Paper of the Month

For July 2017, we have selected: Fernandez HH, Factor SA, Hauser RA, et al. Randomized controlled trial of deutetrabenazine for tardive dyskinesia. Neurology 2017;88:2003-2010. Tardive dyskinesia (TD) is a relatively frequent complication of antipsychotic treatment. TD can be observed in any part of the body, can be very disabling, and often persists even after stopping the causative medication.

For June 2017, we have selected: Breitenstein C, Flöel A, Ziegler W, et al., for the FCET2EC study group. Intensive speech and language therapy in patients with chronic aphasia after stroke: a randomized, open-label, blinded-endpoint, controlled trial in health-care setting. Lancet Neurol 2017;389:1528-1538. Speech and language impairments are among the most disabling symptoms after a stroke. Patients with aphasia persisting 6 months (chronic aphasia) after a stroke are not infrequent (20%). Hence, the social and economic impact of chronic aphasia is substantial.

or May 2017 we have selected: Kermer P, Eschenfelder CC, Diener H-C, et al.  Antagonizing dabigatran by idarucizumab in cases of ischemic stroke or intracranial hemorrhage in Germany – A national case collection. International Journal of Stroke 2017; doi: 10.1177/1747493017701944. The use of non-vitamin-K-antagonist oral anticoagulants (NOACs) to prevent stroke in patients with atrial fibrillation is increasing worldwide.

For April 2017, we have selected: Chen H, Kwong JC, Copes R, et al.  Living near major roads and the incidence of dementia, Parkinson’s disease, and multiple sclerosis: a population-based cohort study. Lancet 2017:389;718-726. Some studies have suggested that smog and noise can play a role in the pathogenesis of neurodegenerative disorders by inducing oxidative stress, neuroinflammation, microglia and neuronal antibody activation.

For March 2017, we have selected: Timm FP, Houle TT, Grabitz SD, et al.  Migraine and risk of perioperative ischemic stroke and hospital readmission: hospital based registry study. BMJ 2017 Jan 10;356:i6635. doi: 10.1136/bmj.i6635. A higher risk of ischemic stroke has been found in patients with migraine, especially in those with migraine with aura.

For February 2017, we have selected: Grool AM, Aglipay M., Momoli F., et al., for the Pediatric Emergency Research Canada Concussion Team.  Association between early participation in physical activity following acute concussion and persistent postconcussive symptoms in children and adolescents. JAMA 2017:316;2504-2514. Practical recommendations in the management of concussion in pediatric patients have stressed the need of physical and cognitive rest starting immediately after the injury.

For January 2017, we have selected: Patel M, Agarwal K, Arshad Q, et al. Intratympanic methylprednisolone versus gentamicin in patients with unilateral Ménière’s disease: a randomized double-blind, comparative effectiveness trial. Lancet Neurol 2016;388:2753-2762. Disabling vertigo attacks and hearing loss are characteristics of Ménière’s disease. In patients with severe and frequent vertigo spells, intratympanic injections of gentamicin have proved to be effective, but at the price of permanent vestibular damage and hearing loss.

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.

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.