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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.

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.

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.

The Optic Nerve as Part of the Diagnostic Criteria for Multiple Sclerosis

A recent prospective study showed that including the optic nerve as an additional topographic area in multiple sclerosis diagnostic decision-making improves sensitivity and diagnostic performance compared to the McDonald 2017 criteria: 92.5% sensitivity of the modified criteria vs. 88.2% of the current criteria.

Cerebral Amyloid Angiopathy Is a Risk Factor for Subdural Hemorrhage

In this large, observational population study using databases from the UK Biobank and the All of Us research program, spontaneous subdural hemorrhage occurred more often in patients with cerebral amyloid angiopathy compared to a matched control group.

Myopathy with Elevated Aldolase and Normal CK: Differential Diagnosis

Elevated serum creatine kinase (CK) is considered the hallmark of myopathy, yet some patients with biopsy-proven myopathy have normal CK with elevated aldolase, a less-specific marker of muscle disease. Most of those cases ultimately prove to be dermatomyositis.

A Comparison of Acute Migraine Therapies Using Big Data

In a big data-driven observational study that compared 3 million treated migraine attacks captured from a migraine diary smartphone app, triptans were found to be the most efficacious treatment class. Among the triptans, eletriptan had the highest rate of success. Consistent with clinical practice and recent consensus statements, the success of triptans was followed by ergots and antiemetics.

Can Young-Onset Dementia Be Prevented?

In this large, population-based prospective cohort study, the investigators identified 15 risk factors that have strong associations with young-onset dementia. Modifications of these risk factors might delay the onset of, or prevent the development of, young-onset dementia.

Electrophysiology, Muscle Ultrasound, and MRI in the Diagnosis of Neuromuscular Disorders

To accomplish accurate diagnosis of nerve and muscle disorders, clinical collaboration with ultrasound and magnetic resonance imaging experts is invaluable and can provide critically important information beyond electrophysiology.

Metformin Use Is Associated with Decreased Diabetes-Associated Dementia

In two recent cohort studies, metformin use was found to decrease the risk of developing dementia in older adults with type 2 diabetes mellitus.