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This Month in Archives of Neurology |

This Month in Archives of Neurology FREE

Arch Neurol. 2010;67(9):1051-1052. doi:10.1001/archneurol.2010.213.
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ALBUTEROL ADD-ON THERAPY IN MULTIPLE SCLEROSIS

Khoury and colleagues Article tested the effect of albuterol, a β-2 adrenergic agonist that reduces interleukin (IL)–12 expression, as an add-on treatment to glatiramer acetate. The primary clinical efficacy measurement was the change in Multiple Sclerosis Functional Composite at 2 years, and the primary immunologic end point was the change in expression of IL-13 and interferon γ at each study time point. Treatment with glatiramer acetate plus albuterol was well tolerated and improved clinical outcome in MS.

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The x-axis represents the estimated mean Multiple Sclerosis Functional Composite (MSFC), adjusted for baseline values. The error bars represent ±1 SE for the model.

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STATINS IN THE TREATMENT OF DISEASES OF THE CENTRAL NERVOUS SYSTEM

Statins may have an effect on neurological diseases including ischemic and hemorrhagic stroke, Alzheimer disease, Parkinson disease, and multiple sclerosis. Willey and Elkind Article review the basic biochemistry of statins as it relates to these pleiotropic effects, the potential role of statins in several neurological disorders, and the results of clinical trials performed for several of these conditions.

NEW PERSPECTIVES ON AMYLOID-Β DYNAMICS FOLLOWING ACUTE BRAIN INJURY

The links between traumatic brain injury (TBI) and Alzheimer disease have been of great interest for many years. However, the importance of amyloid-β–related neurodegenerative pathophysiological processes following TBI is still unknown. In their review, Magnoni and Brody Article present an overview of the scientific evidence regarding TBI as a contributor to Alzheimer disease and describe recent results showing significant changes in brain extracellular amyloid-β dynamics in patients with severe brain injury.

UNMET NEEDS OF HOSPITALIZED PATIENTS WITH SPINAL CORD INJURY

New Article proposes that a specialized multidisciplinary consultation team be established for all hospitalized patients with spinal cord injury (SCI). The team would function as a mobile unit, available to access and evaluate all patients with SCI without a specialist SCI service. The team's principal aim would be to assist in the prevention and management of SCI-related complications. This applies especially to patients with a recent-onset SCI but also to those with a preexisting SCI. (page 1074)

A SERUM PROTEIN–BASED ALGORITHM FOR THE DETECTION OF ALZHEIMER DISEASE

O’Bryant and colleagues Article analyzed serum protein–based multiplex biomarker data from 197 patients diagnosed with Alzheimer disease (AD) and 203 controls from a longitudinal study of AD being conducted by the Texas Alzheimer Research Consortium to develop an algorithm that separates AD from controls. Their initial data suggest that serum protein–based biomarkers can be combined with clinical information to accurately classify AD. Of note, a disproportionate number of inflammatory and vascular markers were weighted most heavily in analyses.

IMMUNE GLOBULIN IN CHRONIC INFLAMMATORY DEMYELINATING POLYRADICULONEUROPATHY

Donofrio et al Article have evaluated the long-term safety of intravenous immune globulin for chronic inflammatory demyelinating polyradiculoneuropathy. They provide data supporting the safety and tolerability of intravenous immune globulin as chronic inflammatory demyelinating polyradiculoneuropathy maintenance therapy.

CAUSES AND OUTCOMES OF ACUTE NEUROMUSCULAR RESPIRATORY FAILURE

Cabrera Serrano and colleagues Article point out that neuromuscular diseases often show respiratory muscle involvement. Respiratory failure can occur acutely, even being the presenting manifestation. The factors that affect the prognosis of these patients are not well known. They report that those without known diagnoses before admission have poorer outcomes. Patients whose diagnoses remain unclear at discharge have the highest rate of disability.

NEUTRALIZING ANTIBODIES AGAINST RECOMBINANT INTERFERON BETA INHIBIT ENDOGENOUS INTERFERON BETA

Sominanda et al Article have determined whether neutralizing antibodies (NAbs) against interferon beta from patients with multiple sclerosis (MS) cross-react with other type 1 interferons, especially endogenous interferon beta, and thus might impede the immune systems of affected patients. They find that a proportion of patients with MS treated with recombinant interferon beta develop NAbs that also neutralize endogenous interferon. Because NAbs at high titers can persist for years, these antibodies may impede the immune system in affected patients with MS regardless of their current treatment regimen.

ELEVATED INTRATHECAL MYELIN OLIGODENDROCYTE GLYCOPROTEIN ANTIBODY PRODUCTION IN MULTIPLE SCLEROSIS

Klawiter Article calculated serum and cerebrospinal fluid recombinant myelin oligodendrocyte glycoprotein (rMOG) antibody and albumin levels to determine an “rMOG index.” They noted that the rMOG index was elevated in subjects with multiple sclerosis compared with controls (P = .01) and that intrathecal anti-MOG antibody production is more pronounced in progressive than relapsing forms of multiple sclerosis.

PARANEOPLASTIC JAW DYSTONIA AND LARYNGOSPASM

Pittock and colleagues Article report that the neurological spectrum of the antineuronal nuclear autoantibody type 2 is broader, includes a syndrome of jaw dystonia and laryngospasm, and can be accompanied by lung carcinoma.

FREQUENCY OF KNOWN MUTATIONS IN EARLY-ONSET PARKINSON DISEASE

Alcalay et al Article have assessed the frequency and clinical characteristics of carriers of previously identified mutations in 6 genes (SNCA, PRKN, PINK1, DJ1, LRRK2, and GBA) associated with early-onset Parkinson disease and provide empirical data that can be used to inform genetic counseling.

ADMISSION BLOOD GLUCOSE AND OUTCOME IN PATIENTS TREATED WITH INTRAVENOUS THROMBOLYSIS

Ahmed and colleagues Article report that admission hyperglycemia was an independent predictor of poor outcome after stroke thrombolysis although symptomatic intracerebral hemorrhage rates did not increase significantly up to 180 mg/dL. These results suggest that tight control of blood glucose may be indicated in the hyperacute phase following thrombolysis.

NEUROMYELITIS OPTICA TREATMENT

Bichuetti et al Article indicate that azathioprine as monotherapy or in association with prednisone reduced the relapse frequency and halted disability progression in most patients.

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The x-axis represents the estimated mean Multiple Sclerosis Functional Composite (MSFC), adjusted for baseline values. The error bars represent ±1 SE for the model.

Graphic Jump Location

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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