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Rituximab Treatment for AChR Myasthenia Gravis: Results of the BeatMG Study

The B-Cell Targeted Treatment In Myasthenia Gravis (BeatMG) study was the first prospective, randomized, double-blind, placebo-controlled clinical trial to explore the role of targeted B-cell depletion in myasthenia patients. Although rituximab was found to be safe and well-tolerated, rituximab treatment did not confer a significant steroid-sparing effect compared to placebo. Results of a futility analysis suggested rituximab treatment would be unlikely to show a clinically meaningful improvement of 30% over placebo in a larger Phase III trial of mild to moderately symptomatic acetylcholine receptor autoantibody-positive generalized myasthenia gravis patients.

Plasma Biomarkers for Neurodegenerative Dementias: We Are Getting Closer

Two recent multicenter studies suggest that plasma biomarkers, including phosphorylated-tau181, could be used as cost-effective and more readily accessible biomarkers for the diagnosis and management of individuals with neurodegenerative dementias.

Is Physical Activity Associated with Mortality Risk in Parkinson’s Disease?

In individuals with Parkinson’s disease (PD), physical activity (PA) at all intensities is associated with reduced all-cause mortality, with the greatest reduction seen in individuals who maintained PA before and after PD diagnosis.

The Effect of Disease-Modifying Therapies for Multiple Sclerosis on the Immune Responses to COVID-19 Vaccination

An analysis of a large group of patients with multiple sclerosis taking various disease-modifying therapies showed that the response to COVID-19 vaccination was not uniform across the therapies. Patients taking anti-CD20 therapies and fingolimod had attenuated responses to vaccines.

Diet and the Risk of Dementia

Specific dietary patterns, such as the Mediterranean-style diet, have been shown to promote brain health, mitigate neuro-inflammation, and reduce the risk of dementia. This prospective cohort study demonstrated an association between a high inflammatory potential diet and increased risk for incident dementia.

Acute Muscle Weakness in Children: Acute Flaccid Myelitis or Guillain-Barré Syndrome?

Compared to children with Guillain-Barré syndrome, children with acute flaccid myelitis have a more rapid presentation to nadir of weakness, fewer sensory abnormalities, and an inflammatory spinal fluid early in the course.

The Effect of Epilepsy on Patients with Brain Tumors

Cancer cells form direct synapses with neurons, whose electrical activity stimulates brain tumor growth. Accumulating evidence suggests that epilepsy enhances the proliferation of malignant brain tumors and that improved management of epilepsy may reduce morbidity and mortality in these patients.

Neuropathological Variability of NMDAR-Encephalitis

The neuropathological features of N-methyl-D-aspartate receptor (NMDAR)-encephalitis are described in an autopsy cohort of four patients — two diagnosed in life with comorbid brain disorders, and two diagnosed at autopsy and never treated. The two untreated patients had inflammatory infiltrates composed of perivascular and parenchymal T cells and B cells/plasma cells in the basal ganglia, amygdala, and hippocampus. The two treated patients had variable pathologies that reflected their underlying neurological disorders (lymphoproliferative disease and multiple sclerosis). Overall, the topographic distribution of inflammation in patients with NMDAR-encephalitis reflects the clinical symptoms of movement disorders, abnormal behavior, and memory dysfunction with inflammation predominantly observed in the basal ganglia, amygdala, and hippocampus. Loss of NMDAR-immunoreactivity correlated with disease severity.

Intravenous Immunoglobulin for Stable CIDP: Stop or Taper?

First-line therapy for chronic inflammatory demyelinating polyneuropathy is intravenous immunoglobulin (IVIG), but the timing and method for withdrawal of this treatment are uncertain. In a retrospective review of stable patients on IVIG, investigators at the National Hospital in London observed that there was no significant difference in the likelihood of deterioration or response to retreatment if IVIG was stopped abruptly or tapered slowly.

Neuropathological Findings in the Brains of Patients Who Died from COVID-19

In an autopsy study of 41 patients who died from COVID-19 in a single medical center in New York City, most of the brain pathology was the result of hypoxic-ischemic injury, infarction, and hemorrhage, with microglial activation and neuronophagia caused by inflammation. Studies for the presence of viral proteins were negative, and very low levels of viral ribonucleic acid were detected.