Clinical Neuroscience

[Sumatriptan-naproxen sodium fix-dose combination for acute migraine treatment, a review]

TAJTI János et al.

[Migraine as a common primary headache disorder has a significant negative effect on quality of life of the patients. Its pharmacotreatment includes acute and preventative therapies. Based on the shared therapeutic guideline of the European Headache Federation and the European Academy of Neurology for acute migraine treatment a combination of triptans and non-steroidal anti-inflammatory drugs is recommended for acute migraine treatment in triptan-nonresponders. In this short review we summarized the results of the randomized controlled clinical trials evaluating the effectiveness and safety of sumatriptan (85 mg)/naproxen sodium (500 mg) fix-dose combination. It was revealed that the fix-dose combination was better than placebo for the primary outcomes of exemption of pain and headache relief at 2 hours. Furthermore the combination showed beneficial effect on accompanying symptoms of migraine attack (i.e. nausea, photo- and phonophobia). Adverse events were mild or moderate in severity and rarely led to withdrawal of the drug.
It can be concluded that sumatriptan (85 mg)/naproxen sodium (500 mg) fix-dose combination is effective, safe and well-tolerated in the acute treatment of migraine. ]

FÓKUSZBAN

hirdetés

Támogatott tartalom, hirdetést tartalmazhat.

Clinical Neuroscience

[Conference of the European Academy of Neurology in Budapest]

CSIBA László

[Between July 1st and 4th, 2023, the European Academy of Neurology (EAN) organized its 9th international conference at the Hungexpo area in Budapest. The Hungarian Neurological Society applied for hosting the conference in 2018 and succeeded in outperforming London and other European capitals during the presentation in Lisbon. This year, the conference became the largest medical event at Hungexpo.]

Clinical Neuroscience

[Importance of personality disorders in epilepsy]

KISS Rita-Judit et al.

[Epilepsy is one of the most common neurological disorders. Therapeutic success shows high variability between patients, at least 20-30% of the cases are drug-resistant. It can highly affect the social status, interpersonal relationships, mental health and the overall quality of life of those affected.
Although several studies can be found on the psychiatric diseases associated with epilepsy, only a few researches focus on the occurrence of personality disorders accompanying the latter. The aim of this review is to help clinicians to recognize the signs of personality disorders and to investigate their connection and interaction with epilepsy in the light of current experiences.
The researches reviewed in this study confirm that personality disorders and pathological personality traits are common in certain types of epilepsy and they affect many areas of patients’ lives. These studies draw attention to the importance of a multidisciplinary approach to this neurological disorder and to provide suggestions about the available help options. Considering the high frequency of epilepsy-related pathological personality traits that can have a great impact on the therapeutic cooperation and on the patients’ quality of life, it important that the neurologist recognizes early the signs of the patient’s psychological impairment. Thus they can get involved in organizing the support of both the patient and their environment by including psychiatrists, psychologists, social and self-help associations.
As interdisciplinary studies show, epilepsy is a complex disease and besides trying to treat the seizures, it is also important to manage the patient’s psychological and social situation. Cooperation, treatment response and quality of life altogether can be significantly improved if our focus is on guiding the patient through the possibilities of assistance by seeing the complexity and the difficulties of their situation.]

Clinical Neuroscience

[Assessment of compliance and patient pathway among multiple sclerosis patients on disease modifying treatment]

MÁTYÁS Klotild et al.

[Epidemiological data and the number of patients treated suggest that the proportion of Hungarian patients with Multiple Sclerosis (MS) receiving disease-modifying therapy (DMT) is lower than in some neighboring countries. We investigated possible reasons for this.

First we analysed patient compliance based on an anonymised database of the National Health Insurance Fund (NHIF). A total of 5441 patients were included in the analysis from NHIF prescription data from 1 July 2014 to 28 February 2021. In the second part of the study, a quantitative and qualitative assessment of patient journeys of MS patients was conducted. 

The compliance of Hungarian MS patients is good compared to international MS treatment data and outstanding compared to other neurological and other diseases, e.g. cardiovascular. This cannot be said about the results of the patient pathway analysis based on patient interviews. Patients indicated that they often have difficulty accessing public health care. Tracing their pathways revealed that they needed to see 3-5 doctors (general practitioner, various specialists) before a diagnosis was made. However, they gave positive feedback about MS Centres. They trusted their doctors, found them empathetic, but they would have liked more time to discuss lifestyle issues.

Compared to some neighbou­ring countries, Hungary has a lower proportion of patients with treated MS, which, given the good compliance of patients, highlights the problem of patient path in Hungary. Further training of fellow physicians is also a task for neurologists specialising in MS. Just as the most common symptoms of stroke have been successfully introduced into the public consciousness, the same can be the aim for MS.]


Clinical Neuroscience

The effects of 30 Hz, 50 Hz AND 100 Hz continuous theta burst stimulation via transcranial magnetic stimulation on the electrophysiological parameters in healthy individuals

OZDEMIR Zeynep et al.

Transcranial magnetic stimulation is a non-invasive procedure that uses robust magnetic fields to create an electrical current in the cerebral cortex. Dual stimulation consists of administering subthre­shold conditioning stimulation (CS), then suprathreshold test stimulation (TS). When the interstimulus interval (ISI) is 1-6 msec, the motor evoked potential (MEP) decreases in amplitude; this decrease is termed “short interval intracortical inhibition” (SICI); when the ISI is 7-30 msec, an increase in MEP amplitude occurs, termed “short interval intracortical facilitation” (SICF). Continuous theta burst stimulation (cTBS), often applied at a frequency of 50 Hz, has been shown to decrease cortical excitability. The primary objective is to determine which duration of cTBS achieves better inhibition or excitation. The secondary objective is to compare 50 Hz cTBS to 30 Hz and 100 Hz cTBS. The resting motor threshold (rMT), MEP, SICI, and SICF were studied in 30 healthy volunteers. CS and TS were administered at 80%-120% and 70%-140% of rMT at 2 and 3-millisecond (msec) intervals for SICI, and 10- and 12-msec intervals for SICF. Ten individuals in each group received 30, 50, or 100 Hz, followed by administration of rMT, MT-MEP, SICI, SICF immediately and at 30 minutes. Greater inhibition was achieved with 3 msec than 2 msec in SICI, whereas better facilitation occurred at 12 msec than 10 msec in SICF. At 30 Hz, cTBS augmented inhibition and suppressed facilitation, while 50 Hz yielded less inhibition and greater inter-individual variability. At 100 Hz, cTBS provided slight facilitation in MEP amplitudes with less interindividual variability. SICI and SICF did not differ significantly between 50 Hz and 100 Hz cTBS. Our results suggest that performing SICI and SICF for 3 and 12 msec, respectively, and CS and TS at 80%-120% of rMT, demonstrate safer inhibition and facilitation. Recently, TBS has been used in the treatment of various neurological diseases, and we recommend preferentially 30 Hz over 50 Hz cTBS for better inhibition with greater safety and less inter-individual variability.

Journal of Nursing Theory and Practice

[Examination of the Strength of Core- and Perineal Muscles in Case of Different Movements]

KISS Noémi et al.

[Aims of the study: to measure the strength of core-, perineal muscles in three groups, to compare different exercises for the aspect of these muscles. 11 sedentary-, 10 women’s doing Pilates, 13 inactive female sudent’s core- and perineal muscles were measured in longitudinal study by DAVID-machine, modified Plank-test, FemiScan at Univerity of Pécs, Faculty of Health Sciences, Zalaegerszeg, 2016. february-november. Data analysis: ANOVA, Scheffe Post Hoc test, two-tailed T-test. The TS-group’s muscles became more symmetrical (p=0.043). According to Plank test, the TS-group’s 3th result became stronger than FH-group (p=0.001) and the PT-group (p=0.018) at first. About the perineal-muscles: usually the PT-group achieved the best results. The FH-group’s perineal-muscles in case of relaxation were significantly symmetrical (p=0.038) than the TS-group’s after training. Pilates-method turned out to be effective to improve the strength and stamina of core muscles. Core-training is effective to improve core muscles, but not enough for perineal muscles with the given frequency and intensity. ]


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