New Neuroimaging Guidelines for Migraine, Lemborexant Improves Sleep Onset, Patients with Parkinsons Have Compromised Swimming Ability


Neurology News Network for the week ending January 11, 2020.

This week Neurology News Network covered the new neuroimaging guidelines for patients with migraine, as well as the phase 3 SUNRISE 1 study of lemborexant, and a new study on patients with Parkinson disease and a compromised ability to swim.

Marco: Welcome to Neurology News Network. I’m Marco Meglio. Let’s get into the news from this week.

The American Headache Society has published new neuroimaging guidelines for the care of patients with migraine, suggesting that in those with normal neurologic examination without atypical features or red flags, there is no need for neuroimaging. The review, conducted by a group of authors including Randolph W. Evans, clinical professor of neurology at Baylor College of Medicine, consisted of 23 articles that attempted to evaluate neuroimaging in migraine. Evans and colleagues began the work with 2269 publications, which was narrowed to 85 articles and finalized to 23 which met inclusion criteria. The majority of studies were retrospective cohort or cross‐sectional studies, and 4 prospective observational studies.

Findings from the phase 3 SUNRISE 1 study demonstrate a significant improvement in sleep onset and sleep maintenance, including during the second half of the night, with treatment with lemborexant compared with both placebo and zolpidem tartrate in patients with insomnia. The small molecule orexin receptor antagonist was recently approved by the FDA for the treatment of insomnia in adults and will be available in 5 mg and 10 mg doses. The approval was based on data from the program’s 2 pivotal phase 3 trials, SUNRISE 1 and SUNRISE 2. Using data collected from polysomnograms from the first 2 and last 2 nights of treatment, investigators assessed the change from baseline in latency to persistent sleep for lemborexant compared with placebo.

New findings suggest that patients with Parkinson disease may have compromised swimming ability, warranting further research into the matter to explore the global frequencies of these difficulties, as well as their identifying factors. The data, from Joaquim J. Ferreira, Faculty of Medicine, University of Lisbon, and colleagues were collected in a small evaluation of 13 patients with Parkinson disease, of which 3 were able to swim, as defined by the study. The results reinforce the attention needed for this issue, and suggest that a formal assessment of swimming performance is required to recommend safety measures and reduce the risk of drowning. Notably, 11 of the study’s patients—85%—performed hydrotherapy on a regular basis.

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