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The Walk ’n Watch Trial: Stroke Recovery Through High-Intensity Walking

An intensive real-life walking protocol, started as soon as possible after acute stroke, resulted in improved overall walking endurance, mobility, balance, and quality of life.

Clinical and Genetic Reassessment of Patients with Presumed Hereditary Polyneuropathy

This is an observational, cross-sectional study of patients seen at a specialized neuromuscular center with a clinical diagnosis of hereditary polyneuropathy, without a previously identified genetic diagnosis. The goal of this study was to assess the combination of clinical reassessment with updated genetic testing, including whole genome sequencing. Reassessment improved the diagnostic clarification rate in these patients.

Treatment Window for Lowering Blood Pressure in Acute ICH

Effective treatment for acute intracerebral hemorrhage (ICH) has remained elusive, with inconclusive results from surgical evacuations, as well as blood pressure management. The investigators performed a pooled analysis of four INTERACT trials that studied the effect of aggressive blood pressure lowering in patients with acute ICH. Ultra-early treatment (< 3 hours from onset) may be beneficial, but most patients are not so quickly diagnosed or treated.

EEG in Patients with Disorders of Consciousness

Abnormal background continuity, ictal-interictal continuum features, and an unreactive electroencephalogram (EEG) background were independently associated with unfavorable outcomes in the overall cohort of patients with acute brain injuries. In addition, an unreactive EEG predicted unfavorable outcomes at six months with high specificity across multiple patient subgroups. However, the sensitivity of unreactive EEG for predicting unfavorable outcomes was low.

Giant Cell Arteritis Has New Options for Steroid-Sparing Therapy

The SELECT-GCA Study trial of patients with giant cell arteritis found that upadacitinib at 15 mg daily combined with a 26-week glucocorticoid taper showed efficacy superior to placebo treatment with a 52-week glucocorticoid taper. The 15-mg dose of oral upadacitinib added to a shorter steroid treatment regimen was well-tolerated and appeared to be safe, as compared to placebo treatment with a longer period of steroid treatment.

Blood GFAP Measurements for Rapid Diagnosis of ICH

The early diagnosis of spontaneous intracerebral hemorrhage (ICH) is important to initiate rapid interventions, such as lowering blood pressure and reversing the effects of antithrombotic medications. Plasma assays of glial fibrillary acidic protein may become a useful tool for the prehospital diagnosis of ICH, but it needs further study before adoption in the clinical setting.

Tolebrutinib May Slow Disability Progression in Patients with SPMS

A recent prospective study showed that tolebrutinib slows disability progression in patients with nonrelapsing secondary progressive multiple sclerosis (SPMS). There were some safety concerns, especially hepatotoxicity. A lack of demonstrated effect on some functional outcomes warrants careful consideration and continuing study.

CSF α-Synuclein Seed Amplification Assays in Parkinsonian Syndromes

This large longitudinal study, which looked at cerebrospinal fluid α-synuclein seed amplification assays (SAAs) from three large cohorts, demonstrated efficacy in distinguishing between Parkinson’s disease and progressive supranuclear palsy, as well as predicting cognitive decline based on kinematic analysis of the SAA samples.

Long-Term Peripheral Nerve Function Changes in People with Well-Controlled Type 2 Diabetes

The authors conducted a prospective observational study comparing the effect of early diagnosed, well-controlled type 2 diabetes on peripheral nerve function. Overall, they found similar rates of decline in nerve function in people with well-controlled diabetes compared to age- and sex-matched individuals with normal glucose tolerance. Given the similar decline in nerve function, the authors concluded that the course of diabetic sensorimotor neuropathy is influenced primarily by nerve function at the time of diagnosis and age-related physiological decline.

Post-Traumatic Headaches: Common and Complicated

The brain’s ability to modulate pain influences the development and persistence of post-traumatic headache (PTH). Functional magnetic resonance imaging (fMRI) studies in people with PTH show higher pain-induced brain activation in specific regions, such as the postcentral gyrus, superior temporal gyrus, and ventral striatum, as compared to healthy controls. Over 16 weeks of observation, progressive normalization in pain-induced brain activation was seen in the PTH group with headache improvement, with persistently elevated activation in the non-improvement PTH group.