Neurology Alert
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Antisense Oligonucleotide Treatment of Huntington’s Disease: A Novel Potential Treatment
In this Phase I/IIa clinical trial, investigators administered antisense huntingtin oligonucleotides intrathecally to patients with early Huntington’s disease (HD), and demonstrated safety, tolerability, and dose-dependent reduction in CSF mutant huntingtin. This approach now is being tested for clinical efficacy in HD in a Phase III clinical trial.
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Carpal Tunnel Syndrome in the Extreme Elderly
Carpal tunnel syndrome (CTS), when seen in the very elderly, is usually severe and is not reliably diagnosed by ultrasound. Nerve conduction studies and electromyography are the most sensitive and specific tests to make accurate diagnosis of CTS.
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Amyloid, Tau, Neurodegeneration Diagnostic Framework to Predict Memory Decline Before the Onset of Dementia
In a population-based longitudinal study of older individuals without dementia, the inclusion of imaging biomarkers for amyloid, tau, and neurodegeneration modestly improved the ability to predict memory decline compared to a model that only used clinical data and APOE genotype.
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Cognitive-Motor Dissociation in Patients Admitted to ICUs After Acute Brain Injuries
In a large, prospective, single-center study, more than one in six patients with acute brain injuries may have cognitive-motor dissociation (CMD) (e.g., they harbor capacity to modulate their brain activity in response to motor commands while remaining behaviorally unresponsive at the bedside). Some acute CMD patients were found to have a much higher chance for recovery of neurological functions and for reaching independent levels of activities of daily living by 12 months after brain injury.
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Neuropathy After Total Knee Arthroplasty
In a large series of cases from the Mayo Clinic, 54 cases of new neuropathy occurred in 14,450 total knee arthroplasties. Most were isolated peroneal neuropathies. No specific risk factors were identified in this series.
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Prevalence of Refractory Juvenile Myoclonic Epilepsy
Juvenile myoclonic epilepsy (JME) is a common form of generalized epilepsy. Although the prognosis of JME is not clear, it is assumed to have a good response to treatment. The authors of this meta-analysis found a higher than expected prevalence of refractoriness in JME, which will affect how neurologists counsel patients with JME.
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EEG Reactivity for Prediction of Neurological Outcomes After Cardiac Arrest
This prospective, multicenter cohort study aimed to determine the utility of electroencephalographic reactivity (EEG-R) testing in neurological prognostication of comatose patients after cardiac arrest. The authors found that EEG-R testing, by itself, is not sufficiently reliable to predict neurological outcomes after cardiac arrest.
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Statin Use Moderately Reduces Dementia Risk After Concussions in Older Individuals
In a large population study, concussion in older adults resulted in significantly higher risk for dementia that was modestly reduced among those taking a statin.