Neurology Alert
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Glymphatic and Lymphatic Functions in Patients with Chronic Migraine
Patients with chronic migraine have dysfunction of their glymphatic and meningeal lymphatic systems, which may play a role in the pathogenesis of migraine.
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Comparing Patients with Early vs. Late-Onset Multiple Sclerosis
A recent retrospective study, combining data from a United Kingdom patient registry with a United Kingdom neuropathology tissue bank, showed that late-onset multiple sclerosis (MS), referring to disease onset after age 50 years, is linked with increased disability and quicker progression compared to MS onset at a younger age, and has distinct pathological features.
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MRI for the Evaluation of Inflammatory Myopathy
Magnetic resonance imaging (MRI) of large muscles is an important adjunctive diagnostic test for inflammatory myopathies, in conjunction with serum muscle enzymes and electrophysiology. MRI also can identify the highest-yielding section of muscle to target a muscle biopsy.
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Timing of Biomarker Changes in Alzheimer’s Disease
In a longitudinal multicenter, nested case-control study of cognitive normal participants from China, the time courses of key Alzheimer’s disease biomarkers were identified during the 20 years preceding clinical diagnosis of sporadic Alzheimer’s disease.
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Post-Traumatic Epilepsy and the Risk of Dementia
A subset of people with head injury will develop post-traumatic epilepsy (PTE). This prospective cohort study demonstrated a 4.5-fold increased risk of dementia in those with PTE compared to people without head trauma or epilepsy, and that this risk exceeds that observed in people with head trauma or epilepsy alone.
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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.
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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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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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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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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.