Neurology, distilled.

To evaluate the efficacy and safety of fremanezumab for the preventive treatment of migraine in Chinese adults with episodic or chronic migraine.

Fremanezumab significantly reduced monthly migraine days (MMD) vs placebo during the 12-week DBP (−4.6 vs −2.8; LS mean difference −1.8, 95% CI −2.66 to −0.95; p<0.0001)

To evaluate whether trial-level mean baseline age is associated with treatment effect size in randomized clinical trials of myasthenia gravis, using systematic review, random-effects meta-analysis, and meta-regression of QMG and MG-ADL outcomes.

Across 18 RCTs (n=1823), treatment improved QMG (pooled MD -2.402; 95% CI -3.099 to -1.706; I²=60.7%) and MG-ADL (pooled MD -1.591; 95% CI -1.874 to -1.309; I²=0.0%) vs control.

To evaluate the safety, tolerability, pharmacokinetics and preliminary efficacy of RAG-17, an oligonucleotide-siRNA conjugate targeting SOD1, in patients with SOD1-amyotrophic lateral sclerosis (ALS).

Primary safety endpoint met with acceptable safety/tolerability; TEAEs in 33% (2/6), all mild-to-moderate (muscle tremor n=2, elevated ALT n=1), all resolved

To evaluate whether an algorithm-based Integrated Care Pathway (ICP) reduces agitation and psychotropic polypharmacy compared with treatment as usual (TAU) in patients with Alzheimer's disease and clinically significant agitation in inpatient and long-term-care settings.

In inpatient and long-term-care settings, an Integrated Care Pathway for agitation in Alzheimer's disease did not reduce agitation symptoms more than usual care, but was associated with lower psychotropic polypharmacy at some time points during the trial, though not at week 12.

To assess the feasibility and short- and long-term efficacy of a 5-week digital, adaptive, multidomain cognitive training combined with a healthy lifestyle-guidance module on executive functions in individuals with isolated REM sleep behavior disorder (iRBD).

Digital cognitive training + lifestyle module improved executive functions vs waiting-list control at 6 weeks (d=0.500, 95% CI 0.221-0.779)

To investigate how a 6-month multimodal physical activity intervention influences sleep quality, duration, and fragmentation, and how these relate to hippocampal subfield and amygdala nucleus volumetry and functional connectivity over 18 months in patients on the Alzheimer's disease continuum.

After the 6-month intervention, the intervention group showed increased hippocampus-amygdala functional connectivity and attenuated subfield atrophy compared to psychoeducation controls

To evaluate the safety and effectiveness of middle meningeal artery embolization (MMAE) with the TRUFILL n-butyl cyanoacrylate (n-BCA) liquid embolic system plus standard of care versus standard of care alone in patients with symptomatic chronic subdural hematoma.

Primary effectiveness end point (residual/re-accumulation of hematoma >10 mm at 6 months or surgery on the cSDH within 6 months) occurred in 11.6% (17/146) with MMAE plus SOC vs 22.1% (29/131) with SOC alone — common OR 0.53 (90% CI, 0.31-0.91); P = .04, a 47% reduction in odds

To evaluate the safety, tolerability, and efficacy of alixorexton (ALKS 2680), an oral orexin 2 receptor (OX2R) agonist, in adults with narcolepsy type 1.

Alixorexton dramatically improved wakefulness at week 6: placebo-corrected LSM change in mean sleep latency on the MWT was +22.2 min (95% CI 17.2–27.2, adjusted p=0.0099) for 4 mg, +24.1 min (19.0–29.1, p<0.0001) for 6 mg, and +26.0 min (21.0–31.0, p<0.0001) for 8 mg; observed MSL reached the normative range (≥20 min) in all dose groups