Notable in Neurology This Week
This issue features an article that examines the effect of intensive arm motor rehabilitation for patients >90 days after a stroke; another investigates the financial conflicts of interest associated with payments from pharmaceutical and medical device companies of US authors in neurology journals. A featured Views & Reviews examines the factors that influence the selection of patients with Tourette syndrome for deep brain stimulation surgery.
Articles
Association of White Matter Hyperintensities With HIV Status and Vascular Risk Factors
This study looked at the prevalence and clinical correlations of white matter hyperintensities (WMH) in patients with well-treated HIV. Patients with HIV had more WMH than controls even after adjusting for covariates, but this was also highly associated with vascular risk factors. Neurologists should recognize the contribution of HIV to WMH but continue addressing modifiable risk factors.
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From editorialists Robinson-Papp and Saylor: “Of particular importance…is that the presence of WMH among people with HIV was not associated with either cognition or depression, the 2 primary clinical outcomes assessed in this study.”
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Association of Digital Clock Drawing With PET Amyloid and Tau Pathology in Normal Older Adults
A digitized, brief digital clock drawing test, DCTclock, provides more nuanced information about cognitive impairments than standard tests by exposing how a task was completed even if the drawing was accurate. In this study, performance on the DCTclock was correlated with longer standard neuropsychological tests and could differentiate people who were cognitively normal from those with MCI and early Alzheimer disease dementia. Digitized measures could be efficient tools to detect early cognitive changes in clinical trials and practice.
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From editorialists Barkhof and Pressman: “The digital clock-drawing test described in the article by Renz et al. may serve as an analog for the increasingly digital face of medicine.”
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Speech, Language, and Oromotor Skills in Patients With Polymicrogyria
All 52 patients with polymicrogyria who underwent standardized assessments of speech, oromotor structure and function, language, and nonverbal IQ in this study had dysarthria, and it was often accompanied by receptive and expressive language impairments. These features were more severe among those with bilateral cortical involvement. Neurologists should consider evaluating patients for targeted dysarthria therapy and encourage sign language or communication devices for nonverbal patients who have sufficient cognitive ability to use them.
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NB: “An Imaging Clue in a Boy With Developmental Delay,” p. e1925. To check out other Resident & Fellow Section Teaching NeuroImages, point your browser to Neurology.org/N and click on the link to the Resident & Fellow Section. At the end of the issue, check out the Video NeuroImage illustrating the association of asymmetric reduction in corticospinal tract fibers with the absence of lower motoneuron involvement in hemiparetic variants of primary lateral sclerosis. This week also includes a Resident & Fellow Section Pearls & Oy-sters article titled “Upbeat Nystagmus and Quadriplegia in a Young Girl With Bilateral Medial Medullary Syndrome.”
COVID-19 Resources: NPub.org/COVID19
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