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Purpose To investigate the differences between interictal and ictal generalized spike-wave discharges (GSWDs) for insights on how epileptic activity propagates and the physiopathological mechanisms underlying childhood absence epilepsy (CAE). Methods Twenty-five patients with CAE were studied using magnetoencephalography (MEG). MEG data were digitized at 6,000 Hz during the interictal and ictal GSWDs. GSWDs were analyzed at both neural magnetic source levels and functional connectivity (FC) in multifrequency bands delta (1-4 Hz), theta (4-8 Hz), alpha (8-12 Hz), beta (12-30 Hz), gamma (30-80 Hz), ripple (80-250 Hz), and fast ripple (250-500 Hz). Brain FC was studied with the posterior cingulate cortex/precuneus (PCC/pC) as the seed region. Results The magnetic source of interictal GSWDs mainly locates in the PCC/pC region at 4-8 and 8-12 Hz, while that of ictal GSWDs mainly locates in the medial frontal cortex (MFC) at 80-250 Hz. There were statistically significant differences between interictal and ictal GSWDs (p less then 0.05). The FC network involving the PCC/pC showed strong connections in the anterior-posterior pathways (mainly with the frontal cortex) at 80-250 Hz during ictal GSWDs, while the interictal GSWDs FC were mostly limited to the posterior cortex region. There was no significant difference in the magnetic source strength among interictal and ictal GSWDs at all bandwidths. Didox Conclusions There are significant disparities in the source localization and FC between interictal and ictal GSWDs. Low-frequency activation in the PCC/pC during inhibition of seizures possibly relates to the maintenance of consciousness during interictal GSWDs. High-frequency oscillations (HFOs) of the MFC during CAE may associate with the inducing or occurrence of GSWDs. Weakened network connections may be in favor of preventing overexcitability and relates to the termination of GSWDs. Copyright © 2020 Shi, Zhang, Miao, Sun, Sun, Chen, Hu, Xiang and Wang.Background and purpose Multiple randomized trials have confirmed that mechanical thrombectomy (MT) is an effective treatment method for patients with acute ischemic stroke (AIS). However, evidence on the safety and efficacy of MT in elderly patients compared with younger patients is controversial. This meta-analysis is aimed to systematically compare the outcomes of elderly patients and younger patients after MT for AIS. Methods A systematic literature search was conducted through the PubMed, EMBASE, and Cochrane Library database. The primary outcomes were favorable functional outcome at 90 days and mortality. The secondary outcomes were symptomatic intracerebral hemorrhage (sICH) and successful recanalization rate. Odds ratios (ORs) were estimated using a random effects model. Results Sixteen studies published between 2014 and 2019 were included in this meta-analysis totally involving 3,954 patients. The pooled results showed that patients aged ≥80 years had worse functional outcome (OR = 0.40; 95% CI, 0.32-nalization in elderly patients with AIS. In addition, advanced technology of endovascular intervention and peri-interventional management might be associated with the prognosis in elderly patients. However, more prospective or randomized studies should be conducted to further explore this issue. Copyright © 2020 Zhao, Ma, Zhang and Yue.Objective A recent systematic review determined that the physiological effects of concussion may persist beyond clinical recovery. Preclinical models suggest that ongoing physiological effects are accompanied by increased cerebral vulnerability that is associated with risk for subsequent, more severe injury. This study examined the association between signal alterations on diffusion tensor imaging following clinical recovery of sport-related concussion in athletes with and without a subsequent second concussion. Methods Average mean diffusivity (MD) was calculated in a region of interest (ROI) in which concussed athletes (n = 82) showed significantly elevated MD acutely after injury ( less then 48 h), at an asymptomatic time point, 7 days post-return to play (RTP), and 6 months relative to controls (n = 69). The relationship between MD in the identified ROI and likelihood of sustaining a subsequent concussion over a 1-year period was examined with a binary logistic regression (re-injured, yes/no). Results Eleter, McCrea and Meier.Objective We conducted this study to analyze the clinical characteristics of the psychiatric symptoms of patients with anti-NMDAR encephalitis. Methods A retrospective study of anti-NMDAR encephalitis in China was performed. The clinical characteristics of the psychiatric symptoms, the relationship between the antibodies titers and clinical characteristics of patients with anti-NMDAR encephalitis were determined. Results A total of 108 patients with a definitive diagnosis of anti-NMDAR encephalitis were included in this study. 103 patients (95%) developed one or several psychiatric symptoms. The comparison of the high titer group and the low titer group showed that more patients presented psychiatric symptoms as the initial symptom in the high titer group (P = 0.020), the prevalence of the symptoms such as depressive, catatonic, and central hypoventilation were also higher in the high titer group than the low titer group (P = 0.033, 0.031 and 0.006, respectively). Meanwhile, more patients received a combination treatment of IVIg and corticosteroids in the high titer group than the low titer group and patients in high titer group were prescript with anti-psychiatric drugs more often than the patients in low titer group (P = 0.026 and 0.003, respectively). Conclusions Psychiatric symptoms are the most common clinical characteristics of patients with anti-NMDAR encephalitis. Patients with higher antibodies titers more often presented with psychiatric symptoms as the initial symptom, and showed a more severe clinical feature. Screening for the anti-NMDAR antibodies is essentially important in patients who present psychiatric symptoms with or without other neurological symptoms. Copyright © 2020 Wang, Zhang, Chi, He, Zhou and Li.
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