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Incident Dementia Cases Connected to Long-Term Air Pollution Exposure

Researchers reported fine particulate matter from agriculture and open fires to be especially harmful.

Disease-Modifying Therapy After Natalizumab Discontinuation in Patients with Relapsing Multiple Sclerosis

In this retrospective cohort study, the investigators found that, when compared to fingolimod and dimethyl fumarate, ocrelizumab use was associated with significantly lower annualized relapse rate and treatment discontinuation. There were no significant differences in outcomes between fingolimod and dimethyl fumarate use. Ocrelizumab use was associated with a lower rate of disability accumulation when compared to fingolimod.

Treatment of Psychotic Symptoms in Alzheimer’s Disease

In a meta-analysis of several large treatment trials of patients with Alzheimer’s disease, Parkinson’s disease, and dementia with Lewy bodies, cholinesterase inhibitors demonstrated a small but statistically significant benefit in reducing psychotic symptoms.

Antidepressants for Chronic Pain: Do They Work?

Antidepressant medications have been widely used for treating a variety of chronic pain disorders but strong evidence to support their efficacy is lacking. Some patients may respond, but available data do not help us to determine which agents may be helpful in a specific type of chronic pain condition.

Celery Seed-Derived Compound: A Legitimate Neuroprotectant for Acute Ischemic Stroke?

A Phase III double-blind, placebo-controlled, randomized controlled trial suggests that early administration of DL-3-n-butylphthalide, when given adjunctively to thrombolysis or endovascular therapy, improves functional outcomes in patients with acute ischemic stroke. Statistically significant results of well-designed analyses are tantalizing, but confidence in the findings is tempered by a lack of generalizability, an unclear mechanism of action, and trial design irregularities.

Brain Atrophy and Type 1 Diabetes

In a long-term longitudinal study of people with type 1 diabetes, excessive brain atrophy and cognitive dysfunction were noted compared to healthy controls. The investigators calculated that type 1 diabetes resulted in six years of accelerated brain aging and brain atrophy that was separate and distinct from Alzheimer’s disease.

New Research Suggests Treating Traumatic Brain Injury as a Chronic Illness

The road to recovery might be longer than initially thought.

Glycoprotein IIb/IIIa Receptor Inhibitor Tirofiban for Ischemic Stroke

Glycoprotein IIb/IIIa receptor inhibitors are potent, rapidly acting antiplatelet agents that have been tried in pilot studies to treat acute ischemic stroke, without significant benefit. Tirofiban is fast-acting, highly selective, and has a short half-life that allows bleeding time to return to normal within three hours after administration is stopped. The investigators proposed that this medication may be of benefit in patients with acute ischemic stroke who arrived within 24 hours after stroke onset but are not eligible for thrombolysis or thrombectomy or have progression of stroke symptoms after receiving thrombolysis.

Endovascular Thrombectomy for Large Ischemic Core Strokes

Endovascular thrombectomy has been rapidly adopted throughout the world for the treatment of patients with acute ischemic stroke and large vessel occlusion. This approach has achieved strong recommendations in stroke guidelines. However, the trials that form the basis of the recommendations have strict imaging recruitment criteria.

Is Dexamethasone Effective in the Treatment of Chronic Subdural Hematomas?

Chronic subdural hematomas are common disorders and may occur after minor trauma or no trauma. For decades, nonsurgical therapies have been tried and proposed, including the use of corticosteroids. Various case series and nonrandomized trials of treatment with corticosteroids have been reported to show benefit, but efficacy of steroid therapy has been uncertain.