The 2012 American Academy of Neurology Annual Meeting

New research was presented at the American Academy of Neurology’s 64th annual meeting from April 21-28, 2012 in New Orleans. The features below highlight just some of the studies that emerged from the conference, including diagnosing Alzheimer’s earlier, an investigational drug to reduce MS lesions, a new drug formulation benefits Parkinson’s, and determining the threshold for head trauma. Diagnosing Alzheimer’s Earlier The Particulars: Alzheimer’s disease (AD) currently can only be confirmed definitively upon autopsies after patients have died or with brain tissue biopsies to detect amyloid plaques, tangles, or both. Florbetaben is an investigational agent that may be beneficial when used as a tracer during PET scans to detect amyloid plaques in patients living with AD. Data Breakdown: In a study, more than 200 patients with and without known dementia who were nearing death and willing to donate their brain to science underwent MRI and florbetaben PET scans. Amyloid plaque levels among those who reached autopsy were compared with scan results. Florbetaben scans were found to have 77% sensitivity and 94% specificity in detecting beta-amyloid. Take Home Pearl: Florbetaben, when used as a PET scan tracer to visualize amyloid plaques in the brain, appears to help diagnose AD in those living with the disease. Investigational Drug May Reduce MS Lesions The Particulars: Patients with multiple sclerosis (MS) who have Gd-enhancing brain lesions have limited treatment options. ONO-4641 is an investigational drug that may help reduce lesions in this patient population. Data Breakdown: Researchers randomized patients with relapsing-remitting MS to placebo or 0.05 mg, 0.10 mg, or 0.15 mg of ONO-4641 once daily for 26 weeks in a study. When...
Guidelines for Intracranial Neurointerventional Procedures

Guidelines for Intracranial Neurointerventional Procedures

Rapid advancements in endovascular interventions have facilitated the use of intracranial endovascular interventions to treat cerebrovascular diseases using minimally invasive intravascular techniques. Developments in computer-aided imaging and high-resolution digital subtraction angiography with reconstruction techniques, as well as easier access to the cerebral vasculature through improved microcatheter design, have lured the interest of physicians across multiple specialties. Consequently, the increasing popularity of these interventions has led to some controversy regarding who should perform these procedures and the methods of training. Other controversies surround how the efficacy and safety of endovascular procedures compare with standard open procedures. Considering these issues, guidelines have been released by the American Heart Association (AHA) and American Stroke Association (ASA). Published in the April 6, 2009 issue of Circulation, the guidelines examine current information and data about the safety and efficacy of procedures that are used for intracranial endovascular interventional treatment of cerebrovascular diseases (Table 1). They also provide recommendations based on the best available evidence to date. A Multidisciplinary Approach AFL may be caused by abnormalities or diseases of the heart as well as diseases elsewhere in the body that affect the heart. These include diseases of the heart valves, especially the mitral valve, and chamber enlargement/hypertrophy. Diseases of the heart that have been linked to AFL include ischemia, atherosclerosis, myocardial infarction, hypertension, and cardiomyopathy. Other diseases/conditions associated with AFL include hyperthyroidism, pulmonary embolism, COPD and emphysema, alcoholism, and stimulant abuse. Some patients with AFL will experience few or no symptoms. For this reason, AFL is often identified incidentally with an electrocardiogram. Other ways to diagnose AFL include cardiac rhythm assessment with outpatient Holter monitoring,...