News Roundup: New and Noteworthy Information
A high level of physical activity is associated with less severe first stroke and improved long-term outcome, according to a report in the October 21 Neurology. Researchers compiled data on 265 subjects (mean age, 68) who represented a subset of patients with first-ever stroke enrolled in the ExStroke Pilot Trial. Prestroke level of physical activity was measured retrospectively using the Physical Activity Scale for the Elderly questionnaire. Stroke severity was measured with the Scandinavian Stroke Scale, and long-term outcome was assessed after two years with the modified Rankin Scale. Patients in the lowest quartile of physical activity had the poorest outcome, as well as a more severe stroke. Higher physical activity was associated with a less severe stroke (odds ratio [OR], 2.54) and a decreased likelihood of poor long-term outcome (OR, 0.46).
Multiplex ligation-dependent probe amplification (MLPA) is an efficient and inexpensive tool for screening chromosomal abnormalities present in autism spectrum disorders, researchers reported in the October BMC Medical Genomics. A screening of 279 unrelated subjects showed duplications of the 15q11-q13 region in two subjects, as well as duplications of the 22q11 region in two subjects. In an additional two patients, smaller de novo duplications were identified. Genes in these novel duplications included GABRB3 and ATP10A in one case and MKRN3, MAGEL2, and NDN in the other. These duplications likely exacerbate symptoms and/or increase liability for autism spectrum disorders. The researchers also found a partial duplication of the ASMT gene in 6% to 7% of cases, compared with 2% of controls, indicating that further study is needed to determine its potential impact on autism spectrum disorders. “MLPA proves to be an efficient method to screen for chromosomal abnormalities,” they stated.
Brain microbleeds are more prevalent in black patients than in white patients, according to a report in the October 7 Neurology. A total of 87 subjects (42 black, 45 white) with intracerebral hemorrhage (ICH) were analyzed. Black subjects were younger and had a greater rate of hypertension but did not have other vascular risk factors. Seventy-four percent of black patients had one or more microbleeds, compared with 42% of white patients. “The black population also tended to have a greater frequency of microbleeds in multiple territories than the white population (38% vs 22%),” the researchers observed. Race remained an independent predictor of microbleeds (odds ratio, 3.3), after adjusting for age, hypertension, and alcohol use. “Microbleeds may be an important emerging imaging biomarker with the potential to provide insights into ICH pathophysiology, prognosis, and disease progression,” the investigators concluded.
Patients with acute ischemic stroke who require aggressive measures to lower blood pressure should not be excluded from receiving intravenous t-PA therapy, according to a study in the September Archives of Neurology. Medical records of 178 patients with acute ischemic stroke who were treated with t-PA therapy were reviewed. Fifty patients required blood pressure–lowering treatment before receiving t-PA therapy; of these, 24 patients received nicardipine as first-line therapy or after receiving labetalol. There were no significant differences in adverse events between those treated with nicardipine or labetalol and those who did not receive blood pressure–lowering treatment. “Data suggest that patients with acute ischemic stroke requiring aggressive treatment to lower blood pressure should not be excluded from receiving t-PA therapy,” the authors concluded, noting that a prospective study is needed.
