• Research Results

    The Department of Neurology at Lahey Hospital & Medical Center supports and participates in various original research efforts.  These efforts include investigator-initiated drug or device trials, observational studies, questionnaire studies, outcome studies, case reports and retrospective reviews. The results of these original projects are often published in peer reviewed journals or as book chapters. 

    2013 Publications

    Fournier CN, Kalra A, Lachance DH, Zarwan C, Srinivasan J. ANNA-1 (anti-Hu) associated sensory neuronopathy with malignant mixed mullerian tumor. Muscle Nerve. 2013 May;47(5):776-7.

    Russell JA, Heiman-Patterson T, Armon C. Neurological assessment and management. Amyotrophic Lateral Sclerosis: A Patient Care Guide for Clinicians. Bedlack RS and Mitsumoto H ed. Demos Medical , NY 2013

    David J. Libon, Melissa Lamar, Catherine C. Price, Kelly Davis Garrett, Tania Giovannetti, Lisa Delano-Wood, Dana L., Penney, Joel Eppig, Christine Nieves, Mark W. Bondi, & Rod Swenson. The Dysexecutive Syndrome Associated with Alzheimer/Vascular Spectrum Dementia Syndromes and Mild Cognitive Impairment: An Analysis of Process and Errors. The Boston Process Approach to Neuropsychological Assessment: A Practitioner's Guide edited by Lee Ashendorf, Rod Swenson, David J. Libon, 2013.

    Kelly Davis Garrett, Catherine C. Price, Melissa Lamar, Tania Giovannetti, Lisa Delano-Wood, Dana L. Penney, Rod Swenson, Mark W. Bondi, Dean Delis, & David J. Libon.  Assessing Verbal Serial Learning: The California Verbal Learning Test and The Philadelphia (Repeatable) Verbal Learning Test. The Boston Process Approach to Neuropsychological Assessment: A Practitioner's Guide edited by Lee Ashendorf, Rod Swenson, David J. Libon, 2013.

    Laura J. Grande, James L. Rudolph, Randall Davis, Dana L. Penney, Rod Swenson, David J. Libon, & William Milberg. Clock Drawing: Standing the Test of Time. The Boston Process Approach to Neuropsychological Assessment: A Practitioner's Guide edited by Lee Ashendorf, Rod Swenson, David J. Libon, 2013. 

    Karakis I, Gregas M, Darras BT, Kang PB, Jones HR. "Clinical correlates of Charcot-Marie-Tooth disease in patients with pes cavus deformities." Muscle Nerve. 2013 Apr;47(4):488-92. 

    ABSTRACT

    • Introduction: Given its association with Charcot-Marie-Tooth disease (CMT), pes cavus is a common reason for referral to a neurologist. We investigated clinical features that may predict CMT in children with pes cavus. Methods: In this study we retrospectively reviewed pes cavus patients referred to Boston Children's Hospital in the past 20 years. Patients were categorized as idiopathic or CMT, based on EMG/genetic testing, and their clinical features were compared. 
    • Results: Of the 70 patients studied, 33 had idiopathic pes cavus, and 37 had genetically confirmed CMT. Symptoms of weakness, unsteady gait, family history of pes cavus and CMT, and signs of sensory deficits, distal atrophy and weakness, absent ankle jerks, and gait abnormalities were associated with CMT. Conclusions: In children with pes cavus, certain clinical features can predict CMT and assist in selection of patients for further, potentially uncomfortable (EMG) and expensive (genetic) confirmatory investigations.

    Past publications by Lahey Hospital & Medical Center neurology staff in 20102011, and 2012

    Complete articles or abstracts may be available at http://www.ncbi.nlm.nih.gov/pubmed/.  

     

    Poster Presentations

    Research Coordinators Junius Beebe and Nick Ventura reviewing a study protocolPhysicians from the Department of Neurology also regularly present preliminary or final results of their original research in the format of poster presentations at peer reviewed neurological meetings often hosted by international professional associations or organizations, including the highly regarded annual meetings of the American Academy of Neurology and American Neurological Association

    June 2013

    17th International Congress of Parkinsons Disease and Movement Disorders  

    23rd Meeting of the European Neurological Society (ENS)  

    6th International Society of Vascular Behavioural and Cognitive Disorders (VAS COG)  

    • The Digital Clock Drawing Test (dCDT) Hooklets: A Novel Graphomotor Measure of Executive Function 
    • The Digital Clock Drawing Test (dCDT) in Mild Cognitive Impairment and Dementia: It’s a matter of time 
    • Defining Mixed Alzheimer’s/Vascular Dementia – I: A Cluster Analysis Approach. David J. Libon, PhD; Joel Eppig, BA; Graham Wicas, BA; Laura Brennan, BA; Deborah Drabick, PhD; Tania Giovannetti, PhD; Catherine C. Price, PhD; Melissa Lamar, PhD; Amy J. Jak, PhD; Daniel A. Nation, PhD; Katherine J. Bangen, PhD; Lisa Delano-Wood, PhD; Mark W. Bondi, PhD; Rhoda Au, PhD; Rod Swenson, PhD; Adam M. Brickman, PhD; Jennifer Manly, PhD; Dana L. Penney, PhD; Kelly Davis Garrett, PhD on behalf of CENDA; The Consortium for Epidemiologic Neuropsychological Data Analysis.  
    • Defining Mixed Alzheimer’s/Vascular Dementia – II: Neuropsychological Comparisons of Cluster-Determined Groups. David J. Libon, PhD; Joel Eppig, BA; Graham Wicas, BA; Laura Brennan, BA; Deborah Drabick, PhD; Tania Giovannetti, PhD; Catherine C. Price, PhD; Melissa Lamar, PhD; Amy J. Jak, PhD; Daniel A. Nation, PhD; Katherine J. Bangen, PhD; Lisa Delano-Wood, PhD; Mark W. Bondi, PhD; Rhoda Au, PhD; Rod Swenson, PhD; Adam M. Brickman, PhD; Jennifer Manly, PhD; Dana L. Penney, PhD; and Kelly Davis Garrett, PhD on behalf of CENDA; The Consortium for Epidemiologic Neuropsychological Data Analysis

    May 2013

    2013 Annual Meeting of the Consortium of Multiple Sclerosis Centers (CMSC) & the Fifth Cooperative Meeting with Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) 

    March 2013

    The 65th Annual Meeting of the American Academy of Neurology (AAN) 

    Previously presented posters from 2009-2011. 

    Clinical Trial Results

    Clinical drug and device trials sponsored by pharamceutical and biotechnology companies are regularly conducted in the department of neurology at Lahey Hospital & Medical Center.  Once the results of these trials are finalized they are published in peer reviewed journals, and results may also be found on www.clinicaltrials.gov.

    Recent Results

    Results of the NINDS and Mt. Sinai School of Medicine sponsored CombiRx clinical trial, A Multicenter Double-Blind Randomized Study Comparing the Combined Use of Interferon Beta-1a and Glatiramer Acetate to Either Agent Alone in Patients with RRMS”, were published in the February 2013 journal of Annals of Neurology  (Lublin FD, Cofield SS, Cutter GR, Conwit R, Narayana PA, Nelson F, Salter AR, Gustafson T, Wolinsky JS; for the CombiRx Investigators. Randomized study combining interferon & glatiramer acetate in multiple sclerosis. Ann Neurol. 2013 Feb 19.) 

     

    Ann Camac, MD was the Lahey Hospital & Medical Center principal investigator and a total of 10 Lahey patients were enrolled into the trial.   

    ABSTRACT

    • Objective: A double-blind, randomized, controlled study to determine if combined use of interferon beta-1a (IFN) 30ug IM weekly and glatiramer acetate (GA) 20mg daily is more efficacious than either agent alone in relapsing-remitting multiple sclerosis (RRMS).
    • Methods: 1008 participants were randomized and followed until the last participant enrolled completed 3 yrs. The primary endpoint was reduction in annualized relapse rate utilizing a strict definition of relapse. Secondary outcomes included time to confirmed disability, Multiple Sclerosis Functional Composite (MSFC) score and MRI metrics.
    • Results: Combination IFN + GA was not superior to the better of the single agents (GA) in risk of relapse. Both the combination therapy and GA were significantly better than IFN in reducing the risk of relapse. The Combination was not better than either agent alone in lessening confirmed EDSS progression or change in MSFC over 36 months. The combination was superior to either agent alone in reducing new lesion activity and accumulation of total lesion volumes. In a post hoc analysis, combination therapy resulted in a higher proportion of participants attaining disease activity free status (DAFS) compared to either single arm; driven by the MRI results.
    • Interpretation: Combining the two most commonly prescribed therapies for MS did not produce a significant clinical benefit over three years. An effect was seen on some MRI metrics. In a test of comparative efficacy, GA was superior to IFN in reducing the risk of exacerbation. The extension phase for CombiRx will address if the observed differences in MRI and DAFS findings predict later clinical differences. PMID:23424159
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