Neurology
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Diagnostic Criteria for Paraneoplastic Neurologic Syndromes
This study evaluates the effectiveness of the updated 2021 Paraneoplastic Neurologic Syndromes (PNS)-CARE score in diagnosing PNS, highlighting significant improvements in sensitivity and specificity compared to the 2004 criteria, while also addressing limitations related to study design, diagnostic criteria comparison, and the need for further research in diverse patient populations.
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Epilepsy and Cardiovascular Events
This large prospective cohort study found that older adults with a lifetime history of epilepsy were more likely to experience cardiovascular events (CVEs), and that enzyme-inducing antiseizure medications (EIASMs) may account for a significant portion of this risk. The findings suggest a potential causal link between epilepsy treated with EIASMs and CVE, highlighting the need for careful medication selection in epilepsy management.
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DOACs Can Safely Be Started Early After Atrial Fibrillation-Associated Stroke
In ischemic stroke associated with atrial fibrillation, early restart of anticoagulation with apixaban one to three days after ischemic stroke, compared to late restart (seven to 14 days), there were no significant differences between the groups in the primary outcome — a composite endpoint including recurrent ischemic stroke, symptomatic intracranial hemorrhage, and systemic embolism.
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Neurologic Toxicity with Immune Checkpoint Inhibitors
In a nationwide, multicenter, retrospective study of patients with neurologic immune-related adverse events related to immune checkpoint inhibitors, more than half of patients developed a chronic condition associated with a higher rate of severe neurologic disability and mortality.
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Migraine Trigger or Prodromal Symptom: Which Came First — the Chocolate or the Craving?
Knowledge of the differentiation between the triggers for a potential migraine attack and the prodromal symptoms of an initiated migraine attack reveals strategies that decrease migraine disability. Recognition of migraine triggers allows for a modification of behavior to avoid precipitating an attack. Recognition of common migraine prodromal symptoms creates an early time window when rapid treatment enhances the therapeutic intervention’s efficacy.
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Xanomeline and Trospium Chloride Capsules (Cobenfy)
The U.S. Food and Drug Administration has approved the first-in-class muscarinic agonist and antagonists for the treatment of schizophrenia in adults. This is the first antipsychotic drug approved in decades and is unique in that it targets cholinergic receptors — unlike traditional agents, which target dopamine receptors.
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Early Bird or Night Owl: Who’s Mentally Sharper?
A large cross-sectional analysis of adults aged 53-86 years found that people with normal sleep durations while being “night owls” often scored higher on cognitive tests than “early bird” types.
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Blood Biomarker for the Diagnosis of Alzheimer’s Disease
In this population-based study of patients in Sweden with cognitive complaints, mild cognitive impairment, and dementia, the use of blood biomarkers, specifically, phosphorylated tau 217 and amyloid-beta 42/40 ratios, improved the diagnostic accuracy for pathological Alzheimer’s disease in primary care patients as well as patients seen by dementia specialists.
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Eculizumab for Treating Aquaporin-4 Antibody-Positive NMOSD
In this retrospective study of a cohort of aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder (NMOSD) patients treated with eculizumab, the authors reported efficacy with decreasing relapse rate, magnetic resonance imaging changes, and disability outcomes, but cautioned about the risk of serious infections.
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A microRNA Diagnostic Biomarker for ALS
A specific pattern of eight micro ribonucleic acids (microRNAs) has been shown to differentiate patients with amyotrophic lateral sclerosis (ALS) from those with primary lateral sclerosis, Parkinson’s disease, and healthy controls. It remains to be determined if these differences will continue throughout the course of the disease.