Migraine doubt, infusions at home and postural sway


By Nicola Garrett

1 Jun 2018

Thursday’s concurrent sessions at ANZAN 2018 covered stroke, general neurology, and neuromuscular and MS. Here are some of the highlights:

Study casts doubt over true prevalence of migraine

Migraine may be more prevalent than we think, say researchers who found neurologists were two to three times more likely to have migraine than the general population.

A survey of 313 delegates attending last year’s ANZAN conference revealed that 65.95% of neurologists, 57.4% of neurology trainees and 52.5% of ‘non-neurologists and non-neurology registrars’ had a history of migraine.  

Population prevalence studies of migraine report prevalence rates of between 2.6 and 21.7%.

According to neurologist Dr Wei Z Yeh, from the Royal Hobart Hospital in Tasmania, the findings were unlikely to indicate that neurologists had a higher risk of migraine. Instead, the findings suggested  a significant under-recognition of migraine in the general population and may “significantly influence the search for genetic predictors and biomarkers of migraine”.

Home infusions of natalizumab safe and cost-effective

The delivery of natalizumab infusions in the home is safe and preferred by patients, a pilot study shows.

Dr Tim Schultz from Adelaide Nursing School randomised 37 adult patients to either infusions at  home followed by in the clinic or clinic infusions followed by home infusions. After three infusions patients switched over to the other treatment arm.

There were no differences in treatment adherence or rates of infection between the groups. There were also no differences in symptom management or quality of life. Patients also preferred to be treated at home.

An economic evaluation also showed that infusions at home were around $74 cheaper per infusion.

Dr Schultz said the study was limited by the fact that it was not an equivalence study. He also noted that 30 percent of patients had declined to participate.

The study was sponsored by Biogen.

Postural sway could be clue to Parkinson’s severity

Postural sway has potential to be a sensitive measure of disease severity and brain function in Parkinson’s Disease, new research shows.

Presenting his findings to congress, neurologist Professor Christian Luek from The Canberra Hospital said  the severity of Parkinson’s Disease was difficult to assess because there was no robust biological marker of disease progression. However postural sway had correlated well with complex brain functioning.

In the study 28 patients with Parkinson’s Disease and an average age of 68 years were assessed for cognition and quality of life using the Montreal Cognitive Assessment (MoCA), Neuropsychiatry Unit Cognitive Assessment (NUCOG) and Parkinson’s Diseases Questionnaire (PDQ-39–1). Postural sway was assessed using a force plate and clinical status was assessed using the motor component of the UPDRS.

Results showed that sway path length was strongly correlated with PDQ-39–1, MoCA and the verbal fluency component of the NUCOG (r=0.63,–0.75 and −0.57, respectively; p=0.002,<0.001 and 0.002, respectively) and, to a lesser degree, with the UPDRS III (r=0.45, p=0.018).

Professor Luek said that postural sway appeared to correlate better with measures of cognition, both general and executive (verbal fluency), and the PDQ measure of disease severity than with the motor component of the UPDRS.

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