European journal of neurology : the official journal of the European Federation of Neurological Societies
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Randomized Controlled Trial
Efficacy of Galcanezumab in Patients with Episodic Migraine and a History of Preventive Treatment Failure: Results from Two Global Randomized Clinical Trials.
The efficacy of galcanezumab, a monoclonal antibody for migraine prevention, has been demonstrated in two pivotal trials in patients with episodic migraine. ⋯ In patients with episodic migraine treated with galcanezumab, those with ≥1 or ≥2 prior preventive failures had significantly larger improvements, versus placebo, in efficacy outcomes. Similar results were observed in patients with no prior failure, with a larger placebo response.
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The pathophysiology of Parkinson's disease (PD) remains unclear. Voxel-based morphometry (VBM) detects local structural differences in brain tissue such as grey matter volume (GMV) between groups, which is helpful in understanding the pathophysiology of PD. Published VBM studies of GMV changes in PD have shown inconsistent results. Therefore, a voxel-wise meta-analysis of VBM studies was conducted to detect consistent GMV changes in PD. ⋯ Parkinson's disease patients have GMV reductions in a number of brain regions involved in specific networks. These findings provide morphological evidence for the pathophysiology of PD.
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Randomized Controlled Trial
Positive Response to Galcanezumab Following Treatment Failure to OnabotulinumtoxinA in Patients With Migraine: Post hoc Analyses of 3 Randomized Double-Blind Studies.
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). ⋯ Galcanezumab is an option for prevention of migraine in patients who have previously failed onabotulinumtoxinA preventive therapy.
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The cervical and thoracic cross-sectional spinal cord area (CS-SCA) in multiple sclerosis (MS) correlates with disability, whilst such a correlation remains to be established in neuromyelitis optica spectrum disorder (NMOSD). Our aim was to clarify differences between MS and NMOSD in spinal cord segments where CS-SCA is associated with disability. ⋯ Thoracic CS-SCA is a useful predictive marker for disability in patients with NMOSD whilst cervical CS-SCA is associated with disability in patients with MS.
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Acute ischemic stroke treatment with intravenous thrombolysis (IVT) is restricted to a time window of 4.5 h after known or presumed onset. Recently, magnetic resonance imaging-guided treatment decision-making in wake-up stroke (WUS) was shown to be effective. The aim of this study was to determine the safety and outcome of IVT in patients with a time window beyond 4.5 h selected by computed tomography perfusion (CTP) imaging. ⋯ In patients presenting in an extended time window beyond 4.5 h, IVT treatment with decision-making based on CTP might be a safe procedure. Further evaluation in clinical trials is needed.