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Fingolimod for the Treatment of ICH
Fu and colleagues investigate whether oral administration of fingolimod, a Food and Drug Administration–approved sphingosine 1–phosphate receptor modulator for multiple sclerosis, is safe and effective in alleviating perihematomal edema (PHE) and neurologic deficits in patients with intracerebral hemorrhage (ICH). They included 23 patients with primary supratentorial ICH with hematomal volume of 5 to 30 mL. They report that in patients with small- to moderate-sized deep primary supratentorial ICH, administration of oral fingolimod within 72 hours of disease onset was safe, reduced PHE, attenuated neurologic deficits, and promoted recovery. Editorial perspective is provided by Kevin N. Sheth, MD, and Jonathan Rosand, MD, MSc.
Continuing Medical Education
Dietary ω-3 PUFA Intake and Risk for ALS
Fitzgerald and coauthors examine the association between ω-6 and ω-3 polyunsaturated fatty acids (PUFA) consumption and amyotrophic lateral sclerosis (ALS) risk. Diet was assessed via food frequency questionnaire developed or modified for each cohort. They find that consumption of foods high in ω-3 PUFAs may help prevent or delay the onset of ALS. Editorial perspective is provided by Michael Swash, MD.
Functional Connectivity in AD
Thomas et al assess the similarities and differences in functional connectivity changes owing to autosomal dominant Alzheimer disease (ADAD) and late-onset AD (LOAD). They analyzed functional connectivity in multiple brain resting state networks in a cross-sectional cohort of participants with ADAD (n = 79) and LOAD (n = 444), using resting-state functional connectivity magnetic resonance imaging at multiple international academic sites. They show resting-state functional connectivity magnetic resonance imaging changes with progressing AD severity are similar between ADAD and LOAD. Editorial perspective is provided by Adam S. Fleisher, MD, MAS.
Thrombolysis Times in Acute Ischemic Stroke
Sauser and colleagues examine the contributions of door-to-imaging time (DIT) and imaging-to-needle (ITN) time to delays in timely delivery of tissue plasminogen activator (tPA) to patients with acute ischemic stroke and assess between-hospital variation in DTN times. They analyzed a cohort of 1193 patients having acute ischemic stroke treated with intravenous tPA between January 2009 and December 2012. Compared with DIT, ITN time is a much greater source of variability in hospital DTN times and is a more common contributor to delays in timely tPA therapy for acute ischemic stroke.
Frontotemporal Dementia and Parkinsonism
Kara and coauthors report a novel family carrying a heterozygous 6.4 Mb duplication of the SNCA locus with an atypical clinical presentation strongly reminiscent of frontotemporal dementia and late-onset pallidopyramidal syndromes and study phenotype-genotype correlations in SNCA locus duplications. They report the clinical and neuropathologic features of this family. These findings further expand the phenotypic spectrum of SNCA locus duplications.
Highlights. JAMA Neurol. 2014;71(9):1069. doi:10.1001/jamaneurol.2013.4166
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