Neurology Digest

This page will be arranged in the standard OPUSeJ Digest form:

EDITORIALS

FEATURE ARTICLES

DISCUSSION PAPAERS

FORUM ARTICLES

These authors find that patients with less formal education are more likely to discontinue cholinesterase inhibitors for dementia by the six month mark. Saleh S, Kirk A, Morgan DG & Karunanayake C, “Less education predicts anticholinesterase discontinuation in dementia patients”, Can J Neurol Sci. 2013 Sep;40(5):684-90.http://www.opusej.org/library/less-education-predicts-anticholinesterase-discontinuation-in-dementia-patients-cover/

READING LIST

A literature review and expert consensus have resulted in these guidelines for acute migraine treatment intended for primary care physicians. Worthington I, et al (Canadian Headache Society Acute Migraine Treatment Guideline Development Group), “Canadian Headache Society Guideline: acute drug therapy for migraine headache”, Can J Neurol Sci. 2013 Sep; 40(5 Suppl 3):S1-S80 http://www.ncbi.nlm.nih.gov/pubmed/23968886

As new drugs become available for the treatment of relapsing-remitting multiple sclerosis, important questions are raised about their effects on the immune system.  In this study, the investigators conclude that teriflunomide does not generally impair effective response to influenza immunization. Bar-Or A, et al, “Teriflunomide effect on immune response to influenza vaccine in patients with multiple sclerosis”, Neurology, 2013 Aug 6;81(6):552-8. doi: 10.1212/WNL.0b013e31829e6fbf. Epub 2013 Jul 12. http://www.ncbi.nlm.nih.gov/pubmed/23851964.

BCG vaccine given very early in the course of multiple sclerosis (MS) appears to slow its development, preliminary results suggest. Bourdette, D & Naismith, RT, 2013, “BCG vaccine for clinically isolated syndrome and MS”, Neurology, Published online before print December 4, 2013, doi: 10.1212/01.wnl.0000438232.40847.c3. http://www.neurology.org/content/early/2013/12/04/01.wnl.0000438232.40847.c3

Many patients take omega-3 fatty acid supplements in an attempt to improve their health or lessen risk of illness.  This assessment of red blood cell levels of these acids did not predict cognitive performance or rate of cognitive decline. Ammann EM, et al, “Omega-3 fatty acids and domain-specific cognitive aging: secondary analyses of data from WHISCA”, Pottala JV, et al, Neurology. 2013 Oct 22;81(17):1484-91. doi: 10.1212/WNL.0b013e3182a9584c. Epub 2013 Sep 25. http://www.ncbi.nlm.nih.gov/pubmed/24068783.

It would be very helpful to be able to predict which patients with mild cognitive impairment will progress to dementia and when.  In this study, performance on an antisaccade test (asking subjects to look away from a target) as a test of executive function, correlated with cortical thickness in frontoparietal regions affected by Alzheimer’s disease. Heuer HW, et al, “Antisaccade task reflects cortical involvement in mild cognitive impairment”, Neurology. 2013 Oct 1;81(14):1235-43. http://www.ncbi.nlm.nih.gov/pubmed/23986300.

These authors find that patients with less formal education are more likely to discontinue cholinesterase inhibitors for dementia by the six month mark. Saleh S, Kirk A, Morgan DG & Karunanayake C, “Less education predicts anticholinesterase discontinuation in dementia patients”, Can J Neurol Sci. 2013 Sep;40(5):684-90.http://www.opusej.org/library/less-education-predicts-anticholinesterase-discontinuation-in-dementia-patients-cover/

Two distinct clinical presentations of chronic traumatic encephalopathy are described in male athletes: one a behavior/mood variant with younger age of onset and one cognitive. Stern RA, et al, “Clinical presentation of chronic traumatic encephalopathy”, Neurology. 2013 Sep 24;81(13):1122-9. http://www.ncbi.nlm.nih.gov/pubmed/?term=stern+daneshvar+clinical

Using diffusion-tensor imaging, these investigators found an association between level of physical activity and structural integrity of cerebral white matter. Gons RA, et al, “Physical activity is related to the structural integrity of cerebral white matter”, Neurology. 2013 Sep 10;81(11):971-6. doi: 10.1212/WNL.0b013e3182a43e33. Epub 2013 Aug 6. http://www.ncbi.nlm.nih.gov/pubmed/?term=gons+tuladhar+physical

Potentially epileptogenic lesions were found on MRI in 23 of 764 adults with new onset seizures, more often in those with focal seizures. Hakami T, et al, “MRI-identified pathology in adults with new-onset seizures”, Neurology. 2013 Sep 3;81(10):920-7. doi: 10.1212/WNL.0b013e3182a35193. Epub 2013 Aug 7. http://www.ncbi.nlm.nih.gov/pubmed/?term=hakami+mcintosh

Using data from a large Canadian survey of spinal cord injury, these authors conclude that the odds ratio is 2.72 of developing heart disease and 3.72 of developing stroke. Cragg JJ, et al, “Cardiovascular disease and spinal cord injury: results from a national population health survey”, Neurology. 2013 Aug 20;81(8):723-8. http://www.ncbi.nlm.nih.gov/pubmed/23884034

This catheter venography study demonstrated no excess of “cerebrospinal venous insufficiency” in patients with MS compared with healthy controls. Traboulsee AL, et al, “Prevalence of extracranial venous narrowing on catheter venography in people with multiple sclerosis, their siblings, and unrelated healthy controls: a blinded, case-control study”, Lancet. 2013 Oct 8. pii: S0140-6736(13)61747-X. doi: 10.1016/S0140-6736(13)61747-X. [Epub ahead of print] http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61747-X/abstract

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