Annals of neurology
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Annals of neurology · Mar 2019
Randomized Controlled TrialA randomized study of solriamfetol for excessive sleepiness in narcolepsy.
Solriamfetol (JZP-110) is a selective dopamine and norepinephrine reuptake inhibitor with wake-promoting effects. This phase 3 study (NCT02348593) evaluated the safety and efficacy of solriamfetol in narcolepsy. ⋯ Solriamfetol has the potential to be an important therapeutic option for the treatment of impaired wakefulness and excessive sleepiness in patients with narcolepsy. ANN NEUROL 2019;85:359-370.
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Annals of neurology · Dec 2018
Vagus nerve stimulation modulates the cranial trigeminal autonomic reflex.
The trigeminal autonomic reflex plays an important role in primary headache syndromes. Noninvasive vagal nerve stimulation (nVNS) may be an effective modulator of this reflex. ⋯ Cervical nVNS resulted in a robust bilateral reduction of provoked lacrimation. This effect could be mediated either by direct bilateral activation of structures such as the nucleus of the solitary tract or by a top-down modulation via the hypothalamus. Ann Neurol 2018;84:886-892.
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Annals of neurology · Nov 2018
Randomized Controlled TrialEfficacy of Botulinum Toxin A for Treating Cramps in Diabetic Neuropathy.
Muscle cramps occur in >50% of diabetic patients and reduce the quality of life. No effective treatment is available. We evaluated the clinical effectiveness of botulinum toxin A (BTX-A) injections for treating cramps in diabetic patients with neuropathy. ⋯ Local BTX-A infiltration is an efficacious and safe procedure for obtaining a sustained amelioration of muscle cramps associated with diabetic neuropathy. Ann Neurol 2018;84:682-690.
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Annals of neurology · Oct 2018
Randomized Controlled Trial Comparative StudyRandomized double-blinded clinical trial of 5% dextrose versus triamcinolone injection for carpal tunnel syndrome patients.
Perineural injection with 5% dextrose (D5W) is a novel strategy in the treatment of carpal tunnel syndrome (CTS). In contrast, perineural injection with corticosteroid has been used for decades for treating CTS, but possible neurotoxicity has been a major concern. No studies investigating the comparative effects have been published so far. The authors performed a prospective, randomized, double-blinded, head-to-head comparative trial to compare these two approaches for patients having mild-to-moderate CTS. ⋯ Our study demonstrates that perineural injection of D5W is more beneficial than that of corticosteroid in patients with mild-to-moderate CTS at 4 to 6 months postinjection. Ann Neurol 2018;84:601-610.
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Annals of neurology · Aug 2018
Mendelian randomization study shows no causal relationship between circulating urate levels and Parkinson's disease.
Observational studies have shown that increased plasma urate is associated with lower risk of Parkinson's disease (PD), but these studies were not designed to test causality. If a causal relationship exists, then modulating plasma urate levels could be a potential preventive avenue for PD. We used a large two-sample Mendelian randomization (MR) design to assess for a causal relationship between plasma urate and PD risk. ⋯ We did not find evidence for a linear causal protective effect by urate on PD risk. The associations observed in previous observational studies may be, in part, attributed to confounding or reverse causality. In the context of the present findings, strategies to elevate circulating urate levels may not reduce overall PD risk. Ann Neurol 2018;84:191-199.