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Neurology

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  • Neuropeptides in Patients with Restless Legs Syndrome

    The diurnal onset of restless legs syndrome (RLS) has been replicated in a mouse model using central instillation of the main melanocortin agonist, α-MSH, which stimulates excessive locomotion and grooming in rodents as well as a state of hyperalgesia. The actions of β-endorphin (β-EDP) oppose those of α-MSH, since β-EDP promotes passivity and analgesia. In this study, these prohormones were measured in plasma and cerebrospinal fluid in patients with RLS and compared to controls. Patients with RLS had elevated levels of α-MSH and lower levels of β-EDP compared to the control group.

  • Posterior Cortical Atrophy: An Important Variant of Alzheimer’s Disease

    This is the first comprehensive international study of patients with posterior cortical atrophy, including clinical, biomarker, and pathology data from 1,092 patients. These patients present at a younger age, have a very high prevalence of amyloid positivity on cerebrospinal fluid studies and positron emission tomography, and 94% had autopsy evidence of Alzheimer’s disease.

  • Identifying Risk Factors for Young-Onset Dementia

    In this large, population-based prospective cohort study, the investigators identified 15 risk factors that have strong associations with young-onset dementia. Modifications of these risk factors might delay the onset of, or prevent the development of, young-onset dementia.

  • Examining Microbiome Metabolites and Parkinson’s Disease

    A Mendelian randomization study shows that trimethylamine N-oxide (TMAO) and its precursor metabolites are not associated with risk of Parkinson’s disease (PD) but have both positive and negative causal effects on some indicators of PD severity and progression.

  • Sleeping Away Dementia

    In this long-term observational study of sleep efficiency in the Framingham Heart Study population, researchers found a strong correlation between a decline in duration of slow-wave sleep during aging and the risk of incident dementia from all causes. However, a direct cause-and-effect relationship cannot be determined from this observational study.

  • The Optic Nerve as Part of the Diagnostic Criteria for Multiple Sclerosis

    A recent prospective study showed that including the optic nerve as an additional topographic area in multiple sclerosis diagnostic decision-making improves sensitivity and diagnostic performance compared to the McDonald 2017 criteria: 92.5% sensitivity of the modified criteria vs. 88.2% of the current criteria.

  • Cerebral Amyloid Angiopathy Is a Risk Factor for Subdural Hemorrhage

    In this large, observational population study using databases from the UK Biobank and the All of Us research program, spontaneous subdural hemorrhage occurred more often in patients with cerebral amyloid angiopathy compared to a matched control group.

  • Myopathy with Elevated Aldolase and Normal CK: Differential Diagnosis

    Elevated serum creatine kinase (CK) is considered the hallmark of myopathy, yet some patients with biopsy-proven myopathy have normal CK with elevated aldolase, a less-specific marker of muscle disease. Most of those cases ultimately prove to be dermatomyositis.

  • A Comparison of Acute Migraine Therapies Using Big Data

    In a big data-driven observational study that compared 3 million treated migraine attacks captured from a migraine diary smartphone app, triptans were found to be the most efficacious treatment class. Among the triptans, eletriptan had the highest rate of success. Consistent with clinical practice and recent consensus statements, the success of triptans was followed by ergots and antiemetics.

  • Can Young-Onset Dementia Be Prevented?

    In this large, population-based prospective cohort study, the investigators identified 15 risk factors that have strong associations with young-onset dementia. Modifications of these risk factors might delay the onset of, or prevent the development of, young-onset dementia.