PurposeTo evaluate the ability of frequency domain optical coherence tomography (fd-OCT) to estimate retinal neural loss in eyes with Alzheimer’s disease (AD). We also verified the existence of a correlation between AD-related cognitive impairment and macular and peripapillary retinal nerve fiber layer (RNFL) thickness measurements.Methodsfd-OCT scans were obtained from 45 eyes of 24 patients with AD and 48 control eyes. Peripapillary RNFL, macular full-thickness and segmented inner macular thickness parameters were calculated. The inner macular parameters included macular retinal nerve fiber layer (mRNFL) thickness, ganglion cell layer (GCL) plus inner plexiform layer thickness (GCL+), and RNFL plus GCL+ thickness (GCL++). The Mini-Mental State Examination (MMSE) was used to assess cognition in all subjects. The two groups were compared and the relationship between MMSE scores and fd-OCT measurements was verified.ResultsAverage, superior and inferior quadrant RNFL thickness parameters and all but one of the nine full-thickness macular measurements were significantly reduced in AD patients compared to controls. The segmented layers, GCL+ and GCL++ were significantly reduced in AD eyes. A significant correlation was found between most fd-OCT parameters (especially macular thickness measurements) and MMSE scores.ConclusionsMost fd-OCT peripapillary RNFL and macular full-thickness and segmented inner retinal layers parameters were reduced in AD eyes compared to controls. Moreover, neuronal loss, especially as reflected in macular parameters, correlated well with cognitive impairment in AD. Our results suggest that fd-OCT could be a potentially useful diagnostic tool in the evaluation and follow-up of AD patients.

The MCI is common in non-elderly patients with CKD not yet on dialysis. Together, the CD, DSR and FEP showed similar performance in identify MCI in this population when compared to MoCA, suggesting impairment of executive functions.

Introduction We compared peripapillary retinal nerve fiber layer and macular thickness measurements in patients with mild cognitive impairment (MCI) and control subjects using swept‐source optical coherence tomography (SS‐OCT). We also assessed the relationship between SS‐OCT measurements and the severity of cognitive impairment. Methods Peripapillary retinal nerve fiber layer and macular thickness were measured in 23 patients and 24 control subjects using SS‐OCT. Cognitive status was assessed using the Mini‐Mental State Examination, the Montreal Cognitive Assessment, and the Pfeffer Questionnaire. Results Most inner retinal layer thickness parameters were significantly smaller in patients with MCI, especially macular ganglion cell complex thickness measurements. Mini‐Mental State Examination and Montreal Cognitive Assessment findings were significantly correlated with most macular thickness parameters. Discussion The SS‐OCT–measured inner retinal layers of patients with MCI displayed thinning, especially in the central macular area. SS‐OCT technology can provide useful information on ocular involvement patterns and holds promise as an ocular biomarker in this patient population.

Objetivo. Relatar um caso de coinfecção por neurotoxoplasmose e neurocisticercose em mulher acometida pela AIDS. Método. Relato de caso prospectivo, descritivo e contemporâneo de paciente do sexo feminino, 36 anos, com quadro clínico compatível com síndrome de hipertensão intracraniana. Os exames complementares diagnostica­ram neurotoxoplasmose e a sorologia anti-HIV foi positiva. Evolui, após semanas, com crises convulsivas e exames subsidiários de imagem demonstrando neurocisticercose. Resultados. As infecções oportunis­tas relacionadas à AIDS são frequentes. A neurotoxoplasmose é cau­sada pelo protozoário Toxoplasma gondii e principal causa de lesão intracraniana expansiva em pacientes com AIDS. A neurocisticercose, provocada por cisticercos (Cysticercus cellulosae ou C. racemosus), formas larvárias da Taenia solium, é bastante prevalente em nosso meio. Conclusão. Após suspeição clínico-radiológica de neurotoxo­plasmose, torna-se imperativo realização de teste anti-HIV, devido sua elevada frequência neste grupo de pacientes. Já a comorbidade neurocisticercose e AIDS é achado excepcional, resultado mais prova­velmente de mera coincidência, sem qualquer vínculo predisponente entre si.

Multiple sclerosis (MS) starting in childhood and adolescence poses a challenge for diagnosis and management of the disease. The aim of the present study was to assess the characteristics of early onset MS in Brazilian patients. Methods: Retrospective data collection from specialized MS units. Results: From 20 MS units in 11 Brazilian states, 117 cases of MS starting before the age of 18 years were collected. These patients had an average of 10 years of disease duration, still typically with low disability and one relapse every 2.5 years. The mean age for disease onset was 13.7 years. Conclusion: The present study introduces a large series of Brazilian cases of pediatric MS. Although some patients presented a very severe form of MS, on the whole the group of patients with MS starting in childhood or adolescence presented a relatively mild form of this disease in Brazil.

Structural imaging of the brain is the most widely used diagnostic tool for investigating neurodegenerative diseases. More advanced structural imaging techniques have been applied to early or prodromic phases, but they are expensive and not widely available. Therefore, it is highly desirable to search for noninvasive, easily accessible, low-cost clinical biomarkers suitable for large-scale population screening, in order to focus on making diagnoses at the earliest stages of the disease. In this scenario, imaging studies focusing on the structures of the retina have increasingly been used for evaluating neurodegenerative diseases. The retina shares embryological, histological, biochemical, microvascular and neurotransmitter similarities with the cerebral cortex, thus making it a uniquely promising biomarker for neurodegenerative diseases. Optical coherence tomography is a modern noninvasive imaging technique that provides high-resolution two-dimensional cross-sectional images and quantitative reproducible three-dimensional volumetric measurements of the optic nerve head and retina. This technology is widely used in ophthalmology practice for diagnosing and following up several eye diseases, such as glaucoma, diabetic retinopathy and age-related macular degeneration. Its clinical impact on neurodegenerative diseases has raised enormous interest over recent years, as several clinical studies have demonstrated that these diseases give rise to reduced thickness of the inner retinal nerve fiber layer, mainly composed of retinal ganglion cells and their axons. In this review, we aimed to address the clinical utility of optical coherence tomography for diagnosing and evaluating different neurodegenerative diseases, to show the potential of this noninvasive and easily accessible method.

-Subacute sclerosing panencephalitis (SSPE) is a progressive inflammatory disorder of the central nervous system with both poor prognosis and high mortality. The disease has been related to a persistent and aberrant measles virus infection and no effective treatment has been available. We report a case of SSPE with atypical features including seizures at onset and a fulminant course in a 8 years-old boy who had been previously immunized against measles.KEY WORDS: subacute sclerosing panencephalitis, measles, immunization.Panencefalite esclerosante subaguda: relato de caso atípico RESUMO -Panencefalite esclerosante subaguda (PES) é uma doença inflamatória e progressiva do sistema nervoso central com prognóstico reservado e alta mortalidade. A doença tem sido relacionada com a infecção persistente e anormal pelo vírus do sarampo e não há tratamento específico disponível. Relatamos um caso de PES com características atípicas representadas por início do quadro com crises convulsivas e apresentação fulminante em menino de 8 anos previamente imunizado contra o vírus do sarampo.PALAVRAS-CHAVE: panencefalite esclerosante subaguda, sarampo, imunização.

A 61-year-old hypertensive man sought neurologic consultation due to a 20-year history of a right-sided dull headache of a low frequency, mild intensity, and without additional features. Headache responded to common analgesics and was not bothersome until his brother was diagnosed with cerebral aneurysm. He then pursued a brain vascular neuroimaging study. His brain magnetic resonance angiography revealed megadolicho-vascular malformation of the intracranial part of the internal carotid arteries and some of its branches and of the basilar artery ( Figure). Megadolicho-diffuse vascular malformation, involving both anterior and posterior circulations, is exceedingly rare and there are only a handful of published cases. Most cases are asymptomatic. When symptoms are present, they can be divided into ischemic, hemorrhagic, and mass effect. Reported manifestations include cerebellar dysfunction, ischemic stroke, trigeminal neuralgia, and brainstem compression syndrome.