Lancet neurology
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Stroke represents a massive public health problem. Carotid atherosclerosis plays a fundamental part in the occurence of ischaemic stroke. European and US guidelines for prevention of stroke in patients with carotid plaques are based on quantification of the percentage reduction in luminal diameter due to the atherosclerotic process to select the best therapeutic approach. ⋯ Advances in imaging techniques have enabled routine characterisation and detection of the features of carotid plaque vulnerability. Intraplaque haemorrhage is accepted by neurologists and radiologists as one of the features of vulnerable plaques, but other characteristics-eg, plaque volume, neovascularisation, and inflammation-are promising as biomarkers of carotid plaque vulnerability. These biomarkers could change current management strategies based merely on the degree of stenosis.
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Randomized Controlled Trial
Safety of the tau-directed monoclonal antibody BIIB092 in progressive supranuclear palsy: a randomised, placebo-controlled, multiple ascending dose phase 1b trial.
Progressive supranuclear palsy is a rare neurodegenerative disease associated with dysfunctional tau protein. BIIB092 is a humanised monoclonal antibody that binds to N-terminal tau and is thus being assessed as a potential novel treatment for progressive supranuclear palsy. We aimed to investigate the safety and tolerability of BIIB092 in individuals with progressive supranuclear palsy. ⋯ Bristol-Myers Squibb, Biogen.
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The management of patients with severe brain injuries and prolonged disorders of consciousness raises important issues particularly with respect to their therapeutic options. The scarcity of treatment options is challenged by new clinical and neuroimaging data indicating that some patients with prolonged disorders of consciousness might benefit from therapeutic interventions, even years after the injury. ⋯ However, only two studies on amantadine and transcranial direct current stimulation provided class II evidence. Although new therapeutic approaches seem to be valuable for patients with prolonged disorders of consciousness, optimised stimulation parameters, alternative drugs, or rehabilitation strategies still need to be tested and validated to improve rehabilitation and the quality of life of these patients.