Notable in Neurology this week
This issue features an article that investigates whether prediagnostic levels of plasma branched-chain amino acids are associated with amyotrophic lateral sclerosis risk; another determines that the different dimensions of pain can be modulated in humans noninvasively. A featured Special Article examines the accuracy of the data extraction process for the Axon Registry®.
Articles
INTREPAD: A randomized trial of naproxen to slow progress of presymptomatic Alzheimer disease
INTREPAD results suggest that the conventional nonsteroidal anti-inflammatory drug naproxen poses health risks but offers no protection against Alzheimer disease (AD), even in healthy at-risk elderly. An innovative design, including a composite biomarker indicator of presymptomatic AD progression, suggested that AD prevention trials can be run at much lower costs than conventional approaches.
Page 835
From editorialists Hershey & Lipton: “A different dose of naproxen, a more CNS penetrant NSAID, or a different ‘high-risk’ group of patients could have led to different study results.”
Page 829
Clinical manifestations of homozygote allele carriers in Huntington disease
Data on the phenotypic characteristics of Huntington disease (HD) homozygotes are scarce and contradictory. This study provides information to support the hypothesis that homozygotes and heterozygotes present a similar phenotype and disease progression. The underlying mechanisms of the lack of significant expression of a double mutant gene dosage in HD are unknown.
Page 838
Safety, tolerability, and efficacy of fluoxetine as an antiviral for acute flaccid myelitis
Fluoxetine inhibits replication of enterovirus D68 strains associated with acute flaccid myelitis (AFM) in vitro, but did not demonstrate a signal of clinical efficacy in this multicenter cohort study of 56 patients with AFM. These findings do not support the use of fluoxetine as a potential antiviral therapy for AFM.
Page 840
Total intake of different minerals and the risk of multiple sclerosis
This article addresses whether multivitamin components other than vitamin D, like minerals, modify multiple sclerosis risk. Dietary and supplemental intake of minerals and trace elements were not linked to multiple sclerosis in 2 large cohorts with diet assessment over a long follow-up. Null findings from methodologically rigorous studies contributed with valuable knowledge, preventing redundant work.
Page 841
NB: “Tongue base retraction and airway obstruction in drug-induced oromandibular dystonia,” p. 859. To check out other Video NeuroImages, point your browser to Neurology.org/N. At the end of the issue, check out the Resident & Fellow Teaching NeuroImage illustrating the GM1 gangliosidosis sign of iron accumulation in a wishbone pattern, and another discussing a presentation of idiopathic hypereosinophilic syndrome. This week also includes a Resident & Fellow Mystery Case titled “A 23-year-old man with headaches, confusion, and lower extremity weakness.”
Editor's Summary: NPub.org/edsum
- © 2019 American Academy of Neurology
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