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Long-Term Effects of Cholinesterase Inhibitors on Cognitive Decline and Mortality
Cholinesterase inhibitors are one of the few drug classes approved by the Food and Drug Administration for the treatment of patients with Alzheimer’s disease. This study shows a long-term benefit in slowing the decline of cognition, as measured by the Mini-Mental State Exam, but it is unclear if there is any benefit in quality of life.
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Genetic Biomarkers of Immunoglobulin Response in Patients with CIDP
Nearly 25% of patients with chronic inflammatory demyelinating polyneuropathy (CIDP) have a poor response to intravenous immunoglobulin treatment. Variations in the PRF1 and FCGR2B genes in CIDP patients offer insights into the heterogenous treatment response.
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Association of Sleepwalking and REM Sleep Behavior Disorder in Men with Parkinson’s
In this retrospective, cross-sectional study of men, both sleepwalking and rapid eye movement sleep behavior disorder were associated with the development of Parkinson’s disease.
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Effectiveness of Bariatric Surgery for the Treatment of Idiopathic Intracranial Hypertension
Idiopathic intracranial hypertension is an important cause of intractable headaches and may cause permanent loss of vision as a result of chronic papilledema. Weight loss is an effective treatment, and this randomized study demonstrated superior outcomes for both weight loss and reduced intracranial pressure from bariatric surgery compared to community weight-loss programs.
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Pitfalls in the Diagnosis of CIDP
Chronic inflammatory demyelinating polyradiculoneuropathy is commonly misdiagnosed. It is important to adhere to established diagnostic criteria and to regularly re-evaluate all patients given this diagnosis.
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Special Report from the 2021 International Stroke Conference
These reviews of studies presented at the virtual 2021 International Stroke Conference were written by Neurology Alert's editor. All comments and opinions are solely those of the editor.
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Atorvastatin and Low-Dose Dexamethasone for Treatment of Chronic Subdural Hematoma
Chronic subdural hematoma is a common cause of serious neurological morbidity and mortality in the elderly population. Atorvastatin has both an anti-inflammatory effect and the ability to mobilize endothelial progenitor cells, which assist in vascular repair. The investigators proposed that adding a low dose of dexamethasone to atorvastatin treatment might enhance the anti-inflammatory benefits without causing the side effects associated with high doses of corticosteroids.
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Tranexamic Acid in Patients with Intracerebral Hemorrhage Does Not Improve Outcomes
Primary intracerebral hemorrhage is a major cause of severe neurological disability and carries a high rate of death. Tranexamic acid was tested in a study of 2,325 patients with intracerebral hemorrhage within eight hours of symptom onset, but did not significantly improve neurological outcome.
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Tenecteplase vs. Alteplase for Thrombolysis in Basilar Artery Occlusion
Basilar artery occlusion is a dangerous clinical syndrome of large artery occlusion that carries a high morbidity and mortality with severe disability in survivors. In multiple trials, alteplase has shown minimal benefit in achieving reperfusion in patients with large artery occlusion, including the basilar artery. Tenecteplase is a modified variant of alteplase that has greater specificity in binding to fibrin, a longer half-life, and can be administered in a single bolus.
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Brain Cancer and Brain Injury Drive Systemic Immunosuppression
Glioblastoma-associated immunosuppression is a significant factor associated with poor survival in this disease. Accumulating evidence suggests that mouse models of glioblastoma and other brain cancers induce systemic immunosuppression through dysregulation of a newly recognized brain-thymus axis and that targeting this pathway may promote more effective immune surveillance of these tumors.