New and Noteworthy Information—December 2016

Economic background does not affect the clinical course or long-term seizure outcome of childhood epilepsy, according to a study in Nova Scotia, Canada, published online ahead of print November 4 in Epilepsia. Researchers examined data for 421 patients with childhood epilepsy and 10 or more years of follow-up. Overall, 33% of families had poor income, 38% had adequate income, and 30% were well-off. Terminal remission occurred in 65% of the poor, 61% of the adequate, and 61% of the well-off populations. Intractable epilepsy, status epilepticus, number of antiepileptic drugs used, and the number of generalized tonic-clonic or focal with secondary generalization seizures through the clinical course was the same in all groups. Neither paternal nor maternal education was associated with remission. Poor children had significantly more adverse social outcomes, however.

A genetic variant near melatonin receptor 1A (MTNR1A) may be associated with job-related exhaustion in shift workers, according to a study published online ahead of print October 10 in Sleep. Researchers assessed intolerance to shift work with job-related exhaustion symptoms in shift workers using the emotional exhaustion subscale of the Maslach Burnout Inventory-General Survey and performed a genome-wide association study. Job-related exhaustion was associated with the rs12506228 variation, located downstream of MTNR1A, in shift workers included in the Finnish national Health 2000 survey. The risk allele was also associated with reduced in silico gene expression levels of MTNR1A in brain tissue and with changes in DNA methylation in the 5' regulatory region of MTNR1A. The risk variant may lead to reduced melatonin signaling in the brain. 

In healthy postmenopausal women, reproductive life events related to sex hormones are positively related to aspects of cognition in later life, according to a study published November 7 in the Journal of the American Geriatrics Society. Researchers evaluated 830 menopausal women using a cognitive battery and a structured reproductive history questionnaire. On multivariable modeling, age at menarche of 13 or older was inversely associated with global cognition. Having a last pregnancy after age 35 was positively associated with verbal memory. Use of hormonal contraceptives was positively associated with global cognition and verbal memory. The association between hormonal contraceptive use and verbal memory and executive function was strongest for more than 10 years of use. Reproductive period was positively associated with global cognition and executive function. 

Physical fitness, BMI, IQ, and stress resilience in young adulthood may be associated with the development of amyotrophic lateral sclerosis (ALS) at an early age, according to a study published in the October issue of the European Journal of Neurology. Data on physical fitness, BMI, IQ, and stress resilience were collected from 1,838,376 Swedish men ages 17 to 20 at conscription from 1968 to 2010. During follow-up, 439 participants developed ALS. People with physical fitness above the highest tertile had a higher risk of ALS before age 45. People with BMI greater than or equal to 25 had a lower risk of ALS at all ages. Individuals with IQ above the highest tertile had a significantly increased risk of ALS at an age of 56 and older. 

Short sleep is associated with greater intake of sugared caffeinated sodas, according to a study published online ahead of print November 9 in Sleep Health. Using data from the 2005 to 2012 National Health and Nutrition Examination Survey, researchers examined self-reported sleep duration and beverage intake from two 24-hour dietary recalls among 18,779 adults. Adults who slept for seven to eight hours each night were considered the reference group. In fully adjusted models, people who slept for five hours or less had 21% higher sugar-sweetened beverage consumption. When analyzed by beverage type, this difference was attributed to caffeinated sugary beverages. Longer sleepers consumed fewer servings of coffee and water. There were no associations between self-reported sleep duration and consumption of 100% juice, tea, or diet drinks.

Treadmill training plus virtual reality reduces fall rates, compared with treadmill training alone, according to a study published September 17 in the Lancet. Adults ages 60 to 90 with motor and cognitive deficits and a high risk of falls were randomly assigned to receive six weeks of treadmill training plus virtual reality or treadmill training alone. Data from 282 participants were included in the prespecified, modified intention-to-treat analysis. In the six months after training, the incident rate of falls was significantly lower in the treadmill-training-plus-virtual-reality group than it had been before training. The incident rate did not decrease significantly in the treadmill-training-alone group. Six months after training, the incident rate of falls was also significantly lower in the treadmill-training-plus-virtual-reality group than in the treadmill-training group. 

Current research does not support specific recommendations for treating hypertension to preserve cognition, according to a scientific statement by the American Heart Association published online ahead of print October 10 in Hypertension. A panel of experts reviewed the literature on hypertension, the treatment of hypertension, and the relationship between hypertension and cognition, and summarized the available data. They found that hypertension disrupts the structure and function of cerebral blood vessels, leads to ischemic damage of white matter regions critical for cognitive function, and may promote Alzheimer pathology. They found strong evidence of a negative influence of mid-life hypertension on late-life cognitive function, but the cognitive effect of late-life hypertension is unclear. Observational studies indicate that high blood pressure damages the brain's blood vessels, leading to reduced blood flow to brain cells. 

Manual-based cognitive behavioral therapy for insomnia delivered by nonclinician sleep coaches improves sleep in older adults with chronic insomnia, according to a study published in the September issue of the Journal of the American Geriatrics Society. Researchers studied veterans age 60 or older who met diagnostic criteria for insomnia of three months' duration or longer. Nonclinician sleep coaches delivered five sessions of manual-based cognitive behavioral therapy for insomnia, including stimulus control, sleep restriction, sleep hygiene, and cognitive therapy, with weekly telephone behavioral sleep medicine supervision. Controls received sleep education. Intervention subjects had greater improvement than controls between baseline and post-treatment, baseline and six months, and baseline and 12 months in sleep onset latency, total wake time, sleep efficiency, Pittsburgh Sleep Quality Index, and Insomnia Severity Index. 

Antioxidants, carotenes, fruits, and vegetables are associated with higher amyotrophic lateral sclerosis (ALS) function at baseline, according to a study published online ahead of print October 24 in JAMA Neurology. A cross-sectional baseline analysis of the ALS Multicenter Cohort Study of Oxidative Stress was conducted at 16 ALS clinics throughout the United States. Baseline data were available on 302 patients (124 women) with ALS (median age, 63.2). Regression analysis of nutrients found that higher intakes of antioxidants and carotenes from vegetables were associated with higher ALS Functional Rating Scale-Revised (ALSFRS-R) scores or percentage forced vital capacity. Empirically weighted indices using the weighted quantile sum regression method of "good" micronutrients and "good" food groups were positively associated with ALSFRS-R scores and percentage forced vital capacity. 

Fluselenamyl detects amyloid clumps better than current FDA-approved compounds, according to a study published online ahead of print November 2 in Scientific Reports. To determine whether fluselenamyl can detect amyloid beta plaques in the brain, researchers used the compound to stain brain slices from people who had died of Alzheimer's disease and from people of similar ages who had died of other causes (ie, controls). Fluselenamyl labeled diffuse and fibrillar plaques in brain sections of patients with Alzheimer's disease, but did not interact with biomarker proteins of other neurodegenerative diseases, thereby indicating specificity for detecting amyloid beta in Alzheimer's disease. Overall, fluselenamyl demonstrated potent binding affinity to autopsy-confirmed Alzheimer's disease homogenates. The binding affinity was superior to that of [¹⁸F]-AV-45, [¹⁸F]-florbetaben, and [¹⁸F]-flutemetamol. 

Preserved hippocampal volumes are associated with increased risk of probable dementia with Lewy bodies, rather than Alzheimer's disease, in patients with mild cognitive impairment (MCI), according to a study published online ahead of print November 2 in Neurology. In the study, 160 people with MCI underwent MRI to measure hippocampal size. During a median follow-up of two years, 38% of people developed Alzheimer's disease, and 13% of people developed probable dementia with Lewy bodies. The people who had no hippocampal shrinkage were 5.8 times more likely to develop probable dementia with Lewy bodies than people who had hippocampal atrophy. Approximately 85% of people who developed dementia with Lewy bodies had a normal hippocampal volume. Furthermore, 61% of people who developed Alzheimer's disease had hippocampal atrophy.

Use of a media device at bedtime is significantly associated with inadequate sleep quantity, poor sleep quality, and excessive daytime sleepiness, according to a systematic review published online ahead of print October 31 in JAMA Pediatrics. Researchers examined published studies of school-age children between ages six and 19 with information about portable screen-based media devices and sleep outcomes. The final analysis included 125,198 children with an average age of 14.5. Children who had access to, but did not use, media devices at night were more likely to have inadequate sleep quantity, poor sleep quality, and excessive daytime sleepiness. Teachers, health care professionals, and parents should cooperate to minimize device access at bedtime, according to the researchers. Future studies should evaluate devices' influence on sleep hygiene, they added. 

The FDA has approved the Amplatzer Patent Foramen Ovale (PFO) Occluder device, which reduces the risk of stroke in patients who previously had a stroke believed to be caused by a blood clot that passed through a PFO. The Amplatzer PFO Occluder is inserted through a catheter that is placed in a leg vein and advanced to the heart. In a randomized study, 499 participants ages 18 to 60 were treated with the Amplatzer PFO Occluder and blood-thinning medications and compared with 481 participants treated with blood-thinning medications alone. There was a 50% reduction in the rate of new strokes in participants using the Amplatzer PFO Occluder and blood-thinning medications, compared with participants taking medications alone. St. Jude Medical, headquartered in Plymouth, Minnesota, markets the Amplatzer PFO Occluder.     

—Kimberly Williams

Economic background does not affect the clinical course or long-term seizure outcome of childhood epilepsy, according to a study in Nova Scotia, Canada, published online ahead of print November 4 in Epilepsia. Researchers examined data for 421 patients with childhood epilepsy and 10 or more years of follow-up. Overall, 33% of families had poor income, 38% had adequate income, and 30% were well-off. Terminal remission occurred in 65% of the poor, 61% of the adequate, and 61% of the well-off populations. Intractable epilepsy, status epilepticus, number of antiepileptic drugs used, and the number of generalized tonic-clonic or focal with secondary generalization seizures through the clinical course was the same in all groups. Neither paternal nor maternal education was associated with remission. Poor children had significantly more adverse social outcomes, however.

A genetic variant near melatonin receptor 1A (MTNR1A) may be associated with job-related exhaustion in shift workers, according to a study published online ahead of print October 10 in Sleep. Researchers assessed intolerance to shift work with job-related exhaustion symptoms in shift workers using the emotional exhaustion subscale of the Maslach Burnout Inventory-General Survey and performed a genome-wide association study. Job-related exhaustion was associated with the rs12506228 variation, located downstream of MTNR1A, in shift workers included in the Finnish national Health 2000 survey. The risk allele was also associated with reduced in silico gene expression levels of MTNR1A in brain tissue and with changes in DNA methylation in the 5' regulatory region of MTNR1A. The risk variant may lead to reduced melatonin signaling in the brain. 

In healthy postmenopausal women, reproductive life events related to sex hormones are positively related to aspects of cognition in later life, according to a study published November 7 in the Journal of the American Geriatrics Society. Researchers evaluated 830 menopausal women using a cognitive battery and a structured reproductive history questionnaire. On multivariable modeling, age at menarche of 13 or older was inversely associated with global cognition. Having a last pregnancy after age 35 was positively associated with verbal memory. Use of hormonal contraceptives was positively associated with global cognition and verbal memory. The association between hormonal contraceptive use and verbal memory and executive function was strongest for more than 10 years of use. Reproductive period was positively associated with global cognition and executive function. 

Physical fitness, BMI, IQ, and stress resilience in young adulthood may be associated with the development of amyotrophic lateral sclerosis (ALS) at an early age, according to a study published in the October issue of the European Journal of Neurology. Data on physical fitness, BMI, IQ, and stress resilience were collected from 1,838,376 Swedish men ages 17 to 20 at conscription from 1968 to 2010. During follow-up, 439 participants developed ALS. People with physical fitness above the highest tertile had a higher risk of ALS before age 45. People with BMI greater than or equal to 25 had a lower risk of ALS at all ages. Individuals with IQ above the highest tertile had a significantly increased risk of ALS at an age of 56 and older. 

Short sleep is associated with greater intake of sugared caffeinated sodas, according to a study published online ahead of print November 9 in Sleep Health. Using data from the 2005 to 2012 National Health and Nutrition Examination Survey, researchers examined self-reported sleep duration and beverage intake from two 24-hour dietary recalls among 18,779 adults. Adults who slept for seven to eight hours each night were considered the reference group. In fully adjusted models, people who slept for five hours or less had 21% higher sugar-sweetened beverage consumption. When analyzed by beverage type, this difference was attributed to caffeinated sugary beverages. Longer sleepers consumed fewer servings of coffee and water. There were no associations between self-reported sleep duration and consumption of 100% juice, tea, or diet drinks.

Treadmill training plus virtual reality reduces fall rates, compared with treadmill training alone, according to a study published September 17 in the Lancet. Adults ages 60 to 90 with motor and cognitive deficits and a high risk of falls were randomly assigned to receive six weeks of treadmill training plus virtual reality or treadmill training alone. Data from 282 participants were included in the prespecified, modified intention-to-treat analysis. In the six months after training, the incident rate of falls was significantly lower in the treadmill-training-plus-virtual-reality group than it had been before training. The incident rate did not decrease significantly in the treadmill-training-alone group. Six months after training, the incident rate of falls was also significantly lower in the treadmill-training-plus-virtual-reality group than in the treadmill-training group. 

Current research does not support specific recommendations for treating hypertension to preserve cognition, according to a scientific statement by the American Heart Association published online ahead of print October 10 in Hypertension. A panel of experts reviewed the literature on hypertension, the treatment of hypertension, and the relationship between hypertension and cognition, and summarized the available data. They found that hypertension disrupts the structure and function of cerebral blood vessels, leads to ischemic damage of white matter regions critical for cognitive function, and may promote Alzheimer pathology. They found strong evidence of a negative influence of mid-life hypertension on late-life cognitive function, but the cognitive effect of late-life hypertension is unclear. Observational studies indicate that high blood pressure damages the brain's blood vessels, leading to reduced blood flow to brain cells. 

Manual-based cognitive behavioral therapy for insomnia delivered by nonclinician sleep coaches improves sleep in older adults with chronic insomnia, according to a study published in the September issue of the Journal of the American Geriatrics Society. Researchers studied veterans age 60 or older who met diagnostic criteria for insomnia of three months' duration or longer. Nonclinician sleep coaches delivered five sessions of manual-based cognitive behavioral therapy for insomnia, including stimulus control, sleep restriction, sleep hygiene, and cognitive therapy, with weekly telephone behavioral sleep medicine supervision. Controls received sleep education. Intervention subjects had greater improvement than controls between baseline and post-treatment, baseline and six months, and baseline and 12 months in sleep onset latency, total wake time, sleep efficiency, Pittsburgh Sleep Quality Index, and Insomnia Severity Index. 

Antioxidants, carotenes, fruits, and vegetables are associated with higher amyotrophic lateral sclerosis (ALS) function at baseline, according to a study published online ahead of print October 24 in JAMA Neurology. A cross-sectional baseline analysis of the ALS Multicenter Cohort Study of Oxidative Stress was conducted at 16 ALS clinics throughout the United States. Baseline data were available on 302 patients (124 women) with ALS (median age, 63.2). Regression analysis of nutrients found that higher intakes of antioxidants and carotenes from vegetables were associated with higher ALS Functional Rating Scale-Revised (ALSFRS-R) scores or percentage forced vital capacity. Empirically weighted indices using the weighted quantile sum regression method of "good" micronutrients and "good" food groups were positively associated with ALSFRS-R scores and percentage forced vital capacity. 

Fluselenamyl detects amyloid clumps better than current FDA-approved compounds, according to a study published online ahead of print November 2 in Scientific Reports. To determine whether fluselenamyl can detect amyloid beta plaques in the brain, researchers used the compound to stain brain slices from people who had died of Alzheimer's disease and from people of similar ages who had died of other causes (ie, controls). Fluselenamyl labeled diffuse and fibrillar plaques in brain sections of patients with Alzheimer's disease, but did not interact with biomarker proteins of other neurodegenerative diseases, thereby indicating specificity for detecting amyloid beta in Alzheimer's disease. Overall, fluselenamyl demonstrated potent binding affinity to autopsy-confirmed Alzheimer's disease homogenates. The binding affinity was superior to that of [¹⁸F]-AV-45, [¹⁸F]-florbetaben, and [¹⁸F]-flutemetamol. 

Preserved hippocampal volumes are associated with increased risk of probable dementia with Lewy bodies, rather than Alzheimer's disease, in patients with mild cognitive impairment (MCI), according to a study published online ahead of print November 2 in Neurology. In the study, 160 people with MCI underwent MRI to measure hippocampal size. During a median follow-up of two years, 38% of people developed Alzheimer's disease, and 13% of people developed probable dementia with Lewy bodies. The people who had no hippocampal shrinkage were 5.8 times more likely to develop probable dementia with Lewy bodies than people who had hippocampal atrophy. Approximately 85% of people who developed dementia with Lewy bodies had a normal hippocampal volume. Furthermore, 61% of people who developed Alzheimer's disease had hippocampal atrophy.

Use of a media device at bedtime is significantly associated with inadequate sleep quantity, poor sleep quality, and excessive daytime sleepiness, according to a systematic review published online ahead of print October 31 in JAMA Pediatrics. Researchers examined published studies of school-age children between ages six and 19 with information about portable screen-based media devices and sleep outcomes. The final analysis included 125,198 children with an average age of 14.5. Children who had access to, but did not use, media devices at night were more likely to have inadequate sleep quantity, poor sleep quality, and excessive daytime sleepiness. Teachers, health care professionals, and parents should cooperate to minimize device access at bedtime, according to the researchers. Future studies should evaluate devices' influence on sleep hygiene, they added. 

The FDA has approved the Amplatzer Patent Foramen Ovale (PFO) Occluder device, which reduces the risk of stroke in patients who previously had a stroke believed to be caused by a blood clot that passed through a PFO. The Amplatzer PFO Occluder is inserted through a catheter that is placed in a leg vein and advanced to the heart. In a randomized study, 499 participants ages 18 to 60 were treated with the Amplatzer PFO Occluder and blood-thinning medications and compared with 481 participants treated with blood-thinning medications alone. There was a 50% reduction in the rate of new strokes in participants using the Amplatzer PFO Occluder and blood-thinning medications, compared with participants taking medications alone. St. Jude Medical, headquartered in Plymouth, Minnesota, markets the Amplatzer PFO Occluder.     

—Kimberly Williams

Economic background does not affect the clinical course or long-term seizure outcome of childhood epilepsy, according to a study in Nova Scotia, Canada, published online ahead of print November 4 in Epilepsia. Researchers examined data for 421 patients with childhood epilepsy and 10 or more years of follow-up. Overall, 33% of families had poor income, 38% had adequate income, and 30% were well-off. Terminal remission occurred in 65% of the poor, 61% of the adequate, and 61% of the well-off populations. Intractable epilepsy, status epilepticus, number of antiepileptic drugs used, and the number of generalized tonic-clonic or focal with secondary generalization seizures through the clinical course was the same in all groups. Neither paternal nor maternal education was associated with remission. Poor children had significantly more adverse social outcomes, however.

A genetic variant near melatonin receptor 1A (MTNR1A) may be associated with job-related exhaustion in shift workers, according to a study published online ahead of print October 10 in Sleep. Researchers assessed intolerance to shift work with job-related exhaustion symptoms in shift workers using the emotional exhaustion subscale of the Maslach Burnout Inventory-General Survey and performed a genome-wide association study. Job-related exhaustion was associated with the rs12506228 variation, located downstream of MTNR1A, in shift workers included in the Finnish national Health 2000 survey. The risk allele was also associated with reduced in silico gene expression levels of MTNR1A in brain tissue and with changes in DNA methylation in the 5' regulatory region of MTNR1A. The risk variant may lead to reduced melatonin signaling in the brain. 

In healthy postmenopausal women, reproductive life events related to sex hormones are positively related to aspects of cognition in later life, according to a study published November 7 in the Journal of the American Geriatrics Society. Researchers evaluated 830 menopausal women using a cognitive battery and a structured reproductive history questionnaire. On multivariable modeling, age at menarche of 13 or older was inversely associated with global cognition. Having a last pregnancy after age 35 was positively associated with verbal memory. Use of hormonal contraceptives was positively associated with global cognition and verbal memory. The association between hormonal contraceptive use and verbal memory and executive function was strongest for more than 10 years of use. Reproductive period was positively associated with global cognition and executive function. 

Physical fitness, BMI, IQ, and stress resilience in young adulthood may be associated with the development of amyotrophic lateral sclerosis (ALS) at an early age, according to a study published in the October issue of the European Journal of Neurology. Data on physical fitness, BMI, IQ, and stress resilience were collected from 1,838,376 Swedish men ages 17 to 20 at conscription from 1968 to 2010. During follow-up, 439 participants developed ALS. People with physical fitness above the highest tertile had a higher risk of ALS before age 45. People with BMI greater than or equal to 25 had a lower risk of ALS at all ages. Individuals with IQ above the highest tertile had a significantly increased risk of ALS at an age of 56 and older. 

Short sleep is associated with greater intake of sugared caffeinated sodas, according to a study published online ahead of print November 9 in Sleep Health. Using data from the 2005 to 2012 National Health and Nutrition Examination Survey, researchers examined self-reported sleep duration and beverage intake from two 24-hour dietary recalls among 18,779 adults. Adults who slept for seven to eight hours each night were considered the reference group. In fully adjusted models, people who slept for five hours or less had 21% higher sugar-sweetened beverage consumption. When analyzed by beverage type, this difference was attributed to caffeinated sugary beverages. Longer sleepers consumed fewer servings of coffee and water. There were no associations between self-reported sleep duration and consumption of 100% juice, tea, or diet drinks.

Treadmill training plus virtual reality reduces fall rates, compared with treadmill training alone, according to a study published September 17 in the Lancet. Adults ages 60 to 90 with motor and cognitive deficits and a high risk of falls were randomly assigned to receive six weeks of treadmill training plus virtual reality or treadmill training alone. Data from 282 participants were included in the prespecified, modified intention-to-treat analysis. In the six months after training, the incident rate of falls was significantly lower in the treadmill-training-plus-virtual-reality group than it had been before training. The incident rate did not decrease significantly in the treadmill-training-alone group. Six months after training, the incident rate of falls was also significantly lower in the treadmill-training-plus-virtual-reality group than in the treadmill-training group. 

Current research does not support specific recommendations for treating hypertension to preserve cognition, according to a scientific statement by the American Heart Association published online ahead of print October 10 in Hypertension. A panel of experts reviewed the literature on hypertension, the treatment of hypertension, and the relationship between hypertension and cognition, and summarized the available data. They found that hypertension disrupts the structure and function of cerebral blood vessels, leads to ischemic damage of white matter regions critical for cognitive function, and may promote Alzheimer pathology. They found strong evidence of a negative influence of mid-life hypertension on late-life cognitive function, but the cognitive effect of late-life hypertension is unclear. Observational studies indicate that high blood pressure damages the brain's blood vessels, leading to reduced blood flow to brain cells. 

Manual-based cognitive behavioral therapy for insomnia delivered by nonclinician sleep coaches improves sleep in older adults with chronic insomnia, according to a study published in the September issue of the Journal of the American Geriatrics Society. Researchers studied veterans age 60 or older who met diagnostic criteria for insomnia of three months' duration or longer. Nonclinician sleep coaches delivered five sessions of manual-based cognitive behavioral therapy for insomnia, including stimulus control, sleep restriction, sleep hygiene, and cognitive therapy, with weekly telephone behavioral sleep medicine supervision. Controls received sleep education. Intervention subjects had greater improvement than controls between baseline and post-treatment, baseline and six months, and baseline and 12 months in sleep onset latency, total wake time, sleep efficiency, Pittsburgh Sleep Quality Index, and Insomnia Severity Index. 

Antioxidants, carotenes, fruits, and vegetables are associated with higher amyotrophic lateral sclerosis (ALS) function at baseline, according to a study published online ahead of print October 24 in JAMA Neurology. A cross-sectional baseline analysis of the ALS Multicenter Cohort Study of Oxidative Stress was conducted at 16 ALS clinics throughout the United States. Baseline data were available on 302 patients (124 women) with ALS (median age, 63.2). Regression analysis of nutrients found that higher intakes of antioxidants and carotenes from vegetables were associated with higher ALS Functional Rating Scale-Revised (ALSFRS-R) scores or percentage forced vital capacity. Empirically weighted indices using the weighted quantile sum regression method of "good" micronutrients and "good" food groups were positively associated with ALSFRS-R scores and percentage forced vital capacity. 

Fluselenamyl detects amyloid clumps better than current FDA-approved compounds, according to a study published online ahead of print November 2 in Scientific Reports. To determine whether fluselenamyl can detect amyloid beta plaques in the brain, researchers used the compound to stain brain slices from people who had died of Alzheimer's disease and from people of similar ages who had died of other causes (ie, controls). Fluselenamyl labeled diffuse and fibrillar plaques in brain sections of patients with Alzheimer's disease, but did not interact with biomarker proteins of other neurodegenerative diseases, thereby indicating specificity for detecting amyloid beta in Alzheimer's disease. Overall, fluselenamyl demonstrated potent binding affinity to autopsy-confirmed Alzheimer's disease homogenates. The binding affinity was superior to that of [¹⁸F]-AV-45, [¹⁸F]-florbetaben, and [¹⁸F]-flutemetamol. 

Preserved hippocampal volumes are associated with increased risk of probable dementia with Lewy bodies, rather than Alzheimer's disease, in patients with mild cognitive impairment (MCI), according to a study published online ahead of print November 2 in Neurology. In the study, 160 people with MCI underwent MRI to measure hippocampal size. During a median follow-up of two years, 38% of people developed Alzheimer's disease, and 13% of people developed probable dementia with Lewy bodies. The people who had no hippocampal shrinkage were 5.8 times more likely to develop probable dementia with Lewy bodies than people who had hippocampal atrophy. Approximately 85% of people who developed dementia with Lewy bodies had a normal hippocampal volume. Furthermore, 61% of people who developed Alzheimer's disease had hippocampal atrophy.

Use of a media device at bedtime is significantly associated with inadequate sleep quantity, poor sleep quality, and excessive daytime sleepiness, according to a systematic review published online ahead of print October 31 in JAMA Pediatrics. Researchers examined published studies of school-age children between ages six and 19 with information about portable screen-based media devices and sleep outcomes. The final analysis included 125,198 children with an average age of 14.5. Children who had access to, but did not use, media devices at night were more likely to have inadequate sleep quantity, poor sleep quality, and excessive daytime sleepiness. Teachers, health care professionals, and parents should cooperate to minimize device access at bedtime, according to the researchers. Future studies should evaluate devices' influence on sleep hygiene, they added. 

The FDA has approved the Amplatzer Patent Foramen Ovale (PFO) Occluder device, which reduces the risk of stroke in patients who previously had a stroke believed to be caused by a blood clot that passed through a PFO. The Amplatzer PFO Occluder is inserted through a catheter that is placed in a leg vein and advanced to the heart. In a randomized study, 499 participants ages 18 to 60 were treated with the Amplatzer PFO Occluder and blood-thinning medications and compared with 481 participants treated with blood-thinning medications alone. There was a 50% reduction in the rate of new strokes in participants using the Amplatzer PFO Occluder and blood-thinning medications, compared with participants taking medications alone. St. Jude Medical, headquartered in Plymouth, Minnesota, markets the Amplatzer PFO Occluder.     

—Kimberly Williams