New and Noteworthy Information—May 2015

Chronic disease burden increases the risk of mild cognitive impairment (MCI), but certain lifestyle factors reduce the risk of MCI in people ages 85 and older, according to a study published online ahead of print April 8 in Neurology. Participants in the population-based prospective study were evaluated at baseline and at 15 monthly intervals to determine incident MCI. At baseline, lifestyle factors in midlife and late life were assessed, and vascular and comorbid conditions were abstracted from participants’ medical records. The risk of MCI was increased for participants with APOE ε4 allele or current depressive symptoms. The risk of MCI was reduced for participants who reported engagement in artistic, craft, and social activities in both midlife and late life, and those who reported the use of a computer in late life.

A new blood test may identify biomarkers for Parkinson’s disease more accurately than before, according to a study published online ahead of print March 18 in Movement Disorders. Researchers used a digital gene expression platform to quantify 175 mRNA markers with low coefficients of variation. They compared whole-blood transcript levels in mouse models overexpressing wild-type LRRK2, overexpressing G2019S LRRK2, lacking LRRK2, and wild-type controls. The investigators then studied a cohort of 34 symptomatic patients with Parkinson’s disease and 32 asymptomatic controls. The expression profiles distinguished the four mouse groups with different genetic backgrounds. Significant differences in blood transcript levels were found between individuals differing in LRRK2 genotype and between patients with Parkinson’s disease and controls. Thus, whole-blood mRNA signatures may correlate with LRRK2 genotype and Parkinson’s disease state.

There is a relationship between Alzheimer’s disease-related white matter alterations and impaired cognitive-motor control, according to a study published January 1 in Journal of Alzheimer’s Disease. Using diffusion-weighted MRI, researchers examined changes in white matter integrity associated with normal aging and increased Alzheimer’s disease risk, and assessed the relationship between these white matter alterations and cognitive-motor performance. The investigators found significant age-related declines in white matter integrity, which were more widespread in patients at high risk of Alzheimer’s disease, compared with those at low risk. Furthermore, an analysis of mean diffusivity measures within isolated white matter clusters revealed a stepwise decline in white matter integrity across young, low Alzheimer’s disease risk, and high Alzheimer’s disease risk groups. Investigators also observed that lower white matter integrity was associated with poorer cognitive-motor performance.

Researchers have developed mild cognitive impairment (MCI) risk scores using variables that are easily assessable in the clinical setting and that may be useful in routine patient care, according to a study published April 7 in Neurology. Investigators randomly selected people between ages 70 and 89 on October 1, 2004, for a population-based sample in a longitudinal cohort study. At baseline and subsequent visits, participants were evaluated for demographic, clinical, and neuropsychologic measures and were classified as cognitively normal, having MCI, or having dementia. Of 1,449 cognitively normal participants, 401 developed MCI. Both men and women in the highest versus lowest sex-specific quartiles of the augmented model’s risk scores had an approximately sevenfold higher risk of developing MCI. The presence of APOE ε4 carrier status improved the model.

The progression of dysfunctional tau protein may be the primary cause of cognitive decline and memory loss in Alzheimer’s disease, according to a study published online ahead of print March 23 in Brain. Researchers evaluated the correspondence of Thal amyloid phase to Braak tangle stage and ante mortem clinical characteristics in a large autopsy cohort. In the brain bank cohort of patients with a high likelihood of Alzheimer’s disease, samples with lower Thal amyloid phases were older at death, had a lower Braak tangle stage, and were less frequently APOE ε4 positive. Regression modeling in these samples with Alzheimer’s disease showed that Braak tangle stage, but not Thal amyloid phase, predicted age at onset, disease duration, and final Mini-Mental State Examination score.

A panel of blood biomarkers distinguishes accurately between patients with isolated concussion and uninjured individuals within the first eight hours after an accident, according to a study published online ahead of print in March 20 in Journal of Neurotrauma. Adult patients were enrolled in a study within 24 hours of concussion. Controls included uninjured people and patients with orthopedic injury. The investigators identified copeptin, galectin 3, matrix metalloproteinase 9, and occludin as biomarkers of concussion. A 3.4-fold decrease in plasma concentration of copeptin was found in patients with mild traumatic brain injury (mTBI) within eight hours after accident, compared with uninjured controls. Plasma levels of all biomarkers but copeptin increased by 3.6 to 4.5 times during the same time postinjury. The levels of at least two biomarkers were altered beyond their cutoff values in 90% of patients with mTBI.

Exploding head syndrome is relatively common in younger individuals, according to a study published online ahead of print March 13 in Journal of Sleep Research. Researchers assessed 211 undergraduate students for exploding head syndrome and isolated sleep paralysis using semistructured diagnostic interviews. A total of 18% of the sample population had exploding head syndrome during their lifetimes, and 16.60% of the population had recurrent cases of the syndrome. Exploding head syndrome affected both genders at equal rates, and investigators found it in 36.89% of participants who had been diagnosed with isolated sleep paralysis. Furthermore, exploding head syndrome episodes were accompanied by clinically significant levels of fear. For a minority of participants (2.80%), the fear was associated with clinically significant distress or impairment.

A distinctive pattern of abnormal protein deposits in the brain could help identify athletes with brain disorders, according to a study published online ahead of print April 6 in Proceedings of the National Academy of Science. Investigators used [F-18]FDDNP PET to detect brain patterns of neuropathology distribution in 14 retired professional football players with suspected chronic traumatic encephalopathy and compared results with those of 28 cognitively intact controls and 24 patients with Alzheimer’s dementia. The [F-18]FDDNP PET imaging results in retired players suggested the presence of the neuropathologic patterns consistent with models of concussion in which brainstem white matter tracts undergo early axonal damage and cumulative axonal injuries along subcortical, limbic, and cortical regions that support mood, emotions, and behavior. The pattern was distinct from that observed in Alzheimer’s disease.

A blood test could help identify women with fragile X syndrome who are at risk of dysexecutive and social anxiety symptoms, according to a study published online ahead of print March 25 in Neurology. Thirty-five women with FMR1 premutation between ages 22 and 55 and 35 age- and IQ-matched controls completed a range of executive function tests and self-reported symptoms of psychiatric disorders. The researchers found that FMR1 intron 1 methylation levels could help dichotomize women with the premutation into categories of greater and lesser risk. FMR1 intron 1 methylation and activation ratio were significantly correlated with the likelihood of probable dysexecutive or psychiatric symptoms. The significant relationships between methylation and social anxiety were mediated by executive function performance, but only in women with the premutation.

Targeted temperature management at 33 °C or 36 °C helps maintain good quality of life in patients with cardiac arrest, according to a study published online ahead of print April 6 in JAMA Neurology. Investigators studied 939 unconscious adults with cardiac arrest at 36 intensive care units. Patients were assigned to temperature management at 33 °C or 36 °C for 36 hours. Cognitive function was measured by Mini-Mental State Examination (MMSE). The median MMSE score was 14 for patients assigned to 33 °C and 17 for patients assigned to 36 °C. Approximately 19% of the 33 °C group and 18% of the 36 °C group reported needing help with everyday activities, and 66.5% in the 33 °C group versus 61.8% in the 36 °C group reported making a complete mental recovery.

Biracial population eligibility for r-tPA is similar by gender, according to a study published in the March issue of Stroke. The study included 1,837 patients with ischemic stroke who were age 18 or older and presented to 16 emergency departments in 2005. Eligibility for r-tPA and individual exclusion criteria were determined using 2013 American Heart Association and European Cooperative Acute Stroke Study III guidelines. The mean age was 72.2 for women and 66.1 for men. Eligibility for r-tPA was similar by sex, and adjusting the data for age did not alter this result. More women than men had severe hypertension, and the investigators found no gender differences in blood pressure treatment rates among patients with severe hypertension. More women were older than 80 and had an NIH Stroke Scale score greater than 25.

The brains of patients with traumatic brain injury (TBI) may appear to be older than their chronological age, according to a study published in the April issue of Annals of Neurology. A predictive model of normal aging was defined using machine learning in 1,537 healthy individuals, based on MRI-derived estimates of gray matter and white matter. Investigators used this aging model to estimate brain age for 99 patients with TBI and 113 healthy controls. Brains with TBI were estimated to be older, with a mean predicted age difference between chronological and estimated brain age of 4.66 years for gray matter and 5.97 years for white matter. The predicted age difference correlated strongly with the time since TBI, indicating that brain tissue loss increases throughout the chronic postinjury phase.

A combination of mental practice and physical therapy may help stroke survivors regain the strength of their motor behaviors, according to a study published March 30 in Frontiers in Human Neuroscience. The researchers recorded fMRI signals from 17 young healthy controls and 13 older stroke survivors. Participants with stroke underwent mental practice or both mental practice and physical therapy within 14 to 51 days following stroke. Investigators discovered that network activity was in the frequency range of 0.06 to 0.08 Hz for all brain regions studied and for controls and participants with stroke. Information flow between brain regions was reduced significantly for stroke survivors. The flow did not increase significantly after mental practice alone, but the flow among the regions during mental practice and physical therapy increased significantly.

—Kimberly Williams

Chronic disease burden increases the risk of mild cognitive impairment (MCI), but certain lifestyle factors reduce the risk of MCI in people ages 85 and older, according to a study published online ahead of print April 8 in Neurology. Participants in the population-based prospective study were evaluated at baseline and at 15 monthly intervals to determine incident MCI. At baseline, lifestyle factors in midlife and late life were assessed, and vascular and comorbid conditions were abstracted from participants’ medical records. The risk of MCI was increased for participants with APOE ε4 allele or current depressive symptoms. The risk of MCI was reduced for participants who reported engagement in artistic, craft, and social activities in both midlife and late life, and those who reported the use of a computer in late life.

A new blood test may identify biomarkers for Parkinson’s disease more accurately than before, according to a study published online ahead of print March 18 in Movement Disorders. Researchers used a digital gene expression platform to quantify 175 mRNA markers with low coefficients of variation. They compared whole-blood transcript levels in mouse models overexpressing wild-type LRRK2, overexpressing G2019S LRRK2, lacking LRRK2, and wild-type controls. The investigators then studied a cohort of 34 symptomatic patients with Parkinson’s disease and 32 asymptomatic controls. The expression profiles distinguished the four mouse groups with different genetic backgrounds. Significant differences in blood transcript levels were found between individuals differing in LRRK2 genotype and between patients with Parkinson’s disease and controls. Thus, whole-blood mRNA signatures may correlate with LRRK2 genotype and Parkinson’s disease state.

There is a relationship between Alzheimer’s disease-related white matter alterations and impaired cognitive-motor control, according to a study published January 1 in Journal of Alzheimer’s Disease. Using diffusion-weighted MRI, researchers examined changes in white matter integrity associated with normal aging and increased Alzheimer’s disease risk, and assessed the relationship between these white matter alterations and cognitive-motor performance. The investigators found significant age-related declines in white matter integrity, which were more widespread in patients at high risk of Alzheimer’s disease, compared with those at low risk. Furthermore, an analysis of mean diffusivity measures within isolated white matter clusters revealed a stepwise decline in white matter integrity across young, low Alzheimer’s disease risk, and high Alzheimer’s disease risk groups. Investigators also observed that lower white matter integrity was associated with poorer cognitive-motor performance.

Researchers have developed mild cognitive impairment (MCI) risk scores using variables that are easily assessable in the clinical setting and that may be useful in routine patient care, according to a study published April 7 in Neurology. Investigators randomly selected people between ages 70 and 89 on October 1, 2004, for a population-based sample in a longitudinal cohort study. At baseline and subsequent visits, participants were evaluated for demographic, clinical, and neuropsychologic measures and were classified as cognitively normal, having MCI, or having dementia. Of 1,449 cognitively normal participants, 401 developed MCI. Both men and women in the highest versus lowest sex-specific quartiles of the augmented model’s risk scores had an approximately sevenfold higher risk of developing MCI. The presence of APOE ε4 carrier status improved the model.

The progression of dysfunctional tau protein may be the primary cause of cognitive decline and memory loss in Alzheimer’s disease, according to a study published online ahead of print March 23 in Brain. Researchers evaluated the correspondence of Thal amyloid phase to Braak tangle stage and ante mortem clinical characteristics in a large autopsy cohort. In the brain bank cohort of patients with a high likelihood of Alzheimer’s disease, samples with lower Thal amyloid phases were older at death, had a lower Braak tangle stage, and were less frequently APOE ε4 positive. Regression modeling in these samples with Alzheimer’s disease showed that Braak tangle stage, but not Thal amyloid phase, predicted age at onset, disease duration, and final Mini-Mental State Examination score.

A panel of blood biomarkers distinguishes accurately between patients with isolated concussion and uninjured individuals within the first eight hours after an accident, according to a study published online ahead of print in March 20 in Journal of Neurotrauma. Adult patients were enrolled in a study within 24 hours of concussion. Controls included uninjured people and patients with orthopedic injury. The investigators identified copeptin, galectin 3, matrix metalloproteinase 9, and occludin as biomarkers of concussion. A 3.4-fold decrease in plasma concentration of copeptin was found in patients with mild traumatic brain injury (mTBI) within eight hours after accident, compared with uninjured controls. Plasma levels of all biomarkers but copeptin increased by 3.6 to 4.5 times during the same time postinjury. The levels of at least two biomarkers were altered beyond their cutoff values in 90% of patients with mTBI.

Exploding head syndrome is relatively common in younger individuals, according to a study published online ahead of print March 13 in Journal of Sleep Research. Researchers assessed 211 undergraduate students for exploding head syndrome and isolated sleep paralysis using semistructured diagnostic interviews. A total of 18% of the sample population had exploding head syndrome during their lifetimes, and 16.60% of the population had recurrent cases of the syndrome. Exploding head syndrome affected both genders at equal rates, and investigators found it in 36.89% of participants who had been diagnosed with isolated sleep paralysis. Furthermore, exploding head syndrome episodes were accompanied by clinically significant levels of fear. For a minority of participants (2.80%), the fear was associated with clinically significant distress or impairment.

A distinctive pattern of abnormal protein deposits in the brain could help identify athletes with brain disorders, according to a study published online ahead of print April 6 in Proceedings of the National Academy of Science. Investigators used [F-18]FDDNP PET to detect brain patterns of neuropathology distribution in 14 retired professional football players with suspected chronic traumatic encephalopathy and compared results with those of 28 cognitively intact controls and 24 patients with Alzheimer’s dementia. The [F-18]FDDNP PET imaging results in retired players suggested the presence of the neuropathologic patterns consistent with models of concussion in which brainstem white matter tracts undergo early axonal damage and cumulative axonal injuries along subcortical, limbic, and cortical regions that support mood, emotions, and behavior. The pattern was distinct from that observed in Alzheimer’s disease.

A blood test could help identify women with fragile X syndrome who are at risk of dysexecutive and social anxiety symptoms, according to a study published online ahead of print March 25 in Neurology. Thirty-five women with FMR1 premutation between ages 22 and 55 and 35 age- and IQ-matched controls completed a range of executive function tests and self-reported symptoms of psychiatric disorders. The researchers found that FMR1 intron 1 methylation levels could help dichotomize women with the premutation into categories of greater and lesser risk. FMR1 intron 1 methylation and activation ratio were significantly correlated with the likelihood of probable dysexecutive or psychiatric symptoms. The significant relationships between methylation and social anxiety were mediated by executive function performance, but only in women with the premutation.

Targeted temperature management at 33 °C or 36 °C helps maintain good quality of life in patients with cardiac arrest, according to a study published online ahead of print April 6 in JAMA Neurology. Investigators studied 939 unconscious adults with cardiac arrest at 36 intensive care units. Patients were assigned to temperature management at 33 °C or 36 °C for 36 hours. Cognitive function was measured by Mini-Mental State Examination (MMSE). The median MMSE score was 14 for patients assigned to 33 °C and 17 for patients assigned to 36 °C. Approximately 19% of the 33 °C group and 18% of the 36 °C group reported needing help with everyday activities, and 66.5% in the 33 °C group versus 61.8% in the 36 °C group reported making a complete mental recovery.

Biracial population eligibility for r-tPA is similar by gender, according to a study published in the March issue of Stroke. The study included 1,837 patients with ischemic stroke who were age 18 or older and presented to 16 emergency departments in 2005. Eligibility for r-tPA and individual exclusion criteria were determined using 2013 American Heart Association and European Cooperative Acute Stroke Study III guidelines. The mean age was 72.2 for women and 66.1 for men. Eligibility for r-tPA was similar by sex, and adjusting the data for age did not alter this result. More women than men had severe hypertension, and the investigators found no gender differences in blood pressure treatment rates among patients with severe hypertension. More women were older than 80 and had an NIH Stroke Scale score greater than 25.

The brains of patients with traumatic brain injury (TBI) may appear to be older than their chronological age, according to a study published in the April issue of Annals of Neurology. A predictive model of normal aging was defined using machine learning in 1,537 healthy individuals, based on MRI-derived estimates of gray matter and white matter. Investigators used this aging model to estimate brain age for 99 patients with TBI and 113 healthy controls. Brains with TBI were estimated to be older, with a mean predicted age difference between chronological and estimated brain age of 4.66 years for gray matter and 5.97 years for white matter. The predicted age difference correlated strongly with the time since TBI, indicating that brain tissue loss increases throughout the chronic postinjury phase.

A combination of mental practice and physical therapy may help stroke survivors regain the strength of their motor behaviors, according to a study published March 30 in Frontiers in Human Neuroscience. The researchers recorded fMRI signals from 17 young healthy controls and 13 older stroke survivors. Participants with stroke underwent mental practice or both mental practice and physical therapy within 14 to 51 days following stroke. Investigators discovered that network activity was in the frequency range of 0.06 to 0.08 Hz for all brain regions studied and for controls and participants with stroke. Information flow between brain regions was reduced significantly for stroke survivors. The flow did not increase significantly after mental practice alone, but the flow among the regions during mental practice and physical therapy increased significantly.

—Kimberly Williams

Chronic disease burden increases the risk of mild cognitive impairment (MCI), but certain lifestyle factors reduce the risk of MCI in people ages 85 and older, according to a study published online ahead of print April 8 in Neurology. Participants in the population-based prospective study were evaluated at baseline and at 15 monthly intervals to determine incident MCI. At baseline, lifestyle factors in midlife and late life were assessed, and vascular and comorbid conditions were abstracted from participants’ medical records. The risk of MCI was increased for participants with APOE ε4 allele or current depressive symptoms. The risk of MCI was reduced for participants who reported engagement in artistic, craft, and social activities in both midlife and late life, and those who reported the use of a computer in late life.

A new blood test may identify biomarkers for Parkinson’s disease more accurately than before, according to a study published online ahead of print March 18 in Movement Disorders. Researchers used a digital gene expression platform to quantify 175 mRNA markers with low coefficients of variation. They compared whole-blood transcript levels in mouse models overexpressing wild-type LRRK2, overexpressing G2019S LRRK2, lacking LRRK2, and wild-type controls. The investigators then studied a cohort of 34 symptomatic patients with Parkinson’s disease and 32 asymptomatic controls. The expression profiles distinguished the four mouse groups with different genetic backgrounds. Significant differences in blood transcript levels were found between individuals differing in LRRK2 genotype and between patients with Parkinson’s disease and controls. Thus, whole-blood mRNA signatures may correlate with LRRK2 genotype and Parkinson’s disease state.

There is a relationship between Alzheimer’s disease-related white matter alterations and impaired cognitive-motor control, according to a study published January 1 in Journal of Alzheimer’s Disease. Using diffusion-weighted MRI, researchers examined changes in white matter integrity associated with normal aging and increased Alzheimer’s disease risk, and assessed the relationship between these white matter alterations and cognitive-motor performance. The investigators found significant age-related declines in white matter integrity, which were more widespread in patients at high risk of Alzheimer’s disease, compared with those at low risk. Furthermore, an analysis of mean diffusivity measures within isolated white matter clusters revealed a stepwise decline in white matter integrity across young, low Alzheimer’s disease risk, and high Alzheimer’s disease risk groups. Investigators also observed that lower white matter integrity was associated with poorer cognitive-motor performance.

Researchers have developed mild cognitive impairment (MCI) risk scores using variables that are easily assessable in the clinical setting and that may be useful in routine patient care, according to a study published April 7 in Neurology. Investigators randomly selected people between ages 70 and 89 on October 1, 2004, for a population-based sample in a longitudinal cohort study. At baseline and subsequent visits, participants were evaluated for demographic, clinical, and neuropsychologic measures and were classified as cognitively normal, having MCI, or having dementia. Of 1,449 cognitively normal participants, 401 developed MCI. Both men and women in the highest versus lowest sex-specific quartiles of the augmented model’s risk scores had an approximately sevenfold higher risk of developing MCI. The presence of APOE ε4 carrier status improved the model.

The progression of dysfunctional tau protein may be the primary cause of cognitive decline and memory loss in Alzheimer’s disease, according to a study published online ahead of print March 23 in Brain. Researchers evaluated the correspondence of Thal amyloid phase to Braak tangle stage and ante mortem clinical characteristics in a large autopsy cohort. In the brain bank cohort of patients with a high likelihood of Alzheimer’s disease, samples with lower Thal amyloid phases were older at death, had a lower Braak tangle stage, and were less frequently APOE ε4 positive. Regression modeling in these samples with Alzheimer’s disease showed that Braak tangle stage, but not Thal amyloid phase, predicted age at onset, disease duration, and final Mini-Mental State Examination score.

A panel of blood biomarkers distinguishes accurately between patients with isolated concussion and uninjured individuals within the first eight hours after an accident, according to a study published online ahead of print in March 20 in Journal of Neurotrauma. Adult patients were enrolled in a study within 24 hours of concussion. Controls included uninjured people and patients with orthopedic injury. The investigators identified copeptin, galectin 3, matrix metalloproteinase 9, and occludin as biomarkers of concussion. A 3.4-fold decrease in plasma concentration of copeptin was found in patients with mild traumatic brain injury (mTBI) within eight hours after accident, compared with uninjured controls. Plasma levels of all biomarkers but copeptin increased by 3.6 to 4.5 times during the same time postinjury. The levels of at least two biomarkers were altered beyond their cutoff values in 90% of patients with mTBI.

Exploding head syndrome is relatively common in younger individuals, according to a study published online ahead of print March 13 in Journal of Sleep Research. Researchers assessed 211 undergraduate students for exploding head syndrome and isolated sleep paralysis using semistructured diagnostic interviews. A total of 18% of the sample population had exploding head syndrome during their lifetimes, and 16.60% of the population had recurrent cases of the syndrome. Exploding head syndrome affected both genders at equal rates, and investigators found it in 36.89% of participants who had been diagnosed with isolated sleep paralysis. Furthermore, exploding head syndrome episodes were accompanied by clinically significant levels of fear. For a minority of participants (2.80%), the fear was associated with clinically significant distress or impairment.

A distinctive pattern of abnormal protein deposits in the brain could help identify athletes with brain disorders, according to a study published online ahead of print April 6 in Proceedings of the National Academy of Science. Investigators used [F-18]FDDNP PET to detect brain patterns of neuropathology distribution in 14 retired professional football players with suspected chronic traumatic encephalopathy and compared results with those of 28 cognitively intact controls and 24 patients with Alzheimer’s dementia. The [F-18]FDDNP PET imaging results in retired players suggested the presence of the neuropathologic patterns consistent with models of concussion in which brainstem white matter tracts undergo early axonal damage and cumulative axonal injuries along subcortical, limbic, and cortical regions that support mood, emotions, and behavior. The pattern was distinct from that observed in Alzheimer’s disease.

A blood test could help identify women with fragile X syndrome who are at risk of dysexecutive and social anxiety symptoms, according to a study published online ahead of print March 25 in Neurology. Thirty-five women with FMR1 premutation between ages 22 and 55 and 35 age- and IQ-matched controls completed a range of executive function tests and self-reported symptoms of psychiatric disorders. The researchers found that FMR1 intron 1 methylation levels could help dichotomize women with the premutation into categories of greater and lesser risk. FMR1 intron 1 methylation and activation ratio were significantly correlated with the likelihood of probable dysexecutive or psychiatric symptoms. The significant relationships between methylation and social anxiety were mediated by executive function performance, but only in women with the premutation.

Targeted temperature management at 33 °C or 36 °C helps maintain good quality of life in patients with cardiac arrest, according to a study published online ahead of print April 6 in JAMA Neurology. Investigators studied 939 unconscious adults with cardiac arrest at 36 intensive care units. Patients were assigned to temperature management at 33 °C or 36 °C for 36 hours. Cognitive function was measured by Mini-Mental State Examination (MMSE). The median MMSE score was 14 for patients assigned to 33 °C and 17 for patients assigned to 36 °C. Approximately 19% of the 33 °C group and 18% of the 36 °C group reported needing help with everyday activities, and 66.5% in the 33 °C group versus 61.8% in the 36 °C group reported making a complete mental recovery.

Biracial population eligibility for r-tPA is similar by gender, according to a study published in the March issue of Stroke. The study included 1,837 patients with ischemic stroke who were age 18 or older and presented to 16 emergency departments in 2005. Eligibility for r-tPA and individual exclusion criteria were determined using 2013 American Heart Association and European Cooperative Acute Stroke Study III guidelines. The mean age was 72.2 for women and 66.1 for men. Eligibility for r-tPA was similar by sex, and adjusting the data for age did not alter this result. More women than men had severe hypertension, and the investigators found no gender differences in blood pressure treatment rates among patients with severe hypertension. More women were older than 80 and had an NIH Stroke Scale score greater than 25.

The brains of patients with traumatic brain injury (TBI) may appear to be older than their chronological age, according to a study published in the April issue of Annals of Neurology. A predictive model of normal aging was defined using machine learning in 1,537 healthy individuals, based on MRI-derived estimates of gray matter and white matter. Investigators used this aging model to estimate brain age for 99 patients with TBI and 113 healthy controls. Brains with TBI were estimated to be older, with a mean predicted age difference between chronological and estimated brain age of 4.66 years for gray matter and 5.97 years for white matter. The predicted age difference correlated strongly with the time since TBI, indicating that brain tissue loss increases throughout the chronic postinjury phase.

A combination of mental practice and physical therapy may help stroke survivors regain the strength of their motor behaviors, according to a study published March 30 in Frontiers in Human Neuroscience. The researchers recorded fMRI signals from 17 young healthy controls and 13 older stroke survivors. Participants with stroke underwent mental practice or both mental practice and physical therapy within 14 to 51 days following stroke. Investigators discovered that network activity was in the frequency range of 0.06 to 0.08 Hz for all brain regions studied and for controls and participants with stroke. Information flow between brain regions was reduced significantly for stroke survivors. The flow did not increase significantly after mental practice alone, but the flow among the regions during mental practice and physical therapy increased significantly.

—Kimberly Williams