Browse Neurology Topics Articles by Topic

24-Hour Activity Rhythms and Amyloid-β Deposition in the Brain

This study of dementia-free adults found that greater variability of the 24-hour activity rhythm (greater during the daytime as well as during sleep time) with fragmentation of sleep predicted increased deposition of amyloid-β (Aβ), especially in apolipoprotein E 4 (APOE4) carriers.

Quantitative Pupillometry in Patients with Large Middle Cerebral Artery Strokes

Secondary neurologic decline after large middle cerebral artery (MCA) stroke is common and is associated with worse outcomes. This study aimed to evaluate the utility of quantitative pupillometry to predict neurologic decline before it occurs. Although no model was found to predict decline, stable Neurological Pupil index (NPi) and dilation velocities may provide some reassurance that an imminent decline is unlikely.

TIA Is Associated with Accelerated Cognitive Decline

The study investigators looked at data from a prospective study of 30,239 Black and white community-dwelling persons aged 45 years or older with cognitive evaluations over the phone every other year until 2022. The researchers documented patients who had transient ischemic attack (TIA) or stroke, and demonstrated that persons who had TIA had a cognitive decline trajectory similar to those patients who had a definite diagnosis of stroke.

Clinical Features of Biopsy-Proven Large-Arteriole and Microvasculitis in Peripheral Nerves

In this retrospective, an observational cohort study undertaken to characterize the clinical features of nerve vasculitis based on vessel size, large-arterial vasculitis (≥ 75 microns) in comparison to microvasculitis (< 75 microns) was demonstrated. Large arteriole vasculitis usually was a distal symmetrical polyneuropathy and associated with a systemic vasculitis illness. Microvasculitis most often presented with radiculopathy and/or plexopathy and was not associated with systemic illness.

Telemedicine for Managing Patients with Epilepsy

This retrospective study found telemedicine (TM) visits to be noninferior to in-person (IP) visits for key outpatient epilepsy care outcomes, including medication adjustment, surgery discussions, and avoiding emergency visits. TM was less effective for assessing the neurologic exam, and seizure freedom rates were inconclusive with respect to noninferiority. Although not a full replacement for IP care, TM remains an effective option since its future in healthcare delivery is being reassessed in the wake of the COVID-19 pandemic.

Medications for Women Aged 10 to 50 Years with Idiopathic Generalized Epilepsy

After failure of first-line anti-seizure medication, women with idiopathic generalized epilepsy may receive either substitution monotherapy or add-on therapy. There were no significant differences in effectiveness or safety between substitution monotherapy and add-on therapy in this retrospective comparative study.

The Effect of High-Dose Vitamin D on Clinically Isolated Syndrome and MS

This study by Thouvenot et al evaluated the effectiveness of high-dose vitamin D treatment on clinically isolated syndrome and early multiple sclerosis as monotherapy and reported a reduced incidence of new disease activity compared to the control group.

Can Anti-Amyloid Antibody Treatment Delay the Clinical Onset of Alzheimer’s Disease?

In this open-label extension of the dominantly inherited Alzheimer’s disease gantenerumab trial (DIAN-TU), long-term continuous amyloid clearance over eight or more years in asymptomatic carriers of autosomal dominant Alzheimer’s mutations showed potential to delay symptom onset and slow progression. Shorter duration or partial clearance did not yield measurable clinical benefit, suggesting that only sustained, near-complete amyloid removal may have disease-modifying effects.

Manual Maneuvers for the Treatment of Benign Positional Vertigo

Benign positional vertigo is a challenge to treat. This clinical trial from investigators in South Korea demonstrated modest efficacy in resolving posterior canal-related vertigo with a head-shaking maneuver that is easily performed in an office setting.

Clinical Consequences of Alzheimer’s and Lewy Body Co-Pathologies

This large study of patients with cognitive impairment-assessed cerebrospinal fluid biomarkers, positron emission tomography imaging, and cognitive tests showed that those with evidence of both Alzheimer’s and Lewy body pathologies had greater cognitive dysfunction and faster progression than those with either pathology alone.