New and Noteworthy Information—November 2016

Exercise may be associated with a small benefit for elderly people who have memory and thinking problems, according to a study published online ahead of print October 19 in Neurology. Researchers studied 70 adults randomized to six months of aerobic exercise training or usual care plus education on cognitive and everyday function. The aerobic exercise training group had significantly improved Alzheimer's Disease Assessment Scale-Cognitive subscale performance, compared with controls. This difference was not significant at six-month follow-up, however. There were no significant between-group differences at intervention completion and at the six-month follow-up in Executive Interview or Alzheimer's Disease Cooperative Study-Activities of Daily Living performance. Examination of secondary measures showed between-group differences at intervention completion favoring the exercise training program group in six-minute walk distance and in diastolic blood pressure.  
 
The FDA has approved Carnexiv (carbamazepine) injection as a short-term replacement therapy for oral carbamazepine formulations in adults with certain seizure types when oral administration is temporarily not feasible. Carnexiv has received orphan drug designation for this indication and will be the first available IV formulation of carbamazepine. The drug is intended for people with partial seizures with complex symptomatology, generalized tonic-clonic seizures, mixed seizure patterns, or other partial or generalized seizures. Carnexiv is not indicated for the treatment of absence seizures. People taking Carnexiv should not discontinue the drug abruptly because of the risk of seizures, status epilepticus, and other withdrawal signs and symptoms. In addition, Carnexiv should not be used in patients with moderate or severe renal impairment. The drug is marketed by Lundbeck, which is headquartered in Deerfield, Illinois.  
 
Chiropractic spinal manipulative therapy (CSMT) is no more effective than placebo for migraine, according to a study published online ahead of print October 2 in the European Journal of Neurology. Investigators randomized 104 migraineurs with at least one migraine attack per month to CSMT, sham chiropractic, or usual pharmacologic management for 17 months. Migraine days were significantly reduced within all three groups from baseline to post treatment. The effect continued in the CSMT and placebo groups at all follow-up time points, but the control group returned to baseline. The reduction in migraine days was not significantly different between the groups. Migraine duration and headache index were reduced significantly more in the CSMT group than in the control group toward the end of follow-up.   
 
Video monitoring facilitates nocturnal surveillance of patients with epilepsy, but the costs are high, according to a study published online ahead of print September 30 in Epilepsia. For six months, researchers asked caregivers at an epilepsy unit to specify whether an acoustic detection system, bed motion sensor, or video monitoring alerted them to seizures and whether the alerts led to interventions. They identified 1,208 seizures in 37 people. Four people had no nocturnal seizures, and 33% of seizures were seen only on video. In 14% of seizures, including 10% of seizures seen only on video, an intervention was made. The extra costs of monitoring were 7,035 euro per seizure seen only on video and leading to an intervention. The results underscore the need for reliable seizure-detection devices, said the authors.  
 
A higher level of physical activity may not reduce a woman's risk of multiple sclerosis (MS), according to a study published online ahead of print September 28 in Neurology. Researchers calculated total metabolic equivalent hours of physical activity per week for women participating in the Nurses' Health Study (NHS) and NHS II. There were 341 confirmed MS cases with first symptoms after baseline. Participants also reported early-life activity. The investigators analyzed the data with Cox proportional hazards models. Compared with women in the lowest baseline physical activity quartile, women in the highest quartile had a 27% reduced rate of MS. This trend was not present in six-year lagged analyses, however. In NHS II, total early life activity at ages 12 to 22 was not associated with MS.  
 
Youth with primary hypertension have significantly worse performance on neurocognitive testing, compared with normotensive controls, according to a study published online ahead of print September 27 in the Journal of Pediatrics.Seventy-five children with newly diagnosed, untreated hypertension and 75 frequency-matched normotensive controls had baseline neurocognitive testing as part of a prospective multicenter study of cognition in primary hypertension. The participants completed general intelligence, attention, memory, executive function, and processing speed tests. Parents rated participants' executive function and sleep disordered breathing. The study groups were well matched. Hypertension was independently associated with worse memory, attention, and executive function, compared with normotension. Results indicated a significant interaction between disordered sleep and hypertension on ratings of executive function. Hypertension heightened the association between increased disordered sleep and worse executive function.
 
Headache disorders may be associated with an increased risk for the development of new-onset hypothyroidism, according to a study published online ahead of print September 27 in Headache. This longitudinal retrospective cohort study used data from 8,412 participants enrolled in the Fernald Medical Monitoring Program. Participants underwent physical examinations and thyroid function testing every three years during the 20-year program. The primary outcome measure was new-onset hypothyroidism, defined as the initiation of thyroid replacement therapy or thyroid-stimulating hormone test value greater than or equal to 10 without thyroid medication. Headache disorders were present in about 26% of the participants, and new-onset hypothyroidism developed in approximately 7% of participants. The hazard ratio for the development of new-onset hypothyroidism was 1.21 for people with headache disorders.
 
People with epilepsy can face various psychosocial adversities and extensively report feeling discriminated against, compared with the general population, according to a study published online ahead of print September 16 in Epilepsia. The Adult Psychiatric Morbidity Survey 2007 included comprehensive interviews with 7,403 people. Overall, people with epilepsy were sevenfold more likely to have reported experiencing discrimination due to health problems than the general population without epilepsy. People with epilepsy also had greater odds of experiencing domestic violence and sexual abuse than the general population, although these associations were also found in people with other chronic conditions. There was less evidence of an association between epilepsy and a history of physical abuse or having a greater burden of other stressful life events.  
 
Short episodes of atrial tachycardia or fibrillation are not associated with increased risk of clinical events, compared with absence of these episodes, according to a study published October 18 in Circulation. The Registry of Atrial Tachycardia and Atrial Fibrillation Episodes enrolled 5,379 patients with pacemakers or implantable cardioverter defibrillators. There were 478 hospitalizations among 342 patients for clinical events. Study authors adjudicated 37,531 electrograms. Patients with clinical events were more likely than those without them to have long atrial tachycardia or fibrillation. Only short episodes of atrial tachycardia or fibrillation were documented in 9% of patients with pacemakers and in 16% of patients with implantable cardioverter defibrillators. Patients with clinical events were no more likely than those without them to have short atrial tachycardia or fibrillation.
 
A brain signature identifies patients with fibromyalgia with 93% accuracy, according to a study published online ahead of print August 31 in Pain. Researchers examined 37 patients with fibromyalgia and 35 matched healthy controls. They analyzed participants' functional MRI responses to painful pressure and nonpainful multisensory stimulation. Investigators used machine-learning techniques to identify a brain-based fibromyalgia signature. When exposed to the same painful stimuli, patients with fibromyalgia had greater Neurologic Pain Signature responses. Furthermore, a new pain-related classifier revealed augmented responses in sensory integration and self-referential regions in fibromyalgia, and reduced responses in the lateral frontal cortex. Combined activity in the Neurologic Pain Signature, fibromyalgia pain, and multisensory patterns classified patients vs. controls with 92% sensitivity and 94% specificity in individuals who were not part of the study sample.  
 
Children have measurable brain changes after a single season of youth football, even when they do not sustain a concussion, according to a study published online ahead of print October 24 in Radiology. Head impact data were recorded using the Head Impact Telemetry system and quantified as the combined-probability risk-weighted cumulative exposure. Twenty-five male participants were evaluated for seasonal fractional anisotropy changes in the inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, and superior longitudinal fasciculus. There were statistically significant linear relationships between risk-weighted cumulative exposure and decreased fractional anisotropy in the whole, core, and terminals of the left inferior fronto-occipital fasciculus. A trend toward statistical significance in the right superior longitudinal fasciculus was observed. Decrease in fractional anisotropy of the right superior longitudinal fasciculus terminal was significantly correlated with risk-weighted cumulative exposure.
 
Zika virus contributes to the development of Guillain-Barré syndrome, according to a study published online ahead of print October 5 in the New England Journal of Medicine. From November 2015 through March 2016, clusters of cases of Guillain-Barré syndrome were observed during an outbreak of Zika virus in Colombia. Researchers characterized the clinical features of 68 patients with Guillain-Barré syndrome during the outbreak and investigated their relationship with Zika virus infection. In all, 97% of patients had symptoms compatible with Zika virus infection before the onset of Guillain-Barré syndrome. Among the 42 patients who had samples tested for Zika virus infection, the results were positive in 40%. Most of the positive results were in urine samples, although three samples of CSF were also positive.  
 
Among patients with amnestic mild cognitive impairment (aMCI), women have better verbal memory than men despite similar levels of brain hypometabolism, according to a study published online ahead of print October 5 in Neurology. In the Alzheimer's Disease Neuroimaging Initiative, 390 controls, 672 participants with aMCI, and 254 people with Alzheimer's disease dementia completed the Rey Auditory Verbal Learning Test and [18F]-fluorodeoxyglucose-PET. Female sex, higher temporal lobe glucose metabolic rates (TLGluMR), and the interaction of the two factors were associated with better verbal memory. The female advantage in verbal memory was greatest in people with moderate to high TLGluMR and minimal or absent among individuals with lower TLGluMR. Diagnosis-stratified analyses revealed that this interaction was driven by the aMCI group.

—Kimberly Williams

Exercise may be associated with a small benefit for elderly people who have memory and thinking problems, according to a study published online ahead of print October 19 in Neurology. Researchers studied 70 adults randomized to six months of aerobic exercise training or usual care plus education on cognitive and everyday function. The aerobic exercise training group had significantly improved Alzheimer's Disease Assessment Scale-Cognitive subscale performance, compared with controls. This difference was not significant at six-month follow-up, however. There were no significant between-group differences at intervention completion and at the six-month follow-up in Executive Interview or Alzheimer's Disease Cooperative Study-Activities of Daily Living performance. Examination of secondary measures showed between-group differences at intervention completion favoring the exercise training program group in six-minute walk distance and in diastolic blood pressure.  
 
The FDA has approved Carnexiv (carbamazepine) injection as a short-term replacement therapy for oral carbamazepine formulations in adults with certain seizure types when oral administration is temporarily not feasible. Carnexiv has received orphan drug designation for this indication and will be the first available IV formulation of carbamazepine. The drug is intended for people with partial seizures with complex symptomatology, generalized tonic-clonic seizures, mixed seizure patterns, or other partial or generalized seizures. Carnexiv is not indicated for the treatment of absence seizures. People taking Carnexiv should not discontinue the drug abruptly because of the risk of seizures, status epilepticus, and other withdrawal signs and symptoms. In addition, Carnexiv should not be used in patients with moderate or severe renal impairment. The drug is marketed by Lundbeck, which is headquartered in Deerfield, Illinois.  
 
Chiropractic spinal manipulative therapy (CSMT) is no more effective than placebo for migraine, according to a study published online ahead of print October 2 in the European Journal of Neurology. Investigators randomized 104 migraineurs with at least one migraine attack per month to CSMT, sham chiropractic, or usual pharmacologic management for 17 months. Migraine days were significantly reduced within all three groups from baseline to post treatment. The effect continued in the CSMT and placebo groups at all follow-up time points, but the control group returned to baseline. The reduction in migraine days was not significantly different between the groups. Migraine duration and headache index were reduced significantly more in the CSMT group than in the control group toward the end of follow-up.   
 
Video monitoring facilitates nocturnal surveillance of patients with epilepsy, but the costs are high, according to a study published online ahead of print September 30 in Epilepsia. For six months, researchers asked caregivers at an epilepsy unit to specify whether an acoustic detection system, bed motion sensor, or video monitoring alerted them to seizures and whether the alerts led to interventions. They identified 1,208 seizures in 37 people. Four people had no nocturnal seizures, and 33% of seizures were seen only on video. In 14% of seizures, including 10% of seizures seen only on video, an intervention was made. The extra costs of monitoring were 7,035 euro per seizure seen only on video and leading to an intervention. The results underscore the need for reliable seizure-detection devices, said the authors.  
 
A higher level of physical activity may not reduce a woman's risk of multiple sclerosis (MS), according to a study published online ahead of print September 28 in Neurology. Researchers calculated total metabolic equivalent hours of physical activity per week for women participating in the Nurses' Health Study (NHS) and NHS II. There were 341 confirmed MS cases with first symptoms after baseline. Participants also reported early-life activity. The investigators analyzed the data with Cox proportional hazards models. Compared with women in the lowest baseline physical activity quartile, women in the highest quartile had a 27% reduced rate of MS. This trend was not present in six-year lagged analyses, however. In NHS II, total early life activity at ages 12 to 22 was not associated with MS.  
 
Youth with primary hypertension have significantly worse performance on neurocognitive testing, compared with normotensive controls, according to a study published online ahead of print September 27 in the Journal of Pediatrics.Seventy-five children with newly diagnosed, untreated hypertension and 75 frequency-matched normotensive controls had baseline neurocognitive testing as part of a prospective multicenter study of cognition in primary hypertension. The participants completed general intelligence, attention, memory, executive function, and processing speed tests. Parents rated participants' executive function and sleep disordered breathing. The study groups were well matched. Hypertension was independently associated with worse memory, attention, and executive function, compared with normotension. Results indicated a significant interaction between disordered sleep and hypertension on ratings of executive function. Hypertension heightened the association between increased disordered sleep and worse executive function.
 
Headache disorders may be associated with an increased risk for the development of new-onset hypothyroidism, according to a study published online ahead of print September 27 in Headache. This longitudinal retrospective cohort study used data from 8,412 participants enrolled in the Fernald Medical Monitoring Program. Participants underwent physical examinations and thyroid function testing every three years during the 20-year program. The primary outcome measure was new-onset hypothyroidism, defined as the initiation of thyroid replacement therapy or thyroid-stimulating hormone test value greater than or equal to 10 without thyroid medication. Headache disorders were present in about 26% of the participants, and new-onset hypothyroidism developed in approximately 7% of participants. The hazard ratio for the development of new-onset hypothyroidism was 1.21 for people with headache disorders.
 
People with epilepsy can face various psychosocial adversities and extensively report feeling discriminated against, compared with the general population, according to a study published online ahead of print September 16 in Epilepsia. The Adult Psychiatric Morbidity Survey 2007 included comprehensive interviews with 7,403 people. Overall, people with epilepsy were sevenfold more likely to have reported experiencing discrimination due to health problems than the general population without epilepsy. People with epilepsy also had greater odds of experiencing domestic violence and sexual abuse than the general population, although these associations were also found in people with other chronic conditions. There was less evidence of an association between epilepsy and a history of physical abuse or having a greater burden of other stressful life events.  
 
Short episodes of atrial tachycardia or fibrillation are not associated with increased risk of clinical events, compared with absence of these episodes, according to a study published October 18 in Circulation. The Registry of Atrial Tachycardia and Atrial Fibrillation Episodes enrolled 5,379 patients with pacemakers or implantable cardioverter defibrillators. There were 478 hospitalizations among 342 patients for clinical events. Study authors adjudicated 37,531 electrograms. Patients with clinical events were more likely than those without them to have long atrial tachycardia or fibrillation. Only short episodes of atrial tachycardia or fibrillation were documented in 9% of patients with pacemakers and in 16% of patients with implantable cardioverter defibrillators. Patients with clinical events were no more likely than those without them to have short atrial tachycardia or fibrillation.
 
A brain signature identifies patients with fibromyalgia with 93% accuracy, according to a study published online ahead of print August 31 in Pain. Researchers examined 37 patients with fibromyalgia and 35 matched healthy controls. They analyzed participants' functional MRI responses to painful pressure and nonpainful multisensory stimulation. Investigators used machine-learning techniques to identify a brain-based fibromyalgia signature. When exposed to the same painful stimuli, patients with fibromyalgia had greater Neurologic Pain Signature responses. Furthermore, a new pain-related classifier revealed augmented responses in sensory integration and self-referential regions in fibromyalgia, and reduced responses in the lateral frontal cortex. Combined activity in the Neurologic Pain Signature, fibromyalgia pain, and multisensory patterns classified patients vs. controls with 92% sensitivity and 94% specificity in individuals who were not part of the study sample.  
 
Children have measurable brain changes after a single season of youth football, even when they do not sustain a concussion, according to a study published online ahead of print October 24 in Radiology. Head impact data were recorded using the Head Impact Telemetry system and quantified as the combined-probability risk-weighted cumulative exposure. Twenty-five male participants were evaluated for seasonal fractional anisotropy changes in the inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, and superior longitudinal fasciculus. There were statistically significant linear relationships between risk-weighted cumulative exposure and decreased fractional anisotropy in the whole, core, and terminals of the left inferior fronto-occipital fasciculus. A trend toward statistical significance in the right superior longitudinal fasciculus was observed. Decrease in fractional anisotropy of the right superior longitudinal fasciculus terminal was significantly correlated with risk-weighted cumulative exposure.
 
Zika virus contributes to the development of Guillain-Barré syndrome, according to a study published online ahead of print October 5 in the New England Journal of Medicine. From November 2015 through March 2016, clusters of cases of Guillain-Barré syndrome were observed during an outbreak of Zika virus in Colombia. Researchers characterized the clinical features of 68 patients with Guillain-Barré syndrome during the outbreak and investigated their relationship with Zika virus infection. In all, 97% of patients had symptoms compatible with Zika virus infection before the onset of Guillain-Barré syndrome. Among the 42 patients who had samples tested for Zika virus infection, the results were positive in 40%. Most of the positive results were in urine samples, although three samples of CSF were also positive.  
 
Among patients with amnestic mild cognitive impairment (aMCI), women have better verbal memory than men despite similar levels of brain hypometabolism, according to a study published online ahead of print October 5 in Neurology. In the Alzheimer's Disease Neuroimaging Initiative, 390 controls, 672 participants with aMCI, and 254 people with Alzheimer's disease dementia completed the Rey Auditory Verbal Learning Test and [18F]-fluorodeoxyglucose-PET. Female sex, higher temporal lobe glucose metabolic rates (TLGluMR), and the interaction of the two factors were associated with better verbal memory. The female advantage in verbal memory was greatest in people with moderate to high TLGluMR and minimal or absent among individuals with lower TLGluMR. Diagnosis-stratified analyses revealed that this interaction was driven by the aMCI group.

—Kimberly Williams

Exercise may be associated with a small benefit for elderly people who have memory and thinking problems, according to a study published online ahead of print October 19 in Neurology. Researchers studied 70 adults randomized to six months of aerobic exercise training or usual care plus education on cognitive and everyday function. The aerobic exercise training group had significantly improved Alzheimer's Disease Assessment Scale-Cognitive subscale performance, compared with controls. This difference was not significant at six-month follow-up, however. There were no significant between-group differences at intervention completion and at the six-month follow-up in Executive Interview or Alzheimer's Disease Cooperative Study-Activities of Daily Living performance. Examination of secondary measures showed between-group differences at intervention completion favoring the exercise training program group in six-minute walk distance and in diastolic blood pressure.  
 
The FDA has approved Carnexiv (carbamazepine) injection as a short-term replacement therapy for oral carbamazepine formulations in adults with certain seizure types when oral administration is temporarily not feasible. Carnexiv has received orphan drug designation for this indication and will be the first available IV formulation of carbamazepine. The drug is intended for people with partial seizures with complex symptomatology, generalized tonic-clonic seizures, mixed seizure patterns, or other partial or generalized seizures. Carnexiv is not indicated for the treatment of absence seizures. People taking Carnexiv should not discontinue the drug abruptly because of the risk of seizures, status epilepticus, and other withdrawal signs and symptoms. In addition, Carnexiv should not be used in patients with moderate or severe renal impairment. The drug is marketed by Lundbeck, which is headquartered in Deerfield, Illinois.  
 
Chiropractic spinal manipulative therapy (CSMT) is no more effective than placebo for migraine, according to a study published online ahead of print October 2 in the European Journal of Neurology. Investigators randomized 104 migraineurs with at least one migraine attack per month to CSMT, sham chiropractic, or usual pharmacologic management for 17 months. Migraine days were significantly reduced within all three groups from baseline to post treatment. The effect continued in the CSMT and placebo groups at all follow-up time points, but the control group returned to baseline. The reduction in migraine days was not significantly different between the groups. Migraine duration and headache index were reduced significantly more in the CSMT group than in the control group toward the end of follow-up.   
 
Video monitoring facilitates nocturnal surveillance of patients with epilepsy, but the costs are high, according to a study published online ahead of print September 30 in Epilepsia. For six months, researchers asked caregivers at an epilepsy unit to specify whether an acoustic detection system, bed motion sensor, or video monitoring alerted them to seizures and whether the alerts led to interventions. They identified 1,208 seizures in 37 people. Four people had no nocturnal seizures, and 33% of seizures were seen only on video. In 14% of seizures, including 10% of seizures seen only on video, an intervention was made. The extra costs of monitoring were 7,035 euro per seizure seen only on video and leading to an intervention. The results underscore the need for reliable seizure-detection devices, said the authors.  
 
A higher level of physical activity may not reduce a woman's risk of multiple sclerosis (MS), according to a study published online ahead of print September 28 in Neurology. Researchers calculated total metabolic equivalent hours of physical activity per week for women participating in the Nurses' Health Study (NHS) and NHS II. There were 341 confirmed MS cases with first symptoms after baseline. Participants also reported early-life activity. The investigators analyzed the data with Cox proportional hazards models. Compared with women in the lowest baseline physical activity quartile, women in the highest quartile had a 27% reduced rate of MS. This trend was not present in six-year lagged analyses, however. In NHS II, total early life activity at ages 12 to 22 was not associated with MS.  
 
Youth with primary hypertension have significantly worse performance on neurocognitive testing, compared with normotensive controls, according to a study published online ahead of print September 27 in the Journal of Pediatrics.Seventy-five children with newly diagnosed, untreated hypertension and 75 frequency-matched normotensive controls had baseline neurocognitive testing as part of a prospective multicenter study of cognition in primary hypertension. The participants completed general intelligence, attention, memory, executive function, and processing speed tests. Parents rated participants' executive function and sleep disordered breathing. The study groups were well matched. Hypertension was independently associated with worse memory, attention, and executive function, compared with normotension. Results indicated a significant interaction between disordered sleep and hypertension on ratings of executive function. Hypertension heightened the association between increased disordered sleep and worse executive function.
 
Headache disorders may be associated with an increased risk for the development of new-onset hypothyroidism, according to a study published online ahead of print September 27 in Headache. This longitudinal retrospective cohort study used data from 8,412 participants enrolled in the Fernald Medical Monitoring Program. Participants underwent physical examinations and thyroid function testing every three years during the 20-year program. The primary outcome measure was new-onset hypothyroidism, defined as the initiation of thyroid replacement therapy or thyroid-stimulating hormone test value greater than or equal to 10 without thyroid medication. Headache disorders were present in about 26% of the participants, and new-onset hypothyroidism developed in approximately 7% of participants. The hazard ratio for the development of new-onset hypothyroidism was 1.21 for people with headache disorders.
 
People with epilepsy can face various psychosocial adversities and extensively report feeling discriminated against, compared with the general population, according to a study published online ahead of print September 16 in Epilepsia. The Adult Psychiatric Morbidity Survey 2007 included comprehensive interviews with 7,403 people. Overall, people with epilepsy were sevenfold more likely to have reported experiencing discrimination due to health problems than the general population without epilepsy. People with epilepsy also had greater odds of experiencing domestic violence and sexual abuse than the general population, although these associations were also found in people with other chronic conditions. There was less evidence of an association between epilepsy and a history of physical abuse or having a greater burden of other stressful life events.  
 
Short episodes of atrial tachycardia or fibrillation are not associated with increased risk of clinical events, compared with absence of these episodes, according to a study published October 18 in Circulation. The Registry of Atrial Tachycardia and Atrial Fibrillation Episodes enrolled 5,379 patients with pacemakers or implantable cardioverter defibrillators. There were 478 hospitalizations among 342 patients for clinical events. Study authors adjudicated 37,531 electrograms. Patients with clinical events were more likely than those without them to have long atrial tachycardia or fibrillation. Only short episodes of atrial tachycardia or fibrillation were documented in 9% of patients with pacemakers and in 16% of patients with implantable cardioverter defibrillators. Patients with clinical events were no more likely than those without them to have short atrial tachycardia or fibrillation.
 
A brain signature identifies patients with fibromyalgia with 93% accuracy, according to a study published online ahead of print August 31 in Pain. Researchers examined 37 patients with fibromyalgia and 35 matched healthy controls. They analyzed participants' functional MRI responses to painful pressure and nonpainful multisensory stimulation. Investigators used machine-learning techniques to identify a brain-based fibromyalgia signature. When exposed to the same painful stimuli, patients with fibromyalgia had greater Neurologic Pain Signature responses. Furthermore, a new pain-related classifier revealed augmented responses in sensory integration and self-referential regions in fibromyalgia, and reduced responses in the lateral frontal cortex. Combined activity in the Neurologic Pain Signature, fibromyalgia pain, and multisensory patterns classified patients vs. controls with 92% sensitivity and 94% specificity in individuals who were not part of the study sample.  
 
Children have measurable brain changes after a single season of youth football, even when they do not sustain a concussion, according to a study published online ahead of print October 24 in Radiology. Head impact data were recorded using the Head Impact Telemetry system and quantified as the combined-probability risk-weighted cumulative exposure. Twenty-five male participants were evaluated for seasonal fractional anisotropy changes in the inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, and superior longitudinal fasciculus. There were statistically significant linear relationships between risk-weighted cumulative exposure and decreased fractional anisotropy in the whole, core, and terminals of the left inferior fronto-occipital fasciculus. A trend toward statistical significance in the right superior longitudinal fasciculus was observed. Decrease in fractional anisotropy of the right superior longitudinal fasciculus terminal was significantly correlated with risk-weighted cumulative exposure.
 
Zika virus contributes to the development of Guillain-Barré syndrome, according to a study published online ahead of print October 5 in the New England Journal of Medicine. From November 2015 through March 2016, clusters of cases of Guillain-Barré syndrome were observed during an outbreak of Zika virus in Colombia. Researchers characterized the clinical features of 68 patients with Guillain-Barré syndrome during the outbreak and investigated their relationship with Zika virus infection. In all, 97% of patients had symptoms compatible with Zika virus infection before the onset of Guillain-Barré syndrome. Among the 42 patients who had samples tested for Zika virus infection, the results were positive in 40%. Most of the positive results were in urine samples, although three samples of CSF were also positive.  
 
Among patients with amnestic mild cognitive impairment (aMCI), women have better verbal memory than men despite similar levels of brain hypometabolism, according to a study published online ahead of print October 5 in Neurology. In the Alzheimer's Disease Neuroimaging Initiative, 390 controls, 672 participants with aMCI, and 254 people with Alzheimer's disease dementia completed the Rey Auditory Verbal Learning Test and [18F]-fluorodeoxyglucose-PET. Female sex, higher temporal lobe glucose metabolic rates (TLGluMR), and the interaction of the two factors were associated with better verbal memory. The female advantage in verbal memory was greatest in people with moderate to high TLGluMR and minimal or absent among individuals with lower TLGluMR. Diagnosis-stratified analyses revealed that this interaction was driven by the aMCI group.

—Kimberly Williams