Neurology Alert – May 1, 2023

Role of the Hypothalamus in Migraine and Cluster Headaches

The hypothalamus plays a regulatory role in both migraine and cluster headaches. However, the two headache types have distinctive clinical features, characteristic areas of resting state functional connectivity on magnetic resonance imaging, and different genetic chronobiological associations.

Focused Ultrasound Ablation of the Subthalamic Nucleus for Parkinson’s Disease Tremor

This paper demonstrated the long-term efficacy and safety of unilateral magnetic resonance imaging-guided high-frequency ultrasound subthalamotomy for Parkinson’s disease patients with motor fluctuations and dyskinesia three years after the procedure.

The Neural Pathways of Pain Treatment Response in Small-Fiber Neuropathy

Pain in peripheral neuropathy, referred to as neuropathic pain, is thought to result from overexpression of pain receptors, regeneration of hypersensitive nerve sprouts, and denervation hypersensitivity of neurons in the sensory ganglia. Additionally, activation of the pain pathways appears to induce secondary structural and functional changes in the brain that contribute to pain perception, persistence, and response.

Inclusion Body Myositis: Variability and Clinical Subsets

Inclusion body myositis (IBM) is a progressive myopathy characterized by prominent finger flexor and quadriceps involvement. Black patients with IBM have more prominent proximal weakness, in addition to finger flexion and quadriceps weakness. Female patients have less prominent finger flexion and quadriceps weakness and slower progression, whereas younger patients had a greater delay in diagnosis. There are variability and distinct clinical subsets among IBM patients, which can have implications in terms of timely diagnosis and possibly response to treatments.

Subcutaneous IVIG for Treatment of Myasthenia Gravis

A Phase II trial comparing subcutaneous (SC) administration of pooled immunoglobulin to intravenous (IV) administration of immunoglobulin in 23 patients with seropositive myasthenia gravis demonstrated a stable course after transition from IV to SC.