Electroencephalographic signatures of migraine in small prospective and large retrospective cohorts.

Migraine is one of the most common neurological disorders in the US. Currently, the diagnosis and management of migraine are based primarily on subjective self-reported measures, which compromises the reliability of clinical diagnosis and the ability to robustly discern candidacy for available therapies and track treatment response. In this study, we used a computational pipeline for the automated, rapid, high-throughput, and objective analysis of encephalography (EEG) data at Cleveland Clinic to identify signatures that correlate with migraine.

Predictors of therapeutic response following thalamic neuromodulation for drug-resistant pediatric epilepsy: A systematic review and individual patient data meta-analysis.

We sought to perform a systematic review and individual participant data meta-analysis to identify predictors of treatment response following thalamic neuromodulation in pediatric patients with medically refractory epilepsy. Electronic databases (MEDLINE, Ovid, Embase, and Cochrane) were searched, with no language or data restriction, to identify studies reporting seizure outcomes in pediatric populations following deep brain stimulation (DBS) or responsive neurostimulation (RNS) implantation in thalamic nuclei. Studies featuring individual participant data of patients with primary or secondary generalized drug-resistant epilepsy were included.

Older adults are impaired in the release of grip force during a force tracking task.

Age-related changes in force generation have been implicated in declines in older adult manual dexterity. While force generation is a critical aspect of the successful manipulation of objects, the controlled release of force represents the final component of dexterous activities. The impact of advancing age on the release of grip force has received relatively little investigation despite its importance in dexterity.

Clinical characteristics and patient-reported outcomes of chronic and episodic migraine patients at a US tertiary headache center: A retrospective observational study.

Objective: To describe differences in clinical and demographic characteristics between patients with episodic migraine (EM) or chronic migraine (CM) and determine the effect of migraine subtype on patient-reported outcome measures (PROM).

Background: Prior studies have characterized migraine in the general population. While this provides a basis for our understanding of migraine, we have less insight into the characteristics, comorbidities, and outcomes of migraine patients who present to subspecialty headache clinics.

Increased Comfortable Gait Speed Is Associated With Improved Gait Biomechanics in Persons With Chronic Stroke Completing an 8-Week Forced-Rate Aerobic Cycling Intervention: A Preliminary Study.

Task-specific gait training is recommended to improve locomotor function after stroke. Our objective was to determine the effects of a forced-rate aerobic exercise intervention on gait velocity and biomechanics in the absence of task-specific gait training. Individuals with chronic stroke ( N = 14) underwent 24 sessions of forced-rate aerobic exercise, at a targeted aerobic intensity of 60%-80% of their heart rate reserve.

A Pilot Trial of Dopamine Replacement for Dynamic Facial Expressions in Parkinson's Disease.

Background: Current conflict exists regarding the potential beneficial effects of dopamine medications on facial expressivity in Parkinson's disease. Via digital video analysis software, we previously found reduced facial movement (entropy) and slower time to reach peak entropy in individuals with Parkinson's disease compared to controls.

Objectives: We aimed to determine whether levodopa medications improved parameters of dynamic facial expressions (amplitude, speed).

Use of combined hormonal contraception and stroke: A case-control study of the impact of migraine type and estrogen dose on ischemic stroke risk.

Objective: To clarify how factors such as estrogen dose and migraine history (including migraine subtype) impact ischemic stroke risks associated with combined hormonal contraceptive (CHC) use.

Background: CHC use in those with migraine with aura has been restricted due to concerns about stroke risk.

Methods: We conducted a case-control analysis of stroke risk associated with estrogen dose and migraine history among CHC users in a large tertiary care center.

An 8-week aerobic cycling intervention elicits improved gait velocity and biomechanics in persons with Parkinson's disease.

Background: It is unknown if improvements in gait velocity following an aerobic cycling intervention are accompanied by improved gait biomechanics in individuals with Parkinson's disease (PD) or if gait abnormalities are exaggerated in response to increased velocity. Research question Can an 8-week aerobic cycling intervention elicit improvements in locomotor function in individuals with mild to moderate PD?

Methods: A secondary analysis of data from a randomized clinical trial was conducted in individuals with mild to moderate idiopathic PD (N = 28). Participants were randomized to an aerobic cycling intervention (PD N = 14) consisting of 24 sessions at a targeted aerobic intensity of 60-80% of heart rate reserve or to a no intervention control group (PD, N = 14).

Changes in somatosensory evoked potentials elicited by lateral cerebellar nucleus deep brain stimulation in the naïve rodent.

Deep brain stimulation (DBS) of the deep cerebellar nuclei has been shown to enhance perilesional cortical excitability and promote motor rehabilitation in preclinical models of cortical ischemia and is currently being evaluated in patients with chronic, post-stroke deficits. Understanding the effects of cerebellar DBS on contralateral sensorimotor cortex may be key to developing approaches to optimize stimulation delivery and treatment outcomes. Using the naïve rat model, we characterized the effects of DBS of the lateral cerebellar nucleus (LCN) on somatosensory evoked potentials (SSEPs) and evaluated their potential use as a surrogate index of cortical excitability.

Development and Validation of a Mobile Application to Detect Visual Dysfunction Following Mild Traumatic Brain Injury.

Introduction: Following mild traumatic brain injury, visual dysfunction is a common occurrence, yet the condition often goes undiagnosed. A mobile application was developed to measure aspects of visual acuity and oculomotor function. The aim of this project was to validate the newly developed suite of outcomes conducive for use in the field to detect visual dysfunction.

Forced and Voluntary Aerobic Cycling Interventions Improve Walking Capacity in Individuals With Chronic Stroke.

Objectives: To determine the efficacy of high-intensity cycling to improve walking capacity in individuals with chronic stroke, identify variables that predict improvement in walking capacity, and quantify the relationship between the 6-minute walk test (6MWT) and cardiopulmonary exercise (CPX) test variables.

Design: Secondary analysis of data from 2 randomized controlled trials.

Setting: Research laboratory.

Recent Advances in the Management of Migraine in Older Patients.

Although the prevalence of migraine tends to decrease in the fifth to sixth decades of life, there are still a significant number of patients > 65 years of age who experience migraine or have new-onset migraine. Because these older patients are often excluded from clinical trials, there are fewer evidence-based treatment guidelines for them. Migraine treatment in the older population requires careful consideration of changes in medication metabolism and increased medical comorbidities.

Predictors of Improved Aerobic Capacity in Individuals With Chronic Stroke Participating in Cycling Interventions.

Objective: To determine demographic and physiological factors that predict improvement in aerobic capacity among individuals with chronic stroke participating in cycling interventions.

Design: Secondary analysis of data from 2 randomized clinical trials.

Setting: Research laboratory.

New Daily Persistent Headache and OnabotulinumtoxinA Therapy.

Objective: The aim of the study was to determine whether onabotulinumtoxinA therapy is effective in the treatment of new daily persistent headache (NDPH).

Background: New daily persistent headache is a difficult to treat headache syndrome resistant to both conventional and unconventional headache therapies. New daily persistent headache was excluded in the registration trials for onabotunlinumtoxinA (onabot) in chronic migraine.

Is it time for flexibility in botulinum inter-injection intervals?

Based largely on old retrospective reports, the recommendation of injecting BoNT as infrequently as possible, with the lowest possible dose, was formed. While BoNT is inherently immunogenic, with improved production, most patients no longer develop immune resistance and poor response to BoNT is often due to other factors. In a randomized controlled trial (RCT) using abobotulinumtoxinA for cervical dystonia (CD) by the German Dystonia Study Group, half of the patients treated with 250 and 500 U, and 39% in the 1000 U group required retreatment after 8 weeks.