Neurology
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Repeated Head Trauma May Lead to Parkinsonism in Patients with CTE
Repeated head injury from years of contact sports play in men with confirmed chronic traumatic encephalopathy (CTE) may cause pathological changes in the substantia nigra that lead to parkinsonism in a subset of patients with CTE.
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Genetic Testing for Patients with Parkinson’s Disease
In this large scale, international study of Parkinson’s disease (PD) patients, approximately 15% of participants were found to have a positive PD-related genetic variant, most commonly in the GBA1 and LRRK2 genes.
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MRI-Guided Focused Ultrasound Thalamotomy for Treating Essential Tremor
This open-label study demonstrated the safety and efficacy of staged bilateral magnetic resonance imaging-guided focused ultrasound thalamotomy for bilateral essential tremor with excellent efficacy rates at one year. Most adverse events were mild, but greater real-world experience is needed to understand its true safety profile.
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What Is the Best First-Line Treatment for Young Women with Generalized Epilepsy?
Valproate is a highly efficacious drug for treating idiopathic generalized epilepsy (IGE) but is not an option for many young women because of known teratogenic risks. This retrospective, multicenter study examined women with IGE who were treated initially with either levetiracetam or lamotrigine monotherapy, demonstrated superior efficacy of levetiracetam, although exclusively in women with juvenile myoclonic epilepsy.
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Thrombectomy for Basilar Artery Occlusion
This randomized trial from China demonstrates a dramatic benefit from endovascular thrombectomy in patients with acute basilar artery occlusion. This benefit was sustained and improved at one year compared to 90 days.
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Clinicopathological Correlation in Motor Neuron Disease and Frontotemporal Degeneration
Frontotemporal lobar degeneration commonly occurs with motor neuron disease and has similar cytoplasmic neuronal aggregates of TAR deoxyribonucleic acid-binding protein 43 (TDP-43) in the brain as well as the spinal cord.
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The Clinical Spectrum of Anti-GQ1b Antibody Syndrome
Antibodies targeting gangliosides, glycosphingolipids that play a role in synaptic plasticity, neurotransmission derangements, and axonal growth all are implicated in many autoimmune peripheral neuropathies. Miller Fisher syndrome (MFS) is the clinical triad of external ophthalmoplegia, ataxia, and areflexia classically associated with anti-GQ1b. However, there are other subtypes that present with only one or two clinical features of the clinical triad.
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Stratifying Seizure Risk with a Rapid EEG
In a retrospective, large, multicenter trial, rapid response electroencephalogram (EEG) was found to be non-inferior to conventional EEG when incorporated into the 2HELPS2B score to guide how long patients should stay on EEG.
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Blood Biomarkers 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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Indications for Reduced-Dose Direct Oral Anticoagulants
A subgroup analysis of the ENGAGE-AF TIMI 48 study of edoxaban 60 mg/day vs. 30 mg/day compared to warfarin in patients with atrial fibrillation of the group 80 years of age or older has shown that 30 mg/day results in less major bleeding without a concomitant increase in stroke risk compared to 60 mg/day or warfarin.