Neurology
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Intensive Blood Pressure Lowering Does Not Affect Small Vessel Disease Progression
Intensive blood pressure lowering was not associated with worsening but did not demonstrate any benefit in this population over standard blood pressure management.
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Infections Before Age 20 Years Increase the Risk of Multiple Sclerosis
The relationship between childhood infections and the risk of multiple sclerosis is supported by increasing evidence. Using the Swedish Total Population Register, researchers found that patients diagnosed with infection in adolescence showed an increased risk of multiple sclerosis, even after exclusion of infectious mononucleosis, pneumonia, and central nervous system infection.
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Environmental Shedding of MRSA Far Greater Than From Multidrug-Resistant Gram-Negative Bacilli
An observational cohort study showed shedding of methicillin-resistant Staphylococcus aureus by colonized patients outside hospital rooms or during outpatient clinic visits occurred more often than in those colonized by multidrug-resistant gram-negative bacilli.
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Gene and Substrate Therapy for Neurogenetic Disease: A Combined Approach to Treat Mitochondrial Myopathy
A combined adenoviral-mediated gene therapy plus substrate therapy delivered to a mouse model of thymidine kinase 2 (TK2) deficiency, manifested most often as a fatal mitochondrial myopathy in infants and children, rescued TK2 activity and prolonged animal lifespan, thus indicating a promising therapeutic approach for affected patients.
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TSPO PET Imaging for Monitoring Natalizumab-Associated Progressive Multifocal Leukoencephalopathy
Authors of a recent study evaluated inflammatory activity in multiple sclerosis patients who developed natalizumab-associated progressive multifocal leukoencephalopathy (PML) using translocator protein positron emission tomography (TSPO PET) for imaging of microglia. They demonstrated that TSPO PET can monitor PML longitudinally.
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COVID-19 Vaccination, Pregnancy, Lactation, and Fertility
Vaccination rates are notably low among pregnant women. Clinicians should underscore the safety of vaccination and the risks of natural infection, particularly in pregnancy and in patients with underlying comorbidities.
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Meat Consumption Associated with Less Anxiety and Depression
A meta-analysis of 20 studies showed meat consumption resulted in better mental health, with less anxiety and depression vs. meat abstinence.
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Incidence, Prevalence, and Long-Term Consequences of Small Fiber Neuropathy
Small fiber neuropathy (SFN), a subtype of peripheral neuropathy characterized by painful distal neuropathic pain and autonomic symptoms, is increasing in incidence. SFN associated with diabetes and other causes is more likely to progress to large-fiber polyneuropathy and have faster deterioration and higher disability compared to slow progression with idiopathic SFN. Glucose impairment, obesity, and elevated triglycerides are modifiable risk factors of idiopathic SFN. Although major disability and neurologic impairment are uncommon in this slowly progressive condition, higher mortality and cardiovascular events are noted in patients with SFN.
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AAN Offers Ethical Guidance on Alzheimer’s Drug
Neurology experts issue caution on costs, side effects regarding the approved-but-controversial Aduhelm.
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Decisional Capacity Is Most Common Issue in Neuro-Oncologic Ethical Consults
For a terminal condition, goals of care need to be identified so they can be honored. If discussions do not happen early, when the patient likely is at his or her peak functional status, it leaves caregivers, families, and physicians with little guidance.