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This Month in Archives of Neurology
Nov 2012

This Month in Archives of Neurology

Arch Neurol. 2012;69(11):1401-1402. doi:10.1001/archneurol.2011.1484

Costa and colleaguesArticle estimate the potential diagnostic added value of the Awaji criteria for diagnosis of amyotrophic lateral sclerosis (ALS), which have been compared with the previously accepted gold standard the revised El Escorial criteria in several studies. They find that the Awaji criteria have a significant clinical impact allowing earlier diagnosis and clinical trial entry in ALS.

Proportion of patients classified as having probable or definite amyotrophic lateral sclerosis. M-H indicates Mantel-Haenszel; rEEC, revised El Escorial criteria.

Baker et alArticle examine the effects of growth hormone–releasing hormone (GHRH) on cognitive function in healthy older adults and in adults with mild cognitive impairment (MCI). They report that 20 weeks of GHRH administration had favorable effects on cognition in both adults with MCI and healthy older adults.

Coric and colleaguesArticle assess the safety, tolerability, and pharmacokinetic and pharmacodynamic effects of the γ-secretase inhibitor avagacestat in patients with mild to moderate Alzheimer disease (AD). This study establishes an acceptable safety and tolerability dose range for future avagacestat studies in AD.

Hall et alArticle assess the ability of 5 cerebrospinal fluid (CSF) biomarkers to differentiate between common dementia and parkinsonian disorders. They conclude ascertainment of the α-synuclein level in CSF somewhat improves the differential diagnosis of Alzheimer disease (AD) vs dementia with Lewy bodies and Parkinson disease with dementia when combined with established AD biomarkers. The level of neurofilament light chain alone may differentiate Parkinson disease from atypical parkinsonian disorders. Editorial perspective is provided by Richard J. Perrin, MD, PhDArticle.

Wang and colleaguesArticle determine the efficacy and safety of low-molecular-weight heparin (LMWH) treating early neurologic deterioration (END) in patients with acute ischemic stroke and large artery occlusive disease (LAOD). For patients with acute ischemic stroke and LAOD, treatment with LMWH within 48 hours of stroke may reduce END during the first 10 days, mainly by preventing stroke progression.

Olindo et alArticle assess a fluid-attenuated inversion recovery vascular hyperintensities score (FVHS) and explore its relationship with recanalization status and clinical outcomes after intravenous thrombolysis. Synergy between FVHS and recanalization status appears to be a critical determinant of final outcomes, supporting intensive reperfusion treatment for patients with a low FVHS.

Kim and colleaguesArticle evaluate atherosclerosis activity of the middle cerebral artery by high-resolution magnetic resonance imaging and determine its relationship with infarction patterns. Vulnerable symptomatic plaque as determined by a high-resolution magnetic resonance imaging technique is associated with artery-to-artery embolic infarction.

Van Gompel et alArticle assess the hypothesis that use of anterior temporal lobectomy (ATL) for temporal epilepsy has diminished over time. In this community-based cohort, the rate of ATL use was 1.2 per 100 000 person-years of follow-up. Use of this procedure has declined over time; the reasons for this are unknown but do not include referral pattern changes.

Qian and colleaguesArticle contrast differences in pain and treatment outcomes between neuromyelitis optica (NMO) and multiple sclerosis. They indicate that NMO is frequently associated with severe pain that appears insufficiently controlled by pharmacologic interventions.

Siepmann et alArticle quantify piloerection using phenylephrine hydrochloride in humans. Phenylephrine provoked piloerection directly and indirectly through an axon reflex–mediated response that is attenuated by lidocaine.

Menke and colleaguesArticle explore the value of diffusion tensor imaging applied to those specific cerebral white matter tracts consistently involved pathologically in amyotrophic lateral sclerosis as a source of prognostic biomarkers. They show that the posterior limb of the internal capsule fractional anisotropy is a candidate prognostic marker in amyotrophic lateral sclerosis, with potential to identify incident cases with more rapid progression.