JNNP Podcast

Nusinersen for SMA

Elizabeth Highton (JNNP Podcast Editor) speaks with Dr. Michelle Farrar (University of New South Wales) discussing nusinersen, the first disease-modifying therapy for spinal muscular atrophy type 1 (SMA). https://jnnp.bmj.com/content/89/9/937

Expanding clinical spectrums in both Kennedy’s disease and poststroke syndromes

Dr. Carlo Rinaldi (University of Oxford) discusses how the traditional view of Kennedy’s disease is evolving, to extend beyond pure motor symptoms. What non-motor features may be present in Kennedy's, and crucially how do they impact on patient's care and management? Read the full paper here: https://jnnp.bmj.com/content/89/8/808. Helle Stangeland and Vaughan Bell join us to discuss a much overlooked clinical syndrome in stroke: poststroke psychosis. Just how often does it occur and how can it be treated? Read their systematic review here: https://jnnp.bmj.com/content/89/8/879.

The use of cannabis in epilepsy, and surgery for tremor

Around 20-30% of patients with epilepsy can demonstrate resistance to commonly used medications. Cannabidiol (CBD) is a compound found in cannabis, which can be used for the treatment of epilepsy, shown to actively modulate seizure activity. Dr Emily Stockings (University of New South Wales in Sydney, Australia ) outlines how CBD can be helpful for patients with drug-resistant epilepsy. Read the full paper here: http://jnnp.bmj.com/content/89/7/741.long
Dr Georg Kaji (Kantonsspital, St.Gallen, Switzerland) provides a historical overview of surgical techniques and incisionless interventions for tremor – how have interventions changed over time? Read the full paper here: http://jnnp.bmj.com/content/89/7/727.long

Epilepsy an evidence update

Is the mesial temporal lobe the seat of psychosis in epilepsy? James Allebone (University of Melbourne, Australia) discusses what neuroimaging can tell us about psychosis in epilepsy. Read the paper here: http://jnnp.bmj.com/content/89/6/611.
Patients with epilepsy are often not permitted to drive, but can this change after surgery? Professor John Duncan (University College London, UK) provides a crucial update on measuring relative risk of seizures following epilepsy surgery, and how this impacts on UK driving regulations. Read the paper here: http://jnnp.bmj.com/content/89/6/599

Evolution or revolution? Should we re-think clinical practice?

Do old habits of screening for potassium channel antibodies stand up to scrutiny? Should clinical neurologists focus on screening for LGI1 and CASPR2 antibodies? Professor Sarosh Irani (John Radcliffe Hospital, Oxford) discusses antibody testing, and whether recent evidence calls for a revolution of clinical practice. Read the full paper here: http://jnnp.bmj.com/content/89/5/526.
In the second half of this podcast, Professor Ryuji Kaji (Tokushima University, Japan) discusses the pathogenesis of dystonia (uncontrolled movements). Is it a basal ganglia or cerebellar disorder? Or both? Read the full paper here: http://jnnp.bmj.com/content/89/5/488.

The Use of Frankincense Extract In MS

Patients with multiple sclerosis (MS) often show interest in complementary and alternative medicines, particularly when on long-term anti-inflammatory treatments. Is frankincense a safe and tolerable treatment? Dr Klarissa Stürner (Christian-Albrechts University, Kiel) discuss the pilot trial (conducted at the Institute of Neuroimmunology and Multiple Sclerosis, Hamburg).
Read the paper here: http://jnnp.bmj.com/content/89/4/330.long
Read the editorial here: http://jnnp.bmj.com/content/89/4/327

A new questionnaire to measure quality of life in inflammatory neuropathies

Quality of life (QoL) is one of the most important outcomes for chronic diseases, although it remains remarkably difficult to quantify. Dr. Thomas Draak (Maastricht University, The Netherlands) discusses his new questionnaire, and how it aims to capture the patient’s perspective. Read the full paper here:
http://jnnp.bmj.com/content/jnnp/early/2017/11/24/jnnp-2017-316634.full.pdf

Marriage and a reduced risk of dementia

Recent research has indicated that being married is associated with a reduced risk of dementia. What is it about marriage? Dr Andrew Sommerlad (University College London) discusses this question and more. Read the full paper here: http://jnnp.bmj.com/content/early/2017/10/30/jnnp-2017-316274

Anti-inflammatory approaches to stroke prevention; monitoring disease progression in ALS

Atherosclerosis is a major contributor to increased risk of stroke. Our patient’s choice, Professor Peter Kelly (University College Dublin, Dublin, Ireland) discusses the evidence base implicating inflammation as a key process in the pathogenesis of atherosclerosis, leading to thromboembolic events. Read the full paper here: http://jnnp.bmj.com/content/89/2/211.
How do you measure disease progression in a highly variable and heterogeneous clinical population, such as amyotrophic lateral sclerosis (ALS)? Can plasma creatinine act as a robust surrogate biomarker in clinical trials? Dr. Ruben P A van Eijk (University Medical Center, Utrecht, The Netherlands) discusses this month’s editor’s choice. Read the full paper here: http://jnnp.bmj.com/content/89/2/156.

Nodes and paranodes; alternative treatments in MS

People with multiple sclerosis (MS) use complementary and alternative treatments (CAM), but what does the evidence say? Patient’s Choice, Professor Bruce Taylor (University of Tasmania) discusses the modern evidence for CAM use. Read the paper here: http://jnnp.bmj.com/content/89/1/34.
What roles do nodes and paranodes play in complex neuropathies? Dr Simon Rinaldi (University of Oxford) summarises the involvement of these specialised domains as this month’s Editor’s Choice. Read the full paper here: http://jnnp.bmj.com/content/89/1/61.
Read the JNNP's January 2018 issue here: http://jnnp.bmj.com/content/89/1.