DemRisk Model Enhances Dementia Prediction in Primary Care
A new risk prediction model, DemRisk, has been developed to identify individuals at high risk of developing dementia within five years, utilizing routinely collected patient data in primary care settings. The study, published in PLOS One, highlights the increasing global burden of dementia, with nearly 40% of cases remaining undiagnosed, and the crucial role of general practitioners in early detection and management.
The DemRisk model incorporates data from electronic health records of 383 general practices, creating separate models for age groups 60-79 and 80-89. For the younger cohort (60-79 years), factors such as age, history of stroke or transient ischemic attack (TIA), epilepsy, gait problems, use of antidepressants and mood stabilizers, anticholinergic burden, and Body Mass Index (BMI) were significantly associated with incident dementia. The model demonstrated a good Harrell’s C-statistic of 0.78 in the validation cohort. In the older cohort (80-89 years), similar associations were observed, though generally weaker.
S100β Levels Predict Stroke Outcomes After Thrombolysis
Research published in BMC Neurology indicates that serum S100β levels measured 24 hours after intravenous thrombolysis (IVT) are independently associated with hemorrhagic transformation (HT), infarct volume, and overall prognosis in acute ischemic stroke patients. IVT, while the most effective treatment for acute disabling ischemic stroke, only leads to favorable outcomes in approximately half of patients.
The multicenter prospective cohort study analyzed 1072 blood samples and found that patients who experienced HT had significantly higher S100β levels (0.237 ng/mL) compared to those without HT (0.118 ng/mL, P < 0.001). Higher S100β levels were also correlated with larger infarct volumes and unfavorable outcomes on the modified Rankin Scale (mRS). Furthermore, elevated S100β levels were predictive of all-cause death within three months of IVT. These findings suggest that S100β could serve as a valuable biomarker for predicting stroke outcomes and guiding treatment strategies.
DaxibotulinumtoxinA Shows Promise in Treating Upper Limb Spasticity
A randomized, double-blind, placebo-controlled trial published in PM&R evaluated the efficacy and safety of DaxibotulinumtoxinA-lanm for injection (DAXI) in adults with upper limb spasticity (ULS) following stroke or traumatic brain injury (TBI). Spasticity, a common outcome of upper motor neuron damage, leads to long-term motor function impairment and reduced quality of life.
The study involved participants receiving either placebo, DAXI 250U, DAXI 375U, or DAXI 500U. At week 6, all DAXI treatment groups showed improvement from baseline compared to placebo, with DAXI 500U demonstrating the largest reduction in Modified Ashworth Scale (MAS) scores. At week 12, the reduction in MAS score from baseline at the primary target spastic muscle group (SMG) was 50.0% for DAXI 500U compared to 25.0% for placebo (p = 0.11). All DAXI doses were well tolerated, suggesting that DAXI 500U offers a significant therapeutic effect with a favorable safety profile for managing ULS.
