Neurology

Breastfeeding not a sustainable therapy

July 11, 2012

REPORT FROM THE AMERICAN ACADEMY OF NEUROLOGY (AAN) ANNUAL MEETING, NEW ORLEANS LA, APRIL 21-28, 2012 – Studies to determine if exclusive breastfeeding reduces relapse frequency postpartum have produced conflicting results (Langer-Gould et al. Arch Neurol 2009;66:958-963; Portaccio et al. Neurology 2011;77:145-150; Nelson et al. JAMA 1988;259:3441-3443).

Langer-Gould and colleagues have now followed 72 women with MS through their pregnancy and for 12 months postpartum to examine this issue further (Hellwig et al. AAN 2012; abstract P06.186).

Exploratory study of higher carbidopa dosing

July 11, 2012

REPORT FROM THE AMERICAN ACADEMY OF NEUROLOGY (AAN) ANNUAL MEETING, NEW ORLEANS LA, APRIL 21-28, 2012 – The recommended doses of carbidopa (CD) to increase levodopa availability are in the range of 75-200 mg/day. A small double-blind crossover trial has explored whether higher carbidopa doses are clinically useful (Nutt et al. AAN 2012; abstract S02.006).

The caveat is that higher carbidopa doses have the potential to inhibit amino acid decarboxylase and reduce dopamine formation in the striatum.

Flunarizine, topiramate effective in migraine prophylaxis

June 6, 2012

A one-year study reports that topiramate and flunarizine are both effective in migraine prophylaxis, although combining the two agents does not produce significantly greater efficacy (Luo et al. Pain Med 2012;13:80-86).

Tai chi improves balance impairments in PD

June 6, 2012

A randomized, controlled trial reports that Tai chi appears to be better than stretching exercises or resistance training in patients with Parkinson’s disease for improving balance and reducing the risk of falls (Li et al. N Engl J Med 2012;366:511-519).

High cost of MS in Canada

May 16, 2012

The Treatment Experience, Burden, and Unmet Needs (TRIBUNE) study is a cross-sectional observational study of the cost of MS in Canada and five European countries. According to the Canadian estimate, the mean annual cost was $30,836 per MS patient with mild disability (EDSS < 3), $46,622 per patient with moderate disability (EDSS 4-6.5), and $77,981 per patient with severe disability (EDSS score 7-9) (Karampampa et al. J Popul Ther Clin Pharmacol 2012;19:e11-25; free full text at www.jptcp.com/jptcp11072e11_e25_karampampa-pdf-r180364). The estimated cost per relapse for an RRMS patient (EDSS < 5) was $10,512.