Neurology Alert
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Rapid Eye Movement Sleep Duration Is Predictive of Life Expectancy
Total sleep duration declines with increasing age, as does the fraction of sleep spent in rapid eye movement (REM) sleep. The decline in REM is associated with increasing mortality, but it is not clear if this is a cause or a marker of declining health and declining brain function.
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Cranial Neuropathy in CIDP
Cranial nerves are infrequently involved in typical chronic inflammatory demyelinating polyneuropathy, but involvement is more common in multifocal acquired demyelinating sensory and motor neuropathy (about 50%). The facial nerve is the most commonly affected cranial nerve, often bilateral.
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Neurotropism of COVID-19: What Is New?
SARS-CoV-2 may gain access to the brain via the olfactory epithelium. The olfactory epithelium and bulbs may serve as an entry point for SARS-CoV-2 infection into the central nervous system.
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Nutritional Interventions in Prodromal Alzheimer’s Disease: The 36-Month LipiDiDiet Multinutrient Clinical Trial
In a randomized, double-blind, placebo-controlled trial of Fortasyn Connect (Souvenaid), a nutraceutical drink, patients with prodromal Alzheimer’s disease demonstrated, over a 36-month period, a slower decline in cognitive functions compared to the control group.
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Disease-Modifying Therapy and Long-Term Disability in Multiple Sclerosis
In a multicenter, observational, retrospective “real world” analysis of a large cohort of relapsing multiple sclerosis (MS) patients, the authors found that being on disease-modifying therapy decreased the risk of long-term disability progression in both pediatric and adult MS patients.
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Multiple Sclerosis and Vascular Disease
This postmortem study of multiple sclerosis (MS) patients evaluated the presence and pathological significance of extracranial systemic and cerebral small vessel disease in patients with MS compared to healthy controls. MS patients had less systemic vascular disease and more small vessel disease in the brain compared to controls.
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Sporadic Creutzfeldt-Jakob Disease: A Genome-Wide Association Study
Sporadic Creutzfeldt-Jacob disease (sCJD), the most common form of human prion disease, is characterized as a rapidly fatal neurodegenerative process caused by propagation of a transmissible misfolded prion protein gene (PRNP). However, selective PRNP mutations only account for a small subset of sCJD cases, leading to interest in discovering additional genetic risk factors. Through a two-stage study design using genome-wide association studies, the authors have identified two novel risk loci, STX6 and GAL3ST1, which encode for proteins involved in cellular trafficking of prions and sphingolipid metabolism, respectively. These findings provide insights into sCJD pathogenesis and are an avenue for further research.
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Big Data Look at Optic Neuritis
In this population-based study of 11 million people in the United Kingdom, the incidence of optic neuritis was 3.7/100,000 person years, and was stable over the time period 1995-2019. The 10-year risk of developing multiple sclerosis in this population was 28.2%.
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Recurrent Stroke After Embolic Stroke of Undetermined Source
Twenty percent to 40% of ischemic strokes are classified as cryptogenic, meaning a specific cause cannot be identified. A subset of those have been classified by some investigators as embolic stroke of undetermined source. However, this remains a controversial category and classification.
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Can Anticoagulant Strategies Reduce Covert Brain Infarcts in Patients with Cardiovascular Disease?
Covert brain infarcts are detected on magnetic resonance imaging studies in the aging brain in about 10% of people at age 65 years, increasing to 25% at age 80 years. Most patients who develop dementia have a combination of multiple small infarcts, plus amyloid deposition. Prevention of covert infarcts is a strategy to mitigate the frequency and severity of late-life dementia.