Neurology.org

In Focus
Neurology.org
Spotlight on the Current Issue

Robert A. Gross, MD, PhD
Editor-in-Chief

► Cognitive and psychosocial features in childhood and juvenile MS: Two-year follow-up cme icon This study addresses neuropsychological issues in a cohort of 56 patients compared with 50 healthy controls. The findings confirm that neuropsychological assessment should be included in the routine clinical evaluation of children and adolescents with MSto monitor symptoms and assist with educational planning and informed decisions regarding MS therapy. See p. 1134; and Editorial, p. 1128

► MS quality of life, depression, and fatigue improve after mindfulness training: A randomized trial podcast icon triangle icon This randomized controlled trial provides evidence that mindfulness-based intervention, compared to usual care, was associated with benefits in health-related quality of life, depression, and fatigue up to at least 6 months after treatment among 150 patients with relapsing-remitting or secondary progressive multiple sclerosis. See p. 1141 From editorialists Jinny Tavee and Lael Stone: "The results of this solidly designed study underscore the importance of treatment directed at quality of life issues in patients with MS, and provide level III evidence that mindfulness-based meditation is a helpful therapeutic option." Editorial, p. 1130

► Clinical spectrum of early-onset epileptic encephalopathies associated with STXBP1 mutations The authors collected and clinically characterized 106 patients with early-onset epileptic encephalopathies. The findings showed that mutations in STXBP1 were not limited to patients with Ohtahara syndrome, but were also present in 10% of patients with early-onset epileptic encephalopathy. See p. 1159; and editorial p. 1132

► Pilot pharmacologic randomized controlled trial for psychogenic nonepileptic seizures triangle icon Treatment options for psychogenic nonepileptic seizures (PNES) are limited. The authors piloted a pharmacologic intervention for PNES and found that patients treated with flexible-dose sertraline had a 45% reduction in PNES, whereas patients treated with placebo experienced an 8% increase. Serotonergic medications may be an adjunctive treatment to psychotherapy for PNES. See p. 1166

► Motor activation in multiple system atrophy and Parkinson disease: A PET study The authors assessed 18 patients with multiple system atrophy, 8 patients with Parkinson disease, and 10 age-matched healthy volunteers by performing rCBF measurements with H2 15O PET at rest and during a right hand movement. Different metabolic patterns resulting from hand movement in these 2 conditions, compared to healthy subjects, emphasizes the divergent recruitment of the cerebellum and frontoparietal cortices. See p. 1174

► Nonsteroidal anti-inflammatory drugs are associated with increased neuritic plaques The authors investigated the association between nonselective nonsteroidal anti-inflammatory drugs and dementia. Mid- to latelife drug exposure from pharmacy records was compared to neuropathologic features of Alzheimer disease, vascular brain injury, and Lewy body disease. Higher exposure to these drugswas associated with increased burden of Alzheimer disease. See p. 1203

NB: Pearls & Oy-sters: Spontaneous venous pulsation. . . . See p. e-53. For more clinical pearls, go to e-Pearl Archive.


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