Iatrogenic cerebral amyloid angiopathy: A multinational case series and individual patient data analysis of the literature.

BACKGROUND: The transmission of amyloid ß (Aß) in humans leading to iatrogenic cerebral amyloid angiopathy (iCAA) is a novel concept with analogies to prion diseases. However, the number of published cases is low, and larger international studies are missing. AIMS: We aimed to build a large multinational collaboration on iCAA to better understand the clinical spectrum of affected patients. METHODS: We collected clinical data on patients with iCAA from Austria, Croatia, Italy, Slovenia, and Spain. Patients were included if they met the proposed Queen Square diagnostic criteria (QSC) for iCAA. In addition, we pooled data on disease onset, latency, and cerebrospinal fluid (CSF) biomarkers from previously published iCAA cases based on a systematic literature review. RESULTS: Twenty-seven patients (22% women) were included in this study. Of these, 19 (70%) met the criteria for probable and 8 (30%) for possible iCAA. Prior neurosurgical procedures were performed in all patients (93% brain surgery, 7% spinal surgery) at median age of 8 (interquartile range (IQR) = 4-18, range = 0-26 years) years. The median symptom latency was 39 years (IQR = 34-41, range = 28-49). The median age at symptom onset was 49 years (IQR = 43-55, range = 32-70). Twenty-one patients (78%) presented with intracranial hemorrhage and 3 (11%) with seizures. CONCLUSIONS: Our large international case series of patients with iCAA confirms a wide age boundary for the diagnosis of iCAA. Dissemination of awareness of this rare condition will help to identify more affected patients.

A superficial siderosis-related transient focal neurological episode in a patient with Marfan syndrome.

Sagittal computed tomography of lumbal spine showing dural ectasia and Tarlow Cyst (red arrows) (A). Magnetic resonance imaging (MRI) axial slice, susceptibility-weighted imaging (SWI) sequences showing siderosis in cerebellar sulci (red arrows) and in the inset uncharacteristic iron deposition in dental nuclei, more pronounced on the left side (red arrows) (B, inset). MRI, SWI, axial slice, showing numerous foci of superficial siderosis (C).

Real­world study of Cerviron® vaginal ovules in the treatment of cervical lesions of various etiologies.

Cervical lesions can be caused by pathogens, hormonal changes or by cervical injury. The recommended treatment in all cases is excision. Local re-epithelialization therapy should be initiated preoperatively and postoperatively. The present study assessed the post-market performance and tolerability of Cerviron® ovules in the treatment and management of cervical lesions postoperatively. The study population included 345 participants aged 20-70 years with either a cervical lesion under treatment or with recent surgical removal of a cervical lesion. The degree of re-epithelialization of the cervical mucosa was improved in 73.17% of the patients evaluated during routine colposcopy exams and 92.73% of patients recorded no bleeding. When adding Cerviron® either as monotherapy or in association with other antimicrobials in postoperative care of the cervical ectropion, improved postoperative outcomes such as reduced post-interventional bleeding and a superior quality of healing were observed. The study and its details are registered in www.clinicaltrials.gov under ID NCT05668806.

Cognitive processing of visual images in migraine populations in between headache attacks.

BACKGROUND AND OBJECTIVE: People with migraine headache have altered interictal visual sensory-level processing in between headache attacks. Here we examined the extent to which these migraine abnormalities may extend into higher visual processing such as implicit evaluative analysis of visual images in between migraine events. METHODS: Specifically, we asked two groups of participants--migraineurs (N=29) and non-migraine controls (N=29)--to view a set of unfamiliar commercial logos in the context of a target identification task as the brain electrical responses to these objects were recorded via event-related potentials (ERPs). Following this task, participants individually identified those logos that they most liked or disliked. We applied a between-groups comparison of how ERP responses to logos varied as a function of hedonic evaluation. RESULTS: Our results suggest migraineurs have abnormal implicit evaluative processing of visual stimuli. Specifically, migraineurs lacked a bias for disliked logos found in control subjects, as measured via a late positive potential (LPP) ERP component. CONCLUSIONS: These results suggest post-sensory consequences of migraine in between headache events, specifically abnormal cognitive evaluative processing with a lack of normal categorical hedonic evaluation.

Interictal neurocognitive processing of visual stimuli in migraine: evidence from event-related potentials.

Research has established decreased sensory habituation as a defining feature in migraine, while decreased cognitive habituation has only been found with regard to cognitive assessment of the relative probability of the occurrence of a stimulus event. Our study extended the investigation of interictal habituation in migraine to include cognitive processing when viewing of a series of visually-complex images, similar to those we encounter on the internet everyday. We examined interictal neurocognitive function in migraine from a habituation perspective, using a novel paradigm designed to assess how the response to a series of images changes over time. Two groups of participants--migraineurs (N = 25) and non-migraine controls (N = 25)--were asked to view a set of 232 unfamiliar logos in the context of a target identification task as their brain electrical responses were recorded via event-related potentials (ERPs). The set of logos was viewed serially in each of 10 separate trial blocks, with data analysis focusing on how the ERP responses to the logos in frontal electrodes from 200-600 ms changed across time within each group. For the controls, we found that the amplitude of the late positive potential (LPP) ERP component elicited by the logos had no significant change across trial blocks. In contrast, in migraineurs we found that the LPP significantly increased in amplitude across trial blocks, an effect consistent with a lack of habituation to visual stimuli seen in previous research. Our findings provide empirical support abnormal cognitive processing of complex visual images across time in migraineurs that goes beyond the sensory-level habituation found in previous research.

When "it" becomes "mine": attentional biases triggered by object ownership.

Previous research has demonstrated that higher-order cognitive processes associated with the allocation of selective attention are engaged when highly familiar self-relevant items are encountered, such as one's name, face, personal possessions and the like. The goal of our study was to determine whether these effects on attentional processing are triggered on-line at the moment self-relevance is established. In a pair of experiments, we recorded ERPs as participants viewed common objects (e.g., apple, socks, and ketchup) in the context of an "ownership" paradigm, where the presentation of each object was followed by a cue indicating whether the object nominally belonged either to the participant (a "self" cue) or the experimenter (an "other" cue). In Experiment 1, we found that "self" ownership cues were associated with increased attentional processing, as measured via the P300 component. In Experiment 2, we replicated this effect while demonstrating that at a visual-perceptual level, spatial attention became more narrowly focused on objects owned by self, as measured via the lateral occipital P1 ERP component. Taken together, our findings indicate that self-relevant attention effects are triggered by the act of taking ownership of objects associated with both perceptual and postperceptual processing in cortex.