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Karissa Lorraine Gable

Associate Professor of Neurology
Neurology, Neuromuscular Disease
DUMC 3909, Durham, NC 27710

Selected Publications


Comparative effectiveness of azathioprine and mycophenolate mofetil for myasthenia gravis (PROMISE-MG): a prospective cohort study.

Journal Article Lancet Neurol · March 2024 BACKGROUND: Myasthenia gravis is an autoimmune disorder of the neuromuscular junction. Treatment typically includes symptomatic oral cholinesterase inhibitors, immunosuppression, and immunomodulation. In addition to corticosteroids, azathioprine and mycoph ... Full text Link to item Cite

Chronic Immune-Mediated Demyelinating Neuropathies.

Journal Article Continuum (Minneap Minn) · October 1, 2023 OBJECTIVE: This article is an overview of chronic demyelinating neuropathies and highlights the phenotypic categorization, diagnosis, and treatment of chronic immune-mediated neuropathies. The clinical and diagnostic characteristics of other chronic demyel ... Full text Link to item Cite

A longitudinal evaluation of fatigue in chronic inflammatory demyelinating polyneuropathy.

Journal Article Brain Behav · August 2022 BACKGROUND AND AIMS: Fatigue is a common but poorly understood complaint in patients with immune-mediated polyneuropathies. We sought to evaluate changes in fatigue over 1 year in a cohort of chronic inflammatory demyelinating polyneuropathy (CIDP) patient ... Full text Link to item Cite

The neuromuscular fellowship portal and match.

Journal Article Muscle Nerve · June 2022 For many years, Neuromuscular Medicine programs lacked a standardized means of handling fellowship applications and offering positions. Programs interviewed applicants and made offers as early as the first half of Post Graduate Year 3 (PGY3), a suboptimal ... Full text Link to item Cite

Classical Complement Pathway Inhibition in a "Human-On-A-Chip" Model of Autoimmune Demyelinating Neuropathies.

Journal Article Adv Ther (Weinh) · June 2022 Chronic autoimmune demyelinating neuropathies are a group of rare neuromuscular disorders with complex, poorly characterized etiology. Here we describe a phenotypic, human-on-a-chip (HoaC) electrical conduction model of two rare autoimmune demyelinating ne ... Full text Link to item Cite

Neuromuscular Disorders and Pregnancy.

Journal Article Continuum (Minneap Minn) · February 1, 2022 PURPOSE OF REVIEW: This article provides an overview of neuromuscular disorders in pregnancy, with a focus on diagnosis and management. RECENT FINDINGS: Neuromuscular disorders with issues that occur in pregnancy include conditions that are acquired (inclu ... Full text Link to item Cite

Reduced plasmablast frequency is associated with seronegative myasthenia gravis.

Journal Article Muscle Nerve · April 2021 BACKGROUND: The immunopathology of autoimmune seronegative myasthenia gravis (SN MG) is poorly understood. Our objective was to determine immune profiles associated with a diagnosis of SN MG. METHODS: We performed high-dimensional flow cytometry on blood s ... Full text Link to item Cite

Knowledge and perceptions of the COVID-19 pandemic among patients with myasthenia gravis.

Journal Article Muscle Nerve · March 2021 BACKGROUND: Patients with myasthenia gravis (MG) may be particularly vulnerable during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic due to risk of worsening disease during infection, potential adverse impacts of coronavirus dis ... Full text Link to item Cite

Effect of Ezogabine on Cortical and Spinal Motor Neuron Excitability in Amyotrophic Lateral Sclerosis: A Randomized Clinical Trial.

Journal Article JAMA Neurol · February 1, 2021 IMPORTANCE: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease of the motor nervous system. Clinical studies have demonstrated cortical and spinal motor neuron hyperexcitability using transcranial magnetic stimulation and thresh ... Full text Link to item Cite

Fatigue in chronic inflammatory demyelinating polyneuropathy.

Journal Article Muscle Nerve · December 2020 INTRODUCTION: In this study we aimed to better understand fatigue in chronic inflammatory demyelinating polyneuropathy (CIDP) as it relates to disease activity status. METHODS: Patients with probable or definite CIDP were stratified into active CIDP or CID ... Full text Link to item Cite

Inhibition of the transcription factor ROR-γ reduces pathogenic Th17 cells in acetylcholine receptor antibody positive myasthenia gravis.

Journal Article Exp Neurol · March 2020 IL-17 producing CD4 T cells (Th17) cells increase significantly with disease severity in myasthenia gravis (MG) patients. To suppress the generation of Th17 cells, we examined the effect of inhibiting retinoic acid receptor-related-orphan-receptor-C (RORγ) ... Full text Link to item Cite

Antagonism of the Neonatal Fc Receptor as an Emerging Treatment for Myasthenia Gravis.

Journal Article Front Immunol · 2019 Myasthenia gravis is an autoimmune disease in which immunoglobulin G (IgG) autoantibodies are formed against the nicotinic acetylcholine receptor (AChR) or other components of the neuromuscular junction. Though effective treatments are currently available, ... Full text Link to item Cite

A dozen years of evolution of neurology clerkships in the United States: Looking up.

Journal Article Neurology · October 9, 2018 OBJECTIVE: To report a 2017 survey of all US medical school neurology clerkship directors (CDs) and to compare the results to similar surveys conducted in 2005 and 2012. METHODS: An American Academy of Neurology (AAN) Consortium of Neurology Clerkship Dire ... Full text Link to item Cite

Validation of a simple disease-specific, quality-of-life measure for diabetic polyneuropathy: CAPPRI.

Journal Article Neurology · June 5, 2018 OBJECTIVE: We studied the performance of a 15-item, health-related quality-of-life polyneuropathy scale in the clinic setting in patients with diabetic distal sensorimotor polyneuropathy (DSPN). METHODS: Patients with DSPN from 11 academic sites completed ... Full text Link to item Cite

Subcutaneous immunoglobulin for maintenance treatment in chronic inflammatory demyelinating polyneuropathy (PATH): a randomised, double-blind, placebo-controlled, phase 3 trial.

Journal Article Lancet Neurol · January 2018 BACKGROUND: Approximately two-thirds of patients with chronic inflammatory demyelinating polyneuropathy (CIDP) need long-term intravenous immunoglobulin. Subcutaneous immunoglobulin (SCIg) is an alternative option for immunoglobulin delivery, but has not p ... Full text Link to item Cite

B10 Cell Frequencies and Suppressive Capacity in Myasthenia Gravis Are Associated with Disease Severity.

Journal Article Front Neurol · 2017 Myasthenia gravis (MG) is a T cell-dependent, B cell-mediated disease. The mechanisms for loss of self-tolerance in this disease are not well understood, and recently described regulatory B cell (Breg) subsets have not been thoroughly investigated. B10 cel ... Full text Open Access Link to item Cite

Comparative effectiveness of azathioprine and mycophenolate mofetil for myasthenia gravis (PROMISE-MG): a prospective cohort study.

Journal Article Lancet Neurol · March 2024 BACKGROUND: Myasthenia gravis is an autoimmune disorder of the neuromuscular junction. Treatment typically includes symptomatic oral cholinesterase inhibitors, immunosuppression, and immunomodulation. In addition to corticosteroids, azathioprine and mycoph ... Full text Link to item Cite

Chronic Immune-Mediated Demyelinating Neuropathies.

Journal Article Continuum (Minneap Minn) · October 1, 2023 OBJECTIVE: This article is an overview of chronic demyelinating neuropathies and highlights the phenotypic categorization, diagnosis, and treatment of chronic immune-mediated neuropathies. The clinical and diagnostic characteristics of other chronic demyel ... Full text Link to item Cite

A longitudinal evaluation of fatigue in chronic inflammatory demyelinating polyneuropathy.

Journal Article Brain Behav · August 2022 BACKGROUND AND AIMS: Fatigue is a common but poorly understood complaint in patients with immune-mediated polyneuropathies. We sought to evaluate changes in fatigue over 1 year in a cohort of chronic inflammatory demyelinating polyneuropathy (CIDP) patient ... Full text Link to item Cite

The neuromuscular fellowship portal and match.

Journal Article Muscle Nerve · June 2022 For many years, Neuromuscular Medicine programs lacked a standardized means of handling fellowship applications and offering positions. Programs interviewed applicants and made offers as early as the first half of Post Graduate Year 3 (PGY3), a suboptimal ... Full text Link to item Cite

Classical Complement Pathway Inhibition in a "Human-On-A-Chip" Model of Autoimmune Demyelinating Neuropathies.

Journal Article Adv Ther (Weinh) · June 2022 Chronic autoimmune demyelinating neuropathies are a group of rare neuromuscular disorders with complex, poorly characterized etiology. Here we describe a phenotypic, human-on-a-chip (HoaC) electrical conduction model of two rare autoimmune demyelinating ne ... Full text Link to item Cite

Neuromuscular Disorders and Pregnancy.

Journal Article Continuum (Minneap Minn) · February 1, 2022 PURPOSE OF REVIEW: This article provides an overview of neuromuscular disorders in pregnancy, with a focus on diagnosis and management. RECENT FINDINGS: Neuromuscular disorders with issues that occur in pregnancy include conditions that are acquired (inclu ... Full text Link to item Cite

Reduced plasmablast frequency is associated with seronegative myasthenia gravis.

Journal Article Muscle Nerve · April 2021 BACKGROUND: The immunopathology of autoimmune seronegative myasthenia gravis (SN MG) is poorly understood. Our objective was to determine immune profiles associated with a diagnosis of SN MG. METHODS: We performed high-dimensional flow cytometry on blood s ... Full text Link to item Cite

Knowledge and perceptions of the COVID-19 pandemic among patients with myasthenia gravis.

Journal Article Muscle Nerve · March 2021 BACKGROUND: Patients with myasthenia gravis (MG) may be particularly vulnerable during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic due to risk of worsening disease during infection, potential adverse impacts of coronavirus dis ... Full text Link to item Cite

Effect of Ezogabine on Cortical and Spinal Motor Neuron Excitability in Amyotrophic Lateral Sclerosis: A Randomized Clinical Trial.

Journal Article JAMA Neurol · February 1, 2021 IMPORTANCE: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease of the motor nervous system. Clinical studies have demonstrated cortical and spinal motor neuron hyperexcitability using transcranial magnetic stimulation and thresh ... Full text Link to item Cite

Fatigue in chronic inflammatory demyelinating polyneuropathy.

Journal Article Muscle Nerve · December 2020 INTRODUCTION: In this study we aimed to better understand fatigue in chronic inflammatory demyelinating polyneuropathy (CIDP) as it relates to disease activity status. METHODS: Patients with probable or definite CIDP were stratified into active CIDP or CID ... Full text Link to item Cite

Inhibition of the transcription factor ROR-γ reduces pathogenic Th17 cells in acetylcholine receptor antibody positive myasthenia gravis.

Journal Article Exp Neurol · March 2020 IL-17 producing CD4 T cells (Th17) cells increase significantly with disease severity in myasthenia gravis (MG) patients. To suppress the generation of Th17 cells, we examined the effect of inhibiting retinoic acid receptor-related-orphan-receptor-C (RORγ) ... Full text Link to item Cite

Antagonism of the Neonatal Fc Receptor as an Emerging Treatment for Myasthenia Gravis.

Journal Article Front Immunol · 2019 Myasthenia gravis is an autoimmune disease in which immunoglobulin G (IgG) autoantibodies are formed against the nicotinic acetylcholine receptor (AChR) or other components of the neuromuscular junction. Though effective treatments are currently available, ... Full text Link to item Cite

A dozen years of evolution of neurology clerkships in the United States: Looking up.

Journal Article Neurology · October 9, 2018 OBJECTIVE: To report a 2017 survey of all US medical school neurology clerkship directors (CDs) and to compare the results to similar surveys conducted in 2005 and 2012. METHODS: An American Academy of Neurology (AAN) Consortium of Neurology Clerkship Dire ... Full text Link to item Cite

Validation of a simple disease-specific, quality-of-life measure for diabetic polyneuropathy: CAPPRI.

Journal Article Neurology · June 5, 2018 OBJECTIVE: We studied the performance of a 15-item, health-related quality-of-life polyneuropathy scale in the clinic setting in patients with diabetic distal sensorimotor polyneuropathy (DSPN). METHODS: Patients with DSPN from 11 academic sites completed ... Full text Link to item Cite

Subcutaneous immunoglobulin for maintenance treatment in chronic inflammatory demyelinating polyneuropathy (PATH): a randomised, double-blind, placebo-controlled, phase 3 trial.

Journal Article Lancet Neurol · January 2018 BACKGROUND: Approximately two-thirds of patients with chronic inflammatory demyelinating polyneuropathy (CIDP) need long-term intravenous immunoglobulin. Subcutaneous immunoglobulin (SCIg) is an alternative option for immunoglobulin delivery, but has not p ... Full text Link to item Cite

B10 Cell Frequencies and Suppressive Capacity in Myasthenia Gravis Are Associated with Disease Severity.

Journal Article Front Neurol · 2017 Myasthenia gravis (MG) is a T cell-dependent, B cell-mediated disease. The mechanisms for loss of self-tolerance in this disease are not well understood, and recently described regulatory B cell (Breg) subsets have not been thoroughly investigated. B10 cel ... Full text Open Access Link to item Cite

International clinimetric evaluation of the MG-QOL15, resulting in slight revision and subsequent validation of the MG-QOL15r.

Journal Article Muscle Nerve · December 2016 INTRODUCTION: The MG-QOL15 is a validated, health-related quality of life (HRQOL) measure for myasthenia gravis (MG). Widespread use of the scale gave us the opportunity to further analyze its clinimetric properties. METHODS: We first performed Rasch analy ... Full text Link to item Cite

Ultrasound in EMG-Guided Biopsies: A Prospective, Randomized Pilot Trial.

Journal Article Muscle Nerve · October 2016 INTRODUCTION: At our institution, core muscle biopsies are performed on muscles selected using electromyography (EMG). Ultrasound (US) guidance is not used routinely. The aim of this study was to determine if US guidance of EMG selected muscles would incre ... Full text Link to item Cite

Construction and validation of the chronic acquired polyneuropathy patient-reported index (CAP-PRI): A disease-specific, health-related quality-of-life instrument.

Journal Article Muscle Nerve · June 2016 INTRODUCTION: Generic health-related quality-of-life (HRQOL) patient-reported outcome measures have been used in patients with chronic immune-mediated polyneuropathies. We have created a disease-specific HRQOL instrument. METHODS: The chronic acquired poly ... Full text Link to item Cite

Presynaptic Disorders: Lambert-Eaton Myasthenic Syndrome and Botulism.

Journal Article Semin Neurol · August 2015 Lambert-Eaton myasthenic syndrome (LEMS) and botulism are acquired presynaptic nerve terminal disorders of the neuromuscular junction. Lambert-Eaton myasthenic syndrome is an idiopathic or paraneoplastic autoimmune syndrome in which autoantibodies of the P ... Full text Link to item Cite

Distal acquired demyelinating symmetric neuropathy after vaccination.

Journal Article J Clin Neuromuscul Dis · March 2013 Neuropathy after vaccination is a rare event. Chronic immune-mediated polyneuropathy developing in the postvaccination period is distinctly unusual and not well described. Almost all such patients have been reported as having typical chronic inflammatory d ... Full text Link to item Cite

Developmental regulation of neural cell adhesion molecule in human prefrontal cortex.

Journal Article Neuroscience · August 4, 2009 Neural cell adhesion molecule (NCAM) is a membrane-bound cell recognition molecule that exerts important functions in normal neurodevelopment including cell migration, neurite outgrowth, axon fasciculation, and synaptic plasticity. Alternative splicing of ... Full text Link to item Cite

Nordihydroguaiaretic acid inhibits insulin-like growth factor signaling, growth, and survival in human neuroblastoma cells.

Journal Article J Cell Biochem · December 15, 2007 Neuroblastoma is a common pediatric malignancy that metastasizes to the liver, bone, and other organs. Children with metastatic disease have a less than 50% chance of survival with current treatments. Insulin-like growth factors (IGFs) stimulate neuroblast ... Full text Link to item Cite

Caspase-3 activation in rat frontal cortex following treatment with typical and atypical antipsychotics.

Journal Article Neuropsychopharmacology · January 2007 In schizophrenia, studies indicate that apoptotic susceptibility in cortex may be increased. A role for apoptosis in schizophrenia could potentially contribute to post-mortem evidence of reduced cortical neuropil and neuroimaging studies showing progressiv ... Full text Link to item Cite

Diarylureas are small-molecule inhibitors of insulin-like growth factor I receptor signaling and breast cancer cell growth.

Journal Article Mol Cancer Ther · April 2006 In breast and certain other cancers, receptor tyrosine kinases, including the insulin-like growth factor I receptor (IGF-IR), play an important role in promoting the oncogenic process. The IGF-IR is therefore an important target for developing new anti-bre ... Full text Link to item Cite

Nordihydroguaiaretic acid (NDGA) inhibits the IGF-1 and c-erbB2/HER2/neu receptors and suppresses growth in breast cancer cells.

Journal Article Breast Cancer Res Treat · November 2005 Nordihydroguaiaretic acid (NDGA) is a phenolic compound isolated from the creosote bush Larrea divaricatta that has anti-cancer activities both in vitro and in vivo. We can now attribute certain of these anti-cancer properties in breast cancer cells to the ... Full text Link to item Cite