White matter integrity related to functional working memory networks in traumatic brain injury
The authors performed an fMRI n-back task and acquired diffusion tensor images in 19 chronic-stage patients with severe traumatic brain injury and evidence of traumatic axonal injury and in 19 controls. Structural white matter changes related to functional network alterations and lower performance in working memory in chronic traumatic brain injury.
Spectrum of cognitive impairment in neurocysticercosis: Differences according to disease phase
This study evaluated 40 treatment-naive patients with the strictly calcified form, 40 active patients with neurocysticercosis, and 40 controls. Twenty-five percent of patients with calcified neurocysticercosis had mild cognitive impairment, while 40% of cases with active disease had impairment (12.5% had dementia). Cognitive impairment was frequent in neurocysticercosis, independently of its phase.
See p. 861
Offspring number, pregnancy, and risk of a first clinical demyelinating event: The AusImmune Study
This study examined the association between past pregnancy, offspring number, and first clinical demyelination risk in 282 subjects with a first clinical diagnosis of CNS demyelination compared to 542 controls. These findings were consistent with a cumulative beneficial effect of pregnancy.
Neuromyelitis optica and pregnancy
The authors identified 124 patients (85 women) from the French NOMADMUS cohort. They found no evidence to suggest that either epidural analgesia or breastfeeding has an aggravating effect on neuromyelitis optica (NMO), but since pregnancy influences NMO activity, close medical monitoring is warranted.
See p. 875 and p. 867
From editorialists Martin Daumer, Brian G. Weinshenker, and Rhonda Voskuhl: “…the results provide some reassurance to women with NMO who are considering pregnancy that there is not a major increase in attack rate during pregnancy and the increase in attack risk postpartum is transient.”
See p. 846
Intravenous thrombolysis in young stroke patients: Results from the SITS-ISTR
The authors assessed the safety and efficacy of thrombolysis in 27,671 patients, aged 18–80 years, treated with IV alteplase within 4.5 hours of symptom onset. This study provides evidence that younger patients (18–50 years) with ischemic stroke symptoms treated with IV alteplase have lower morbidity and mortality compared to older patients (51–80 years).
See p. 880
Eight new mutations and the expanding phenotype variability in muscular dystrophy caused by ANO5
This paper describes expansion of the clinical phenotype spectrum associated with ANO5 mutations. Clinical symptoms varied considerably; there was no particular genotype–phenotype correlation, but the sex difference in disease severity was significant. For undetermined muscle diseases, the possibility of ANO5 mutation should be considered and tested more readily.
See p. 897
CONTEMPORARY ISSUES IN NEUROLOGIC PRACTICE
Lamotrigine and aseptic meningitis
The authors performed a data-mining analysis of 9 antiepileptic drugs from the FDA's Adverse Event Reporting System database, applying the multi-item gamma Poisson shrinker algorithm. There appeared to be an association between lamotrigine use and aseptic meningitis, with nearly 40% in this case series reporting a positive rechallenge.
NB: Resident & Fellow Journal Club: “Early stroke risk and ABCD2 score performance in tissue vs time-defined TIA,” see p. e77. To check out other Resident & Fellow submissions, point your browser to www.neurology.org and click on the link to the Resident & Fellow Section.
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