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Aspirin is First-Line Treatment for Migraine and Episodic Tension-Type Headache


Aspirin is First-Line Treatment for Migraine and Episodic Tension-Type Headache Regardless of Headache Intensity

Headache: The Journal of Head and Face Pain, 09/08/2011  Clinical Article

Aspirin is First-Line Treatment for Migraine and Episodic Tension-Type Headache

Lampl C et al. – In neither migraine nor episodic tension–type headache (ETTH) does pre–treatment headache intensity predict success or failure of aspirin. This is not an arguable basis for stratified care in migraine. In both disorders, aspirin is first–line treatment regardless of headache intensity.

  • With regard to the first assumption, authors developed a rhetorical argument that need for treatment is underpinned by expectation of benefit, not by illness severity.
  • To address the second, authors reviewed individual patient data from 6 clinical trials of aspirin 1000 mg in migraine (N = 2079; 1165 moderate headache, 914 severe) and one of aspirin 500 and 1000 mg in ETTH (N = 325; 180 moderate, 145 severe), relating outcome to pre–treatment headache intensity.
  • In migraine, for headache relief at 2 hours, a small (4.7%) and non–significant risk difference (RD) in therapeutic gain favored moderate pain; for pain freedom at more
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Valproate for the treatment of medication-induced impulse-control disorders in three patients with Parkinsons disease


Valproate for the treatment of medication-induced impulse-control disorders in three patients with Parkinsons disease

Parkinsonism & Related Disorders, 06/08/2011  Clinical Article

Hicks CW et al. – Based on these encouraging preliminary observations, future controlled clinical trials investigating the efficacy of valproate for Impulse–control disorders in Parkinson disease are recommended.

  • Impulse–control disorders are becoming more commonly recognized in the Parkinson disease population.
  • To date, there are no definitive methods of treating dopamine dysregulation syndromes in Parkinson disease patients.
  • The authors sought to uncover an effective treatment option for more

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Risk Factors and Preventive Interventions for Alzheimer Disease: State of the Science


Archives of Neurology, 05/11/2011

Daviglus ML et al. – Currently, insufficient evidence exists to draw firm conclusions on the association of any modifiable factors with risk of Alzheimer disease(AD).

  • Study inclusion criteria for the evidence report were participants aged 50 years and older from general populations in developed countries.
  • Minimum sample sizes of 300 for cohort studies and 50 for randomized controlled trials.
  • At least 2 years between exposure and outcome assessment; and use of well–accepted diagnostic criteria for AD.
  • Included studies were evaluated for eligibility and data were ed.
  • Quality of overall evidence for each factor was summarized as low, moderate, or high.
Results more
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Randomized, double-blind, placebo-controlled trial of ezogabine (retigabine) in partial epilepsy


Neurology, 05/04/2011  Clinical Article

French JA et al. – This study demonstrates that EZG(RTG) is effective as add-on therapy for reducing seizure frequency in patients with drug-resistant partial-onset seizures.

  • RESTORE 1 was a multicenter, randomized, double-blind, parallel-group trial.
  • Following a prospective 8-week baseline phase, patients entered an 18-week double-blind treatment period (6-week forced dose titration to EZG[RTG] 1,200 mg/day in 3 equally divided doses or placebo, followed by a 12-week maintenance phase).
  • Results were analyzed on an intent-to-treat basis for the entire 18-week period and for patients reaching the maintenance phase.
Results more 

Temporoparietal Hypometabolism in Frontotemporal Lobar Degeneration and Associated Imaging Diagnostic Errors

Archives of Neurology, 03/30/2011

Womack KB et al. – Temporoparietal hypometabolism in Frontotemporal Lobar Degeneration(FTLD) is common and may cause inaccurate interpretation of positron emission tomographic scans with fludeoxyglucose F 18 scans. An interpretation paradigm that focuses on the absence of hypometabolism in more

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Coffee Consumption and Risk of Stroke in Women


Stroke, 03/15/2011

Larsson SC et al. – The association between coffee consumption and cerebral infarction was not modified by smoking status, body mass index, history of diabetes or hypertension, or alcohol consumption. These findings suggest that low or no coffee consumption is associated with more

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Barthel Index for Stroke Trials


Stroke, 03/08/2011  Exclusive author commentary

Quinn TJ et al. – Substantial literature describing BI clinimetrics in stroke is available; however, questions remain regarding certain properties. The "BI" label is used for a number of instruments and the authors urge greater consistency in methods, content, and scoring.

Terence J. Quinn (03/07/2011) comments:
The Barthel Index of activities of daily living is a prevalent outcome measure in rehabilitation and stroke trials and is popular in clinical practice. Properties of Barthel have been described in numerous studies, but assessmnet of this literature is complicated by the heterogeneity of Barthel assessment (direct interview, proxy interview, observed assessment, telephone and more

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Risk Factors and Outcome of Seizures After Chronic Subdural Hematoma


Neurocritical Care , 02/16/2011

Huang YH et al. – Lower mean GCS on admission is independently predictive of seizures, most of which occur within the first three months after chronic subdural hematoma.  Read More

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Prehypertension, Racial Prevalence and Its Association With Risk Factors


Prehypertension, Racial Prevalence and Its Association With Risk Factors: Analysis of the REasons for Geographic And Racial Differences in Stroke (REGARDS) Study  

American Journal of Hypertension, 01/21/2011  Exclusive author commentary

Glasser SP et al. – The prevalence of Prehypertension increased by age and African–American race. In addition, a higher prevalence of Prehypertension was observed with elevated high–sensitivity C reactive protein, diabetes, microalbuminuria, and those with heavy alcohol consumption compared to those without these factors.

Stephen P. Glasser (01/20/2011) comments:
Literature is accumulating that the presence of prehypertension (preHTN- defined as a blood pressure of 120-139 mmHg systolic and/or 80-90 mmHg diastolic) is associated with increased long-term risk. It remains controversial, however, as to whether prehypertensive BPs alone, or its association with its common risk factor accompaniments is important in determining ultimate risk. However, while answering these questions, it is important to understand the epidemiology of prehypertension; and, The Reasons for Geographic And more

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Impact of exposure to interferon beta-1a on outcomes in patients with relapsing–remitting multiple sclerosis


Impact of exposure to interferon beta-1a on outcomes in patients with relapsing–remitting multiple sclerosis: exploratory analyses from the PRISMS long-term follow-up study

Therapeutic Advances in Neurological Disorders, 01/14/2011  Exclusive author commentary

Uitdehaag B et al. – The findings of these post hoc analyses suggest that high exposure to sc interferon beta–1a may be associated with better clinical outcomes than low exposure, and also highlight the importance of maximizing adherence. Additional prospective investigation is warranted to evaluate further the effects of treatment exposure on outcomes and to determine the benefits of interventions to improve adherence.

Victor Rivera. (01/13/2011) comments:
This multi authored international ad hoc analyses addresses long-term follow-up, 7-8 years, after enrolment in the PRISMS (Prevention of Relapses and disability by Interferon beta-1a Subcutaneously in Multiple Sclerosis) study. Patients exposed to 44 mcg high dose and that received continuous therapy had better clinical outcomes (annual relapse rate, progression of disability and conversion to secondary progressive disease) as well more

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