European Journal of Neurology

Both reduced cognitive ability and traumatic brain injuries (TBIs) have been proposed as risk factors for dementia later in life. Moreover, a 2008 case-control study comparing 55 controls to 197 TBI patients from the Vietnam War indicated that higher intelligence could offer protection from dementia after a penetrating brain injury [1]. However, gathering sufficient data concerning the moderating effect of cognitive ability on the increased risk of dementia after TBI is challenging, as TBIs are not common and follow-up times after the lesion have to be on the order of decades...

Although many national surveys have been published on migraine epidemiology, such as that carried out by Wolfson et al in Canada [1], recent information on global epidemiologic burden of this condition has not been published. Therefore, in this succinct report we present an update on worldwide epidemiology of migraine, based on data retrieved from the official database of the World Health Organization (WHO) [2].

It will be a big challenge for the new editorial team to succeed Tony Schapira who was a great Editor-in-Chief. With his team of editors, he made the journal important in the field of neurology. Being his successor will be a difficult, but comfortable task because the journal is going well, and we have good reasons to see the future with optimism.

BACKGROUND: The aim of this study was to assess the effective treatments of cladribine in a population of patients with refractory myasthenia gravis. METHODS: In prospective, an open label study of cladribine in refractory myasthenia gravis, 13 patients received cladribine at a baseline with repetitive cycles driven by clinical response. A myasthenia gravis composite was scored (MGC) and a standard dose of steroids were measured. RESULTS: Eleven patients achieved significant clinical improvement in MGC scale during their therapy...

BACKGROUND AND PURPOSE: Existing research studies have demonstrated a relationship between MRI neuroimaging measures and walking speed in people with multiple sclerosis (PwMS). However, to date there are no data as to the brain structures involved in gait coordination and control in PwMS. Therefore, the aim of our study was to investigate the association between walk ratio, an indicator of gait coordination, and related brain structures in PwMS. METHODS: A brain MRI was performed by a 3...

BACKGROUND AND PURPOSE: Studies on using antiplatelet agents for secondary prevention in ischemic stroke patients with renal dysfunction are limited. We used the Taiwan Stroke Registry (TSR) database to compare the efficacy of antiplatelet agents. METHODS: From the TSR data, we identified 39174 acute ischemic stroke patients and classified them into three groups by the antiplatelet agent: aspirin, clopidogrel, and dual antiplatelet therapy (DAPT) with the combination of aspirin and clopidogrel...

BACKGROUND: Efficacy of galcanezumab, a monoclonal antibody for migraine prevention, has been demonstrated in two pivotal trials in patients with episodic migraine. METHODS: EVOLVE-1&-2 were identical Phase 3, randomised, double-blind, placebo-controlled studies in patients with episodic migraine. Mean migraine headache days/month at baseline was 9. Patients were randomized 2:1:1 to monthly injections of placebo, galcanezumab 120mg/240mg during the 6-month double-blind treatment period...

BACKGROUNG: It is well established that patient-related constitutional features predispose to focal peripheral neuropathies. We investigated some of these risk factors in common focal neuropathies encountered in patients referred for EMG. METHODS: We analyzed retrospectively gender, age, height, and body mass index (BMI) as risk factors for 11 focal neuropathies. 9.686 patients (age range 18-96 years; 58% women) were included from in three different centers, with identical methods and equipment...

BACKGROUND AND PURPOSE: Elevated C-reactive protein (CRP) is associated with an increased risk of ischemic stroke (IS). However, the causality of this association is uncertain. We aim to investigate whether genetically raised plasma CRP concentration levels are associated with the IS based on the Mendelian randomization (MR) method. METHODS: Based on the National Center for Biotechnology Information SNP database, the Chinese online genetic database as well as previously published studies, four CRP-associated SNPs alleles (rs1130864, rs1205, rs876537 and rs3093059) with minor allele frequency (MAF) ≥ 0...

BACKGROUND: Biomarkers support the etiological diagnosis of neurocognitive disorders in vivo. Incomplete evidence is available to drive clinical decisions; available diagnostic algorithms are generic and poorly helpful in clinical practice. We aim to develop a biomarker-based diagnostic algorithm for MCI patients, leveraging on knowledge from recognized national experts. METHODS: With a Delphi procedure, experienced clinicians making variable use of biomarkers in clinical practice and representing five Italian Scientific Societies (Neurology: SINDEM; Neuroradiology: AINR; Biochemistry: SIBioC; Psychogeriatrics: AIP; Nuclear Medicine: AIMN) defined theoretical framework, relevant literature, the diagnostic issues to be addressed, and the diagnostic algorithm...

OBJECTIVES: To review the existing reports on cognitive and behavioral symptoms in monogenic forms of Parkinson's disease (PD) and to identify recurring patterns of clinical manifestations in those with specific mutations. METHODS: A systematic literature search was conducted to retrieve observational studies of monogenic PD. Data pertaining to cognitive and psychiatric manifestations were extracted using standardized templates. We adhered to the PRISMA guidelines...

With great interest, we read Alves and colleagues article just accepted on European Journal of Neurology, where they provide high-quality evidence of Parkinson's disease (PD) as a risk factor for stroke 1 . The authors evaluated 11 studies, comprising over seven thousand patients with PD, in the most comprehensive analysis of the subject to date. Their strict selection criteria (disregard of disease severity, age and gender-adjusted controls) and standardized outcomes (stroke, myocardial infarction or cardiovascular death) minimize the risk of bias and add soundness to the results...

BACKGROUND: Observational studies have implicated migraine as a risk factor for coronary artery disease (CAD) and atrial fibrillation (AF), however it is unclear whether migraine is causal in this relationship. We investigated potential causality between genetically instrumented liability to migraine and cardiovascular disease outcomes using two-sample Mendelian randomization. METHODS: The exposure comprised 35 independent, genome-wide significant genetic variants identified in the largest published migraine GWAS (Ncases = 59,674 / Ncontrols =316,078)...

Spasticity is a frequent multifactorial manifestation of multiple sclerosis, affecting mostly the chronic courses of the disease. Its impact on patient functioning and quality of life is profound. Treatment of spasticity includes oral and intrathecal anti-spastic drugs, muscle injections with relaxant agents, physical therapy, electrical and magnetic stimulation, peripheral nerve stimulation, alone or in variable combinations. This Italian Consensus on the treatment of spasticity in MS was produced by a large group of Italian MS experts in collaboration with neurophysiologists, experts in the production of guidelines, and patients representative operating under the umbrella of the Italian Neurological Society, the Associazione Italiana Sclerosi Multipla and the European Charcot Foundation...

Parkinson disease (PD) is the most common neurodegenerative movement disorder [1]. Its cardinal motor symptoms are tremor, rigidity, bradykinesia/akinesia and postural instability, but the clinical picture includes other motor and non-motor symptoms (NMS). The diagnosis is principally clinical, although specific investigations can help the differential diagnosis from other forms of Parkinsonism. The pathological hallmarks of PD are loss of dopaminergic neurons in the substantia nigra (SN) pars compacta (SNpc) and accumulation of misfolded alpha-synuclein, which is found in intra-cytoplasmic inclusions called Lewy bodies (LBs)...

BACKGROUND: Factors influencing outcome after Critical Care Unit (CCU) for patients with status epilepticus (SE) are poorly understood. We examined survival for these patients to establish (a) whether the risk of mortality has changed over time and (b) whether admission to different unit types affects mortality risk over and above other risk factors. METHODS: We analysed the Intensive Care National Audit & Research Centre (ICNARC) database and the Case Mix Programme Database (CMPD) (January 2001 - December 2016)...

BACKGROUND: The pathophysiological model of tics generally describes disruption of γ-aminobutyric acid transmission, and taurine is found to be an agonist of γ-aminobutyric acid receptors. METHODS: 404 youngsters with tic disorders were randomly assigned to 12 weeks of either oral taurine or placebo. The Yale Global Tic Severity Scale was used to measure tic severity. The primary outcome measure was global severity scores reduced by more than 60% compared with baseline scores...

BACKGROUND: Clinical trials are probably the most informative experiments to help understanding of multiple sclerosis (MS) biology. Recent successes with CD20-depleting antibodies have focussed attention towards B cell subsets as important mediators in MS. METHOD: We report and review the trial of tabalumab (NTC00882999), which inhibits B cell Activation Factor (BAFF), and contrast this with inhibition of A Proliferation-Inducing Ligand (APRIL) and BAFF using atacicept (NCT00642902)...

This paper describes ten core features of a neuropsychological assessment with the aim of helping neurologists understand the unique contribution the evaluation can make within the wider context of diagnostic methods in epilepsy. The possibilities, limitations and cautions associated with the investigation are discussed under the headings below: 1. A neuropsychological assessment is a collaborative investigation. 2. Assessment prior to treatment allows for the accurate assessment of treatment effects. 3. The nature of an underlying lesion and its neurodevelopmental context play an important role in shaping the associated neuropsychological deficit...

BACKGROUND AND PURPOSE: Humanized monoclonal antibody galcanezumab, which binds to calcitonin gene-related peptide, has shown efficacy for episodic and chronic migraine prevention. These analyses evaluated galcanezumab response for migraine headache prevention in patients who previously failed onabotulinumtoxinA ("nonresponse" or "inadequate response" or safety reasons). METHODS: Post hoc analyses included data from 3 double-blind, placebo-controlled, Phase 3 episodic or chronic migraine studies; 2,886 patients randomly received 120mg or 240mg galcanezumab or placebo...