Spotlight on the March 5 Issue

Postinfectious neurologic syndromes: A prospective cohort study

The authors analyzed a cohort with postinfectious central and peripheral nervous system syndromes. Multivariate analysis showed that older age and peripheral nervous system involvement were independent predictors of relapse and poor prognosis. In comparing both groups with a multiple sclerosis cohort, differences emerged in demographics, disease course, and CSF profile.

See p. 882; Editorial, p. 968

Brain β-amyloid load approaches a plateau

Serial amyloid PET was measured in 205 cognitively normal and 55 cognitively impaired participants. Amyloid accumulation had a sigmoid-shaped curve with respect to time. The estimated time from a low amyloid load to that typically seen in patients with dementia was approximately 15 years, defining the therapeutic window for secondary preventive interventions.

See p. 890

From editorialists Burns & Swerdlow: “Studies of factors that regulate amyloid precursor protein handling could yield mechanistic insights into why parenchymal amyloid accumulation rates vary over the course of AD [Alzheimer disease].”

See p. 878

Total antioxidant capacity of the diet and major neurologic outcomes in older adults

The authors examined the association between dietary antioxidant scores and risks of major neurologic outcomes in a cohort of 5,395 participants 55 years and older in the Rotterdam Study. Total antioxidant capacity of the diet, as measured by the ferric-reducing antioxidant power assay, does not appear to predict risks of major neurologic diseases.

See p. 904

Thrombogenic microvesicles and white matter hyperintensities in postmenopausal women

White matter hyperintensities (WMH) were present in 95 women at baseline who were then randomized to receive hormone treatments in the Early Estrogen Prevention Study. The WMH volume increased at 36 and 48 months after randomization. Associations of platelet-derived, thrombogenic microvesicles at baseline and increases in WMH suggest that in vivo platelet activation contributes to WMH in recently menopausal women.

See p. 911

Long-term outcome in stroke patients treated with IV thrombolysis

At 3 years, 37.0% of 257 patients treated with IV thrombolysis (IVT) had modified Rankin Scale scores of 0 or 1; 29.2% had died. At 3 years after IVT, one-third of patients had an excellent outcome and one-third had died. Epileptic seizures seem to have an unfavorable effect on long-term outcome, although a mechanism remains to be clarified.

See p. 919

Octanoic acid in alcohol-responsive essential tremor: A randomized controlled study

This study evaluated the effect of 4 mg/kg oral octanoic acid (OA) in 19 patients with essential tremor. There was no difference in the primary outcome (accelerometric tremor power) at 80 minutes after a single low dose of OA, but there was a reduction of tremor amplitudes, measured by accelerometry, at points up to 5 hours.

See p. 933

Postdural puncture headache in migraineurs and nonheadache subjects: A prospective study

This study assessed postdural puncture headache in 160 migraineurs and 53 controls. Migraineurs were not at increased risk for postdural puncture headache and a lumbar puncture did not trigger attacks; however, the stress during lumbar puncture increased the duration of postdural puncture headache.

See p. 941

HISTORICAL NEUROLOGY