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American Academy of Neurology, April 17-22

Patient with backache being examined

The annual meeting of the American Academy of Neurology was held virtually this year from April 17 to 22 and attracted participants from around the world, including clinicians, academicians, allied health professionals, and others interested in neurology. The conference highlighted recent advances in neurological disorders, with presentations focusing on the diagnosis, management, and treatment of disorders impacting the brain and nervous system.

In one study, Zachary A. Miller, M.D., of the University of California at San Francisco (UCSF), and colleagues found that early forms of Alzheimer disease have a greater degree of psychiatric symptomatology.

The authors performed a retrospective chart review of 1,500 individuals who received Alzheimer disease diagnoses at the UCSF Memory and Aging Center. The researchers found that in addition to depression, anxiety and posttraumatic stress disorder were associated with younger age of onset in Alzheimer disease. The investigators also found that the combination, or burden, of these conditions led to even further reductions in age at onset of Alzheimer disease.

"Lastly, we also found that increased symptom severity of depression and/or anxiety was associated with decreasing Alzheimer disease age at onset," Miller said. "It remains unclear the direction of this association but raises exciting future possibilities regarding dementia disease monitoring and therapeutic intervention."

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In another study, Anne-Marie A. Wills, M.D., of Harvard Medical School and Massachusetts General Hospital in Boston, and colleagues found that golf was as safe as tai chi -- and appeared to be more enjoyable -- for patients with Parkinson disease.

The authors evaluated two common forms of exercise: golf, which is a popular sport, but which has very little academic research, and tai chi, which is well established as a therapy for Parkinson disease. The researchers randomly assigned patients who were not active in either sport to free tai chi or golf lessons for 10 weeks. A blinded rater measured their gait and balance before and after the interventions. The researchers found that more patients in the golf arm said they would continue with the sport than patients in the tai chi arm. The golf arm also saw a significant improvement in the Timed Up and Go test: Golf participants were 0.96 seconds faster on the test at the end of the study, while those who did tai chi were 0.33 seconds slower.

"I personally have started to recommend golf to my patients based on the results of the study," Wills said. "We are hoping to repeat the study with a larger multicenter cohort to confirm our results."

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llya Kister, M.D., of the New York University Grossman School of Medicine in New York City, and colleagues found that Black patients with multiple sclerosis (MS) or neuromyelitis optica spectrum disorder (NMOSD) respond differently to immune-modulating therapy than White patients.

The authors performed a retrospective chart review of MS and NMOSD patients on anti-CD20 infusion therapies. These therapies suppress B cell counts in blood down to 0, but eventually the B cells start coming back into blood circulation. The researchers showed that this process of coming back is faster in Black patients compared with White patients. This was the case even after adjusting for time to last infusion and body mass index.

"It is not clear whether our results have implications for clinical practice, since the drugs are given on an every-six-months basis, and almost no patient has repopulation before six months, whether they are Black or White," Kister said. "It is also not clear whether B cells coming back into circulation has clinical significance in MS (though it does seem to have significance in NMOSD). Our study points to different immune responses by race/ethnicity, and it will require future studies to figure out whether these differences are clinically relevant or not."

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AAN: Stroke Occurs in 2.2 Percent of Patients Admitted to ICU With COVID-19

MONDAY, April 19, 2021 (HealthDay News) -- For patients with COVID-19 admitted to the intensive care unit, stroke is not a common complication, according to a study presented at the annual meeting of the American Academy of Neurology, held virtually from April 17 to 22.

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AAN: Neurological Manifestations Common in Children With PIMS-TS

THURSDAY, April 15, 2021 (HealthDay News) -- About half of children with pediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 have new-onset neurological symptoms, according to a study presented at the annual meeting of the American Academy of Neurology, held virtually from April 17 to 22.

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AAN: Race May Affect Response to Anti-CD20 Therapy for MS, NMOSD

THURSDAY, April 15, 2021 (HealthDay News) -- For patients with multiple sclerosis and neuromyelitis optica spectrum disorder receiving anti-CD20 treatment, B-cell repopulation occurs in more African American than White patients between six and 12 months after infusion, according to a study presented at the annual meeting of the American Academy of Neurology, held virtually from April 17 to 22.

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AAN: Fetal Exposure to Antiseizure Meds Has No Neuropsychological Impact

WEDNESDAY, March 10, 2021 (HealthDay News) -- Children with fetal antiseizure medication (ASM) exposure do not have neurodevelopmental delays to age 3 years, according to a study scheduled for presentation at the upcoming annual meeting of the American Academy of Neurology, to be held virtually from April 17 to 22.

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AAN: Prior Psych Diagnosis Tied to Younger Age of Alzheimer Onset

TUESDAY, March 9, 2021 (HealthDay News) -- Previous diagnoses of depression and anxiety are inversely associated with age of onset of Alzheimer disease, according to a study scheduled for presentation at the upcoming annual meeting of the American Academy of Neurology, to be held virtually from April 17 to 22.

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AAN: Anomalously Warm Weather Tied to More MS Hospital Visits

WEDNESDAY, March 3, 2021 (HealthDay News) -- People with multiple sclerosis may expect worsening symptoms with rising average temperatures, according to a study scheduled for presentation at the upcoming annual meeting of the American Academy of Neurology, to be held virtually from April 17 to 22.

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AAN: Antidepressants Not Tied to Increased Intracerebral Hemorrhage Risk

WEDNESDAY, March 3, 2021 (HealthDay News) -- Antidepressant use is not associated with an increased rate of intracerebral hemorrhage, according to a study scheduled for presentation at the upcoming annual meeting of the American Academy of Neurology, to be held virtually from April 17 to 22.

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AAN: Smell Loss Can Persist for Five Months After COVID-19

WEDNESDAY, Feb. 24, 2021 (HealthDay News) -- Chemosensory dysfunction persists in a considerable proportion of patients up to five months after COVID-19, according to a study scheduled for presentation at the upcoming annual meeting of the American Academy of Neurology, to be held virtually from April 17 to 22.

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AAN: Many Patients With Migraine Do Not Get Enough Exercise

WEDNESDAY, Feb. 24, 2021 (HealthDay News) -- Many patients with migraine do not get enough exercise, and insufficient exercise is associated with migraine triggers, including depression, anxiety, and sleep problems, according to a study scheduled for presentation at the upcoming annual meeting of the American Academy of Neurology, to be held virtually from April 17 to 22.

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