Neurology
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Differentiating MELAS from Bland Ischemic Stroke: Clinicoradiologic Criteria
Stroke symptoms in mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) are difficult to diagnose correctly, which leads to missed opportunities to provide MELAS-specific treatment. Delay in diagnosis also complicates efforts to investigate acute treatments for MELAS. Khasminsky et al proposed clinicoradiologic criteria based on a single-center validation study. Although there are methodological limitations, the concepts highlighted by the authors are valuable.
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Incident Dementia Cases Connected to Long-Term Air Pollution Exposure
Researchers reported fine particulate matter from agriculture and open fires to be especially harmful.
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Disease-Modifying Therapy After Natalizumab Discontinuation in Patients with Relapsing Multiple Sclerosis
In this retrospective cohort study, the investigators found that, when compared to fingolimod and dimethyl fumarate, ocrelizumab use was associated with significantly lower annualized relapse rate and treatment discontinuation. There were no significant differences in outcomes between fingolimod and dimethyl fumarate use. Ocrelizumab use was associated with a lower rate of disability accumulation when compared to fingolimod.
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Treatment of Psychotic Symptoms in Alzheimer’s Disease
In a meta-analysis of several large treatment trials of patients with Alzheimer’s disease, Parkinson’s disease, and dementia with Lewy bodies, cholinesterase inhibitors demonstrated a small but statistically significant benefit in reducing psychotic symptoms.
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Antidepressants for Chronic Pain: Do They Work?
Antidepressant medications have been widely used for treating a variety of chronic pain disorders but strong evidence to support their efficacy is lacking. Some patients may respond, but available data do not help us to determine which agents may be helpful in a specific type of chronic pain condition.
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Celery Seed-Derived Compound: A Legitimate Neuroprotectant for Acute Ischemic Stroke?
A Phase III double-blind, placebo-controlled, randomized controlled trial suggests that early administration of DL-3-n-butylphthalide, when given adjunctively to thrombolysis or endovascular therapy, improves functional outcomes in patients with acute ischemic stroke. Statistically significant results of well-designed analyses are tantalizing, but confidence in the findings is tempered by a lack of generalizability, an unclear mechanism of action, and trial design irregularities.
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Brain Atrophy and Type 1 Diabetes
In a long-term longitudinal study of people with type 1 diabetes, excessive brain atrophy and cognitive dysfunction were noted compared to healthy controls. The investigators calculated that type 1 diabetes resulted in six years of accelerated brain aging and brain atrophy that was separate and distinct from Alzheimer’s disease.
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ICU Admission Means Trouble for Alzheimer's and Dementia Patients
If they are released, such patients are twice as likely to die soon after discharge.
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Alcohol: Double-Edged Sword, or Hatchet?
Researchers reported consuming two to 14 alcoholic drinks per week was associated with fewer major adverse cardiovascular events, which the authors noted could be explained in part by less stress-related neural activity demonstrated on PET and CT scans.
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New Research Suggests Treating Traumatic Brain Injury as a Chronic Illness
The road to recovery might be longer than initially thought.