News Express

Science News: Ratio of Urinary N-terminal Titin Fragment to Urinary Creatinine is a Novel Biomarker for Amyotrophic Lateral Sclerosis

February 06, 2022

Sensitive and specific disease biomarkers for amyotrophic lateral sclerosis (ALS) are lacking. There has been ongoing research in the past several years looking for them. Titin is a giant myofibrillar protein in skeletal muscle. Elevated levels of urinary N-terminal fragment of titin has been reported in degenerative conditions, such as Duchene muscular dystrophy (DMD). This study looked at the validity and reliability of urinary N-terminal titin fragment as a biomarker in ALS.

Science News: Frequency of Neurologic Manifestations in COVID-19: A Systematic Review and Meta-Analysis

January 25, 2022

More than 1 year into the coronavirus disease 2019 (COVID-19) pandemic, severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) has caused more than 200 million cases and 4.28 million deaths across 220 countries as of August 9, 2021. This article is a systemic review and meta-analysis to obtain pooled prevalence estimates to understand the variation in reported frequencies of various neurologic manifestations in patients with COVID-19 across different groups in literature published from December 31, 2019, to December 15, 2020.

Science News: Association Between SARS-CoV-2 Infection and Immune-Mediated Myopathy in Patients Who Have Died

January 25, 2022

This is a case-control, postmortem (within 6 days) study in Germany focusing on the skeletal (either deltoid or quadriceps) and cardiac muscle pathology in SARS-CoV-2 patients. This study shows SARS-CoV-2 may be associated with a post-infectious, immune-mediated myopathy. 

Science News: Free-Living Physical Activity and Sedentary Behavior in Autoimmune Myasthenia Gravis: A Cross-Sectional Study

January 06, 2022

Physical activity in patients with myasthenia gravis (MG) can be limited due to fatigability and undertreated disease. This prospective cross-sectional study looked at physical activity patterns of women with MG.

Significant Pay Cuts Averted for 2022

December 29, 2021

In response to a large, concerted effort on the part of many physician groups, including AANEM, Congress took action at the very end of 2021 to avoid an impending nearly 10% cut to Medicare payments that would have gone into effect January 1, 2022.

On December 21, 2021, Congress passed the Protecting Medicare and American Farmers from Sequester Cuts Act which avoided a 4% statutory cut from the PAYGO (Pay-As-You-Go Act of 2010) provisions, extended the moratorium on the 2% Medicare payment sequester, and mitigated the significant 3.75% reduction in the Medicare conversion factor.

AANEM State Liaisons – Virtual Visits to Capitol Hill

December 29, 2021

AANEM returned to Washington, D.C. virtually for its 8th Annual Day on Capitol Hill in November. AANEM State Liaisons met with key legislative offices throughout the month of November to educate Senators and Representatives about electrodiagnostic (EDX) medicine and the current challenges facing the patient and professional community. 

The Liaisons’ primary “ask” of the offices was for support of AANEM’s continued efforts to advance quality standards for EDX medicine to both improve patient care and stop fraud and abuse in this area. Nearly every office was very supportive of this cause and seem poised to take actionable steps in support of the effort in the new year.

Science News: European Academy of Neurology/Peripheral Nerve Society Guideline on Diagnosis and Treatment of Chronic Inflammatory Demyelinating Polyradiculoneuropathy: Report of a Joint Task Force-Second Revision

December 28, 2021

CIDP diagnosis is based on clinical, electrophysiological and other laboratory investigations. The EFNS/PNS diagnostic criteria (2010) for CIDP has been found to have high sensitivity and specificity. The second revision has been recently published with goal in improving diagnostic accuracy and treatment outcome.

Science News: Critical Illness Polyneuropathy, Myopathy and Neuronal Biomarkers in COVID-19 Patients: A Prospective Study

December 14, 2021

This article determines the risk factors for developing critical illness neuropathy (CIN) and/or myopathy (CIM) in 111 COVID patients admitted to an ICU in Sweden, as well as differences between COVID and non-COVID patients with ICU weakness.

Science News: Clinical Features and Treatment Response in Immune-Mediated Small Fiber Neuropathy with Trisulfated Heparin Disaccharide or Fibroblast Growth Factor Receptor 3 Antibodies

December 14, 2021

The objective of the article was to describe clinical features and treatment responses in cryptogenic small fiber neuropathy (SFN) cases harboring novel antibodies to trisulfated heparin disaccharide (TS-HDS) and fibroblast growth factor receptor 3 (FGFR-3).

Science News: Diagnostic Utility of Gold Coast Criteria in Amyotrophic Lateral Sclerosis

November 30, 2021

Existing diagnostic criteria for amyotrophic lateral sclerosis (ALS) such as El Escorial criteria (rEEC) and Awaji criteria have certain limitations, particularly for early disease or atypical presentations of ALS. A new diagnostic criterion has been proposed, with the goal of making it simpler to implement and include atypical presentations.

Science News: Charcot-Marie-Tooth Disease Misdiagnosed as a Chronic Inflammatory Demyelinating Polyradiculoneuropathy: An International Multicentric Retrospective Study

November 30, 2021

Charcot–Marie–Tooth (CMT) disease, a common hereditary polyneuropathy, has no treatment besides symptomatic relief. Authors performed a large retrospective study in 16 university hospitals in three European countries (France, Belgium, and Switzerland). Among 1,104 chronic inflammatory demyelinating polyneuropathy (CIDP) cases, there were 35 CMT patients (3.2%) misdiagnosed as CIDP.

Science News: Effect of High-Frequency (10-kHz) Spinal Cord Stimulation in Patients With Painful Diabetic Neuropathy: A Randomized Clinical Trial

November 15, 2021

Nevro's SENZA-PDN study, RCT of spinal cord stimulation treatment conducted for PDN-painful diabetic polyneuropathy, compares 10 kHz SCS plus Conventional Medical Management (CMM) to CMM alone in 216 patients at 18 centers in the United States.

Science News: Assessing Diagnostic and Severity Grading Accuracy of Ultrasound Measurements for Carpal Tunnel Syndrome Compared to Electrodiagnostics

November 15, 2021

This is a prospective study of 95 18 to 80-year-old patients referred for electrodiagnostic (EDX) testing of idiopathic carpal tunnel syndrome (CTS). Exclusion criteria for prior CTS and other concomitant confounding factors. The combined sensory index (CSI) and Bland criteria were used to assess for severity.

Science News: Skeletal Muscle and Peripheral Nerve Histopathology in COVID-19

November 03, 2021

This study discusses spectrum of skeletal muscle and nerve pathology of patients who died following SARS-CoV-2 infection.

Science News: Impact of Coronavirus Disease 2019 in a French Cohort of Myasthenia Gravis

November 03, 2021

Among 3,558 patients with MG registered in the French database for rare disorders, 34 (0.96%) had COVID-19. The mean age at COVID-19 onset was 55.0 ± 19.9 years (mean MG duration: 8.5 ± 8.5 years). By the end of the study period, 28 patients recovered from COVID-19, 1 remained affected, and 5 died.

Science News: Childhood Amyotrophic Lateral Sclerosis Caused by Excess Sphingolipid Synthesis

October 19, 2021

Amyotrophic lateral sclerosis (ALS) is a devastating disease with poorly understood underlying pathophysiology. This article describes a rare cause of the early onset of motor neuron disease in children due to mutation in SPLTC1, a subunit of the SPT (serine palmitoyltransferase).

Science News: Epidemiology and Natural History of Inclusion Body Myositis A 40-Year Population-Based Study

October 19, 2021

This study determines the prevalence and natural history of sporadic inclusion body myositis (sIBM) and tests the hypothesis that patients with sIBM have higher cancer or mortality rates than the general population.

Science News: Acute Flaccid Myelitis: Long-Term Outcomes Recorded in the CAPTURE Study Compared With Paediatric Transverse Myelitis

October 05, 2021

This is a prospective, multicenter, non-randomized, observational cohort study of children with myelitis seen at academic centers in North America. The study lasted 5 years and the length of follow-up was 1 year. Pediatric patients diagnosed with myelitis were eligible for enrollment in the study within 6 months of onset of symptoms. Patients were classified as transverse myelitis (TM) or the acute flaccid myelitis (AFM) variant based on clinical and radiographic findings.

Brian Wallach Receives AANEM Public Recognition Award

October 05, 2021

AANEM's Public Recognition Award is awarded to public figures, celebrities, or entities that have made extraordinary contributions toward increasing public awareness of muscle and nerve disorders. This year's recipient is Brian Wallach, founder of I AM ALS. Since I AM ALS was founded, it has built partnerships with more than 30 organizations, testified three times before Congress, pushed long-awaited FDA ALS clinical trial guidance, built a 100 member congressional caucus, and delivered more than $83 million worth of federal research funding for ALS.

Patient Safety: NM Complications of Immune Checkpoint Inhibitors

October 05, 2021

Immune checkpoint inhibitors (ICPI’s) are monoclonal antibodies that target the immune checkpoints programmed death 1 (PD1), programmed death ligand 1 (PDL-1) and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) on T cells and promote immune mediated destruction of cancer cells. They are used to treat a variety of cancers including breast, bladder, cervical, colon, lung cancer, Hodgkin’s lymphoma, melanoma, etc. ICPI treatment is associated with an array of immune related adverse events affecting many organ systems. Neurologic adverse events have also been reported.