Letter re: Prolonged sleep duration as a marker of early neurodegeneration predicting incident dementia
Westwood et al.1 demonstrated that long sleep duration could represent a marker of early neurodegeneration leading to dementia. There is evidence of an interplay between sleep and cognition.2 In particular, sleep disturbances are related to the occurrence of dementia by altering brain processes active during sleep.2 The observation by Westwood et al. adds to the literature on sleep and neurodegeneration.3 However, the absence of polysomnographic recordings leaves an unresolved question: why are neurodegenerative processes promoted by long sleep duration? (Source: Neurology)
Source: Neurology - October 2, 2017 Category: Neurology Authors: Liguori, C., Izzi, F., Mercuri, N. B., Placidi, F. Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research
Editors' Note
: In "Prolonged sleep duration as a marker of early neurodegeneration predicting incident dementia," Westwood et al. found an association between long sleep duration and incident dementia. Liguori et al. propose obstructive sleep apnea (OSA) as a possible link between increased sleep duration and neurodegeneration. (Source: Neurology)
Source: Neurology - October 2, 2017 Category: Neurology Authors: Alcauskas, M., Galetta, S. Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research
Serpiginous cranial arterial calcification in uremia
A 65-year-old man with chronic kidney disease (CKD) on hemodialysis presented with a subcortical stroke. Unenhanced CT scan of the brain revealed widespread arterial calcification, notably involving the carotid siphons (figure 1) and external carotid artery branches (figure 2, A and B). Vascular calcification in CKD closely resembles ossification, and may involve the intima (as in atherosclerosis) or more commonly the media.1 Both patterns of calcification are associated with increased cardiovascular mortality, though no specific treatment has been shown to modify this risk.2 This example is particularly striking for the s...
Source: Neurology - October 2, 2017 Category: Neurology Authors: Shamy, M. C., Yogendrakumar, V., Iancu, D., Bourque, P. R. Tags: CT, All Medical/Systemic disease, All Cerebrovascular disease/Stroke NEUROIMAGES Source Type: research
Spinal epidural gas mimicking lumbar disc herniation
A 73-year-old woman presented with acute lower back pain and right sensory radicular L4 syndrome. Spinal MRI showed a cranially shifted T2-hypointense mass suspicious for disc herniation in the L3/4 segment with compression of the right nerve root L4 (figure 1). Due to atypical morphology, CT was performed and disclosed an intraspinal epidural gas bubble mimicking disc herniation on MRI (figure 2). In association with coexisting intravertebral vacuum disc phenomenon (figure 2B), it appears likely that the gas gained access to the epidural space after annulus fibrosus rupture.1 Vacuum disc phenomenon results from the accumu...
Source: Neurology - October 2, 2017 Category: Neurology Authors: Hassler, E., Gattringer, T., Wiesspeiner, U., Deutschmann, H., Fazekas, F. Tags: CT, MRI, Disc disease NEUROIMAGES Source Type: research
Procoagulant imbalance in premenopausal women with chronic migraine
Migraine has been associated with an increased risk for stroke, especially in young women.1 Among the pathophysiologic mechanisms linking migraine and stroke, coagulation abnormalities have been regarded as a logical link.2 (Source: Neurology)
Source: Neurology - October 2, 2017 Category: Neurology Authors: Ferroni, P., Barbanti, P., Aurilia, C., Egeo, G., Fofi, L., La Farina, F., Valente, M. G., De Marchis, M. L., Spila, A., Palmirotta, R., Della-Morte, D., Guadagni, F. Tags: CLINICAL/SCIENTIFIC NOTES Source Type: research
Neurologic complications of sickle cell disease in Africa: A systematic review and meta-analysis
Conclusions:
The burden of neurologic complications of SCD is important in Africa and most likely underestimated. A better evaluation of this burden requires larger prospective studies using standard up-to-date screening methods. Accessibility to diagnostic tools such as neuroimaging, transcranial Doppler, EEG, and neuropsychological evaluation, as well as to preventive and therapeutic interventions and trained health care providers, should be improved in routine clinical practice. (Source: Neurology)
Source: Neurology - October 2, 2017 Category: Neurology Authors: Noubiap, J. J., Mengnjo, M. K., Nicastro, N., Kamtchum-Tatuene, J. Tags: VIEWS & amp;amp; REVIEWS Source Type: research
Reducing placebo exposure in trials: Considerations from the Research Roundtable in Epilepsy
The randomized controlled trial is the unequivocal gold standard for demonstrating clinical efficacy and safety of investigational therapies. Recently there have been concerns raised about prolonged exposure to placebo and ineffective therapy during the course of an add-on regulatory trial for new antiepileptic drug approval (typically ~6 months in duration), due to the potential risks of continued uncontrolled epilepsy for that period. The first meeting of the Research Roundtable in Epilepsy on May 19–20, 2016, focused on "Reducing placebo exposure in epilepsy clinical trials," with a goal of considering new designs...
Source: Neurology - October 2, 2017 Category: Neurology Authors: Fureman, B. E., Friedman, D., Baulac, M., Glauser, T., Moreno, J., Dixon-Salazar, T., Bagiella, E., Connor, J., Ferry, J., Farrell, K., Fountain, N. B., French, J. A. Tags: Clinical trials Randomized controlled (CONSORT agreement), Clinical trials Methodology/study design, All Epilepsy/Seizures, Antiepileptic drugs, All Ethics in Neurology/Legal issues CONTEMPORARY ISSUES Source Type: research
Functional impairments for outcomes in a randomized trial of unruptured brain AVMs
Conclusion:
Death or stroke with functional impairment in ARUBA after a median follow-up of 33 months was significantly lower for those in the MM arm both as randomized and as treated compared with those with IT. Functional severity of outcomes was lower in the MM arm, regardless of Spetzler-Martin grades.
ClinicalTrials.gov identifier:
NCT00389181.
Classification of evidence:
This study provides Class II evidence that for adults with unruptured brain AVMs, interventional management compared to MM increases the risk of disability and death over 3 years. (Source: Neurology)
Source: Neurology - October 2, 2017 Category: Neurology Authors: Mohr, J. P., Overbey, J. R., von Kummer, R., Stefani, M. A., Libman, R., Stapf, C., Parides, M. K., Pile-Spellman, J., Moquete, E., Moy, C. S., Vicaut, E., Moskowitz, A. J., Harkness, K., Cordonnier, C., Biondi, A., Houdart, E., Berkefeld, J., Klijn, C. J Tags: All Clinical trials, All Cerebrovascular disease/Stroke, Arteriovenous malformation, Class II, Intracerebral hemorrhage ARTICLE Source Type: research
Amyloid-PET in sporadic cerebral amyloid angiopathy: A diagnostic accuracy meta-analysis
Conclusions:
Amyloid-PET appears to have moderate to good diagnostic accuracy in differentiating patients with probable CAA from cognitively normal healthy controls or patients with deep ICH. Given that amyloid-PET labels both cerebrovascular and parenchymal amyloid, a negative scan might be useful to rule out CAA in the appropriate clinical setting. (Source: Neurology)
Source: Neurology - October 2, 2017 Category: Neurology Authors: Charidimou, A., Farid, K., Baron, J.-C. Tags: MRI, PET, Intracerebral hemorrhage ARTICLE Source Type: research
Causal inference methods to study gastric tube use in amyotrophic lateral sclerosis
Conclusions:
In the absence of randomization, causal inference methods are necessary to correct for time-varying confounding. G-tube placement may have a negative effect on survival with no QOL-related benefit for people with ALS. A randomized controlled trial is warranted to further evaluate the efficacy of this widely used intervention.
Clinicaltrials.gov identifier:
NCT00349622.
Classification of evidence:
This study provides Class III evidence that for patients with ALS, G-tube placement decreases survival time and does not affect QOL. (Source: Neurology)
Source: Neurology - October 2, 2017 Category: Neurology Authors: McDonnell, E., Schoenfeld, D., Paganoni, S., Atassi, N. Tags: Quality of life, Amyotrophic lateral sclerosis, Class III, All epidemiology, Palliative care ARTICLE Source Type: research
Long-term risk of seizures in adult survivors of sepsis
Conclusions:
We found that survivors of sepsis faced a significantly higher long-term risk of seizures than both the general population and other hospitalized patients. Our findings suggest that sepsis is associated with pathways that lead to permanent neurologic sequelae. (Source: Neurology)
Source: Neurology - October 2, 2017 Category: Neurology Authors: Reznik, M. E., Merkler, A. E., Mahta, A., Murthy, S. B., Claassen, J., Kamel, H. Tags: All Infections, All Medical/Systemic disease, Risk factors in epidemiology, All Epilepsy/Seizures ARTICLE Source Type: research
Antibody-associated CNS syndromes without signs of inflammation in the elderly
Conclusions:
In patients ≥60 years of age, the correct identification of characteristic CNS syndromes (FBDS, anti-IgLON5 syndrome, AE) should prompt antibody testing even without evidence of inflammation in MRI and CSF studies. Up to 15% of the patients developed rapidly progressive cognitive deterioration, which further complicated the differential diagnosis with a neurodegenerative disorder. (Source: Neurology)
Source: Neurology - October 2, 2017 Category: Neurology Authors: Escudero, D., Guasp, M., Arino, H., Gaig, C., Martinez-Hernandez, E., Dalmau, J., Graus, F. Tags: Autoimmune diseases, Encephalitis, All Clinical Neurology, All Epilepsy/Seizures ARTICLE Source Type: research
Subjective memory complaints in preclinical autosomal dominant Alzheimer disease
Conclusions:
Cognitively unimpaired PSEN-1 carriers have elevated SMC. Self-reported SMC may be a relatively early indicator of preclinical AD, while partner- reported SMC increases later in preclinical AD, closer to clinical onset. (Source: Neurology)
Source: Neurology - October 2, 2017 Category: Neurology Authors: Norton, D. J., Amariglio, R., Protas, H., Chen, K., Aguirre-Acevedo, D. C., Pulsifer, B., Castrillon, G., Tirado, V., Munoz, C., Tariot, P., Langbaum, J. B., Reiman, E. M., Lopera, F., Sperling, R. A., Quiroz, Y. T. Tags: Alzheimer's disease, Cognitive aging, Assessment of cognitive disorders/dementia ARTICLE Source Type: research
Polycystic kidney disease is significantly associated with dementia risk
Conclusions:
In clinical practice, health care professionals should be aware of the risk of neurodegenerative diseases in patients with PKD. (Source: Neurology)
Source: Neurology - October 2, 2017 Category: Neurology Authors: Yu, T.-M., Chuang, Y.-W., Sun, K.-T., Yu, M.-C., Kung, S.-C., Lee, B. K., Huang, S.-T., Chen, C.-H., Lin, C.-L., Kao, C.-H. Tags: All Cognitive Disorders/Dementia, Parkinson's disease with dementia, Cohort studies, Risk factors in epidemiology ARTICLE Source Type: research
A predictive model to identify Parkinson disease from administrative claims data
Conclusions:
Using only demographic data and selected diagnosis and procedure codes readily available in administrative claims data, it is possible to identify individuals with a high probability of eventually being diagnosed with PD. (Source: Neurology)
Source: Neurology - October 2, 2017 Category: Neurology Authors: Searles Nielsen, S., Warden, M. N., Camacho-Soto, A., Willis, A. W., Wright, B. A., Racette, B. A. Tags: Parkinson's disease/Parkinsonism, Case control studies ARTICLE Source Type: research
