Spotlight on the January 5 Issue

Cerebral injury in perinatally HIV-infected children compared to matched healthy controls

This study included 35 perinatally HIV-infected children and 37 controls who underwent 3.0 T MRI. Children with HIV had lower brain volumes, a higher white matter hyperintensity load, and poorer white matter integrity, along with poor cognitive performance. Further longitudinal studies are needed to increase our understanding of HIV-induced cerebral injury.

See p. 19

From editorialists Ances & Hoare: “While there are clinical criteria for the diagnosis of HIV encephalopathy (HIVE), it is important to identify HIV+ children and adolescents with functional cognitive impairments who do not fit criteria for HIVE as initiation of cART [combination antiretroviral therapy] could maintain brain structure.”

See p. 13

¹⁸F-FDG-PET correlates of cognitive impairment in ALS

The authors found reduced frontal and prefrontal metabolism in 170 patients with amyotrophic lateral sclerosis (ALS), based on brain ¹⁸F-2-fluoro-2-deoxy-d-glucose-PET (¹⁸F-FDG-PET). Because ¹⁸F-FDG-PET estimates the cerebral lesion load in vivo in neurodegenerative diseases, it may be helpful in ALS to investigate an association with neuropsychological testing so as to disclose the early metabolic signature of possible cognitive impairment.

See p. 44

Disparities in surgery among patients with intractable epilepsy in a universal health system

Using linked health care databases, the authors identified patients with medically intractable epilepsy who underwent surgery within 2 years of diagnosis. In a publicly funded universal health care system, more than 10% of patients died within 2 years of developing medically intractable epilepsy. Even though epilepsy surgery may be an effective treatment for these patients, fewer than 2% received it.

See p. 72

Association between age at onset of multiple sclerosis and vitamin D level–related factors

The underlying effects of vitamin D may explain the results of this study; however, independent protective effects of ultraviolet B light and harmful effects of adipose tissue may also contribute to these findings. Because both sun exposure and body mass index were modifiable factors, these should be considered in the modification for risk of multiple sclerosis.

See p. 88