Joel Neves Briard

A Phase 3 Trial of Inebilizumab in Generalized Myasthenia Gravis | NEJM Autoimmune generalized myasthenia gravis is a disease that manifests with fluctuating muscle weakness. Inebilizumab is a monoclonal antibody that depletes CD19+ B cells, which are central to diseas...

A Phase 3 Trial of Inebilizumab in Generalized Myasthenia Gravis | New England Journal of Medicine www.nejm.org/doi/full/10....

More data on this approach just published in the ANGEL-TNK Randomized Clinical Trial !

jamanetwork.com/journals/jam...

Intra-Arterial Thrombolysis Following Endovascular Recanalization for Large Vessel Occlusion Stroke | Neurology Background and ObjectivesThis systematic review and meta-analysis aims to evaluate the treatment effects of intra-arterial thrombolysis (IAT) after endovascular recanalization in patients with acute i...

This systematic review and meta analysis of RCTs found that intra-arterial thrombolysis after endovascular recanalization adds additional benefits to functional outcomes among patients with AIS due to LVO, with no increased risk of death or intracranial hemorrhage.

www.neurology.org/doi/10.1212/...

More screen time is associated with more depressive symptoms during early adolescence.

From JAMA Pediatrics: More screen time is associated with more depressive symptoms, potentially due to shorter sleep and worse white matter organization during early adolescence. https://ja.ma/3TIXNKz

Recurrence and Mortality After a First Status Epilepticus | Neurology Background and ObjectivesStatus epilepticus (SE) is associated with high short-term mortality, but data on long-term outcomes, including recurrence and mortality, are limited. The aim of this study wa...

Recurrence and Mortality After a First Status Epilepticus: A Retrospective Nationwide Study From the French National Health Data System

www.neurology.org/doi/10.1212/...

Effects of blood pressure lowering in relation to time in acute intracerebral haemorrhage: a pooled analysis of the four INTERACT trials Intensive BP-lowering initiated within several hours of intracerebral haemorrhage onset was safe and improved functional recovery, without a clear effect on haematoma growth. The greatest benefits for...

Effects of blood pressure lowering in relation to time in acute intracerebral haemorrhage: a pooled analysis of the four INTERACT trials - The Lancet Neurology www.thelancet.com/journals/lan...

Congratulations to my mentor Michaël Chassé and all colleagues in the INDex team for completing this work ! What a pleasure working on this together. A great 🇨🇦 collaboration !

Forest plots of the subgroup analyses

Presented at #CCR25:

In a cluster-randomized, crossover trial, hospital-wide use of lactated Ringer’s solution as compared with normal saline did not alter the incidence of death or hospital readmission within 90 days. Full trial results: nej.md/45SaEBs

@criticalcarereviews.com

Oveporexton, an Oral Orexin Receptor 2–Selective Agonist, in Narcolepsy Type 1 | NEJM Narcolepsy type 1 is a disorder of hypersomnolence caused by a loss of orexin neurons, which results in low orexin levels in the brain. In this phase 2, randomized, placebo-controlled trial, partic...

Oveporexton shows promise for the treatment of narcolepsy in this phase 2 trial. Exciting findings for those impacted by this rare condition and everyone in the sleep medicine community !

www.nejm.org/doi/full/10....

Page 1 of article

Most viewed this week from JAMA: Restrictive platelet transfusion strategies are recommended for various clinical populations to minimize adverse reactions, mitigate platelet shortages, reduce costs, and ensure patient-centric care.

https://ja.ma/4jtHFan

Extended CT angiography versus standard CT angiography for the detection of cardioaortic thrombus in patients with ischaemic stroke and transient ischaemic attack (DAYLIGHT): a prospective, randomised... Performing extended CT angiography during acute code strokes is feasible and results in increased cardioaortic thrombi detection without causing delays in CT angiography completion. Future studies sho...

DAYLIGHT study from Western University finds higher rates of cardioaortic thrombus in the extended CT angiography group (8·8%) than the standard CT angiography group (1·7%; odds ratio 5·70, 95% CI 1·92–16·96; p=0·002).

www.thelancet.com/journals/lan...

Figure 2. Cumulative Incidence Plot for Time From Randomization to Successful Extubation

In critically ill patients, neither dexmedetomidine nor clonidine was superior to propofol in reducing time to successful extubation. #ATS2025

https://ja.ma/3Sw1K4Z

Evaluations of the New Brunswick Neurological Syndrome of Unknown Cause This cross-sectional study examines findings from second, independent clinical evaluations of patients initially diagnosed with an alleged “mystery” neurological illness in New Brunswick, Canada, to d...

All 25 participants in this study of « New Brunswick Neurological Syndrome of Unknown Cause (NSUC) » had a well known condition diagnosed on second evaluation or neuropathology. Medical, scientific and journalistic rigor are essential in addressing « mystery » cases.

jamanetwork.com/journals/jam...

In this recent study from Québec, door-in-door-out metrics were surprisingly not associated with 90-day functional outcomes or mortality among acute stroke patients treated by EVT following transfer from a primary stroke center.
@crchum.bsky.social
www.cambridge.org/core/journal...

Visual Abstract. Prothrombin Complex Concentrate vs Frozen Plasma for Coagulopathic Bleeding in Cardiac Surgery

In patients needing coagulation factor replacement after cardiac surgery, prothrombin complex concentrate showed superior hemostatic effectiveness and fewer serious adverse events and acute kidney injuries compared to frozen plasma. #ACC25 https://ja.ma/43w3phs

In this observational Canadian study, patients with benzodiazepine-refractory status epilepticus who received a higher weight-based dosing of levetiracetam had a higher proportion of seizure termination as compared to the lower weight based group (aOR 3.07).

www.cambridge.org/core/journal...

Reversible reduction in brain myelin content upon marathon running - Nature Metabolism Using magnetic resonance imaging on marathon runners, Ramos-Cabrer, Cabrera-Zubizarreta et al. report that the signal detected as a surrogate of myelin content is significantly reduced after exercise,...

The brain myelin content in marathon runners
“This study offers the striking observation that extreme exercise has a profound effect in the brain that is reflected in reversible structural alterations" @naturemetabolism.bsky.social
www.nature.com/articles/s42...
www.nature.com/articles/s42...

Decisions to withdraw or withhold life-sustaining therapies in patients with and without acute brain injury: a secondary analysis of two prospective cohort studies Our findings suggest that WLST decisions are significantly more common in patients with ABI versus patients without ABI and occur earlier in this group. The rationale for early WLST following ABI warr...

Decisions to withdraw or withhold life-sustaining therapies in patients with and without acute brain injury: a secondary analysis of two prospective cohort studies - The Lancet Respiratory Medicine www.thelancet.com/journals/lan...

«Ça change tout pour moi»: cette jeune maman atteinte d’un cancer du cerveau a encore de belles années devant elle grâce à un nouveau traitement Une jeune mère de Terrebonne atteinte d’un cancer du cerveau incurable peut espérer vivre encore plusieurs années en santé grâce à un médicament.

Les avancées en neuro-oncologie s’annoncent importantes !

@chumontreal.bsky.social

www.journaldemontreal.com/2025/03/10/c...

Very good summary of the facts and myths about measles.
The vaccine saves lives!

And it's the antivaxers who make money on the backs of future victims.

Sleep spindles as a predictor of cognitive motor dissociation and recovery of consciousness after acute brain injury Nature Medicine - In acutely brain injured patients, well-formed sleep spindles on EEG were more likely present in patients with cognitive motor dissociation, were associated with a shorter time to...

Fascinating findings from the Columbia DoC Lab! Sleep spindles predict cognitive motor dissociation and recovery of consciousness after acute brain injury
rdcu.be/ech6L

Antiseizure Medications in Poststroke Seizures
A Systematic Review and Network Meta-Analysis

www.neurology.org/doi/10.1212/...

The Brussels consensus for non-invasive ICP monitoring when invasive systems are not available in the care of TBI patients (the B-ICONIC consensus, recommendations, and management algorithm) - Intensi... Background Invasive systems are commonly used for monitoring intracranial pressure (ICP) in traumatic brain injury (TBI) and are considered the gold standard. The availability of invasive ICP monitori...

The Brussels consensus for non-invasive ICP monitoring when invasive systems are not available in the care of TBI patients (the B-ICONIC consensus, recommendations, and management algorithm)

link.springer.com/article/10.1...

Cinq ans de pratique obligatoire au public | Voulez-vous vraiment que les médecins restent ? Les cosignataires s’adressent au ministre de la Santé et à la PDG de Santé Québec

Voulez-vous vraiment que les médecins restent ? www.lapresse.ca/dialogue/opi...

Endovascular Treatment of Stroke Due to Medium-Vessel Occlusion | NEJM Whether the large effect size of endovascular thrombectomy (EVT) for stroke due to large-vessel occlusion applies to stroke due to medium-vessel occlusion is unclear. In a multicenter, prospective,...

In this latest Canadian study, EVT for acute stroke due to medium vessel occlusion did not reduce neurologic disability at 90 days. Higher proportions of ICH and death in the EVT group.

www.nejm.org/doi/full/10....

The ninth trial result for #CCR25 in Titanic Belfast in June is INdex

CT-perfusion for the Neurological Determination of Death

Investigators - Michaël Chassé & Jai Shankar

Register at https://criticalcarereviews.com/meetings/ccr25

@chumontreal.bsky.social
@crchum.bsky.social
@umontreal.ca

Thoraco-abdominal normothermic regional perfusion does not restore cerebral blood flow or electrical activity despite collateral supra-aortic blood flow in a porcine model It is unknown whether ligation of supra-aortic vessels during thoraco-abdominal normothermic regional perfusion (TA-NRP) can prevent postmortem brain function, ensuring the permanence of death. Our ob...

In this porcine model we found no evidence of brain blood flow or electrical activity during TA-NRP despite occasional collateral extracranial blood flow. More work needed to understand the impact of TA-NRP on brain physiology in different human donor populations.

www.jhltopen.org/article/S295...

Apixaban to Prevent Infarcts After Stroke in Patients With Atrial Cardiopathy This secondary analysis of a parallel-design double-blind secondary stroke prevention trial in patients with cryptogenic stroke and atrial cardiopathy evaluates the association between apixaban and th...

Very interesting ancillary study shedding light on the potential role of anticoagulation in patients with recent cryptogenic stroke and atrial cardiopathy.

jamanetwork.com/journals/jam...

Cyclooxygenase 2 Inhibitors for Headache After Elective Cranial Neurosurgery: Results from a Systematic Review of Efficacy of Cyclooxygenase 2 Inhibitors for Headache After Acute Brain Injury - Neuroc... Headache management after acute brain injury (ABI) is challenging. Although opioids are commonly used, selective cyclooxygenase 2 inhibitors (COXIBs) may be promising alternatives. However, concerns a...

According to this systematic review, COX2 inhibitors have never been studied for the management of headache in patients with acute brain injury. A definitive major knowledge gap for neurocritical care patients!

link.springer.com/article/10.1...