Duke Neurology Research Round Up, August 2019

What do new candidates for effective, non-addictive treatments for pain relief, a review of the past 20 years of how repetitive transcranial magnetic stimulation affects cognition, and an examination of how stroke-like conditions respond to treatments for stroke have in common? They’re all the subjects of research published by members of the Duke Department of Neurology in the past month. Read more about each of the 11 articles authored (or co-authored) by members of our faculty in August 2019, and find links to the original publications below.

Research Techniques

• In the latest issue of the Journal of Visualized Experiments (JOVE), senior authors Constanza Cortes, PhD and Virginia Wertman demonstrate a new, low-cost alternative to digitized gait analysis programs for research projects examining movement abnormalities in mice. This method offers speed, simplicity and the potential for longitudinal analysis compared to other methods. Al La Spada, MD, PhD, and Anastasie Gromova contributed to the video and article, which appears here.

Memory Disorders

• Obesity has been consistently associated with impairments in neurocognition and greater dementia risk, but the underlying reasons for these links are not fully understood.James Burke, MD, PhD, and Kathie Welsh-Bohmer, PhD, were part of a team that examined the metabolic mechanisms that may be responsible for these associations. Their Journal of Alzheimer’s Disease article found that higher leptin resistance play a role. Read that story here.
• Assessing an individual’s willingness to undergo a potentially risky treatment is complex and difficult, especially for individuals dealing with cognitive impairment. Brenda Plassman, PhD, contributed to a study that examined willingness to accept risky treatments for both individuals with cognitive impairment who received amyloid PET scans as well as the willingness of their care partners. Read what they found in Alzheimer’s Disease & Associated Disorders.
• A new meta-analysis by a team including Simon Davis, PhD, reviews the published literature surrounding how repetitive transcranial magnetic stimulation affects cognitive processing over the past 20 years. The Neuroscience Behavioral Reviews article examined more than 120 studies. Read their findings here.

Stroke

• Prompt treatment with intravenous tPA offers enormous benefits for patients with acute ischemic stroke. However the need to treat patients quickly means there is also a risk of administrating tPA to patients presenting with noncerebrovascular conditions that closely resemble stroke. Ying Xian, MD, PhD, was the senior author of a study that analyzed national data from nearly 73,000 patients in nearly 500 hospitals to examine the safety of tPA in stroke-like conditions. Read what they found in Circulation: Cardiovascular Quality and Outcomes.
• Xian also contributed to an American Heart Journal study that examined the associations between two types of preceding oral anticoagulant (warfarin or DOACs) and in-hospital mortality in patients admitted with gastrointestinal bleeding. Their analysis of nearly 6,000 patients found no significant differences in mortality between these two treatments. Read the full study here.
• Michael “Luke” James, MD was part of a team that investigated the association of computed tomography–based markers of cerebral small vessel disease with functional outcome and recovery after intracerebral hemorrhage. Read their article in the latest issue of Stroke.

Neuro-Oncology

• Chemotherapy-induced nausea and vomiting is a persistent, distressing side effect of treatment for many glioma patients. Annick Desjardins, MD, Katy Peters, MD, PhD, and Dina Randazzo, MD, contributed to a randomized open-label phase 2 trial of prepitant plus ondansetron compared to ondansetron alone to reduce these symptoms in a group of glioma patients. Read that article in Supportive Care in Cancer.

Headache and Pain

• The DN-9 peptide has been identified as a promising candidate in the quest for anti-pain medications that engage the opioid system without producing opioid side effects. A team including Wolfgang Liedtke, MD, PhD, and Yong Chen, PhD, now reports that peripheral application of DN-9 provides potent pain relief with minimal side effects. Read that article in the British Journal of Pharmacology.

Biomedical Engineering

• Cellular therapeutics offer great potential for treating medical conditions, but these therapeutics need a way to be effectively and safely delivered to the proper tissue compartment. Tatiana Segura, PhD, contributed to a new study that examines the use of microporous annealed particle scaffolds for this purpose. Read that study here.

Neurogenetics

• An individual’s risk for developing schizophrenia is linked with lower cognitive abilities, at both the phenotypic and genetic level. Ornit Chiba-Falek, PhD, was part of an international team that  analyzed existing genome-wide association studies (GWAS) in cognitive ability, education, and schizophrenia to examine the possible biological mechanisms for these trends. Read their results in the American Journal of Human Genetics.