Background: Intra-arterial thrombolysis may reduce mortality in acute basilar artery (BA) occlusion. We wanted to identify an easy-to-use pre-treatment MR-based predictor of clinical outcome in patients with acute BA occlusion treated with IAT. Methods: We analyzed 16 patients with acute BA occlusion prospectively. Vascular risk factors, as well as National Institutes of Health Stroke Scale (NIHSS) and Glasgow Coma Scale (GCS) scores were recorded on admission, together with a 10-point semiquantitative score reflecting the number of acute ischaemic brain lesions on diffusion-weighted imaging. The recanalization grade was evaluated by angiography. The clinical outcome, using the modified Rankin scale (mRs), was measured 3 months later. Results: Risk factors, NIHSS and GCS scores, time from symptom onset to treatment, recanalization rate, outcome and outcome predictors (such as age, NIHSS and GCS scores) were comparable to other studies. Haemorrhagic transformation of infarction occurred in 2 patients (12.5%). We found that a high lesion score was an additional predictor of poor outcome (p = 0.026). Conclusions: In patients with acute BA occlusion, treated with intra-arterial recombinant tissue plasminogen activator, a high number of acute ischaemic lesions, based on diffusion-weighted imaging, is a predictor of poor clinical outcome.

Rhythmic auditory cues can immediately improve gait in Parkinson’s disease. However, this effect varies considerably across patients. The factors associated with this individual variability are not known to date. Patients’ rhythmic abilities and musicality (e.g., perceptual and singing abilities, emotional response to music, and musical training) may foster a positive response to rhythmic cues. To examine this hypothesis, we measured gait at baseline and with rhythmic cues in 39 non-demented patients with Parkinson’s disease and 39 matched healthy controls. Cognition, rhythmic abilities and general musicality were assessed. A response to cueing was qualified as positive when the stimulation led to a clinically meaningful increase in gait speed. We observed that patients with positive response to cueing (n = 17) were more musically trained, aligned more often their steps to the rhythmic cues while walking, and showed better music perception as well as poorer cognitive flexibility than patients with non-positive response (n = 22). Gait performance with rhythmic cues worsened in six patients. We concluded that rhythmic and musical skills, which can be modulated by musical training, may increase beneficial effects of rhythmic auditory cueing in Parkinson’s disease. Screening patients in terms of musical/rhythmic abilities and musical training may allow teasing apart patients who are likely to benefit from cueing from those who may worsen their performance due to the stimulation.

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BackgroundWe recently demonstrated in a randomized controlled trial (APOMORPHEE, NCT02940912) that night‐time only subcutaneous apomorphine infusion improves sleep disturbances and insomnia in patients with advanced Parkinson's disease and moderate to severe insomnia.ObjectivesTo identify the best candidates for receiving night‐time only subcutaneous apomorphine infusion in routine care.MethodsIn this post‐hoc analysis of APOMORPHEE, we compared the characteristics of patients according to whether they chose to continue night‐time only subcutaneous apomorphine infusion at the end of the study period or not.ResultsHalf of the patients (22/42) chose to continue the treatment. Off duration (day or night), painful Off dystonia, and insomnia severity at baseline were associated with night‐time only apomorphine continuation. Multivariate analysis retained only Off duration as an independent predictor of continuation.ConclusionsThe best candidates for night‐time only apomorphine are patients with severe and prolonged Off periods (day or night) and severe insomnia.

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