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Safety and efficacy of active blood-pressure reduction to the recommended thresholds for intravenous thrombolysis in patients with acute ischaemic stroke in the Netherlands (TRUTH): a prospective, observational, cluster-based, parallel-group study 荷兰急性缺血性脑卒中患者主动降压至静脉溶栓推荐阈值的安全性和有效性(TRUTH):一项前瞻性、观察性、分组平行研究
Pub Date : 2024-05-01 DOI: 10.1016/S1474-4422(24)00177-7
T. Zonneveld, S. Vermeer, E. W. V. Zwet, A. E. Groot, Ale Algra, L. Aerden, K. Alblas, F. D. Beer, P. J. A. M. Brouwers, K. D. Gans, H. V. Gemert, Bart C A M van Ginneken, Gerke S. Grooters, P. Halkes, Tonny A M H G van der Heijden-Montfroy, K. Jellema, Sonja W de Jong, Harry Lövenich-Ciccarello, W. D. V. D. Meulen, Edwin W Peters, T. C. V. D. Ree, M. Remmers, Edo Richard, Jörgen M P Rovers, Ritu Saxena, S. M. V. Schaik, W. Schonewille, T. Schreuder, E. Schryver, W. Schuiling, Fianne H Spaander, J. V. Tuijl, Marieke C Visser, Sanne M. Zinkstok, E. Zock, D. Dippel, L. J. Kappelle, R. J. V. Oostenbrugge, Y. Roos, F. Vermeij, M. Wermer, H. B. Worp, P. Nederkoorn, N. Kruyt
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引用次数: 1
Challenging the management of blood pressure before intravenous thrombolysis in acute ischaemic stroke 急性缺血性脑卒中静脉溶栓前的血压管理挑战
Pub Date : 2024-05-01 DOI: 10.1016/S1474-4422(24)00208-4
Verónica V Olavarría
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引用次数: 0
A neurotransmitter with a fascinating story Mark P Mattson 一种有着动人故事的神经递质 Mark P Mattson
Pub Date : 2024-05-01 DOI: 10.1016/S1474-4422(24)00138-8
Jennifer Pocock
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引用次数: 0
Specialist physiotherapy for functional motor disorder in England and Scotland (Physio4FMD): a pragmatic, multicentre, phase 3 randomised controlled trial 英格兰和苏格兰功能性运动障碍的专业物理治疗(Physio4FMD):一项务实、多中心、第三阶段随机对照试验
Pub Date : 2024-05-01 DOI: 10.1016/S1474-4422(24)00135-2
Glenn Nielsen, Jon Stone, Teresa C Lee, Laura H Goldstein, Louise Marston, Rachael Hunter, Alan Carson, K. Holt, Jon Marsden, Marie Le Novere, Irwin Nazareth, Hayley Noble, Markus Reuber, Ann-Marie Strudwick, Beatriz Santana Suarez, Mark J Edwards, Emily Beaves, David Breen, C. Burness, S. Caddy, H. Callaghan, Andrew Carberry, Luke Chetham, A. Clyne, Susie Cobb, Jan Coebergh, Lewis Cook, Patrick Cookson, Paul Cooper, Clare Diamond, Lee Drake, Victoria Dunn, Paula Gardiner, Thomas Gilbertson, Dawn Golder, Rebecca Gregory, Helen Harbinson, Rory Higgins, I. Hoeritzauer, Laura Irvine, Jeremy Isaacs, Emily Jay, Danielle Kearney, Uzma Khan, James Magro, Elizabeth Mallam, Eleanor Harle, Luke Massey, Sarah McRae, Shagun Misra, Steph Mitchell, Cameron Moss, Esther Mountain, Shona Murray, Rachel Newby, Marianne Novak, Annie Ross, Anna Rutherford, Gillian Sare, Rhiannon Sears, Will Sedley, Sumeet Singhal, B. Stanton, Charlotte Stone, Gillian Szeto, Lauren Tarr, Tiago Teodoro, Volker Teweleit, Michael Walsh, Rhian Wa
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引用次数: 0
Progress in physical therapy for functional motor disorder 功能性运动障碍的物理治疗进展
Pub Date : 2024-05-01 DOI: 10.1016/S1474-4422(24)00162-5
Mark Hallett
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引用次数: 0
Safety and efficacy of continuous subcutaneous levodopa–carbidopa infusion (ND0612) for Parkinson's disease with motor fluctuations (BouNDless): a phase 3, randomised, double-blind, double-dummy, multicentre trial 持续皮下注射左旋多巴-卡比多巴(ND0612)治疗伴运动性波动帕金森病(BouNDless)的安全性和疗效:3 期随机、双盲、双哑药、多中心试验
Pub Date : 2024-03-15 DOI: 10.1016/s1474-4422(24)00052-8
Prof Alberto J Espay MD, Prof Fabrizio Stocchi MD, Prof Rajesh Pahwa MD, Prof Alberto Albanese MD, Aaron Ellenbogen MD, Prof Joaquim J Ferreira MD, Prof Nir Giladi MD, Tanya Gurevich MD, Sharon Hassin-Baer MD, Jorge Hernandez-Vara MD, Stuart H Isaacson MD, Prof Karl Kieburtz MD, Prof Peter A LeWitt MD, Lydia Lopez-Manzanares MD, Prof C Warren Olanow MD, Prof Werner Poewe MD, Harini Sarva MD, Tami Yardeni MA, Liat Adar PhD, Laurence Salin MD, Nelson Lopes MD, Nissim Sasson MA, Ryan Case PhD, Prof Olivier Rascol MD, BouNDless Study Group, Mitra Afshari, Alexander Amelin, David Arkadir, Samih Badarny, Ernest Balaguer Martinez, Andrzej Bogucki, James Boyd, Laura Buyan Dent, Camille Carroll, Kallol Ray Chaudhuri, Jeffrey Cooney, Anne-Gaëlle Corbillé, Teodor Danaila, Maria Francesca De Pandis, Sophie Dethy, Rohit Dhall, Ruth Djaldetti, Franck Durif, Stephen Flitman, Eric Freire Alvarez, John Goudreau, Francisco Grandas Perez, Tanya Gurevich, Arnaldo Isa, Jorge L Juncos, Sulada Kanchana, Gabriela Klodowska-Duda, Dariusz Koziorowski, Jaime Kulisevsky Bojarski, Juan Lopez Lozano, Lan Luo, Nataliya Lytvynenko, Roberto Marconi, Ana-Raquel Marques, Juan Carlos Martinez Castrillo, Irene Martinez Torres, Aashoo Mentreddi, Pablo Mir Rivera, Sergii Moskovko, Yuliya Neryanova, Marco Onofrj, Jill Ostrem, Claudio Pacchetti, Nicola Pavese, Clelia Pellicano, Gonzalo Revuelta, Ana Margarida Rodrigues, Ramon Rodriguez, Monika Rudzinska, Nighat Sarwar, Julie Schwartzbard, Laura Scorr, John Slevin, Tatyana Slobodin, Gianfranco Spalletta, Michele Tagliati, Yen Tai, Alessandro Tessitore, Peter Valkovic, Leo Verhagen, Elena Vostrikova, Gilad Yahalom, Zuleykha Zalyalova, Katerina Zarubova, Irina Zhukova
Conventional oral levodopa therapy for the treatment of Parkinson's disease can be associated with variations in plasma concentrations. Levodopa infusion strategies might provide more consistent drug delivery and fewer motor fluctuations. We aimed to assess the safety and efficacy of a continuous 24 h/day subcutaneous infusion of ND0612 (a levodopa–carbidopa solution) compared with oral immediate-release levodopa–carbidopa for the treatment of motor fluctuations in people with Parkinson's disease. We conducted a phase 3, randomised, double-blind, double-dummy, active-controlled, multicentre trial at 117 academic and community neurology sites in 16 countries, including in Europe, Israel, and the USA. Eligible participants were men and women aged 30 years or older with a diagnosis of Parkinson's disease (Hoehn and Yahr stage ≤3 in the on state) who experienced at least 2·5 h/day of off time. Participants underwent an open-label run-in phase (<12 weeks), during which time optimal regimens were established for both oral immediate-release levodopa–carbidopa and for 24 h/day subcutaneous ND0612 infusion (levodopa–carbidopa 60·0/7·5 mg/mL), with supplemental oral levodopa–carbidopa if needed. Participants were then randomly assigned (1:1) to 12 weeks of double-blind treatment with their optimised regimen of either subcutaneous ND0612 or oral levodopa–carbidopa, with matching oral or subcutaneous placebo given as required to maintain blinding. Randomisation was done via an interactive web response system, stratified by region, using a permuted block schedule. Participants, study partners, treating investigators, study site personnel, and the sponsor were masked to treatment group allocation. The primary efficacy endpoint was the change from baseline (ie, time of randomisation, when all patients were receiving an optimised open-label ND0612 regimen) to end of the double-blind phase in total daily on time without troublesome dyskinesia, analysed by intention to treat. This trial is registered with , , and is complete. Between Sept 30, 2019, and April 8, 2022, 381 participants were enrolled, of whom 259 (68%) were randomly assigned, 128 (49%) to subcutaneous ND0612 and 131 (51%) to oral levodopa–carbidopa. 243 (94%) participants completed the study. Treatment with subcutaneous ND0612 provided an additional 1·72 h (95% CI 1·08 to 2·36) of on time without troublesome dyskinesia compared with oral levodopa–carbidopa (change from baseline of –0·48 h [–0·94 to –0·02] with subcutaneous ND0612 –2·20 h [–2·65 to –1·74] with oral levodopa–carbidopa; p<0·0001). Significant treatment differences favouring subcutaneous ND0612 were also found in the first four of nine prespecified hierarchical outcomes of daily off time (–1·40 h [95% CI –1·99 to –0·80]), Movement Disorders Society-Unified Parkinson's Disease Rating Scale part II scores (–3·05 [–4·28 to –1·81]), Patients Global Impression of Change (odds ratio [OR] 5·31 [2·67 to 10·58]), and Clinical Global Impression of
治疗帕金森病的传统左旋多巴口服疗法可能与血浆浓度变化有关。左旋多巴输注策略可提供更稳定的药物输送,减少运动波动。我们旨在评估连续24小时/天皮下注射ND0612(左旋多巴-卡比多巴溶液)与口服速释左旋多巴-卡比多巴治疗帕金森病患者运动波动的安全性和有效性。我们在 16 个国家(包括欧洲、以色列和美国)的 117 个学术和社区神经病学研究机构开展了一项 3 期随机、双盲、双哑药、主动对照、多中心试验。符合条件的参与者为年龄在 30 岁或 30 岁以上、确诊患有帕金森病(Hoehn 和 Yahr 分期≤3,处于开启状态)、每天至少有 2-5 小时休息时间的男性和女性。在此期间,确定了口服速释左旋多巴-卡比多巴和24小时/天皮下注射ND0612(左旋多巴-卡比多巴60-0/7-5毫克/毫升)的最佳方案,必要时可补充口服左旋多巴-卡比多巴。然后,参与者被随机分配(1:1)接受为期12周的双盲治疗,采用皮下注射ND0612或口服左旋多巴-卡比多巴的优化方案,并根据需要给予相应的口服或皮下注射安慰剂以保持盲法。随机化是通过交互式网络响应系统进行的,按地区分层,采用包块计划。参与者、研究合作伙伴、治疗研究人员、研究机构人员和赞助商均对治疗组分配蒙蔽。主要疗效终点是从基线(即随机分组时,当时所有患者都在接受优化的开放标签ND0612方案治疗)到双盲阶段结束时每天无运动障碍总时间的变化,按意向治疗进行分析。该试验已在、、注册,并已完成。2019年9月30日至2022年4月8日期间,共有381名参与者入组,其中259人(68%)被随机分配,128人(49%)被分配至皮下注射ND0612,131人(51%)被分配至口服左旋多巴-卡比多巴。243人(94%)完成了研究。与口服左旋多巴-卡比多巴相比,皮下注射ND0612治疗可增加1-72小时(95% CI为1-08至2-36)的无运动障碍时间(与基线相比,皮下注射ND0612为-0-48小时[-0-94至-0-02],口服左旋多巴-卡比多巴为-2-20小时[-2-65至-1-74];P<0-0001)。在九项预设分层结果的前四项中,也发现了有利于皮下注射ND0612的显著治疗差异(-1-40 h [95% CI -1-99 to -0-80])、运动障碍协会-统一帕金森病评定量表 II 部分评分(-3-05 [-4-28 to -1-81] )、患者总体变化印象(几率比 [OR] 5-31 [2-67 to 10-58])和临床总体改善印象(OR 7-23 [3-57 to 14-64])。层次测试在第四个次要终点之后结束。在开放标签ND0612优化期间,322名参与者中有287人(89%)报告了不良事件,在双盲阶段,ND0612组128人中有103人(80%)报告了不良事件,口服左旋多巴-卡比多巴组131人中有97人(74%)报告了不良事件。最常见的不良反应是输液部位反应(开放标签ND0612期间266人[83%],双盲阶段ND0612组73人[57%],口服左旋多巴-卡比多巴组56人[43%]),其中大多数为轻度反应。ND0612组有4名参与者发生的严重不良事件与研究治疗有关(输液部位蜂窝织炎[n=2]、输液部位脓肿和输液部位溃疡[n=1];以及麻痹和外周感觉运动神经病[n=1])。ND0612组有一名参与者在双盲阶段死亡,但死亡与研究治疗无关(摔倒导致脑外伤)。这项3期研究的结果表明,皮下注射ND0612与口服速释左旋多巴-卡比多巴联用可增加患者的服药时间,但不会出现令人烦恼的运动障碍,并可减少停药时间,其获益-风险状况良好。ND0612可能是一种安全有效的左旋多巴皮下注射方法,可用于控制帕金森病患者的运动波动。目前正在进行的开放标签扩展阶段将提供有关长期疗效和安全性的进一步信息。NeuroDerm。
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The primary efficacy endpoint was the change from baseline (ie, time of randomisation, when all patients were receiving an optimised open-label ND0612 regimen) to end of the double-blind phase in total daily on time without troublesome dyskinesia, analysed by intention to treat. This trial is registered with , , and is complete. Between Sept 30, 2019, and April 8, 2022, 381 participants were enrolled, of whom 259 (68%) were randomly assigned, 128 (49%) to subcutaneous ND0612 and 131 (51%) to oral levodopa–carbidopa. 243 (94%) participants completed the study. Treatment with subcutaneous ND0612 provided an additional 1·72 h (95% CI 1·08 to 2·36) of on time without troublesome dyskinesia compared with oral levodopa–carbidopa (change from baseline of –0·48 h [–0·94 to –0·02] with subcutaneous ND0612 –2·20 h [–2·65 to –1·74] with oral levodopa–carbidopa; p<0·0001). Significant treatment differences favouring subcutaneous ND0612 were also found in the first four of nine prespecified hierarchical outcomes of daily off time (–1·40 h [95% CI –1·99 to –0·80]), Movement Disorders Society-Unified Parkinson's Disease Rating Scale part II scores (–3·05 [–4·28 to –1·81]), Patients Global Impression of Change (odds ratio [OR] 5·31 [2·67 to 10·58]), and Clinical Global Impression of","PeriodicalId":22676,"journal":{"name":"The Lancet Neurology","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140146232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Fluctuations in Parkinson's disease: progress and challenges 帕金森病的波动:进展与挑战
Pub Date : 2024-03-15 DOI: 10.1016/s1474-4422(24)00116-9
Francisco Cardoso, Eduardo Tolosa
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引用次数: 0
A call for awareness in encephalitis 呼吁提高对脑炎的认识
Pub Date : 2024-02-21 DOI: 10.1016/s1474-4422(24)00074-7
Ava Easton
{"title":"A call for awareness in encephalitis","authors":"Ava Easton","doi":"10.1016/s1474-4422(24)00074-7","DOIUrl":"https://doi.org/10.1016/s1474-4422(24)00074-7","url":null,"abstract":"","PeriodicalId":22676,"journal":{"name":"The Lancet Neurology","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139917021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Thank you to The Lancet Neurology's peer reviewers in 2023 感谢《柳叶刀神经病学》2023 年的同行评审员
Pub Date : 2024-02-15 DOI: 10.1016/s1474-4422(24)00047-4
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引用次数: 0
The source of imagination 想象力的源泉
Pub Date : 2024-02-15 DOI: 10.1016/s1474-4422(24)00044-9
Robert Stirrups
{"title":"The source of imagination","authors":"Robert Stirrups","doi":"10.1016/s1474-4422(24)00044-9","DOIUrl":"https://doi.org/10.1016/s1474-4422(24)00044-9","url":null,"abstract":"","PeriodicalId":22676,"journal":{"name":"The Lancet Neurology","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139917020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
The Lancet Neurology
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