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This week in Neurology®

Highlights of the Current Issue

Risk of premature stroke in recent immigrants (PRESARIO): Population-based matched cohort study cme icon This study counters the common belief that new immigrants are at higher risk of cardiovascular disease, including stoke. The authors examined 965,829 new immigrants and 3,272,393 matched long-term residents/native-born adults in Ontario, Canada; the incidence of acute stroke was 1.69 per 10,000 person-years among new immigrants and 2.56 per 10,000 person-years among long-term residents. See p. 451; and Editorial, p. 446

Altered control of postural sway following cerebral infarction: A cross-sectional analysis Subjects with right middle cerebral artery (MCA) infarct (n = 17, age = 65 ± 8 years, 7 ± 6 years post-stroke), left MCA infarct (n = 20, age = 65 ± 8 years, 7 ± 6 years post-stroke), and controls (n = 55, age = 65 ± 8 years) were compared. The authors found that patients with chronic MCA infarctions within the right hemisphere, as opposed to the left hemisphere, exhibited increased dependence on vision and noninfarcted brain regions for postural control. See p. 458; and Editorial, p. 448

How preserved is episodic memory in behavioral variant frontotemporal dementia? The authors analyzed neuropsychological memory performance in patients with a clinical diagnosis of behavioral variant frontotemporal dementia (bvFTD) divided into those who progressed and those who remained stable, compared to patients with Alzheimer disease (AD) and healthy controls. Their results provide evidence for an underlying memory deficit in “real” or progressive bvFTD similar to AD.See p. 472

11C-PIB binding is increased in patients with cerebral amyloid angiopathy–related hemorrhage podcast icon
Twelve patients with cerebral amyloid angiopathy–related hemorrhage (CAAH) (mean age 73.9 years) were compared to 22 normal controls and 13 patients with AD (mean age 71.8 years and 73.8 years). The authors found that 11C-PIB binding is moderately increased in most patients with probable CAAH and differs from that seen in AD. See p. 487

Intracerebral and subarachnoid hemorrhage in patients with cancer cme icon The authors analyzed retrospectively 208 patients with the diagnosis of intracranial hemorrhage from the Memorial Sloan-Kettering neurology database registered from January 2000 through December 2007. They found that the majority of intracranial hemorrhages in patients with cancer were due to intratumoral hemorrhage or coagulopathy. Aggressive care is warranted despite high mortality because functional outcome can be good.See p. 494

Severe epilepsy as the major symptom of new mutations in the mitochondrial tRNAPhe gene Histologic stainings were performed on skeletal muscle slices along with complete mitochondrial DNA (mtDNA) and the relevant mtDNA from 2 patients. The authors found that deleterious mutations in the mitochondrial tRNAPhe may solely manifest with epilepsy when segregating to homoplasmy and may be overlooked in the absence of lactate accumulation and typical mosaic mitochondrial defects in muscle.See p. 507

Availability of brain serotonin transporters in patients with restless legs syndrome The authors compared the availability of serotonin transporters (SERT) between 16 drug-naive patients with restless legs syndrome (RLS) and 16 healthy controls. SERT was measured in the pons and medulla via [123I]-2β- carbomethoxy-3β-(4-iodophenyl) tropane (β-CIT) SPECT. These data partially support the hypothesis that an increase of serotonergic neurotransmission in the brainstem may exacerbate RLS. See p. 513

Neurology Podcasts™

Neurology& Podcast Cover
This Week's Podcast

This Podcast begins and closes with Dr. Robert Gross, Editor-in-Chief, briefly discussing highlighted articles from the February 2 print issue of Neurology. In the second segment, Dr. Mark Quigg interviews Dr. Rainer Surges and Prof. Matthew Walker about their paper on generalized seizures. In the next segment, Dr. Ryan Overman reads the e-Pearl of the week about HSV-1 encephalitis and falsely negative PCR. Finally, Dr. Alberto Espay interviews Dr. Curt LaFrance for our Lesson of the week toolbox about psychogenic non-epileptic seizures.

Disclosures: The participants had nothing to disclosure except for Prof. Walker, Drs. Surges and Espay. Prof. Walker serves on scientific advisory boards for GlaxoSmithKline, Eisai Inc., UCB, and Sierra Neuro; has received travel expenses and honoraria for lectures or educational activities not funded by industry; serves as an Associate Editor of Epilepsia and Therapeutic Advances in Neurological Disorders and on the editorial boards of The Open Neurology Journal, Expert Opinion on Emerging Drugs, and Metabolic Brain Disease; receives royalties from publishing Understanding Epilepsy (BMA Family Doctor books, 1995); has received speaker honoraria from Eisai Inc. and UCB; serves as a consultant to Sierra Neuro; estimates that 20% of his clinical effort is on Video-EEG telemetry; and has received/receives research support from the Medical Research Council [G0400136 (PI), G0802158 (Co-I), G0701050 (Co-I), and G069336 (Co-I)], the European Community, Wellcome Trust, and Epilepsy Research UK. Dr. Surges received research support from Deutsche Forschungsgemeinschaft. Dr. Espay has received personal compensation as a consultant for Boehringer Ingelheim; grant support from Codman; Medtronic, Inc; Allergan, Inc.; and CleveMed, and honoraria from UCB-SCHWARZ PHARMA AG; Medtronic, Inc. and Novartis.

NEW CME Opportunity: Listen to this week's Neurology Podcast and earn 0.5 AMA PRA Category 1 CME Credits by answering the multiple-choice questions in the online Podcast Quiz

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