A history of stroke is related to a progressive decline in memory and abstract/visuospatial performance, as reported in the April Archives of Neurology. Researchers conducted a five-year study of 1,271 elderly persons who were nondemented at baseline. In the generalized estimating equation analysis, memory declined significantly over time, while abstract/visuospatial and language performance remained stable. However, after stratification for gender and apolipoprotein E e4 (APOE e4) genotype, the association between stroke and decline in memory and abstract/visuospatial performance was strongest for men and for persons without an APOE e4 allele.

Ovariectomy raises the risk of dementia or cognitive impairment, according to findings presented at the 58th Annual Meeting of the American Academy of Neurology. Researchers studied 1,209 women who had had both ovaries removed and 1,302 women with only one ovary removed and found that the risk is especially increased if a woman has her ovaries removed at a young age. Low estrogen levels due to the ovariectomy or gene variations that necessitate the ovary removal were two theories suggested to explain the increased risk.

Early intervention and long-term treatment with electrical stimulation can significantly reduce the loss of bone mineral density in patients with spinal cord injury, according to a study in the April Journal of Neurophysiology. Patients began unilateral plantar flexion electrical stimulation training within six weeks after spinal cord injury; the untrained leg served as the control. Results showed that the intervention was sufficient to limit many of the deleterious musculoskeletal adaptations that normally occur after spinal cord injury.

Moderate alcohol consumption may be associated with better cognitive performance in women, as reported April 6 in the online Stroke. Researchers found that for women—but not for men—having from one drink weekly to two drinks daily was associated with better performance on the Mini-Mental State Examination than was abstinence from alcohol. Carotid plaque was not found to be a mediator of this association, suggesting that alcohol may impact cognition through a separate vascular or degenerative pathway.

In persons with migraine and without clear interictal signs of autonomic nervous system dysfunction, there may be an elevated prevalence of syncope and orthostatic intolerance, as reported in the April 11 Neurology. Researchers examined 323 migraineurs with and without aura and 153 controls. Results showed that the lifetime prevalence of syncope in all participants was 41%. In addition, participants with migraine had a higher lifetime prevalence of syncope, frequent syncope, and orthostatic intolerance than did controls.

Neurologic signs are increased in adults who were born very prematurely compared to term-born controls and are strongly associated with reduced neuropsychological function, as reported in the April Journal of Neurology, Neurosurgery, and Psychiatry. A total of 153 very preterm participants and 71 term-born controls were assessed at ages 17 to 18 using a comprehensive neurologic examination. Sensory integration and motor confusion scores were significantly increased in the very preterm group within the integrative domain, and integrative neurologic abnormalities at age 18 were strongly associated with a lower IQ.

Subthalamic nucleus stimulation has good outcomes with relatively low risk and little cost burden in Parkinson’s disease patients with levodopa-induced motor complications, according to a study published in the April Journal of Neurology, Neurosurgery, and Psychiatry. In 95 consecutive Parkinson’s disease patients receiving bilateral subthalamic nucleus stimulation, the Unified Parkinson’s Disease Rating Scale motor score had improved by 57% and ability to perform activities of daily living had improved by 48% at 12-month follow-up. Additionally, double-blind motor scoring improved by 51% at three-month follow-up.

Acute postoperative seizures predict poor postoperative seizure outcomes at six, 12, and 24 months, according to findings published in the April 11 Neurology. Researchers conducted a retrospective analysis of children younger than 18 who underwent extratemporal cortical resection or hemispherectomy for intractable epilepsy. Results showed that 34 of the 132 participants (26%) had acute postoperative seizures; these occurred in 26 of 71 patients (37%) who underwent extratemporal cortical resection and in eight of 61 patients (13%) who underwent hemispherectomy.

Surgery is worth pursuing in epilepsy patients with normal neuroimaging results, researchers reported in the April Journal of Neurology, Neurosurgery, and Psychiatry. The investigators found that among 19 epilepsy patients who were surgically treated and had normal neuroimaging, 74% had a favorable outcome, and among 93 operated patients who had abnormal neuroimaging, 73% had a favorable outcome. In patients with temporal resections, 92% of the 13 operated patients with normal neuroimaging had a favorable outcome, whereas among the 70 operated patients with abnormal neuroimaging, 80% had a favorable outcome. The investigators concluded that surgery in patients with normal neuroimaging "results in good seizure control" and that "the incidence of permanent deficits associated with intracranial studies is low."

A postural instability gait difficulty motor subtype is associated with a faster rate of cognitive decline in Parkinson’s disease and may be considered a risk factor for incident dementia in Parkinson’s disease, according to a report in the May Journal of Neurology, Neurosurgery, and Psychiatry. Investigators examined rates of cognitive and motor decline over two years in 40 patients with Parkinson’s disease, 42 patients who had Parkinson’s disease with dementia, 41 patients who had dementia with Lewy bodies, and 41 controls. Cognitive decline was greater in patients who had Parkinson’s disease with dementia and in those who had dementia with Lewy bodies, compared with controls and Parkinson’s disease patients. A total of 25% of 16 Parkinson’s disease patients with a postural instability gait difficulty subtype developed dementia over two years.

A ketogenic diet may prevent the progression of amyotrophic lateral sclerosis, as reported in the April 3 BMC Neuroscience. Investigators administered a ketogenic diet to superoxide dismutase 1-G93A transgenic amyotrophic lateral sclerosis mice. Results showed that blood ketone levels were more than 3.5 times higher in mice that were fed a ketogenic diet compared to controls. Ketogenic diet mice also lost 50% of baseline motor performance 25 days later than disease controls did, and they weighed 4.6 g more than disease controls at the end of the study. In addition, more motor neurons were observed in mice fed a ketogenic diet. "These effects may be due to the ability of ketone bodies to promote adenosine triphosphate synthesis and bypass inhibition of complex I in the mitochondrial respiratory chain," concluded the researchers.

No statistically significant differences in health effects were observed among children who received dental restoration using either amalgam or mercury-free materials, according to two studies in the April 19 JAMA. Both studies, including a combined total of 1,041 children, did not find any differences in neuropsychological and renal function, memory, attention/concentration, motor/visuomotor functions, and nerve conduction velocities by type of dental restoration received. The researchers concluded that "the health effects of amalgam restorations in children need not be the basis of treatment decisions when choosing restorative dental materials."

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