CNM-Au8 affects neuronal structural integrity, mobile stroke units and direct transfer to angiography, cognitive impairments that are higher in RBD prior to Parkinson’s disease

TIME: 4 minutes

Welcome to this special edition of Neurology News Network. I’m Marco Meglio.

Recently announced results from the Phase 2 VISIONARY-MS study evaluating Clene Nanomedicine’s investigational compound CNM-Au8 in patients with relapsing forms of multiple sclerosis (MS) showed that the compound significantly affected the structural integrity of brain neurons, as indicated by changes in the integrity of the neurons axons and white matter. Over a 48-week period, the researchers observed a least-squares mean difference in the fractional anisotropy change in whole brain of 0.0029 and in the fractional anisotropy change in whole cerebral white matter of 0.0026. In addition, there was a 0.0025 least squares mean difference in change within the total cerebral normal-appearing white matter at the same time point. Each of these findings, observed by diffusion tensor imaging, highlight improvements in the areas of fractional anisotropy, radial diffusivity, and mean diffusivity across all 9 predefined brain regions and brain white matter pathways for each metric.

The results of a retrospective review comparing patients with emerging large vessel occlusion (ELVO) showed that a direct-to-angiography approach from the mobile stroke unit (MSU) was associated with less successful recanalization and increased mortality than the decision for additional imaging studies first. These data were presented at the International Stroke Conference (ISC) 2023, February 8-10 in Dallas, Texas, by lead investigator Shazam Hussain, MD, FRCP, FAHA, director of the Cleveland Clinic’s Cerebrovascular Center. The study included 14 patients with ELVO who went directly to angio (DTA) and 52 patients who underwent supplemental imaging (CTA), with no differences in age, gender, premorbid vascular risk factors, or symptoms. At the end of the analysis, the mortality rate was significantly higher in the DTA group (35% vs. 9%; P=0.028); however, there was no difference between the groups in functional outcomes as assessed by modified Rankin scale scores ranging from 0-2 (28% vs. 17%; P=0.45).

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Recently published data with participants in the PREDICT-PD study showed that cognitive function is impaired in groups at higher risk for developing Parkinson’s disease (PD), particularly those with REM sleep behavior disorder. Of the PREDICT-PD participants, 117 were classified as lower risk and 91 as higher risk based on their MOCA percentile. Of those with RBD, 15 had RBD with level 2 MCI and 10 were cognitively normal. Overall, overall MOCA scores were worse in the higher-risk group than in the lower-risk group (P=0.009) and in the RBD group compared to PREDICT-PD participants. Specifically, MCI level 1 rates were 12.8% in lower-risk patients, 21.9% in higher-risk patients, and 64% in patients with RBD.

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