Neurology Alert – March 1, 2023

A Population-Based Study of Progressive Multifocal Leukoencephalopathy

In this population-based cohort study of 584 cases of progressive multifocal leukoencephalopathy (PML), predisposing conditions with the highest risk of PML were human immunodeficiency virus (HIV) infection, hematological malignancies, chronic inflammatory disease, solid organ transplantation, solid malignancies, and primary immune deficiency. The one-year mortality rate was 38.2% for all cases of PML. Factors independently associated with higher mortality rate were older age, male gender, and immunosuppressive diseases, such as hematological malignancies, solid neoplasms, and HIV.

Self-Treatment of Recurrent Benign Paroxysmal Positional Vertigo

Using a cell phone-based app, self-treatment of recurrent benign positional paroxysmal vertigo was feasible and effective in most patients.

Leriglitazone for the Treatment of Adrenomyeloneuropathy

A 96-week trial of leriglitazone to slow the progression of symptoms in adrenomyeloneuropathy did not meet the primary endpoint. However, post-hoc analyses revealed a beneficial effect in patients treated earlier in their disease course.

Insulin Resistance at the Blood-Brain Barrier in Alzheimer’s Disease

Alterations in cerebrovascular insulin receptor isoform levels are associated with Alzheimer’s disease pathology and cause deficits in insulin signaling at the level of the blood-brain barrier.

Electrodiagnostic Features of Vasculitic Neuropathy

Electrophysiological studies of vasculitic neuropathy indicate that the best discriminators of vasculitis vs. other axonal neuropathies are the side-to-side differences between the same bilateral nerves. When the diagnosis is uncertain, nerve biopsy may be definitive.