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This Month in Archives of Neurology
Feb 2012

This Month in Archives of Neurology

Arch Neurol. 2012;69(2):156-157. doi:10.1001/archneurol.2011.1439

CarmichaelArticle supports the view that there is no current medical therapy for stroke recovery. Principles of physiological plasticity have been identified during recovery in both animal models and human stroke. He points out that changes in the excitability of neuronal circuits in peri-infarct cortex after stroke may underlie the process of remapping motor and sensory function after stroke and may identify new therapeutic targets to promote stroke recovery.

Hachinski and colleaguesArticle provide new data to consolidate and further validate the Hachinski Ischemic Score (HIS). Depending on the specific setting, 2 reduced HIS versions consisting of 5 composite-question items or 7 single-question items classify as well as or better than the original HIS instrument.

Bardin et alArticle detect covert volitional brain activity in patients with severe brain injury using pattern classification of the blood oxygenation level–dependent response during mental imagery and compare these results with those of a univariate functional magnetic resonance imaging (fMRI) analysis. They report that pattern classification in fMRI is a promising technique for advancing the understanding of volitional brain responses in patients with severe brain injury and may serve as a powerful complement to traditional general linear model–based univariate analysis methods. Editorial perspective is provided by Joseph J. Fins, MDArticle.

Villar et alArticle explore cell subsets and molecules that changed specifically in patients with multiple sclerosis (MS) who had an optimal response to natalizumab. Their data indicate that inhibition of intrathecal antibody synthesis is associated with a complete therapeutic response to natalizumab in patients with aggressive MS.

Kinkel and colleaguesArticle determine whether immediate initiation of treatment at the time of a clinically isolated syndrome in patients at high risk for clinically definite multiple sclerosis alters disease course over 10 years. They report that immediate initiation of intramuscular interferon beta-1a at the time of a clinically isolated syndrome in high-risk patients reduces relapse rates over 10 years but does not improve disability outcomes compared with a control group that also initiated therapy relatively early in the disease course.

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Kaplan-Meier rates for the development of clinically definite multiple sclerosis (CDMS) by treatment group, calculated using timing from the first month. Data include all patients (n = 383) originally randomly assigned to the Controlled High-Risk Subjects Avonex Multiple Sclerosis Prevention Study. Patients not meeting the criteria for CDMS were censored on the date of their last neurologic examination.

Ostrowitzki and colleaguesArticle investigate whether treatment with gantenerumab leads to a measurable reduction in the level of Aβ amyloid in the brain and to elucidate the mechanism of amyloid reduction. They report that gantenerumab treatment resulted in a dose-dependent reduction in brain amyloid level, possibly through an effector cell–mediated mechanism of action.

Messing et alArticle describe genetic analyses of the 2 most thoroughly studied, historically seminal multigenerational families with Alexander disease described prior to the identification of GFAP as the related gene, as well as 1 newly discovered family.

Small and colleaguesArticle determine whether 2-(1-{6-[(2-[fluorine 18–labeled]fluoroethyl)(methylamino]-2-naphthyl}ethylidene) malononitrile ([18F]FDDNP) brain regional values in individuals without dementia predict and correlate with future cognitive change.

Perrotin et alArticle study the relationship between subjective cognition and the neuropathological hallmark of Alzheimer disease (AD), amyloid-beta peptide deposition, using carbon 11–labeled Pittsburgh compound B (PiB) positron emission tomography in normal elderly individuals. Their findings suggest that a decrease of self-confidence about memory abilities in cognitively normal elderly subjects is related to the neuropathological hallmark of AD measured with PiB–positron emission tomography.

McKeon and colleaguesArticle report the characteristics of the Mayo Clinic Rochester stiff-man syndrome (SMS) cohort (99 patients), comparing patients with classic SMS with patients with variants of the disorder, both GAD65 antibody seropositive and seronegative, with respect to neurological, autoimmune, serological, and oncological findings; treatments; and outcomes between 1984 and 2008.

Kleiter et alArticle describe first experiences with the integrin inhibitor natalizumab, given to patients with suspected relapsing-remitting multiple sclerosis (MS) who were later diagnosed with aquaporin 4–positive neuromyelitis optica (NMO). Their results suggest that natalizumab fails to control disease activity in patients with NMO. Neuromyelitis optica should be considered as a differential diagnosis in patients with suspected MS who are unresponsive to natalizumab therapy.

Moghekar and colleaguesArticle determine whether cerebrospinal fluid (CSF) biomarkers for Alzheimer disease fluctuate significantly over time in a cohort of older, mildly symptomatic individuals. They report that, in a cohort of elderly patients, little fluctuation in the levels of important Alzheimer disease biomarkers in lumbar CSF is seen as a function of time.

Gardener and colleaguesArticle examine the association between a Mediterranean-style diet (MeDi) and brain magnetic resonance imaging white matter hyperintensity volume (WMHV). The MeDi has previously been associated with a reduced risk of cardiovascular morbidity, possibly including stroke. They report that an MeDi was associated with a lower WMHV burden, a marker of small-vessel damage in the brain.