Welcome to the January–February 2016 issue of Innovations in Clinical Neuroscience. We start this issue with the article “Erectile Dysfunction in Individuals with Neurologic Disability: A Hospital-based Cross-sectional Study,” by Calabró et al. Here, the investigators evaluated the prevalence and causes of erectile dysfunction in a group of hospital inpatients suffering from neurologic disorders. The subjects were divided into two groups according to their lesion sites: G1 (lesions above the S2–S4 center) and G2 (lesions below the S2–S4 center). The authors found that erectile dysfunction was more prevalent among neurologically disabled men compared to the general population, and the frequency and severity of ED was greater in the subjects with lesions below S2–S4. The authors conclude that considering the prevalence of erectile dysfunction among neurologically disabled men, sexual functioning should be regularly evaluated during acute and long-term rehabilitation, and any existing sexual dysfunction should be addressed in the treatment plan.
Next, Alphs and Bossie describe their new tool, A Study Pragmatic-Explanatory Characterization Tool-Rating—or ASPECT-R in their article, “ASPECT-R—A Tool to Rate the Pragmatic and Explanatory Characteristics of a Clinical Trial Design.” The authors adapted the PRECIS and Pragmascope instruments to create the ASPECT-R tool in order to permit both design support and post-hoc evaluation of clinical trials and to improve consistency of use and interpretation across raters.
Following this, Daniel et al summarize the results of the CNS Summit Data Quality Monitoring Workgroup analysis of current data quality monitoring techniques used in CNS clinical trials. In their executive summary, “Data Quality Monitoring in Clinical Trials: Has It Been Worth It? An Evaluation and Prediction of the Future by All Stakeholders,” the authors reveal and discuss the results of audience polls conducted during the CNS Summit 2014, where audience members were asked about their existing data monitoring techniques. The authors present and discuss case examples of current data quality methodology and offer predictions for future outcome measures and patient selection approaches.
Next, in their case report, “Quetiapine-induced Bradycardia and Hypotension in the Elderly—A Case Report,” Nakamura et al describe the case of an elderly man with a history of heart disease who developed symptomatic bradycardia and hypotension simultaneously while taking quetiapine. The authors discuss treatment and possible mechanisms that may cause bradyarrhythmogenic characteristics in those individuals taking second-generation antipsychotics, such as quetiapine. The authors conclude that elderly patients on quetiapine, particularly at higher dosages, should be continually and closely monitored for any symptoms of cardiac distress.
Following this, Bonda et al describe a case of a patient with autosomal dominant amyotrophic lateral sclerosis and frontotemporal dementia (ALS-FTD) in the presence of C9orf72 repeat expansion. The authors believe their case supports the theory that the presence of C9orf72 repeat expansion in patients with a family history of amyotrophic lateral sclerosis and/or frontotemporal dementia significantly increases their risk of developing either or both diseases.
And finally, in their article, “Sleep-isolated Trichotillomania (SITTM): A Case Report,” Goyal and Surya describe a case of a woman with sleep-isolated trichotillomania who was admitted to the hospital for alcohol detoxification. The authors describe their patient’s treatment plan and how diagnostic polysomnography can be helpful in correlating sleep-isolated trichotillomania behaviors with the sleep cycle so that a specific treatment plan for sleep-isolated trichotillomania can be formulated.
We hope you enjoy the issue. As always we welcome your submissions and feedback.
Amir Kalali, MD
Editor, Innovations in Clinical Neuroscience