Neurology
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Randomized Controlled Trial
nVNS sham significantly affects the trigeminal-autonomic reflex: A randomized controlled study.
To determine whether high placebo effects observed in recently published clinical noninvasive vagal nerve stimulation (nVNS) trials can be attributed to an active modulation of the trigeminal-autonomic reflex by the sham device. ⋯ These results suggest that both the regular nVNS and the sham device used in some of the clinical nVNS trials modulate the trigeminal-autonomic reflex. This could explain the high sham effect in these trials and suggests that stimulation of the posterior neck may be considered as a real sham condition.
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Randomized Controlled Trial
Repetitive TMS does not improve cognition in patients with TBI: A randomized double-blind trial.
To determine whether high-frequency repetitive transcranial magnetic stimulation (rTMS) improves cognition in patients with severe traumatic brain injury. ⋯ This study provides Class II evidence that for individuals with chronic DAI, high-frequency rTMS over the left DLPFC does not significantly improve cognition.
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Randomized Controlled Trial
Randomized phase 2 study of FcRn antagonist efgartigimod in generalized myasthenia gravis.
To investigate safety and explore efficacy of efgartigimod (ARGX-113), an anti-neonatal Fc receptor immunoglobulin G1 Fc fragment, in patients with generalized myasthenia gravis (gMG) with a history of anti-acetylcholine receptor (AChR) autoantibodies, who were on stable standard-of-care myasthenia gravis (MG) treatment. ⋯ This study provides Class I evidence that efgartigimod is safe and well-tolerated in patients with gMG.
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Randomized Controlled Trial Multicenter Study
Framing advance care planning in Parkinson disease: Patient and care partner perspectives.
Advance care planning (ACP) is a core quality measure in caring for individuals with Parkinson disease (PD) and there are no best practice standards for how to incorporate ACP into PD care. This study describes patient and care partner perspectives on ACP to inform a patient- and care partner-centered framework for clinical care. ⋯ ACP in PD may be influenced by patient and care partner perceptions and misperceptions, symptoms of PD (e.g., apathy, cognitive dysfunction, disease severity), and models of clinical care. Optimal engagement of patients with PD and care partners in ACP should proactively address misperceptions of ACP and utilize clinic teams and workflow routines to incorporate ACP into regular care.
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Randomized Controlled Trial
Erenumab in chronic migraine with medication overuse: Subgroup analysis of a randomized trial.
To determine the effect of erenumab, a human anti-calcitonin gene-related peptide receptor monoclonal antibody, in patients with chronic migraine and medication overuse. ⋯ This study provides Class II evidence that erenumab reduces monthly migraine days at 3 months in patients with chronic migraine and medication overuse.