Multiple sclerosis

Oligoclonal bands (OCBs) in the cerebrospinal fluid (CSF) of patients with clinically isolated syndrome indicate a diagnosis of multiple sclerosis. These diagnostic markers can also be detected in tears. Calais and co-workers compared the diagnostic value of the two detection methods in 69 patients with clinically isolated syndrome. OCBs were detected in the CSF of 63.8% of the patients, around two-thirds of whom also showed OCBs in their tears. The authors suggest that tear analysis might one day replace invasive lumbar puncture for the detection of OCBs in some patients.

Parkinson disease

Bilateral subthalamic deep brain stimulation can reduce motor dysfunction in patients with advanced Parkinson disease. This technique has, however, been linked with impairments in cognitive–motor functioning and cognition, possibly because the current spreads to areas of the brain involved in such functioning. New research shows that the cognitive and cognitive–motor decline can be reversed by administering deep brain stimulation under the guidance of a computational model that minimizes the spread of current into nonmotor regions of the subthalamic nucleus.

Headache

Neck pain is commonly associated with migraine, Calhoun et al. report. In a prospective, observational cross-sectional study of 113 people with migraine, neck pain was a more prevalent symptom than nausea, a finding that did not differ according to the intensity of headache pain. Diagnostic accuracy and time to treatment might be improved by considering the involvement of neck pain in migraine.

Clinical trials

Dunaway and colleagues have described a method of overcoming the difficulties of collecting data for research studies from patients with spinal muscular atrophy. Such patients are often unable to visit medical centers owing to mobility and health issues associated with their condition. Administering the Pediatric Quality of Life inventory over the telephone proved to be a reliable method of data collection, even in patients as young as 8 years.