RESILIENT Long-Term Extension Data, Associations Between Abuse and Migraine, Retinal Biomarkers in Alzheimer Disease


Neurology News Network for the week ending April 10, 2021.

This week Neurology News Network covered the long-term extension results of bimagrumab in patients with sporadic inclusion body myositis, data examining the history of abuse and its association with greater migraine-related sensory hypersensitivity symptoms, and the use of retinal biomarkers in vivo Alzheimer disease.

Welcome to this special edition of Neurology News Network. I’m Marco Meglio. Please excuse our appearance this week as a majority of the US workforce, including the NeurologyLive team, moves to working remote as we come together to help reduce the spread of the novel coronavirus.

Results from the RESILIENT long-term extension study showed that treatment with bimagrumab produced a good safety profile and was well-tolerated but did not provide clinical benefits in terms of improvement of mobility in patients with sporadic inclusion body myositis. Researchers used 6-minute walk distance (6MWD) and safety as the co-primary end point outcomes. They found that the mean change in 6MWD from baseline was highly variable across treatment arms and showed progressive decline from week 24 to week 104 in all treatment groups. Notably, this decline followed a small transient increase during the first 6 months of the core study. Lead author Anthony A Amato, MD, neurologist, Brigham and Women’s Hospital, and professor of neurology, Harvard Medical School, and colleagues terminated the extension study due to the core study not meeting its primary end point of significant change in 6MWD.

Recently published data from a cross-sectional observational study demonstrated that patients with migraine who have a history of abuse are associated with greater migraine-related sensory hypersensitivity symptoms, prompting the need for future studies to evaluate ways to reduce the impact of abuse. A history of abuse, whether emotional, physical, or sexual, was reported in 222 (38%) of the 588 participants. The history of abuse led to statistically significantly greater average headache frequency, and among patients with a history of abuse, 25% were diagnosed with episodic migraine and 75% were diagnosed with chronic migraine. Lead author Meesha Trivedi, BS, clinical research trainee, Mayo Clinic, and colleagues concluded that “given survivors’ increased vulnerability to more severe chronic health symptoms, these findings emphasize the importance of screening patients for abuse when treating migraine.”

The use of retinal biomarkers may be used for early detection of in vivo Alzheimer disease pathologic abnormalities after results from a cross-sectional study demonstrated both functional and structural changes of the retina in cognitively normal older adults. Min S Byun, MD, PhD, department of neuropsychiatry, Seoul National University Bundang Hospital, and colleagues evaluated 49 CN individuals who underwent complete ophthalmic examination, including swept-source optical coherence tomography (SS-OCT) and multifocal electroretinogram as well as amyloid-ß (Aß) PET and MRI. Compared with 33 CN individuals without Aß deposition (Aß-CN), the 16 participants with Aß (Aß+CN) showed reduced inner nasal macular thickness on SS-OCT (mean, 308.9 µm [standard deviation (SD), 18.4] vs 286.1 µm [SD, 22.5];  = .007) and retinal nerve fiber layer thickness (RNFL-T), particularly in the inferior quadrant.

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