Walton – Standards for the Diagnosis and Management of Complex Regional Pain Syndrome: Results of a European Pain Federation Task Force

Authors: Goebel A, Barker C, Birklein F, Brunner F, Casale R, Eccleston C, Eisenberg E, McCabe CS, Moseley GL, Perez R, Perrot S, Terkelsen A, Thomassen I, Zyluk A, Wells C.

Source: Eur J Pain. 2019 Jan 8. doi: 10.1002/ejp.1362. [Epub ahead of print]

PMID: 30620109 [PubMed – as supplied by publisher]

Walton – Cognitive Rehabilitation, Self-Management, Psychotherapeutic and Caregiver Support Interventions in Progressive Neurodegenerative Conditions: A Scoping Review

Author(s): Clare L.; Kudlicka A.; Evans I.; Hindle J.V.; Thompson-Coon J.; Teale J.C.; Toms G.; Abrahams S.; Goldstein L.H.; Morris R.; Ho A.K.; Jahanshahi M.; Langdon D.; Snowden J.S.; Davies R.; Markova I.; Busse M.

Source: NeuroRehabilitation; 2019; vol. 43 (no. 4); p. 443-471

Publication Date: 2019

Publication Type(s): Review

PubMedID: 30412509

Abstract:Background: Despite its potentially significant impact, cognitive disability may be overlooked in a number of progressive neurodegenerative conditions, as other difficulties dominate the clinical picture. Objective(s): We examined the extent, nature and range of the research evidence relating to cognitive rehabilitation, self-management, psychotherapeutic and caregiver support interventions in Parkinsonian disorders, multiple sclerosis (MS), frontotemporal dementias (FTD), motor neuron disease and Huntington’s disease. Method(s): Scoping review based on searches of MEDLINE and CINAHL up to 15 March 2016. Result(s): We included 140 eligible papers. Over half of the studies, and almost all the randomised controlled trials, related to MS, while a number of single case studies described interventions for people with FTD. CR interventions addressed functional ability, communication and interaction, behaviour or memory. The majority of psychotherapy interventions involved cognitive behavioural therapy for depression or anxiety. Self-management interventions were mainly available for people with MS. There were few reports of interventions specific to caregivers. Numerous methodological challenges were identified. Conclusion(s): The limited range of studies for all conditions except MS suggests a need firstly to synthesise systematically the available evidence across conditions and secondly to develop well-designed studies to provide evidence about the effectiveness of CR and other psychological interventions.

Copyright © 2018 IOS Press and the authors. All rights reserved.

Database: EMBASE

Aintree – Incidence and Evolution of Imaging Changes on Cone-Beam CT During and After Radical Radiotherapy for Non-Small Cell Lung Cancer

Author(s): Clarke E.; Brada M.; Curtis J.

Source: Radiotherapy and Oncology; Mar 2019; vol. 132 ; p. 121-126

Publication Date: Mar 2019

Publication Type(s): Article

Abstract:Background and purpose: Cone beam CT (CBCT) is used to improve accuracy of radical radiotherapy by adjusting treatment to the observed imaging changes. To ensure appropriate adjustment, image interpretation should precede any changes to treatment delivery. This study provides the methodology for image interpretation and the frequency and evolution of the changes in patients undergoing radical radiotherapy for localised and locally advanced non-small cell lung cancer (NSCLC). Patients and Methods: From December 2012 to December 2014, 250 patients with localised and locally advanced NSCLC had 2462 chest CBCT scans during the course of fractionated radical radiotherapy (RT) (3-5 daily CBCTs in the first week followed by at least weekly imaging, mean 9.5 per patient, range 1-21). All CBCT images were reviewed describing changes and their evolution using diagnostic imaging definitions and validated by an independent chest radiologist. Result(s): During radical RT for NSCLC 328 imaging changes were identified on CBCT in 180 (72%) patients; 104 (32%) had reduction and 41 (13%) increase in tumour size; 48 (15%) had changes in consolidations contiguous to the primary lesion, 26 (8%) non-contiguous consolidations, 43 (13%) changes in tumour cavitation, 36 (11%) pleural effusion and 30 (9%) changes in atelectasis. In 105 patients imaging changes were noted in continuity with the treated tumour of which only 41 (39%) represented tumour enlargement; others included new or enlarging adjacent consolidation (34%), and new or enlarging atelectasis (19%). The changes evolved during treatment. Conclusion(s): Imaging changes on CBCT include real and apparent changes in tumour size and parenchymal changes which evolve during treatment. Correct image interpretation, particularly when occurring adjacent to the tumour, is essential prior to adjustment to treatment delivery.

Copyright © 2018 Elsevier B.V.

Walton – Study Protocol for a Randomised Pilot Study of a Computer-Based, Non-Pharmacological Cognitive Intervention for Motor Slowing and Motor Fatigue in Parkinson’s Disease

Authors: Payne JS, Hindle JV, Pritchard AW, Rhys Davies R, Coetzer R, D’Avossa G, Martyn Bracewell R, Charles Leek E.

Source: Pilot Feasibility Stud. 2018 Dec 26;4:190.

doi: 10.1186/s40814-018-0375-4. eCollection 2018.

PMID: 30603099 [PubMed] Free PMC Article

Aintree – Socioeconomic Status and 30-Day Mortality after Minor and Major Trauma: A Retrospective Analysis of the Trauma Audit and Research Network (TARN) Dataset for England.

Authors: McHale P, Hungerford D, Taylor-Robinson D, Lawrence T, Astles T, Morton B.

Source: PLoS One. 2018 Dec 31;13(12):e0210226.

doi: 10.1371/journal.pone.0210226. eCollection 2018.

PMID: 30596799 [PubMed – in process]

Walton – Investigating Depression and Disability in a Cross-Sectional Sample of People with ALS/MND

Author(s): Granger N.; Schluter D.K.; Bredin A.; Mills R.J.; Young C.A.

Source: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration; 2018; vol. 19 ; p. 311

Publication Date: 2018

Publication Type(s): Conference Abstract

Abstract:Background: Previous work in ALS/MND showed correlations between depression and restrictions of everyday functioning, using the Barthel Index, as well as sleep and eating scores, using the Sickness Impact Profile (1). Literature search shows no published analyses of the relationships between depression and disability using current conceptual frameworks of disability assessment. Objective(s): To examine the relationship of disability to depression in ALS/MND. Method(s): As part of the ongoing UK wide Trajectories of Outcomes in Neurological Conditions (TONiC) study, a questionnaire pack was completed by people with ALS/MND, including the Depression subscale from the modified Hospital Anxiety and Depression Scale-MND (HADS-D) (2) and the World Health Organisation Disability Assessment Scale (WHODAS-2.0). The WHODAS-2.0 measures disability in six life domains: Understanding and communication, Getting around, Selfcare, Getting along with people, Life activities, and Participation in society. Work related items were omitted from analysis as most of the respondents were not working, and each domain was scored using WHO complex method (3). Factors were then added to a multifactor model using a ‘forwards’ method to determine the most parsimonious model. Result(s): From 465 participants at the time of this analysis, most were male (60.6%) with mean age 64.9 years and mean duration since diagnosis 26.2 months; 60% had limb onset, 24.7% bulbar onset, and 15.3% unknown onset type. Using published cut-offs for possible and probable depression, 7.1% had probable depression, 22.3% had possible depression. Multiple linear regression revealed the most parsimonious model to incorporate WHODAS-2.0 domains Participation in society, Getting along with people, and Understanding and communicating. Interaction terms for these domains were not significant. The final model accounted for 38.2% of the variance in HADS-D scores. Discussion and conclusions: This study highlights the main disability drivers for depression in ALS/MND to be related to social interaction rather than physical function. Causation cannot be determined with this cross-sectional data; it may be that higher levels of depression cause patients to struggle to communicate, get along with people and participate in society, or that these disabilities drive increased depression. Equally, the interaction may be bidirectional. Disability assessment in routine neurological practice often emphasises mobility and self-care; clinicians should recognise the importance of including disabilities of social interaction in their assessments.

Database: EMBASE


Walton – Smoking is Associated with Younger Age of Onset in Motor Neurone Disease

Author(s): Mills R.J.; Young C.A.; Tennant A.

Source: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration; 2018; vol. 19 ; p. 183-184

Publication Date: 2018

Publication Type(s): Conference Abstract

Abstract:Background: Cellular oxidative stress is thought to be important in the pathogenesis of motor neurone disease (MND) in susceptible individuals (1). Smoking promotes oxidative stress and in a metanalysis of case-control studies, smoking has been established as a risk factor for developing MND (2). A smoking history is also linked with shorter survival time (3). Objective(s): To explore whether a history of smoking affects age of onset in patients with an established diagnosis of MND. Method(s): Subject demographics and disease data as well as detailed smoking history were collected through a questionnaire pack for self-completion, in the ongoing longitudinal Trajectories of Outcomes in Neurological Conditions (TONiC) study in the UK. Comparisons were made by T test or one way ANOVA (alpha 0.05). Result(s): 327 records with smoking history data were available for analysis. 61% were male; mean age of 65 years, median disease duration 8 months. Mean age of disease onset was 63.5 years. 172 subjects had never smoked, 126 had previously smoked and 29 were current smokers. ANOVA revealed a significant difference in the age of onset between groups with a mean difference of 6.1 years (p=0.07). Duncan’s post hoc test revealed that never smokers and former smokers were an homogenous subgroup and that the difference was therefore between these (mean age onset 64 years) and current smokers (mean age onset 57.9 years). Discussion and conclusions: Subjects who continued to smoke developed MND, on average, 6.1 years before those who were previous or never smokers. Further work is required to determine the minimum tobacco exposure necessary to produce this effect and the minimum length of time required for smoking cessation to mitigate the effect. The study provides another reason for smoking avoidance in the general population and suggests smoking cessation advice should be imperative for individuals thought to be at higher risk of developing MND.

Database: EMBASE