health categories of family unit dynamics (OR, 1.1; 95% CI, 1.06-1.14) and income and social protection (OR, 1.13; 95% CI, 1.08-1.18) were associated with a higher odds of being in the migraine vs headache cohort.

Findings from a pilot study (NCT04437199) assessing up to 60 g/day of tricaprilin (Cerecin), an investigational ketogenic compound, suggested potential benefit in treating patients with migraine. At the end of the 3-month treatment period, some patients opted to enter the Compassionate Access Program, which provides continued access to the therapy for up to 1 year after completion of the clinical study.

According to a new update from WL Gore & Associates, also known as Gore, patients in the RELIEF clinical study (NCT04100135) have completed their multi-month enhanced screening process and have begun entering the final randomization phase. The trial, initiated in November 2022, assesses whether closing the patent foramen ovale (PFO) using the GORE CARDIOFORM Septal Occluder may provide relief for patients with migraine. The GORE CARDIOFORM Septal Occluder is a permanently implanted device indicated for the percutaneous, transcatheter closure of ostium secundum atrial septal defects (ASDs) and PFO, intended to reduce the risk of recurrent ischemic stroke.

At the 2023 International Headache Congress, held September 14-17, in Seoul, Korea, new data from the phase 2 HOPE trial (NCT05133323) highlighted the effects of Lu AG09222 (Lundbeck), a pituitary adenylate cyclase-activating polypeptide (PACAP)-targeting agent, as a potential preventive for migraine. All told, the trial met its primary end point, with significant between-group differences observed in the high dose group of treated patients over a 12-week double-blind period.

The European Commission approved AbbVies atogepant (Aquipta) for the prophylaxis of migraine in adults who have 4 or more migraine days per month, becoming the first and only calcitonin gene-related peptide (CGRP) agent indicated for prevention of both episodic and chronic migraine. The approval was based on data from 2 phase 3 studies, PROGRESS (NCT03855137) and ADVANCE (NCT02848326), in which atogepant-treated patients showed greater reduction of monthly migraine days (MMDs) than placebo.

Investigators published full findings of the phase 3 PRODROME study (NCT04492020) demonstrating ubrogepants (Ubrelvy; AbbVie) positive impact on migraine during the prodrome phase in The Lancet. At the conclusion of the trial, absence of moderate or severe headache within 24 hours after initiating treatment occurred in 46% (190 of 418) of qualifying prodrome events that had been treated with ubrogepant compared with 29% (121 of 423) of events treated with placebo (OR, 2.09; 95% CI, 1.63-2.69; P <.0001).

Newly announced topline findings from the CHALLENGE-MIG trial (NCT05127486), the first head-to-head clinical study comparing 2 medications targeting calcitonin gene-related peptide (CGRP), revealed similar efficacy between galcanezumab (Emgality; Eli Lilly) and rimegepant (Nurtec ODT; Biohaven Pharmaceuticals). Despite this, galcanezumab outperformed Rimegepant on secondary end points at the end of the 3-month trial.

The FDA has accepted Satsuma Pharmaceuticals 505(b)(2) new drug application (NDA) for its novel, investigational dihydroergotamine (DHE) nasal powder product, STS101, for the acute treatment of migraine. The agency is expected to make a decision on the therapy by January 2024. STS101 is designed to provide significant benefits vs existing acute treatments for migraine, including the combination of quick and convenient self-administration and other clinical advantages that current DHE liquid nasal spray products and injectable dosage forms lack.

See the rest here:
NeurologyLive Year in Review 2023: Top Stories in Headache and Migraine - Neurology Live

Posted in Neurology | Comments Off on NeurologyLive Year in Review 2023: Top Stories in Headache and Migraine – Neurology Live

NeurologyLive Year in Review 2023: Most Watched Interviews in Sleep Disorders – Neurology Live

In 2023, the NeurologyLive team spoke with hundreds of people and posted hundreds of hours of interview clips. The staff spoke with neurologists, investigators, advanced practice providers, physical therapists, advocates, patients, pharmacists, and industry expertsanyone involved in the process of delivering clinical care.

These conversations were had with individuals from all over the world, both virtually and in person. The team attended more than a dozen annual meetings of medical societies, each time sitting down with experts on-site to learn more about the conversations driving care and the challenges being overcome.

From those in the field of sleep medicine, we learned much this year: recent updates to restless legs syndrome care; the challenges in managing narcolepsy's secondary symptoms; CPAP's effects in other neurologic disorders; heart health associations with sleep; and more.

Here, we'll highlight the most-viewed expert interviews on NeurologyLive this year. Click the buttons to watch more of our conversations with these experts.

The chief of the Sleep Disorders Clinical Research Program at Massachusetts General Hospital provided insight on new updates to the management of restless legs syndrome, including removing dopamine agonists as first line treatments.

WATCH TIME: 8 minutes

"Dopamine agonists are not first line treatments. The reason for that is theres substantial evidence that dopamine agonists when used for restless legs syndrome are associated with an augmentation of symptoms, a worsening of the underlying disorder."

The pediatric neurologist and sleep medicine specialist at Geisinger Medical Center provided commentary on the current unmet needs for patients with narcolepsy, including improvements in treatment options.

WATCH TIME: 3 minutes

"The reality is the disease is characterized, at a minimum, by a pentad of symptoms, which is excessive daytime sleepiness, cataplexy, sleep-related hallucinations, sleep paralysis, and disturbed nocturnal sleep.

The associate professor in the department of neurology and neurosurgery at McGill University discussed results from a study on the long-term use of continuous positive airway pressure treatment among patients with multiple sclerosis and sleep apnea presented at MSMilan 2023.

WATCH TIME: 5 minutes

"Our study indicates that CPAP treatment in patients with MS and sleep apnea is associated with a reduction in fatigue and an improvement in physical quality of life, offering potential benefits for long-term symptom management. Clinicians should consider exploring sleep apnea as a factor contributing to fatigue and poor sleep quality in patients with MS, as adequate treatment may lead to noticeable symptom improvement."

The medical director of SleepMed in South Carolina discussed the need for more overall awareness of poor sleep and the risk factors associated with worsened heart health.

WATCH TIME: 3 minutes

"Its critical to get the word out. We need to understand whats happening biologically, in terms of sleep homeostasis, sleep wake processor, and how thats controlled. What are the set points of heart rate and blood pressure? How are they modified? [We need to] Get the message out."

The cofounder and chief product development officer of Zevra Therapeutics talked about the phase 1 clinical trial of KP1077 for narcolepsy and potentially using it to treat other conditions..

WATCH TIME: 5 minutes

The biggest thing with this study is it is will help us inform study designs for future research. We are looking for the appropriate dosing regimen [of KP1077] and what will work best for patients with narcolepsy.

The senior vice president of medical and clinical affairs for Avadel Pharmaceuticals provided commentary on recently published research supporting once-nightly sodium oxybate (Lumryz) in narcolepsy regardless of the subtype.

WATCH TIME: 5 minutes

"Ensuring that clinicians are having conversations with patients with narcolepsy routinely, and asking about the more subtle presentation of cataplexy, is important. Many patients have their diagnosis changed from NT2 to NT1."

The associate professor, department of medicine, division of neurology, Institute of Medical Science, University of Toronto, talked about the importance of establishing normal values for sleep studies, particularly the multiple sleep latency test, to help with effectively diagnosing sleep disorders.

WATCH TIME: 5 minutes

The purpose of this study was to perform a larger and pretty comprehensive meta-analysis on the mean sleep latency derived from the MSLT (Multiple Sleep Latency Test). We also wanted to look at the impact of things like age, sex, body mass index, other sleep metrics. In addition, we wanted to investigate different methodological variables, such as sleep onset definitions, and sleep study features, as well other markers preceding the sleep study and see if that did affect the mean sleep latency on the MSLT that was performed.

The duo from Indiana University School of Medicine discussed the ongoing research initiatives to better understand sleep disorders among pediatrics, and ways to improve approaches like cognitive behavioral therapy.

WATCH TIME: 4 minutes

"There is a tendency in medicine and in society to focus on the need to eliminate screens and/or to assume that screens are causing the insomnia. This can be very minimizing to kids with insomnia because it implies that theres a simple solution and that a lifestyle factor is causing the insomnia."

The professor of neurology at UMass Chan School of Medicine discussed the various impacts Daylight Savings Time has on sleep quality and overall health in children and adolescents.

WATCH TIME: 3 minutes

"But what a lot of people don't realize is the long-term effects during the 8-month period on Daylight Saving Time. We may blame it on other things, but what we know is that those hour later sunrises and sunsets are associated with about a 10% increase rate of cancer, at least a 10% increase risk of obesity, and increased risk of heart disease."

The sleep epidemiologist and assistant professor at the Rollins School of Public Health at Emory University discussed the multi-level effort needed to improve sleep issues seen in individuals most impacted by social determinants of health.

WATCH TIME: 3 minutes

"The other piece is, how can we modify some of our recommendations to fit disadvantaged communities. For example, we say to sleep in a dark, quiet room, but we know that everyone cant do that because of safety issues. Adjusting the recommendation to say, put a light on in a hallway or somewhere else in the house."

Visit link:
NeurologyLive Year in Review 2023: Most Watched Interviews in Sleep Disorders - Neurology Live

Posted in Neurology | Comments Off on NeurologyLive Year in Review 2023: Most Watched Interviews in Sleep Disorders – Neurology Live

NeurologyLive Year in Review 2023: Top Stories in Epilepsy and Seizure Disorders – Neurology Live

In 2023, the NeurologyLive staff was a busy bunch, covering clinical news and data readouts from around the world across a number of key neurology subspecialty areas. From major study publications and FDA decisions to societal conference sessions and expert interviews, the team spent all year bringing the latest information to the website's front page.

Among our key focus areas is epilepsy and related seizure disorders, a field that features complex diseases that are often medically refractory and difficult to manage. Although major news items often appear among the top pieces our team produces, sometimes smaller stories reach those heights for other reasonsclinical impact and interest, or concerns about the small- or big-picture parts of care, for example. Whatever the reason for the attention these stories got, their place here helps provide an understanding of the themes in this field in 2023.

Here, we'll highlight some of the most-read content on NeurologyLive this year. Click the buttons to read further into these stories.

Findings from a comparative effectiveness research study showed that use of levetiracetam and lamotrigine as first-line treatments have similar efficacy on idiopathic generalized epilepsy (IGE) syndromes in females; however, levetiracetam was more effective in treating juvenile myoclonic epilepsy. Further studies are still needed to identify the most effective antiseizure medication alternative in other IGE syndromes.

The FDA has issued a warning for the use of antiseizure medicines levetiracetam (Keppra, Keppra XR, Elepsia XR, Spritam) and clobazam (Onfi, Sympazan), which can cause drug reaction with eosinophilia and systemic symptoms, known as DRESS, arare but serious adverse effect. The reaction may start as a rash but can quickly progress, resulting in injury to internal organs, the need for hospitalization, and even death. As a result, the FDA is requiring new warnings about this risk to be added to theprescribing informationand patientmedication guidesfor these medicines.

According to an announcement from Cumulus Neuroscience, the FDA has granted clearance to its novel, dry-sensor EEG headset, a user-friendly device that enables self-directed use and generates clinical-grade data for remote physician review. The Cumulus EEG device, designed for both adult and adolescent patients, is available in 4 sizes, and is easily self-applied with guidance from the Cumulus mobile app. The platform combines clinical-grade, at-home data with machine learning analytics and a large real-world database of annotated, longitudinal, matched data.

Using a large-scale cohort of electronic health records, recently published findings identified robust and clinically meaningful independent associations between incident epilepsy and both epilepsy/enzyme-inducing antiseizure medication use with incident osteoporosis. These data highlight the need for enhanced vigilance and consideration of prophylaxis for all patients with epilepsy.

At the 35th International Epilepsy Congress, held September 2-6, 2023, in Dublin, Ireland, UCB Pharma presented several posters showcasing the clinical benefits of fenfluramine (Fintepla) across multiple forms of epilepsy, including rare epileptic disorders such as Dravet syndrome (DS), Lennox-Gastaut syndrome (LGS), and CDKL5 deficiency disorder. The first presentation was a review of 13 studies assessing the impact of the therapy on generalized tonic-clonic or tonic-clonic seizures in a cohort of rare epilepsy syndromes; another abstract assessed the safety and efficacy of adult patients with DS who did not participate in the phase 3 clinical trials but enrolled in the open-label extension study de novo; and a comparative analysis of clinical trial data further highlighted fenfluramines impact on drop seizure frequency (DSF) in dose-capped patients with LGS.

Cornelia Drees, MD, senior associate consultant in the Department of Neurology at Mayo Clinic, provided insight on an early feasibility study on the clinical impact of microburst vagus nerve stimulation in patients with drug-resistant epilepsy, presented at the 2023 American Academy of Neurology (AAN) Annual Meeting, held April 22-27, in Boston, Massachusetts.

A post hoc analysis newly published in Epilepsy & Behavior on the phase 3 open-label extension (OLE) study (NCT01529034) assessing midazolam (Nayzilam; UCB), an FDA-approved nasal spray, showed that 90 minutes was the estimated median time to return to full baseline functionality (RTFBF) regardless of treatment with 1 or 2 doses among patients who experienced seizure clusters (SCs). These findings suggest that the dose of midazolam did not influence the time to RTFBF in SC episodes and further support the favorable profile of repeated intermittent use of midazolam in patients with SCs.

Using data from spontaneous and solicited reports, findings from a new analysis showed that lacosamide (Vimpat; UCB Pharma), an antiseizure medication, was safe to use during pregnancy, with most exposed pregnancies resulting in live births. Lacosamide, listed as a Pregnancy Category C medication, had no new safety concerns associated with its use in data presented at the 2023 American Epilepsy Society (AES) annual meeting, held December 1-5, in Orlando, Florida.

Data from a published retrospective analysis of adolescents and children presenting with seizures showed that midazolam is not an effective first-line therapy in prehospital settings, indicated by the nearly 40% of patients who required rescue therapy. Published in JAMA Network, the study featured 1172 children with a mean age of 5.7 years for whom a mobile intensive care unit was dispatched for an active seizure.

New post hoc data from a recently completed phase 3 trial (NCT02721069) assessing diazepam nasal spray (Valtoco; Neurelis), an FDA-approved antiseizure medication (ASM), indicated that faster time to administration was associated with shorter time to seizure cluster cessation and overall shorter seizure duration. Over 12 months, investigators also noticed a statistically significant change in SEIzure interVAL, or the time between seizure clusters, that was independent of the age of changes with concomitant ASMs.

Read more here:
NeurologyLive Year in Review 2023: Top Stories in Epilepsy and Seizure Disorders - Neurology Live

Posted in Neurology | Comments Off on NeurologyLive Year in Review 2023: Top Stories in Epilepsy and Seizure Disorders – Neurology Live

Football linked to more brain damage beyond white matter marks – News-Medical.Net

Signs of injury to the brain's white matter called white matter hyperintensities, as seen on brain scans, may be tied more strongly to vascular risk factors, brain shrinkage, and other markers of dementia in former tackle football players than in those who did not play football, according to a study published in the December 20, 2023, online issue of Neurology, the medical journal of the American Academy of Neurology.

Studies have shown that athletes exposed to repetitive head impacts can have increased white matter hyperintensity burden in their brains. White matter hyperintensities are easily seen on MRI as markers of injury of various causes. We know these markers are more common as people age and with medical conditions such as high blood pressure, but these results provide initial insight that they may be related to multiple aspects of brain damage from repetitive head impacts."

Michael L. Alosco, PhD, study author of Boston University Chobanian & Avedisian School of Medicine

Alosco said looking at white matter hyperintensities on brain scans may be a promising tool to study the long-term effects of repetitive head impacts. Repetitive head impacts have also been associated with chronic traumatic encephalopathy (CTE), a neurodegenerative disease that can result in dementia.

The study does not prove that repetitive head impacts and white matter hyperintensities cause other brain changes. It only shows an association.

The study involved 120 former professional football players and 60 former college football players with an average age of 57. They were compared to 60 men with an average age of 59 who had no symptoms, did not play football, and had no history of repetitive head impacts or concussion.

The participants had brain scans and lumbar punctures to look for biomarkers of neurodegenerative disease and white matter changes, along with other assessments.

In the former football players, a higher burden of white matter hyperintensities was associated with greater vascular risk factors; increased concentrations of p-tau proteins found in Alzheimer's disease, CTE, and other neurodegenerative diseases; more brain shrinkage and a decrease in the integrity of the white matter pathways in the brain.

The relationship between white matter hyperintensities and stroke risk was more than 11 times stronger in former football players than in those who did not play football. For p-tau, the relationship was 2.5 times stronger in the football players. For a measure of white matter integrity, the relationship was nearly 4 times stronger in the former football players.

"While our research previously showed that former football players still have elevated white matter hyperintensity burden after controlling for sleep apnea, alcohol use and high cholesterol, it is still important to consider working on modifying these risk factors due to their effects on cognitive problems and other symptoms," Alosco said.

A limitation of the study was that participants volunteered to take part, so they may not represent all former football players. In addition, since only elite football players were included, the results cannot be easily translated to other populations.

The study was supported by the National Institutes of Health and National Institute of Neurological Disorders and Stroke.

Source:

Journal reference:

Ly, M.T., et al. (2023) Association of Vascular Risk Factors and CSF and Imaging Biomarkers With White Matter Hyperintensities in Former American Football Players. Neurology. doi.org/10.1212/WNL.0000000000208030.

See the rest here:
Football linked to more brain damage beyond white matter marks - News-Medical.Net

Posted in Neurology | Comments Off on Football linked to more brain damage beyond white matter marks – News-Medical.Net