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This Month in Archives of Neurology
November 2005

This Month in The Archives of Neurology

Arch Neurol. 2005;62(11):1659-1660. doi:10.1001/archneur.62.11.1659
Microarrays: Applications and Pitfalls

Fathallah-Shaykhreviews the precision and value by which microarrays measure the relative expression levels of tens of thousands of genes. Microarrays can be extremely useful for many biological fields, particularly in neurology and systems biology. As pointed out in this review, the full potential of microarrays awaits additional advances in methodologies to provide clear signals that separate genotype-phenotype relationships, including those for brain tumors, Alzheimer disease, and prion diseases.

Acute Disseminated Encephalomyelitis: An Update

Menge and colleaguesreview current and emerging concepts of acute disseminated encephalomyelitis, defined as a monophasic autoimmune demyelinating disease of the central nervous system that follows a febrile infection or a vaccination. Recent studies have broadened our understanding about the clinical phenotype, the diagnosis, and the progress of acute disseminated encephalomyelitis, which are succinctly summarized and discussed.

Interferon Beta-1a Treatment in African American Patients With Multiple Sclerosis

Cree et aldescribe their experience in treating African American patients with multiple sclerosis with beta-1a interferon. African American patients experienced more exacerbations and were less likely to remain exacerbation free than white patients with multiple sclerosis. African American patients responded less well to interferon beta-1a therapy than white patients on all outcome measures.

Treating Myasthenia Gravis With Intravenous Immunoglobulin

Gajdos et alcompared the optimal dose of intravenous immunoglobulin for treating myasthenia gravis. They compared 1 g/kg of intravenous immunoglobulin on day 1 and placebo on day 2 vs 1 g/kg of intravenous immunoglobulin on 2 consecutive days. They found no significant superiority of 2 g/kg over 1 g/kg of intravenous immunoglobulin in the treatment of myasthenia gravis exacerbation.

Interferon Beta-1b on Black Holes in Multiple Sclerosis

Bagnato and colleaguesanalyzed the effects of interferon beta-1b in reducing the frequency or duration of T1 black holes in patients with multiple sclerosis. They report that the rate of black hole accumulation decreased with treatment (P = .01), but Kaplan-Meier models revealed that the duration of black holes did not decrease (P = .116). Thus, interferon beta-1b shows promise selectively to reduce black hole lesions. Editorial perspective is provided by Robert T. Naismith, MD, and Anne H. Cross, MD.

Figure.
Nonlinear regression curves for the accumulation of black holes (BHs) in each individual over the natural history phase (NHP) and therapy phase (TP).

Nonlinear regression curves for the accumulation of black holes (BHs) in each individual over the natural history phase (NHP) and therapy phase (TP).

Refractory Status Epilepticus: Effect of Treatment Aggressiveness on Prognosis

Rossetti and colleaguesfound that refractory status epilepticus is more prevalent in incident than in recurrent status epilepticus; it also shows higher mortality and has a lower likelihood to return to baseline than non–refractory status epilepticus. Outcome was independent of the specific coma-inducing agents and the extent of electroencephalographic burst suppression, suggesting that the underlying cause represents its main determinant.

Topiramate and Juvenile Myoclonic Epilepsy

Biton et alevaluated topiramate as add-on therapy in patients with juvenile myoclonic epilepsy. They report that topiramate is effective in reducing primary generalized tonic-clonic seizures. Primary generalized tonic-clonic seizures were reduced by more than 50% in 8 (73%) of 11 patients receiving topiramate and 2 (18%) of 11 patients receiving placebo. As a broad-spectrum agent, topiramate is an effective option for patients with juvenile myoclonic epilepsy.

Muscle Coenzyme Q10 in Statin-Related Myopathy

Lamperti and colleaguesstudied the role that the reduction of muscle coenzyme Q10 has in the pathogenesis of statin-related myopathy. They report that statin-related myopathy is associated with a mild decrease of muscle coenzyme Q10, which, however, does not cause histochemical or biochemical evidence of mitochondrial myopathy nor morphological evidence of apoptosis in most patients.

Multiple Cranial Nerve Palsies

Keaneanalyzed 979 cases of personally examined patients with multiple cranial nerve palsies. Although the locations and causes of multiple cranial neuropathies are highly diverse, the fact that tumor composes more than one quarter of cases places a premium on prompt diagnosis.

Neuroanatomical Predictors of Response to Donepezil in Patients With Dementia

Csernansky and colleaguesfound that measures of hippocampal volume and surface variation can be used to predict the response of dementia in patients with dementia of the Alzheimer type to the acetylcholinesterase inhibitor donepezil.

Glucose Metabolism in Mild Cognitive Impairment Predicts Progression to Alzheimer Disease

Anchisi et alprovide comprehensive data in patients with amnesic mild cognitive impairment suggesting that values from positron emission tomography with fludeoxyglucose F 18 combined with specific memory test scores can be predictive of short-term conversion to Alzheimer disease.

Circulating Soluble Receptor for Advanced Glycation End Products in Alzheimer Disease and Vascular Dementia

Emanuele et alreport that patients with Alzheimer disease have reduced levels of soluble receptor for advanced glycation end products (sRAGE) in plasma compared with patients with vascular dementia and control subjects. This striking reduction of circulating sRAGE in Alzheimer disease supports a role for RAGE in the pathogenesis of Alzheimer disease.

Diagnostic Criteria for Mild Cognitive Impairment in an Urban Community

Manly et alstudied the diagnostic criteria for mild cognitive impairment and examined the frequency of the diagnosis in an ethnically and linguistically diverse community of urban elderly participants. They found that age and education are associated with higher frequency of mild cognitive impairment, not race and ethnicity.

Physician and Cognitive Activity and Associated Cognitive Decline in a Biracial Community

Sturman et alstudied whether physical activity by adults aged 65 years and older reduces the rate of cognitive decline. They found that each additional physical activity hour per week was associated with a slower rate of cognitive decline by 0.0007 U/y (P = .04). However, other events, such as cognitive activity, depression, and vascular disease, also contribute to slowing cognitive loss.

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