Neurology Alert – March 1, 2024
March 1, 2024
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Posterior Cortical Atrophy: An Important Variant of Alzheimer’s Disease
This is the first comprehensive international study of patients with posterior cortical atrophy, including clinical, biomarker, and pathology data from 1,092 patients. These patients present at a younger age, have a very high prevalence of amyloid positivity on cerebrospinal fluid studies and positron emission tomography, and 94% had autopsy evidence of Alzheimer’s disease.
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Neuropeptides in Patients with Restless Legs Syndrome
The diurnal onset of restless legs syndrome (RLS) has been replicated in a mouse model using central instillation of the main melanocortin agonist, α-MSH, which stimulates excessive locomotion and grooming in rodents as well as a state of hyperalgesia. The actions of β-endorphin (β-EDP) oppose those of α-MSH, since β-EDP promotes passivity and analgesia. In this study, these prohormones were measured in plasma and cerebrospinal fluid in patients with RLS and compared to controls. Patients with RLS had elevated levels of α-MSH and lower levels of β-EDP compared to the control group.
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Medications for Progressive Supranuclear Palsy: A Note of Caution
In this post hoc secondary analysis of a Phase II/III randomized clinical trial of davunetide for progressive supranuclear palsy (PSP), investigators found that patients with PSP prescribed benzodiazepine derivatives experienced more rapid worsening of their PSP Rating Scale scores over time.
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Cholinergic Basal Forebrain Involvement in Posture, Gait, and Cognitive Impairment in Parkinson’s Disease
The features of gait difficulty, postural instability, and cognitive deficits in patients with Parkinson’s disease appear to be attributable to degeneration of cholinergic basal forebrain systems, including loss of fiber tract integrity and reduction of cortical projections.
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Acute Small Fiber Neuropathy
Acute-onset small fiber neuropathy most often is precipitated by infections, medication side effects, or vaccinations. Most cases recover spontaneously.