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Blood GFAP Measurements for Rapid Diagnosis of ICH

The early diagnosis of spontaneous intracerebral hemorrhage (ICH) is important to initiate rapid interventions, such as lowering blood pressure and reversing the effects of antithrombotic medications. Plasma assays of glial fibrillary acidic protein may become a useful tool for the prehospital diagnosis of ICH, but it needs further study before adoption in the clinical setting.

Tolebrutinib May Slow Disability Progression in Patients with SPMS

A recent prospective study showed that tolebrutinib slows disability progression in patients with nonrelapsing secondary progressive multiple sclerosis (SPMS). There were some safety concerns, especially hepatotoxicity. A lack of demonstrated effect on some functional outcomes warrants careful consideration and continuing study.

CSF α-Synuclein Seed Amplification Assays in Parkinsonian Syndromes

This large longitudinal study, which looked at cerebrospinal fluid α-synuclein seed amplification assays (SAAs) from three large cohorts, demonstrated efficacy in distinguishing between Parkinson’s disease and progressive supranuclear palsy, as well as predicting cognitive decline based on kinematic analysis of the SAA samples.

Long-Term Peripheral Nerve Function Changes in People with Well-Controlled Type 2 Diabetes

The authors conducted a prospective observational study comparing the effect of early diagnosed, well-controlled type 2 diabetes on peripheral nerve function. Overall, they found similar rates of decline in nerve function in people with well-controlled diabetes compared to age- and sex-matched individuals with normal glucose tolerance. Given the similar decline in nerve function, the authors concluded that the course of diabetic sensorimotor neuropathy is influenced primarily by nerve function at the time of diagnosis and age-related physiological decline.

Post-Traumatic Headaches: Common and Complicated

The brain’s ability to modulate pain influences the development and persistence of post-traumatic headache (PTH). Functional magnetic resonance imaging (fMRI) studies in people with PTH show higher pain-induced brain activation in specific regions, such as the postcentral gyrus, superior temporal gyrus, and ventral striatum, as compared to healthy controls. Over 16 weeks of observation, progressive normalization in pain-induced brain activation was seen in the PTH group with headache improvement, with persistently elevated activation in the non-improvement PTH group.

Epilepsy in Frontotemporal Dementia

This Finnish case-control study explores the relationship between frontotemporal dementia (FTD) and epilepsy, revealing that individuals with FTD have a higher prevalence of epilepsy compared to those with Alzheimer’s disease (AD) and healthy controls. The findings suggest that epilepsy may precede FTD diagnosis and is more common in FTD than previously recognized, highlighting the need for broader research and clinical awareness of this comorbidity.

Use of IV Tenecteplase Prior to Thrombectomy in Stroke

In patients with acute ischemic stroke arriving at a thrombectomy-ready hospital within 4.5 hours of stroke onset, the combination of treatment with intravenous tenecteplase followed by mechanical thrombectomy resulted in superior outcomes compared to thrombectomy alone.

Rituximab to Prevent Relapse in Anti-NMDAR Antibody-Mediated Encephalitis

This long-term follow-up study of 67 patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis demonstrated that initial treatment with rituximab was associated with a longer time before a relapse occurred.

Treating Small Vessel PCNSV with Cyclophosphamide

In this single-center study, 26 adults with biopsy-confirmed small vessel primary central nervous system vasculitis (PCNSV) were followed for a median of 49 months. Patients receiving early treatment with cyclophosphamide within three months of immunosuppression initiation achieved remission faster than those receiving conservative initial treatment with corticosteroids, either as monotherapy or with azathioprine, mycophenolate, or methotrexate. Retrospective design, treatment selection bias, small sample size, and clinicopathologic heterogeneity limit therapeutic inferences and highlight the need for prospective trials.

Epigenetic Changes in Perilesional Brain Tissue After Radiotherapy

Epigenetic and transcriptomic studies of irradiated perilesional brain tissue identified clear changes in deoxyribonucleic acid (DNA) methylation patterns and neuropeptide upregulation that contributed to neuroinflammation, which may underly radiation-related neurotoxicity.