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This week in Neurology®
Risk of premature stroke in recent immigrants (PRESARIO):
Population-based matched cohort study 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 
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 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
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Neurology Podcasts™
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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